Multidimensional Tool Research Articles

Going green at work: a psychometric assessment of the green innovative work behaviour scale

Purpose The purpose of this study is to examine and validate the psychometric properties of the Green Innovative Work Behaviour (G-IWB) measure, aiming to enhance its conceptualisation and reliable assessment in the context of increasing environmental awareness. Design/methodology/approach Data for this research were collected using a survey method across three distinct samples and analysed to evaluate the multidimensionality, validity and reliability of the G-IWB scale. Findings The thorough assessment of the G-IWB scale provided critical insights into its psychometric robustness. Results confirmed the reliability and validity of the G-IWB scale, featuring a correlated five-factor model and higher-order structure, encapsulating 23 items that comprehensively reflect the dimensions of G-IWB. Practical implications The findings of this study offer substantial practical value for hospitality organisations, providing a reliable tool for measuring, assessing and fostering G-IWB. This research contributes to the expanding literature on green innovation by focusing on individual behaviours and enriching theoretical models with data-driven insights for advancing sustainable practices within the hospitality sector. Originality/value This research makes a significant contribution by introducing a multidimensional psychometric tool for evaluating G-IWB. It addresses the scholarly tendency to focus on unidimensional G-IWB measurements, thereby advancing a nuanced understanding that broadens the scope of G-IWB.

The Organic Farmer Safety, Health & Life Questionnaire (OFSHLQ): A Tool for an Expanded Paradigm on Occupational Safety and Health.

Develop and validate a multidimensional tool consistent with an expanded occupational safety and health (OSH) paradigm. Systematic development process; cross-sectional survey design for psychometric properties. Exploratory factor analyses (EFA) and reliability estimates on key theoretical constructs. The Organic Farmer Safety, Health & Life Questionnaire (OFSHLQ) is a population-specific, theory-based, multilevel tool that integrates work and life dimensions. The development process contributed to face and content validity. The EFA identified 11 scales with acceptable factor loadings. Reliability estimates across scales ranged from 0.58 to 0.92. OFSHLQ integrates traditional dimensions of OSH and other intrapersonal, interpersonal, and contextual factors that contribute to overall workers' health and well-being. OFSHLQ constitutes a resource for traditional OSH surveillance and research, and is also consistent with an expanded paradigm of OSH.

Validation of the Neuroception of Psychological Safety Scale (NPSS) Among Health and Social Care Workers in the UK

Psychological safety is essential for rest, recovery, and fostering social connections, particularly for health and social care workers (HSCWs) who frequently operate in high-pressure environments. These workers are prone to traumatic stress, which can elevate their sense of threat and undermine their psychological safety. This study aimed to validate the Neuroception of Psychological Safety Scale (NPSS) among HSCWs in the UK (n = 443). The NPSS is based on polyvagal theory and assesses the dimensions of compassion, social engagement and bodily sensations. Internal consistency, test–retest reliability, convergent, discriminant, and concurrent validity were examined, along with the scale’s dimensionality. A three-factor structure was confirmed, with internal consistencies ranging from acceptable to excellent across subscales. Validity was supported by significant associations with measures of team psychological safety, well-being, post-traumatic stress, burnout, body perception, and personality. The NPSS also demonstrated strong test–retest reliability. These results validate the NPSS as a reliable and multidimensional tool for assessing psychological safety in health and social care settings. The study highlights the importance of psychological safety for HSCWs and provides a valuable measure to support interventions aimed at fostering safer and more supportive work environments.

CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE TRADITIONAL CHINESE VERSION OF THE CORE OUTCOME MEASURES INDEX FOR PEOPLE WITH LOW BACK PAIN IN HONG KONG

Purpose: The Core Outcome Measures Index (COMI) is a multidimensional tool designed to assess the changes in health status of individuals with low back pain (LBP) over time as reported by them. It has been validated and translated into several languages. The objective of this study was to translate COMI into traditional Chinese and test its reliability and validity among the Cantonese-speaking people with LBP in Hong Kong. Methods: The COMI was translated into traditional Chinese following standard procedures and avoiding region-specific terminology. A total of 120 Cantonese-speaking individuals with LBP from The Hong Kong Polytechnic University were recruited. Participants completed a baseline translated COMI questionnaire online. After two–three days, a second set of online questionnaires, including the translated COMI, the traditional Chinese version of the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ), and the EuroQol Five-Dimensional Five-Level Questionnaire (EQ-5D-5L), were administered to assess the reliability and validity of the translated COMI. Results: The standard Chinese version of COMI was successfully back-translated. There were low floor and ceiling effects, except for symptom-based well-being (floor effect) and disability (ceiling effect). In two rounds of surveys, the Cronbach’s alpha values were 0.79 and 0.80, respectively, indicating sufficient internal consistency. The intraclass correlation coefficient [ICC(2,1)] for the overall score of the COMI was 0.91 (95% CI: 0.86–0.94), and for each item, it ranged from 0.7 to 0.88, demonstrating good test–retest reliability. The HK-COMI was confirmed to be a valid measure. Spearman’s rho correlation tests showed a high correlation with ODI ([Formula: see text]) and EQ-5D-5L ([Formula: see text]), and a moderate correlation with RMDQ ([Formula: see text]). Conclusion: The traditional Chinese version of COMI is a valid and reliable tool for measuring the effectiveness of treatment for LBP among the Cantonese-speaking people in Hong Kong. Future studies should focus on assessing the sensitivity of this measure among the people with LBP in Hong Kong.

Decision-making during training of a Swedish navy command and control team: a quantitative study of workload effects.

The study compared two simulation environments for training of Swedish naval Command and Control teams by using indirect measures, including workload, combat readiness, and situation awareness. The literature explains simulation-based training as providing a safe avenue to practice relevant scenarios. Fidelity, the degree of realism in the simulation, and workload, the equilibrium between demands and assigned tasks, are crucial factors examined in this study of low- and high-fidelity naval simulations. This study was conducted to better understand the effects of various training methods. An experimental design with repeated measures was used with three consecutive escalating parts. The subjective, multidimensional assessment tool, NASA-Task Load Index was used to rate perceived workload. Combat readiness of the ship and mental demand yielded significant results. For combat readiness of the ship, there was a difference between the low and the high-fidelity setting, for the initial part of the scenario p = 0.037 and for the second part p = 0.028. Mental demand was experienced as higher in the low-fidelity setting, p = 0.036. Notably, the simulated internal battle training for onboard command teams in a low-fidelity setting was found to induce a level of stress comparable with that experienced in a high-fidelity setting. The results indicate that low-fidelity training results in a workload not distinguishable from high-fidelity training and has practical implications for increased use of low-fidelity training as part of (naval) command team training programmes.

Reliability of the Cleveland Clinic Behavioral Rating System (CCBRS) Among Diverse Patients Seeking Bariatric Surgery.

The CCBRS is a multidimensional assessment tool developed to aid in the psychosocial evaluation of patients seeking bariatric surgery. To date, three studies support the interrater reliability, internal consistency, and predictive validity of the CCBRS for a number of postoperative outcomes. However, research has predominantly been with White females. This study examines the reliability of the CCBRS with diverse individuals from three surgery clinics. The relative contribution of demographic and psychosocial variables to overall CCBRS ratings and differences in overall CCBRS ratings based on these factors are also explored. Patients seeking bariatric surgery (n = 407; 86.2% female; 49.6% Black; mean BMI 48.3kg/m2, SD = 8.5) were evaluated with a standardized multimodal assessment. CCBRS domain and overall ratings were made based on the integration of assessment data. Patient weight, BMI, and weight loss surgery procedure were obtained from the initial bariatric surgery consult. Internal consistency of the CCBRS was good (Cronbach's alpha = .80) for this sample though lower than previously found. Most patients (75.6%) were cleared for surgery. Statistically significant differences in overall CCBRS ratings were found only based on employment status and referring clinic. Hierarchical regression analysis demonstrated a small effect for demographic and psychosocial factors, with only past alcohol abuse, current substance abuse, and referring clinic explaining statistically significant variance in overall CCBRS ratings. Results support the reliability of the CCBRS; however, additional research is needed with diverse populations.

Assessment of chronic pain: multidimensional tools, applicability, and practicality

Introduction: Chronic pain (CP) negatively impacts patients’ physical and psychological status. Thus, it has the potential to affect every aspect of everyday life. In Portugal, CP is a major public health problem that affects roughly 36.7% of adults. Nevertheless, assessment of this condition is still far from ideal. A Portuguese study showed that most of last year’s medical students and first-year residents did not routinely assess pain. Additionally, the best-known pain assessment tools are the ones that focus only on pain intensity, thus disregarding the multidimensional nature of pain. Objectives: This study aims to review pain assessment tools that consider the nature of pain and its impact on patients' functionality. The ultimate goal is to increase the knowledge and dissemination of such tools. Methods: Focus groups were conducted with a panel of 29 Portuguese physicians specialized in family medicine and orthopaedics. Several pain assessment tools were debated regarding applicability, practicality, and relevance. After group discussion, five pain assessment tools were considered particularly relevant. Results: The characteristics, advantages, and disadvantages of five pain assessment tools (ACT-UP, CAPA, Barthel index, BPI, and EQ-5D), and the need for their applicability in the family medicine clinical practice are summarized and highlighted. Functional assessment of CP patients is a key step to deciding the most adequate treatment regimen since the individual nature of patients will cause them to be differently affected by distinct limitations, even if the intensity of pain is similar. Conclusion: The implementation use of these tools in clinical practice will be crucial for the improvement of CP management.

Record linkage as a vital key player for the COVID-19 syndemic

Abstract Chronicity, comorbidities, and social context influence COVID-19 risk and prognosis, drawing attention to a syndemic dimension. We discuss how linking routinely collected data and data collected through observational population-based cohorts can contribute to advance knowledge on the association between COVID-19 and chronic diseases and social indicators. Record linkage as a multidimensional tool may ultimately enable defining and optimizing of integrated strategies, which may create multilevel public health measures to foster solidarity on health in all policies when ethical and legal barriers under prerequisite data protection and privacy can be overcome. Legal discrepancies have been proving detrimental to research in member states, including those which already had established a margin for research for the common good without explicit consent. We hence call for further harmonization of data protection requirements for scientific research activities in the EU/EEA, focusing in particular on health-related research. A proposed framework demonstrates the role of record linkage as a trailblazing key player in research optimization due to its multidimensional possibilities calling for harmonization. Key messages • Further harmonization of data protection requirements for scientific research may create multilevel public health measures. • As a multidimensional tool, it optimizes integrated strategies and fosters solidarity on Health in All Policies (HiAP).

Psychometric Properties of the German Version of the Benzodiazepine Dependence Self-Report Questionnaire

AbstractTo facilitate measurement and screening of benzodiazepine/Z-drug dependence, the Dutch “Benzodiazepine Dependence Self-Report Questionnaire” was translated into German (Bendep-SRQ-GV) and psychometrically evaluated. A cross-sectional online study with 343 benzodiazepine/Z-drug users was conducted. Structural validity and reliability were assessed using confirmatory factor analysis, while convergent validity was evaluated through correlation and receiver operating characteristic analyses with the “Severity of Dependence Scale” (SDS). Furthermore, the use of simple sum subscale and total scale scores was reviewed. A model with four first-order factors and one second-order factor fitted the data best. The questionnaire showed good to excellent reliability. The scores correlated satisfactorily with the model-based factor scores and the SDS, indicating good convergent validity and supporting the use of simple sum scores. The study provided strong evidence for the validity and reliability of the Bendep-SRQ-GV as a measure of benzodiazepine/Z-drug dependence, which represents a significant step towards developing a multidimensional screening tool.

Review article: Prevention of inflammatory bowel disease-The path forward.

The possibility of preventing inflammatory bowel disease (IBD) is becoming more plausible due to advances in understanding preclinical disease and successful prevention trials in other immune-mediated diseases, such as type 1 diabetes and rheumatoid arthritis. However, before that possibility becomes reality, several efforts need to occur in parallel and in a coordinated way. To propose some critical steps necessary for advancing the field of IBD prediction and prevention. We reviewed the current literature to identify the necessary steps toward a preventive strategy for IBD. The first step should determine the most robust predictive biomarkers and validate them across independent cohorts, creating a multidimensional predictive tool. The second step is to gain a better understanding of the preferences of first-degree relatives and people at risk for IBD, informing the implementation of screening and preventive strategies. Third, these efforts should contribute to the development of high-risk clinics and establish the necessary networks for disease prevention trials. Advancing the field of IBD prediction and prevention will require a multifaceted approach, integrating biomarker discovery, understanding patient preferences, and establishing infrastructure for a collaborative network to support the practical implementation of IBD prevention strategies.

An Automated Electronic Health Record Score to Estimate Length of Stay and Readmission in Patients Undergoing Radical Cystectomy for Bladder Cancer.

Patients treated with radical cystectomy experience a high rate of postoperative complications and frequent hospital readmissions. We sought to explore the utility of the Care Assessment Need (CAN) score, derived from electronic health data, to estimate the risk of these adverse clinical outcomes, thereby aiding patient counseling and informed treatment decision-making. We retrospectively examined data from 982 patients with bladder cancer who underwent radical cystectomy between 2013 and 2018 within the national Veterans Health Administration system. We tested for associations between the preoperative CAN score and length of stay, discharge location, and readmission rates. We observed a correlation between higher CAN scores and longer hospital stays (adjusted relative risk = 1.03 [95% CI: 1.02-1.05]). An increased CAN score was also linked to greater odds of discharge to a skilled nursing facility or death (adjusted odds ratio = 1.16 [95% CI: 1.06-1.26]). Furthermore, the score was associated with hospital readmission at both 30 and 90 days postdischarge (adjusted HR = 1.03 [95% CI: 1.00-1.07] and 1.04 [95% CI: 1.00-1.07], respectively). The CAN score is associated with length of hospital stay, discharge to a skilled nursing facility, and readmission within 30 and 90 days after radical cystectomy. These findings highlight the potential of health care systems leveraging electronic health records for automatically calculating multidimensional tools, such as the CAN score, to identify patients at risk of adverse clinical outcomes after radical cystectomy.

Ecological-economic assessment of environmental quality as a natural basis for territorial sustainable development: conceptual-categorical analysis

In the context of growing global problems of resource using and environmental protection the development of a sustainable environmental-economic development strategy, including at the territorial level is becoming increasingly actual. The purpose of the research is conceptual-categorical analysis of ecological-economic assessment of environmental quality as a natural basis for territorial systems of different levels sustainable development, elaboration and justification of the conceptual assessment model and methods of its implementation. Methodological issues focus on how to comprehensively assess the environmental quality of the territory and how this assessment can be taken into account in the formation of a strategy for environmentally sustainable development of spatial-economic systems. The scientific novelty of the research results lies in the consolidation of the theories of territorial development sustainability and environmental quality environmental-economic assessment in the conceptual model, as well as in the substantiation of tools for quantitative measurement of environmental quality, increasing the accuracy and reliability of the obtained environmental-economic assessments. The significance of the research results lies in providing decision-makers with comprehensive information on the long-term consequences of environmental-economic decisions and facilitating the transition to environmentally sustainable economic development of territories. This information can be obtained as a result of systematic application of multi-dimensional environmental-economic assessment tools that take into account not only the full socio-economic value of natural environmental resources, but also the spatial characteristics of territories.

Efficiency as a tool for measuring law-making and its policy

In the scientific work, the author made an attempt to establish the methodological significance of the category «efficiency» in terms of the dimension of law-making and law-making policy. Attention is focused on the relevance of strengthening the scientific development of the methodology of studying law- making and its policy. It was emphasized that law-making requires systematic analysis, improvement of law-making mechanisms and the involvement of a wide range of experts to ensure the effective functioning of the legal system. Taking into account the constant changes in the social and political life of our country and the need to adapt legislation to European standards, law-making activity becomes an even more relevant phenomenon that not only needs its own scientific research, but also measurement for its effectiveness. Therefore, the relevance of the topic of this scientific work is determined both by the possibility of measuring the effectiveness of law-making, and by the necessity of such a measurement in order to provide a comprehensive assessment of the practice of law-making in Ukraine. The analysis of the views of scientists, which relate to the methodological significance of effectiveness as a tool for measuring the phenomena of legal reality, has been carried out. It is concluded that efficiency is a multidimensional tool that should establish the effectiveness of both directly law-making (on the micro-level) and the entire law-making policy (on the macro-level). It is noted that law-making and law-making policy can be studied from the point of view of their effectiveness, the results of which will have either a substantive nature (law-making effectiveness) or a strategic nature (law-making policy effectiveness). From the point of view of methodological significance, efficiency as a tool for measuring law-making and law-making policy is an independent: 1) a way of measuring indicators that reflect the result of the functioning of law-making or law-making policy; 2) a means of identifying and characterizing the role and purpose of law-making and its policy in socio-political and legal aspects; 3) a mechanism for identifying deficiencies in law-making activity and the content of law-making policy; 4) a prerequisite for substantiating ways of improving law-making activity and the content of law-making policy.

Research progress in stroke risk perception assessment tool.

One of the main illnesses in the globe that causes impairment and death in people is stroke. In the globe today, it ranks as the second leading cause of death and the leading cause of death in China. This paper analyses into the critical role of risk perception in developing individual awareness of stroke risk and encouraging proactive preventive health behaviors, essential for effective primary stroke prevention strategies and reduced stroke incidence. It discusses the concept of risk perception, the content and dimensions of global stroke assessment tools, and their application status, aiming to provide insights for their development and intervention research. Risk perception encompasses subjective assessments of stroke likelihood and severity, influenced by personal experiences, knowledge of risk factors, beliefs about prevention effectiveness, and emotional responses. Global stroke assessment tools, like the Framingham Stroke Risk Score and CHA2DS2-VASc Score, evaluate stroke risk based on factors such as age, gender, blood pressure, and cholesterol levels. In order to improve risk perception and proactive health management and lower the burden of strokes, the paper assesses the advantages and disadvantages of these tools and makes recommendations for improving accessibility, customizing interventions, running educational campaigns, promoting multidisciplinary collaboration, and integrating technology. By combining the research tools of stroke risk perception, it is found that the evaluation tools are mostly single-dimensional evaluation tools centered on the two dimensions of onset possibility and susceptibility. Some scholars have developed multi-dimensional evaluation tools, but the evaluation population is relatively limited, and the evaluation system lacks comprehensiveness and systematization.

Current Trends in Modalities of Pain Assessment: A Narrative Review.

Pain is a common complaint among a spectrum of diseases. Although an ideal objective method of pain assessment is lacking, several validated tools are available for use in clinical research and practice. The tool considerations are based upon the parameters to be assessed and factors specific to patient, disease, and availability of instruments. This review classifies and brings the key aspects of currently available pain assessment tools on a single platform to ease the selection process for researchers/practitioners. The tools utilized for pain assessment were collected from articles available in PubMed and Google Scholar databases and classified into the following domains: unidimensional, multi-dimensional, investigation-based, and computerized algorithm-based tools. Their purpose of use and limitations are reviewed. The unidimensional scales are used to describe only the characteristics of pain, like intensity (e.g. numerical rating scale), type (e.g. neuropathic pain questionnaire), or pattern. In contrast, multi-dimensional tools, like Mc Gill Questionnaire, assess not only pain as an individual symptom but also its influence on physical functioning and general well-being. However, certain components like ethnicity, age, cognitive impairment, sedation, and emotion become a limiting factor in selecting the scale. In addition to these scales, a potential role of parameters such as biopotentials/markers has also been shown in pain assessment. Last, artificial intelligence is also being applied in evaluation of pain. Pain measurement is subjective in nature as assessed through questionnaires and observational tools. Currently, multi-dimensional approaches of pain assessment are available, which can lead to precision pain management.

A multidimensional tool to measure farm stressors: development and initial validation of the farmer stress assessment tool (FSAT)

BackgroundFarming is a stressful occupation, and a growing body of research shows that farm stressors are associated with poor mental health. To date, there are few methodologically sound surveys that assess farm stressors, and none have been validated for the Canadian context. Our study aimed to: (a) investigate the types of stressors experienced by farmers, (b) develop a farm stress assessment tool and test its factor structure and internal consistency, and (c) assess its criterion-related validity to self-reported levels of anxiety, depression, burnout, and resilience among farmers.MethodsWe developed a 20-item survey based on a review of the literature, examining existing farm stress surveys, and consulting 10 farmers and agricultural industry experts. Then, a convenience sample of farmers living in Alberta, Canada (Sample 1, N = 354) completed a questionnaire containing the 20-item farm stress survey and four validated measures that assessed depression, anxiety, burnout, and resilience. Sample 1 was used to assess the factor structure using exploratory factor analysis (EFA), internal consistency, and criterion-validity of the survey. Next, a convenience sample of farmers living outside of Alberta (Sample 2, N = 138) was used to evaluate the factor structure of the survey using confirmatory factor analysis (CFA).ResultsThe results of the EFA revealed five underlying dimensions of farm stressors: Unexpected work disruptions, Agricultural hazards, Farm and financial planning, Isolation, and Regulations and public pressure. The subscales accounted for 61.6% of the variance, and the internal consistency (Cronbach’s alpha) ranged from 0.66 to.75. Subscale correlations were below 0.44, indicating evidence of discriminant validity. Correlations between the five subscales and the four mental health outcome variables supported the criterion-related validity of the survey. The results of the CFA indicated that the data fit the model, and fit was further improved by correlating one pair of error terms.ConclusionsPreliminary analysis of our Farmer Stress Assessment Tool (FSAT) suggests it is a reliable and valid instrument for measuring a range of stressors farmers face. Implications for policy and community-based mental health interventions that help farmers manage the enduring stressors of agriculture is discussed.

A qualitative exploration of food choice motives of urban indigenous food gatekeepers in Fiji: Implications for the use of the food choice questionnaire

Pacific Island Countries (PICs) have exceptionally high rates of obesity and non-communicable diseases. The causes are complex but one prominent factor is the notable shift from traditional plant and seafood diets to diets high in unhealthy processed foods. Literature is sparse on the motives behind food choice decisions of Pacific Islanders. The widely used Food Choice Questionnaire (FCQ) (Steptoe et al., 1995) is a multi-dimensional tool capturing nine potential food choice motives. This study used a hybrid thematic analysis. Fourteen in-depth semi-structured interviews with urban indigenous Fijian mothers were conducted to (1) explore how the nine FCQ motives impact food choice (2) to examine conceptual equivalence of the nine FCQ motives and (3) to identify additional food choice motives, not captured in the FCQ. Mothers identified seven of the nine FCQ motives (i.e., health, mood, convenience, sensory appeal, weight control and familiarity) and three new food choice motives (i.e., food that is filling, religious dietary restrictions and food quality) as important determinants of food choice. Moreover, while choosing foods that promote health and well-being was identified as an important food choice motive, mothers also identified four other motives, that they considered important, which lead to over-eating and unhealthy eating. Food choice is a complex, layered decision, driven by multiple considerations, some more important than others. These findings can inform diet-related interventions and policy within this community. Adapting the FCQ for broader PIC use through further qualitative exploration in PICs, and validating the adapted FCQ with larger samples will enhance its utility in measuring food choice motives in PICs.

The CAREPAL-8: a short screening tool for multidimensional family caregiver burden in palliative care

BackgroundFamily caregivers of terminally ill and dying people do not only experience varying levels but also different dimensions of caregiver-related strain and burden. The aim of the study was to develop a short multidimensional screening tool for the detection of burden in family caregivers in palliative care.MethodsFamily caregivers of cancer patients newly admitted to specialist inpatient palliative care (N = 232) completed questionnaires on psychological burden, quality of life, social support and need fulfillment. A latent class mixture model was used to identify discrete classes of family caregivers related to their multidimensional caregiver burden. Multinomial logistic regression analyses were performed to identify the most predictive items from a set of established questionnaires.ResultsFour latent classes of family caregivers were identified: Currently stable caregivers (37%), Caregivers with unmet needs (20%), Psychologically burdened caregivers (30%), and High-risk caregivers (13%). Each of these classes describes a different risk profile of multidimensional family caregiver burden, although family caregivers exhibit high levels of distress across all classes. From a set of 48 items, we identified eight items that predicted the class membership best. These items represent the items of the novel multidimensional screening tool: The 8-item Screening Tool for Family Caregiver Burden in Palliative Care (CAREPAL-8). Except for social support, the items maintained fidelity to the conceptualization of multidimensional caregiver burden used in this study. A preliminary classification system was developed, which has yet to be validated.ConclusionsThis study represents the first step in the establishment of a practical, self-administered screening tool that might help healthcare providers to tailor caregiver care according to their burden in daily practice. Brevity of the 8-item tool might facilitate its use in routine clinical care.

Defining optimal left ventricular assist device short-term outcomes may provide insight into programmatic quality assessment

BackgroundPatients have substantial variability in perioperative outcomes after left ventricular assist device (LVAD) implant. A perioperative multidimensional tool integrating mortality, adverse events (AEs), and patient-reported outcomes to assist in quality improvement initiatives is needed. MethodsPatients undergoing HeartMate 3 LVAD implant (1/1/2017 and 1/31/2024) in the Society of Thoracic Surgeons’ Intermacs registry were studied. A Cox proportional hazard multivariable analysis incorporating AEs as time-varying covariates for mortality out to 180 days was used to generate the Intermacs Short-Term Composite Quality (INSITE) score, reflecting the adjusted hazard ratio (HR) for mortality contributed by each AE, applying global ranking methodology. In those alive and on support at 6 months, multivariable logistic regression (odds ratio, OR) was used to examine the impact of AEs on health-related quality of life (QOL) at 180 days, captured through the INSITE-QOL score. Failure to achieve ≥1 point increase in visual analog scale (VAS) from baseline was the event in the QOL analysis. ResultsOf 13,148 patients, 4,389 (33.4%) suffered at least one AE or death through 180 days. Stroke (survival: HR 13.1; QOL: HR 1.7), dialysis (survival: HR 31.4; QOL: HR 4.2), prolonged respiratory failure (survival: HR 5.7; QOL: HR 2.3), reoperation (Survival: HR 3.4; QOL: HR 1.6) and right heart failure (survival: 5.0; QOL: HR 1.4), contributed to both mortality and failure to improve QOL at 180 days (all p<0.05). The median INSITE and INSITE-QOL scores were 0.0 [0.0,1.6] and 0.0 [0.0,0.0], respectively. At 9.4% (n=17) of centers, a high INSITE score (≥13) was present in 15% of patients while the top 25% of centers had perfect INSITE-QOL scores in at least 75% of patients. ConclusionsAEs after LVAD confer differential impact on mortality and QOL, enabling development of global rank outcome scores. Given the high mortality hazard conferred by 180-day AEs, center-specific quality interventions aimed at reducing early complications provide the greatest opportunity to improve long-term survival and QOL.

Quality of reporting health behaviors for multiple sclerosis (QuoRH-MS): A scoping review to inform intervention planning and improve consistency of reporting.

Multiple sclerosis (MS) is a neurological condition that necessitates a multidisciplinary approach to aid those living with MS in managing their disease. Health behavior, or lifestyle modification, is an emerging approach to MS self-management. MS researchers utilize measurement tools to ensure that interventions are best suited to the outcomes, thereby potentially influencing practice. The aim of this study was to investigate which tools are being used for health behavior management studies in people living with MS and develop an aid for tool selection. A scoping review guided by the PRISMA-Sc checklist and the JBI manual for evidence synthesis was employed with a systematic search strategy executed across four scientific databases: Medline, PubMed, CINAHL, and Cochrane Libraries. The types of assessment tools used were extracted from the included studies. Each tool was categorized into the health behavior intervention discipline (nutrition, exercise, and psychology) and then subcategorized by the tool's purpose. The frequency of use was determined for each tool. Reporting of validation of the assessment tools were collated to inform a tool selection checklist. The review identified a total of 248 tools (12 nutrition, 55 exercise, and 119 psychology unique reports) from 166 studies. Seventy-seven multidimensional tools were identified including measures of quality of life, fatigue, and functional scales. Only 88 studies (53%) referred to the validity of the tools. The most commonly reported tools were the dietary habits questionnaire (n=4, nutrition), 6-minute walk test (n=17, exercise), Symbol Digits and Modalities Test, and Hospital Anxiety and Depression Scale (n=15 each, psychology) with the Expanded Disability Status Scale reported 43 times. Evidence from interventions may inform practice for health professionals. This review provides insights into the range of tools reported across health behavior intervention studies for MS and offers a guide toward more consistent reporting of study methods.