Valid Instrument Research Articles

Validity of the Oral Hygiene Ability Instrument (OHAI).

To evaluate the validity of the newly developed Oral Hygiene Ability Instrument (OHAI), created to assess the cause of any inability of older adults to perform oral hygiene, and to revise the instrument based on the results. Good oral hygiene is among the most important prophylactic measures for oral health. This applies especially to older adults, among whom risk factors and physical and cognitive barriers are more common and can hamper oral hygiene. The OHAI contains (I) an interview, (II) clinical examination, (III) observation of oral hygiene activities and a summarising part. In the study, 149 older adults in three groups participated: stroke, cognitive disorder and general dental patients. Inclusion criteria were to be ≥65 years old, have at least one tooth and to manage oral hygiene without assistance. For criterion validity, sensitivity and specificity were calculated using eight reference instruments. To determine construct validity, we used known group validity, factor analysis and Rasch analysis. The criterion and construct validity of the OHAI were found to be acceptable to good. In the stroke group, balance and fine motor skills were assessed to affect oral hygiene most; in the cognitive disorder group, it was balance, coordination, spatial ability and cognitive functions. Analyses revealed that one item had no added value and that some response options were not optimal. The OHAI proved to be valid for the group it is intended for, with only minor revisions needed, resulting in a 32-item instrument. The OHAI could be a valuable person-centred tool in prophylactic work with older adults with failing oral hygiene.

Effect of Green Value Cocreation on Consumer Behavior: A Professional Baseball Franchise’s “Sustainable Party” Event

This study examined whether participation in green activities affects the green purchase intention, team identification, and subjective well-being of sports fans through green value cocreation. In addition, this study explored the mediating role of team identification and the moderating role of subjective well-being in green value cocreation. Composite reliability and confirmatory factor analyses were conducted to evaluate the validity and reliability of the research instruments, and structural equation modeling was used to test the study hypotheses. The results indicated that green value cocreation significantly predicted green purchase intention, team identification, and subjective well-being. Team identification partially mediated the relationship between green value cocreation and green purchase intention. However, subjective well-being did not moderate the effect of green value cocreation on green purchase intention. This study investigated how green value cocreation enhances fan participation in environmental actions and translates into green purchase intention. The findings provide insights into the emotional connection between fans and teams and the effect of this connection on green value cocreation and green purchase intention. This study addresses a research gap regarding the role of green value cocreation in professional sports and provides practical insights for businesses, teams, and society to promote environmentally conscious consumption and behavior.

Development and Validation of the Short Form (JAEN-10) of the Joint Assessment of Equilibrium and Neuromotor Status Scale (JAEN-20)

Objectives: The objective of this study was to develop and validate the short version of The Joint Assessment of Equilibrium and Neuromotor Status Scale (JAEN scale) for use in women with Fibromyalgia Syndrome (FMS) to make the balance disorder measurement process more efficient. Methods: A cross-sectional observational validation study was conducted. Fifty-six women with FMS and forty-four healthy controls were included. Certain items from the original tool were selected with the aim of (1) improving internal consistency by reducing item redundancy and (2) obtaining a diagnostic capacity with an area under the ROC curve (AUC) greater than 0.70 for discriminating FMS patients and fallers. The internal consistency, factorial validity, concurrent validity and diagnostic capacity of the new tool were analyzed. Results: Factorial analysis showed a two-factor structure that explained 72% of the variance. Cronbach alpha coefficients of 0.904 were obtained for the total score of the JAEN-10 items. Concurrent validity analysis showed strong correlations of the JAEN-10 with other instruments that measured quality of life, postural balance or disability related to dizziness. The score of the JAEN-10 items showed an AUC of 0.858 with a sensitivity of 64.29 and a specificity of 95.45 for discriminating between FMS and healthy controls, and an AUC of 0.835 with a sensitivity of 90.48 and a specificity of 67.24 for discriminating between fallers and non-fallers. Conclusions: The 10-item JAEN scale is a valid instrument for discriminating between subjects with or without FMS and between fallers and non-fallers. Its psychometric properties are good and are similar to those of the original 20-item scale. Moreover, it is quicker to complete, which may be relevant for subjects with a tendency to experience fatigue.

Mapping design stages and methodologies for developing STEM concept inventories: a scoping review

BackgroundConcept inventories (CIs) have become widely used tools for assessing students’ learning and assisting with educational decisions. Over the past three decades, CI developers have utilized various design approaches and methodologies. As a result, it can be challenging for those developing new CIs to identify the most effective and appropriate methods and approaches. This scoping review aimed to identify and map key design stages, summarize methodologies, identify design gaps and provide guidance for future efforts in the development and validation of CI tools.MethodsA preliminary literature review combined theoretical thematic analysis (deductive, researcher-driven) focusing on specific data aspects, and inductive thematic analysis (data-driven), using emerging themes independent of specific research questions or theoretical interests. Expert discussions complemented the analysis process.ResultsThe scoping review analyzed 106 CI articles and identified five key development stages: define the construct, determine and validate content domain; identify misconceptions; item formation and response processes design; test item selection and validation; and test application and refinement. A descriptive design model was developed using a mixed-method approach, incorporating expert input, literature review, student-oriented analysis, and statistical tests. Various psychometric assessments were employed to validate the test and its items. Substantial gaps were noted in defining and determining the validity and reliability of CI tools, and in the evidence required to establish these attributes.ConclusionThe growing interest in utilizing CIs for educational purposes has highlighted the importance of identifying and refining the most effective design stages and methodologies. CI developers need comprehensive guidance to establish and evaluate the validity and reliability of their instruments. Future research should focus on establishing a unified typology of CI instrument validity and reliability requirements, as well as the types of evidence needed to meet these standards. This effort could optimize the effectiveness of CI tools, foster a cohesive evaluation approach, and bridge existing gaps.

Insights From the ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 1: Polytomous Rasch Analysis of Surgeon Endorsement of Endoscopic Discectomy/Foraminotomy, Interbody Fusion, and Importance of Patient Feedback During Surgery.

The International Society for the Advancement of Spine Surgery hosted the first of a series of 4 webinars on endoscopic spine surgery techniques, focusing on end§oscopic discectomy, foraminotomy, instrumented endoscopic fusion, standalone lumbar interbody fusion with innovative materials, and the role of patient feedback in awake procedures. This series aims to share knowledge and discuss the complexities and clinical evidence of modern endoscopic spine surgery. To analyze the level of surgeon endorsement for the presented endoscopic spine surgery techniques before and after the webinar, utilizing polytomous Rasch analysis, and to evaluate the potential for these insights to inform clinical guideline recommendations. A survey was available to 1311 potential respondents during the Zoom webinar, collecting data on surgeon endorsements using a Likert scale. The polytomous Rasch model was employed to analyze responses, considering the complexity of decisions against surgeon expertise, developing a logarithmic measurement scale, allowing objective statistical analysis of categorical variables, highlighting incongruent or out-of-order items vs congruent and in-order items, and driving improvement in clinical guidelines. All 4 topics received higher confidence ratings demonstrated by descriptive statistics, highlighting the webinar's effective role in surgeon education and in identifying ongoing trends in spine surgery. The logarithmic transformation of these data during Rasch analysis showed noticeable shifts in surgeon confidence levels postwebinar, with increased endorsement for transforaminal full-endoscopic thoracolumbar interbody fusion for hard disc herniation and standalone endoscopic lumbar interbody fusion. The Wright plot and person-item map analyses demonstrated that the webinar effectively targeted areas of initial low confidence, significantly impacting surgeons' perceptions. Disordered endorsement thresholds remained in the topics of uniportal transforaminal discectomy/foraminotomy and patient feedback during endoscopic spine surgery, indicating issues in response category discrimination or confounding factors not captured by the survey. Ongoing controversies were highlighted by the influence of confounding factors, stemming from preconceived notions and limited familiarity with high-grade evidence. The first in the 4-part webinar series effectively shifted professional confidence and acceptance of innovative surgical approaches among spine surgeons. Observations indicated a high level of interest in applying the endoscopic surgery platform with other advanced technologies. The polytomous Rasch analysis provided nuanced insights into ongoing trends and areas in need of further clarification. Assessing surgeon confidence and acceptance of endoscopic spinal surgeries using polytomous Rasch analysis. Level 2 (inferential) and 3 (observational) evidence because Rasch analysis provides statistical validation of instruments rather than direct clinical outcomes.

Language and parental satisfaction during inpatient stay: A pilot survey study in a quaternary pediatric hospital.

Considering the significant volume of non-English speakers seeking medical care in the United States and the challenges they may encounter within the hospital environment, it is necessary to assess the satisfaction of non-English-speaking families during their hospital stays and to determine potential areas of improvement in order to optimize care. We aimed to evaluate and describe the satisfaction of Arabic-, Spanish-, and English-speaking families at a quaternary pediatric hospital. From the measures assessed, we sought to identify perceived strengths and weaknesses of the inpatient experience for families who spoke different languages. In doing so, we aimed to identify ways to improve the hospital experience for patients and their families. We created a 23-item satisfaction questionnaire that was vetted by the hospital's Global Services Department, professionally translated into Arabic and Spanish, and tested by native speakers. The survey contained questions pertaining to parent/guardian demographics, their experience with the hospital environment, and their care team or services. Using the questionnaire, we surveyed Arabic-, Spanish-, and English-speaking parents/guardians of post-procedural patients under 18 years of age in intensive care units (ICUs) and on inpatient floors. A total of 162 surveys were collected with roughly equal distribution across the three language groups (52 Arabic, 53 Spanish, 57 English). We found no statistically significant difference in satisfaction scores across the three language groups, nor across self-reported English-proficient and non-English-proficient Arabic and Spanish respondents. In addition, there was no statistically significant difference in satisfaction between parents/guardians in ICUs and those on inpatient floors. This pilot survey suggests that inclusivity and availability of interpretation resources play a role in successfully creating an environment where both English and non-English speakers are satisfied. Further development and validation of the survey instrument should be performed, along with testing at other institutions.

The Design of a Valid and Reliable Instrument to Measure Pre-service Teachers’ Content Knowledge for Teaching Organic Chemistry

The Design of a Valid and Reliable Instrument to Measure Pre-service Teachers’ Content Knowledge for Teaching Organic Chemistry

Design, validation and psychometric properties of a questionnaire to assess intrapreneurial behaviours in sports organisations

Intrapreneurs in sports organisations can detect early signs of new opportunities and threats and introduce early changes to adapt to the constant changes in the sports sector. In addition, intrapreneurs are considered a fundamental pillar in the growth and development of innovation in sports organisations. Thus, the objective of this work is to design and validate an instrument to detect employees with intrapreneurial behaviours in sports organisations. Based on the dimensions of intrapreneurship identified in the scientific literature and related questionnaires, a tool—the COINDE—composed of 46 items distributed in five dimensions was constructed and subjected to expert judgment and a pilot study and subsequently reduced to 26 items and five statistically validated dimensions. Exploratory factor analysis (EFA) yielded two valid and reliable models to detect employees with intrapreneurial behaviours in sports organisations, with 5 and 6 dimensions and 25 and 26 items, respectively. The 5-factor model is proposed and justified. The dimensions are: creativity/innovation, risk-taking, proactivity, recognition of opportunities and priority of the internal project. The COINDE is a valid and reliable instrument representing an important advance over the existing instruments by providing specificity of the measure in the sports context, the work profile of the employees of these organisations, and allowing direct evaluation of intrapreneurial behaviour.

Dimensionality, reliability, and validity of the Finnish version of the pain catastrophizing scale in chronic low back pain.

The 13-item pain catastrophizing scale (PCS) is the most commonly used measure of pain catastrophizing. A validated Finnish version of the PCS has previously been unavailable. The objectives were to translate the original English version of the PCS into Finnish (PCS-FI), then to evaluate (i) structural validity of the PCS-FI with a confirmatory factor analysis (CFA), (ii) internal reliability with Cronbach's alpha, Omega, and Omega hierarchical, (iii) convergent validity with measures of well-being, quality of life, sleep quality, symptoms of central sensitization, and anxiety, and (iv) known-groups validity between participants with chronic low back pain (CLBP) and pain-free controls. The translation process was performed with established guidelines. The PCS-FI was psychometrically validated using 92 participants with CLBP and 53 pain-free controls. Structural validity with CFA supported a bifactor solution. However, low reliability was found for the three specific factors (ω h ranging from 0.14 to 0.18) compared to the general factor (ω h = 0.88) suggesting that only the total score should be used. Convergent validity analysis showed satisfactory correlations and medium effect sizes with the other patient-reported outcome measures. Participants with CLBP had significantly higher total PCS-FI scores than pain-free controls. The PCS-FI appears to be a valid and reliable instrument for assessing pain-related catastrophizing in Finnish-speaking populations. Ethical approval for this study was obtained from the Research Ethics Committee of the Northern Savo Hospital District, identification number 2131/2022, on the 31st of January 2022.

Psychometric Properties of the Anxiety Measure: Stress and Anxiety to Viral Epidemics-6 (SAVE-6) for Spanish Medical Students

Backgroud and Objective: The aim of this study was to evaluate the psychometric properties of SAVE-6 in the medical student population and assess its gender invariance. Subjects and Methods: The sample consisted of 320 medical students aged 18–23 years (153 men and 167 women) who completed an anonymous online questionnaire. Data collection took place in June 2024. To assess the scale structure, a descriptive analysis of the items was carried out, followed by a confirmatory factor analysis (CFA). To analyze whether there were differences in the invariance of the measure by gender, a multigroup CFA was performed. Results: SAVE-6 showed high internal consistency, α = 0.89 and ω = 0.92, a minimum score of 12, a maximum score of 22, an unifactorial structure, and adequate convergent validity. Specifically, the following were found: the positive and significant relationship with HADS was 0.98 for the full scale, 0.76 for depression, and 0.91 for anxiety, and there was a negative and significant convergent validity with resilience (−0.82) and resilience to suicide attempts (−0.88). Regarding the gender invariance, relevant data is that the factor loadings between each item and the SAVE-6 factor were not the same, so women present a higher level of anxiety than men (Δχ 2 (6) = 42.53). Discussion: The results showed good internal reliability of SAVE-6 and good suitability. Data also revealed that they were not equal in relation to gender. Specifically, the scalar invariance revealed significant differences by items between men and women in anxiety. Conclusions: This scale can be applied to medical students as a reliable and valid instrument to assess the anxiety response to disease contagion in future health professionals.

Pengaruh Pengetahuan, Religiusitas dan Lingkungan Keluarga terhadap Minat Berkarir di Bank Syariah Dengan Memoderasi Motivasi

One of the careers that can be an option for students of Islamic Economics is a career in Islamic Banking. This study was conducted to analyze the influence of Islamic bank knowledge, religiosity, and family environment on interest in a career in Islamic banks, with motivation as a variable of moderation. The population in this study comprised 164 students of the Islamic Economics Study Program, with a sample of 116 students selected using a simple random sampling method. Data collection was carried out by distributing questionnaires in the form of Google Forms. The data analysis techniques performed in this study included instrument validity and reliability tests, classical assumption tests such as normality tests, multicollinearity tests, and heteroscedasticity tests. Hypothesis testing included multiple linear regression tests and MRA tests. The results of the analysis using the SPSS 26 program showed that knowledge of Islamic banks, religiosity, and family environment significantly influence career interest in Islamic banks. However, the motivation variable could not moderate the influence of Islamic bank knowledge, religiosity, and family environment on career interest in Islamic banks. This indicates that while these factors are important, motivation alone does not strengthen their impact on career interest in this field.

Adaptation and validation of the Parents’ Self-stigma Scale into Turkish and its association with parenting stress and parental self-efficacy

ObjectivesIn the present era, parents frequently stigmatize themselves for their children’s negative behaviors and inadequate social skills. Parents’ self-stigma (PSS) may lead to a decrease in parental self-efficacy and quality of marital and family life. In light of these reasons, the principal objective of this study to assess the validity and reliability of the Turkish version of the PSS Scale (PSSS) as developed by Eaton et al. (2019) and to investigate the indirect effect that parenting stress has on the relationship between PSS and parental self-efficacy.MethodsWe collected data from a total of 1,118 parents via random sampling, with the first part of the study involving 645 participants (Mage = 32.64 ± 7.28) and the second part of the study involving 473 participants (Mage = 27.43 ± 9.87). In the first part of the study, we employed structural equation modeling for the confirmatory factor analysis and Pearson’s correlation coefficient for the criterion-related validity, average variance extracted, and composite reliability analyses. Moreover, we calculated Cronbach’s alpha, McDonald’s omega, and Guttman split-half coefficients for the reliability analyses. In the second part of the study, we utilized Hayes’ bootstrapping method to assess the indirect effect of parenting stress on the relationship between PSS and parental self-efficacy.ResultsThe first part of the study confirms the PSSS’s 11-item, 3-factor structure, showing the Turkish form to have acceptable goodness-of-fit indices, and found Cronbach’s alpha for the PSSS to be 0.89. Furthermore, the first part of the study demonstrates a significant negative correlation between marital life satisfaction and PSS. Meanwhile, the second part of the study has determined PSS to be positively related to parenting stress and negatively related to parental self-efficacy. The second part of the study also indicates parenting stress to have an indirect effect on the association between PSS and parental self-efficacy.ConclusionsThe study indicates the Turkish version of the PSSS to be a valid and reliable instrument in Turkish culture for measuring parents’ PSS levels regarding their children, with higher scores indicating greater PSS. The scale can be effectively used in both research and clinical settings. The study also suggests parental stress to have a possible impact on the association between PSS and parental self-efficacy. Furthermore, addressing the variables of PSS and parenting stress in family-focused interviews and therapeutic interventions may contribute to increasing parental self-efficacy.

Validation of the Zarit Burden Interview in Informal Caregivers of Patients with Severe Visual Impairment and Blindness.

The needs of family caregivers providing care to relatives with visual impairment are often dismissed, leading to caregiver burden. The Zarit Burden Interview (ZBI) can measure the caregiver burden of caring for a family member with vision impairment. The purpose of this study is to validate the ZBI in Mexican family caregivers of patients with visual impairment. The ZBI was applied to 137 family caregivers of patients with visual acuity ≤ 20/200 in the best eye for ≥ 6months. The ZBI's reliability was determined using Cronbach's α and the factor structure using exploratory factor analysis (EFA, principal axis factoring with promax rotation). Items with loadings < 0.400 were eliminated. Retained factors were determined using the scree test and Horn's parallel analysis (95%CI). Associations between burden factors and other variables were evaluated with descriptive and inferential statistics. Mean ZBI score was 26.2 ± 13.1, and internal consistency was high (α = 0.871). EFA yielded four factors: (1) embarrassment and frustration, (2) self-efficacy expectations, (3) interference in personal relationships, and (4) personal strain. The α values ranged from 0.649 to 0.812. Spousal caregivers had significantly higher scores (factors 1, 2, and 4), whereas adult children had less scores (factor3). There was a significant positive correlation between hours of daily caregiving and factors 2 (r = 0.350) and 3 (r = 0.388). A worse degree of visual impairment was associated with higher mean factor scores in all factors. The ZBI is a valid instrument to detect burden in Mexican caregivers of patients with visual impairment. We identified a four-factor structure that improved our understanding of the ZBI's underlying constructs. Interventions targeting specific types of burden are warranted.

Habilidades no técnicas en la educación en cirugía. Una revisión panorámica de la literatura

IntroductionThere is a growing recognition of incorporating non-technical skills during the training process of a surgeon, as a strategy to increase their future professional performance. There is a gap in the educational methodology used. A panoramic review of the literature is carried out to identify the status, gaps and research opportunities. MethodsPanoramic review of the literature with the Joanna Briggs Institute methodology. Studies that addressed instruction, measurement, outcome evaluation, and the educational impact of non-technical skills on residents were analyzed. ResultsThe studies analyzed were carried out between 2012 and 2021. The skills studied were situational awareness, decision making, communication, teamwork, and leadership. There are studies on validation of instruments and implementation of education models. The knowledge gaps identified were the lack of standardization of the methods used for the training and evaluation of these competencies, as well as the lack of studies in Latin America. DiscussionThe teaching of non-technical skills is a pending issue in the training of a surgeon. The relevance of the topic requires its study and incorporation into study curricula.

Integrated measure for training transfer in nursing practice: Development and validation study

BackgroundThe persistent knowledge-practice gap in nursing, where competencies gained through continuing professional development fail to integrate into practice, remains a significant challenge. Effective transfer of acquired knowledge and skills to the workplace is essential for bridging this gap. However, there is a lack of comprehensive, validated instruments to assess factors influencing training transfer in nursing practice. ObjectiveThis study aims to develop a questionnaire capable of assessing training transfer as an integrated construct, encompassing all factors influencing this process in nursing practice. DesignThe study followed a developmental, iterative approach guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Setting(s)Eight tertiary teaching hospitals in the Netherlands. ParticipantsEducational experts (n = 8) and nurses (n = 1588). MethodsThe questionnaire development consisted of three phases: Phase 1) content development, in which instruments were identified based on a literature study and translation of included instruments into Dutch, Phase 2) pilot phase: content validation and usability testing using Delphi studies with experts and nurses, Phase 3) psychometric validation: construct validation using exploratory and confirmatory factor analysis, composite reliability and discriminant validity. The phases were completed from January 2023 till June 2024. ResultsThe literature review led to the inclusion of two key instruments: the Learning Transfer System Inventory (LTSI) and the Learning Climate Questionnaire (LCQ). Following item reduction based on Delphi rounds, nurses completed the adapted instruments. Psychometric validation demonstrated a good fit for these instruments in nursing practice. The adapted LTSI showed loadings ranging from 0.37 to 0.99, with a Normed Χ2 of 1.996, TLI of 0.908, CFI of 0.920, and RMSEA of 0.050 [CI = 0.047–0.054]. The adapted LCQ exhibited loadings from 0.64 to 0.94, with a Normed Χ2 of 3.385, TLI of 0.963, CFI of 0.974, and RMSEA of 0.069 [CI = 0.061–0.078]. The combined model demonstrated a Normed Χ2 of 2.014, TLI of 0.900, CFI of 0.907, and RMSEA of 0.051 [CI = 0.048–0.054]. ConclusionsThe adapted LTSI and LCQ, both separately and combined, are reliable and valid instruments for use in the Dutch nursing hospital context. Together, they provide a comprehensive assessment of factors influencing training transfer. They can also be used independently to examine specific components such as trainers (LCQ), context (LTSI), personal aspects (LTSI), or training (LTSI/LCQ). Furthermore, these instruments can facilitate discussions between nurses, managers, and educational experts to address barriers to training transfer in nursing practice.

Effect of Parental Involvement by the Headteachers in the Education of their Children on Students Retention in Masinga Sub-County, Kenya

The study focuses on the effect of parents’ involvement by head teachers in the education of their children and students’ retention in secondary school education in Masinga sub – county Kenya. It was guided by the following objective: to determine the extent to which parents’ involvement by the headteachers in the education of their children influences students’ retention in secondary school education. The study adopted a descriptive survey research design. The study was anchored on Epstein theory. The target population was 50 head teachers,50 deputy head teachers and 5022 form 3 and 4 students. Purposive, stratified proportionate sampling and simple random sampling were employed to sample 25 head teachers, 25 deputy head teachers and 370 students. Data collection instruments included questionnaires for headteachers and students, an interview guide for deputy headteachers and a document analysis guide. Validity of the research instruments was ascertained through expert judgement and piloting. Reliability was achieved through test – retest method where the instruments were piloted in a time interval of two weeks and the two results were correlated using Pearson’s product moment correlation method. Further, inferential analysis was employed that involved correlational analysis at a 0.05 level of significance. The hypothesis was accepted or rejected at 0.01 level of significance. The findings showed that there is a positive correction between parents’ involvement in the education of their children and students’ retention (r = 0.811; p = 0.00), hence the hypothesis was rejected and an alternative hypothesis accepted. The study concluded that the head teachers’ efforts to engage parents in the educational matters positively influence students’ retention. The study recommends that head teachers should use more communication strategies in order to involve all the parents in the education of their children.

Valid and reliable instrument for measuring Indonesian students’ reading literacy

The study aims to verify the validity and reliability of a set of tests for measuring Indonesian students’ reading literacy achievement that has been developed by the Center for Language Strategy and Diplomacy Development as well as the Educational Assessment Center, two institutions under the auspices of the Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia. The construct validity of the test was verified using confirmatory factor analysis (CFA) and the reliability was estimated using the composite reliability (CR) formula. The data used were responses from a sample of 6,539 students from 294 high schools in 34 provinces in Indonesia. The sample was established using a multistage sampling technique from the study population of 15-year-old students in Indonesia. The results indicated that the construct validity of the test was verified and the reliability coefficient was 0.805, which was defined good. Based on the results, it can be concluded that the set of tests is appropriate to be used to measure Indonesian students’ reading literacy achievement. In other words, using the set of tests will establish measurement that can reflect the reading literacy achievement of Indonesian students.

The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During the COVID-19 Pandemic and the Impact of Pandemic on Tinnitus.

This study aimed to examine the frequency of anxiety disorder, coronavirus anxiety and health anxiety in tinnitus patients during the pandemic and also, determined the psychophysiological impact of COVID-19 on tinnitus. This cross-sectional study was conducted in a tertiary central pandemic hospital from 15 July 2021 to 15 December 2022. In total, 124 patients with tinnitus and 77 healthy controls participated in the study. The sociodemographic data, a set of valid and reliable assessment instruments were used to measure outcomes of anxiety disorder, coronavirus anxiety, health anxiety and severity of tinnitus. Patients with tinnitus were found to experience higher levels of coronavirus anxiety, health anxiety and anxiety disorder than controls (p < 0.05). In tinnitus patients, the frequency of coronavirus anxiety was 22.6% and anxiety disorder was 18.5%. Notably, the levels of tinnitus severity were moderate to severe in more than half of the patients (51.6%) and also most of them (81.3%) reported that the severity of tinnitus during the pandemic was higher compared with the pre-pandemic. Tinnitus patients had high levels of anxiety disorder, coronavirus anxiety and health anxiety. In line with these findings, it was evaluated that there was a relationship between the COVID-19 pandemic with psychological problems and tinnitus. Therefore, the predominance of tinnitus symptoms at presentation should not lead the clinician to neglect the underlying psychopathological problems in these patients.

Evaluating anxiety and self-confidence in nursing students: Adaptation and validation of the NASC-CDM scale for high-fidelity simulation training

BackgroundAnxiety and self-confidence impact performance and decision-making during high-fidelity simulation in nursing education. A validated tool to assess these factors is lacking. MethodsThe Nursing Anxiety and Self-Confidence with Clinical Decision-Making© scale (NASC-CDM) was translated, adapted for high-fidelity simulation and validated using a five-step approach. This included a Content Validity Index review by experts and pilot-testing with first-year nursing students. Construct validity and internal consistency were evaluated using Exploratory Factor Analysis and Cronbach's alpha. ResultsA total of 187 first-year nursing students participated. Exploratory Factor Analysis identified constructs for anxiety (two factors, 60.72% variance) and self-confidence (three factors, 61.22% variance). The tool demonstrated high internal consistency, with Cronbach's alpha values of 0.956 for anxiety and 0.955 for self-confidence. ConclusionThe 19-item Dutch Nursing Anxiety and Self-Confidence with Clinical Decision-Making for High-Fidelity Simulation scale is a valid and reliable instrument measuring anxiety and self-confidence in nursing students during high-fidelity simulation.

Identification and Validation of an Instrument to Measure Physicians‘and Nurses' Knowledge, Attitudes, and Practices Regarding Antibiotic Resistance and Antimicrobial Stewardship

Background: In Italy, the presence of a suitable instrument to measure the knowledge, attitudes, and practices of intensive care physicians and nurses with respect to antibiotic resistance and antimicrobial stewardship could not be identified Objectives: To validate the Italian version of the Ashiru-Oredope tool used by the European Centre for Disease Prevention and Control (ECDC) in 2019 to investigate intensive care nurses' and physicians' knowledge, attitudes, and practices (KAP) regarding antibiotic resistance. Methods: Content validity was assessed using the Item-Content Validity Index (I-CVI), Scale Level-Content Validity Index/Universal Agreement (S-CVI/UA) score, Scale Level-Content Validity Index/Average (S-CVI/Ave) score, and Average Content Validity Ratio (CVR). Multiple correspondence analysis (MCA) was then carried out together with cluster analysis (CA) to check the correspondence of the items with the eight subdivision domains of the scale. Results: The final version consisted of 55/60 deemed relevant items, with Item-Content Validity Index (I-CVI) scores ranging from 0,625 to 1. The Scale Level-Content Validity Index/Universal Agreement (S-CVI/UA) score was 0.43; the Scale Level-Content Validity Index/Average (S-CVI/Ave) 0.90. The mean CVR of the scale was 0.43. The inter-rater reliability (Cohen's K) was between good and excellent. The combination of MCA and CA confirmed the correspondence of the items with the domains. Conclusion: The Italian version is a reliable and valid instrument for investigating antibiotic resistance and antimicrobial stewardship among Italian intensive care nurses and physicians.