Inter-item Correlations Research Articles

Validity and Reliability Assessment of a Food and Physical Activity Questionnaire for Adolescents From Low-Income Communities

ObjectiveDevelop and validate an evaluation questionnaire for sixth-12th grade Expanded Food and Nutrition Education Program (EFNEP) participants. DesignFive-step process: domain concept prioritization, question generation, question pretesting, reliability testing, and criterion validity testing. SettingCommunity sites in 4 states and New Jersey EFNEP secondary program data. ParticipantsNineteen sixth-12th graders were interviewed; secondary data included 164 ninth-12th graders. Variables MeasuredContent, face, and criterion validity; internal reliability. AnalysisIterative template analysis to gauge conceptual understanding; exploratory factor analysis with orthogonal Varimax rotation, interitem correlations, and Cronbach α; Spearman correlations and Bland-Altman plots against the Physical Activity Questionnaire for Adolescents and Youth Risk Behavior Survey questions. ResultsFourteen questions with acceptable face validity were developed. One item (handwashing) had a ceiling effect and was removed. Eleven of the remaining 13 items were loaded onto 4 factors. The remaining 2 items were kept because of conceptual relevance. The questionnaire demonstrated acceptable reliability and validity overall, but subscale Cronbach α values ranged from 0.53–0.75. Conclusions and ImplicationsThis 13-item questionnaire was presented to national EFNEP program leaders and was implemented by EFNEP in October 2023. Further research could establish temporal reliability and gold standard criterion validity estimates with a multistate sample of sixth through 12th graders.

Validity of the TGI-SR+ in Francophone populations: Insights from Quebec and Belgium

The loss of a significant person can lead to a broad spectrum of responses. While most individuals gradually recover within a year, a minority develop Prolonged Grief Disorder (PGD). The Traumatic Grief Inventory Self-Report Plus (TGI-SR+) was recently developed to ensure that the original scale (TGI-SR) still accurately assesses PGD in line with the latest diagnostic standards of the DSM-5-TR and ICD-11. This study aimed to validate the TGI-SR+ within two French-speaking cohorts: 276 French-Canadian and 469 Belgian participants. Data were collected through an online survey in 2022. Confirmatory factor analysis resulted in a 4-factor model for the TGI-SR+ total scale, but high inter-item correlations favored a 1-factor solution. A 1-factor model was found for the DSM-5-TR and ICD-11 PGD scores. Convergent validity with mental health disorder, depression, and post-traumatic growth, and known-group validity were confirmed. The findings endorse the TGI-SR+ as a valid tool for detecting potential PGD.

Validity, Reliability, and Cultural Adaptability of the Arabic Cognitive Flexibility Scale (Ar-CFS) Among Saudi Arabians: A Two-Cohort Investigation

Background/objectives: Cognitive flexibility is the mental skill that allows a person to shift between different ideas or concepts and think about several concepts simultaneously. A commonly used tool to assess cognitive flexibility is the Cognitive Flexibility Scale (CFS). This study focused on translating and validating the CFS into Arabic, given the lack of existing Arabic tools for assessing cognitive flexibility. Methods: Conducted at King Saud University, Riyadh, between April and June 2024, the study employed random sampling and involved 529 participants, including 419 students and 110 patients. Results: The average participant age was 25.8 years, with females making up 56.9% of the sample. Participants completed the Arabic CFS, along with the Emotion Regulation Questionnaire (ERQ) and the Perceived Stress Scale (PSS), at two time points 3–6 weeks apart. Reliability was evaluated through internal consistency (Cronbach’s alpha = 0.8) and test–retest reliability (intraclass correlation coefficient = 0.82). Item analysis indicated that removing any single item did not significantly impact overall reliability, and inter-item correlations were strongest between items 4 and 6 (0.55) and items 6 and 7 (0.51). Validity was assessed through face, content, and construct validity, with factor analysis revealing a dominant single component accounting for 34.4% of the variance, confirming the scale’s unidimensionality. Content validity indices for all items exceeded 0.9 in terms of relevance, importance, simplicity, and clarity. The Arabic CFS demonstrated good construct validity, showing significant correlations with the ERQ’s reappraisal and suppression dimensions and the PSS. Conclusion: In conclusion, the Arabic version of the CFS is a valid and reliable tool for assessing cognitive flexibility in Arabic-speaking populations. This tool will be valuable in both clinical and research settings within Saudi Arabia, offering a robust instrument for evaluating cognitive flexibility.

Measuring health-related quality of life in a Chinese Mainland adolescent population: psychometric properties of the Mandarin Chinese self-reported KIDSCREEN-27 and KIDSCREEN-10 index

BackgroundThe self-reported KIDSCREEN questionnaires are ideal for capturing children’s and adolescents’ health-related quality of life (HRQoL) and have gained worldwide popularity. Responding to demands for the concise nature of KIDSCREEN among Chinese Mainland researchers and practitioners, this study aimed to evaluate the psychometric properties of the Mandarin Chinese self-reported KIDSCREEN-27 (KS-27) and KIDSCREEN-10 index (KS-10), which are short versions of the self-reported KIDSCREEN-52 (KS-52).MethodsThis study reanalyzed the validation dataset of the Mandarin Chinese self-reported KS-52. The dataset originated from a cross-sectional survey conducted in Weifang City, the Chinese Mainland, from October to November 2016. Adolescents aged 11–17 years (N = 4385) were surveyed, and sub-samples (N = 841) were retested. Statistical analyses were conducted on the feasibility, item and dimension properties, reliability, and validity of the Mandarin Chinese self-reported KS-27 and KS-10.ResultsIndirect evidence from the Small Group Pilot Survey indicated that the Mandarin Chinese self-reported KS-27 and KS-10 can be completed on average in less than 12.33 mins. Their response rate exceeded 90% regardless of the unit- and item (dimension)-level. The psychometric properties of items and dimensions were likewise found to be satisfactory. Internal consistency was robust with inter-item and item-total correlations (0.173–0.873, 0.422–0.786), Cronbach’s alpha (0.786–0.881), Guttman’s lambda-2 and - 6 (0.807–0.889, 0.829–0.896), and McDonald’s omega (0.725–0.886). Test–retest reliability at both item- and dimension-level was excellent, with intraclass correlation coefficients (ICCs) of (0.590–0.696, 0.785–0.842); standard error of measurements (SEMs) of (0.352–0.635, 0.949–1.949). Confirmatory factor analysis (CFA) confirmed their five- and one-dimensional structures, albeit with slight modifications. Moreover, the multi-group confirmatory factor analysis (MG-CFA) substantiated their configural and metric invariance across gender and grade groups. Convergent validity was robust, with stronger correlations observed with comparable dimensions of the Mandarin Chinese self-reported PedsQL™ 4.0, while discriminant validity was evident with low correlations observed with less comparable dimensions. The known-group validity was mainly supported by medium to large effect sizes concerning differences in socioeconomic status (η2 = 0.07–0.17, Cohen’s d = 0.55–1.03) and mental health status (η2 = 0.09–0.40, Cohen’s d = 0.73–1.83). The Mandarin Chinese self-reported KS-52 served as the criterion; the ICCs between the Mandarin Chinese self-reported KS-27 and KS-10 and their comparable dimensions were stronger, indicating robust criterion validity.ConclusionsThe Mandarin Chinese self-reported KS-27 and KS-10 demonstrated excellent psychometric properties, indicating their good potential for measuring HRQoL for children and adolescents in the Chinese Mainland.

Polish validation of the wisconsin stone quality of life questionnaire (POL-WISQoL)

PurposeUrolithiasis significantly affects patient quality of life, yet the global standard of care predominantly focuses on achieving a stone free status, often ignoring patient reported outcomes. Currently, there are no specific measures available to assess the quality of life in the Polish population suffering from kidney stones. Therefore, this study aimed to develop and validate the Polish version of the Wisconsin Stone Quality of Life Questionnaire.MethodsThe translation of WISQOL was carried out in accordance with the best available guidelines. Patients treated for kidney stones at a tertiary centre were recruited and completed both POL-WISQOL and SF36 questionnaires. Comprehensive analyses were conducted to assess internal consistency, inter-item and inter-domain correlations, as well as convergent and construct validity. Additionally, test-retest reliability was evaluated to ensure the accuracy and stability of the findings.ResultsA total of 102 participants fully completed both questionnaires and were included in the analysis. The translated survey demonstrated excellent internal consistency (Cronbach’s coefficient 0.967) and significant convergent validity (Spearman’s correlation = 0.847, p < 0.001). Furthermore, an ANOVA with Tukey’s post hoc analysis revealed a significant decline in WISQOL scores between symptomatic and asymptomatic individuals, thereby confirming tool’s construct validity.ConclusionPOL-WISQoL turned out to be a valid disease specific health related quality of life measuring tool. Its widespread utilisation has the potential to shift the standard of care towards patient centered outcomes.

71 Development and validation of the COCINL scale assessing family resilience in the NICU among parents of preterm infants

Abstract Background Given the negative impact of parental distress on preterm infants and their families, examining the role of family resilience in the neonatal intensive care unit (NICU) is a promising avenue for promoting parental mental health while remaining consistent with family-centered care. A tool to assess NICU family resilience is essential to guide care and research, yet none specifically adapted for the neonatal context exists to date according to a recent systematic review. Objectives Therefore, the aim of this study was to develop and validate a new scale, the COCINL scale, designed to measure family resilience in the context of neonatal care among French-speaking parents of preterm infants. Design/Methods This methodological design study was carried out in four successive phases: (I) compilation of an item pool (II) mixed-method evaluation of content validity (clarity, relevance, representativeness) involving 12 experts, (III) pre-testing and electronic administration of the COCINL scale, along with a measure of psychological distress (Kessler-6) and an open-ended self-report question on family resilience to parents of preterm infants (n=88) and (IV) psychometric testing of the COCINL scale (internal consistency, construct validity, exploratory sensitivity and specificity). Parents of preterm infants and experts were recruited by convenience sampling from two urban, level III NICUs. Results From a pool of 112 items, 55 items were favorably evaluated after content validation (S-CVI&amp;gt;0.95). Based on preliminary interitem correlations and internal consistency results, the COCINL scale was shortened to 42 items and divided in four subscales. High internal consistency is also shown in subscales (0.796 to 0.908) and total scale (0.937) Cronbach’s alphas. The COCINL scale displays adequate construct validity, as determined by the Pearson correlation obtained between scores of family resilience and psychological distress (r=-0.236, p=0.027). Strong in between correlations of the four subscales and with the COCINL total score (0.732 to 0.851), further indicated good construct validity. Exploratory sensitivity and specificity analysis revealed the COCINL scale compares to participants' self-reported perception of family resilience (AUC 0.754). Conclusion The COCINL scale has shown strong evidence of validity and internal consistency. Thus, the scale can be recommended for research use as a measure of family resilience in the neonatal context. Still, additional evidence of its validity and reliability should be compiled before clinical use is considered. The COCINL scale could potentially support the development, evaluation and implementation of nursing interventions consistent with the family-centered care approach being promoted in NICUs across Canada and worldwide.

Development and Validation of a Patient-Reported Outcome Measure of the Impact of Chronic Hand Eczema on Health-Related Quality of Life: the Hand Eczema Impact Scale (HEIS).

Chronic Hand Eczema (CHE) is an inflammatory skin disease that causes significant impact on health-related quality of life (HRQoL). The Hand Eczema Impact Scale (HEIS) is a new patient-reported outcome(PRO) measure designed to assess the impact of CHE on key domains of HRQoL. This study aimed to develop and evaluate content and psychometric validity of the HEIS. The HEIS was initially developed on the basis of a literature review and concept elicitation interviews. Qualitative cognitive debriefing interviews (n = 20) were conducted with patients with CHE to assess relevance and understanding of items, response options, and recall period. Psychometric properties (item performance, dimensionality, reliability, validity, responsiveness, and estimation of meaningful change thresholds) were then assessed using data (n = 258) from a phase 2b trial (NCT03683719). Cognitive debriefing confirmed all items were understood and relevant to patients. Inter-item correlations (all > 0.50) and confirmatory factor analysis (factor loadings ≥ 0.80) supported unidimensionality of the HEIS score, and mostly provided support for the HEIS Proximal Daily Activity Limitations (PDAL) score, with only one item loading below the prespecified threshold. Item properties and previous qualitative work supported retaining this item in the total score but removed from the HEIS PDAL domain. Internal consistency (Cronbach's alpha ≥ 0.89) and test-retest reliability (intra-class correlation coefficient ≥ 0.79) results were very strong. Strong correlations with concurrent measures (0.66-0.87) and significant differences between severity groups (p < 0.001) supported construct validity. Large effect sizes for mean change scores in participants that improved and significant differences between groups indicated ability to detect change. Anchor-based analyses supported within-individual responder definitions of ≥ 1.3 points for improvements in both HEIS score and HEIS PDAL score (covering three items) and of ≥ 1.5 points for HEIS embarrassment with the appearance of hands (Emb) score (covering two items). The 9-item HEIS is the first CHE-specific PROmeasure developed and validated according to regulatory guidance for assessment of the impact of CHE on key domains of HRQoL. This article provides evidence of strong content and psychometric validity and shows improvements of ≥ 1.3 points in HEIS score and HEIS PDAL score, and improvements of ≥ 1.5 points in HEIS Emb score represent clinically meaningful, important changes. NCT03683719.

Validity and reliability of the Endotracheal Suction Assessment Tool© in adult ICU patients: A methodological study

BackgroundNovice nurses often find endotracheal suctioning signs unfamiliar. The Endotracheal Suction Assessment Tool© (ESAT©) aids pediatric nurses in suctioning but lacks an adult equivalent. A valid and reliable ESAT© for assessing intensive care unit patients’ suction needs across different populations is necessary. AimTo test the validity and reliability of the ESAT© in adult ICU patients. MethodsThis methodological study assessed suction needs in patients at a tertiary adult ICU of a university hospital. Two independent observers used the ESAT© to determine suction needs. Data from 106 suction procedures were collected using a patient characteristics form, the ESAT©, and a suction monitoring form. The ESAT© includes eight respiratory and ventilation parameters and seven clinical consideration parameters. Hemodynamic and respiratory parameters were measured before, and one and five minutes after suction. Linguistic validity, content validity, and pilot testing were conducted. Interobserver agreement was evaluated, and psychometric evaluation was done using content validity index (CVI) and intraclass correlation coefficient (ICC). Data were analyzed with paired samples t-test and ANOVA. ResultsItem CVI ranged from 0.80 to 1.00, and scale CVI was 0.96. Inter-item correlation and ICC for inter-rater reliability were both 0.933 (95 % CI = 0.903–0.954, p < 0.001 for ICC). Cohen’s Kappa coefficients ranged from 0.690 to 1.000 (p < 0.001), indicating high consistency between raters for all tool items. All scale items showed near-perfect agreement except SpO2, which showed substantial agreement. ConclusionThe S-CVI was good, indicating near-perfect agreement among raters. ESAT© is highly reliable and valid for determining suction needs in adult intensive care patients. Implications for PracticeThe ESAT© aids autonomous decision-making for suctioning needs. Originally for novice pediatric nurses, the ESAT© was adapted for adult intensive care nurses. The ESAT© is valid and reliable for adult intensive care patients.

Extension and Further Replication of the Reliability, Criterion Validity, and Treatment Sensitivity of the PANSS10 and PANSS20 for Pediatric Trials.

Introduction: The Positive and Negative Syndrome Scale (PANSS) is a widely accepted outcome measure for pediatric schizophrenia trials; however, it has notable limitations. Psychometric investigations have shown a multifactorial structure and some items have limited utility assessing symptom severity in children. To address these issues, we developed and evaluated optimized 10- and 20-item PANSS short-forms (PANSS10 and PANSS20) using patient-level clinical trial data. This study further assesses these optimized forms using independent clinical trial data. Methods: We examined patient-level data from a randomized pediatric schizophrenia trial comparing paliperidone ER to aripiprazole. Data were accessed through the Yale Open Data Access (YODA) secure platform. Analyses included confirmatory factor analyses, graded response models, ω score reliability, internal consistency, sensitivity to change, and criterion validity versus the Clinical Global Impressions of Severity (CGI-S). Bland-Altman analyses examined score calibration versus the 30-item PANSS and inclusion cut scores. Results: Participants (N = 288) were ages 12 to 17 years (M = 15.3, SD = 1.46; 66% male). Total scores for the PANSS10 and PANSS20 showed strong correlations with the 30-item PANSS (0.90 and 0.97, respectively). Average inter-item correlations were 0.10 and 0.14 and ωTotal reliabilities were 0.74 and 0.85. Both PANSS10 and PANSS20 scores showed reliability >0.80-2.3 to 4.5 SD and -3.0 to 6.0 SD about mean symptom severity, respectively. Sensitivity to treatment was also similar (partial eta squared 0.23 and 0.22), as was correlation with CGI-S at baseline (0.45 and 0.48; not significantly different). The mean item-average discrepancy with the 30-item PANSS was 0.095 for PANSS10 and 0.033 for PANSS20. Conclusions: The optimized PANSS forms continue to show impressive reliability, validity, and calibration compared with the 30-item PANSS. Researchers should consider replacing the 30-item PANSS with the PANSS10 as a clinical outcome and screening measure due to its length and psychometric performance.

Comparison of SF-36 and RAND-36 in Cardiovascular Diseases: A Reliability Study

Background/Objectives: Cardiovascular diseases are one of the leading causes of morbidity and mortality worldwide. Health-related quality of life is crucial to assess the impact of cardiovascular diseases and to guide therapeutic strategies. The Short Form 36 Health Survey and the RAND 36-Item Health Survey questionnaires are common tools for measuring health-related quality of life in patients with cardiovascular disease, but their reliability may vary according to the population studied. The aim of this study is to compare the reliability of the SF-36 and the RAND-36 in a population with cardiac pathology, addressing the question of which of these instruments offers a more consistent and useful measurement in this specific group. Methods: A cross-sectional observational study was carried out at the University Hospital of Burgos (Spain). A total of 413 patients with cardiovascular pathology referred to the Cardiac Rehabilitation Unit were included. Patients with incomplete data or who did not participate in the program were excluded. Internal consistency (Cronbach’s alpha), item–total correlation and reliability, and a half-and-half analysis were performed. Results: Both questionnaires showed similar and adequate reliability for patients with cardiovascular pathology. Internal consistency, as measured with Cronbach’s alpha, was above 0.80 for most dimensions, supporting its robustness. Significant inter-item and inter-dimension correlations were found in both scales, except in some specific cases in the dimension ‘Physical Functioning’. The half-and-half analysis confirmed the good reliability of both scales. Conclusions: Both the SF-36 and the RAND-36 are highly reliable tools for assessing health-related quality of life in patients with cardiovascular disease. The results may have significant implications for clinical practice, helping in the selection of health-related quality of life monitoring instruments and in the evaluation of the efficacy of therapeutic interventions.

Evaluation of validity, reliability and ability to detect change for the Hand Eczema Severity Index (HECSI) and evaluation of HECSI-75 and HECSI-90 as within-patient responder definitions.

The Hand Eczema Severity Index (HECSI) is a Clinician-Reported Outcome measure of the severity of hand eczema (HE). This study aimed to evaluate the validity, reliability and ability to detect change of the HECSI, and the HECSI-75 and HECSI-90 as responder definitions. Analyses were performed using data from a sample of n = 258 patients with Chronic Hand Eczema (CHE) from a Phase 2b, randomised, double-blind, vehicle-controlled trial of delgocitinib cream, pooled across treatment groups. The measurement properties of the HECSI were assessed and the adequacy of the HECSI-75 and HECSI-90 as responder definitions was explored through cross-tabulation. Inter-item correlations provided support for the scoring, whereby items are grouped by areas of the hand. HECSI demonstrated good test-retest reliability with intra-class correlations >0.70. Construct validity was supported by a logical pattern of correlations with concurrent measures and significant differences in HECSI scores across severity groups (p < 0.001). HECSI was responsive with statistically significant improvements over time and with significant differences (p < 0.001) between improved and stable groups. Data provided support for both HECSI-75 and HECSI-90 as within-patient responder definitions. HECSI has strong validity, reliability and ability to detect change as a measure of CHE severity. HECSI-75 and HECSI-90 are appropriate responder definitions.

The Persian version of the fear of pain questionnaire mong Iranian post-surgery patients: a translation and psychometrics

IntroductionThe Fear of Pain Questionnaire (FOPQ) is a self-report tool designed to measure an individual’s fear of pain (FOP). While the Persian version of the FOPQ (FOPQ-P) has been developed, its validity and reliability have not yet been assessed in the Iranian context. This study aims to evaluate the psychometric properties of the FOPQ-P among Iranian patients after surgery.MethodsA methodological study was conducted in 2023 involving 400 post-surgery patients selected with a convenience sampling. The FOPQ was translated into Persian, and its psychometric properties were analyzed using network analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), as well as assessments of convergent and discriminant validity. Internal consistency was measured using Cronbach’s alpha, McDonald’s Omega, average inter-item correlation coefficient, Composite Reliability, and Maximal Reliability.ResultsThe EFA results with Promax and Kaiser Normalization rotation identified two factors that explained 54.32% of the variance, comprising seven items. The CFA confirmed the model’s validity. Both convergent and discriminant validity were established. The reliability analyses showed that Cronbach’s alpha, McDonald’s omega, composite reliability, and MaxR for all constructs were above 0.7. Additionally, the average inter-item correlation coefficient was greater than 0.5, indicating strong internal consistency and construct reliability.ConclusionThe findings suggest that the FOPQ-P possesses a valid structure and was acceptable reliability in patients cultural context of Iran post-surgery, making it a suitable instrument for measuring fear of pain in this population.

Measuring internalized health-related stigma across health conditions: development and validation of the I-HEARTS Scale.

Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions. An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma. Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1-7 rating scale was determined to indicate clinically meaningful levels of internalized stigma. The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions. STUDY PRE-REGISTRATION: https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f .

Prospects and Challenges that Teachers and Learners Face when using Field Study in Teaching and Learning Biology Subject at Ordinary Level of Secondary Education: A Case Study of Public Secondary Schools in Morogoro Municipality

Learning that occurs in a field setting is widely recognized as a very effective approach to connect science content to the real world. It is also a powerful experience that promotes the development of learners’ scientific skills, enhances active learning and promotes enthusiasm to biology subject among students. However, teaching biology through field study encounters several challenges that impedes effective implementation in public secondary schools. Thus, this study seeks to investigate the Prospects and Challenges that Teachers and Learners Face when using field study in teaching and learning biology at ordinary level of secondary education and to establish remedial measures to address these challenges. The study uses purposive sampling to select 56 respondents from 107 population including 10 heads of public secondary schools and 46 biology teachers. The study also adopted a concurrent transformative mixed approach. Data were collected by using interview guide and questionnaire. The reliability of the instruments was tested by computing Cronbach’s coefficient alpha (α) during pilot study where inter-item correlation was proved to be r = 0.872. The qualitative data was confirmed to be credible, transferable, confirmable and dependable through trustworthiness. The quantitative data analysis was done through Statistical Package for Social Science (SPSS) version 25 computer, while qualitative data were analyzed thematically. The study identifies institutional barriers to field study such as inadequate resources, overcrowded classes and fear of risk. Teachers face barriers such as traditional teaching styles, shortage of biology teachers, inadequate training, lack of experience, and fear of student risks. To address these challenges, the study recommends that the collaboration between school administrators, and field site management ad teacher’s training may foster a positive school culture, resource mobilization, employing more teachers, formulating supportive policies and utilizing school surroundings for study.

The McMaster Cough Severity Questionnaire (MCSQ): a cough severity instrument for patients with refractory chronic cough.

Cough severity represents an important endpoint to assess the impact of therapies for patients with refractory chronic cough (RCC). To develop a new patient-reported outcome measure addressing cough severity in patients with RCC. Phase 1 (item generation): A systematic survey, focus groups, and expert consultation generated 51 items. Phase 2 (item reduction): From a list of 51 items, 100 patients identified those they had experienced in the previous year and rated their importance on a 5-point scale. The MCSQ included items reported to occur most frequently and that had the highest importance scores. Patient feedback on the MCSQ led to elimination of redundant items. Another 100 patients completed the MCSQ, from which we performed an exploratory factor analysis and a Rasch analysis to further refine items on the MCSQ. Phase 2 led to selection of 15 items from the initial 51. Patient feedback on the 15 items led to elimination of 5 redundant items. An exploratory factor analysis of the 10-item MCSQ led to selection of two domains, elimination of one item that demonstrated cross-loading, and another that had high inter-item correlations. A Rasch analysis of the 8-item MCSQ confirmed that the response options functioned in a logically progressive manner and that no items exhibited differential item functioning. The final 8-item MCSQ has a one-week recall period and includes two domains (intensity and frequency). The 8-item MCSQ had high internal consistency (Cronbach's alpha, 0.89), proved able to distinguish different levels of cough severity (Pearson separation index, 0.89), and demonstrated high cross-sectional convergent validity (Pearson's correlation, 0.76 [95% CI 0.66 to 0.83]) with the 100-mm cough severity visual analogue scale. Initial evidence supports the validity of the MCSQ, an 8-item instrument measuring cough severity in patients with RCC. Future studies should evaluate its properties in measuring change over time.

Script Concordance Test in Physiology: Preparation, Scoring, and Student Perceptions – A Mixed Method Study

Background: Although the curriculum has changed, assessment tools are not in alignment with the new types of teaching such as early clinical exposure (ECE) and self-directed learning. Both in summative and formative assessment most commonly used tools for assessment of cognitive domain are written formats including MCQ. However, these assessment tools such as MCQ and written essays cannot assess the higher order thinking skills and clinical reasoning skills. Materials and Methods: The present study was conducted in the department of physiology, in collaboration with medical simulation center, as a part of formative assessment for topics on pathophysiology of shock and obstructive and restrictive lung disorders taught during ECE using case scenarios. Two script concordance tests (SCTs) each on the topic of pathophysiological mechanism of different types of shock and obstructive and restrictive lung disorders each were prepared and administered to the students. Student perception to this assessment tools was obtained. Results: The Cronbach’s alpha of the 6-item SCT for respiratory and cardiovascular topic administered to the students (n = 107, 98) was 0.83 and 0.82, respectively. The inter-item correlation was respiratory and cardiovascular topic for 0.71, 0.69 suggesting that they are close and repetitive. Students were of the opinion that SCT are difficult to understand (75.8%), challenging to answer (47.2%), and it tested the clinical content better (71.4%). Conclusions: In our study, students felt though SCT tested the clinical content better when compared to conventionally used MCQ, they still find it challenging to understand and are not in favor of its use in summative and formative assessments.

Self-perception of Teaching Difficulties in Prospective Teachers: Adaptation of the Teaching Problems Inventory

The aim of this article is to analyze the psychometric properties of an abbreviated version of the Teaching Problems Inventory. For this purpose, the scale is subjected to a previous exploratory factor analysis to statistically examine the underlying constructs. Previously, a confirmatory factor analysis was performed and a new grouping into dimensions was generated. To analyze the properties of the items, descriptive statistics were performed: mean, standard deviation and inter-item correlations. To study the psychometric properties of the scale, Cronbach's alpha, Exploratory Factor Analysis (EFA) -to identify the latent structure of the variables-, and Confirmatory Factor Analysis (CFA) were used as a procedure to check the results of the EFA. As recommended, participants were randomly divided into two groups to perform the AFE with one group and the AFC with the other to avoid distortions Participant: the proportion of items, sample size, normality, linearity, and correlation between variables were checked as assumptions for the factor analysis. The sample consisted of 992 undergraduate teacher training and master's degree students from different Spanish regions: Valencia, Andalusia, Catalonia, Madrid, Castilla la Mancha, and Castilla y León. The results of the different reliability and validity analyses showed that the reduced scale has higher reliability values and is still sensitive to capture gender and age scoring difference. As a conclusion, the consistency of the instrument to evaluate the teaching difficulties of students of different degrees and postgraduate degrees in education is highlighted. As for the limitations, the elimination of 2 items relevant at a theoretical level stands out: Motivating students in school tasks and Discipline problems with students/groups of students.

The psychometric properties of the Persian version of the innovation support inventory (ISI-12) in clinical nurses: a methodological cross-sectional study

BackgroundInnovation in nursing involves applying new knowledge to create novel ideas, methods, or technologies, resulting in higher-quality care and improved patient outcomes. Adequate support for innovation is crucial for progress in nursing. This study aimed to translate the Innovation Support Inventory (ISI-12) into Persian and assess its psychometric properties specifically among clinical nurses.MethodsA methodological cross-sectional study was conducted from September 2022 to July 2023 to evaluate the face, content, and construct validity of the ISI-12. Construct validity was assessed through confirmatory factor analysis (CFA) and convergent and discriminant validity evaluation using data obtained from 321 clinical nurses. The test–retest stability and internal consistency of the ISI-12 were also evaluated to assess its reliability.ResultsThe Persian version of the ISI-12 validation through confirmatory factor analysis has confirmed its fit with the proposed three-factor model. The ISI-12 demonstrated high reliability, as evidenced by a Cronbach's alpha coefficient (α = 0.969), McDonald's omega coefficient (ω = 0.922), coefficient H (H = 0.979), and mean inter-item correlation (ρ = 0.418). Additionally, the stability of the ISI-12 during two weeks among 40 clinical nurses was found to be excellent, with an ICC of 0.951.ConclusionThe Persian version of the ISI-12 is a valid inventory for evaluating the innovation Support of clinical nurses.

Measuring Theory of Mind: a preliminary analysis of a novel linguistically simple and tablet-based measure for children

This study introduces a novel linguistically simple, tablet-based, behavioral Theory of Mind (ToM) measure, designed for neurotypical (NT) and autistic children aged 4–10 years. A synthesis of five comprehensive reviews of existing ToM measures revealed significant gaps in their designs; the weaknesses include a mismatch between the operational and conceptual definition of ToM, high verbal demands in most measures, materials that are minimally interesting for children, and often a lack of psychometric evaluations. These findings call into question the suitability of most of the currently available ToM measures used in children, both with and without developmental disorders, such as children with autism spectrum disorder (ASD). For example, the assessment of ToM in children with ASD may require reduced reliance on complex language or social interaction that can be part of the diagnostic criteria of the condition. This newly designed ToM measure, developed in line with the “Standards for Educational and Psychological Testing” of the American Educational Research Association, is linguistically simple, tablet-based, suitable for children with ASD, and is available in English, German, French, Italian, and Spanish. With a sample of 234 participants, including 152 NT children and 82 children with ASD between 4 and 10 years of age, the new ToM measure's psychometric properties were preliminarily evaluated. Descriptive statistics, measures of internal consistency, inter-item correlation, and validity checks were conducted in both groups. Further inspections of the measure's scale- and item-level characteristics were conducted with the help of exploratory factor analyses (EFA), and item response theory (IRT) within the NT children's group. These preliminary evaluations suggest that the newly developed ToM measure possesses good psychometric properties and is both accessible and engaging for children. Further investigation with a larger group of participants is necessary to reinforce these initial results. This will allow item- and scale-level assessments within a wider range of autistic children. For this purpose, the task will be made freely available to the scientific community.

Examining the psychometric properties of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 among young urban South African women

BackgroundValid, reliable, and easy-to-administer scales are crucial for identifying mental health conditions, especially in LMICs where such scales tend not to be validated. This study aims to address this gap by investigating the psychometric properties and factorial structure of the PHQ-9 and GAD-7 in a sample of young women in Soweto, South Africa. MethodsThe PHQ-9 and GAD-7 were administered to 6028 women aged 18–28 years old. Cronbach's alpha, Mokken scale analysis, and Confirmatory Factor Analysis were used to provide support for the internal consistency and construct validity of these scales. ResultsBoth scales demonstrated good internal consistency (α = 0.81 for PHQ-9 and α = 0.84 for GAD-7). Internal consistency reliability was further supported by positive inter-item correlations and item-by-scale correlations for all items on both measures. CFA of the PHQ-9 and GAD-7 showed a reasonable fit for the 1-factor model and 2-factor models (depression and anxiety with somatic and cognitive subtypes). LimitationsThis study was limited to young African women in urban Soweto who were proficient in English, which may affect generalizability. Differences in language or cultural context may impact the accuracy and applicability of these scales to other African populations. ConclusionThe PHQ-9 and GAD-7 are valid and reliable for identifying psychological distress in the studied population. Despite showing good psychometric properties, further diagnostic assessment is needed to confirm clinical diagnoses. The scales are useful for identifying those at risk but not a substitute for comprehensive diagnostic evaluations.