Root Mean Square Error Of Approximation Research Articles

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 >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.

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 < 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 < 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

Introduction: Empathy is a complex and multidimensional attribute. Attempts have been made to explain empathic behavior based on other variables. Empirical evidence shows that empathy could be the product of the influence of several factors. One of these factors could be resilience. There is still no developed theory and consistent empirical evidence demonstrating that empathy depends on resilience. Objective: The aim of this study is to determine if resilience can predict empathic behavior. Methodology: This study is non-experimental and ex post facto with a cross-sectional design. Variables. Dependent: Empathy; Independent: Resilience. Population: Medical students belonging to the Faculty of Health Sciences of the Universidad Autónoma de Santa Ana (UNASA), Santa Ana, El Salvador (N=579). The sample (n=465) consisted of students (both sexes). Convenience sampling. Jefferson Scale of Empathy for Healthcare Professionals, student version (JSE-HPS). Trait Resilience Scale (EEA). A Structural Equation Modelling (SEM) model was used. Additionally, the Comparative Fit Index (CFI) (>0.95), Tucker-Lewis Index (TLI) (>0.95), Root Mean Square Error of Approximation (RMSEA) (<0.08), and Standardized Root Mean Square (SRMR) (<0.08), Confirmatory Factor Analysis (CFA) were employed. The significance level employed was ? < 0.05. Results: All these results show that both measurement models (empathy and resilience) are adequately represented and are suitable for the structural model. Discussion: Individual resilience is a variable that can predict empathic behavior in medical students belonging to a Faculty of Health Sciences. The results constitute indirect empirical evidence that it is possible to define empathy as a dependent variable and resilience as an independent variable.

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.

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.

A Chinese version of the infertility self-efficacy scale: Reliability and validity assessment

ObjectiveTo translate, cross-culturally adapt and test the reliability and validity of a Chinese version of the Infertility Self-Efficacy scale. MethodsThe Infertility Self-Efficacy (ISE) scale was translated into Chinese using forward and backward translations, expert consultation, cognitive interviews and a pilot study. To test the scale's reliability and validity, 515 infertile women in two hospitals were recruited to evaluate the Chinese version of the scale. Content validity was assessed by means of expert consultation. Exploratory factor and confirmatory factor analyses were performed using SPSS 26.0 and Amos 24.0. Reliability tests of the scale included Cronbach's alpha coefficient, split-half reliability and test-retest reliability. ResultsThe Chinese version of the ISE scale contains 16 items and one dimension. Content validity of the scale was 0.96. Results of exploratory factor analysis suggested that the one factor model was suitable for the scale, and factor loading of all items was greater than 0.4. Model fitting parameters of confirmatory factor analysis of the ISE scale were χ2/df = 2.710, Root Mean Square Error Approximation (RMSEA) = 0.079, Standardized Root Mean Square Residual (SRMR) = 0.042, Comparative Fit Index (CFI) = 0.953, and Tucker–Lewis Index (TLI) = 0.939. Cronbach's alpha coefficient of the Chinese ISE was 0.980; split-half coefficient was 0.972 and retest reliability was 0.848 (P < 0.01). ConclusionThe Chinese ISE scale is a reliable and valid instrument to evaluate the self-efficacy of infertile Chinese women.

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.

TRADITIONAL AND COMPLEMENTARY MEDICINE BELIEFS INVENTORY IN ADULTS: A METHODOLOGICAL STUDY

Aims: This study was conducted to establish the Turkish validity and reliability of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI) used to measure adults' beliefs about complementary and alternative medicine practices. Methods: The study was designed as a methodological study. The population of the study consisted of individuals receiving services from a family health center in Ankara. The sample consisted of 354 individuals who agreed to participate in the study and met the inclusion criteria. Descriptive statistics (number, percentage, mean, standard deviation, minimum, and maximum) of the data obtained in the study were calculated. Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted to test validity. The reliability of the scale was assessed through item-total correlation, item analysis, Cronbach α, and test-retest correlation. Results: The results of the Exploratory Factor Analysis revealed that there is only one factor with an eigenvalue above 1, explaining 73.11% of the total variance. Additionally, fit indices obtained from the results of the Confirmatory Factor Analysis yielded a χ2/df fit index of 3.214, a Root Mean Square Error of Approximation (RMSEA) of 0.079, a Comparative Fit Index (CFI) of 0.901, and an Adjusted Goodness-of-Fit Index (AGFI) of 0.854. The Cronbach’s α value of the scale in our study was 0.97. Conclusion: The adapted Turkish version of the 16-item scale has been determined to be a measurement tool that adheres to validity and reliability criteria. It serves as an assessment instrument usable by healthcare professionals to evaluate adult individuals' beliefs regarding complementary and alternative medicine (CAM) methods.

Psychometric properties of the Thai Qualifications Framework for Higher Education instrument among Royal Thai Air Force nurse stakeholders.

The Thai Qualifications Framework for Higher Education (TQF: HEd) serves as a framework to enhance the quality of higher education in Thailand. However, no valid and reliable TQF: HEd instrument is available to measure the quality of graduates among Royal Thai Air Force Nurses. This study aimed to assess the psychometric properties of the TQF: HEd instrument among graduate nurses of the Royal Thai Air Force. Psychometric testing of the instrument was conducted. The instrument's validity was evaluated through a review by a panel of five experts, providing a content validity index (CVI). Construct validity was assessed using Confirmatory Factor Analysis (CFA) with a sample size of 308, and Cronbach's α coefficient was utilized to measure the scale's internal consistency. The Scale-Content Validity Index (S-CVI) was 0.88. CFA yielded the following fit indices: χ2 = 265.861, p = 0.068, df = 233, χ2/df ratio = 1.141, Comparative fit index (CFI) = 0.996, Tucker Lewis Index (TLI) = 0.993, Root Mean Square Error of Approximation (RMSEA) = 0.021, and Standardized Root Mean Square Residual (SRMR) = 0.033. The scale reliability was acceptable, with a Cronbach's alpha coefficient of 0.93 and 0.85-0.92 for the six factors. The TQF: HEd instrument demonstrates satisfactory psychometric properties, which will be valuable for those in charge of the curriculum in utilizing the instrument to measure graduate competency and guide curriculum development.

Psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool

BackgroundHypertension is prevalent in China. Hypertensive patients suffer from many health problems in life. Hypertension is a common chronic disease with long-term and lifelong characteristics. In the long run, the existence of chronic diseases will affect the patient’s own health beliefs. However, people’s health beliefs about Hypertension are not explicit. Therefore, it is vital to find a suitable instrument to comprehend and improve the health beliefs of hypertensive patients, thus, better control of blood pressure and improvement of patient’s quality of life are now crucial issues. This study aimed to translate the Hypertension Belief Assessment Tool (HBAT) into Chinese and examine the psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool in hypertensive patients.MethodsThis is a cross-sectional study. We translated the HBAT into Chinese and tested the reliability and validity of the Chinese version among 325 hypertensive patients.ResultsThe Chinese version of the scale contains 21 items. The Exploratory Factor Analysis (EFA) revealed six factors and explained 77.898% of the total variation. A six-factor model eventually showed acceptable fit indices in the Confirmatory Factor Analysis (CFA). With modified Confirmatory Factor Analysis, the fit indices were Chi-square/Degree of Freedom (CMIN/DF) = 2.491, Comparative Fit Index (CFI) = 0.952, Incremental Fit Index (IFI) = 0.952, Root-mean-square Error of Approximation (RMSEA) = 0.068, Tucker Lewis Index (TLI) = 0.941. The HBAT exhibits high internal consistency reliability (0.803), and the scale has good discriminant validity.ConclusionThe results suggest that the HBAT is a reliable and valid instrument for assessing the beliefs of Chinese hypertensive patients.

Evaluating the Psychometric Properties of the Sexual and Gender Minority Adverse Childhood Experiences Scale Among Sexual Minority Men and Women.

Adverse childhood experiences (ACEs) are known determinants of negative health outcomes. Sexual and gender minority (SGM) individuals have higher ACE scores than non-SGM individuals. The SGM-ACE scale was developed to better assess this population but is not yet validated in SGM subgroups. This study aims to validate the sexual and gender minority adverse childhood experiences (SGM-ACE) scale among sexual minority men (SMM) and sexual minority women (SMW), while testing measurement invariance across both groups. A cross-sectional survey included 530 sexual minority adults (265 men, 265 women) in the United States. Cronbach's alpha established internal consistency reliability. Validity was assessed via confirmatory factor analysis (CFA) for the SGM-ACE's theoretical structure and Pearson's correlations for concurrent validity with substance use outcomes (alcohol, cannabis, and drugs). Multigroup structural equation modeling (SEM) determined measurement invariance between SMM and SMW. The CFA of the original model exhibited good fit. Fit was improved after removing the institutionalization item, chi-square (χ2) = 14.26, degrees of freedom (df) = 9, p = 0.113, minimum discrepancy (CMIN/df) = 1.59, comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.03, 90% confidence interval (CI): (0.00-0.06), and standardized root mean square residual (SRMR) = 0.02. Internal consistency reliability was established (α = 0.78). SGM-ACE exhibited weak, yet significant relationships with each substance use outcome. Multigroup SEM indicated measurement invariance between SMM and SMW. This study provides psychometric validation of the SGM-ACE, establishing measurement invariance between SMM and SMW. Future research should explore its utility in diverse SGM minority subgroups.

The relationship between maternal-infant bonding and postpartum depression/anxiety: moderating effect of childhood psychological abuse and validation of the Mother-to-Infant Bonding scale (MIBS-8) in Arabic

BackgroundThe emotional bond that a mother senses to her infant is essential to their social, emotional, and cognitive development. Understanding the level of mother-infant bonding plays an imperative role in the excellence of care. However, in Lebanon, there is a paucity of information about mother-infant bonding in the postpartum period. Given that Lebanese pregnant women constitute an important part of the population to look at, the objectives of the study were to (1) validate the Arabic version of the mother–infant bonding scale and (2) the relation between mother-infant bond and postpartum depression/anxiety; (3) the moderating effect of child abuse in the association between mother-infant bond and postpartum depression/anxiety.MethodsThis cross-sectional study was conducted from September 2022 until June 2023, enrolling 438 women 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years). To examine the factor structure of the mother-infant bond scale, we used an Exploratory-Confirmatory (EFA-CFA) strategy. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ2/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI).ResultsEFA was conducted on the first subsample. Three items were removed. The five items remaining loaded on one factor, which explained 73.03% of the common variance (ω = .91 / α = .90). After adding a correlation between residuals for items 2–7 and 5–8, fit indices of the CFA results were acceptable: χ2/df = 6.97/3 = 2.32, RMSEA = .068 (90% CI .001, .135), SRMR = .017, CFI = .996, TLI = .988. The interaction maternal-infant bonding by child psychological abuse was significantly associated with depression and anxiety respectively. At low, moderate and high levels of child psychological abuse, higher maternal-infant bonding scores (greater difficulty in bonding) were significantly associated with higher depression and higher anxiety respectively.ConclusionThis study provides, for the first time, a specific Arabic scale to assess mother-infant bonding reliably and validly. Furthermore, our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese postpartum women, namely a history of psychological child abuse. Therefore, laborious awareness programs and healthcare services need to be implemented in order to prevent maternal mental health disorders from being unrecognized and left untreated.

Validation of an adapted Italian-language version of the Sociocultural Attitudes Toward Appearance Questionnaire-3 (SATAQ-3), within a female population: the Sociocultural Attitudes Toward Appearance Questionnaire - Social Media (SATAQ-SM).

Sociocultural Attitudes Towards Appearance Questionnaire-Social Media (SATAQ-SM) is a self-administered questionnaire for the evaluation of social media pressure and internalization of beauty standards. This study aims to validate the SATAQ-SM an adapted Italian version of the Sociocultural Attitudes Towards Appearance Questionnaire third version (SATAQ-3). Confirmatory factor analysis was used to investigate whether the empirical data fitted the four-factor structure of SATAQ-3. Assessment of goodness-of-fit was based on standard model fit criteria: relative χ2 value (χ2/df), Root Mean-Squared Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI). Internal consistency was assessed using McDonald's omega. Criterion validity was calculated by correlating the SATAQ-SM factors scores with the total score of the Rosenberg self-esteem scale (RSES) and Eating Attitudes Test (EAT-26). Four-hundred and eighty-five females agreed to participate in the study. The four-factor model appears to be confirmed by the fit indices: χ2/df = 3.73, RMSEA = 0.07, CFI = 0.99 and TLI = 0.99. All the items defining the four factors had a factor loading of ≥0.40. McDonald's omega of the entire questionnaire was equal to 0.95 and for the four subscales it did not assume values lower than 0.81. The correlations between the factor score of SATAQ-SM and the RSES were all negative and statistically relevant (p < 0.001); the correlations between the scores of the SATAQ-SM subscales and the total score of the EAT-26 are all positive and statistically significant. SATAQ-SM demonstrated good psychometric properties to assess the influence of social media on body image perception related to social media.

Inflammatory bowel disease patients’ perspectives of non-medical needs

BackgroundInflammatory bowel disease (IBD) imposes a huge burden on the healthcare systems and greatly declines the patient’s quality of life. However, there is a paucity of detailed data regarding information and supportive needs as well as sources and methods of obtaining information to control different aspects of the disease from the perspectives of the patients themselves. This study aimed to establish the IBD patients’ preferences of informational and supportive needs through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).MethodsIBD patients were recruited from different centers. Considering inclusion and exclusion criteria, 521 participants were filled a predefined questionnaire. This questionnaire was prepared through literature review of the recent well-known guidelines on the needs of IBD patients, which was further approved by the experts of IBD area in three rounds of Delphi consensus. It includes 56 items in four sections of informational needs (25), supportive needs (15), sources of information (7), and methods of obtaining information (9).ResultsIn particular, EFA was used to apply data reduction and structure detection. Given that this study tries to identify patterns, structures as well as inter-relationships and classification of the variables, EFA was utilized to simplify presentation of the variables in a way that large amounts of observations transform into fewer ones. Accordingly, the EFA identified five factors out of 25 items in the information needs section, three factors out of 15 items in the supportive needs section, two factors out of 7 items in the information sources section, and two factors out of 9 items in the information presentation methods. Through the CFA, all 4 models were supported by Root Mean Squared Error of Approximation (RMSEA); Incremental Fit Index (IFI); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); and SRMR. These values were within acceptable ranges, indicating that the twelve factors achieved from EFA were validated.ConclusionsThis study introduced a reliable 12-factor model as an efficient tool to comprehensively identify preferences of IBD patients in informational and supportive needs along with sources and methods of obtaining information. An in-depth understanding of the needs of IBD patients facilitates informing and supporting health service provision. It also assists patients in a fundamental way to improve adaptation and increase the quality of life. We suggest that health care providers consider the use of this tool in clinical settings in order to precisely assess its efficacy.

Investigating the internal structure of multiple mini interviews-A perspective from Pakistan.

Healthcare professionals require many personal attributes in addition to cognitive abilities and psychomotor skills for competent practice. Multiple Mini- Interviews are being employed globally to assess personality attributes of candidates for selection in health professions education at all level of entry; these attributes are namely, communication skills, critical thinking, honesty, responsibility, health advocacy, empathy and sanctity of life. Considering the high stakes involved for students, faculty, institutions and the society, rigorous quality assurance mechanisms similar to those used for student assessment must be employed for student selection, throughout the continuum of medical education. It is a difficult undertaking as these psychological constructs are difficult to define and measure. Though considered to yield reliable and valid scores, studies providing multiple evidences of internal structure especially dimensionality of Multiple Mini-Interviews are sparse giving rise to questions if they are measuring a single or multiple constructs and even if they are measuring what they are purported to be measuring. The main objective is to provide statistical support of the multi-dimensional nature of our Multiple Mini Interviews, hypothesized a-priori, through CFA. Another objective is to provide multiple evidences for the internal structure. Our study highlights the link between content and internal structure evidences of the constructs, thus establishing that our Multiple Mini Interviews measure what they were intended to measure. After securing permission from the Institutional review board, an a-priori seven factor-model was hypothesized based on the attributes considered most essential for the graduating student of the institution. After operationally defining the attributes through extensive literature search, scenarios were constructed to assess them. A 5-point rating scale was used to rate each item on the station. A total 259 students participated in the multiple mini interviews over a period of three days. A training workshop had been arranged for the participating faculty. The reliability coefficient using Cronbach's alpha were calculated (range from 0.73 to 0.94), Standard Error of Measurement (ranged from 0.80 to1.64), and item to station-total correlation ranged from 0.43-0.50 to 0.75-0.83. Inter-station correlation was also determined. Confirmatory factor analysis endorsed the results of Exploratory factor analysis in the study revealing a seven model fit with multiple indices of Goodness-of-fit statistics such as Root mean square error of approximation (RMSEA) value 0.05, Standardized root mean square residual (SRMR) value with less than 0.08. All these indices showed that model fit is good. The Confirmatory factor analysis confirmed the multi-dimensional nature of our MMIs and also confirmed that our stations measured the attributes that they were supposed to measure. This study adds to the validity evidence of Multiple Mini-Interviews, in selection of candidates, with required personality traits for healthcare profession. It provides the evidence for the multi-dimensional structure of Multiple Mini interviews administered with multiple evidences for its internal structure and demonstrates the independence of different constructs being measured.

Translation, cross-cultural adaptation, and validation of the 10-item spine functional index (SFI-10) in the Brazilians with musculoskeletal spine disorders

PurposeTo translate and cross-culturally adapt the Spine Functional Index (SFI) into Brazilian Portuguese (SFI-Br) in individuals with musculoskeletal spine disorders.MethodsParticipants (n=194) answered the Numerical Pain Rating Scale (NPRS), 36-item Short-Form Health Survey (SF-36), Roland-Morris Disability Questionnaire for General Pain (RMDQ-g), and SFI-25 incorporating the SFI-10. Structural validity, from confirmatory factor analysis (CFA), used comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). The best structure was considered from the lower values of the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Construct and criterion validity used Spearman’s correlation coefficient (rho). Internal consistency used Cronbach’s alpha, reliability used intraclass correlation coefficient (ICC2,1), with ceiling and floor effects determined. Error used the standard error of the measurement (SEM) and minimal detectable change, 90% level (MDC90).ResultsAdequate fit indices demonstrated an unequivocal one-factor structure only for the SFI-10 (chi-square/DF <3.00, CFI and TLI >0.90, RMSEA <0.08). The SFI-10-Br correlation was high with the SFI-Br (rho=0.914, p<0.001), moderate for the RMDQ-g (rho=-0.78), SF-36 functional capacity domain (rho=0.718) and NPRS (rho=-0.526); and adequate for the remaining SF-36 domains (rho>0.30). Test-retest reliability (ICC2,1=0.826) and internal consistency (alpha=0.864) were high. No ceiling or floor effects were observed, and error was satisfactory (SEM=9.08%, MDC90=25.15%).ConclusionThe SFI Brazilian version was successfully produced with the 10-item version showing an unequivocal one-factor structure, high construct and criterion validity, reliability, internal consistency, and satisfactory error. Further research on responsiveness is required.

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...

Determining causality in travel mode choice

This article presents one of the pioneering studies on causal modeling in travel mode choice decision-making using causal discovery algorithms. These models are a major advancement from conventional correlation-based techniques. We propose a novel methodology that combines causal discovery with structural equation modeling (SEM). This modeling approach overcomes some of the limitations of SEM by combining the strengths of both causal discovery and SEM. Causal discovery algorithms determine causal graphs from observational data and domain knowledge, and SEMs estimate direct causal effects and test the performance of causal discovery algorithms. In this study, we test four causal discovery algorithms: Peter-Clark (PC), Fast Causal Inference (FCI), Fast Greedy Equivalence Search (FGES), and Direct Linear Non-Gaussian Acyclic Models (DirectLiNGAM). The results show that DirectLiNGAM based SEM model best captures causality in mode choice behavior. It passes several goodness-of-fit tests, including Root Mean Square Error of Approximation (RMSEA) and Goodness-of-Fit Index (GFI), and it achieves the lowest Bayesian Information Criterion (BIC) value. The analyses are conducted on data collected from the 2017 National Household Travel Survey in the New York Metropolitan area.

Development and Validation of a Scale to Measure Job Satisfaction Among Human Resources for Health in Morocco.

This study aims to develop and validate a job satisfaction scale for human resources for health (HRH) who are employed by the Ministry of Health. The scale was developed through a comprehensive literature review, and its validity and reliability were assessed using several psychometric properties, including expert evaluation, a pilot survey, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). A large sample psychometric evaluation was made by all kinds of HRH staff (n = 2122), and the final version of the job satisfaction scale included 25 items. The EFA revealed seven factors with modest internal consistency ranging from 0.68 to 0.85. The goodness of fit of the model was found to be satisfactory, with root mean square error approximation (RMSEA) = 0.05, chi-square/df = 6.4, and both Tucker-Lewis Index (TLI) = 0.92 and CFI = 0.93 being higher than 0.9. The standardized root mean square residual had a value of 0.035. This instrument proved to be a reliable and valid tool for measuring job satisfaction in health institutions.