Mean Squared Error Of Approximation Research Articles

Reliability and Validity Evidence for Health Care-Seeking Behavior Questionnaire on Sexual Health Among Filipino Men: A Confirmatory Factor Analysis.

Background and Purpose: Healthcare-seeking behavior is an issue affecting the promotion of sexual health among Filipino men. However, tools to measure healthcare-seeking behaviors among men, in general, are scarce. This study aimed to find evidence of validity and reliability of the Health Care-Seeking Behavior Questionnaire (HCSBQ). Methods: A cross-sectional online survey was conducted among N = 464 Filipino men. Linear Structural Relations (LISREL®) was used for statistical analysis. Results: The HCSBQ demonstrates validity and reliability after data analysis. The overall Cronbach's alpha of 0.94 shows excellent internal consistency. The exploratory factor analysis revealed three latent variables, namely, interactional, intellectual, and active and decision-making. Cronbach's alpha for each latent variable is 0.91, 0.84, and 0.88, respectively. A confirmatory factor analysis shows an excellent goodness-of-fit indices (Adjusted Goodness-of-Fit Index [AGFI] = .95; Goodness-of-Fit Index [GFI] = .97; Comparative Fit Index [CFI] = .99; Incremental Fit Index [IFI] = .99; Expected Cross Validation Index [ECVI] = .45; and Root Mean Square Error of Approximation [RMSEA] = .03). Conclusions: The HCSBQ is a valid and reliable tool to measure healthcare-seeking behaviors among Filipino men.

Considering Communication Theory in Health Education and Behavior: Applying the Integrated Model of Advice-Giving in Friendship Sex Talks.

Individuals may find it challenging and discomforting to communicate about sex because they may lack the skills and efficacy necessary to communicate their sexual desires. When individuals do have opportunities to have such discussions about sex in open and comfortable settings, they may seek informational support (i.e., advice) from a close friend because of knowledge sharing and past experiences navigating sex-related concerns. This research study used a communication theory-based quantitative analysis to examine how advice givers' prosocial behaviors influence their advice outcome messages during conversations about sex. A total of 264 participants completed a survey developed based on the Integrated Model of Advice-Giving (IMA). Data were analyzed using structural equation modeling. Advice givers reported that their emotional supportive messages elicited better quality advice. Additionally, advice givers indicated that being attentive and understanding to others' feelings elicited better disclosures about their own sexual experiences. Structural equation modeling results suggested a good model fit for the theoretical model (comparative fit index [CFI] = .939, tucker-lewis fit index [TLI] = .931, root mean square error of approximation [RMSEA] = .056, 90% confidence interval: [.049, .063], and standardized root mean square residual [SRMR] = .082). This study highlights the theoretical and pragmatic implications of communication theory in sexual health education interventions.

The Use of Multidimensional Nomial Logistic Model and Structural Equation Model in the Validation of the 14-Item Health-Literacy Scale in Chinese Patients Living with Type 2 Diabetes.

To evaluate the psychometric properties of the 14-item health literacy scale (HL-14) in patients living with type 2 diabetes mellitus (T2DM) in clinical setting. Cross-sectional study using item response theory and structural equation modeling (SEM) for testing the item difficulty and three dimensional-HL configurations was adopted in this study. Chinese patients living with T2DM admitted to endocrinology department of Huadong hospital were evaluated by the HL-14 including communication, functional and critical health literacy from August to December 2021. The multidimensional random coefficients multinomial logistic model indicated the difficulty settings of the scale are appropriate for the study populations, and differential item functioning was not observed for sex in the study. SEM demonstrated that the three-dimensional configuration of the scale is good in the study population (x2/df=2.698, Comparative Fit Index = 0.965, Root Mean Square Error of Approximation = 0.076, standard residual mean root = 0.042). The HL-14 scale is a reliable and valid measurement, which can perform equitably across sex in evaluating the health literacy in Chinese patients living with T2DM. Moreover, the scale may help fill the gaps of multidimensional health literacy assessment and rapid screening of health literacy ability for clinical practice.

Neuro-11: a new questionnaire for the assessment of somatic symptom disorder in general hospitals

BackgroundSomatic symptom disorder (SSD) commonly presents in general hospital settings, posing challenges for healthcare professionals lacking specialised psychiatric training. The Neuro-11 Neurosis Scale (Neuro-11) offers promise in screening and evaluating...

Urdu Translation and the Validation of a 14-Item Measure to Assess Stress Management Skills in Healthcare Workers: Measurement Invariance Across Gender

This study aims to conduct an Urdu translation and a validation of the ISBF Stress Management Skills Scale in two distinct phases. The first phase includes the forward-back translation method for ISBF. The second phase includes cross validation and the establishment of psychometric properties for the ISBF scale. A sample of 500 adults working in health care was taken from different hospitals and dispensaries. The first phase of the study includes the forward-back translation method. The second phase includes exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with invariance measurement. The total reliability of the scale is reported to be .812. EFA revealed a two-factor structure for ISBF scale, with configural, metric and scalar invariance across males and females, and comparable latent mean scores for males and females. CFA showed goodness-of fit indices for the two factors. The scale showed good internal consistency values. The model fit value includes the value for the goodness of fit index, which was .979, for the adjusted goodness-of fit index: .961, for the comparative fit index: .993, for the incremental fit index: .993, and for the root mean square error of approximation (RMSEA) value: .033. Good values of composite reliability and convergent validity were measured for both dimensions of the scale. The scale shows that this diagnostic tool can help to assess the skills used to manage stress. For criterion validity, the coping Inventory for Stressful Situations (CISS-21) was used, which showed positive correlations. The subscale of stress management was taken from the Health Promoting Life Style Profile II (HPLP-II), which also showed positive correlations. Significant mean differences were found between scores of healthcare workers with stress management skills and with those without stress management skills. The group of mean differences indicated the females have greater stress management skills as compared to men. The Urdu translated and validated instrument will be helpful in understanding behavior in healthcare settings.

The Internal Reliability and Construct Validity of the Evidence-Based Practice Questionnaire (EBPQ): Evidence from Healthcare Professionals in the Eastern Mediterranean Region.

Fostering a culture of clinical effectiveness among healthcare professionals (HCPs) is crucial to achieving optimal patient health outcomes. To our knowledge, there is a lack of robust evidence-based practice (EBP) tools to assess the competence of HCPs in EBP in the Eastern Mediterranean Region (EMR). This study aims to comprehensively investigate the construct validity and internal reliability of the evidence-based practice questionnaire (EBPQ) among HCPs in the EMR. This multinational and multi-disciplinary cross-sectional study was conducted between 27 April and 11 May 2023. Convenience and snowball sampling methods were used to recruit a sample of HCPs (physicians, nurses, physiotherapists, dentists, and pharmacists) using an electronic survey questionnaire for data capture. To assess the reliability of the instrument, Cronbach's alpha, inter-item reliability, and split-half reliability analyses were conducted. Furthermore, the convergent and discriminant validity of the questionnaire was ensured by calculating the average variance extracted (AVE) and the correlation coefficient between the different constructs, respectively. Factor loadings and cross-loadings of different indicators within each construct were calculated by performing both exploratory and confirmatory factor analyses. A total of 1536 HCPs from 18 countries in the EMR (response rate = 96.786%) with a median age of 28 years participated; 47% were female, and 55% had Arabic as their first language. English was the most common language for a bachelor's degree in science (54%). The construct validity of the EBPQ was investigated using exploratory factor analysis (EFA), which yielded four loaded factors. The confirmatory factor analysis (CFA) confirmed the four loaded factors. The CFA model showed that the root mean square error of approximation = 0.066, comparative fit index = 0.95, Tucker-Lewis's index = 0.94, standardized root mean square residual = 0.033, normal fit index = 0.94, goodness of fit = 0.91, and χ2 test statistic= 22,553, with p < 0.001. The AVE values of the four factors were close to 1 (knowledge = 0.6, practice = 0.6, attitude = 0.5, and sharing = 0.7), thus supporting the convergent validity of the EBPQ. The four domains had Cronbach's alpha coefficients and Omega ≥ 0.7 (knowledge = 0.9, practice = 0.9, attitude = 0.7, and sharing = 0.8), suggesting that the items within each domain had good internal consistency. These results support the discriminant validity of the EBPQ. The EBPQ is a robust questionnaire that can be completed in less than 10 min by EMR HCPs and can be used as a gold-standard questionnaire to collect valid data on the attitudes, knowledge, and proficiency of HCPs in making clinical decisions based on evidence. Future studies are recommended to investigate the retest reliability.

Validation of the Chinese version of the Perceived Stress Scale-10 integrating exploratory graph analysis and confirmatory factor analysis

ObjectiveThe study aimed to initially assess the measurement properties of the 10-item simplified Chinese version of the Perceived Stress Scale (PSS-C-10) and as a first, assess a longitudinal measurement invariance (LMI). MethodsA longitudinal survey was conducted with a convenient sample of healthcare students using the PSS-C-10. We assessed the PSS-C-10 mainly using composite analytical approaches, including exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) to suggest the best-fit factor structure and assess measurement invariance. ResultsThe EGA identified a two-factor structural solution with an accuracy of 98.6% at baseline and 100% at a 7-day follow-up. The CFA subsequently confirmed this structure, with a comparative fit index of 0.963 at baseline and 0.987 at follow-up, Tucker-Lewis index of 0.951 at baseline and 0.982 at follow-up, and root mean square error of approximation of 0.111 at baseline and 0.089 at follow-up. The LMI was supported by the goodness-of-fit indices, and their changes fell within the recommended cut-off range. Additionally, Cronbach's alpha (0.885 at baseline and 0.904 at follow-up), McDonald's omega (0.885 at baseline and 0.902 at follow-up), and an ICC value of 0.816 for 7 days demonstrated the robust reliability of the PSS-C-10. ConclusionThe PSS-C-10 exhibited a stable two-factor structure with promising LMI and measurement properties.

Excluding items on salt and fluid restriction from the European Heart Failure Self-care Behaviour Scale - a confirmatory factor analysis

Abstract Funding Acknowledgements Type of funding sources: None. Background Self-care is an important component in heart failure (HF) care, and worse, self-care is an independent predictor of mortality, HF hospitalization, and quality of life. The European Heart Failure Self-care Behaviour scale (EHFScB-9) is a validated scale with a nine-item scale and two subscales (autonomy-based adherence and consulting behavior). The items in the EHFScB-9 are based on evidence and consensus. However, in recent years two items regarding salt and fluid restriction have been questioned due to the lack of evidence on their effects. Aim The aim of the study was to evaluate the factor structure of the EHFScB-9 when items on fluid- (item 5) and salt restriction (item 7) were excluded. Method Confirmatory factor analysis (CFA) was used to evaluate the factor structure of the different models of EHFScB-9. Since the item responses of the EHFScB-9 are ordinal, the recommended estimation Weighted Least Squares with Means and Variances (WLSMV) was used. The WLSMV is based on polychoric correlations. The fit indices and recommended cut-off used to support model fit were: the root mean square error of approximation (RMSEA) (≤0.06), Comparative Fit Indices (≥0.95), and Tucker Lewis Index (&amp;gt;0.95). Reliability was evaluated by composite reliability. Results A total of 605 patients were included (mean age 66.9 years (SD=11.7), 71% (n=430) males). All response options were used, but a floor effect was evident for all items (i.e., extreme scores &amp;gt; 15%). The missing values for the items ranged from 2.0 to 2.6%. A total of 10 patients had missing values on all items of the EHFScB-9 and were not included in the CFA. The original two-factor 9-item version (Model 1 in table 1) presented good model fit in all fit indices, including RMSEA: 0.058 (90% confidence interval 0.043-0.073) (Table 1) and reliability of 0.678 in factor 1 "Adherence to regimen" and 0.878 in factor 2 "Consulting behavior". The RMSEA only slightly increased to 0.62 when the items on fluid- (item 5) and salt restriction (item 7) were both excluded (Model 1.2). The model presenting the best model fit was the model where item 5 (fluid restriction) was excluded from the model (RMSEA 0.047, 90% confidence interval 0.029-0.066) (Model 1.3 in the table). As expected, the reliability decreased in factor 1 ("Adherence to regimen") as the number of items was reduced. Conclusion Considering the clinical evidence and the model fit indices, both item 5 and item 7 can be excluded from the EHFScB. As expected, when reducing the number of items, the reliability decreases in factor 1 ("Adherence to regimen"). Nevertheless, the results open for an opportunity to exclude self-care items with less evidence from the EHFScB. The suggested version of the EHFScB needs to be further tested in other contexts, and adding items to factor 1 may be considered.

Turkish Version of the Perceived Future Decent Work Securement Scale: Validity and Reliability for Nursing Students

BackgroundThe aim of the study was to test the validity and reliability of the Perceived Future Decent Work Securement Scale for Turkish nursing students. MethodsA cross-sectional, methodological study design was used. The study was carried out at three nursing undergraduate programs in Turkey during the academic year of 2020–2021 with 336 senior nursing students. Language validity and content validity analyses were performed for the scale adaptation, followed by confirmatory factor analysis (CFA) for construct validity. The reliability of the scale was determined using the test-retest and Cronbach's alpha internal consistency coefficient. ResultsThe scale-content validity index score was 0.988. In CFA, all goodness-of-fit indices verified the acceptable fit of the model; its root mean square error of approximation was 0.076; the normed fit index was 0.909; the standardized mean square residual was 0.097; the relative fit index was 0.881; the goodness-of-fit index was 0.915; the adjusted goodness-of-fit index was 0.872 and χ2/df = 2.932. The overall reliability was α = 0.86. The item-total correlations of the scale were above the acceptable level, and the test-retest analysis had a high correlation. The access to healthcare (14.68, SD 3.53) obtained the highest average score, and the adequate compensation (8.52, SD 3.76) was the lowest rated by the senior nursing students. ConclusionThe Perceived Future Decent Work Securement Scale is a valid and reliable scale to assess nursing students' future decent work securement.

Translation, cross-cultural adaptation, and validation of the Persian version of the Attitude Towards Menopause scale.

This study describes translation, cross-cultural adaptation, and validation of the Attitude Towards Menopause (ATM) scale in Persian. A standard process was followed for translation and cross-cultural adaptation of the ATM scale into Persian. The content validity index and content validity ratio were used to measure content validity. The construct validity was tested using exploratory factor analysis and confirmatory factor analysis. The average variance extracted and construct reliability were used to indicate convergent and discriminant validity, respectively. Internal consistency and test-retest reliability of the Persian ATM scale were assessed using Cronbach α and intraclass correlation coefficient (ICC). A revised version of the ATM scale, including 26 items assigned to seven factors, was obtained in exploratory factor analysis. The factors were interpreted as negative affect, postmenopausal recovery, control of symptoms, sexuality, psychological losses, unpleasant confrontation, and menstrual freedom, explaining 66.18% of the total variance. The factor structure of the scale was confirmed using confirmatory factor analysis (Comparative Fit Index = 0.90, Tucker-Lewis Index = 0.88, Goodness-of-Fit Index = 0.90, Adjusted Goodness-of-Fit Index = 0.86, Root Mean Square Error of Approximation = 0.07, χ2 / df = 4.56). The values of Cronbach α coefficient and ICC indicated an acceptable level of reliability ( α = 0.70, ICC = 0.89). The construct reliability for all factors was more than or equal to 0.7 except for psychological losses, indicating good discriminating validity. The values of average variances extracted for subscales varied from 0.48 to 0.99, representing adequate convergent validity. The Persian version of the ATM scale is a reliable and valid tool to evaluate the attitudes of Iranian women toward menopause.

Developing a model to explain users' ethical perceptions regarding the use of care robots in home care: A cross-sectional study in Ireland, Finland, and Japan

To date, research on ethical issues regarding care robots for older adults, family caregivers, and care workers has not progressed sufficiently. This study aimed to build a model that universally explains the relationship between the use of care robots and ethical awareness, such as regarding personal information and privacy protection in home care. We examined data obtained from cross-sectional surveys conducted in Japan (n=528), Ireland (n=296), and Finland (n=180). We performed a confirmatory factor analysis by using responses to 11 items related to the ethical use of care robots. We evaluated the model based on the chi-square to degrees of freedom ratio, the comparative fit index, and the root mean square error of approximation. Subsequently, we compared the model with the Akaike's information criterion. Ten items were adopted in the final model. There were 4 factors in the model: ‘acquisition of personal information’, ‘use of personal information for medical and long-term care’, ‘secondary use of personal information’, and ‘participation in research and development’. All factor loadings of the final model ranged between 0.63 and 0.92, which were greater than 0.6, showing that the factors had a high influence on the model. The final model was applied to each country; the fit was relatively good in Finland and poor in Ireland. Although the three countries have different geographies, cultures, demographics, and systems, this study showed that the impact of ethical issues regarding the use of care robots in home care can be universally explained by the same model.

Validation of the Japanese version of the full and short form Trust in Oncologist Scale.

This study aimed to validate the Japanese versions of the Trust in Oncologist Scale (TiOS-J) and the TiOS-Short Form (TiOS-SF-J). A cross-sectional web-based survey was conducted among cancer patients in Japan. The forward-backward translation method was used to develop the TiOS-J. The web-based survey was mailed to 633 people, of whom 309 responded. After 2 weeks, 103 among the 156 first-time respondents completed the second survey to verify the reliability of the retest method. The validity was evaluated by exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Spearman's correlation coefficients between the Patient Satisfaction Questionnaire-Japanese, willingness to recommend the oncologist, trust in health care, and number of oncological consultations. To evaluate reliability, Cronbach's α and test-retest correlation were calculated. The theoretically driven four-factor model and the EFA-driven one-factor model of the full-form TiOS-J (18 items) did not result in an acceptable fit; however, CFA supported the one-dimensionality of the 5 items from the TiOS-SF-J (χ2 (5)=12.36, p=0.03, goodness-of-fit index=0.984, adjusted goodness-of-fit index=0.952, comparative fit index=0.991, and root mean square error of approximation=0.069). With regard to the reliability of TiOS-J and TiOS-SF-J, the Cronbach's alpha values were 0.94 and 0.89, respectively; the test-retest values were 0.82 and 0.78. This study indicated that the TiOS-J and TiOS-SF-J are valid and reliable instruments for measuring patients' trust in their oncologists and can be used to assess trust in oncologists for both clinical and research purposes.

A psychometric analysis of a Ghanaian tool (PCaKAB-Gh) for studying prostate cancer knowledge, attitudes and beliefs amongst women

Several Ghanaian studies have examined prostate cancer knowledge, attitudes and beliefs. However, none of these studies was conducted in women except our previous study which served as the third stage in the development of a local robust tool, PCaKAB-Gh, to assess women's knowledge about prostate cancer. Although the subject had previously been studied in Ghana, none of the studies utilized a psychometrically valid tool and focused on involving women in the early detection of prostate cancer. For this purpose, we performed a psychometric study on a 41-item tool to improve robustness. The study which was the final stage of the tool development process employed a cross-sectional approach and conveniently recruited 500 participants. Statistical analysis to assess the reliability and construct validity of the tool was performed. The factors of the tool had Cronbach's alpha and McDonald's omega coefficients of 0.53 – 0.78 and reflected favourable internal consistency. The Exploratory Factor Analysis, using the Principal Component Analysis with Varimax with Kaiser Normalization, generated 5 factors with itemized factor loadings of 0.44 – 0.80, Kaiser-Meyer-Olkin Measure of Sampling Adequacy of 0.857, and a significant Bartlett's Test of Sphericity (2293.448, p-value < 0.001). A variance of 55.3% was explained. The Confirmatory Factor Analysis had a Root Mean Square Error of Approximation and a Standardized Root Mean Square Residual below 0.050, and a Comparative Fit Index and a Tucker-Lewis Index above 0.900 which indicated satisfactory fit indices (p-value < 0.001). The study successfully developed a 24-item psychometrically valid tool, with 5 factors, to be used to study the knowledge, attitudes, and beliefs about prostate cancer among Ghanaian women. The availability of the PCaKAB-Gh tool, the first of its kind, would permit the active involvement of women in improving the early detection of prostate cancer to reduce the cost of therapy and improve management outcomes.

Measuring public attitudes towards people living with chronic diseases in Arabic-speaking populations: adaptation and development of the Social Stigma Scale of Chronic Diseases (SSS-CD)

BackgroundA large proportion of the population in Arab countries suffer from chronic diseases. According to the statistics by the Global Health Estimates, chronic illnesses contribute by 71% to total deaths in the Arab region. While chronic illnesses have been demonstrated to carry high levels of social stigma, it is only recently that little research attention has been given to this topic in the Arab world. It is well-established that the social stigma construct is culturally-dependent. Therefore, the lack of an Arabic measure highlighted the urgent need for developing a culturally adapted and valid instrument to assess social stigma toward people living with chronic diseases. In this study, we aimed to examine the psychometric properties of the Arabic translation, adaptation and development of “the Social Stigma Scale of Chronic Diseases” (SSS-CD).MethodFifteen items derived from the literature and assessing social stigma towards chronic diseases have been administered to 570 Arabic-speaking adults from the Lebanese general population (aged 24.59 ± 6.75years; 68.6% women). Items were translated into Arabic using a forward-backward translation method. Exploratory factor analysis (EFA) using a principal-axis EFA on the first split-half subsample, followed by a confirmatory factor analysis (CFA) tested on the model extracted from the EFA on the second split-half subsample, were conducted to examine the construct validity of the SSS-CD. Fit indices were deemed adequate if the normed model chi-square (χ²/df) ≤ 3, the Steiger-Lind root mean square error of approximation (RMSEA) ≤ 0.08, the Tucker-Lewis Index (TLI) and the comparative fit index (CFI) ≥ 0.90.ResultsFindings revealed that the 10-item SSS-CD has a unidimensional factor structure, with the following fit indices: χ2/df = 92.95/34 = 2.73, RMSEA = 0.077 (90% CI 0.059, 0.096), SRMR = 0.062, CFI = 0.939, TLI = 0.919. A good internal consistency was demonstrated by a McDonald’s omega value of 0.73 for the total score. Findings also supported invariance across gender, with men exhibiting higher levels of social stigma attached to chronic diseases than women. All three dimensions of stigmatization (social, psychological and evolutionary stigmatization) were positively correlated with SSS-CD scores (Social self-interest [r = .40; p < .001], Evolutionary self-interest [r = .37; p < .001], Psychological self-interest [r = .42; p < .001]), demonstrating relatively strong convergent validity.ConclusionOur findings suggest that the SSS-CD has robust psychometric qualities. We thus preliminarily suggest that the scale is valid, reliable and suitable for use among Arabic-speaking people from the general population to measure public attitudes towards people living with chronic diseases. Providing this psychometrically sound measure will hopefully enable to foster research in this area in order to draw a clear overview of the prevalence and characteristics of social stigma attached to chronic diseases in Arabic-speaking communities. However, given that this was the first study to examine the psychometric properties of the SSS-CD, the present findings and conclusions should be considered tentative pending future cross-national validation studies.

The Mediating Role of Emotion Regulation in the Relationship Between Defense Styles and Psychological Vulnerability Among Emergency Medicine Physicians

Background: Excessive work-related psychological pressures can endanger health by causing physical, mental, and behavioral complications. Objectives: The present study aimed to investigate the mediating role of emotion regulation in the relationship between defense styles and psychological vulnerability among emergency medicine physicians. Methods: The statistical population of this descriptive correlational study comprised all emergency medicine physicians working in Tehran hospitals in 2021 - 2022, from whom a sample of 380 was selected using cluster sampling. The research instruments included the symptom checklist-25 (SCL-25), The Defense Style Questionnaire (DSQ), and Cognitive Emotion Regulation Questionnaire (CERQ). The data were analyzed by structural equation modeling (SEM) in LISREL 8.8. Results: Based on the results, the research model had a good fit (CFI = 0.96, root mean square error of approximation (RMSEA) = 0.058). There was an indirect relationship between the defense styles of emergency medicine physicians and psychological vulnerability, mediated by emotion regulation (P &lt; 0.001). There were direct relationships between defense styles and psychological vulnerability, between emotion regulation and psychological vulnerability, and between defense styles and emotion regulation (P &lt; 0.001). Conclusions: Health professionals and therapists can thus reduce psychological vulnerability among emergency medicine physicians by improving their immature and neurotic defense styles and enhancing their cognitive emotion regulation.

Confirmatory factor analysis of cognitive ability and its psychosocial correlates

The present study was designed to find out the role of gender and age on cognitive abilities and confirmatory factor analysis of cognitive ability test (CAT)among school students. While employing descriptive survey method, the present study was conducted on a sample of 118 school students. The sample was selected by using random sampling techniques. Cognitive abilities test developed by Gupta and Lakhani, was used for data collection. ANOVA was used to find out the role of gender and age on cognitive abilities with the help of SPSS. Model fit was excellent in the sample for CAT (Chi-square test=4.871, df=5, p=0.511; Root mean square error of approximation (RMSEA)=0.109; Standardized root mean square residual (SRMR)=0.073; Goodness of fit index (GFI)=0.947, McDonald fit index (MFI)=0.946). There was significant difference among the 13th, 14th and 15th age in mean score of memory. There were significant differences between male and female in mean score of awareness, memory and understanding. The CAT is suitable to measure the cognitive abilities in children of India. This study also contributes to the better understanding of the predictors like gender and age of cognitive abilities in a well-defined group of children.

Factor structure of the Harmonized Cognitive Assessment Protocol neuropsychological battery in the Health and Retirement Study.

The Harmonized Cognitive Assessment Protocol (HCAP) describes an assessment battery and a family of population-representative studies measuring neuropsychological performance. We describe the factorial structure of the HCAP battery in the US Health and Retirement Study (HRS). The HCAP battery was compiled from existing measures by a cross-disciplinary and international panel of researchers. The HCAP battery was used in the 2016 wave of the HRS. We used factor analysis methods to assess and refine a theoretically driven single and multiple domain factor structure for tests included in the HCAP battery among 3,347 participants with evaluable performance data. For the eight domains of cognitive functioning identified (orientation, memory [immediate, delayed, and recognition], set shifting, attention/speed, language/fluency, and visuospatial), all single factor models fit reasonably well, although four of these domains had either 2 or 3 indicators where fit must be perfect and is not informative. Multidimensional models suggested the eight-domain model was overly complex. A five-domain model (orientation, memory delayed and recognition, executive functioning, language/fluency, visuospatial) was identified as a reasonable model for summarizing performance in this sample (standardized root mean square residual = 0.05, root mean square error of approximation = 0.05, confirmatory fit index = 0.94). The HCAP battery conforms adequately to a multidimensional structure of neuropsychological performance. The derived measurement models can be used to operationalize notions of neurocognitive impairment, and as a starting point for prioritizing pre-statistical harmonization and evaluating configural invariance in cross-national research.

Acceptance of smart sensing: a barrier to implementation-results from a randomized controlled trial.

Accurate and timely diagnostics are essential for effective mental healthcare. Given a resource- and time-limited mental healthcare system, novel digital and scalable diagnostic approaches such as smart sensing, which utilizes digital markers collected via sensors from digital devices, are explored. While the predictive accuracy of smart sensing is promising, its acceptance remains unclear. Based on the unified theory of acceptance and use of technology, the present study investigated (1) the effectiveness of an acceptance facilitating intervention (AFI), (2) the determinants of acceptance, and (3) the acceptance of adults toward smart sensing. The participants (N = 202) were randomly assigned to a control group (CG) or intervention group (IG). The IG received a video AFI on smart sensing, and the CG a video on mindfulness. A reliable online questionnaire was used to assess acceptance, performance expectancy, effort expectancy, facilitating conditions, social influence, and trust. The self-reported interest in using and the installation of a smart sensing app were assessed as behavioral outcomes. The intervention effects were investigated in acceptance using t-tests for observed data and latent structural equation modeling (SEM) with full information maximum likelihood to handle missing data. The behavioral outcomes were analyzed with logistic regression. The determinants of acceptance were analyzed with SEM. The root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) were used to evaluate the model fit. The intervention did not affect the acceptance (p = 0.357), interest (OR = 0.75, 95% CI: 0.42-1.32, p = 0.314), or installation rate (OR = 0.29, 95% CI: 0.01-2.35, p = 0.294). The performance expectancy (γ = 0.45, p < 0.001), trust (γ = 0.24, p = 0.002), and social influence (γ = 0.32, p = 0.008) were identified as the core determinants of acceptance explaining 68% of its variance. The SEM model fit was excellent (RMSEA = 0.06, SRMR = 0.05). The overall acceptance was M = 10.9 (SD = 3.73), with 35.41% of the participants showing a low, 47.92% a moderate, and 10.41% a high acceptance. The present AFI was not effective. The low to moderate acceptance of smart sensing poses a major barrier to its implementation. The performance expectancy, social influence, and trust should be targeted as the core factors of acceptance. Further studies are needed to identify effective ways to foster the acceptance of smart sensing and to develop successful implementation strategies. identifier 10.17605/OSF.IO/GJTPH.

Understanding Discordant Perceptions of Disease Severity Between Physicians and Patients With Eczema and Psoriasis Using Structural Equation Modeling

Patients and physicians often have differing opinions on the patient's disease severity. This phenomenon, termed discordant severity grading (DSG), hinders the patient-physician relationship and is a source of frustration. To test and validate a model explaining the cognitive, behavioral, and disease factors associated with DSG. A qualitative study was first performed to derive a theoretical model. In this subsequent prospective cross-sectional quantitative study, the qualitatively derived theoretical model was validated using structural equation modeling (SEM). Recruitment was conducted between October 2021 and September 2022. This was a multicenter study in 3 Singapore outpatient tertiary dermatological centers. Dermatology patients and their attending physicians were recruited by convenience sampling. Patients were aged 18 to 99 years with psoriasis or eczema of at least 3 months' duration and recruited only once. The data were analyzed between October 2022 to May 2023. The outcome was the difference between global disease severity (0-10 numerical rating scale with a higher score indicating greater severity) as independently scored by the patient and the dermatologist. Positive discordance was defined as patient-graded severity more than 2 points higher (graded more severely) than physicians, and negative discordance if more than 2 points lower than physicians. Confirmatory factor analysis followed by SEM was used to assess the associations between preidentified patient, physician, and disease factors with the difference in severity grading. Of the 1053 patients (mean [SD] age, 43.5 [17.5] years), a total of 579 (55.0%) patients were male, 802 (76.2%) had eczema, and 251 (23.8%) had psoriasis. Of 44 physicians recruited, 20 (45.5%) were male, 24 (54.5%) were aged between 31 and 40 years, 20 were senior residents or fellows, and 14 were consultants or attending physicians. The median (IQR) number of patients recruited per physician was 5 (2-18) patients. Of 1053 patient-physician pairs, 487 pairs (46.3%) demonstrated discordance (positive, 447 [42.4%]; negative, 40 [3.8%]). Agreement between patient and physician rating was poor (intraclass correlation, 0.27). The SEM analyses showed that positive discordance was associated with higher symptom expression (standardized coefficient B = 0.12; P = .02) and greater quality-of-life impairment (B = 0.31; P < .001), but not patient or physician demographics. A higher quality-of-life impairment was in turn associated with lower resilience and stability (B = -0.23; P < .001), increased negative social comparisons (B = 0.45; P < .001), lower self-efficacy (B = -0.11; P = .02), increased disease cyclicity (B = 0.47; P < .001), and greater expectation of chronicity (B = 0.18; P < .001). The model was well-fitted (Tucker-Lewis: 0.94; Root Mean Square Error of Approximation: 0.034). This cross-sectional study identified various modifiable contributory factors to DSG, increased understanding of the phenomenon, and set a framework for targeted interventions to bridge this discordance.

Development and testing of a patient-reported experience measure for cancer: A cross-sectional survey.

To develop and psychometrically test the Patient-reported Experience Measure-Cancer (PREM-C), reflecting patients' perceptions of cancer care experiences according to the Institute of Medicine domains. A three-phase cross-sectional survey was conducted. Development, reliability and validity testing of the PREM-C measure was undertaken. Data collection included three phases: firstly (development) between October and November, 2015; secondly (psychometric testing), May 2016-June, 2017, and finally, (revision and psychometric testing) May 2019-March 2020. The final PREM-C structure, created using the Institute of Medicine domains, was psychometrically sound with five factors identified in the Exploratory Factor Analysis, demonstrating internal reliability ranging from 0.8 to 0.9. Confirmatory Factor Analysis indicated the hypothesized model fitted well (Root mean square error of approximation = 0.076). External convergent and divergent validity was established with the PREM-C found to be moderately correlated with the Picker Patient Experience Questionnaire but weakly correlated with the WHOQoL-BREF. The development and testing of the PREM-C demonstrated good fit as a clinically relevant measure of ambulatory cancer patients' experiences of care. To make meaningful changes to nursing practice and health services, patient experience measures such as the PREM-C might support staff to identify areas for service improvement. Few reliable measures and less validated measures collect patients' perceptions of the quality of their healthcare provision. Rigorous psychometric testing of the newly developed PREM-C demonstrated good internal consistency, test-retest reliability, and external convergent and divergent validity. The PREM-C is a potentially relevant measure of cancer patients' experiences of care. It might be used to assess patient-centred care and guide safety and quality improvements in clinical settings. PREM-C use might inform service providers of experiences of care in their institution and inform policy and practice development. This measure is sufficiently generic, allowing potential use in other chronic disease populations. This conduct of this study was supported by the participating patients of the hospital Cancer Outpatients Service.