Item Scale Research Articles

Development and psychometric evaluation of the Khaini Smokeless Tobacco Dependence Scale.

Khaini is a smokeless tobacco (SLT) product commonly used in the South-Asian region. It is the most common smokeless tobacco product used in India, having a prevalence of 11.2% and is used by 104.1 million adults. No scales exist to assess khaini dependence. Existing scales available to assess dependence on smokeless tobacco products are not ideal as these are adapted from cigarette dependence scales and developed for western populations. This study aimed to develop a khaini dependence scale and assess its reliability and validity. Recommended methods for scale development were followed for item development, scale development and scale evaluation. Scale development was guided by a theoretical framework, a review of existing scales and in-depth interviews with 21 khaini users recruited from a tertiary care hospital in Mumbai, India. The process involved the identification of domains for dependence and the development of an item pool. Cognitive interviews and pre-testing were conducted with 20 khaini users to assess content validity. A cross-sectional survey with 323 khaini users was conducted, and Exploratory Factor Analysis (EFA) was used to determine the factor structure of the draft scale. The content validity, criterion validity (by cross-referencing with the cotinine level of users), convergent validity and internal consistency of the new scale were assessed. The final version of the Khaini SLT Dependence Scale (KSLTDS) had 20 items. EFA indicated an acceptable goodness of fit for a three-factor structure with physical, psychological and sociocultural-behavioral sub-scales. It showed evidence of acceptable criterion validity with cotinine (ρ=0.43, p=0.0002), convergent validity with FTND-ST (ρ=0.51, p<0.0001) and frequency of khaini use (ρ=0.38, p<0.0001). The sub-scales (α=0.87-0.90) showed acceptable internal consistency. The psychometric evaluation of the KSLTDS showed preliminary validity and reliability for assessing dependence on khaini, and therefore, it is appropriate for clinical and research purposes. Re-validation studies are required with various khaini user populations.

Preliminary development and validation of basic psychological needs fulfillment for ESP teachers in online instruction

ABSTRACT The transition of traditional classroom teaching to online teaching platforms in English as a foreign or second language context has caused the shift of teachers’ motivational factors. The present study aimed to develop a new motivational teaching instrument and provide indication for the scale’s validity and reliability of English for Specific Purposes (ESP) teachers’ basic psychological need fulfillment in online teaching (BPNOT), using samples of Indonesian novice and experienced ESP teachers across genders. The author employed four different development stages of BPNOT’s scale using four different independent samples of ESP teachers in Indonesian EFL context (total n = 566). The first developmental stage was designed to develop items for the scale and to establish structure of factorial design utilizing a multivariate statistics of exploratory factor analysis (EFA) test. The second scale development was continued to determine the item scale factorial structure using confirmatory factor analysis (CFA) to confirm whether the construct was consistent or not. The third development stage estimated the test of invariance across gender and teaching experience. Finally, the last developmental stage aimed to revalidate the validity and reliability of the new scale over time. The findings of the preliminary scale validation revealed that the scale has acceptable psychometric features.

Real world effectiveness of repeated ketamine infusions for treatment-resistant depression with comorbid borderline personality disorder

Borderline personality disorder (BPD) has high rates of comorbidity with mood disorders, including treatment-resistant depression (TRD). Comorbidity of BPD with depression is associated with poorer response to antidepressants. Intravenous ketamine is a novel treatment for TRD that has not been specifically evaluated in patients with comorbid BPD. In this retrospective analysis of data collected from participants who received care at the Canadian Rapid Treatment Centre of Excellence (CRTCE; Braxia Health; ClinicalTrials.gov: NCT04209296), we evaluated the effectiveness of intravenous ketamine in a TRD population with comorbid BPD (N=100; n=50 BPD-positive compared with n=50 BPD-negative). Participants were administered four doses of intravenous ketamine (0.5-0.75mg/kg over 40 minutes) over two weeks. The primary outcome measures were changes in depressive symptom severity (as measured by Quick Inventory of Depressive Symptomatology–Self Report 16-item (QIDS-SR16)) and borderline symptom severity (as measured by Borderline Symptom List 23-item (BSL-23)). Both BPD-positive and BPD-negative groups improved significantly on the QIDS-SR16, QIDS-SR16 suicide ideation item, anxiety, and functionality scales with large effect sizes. There was no significant difference between groups. The BPD-positive group exhibited significant reduction of 0.64 on BSL-23 scores and a significant reduction of 5.95 on QIDS-SR16 scores. Patients with TRD and comorbid BPD receiving ketamine exhibited a significant reduction in symptoms of depression, borderline personality, suicidality, and anxiety.

IDENTIFYING THE PSYCHOLOGICAL CORRELATES OF LOW ACADEMIC GRADES AMONG UNIVERSITY STUDENTS: SOCIO-ECONOMIC STATUS AS A MEDIATOR

Considering the psychological factors that significantly associated either positive or negative with student’s academic grades is vital to help the student’s success and persist in higher education. Therefore, this study was carried out to address the psychological correlates of low academic grades among university students. This study also highlighted the mediating role of socio-economic status in relation to psychological correlates (stress, anxiety, and depression) that affect the low level of academic outcomes among university students. For that purpose, a sample of (N=300) students belonging to diversified socio-economic status were selected by using an online G. Power sample calculator. The sample was chosen by using a convenient sampling method. In this study, the psychological correlates were level of stress, anxiety and depression that was measured by using DASS-42 item scale and the current CGPA was considered as student’s level of academic grade. Similarly, self reported socio-economic status was considered as a mediating variable in relation to stress, depression, and anxiety among students. The collected data was analyzed by using SPSS. The results of this study revealed that stress, anxiety, and depression were significantly correlated with the low level of academic grades among the students. The findings also showed that the level of socio-economic status of university students plays a significant mediating role in relation to stress, anxiety, and depression. Based on the results, the study suggested minimizing the level of stress, anxiety, and depression to improve the academic grades of the students. Keywords: Stress, Anxiety, Depression, Socio-Economic Status, Mediator.

Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan

Ukraine has been embroiled in an increasing war since February 2022. In addition to Ukrainians, the Russo-Ukraine war has affected Poles due to the refugee crisis and the Taiwanese, who are facing a potential crisis with China. We examined the mental health status and associated factors in Ukraine, Poland, and Taiwan. The data will be used for future reference as the war is still ongoing. From March 8 to April 26, 2022, we conducted an online survey using snowball sampling techniques in Ukraine, Poland, and Taiwan. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale; post-traumatic stress symptoms by the Impact of Event Scale-Revised (IES-R) and coping strategies by the Coping Orientation to Problems Experienced Inventory (Brief-COPE). We used multivariate linear regression to identify factors significantly associated with DASS-21 and IES-R scores. There were 1626 participants (Poland: 1053; Ukraine: 385; Taiwan: 188) in this study. Ukrainian participants reported significantly higher DASS-21 (p < 0.001) and IES-R (p < 0.01) scores than Poles and Taiwanese. Although Taiwanese participants were not directly involved in the war, their mean IES-R scores (40.37 ± 16.86) were only slightly lower than Ukrainian participants (41.36 ± 14.94). Taiwanese reported significantly higher avoidance scores (1.60 ± 0.47) than the Polish (0.87 ± 0.53) and Ukrainian (0.91 ± 0.5) participants (p < 0.001). More than half of the Taiwanese (54.3%) and Polish (80.3%) participants were distressed by the war scenes in the media. More than half (52.5%) of the Ukrainian participants would not seek psychological help despite a significantly higher prevalence of psychological distress. Multivariate linear regression analyses found that female gender, Ukrainian and Polish citizenship, household size, self-rating health status, past psychiatric history, and avoidance coping were significantly associated with higher DASS-21 and IES-R scores after adjustment of other variables (p < 0.05). We have identified mental health sequelae in Ukrainian, Poles, and Taiwanese with the ongoing Russo-Ukraine war. Risk factors associated with developing depression, anxiety, stress, and post-traumatic stress symptoms include female gender, self-rating health status, past psychiatric history, and avoidance coping. Early resolution of the conflict, online mental health interventions, delivery of psychotropic medications, and distraction techniques may help to improve the mental health of people who stay inside and outside Ukraine.

Developing Psychometric Property on the Psychological Capital Scale for Vocational High Schools in Indonesia

Efforts to understand psychological capital (PsyCap) in positive psychological intervention efforts in education are believed to improve teacher performance. The development of a PsyCap scale in vocational education is very important because it has not been widely implemented in Indonesia. This study aims to develop a new, valid, and reliable Teachers' Psychological Capital Scale (TPCS) based on a psychometric approach uses research development. In all, there are nine processes involved in the three stages (item development, scale development, and scale evaluation) of establishing a rigorous scale. Data analysis to test the validity of the items using structural equation models (SEM) with confirmatory factor analysis (CFA) techniques. The TPCS measurement tool consists of 24 items that describe four dimensions, i.e. self-efficacy, optimism, hope, and resilience. The research subjects were vocational school teachers (N = 300) spread across 10 districts in Indonesia. The results of the study show that the PsyCap measurement model fits significantly with the data, meaning that TPCS has strong psychometric feasibility and the deviation from the existing measurements is not substantial. Thus, TPCS is suitable for assessing teachers' PsyCap in a more general sense. Further research into TPCS is made easier now that scientists and practitioners have a deeper grasp of the ontology and technique of scale building and validation thanks to this work.

Application of Stress and Anxiety to Viral Epidemics-6 to Measure the Anxiety Response of Cold Chain Practitioners During the COVID-19 Post-Pandemic Era in China.

This study explored the psychometric properties of the Chinese version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale for cold chain practitioners exposed to moderate-to-high risk of infection. A total of 233 cold chain practitioners participated in an anonymous online survey, conducted from October to November 2021. The questionnaire comprised participant demographic characteristics, the Chinese version of SAVE-6, the Generalized Anxiety Disorders-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) scales. Based on the results of the parallel analysis, the single-structure model of the Chinese version of SAVE-6 was adopted. The scale showed satisfactory internal consistency (Cronbach's alpha=0.930) and good convergent validity based on Spearman's correlation coefficient with the GAD-7 (rho=0.616, p<0.001) and PHQ-9 (rho=0.540, p<0.001) scale scores. The optimal cutoff score for Chinese Stress and Anxiety to Viral Epidemics-9 Items was identified as ≥12 (area under the curve=0.797, Sensitivity=0.76, Specificity=0.66) for cold chain practitioners. The Chinese version of the SAVE-6 scale has good psychometric properties and can be applied as a reliable and valid rating scale to assess the anxiety response of cold chain practitioners in the post-pandemic era.

INNOSERV: Generalized scale for perceived service innovation

Existing scales for Service Innovation focused mostly on technological newness in firms where the non-technological components were ignored. This study emphasizes the need for measures that could include both technological and non-technological constructs from customer perspective across a range of sectors. Mixed Method approach was adopted where qualitative techniques like in-depth interview, focus group discussion were used for item generation and purification followed by quantitative tests like PCA, EFA and path analysis to establish the item validation. A 22 items scale named INNOSERV with seven major typologies that measure service innovation was developed. Theoretically this study helps in emphasizing the importance of considering non-technological innovation to be viewed while measuring performance by the service industry. Managerially, the scale could be adopted by the service industry in understanding how their customers perceive or diffuse their innovation activity. For society, this scale organization understands that non-technological innovation also plays a major role in contributing to economic, social and environmental sustainability. This study highlights the need for exclusive approaches, theories and measurement tools which are essential to be defined in the service sector.

Measuring Importance of Physical Self-Care Behavior in Patients with Heart Failure: Validation and Reliability Analysis of IPSC-14 Item Scale

Heart failure (HF) is a complex clinical syndrome associated with increased disability, morbidity and mortality globally. HF is characterized by recurrent exacerbations and a high rate of hospital readmissions. Self-care is a crucial component of treatment. The way patients assess the importance of self-care may shed light on planning effective individualized interventions. The aim of this study was to conduct a validity and reliability analysis of the new 14-item IPSC scale, which measures how important HF patients consider their physical self-care behavior (IPSC, Importance of Physical Self-Care). The 14-item IPSC scale was created by the researchers to explore how important HF patients consider their physical self-care behavior. The validation of the IPSC scale included face and content validity, construct validity, internal consistency, repeatability and discriminant validity. Patients' characteristics were also included. In the present study, 52 hospitalized HF patients were enrolled, of whom 55.8% were female, 34.6% above 70 years old, 48.1% of NYHA class III and 32.7% suffered this illness from 6 to 10 years. The total IPSC score had a possible range of 14-56, with higher scores indicating a low importance of self-care. The descriptive statistics in the IPSC scale showed a mean score of 27.9 ± 4.9 and a median score of 29, indicating that HF patients evaluated self-care behavior as moderately important. All items were found to be statistically significantly correlated with total scale scores (p ≤ 0.05), with correlation coefficients rho > 0.250, indicating moderate to strong correlations and meaning that all items are important in the calculation of the final score (construct validity). The internal consistency of the items that constituted the total score was found to be high (Cronbach's a > 0.7). Furthermore, it was found that scores had high repeatability (p ≤ 0.001 and ICCs > 0.7). Regarding discriminant validity, a statistically significant association was observed between the importance of physical self-care behavior and both years suffering the illness (p = 0.007) and the NYHA class (p = 0.030). The 14-item IPSC scale is a reliable instrument that help nurses in clinical settings to gain a better and prompt understanding of the importance which patients invest in their physical self-care behavior.

Impact of the COVID-19 pandemic on women's perinatal mental health and its association with personality traits: An observational study.

The burden of perinatal mental health problems was expected to increase during the COVID-19 pandemic. We prospectively investigated the impact of the COVID-19 pandemic on the mental health of pregnant and postpartum women in Norway and explored associations with their sociodemographic characteristics and personality traits. Sociodemographic information and the self-reported impact of pandemic on wellbeing of pregnant women was collected using an online survey. To assess women's mental health, two validated questionnaires, the Edinburgh Postpartum Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 item Scale (GAD-7), were used prenatally and postnatally. Personality traits were evaluated using HumanGuide, a web-based ipsative psychological evaluation instrument. 772 women were included prenatally, of which 526 also responded to the survey 4-6 weeks postnatally. The median age was 29 years, 53.6% of the women were nulliparous when enrolled, and 35.1% worked in the healthcare sector. The median EPDS (6.0; interquartile range [IQR] 3.0-10.0 vs 6.0; IQR: 3.0-10.0) and the median GAD-7 (5.0; IQR 2.0-9.0 vs 5.0; IQR 2.0-9.0) were similar pre-and postnatally. Prenatally, the proportion of women scoring ≥13 on EPDS and ≥10 on GAD-7 was 14.5% (112/772) and 21.5% (166/772), whereas the postnatal figures were 15.6% (82/526) and 21.5% (113/526), respectively. The differences were not significant (P=0.59 and P=0.99). Being <25 years of age, being on pre-pregnancy psychotherapy or psychotropic medication, frequent voluntary isolation, perception of maternity care not proceeding normally, avoiding seeking medical assistance due to fear of infection and having negative economic consequences during the COVID19 pandemic significantly increased the risk of both anxiety (GAD-7 ≥10) and depression (EPDS ≥13). Nullipara had a higher risk of anxiety, whereas being a healthcare worker had a lower risk. The personality trait factors Power (P=0.008), Quality (P=0.008), Stability (P < 0.001) and Contacts (P < 0.001) were significant predictors of depression among pregnant women, whereas the Quality (P=0.005) and Contacts (P=0.003) were significant predictors of anxiety. During the initial phase of the COVID-19 pandemic, the prevalence of depression (EPDS ≥ 13) and anxiety (GAD-7 ≥ 10) was 14.5% and 21.5%, respectively, among Norwegian pregnant women. Certain sociodemographic characteristics and personality traits were significant predictors of depression and anxiety.

The Individual- and Organization-Related Stressors in Pandemic Scale for Healthcare Workers (IOSPS-HW): Development and Psychometric Properties of a New Instrument to Assess Individual and Organizational Stress Factors in Periods of Pandemics.

The validation and psychometric properties of the Individual and Organization related Stressors in Pandemic Scale for Healthcare Workers (IOSPS-HW) were presented. This is a new measure to assess individual factors related to the health and well-being of individuals, such as family and personal relationships, as well as organizational factors related to the management of the pandemic, including workplace relationships, job management and communication. Across two studies conducted at different time points of the pandemic, psychometric evidence of the IOSPS-HW is presented. In Study 1, through a cross-sectional design, we conducted exploratory and confirmatory factor analysis through which the originally developed 43 items scale was reduced to a 20-item bidimensional scale with two correlated dimensions: Organization-related Stressors (O-S; 12 items) and Individual- and Health-related Stressors (IH-S; 8 items). Internal consistency and criterion validity were also provided by investigating the relationship with post-traumatic stress. In Study 2, we provided evidence for the temporal invariance of the measure and for temporal stability through a Multigroup-CFA through a longitudinal design. We also supported the criterion and predictive validity. The results suggest that IOSPS-HW is a good instrument to simultaneously investigating individual and organizational factors related to sanitary emergencies in healthcare workers.

EFAS Score—Validation of Spanish and Estonian Versions by the Score Committee of the European Foot and Ankle Society (EFAS)

BackgroundThe Score Committee of the European Foot and Ankle Society (EFAS) developed, validated, and published the EFAS Score in 11 languages (Dutch, English, German, Finnish, French, Italian, Polish, Portuguese, Persian, Swedish, Turkish). From other languages under validation, the Spanish and Estonian versions completed data acquisition and underwent further validation. MethodsThe EFAS Score was developed and validated in three stages: 1) item (question) identification (completed during the initial validation study), 2) item reduction and scale exploration (completed during the initial validation study), 3) confirmatory analyses and responsiveness of the Spanish and Estonian versions (completed during the initial validation study in seven other languages). The data were collected pre-operatively and post-operatively at a minimum follow-up of 3 months and mean follow-up of 6 months. Item reduction, scale exploration, confirmatory analyses and responsiveness were executed using classical test theory and item response theory. ResultsThe internal consistency of the scale was confirmed in the Spanish and Estonian versions (Cronbach’s Alpha>0.8). Responsiveness was good, with moderate to large effect sizes in both languages, and evidence of a statistically significant positive association between the EFAS Score and patient-reported improvement. ConclusionsThe Spanish and Estonian EFAS Score versions were successfully validated in orthopaedic ankle and foot surgery patients, with a wide variety of foot and ankle pathologies. All score versions are freely available at www.efas.net.

Toward Individualized Prediction of Binge-Eating Episodes Based on Ecological Momentary Assessment Data: Item Development and Pilot Study in Patients With Bulimia Nervosa and Binge-Eating Disorder.

Prevention of binge eating through just-in-time mobile interventions requires the prediction of respective high-risk times, for example, through preceding affective states or associated contexts. However, these factors and states are highly idiographic; thus, prediction models based on averages across individuals often fail. We developed an idiographic, within-individual binge-eating prediction approach based on ecological momentary assessment (EMA) data. We first derived a novel EMA-item set that covers a broad set of potential idiographic binge-eating antecedents from literature and an eating disorder focus group (n=11). The final EMA-item set (6 prompts per day for 14 days) was assessed in female patients with bulimia nervosa or binge-eating disorder. We used a correlation-based machine learning approach (Best Items Scale that is Cross-validated, Unit-weighted, Informative, and Transparent) to select parsimonious, idiographic item subsets and predict binge-eating occurrence from EMA data (32 items assessing antecedent contextual and affective states and 12 time-derived predictors). On average 67.3 (SD 13.4; range 43-84) EMA observations were analyzed within participants (n=13). The derived item subsets predicted binge-eating episodes with high accuracy on average (mean area under the curve 0.80, SD 0.15; mean 95% CI 0.63-0.95; mean specificity 0.87, SD 0.08; mean sensitivity 0.79, SD 0.19; mean maximum reliability of rD 0.40, SD 0.13; and mean rCV 0.13, SD 0.31). Across patients, highly heterogeneous predictor sets of varying sizes (mean 7.31, SD 1.49; range 5-9 predictors) were chosen for the respective best prediction models. Predicting binge-eating episodes from psychological and contextual states seems feasible and accurate, but the predictor sets are highly idiographic. This has practical implications for mobile health and just-in-time adaptive interventions. Furthermore, current theories around binge eating need to account for this high between-person variability and broaden the scope of potential antecedent factors. Ultimately, a radical shift from purely nomothetic models to idiographic prediction models and theories is required.

Multidimensional scale development and validation: university service quality (UNIQUAL)

PurposeThis study aims to develop an assessment scale for university service quality (university SQ) and examine University Service Quality assessment model (UNIQUAL) of higher education during the pandemic.Design/methodology/approachTwo studies applied a mixed-method design to develop and validate the UNIQUAL scale. In-depth interviews and literature reviews were conducted to refine the initial dimensions and items of UNIQUAL in Study 1. Item analysis, EFA and CFA were then conducted to purify item refinement, scale refinement, purification and validation in Study 2. Finally, a confirmed UNIQUAL model was analyzed via partial least squares structural equation modeling (PLS-SEM) using Smart-PLS 4.0.FindingsThe research confirms the four-factor structure of UNIQUAL, with a total of 16 items, to be a valid and reliable scale for the assessment of the service quality (SQ) of universities. Having adopted the bias-corrected and accelerated (BCa) bootstrap approach to study 5,000 subsamples from 27 countries, the authors found “responsiveness” and “empathy” to be significantly associated and have positive relationships with students' satisfaction with university SQ. Furthermore, university SQ and satisfaction were mediated by “health and safety” concerns.Practical implicationsThe newly developed UNIQUAL scale would be of value to educators and authorities of higher education to assess the SQ of their universities to enhance the effectiveness of student learning. The improvement in satisfaction with higher education's SQ ultimately helps in retaining both international and local students amidst concerns about traveling and studying during the pandemic.Social implicationsCOVID-19 has affected the private and public sectors worldwide. Millions of students have been affected by schools being shut down and substituted with distance-learning programs. Thus, the assessment of the quality of university services has become an important support mechanism for retaining the sustainability of higher education.Originality/valueThe UNIQUAL scale provides a conceptual model and validates an assessment tool. The research hypotheses confirm the relationship between university SQ and satisfaction from the perspective of international students.

Remote cognitive behavioral therapy for older adults with anxiety symptoms: A systematic review and meta-analysis

Introduction In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults. Methods We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen's d, obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire – Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively. Results Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: −0.63; 95% CI: −0.99 to −0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: −0.74; 95% CI: −1.24 to −0.25). Discussion Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults.

The Chinese version of patient-doctor-relationship questionnaire (PDRQ-9): Factor structure, validation, and IRT psychometric analysis.

The patient-doctor relationship has been considered as a crucial concept in primary healthcare, while the medical reform launched by the Chinese government in 2009 has brought significant changes to the healthcare system, which made it urgent to introduce reliable measurement instruments for assessing today's doctor-patient relationship in China. This study examined the psychometric properties of the Chinese version of the Patient-Doctor-Relationship Questionnaire-9 item (PDRQ-9) scale among general hospital inpatients in China. A total of 203 participants responded to the survey, of which 39 completed retest after 7 days. Factor analyses were used to test the construct validity of the scale. Convergent validity was evaluated by the correlation between PDRQ-9 and depressive symptoms measured using PHQ-9 (Patient Health Questionnaire Depression Scale-9 item). Both multidimensional item response theory (MIRT) and unidimensional item response theory (IRT) framework were used to estimate the parameters of each item. The two-factor model of relationship quality and treatment quality was supported (χ2/df = 1.494, GFI = 0.925, RMSEA = 0.071, RMR = 0.008, CFI = 0.985, NFI = 0.958, NNFI = 0.980, TLI = 0.980, IFI = 0.986). The PDRQ-9 and both subscales showed significant correlation with PHQ-9 (r = -0.196∼-0.309) and good internal consistency (Cronbach's alpha = 0.865∼0.933). ANCOVA analysis adjusted with age revealed significant difference in PDRQ-9 ratings between patients with or without significant depressive symptoms (P = 0.019). The 7-day test-retest reliability of the scale was 0.730. The MIRT model of full scale and IRT models of both subscales showed high discrimination of all items (a = 2.46∼38.46), and the test information within the range of low-quality relationship was relatively high. The Chinese version of PDRQ-9 is a valid and reliable rating scale, which can measure the doctor-patient relationship among Chinese patients.

Development and validation of educational pamphlet to prevent sleepapnea

Background. Obstructive sleep apnea (OSA) is characterized by recurrent complete (apneas) and partial (hypopneas) upper airway obstructive. The Obstructive Sleep Apnea is one of the leading risk factor for coronary heart diseases and heart failure. Aim. The aim of the study was to develop and validate the educational pamphlet on Obstructive sleep apnea (OSA) Design. A mixed method research design with quantitative research approach was adopted in this study. Methods. Educational pamphlet was developed on prevention and control of Obstructive sleep apnea. The pamphlet was developed in three phases which includes review of content, design / layout of the pamphlet and validation with expert opinion. The pamphlet was validated using Item level content validity index (I-CVI) and Scale level Content Validity Index (S-CVI). individual items which ranged from 0.94 – 1. Scale level Content Validity Index (S-CVI) was 0.9120.

Development and psychometric properties of the sleep problems and coping with sleep problem scales for pregnant women.

The aim of this study is to develop a sleep problems scale and a coping with sleep problems scale for pregnant women and assess their reliability and validity. An empirical research quantitative design. Self-reported instruments were developed through (1) item generation, (2) preliminary item evaluation and (3) scale refining and evaluation. Item pools were created via literature review, opinions of experts and women with experience in pregnancy sleep. Content, construct and criterion validities were tested. Reliability was assessed using Cronbach's alpha, split-half reliability and corrected item-total correlation. Data were collected between January 23 and July 22, 2020, at a hospital's obstetrics polyclinic. In the pilot and main study, 30 and 368 pregnant women (gestational age: 8-42 weeks) were included, respectively. The content validity index was >0.9 for each scale. Factor analysis showed 24 and 18 items in the two scales, both with four subdimensions. The corrected item-total correlations were acceptable, and Cronbach's alpha coefficient was 0.883 and 0.799, respectively. Both scales developed in this study are valid and reliable for theTurkishsociety. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE/GLOBAL CLINICAL COMMUNITY: This study's findings may prevent the lack of validated screening instruments to identify pregnancy-specific sleep features. We developed two scales to assess sleep problems in pregnant women. These were valid and reliable, can be routinely used by health professionals and may guide nurses and midwives in assessing and managing sleep problems during pregnancy. The study conforms to the COSMIN checklist. Data were collected during face-to-face surveys. Ten women contributed to the item pool generation, 30 pregnant women participated in the pilot study, and 368 antenatal service users participated in the main study.

Confirmatory Factor Analysis of the Hip Disability and Osteoarthritis Outcome Score (HOOS) and Associated Sub-scales.

Hip Disability and Osteoarthritis Outcome Score (HOOS), HOOS-Joint Replacement (JR), HOOS Physical Function (PS), and HOOS-12 item scale have been suggested as reliable and valid instruments for assessing hip disability. However, factorial validity, invariance across subgroups, and repeated measures of the scale across different populations have not been well supported in the literature. The primary study objectives were to: (1) assess model fit and psychometric properties of the original 40-item HOOS scale, (2) assess model fit of the HOOS-JR, (3) assess model fit of the HOOS-PS, and (4) assess model fit of the HOOS-12. A secondary objective was to perform multigroup invariance testing across physical activity level and hip pathology subgroups for models that met recommended fit indices. Cross-Sectional Study. Individual confirmatory factor analyses (CFAs) were conducted for the HOOS, HOOS-JR, HOOS-PS, and HOOS-12. Additionally, multigroup invariance testing (i.e., activity level, injury type) was conducted on the HOOS-JR and HOOS-PS. Model fit indices did not meet contemporary recommendations for the HOOS and the HOOS-12. Model fit indices for the HOOS-JR and the HOOS-PS met some, but not all, contemporary recommendations. Invariance criteria was met for the HOOS-JR and HOOS-PS. The scale structure of the HOOS and HOOS-12 were not supported; however, preliminary evidence to support the scale structure of the HOOS-JR and HOOS-PS was found. Clinicians and researchers who utilize the scales should do so with caution due to their limitations and untested properties until further research establishes the full psychometric properties of these scales and recommendations for their continued use.

Content validity and inter-rater reliability of procedural skill checklists used in the online OSCE scoring management system

Introduction: The use of online Objective Structured Clinical Examination (OSCE) scoring system in medical and nursing education is emerging. To ensure valid student’ score, the OSCE check lists need to be assessed for its validity and reliability. This study aims to test the validity and reliability of several procedural check lists commonly used in nursing profession such as peripheral intravenous insertion, electrocardiogram placement, nasogastric tube insertion, urinary catheter insertion and oxygenation procedure. Methods: The expert consensus was used to generate items, content validity index and inter-rater reliability was used to evaluate the validity and reliability of the check lists. Five experts assessed the content validity of the checklists and five raters used the check list to evaluate performance of 11 students. Data were collected from April to May 2022. The panel experts rated the content relevance of each instrument using a four-point rating scale. Item level and scale level content validity index were calculated. Inter-rater reliability was calculated using Fleiss Kappa. Results: The item validity index for the five check lists reviewed showed relatively high content validity among experts. I-CVI for each tool was very good, ranging from 0.8 to 1. The average content agreement (S-CVI/Ave) and the universal agreement (S-CVI/UA) for each check list were also very good. The inter-rater reliability results indicated that the agreement among raters was ranged from moderate to very good/excellent. The lowest Kappa value was for the nasogastric insertion check list (0.40, 95%CI 0.40 – 0.41) and the highest Kappa value was for the oxygenation check list (1, 95% CI 0.99 – 1). Conclusion: The face validity was reported as easy to understand and presented logically. Nonetheless, re-formatting of some items and addition of details in the checklists are needed to avoid ambiguity, which could lead to confusion for the examiner and examinee.