Mean Squared Error Of Approximation Research Articles

Validity and Reliability of the Korean Version of the Trauma-Informed Climate Scale-10

PurposeThe Trauma-Informed Climate Scale-10 is a short form developed to efficiently measure staff perceptions of the values of trauma-informed care within the service environment. This study aimed to evaluate the reliability and validity of the Korean version of the Trauma-Informed Climate Scale-10 (K-TICS-10) among Korean nurses. MethodsThe K-TICS-10 underwent a linguistic validation process, including translation, back-translation, and expert committee review. Data were collected from 218 nurses in tertiary general hospital in South Korea. Internal consistency reliability was assessed using Cronbach’s α. Structural validity was tested through confirmatory factor analysis. Convergent validity was examined using Pearson’s correlation with affective commitment and burnout. Item-convergent validity was evaluated to examine the internal structure of the scale. ResultsThe Korean version of the TICS-10 demonstrated reliable internal consistency, with Cronbach’s α of .82. The fitness of the modified model was acceptable (χ2/Df = 2.85, goodness-of-fit index = .92, root mean square error of approximation = .09, standardized root mean square residual = .08, Normed fit index = .88, Tucker–Lewis index = .88, and comparative fit index = .91). Convergent validity of the K-TICS-10 was confirmed by significant correlation with affective commitment (r = .56, p <.001) and burnout (r = -.53, p <.001), respectively. The average extracted variances (.34) and composite reliability (.81) indicated adequate convergent validity of the items. ConclusionThe findings of this study support the satisfactory psychometric properties of the K-TICS-10, indicating its utility for evaluating the trauma-informed climate among nursing work environment in Korea.

Development and Psychometric Evaluation of the Symptom Assessment Scale for Turkish Children with Cancer

Objective: The present study was conducted to developed the Symptom Assessment Scale for Children with Cancer (SAS-CC) and assessed its reliability and validity for Turkish children. Methods: This research was conducted among in 497 children with cancer who were between 7 and 18 years old. The data were collected with a demographic form and SAS-CC. Descriptive statistics, reliability and validity analysis were used to analyze the data. Results: The mean age of children with cancer was 12.02 +3.38 years. The scale consists of 16 items and 3 sub-dimensions. Total factor loads were more than 0.30 in factor analyses. The confirmatory factor analysis revealed all fit indexes as higher than 0.91, and the root mean square error of approximation (RMSEA) was less than 0.080. Cronbach’s alpha values of total was 0.96. According to the split-half analysis, α values of the first and second halves were 0.94 and 0.93, respectively. Conclusions: This study demonstrated that SAS-CC is the first study to develop and test and a valid scale to evaluate symptoms in children with cancer. Effective strategies of coping with symptoms in children with cancer are required to improve prognosis, increase survival, and improve the quality of life. Therefore, assessing symptoms and their frequency in children with cancer is an majority initiative of nurses working in the pediatric oncology clinic.

Socioeconomic status, reserve capacity, and depressive symptoms predict pain in Rheumatoid Arthritis: an examination of the reserve capacity model

BackgroundGuided by the reserve capacity model, we evaluated the unique relationships between socioeconomic status (SES), reserve capacity (helplessness, self-efficacy, social support), and negative emotions on pain in patients with Rheumatoid Arthritis (RA).MethodsThe secondary analysis used baseline, cross-sectional data from 106 adults in a clinical trial comparing behavioral treatments for RA. Patients were eligible if they were ≥ 18 years old, met the ACR criteria for RA (determined by study rheumatologist), had stable disease and drug regimens for 3 months, and did not have a significant comorbid condition. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness- Arthritis Helplessness Index, self-efficacy -Personal Mastery Scale, social support- Social Provisions Scale) and negative emotions (stress and depressive symptoms- Perceived Stress Scale and Hamilton Depression Rating Scale) on pain (Rapid Assessment of Disease Activity in Rheumatology-RADAR & visual analog scale-VAS), and the indirect effects of SES as mediated by reserve capacity and negative emotions. The SEM model was evaluated using multiple fit criteria: χ2 goodness-of-fit statistic, the comparative fit index (CFI), the standardized root mean square residual (SRMR), and the root mean square error of approximation (RMSEA).ResultsParticipants were mostly female (85%), 55.45 years old on average, self-identified as white (61%), Hispanic (16%), black (13%), and other (10%), and had RA for an average of 10.63 years. Results showed that low SES contributed to worse pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain. The final model explained 39% of the variance in pain.ConclusionsThe findings indicate that lower SES was related to worse clinical pain outcomes and negative emotions and reserve capacity (helplessness, social support, and self-efficacy) mediated the effect of SES on pain. A primary limitation is the small sample size; future studies should evaluate this model further in larger, longitudinal approaches. Interventions that target negative emotions in patients with low SES may facilitate better pain control with RA.Trial registrationclinicaltrials.gov NCT00072657 01/02/2004 20/03/2009.

Psychometric validation of the Chinese version of the dry eye-related quality-of-life score questionnaire.

To psychometrically validate the Chinese version of the dry eye-related quality-of-life score questionnaire (DEQS-CHN) among Chinese patients with dry eye. This study involved 231 participants, including 191 with dry eye disease (DED) comprising the dry eye disease group, and 40 healthy participants forming the control group. Participants were required to complete the DEQS-CHN, and Chinese dry eye questionnaire and undergo clinical tests including the fluorescein breakup time (FBUT), corneal fluorescein staining (CFS), and Schirmer I test. To assess the internal consistency and retest reliability, Cronbach's α and the intraclass correlation coefficient (ICC) were employed. Content validity was assessed by item-level content validity index (ICV) and an average scale-level content validity index (S-CVI/Ave). Construct validity was assessed by confirmatory factor analysis. The concurrent validity was assessed by calculating correlations between DEQS-CHN and Chinese dry eye questionnaire. Discriminative validity was evaluated through non-parametric tests, with receiver operating characteristic (ROC) curve serving as conclusive indicators of the questionnaire's distinguishing capability. The Cronbach's α coefficients for frequency and degree of ocular symptoms, impact on daily life, and summary score were 0.736, 0.704, 0.811, 0.818, 0.861, and 0.860, respectively, and the ICC were 0.611, 0.677, 0.715, 0.769, 0.711, and 0.779, respectively. All I-CVI scores ranged from 0.833 to 1.000, with an S-CVI/Ave of 0.956. Confirmatory factor analysis results exhibited a well-fitting model consistent with the original questionnaire [χ 2/df=2.653, incremental fit index (IFI)=0.924, comparative fit index (CFI)=0.924, Tucker-Lewis index (TLI)=0.909, and root mean square error of approximation (RMSEA)=0.065]. There was a moderate positive correlation between the DEQS-CHN and the Chinese dry eye questionnaire (r 2=0.588). The dry eye group demonstrated significantly higher scores compared to the control group, and the area under the curve (AUC) value was 0.8092. The DEQS-CHN has been demonstrated as a valid and reliable instrument for assessing the impact of dry eye disease on the quality of life among Chinese individuals with DED.

The Patient Specific Functional Scale - Brazil as an instrument for the functional assessment of patients with chronic non-specific low back pain: Construct validity (hypothesis testing and structural validity) and test-retest reliability

The objective was to assess the validity and reliability of the Patient-Specific Functional Scale-Brazil (PSFS-B) in patients with non-specific chronic low back pain. A methodological study was conducted, and 101 volunteers with chronic non-specific low back pain were interviewed and asked to complete the PSFS-B questionnaire and the Oswestry Disability Index-Brazil 2.0 reference questionnaire. The Oswestry Disability Index-Brazil 2.0 is a standardized tool used to assess functional disability of the lumbar spine. A new assessment (follow-up) was conducted one week later using the same instruments. The COSMIN checklist was utilized as a guide. Two questionnaires were employed to assess patients: the Patient-Specific Functional Scale-Brazil (PSFS-Br) and the Oswestry Disability Index-Brazil 2.0 (ODI-Br). Data were analyzed to assess construct validity (hypothesis testing and structural validity), internal consistency, and test-retest reliability. The statistical methods employed included Pearson's correlation coefficient, confirmatory factorial analysis, Cronbach's alpha, and intraclass correlation coefficient. The results of the Patient-Specific Functional Scale-Brazil demonstrated a moderate negative correlation with the ODI-Br in hypothesis testing (r = −0.691 and r = −0.754) and in structural validity (Comparative Fit Index (0.986), Tucker-Lewis Index (0.958), Root Mean Square Error of Approximation (0.194), and Standardized Root Mean Square Residual (0.134). Furthermore, the instrument demonstrated excellent internal consistency (α = 0.951) and test-retest reliability (intraclass correlation coefficient = 0.978), and was additionally validated by the Bland-Altman plot (0.125). In conclusion, the Patient-Specific Functional Scale-Brazil is a valid and reliable tool for the evaluation and follow-up of patients with non-specific chronic low back pain.

Development of cyber wellness indicators among Thai older persons: Mixed method research

ABSTRACT This mixed methods Ph.D. study aims to evaluate the structure of a new five component Cyber Wellness model from research with 320 participants from a multi-stage random sampling method. This model includes five components found from critical literature review: 1. Cyber Use, 2. Cyber Citizenship, 3. Cyber Ethical Relationship, 4. Cyber Safety and 5. Cyber Rights. Participants responded to a 5-point Likert scale with X questions. In our analysis, we found an overall Cronbach’s alpha was .938, with individual component alphas ranging from .733 to .889. Statistical analyses included; mean, percentage, standard deviation, and confirmatory factor analysis. We found that each model component demonstrated significance at the .01 level, with factor loadings ranging from .71 to .96, with the highest factor loading for being Cyber Ethical Relationship. This means that improved cyber ethical relationships among older individuals could greatly enhance their overall wellness. Our confirmatory factor analysis results showed Chi-Square (χ2) = 64.00, df = 50, p = .088, goodness of fit index (GFI) = .97, adjusted goodness of fit index (AGFI) = .95, root mean square error of approximation (RMSEA) = .030. These results indicate that the chi-square value significantly differs from zero at the .05 level, supporting our main hypothesis that the measurement model aligns with empirical data and that the Cyber Wellness model developed in this study can serve as a foundational concept for designing learning programs that enhance Cyber Wellness among Thai older people using the identified indicators to create micro-learning modules suitable for their needs.

Validation of the Jamaican version of the Oral Health Impact Profile (OHIP-14) in adults: JAM-OHIP study

Background: The Oral Health Impact Profile (OHIP-14) is a widely used tool for measuring the effects of oral health-related quality of life (OHRQoL). However, the validity of the OHIP-14 in the Jamaican context, referred to as the Jamaican Oral Health Impact Profile (JAM-OHIP), has yet to be established. Purpose: To determine the validity of the Jamaican language version of the OHIP in evaluating the OHRQoL of Jamaican adults. Methods: The original English version of the Oral Health Impact Profile (OHIP-14) was translated into the Jamaican language using forward and backward translation. The JAM-OHIP was used to evaluate the OHRQoL of 236 individuals at the University of the West Indies Dental Polyclinic. The overall fit was checked using a chi-square test (p &gt; 0.05), comparative fit index (CFI), Tucker–Lewis index (TLI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). Results: More DMFT (p &lt; 0.01) was associated with high JAM-OHIP scores, and the most impacted domain was physical pain. Cronbach’s alpha and the standardized item alpha for the JAM-OHIP were 0.82. The overall fitting results for the CFA were χ²(68) = 80.558, p = 0.142, and χ²/g.l. = 1.185. The CFI and TLI were 0.996 and 0.994, respectively. The SRMR was 0.072 and the RMSEA was 0.028 (CI95% = [0.000; 0.050]) p = 0.953. Conclusions: The JAM-OHIP instrument was shown to be reliable and valid for the assessment of OHRQoL in the Jamaican adult population.

Development and psychometric evaluation of the self-care of informal caregivers inventory

BackgroundIn recent years, a growing body of literature on informal caregivers’ health and well-being has emerged, highlighting the need for a tool to measure their self-care practices. ObjectiveThe aim of the study was to develop a theory-based instrument measuring the self-care behaviors of informal caregivers and test its psychometric properties. DesignThe initial phase of instrument development entailed a detailed, six-step process (conceptualization, theoretical adaptation, back-translation and cultural adaptation, cognitive interviewing, item enhancement, and content validity), followed by formal psychometric testing (participant engagement, validity, internal consistency reliability, test-retest reliability). SettingStudy conducted at a hospital located in Tehran, Iran. ParticipantsA sample of 234 informal caregivers of cancer outpatients receiving treatment in oncology wards was enrolled. Caregivers had to be 18 years or older, recognized as the primary caregiver by the patient, and willing to provide informed consent. MethodsThe Self-Care of Informal Caregivers Inventory items comprise three dimensions: self-care maintenance (11 items), self-care monitoring (7 items), and self-care management (9 items), which achieved a content validity index rating of 100 % in a panel of experts. Data were collected from caregivers during routine clinic visits. Construct validity was verified through exploratory structural equation modelling and reliability was verified using Cronbach's α and multidimensional model-based reliability. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient. ResultsAll three dimensions showed good model fit indices (self-care maintenance: Comparative Fit Index = 1.00, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.044; self-care monitoring: Comparative Fit Index = 1.00, Tucker-Lewis Index = 1.00, Root Mean Square Error of Approximation = 0.027; self-care management: Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.048) and Cronbach's α of 0.88, 0.88, and 0.91, respectively. The overall multidimensional model-based reliability was 0.93. The Intraclass Correlation Coefficient values for the three dimensions were 0.94, 0.60, and 0.51, respectively. ConclusionPreliminary testing provides support for use of the Self-Care of Informal Caregivers Inventory in research. Using this theory-based instrument to assess the self-care practices of informal caregivers can assist in identifying topics to discuss and opportunities for guidance. Tweetable AbstractThe Self-Care of Informal Caregivers Inventory: A validated tool for informal caregivers is useful for research. #Informalcaregivers #SelfCare

Validation of the HIV/AIDS-Targeted Quality of Life (HAT-QOL) for Evaluation of Health-related Quality of Life in People Living with HIV/AIDS in Brazil.

HIV/AIDS-Targeted Quality of Life (HAT-QOL) is an instrument for evaluating health-related quality of life (HRQOL) in people living with HIV (PLWHIV). This has been adapted into Brazilian Portuguese, but its dimensional structure has not been analyzed. This study evaluated the psychometric properties of the Brazilian Portuguese version of the HAT-QOL, using a sample of 319 PLWHIV in Salvador, Brazil. The study performed Exploratory Factor Analysis (EFA) to assess the HAT-QOL dimensional structure. The analysis used a polychoric correlation matrix, Robust Diagonally Weighted Least Squares (RDWLS) as an extraction method, Parallel Analysis for factor retention, robust promin as oblique rotation, and Generalized H-index (G-H) for construct replicability of each factor. Model adequacy was assessed using the Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI). Concurrent validity was evaluated with the 36-item Short Form Health Survey, version 2 (SF-36v2). EFA identified a HAT-QOL six-factor solution: Financial Worries, Sexual Function, Medication Concerns, Life Satisfaction, Health Worries, and Overall Function. This solution showed high G-H indexes, concurrent validity, and satisfactory adequacy indexes (X2 = 231.345, df = 291, p < 0,001; RMSEA = 0.001, CFI = 0.999, TLI = 1.028). HIV Mastery, Disclosure Worries, and Provider Trust domains were not retained in EFA and did not have evidence of concurrent validity. This study proposed a HAT-QOL six-factor model for measuring HRQOL in the Brazilian PLWHIV. Future research could help identify another latent construct from not-included domains.

Further Psychometric Testing of the Chest Pain Conception Questionnaire in a Racially and Ethnically Diverse Sample.

The Chest Pain Conception Questionnaire was developed to measure the lay public's conceptions of chest pain related to acute coronary syndrome. The purpose of this study was to further test the Chest Pain Conception Questionnaire in a racially and ethnically diverse sample. Participants from across the United States completed an online survey. Confirmatory factor analysis and descriptive statistics were used to characterize the instrument's performance. Participants (N = 597) were primarily women (59.6%), White (69.3%), and non-Hispanic (83.4%) with a mean age of 54.0 years (SD = 11.5). Confirmatory factor analysis supported the original 3-factor structure of the instrument, c2(58) = 132.32, P = .000, root mean square error of approximation = 0.04, confirmatory fit index = 0.95, Tucker-Lewis index = 0.93, standardized root mean square residual = 0.04. Other instrument characteristics from this validation study were similar to the initial development study. This study further supports construct validity and internal consistency of the instrument in the target population.

Psychometric analysis and validation of the SF-34 PREG: An adaptation of the SF-36 for assessing quality of life in pregnant women.

This study aims to perform a psychometric analysis of the 36-item short form health survey (SF-36) in a population of pregnant women and validate an adapted version of the instrument to measure health-related quality of life specific to pregnancy. A cross-sectional study design was carried out with data collection between 7 and 36 weeks of gestation, with a total sample of 547 pregnant women divided into two randomized subsamples. Data were collected between September 2021 and April 2023. An exploratory factor analysis was initially performed on one subsample, followed by a confirmatory factor analysis on the other. Internal consistency was assessed using Cronbach's alpha and McDonald's omega, and correlations between factors were analyzed. Results from the exploratory factor analysis proposed a seven-factor model explaining 56% of the variance. All proposed dimensions achieved Cronbach's alpha scores above 0.75, with a total test score of 0.92. Furthermore, all dimensions exhibited positive and statistically significant correlations. Bartlett's test of sphericity and the Kaiser-Meyer-Olkin test yielded values of 5599 (P < 0.001) and 0.871, respectively. The confirmatory factor analysis reaffirmed this model with good fit indices: χ2 792 (P < 0.001), comparative fit index (CFI) and Tucker-Lewis index (TLI) >0.90, and standardized root mean square residual (SRMR) and root mean square error of approximation (RMSEA) <0.06. This study developed and validated the "SF-34 PREG," an adapted version of the SF-36, specifically designed for pregnant women. The SF-34 PREG demonstrated high reliability and a robust factorial structure, making it a more precise and relevant tool for assessing health-related quality of life during pregnancy. Although it does not include the social functioning dimension of the original SF-36, the SF-34 PREG offers improved relevance and accuracy for this specific population. Further research and clinical use of the SF-34 PREG are recommended.

Investigating the psychometric properties of the Persian version of the Quality of Life Questionnaire for Women Infected with HPV (EQUALI-HPV)

IntroductionPeople with human papiloma virus (HPV) struggle with numerous challenges and needs in physical, and psychological aspects of quality of life related to this virus. Several studies have recommended counseling interventions to improve the quality of life for these individuals. There is also a need for standardized and normalized instruments in Iran to evaluate the effect of educational and therapeutic interventions on the quality of life of these patients. Therefore, this study was conducted in gynecological cancer clinics in Kerman and Mashhad to investigate the psychometric properties of the Persian version of the “Quality of Life Questionnaire for Women Infected with HPV”.MethodsThis study cross-sectional study included 580 women infected with HPV referred to Kerman and Mashhad’s gynecologic cancer clinics. The samples were selected using convenience sampling method in 2023. Content validity, face validity, and construct validity were assessed using explanatory factor analysis (EFA) and confirmatory factor analysis (CFA).ResultsThe results of the content validity assessment, which included the Content Validity Index (CVI) and the Content Validity Ratio (CVR), indicated strong content validity. Additionally, qualitatively confirmed face validity, further supports these findings. The results of the EFA revealed that the Persian version of the EQUALI-HPV questionnaire has a 6-factor structure, with 34 items remaining from the 54 items. These 6 factors accounted for 48.9% of the variance and were confirmed by confirmatory factor analysis and using robust root mean square error of approximation (RMSEA = 0.054), comparative fit index (CFI = 0.928), and Tucker-Lewis index (TLI = 0.920). The content validity results showed that all the items had a good validity ratio and index. Cronbach’s alpha and Raykov’s rho were greater than 0.7 for all dimensions.ConclusionThe results showed that the Persian version of the “Quality of Life Questionnaire for Women Infected with HPV” had acceptable validity and reliability and can be utilized to measure the quality of life of these people and conduct psychological studies.

Development and validation of the mpox stigma scale (MSS) and mpox knowledge scale (MKS)

BackgroundFew validated brief scales are available to measure constructs that may hinder mpox-related prevention and care engagement, such as knowledge and stigma. Both are highly salient barriers to infectious disease care and disease understanding, precursors to evaluating one’s risk and need to, for example, accept vaccination. To address this gap, we developed and validated the Mpox Stigma Scale (MSS) and Mpox Knowledge Scale (MKS).MethodsAs part of a full-scale clinical trial, we offered an optional mpox survey to participants who self-identified as African American or Black, were 18–29 years old, and lived in Alabama, Georgia, or North Carolina (2023, N = 330). We calculated psychometric properties through confirmatory factor analyses (CFA) and applied Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Tucker-Lewis Index (TLI) values equal to or exceeding 0.90 and Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) values less than 0.08 to determine adequate model fit. We computed internal reliability using Cronbach’s alpha and calculated Pearson or Spearman correlation coefficients between the MSS and MKS and related variables.ResultsFor the MSS, CFA results showed that the one-factor model fit the data well (χ2(df = 5, N = 330) = 34.962, CFI = 0.97, GFI = 0.99, TLI = 0.94, RMSEA = 0.13, SRMR = 0.03). For the MKS, the one-factor model provided a good fit to the data (χ2(df = 6, N = 330) = 8.44, CFI = 0.99, GFI = 0.99, TLI = 0.95, RMSEA = 0.15, SRMR = 0.02). Cronbach’s alphas were MSS = 0.91 and MKS = 0.83, suggesting good to excellent reliability. The MSS was correlated with the MKS (r = .55, p < .001), stigmatizing attitudes (r = .24, p < .001), attitudes towards mpox vaccination (r=-.12, p = .030), and worry about contracting mpox (r = .44, p < .001). The MKS was correlated with worry about contracting mpox (r = .30, p < .001) and mpox disclosure (r=-.16, p = .003).ConclusionsThe MSS and MKS are reliable and valid tools for public health practice, treatment and prevention research, and behavioral science. Further validation is warranted across populations and geographic locations.Trial RegistrationClinicalTrials.gov NCT05490329.

The Reliability and Validity of the Turkish Oral Presentation Evaluation Scale for Nursing Students.

Background and Purpose: In nursing education, students are often expected to make presentations. This study aimed to adapt the Oral Presentation Evaluation Scale (OPES) into Turkish language and investigate its psychometric properties. Methods: This methodological study comprised 311 undergraduate students. The data were analyzed by descriptive statistics, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha (α) coefficient, and item-total correlation. Results: The item-total score correlation coefficients of the scale were between 0.636 and 0.787, and according to the CFA, the factor loads of all items varied between 0.533 and 0.846. The chi-square/standard deviation value, goodness of fit index, comparative fit index, normed fit index, and root mean square error of approximation were 2.056, 0.928, 0.973, 0.949, and 0.058, respectively. Cronbach's α value was 0.951. According to the results of EFA, the scale consists of a two-factor structure in Turkish culture. Conclusions: The OPES is a valid and reliable tool to evaluate the oral presentations of Turkish nursing students.

Psychometric validation of the Persian version of the CarerQol-7D instrument on caregivers of patients with multiple sclerosis.

Background: Providing informal care can deeply influence, both physically and emotionally, the quality of life (QoL) of caregivers, especially when the disease becomes chronic. CarerQol-7D is one of the most common instruments for measuring informal care. We aimed to develop a Persian version of the CarerQol-7D in the context of Iranian caregivers of patients with multiple sclerosis (MS). To this end, we investigated the validity and reliability of the mentioned instrument. Methods: In this cross-sectional study using consecutive sampling method, the backward-forward translation method was used to achieve the Persian version of CarerQol-7D. Structural equation modeling (SEM) was used to perform confirmatory factor analysis (CFA). Cronbach's alpha was also reported for this instrument for the evaluation of internal consistency. Results: This tool was evaluated based on a sample of 452 caregivers of patients with MS from Sina Hospital, Tehran, Iran. Most of the participants were men (62.6%) and spouses of patients (56.6%). Based on the correlation of caregivers' characteristics, the clinical validity of this tool was observed to be relatively moderate. The Cronbach's alpha for this tool was estimated to be 65%. The normed fit index (NFI) (0.906), relative fit index (RFI) (0.812), incremental fit index (IFI) (0.948), Tucker-Lewis index (TLI) (0.892), comparative fit index (CFI) (0.946), and root mean square error of approximation (RMSEA) (0.049) were the model fit indices for the CarerQol-7D instrument. Conclusion: The findings showed good internal consistency and strong validity of the CarerQol-7D. Thus, we suggest researchers use this instrument to measure the QoL of caregivers for use in economic evaluations.

Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis

BackgroundNarrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive.DesignThis was an observational, cross-sectional study using convenience sampling method.MethodsAfter obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established.ResultsThe score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P < 0.001; βattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (βsocial support = 0.04, P < 0.001; βattitude = 0.06, P < 0.001). In addition, narrative nursing knowledge (β = 0.08, P < 0.001) and the nurses’ growth environment (β=-0.06, P < 0.001) also affected the practice of narrative nursing.ConclusionNarrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices.

A General Factor of Hypnotizability Revealed by Confirmatory Factor Analysis

ABSTRACT The objective of this study was to determine the model fit of a standardized hypnotizability measure in a targeted clinical sample. The Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) was administered to 168 post-menopausal women aged 39 to 75 years. Confirmatory factor analysis was conducted, and comparative fit index (CFI) and root mean square error of approximation (RMSEA) were used to determine goodness of fit. Results indicated that the single-factor structure modeled with twelve indicators based on the individual items on the SHSS:C provided the best description of fit. Results of the present study demonstrate that the SHSS:C has a single-factor structure. These findings suggest that new scales of hypnotizability can be optimized by focusing on the use of items that correlate highly with the overall score representing the unidimensional construct of hypnotizability. The findings should be interpreted with caution due to the small sample size, and further research is needed with other populations to clarify generalizability.

Omissions by Design in a Survey: Is This a Good Choice when using Structural Equation Models?

Abstract Missing observations can arise due to the effort required to answer many questions in long surveys and the cost required to obtain some responses. Implementing a planned missing design in surveys helps reduce the number of questions each respondent needs to answer, thereby lowering survey fatigue and cutting down on implementation costs. The three-form and the two-method design are two different types of planned missing designs. An important consideration when designing a study with omissions by design is to know how it will affect statistical results. In this work, a simulation study is conducted to analyze how the usual fit measures, root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), comparative fit index (CFI), and Tucker-Lewis index (TLI) perform in the adjustment of a Structural Equation Model. The results revealed that the CFI, TLI, and SRMR indices exhibit sensitivity to omissions with small samples, low factor loadings and large models. Overall, this study contributes to our understanding of the importance of considering omissions by design in market research.

Psychometric Evaluation of the Brief-COPE Inventory and Exploration of Factors Associated with Perceived Stress among Peruvian Nurses.

This study aimed to analyze the psychometric properties of the Brief-COPE Inventory and to determine its concurrent validity by examining its association with perceived stress among Peruvian nurses. A psychometric study was conducted with 434 Peruvian nurses to evaluate the psychometric properties of the Brief-COPE Inventory through confirmatory factor analysis. Three stepwise variable selection regression models were implemented. The three-factor model of the Brief-COPE Inventory demonstrated adequate fit indices (root mean square error of approximation = 0.052, standardized root mean square residual = 0.068, and both the comparative fit index and the Tucker-Lewis index = 0.95). Additionally, the factors were significantly correlated (p < 0.001), and the reliability was adequate (ω = 0.90). Nurses reported a medium level of perceived stress, with associated factors including having received stress management training, fear of COVID-19, and problem-focused coping strategies (p < 0.05). This study confirms that the Brief-COPE Inventory is a valid tool for measuring coping strategies among Peruvian nurses due to its good model fit, excellent reliability, and concurrent validity with perceived stress. However, further research is needed to assess its validity in the specific areas of performance perceived by nursing professionals.

Internalized HIV stigma and viral suppression: examining the mediating and moderating roles of substance use and social support.

To examine the effects of internalized HIV stigma on viral non-suppression via depressive symptoms, alcohol use, illicit drug use, and medication adherence and investigate whether social support moderates these effects. Longitudinal observational clinical cohort of patients in HIV care in the US.Methods: Data from the CFAR Network for Integrated Clinical Systems (2016-2019) were used to conduct structural equation models (SEM) to test the indirect effects of internalized HIV stigma on viral non-suppression through depressive symptoms, illicit drug use, alcohol use, and medication adherence. Moderated mediation with an interaction between social support and internalized HIV stigma was examined. Among 9,574 individuals included in the study sample, 81.1% were male and 41.4% were Black, non-Hispanic. The model demonstrated good fit (root mean square error of approximation = 0.028; standardized root means square residual = 0.067). The overall indirect effect was significant (b = 0.058; se = 0.020; β = 0.048; 95%CI = .019-.098), indicating that internalized HIV stigma's impact on viral non-suppression was mediated by depressive symptoms, illicit drug use, and medication adherence. An interaction was observed between internalized HIV stigma and social support on alcohol use, however, there was no moderated mediation for any of the mediators. Internalized HIV stigma indirectly impacts viral non-suppression through its effects on depressive symptoms, illicit drug use, and medication adherence. Social support may buffer the impact, but more research is needed. Understanding the pathways through which internalized stigma impacts viral suppression is key to improving health of people with HIV.