Mean Squared Error Of Approximation Research Articles

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.

Exploring the Components of Multicultural Competence among Pre-Service Teacher Students in Thailand: An Approach Utilizing Confirmatory Factor Analysis.

The aim of this study is to examine the components of multicultural competence among pre-service teacher students in Thailand and to develop and assess the reliability of a model of multicultural competence for pre-service teacher students in Thailand. Multistage stratified random sampling was utilized to recruit 600 pre-service teacher students from undergraduate education programs at the Faculty of Education in Thailand. Data were collected through self-report questionnaires. The data analysis employed descriptive statistics and second-order confirmatory factor analysis (CFA). The findings indicate that multicultural competence among pre-service teacher students comprises three components: cultural awareness, cultural knowledge, and personal skills. Furthermore, this study identified that the model of multicultural competence among pre-service teacher students demonstrated good fit indices for the modified model (χ2 = 30.902, df = 21, p-value = 0.0753, χ2/df = 1.472; root mean square error of approximation (RMSEA) = 0.028; standardized root means square residual (SRMR) = 0.013; Tucker-Lewis index (TLI) = 0.996; comparative fit index (CFI) = 0.999). Based on these findings, effective teaching in diverse environments necessitates a thorough understanding of multicultural competence.

Evaluating the Reliability and Model Fit of the 13-Item and 10-Item Big Five Inventory (Malay Version) among Malaysian Firefighters.

Lengthy instruments for assessing personality traits may not be applicable in certain research settings. In situations where time is scarce, a briefer measurement is preferable. However, the reliability of a briefer measurement of the Big Five Inventory (BFI) among firefighters in Malaysia has not been reported. This study aimed to investigate the reliability and model fit of the Malay version of the BFI with 13 items (BFI-13) and 10 items (BFI-10) among Malaysian firefighters. A cross-sectional study using cluster sampling was conducted in a state in Malaysia. Each respondent completed BFI-10 and BFI-13 using an online survey with a 1-month interval between each response. Reliability testing was evaluated using internal consistency and a 2-week interval test-retest. The model fit of these two BFI questionnaires was evaluated via confirmatory factor analysis (CFA). A total of 124 firefighters participated in the study, with a zero-dropout rate. The Malay version of BFI-13 exhibited higher reliability by displaying good internal consistency with Cronbach's alpha of 0.919, 0.838, 0.871 and 0.896 for the domains conscientiousness, neuroticism, agreeableness and extraversion, respectively, and acceptable test-retest reliability with moderate to good intraclass correlation (0.588-0.806). The CFA model also indicated that BFI-13 has a better model fit (comparative fit index [CFI] = 0.993; Tucker-Lewis index [TLI] = 0.991; standardised root mean squared residual [SRMR] = 0.029; root mean square error of approximation [RMSEA] = 0.035). The Malay version of BFI-13 is reliable and applicable enough to be supplementarily used in surveys among Malaysian firefighters. By using a brief personality assessment, it will reduce the cognitive and emotional burden on respondents.

French validation of the tonic immobility scale in patients with post-traumatic stress disorder

Introduction: Tonic immobility (TI) in humans is characterized by muscle inhibition, hypertonia and analgesia that may occur during a traumatic event. TI is associated with an increased risk of severe and treatment-resistant post-traumatic stress disorder (PTSD). To date, there is no French validated scale for TI. Methods: We studied the face validity (qualitative study) and psychometric properties concerning a French version of the 10-item Tonic Immobility Scale (FR-TIS) in adult with PTSD. Results: Concerning face validity, six participants confirmed that the FR-TIS was simple, clear, and comprehensible, but has some limitations concerning the recall according to age of trauma, peritraumatic dissociation intensity, avoidance behaviors, the type and the context of the trauma. For psychometric properties, 120 patients completed a computerized version of the FR-TIS. FR-TIS showed good psychometric properties in a three-dimensional form with 8 items (Root Mean Square Error of Approximation (RMSEA) = 0.056) including 4 items for TI (Cronbach's α = 0.76), 2 items for fear (Cronbach's α = 0.63), 2 items for dissociation (Cronbach's α = 0.68). Conclusion: The FR-TIS is a potentially useful and easy-to-use tool in clinical practice, to help improving screening and assessment of TI

Psychometric evaluation of the Afaan Oromo version of the exclusive breastfeeding social support scale among Ethiopian women

ProblemThere is a lack of validated tools for assessing social support for Exclusive Breastfeeding (EBF) practice in Ethiopia. BackgroundValidating instruments ensures culturally appropriate and reliable data collection for effective research and interventions. AimThis study aimed to translate the exclusive breastfeeding social support scale into the Afaan Oromo language (EBFSS-AO) and test its psychometric properties among Ethiopian women. MethodsThe scale was first subjected to forward and backward translation before undergoing psychometric evaluation. Then, a cross-sectional study was conducted on convenience sample of 160 postpartum women. Content validity was assessed via Content Validity Index (CVI), and construct validity was tested using confirmatory factor analysis (CFA) with maximum likelihood estimation. The scale's reliability was measured using Cronbach's alpha and intraclass correlation coefficient (ICC). FindingsThe CFA verified that the EBFSS-AO for Ethiopian women is a three-dimensional scale with satisfactory fit indices; x2/df: 2.76; Comparative fit index: 0.917; Tucker-Lewis Index: 0.902; Standardized Root Mean square residual: 0.061; and Root mean square error of approximation: 0.105. Item-level CVI ranged from 0.86 to 1.00, and scale-level CVI was 0.98. The overall scale had a Cronbach's alpha of 0.95 while instrumental, emotional, and informational support subscales had a Cronbach's alpha of 0.89, 0.92, and 0.93 respectively. After a 4-week re-test, the ICC yielded a value of 0.94. Partner support on EBF showed no socio-demographic differences except for income. ConclusionThe EBFSS-AO showed satisfactory psychometric properties, suitable for assessing social support among Ethiopian women in both research and clinical contexts.

Frailty Assessment Scale for Heart Failure: Development and Psychometric Validation.

Frailty is common in patients with heart failure. Specific scales, including the Clinical Frailty Scale, exist but have not undergone thorough psychometric validation among patients with heart failure. The aim of this study was to develop and validate the Frailty Assessment Scale for Heart Failure (FAS-HF) in patients with heart failure. This study included 3 phases. In phase I, conceptualization and item generation, the FAS-HF was initially developed through the analysis of qualitative research data and a literature review. In phase II, item selection and content validity, the Delphi method was used to gather experts' opinions and suggestions regarding the FAS-HF. In phase III, field testing and psychometric evaluation, a cross-sectional study of 184 patients with heart failure in northern Taiwan was conducted to test the reliability and validity of the FAS-HF. The 15-item FAS-HF included the physical, psychological, and social frailty domains. The total score ranged from 0 to 45, with higher scores representing frailer individuals. Exploratory factor analysis revealed that the cumulative loading variance was 57.39%. In the confirmatory factor analysis, the goodness-of-fit index (0.91), adjusted goodness-of-fit index (0.87), and root mean square error of approximation (0.06) were acceptable for model fit. Acceptable reliability was found, with a Cronbach α coefficient of 0.87 and a test-retest reliability of 0.99. Compared with the Fried frailty phenotype, the area under the receiver operating characteristic curve was 0.94, and the optimal cutoff score for frailty was 20. The FAS-HF has good reliability, validity, and discrimination and can be used as a frailty indicator for patients with heart failure.

Reexamination of the relationships among neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in a sample of patients diagnosed with chronic schizophrenia and schizoaffective disorder

PurposeThis study proposed and evaluated a theoretical model for exploring the relationships between neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in individuals with chronic schizophrenia.MethodThe study recruited 229 individuals given a diagnosis of schizophrenia and schizoaffective disorders from outpatient clinics and the day ward of a mental health hospital. After informed consent was obtained, the participants underwent assessments using the backward digit span, the digit symbol, and measures of self-defeatist beliefs, experiential negative symptoms, and social functioning. A structural equation model was applied to assess the fitness of the hypothesized model, with indices such as the goodness-of-fit index, comparative fit index, root mean square error of approximation, and standardized root mean square residual being used for model evaluation.ResultsThe hypothesized model had an adequate fit. The study findings indicated that neurocognition might indirectly influence self-defeatist beliefs through its effect on experiential negative symptoms. Contrary to expectations, the study did not observe a direct influence of neurocognition, self-defeatist beliefs, or negative symptoms on social functioning. The revised model revealed the role of experiential negative symptoms in mediating the association between neurocognition and social functioning. However, self-defeatist beliefs did not significantly affect social functioning.DiscussionBefore modifying negative thoughts, enhancement of self-awareness ability can help improve negative symptoms and thereby improve the performance of social functions. Future research should develop a hierarchical program of negative symptoms, from cognition rehabilitation to enhancement of self-awareness, and end with modifying maladaptive beliefs.

Validation and Refinement of the Self-Regulatory HIV/AIDS Symptom Management Model Among People With HIV in China Using Path Analysis: A Secondary Data Analysis.

This study explored the path affecting the quality of life (QOL) of people with HIV in China and clarified the applicability and interpretability of the Self-Regulatory HIV/AIDS Symptom Management Model. We conducted a cross-sectional survey in nine regions of China and collected information about demographics, symptom experience, social support, perceived symptom manageability, self-efficacy, and QOL. A total of 711 patients participated in this survey. After four rounds of path analysis were conducted, the most fit indices met the standards (χ 2 /df = 2.633, Root Mean Square Error of Approximation = 0.081, Goodness-of-Fit Index/Adjusted Goodness-of-Fit Index/Comparative Fit Index/Incremental Fit Index/Tucker-Lewis Coefficient > 0.9), and the relationships between variables were statistically significant ( p < .05). Among all the pathways, social support had the most significant impact on the QOL, with a total path coefficient of 0.665. Symptom experience, as a negative factor, had a total effect value of -0.361. This study showed how all the factors influencing QOL were interconnected, serving as a crucial theoretical foundation for intervention strategies in future clinical practice.

Validation of a Questionnaire to Assess Patient Satisfaction with an Automated Drug Dispensing System.

Automated drug dispensing systems (ADDs) have been introduced to improve the efficiency of dispensing and patient safety. The available questionnaires measure patient satisfaction with particular aspects of ADDs. Also, the level of patient satisfaction with ADDs is not widely established. This study aimed to develop and validate a novel questionnaire to assess patient satisfaction with ADDs. Content and construct validity procedures were used to validate the 20-item questionnaire with four domains, including pharmacy administration, dispensing practice, patient education, and the dispensing system. Two hundred consenting participants took part in this study, from those who visited the outpatient pharmacy in a government hospital. The internal consistency of all four scale items shows acceptable reliability (>0.7). In the exploratory factor analysis, three items were removed due to poor factor loading and cross-loading. In the confirmatory factor analysis, the model has acceptable fit indices, including the comparative fit index (0.937), Tucker-Lewis's index (0.924), standardized root mean square residual (0.051), root mean square error of approximation (0.057), and χ2/df (1.67). The convergent and discriminant validity were established, since the average variance extracted (AVE) was ≥0.5 and the squared correlation (SC) values of one construct with other constructs were less than the AVE of the specific construct. This study offered a reliable and valid 17-item questionnaire incorporating a multi-dimensional four-factor model to evaluate patient satisfaction with ADDs. The validated questionnaire can be utilized to explore patients' perspectives on ADDs.

Problematic use of the internet as a predictor of oral health-related quality of life: the mediating role of lifestyles in Peruvian schoolchildren

BackgroundThe pervasiveness of the Internet in everyday life, especially among young people, has raised concerns about its effects on mental health, education, and, recently, oral health. Previous research has suggested a complex relationship between Problematic Internet Use (PIU), lifestyles, and oral health-related quality of life, highlighting the need to examine these interactions further. This study seeks to explore the PIU as a predictor of oral health-related quality of life and examine the mediating role of lifestyles between both in a sample of Peruvian schoolchildren.MethodsA cross-sectional study was carried out with 293 Peruvian students aged 12 to 17 years (M = 14.42, SD = 1.5), using structural equations to analyze the relationship between PIU, lifestyles, and quality of life related to oral health. The data collection procedure was through a face-to-face survey. Validated instruments measured PIU, lifestyles, and oral health-related quality of life. The study’s theoretical model was analyzed through structural equation modeling with the MLR estimator. The fit assessment was performed using the comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR).ResultsThey indicated significant correlations between PIU, lifestyles, and oral health-related quality of life. A negative influence of PIU on lifestyles (β = -0.30, p < .001) and on oral health-related quality of life (β = -0.35, p < .001) was observed, as well as a positive relationship between PIU and oral health-related quality of life (β = 0.29, p < .001). The mediation of lifestyles was statistically significant, suggesting that they mediate the relationship between PIU and oral health-related quality of life.ConclusionsThe study confirms that PIU can negatively affect adolescents’ oral health-related quality of life, mediated by unhealthy lifestyles. It underlines the importance of promoting balanced Internet use and healthy lifestyles among young people to improve their oral well-being.

Construct validity and reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science students

BackgroundDASS-21 is the common and widely used tool for assessing depression, anxiety and stress. However, its validity and Reliability in Ethiopian Amharic language is not assessed.ObjectiveTo translate the DASS-21 and assess its validity and reliability among Ethiopian Defense University college of health science students in Bishoftu, Ethiopia.MethodAn institutional based cross-sectional study was conducted using a self-administered questionnaire. A total of 435 students from different departments in accordance with their proportional size were participated in this study. As to the sampling technique, the study units were selected from each department and year of study using simple random sampling proportional to size. Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the DASS-21. Cronbach alpha coefficient and corrected item total correlation was calculated to assess the internal consistency of Amharic version of DASS-21.ResultAmong 435 undergraduate students who participated in the study, 246(56.6%) were the age of 18–25 year and majority 347(79.8%) were males. Regarding their year of study; 200 (46.0%) were first year students. Confirmatory factor analysis indicates a good model fit of the three correlated factors (Comparative fit index (CFI) = 0.92 with root mean square error of approximation (RMSEA) = 0.059[0.052–0.066] and standardize root mean residual SRMR = 0.045). The internal consistency of overall DASS-21 and each sub scale were in acceptable range (0.91, 0.82, 0.77 and 0.77) respectively.ConclusionAmharic version of DASS-21 was found to be a valid and reliable instrument to measure the mental problem especially, Depression, Anxiety and Stress among university students.

Evaluating the Construct Validity of the Charité Alarm Fatigue Questionnaire using Confirmatory Factor Analysis.

The Charité Alarm Fatigue Questionnaire (CAFQa) is a 9-item questionnaire that aims to standardize how alarm fatigue in nurses and physicians is measured. We previously hypothesized that it has 2 correlated scales, one on the psychosomatic effects of alarm fatigue and the other on staff's coping strategies in working with alarms. We aimed to validate the hypothesized structure of the CAFQa and thus underpin the instrument's construct validity. We conducted 2 independent studies with nurses and physicians from intensive care units in Germany (study 1: n=265; study 2: n=1212). Responses to the questionnaire were analyzed using confirmatory factor analysis with the unweighted least-squares algorithm based on polychoric covariances. Convergent validity was assessed by participants' estimation of their own alarm fatigue and exposure to false alarms as a percentage. In both studies, the χ2 test reached statistical significance (study 1: χ226=44.9; P=.01; study 2: χ226=92.4; P<.001). Other fit indices suggested a good model fit (in both studies: root mean square error of approximation <0.05, standardized root mean squared residual <0.08, relative noncentrality index >0.95, Tucker-Lewis index >0.95, and comparative fit index >0.995). Participants' mean scores correlated moderately with self-reported alarm fatigue (study 1: r=0.45; study 2: r=0.53) and weakly with self-perceived exposure to false alarms (study 1: r=0.3; study 2: r=0.33). The questionnaire measures the construct of alarm fatigue as proposed in our previous study. Researchers and clinicians can rely on the CAFQa to measure the alarm fatigue of nurses and physicians.

DEVELOPMENT AND INITIAL TESTING OF A BRIEF, GENERIC, SELF-REPORTED DISABILITY QUESTIONNAIRE: THE UNIVERSAL DISABILITY INDEX

BackgroundDisability is an important multifaceted construct. The aim of this study was to develop and evaluate a brief, generic self-reported disability questionnaire: the Universal Disability Index (UDI).MethodsConvenience sampling was used to collect general population data via an online survey. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency was also assessed.Results403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α &gt; 0.90) and were strongly correlated (Pearson's r &gt; 0.7) with both GARS and GCPS disability scores, indicating concurrent validity.ConclusionsA brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted.Conflicts of interestNo conflicts of interestSources of fundingNo funding obtained

Cultural adaptation and validation of the knee injury and osteoarthritis outcome score into Sinhala language in patients with primary knee osteoarthritis: a cross-sectional study

BackgroundKnee Injury and Osteoarthritis Outcome Score (KOOS) scale is a patient-reported outcome measurement tool. It evaluates both short- and long-term consequences of knee injury and primary osteoarthritis. This study aims to translate and validate the KOOS scale for a Sinhala-speaking Sri Lankan population.MethodsA cross sectional study was conducted in three hospitals. Four hundred and fifteen patients comprising 185 males and 227 females (3 subjects did not reveal their gender) with knee osteoarthritis (KOA) participated in the study. Seventy nine participants without KOA were recruited as controls. The functionality and quality of life level in patients and healthy participants were assessed using translated versions of the KOOS and Short Form-36 (SF-36) scales. Internal consistency of the instrument was assessed by Cronbach alpha. Construct validity and test-retest reliability were examined using the Intraclass Correlation Coefficient (ICC). Confirmatory Factor Analysis (CFA) was used to assess factorial validity.ResultsThe mean age (± sd) of the KOA subjects was 54.9 (± 9.2) years and for the control group was 49.2 (± 8.0) years. Majority of the respondents were female and Sinhalese in both groups. Internal consistency reliability was high (Cronbach’s alpha values ≥ 0.70). The test–retest reliability was excellent with the intraclass correlation coefficient for all subscales being above 0.90. Construct validity was assessed by the magnitude of the correlation coefficient between KOOS and SF-36 subscale scores. KOOS Pain scale moderately correlated with SF-36 bodily pain (Pearson’s r = 0.41). SF-36 physical function scores had a weak positive correlation with all KOOS subscales and SF-36 emotional wellbeing was not significantly correlated with KOOS Quality of Life (QoL) subscale. A five-factor Confirmatory Factor Analysis (CFA) model yielded a Comparative Fit Index (CFI) = 0.950, Tucker Lewis Index (TLI) = 0.946, Root Mean Square Error of Approximation (RMSEA) = 0.082 and Standardised Root Mean squared Residual (SRMR) = 0.072.ConclusionThe Sinhala translation of the KOOS scale is a reliable and valid instrument to assess KOA in a Sinhala-speaking Sri Lankan population. Studies to assess its use as a scale to evaluate responsiveness are recommended.

The Chinese version of patient experience with treatment and self-management (PETS vs. 2.0): translation and validation in patients with multimorbidity in primary care in Hong Kong

BackgroundValidated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care.MethodologyThe translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach’s alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity.ResultsThe mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ2/df = 1.741; root mean square error of approximation (RMSEA) = 0.038; standardized root mean square residual (SRMR) = 0.058; comparative fit index (CFI) = 0.911; Tucker-Lewis Index (TLI) = 0.903). All standardized factor loadings were 0.30 or above. Significant positive correlations between the latent factors were found for all factor pairs (correlation coefficient < 0.8).ConclusionsThe Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained.

Pain Predictors in Patients in the Postanesthesia Care Unit

To analyze the effects of pain-predicting factors on patients in the postanesthesia care unit (PACU). This is an observational and prospective study. This study was conducted at a University Hospital in the state of Minas Gerais (Brazil). To collect data on demographic, clinical, and surgical factors, a collection instrument was devised. The verbal numerical scale was employed to measure pain levels before and after surgery in the PACU. A path analysis was used to assess a predictive model. A total of 226 patients were included in this study. The incidence of pain in the PACU was 31.9%. A model with demographic, clinical, and surgical variables was tested. The final model, after including modification indices, obtained results that indicated an acceptable data fit (comparative fit index=0.996; root mean square error of approximation=0.08). Age (being young), sex (being a woman), oncological diagnosis as an indication for the surgical procedure, type of surgery (surgery of the digestive system), duration of surgery (longer surgeries), and high intraoperative doses of opioids were predictive variables for pain in the PACU. This study's findings provide support for pain management in the PACU. Furthermore, the results of this research can be used to anticipate the occurrence of acute postoperative pain and personalized perioperative analgesia needs.

Development and Validation of a Malay Version Questionnaire to Evaluate Remote Health Monitoring of COVID-19 via Telehealth Applications: Navigating Telehealth Evolution.

Introduction The rapid adoption of telehealth services due to the COVID-19 pandemic has highlighted the necessity for effective tools to evaluate patient experiences. This study developed and validated the Telehealth Usability, Acceptability, and Satisfaction Questionnaire (TUASQ) for virtual COVID-19 Assessment Centres (CACs) in Malaysia, aiming to comprehensively measure usability, acceptability, and satisfaction. Methodology The TUASQ was developed in two phases. Initially, the questionnaire development phase included item generation guided by the Technology Acceptance Model (TAM) and the Health Belief Model (HBM), with feedback from a panel of six experts. Items were refined through Content Validity Index (CVI) - Item-Level Content Validity Index (I-CVI) ≥ 0.82, Scale-Level Content Validity Index (S-CVI) ≥ 0.82, and Content Validity Ratio (CVR ≥ 0.78); and Face Validity Index (FVI) by 10 respondents - Item-Level Face Validity Index (I-FVI) ≥ 0.82and Scale-Level Face Validity Index (S-FVI ≥ 0.82). The psychometric validation phase involved a cross-sectional study of 705 respondents, recruited through convenience sampling from March to July 2024, to perform Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), followed by reliability testing using Cronbach's alpha, Composite Reliability (CR), and Average Variance Extracted (AVE). Results Content validation showed that most items' I-CVI exceeded 0.82, indicating significant expert consensus on relevance and clarity. The CVR also surpassed the 0.78 threshold, affirming their essential role. Face validation indices generally exceeded 0.80, confirming the questionnaire's clarity and comprehensiveness from the users' perspective. EFA with 250 participants indicated a high Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) of 0.933 and significant Bartlett's test (χ² (136) = 3752.698, p < 0.001), supporting the factorability of the data and extracting three distinct factors. CFA with 455 participants initially showed a poor fit, prompting model adjustments that subsequently improved the fit indices (Root Mean Square Error of Approximation (RMSEA) = 0.076, Standardized Root Mean Square Residual (SRMR) = 0.045, Goodness of Fit Index (GFI) = 0.94, Tucker-Lewis Index (TLI) = 0.96, Comparative Fit Index (CFI) = 0.97). Reliability testing revealed a high internal consistency with Cronbach's alpha of 0.975. CR for each factor exceeded the 0.70 threshold, and the AVE for each factor was above 0.50, indicating good convergent validity. Conclusion The validated TUASQ is a reliable and effective instrument for assessing the experiences of Malaysian patients using virtual CAC. Demonstrating robust psychometric properties through comprehensive validation processes, the TUASQ accurately measures usability, acceptability, and satisfaction, identifying strengths and areas for improvement in telehealth services. This contributes to enhanced care quality and patient satisfaction in the evolving healthcare landscape.