Item-total Correlations Research Articles

Ecological momentary assessment is well-suited for capturing rapid symptom dynamics, and it is increasingly used to measure depression symptoms. However, few depression measures are validated for ecological momentary assessment use in the manner expected for traditional questionnaires. Therefore, this study examined the internal consistency, longitudinal stability, and convergent validity of the Mobile Patient Health Questionnaire-9 (MPHQ-9), a version of the Patient Health Questionnaire-9 (PHQ-9) modified for ecological momentary assessment. Depressed participants (N = 280; female = 83.93%; White = 79.29%) completed the MPHQ-9 three times daily for 90 days. Data from the first and last 2 weeks were analyzed to align with a prestudy PHQ-9 and poststudy PHQ-9 and Inventory of Depression and Anxiety Symptoms-II. The MPHQ-9 demonstrated fair to substantial adjusted item-total correlations (r = .42-.83), often exceeding the PHQ-9 (r = .39-.72), with Cronbach's α coefficients of .91 and .81, respectively. Reliability analyses of the MPHQ-9 using generalizability theory and multilevel modeling to account for repeated measures yielded substantial between-person reliability (∼1.0) but mixed within-person reliability estimates of .81 (generalizability theory) and .44 (multilevel modeling). The MPHQ-9 showed moderate stability (r = .69, intraclass correlation coefficient = .58), compared to the slight stability of the PHQ-9 (r = .39, intraclass correlation coefficient = .37). There was moderate agreement between the MPHQ-9 and both the PHQ-9 (r = .71) and the Inventory of Depression and Anxiety Symptoms-II General Depression subscale (r = .65). Supplementary analyses identified short forms with similar convergent validity but reduced symptom-level information. This study provides initial validation of the MPHQ-9 and compares its psychometric properties to the traditional PHQ-9. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: This study aimed to evaluate the validity and reliability of the Turkish version of the Wound-QoL-14 questionnaire. Methods: This methodological study included 141 patients with chronic wounds (mean age 63.52±13.94 years; 57% male) treated in a university hospital in Istanbul between March 2022 and April 2023. Content validity was assessed using both expert panel and patient feedback. Internal consistency was assessed with Cronbach’s alpha, and item-total correlations were analyzed using Pearson correlation coefficient. Test–retest reliability was evaluated in 35 patients after one week interval. Convergent validity was tested using the SF-12 Health Survey. Construct validity was assessed through confirmatory factor analysis (CFA). Results: Based on the Davis method, the item-level content validity indices ranged from 0.90 to 1.00. Cronbach’s alpha coefficients for scale items ranged from 0.76 to 0.97, and item–total correlations ranged from 0.42 to 0.78. The test–retest intraclass correlation coefficient was 0.95. Wound-QoL total scores showed a significant negative correlation with SF-12 sub-dimensions (r = -0.284 to -0.718). CFA confirmed the four-factor structure (body, psyche, everyday life, and a separate item 5) with factor loadings ranging from 0.67 to 0.93. Conclusion: The Turkish version of the Wound-QoL-14 is a valid and reliable instrument for assessing wound-related quality of life in patients with chronic wounds.

The purpose of the study was to develop a self-administered screening tool to assist case managers, primary care physicians, and other clinicians in quickly and accurately identifying patients with complex health needs who require a definitive and detailed case management evaluation. In addition to medical and psychiatric items, this tool incorporates multiple social determinants of health (SDOH), known to add to clinical complexity. This instrument is most appropriate for identifying patients with high complexity in the primary care sector. Due to the abundance of such patients with high biopsychosocial complexity and costs of treating these patients, this tool can select those patients at greatest need for more detailed and comprehensive evaluation and treatment planning to identify and address the patient's barriers to health improvement. Potential participants were recruited from medical, psychiatric, and addiction outpatient and inpatient settings at a large metropolitan medical center. In Phase 1 of the study, a pool of potential screening items was drawn from several sources: the self-rated and interviewer-rated Patient Centered Assessment Method (PCAM; Pratt et al., 2015), the INTERMED self-assessment instrument (IMSA; Van Reedt Dortland et al., 2017), and additional items generated by one of the authors (S.A.F.). Forty participants completed this phase. Statistical analyses yielded a homogeneous scale with a smaller number of items. The screening instrument (Health Complexity Screener [HCS]) was then correlated with the criterion measure, the Value-Based Integrated Case Management Complexity Assessment Grid (VB-ICM-CAG; Kathol et al., 2018) with 35 participants, resulting in a receiver operating characteristic (ROC) analysis. Sixteen items were selected from a larger item pool based on item total correlations. This instrument was then correlated with the gold standard VB-ICM-CAG, and the internal consistency reliability was assessed (standardized coefficient alpha of .892). The VB-ICM-CAG criterion measure was dichotomized at the median value. An ROC curve analysis produced a cut score on the Screener that best represented the tradeoff between an elevated proportion of true positive (TP) rates above the median and a low proportion of false positive (FP) rates. The summary finding of predictive accuracy or area under the curve (AUC) was .83 (p =.001), with a TP rate of .81 and a FP rate of .21. These data suggest a screening instrument with acceptable psychometric characteristics. For patients of Primary Care Clinics, Mental Health Clinics, and/or Behavioral Health Providers, the HCS is an efficient way to screen all new patients, quickly identifying those who need additional case management assessment and/or assistance to follow their provider's treatment plan. For patients in facility care (e.g., inpatient, residential treatment facility, and skilled nursing facility), this screening tool would augment the discharge planning process by quickly identifying patients at high risk of readmission due to barriers to following the discharge plans. For insurance case managers, this tool would be an efficient way for intake coordinators to effectively screen and identify members for complex case management versus those that would benefit from less intensive case management services.

Validity and reliability of the pediatric pressure ulcer prediction and evaluation tool in the Turkish population: Comparison with Braden QD-T.

Firefighters are exposed to carcinogens from combustion, necessitating decontamination practices. This study developed and validated the Firefighter Exposure to Carcinogens Scale (FECS) to assess exposure-mitigating behaviors. The sample included 179 volunteer firefighters from across Canada, comprising both English and French speakers, evaluated 20 items on exposure prevention across the following three dimensions: perceived importance, past behavior, and future intention. Principal axis factor analysis was conducted, and parallel analysis based on principal components determined the number of factors. McDonald's Omega measured internal consistency, and item-total correlations were examined. A one-factor solution was acceptable for all scales, with high coefficient omega values indicating strong internal consistency. Small mean differences between language groups were nonsignificant, and no correlations were found with demographic variables. The FECS is a reliable, valid one-factor model for both languages, supporting cancer prevention efforts.

Investigating older adults' technology attitudes: Psychometric evaluation and cross-cultural adaptation of the TechPH scale.

Turkish adaptation of the catheter assessment, management and performance scale for nurses: Validity, measurement invariance and reliability study.

BackgroundWhile triggering by physical activity is a criterion for the diagnosis of migraine, evaluations regarding fear of movement related to physical activity are lacking in the literature. This study aimed to investigate the validity and reliability of the Turkish version of the Tampa Scale of Kinesiophobia, adapted to headache (TSK-H), in patients with episodic migraine (EM) and chronic migraine (CM). This questionnaire is a newly developed version adapted for headache, based on but different from the original TSK used in low back pain, and has not been previously validated in Turkish for headache.MethodsPatients between the ages of 18–70 were included in the study. Demographic-clinical information was obtained after expert committee evaluation and cross-cultural adaptation of the questionnaire. Numerical Pain Rating Scale (NPRS), Migraine Disability Assessment (MIDAS), Headache Impact Test-6 (HIT-6), Hospital Anxiety and Depression Scale (HADS) and TSK-H were evaluated for structural validity. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed. Intraclass Correlation Coefficient (ICC) and Cronbach’s α values ​​were analyzed for reliability.ResultsA total of 329 patients (n = 148 EM, n = 181 CM) with a mean age of 37.2 ± 10.6 years for EM and 39.8 ± 13.1 years for CM were included in the study. Headache intensity on NPRS was 6.89 ± 1.86 for EM and 7.56 ± 2.10 for CM. Item-total correlations ranged from − 0.030 to 0.758. Cronbach’s α was 0.925. TSK-H had good test-retest reliability (ICC = 0.866, n = 151) and high internal consistency (Cronbach’s α = 0.928). TSK-H was associated with NPRS, MIDAS, HIT-6 and HADS (p < 0.000 for each one). EFA identified a four-factor structure explaining 58.64% of the variance. CFA remained within acceptable limits.ConclusionThe Turkish version of the 23-item TSK-H is a valid and reliable tool for assessing kinesiophobia in patients with migraine and is significantly associated with physical, functional and psychosocial factors.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12883-025-04471-3.

Development and psychometric evaluation of the delirium detection and management scale for pediatric intensive care nurses.

BackgroundThe increasing complexity of healthcare requires nursing students to acquire both theoretical knowledge and practical skills. Nursing care plans are essential for developing clinical competence and bridging the gap between theory and practice. However, many student care plans remain incomplete or lack patient-centred outcomes, highlighting the need for valid tools to assess competence. Currently, no such instrument exists in Turkey.AimThis study aims to translate the ‘Student Survey on Writing Nursing Care Plans’, which was developed to evaluate nursing students’ attitudes towards writing nursing care plans, into Turkish, and to examine the validity and reliability of the translated version.MethodThis methodological study, conducted in April 2025, involved 362 undergraduate nursing students enrolled at Sivas Cumhuriyet University in Turkey. The majority of participants were female second-year students with a mean age of 20.9 years. The scale was evaluated through translation and back-translation, as well as apparent, content and construct validity and reliability analyses.ResultsThe item–total correlation coefficients ranged from 0.656 to 0.894. Confirmatory factor analysis showed that the model fit was acceptable (χ²/df = 3.253; RMSEA = 0.079; CFI = 0.944; TLI = 0.939; NFI = 0.921). The factor loadings of the items ranged from 0.658 to 0.906. The scale exhibited excellent internal consistency, with Cronbach’s alpha equalling 0.98.ConclusionThe findings suggest that the Turkish version of the ‘Student Survey on Writing Nursing Care Plans’ is a valid and reliable measurement tool. It is recommended as a suitable instrument for evaluating the care plan development skills of nursing students within the nursing education process.Implications for nursing education and practiceThe Turkish version of the ‘Student Survey on Writing Nursing Care Plans’ is a valid and reliable tool for evaluating the skills of nursing students in writing care plans. It helps to identify areas where students are particularly struggling, such as planning and evaluation, and supports the development of targeted educational strategies.Clinical trial numberNot applicable.

Neonatal resuscitation is a high acuity, low occurrence event that requires precision, teamwork, and rapid decision-making. Simulation using Neonatal Resuscitation Program (NRP) guidelines allows teams to build competency and preparedness, improving neonatal outcomes. Accurate, reliable performance evaluation during simulation is essential to the provision of meaningful feedback. Evidence supporting the reliability and validity of existing tools when used in telesimulation (TS) is limited. We sought to evaluate the psychometric properties of the modified NRP (mNRP) tool when assessing interprofessional team performance in onsite and TS environments.We employed a methodological design to conduct secondary analyses of data from a larger study using simulation to enhance resuscitation skills as assessed by the mNRP. Item-level data from 96 simulations were subjected to Classical Test Theory-based item analyses, including evaluation of item difficulty, discrimination, and item-to-total correlation; reliability; and exploratory factor analysis (EFA). Interrater reliability (IRR) between novice and expert raters was assessed for a subset of cases.Item difficulties reflected a desirable mix of difficulty in endorsement, suggesting that items capture a range of guideline adherence. Most item discrimination (range: 0.05-0.81) and corrected item-total correlation (range: 0.005-0.68) values had moderate-to-strong, positive correlations with total scores, indicating discriminative ability. EFA yielded three and four components for the onsite and TS groups, respectively. Cronbach's α was 0.76 (onsite) or 0.78 (TS). Lowest versus highest mNRP quartiles differed significantly in both formats (p < 0.001 for each), supporting construct validity. IRR ranged from 0.5 to 0.9, supporting moderate to good agreement between novice and expert raters.Findings provide evidence supporting the reliability and validity of the mNRP tool when applied in both the in situ and TS settings. IRR was acceptable for expert and novice evaluators. This analysis provides additional validity evidence for the mNRP when used to evaluate interprofessional team performance in both onsite and TS formats. · Neonatal resuscitation is a high-acuity, low-occurrence event.. · Many rural clinicians feel underprepared for high acuity, low occurrence events.. · Simulation-based training can improve preparedness.. · Performance is assessed using the mNRP tool.. · Psychometric features support the tool for use in onsite and TS formats..

Validation of the Bronchiectasis Health Questionnaire in Bronchiectasis and Estimation of the Meaningful Score Difference for ABPA.

This study uses a quantitative approach with a causal research design. The main objective is to determine the effect of job satisfaction, organizational commitment, and coworker support on the Organizational Citizenship Behavior (OCB) of employees at Bina Mitra Insani Yogyakarta. The research population consists of all employees at Bina Mitra Insani. Due to the relatively limited number of employees, a saturated sample technique was used, meaning that all members of the population were included as respondents. Data were collected using a questionnaire with a five-point Likert scale, supplemented by a literature review to support the theoretical basis. The variables in this study included job satisfaction (X1), organizational commitment (X2), coworker support (X3), and OCB (Y). Validity was tested using item-total correlation, while reliability was tested using Cronbach's Alpha. Data analysis was performed using multiple linear regression, with stages of classical assumption testing, F-test for simultaneous effects, and t-test for partial effects

The study sought to validate the original and Filipino-translated versions of the PISA math test items as preparatory instruments to a quasi-experimental research design of Philippine secondary school students. Seventy-three Grade 9 students from two intact classes at Dologon National High School were included in the January 2025 pilot testing. One group had to respond to the English version of the test, while the other group was given the Filipino-translated version. The instrument, which had 37 items and was designed to be congruent to the PISA math framework, was administered within a 1.5-hour time limit, and it was subjected to reliability and item-level analyses. The English translation had a Cronbach's alpha coefficient of 0.707, which is an acceptable internal consistency based on standard psychometric criteria (George &amp; Mallery, 2003). The Filipino translation, however, initially had a relatively marginal alpha of 0.639, which, while less than optimal, reflects the usual challenges with translated and culturally adapted tests (Hambleton &amp; Patsula, 1999). By the removal of items with zero or negative item-total correlations, the Filipino version then had its reliability substantially enhanced to 0.739 for the remaining 30 items and thus satisfied the minimum reliability threshold for exploratory studies in educational measurement. This study offers empirical support for the internal consistency of both versions, suggesting that language translation—when thoroughly examined and empirically tested—is not necessarily at the cost of the integrity of cognitive measurement. This study provides empirical evidence supporting the internal consistency of both versions, indicating that language translation—when rigorously evaluated and empirically validated—does not inherently compromise the integrity of cognitive measurement. After item revision, the Filipino version showed not only greater reliability but also greater concordance between item content and the underlying mathematical problem-solving construct. This study emphasizes the value of item-level diagnostics in the validation of bilingual tools, particularly in multilingual environments where students may have different degrees of proficiency in the language of assessment. The study also highlights the need for the adaptation of international assessment frameworks like PISA to enable fair measurement and policy-relevant comparisons across diverse groups of learners.

Self-compassion plays a crucial role in emotional well-being and positive mental health. Self-Compassion Scale (SCS) can facilitate measurement of psychological distress and positive affect. SCS-Short Form (SCS-SF) offers an economical and efficient means of reducing burden of both respondents and researchers. This study conducted secondary data analysis to construct and validate the Korean version of the SCS-SF (K-SCS-SF) using a sample of 650 young adults residing in Korea. To evaluate the factorial structure of the scale, confirmatory factor analyses were performed on two-, three-, and six-factor models, and model comparisons were conducted using multiple fit indices. Concurrent validity was assessed by analyzing correlations of the SCS-SF with measures of resilience, depression, and anxiety. Reliability was examined based on item-total correlations and internal consistency analysis. Findings revealed that the two-factor model comprising negative and positive indicators was the best-fitting model. The two-factor model demonstrated strong validity and reliability in its application, highlighting its robustness in assessing self-compassion and its associations with resilience, depression, and anxiety. The validated K-SCS-SF serves as a reliable, efficient, and practical assessment tool, advancing self-compassion research and its applications in mental health assessment, intervention studies, and psychological well-being research.

As the average age of pubertal onset continues to decline, the need for reliable and culturally appropriate tools to assess pubertal development has become increasingly important. However, no validated, non-invasive, self-report instrument has been available for use in Korea. This study aimed to translate, culturally adapt, and evaluate the Korean version of the Pubertal Development Scale (PDS-K). The original PDS was translated using a forward-backward translation procedure and reviewed by experts to ensure cultural relevance. The PDS-K was administered to a total of 217 elementary school students (grades 4-6). Internal consistency and test-retest reliability were evaluated using Cronbach's α, item-total correlations, Cohen's kappa, and intraclass correlation coefficients (ICC). The PDS-K demonstrated acceptable internal consistency (Cronbach's α: boys = 0.79, girls = 0.74) and good test-retest reliability (ICCs: 0.77 for boys, 0.87 for girls). Sex-specific patterns of pubertal progression were also observed. Although further validation across broader age groups and against clinical benchmarks is warranted, the PDS-K provides a practical and culturally adapted tool for the non-invasive assessment of pubertal development and holds promise for large-scale epidemiological research.

Improving orthodontic care and academic orthodontic education in a university-based postgraduate clinic requires identifying key challenges and enhancing service quality. Therefore, this study aimed to develop and validate a patient satisfaction questionnaire in a postgraduate orthodontic department. A group of experts, consisting of four females and six males (with a mean age of 40.30 years and an average of 12.10 years of work experience), evaluated the validity and reliability of a novel orthodontic treatment satisfaction questionnaire. The validity of the initial version, which included 27 items, was assessed by 10 orthodontic faculty members. Following this evaluation, the questionnaire was revised, resulting in a second version that contained 10items. This revised version was administered to 30 patients (20 females and 10 males) after they completed their treatment (T1). To assess reliability, the same 30 participants completed a follow-up questionnaire two weeks later (T2). Various measures were employed, including the intraclass correlation coefficient (ICC), corrected item-total correlation (CITC), Kappa coefficient, and Cronbach's alpha. The questionnaire was revised on the basis of an expert panel's evaluation of its validity and readability. After 17 items with a content validity ratio (CVR) below 0.62 were removed and one question was revised, 10 items remained. These items yielded a Cronbach's alpha of 0.92 and an ICC of 0.93. This study developed a validated questionnaire to assess patient satisfaction in a university-based postgraduate orthodontic clinic, providing a reliable tool for service evaluation and improvement.

This study examines how three human resource levers—job promotion, staffing/procurement, and employee competence—shape performance among civil servants at the Directorate General of National Export Development (DITJEN PEN), Ministry of Trade. Using an explanatory, cross-sectional survey of 154 employees (simple random sampling), we operationalized constructs on 5-point Likert scales and verified measurement quality via corrected item–total correlations and Cronbach’s alpha (all α ≥ 0.70 after two weak competence items were dropped). Correlational and regression analyses show that competence is the dominant predictor of performance (r = 0.676; β = 0.599, p &lt; 0.001), job promotion has a positive but small effect (r = 0.181; β = 0.093, p = 0.025), and staffing/procurement perceptions are not statistically significant (r = 0.047; β = 0.016, p = 0.724). The full model is strong (F = 45.583, p &lt; 0.001) with R² = 0.477, indicating that the three levers jointly explain nearly half of performance variance. Managerially, returns are highest from targeted competence development aligned to role demands, while promotion processes should be made more timely and transparently merit-based; staffing practices need re-engineering around person–job fit to reveal their contribution to performance. Limitations include cross-sectional design and perceptual measures; future work should integrate administrative data and test mediated pathways (e.g., staffing → competence → performance).

Background: Multiple Sclerosis (MS) is a chronic, autoimmune disease that causes physical and psychological damage and has a highly variable prognosis. It is very important to develop self-care skills apart from symptom treatment that causes individuals to become physically dependent. Objectives: The study was planned and carried out methodologically to adapt the Multiple Sclerosis Self-Management Scale-Revised (MSSM-R) to Turkish society. Methods: The study was conducted with individuals with multiple sclerosis who presented to the neurology clinic of a university hospital between July 2019 and May 2020. The validity and reliability of the MSSM-R were tested with 169 participants. Construct validity was examined using confirmatory factor analysis (AMOS), test–retest reliability through paired-sample t-tests and Pearson correlation analysis, and internal consistency using Cronbach’s alpha. Item-level analyses were also performed. Results: The validity of the MSSM-R was evaluated with language validity, construct validity Confimatory factor analysis (CFA), and content validity. The reliability coefficient of the internal consistency analysis (Cronbach’s Alpha) was found to be very high (.88). Item total correlation was examined, and no items were removed from the scale accordingly. The scale was administered to 30 patients at a two-week interval to evaluate test-retest reliability and time-dependent invariance. Conclusion: The MSSM-R, which was adapted to Turkish society to evaluate the self-management of individuals with multiple sclerosis, is a valid and reliable tool. The Turkish-adapted MSSM-R is a valid and reliable tool and can be used in both clinical practice and research to support self-management interventions for individuals with multiple sclerosis.

The paper has discussed the development of the 50-item scale and pilot validation of a scale to measure socio-economic impact of the Pradhan Mantri Awas Yojana (PMAY) among micro-credit beneficially receiving beneficiaries within the Rohilkhand region of Uttar Pradesh. This was based on the Sustainable Livelihoods Framework (SLF), Social Exclusion Theory and Theory of Planned Behaviour (TPB). The performance of the items, the internal consistency (Cronbach’s A) and the item-total correlation was measured by a purposive pilot sample of N = 67 PMAY beneficiaries through the application of exploratory factor analysis (Principal Component Analysis with Varimax rotation) to assess the latent dimensionality. The descriptive statistics demonstrated that the full 5-point response scale was used reasonably; the overall reliability was satisfactory (a = 0.785). Analysis of item-total correlation created 13 items (&lt; 0.30) to be reworded or eliminated (26% of items). KMO = 0.653, and Bartlett (kh2 = 986.015, df = 528, p &lt; 0.001) test was an indication that data were sufficient to conduct a factor analysis. PCA has 10 components that explain 68.54 percent of the variation; the rotated values reported consistent factors besides two singleton factors (PHQ8 and SO3) that were suggested to be removed. Recommendations to revise the item, proceed with additional large-scale piloting, and make some steps towards confirmatory validation are offered based on the statistics and theoretical arguments. The sophisticated tool will facilitate the careful evaluation of the socio-economic impact of PMAY in Rohilkhand and other areas like these.