Root Mean Square Error Of Approximation Research Articles

Menstrual Practice Needs Scale short form (MPNS-SF) and rapid (MPNS-R): development in Khulna, Bangladesh, and validation in cross-sectional surveys from Bangladesh and Uganda

ObjectivesDevelop and validate short and rapid forms of the 36-item Menstrual Practice Needs Scale (MPNS-36).DesignItem reduction prioritised content validity and was informed by cognitive interviews with schoolgirls in Bangladesh, performance...

Identifying neurofunctional domains across substance use disorders

ABSTRACT Background: Substance use disorders (SUDs) are heterogeneous across multiple functional domains. Various frameworks posit that domains (e.g., executive function) contribute to the persistence of SUDs; however, the domains identified in different studies vary. Objectives: We used factor analysis to identify the underlying latent domains present in a large sample (N = 5,244, 55.8% male) with a variety of SUDs to yield findings more generalizable than studies with a narrower focus. Method: Participants (1,384 controls and 3,860 participants with one or more SUDs including alcohol, cocaine, cannabis, and/or opioid use disorders) completed the Semi-Structured Assessment for Drug Dependence and Alcoholism, the NEO Personality Inventory, and the Wisconsin Card Sorting Test. Exploratory factor analysis (EFA) and fit indices (root mean-squared error of approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI)) were used to examine different latent variable models. A multiple indicators, multiple causes (MIMIC) approach-tested associations of the latent variables with sociodemographics, substance use, and a history of abuse/neglect. Results: A six-factor model (predominant alcohol, predominant cocaine, predominant opioid, externalizing, personality, and executive function) provided the best fit [RMSEA = 0.063 (90% CI 0.060, 0.066), CFI = 0.98, TLI = 0.96]. All factors were moderately correlated (coefficient = 0.25–0.55, p < .05) with the exception of executive function. MIMIC analysis revealed different patterns of associations (all p < .0001) with sociodemographics, substance use, and a history of abuse/neglect among the factors. Conclusions: The domains identified, particularly executive function, were parallel to those observed previously. These factors underscore the heterogeneous nature of SUDs and may be useful in developing more targeted clinical interventions.

Developing an Emotional Labor Scale for Employees in the Service Industry

Purpose: This research aims to develop an emotional labor scale and examine the consistency of the emotional labor measurement model with empirical data. The study focuses on individuals with long-term work experience and incorporates cross-cultural perspectives to address gaps in current research. Additionally, it seeks to create a standardized model for measuring and evaluating emotional labor that is applicable to contemporary work environments. Methodology: The population is front-service employees of hotels in Chonburi Province, and the sample consists of 280 front-service employees of hotels in Pattaya City, Chonburi Province. The research methodology for developing the emotional labor scale in this phase is quantitative research, using confirmatory factor analysis to examine the consistency of the emotional labor measurement model. Findings: The results of the model fit analysis and quality assessment of the CFA model found that the RMSEA (Root Mean Square Error of Approximation) was 0.217, indicating a lack of fit between the model and data. The CFI (Comparative Fit Index) was 0.591. The TLI (Tucker-Lewis Index) was 0.442. Finally, the IFI (Incremental Fit Index) was 0.595. Based on the presented indices, this model has a poor fit with the data. The RMSEA, CFI, TLI, and IFI values are lower than the recommended criteria, indicating a discrepancy between the model and data. Unique Contribution to Theory, Policy and Practice: These findings suggest that current emotional labor measurement models may not accurately capture the experiences of workers across different cultures and with varying lengths of work experience. Policymakers and organizations should consider developing more nuanced and culturally sensitive approaches to assess and manage emotional labor in the workplace. This could involve creating tailored training programs, revising performance evaluation metrics, and implementing supportive policies that acknowledge the complexity of emotional labor across diverse work environments.

Validation of Kannada Version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS).

Preoperative anxiety is a complex and subjective phenomenon, most commonly observed in patients posted for elective surgery. The Amsterdam Preoperative Anxiety Information Scale (APAIS) has been widely used in preoperative settings to measure anxiety quickly. This study aimed to translate the APAIS into Kannada and to evaluate its psychometric properties. The study involved forward and backward translation of APAIS into Kannada followed by a cognitive interview of 10 patients by clinical psychologist to confirm the correct translation. The translated version was then administered to 240 patients who were posted for elective surgery along with the Visual Analogue Scale for Anxiety (VAS-A). Reliability and internal consistency were assessed by calculating Cronbach's alpha. Construct validity was assessed by principal component analysis and confirmatory factor analysis. Criteria validity was assessed by evaluating the correlation between APAIS and VAS-A. The Kannada-translated version of APAIS was completed by 224 patients posted for elective surgery. Cronbach's alpha was 0.82 and 0.83 for anxiety and need for information items, respectively. Root mean square error of approximation (RMSEA), comparative fit index (CFI),and Tucker-Lewis index (TLI) were 0.07, 0.98, and 0.96, respectively, for three-factor model, indicating it to be best fit for Kannada version of APAIS. The Kannada version of APAIS is a valid and reliable tool for measuring preoperative anxiety in patients undergoing elective surgery.

Development and its reliability and validity of the Knowledge, Attitude and Practice Scale for Informal Caregivers of Pressure Injury Patients.

There is a lack of scientifically validated tools to measure the knowledge attitude and practice (KAP) of informal caregivers for patients with pressure injury (PI). This study aims to develop a KAP Scale for Informal Caregivers of PI Patients and to evaluate its reliability and validity. Based on the KAP theory framework and relevant literature, an initial pool of items was created through expert brainstorming sessions. The initial scale was formed after a Delphi expert consultation and a preliminary survey. From April to October 2023, a convenient sample of informal caregivers for PI patients was recruited from an inpatient department of the Third Xiangya Hospital of Central South University, as well as its associated community and nursing homes. The first round included 186 participants, and the second round included 213 participants, who were used for item analysis and reliability and validity testing. After a 3-week interval, 20 participants from the initial group were randomly selected for a retest to assess the test-retest reliability of the scale. The KAP Scale for informal caregivers of PI patients consists of 3 dimensions with 19 items. The overall internal consistency (Cronbach's α) of the scale was 0.916. The item-level content validity index (I-CVI) ranged from 0.826 to 1.000, and the scale level-content validity index/average (S-CVI/Ave) was 0.94. Exploratory factor analysis extracted 3 common factors, accounting for 64.643% of the total variance. Confirmatory factor analysis showed that the model fit the data well, with χ2/df=2.54, root mean square error of approximation (RMSEA)=0.085, comparative fit index (CFI)=0.920, and standardized root mean square residual (SRMR)=0.059. The KAP scale for informal caregivers of PI patients demonstrates good reliability and validity and can be used to assess the KAP levels of informal caregivers regarding PI.

A model of the organizational resilience of hospitals in emergencies and disasters

BackgroundIn the health system, hospitals are intricate establishments that offer vital medical services. Their resilience plays a crucial role in mitigating the societal repercussions of disasters. A hospital must possess the capacity to withstand risks, preserve its fundamental structure and operations, and enhance its preparedness by augmenting various capabilities and promptly recovering from the impacts of potential risks. It enables the hospital to attain a heightened level of readiness. Therefore, this study aimed to develop a resilience model tailored for hospitals to navigate crises and disasters effectively.MethodsThis mixed-method study was conducted in 2023 in three phases: (1) Identification of the factors influencing the organizational resilience of the hospital, (2) Evaluation of the influential factors by an expert panel. (3) Following the standardization process, we administered 371 questionnaires to individuals, such as university staff managers and supervisors, nursing managers, and research unit managers. The sample size was determined by multiplying the components by 10, resulting in 360 (10 * 36). Therefore, we selected a sample size of 371 participants. Structural Equation Modeling (SEM) was employed to examine the causal relationships between variables. These steps were performed using SPSS 25.0 and AMOS 22 software. Finally, we identified and presented the final model. We utilized AMOS 22 and applied the SEM to assess the correlation between the variables, with a significance level of 0.05.ResultsFindings indicate that the appropriate modeling identified five dimensions comprising 36 components. These dimensions include vulnerability, preparedness, support management, responsiveness and adaptability, and recovery after the disaster. The model demonstrates a good fit, as indicated by the X2/d indices with a value of 2.202, a goodness of fit index (GFI) of 0.832, a root mean square error of estimation (RMSEA) of 0.057, an adjusted comparative fit index (CFI) of 0.931, and a smoothed fit index (NFI) of 0.901.ConclusionEnhancing hospital resilience is crucial for effective preparedness and response to accidents and disasters. Developing a localized tool for measuring resilience can help identify vulnerabilities, ensure service continuity, and inform rehabilitation programs. The proposed model is a suitable framework for assessing hospital resilience. Key factors include human resource scarcity, hospital specialization, and trauma center capacity. Hospitals should prioritize efficient resource allocation, information technology infrastructure, in-service training, waste management, and a proactive organizational framework to build resilience. By adopting this approach, hospitals can better respond to crises and disasters, ultimately reducing casualties and improving overall preparedness.

We need to change how we compute RMSEA for nested model comparisons in structural equation modeling.

Comparison of nested models is common in applications of structural equation modeling (SEM). When two models are nested, model comparison can be done via a chi-square difference test or by comparing indices of approximate fit. The advantage of fit indices is that they permit some amount of misspecification in the additional constraints imposed on the model, which is a more realistic scenario. The most popular index of approximate fit is the root mean square error of approximation (RMSEA). In this article, we argue that the dominant way of comparing RMSEA values for two nested models, which is simply taking their difference, is problematic and will often mask misfit, particularly in model comparisons with large initial degrees of freedom. We instead advocate computing the RMSEA associated with the chi-square difference test, which we call RMSEAD. We are not the first to propose this index, and we review numerous methodological articles that have suggested it. Nonetheless, these articles appear to have had little impact on actual practice. The modification of current practice that we call for may be particularly needed in the context of measurement invariance assessment. We illustrate the difference between the current approach and our advocated approach on three examples, where two involve multiple-group and longitudinal measurement invariance assessment and the third involves comparisons of models with different numbers of factors. We conclude with a discussion of recommendations and future research directions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychometric properties of a questionnaire on medical students’ satisfaction with a community health program

Changes in the learning modes during the recent COVID-19 pandemic has provided a need to construct a feedback questionnaire to measure medical students’ satisfaction with community-based health programs. A total of 551 forms which has a 5-point Likert scale were submitted by the medical students upon concluding the public health program in 2018-2021 (which includes face-to-face and virtual learning). Reliability coefficients were estimated for each factor (domain) with values &amp;gt;0.70. Exploratory factor analysis (EFA) was used to assess the validity of the instrument, using principal components analysis with varimax rotation. EFA identified two factors; the first included 6 items (67.031%) of the total variance, the second explained 4 items (10.114%) and together explained 77.15%. root mean squared error of approximation (RMSEA): 0.074; normed fit index (NFI): 0.975; comparative fit index (CFI): 0.981; incremental fit index (IFI): 0.981; goodness of fit index (GFI): 0.956; Tucker Lewis index (TLI): 0.972. The overall students’ satisfaction had a Cronbach’s alpha test of 0.945 with a 95% confidence interval (0.938-0.952), and a reliability using Guttman Split-Half for overall was 0.894. Students’ satisfaction questionnaire with the public health program has a good reliability and validity in contrasting educational situations and it is worthwhile to include as part of the quality improvement.

Adaptation and validation of the children’s cognitive triad inventory for Indonesian students

Depression causes student learning problems. Depressive symptoms are influenced by automatic thoughts that contain a negative cognitive triad. A valid and reliable instrument to measure the cognitive triad in adolescents is essential to identify one of the risk factors for depressive disorders in adolescents. At the same time, Indonesia has no instrument to measure this. This study aims to adapt the children’s cognitive triad inventory (CTI-C) into an Indonesian version and to examine its psychometric properties. Data were collected from 1,184 students aged 13-19 (mean=15.32, SD=1.62) using the 36-item CTI-C. The CTI-C instrument adaptation process refers to the international test commission (ITC). The results of confirmatory factor analysis (CFA) showed comparative fit index (CFI)=0.95, Tucker-Lewis’s index (TLI)=0.94, root mean square error of approximation (RMSEA)=0.071, standardized root mean square residual (SRMR)=0.056, and goodness of fit index (GFI)=0.82, with a load factor range of 0.43-0.80 for the view of self, 0.43-0.68 for the view of the world, and 0.37-0.70 for the view of the future. The Cronbach’s alpha coefficient ranged from 0.81 to 0.84 for the subscales and 0.93 for the total score. Thus, the Indonesian version of the CTI-C can measure the cognitive triad in Indonesian students aged 13-19.

A causal model of eating behaviors among Thai pregnant women working in industrial factories

Abstract Objective This study aimed to examine the causal model of eating behaviors among pregnant women working in industrial factories. Methods This cross-sectional study was conducted on 210 participants, attending 4 healthcare centers, at a tertiary care hospital in Chonburi province, Thailand. Data were collected using 7 questionnaires: demographic form, eating behavior questionnaire, perceived benefits of the healthy eating questionnaire, perceived barriers to the healthy eating questionnaire, perceived self-efficacy questionnaire, social support questionnaire, and accessibility to healthy foods questionnaire. Descriptive statistics and path analysis were used for data analysis. Results The participants had relatively high mean scores for eating behaviors. The final model fitted well with the data χ2 = 12.86, df = 10, P = 0.23; χ2/df = 1.29; comparative fit index (CFI) = 0.98; goodness-of-fit index (GFI) = 0.98; adjusted goodness-of-fit index (AGFI) = 0.95; root mean square error of approximation (RMSEA) = 0.04. Four factors—perceived benefits (β = 0.13, P &lt; 0.05), perceived self-efficacy in healthy eating (β = 0.22, P &lt; 0.001), pregnancy planning (β = 0.28, P &lt; 0.001), and accessibility to healthy foods in the factory (β = 0.12, P &lt; 0.05)—positively affected eating behavior, while only perceived barriers to healthy eating had a negative effect on eating behavior (β = −0.24, P &lt; 0.001). All the above factors explained 27.2% of the variance in eating behaviors. Conclusions Nurses or healthcare providers can apply these findings to create an eating behavior modification program, focusing on pregnancy planning, behavior-specific variables, and interpersonal and situational influence, to promote the nutritional status of pregnant women working in industrial factories.

Development of a scale examining post-disaster coping motivations in Turkey after the 6 February earthquake.

The aim of this study was to develop the Motivations for Coping After Disaster Scale. To test the construct validity of the scale, a total of 676 data were collected from three different sampling groups (N1: 388; N2: 194; N3: 94). Exploratory Factor Analysis, Confirmatory Factor Analysis (CFA) and Criterion validity analysis were conducted to test the construct validity of the scale. As a result of CFA, it was seen that the post-disaster scale had a five-dimensional structure (spiritual values, hope, friend support, solidarity, family support). The loadings of the items of the scale are at a good level. As a result of CFA, the scale was found to have acceptable and good fit indices (χ2/sd=2.690; RMSEA (Root Mean Square Error of Approximation)=0.066; SRMR (Standardized Root Mean Square Residual)=0.047; CFI (Comparative Fit Index)=0.948; GFI (Goodness of Fit Index)=0.917). The results of the criterion validity analysis show that the scale has criterion validity. Cronbach Alpha internal consistency coefficient shows that the scale is highly reliable (Total=0.923). The results of this study show that the Post-Disaster Coping Motivations Scale is a valid and reliable instrument. It is thought that the scale can make an important contribution to understanding psychological recovery processes after disaster and providing appropriate support to individuals.

TENDINopathy Severity assessment–Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations

ObjectiveTo evaluate the construct validity (structural validity and hypothesis testing), reliability (test–retest reliability, measurement error and internal consistency) and minimal important change (MIC) of the 13-item TENDINopathy Severity assessment–Achilles (TENDINS-A).MethodsParticipants...

Core Competencies for Gerontogeriatric Nursing: A Validation Study.

As the aging population grows, facing multifaceted health challenges and escalating care costs, equipping newly graduated nurses with the requisite skills for high-quality gerontogeriatric care becomes crucial. This study assesses the psychometric properties of a Gerontogeriatric Competency (GGC) scale to evaluate the competencies of newly graduated registered nurses (RNs). Using a convenience sampling approach, a nationwide, observational prospective cohort study was conducted among 272 newly graduated RNs. The evaluation framework included a sociodemographic questionnaire, three groups of questions targeting gerontogeriatric nursing education aspects, and the GGC scale, with 64 competencies. Construct validity (via confirmatory factor analysis), known-group validity and reliability (assessed by Cronbach's α) were examined. The confirmatory factor analysis (CFA) showed an adequate index fit: the ratio of chi-square to degrees of freedom (χ2/df) = 2.785, the goodness-of-fit index (GFI) = 0.579, confirmatory fit index (CFI) = 0.864, the parsimony goodness-of-fit index (PGFI) = 0.526, the parsimony confirmatory-of-fit index (PCFI) = 0.809, the root mean square error of approximation (RMSEA) = 0.087, and the modified expected cross-validation index (MECVI) = 24.418. Differences were observed in gerontogeriatric competencies based on curriculum inclusion, self-confidence, knowledge in caring for older adults, and satisfaction with the nursing program content. The Cronbach's α coefficient was 0.992 for the overall scale and ranged from 0.935 to 0.983 for the GGC dimensions. The GGC scale is a valid and reliable tool for assessing the gerontogeriatric competencies of new graduate RNs, highlighting its potential to enhance education, training, and, ultimately, the quality of care provided to the older population.

Investigating Structural Model Fit Evaluation

A full structural equation model (SEM) typically consists of both a measurement model (describing relationships between latent variables and observed scale items) and a structural model (describing relationships among latent variables). However, often researchers are primarily interested in testing hypotheses related to the structural model while treating the measurement model as a necessary but not primary focus of the overall model. In this case, researchers often wish to isolate and just evaluate the fit of the structural model. In our research, we examine a two-stage approach that can compute the chi-square statistic and fit indices for evaluating only the fit of the structural model in a full SEM. We call these the structural chi-square statistic and structural fit indices. For structural fit indices, we focused on the root mean square error of approximation (RMSEA), comparative fit index (CFI), and standardized root mean square residual (SRMR). We developed several new versions of the structural chi-square statistic, structural fit indices, and confidence intervals (CIs) of the structural fit indices. Through a simulation study, we demonstrated that several versions of our newly developed structural chi-square statistic yielded the nominal Type-I error rate; and the same versions of the structural fit indices exhibited low bias and their corresponding CIs had high coverage rates. Therefore, we recommend researchers use these versions of the structural chi-square test of fit alongside the structural fit indices when evaluating the fit of the structural model.

Psychometric properties of the Persian version of the Engaged teachers Scale (ETS)

Background & AimTeacher engagement can be defined as the teachers’ effort and attention to teaching professional tasks, adequate emotions and commitment to relationships with students and colleagues in classroom and school. The Engaged Teacher Scale (ETS) is the frequently used scale, measuring teacher engagement developed by Klassen et al., 2013 in the UK, and consists of four dimensions: cognitive engagement (CE), emotional engagement (EE), social engagement with students (SES), and social engagement with colleagues (SEC). Therefore, the aim of this study was to measure the psychometric properties of the Persian version of the Engaged Teachers Scale (ETS).Materials & methodsA total of 123 teachers who worked at Shahid Beheshti University of Medical Sciences, Tehran, Iran, were included in this study. The study participants were selected using the convenience sampling. The Persian version of a 16-item scale developed by Klassen et al. was validated by this study. Face and Content validity index and reliability were assessed after translation and cultural adaptation, and also construct validity was calculated by confirmatory factor analysis using the PLS22.ResultsOf the 123 study participants, 74 (60.01%) were females and 49 (39.9%) were males. The mean age of the subjects was about 30–40 years. The majority of the study participants were general practitioners (n = 75; 60.9%) and others were from different specialists. Content validity among 15 experts was 0.88. Confirmatory factor analysis for all 16 items loaded across four factors, and this four-factor scale showed a good fit in the Iranian community. Reliability using Cronbach’s alpha was 0.79. The value of root mean square error of approximation (RMSEA) was 0.0094 with the 99% confidence interval, and also the goodness of fit index GFI value was 0.98.ConclusionThe Persian version of ETS had good validity and reliability in Iran and could be a useful tool for measuring the teacher engagement factors of faculty members that can be used by teachers and educational administrators.

EGame-flow: psychometric properties of the scale in the Mexican context

PurposeThe present study examined the psychometric properties of the EGame- flow scale in a Mexican sample, presenting evidence of construct validity (exploratory factor analysis and confirmatory factor analysis), reliability (Cronbach’s alpha and McDonald’s omega) and discriminant validity (mean variance extracted).Design/methodology/approachParticipants: Of the 255 Mexican participants in the non-probabilistic sample who had previously interacted with the LOST logistics simulator, 166 (65%) were men and 89 (35%) were women; their ages ranged from 22 to 45. The statistical packages SPSS 25, JASP 0.16 and AMOS 23 facilitated the corresponding analyses. First, we calculated the means and standard deviations of the scale items. Next, we performed an exploratory factor analysis to examine the measurement model’s internal structure and a confirmatory factor analysis to confirm the structure proposed in the exploratory factor analysis. To analyze the internal structure of the measurement model so that the estimates were not affected by multivariate normality problems, we utilized the AMOS bootstrap method (with 500 repetitions, 95% CI), the maximum likelihood (MV) estimation method, and the fit indices: X2, p (chi-square and associated likelihood), Tucker–Lewis index (TLI), standardized statistical mean square residual (SRMR), comparative fit index (CFI) and root mean Square error approximation (RMSEA) with its confidence interval, the values of X2 with p &lt; 0.001; TLI, CFI, AGFI = 0.95; RMSEA and SRMR = 0.08 (Byrne, 2016). Finally, we estimated the reliability of the measurement model with Cronbach’s alpha (a), McDonald’s omega (ω) coefficient and the mean variance extracted (VME).FindingsAn exploratory factor analysis with the MV method and obliminal rotation showed a good fit of the data to the model, which aligns with the significance of the Barlette sphericity test (X2 = 8443.2, p &lt; 0.000) and the Kaiser–Meyer-Olkin (KMO) value of 0.94. The indices confirmed the fit of the data to the six-dimensional model for measuring the users' level of enjoyment of online games (X2 = 678.2 gl = 411, p = 0.000; SRMR = 0.05; TLI = 0.95, CFI = 0.95 and RMSEA = 0.05, IC 90% [0.04, 0.05]).Research limitations/implicationsThe self-reporting format of the scale increases the social desirability of the responses, but the sample only collects information from a specific geographic location, so these findings cannot extrapolate to populations with very marked cultural differences. Finally, the study did not measure other validity evidence, such as predictive and concurrent validity, which should be considered in future studies.Practical implicationsFrom a practical perspective, the study offers a measurement scale with fewer items and robust psychometric evidence that ensures the fit of the data to the EGame-flow measurement scale. Further research must continue to learn about the behavior of the EGame-flow scale in different samples that new evidence of psychometric properties continues to appear and that other factors associated with the users' gaming enjoyment experience are analyzed.Originality/valueThe value and originality of the study lie in the type of evidence of psychometric properties that the instrument has and particularly in the style of sample in which the study is carried out, in this case, in the context of Mexico, where there are not enough instruments that measure the flow experience of users.

Resilience as a Modulating Factor of Empathy in Medical Students

Resilience as a Modulating Factor of Empathy in Medical Students

Confirmatory factor analysis of the Tinnitus Impact Questionnaire using data from patients seeking help for tinnitus alone or tinnitus combined with hyperacusis.

A confirmatory factor analysis (CFA) of the Tinnitus Impact Questionnaire (TIQ) was performed. In contrast to commonly used tinnitus questionnaires, the TIQ is intended solely to assess the impact of tinnitus by not including items related to hearing loss or tinnitus loudness. This was a psychometric study based on a retrospective cross-sectional analysis of clinical data. Data were available for 155 new patients who had attended a tinnitus and hyperacusis clinic in the UK within a five-month period and had completed the TIQ. The mean age was 54 years (standard deviation = 14 years). The TIQ demonstrated good internal consistency, with Cronbach's α = 0.84 and McDonald's ω = 0.89. CFA showed that two items of the TIQ had low factor loadings for both one-factor and two-factor models and their scores showed low correlations with scores for other items. Bi-factor analysis gave a better fit, indicated by a relative chi-square (χ2) of 18.5, a Root-Mean Square Error of Approximation (RMSEA) of 0.103, a Comparative Fit Index (CFI) of 0.97, a Tucker Lewis Index (TLI) of 0.92, and a Standardized Root-Mean Residual (SPMR) of 0.038. Total TIQ scores were moderately correlated with scores for the Visual Analogue Scale of effect of tinnitus on life and the Screening for Anxiety and Depression-Tinnitus questionnaire, supporting the convergent validity of the TIQ. The TIQ score was not correlated with the pure-tone average hearing threshold, indicating discriminant validity. A multiple-causes multiple-indicator (MIMIC) model showed no influences of age, gender or hearing status on TIQ item scores. The TIQ is an internally consistent tool. CFA suggests a bi-factor model with sufficient unidimensionality to support the use of the overall TIQ score for assessing the impact of tinnitus. TIQ scores are distinct from the impact of hearing impairment among patients who have tinnitus combined with hearing loss.

Attachment and negative affect on mental health and pain experience patients with Multiple Sclerosis: Mediated by coping strategies and loneliness

BackgroundMultiple sclerosis and its related stressors significantly affect the mental health of people with MS. Considering the progressive and relapsing-remitting nature of the disease and somatic complaint, the Pain experience for MS patients is challenging. We examined the direct effects of Attachment and the negative affect on mental health and pain experience and the indirect effects of Attachment, negative affect, loneliness, and coping strategies on the mental health and pain experience of people with multiple sclerosis. MethodsThree hundred forty-five patients with MS were selected through the Iranian MS Association. Measures included the negative affect (PANAS), Adult Attachment Inventory (AAI), General Health Questionnaire (GHQ28), short-form McGill pain questionnaire (SF-mpq-2), Social and emotional loneliness scale for adults (SELSA-S), Coping Inventory for Stressful Situations(CISS-21). The present study has employed the Structural Equation Model (SEM) to investigate the direct and indirect effects of coping strategies, attachment, loneliness, and negative affect on mental health and pain experienced by individuals with MS. The fit of the model to the data was examined using the Discrepancy Function Divided by Degrees of Freedom (CMIN/DF), Normed Fit Index (NFI), TuckerLewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA). ResultsThe fit indices results showed that the model's fit was good. Furthermore, findings indicate that 13 % (R2=13) of the pain experience Changes and 47 % (R2=47) of the mental health Changes are explained via study predictors. Negative affect directly affects mental health and pain experience, and Attachment directly affects mental health. Negative affect indirectly affects coping strategies. Attachment and Negative affect indirectly affect loneliness. Loneliness and coping strategies indirectly affect mental health and pain experience. ConclusionStudy findings contribute to our understanding of the crucial structures that play a role in the mental health and pain experience of individuals with MS. Loneliness and coping strategies as mediating variables play essential roles in these people's mental health and pain experience. In the times ahead, it would be beneficial to prioritize addressing negative affect, attachment, coping strategies, and loneliness in the patients with MS' medical and psychological intervention.

Development and initial testing of a brief, generic self-reported disability questionnaire: The Universal Disability Index.

Disability is an important multifaceted construct. A brief, generic self-reported disability questionnaire that promises a broader and more comparable measure of disability than disease-specific instruments does not currently exist. The aim of this study was to develop and evaluate such a questionnaire: the Universal Disability Index (UDI). An online survey was used to collect general population data. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency and discriminant validity were also assessed. Bootstrapping was used to evaluate model stability and generalisability. 403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α > 0.90), were strongly correlated (Pearson's r > 0.7) with both GARS and GCPS disability scores, indicating concurrent validity, and could accurately discriminate between upper and lower quartiles of these comparators. Confidence intervals of estimates were narrow, suggesting model stability and generalisability. A brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted.