Inter-item Correlations Research Articles

Factorial structure and measurement invariance of the Italian version of the Cooper – Norcross Inventory of Preferences (C-NIP)

Abstract There is increasing evidence that psychotherapy efficacy can be enhanced by accommodating clients’ preferences regarding their role, the treatment, and the therapist. Several instruments are available to measure these concepts, although only the Cooper-Norcross Inventory of Preferences (C-NIP) appears particularly suitable for psychotherapy. This study aimed to validate the Italian version of the C-NIP and to provide norms for both clinical and research use for Italian-speaking individuals. We adopted a multi-step procedure to translate the C-NIP into Italian. Then, 1084 (70.3% females; Mage = 27.22 ± 11 years) Italian adults completed an online survey. Psychometric properties of both the original C-NIP and a revised, 15-item, five-scale version of this questionnaire were analysed through a Confirmatory Factor Analysis (CFA), McDonald’s omega coefficients, mean inter-item correlations, measurement invariance, and Pearson correlations. The Italian translation of the original version of the C-NIP scales did not show good psychometric properties. However, the CFA on a revised factorial structure of the C-NIP evidenced adequate fit to the data. We found good support for the unidimensionality of all scales, but only one of the scales demonstrated an acceptable internal consistency. Measurement invariance was confirmed across both patient sex and across individuals who were and were not in psychotherapy. Results showed that the revised version of the C-NIP has satisfactory factorial structure for use with Italian adults. More research is needed to investigate how preferences vary over time and in relation to psychopathologies and client characteristics.

Assessing gender essentialist beliefs towards youth athletes: Development and preliminary validation of the gender essentialist beliefs towards girls in sport scale (GEGS)

Despite evidence refuting the legitimacy of inherent and unchanging qualities and the existence of a gender sport continuum, a prevailing gender essentialist ideology persists among coaches. This ideology perpetuates the belief in a binary, hierarchical, and static structure of gender, which imparts higher cultural and social values to men's sport compared to women's and impacts girls’ development, participation, and enjoyment in sport. Some interventions have been proposed to address this issue; however, at present, no validated scale exists to assess intervention outcomes related to coaches’ gender essentialist beliefs. The aim of the current study was therefore to develop and validate the Gender Essentialist Beliefs Towards Girls in Sport Scale (GEGS), to assess gender essentialism among sport coaches. Content validity was judged by a panel of experts ( N = 4) and through interviews with coaches ( N = 5) across various sports and experience levels. Following initial item iteration, the GEGS was assessed with 633 coaches for reliability and validity. The final scale comprised 20 items and showed good reliability (internal consistency, test-retest reliability, inter-item and item-total correlations), validity (convergent validity, differentiation between known groups), and factor structure. We also found partial support for the discriminant validity of the GEGS. Overall, the GEGS provides a valuable tool for addressing gender essentialism in sport coaching and informing coach education programs. Future research should further validate the scale and explore its sensitivity to change in gender essentialist beliefs over time.

Development of the symptomatic dermographism quality of life questionnaire.

Symptomatic Dermographism (SD), also known as "urticaria factitia", is the most common subtype of chronic inducible urticaria. Affected patients develop itch and strip-shaped wheals that usually last for 30min after minor stroking, rubbing, or scratching of the skin. The quality of life (QoL) of patients with SD is often strongly affected. However, a QoL instrument to properly assess this impairment is not yet available. The aim of this study was to develop the first disease-specific patient reported outcome measure|patient reported outcome measures (PROM) to evaluate QoL impairment in SD patients, the Symptomatic Dermographism Quality of Life Questionnaire (SD-QoL). SD-QoL was developed following current guidelines for PROM development. We first generated a hypothetical conceptional framework of the SD-QoL, followed by an item generation and an item selection/reduction phase. During the item generation phase, 69 potential items of the SD-QoL were generated by applying a combined approach consisting of literature review, expert input as well as semi-structured interviews with affected patients. During the item selection phase, we reduced this long list of items to a final 13-item set by means of impact analysis, inter-item correlation, and additional criteria for item reduction, including an expert review for content (face) validity. Finally, a US-American-English version of the SD-QoL was developed using a structured translation process. The SD-QoL is the first disease-specific-QoL instrument for SD with a recall period of 7days that allows the assessment of QoL in SD patients. A subsequent validation study will determine its validity and reliability.

Exploring the Unidimensionality of the GAD-7 for South African First Responders: Evidence from Multiple Psychometric Approaches

Generalized Anxiety Disorder (GAD) is a prevalent mental health condition and the GAD-7 is widely used as a screening tool and measure of GAD severity. However, research has yielded conflicting findings regarding the factor structure of the instrument, with some studies supporting a unidimensional interpretation while others suggest a two-factor solution. These inconsistencies highlight the importance of validating the GAD-7 across diverse populations. This study aimed to assess the psychometric properties and factor structure of the GAD-7 among South African first responders (n = 429). Participants completed a demographic questionnaire along with the GAD-7, the Patient Health Questionnaire, the Post-Traumatic Stress Disorder Checklist, and subscales from the Maslach Burnout Inventory, namely Emotional Exhaustion and Depersonalization. The dimensionality of the GAD-7 was examined using Mokken Scale Analysis (MSA), parallel analysis, and Confirmatory Factor Analysis (CFA) with a Schmid-Leiman transformation. Results supported the unidimensionality of the GAD-7. MSA indicated that all items were loaded onto a single scale, with strong inter-item correlations and a high H-coefficient. The parallel analysis confirmed that only one factor was necessary, and the Schmid-Leiman transformation extracted a general factor accounting for 84% of the item variance. Furthermore, the reliability of the GAD-7 was excellent, with alpha and omega coefficients exceeding 0.90, indicating high internal consistency. The strong reliability and validity of the GAD-7 in this study reinforce its utility as a reliable tool for assessing generalized anxiety in a non-clinical setting.

A framework for the continuous monitoring of person-centred hospital care: validation of a checklist for participatory service improvement

BackgroundIn 2018, a nationwide survey carried out in 387 acute care hospitals from 16 out of 21 Italian regions, allowed defining an extended checklist for the participatory evaluation of person-centredness in hospital care. We aimed to validate a reduced set of core items for continuous use across the country.MethodsFactor analysis was used to validate the construct of the checklist. Varimax rotation with eigenvalues > 1 was used to optimize factor structure. Items with an item-total correlation > 0.30 and factor loadings > 0.4 were attributed to individual factors. Items with inter-item correlation coefficient > 0.70 were submitted to expert opinion for final decision. Overall internal consistency was assessed through Cronbach’s alpha.ResultsA total of 183 out of 243 items in the original checklist were submitted to factor analysis. A subgroup of 67 items was retained in 4 main areas, allocated as follows: 16 items in 4 sub-areas of “Person-oriented organizational and care processes”, 16 items in 4 sub-areas of “Physical accessibility, liveability and comfort of the facilities”, 15 items in 3 sub-areas of “Access to information, streamlining and transparency”, and 20 items in 4 sub-areas of “Taking care of the relationship with patients and citizens”. Overall values of Cronbach’s alpha ranged between 0.77 and 0.90, showing high consistency.ConclusionsThis study validated a “core” checklist that can be routinely used to monitor the implementation of person-centred care in Italian hospitals. The tool can be applied more widely by multiple stakeholders as a measurement instrument for the participatory evaluation of person-centredness.

The Cronbach’s Alpha of Domain-Specific Knowledge Tests Before and After Learning: A Meta-Analysis of Published Studies

Knowledge is an important predictor and outcome of learning and development. Its measurement is challenged by the fact that knowledge can be integrated and homogeneous, or fragmented and heterogeneous, which can change through learning. These characteristics of knowledge are at odds with current standards for test development, demanding a high internal consistency (e.g., Cronbach's Alphas greater .70). To provide an initial empirical base for this debate, we conducted a meta-analysis of the Cronbach's Alphas of knowledge tests derived from an available data set. Based on 285 effect sizes from 55 samples, the estimated typical Alpha of domain-specific knowledge tests in publications was α = .85, CI90 [.82; .87]. Alpha was so high despite a low mean item intercorrelation of .22 because the tests were relatively long on average and bias in the test construction or publication process led to an underrepresentation of low Alphas. Alpha was higher in tests with more items, with open answers and in younger age, it increased after interventions and throughout development, and it was higher for knowledge in languages and mathematics than in science and social sciences/humanities. Generally, Alphas varied strongly between different knowledge tests and populations with different characteristics, reflected in a 90% prediction interval of [.35, .96]. We suggest this range as a guideline for the Alphas that researchers can expect for knowledge tests with 20 items, providing guidelines for shorter and longer tests. We discuss implications for our understanding of domain-specific knowledge and how fixed cut-off values for the internal consistency of knowledge tests bias research findings.

Validation and reliability of the Persian version of the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire for Iranian patients with patellofemoral pain

Background/Aims Patellofemoral pain and osteoarthritis are common among the general population in Iran and have a significant impact on daily activities and quality of life. The aim of this study was to translate and validate the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire for Iranian patients with patellofemoral pain. Methods This study employed a methodological approach and took place at Imam Khomeini Hospital in Sari, Iran, and clinics affiliated with the hospital. Content and face validity were measured by 10 orthopaedic and rehabilitation specialists using the Delphi method. For the reliability process (internal consistency), the questionnaire was administered to 90 patients with patellofemoral pain. For the reliability process (test–retest), the questionnaire was repeated on 30 patients after 48 hours. Descriptive statistical methods, such as mean and frequency, as well as analytical statistical methods, including Cronbach's alpha and intra-class correlation coefficient, were used to determine validity. Results The study included 90 participants, with a mean age of 58.72 ± 11.95 years, ranging from 30 to 82 years. The highest chosen response for all questions was either 3 or 4. The observed Cronbach's alpha was greater than 0.7, indicating the questionnaire's reliability. The average inter-item correlations ranged between 0.15 and 0.50, signifying good homogeneity among the items. Except for items 3 and 11, the correlation exceeded 0.4, indicating their excellent discriminatory power. The correlation for items 3 and 11 was between 0.2 and 0.39, which is considered good. Conclusions The Iranian version of the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire demonstrated excellent measurement properties, including reliability, homogeneity among items and responsiveness. Implications for practice The Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire can be used when engaging with Iranian-speaking patients for clinical and research purposes related to patellofemoral pain and osteoarthritis.

The Psychometric Properties of the EuroQol 5D Five Level in Survivors of Critical Illness.

The EuroQol 5D five level (EQ-5D-5L) instrument is a standardized measure of health-related quality of life and is routinely used in survivors of critical illness. However, information on its psychometric properties and minimal clinically important difference (MCID) in this patient group is lacking. Secondary analysis of data from the previously published PREDICT (a registry in critically ill patients to determine predictors of disability-free survival) study, a prospective, multicenter cohort study. Six ICUs in the state of Victoria, Australia. Four hundred fifty adult patients admitted to the ICU and ventilated for over 24 hours. None. The EQ-5D-5L was administered by telephone at 6 months following ICU admission. Internal consistency (inter-item correlations, Cronbach's α, and split-half reliability coefficients), construct validity (against age, body mass index, and other outcome measures), responsiveness (observing change over time and effect sizes), percentage of participants presenting no change, and MCID (triangulation of distribution-based and anchor-based estimates) were evaluated. The EQ-5D-5L showed high internal consistency, Cronbach α coefficients of 0.82 (between dimensions) and 0.79 (between the EuroQol-Visual Analogue Scale [EQ-VAS] and utility score), and average split-half coefficients of 0.79 each (between dimensions and between EQ-VAS and utility score). Construct validity was confirmed with a strong correlation between the EQ-5D-5L and the World Health Organization Disability Assessment Schedule 2.0 (EQ-VAS: r = 0.72; p < 0.001 and utility score: r = 0.81; p < 0.001). Effect sizes for change over time for EQ-VAS and utility score were low. The final MCID estimates were 10 (EQ-VAS) and 0.11 (utility score). The EQ-5D-5L, using the Australian value set, demonstrated evidence of good internal consistency and validity, but poor responsiveness in a critically ill population.

The Creation of the Arabic Version of the Hyperhidrosis Quality of Life Index (HidroQoL©) with Validation and Cross-Cultural Adaptation.

Hyperhidrosis (HH) is characterized by excessive sweating, which can significantly affect quality of life. The Hyperhidrosis Quality of Life Index (HidroQoL©) is the latest tool that has been developed and validated for assessing the quality of life of patients with HH. Because of the absence of an Arabic version of the HidroQoL©, this research aimed to create, validate, and adapt the HidroQoL© into Arabic. A quantitative, analytical, cross-sectional study was conducted with HH patients followed up in dermatology or thoracic surgery clinics. We assessed the results reliability through internal consistency and reproducibility by assessing test‒retest reliability. For validity, we conducted an exploratory factor analysis with an interitem correlation matrix and a rotated component matrix. A total of 167 participants were enrolled in this study; 61.1% were males, and 92.8% were Saudi. All 18 items of the HidroQoL©, including the daily life activities domain, psychosocial life domain, and whole HidroQoL©, had Cronbach's alpha values above 0.7. The test-retest reliability assessment demonstrated strong reproducibility. The correlations between each item and the other 17 items of the scale were positive, ranging between 0.2 and 0.6, and the results of the components analysis suggested that the questionnaire has three domains. The correlation between the test-retest results of the HidroQoL© revealed a significant strong positive correlation (r=0.9, P˂0.001). Our findings revealed excellent psychometric properties of the Arabic HidroQoL© in terms of structural and construct validity, internal consistency, and reproducibility. Proper utilization of the Arabic HidroQoL© adequately assesses the quality of life of those affected by HH.

Development and validation of the gift reciprocation anxiety scale (GRAS) for youths and adults in intimate relationships.

The development and validation of any scale measuring reciprocation anxiety induced from gift reciprocation contexts are yet to be addressed for intimate relationships. To this end, the present study aimed to develop and validate the gift reciprocation anxiety scale (GRAS) using modern psychometric methods for Bangladeshi youths and adults engaged in informal romantic and formal marital relationships. A total of 763 Bangladeshi youths of different public universities and adults in different professions with the ages ranged from 17 to 36 years were the study participants recruited through convenient sampling technique. Firstly, items were generated, and the content validity coefficients were determined through appropriate procedure to finalize the 7-item GRAS for administering on a large sample (n=763). Next, the adequacy of the data for factor analysis was checked and exploratory factor analysis (EFA) was done, extracting a single factor structure which was confirmed through the same factor retention using parallel analysis (PA). Model fit indices of confirmatory factor analysis (CFA) validated the unifactorial solution of GRAS. In addition, the item response theory (IRT) analyses confirmed that the items of the GRAS had high discriminative power, satisfactory threshold parameters, and covered a wide range of the latent trait. Mean inter-item correlations, corrected item-total correlations, and internal consistency reliabilities of the newly developed GRAS fall within the suggested limits. Multi-group confirmatory factor analysis (MGCFA) revealed that the GRAS can invariably be applied across gender, age, and marital status. A moderately positive association of GRAS with reciprocity anxiety, depression, and anxiety indicated the convergent validity of the scale. Altogether, GRAS has been found to be a psychometrically sound tool to objectively measure gift reciprocation anxiety in close relationships, implicating gift reciprocation less as an obligation and more as signs of trust, commitment, security, and care for ensuring better intimate relationships.

Validation of a Questionnaire Assessing Pregnant Women's Perspectives on Addressing the Psychological Challenges of Childbirth.

Pregnant women's experiences and concerns regarding childbirth are complex, necessitating a multidimensional and personalized approach in maternal care. This study explores the psychological and emotional factors influencing pregnant women's decisions regarding their mode of delivery. The results will provide valuable insights for the development of educational and counseling strategies designed to support pregnant women in making informed and conscious decisions about their childbirth. This cross-sectional study aimed to develop and validate a questionnaire exploring the psychological dimensions of childbirth. Factor analysis was employed to assess emotional perceptions, perceived medical risks, and the impact of cesarean section on pregnant women. The questionnaire was distributed online via Google Forms, using social networks like Facebook and Instagram to ensure rapid and broad accessibility. The questionnaire was available for seven months, from January to July 2023. McDonald's ω, Cronbach's α, average inter-item correlation, and total item correlations were calculated to assess the consistency of the questionnaire items in measuring the same construct. The three-factor model emerged as the primary structure based on exploratory and confirmatory factor analyses (EFA and CFA). The first profile, centered on the psychological and emotional benefits of vaginal birth, highlights the importance of the natural birth experience for the mother's psychological well-being. The second profile addresses concerns about medical risks and the need for interventions. The third profile focuses on perceptions and concerns related to the intelligence and adaptability of children born by cesarean section and the effects of anesthesia. Each profile reflects different strategies for seeking control and security amid childbirth uncertainties. These include emphasizing the psychological benefits of vaginal birth, addressing medical risks, and focusing on the impact of interventions on child development. Understanding these variables is essential for providing appropriate counseling and psychosocial support, thereby optimizing the birth experience and promoting the health of both mother and child. The integration of multi-factor and single-factor models in the questionnaire analysis serves complementary purposes, providing distinct yet interrelated insights into the instrument's structure and validity.

Adaptation and Validation of Version B of the Edinburgh Cognitive and Behavioural ALS Screen for the Portuguese Population.

This study aims to adapt and provide psychometric support for the validation of version B of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) for the Portuguese population, addressing the need for consistent cognitive evaluations in amyotrophic lateral sclerosis (ALS). A second culturally adapted ECAS screen facilitates the accurate characterization of ALS progression, mitigates learning effects, and supports tailored care management. The adaptation process included forward-backward translation, cultural adaptation, and cognitive debriefing on a prospective sample of 193 ALS patients and 106 controls. A multiple regression analysis identified predictors relevant for establishing ECAS cut-off scores. Psychometric evaluations, including reliability assessments and tests of convergent, construct, and criterion validity, were conducted. Additionally, version A's psychometric properties were reevaluated with complementary analyses and a larger sample. Version B demonstrated good internal consistency with Cronbach's alpha of 0.802, comparable to the previously established version A. Moderate inter-item correlations further supported reliability, reflecting internal coherence. Equivalence testing between the Portuguese versions supported convergent validity, confirming version B's alignment with version A's theoretical framework. Exploratory factor analysis provided preliminary support for construct validity, and receiver operating characteristic analyses established cut-off values for both versions, revealing moderate sensitivity with a tendency toward false negatives, and higher specificity. This study provided evidence for the cultural suitability, reliability, and validity of the Portuguese ECAS B. As evidence supports the equivalence of the Portuguese ECAS versions, they can be used for flexible screenings and applied with the calculated cut-off values to enhance diagnostic accuracy.

Translation and psychometric validation of the Heart Failure Symptom Tracker (HFaST)

Abstract Background Heart Failure (HF) is a global public health issue with high morbidity and mortality rates. Symptom management improves HF patients’ quality of life and demonstrates a potential reduction in hospitalisation, particularly among individuals aged 65 and over. Early identification of patients at higher risk of hospitalisation is essential to guide patient-centred interventions. This study aimed to translate, cross-culturally adapt and evaluate the psychometric properties of the Heart Failure Symptom Tracker (HFaST) tool for the Portuguese population. Additionally, it aimed to test the hypothesis that higher scores of the HFaST are associated with increased hospitalisations due to HF decompensation. Methods This cross-sectional study was conducted in two phases. The first phase involved the linguistic translation and cross-cultural adaptation of the HFaST tool into European Portuguese. Content validity was assessed by a panel of ten experts, who evaluated the clarity, relevance and equivalence of the pre-final version. A pre-test, using cognitive interviews with a sample of forty individuals was conducted to assess the item comprehensibility of the adapted tool. The second phase involved the psychometric validity in a sample of sixty HF patients. Participants completed a demographical and clinical assessment, the Portuguese version of the HFaST tool and the Portuguese version of the KCCQ-23 questionnaire. Additionally, the association between HFaST scores and HF hospitalisations were analysed. Results Equivalence between versions showed substantial to perfect agreement, with Fleiss’ k ranging from 0.678 to 1.000. Necessary adjustments were performed. Pre-test confirmed 95% comprehensibility. Internal consistency was acceptable, with a Cronbach’s Alpha of 0.724, moderate to strong inter-item correlations, and significant correlations between the HFaST and the KCCQ-23 items were observed. Higher HFaST scores were significantly associated with increased hospitalisations, highlighting its role as a predictive tool for clinical risk stratification. Conclusions The Portuguese version of the HFaST demonstrated to be a reliable and valid self-management tool for HF patients in Portugal. By predicting the likelihood of hospitalisation risk, the HFaST enables clinicians to implement early interventions, potentially reducing hospital admissions, improving patients’ outcomes and contributing to a better quality of life. Clinical trial number not applicable.

Adaptation and Validation of an Evaluation Instrument for Student Assessment of Veterinary Clinical Teaching.

There is a dearth of validated instruments for assessing clinical teaching in veterinary education. This study describes the development and validation of a veterinary-adapted Stanford Faculty Development Program 26 (SFDP-Vet22) instrument for student evaluation of veterinary clinical educators. Validity evidence was gathered in three specific categories: (a) content, (b) response process, and (c)internal structure. Content validity was supported by the educational theory and research underlying the Stanford Faculty Development Program 26 (SFDP-26) instrument. The process of adapting the SFDP-26 to the veterinary clinical education setting and piloting the SFDP-Vet22 supported validity in the response process, but straightlining indicated that some students ([Formula: see text]) did not use the instrument as intended. Validity in internal structure was supported by the result of exploratory factor analysis with a six-factor solution. This was performed using principal axis factoring extraction and direct oblimin oblique rotation ([Formula: see text]) on Box-Cox-transformed data. Twenty of the 22 items loaded in the predicted factors. Cronbach's alphas for each factor were above .846, mean inter-item correlations ranged from .594 to .794, and mean item-total correlations ranged from .693 to .854. The six-factor solution explained 75.5% of the variation, indicating a robust model. The results indicated that the control of session, communication of goals, and self-directed learning factors were stable and consistently loaded as predicted and that learning climate, evaluation, and feedback were unstable. This suggests the transference of these constructs from medical to veterinary education and supports the intended use: low-stakes decisions about clinical educator performance and identifying areas of potential growth of educators.

Validity and Reliability of the Basic Psychological Need Satisfaction and Frustration Scale Among Cancer Survivors in Korean Healthcare Contexts.

Basic psychological needs are essential for fostering motivation, self-regulated behaviors, and overall well-being. For cancer survivors, fulfilling these needs is crucial for coping with the various challenges of survivorship and for enhancing psychosocial health. This study aimed to assess the validity and reliability of the Korean version of the Basic Psychological Needs Satisfaction and Frustration Scale (K-BPNSFS) in a cancer survivor population. A cross-sectional design was employed, involving 367 community-dwelling cancer survivors. Construct validity was assessed using confirmatory factor analysis with multiple fit indices, while convergent validity was examined through Pearson's correlation coefficients. Reliability was evaluated using internal consistency, inter-item correlations, and item-total correlations. The findings confirmed a robust six-factor structure of the K-BPNSFS, which includes satisfaction and frustration dimensions corresponding to autonomy, relatedness, and competence needs. Convergent validity was supported by significant correlations with relevant constructs, aligning with the scale's theoretical underpinnings. Reliability analysis demonstrated high internal consistency across all dimensions, with strong Cronbach's alpha values and substantial item-total and inter-item correlations. This study establishes the K-BPNSFS as a valid, reliable, and culturally relevant instrument for assessing the basic psychological needs of Korean cancer survivors. Application of this scale provides critical insights into the unique psychological needs of this population, supporting the development of targeted healthcare strategies to enhance intrinsic motivation, self-care, and overall quality of life.

Psychometric properties of the pain anxiety symptom scale among postoperative patients in Amol, Iran.

So far, the psychometric properties of the Persian version of the Pain Anxiety Symptom Scale have not been assessed in Iran. Therefore, this study was conducted to determine the validity and reliability of the Persian version of the Pain Anxiety Symptom Scale among a group of Iranian patients in Amol. This methodological study was conducted in 2023 with a sample of 400 postoperative patients from Amol, Iran, selected through convenience sampling. The dataset was divided into two groups of 200 for exploratory and confirmatory factor analyses. Construct validity was assessed using maximum likelihood exploratory factor analysis with Promax rotation, supported by Horn's parallel analysis and network analysis to visualize item relationships. Confirmatory factor analysis, convergent and discriminant validity was performed on the second dataset. Reliability was evaluated through various statistical measures, including Cronbach's alpha, McDonald's omega, average inter-item correlation coefficient, composite reliability, and maximal reliability (MaxR). Among the 400 participants, the mean age was 44.38 years (SD = 13.49), with 152 (46.1%) being women and 178 (53.9%) men. Most participants (n = 268, 81.2%) had an education level lower than a diploma, and 93 individuals (28.2%) reported a history of surgery. The results of exploratory factor analysis with Promax rotation developed two factors accounting for 66.29% of the variance comprising 15 items. Also, after necessary modifications during confirmatory factor analysis, the final model was approved. As for reliability, the Cronbach's alpha, composite reliability, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. According to the results, the Persian version of the Pain Anxiety Symptom Scale has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.

The Italian version of the Postural Assessment Scale for Stroke Patients (PASS): transcultural translation and validation.

The Postural Assessment Scale for Stroke Patients (PASS) is commonly used by health professionals in Italy in several different translations. This study aimed to provide a validated version in Italian. The main focus is on the evaluator, to guarantee a uniform application and interpretation of the statements and scoring for each item in the Italian context. A standardized protocol was used for the translation and cross-cultural adaptation. A pilot study conducted using the first draft of the scale led to a revised version, PASS-IT. A principal component analysis (PCA) was performed. The correlation with the Trunk Control Test (TCT) was examined for concurrent validity. In addition, the relationship with the Barthel Index (BI) and the Functional Ambulation Categories (FAC) was tested. Patients with recent stroke were tested for intra-rater (N = 49) and inter-rater agreement (N = 30). Cronbach's alpha, item-to-total correlation, corrected inter-item correlation, the intraclass correlation coefficient (ICC), and measurement error were used to evaluate internal consistency and intra-/inter-rater reliability. The PCA showed a two-dimensional structure, with high reliability in both subsections ("non-weight-bearing" α = 0.865; "weight-bearing" α = 0.949). A strong correlation (ρ > 0.80) was found with the TCT, the BI, and the FAC. The PASS-IT showed high internal consistency, intra-rater (ICC = 0.942) and inter-rater reliability (ICC = 0.940). The PASS-IT is a recommended scale, suitable for clinical practice and research in the acute and subacute stage. The introduction of operating instructions resulted in the uniform application. A different order of the items allows faster administration, reducing changes of posture.

The Mastocytosis Control Test: A Patient-Reported Outcome Measure Assessing Disease Control

BACKGROUNDMastocytosis is characterized by expanding neoplastic mast cells in organs such as the skin, bone marrow, and gastrointestinal tract. The release of mast cell mediators triggers cutaneous, gastrointestinal, and other symptoms. Currently, no validated mastocytosis-specific patient-reported outcome measure (PROM) exists to assess disease control. OBJECTIVEHere, we developed a disease-specific instrument, the Mastocytosis Control Test (MCT), for evaluating and monitoring disease control in patients with non-advanced disease. METHODSSix potential MCT items were generated using a combined approach consisting of a literature review, patient interviews, and expert input. Item selection and reduction were performed by impact analysis and inter-item correlation, followed by expert reviews and cognitive debriefings. In a validation study, the resulting MCT was tested for validity and reliability by assessing internal consistency, test-retest reliability, convergent validity, known-groups validity, and receiver operating characteristics (ROC) analysis. RESULTSTen patients participated in the item generation phase and 101 in the item reduction and validation phase. The final MCT consisted of five items. Our methods showed a valid total score, high internal consistency, and test-retest reliability. Convergent and known-groups validity demonstrated a strong correlation with related anchors. The ROC curve analysis suggested a cutoff value of ≥13 points to identify patients with good disease control. CONCLUSIONSThe MCT is a disease-specific, valid, and reliable PROM for adult patients with non-advanced disease. It may measure and monitor disease control in routine daily practice and clinical trials.

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.

Development, Validity, and Reliability of Adolescent Motivation Inventory-Cerebral Palsy

Objectives: Motivation is the most influential factor in the drive and performance of adolescents with cerebral palsy (CP). As identification and analysis of volition in Iranian adolescents with CP seem to be essential, designing appropriate tools for assessing their motivation is crucial. To achieve this goal, we developed an adolescent motivation inventory-CP (AMI-CP) and evaluated its psychometric properties. Methods: In the first phase, item generation was conducted. Next, in the second phase, face and content validities of the items were assessed. Moreover, construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A total of 304 adolescents with CP participated in the EFA, while 210 adolescents with CP participated in the CFA. Afterward, convergent and discriminant validities of the inventory were measured. Moreover, reliability was evaluated by calculating Cronbach α, McDonald’s omega, average inter-item correlation, composite, and test re-test reliability. Lastly, the standard error of measurement (SEM) and the minimum detectable change (MDC) were applied. Results: Five factors with 22 items were extracted by EFA, accounting for 50.42% of the variance. The results of model fit indexes confirmed the goodness-of-fit of the final model with 20 items. In addition, the AMI-CP had a Cronbach α value of 0.75 and an intra-class correlation coefficient of 0.94. Moreover, the SEM and MDC of the inventory were 2.63 and 7.31, respectively. Discussion: The AMI-CP is a helpful measure of motivation in adolescents with CP. This inventory can enhance the assessment of the CP adolescents’ motivation by evaluating values, interests, personal causation, and physical and social environments.