Factor Loadings Of Items Research Articles

Development and Psychometric Validation of a Comprehensive Questionnaire to Assess Oncologists' Knowledge of Chemotherapy-Drug Interaction.

Chemotherapy-drug interactions (CDIs) pose significant challenges in oncology, affecting treatment efficacy and patient safety. Despite their importance, there is a lack of validated tools to assess oncologists' knowledge of CDIs. This study aimed to develop and validate a comprehensive questionnaire to address this gap and ensure the reliability and validity of the instrument. A cross-sectional study was conducted among 135 oncologists from various clinical roles in Iraq. The questionnaire included 46 general knowledge and 26 specific knowledge items, developed based on literature and expert consultation. Psychometric validation involved exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess structural validity. Reliability was evaluated through Cronbach's alpha, composite reliability (CR), and test-retest reliability using the intraclass correlation coefficient (ICC). Item Response Theory (IRT) analysis was applied to evaluate item-level performance. The EFA and CFA identified six distinct domains in the general knowledge section, with strong factor loadings for most items. Items addressing definitions, classifications, and risk factors demonstrated high loadings (e.g., "Severe chemotherapy-drug interactions often necessitate aggressive monitoring," EFA: 0.73, CFA: 0.78). Specific knowledge items also exhibited robust psychometric properties, with high discrimination indices (a > 1.5) and low guessing parameters. Reliability analysis indicated excellent internal consistency (Cronbach's alpha > 0.8) and stability over time (ICC > 0.75). The questionnaire effectively differentiated respondents based on their knowledge levels and demonstrated good model fit (CFI: 0.93, RMSEA: 0.06). This study developed and validated a reliable and robust questionnaire to assess oncologists' knowledge of CDIs. The tool provides a standardized method for evaluating CDI knowledge, addressing a critical gap in oncology practice. Future research should focus on applying this questionnaire in diverse contexts and updating it to reflect advancements in clinical guidelines and drug interaction knowledge.

Psychometric study of the Maslach Burnout Inventory-Student Survey on Thai university students

The Maslach Burnout Inventory-Student Survey (MBI-SS) is a widely used instrument to assess burnout levels, which provides valuable insight into their psychological well-being. Accurate measurement of burnout is crucial for developing interventions aimed at reducing stress and promoting mental health among students. This study aims to validate the MBI-SS when applied among Thai university students and to examine whether the psychometric properties of the scale are consistent with the original conceptual framework. A total of 413 undergraduate students from Thailand participated in the study, with 57.63% females and 42.37% males, and a mean age 21.75 years (SD = 2.40). The MBI-SS was translated into Thai by following rigorous procedures to maintain accuracy and cultural relevance. The factorial structure of the MBI-SS Thai version was evaluated using confirmatory factor analysis (CFA) for both a three-factor model and second-order factor model. The Thai version of the MBI-SS demonstrated a three-dimensional structure consistent with the original inventory, with excellent model fit indices. All item factor loadings exceeded the recommended threshold, and the instrument showed high internal consistency, establishing it a valuable tool for future research and practical application in educational settings aimed at addressing and reducing student burnout.

Turkish Validity and Reliability of the Novel Validated Short Questionnaire for Assessing Adherence to the Mediterranean Diet and Nutritional Sustainability (MedQ-Sus): A Methodological Study

This study aims to validate the "Adherence of Mediterranean Diet and Nutritional Sustainability Questionnaire (MedQ-Sus)" and Filling the gap of a reliable, alcohol-free Mediterranean diet adherence tool for the Turkish population, considering the culture of low alcohol consumption. This study, which involved 290 participants aged 18 to 64, was conducted from October 2023 to May 2024. Content validity was assessed by an expert panel of 10 dietitian academics. The Davis method was applied to calculate the Content Validity Index (CVI). With CVI scores ranging from 0.8 to 1.0, none of the scale items were removed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) served to assess the construct validity of the scale. The data were deemed appropriate for factor analysis, as indicated by the Kaiser-Meyer-Olkin (KMO) value of 0.905 and the Bartlett test results (χ² = 2426.436, p < 0.001). The single-factor structure of the scale was supported by the EFA results, with item factor loadings between 0.699 and 0.916. The Cronbach's α coefficient for the scale was found to be 0.954 in the internal consistency analyses. Positive item-total correlations were observed, and removing any item did not result in a significant increase in the Cronbach's α coefficient. As a result, it was concluded that the MedQ-Sus scale in its Turkish version is both valid and reliable. In Turkey, this scale can be utilized to evaluate the adherence of adults to the Mediterranean diet (MD) as well as their perception of nutritional sustainability. This study contributes to validating and establishing the reliability of a tool for measuring adherence to the MD among Turkish speakers.

Initial Validation of the Mandarin Translation of the Stanford Social Dimensions Scale (SSDS).

This study aimed to validate the Mandarin translation of the Stanford Social Dimensions Scale (SSDS). The initial validation sample consisted of 480 children with Autism Spectrum Disorder (ASD) (Mage = 9.35). Discriminant validity was appraised by comparing relevant SSDS scores among samples of children with ASD, typical development (TD) (N = 160, Mage = 7.16), and non-ASD but Neurodevelopmental Disorders (NDDs) (N = 170, Mage = 5.08). Confirmatory application of the Exploratory Structural Equation Modelling indicated that a five-factor model encompassing Social Motivation (SM), Social Affiliation (SA), Expressive Social Communication (ESC), Social Recognition (SR) and Unusual Approach (UA) provided adequate to excellent fit to the data in ASD group ([CFI] = .908, [TLI] = .930, [RMSEA] = .052, [SRMR] = .028). The factor loadings of most items constituting SM, SA, ESC, and SR factors were aligned with the original factor structure in the US sample, except items on the UA factor that showed lower loadings. The internal consistency was .93-.96, and test-retest reliability was .86. Discriminate validity was excellent, with the ASD group showing significantly lower scores compared to non-ASD NDDs and TD groups. Convergent and divergent validity of the SSDS was strong, as indexed by the pattern of correlations with relevant Social Responsiveness Scale, second edition (SRS-2), and Social Communication Questionnaire (SCQ) domains. This study provided preliminary validation of the Mandarin translation of the SSDS by largely replicating the original factor structure and showing evidence for strong discriminant, convergent, and divergent validity. Potential areas where further refinement and potential expansion of the SSDS are needed were identified.

Psychometric Properties of the Turkish Adaptation of Stress Mindset Measure

Objective: This study aimed to adapt the Stress Mindset Measure to Turkish culture by conducting validity and reliability analyses. Method: Convenience sampling method was used in this study, which was conducted with the survey model. With 354 adult participants, Stress Mindset Measure, Life Satisfaction Scale and Perceived Stress Scale were used as data collection tools. Cronbach's alpha and two-half reliability coefficient were used for the reliability of the Stress Mindset Measur. The results of the analyses showed that the internal consistency coefficient was .85 and the split-half reliability coefficient was .76. Furthermore, the difference between the 27% lower and upper groups among the participants was statistically significant. Confirmatory Factor Analysis (CFA) was used to test the construct validity of the Stress Mindset Measure. Results: The model fit values were at an acceptable level. Item factor loadings ranged between .49 and .78 and the scale was found to have a single-factor structure. Besides, the results of the analyses conducted to ensure convergent validity were found to be at the desired level. The concepts of perceived stress and life satisfaction were used to test criterion validity. Conclusion: Turkish adaptation of the Stress Mindset Measures a valid and reliable measurement tool.

Development of the Bisphenol A exposure scale in adults.

This study was conducted to develop a scale for assessing the attitudes of adults regarding the determination of Bisphenol A exposure. The study sample comprised of 370 individuals who volunteered to participate. According to the Explanatory Factor Analysis (EFA) results of the investigation, a scale structure consisting of a total of 3 sub-dimensions was obtained. In the Confirmatory Factor Analysis, the scale item factor loading values were acceptable. The fit indices for the scale were CMIN/df = 1,618, RMSEA = 0.058, NFI = 0.914, CFI = 0.965, and IFI = 0.790, indicating a satisfactory level of agreement. The scale was determined to have a Cronbach value of 0.79 and a high degree of reliability. The item-total score correlation coefficients of the scale ranged from 0.327 to 0.534 and exhibited a high degree of discrimination, as determined. Based on the analyses conducted, it was determined that the Adult Bisphenol A Exposure Scale is a valid and reliable instrument for determining the attitudes of adults toward contact with and use of Bisphenol A-containing products.

Validation of Gottman's "Success and Failure in Marriage" Questionnaire based on the Multivariate Item-Response Theory

Aim: The success and failure of marriage plays a fundamental role in well- being of society and individuals. Therefore, it is highly desirable to have a method to evaluate and predict the future of a marriage. As such, the aim of the present study is to validate Gottman's (2012) “success and failure in marriage questionnaires”. Methods: This is a cross-sectional study and the research design used a descriptive-correlation and test validation. Modern method of multivariate item-response theory was used for data analysis. The questionnaires used in this research were for validation, criticism, contempt, defensiveness, stonewalling, and attitude about Gottman’s past (1401). Results: In this study, the best model for factor analysis was determined to be the item-response multivariate factor analysis method and with the aid of this model, two dimensions were reported for the Gottman questionnaires. Also, the items factor loadings, the parameters of the Item-response theory and the analysis of the Items were reported. Conclusion: At the end, two dimensions of "fight mode" and "positive and negative emotions towards marriage and spouse" were identified for these questionnaires. Data analysis showed that Gottman's questionnaires have good validity in Iranian families and can be used in clinical, research and organizational environments and it is suitable to assess Iranian families. Also, the data in this research showed that Gottman's theory has good empirical support, regardless of the cultural context.

Psychometric Properties of Turkish Versions of the Non-Attachment Scale Short Form

This study aimed to examine the psychometric properties of the Non-Attachment Scale Short Form in a Turkish sample. With the participation of 244 adults over 18 years of age, the Short Form of the Nonattachment Scale, the Resilience Scale and the Ontological Addiction Scale were used as data collection tools. Cronbach's alpha and McDonald's omega coefficient were used for the reliability of the Non-Attachment Scale Short Form. According to the results of the analyses, the internal consistency coefficient and McDonald's value were found to be .77 and .78, respectively. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to test the construct validity of the scale. The results of the analyses showed that the model fit and Kaiser-Meyer-Olkin (KMO) values were at an acceptable level. Item factor loadings ranged between .40 and .67 and the scale was found to have a single factor structure. The statistically significant difference between the 27% lower and upper groups among the participants showed that the item discrimination index of the scale was at a good level. According to the correlation findings conducted to test the criterion validity of the scale, non-attachment was found to have positive significant relationships with resilience (r = .60) and negative significant relationships with ontological dependence (r = -.39). As a result, adaptation of the Short Form of the Non-Attachment Scale can be said to be a valid and reliable measurement tool.

The psychometric properties of Chinese version of the Gilles de la Tourette syndrome-quality of life scale (GTS-QOL) for children and adolescents

BackgroundGilles de la Tourette syndrome (GTS) is a persistent neurological disorder that profoundly affects the quality of life for afflicted individuals, however, tailored health-related quality of life (QOL) measures for Chinese pediatric GTS patients are lacking. This pioneering study aims to develop a QOL scale for Chinese children with GTS.MethodsA cohort of 1,121 children (aged 6–16 years) diagnosed with GTS participated in scale development. Internal consistency was evaluated using Cronbach’s alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess the factor structure of the GTS-QOL-Chinese, examining goodness-of-fit indices, factor loadings of individual items, and covariances between factors. Validity was determined through interscale correlations and comparisons with external measures to establish convergent and discriminant validity.ResultsFollowing reliability and validity analyses, a Chinese version of the 24-item GTS-specific quality of life scale was conclusively established, encompassing five subscales (psychological, compulsive, cognitive, physical, social). The scale demonstrated high internal consistency with a Cronbach’s alpha coefficient of 0.93, and validity was substantiated through interscale correlations ranging from 0.46 to 0.68. EFA identified five factors, explaining 61.26% of the total variation. CFA further confirmed the scale’s robustness, with all goodness-of-fit indicators meeting acceptable criteria (AGFI = 0.86, PCFI = 0.78, GFI = 0.89, CFI = 0.89, RMSEA = 0.07, SRMR = 0.06).ConclusionsThe Chinese version of the GTS-QOL scale has exhibits robust reliability and validity and is valuable for assessing the quality of life of Chinese children and adolescents with GTS. This scale may assist in tailoring interventions and improving patient care.

Assessing the psychometric properties of Connor-Davidson Resilience Scale 25 (CD-RISC 25) in pharmacy students and academics in the Eastern Mediterranean Region

BackgroundResilience is a complex concept that is defined and influenced by the context of individuals, organisations, societies and cultures. The Connor-Davidson Resilience Scale (CD-RISC) is a widely used validated tool to evaluate psychological resilience. CD-RISC is a self-administered scale of twenty-five items, each rated by a 5-point Likert scale. The scale evaluates overall personal resilience through assessing five main resilience-related constructs; personal competence, trust in one's instincts, positive acceptance of change, control and spiritual influences. As per the scale's developers, higher scores reflecting greater level of resilience. This particular tool has not previously been tested with a pharmacy student or academic population sample. ObjectiveThis study aims to assess the factor structure, validity, and reliability of the CD-RISC-25 in a sample of pharmacy students and academics from faculties drawn across the Eastern Mediterranean Region (EMR). MethodsA cross-sectional study was carried out between October 2020 and January 2021 sampling pharmacy students and academics across the EMR who were invited to complete the self-administered CD-RISC 25 questionnaire. Confirmatory factor analysis using principal components analysis with oblique rotation was conducted on sample responses (n = 616). The internal consistency and reliability for each identified factor and from the CD-RISC scale was evaluated by using Cronbach's alpha coefficient. ResultsFive factors were isolated accounting for 51.5 % total cumulative model variance. Identification of factors showed high convergence with previous work on the CD-RISC resilience tool. The current study in our sample found a five–factor structure which differed from the original scale reliabilities. This study did identify a five-factor solution with differing item factor loadings. The reliability analysis on the CD-RISC-25 items in our study sample revealed an overall Cronbach Alpha value of 0.89; however, three items showed corrected Item-total correlations of <0.3. Our analysis, in this respondent sample, suggested a re-adjustment of the scale inclusions to improve overall scale stability and performance. ConclusionsThe current research findings propose a modified five-factor structure to resilience, with a 22-item unidimensional model of CD-RISC scale.

Development and validation of the infodemic scale

ABSTRACT Infodemic is closely related to all healthcare professionals. Nurses take the lead in health professions that spend a long time with the society and try to present accurate information due to their roles. Infodemic is the massive spread of false or unreliable information in times of crisis. This study aims to develop a valid and reliable tool that identifies individuals’ approaches to infodemic. This study was methodological. The sample consisted of 504 people (N = 504). Data were collected using the Information Form and the Infodemic Scale. The sample was divided into two for the explanatory factor analysis (EFA) and the confirmatory factor analysis (CFA). The scale was developed using the scale development process in health and social research, which consists of three steps. The EFA revealed 14 items under two factors, which are awareness and literacy. Item factor loadings were found to range between 0.334 and 0.907. The CFA confirmed the two-factor scale structure. The total Cronbach’s alpha of the scale was 0.87, and the composite reliability value was 0.89. The intra-class correlation coefficient (ICC) value was found to be 0.857. According to psychometric evaluations, the Infodemic Scale is a valid and reliable instrument that can make consistent measurements.

Cognitive reserve as residual variance in cognitive performance: Latent dimensionality, correlates, and dementia prediction.

Cognitive reserve (CR) is typically operationalized as episodic memory residualized on brain health indices. The dimensionality of more generalized models of CR has rarely been examined. In a sample of N = 113 dementia-free older adults (ages 62-86 years at MRI scan; 58.4% women), the domain-specific representation of general cognition (COG) before vs. after residualization on brain indices (brain volume loss, cerebral blood flow, white matter hyperintensities) was compared (i.e., COG vs. CR). COG and CR were assessed by 15 tasks spanning five domains: processing speed, verbal memory, visuospatial memory, fluid reasoning, and vocabulary. Measurement invariance and item-construct representation were tested in a series of structural factor analyses. COG and CR were then examined in relation to 22 risk and protective factors and dementia status at time of death. Item-factor loadings differed such that CR more strongly emphasized fluid reasoning. More years of education, higher occupational class, more hobbies/interests, and fewer difficulties with personal mobility similarly predicted better COG and CR. Only the sub-domain of visuospatial memory (both before and after residualization) was associated with conversion to dementia by end-of-life (r = -.30; p = .01). Results provide tentative support for the role of fluid reasoning (intelligence) as a potential compensatory factor for age- and/or neuropathology-related reductions in processing speed and memory. Intellectually stimulating work, efforts to preserve personal mobility, and a diversity of hobbies and interests may attenuate age- and/or pathology-related reductions in cognitive functioning prior to dementia onset.

Validity and Reliability of an Evaluation Instrument for English Curriculum System in Chinese Vocational Higher Education Institutions

The English curriculum is the basic part of the curriculum system of vocational higher education institutions (VHEIs) in China, and it is the public compulsory curriculum that students of all majors must study. It not only cultivates students' ability to learn and apply English but also lays an English foundation for students' future further learning and lifelong development. The purpose of this study is to validate the evaluation instrument for English curriculum system. This is a quantitative research and the questionnaire has adapted from previous scholars. A stratified random sampling technique has been employed to select 350 English lecturers from a total of 864 English lecturers at 20 vocational HEIs in Shandong Province, China. The results showed: ⅰ) Each dimension Clonbach alpha coefficient and McDonald’s omega (Composite reliability) are more than 0.70. ⅱ) For the convergent validity, each item factor loading &gt; 0.5, each dimension AVE &gt;0.5. ⅲ) For the discriminant validity, the square root of the AVE of the five dimensions is greater than the corresponding correlation coefficients between the two dimensions. ⅳ) Measurement model meet the fit indices, that CMIN χ2=411.228, with degrees of freedom (df) 314, CMIN/df=1.310 (1-3), CFI=0.979 (&gt;0.9), GFI=0.916 (&gt;0.9), NFI=0.916 (&gt;0.9), and RMSEA=0.031(&lt;0.08). The results prove that this English curriculum implementation instrument has good validity and reliability. The instrument can measure the level of English curriculum systems in VHEIs in Shandong Province, China. The research findings showed there were five dimensions in the evaluation of English curriculum system. The research can be used as the basis for evaluation curriculum system for other researchers and education administrators.

Self-concealment scale (SCS) in middle-aged people: psychometric features and cross-age equivalence test

BackgroundIndividuals’ concealment of negative information and privacy may lead to impaired social interactions and threatened health conditions. This study aimed to investigate the effectiveness of the Self-Concealment Scale (SCS) in the middle-aged Chinese population and to examine the equivalence of the SCS among different age groups.MethodsThe current research adopted the SCS, Distress Disclosure Index (DDI), Revised Cheek and Buss Shyness Scale (RCBS), Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), UCLA Loneliness Scale (ULS-8), and Kessler Psychological Distress Scale (K10) to survey 1124 middle-aged people. To explore the factor structure of the SCS, the study employed exploratory factor analysis and confirmatory factor analysis. The reliability of the SCS was measured based on Cronbach’s α coefficients, McDonald’s Omega coefficients, and split-half reliability. Correlation analysis was applied to examine the relationship between SCS and RCBS, SIAS, SPS, ULS-8, and K10. Moreover, this study recruited 1458 emerging adults and 1104 older adults to identify the cross-age invariance of the SCS.ResultsExploratory factor analysis of the middle aged adults’ data supported a single factor model. The factor loadings of SCS items ranged from 0.62 to 0.73, the commonality ranged from 0.39 to 0.53, and the single-factor model fitted well. The scale showed a Cronbach’s α coefficient value of 0.895, McDonald’s Omega coefficient of 0.893, and a split-half reliability coefficient value of 0.861. In addition, the SCS demonstrated invariance in emerging adults, middle-aged adults, and older adults. Further analysis showed that the scores of the SCS (F = 3.55, p = 0.029) among emerging adults (M = 26.43, SD = 7.96) were significantly higher than among middle-aged (M = 25.77, SD = 7.79), and older cohort (M = 25.69, SD = 7.91).ConclusionThe SCS revealed favorable psychometric characteristics among the middle-aged Chinese population. The degree of self-concealment among emerging adults was higher than that of middle-aged and older people.

Psychometric Properties of the Turkish Version of the Rating Scale of Pain Expression during Childbirth Scale (ESVADOPA-TR).

Evaluation of a specific and dynamic pain, such as labor pain, with a situation-specific measurement tool will increase the quality of care given during childbirth. The Rating Scale of Pain Expression during Childbirth (ESVADOPA) is a situation-specific measurement tool for labor pain. The aim was to examine the psychometric properties of a Turkish version of the ESVADOPA scale. This study utilized a methodological design. Participants were 158 pregnant women at term and in spontaneous labor. Two measurements were performed during the passive and active phases of labor. To avoid bias between the raters, all the evaluations were performed by a single midwife. Validity analyses of the scale were performed using exploratory factor analysis and confirmatory factor analysis. The scale was composed of a one-factor structure that had an eigenvalue of over 1 and explained 71.79% of the variance. Cronbach's alpha internal consistency coefficient of the scale is 0.92. An analysis of the factor structure showed that the item factor loads ranged between 0.729 and 0.897. In the confirmatory factor analysis, the results showed that the data had a good fit with the model. The Turkish version of the ESVADOPA was found to have high reliability and validity for determining the expression of pain during childbirth.

Validation of A Short Form Three Facet Mindfulness Questionnaire (TFMQ-SF) in Pregnant Women

Objective: The aim of this study was to adapt the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) into Turkish. Method: The sample of the methodological study consisted of 302 pregnant women. The data of the study were collected between May and August 2022 by using the Personal Information Form, TFMQ-SF and Tilburg Pregnancy Distress Scale. There are 12 items in the TFMQ-SF. Validity analysis of the data; content validity index, exploratory factor analysis and confirmatory factor analysis and reliability analysis were performed with Cronbach's Alpha reliability coefficient. Ethics committee permission was obtained. Results and Conclusion: The content validity index of the scale was found to be 0.93. As a result of Confirmatory Factor Analysis, x2: 1178,445 (degrees of freedom: 66), x2/df: 2.407 and RMSEA: 0.068 were found and the model indicated a good/excellent fit. The item means of the scale ranged between 2.34±1.20 and 2.99±1.15, the item factor-loads ranged between. 59-.82, and the effect of the scale items on the sub-dimension was found to be statistically significant (p

Turkish adaptation of the Neonatal Eating Assessment Tool-Bottle-Feeding in preterm infants discharged to home.

Preterm infants often continue to have feeding difficulties after hospital discharge. Parental use of assessment tools and collaboration with health professionals are important for the early diagnosis of postdischarge feeding difficulties. This methodological study examined the validity and reliability of the Turkish version of the Neonatal Eating Assessment Tool (NeoEAT)-Bottle-feeding in postdischarge preterm infants in Türkiye. A Turkish version of the NeoEAT-Bottle-feeding was developed and applied to 321 mothers of preterm infants younger than 7 months of corrected age between August 2021 and December 2022. Cronbach's alpha, exploratory factor, confirmatory factor, item-total correlation, test-retest, and known-groups validity analyses were performed. The Turkish NeoEAT-Bottle-feeding has 60 items in five factors explaining 55.785% of the total variance. Exploratory factor analysis indicated that the item factor loading ranged from 0.320 to 0.792. The known-group validity analysis confirmed that preterm infants with diagnosed feeding problems had higher total and subscale scores than those without (p = 0.001). The Cronbach's alpha (α) of the entire scale was 0.96. The item-total correlation coefficients were between 0.31 and 0.77 (p = 0.001). There was excellent agreement between test values and retest values obtained after a 2-week interval (intraclass correlation coefficient: 0.930-1.000). The Turkish NeoEAT-Bottle-feeding was shown to be a reliable and valid parent-reported assessment tool for oral feeding skills and difficulties after neonatal intensive care unit discharge in bottle-fed preterm infants younger than 7 months of corrected age. Healthcare professionals can use this assessment tool during the initial evaluation of risk factors contributing to problematic feeding and to determine the effectiveness of planned interventions in preterm infants.

Effect of present state bias on minimal important change estimates: a simulation study.

The minimal important change (MIC) in a patient-reported outcome measure is often estimated using patient-reported transition ratings as anchor. However, transition ratings are often more heavily weighted by the follow-up state than by the baseline state, a phenomenon known as "present state bias" (PSB). It is unknown if and how PSB affects the estimation of MICs using various methods. We simulated 3240 samples in which the true MIC was simulated as the mean of individual MICs, and PSB was created by basing transition ratings on a "weighted change", differentially weighting baseline and follow-up states. In each sample we estimated MICs based on the following methods: mean change (MC), receiver operating characteristic (ROC) analysis, predictive modeling (PM), adjusted predictive modeling (APM), longitudinal item response theory (LIRT), and longitudinal confirmatory factor analysis (LCFA). The latter two MICs were estimated with and without constraints on the transition item slope parameters (LIRT) or factor loadings (LCFA). PSB did not affect MIC estimates based on MC, ROC, and PM but these methods were biased by other factors. PSB caused imprecision in the MIC estimates based on APM, LIRT and LCFA with constraints, if the degree of PSB was substantial. However, the unconstrained LIRT- and LCFA-based MICs recovered the true MIC without bias and with high precision, independent of the degree of PSB. We recommend the unconstrained LIRT- and LCFA-based MIC methods to estimate anchor-based MICs, irrespective of the degree of PSB. The APM-method is a feasible alternative if PSB is limited.

Psychometric Properties of the Turkish Version of Self-Efficacy Measure for Sleep Apnea (SEMSA) Instrument.

Determining the self-efficacy perceptions of obstructive sleep apnea (OSA) patients has a key role in health care practices. With further evaluation, the Self-Efficacy Measure for Sleep Apnea (SEMSA) could serve as a useful scale to develop specific interventions to increase self-efficacy in patients with OSA during the acceptance and maintenance of continuous positive airway pressure (CPAP) therapy. The aim of this study is to translate the SEMSA into Turkish and to evaluate the psychometric properties of the translation. This cross-sectional study was carried out with a sample of patients recently diagnosed with CPAP-naïve OSA. Linguistic and content validity of the scale were evaluated, while exploratory factor analysis and 2-level confirmatory factor analysis were used for validity. Internal consistency and test-retest methods were used in reliability analyses. The mean (SD) age of the patients with OSA was 51.36 (11.29), and 68% were male. The item factor loads obtained as a result of the confirmatory factor analysis ranged from 0.44 to 0.94, confirming the three-factor structure of the instrument. The Cronbach's α coefficient of the scale was found to be 0.90. Measurements made within the scope of test-retest analysis were found to be related and consistent results were obtained in the intervening time (P < .01). In this study, the Turkish version of SEMSA was found to be a valid and reliable tool and it could be used to evaluate the adherence-related cognition in Turkish patients with OSA on CPAP therapy.

Assessing Lean Six Sigma and quality performance improvement in Italian public healthcare organizations: a validated scale

PurposeThis study aims to fully assess the readiness for Lean Six Sigma (LSS) and Quality Performance Improvement (QPI) in an Italian Public Healthcare ecosystem.Design/methodology/approachDrawing from previously established survey development and adaptation protocols, a replication study was carried out; Lean, Six Sigma and QPI were extracted and validated through confirmatory factor analysis in an Italian Public Healthcare setting, with a sample of health professionals from the Campania region.FindingsThis study reports the adaptation of an existing scale for measuring LSS and QPI in an Italian public healthcare organisation. This analysis extracts six conceptual domains and constitutes an original adaptation of an existing scale to assess the readiness to adopt Lean, Six Sigma and Quality Performance in Italian Public Health Organizations. The constructs show strong levels of internal consistency, as demonstrated by each item factor loading and each subscale reliability.Practical implicationsManagers, policymakers and academics can employ the proposed tool to assess the public healthcare ecosystem’s capability to implement LSS initiatives and strategies to improve quality performance.Originality/valueThis is one of the first studies to assess cross-regional organisational readiness for LSS and QPI in an Italian Public Healthcare environment at this scope and level.