Item Content Validity Index Research Articles

Validation of the Cantonese version of the Traditional Chinese Medicine (TCM) Body constitution Questionnaire in elderly people

BackgroundThe Traditional Chinese Medicine (TCM) Body Constitution Questionnaire (For Elderly People) (TCMECQ) is a patient-reported outcome questionnaire developed in Mandarin in 2013 to differentiate the body constitutions of the elderly aged 65 and above. Considering the cultural and linguistic differences between Mainland China and Hong Kong (HK) Special Administrative Region, the TCMECQ was translated into Cantonese following “back translation” policy and validated in proper process.MethodsTen Chinese Medicine Practitioners (CMPs) and 30 senior citizens aged 65 or above were recruited to evaluate the first version of the Traditional Chinese Medicine Body Constitution Questionnaire (For Elderly People) (Cantonese version) (TCMECQ-C). Based on their comments, the second version was developed and discussed in the panel meeting to form the third version, validated the third version on 270 recruited seniors. Based on the validation results, a panel of 5 experts finalized the Questionnaire as the final version. The TCMECQ-C developers finalized the Questionnaire as the validated endorsed third version (i.e. final version).ResultsThe item-level content validity index of most items of the TCMECQ-C (First Version) were ranging from 0.80 to 1.00 in terms of clarity, relevance and appropriateness. Factor loadings of Qi-deficiency Constitution ranging from 0.37 to 0.71, Yang-deficiency Constitution ranging from 0.36 to 0.65, Yin-deficiency Constitution ranging from 0.36 to 0.65, and Stagnant Qi Constitution ranging from 0.68 to 0.82. The chi-squared degree-of-freedom ratio was 2.13 (928.63/436), Goodness-of-Fit Index (0.83), Adjusted Goodness-of-Fit Index (0.79), Normed Fit Index (0.66), Comparative Fit Index (0.78), Incremental Fit Index (0.78), Relative Fit Index (0.61) and Tucker–Lewis Index (0.75), and Root Mean Square Error of Approximation (0.07) and Standardized Root Mean Square Residual (0.07), implied acceptable Confirmatory Factor Analysis model fit of the overall scale. A Pearson correlation coefficient (r) showed the sufficient convergent validity for excessive subscales (Phlegm-dampness Constitution and Dampness-heat Constitution with r = 0.35, p < 0.01). Cronbach’s alpha coefficient ranged from 0.56 to 0.89, including Qi-deficiency Constitution (0.67), Yang-deficiency Constitution (0.84), Yin-deficiency Constitution (0.59), Stagnant Blood Constitution (0.56), Stagnant Qi Constitution (0.89), Inherited Special Constitution (0.76) and Balanced Constitution (0.73), indicating acceptable internal consistency for subscales. The intra-class correlation coefficients of the TCMECQ-C ranged from 0.70 to 0.87 (p < 0.001), indicating moderate to good test–retest reliability.ConclusionTCMECQ-C is a valid and reliable questionnaire for assessing the body constitution in Cantonese elderly.

Adaptation and validation of the Turkish version of the alarm fatigue assessment questionnaire

ObjectiveAlarm fatigue may endanger the safety of patients by negatively affecting nurses' concentration and ability to provide effective care. Identifying alarm fatigue and taking appropriate measures are critical in preventing medical errors and for nurses to work with high motivation. This study aimed to test the psychometric properties of the Turkish version of the 23-item Alarm Fatigue Assessment Questionnaire (AFAQ). MethodThe study was conducted between February 2022 and April 2022 and included nurses with at least one year of clinical or intensive care experience. The data were collected via a web-based questionnaire. During the adaptation of AFAQ, language, content, and construct validity were evaluated; reliability was examined by internal consistency analysis. ResultsThe item and scale content validity index of AFAQ were found to be high (>0.80). The Kaiser–Meyer–Olkin measure of sampling adequacy indicated an adequate sampling (0.85); Bartlett's test of sphericity χ2 was 1935.074, p<0.001. Exploratory factor analysis (EFA) showed that the 21-item scale had a five-factor structure, explaining 51.606% of the total variance, and the factor loadings of the items were >0.30 (0.422−0.803). Confirmatory factor analysis (CFA) showed that the five-factor model had a good fit index (χ2/df=1.855, SRMR=0.039, RMSEA=0.048, CFI=0.915, and TLI=0.908) and appropriate factor loadings (>0.30). The internal consistency of AFAQ (Cronbach's alpha coefficient) was 0.85, and the corrected item-total correlations were between 0.32−0.55. ConclusionThe results indicated that the Turkish version of the Alarm Fatigue Assessment Questionnaire was sufficiently valid and reliable to measure alarm fatigue in nurses.

Cross-Cultural Adaptation and Measurement Properties of the Expectations for Treatment Scale (ETS) for Greek-Speaking Patients.

Introduction Patients' treatment expectations are key factors influencing the health outcomes in various medical conditions. Using validated measures to capture these expectations has been strongly suggested to improve the prognosis of the health outcome and promote research investigations. The Expectations for Treatment Scale (ETS) is a well-established questionnaire designed to accurately measure treatment expectations in patients with low back pain; however, it is not available in Greek yet. We aimed to translate and cross-culturally adapt the ETS in Greek (ETS-Gr) and evaluate its reliability and validity in a Greek-speaking population with musculoskeletal disorders. Methods We followed published recommendations for the translation and cross-cultural adaptation process of the scale.Face and content validity were evaluated using interviews with patients and experts. Internal consistency, test-retest reliability, and measurement error were evaluated in 52 patients with musculoskeletal conditions. Results During forward and backward translation minor linguistic discrepancies were detected and effectively adapted for Greek-speaking patients. The ETS-Gr presented a high level of content validity (item content validity index: 0.88-1; and average scale content validity index: 0.90), acceptable internal consistency (Cronbach's alpha: 0.84), and excellent test-retest reliability (intraclass correlation coefficient: 0.96, 95% confidence interval: 0.93-0.98). Conclusions The ETS-Gr is a short, reliable, and valid instrument to measure pre-treatment expectations in patients with musculoskeletal disorders. Future investigations including other medical conditions are required.

Reliability and validity of the Chinese version of the trauma-specific frailty index (TSFI) for geriatric trauma patients

BackgroundPre-traumatic frailty in geriatric trauma patients has caught attention from emergency medical workers and the assessment of it thus become one of the important aspects of risk management. Several tools are available to identify frailty, but limited tools have been validated for geriatric trauma patients in China to assess pre-traumatic frailty.The aim of this study is to translate the Trauma-Specific Frailty Index(TSFI) into Chinese, and to evaluate the reliability and validity of the translated version in geriatric trauma patients.MethodsA cross-sectional study was conducted. The TSFI was translated with using the Brislin model, that included forward and backward translation. A total of 184 geriatric trauma patients were recruited by a convenience sampling between October and December 2020 in Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan. Using reliability or internal consistency tests assessed with Cronbach’s alpha coefficient, split-half reliability and test-retest reliability. Content validity and construct validity analysis were both performed. Sensitivity, specificity and maximum Youden index(YI) were used to determine the optimal cut-off value. The screening performance was examined by Kappa value.ResultsThe total study population included 184 subjects, of which 8 participants were excluded, resulting in a study sample size of 176 elderly trauma patients (the completion rate was 95.7%). The Chinese version of Trauma-Specific Frailty Index(C-TSFI) have 15 items with 5 dimensions. Cronbach’s alpha coefficient of the C-TSFI was 0.861, Cronbach’s alpha coefficient of dimensions ranged from 0.837 to 0.875, the split-half reliability of the C-TSFI were 0.894 and 0.880 respectively, test-retest reliability ranged from 0.692 to 0.862. The correlation coefficient between items and the C-TSFI ranged from 0.439 to 0.761. The content validity index for items (I-CVI) of the C-TSFI scale was 0.86~1.00, and the scale of content validity index (S-CVI) was 0.93. The area under curve (AUC) of the C-TSFI was 0.932 (95%CI 0.904–0.96, P < 0.05), the maximum YI was 0.725, the sensitivity was 80.2%, the specificity was 92.3%, and the critical value was 0.31. Kappa value was 0.682 (P < 0.05).ConclusionsThe Chinese version of TSFI could be used as a general assessment tool in geriatric trauma patients, and both its reliability and validity have been demonstrated.

Development and Validation of the Outpatient Nurses Communication Behavior Inventory

Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings. The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity. During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 - January 2019.) The construct validity and internal consistency of the inventory were evaluated. The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (Χ ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, NNFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89. The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care.

Assessment of Drug-Induced QTc Prolongation in Mental Health Practice: Validation of an Evidence-Based Algorithm.

Drug-induced QTc interval prolongation (QTcIP) can lead to serious consequences and is often a concern for mental health practitioners, as access to experts such as cardiologists, for consultation is time-limiting and can delay treatment decisions. This research aimed at validating the content of an algorithm for the assessment, management and monitoring of drug-induced QTcIP in mental health practice. Following an initial face validity by content experts, a cross-sectional survey of mental health care practitioners with a 4-point Likert-type scale was used to assess the validity of the decision steps on the QTcIP algorithm (QTcIPA) by estimating the content validity index (CVI) and the modified kappa statistic (κ*). Participants' open-ended comments were also thematically analyzed. Mental health practitioners found the QTcIPA to be appropriate, safe, and evidence-based, as indicated by the high individual item CVI scores ranging from 0.89 to 1 for all of the steps/decision statements in the three domains assessed: appropriateness, safety and reliability of the references used. Five themes emerged from the qualitative analysis of the open-ended comments, of which three were identified as strengths, including practical usability, reliable references and beneficial for pharmacists. Two themes were recognized as limitations, namely, the need for additional clinical content and application barriers. These results suggest that the QTcIPA may be a useful tool for mental health clinicians at the time of prescribing medications with potential risk of QTcIP. Future research will explore the implementation of the QTcIPA into clinical practice using computerized decision support tools through web-based and mobile applications.

Translation and psychometric testing of Indonesian Version of Chronic Kidney Disease– Symptom Burden Index

Introduction: Chronic Kidney Disease Symptom Burden Index (CKD-SBI) is an instrument measuring symptom burden developed by Almutary and colleagues in 2015 to refine the identification of symptom burden in chronic kidney disease population. This instrument has not been tested for Indonesian language, thus, the aim of study was to translate and psychometrically testing the Indonesian version of CKD-SBI. Methods: This study design was cross-sectional study. The study methods were divided into translation and psychometric testing. The translation was conducted by adapting Guillemin and Beaton's guidelines. The psychometric properties determined 320 hemodialysis patients with several inclusion criteria such as above 18 years old, regularly receiving hemodialysis for more than 3 months. Patients with cognitive impairment, psychiatric patients, and in critical condition were excluded. Results: The item content validity index of the Indonesian version was 0.92, and the subscale content validity was 0.78. The instrument demonstrated convergent validity with the Kidney Disease Quality of Life. Excellent internal consistency was demonstrated based on a Cronbach’s alpha coefficient of .91 and a subscale ranging from 0.86 to 0.92. The confirmatory factor analysis showed that the five factors of English Version did not fit the Indonesian version. Conclusions: Translated Indonesian versions of CKD-SBI can be used as instruments to assess symptom burden among patients with hemodialysis. By assessing symptom burden, we hope nurses in the hospital are able to decide effective symptom management to increase the health-related quality of life among these populations.

Health Education for Chronic Kidney Disease Patients Not on Dialysis Through the Pictorial Patient Information Leaflet

Background: Educating the patient with patient information leaflets is helpful to increase understanding and awareness about chronic kidney disease. Various educational materials are available online, but their quality is mixed. The content was found to be unreliable or incomprehensible. Objective: The study aimed to develop, validate, test the readability, translation, and design of the patient information leaflet and focused on assessing patients’ knowledge levels using questionnaires after providing the validated patient information leaflet. Methods: A prospective study was conducted among chronic kidney disease patients who were not on dialysis. The patient information leaflet was prepared based on experts’ opinions and a thorough review of various resources. Experts validated the content of the patient information leaflet through the content validity index. After being validated, the Baker Able leaflet design scale was used to evaluate the layout and design. Knowledge assessment questions were validated using item-content validity index scores to assess patient knowledge before and after providing the patient information leaflet. Results: A total of 60 randomly selected chronic kidney disease patients were enrolled. The content validity index of the patient information leaflet was found to be 0.9. The Baker Able leaflet design score was found to be 25. Knowledge was assessed and it showed that score had increased from 42 ± 6.95 to 73.5 ± 6.70, respectively, with a P-value &lt;0.000. Conclusion: This study concluded that the patient information leaflet was developed based on standard procedures. Significant improvement was seen in patients’ knowledge after utilizing a validated patient information leaflet.

Development and validation of the genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM-SVTAQ): An electronic patient-reported outcomes measure.

To develop and validate an electronic, patient-reported outcomes measure (PROM) specific for genitourinary syndrome of menopause (GSM) patients. The PROM aimed to accurately assess the burden of GSM symptoms, their impact on health-related and sexual quality of life, and the acceptability of vaginal treatments. The study encompassed a comprehensive three-stage approach to the development and validation of the PROM. Initially, during the preliminary design stage, the necessity for a new PROM was recognized, an expert panel was formed, and semi-structured qualitative interviews were carried out with GSM patients. In the second stage, the study used the five-step pre-validation methodology established by Prior et al. to generate and refine the PROM items. The third and final stage encompassed the determination of scale and item content validity indexes to ensure validity. Additionally, the reliability of each construct was evaluated using Cronbach's α. The resulting PROM was named GSM-SVTAQ (GSM-symptoms and vaginal treatments acceptability questionnaire). It demonstrated excellent validity in assessing symptoms burden, health-related and sexual quality of life, and vaginal treatment acceptability, with high content validity indices and strong internal consistency. The scale content validity indices and Cronbach's α coefficients for the three domains were (0.926, 0.939), (0.875, 0.947), and (0.824, 0.855), respectively. The GSM-SVTAQ stands as the first GSM-specific, valid, and reliable PROM capable of comprehensively measuring the three components of GSM and the acceptability of vaginal treatments. Its implementation has the potential to significantly enhance patient care and outcomes in GSM management.

Development of the Workplace Interpersonal Problems Scale for Care Workers (WIPS) and examination of its reliability and validity

IntroductionThe turnover rate of care workers has remained high by global standards, with previous studies showing an association between workplace interpersonal relations and care worker turnover and turnover intentions. This study details the development of the Workplace Interpersonal Problems Scale for Care Workers (WIPS) and examines its reliability and validity according to the COSMIN guidelines. MethodsA total of 476 care workers employed by elder care facilities participated in the study. This study examined the reliability and validity of the WIPS after its development. Reliability was evaluated using Cronbach's α, test reliability with the standard error of measurement, and test–retest reliability with the intraclass correlation coefficient. Content validity, construct validity, and structural validity were examined to evaluate validity. ResultsBoth total and subscale scores of the WIPS had a Cronbach's α coefficient >0.75 and high test–retest reliability (intraclass correlation coefficient, 0.75). Content validity analysis showed the item-content validity index of ≥0.90 for all WIPS items, confirming 100% of the hypotheses for testing construct validity. Confirmatory factor analysis showed an acceptable fit for the hypothesized six-factor construct (CFI = 0.92, TLI = 0.91, RMSEA = 0.07, SRMR = 0.05). ConclusionsThe WIPS was found to be a valid and reliable instrument. With the growth of the elderly population worldwide, we believe that the WIPS will be a useful quantitative measure to assess workplace interpersonal problems affecting care workers in various aspects.

Further development and evaluation of a questionnaire targeting person-centred outpatient care for persons with long-term conditions

AimTo further develop the Person-Centred Care instrument for outpatient care (PCCoc), evaluate its user-friendliness and content validity, and to explore its basic psychometric properties in various outpatient settings for adults with long-term conditions.BackgroundPerson-centred care (PCC) has been identified as a key factor to provide high-quality care. However, there is still a lack of instruments that are based on a clearly defined framework for PCC for persons with long-term conditions in an outpatient context. The PCCoc is a patient-reported experience measure under development aiming to fill this gap.MethodsFirst, the 35-item PCCoc was reviewed and further developed in collaboration with a user-council. Second, the revised 36-item PCCoc was tested among persons receiving outpatient care for various long-term conditions. A total of 179 persons with long-term conditions from four different specialties participated in the study. User-friendliness and content validity were assessed through structured interviews and relevance ratings of each item. Content validity index (CVI) for individual items (I-CVI) and for the overall scale (S-CVI) were calculated, and basic psychometric properties of the PCCoc using classical test theory were explored.ResultsIt took a median of 8 min for participants to complete the PCCoc. The majority found items easy to understand, response categories distinct and that no important areas were missing. Results from the CVI analyses suggested that participants found the content of the PCCoc relevant (I-CVI range 0.82-1, S-CVI = 0.95). All psychometric properties examined were satisfactory (e.g., item-total correlations, 0.45–0.75; Cronbach’s alpha, 0.96; test-retest stability, 0.83).ConclusionThe PCCoc was considered user-friendly and relevant by the intended users, and its psychometric properties were satisfactory. This implies that the PCCoc can be a valuable instrument for evaluating and developing PCC in outpatient care for persons with long-term conditions. However, further studies of the PCCoc are needed to establish its measurement properties in various outpatient settings.

Cross-cultural adaptation and psychometric validation of the Vietnamese version of the evidence-based practice competency questionnaire for registered nurses (EBP-COQ Prof©)

Background &amp; Aim: Establishing strategies to enhance evidence-based practice (EBP) requires a reliable instrument for assessing EBP competency. This study focused on translating and validating the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©) in the Vietnamese context.&#x0D; Methods &amp; Materials: Through a methodological approach, this study performed cross-cultural adaptation and psychometric validation. The study involved 372 nurses selected through convenience sampling. Content validity was established using the Content Validity Index for Items (I-CVI) and the Content Validity Index for Scales (S-CVI). Construct validity was assessed via exploratory (EFA) and confirmatory factor analysis (CFA). Reliability was determined using Cronbach's alpha and the intra-class correlation coefficient (ICC). Criterion validity was examined by comparing EBP-COQ Prof© competency between nurses with and without prior EBP education.&#x0D; Results: The Vietnamese version of EBP-COQ Prof© maintained consistency with the original version following cross-cultural adaptation. Content validity was confirmed with I-CVI&gt; 0.78 and S-CVI/AVE= 0.97. EFA and CFA revealed consistent components with the original version: attitude (8 items), knowledge (11 items), skills (6 items), and utilization (10 items). Cronbach's alpha values were high: attitudes (0.965), knowledge (0.962), skills (0.909), and utilization (0.926). ICC values were also significant: attitudes (0.754), knowledge (0.895), skills (0.823), and utilization (0.966). Nurses with prior EBP education demonstrated higher EBP-COQ Prof© competency.&#x0D; Conclusion: The translated and validated EBP-COQ Prof© provides a robust tool for assessing EBP competency among Vietnamese nurses. Its reliability, validity, and sensitivity to educational effects underscore its potential for promoting EBP in nursing.

Co-designing psychosis simulated patient scenarios with mental health stakeholders for pharmacy curricula

BackgroundPharmacists need knowledge and confidence to support people living with mental illness. Evidence-based educational materials for pharmacy students to provide psychosis care is limited.AimTo co-design, content validate and pilot-test, with mental health stakeholders, simulated patient scenarios to educate and assess students in providing psychosis care.MethodMental health consumers were invited to co-design three simulated patient scenarios (first-episode psychosis, carer of someone living with schizophrenia, non-adherence to antipsychotics), guided by published and psychometrically-tested materials. A panel of mental health stakeholders participated in two rounds of content validation (RAND/UCLA appropriateness model). Round 1 involved individual survey completion to calculate item content validity index (I-CVI) for relevance/clarity, content validity ratio for essentiality and overall scale content validity index (S-CVI/Ave and S-CVI/UA) scores for each scenario. Scores analyses and feedback comments informed revisions. Round 2 involved a panel meeting to discuss revisions and finalise content. The scenarios were then pilot-tested with pharmacy students.ResultsTwo consumers participated in co-design, nine stakeholders in content validation. All items showed excellent content validity for relevance/clarity. Eleven items were revised for essentiality, discussed, then re-rated at the panel meeting for consensus. The scenarios were pilot-tested with pharmacy students (n = 15) and reported to be realistic and relevant to future practice, contributing to students’ confidence in supporting people experiencing mental health symptoms or crises.ConclusionPartnering with mental health stakeholders has enabled co-design of authentic, content valid educational materials for pharmacy students to provide psychosis care, in preparation for future provision of mental health support.

Content Validity of the Spanish Adaptation of the Premature Infant Pain Profile Revised

BackgroundTo the best of our knowledge, there are no validated neonatal pain assessment scales in Spanish. Given the need for such a scale, a study was undertaken to adapt and validate the Premature Infant Pain Profile-Revised (PIPP-R) scale. After translation and back-translation, content validity was addressed, a crucial phase in validation studies, in which researchers examine whether the items that make up the scale represent the content that the scale is intended to assess. AimsThe aim was to provide evidence for the content validity of the Spanish adaptation of the PIPP-R scale. MethodThe study used the Delphi technique with 10 experts. Data collection was anonymous and was conducted through an online platform. It was an ad hoc survey consisting of four questions, with a five-point Likert scale for each item on the scale and for the instruction table. An item-content validity index (I-CVI) and a scale-content validity index (S-CVI) were calculated for the analysis. ResultsAfter two rounds of the survey, all items exceeded an I-CVI of 0.9. The S-CVI value was 0.98 (±0.03) for the scale, and 1 for its instruction table. The kappa index yielded values indicating an excellent degree of agreement. ConclusionsThe Spanish version of the PIPP-R obtained a high degree of content validity according to the expert group and the Delphi technique.

Psychometric Properties of the Persian Version of the Gaming Motivation Scale.

Gaming motivations are a central aspect of playing video games, and their importance to understanding both healthy and problematic gaming behavior has been increasingly elucidated. In this study, we aimed to translate the 18-item Gaming Motivation Scale (GAMS-18) to Persian and validate it in a population of Persian speaking gamers, specifically for the assessment of online gaming. After translation from English to Persian, content validity of the questionnaire was assessed by a panel of experts and test-retest reliability was calculated in a sample of 70 students. Data from an online survey of 791 Iranian online gamers were used for the assessment of construct validity using confirmatory factor analysis. The item content validity index and the scale content validity index for clarity and relevance ranged from 0.80 to 1.00. Internal consistency reliability of the GAMS-18 was 0.90 and the test-retest reliability was 0.89. The test-retest reliability of the GAMS-18 was 0.89, and the internal consistency was 0.90. The GAMS factors had acceptable correlation with other motivational scale such as Player Experience of Need Satisfaction. Incorporating the proposed additional error paths improved the model fit to an acceptable level. The Persian version of the GAMS can assess digital gaming behavior based on the six self-determination theory motivation types, and measures different aspects of motivation that other instruments. It is also demonstrated to have good reliability and validity and could be used in research on the motivations of online gamers in Persian-speaking populations.

Validity and Reliability of Dementia Knowledge Assessment Scale and Dementia Attitude Scale in the Indonesian Language among Nursing Students

BACKGROUND: The population of persons with dementia (PwD) in Indonesia is increasing. As future nurses, it is important to evaluate the knowledge and attitudes of nursing students because they can affect the quality of health services for PwD. However, no instrument is available in the Indonesian language through a good, valid, and reliable translation process. AIM: The aim is to report the translational process and determine the validity and reliability of the Indonesian dementia knowledge assessment scale (DKAS) and dementia attitude scale (DAS) questionnaires in nursing students. METHODS: A quantitative cross-sectional study was conducted involving 486 nursing students from two universities in Yogyakarta, Indonesia. The Brislin method was used to translate DKAS and DAS, then continued with content (involved four experts using items-content validity index [I-CVI]), face, and construct validity tests, as well as reliability tests using Cronbach’s alpha. RESULTS: The I-CVI results were 1.00 for DKAS and 0.98 for DAS, demonstrating a good construct validity index. In addition, the reliability testing had good results, whereas Cronbach’s alpha of the DKAS was 0.713, while DAS was 0.779. CONCLUSION: DKAS and DAS in the Indonesian language are considered valid and reliable to measure nursing student’s knowledge and attitudes toward PwD.

Development of outcome measures for giant cell arteritis for use in clinical trials and standard practice.

Developments in outcome measures in the rheumatic diseases are promoted by the development of successful treatments. Giant cell arteritis (GCA) is a multifaceted disorder and, therefore, measurement of multiple outcomes is relevant to this illness. It is a privilege to analyze and monitor/transfer long-term patients' management outcomes particularly if the same outcomes are used in practice and in trials. To classify the outcome measures for GCA with a discriminative ability to identify the disease activity status and response to therapy. This study was composed of two steps, instrument design (item generation) and judgmental evidence. A panel of 13 experts was used to validate the instrument through quantitative (content validity) and qualitative (cognitive interviewing) methods. Content validity index was used to assess content validity quantitatively. Five items achieved high content validity where item-content validity index score was >0.79, and in the meantime achieved high content validity response score reflecting greater agreement among panel members. Through qualitative methods, items were improved until saturation was achieved. This agreed with the expert panel ranking of the items included in GCA disease outcome measures set. For daily clinical practice, outcome measures should reflect the patients' disease activity status and have to be easily assessed and recorded. The study identified composite outcome measures for GCA able to assess the disease state and monitor response to therapy. Key Points • Despite the cohort studies published in giant cell arteritis (GCA), there are no fully validated outcome measures for use in standard practice or clinical trials. • There is a gap in international standards for assessing GCA disease activity. • Identifying disease specific outcome measures is vital for monitoring response to therapy, treatment case series and therapeutic clinical trials in GCA. • This study was carried out aiming to classify the outcome measures for GCA with a discriminative ability to identify the disease activity status and response to therapy.

Development of a menu of recovery goals to facilitate goal setting after critical illness

ObjectiveTo develop an expert-informed (including end users) recovery goal menu for adults recovering from critical illness applicable to the community/home setting. Research methodology/designStage 1 Item generation: iterative development of domains, sub-domains, and goals in consultation with former intensive care patients, family members and expert clinicians. Stage 2 Content validity assessment: cognitive interviews and the content validity index. SettingVirtual consultation meetings facilitated by the research team at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust. Main outcome measuresContent validity as assessed by: the Item-Content Validity Index (I-CVI), Scale Level-Content Validity Index/Universal Agreement (S-CVI/UA) score, the Scale Level-Content Validity Index/Average (S-CVI/Ave) score and Average Content Validity Ratio (CVR). ResultsItem generation resulted in a goal menu comprising 4 domains, 22 sub-domains and 95 goals assigned as follows: Self-care: 9 sub-domains with 37 goals, Productivity: 7 sub-domains with 13 goals, Leisure: 3 sub-domains with 25 goals, and Person domain 3 sub-domains with 20 goals. Cognitive interviews resulted in addition of 79 goals and modification of 7, addition of 4 new sub-domains and modification of 4, thus resulting in 4 domains, 26 sub-domains with a total of 174 goals. Twenty-four sub-domains (169 goals) were deemed relevant with Item-Content Validity Index (I-CVI) scores ranging from 0.72 to 1. Two sub-domains (5 goals) did not meet the 0.7 cut-off and were removed. The Scale Level-Content Validity Index/Universal Agreement (S-CVI/UA) score was 0.46; the Scale Level-Content Validity Index/Average (S-CVI/Ave) 0.91. Average Content Validity Ratio (CVR) was 0.93. ConclusionAn expert informed recovery goal menu for former intensive care patients has been developed with excellent content validity. The final goal menu comprises 169 goals within 24 sub-domains grouped under 4 domains. Implications for Clinical PracticeThis menu will help patients to set goals and increase our understanding of how individuals recover from critical illness.

Reliability and Validity of the Chinese Version of Advance Care Planning Self-efficacy Scale for Physicians.

Background: Chinese patients prefer physicians to initiate advance care planning (ACP) conversations, but there is no appropriate tool to evaluate physicians' ACP self-efficacy level in mainland China. This study aimed to translate the ACP self-efficacy scale into Chinese (ACP-SEc) and measure its psychometric properties among clinical physicians. Method: The original scale was translated by literal translation, synthesis, and reverse translation, according to Brislin's translation model. Seven experts were invited to further revise the scale and evaluate the content validity. 348 physicians were conveniently sampled to evaluate the reliability and validity of the scale from May to June 2021 in 7 tertiary hospitals. Results: The ACP-SEc contained 17 items, 1 dimension, with a total score of 17 to 85 points. In this study, the critical ratios of the items ranged from 12.533 to 23.306, the item-total correlation coefficients ranged from 0.619 to 0.839. The item-content validity index ranged from 0.86 to 1.00, and the average scale-level content validity index was 0.98. In total, 75.507% of the total variance was explained by 1 common factor. The results of confirmatory factor analysis showed that the fitting indices of the modified model were desirable. The ACP-SEc was moderately correlated with General Self-Efficacy Scale (r = 0.675, P < .001), and it differentiated between physician groups based on the knowledge level of ACP, palliative care or ACP-related training experience, attitude toward ACP, willingness to initiate ACP discussions with patients, and experience of discussing ACP with family and friends, willingness to initiate ACP discussions with family and friends (P <.05). The total Cronbach's α and test-retest reliability of the scale were .960 and .976, respectively. Conclusion: The ACP-SEc shows good reliability and validity, and it can be used to assess the ACP self-efficacy level of physicians.

Cross-Cultural Adaptation, Validity, and Reliability Testing of the Tilburg Frailty Indicator (TFI) Amharic Version for Screening Frailty in Community-Dwelling Ethiopian Older People.

Frailty is a global health problem, including in African countries. Despite this, no reliable or valid frailty instruments incorporate any African language, and no research exists to cross-culturally adapt and test the validity and reliability of instruments commonly used in other countries for use within African countries. The Tilburg Frailty Indicator (TFI) is a reliable and validated instrument with the potential to be relevant for older populations living in Africa. This study aimed to develop the TFI Amharic (TFI-AM) version for use within Ethiopia. This study employed psychometric testing and the evaluation of a translated and adapted instrument. The original English language version of the TFI was translated and culturally adapted into Amharic using the World Health Organization process of translation and adaptation of an instrument. A convenience sample of ninety-six community-dwelling older people 60 years and over was recruited. Cronbach's alpha was used for the analysis of the internal consistency of the TFI Amharic (TFI-AM) version using IBM SPSS 26.0 (IBM Corp., Armonk, NY, USA). Face and content validities of the TFI-AM were determined. The TFI-AM total mean score was 5.76 (±2.89). The internal consistency of the TFI-AM was very good with an overall Cronbach alpha value of 0.82. The physical domain showed the highest reliability with a 0.75 Cronbach's alpha value while the social domain was the lowest with a 0.68 Cronbach's alpha value. The Cronbach's alpha reliability coefficients of the instrument ranged from 0.68 to 0.75. The item content validity index value ranged from 0.83 to 1.0 and the total content validity index average for the instrument was 0.91. The TFI-AM is reliable, valid, and reproducible for the assessment of frailty among community-dwelling older populations in Ethiopia. TFI-AM proved an easy-to-administer, applicable and fast instrument for assessing frailty in community-dwelling older populations.