Internal Consistency Reliability Research Articles

Psychometric Measurements of the Adherence to Refills and Medication Scales Among Patients With HIV/AIDS in Indonesia

ObjectiveThis study aimed to conduct a psychometric evaluation of the Adherence to Refills and Medications Scale (ARMS) among patients with HIV/AIDS in Indonesia. MethodsPsychometric analysis was conducted at 2 hospitals and 7 public health centers at the voluntary counseling and testing clinic. Content validity was measured by assessing the relevance and clarity of each ARMS item. Construct validity was also assessed. Reliability was evaluated using internal consistency and test-retest reliability. ResultsThis study involved 11 experts in the assessment of the content validity and 240 participants in the estimation of the construct validity. All ARMS items were generally considered easy to understand and relevant, with scale-level content validity index based on the average method (S-CVI/Ave) of 0.9 (>0.78) and item-level content validity index (I-CVI) in the range from 0.5 to 1 for the relevance level and S-CVI/Ave of 0.95 (>0.78) and I-CVI in the range from 0.8 to 1 for the clarity level. Two items (numbers 2 and 3) were revised based on experts’ suggestions to enhance comprehension. Confirmatory factor analysis supported 2 subscales: adherence to taking medications and adherence to refilling prescriptions. Good reliability was supported by internal consistency (Cronbach’s α 0.793) and test-retest reliability (intraclass correlation coefficient 0.722) for the overall adherence score. ConclusionsThe Indonesian version of ARMS is a valid and reliable medication adherence scale when used in Indonesian patients with HIV/AIDS.

Shared decision-making in long-term care: A systematic review of assessment instruments

This systematic review explored the instruments used to measure Shared Decision Making (SDM) within long-term care (LTC) settings. Relevant publications from the period between January 2000 and October 2022 were searched across five databases. Thirty-six SDM assessment instruments were identified, which encompassed those measuring SDM for LTC recipients/family caregivers and/or healthcare providers. These instruments were either specifically tailored for LTC settings or more broadly applicable across healthcare contexts, including LTC. In terms of psychometric properties of the instruments, internal consistency reliability, content validity, structural validity, and hypothesis testing were commonly tested. The findings of this research can aid health researchers, managers, and scholars in choosing suitable instruments for assessing SDM in specific LTC scenarios, considering factors such as measurement scope, assessment methods, and instrument reliability. Additionally, these findings offer valuable insights for the future development of high-quality SDM assessment instruments in LTC field.

Development of a tool to assess the compliance of canteen menus with the Mediterranean Diet

Abstract The Mediterranean Diet (MD) is one of the healthiest food patterns associated with important health benefits. Acknowledging this, it’s important to understand how the dietary patterns of the consumers align with the MD. Over time, different authors have formulated several indexes for this purpose. However, current indexes lack standardization, and they only evaluate the quality of the diet of individuals to be used by health professionals and political decision-makers. Although there are indexes to assess the food options at the restaurants, none of them assess the menu compliance with the MD. Due to the importance of the food services in the food choices and dietary patterns of the consumers, this research developed an index to assess the alignment of the food availability with the MD key points. To address this gap, after reviewing the existing indexes in the literature, the authors created a tool that assesses the degree of compliance of menus with the MD - MedCIn. This index is divided into 4 dimensions, the first one assesses the availability (part A) and variety (part B) of the food/food groups. The second dimension assesses the nutritional quality of the menus based on the nutritional declaration, the third dimension assesses the food portions and culinary options, and the fourth dimension allows the verification of the previous information on site. Although the use of all dimensions allows for a more comprehensive menu evaluation, dimension one can be used as a first approach MD compliance. The index is meant to be applied in a 4-week cycle, though it can be adapted for each food service. Validation of this tool included construct validity, internal consistency and inter-rater reliability, all of which returned high values (alpha-Cronbach=0.88; Coheńs Kappa=0.92). The researchers consider this a reliable tool to easily assess compliance of menus with MD key points, allowing for the identification of issues to be addressed and improved

Wellbeing, career satisfaction, and educational requirements in healthcare assistants in Ireland

Abstract Background The long-term residential care (LTRC) sector in Ireland relies heavily on Health Care Assistants and Carers (HCAs). This workforce has become increasingly diverse in recent years, often relying on non-national temporary workers with varying levels of education. In 2022, of 22,495 HCAs and 5,289 Healthcare Support Assistants working in 563 nursing homes caring for some 30,000 residents, 22% were non-national. Their plight became evident during COVID-19 which had profound consequences in the LTRC sector. Objectives In this study, we investigate the recruitment, training, employment terms and conditions of HCAs in Ireland, as well as their general well-being and career satisfaction. Methods A cross-sectional study of members of ‘Care Assistance Ireland’, for which ethics approval was granted for an estimated sample of 1,052, is conducted. Validated instruments used are: the Maastricht Instrument for Sustainable Employability (MAISE); Utrecht Work Engagement Scale (UWES); General Wellbeing Schedule (GWBS) and Minnesota Career Satisfaction Survey (MCSS). Results The internal consistency reliability (Cronbach’s alpha) of GWBS and MCSS instruments were high. The response rate in the selected sample is estimated circa 60%, the majority being female and qualified. General well-being status will be investigated once all responses are submitted. Spearman correlation is predicated to show moderate to strong positive correlations (0.2-0.9) for all GWBS and MCSS questionnaires questions. While MAISE and UWES are still under investigation. It is predicted that there is variability in the requirements for, and terms and conditions of, employment among HCAs in Ireland, while job security remains a concern. Conclusions These findings reinforce the importance of ensuring standards for recruitment, training, job security and well-being for the LRTC workforce. The lack of educational requirements for HCAs in some settings is a critical consideration. Key messages • Findings will impel a more agreeable, consistent entry award in the healthcare system. • It profiles career needs of HCAs outlining the long-term shortfalls preventable with health policy enactments.

Reliability, reproducibility, and feasibility of youth activity profile (YAP) questionnaire in Chilean children and adolescents

ABSTRACT This study aimed to evaluate the reliability, reproducibility, and feasibility of the Youth Activity Profile Questionnaire (YAP-SL) in the Chilean version (YAP-C) in a sample of children and adolescents. This cross-sectional study included 160 youth, 59 children (5–11 years old), and 101 adolescents (12–17 years old) from the city of Viña del Mar (Chile). The YAP-SL is a 15-item self-report instrument which was administered twice at an interval of 7 days apart. This questionnaire was designed to capture physical activity (PA) and sedentary behaviour in youths in the last week, categorizing them into three domains: PA at school, PA out-of-school, and sedentary habits. Cronbach’s α coefficients were calculated to evaluate the internal consistency (reliability), and the reproducibility was determined by test-retest and Kendall’s tau b coefficients. Concerning the total YAP-C score, results indicated moderate-to-high reliability in the total sample (0.71), boys (0.76) and girls (0.66), as well as for children (0.73) and adolescents (0.70). The results also revealed variations in reliability and reproducibility across the three domains. In conclusion, the YAP-SL questionnaire presents moderate-to-high reliability in Chilean children and adolescents. However, the reliability and consistency of the YAP varied across the domains.

Development and validation of a measure for father involvement during early childhood in a resource-limited context

BackgroundGlobally, there is mounting evidence about the importance of father involvement for improving child and family wellbeing. However, there are limited measurement tools available for assessing father involvement in low-resource settings globally. The objective of this study was to develop and validate a scale for measuring fathers’ engagement in caregiving activities for young children and families in rural Kenya.MethodsWe used baseline data collected in February–March 2023 from a cluster-randomized controlled trial of a parenting intervention aimed at improving early child development in Nyamira and Vihiga counties in Western Kenya. The analytic sample comprised 460 primary caregivers of children under 18 months of age (91.3% mothers) who were in a relationship with a male caregiver of the young child (i.e., father). The primary caregiver reported on the 25-item father involvement scale. We conducted exploratory and confirmatory factor analyses to determine the dimensionality of the measure and estimated latent variable regression models to assess construct and predictive validity in terms of associations with sociodemographic factors, other paternal and maternal psychosocial measures, and early child development outcomes.ResultsThe scale had a four-factor structure representing father involvement in (1) childcare activities, (2) play and affection, (3) household chores, and (4) early learning activities. Each factor showed good internal consistency reliability and evidence of multiple forms of validity. The four factors were associated with child and household sociodemographic characteristics and more positive paternal and maternal psychosocial outcomes. Father involvement across all four domains was associated with higher early child cognitive, language, motor, and socioemotional development scores.ConclusionsOur findings highlight the multidimensional nature of fathers’ caregiving roles in the lives of young children and their families. We establish a valid tool for assessing father involvement in rural Western Kenya that has potential for use in other similar contexts.

Tests employed in the psychometric validation of the Insulin Treatment Appraisal Scale (ITAS) in T2DM patients; a systematic review of the literature

BackgroundPsychological Insulin Resistance (PIR) and negative perceptions regarding insulin treatment are noteworthy challenges in T2DM management, which hinder the timely initiation of insulin treatment. To get past these obstacles a reliable tool is required to evaluate patients’ perspectives on insulin administration. Our study aims to conduct a comprehensive systematic review to evaluate the validity and reliability of different validation tests used in the psychometric validation of the ITAS in T2DM patients.MethodsA literature search was carried out, using PubMed, Google Scholar, EMBASE, Cochrane Library and Science Direct. Only those studies assessing content validity, construct validity, concurrent validity, discriminant validity, internal consistency reliability (Cronbach’ α), and items-total correlation were retrieved.ResultsA total of 14 studies illustrated the validity and reliability of ITAS in T2DM patients. Content validity results of S-CVI was 0.97, and I-CVI was 0.8–1.00. Construct validity with factor loading was greater than the threshold value of 0.3. The concurrent validity of ITAS vs. PAID, WHO-5, and SPI was 0.35 (P < 0.05), −0.14 (P < 0.05), and 0.80 (P < 0.001) respectively. The mean difference between insulin and non-insulin group was significant (P < 0.001) showing reliable discriminant validity. Reported results of Cronbach’s α for the main scale (0.79–0.89), subscale-1 (0.72–0.9), and subscale-2 (0.61–0.89) showed “good to excellent” internal consistency reliability of ITAS. Item-total correlation results for the main scale, subscale-1, and subscale-2 were (0.40–0.82), (0.31–0.74) and (0.34–0.58) respectively. Test-retest reliability of ITAS was 0.571–0.87.ConclusionsStudy findings confirm the robustness of various validation tests utilized in the psychometric validation of ITAS in T2DM patients. ITAS is a well-validated and reliable tool for determining the perspectives, PIR, and changes in patients’ perception over time and it can be used to overcome hurdles in the timely initiation of insulin treatment in T2DM patients.

Psychometric Properties of the Credibility/Expectancy Questionnaire in Individuals with Opioid Use Disorder

ABSTRACT Credibility and expectancy are important aspects of therapy/treatment processes. We aimed to perform cross-cultural validation and examine the psychometric properties of the Credibility/Expectancy Questionnaire (CEQ). Ninety-one patients with opioid use disorder from Tobacco, Alcohol, and Drug Addiction Treatment Program were included in the study. Sociodemographic data form, CEQ, Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), and Attitudes Toward Seeking Psychological Professional Help Scale-Short Form (ATSPPHS-SF) were filled out by participants. Confirmatory factor analyses showed that CEQ has two factors in our sample, similar to the original version. Reliability analyses showed that CEQ has a high internal consistency and test-retest reliability. Regarding convergent validity results, CEQ was correlated with ATSPPHS-SF. No significant correlation was found between CEQ and BDI and STAI regarding discriminant validity results. In conclusion, the Turkish version of CEQ is a valid, reliable scale and could be used in patients with opioid use disorder. In patients with opioid use disorder, we contributed to the addiction literature by adapting a short and effective survey that measures trust and expectation.

The Perspectives of Community Pharmacists Toward the Name-Based Rationing System During the COVID-19 Pandemic in Taiwan: Cross-Sectional Survey Study.

In Taiwan's public health system, community-based pharmacists are key first-line health care providers due to their high accessibility. During the COVID-19 pandemic, the pharmacists played a central role in the distribution of these supplies through the Name-Based Rationing System (NBRS), during an acute shortage of masks and testing kits, that helped reduce the spread of the disease. The NBRS, an innovative government-guided strategy developed after the COVID-19 outbreak, provided equitable and convenient access to masks and COVID-19 test kits. This study aimed to investigate (1) Taiwanese pharmacists' knowledge, attitude, and practices (KAPs) of COVID-19, with the intention to assess their preparedness for public health emergencies and their capabilities to implement COVID-19-related policies effectively; (2) their perspectives toward the NBRS; and (3) the association between individual's KAP and corresponding perspectives toward the NBRS. A cross-sectional, web-based survey was conducted in 2 major cities in Taiwan, from June 18 to September 11, 2022, during the peak of the COVID-19 pandemic. To gauge community pharmacists' KAP, a 66-question instrument was developed using guidelines from the Taiwanese Centers for Disease Control, the International Pharmaceutical Federation, and the Taiwanese Pharmacist Association. The instrument's internal consistency reliability was ascertained using Cronbach α (0.819), and its content validity was verified by field experts. Overall, 343 Taiwanese community pharmacists were recruited in the study. Among them, 88% (303/343) scored high on knowledge domain questions related to SARS-CoV-2; 58% (201/343) and 39% (136/343) held positive and neutral attitudes toward COVID-19-related policies, respectively; and 77% (266/343) practiced infectious disease prevention measures in compliance with official guidelines. The results demonstrated a high level of competency in pharmacists in a public health crisis. It revealed that factors including age, pharmacy characteristics, and the number of customers were associated with their perceptions and willingness to continuously participate in the NBRS. Overall, the community pharmacists showed greater support for the COVID-19-testing NBRS compared with the mask NBRS, because of the more favorable influence on the revenue and workforce of the pharmacies and the well-being of the pharmacists. Responses also highlighted concerns about rapid government policy changes and supply dynamics, underscoring the importance of effective communication and considering supply availability in facilitating a successful NBRS. The strong KAP of the community pharmacists justified the government leveraging their expertise in Taiwan's COVID-19 response. While community pharmacies have proven to be essential distribution centers through the NBRS, improving community connections, communication with the government, and supply management are recommended to strengthen the system. These potential approaches aim to ensure successful NBRS implementation and better preparedness for future public health emergencies. Overall, pharmacists have demonstrated their integral role in achieving equitable outcomes and their dedication to public health efforts during crises.

Chinese Version of the Nonverbal Pain Assessment Tool: Critical Patient Reliability and Validity.

To translate and validate the Nonverbal Pain Assessment Tool. Timely assessment of the pain degree of nonverbal intensive care unit (ICU) patients can provide humanistic care. However, there is a lack of pain assessment tools that can meet the needs of patients who cannot use language in ICUs in China. A cross-sectional survey. We conducted forward-backward translation of the Nonverbal Pain Assessment Tool. A total of 300 critically ill patients in the intensive care unit who could not communicate verbally completed the Chinese version of the Nonverbal Pain Assessment Tool and the Critical Care Pain Observation Tool. Exploratory and confirmatory factor analyses were performed to verify structural validity, and content validity and reliability analyses were also conducted. The Nonverbal Pain Assessment Tool demonstrated high internal consistency (α = 0.901) and interrater reliability (intraclass correlation coefficient = 0.981), with good split-half reliability. Content validity was established through acceptable item-level content validity index and scale-level content validity index scores. Exploratory factor analysis showed a single factor explaining 71.79% of total variance, and confirmatory factor analysis confirmed good model fit. The Spearman rank correlation coefficient was 0.917 between the Nonverbal Pain Assessment Tool and the Critical Care Pain Observation Tool. The Chinese Nonverbal Pain Assessment Tool demonstrated significant differences in scores between different states of consciousness and illness severity, supporting its known-groups validity. The Chinese version of the Nonverbal Pain Assessment Tool is a reliable and valid tool for nonverbal pain assessment in ICU patients in China. The Chinese version of the Nonverbal Pain Assessment Tool can assess the pain of patients who cannot use language in ICU, which provides a new valuable assessment tool for Chinese clinicians and nurses in pain assessment and management. Our study followed the STROBE Checklists. Patients actively cooperated and participated in data collection during the implementation of the study.

A Study on the Reliability and Validity of the Social Media Leadership Scale in Education Organizations Sample

Purpose: In this study, it is aimed to develop a Likert-type scale that can measure the status of managers and employees working in organizations in the context of social media leadership in a sample of educational organizations. Design/Methodology/Approach: The study was conducted on teachers working in schools affiliated with the Ministry of National Education during the 2022–2023 academic year. Expert opinions were sought to ensure the construct validity of the scale. The content validity rates of the items were determined, and the content validity index of the scale was calculated as 0.88. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted to test the validity of the scale. KMO and Bartlett tests were used to determine the suitability of the obtained data for factor analysis. The EFA revealed that the scale had a 5-factor structure, which was then confirmed by the CFA. The CFA results were supported by acceptable and excellent fit values. The conformity and validity of the scale and the correlation between the factors were calculated. The internal consistency reliability coefficient was used to determine the reliability of the scale. After the aforementioned procedures, the Social Media Leadership Scale (SMLLS) was developed. The SMLLS consists of 24 items with 5 factors: guidance, innovation, ethical principles, sensitivity, and awareness. The lowest score on the scale is 24, and the highest score is 120. Findings: The SMLS is a measurement tool developed to determine the leadership levels of social media users. The findings regarding the validity and reliability of the scale indicate that it has sufficient psychometric properties to determine the leadership levels of social media users. Highlights: This scale can be used to assess the current status of teachers and administrators working at various levels within educational institutions in the context of social media leadership.

Psychometric properties of the Chinese version of the nurses’ attitudes towards communication with the patient scale among Chinese nurses

BackgroundNurses’ attitudes towards communication with patients influence the effectiveness of communication, which could reduce patients’ negative emotions and improve their adherence to medication and treatment. The aim of this study was to develop a Chinese version of the nurses’ attitudes towards communication with the patient (ACO) scale and examined its validity and reliability.MethodsThe Chinese version ACO scale was generated using the translation-backward translation method and cross-cultural adaption.The psychometric properties of the scale, including item-to-total correlations, discriminative validity, content validity, structural validity, convergent validity, internal consistency reliability and test-retest reliability, were evaluated. Data were collected from a convenience sample of 610 clinical nurses from four hospitals and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis.ResultThe reliability was demonstrated with item-to-total correlations of greater than 0.40, Cronbach’s alpha of 0.946 and intraclass correlation coefficients of 0.879. Content validity was acceptable and discriminative validity showed a significant discriminative ability. Exploratory and confirmatory factor analyses revealed a three-factor model. Convergent validity was confirmed by a moderate relation with a measure for nurses’ empathy (r = 0.375, P<0.01).The test-retest reliability was satisfactory within a 2-week interval.ConclusionThe ACO is a reliable and valid instrument to assess nurses’ attitudes towards communication with patient in Chinese hospitals.

Cultural adaptation, validity and reliability of the Turkish version of north star ambulatory assessment.

The North Star Ambulatory Assessment (NSAA) is a functional motor outcome measure originally developed for patients with Duchenne muscular dystrophy (DMD). The aim of this study was to perform the cultural adaptation and investigate the validity and reliability of the Turkish version of the NSAA (T-NSAA) in DMD. After translation process, internal consistency, interrater and test-retest reliability of the NSAA were determined by using the Cronbach Alpha Coefficient and Intraclass Correlation Coefficient (ICC), respectively. Absolute reliability was determined by using the Standard Error of Measurement (SEM) with minimal detectable change at 95% limits of confidence (MDC95). Lower limb functionality of children was evaluated by Vignos Lower Extremity Scale (VLERS). To establish convergent validity, the correlations between T-NSAA and Motor Function Measure (MFM-32), 6-minute walk test (6-MWT), and VLERS were analyzed by using the Spearman's correlation coefficient. The study was completed with 86 patients with DMD whose age were mean 104.56 ± 24.66 months. The internal consistency (Cronbach's α = 0.94), intra-reliability (ICC = 0.977) and inter-reliability (ICC = 0.972) of T-NSAA were excellent. SEM and MDC values were low indicating satisfactory absolute agreement (< %10). The T-NSAA had strong correlations with the MFM-total score, 6-MWT, and VLERS (p < 0.01). T-NSAA is a valid and reliable tool to assess ambulatory status of Turkish-speaking DMD population. NCT05549999, Date of registration: September 19, 2022.

Redefining the impact of professional development in education with ProDES (Professional Development Evaluation Scale)

This study introduces the Professional Development Evaluation Scale (ProDES), a tool that has been developed to evaluate the impact of professional development as it relates to participants' Learning and Use of New Knowledge and Skills, Organisational Support, Student Learning Outcomes, and reactions. Grounded in Guskey’s (2000) framework for evaluating Professional Development, ProDES was developed with data from five study groups in Turkey and underwent refinement across four factors. Exploratory and Confirmatory Factor Analyses confirmed the scale's structure, accounting for 62.72% of the total variance, with robust fit indices. Within this, ProDES demonstrated high internal consistency and test-retest reliability, with significant correlations validating its effectiveness. The scale's high internal consistency and test-retest reliability ensure that it can be used to make evidence-informed decisions that can foster more effective and supportive professional development activities. As a result, by identifying which professional development initiatives lead to improvements, those associated with professional development can use resources more efficiently, leading to enhanced school and system-wide improvements. Moreover, the use of ProDES can also help schools and education systems track progress over time, making ProDES an invaluable tool for continuous improvement and strategic planning.

Development and Validation of a Patient-Reported Outcome Measure of the Impact of Chronic Hand Eczema on Health-Related Quality of Life: the Hand Eczema Impact Scale (HEIS).

Chronic Hand Eczema (CHE) is an inflammatory skin disease that causes significant impact on health-related quality of life (HRQoL). The Hand Eczema Impact Scale (HEIS) is a new patient-reported outcome(PRO) measure designed to assess the impact of CHE on key domains of HRQoL. This study aimed to develop and evaluate content and psychometric validity of the HEIS. The HEIS was initially developed on the basis of a literature review and concept elicitation interviews. Qualitative cognitive debriefing interviews (n = 20) were conducted with patients with CHE to assess relevance and understanding of items, response options, and recall period. Psychometric properties (item performance, dimensionality, reliability, validity, responsiveness, and estimation of meaningful change thresholds) were then assessed using data (n = 258) from a phase 2b trial (NCT03683719). Cognitive debriefing confirmed all items were understood and relevant to patients. Inter-item correlations (all > 0.50) and confirmatory factor analysis (factor loadings ≥ 0.80) supported unidimensionality of the HEIS score, and mostly provided support for the HEIS Proximal Daily Activity Limitations (PDAL) score, with only one item loading below the prespecified threshold. Item properties and previous qualitative work supported retaining this item in the total score but removed from the HEIS PDAL domain. Internal consistency (Cronbach's alpha ≥ 0.89) and test-retest reliability (intra-class correlation coefficient ≥ 0.79) results were very strong. Strong correlations with concurrent measures (0.66-0.87) and significant differences between severity groups (p < 0.001) supported construct validity. Large effect sizes for mean change scores in participants that improved and significant differences between groups indicated ability to detect change. Anchor-based analyses supported within-individual responder definitions of ≥ 1.3 points for improvements in both HEIS score and HEIS PDAL score (covering three items) and of ≥ 1.5 points for HEIS embarrassment with the appearance of hands (Emb) score (covering two items). The 9-item HEIS is the first CHE-specific PROmeasure developed and validated according to regulatory guidance for assessment of the impact of CHE on key domains of HRQoL. This article provides evidence of strong content and psychometric validity and shows improvements of ≥ 1.3 points in HEIS score and HEIS PDAL score, and improvements of ≥ 1.5 points in HEIS Emb score represent clinically meaningful, important changes. NCT03683719.

Predicting language, cognition, and social skills in individuals with Autism spectrum disorder using the Arabic validation of Gilliam Autism Rating scale-Third Edition

The Gilliam Autism Rating Scale-Third Edition (GARS-3) has emerged as a pivotal instrument in the diagnostic assessment of Autism Spectrum Disorder (ASD), with its utility extending across linguistic and cultural boundaries. This study endeavors to adapt and validate the GARS-3 for the Arabic-speaking population, addressing the paucity of culturally congruent diagnostic tools in the Arab world. The primary objective is to validate the Arabic version of GARS-3 (A-GARS-3) to assess children with and without ASD, ensuring the scale’s reliability and validity within the target population. A methodical cross-sectional study design was employed, encompassing a sample of 178 participants from both educational and clinical settings in Saudi Arabia. The process involved direct translation, expert panel review, back-translation, and pilot testing to ensure semantic equivalence and cultural relevance. Data were collected using the A-GARS-3, and analyses included Exploratory and Confirmatory Factor Analysis (EFA and CFA), internal consistency reliability measures, and a One-Way Analysis of Variance (ANOVA) to establish concurrent validity. The A-GARS-3 demonstrated high internal consistency (Cronbach’s alpha = 0.971; McDonald’s omega = 0.972) and strong construct validity, with factor loadings and model fit indices substantiating the factor structure. Predictive validity was confirmed through significant correlations between the Autism Index and the subscales, particularly in the domains of social interaction and communication. The A-GARS-3 is a psychometrically sound instrument that offers reliable assessment for ASD within the Arab cultural context. The positive validation outcomes indicate that the scale is an effective, culturally adapted tool for the localized diagnosis of ASD. The validated scale has significant implications for enhancing ASD screening and diagnostic practices in Arabic-speaking regions, potentially improving early diagnosis and intervention strategies.

Translation and Validation of the Diabetes Knowledge Questionnaire in Indonesian Patients With Type 2 Diabetes.

The purpose of the study was to translate and cross-culturally adapt the 24-item Diabetes Knowledge Questionnaire (DKQ) for Indonesian patients with type 2 diabetes (T2D) and evaluate its psychometric properties. Forward-backward translation, adaptation involving 7 experts, and pretesting to develop the Indonesian version of DKQ were conducted. Psychometric analysis was carried out among T2D patients from 40 primary health care centers in Indonesia. Known-group, convergent and discriminant validity, internal consistency and test-retest reliability were assessed. Additionally, a descriptive item analysis was conducted. In total, 39 patients participated in the pretesting and 304 patients in the validation process and descriptive analysis. Of the 24 items, 2 were adjusted during the adaptation process, and 1 item was deleted because it did not adequately reflect the original item. Known-group validity was demonstrated because patients with younger ages, higher educational levels, and longer diabetes duration had significantly higher DKQ scores. Convergent validity was demonstrated by a significant positive correlation of the DKQ scores with overall treatment satisfaction. The 23-item DKQ Bahasa Indonesia showed satisfactory internal consistency (Cronbach's α = 0.73; omega total = 0.72) and good test-retest reliability (intraclass correlation coefficient = 0.87 in a sample of 27 patients). No floor and ceiling effects were found in the item analysis. The study demonstrates adequate validity and reliability of the 23-item DKQ Bahasa Indonesia for assessing diabetes knowledge in Indonesian primary care patients with T2D. This instrument can be used to identify room for improvement and develop diabetes education programs.

Validity, test-retest reliability, and responsiveness of the Indonesian version of FACIT-COST measure for subjective financial toxicity.

Financial toxicity describes the impairment of financial wellbeing in patients due to the burden of cancer diagnosis and care. The COST: A Functional Assessment of Chronic Illness Therapy Measure of Financial Toxicity (FACIT-COST) is the most widely used cancer-specific measure of subjective financial toxicity, having been validated in multiple languages, but not in Indonesian. This study aimed to validate the Indonesian version of FACIT-COST in a breast cancer sample. A single-center prospective cohort study was performed in Indonesia. Female breast cancer patients aged ≥ 18 undergoing treatment at baseline were invited to participate and followed for up to six months. The survey included the official Indonesian version of FACIT-COST (v2) which was administered to the patients by interviewers. Clinical information (e.g., metastasis status, disease duration) was provided based on medical records. The following measurement properties of FACIT-COST were tested: distributional characteristics, structural validity (principal component [PCA] and confirmatory factor analyses [CFA]), internal consistency reliability (Cronbach's alpha and McDonald's omega), known-groups validity (Mann-Whitney U or Kruskal-Wallis H test), test-retest reliability, and responsiveness to change. Overall, 300 female patients participated at baseline. No patients reported the best or worst possible FACIT-COST total scores. The PCA proposed a two-factor model structure for the instrument, which was confirmed by the CFA (RMSEA = 0.042, SRMR = 0.049, CFI = 0.99, TLI = 0.99). The internal consistency reliability of the two factors was considered adequate (Cronbach's alpha = 0.774-0.882, McDonald's omega = 0.786-0.888). The FACIT-COST total score significantly discriminated across the following known-groups: age, education, residential setting, income, employment, metastasis status, number of symptoms, and financial coping strategies. The FACIT-COST demonstrated excellent test-retest reliability (intraclass correlation coefficient = 0.96) and satisfactory responsiveness to change (standardized response mean and effect size ranges=|0.39| to |0.92|). This is the first study to validate the FACIT-COST in patients with breast cancer and to present the measurement properties of the Indonesian version of FACIT-COST. The Indonesian FACIT-COST demonstrates acceptable psychometric performance and shows potential as a valid measure of subjective financial toxicity. The instrument may serve as a valuable tool for informing health policies that focus on providing resource support to improve cancer care in Indonesia.

Evaluation of Lifestyle for Women with Breast Cancer

Introduction: Breast cancer is a significant global health concern, affecting millions of women worldwide. While advancements in diagnosis and treatment have improved survival rates, the impact of this disease extends beyond physical health. It also significantly influences a woman's lifestyle and overall well-being. Objectives: The current study intends to analyze the lifestyle of breast cancer patients who are receiving therapy or are being followed up at the Oncology Teaching Hospital in Medical City, Baghdad, Iraq. Method: The present study uses a descriptive design with an application of an evaluation approach. A convenience sample of 100 women with breast cancer was selected from the Teaching Oncology Hospital at the Medical City in Baghdad City, Iraq. The study's objectives are served by a questionnaire. Physical, role, emotional, cognitive, and social functioning are its five functional domains. These domains are evaluated as low, moderate and high. Each study participant received a questionnaire explaining how to complete it, along with a form requesting their approval to remain anonymous. They also had the opportunity to leave the study at any time without being provided an explanation. A panel of (10) experts determines the questionnaire's content validity, and its internal consistency reliability is calculated via the split-half method with a Cronbach’s alpha correlation coefficient of (r=0.92). Data are collected using the study questionnaire, and they are then analyzed via a descriptive statistical data analysis approach on the basis of frequency and percentage. Results: The study revealed that the majority of these women experienced sleep issues, but most of them experienced problems with body weight gain (70%), social and community activity (70%), sexuality (60%), stress (60%), diet (56%), physical activity (50%) and smoking (45%), and some of them took birth control pills and used hormone replacement therapy (43%). Conclusion: This study revealed that women with breast cancer have experienced a variety of lifestyle domain-associated problems. These problems are clearly manifested in the results of this study.

Cross-cultural adaptation and reliability of the inventory of vicarious posttraumatic growth and research of its influencing factors: a cross-sectional study

ObjectiveThe purpose of this study was to translate the Vicarious Posttraumatic Growth Inventory (VPTGI) into Chinese and to assess its reliability and validity in Nurses, Additionally, it explored the correlations between vicarious posttraumatic growth (VPTG), Secondary Traumatic Stress (STS) and demographic variables.MethodsThe Brislin translation model was used to translate the VPTGI into Chinese. Validity analysis involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent validity, discriminant validity, and content validity. Reliability analysis included split-half reliability, internal consistency reliability, and test-retest reliability. Item analysis employed the Critical Ratio Decision Value (CR) method, item-total correlation method, and reliability change method. Single-factor analysis was conducted to examine the relationship between demographic variables and VPTG, while correlation analysis explored the association between STS and VPTG.ResultsThe Chinese version VPTGI demonstrated robust content validity (I-CVI: 0.83-1, S-CVI: 0.97), supported by EFA (KMO: 0.933) and significant Bartlett’s test (p < 0.001). Four factors explained 67.82% variance, CFA confirmed the model fit (χ2/df = 2.255, RMSEA = 0.079, IFI = 0.931, TLI = 0.914, CFI = 0.930, NFI = 0.882). The Chinese version VPTGI demonstrated high internal consistency (Cronbach’s α = 0.951), with dimensions’ Cronbach’s α ranging from 0.806 to 0.912. Overall, nurses demonstrated a moderate to low level of VPTG and a severe level of STS. Furthermore, there was a significant negative correlation between STS and VPTG.ConclusionThe Chinese version of VPTGI demonstrated satisfactory reliability, validity, and factor structure, making it a reliable tool to assess VPTG in Chinese nurses. These findings underscore the importance of promoting VPTG and addressing STS among healthcare professionals. Further research in this area is warranted to better understand and support the psychological well-being of nurses.