Reliable Measure Research Articles

Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability.

The Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet. We used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland-Altman plots, to evaluate the reliability of the RBT's outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures. The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690). Test-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI.

Assessing Itch Severity: Content Validity and Psychometric Properties of a Patient-Reported Pruritus Numeric Rating Scale in Atopic Dermatitis.

Pruritus, or itch, is a key symptom of atopic dermatitis (AD); as such, mitigating itch is an important outcome of AD treatment. This study explored the content validity and measurement properties of the Pruritus Numeric Rating Scale (Pruritus NRS), a novel single-item scale for assessing itch severity in clinical trials of AD treatments. In this mixed-methods study, qualitative interviews were conducted with 21 people with moderate-to-severe AD (n = 15 adult, n = 6 adolescent) to develop a conceptual model of the patient experience in AD and explore the content validity of the Pruritus NRS. Data collected daily from adults with moderate-to-severe AD enrolled in a phase2b study (NCT03443024) were used to assess the Pruritus NRS' psychometric performance, including reliability, construct validity, and responsiveness. Meaningful within-patient change (MWPC) thresholds were also determined using anchor-based methods. Qualitative findings highlighted the importance of itch in AD, including severity, persistence, frequency, and daily life interference. Patient debriefing of the Pruritus NRS indicated that the scale was relevant, appropriate, and interpreted as intended. Trial data supported overall good psychometric properties. MWPC was defined as a 3-point improvement in Pruritus NRS score, a finding supported by qualitative data. The Pruritus NRS provides a valid and reliable patient-reported measure of itching severity in patients with moderate-to-severe AD, and can detect change, indicating it is fit-for-purpose to evaluate the efficacy of AD treatments in this population. ClinicalTrials.gov identifier, NCT03443024.

Psychometric Properties of the Body-Mind-Spirit Wellness Behavior and Characteristic Inventory for the Greek Population.

The Body-Mind-Spirit Wellness Behavior and Characteristic Inventory (BMS-WBCI) is a free-of-charge wellness tool with good psychometric properties, widely used mainly in studies assessing quality of life and healthy lifestyle habits. This certain tool is based on the Hettler's (1980) model and has been validated for use with students aged 18-36. The purpose of this study was to adapt the BMS-WBCI in the Greek language and at the same time to validate it for use in the general population. This study included 520 participants aged 16-75 (M = 39.86, SD = 10.5), who were recruited from the Greek population using the snowball procedure. The BMS-WBCI was adapted into Greek language, following a multiple forward-and-backward translation protocol. Confirmatory Factor Analysis (CFA) was used to validate the overall construct of the Greek BMS-WBCI. The final solution was a three-factor model with 38 items, after removing the items B1, B8, B9, M11, M24, and S43. This final model demonstrated an acceptable to good fit, presenting higher goodness-of-fit indices (CFI = 0.91, TLI = 0.90) and lower badness-of-fit indices (χ2/653 = 2.29, p < 0.001, RMSEA = 0.05, SRMR = 0.06). All items in the hypothesized model exhibited statistically significant standardized factor loadings (p < 0.001), with loadings consistently above 0.40. A very good internal consistency was found using the composite reliability measures (Body 0.86, Mind 0.95, Spirit 0.94). Further analysis indicated a good convergent validity (average variance extracted values: Body 50.5%, Mind 50.7%, Spirit 54.9%). The results indicated adequate discriminant validity, as all square roots of average variance extracted were higher than the correlation between construct items. In conclusion, this psychometric evaluation of the BMS-WBCI adds to the evidence supporting its use in the Greek language, not only in students, but also in the general population.

Multiscale assessment of North American terrestrial carbon balance

Abstract. Comparisons of carbon uptake estimates from bottom-up terrestrial biosphere models (TBMs) to top-down atmospheric inversions help assess how well we understand carbon dioxide (CO2) exchange between the atmosphere and terrestrial biosphere. Previous comparisons have shown varying levels of agreement between bottom-up and top-down approaches, but they have almost exclusively focused on large, aggregated scales (e.g., global or continental), providing limited insights into reasons for the mismatches. Here we explore how consistency, defined as the spread in net ecosystem exchange (NEE) estimates within an ensemble of TBMs or inversions, varies with at finer spatial scales ranging from 1∘×1∘ to the continent of North America. We also evaluate how well consistency informs accuracy in overall NEE estimates by filtering models based on their agreement with the variability, magnitude, and seasonality in observed atmospheric CO2 drawdowns or enhancements. We find that TBMs produce more consistent estimates of NEE for most regions and at most scales relative to inversions. Filtering models using atmospheric CO2 metrics causes ensemble spread to decrease substantially for TBMs, but not for inversions. This suggests that ensemble spread is likely not a reliable measure of the uncertainty associated with the North American carbon balance at any spatial scale. Promisingly, applying atmospheric CO2 metrics leads to a set of models with converging flux estimates across TBMs and inversions. Overall, we show that multiscale assessment of the agreement between bottom-up and top-down NEE estimates, aided by regional-scale observational constraints is a promising path towards identifying fine-scale sources of uncertainty and improving both ensemble consistency and accuracy. These findings help refine our understanding of biospheric carbon balance, particularly at scales relevant for informing regional carbon-climate feedbacks.

Engaging classroom observation: A brief measure of active learning in the college classroom

The purpose of this study was to develop a valid, reliable, and brief measure of active learning in college classrooms that is cheap and easy to complete and yields results that faculty can easily use to inform their development as instructors. Initial construct and face validity was achieved by modifying existing instruments and creating a draft of a brief measure of active learning for external expert review. Following the suggested revisions, the engaging classroom observation was then piloted and revised as necessary. Reliability was tested and measures of internal consistency and interrater reliability were acceptable. A principal component analysis showed two components that were moderately correlated, which indicated the potential they could be combined. An Exploratory Factor Analysis confirmed the instrument is measuring one factor, which we propose as active learning. This study is significant because it offers a brief instrument based on students’ perceptions that can be used formatively by faculty.

The Moral Distress Instrument (MDI): Development, Validation and Associations with Burnout among Finnish Social Workers

ABSTRACT Moral distress (MD), the suffering experienced by professionals due to their restricted moral agency, has become a popular subject of study in the fields of social work and health care. Many of the existing measures of MD are targeted at certain professionals, such as health care workers, and are thus restricted to such contexts. This has challenged the conceptual development and empirical examination of MD as a phenomenon occurring across diverse professional groups in different work settings. This study introduces a general measure of MD, the Moral Distress Instrument (MDI). It is not bound to specific professional contexts, and it aims to enable comparative and cross-disciplinary analyses of MD. The MDI consists of seven items that capture different forms of constrained moral agency and follow-up items measuring the level of distress related to these experiences. The reliability and validity of the MDI is investigated, and its distinctiveness from and associations with burnout are studied among a sample of Finnish social workers (n = 367). The MDI was shown to be a reliable and valid measure among the sample. The measures of MD and burnout were shown to tap separate constructs, although these experiences were strongly associated with each other.

Cultural adaptation and psychometric properties of the online learning climate scale for Chilean university students.

The COVID-19 pandemic has profoundly changed university teaching and learning formats, leading to a significant increase in online learning. Consequently, the crisis has facilitated the potential development of this educational modality. However, researchers need adapted and validated instruments to assess the online learning climate in universities. This study aimed to adapt and psychometrically validate the Online Learning Climate Scale (OLCS) for Chilean university students. Quantitative research was conducted with a non-experimental and cross-sectional, design executed in two phases: the first was oriented to the cultural adaptation of the instrument, and the second was focused on analyzing its psychometric properties in a sample of 491 university students. A translated and culturally adapted version was obtained, composed of 15 items distributed in a factorial structure composed of four dimensions that showed excellent adjustment to the data [χ2 (84) = 189.628; p < 0.001; CFI = 0.979; TLI = 0.973; RMSEA = 0.051 (IC90% 0.044-0.059); SRMR = 0.028]; internal consistency was estimated through Cronbach's alpha and ranged between 0.892 and 0.955, and strict invariance between men and women was achieved. The Online Learning Climate Scale (OLCS) is a valid and reliable measure for measuring the online learning climate within the Chilean higher education context so that it can be used both in research and in monitoring management programs in educational environments.

Development and validation of the physical effort scale (PES)

ObjectivesPrevious literature has primarily viewed physical effort as an aversive experience. However, recent research suggests that effort can also be valued positively. These differences in approach and avoidance tendencies toward physical effort may play a key role in the self-regulation of physical activity behaviors. The aim of this study was to develop a scale that measures these tendencies and contributes to a better understanding of physical effort and how it affects behavior. MethodsThe Physical Effort Scale (PES) was developed in Study 1 based on expert evaluations (n = 9) and cognitive interviews (n = 10). In Study 2 (n = 680, 69% female), content validity and dimensional structure were examined using principal component analysis and confirmatory factor analysis. Item reduction was conducted using item response theory. Preliminary construct validity was explored using regression. Study 3 (n = 297, 71% female) was used to validate dimensional structure, internal consistency, and construct validity, and to assess test-retest reliability. ResultsIn Study 1, 44 items were rated for content validity, of which 18 were selected and refined based on cognitive interviews. Analyses from Study 2 allowed reducing the scale to 8 items with a two-dimension structure: tendency to approach (n = 4) and to avoid physical effort (n = 4). The two subscales showed high internal consistency (α = 0.897 for the approach dimension and 0.913 for the avoidance dimension) and explained usual levels of physical activity, providing preliminary evidence of construct validity. Study 3 confirmed the two-dimension structure with high internal consistency (α = 0.907 and 0.916 for the approach and avoidance dimension, respectively) and revealed acceptable test-retest reliability (intraclass correlation >0.66). Patterns of associations with other constructs showed expected relationships, confirming the concurrent, convergent, and discriminant validity of the scale. ConclusionsThe PES is a valid and reliable measure of individual differences in the valuation of physical effort. This scale can assess the propensity to engage in physically demanding tasks in non-clinical populations. The PES and its manual are available in the Supplementary Material.

Rethinking the applicability domain analysis in QSAR models.

Notwithstanding the wide adoption of the OECD principles (or best practices) for QSAR modeling, disparities between in silico predictions and experimental results are frequent, suggesting that model predictions are often too optimistic. Of these OECD principles, the applicability domain (AD) estimation has been recognized in several reports in the literature to be one of the most challenging, implying that the actual reliability measures of model predictions are often unreliable. Applying tree-based error analysis workflows on 5 QSAR models reported in the literature and available in the QsarDB repository, i.e., androgen receptor bioactivity (agonists, antagonists, and binders, respectively) and membrane permeability (highest membrane permeability and the intrinsic permeability), we demonstrate that predictions erroneously tagged as reliable (AD prediction errors) overwhelmingly correspond to instances in subspaces (cohorts) with the highest prediction error rates, highlighting the inhomogeneity of the AD space. In this sense, we call for more stringent AD analysis guidelines which require the incorporation of model error analysis schemes, to provide critical insight on the reliability of underlying AD algorithms. Additionally, any selected AD method should be rigorously validated to demonstrate its suitability for the model space over which it is applied. These steps will ultimately contribute to more accurate estimations of the reliability of model predictions. Finally, error analysis may also be useful in "rational" model refinement in that data expansion efforts and model retraining are focused on cohorts with the highest error rates.

Probabilistic relative entropy in elasto‐plasticity using the iterative generalized stochastic stress‐based Finite Element Method

AbstractThe generalized iterative stochastic perturbation approach to the stress‐based Finite Element Method has been proposed in this work. This approach is completed using the complementary energy principle, Taylor expansion of the general order applicable to all random functions and parameters as well as nodal polynomial response bases determined with the use of the Least Squares Method. The main aim of this elaboration is the usage of such a probabilistic approach to determine Bhattacharyya relative entropy for some nonlinear engineering stress analysis with uncertainty. Mathematical apparatus with its numerical implementation has been used to study elastoplastic torsion of some prismatic bar with Gaussian material uncertainty and the corresponding reliability measures. This problem has been solved using the Constant Stress Triangular (CST) plane finite elements, the modified Newton–Raphson algorithm, whereas the first four probabilistic characteristics resulting from the iterative generalized stochastic perturbation method have been contrasted with these obtained with the crude Monte‐Carlo sampling and the semi‐analytical probabilistic approach.

Deep learning integrated Bayesian health indicator for cross-machine health monitoring

Constructing a good health indicator (HI) plays a key role in machinery health monitoring. However, due to the training dataset dependency, most conventional deep-learning-based HIs exhibit inconsistent HI scales and limited cross-domain applicability. This study proposes a deep learning integrated Bayesian health indicator (DBHI) to quantify and evaluate system health states in cross-domain applications accurately. The construction of the DBHI comprises two steps: probability space mapping and probabilistic inference. In the first step, the degradation features are extracted from the data and mapped into a probability space by the proposed adversarial autoencoder model. In the second step, the DBHI is calculated by evaluating the relative risk of the current state based on Bayes’ theorem. The effectiveness of the proposed DBHI was validated on two run-to-failure degradation test datasets. In a cross-domain application, the proposed DBHI achieved good performance without retraining compared to other deep learning-based methods that showed invalid results. The proposed DBHI addresses the limitations of conventional deep-learning-based HIs and provides a more reliable and consistent measure of system health, even in a cross-domain application.

Retinal Nerve Fiber Layer as The Preferred Objective Measure in Differentiating Pseudopapilledema with True Papilledema: A Systematic Review

Abstract&#x0D; Introduction &amp; Objectives : Distinguishing pseudopapilledema from true papilledema may generate confusion for some cases. Regardless of the subjective judgment on clinical examination alone, objective measurement for confirmation of diagnosis might be costly, operator-dependent, invasive, or not readily available. This study aims to evaluate whether retinal nerve fiber layer (RNFL) could be the reliable and efficient objective measure to ascertain the diagnosis.&#x0D; Methods : Literatures were obtained by comprehensive searching on PubMed, ProQuest, Google Scholar, and Cochrane between 2012 - 2023. Last search was March 26, 2023. Non-english study, animal study, review articles, case studies, and editorial letters were excluded. We included studies with available full-text containing both groups of papilledema and pseudopapilledema. The result was presented according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline.&#x0D; Results : A total of 615 participants were included from 8 different studies all comprising a group of papilledema and pseudopapilledema with or without optic disc drusen (ODD). Studies resulted in good accuracy on RNFL in differentiating pseudopapilledema with papilledema as the area under curve ranging from 0,78 to 0,91. However, specificity and sensitivity were varied between 65-100% and 33-91% respectively. Lower accuracy was found when pseudopapilledema only includes patients with ODD or papilledema was narrowed to mild papilledema.&#x0D; Conclusion : RNFL is a useful objective measure with favorable accuracy in differentiating pseudopapilledema with papilledema especially in acute settings or whenever operator-dependent examination is not obtainable

Development of the Valued Living Questionnaire – Comprehension Support version (VLQ-CS) and validation in adults with acquired brain injury

Purpose Valued living (acting in accordance with personal values) is associated with better outcomes after acquired brain injury (ABI), but its measurement using the Valued Living Questionnaire (VLQ) may not be valid due to comprehension errors relating to structure and content. We aimed to modify the VLQ to improve its accessibility and evaluate construct validity and reliability in an ABI cohort. Materials and methods Adaptations made in the VLQ – Comprehension Support version (VLQ-CS) used established communication support methods and addressed common comprehension errors. 103 community-dwelling participants (34% female; mean age 52.17, range 19–79) with ABI (66% stroke, 16% TBI, 18% other) completed the VLQ-CS, and measures of convergent (valued living, mood, wellbeing, psychological inflexibility) and divergent validity (subjective memory). Test-retest reliability was evaluated with repeated administrations 6–8 weeks apart for a subset of participants (n = 44), using Intraclass Correlation Coefficients (ICCs). Results Convergent validity was supported; VLQ-CS scores were positively correlated with measures of valued living (r=.60–.65) and wellbeing (r=.64–.67), and negatively correlated with depression (r=-0.56–.58), anxiety (r=-0.35–.38) and psychological inflexibility (r=-0.37–.41). Divergent validity was marginal (r=-0.29). Test-retest reliability was good for the VLQ-CS Composite score (ICC=.80). Conclusions The VLQ-CS shows promise as a valid, reliable measure of valued living post-ABI. Future research should extend to neurotypical and other clinical populations.

Problematic overstudying, Big Five personality, and music performance anxiety: associations with well-being and GPA

BackgroundProblematic overstudying is a compulsive and pathological overinvolvement in studying leading to harm and considerable functional impairments. It is conceptualized as “study addiction,” a precursor to work addiction. It has been investigated within the addictive behaviours framework in general populations of students for over a decade. A previous study analysed the problem among young musicians as a particularly vulnerable group. It found some important differences in potential personality risk factors among music academy students compared to general populations of students and showed an im-portant role of social anxiety. The current study aimed to validate these findings in a separate larger sample and extend them by investigating the role of music performance anxiety (MPA).Participants and procedureThe study was conducted among 213 students of music academies. Valid and reliable measures of study addiction, MPA, Big Five personality and well-being were used.ResultsThe results showed that MPA played a similar role as social anxiety in terms of being a predictor, mediator, and moderator of the main replicated effects supporting the hypothesised mechanisms regulating study addiction. However, extraversion was not associated with study addiction in multiple hierarchical regression analysis, but conscientiousness and neuroticism were. Study addiction was associated with indicators of decreased well-being, above and beyond MPA, and personality.ConclusionsThese results show that MPA plays an analogous role to social anxiety and that the role of Big Five personality in study addiction among young musicians requires further investigation due to inconsistent findings.

Digital health technologies and machine learning augment patient reported outcomes to remotely characterise rheumatoid arthritis

Digital measures of health status captured during daily life could greatly augment current in-clinic assessments for rheumatoid arthritis (RA), to enable better assessment of disease progression and impact. This work presents results from weaRAble-PRO, a 14-day observational study, which aimed to investigate how digital health technologies (DHT), such as smartphones and wearables, could augment patient reported outcomes (PRO) to determine RA status and severity in a study of 30 moderate-to-severe RA patients, compared to 30 matched healthy controls (HC). Sensor-based measures of health status, mobility, dexterity, fatigue, and other RA specific symptoms were extracted from daily iPhone guided tests (GT), as well as actigraphy and heart rate sensor data, which was passively recorded from patients’ Apple smartwatch continuously over the study duration. We subsequently developed a machine learning (ML) framework to distinguish RA status and to estimate RA severity. It was found that daily wearable sensor-outcomes robustly distinguished RA from HC participants (F1, 0.807). Furthermore, by day 7 of the study (half-way), a sufficient volume of data had been collected to reliably capture the characteristics of RA participants. In addition, we observed that the detection of RA severity levels could be improved by augmenting standard patient reported outcomes with sensor-based features (F1, 0.833) in comparison to using PRO assessments alone (F1, 0.759), and that the combination of modalities could reliability measure continuous RA severity, as determined by the clinician-assessed RAPID-3 score at baseline (r2, 0.692; RMSE, 1.33). The ability to measure the impact of the disease during daily life—through objective and remote digital outcomes—paves the way forward to enable the development of more patient-centric and personalised measurements for use in RA clinical trials.

Frequency and duration measurements of children’s outdoor free play: A Scoping review

Outdoor free play encompasses unstructured, self-directed play in the outdoors and has been shown to support children’s health and development. Accurate and reliable measures are required to conduct research on children’s outdoor free play and examine cross-sectional and longitudinal variation. This study systematically reviews and evaluates measurement approaches for children’s outdoor free play used in existing literature. A scoping review was conducted to identify English-language peer-reviewed and grey literature that included measurements of the occurrence, frequency or duration of outdoor free play with children aged 2 to 17 years old. Studies were excluded if the outdoor free play measure included structured settings or activities, or focused on a specific location or play activity. Quantitative and qualitative content analysis was used to consider outdoor free play terminology, definition, and operationalization; positioning in relation to other variables and the topic of interest; and data collection context. A total of 4,860 unique studies were identified. After screening and full-text review, 184 papers were taken forward for analysis. Parent-recall questionnaires were used in 70.1% of included studies to measure outdoor free play, often using a single question to capture the variable. A lack of differentiation between outdoor play emanating from structured and unstructured settings was common, as was limited consideration of contextual factors such as season, school or non-school days, and time of day. The implications of existing approaches to measuring children’s outdoor free play and the need for valid and reliable measures to further research examining children’s outdoor free play are discussed.

Adapting the Dietary Fat and Free Sugar Short Questionnaire: A Comprehensive Polish Modification for Enhanced Precision in Nutritional Assessments.

This study aimed to investigate whether The Dietary Fat and Free Sugar-Short Questionnaire (DFS) is a reliable and valid measure that can be used in Polish conditions. It involved 291 participants, aged 14 to 70 (M = 25.9, SD = 10.1), the majority of whom were women (75%). The questionnaire consisted of, among others, Polish DFS version, FFQ-6, TFEQ, and SCOFF. Test-retest reliability was established on the group of 26 students with a 2-week interval. Participants' percentage of energy intake from both free sugars and saturated fats based on FFQ was correlated with DFS total and subscales scores. To investigate convergent and divergent validity, DFS scores with TFEQ correlations were performed. Diagnostic validity was established based on difference analysis between groups with the risk of eating disorders and those without the risk of those based on SCOFF. Test-retest reliability (rtr = 0.856) and internal consistency (α = 0.797) indicated excellent reliability. DFS correlated significantly with FFQ for both total scores (r = 0.82) and each subscale: sugar (0.79), fat (0.75), and fat-sugar (0.59). The correlations of DFS and TFEQ were statistically significant for cognitive restraint (r = 0.32) and uncontrolled eating (r = 0.19). There also have been found significant differences based on SCOFF regarding DFS. The results suggest good reliability and validity of the Polish version of DFS.

Screening for Light Personalities in Portugal: A Cross-Cultural Validation of the Light Triad Scale With an At-risk-of-delinquency Sample

The Light Triad of personality refers to three prosocial personality traits—Faith in Humanity, Humanism, and Kantianism—that promote the worth and dignity of other people, focus on ethical behavior and empathy, and confidence that other people are naturally good. The aim of the present study is to examine the psychometric properties of the Light Triad Scale (LTS)—Portuguese version. Our convenience sample consisted of 242 male and female participants ( M = 30.19 years, SD = 12.78, range = 16–77) from Portugal. The proposed latent structure models of the LTS obtained adequate fits. Internal consistency/reliability, as measured by the alpha and omega coefficients, was adequate to good. Construct validity with other psychometric measures (i.e., empathy, dark traits of personality, propensity to morally disengage, and antisociality/criminality measures) and criterion-related validity (with justice involvement variables such as problems with the law, arrested by the police, sentenced to prison and alcohol/drug abuse variables) were demonstrated. Cross-gender measurement invariance was established, with females scoring higher than males. The findings support the use of the LTS as a valid and reliable measure.

Development and Psychometric Validation of the Breast Cancer Stigma Assessment Scale for Women with Breast Cancer and Its Survivors.

The increase in breast cancer cases and breast cancer survival makes it advisable to quantify the impact of the health-related stigma of this disease. To develop and validate a breast cancer stigma scale in Spanish. Women diagnosed with, or survivors of, breast cancer were included. The development of the Breast Cancer Stigma Assessment Scale (BCSAS) involved both a literature review and personal interviews. Content validity was assessed using a Delphi study and a pilot test; construct validity was evaluated using an exploratory factor analysis; and convergent validity was assessed using six scales. Cronbach's α internal consistency and test-retest reliability were used to determine the reliability of the scales. 231 women responded to the 28-item scale. The BCSAS showed good reliability, with α = 0.897. Seven factors emerged: concealment (α = 0.765), disturbance (α = 0.772), internalized stigma (α = 0.750), aesthetics (α = 0.779), course (α = 0.599), danger (α = 0.502), and origin (α = 0.350). The test-retest reliability was 0.830 (p < 0.001). Significant correlation was observed with event centrality (r = 0.701), anxiety-depression (r = 0.668), shame (r = 0.645), guilt (r = 0.524), and quality of life (r = -0.545). The BCSAS is a reliable and valid measure of stigma in women with breast cancer and its survivors. It could be useful for detecting stigma risk and establishing psychotherapeutic and care priorities.

HRM practices in the public service: a measurement model

Purpose Considering the significant increase in researchers’ interest in human resource management (HRM) in the public sector domain, this study aims to focus on producing a scale of HRM practices customized for the context of public organizations. Design/methodology/approach Experts and semantic analysis were performed for the scale development (qualitative stage), and exploratory and confirmatory factor analysis through structural equation modeling was conducted for the scale validation (quantitative stage). Findings The public HRM practices scale (public HRMPS) is composed of 19 items, distributed along four factors/dimensions, named training, development and education; relationship; work conditions; and competency and performance appraisal. The scale showed evidence of internal and construct validity (convergent, divergent, criterion-related and discriminant), as well as reliability and content validity. Research limitations/implications The public HRMPS can be applied in relational studies to test structural models of prediction, mediation and moderation to evaluate relationships with organizational behavior variables, such as leader-members exchange, engagement at work, life quality at work and well-being at work, among others. Practical implications The public HRMPS may also serve as a useful diagnostic tool for the decision-making process made by public managers so they can promote a strategic, evidence-based HRM. Furthermore, the transforming role of strategic HRM can be operationalized by adopting practices gathered in the public HRMPS, advancing toward new HRM strategies to promote healthier and more productive work environments. Social implications Healthier and more productive environments translate into real impacts for society, the first beneficiary of public services with more quality, efficiency and accountability. Originality/value The public HRMPS is the first attempt to produce an operationally valid and reliable measure to evaluate strategic HRM practices, responding to calls in the literature concerning the need for an integrated, comprehensive and customized HRM practices scale for the public service context.