Standardized Root Mean Square Residual Research Articles

Validity and reliability study of clinician attitude towards rural health extension program in Ethiopia: exploratory and confirmatory factor analysis

BackgroundThe Ethiopian health extension program (HEP) is an innovative community-based strategy aimed at disease prevention and health promotion. While health extension workers (HEWs) are its front-line workers, the involvement of clinicians remains an integral part. The goals of this study were to: (1) assess the correlation of clinician attitude with predictors and (2) assess the reliability and validity of the survey instrument.MethodsA cross-sectional study design was utilized to collect data from a sample of 1239 clinicians using 28 items of attitude questions. Exploratory factor analysis (EFA) was applied to create the latent variables. Oblique Promax type rotation with factor loading (> 0.5) was used. Cronbach’s alpha was used to assess reliability, with a level of > 0.7 suggesting good reliability. Confirmatory factor analysis (CFA) was undertaken, with the values of Root Mean Square Error Administration (RMSEA) < 0.08, Standardized Root Mean Square Residual (SRMR) < 0.05, comparative fit index (CFI) 0.9–0.95, and Tucker-Lewis index (TLI) 0.9–0.95 suggesting acceptable model fit. A linear regression analysis was conducted.ResultsEFA produced two latent variables which explained 93.2% of the total variance. The latent variables were labeled as perceived attitude towards the skill of HEWs (F1), and perceived attitude towards the impact of HEP (F2). Internal reliability for the 28 items was reported with a Cronbach’s alpha of 0.94, and for F1 and F2 it was 0.91 and 0.90, respectively. CFA was done and RMSEA was reported at 0.04, SRMR was 0.03, and CFI and TLI were each 0.97. The value of clinician attitude increased by 3.5, 95% CI (1.5, 5.3), P-value < 0.001 for those who have been exposed to the HEP program than non-exposed. Similarly, clinician attitude was lower for degree holders compared to those with diplomas by − 2.7, 95% CI (− 4.4, − 0.94), P-value < 0.002.ConclusionClinician attitude increased as exposure to HEP increased. Clinician attitude towards HEP has two latent variables. Furthermore, the assessment tool demonstrated good reliability and validity. In conclusion, it is worthy valued for clinicians to receive orientation about HEP, and researchers and program evaluators can use this assessment tool.

Development and validity of the subjective training quality scale

ABSTRACT This study aimed to define, develop, and validate a subjective scale of training quality. Two related studies were used to 1) define training quality and 2) develop and validate a subjective scale. Part One: a purposive sample of 15 sub-elite (i.e. national) and elite (i.e. international) swimmers participated in one, 20-30-min semi-structured interview. Thematic analysis of interview responses established three constructs to define training quality. These were the physical, technical, and mental aspects of training. Part Two: development of the Subjective Training Quality (STQ) scale based on the three constructs identified in Part One. 252 sub-elite and elite athletes, across eight sports completed the STQ scale. Cronbach’s alpha (α) assessed internal consistency, histogram plot analysis assessed face validity, and confirmatory factor analysis (CFA) compared physical, technical, and mental constructs with training quality. Root mean square error of approximation (RMSEA) and standardised root mean square residual (SRMR) evaluated CFA quality of fit. Physical, technical, and mental constructs demonstrated a high “acceptable” level of internal consistency (α = 0.85) and excellent face validity. Comparatively, the CFA quality of fit was “excellent” (RMSEA = <0.01 “good”, SRMR = 0.00 “perfect”). The STQ scale demonstrated excellent internal consistency and face validity, establishing capacity to monitor training quality. The STQ scale could be used in conjunction with traditional training monitoring tools to provide additional insight into athlete’s training quality. Further investigation is required to determine how the STQ scale may interact with subjective and objective training performance measures, and how it could be incorporated into daily training monitoring. Highlights Athletes perceive the subjective training quality (STQ) scale adequately represents the physical, technical, and mental constructs of training quality. Excellent internal consistency and confirmatory factor analysis fit demonstrates the STQ scale is an effective tool to monitor training quality. With additional validation, the STQ scale could be used in conjunction with traditional load monitoring tools to provide greater insight to an athlete’s training response, and subsequently inform training prescription.

Factor structure of the Maslach Burnout Inventory Human Services Survey in Spanish urgency healthcare personnel: a cross-sectional study

BackgroundThe Maslach Burnout Inventory (MBI) is an instrument commonly used to evaluate burnout syndrome. The goal of the present study was to assess the internal reliability and the performance of the items and the subscales of the MBI-HSS (the version for professionals working in human services) by validating its factorial structure in Spanish urgency healthcare personnel.MethodsCross-sectional study including 259 healthcare emergency professionals (physicians and nurses) in the Spanish health region of Lleida and the Pyrenees. Burnout was measured using the Spanish validated version of the MBI-HSS. Internal reliability was estimated using Cronbach’s alpha coefficient. The sampling adequacy was assessed using the Kaiser-Meyer-Olkin measure along with the Bartlett’s test of sphericity. A principal axis exploratory factor analysis with an oblique transformation of the solution and a confirmatory factor analysis with maximum likelihood estimation were performed. Goodness-of-fit was assessed by means of the chi-square ratio by the degrees of freedom, the standardized root mean square residual (SRMR), the root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI).ResultsThe three subscales showed good internal reliability with Cronbach’s alpha coefficients exceeding the critical value of 0.7. Exploratory factor analysis revealed five factors with eigenvalues greater than 1. Nevertheless, confirmatory factor analysis showed a relatively satisfactory fit of the three-factor structure (χ2/df = 2.6, SRMR = 0.07, RMSEA = 0.08, TLI = 0.87, CFI = 0.89), which was improved when several items were removed (χ2/df = 1.7, SRMR = 0.04, RMSEA = 0.05, TLI = 0.97, CFI = 0.98).ConclusionsAlthough it is necessary exploring new samples to get to more consistent conclusions, the MBI-HSS is a reliable and factorially valid instrument to evaluate burnout syndrome in health professionals from the Spanish emergency services.

Psychometric properties and clinical utility of COVID-19-related distress scale among children and adolescents with Disabilities

BackgroundThe aim was to estimate the psychometric properties of the COVID-19-related distress scale in our society, as well as verifying the global structure of the COVID-19-related distress scale through exploratory factor analysis and the confirmatory factor analysis model for the dimensions prepared in the light of previous studies and the general factor model. MethodsThe study follows the design of the exploratory cross-sectional studies by applying a scale electronically using the Google Forms tool. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach's alpha reliability coefficient, and test-retest methods were used to evaluate reliability. ResultsIn the analysis made for internal consistency in the reliability study of the scale, the Cronbach's alpha reliability coefficients were determined as α = 0.93 for the physical dimension subscale, 0.90 for the psychological and emotional dimension, 0.92 for cognitive dimension, 0.91 for the social dimension, 0.92 for behavioral dimension, 0.87 for living Dimension and 0.94 for the whole scale. The total number of items on the scale is 62. It is clear that the items of the scale explained 55.49 % of the variance of the correlation matrix between the items, which indicates that the scale has an appropriate degree to extract the variance that explains COVID-19-related distress. The fit indices were found to be Chi square = 862.30 (p < .001), degree of freedom = 210 (χ2 = 862.30; df = 210, χ2/df = 4.10), root mean square error of approximation (RMSEA) = 0.07 (p < .05) standardized root mean- square residual (SRMR) = 0.05, comparative fit index (CFI) = 0.92, non-normed fit index (NNFI) = 0.95, goodness of fit index (GFI) = 0.95, and adjusted goodness of fit index (AGFI) = 0.94. ConclusionsThe COVID-19-related distress scale is an easy to administer, valid, and reliable instrument to assess COVID-19-related distress. This instrument can be a helpful tool informing us about distress related to COVID-19 and hence may prevent adverse long-term consequences arising due to pandemic.

Exploring academic procrastination among nursing students during pandemic COVID-19

Introduction: An instrument that is frequently used to gauge academic procrastination is the Procrastination Assessment Scale for Students (PASS). During covid-19 pandemic the chance to get more into procrastination mode is higher because while students is studying at home they have something distracted their mind such as watching movie, using social media and the others things. The objective of this study was to evaluate the constructs of validity and reliability of the procrastination assessment scale for nursing students during the pandemic COVID-19 are examined. Method: It is a cross sectional study where distributed to 416 nursing students and the data taken by stratified sampling. The scale consists of two part, part one is area of procrastination had 18 items and second part is reason for procrastination had 26 items. The data was analyzed with Stata. Results: The reliability of first part was 0.6615 and the second part was 0.9136. The model was acceptable where root mean squared error of approximation (RMSEA) = 0.108, standardized root mean square residual (SMRS) = 0.063, comparative fit index 0.957, CI 90%. Conclusion: Based on the investigation, the dimensions and indicators that make up the academic procrastination construct are credible and valid ways to assess it among Indonesian nursing students.

Goal orientation motivation theory in surgical trainees: a multi-institutional validation study of the GO-ST scale

PurposeGoal orientation is an important psychological construct which describes the nature of an individual’s intrinsic motivation for learning in terms of mastery and performance. Research on goal orientation in primary school through college-level learners has consistently demonstrated a relationship between goal orientation and learning outcomes, test scores, motivation, feedback incorporation and burnout. The aim of this study was to create and validate a novel instrument to measure goal orientation motivation in surgical trainees.MethodsA validation study of a novel survey instrument specific for surgical trainees was conducted at five general surgery training programs across the United States over the course of a single academic year. A 14 item goal orientation in surgical trainees (GO-ST) instrument was developed and responses were scored on a 5-point Likert scale measuring frequency over a month. Exploratory and confirmatory factor analyses were performed.ResultsA total of 144 residents participated for an 87.8% response rate. Confirmatory factory analysis using 3 domains yielded a final instrument with ten total questions. The Comparative Fit index (CFI) of this model was 0.950, the Goodness of Fit index (GFI) was 0.920, and the Standardized Root Mean Square Residual (SRMR) was 0.064.ConclusionsUsing the goal orientation theory of motivation, The GO-ST instrument was successfully developed to measure the three domains of goal orientation, mastery, performance approach, and performance avoid in surgical trainees. The ability to distinguish the way in which a learner internalizes educational opportunities in terms of motivation paves the way to understanding a new perspective on wellness, mastery and the clinical learning environment.

Development and validation of a maternal anxiety for neonatal jaundice scale in China

BackgroundMaternal anxiety induced by neonatal jaundice has adverse effects on maternal and infant health, but there was no specific tool to identify the anxiety level of mothers. This study aims to develop a Maternal Anxiety for Neonatal Jaundice Scale (MANJS) and to validate it in the target population.MethodsAn initial 11-items MANJS was developed through literature review, expert panel consultation, and a pilot-test. Subsequently, mothers of neonates with jaundice were recruited from the Maternal and Child Health Hospital of Hainan Province, China, from June to December 2018, for a formal questionnaire survey. Based on the data collected, the scale was validated for construct validity, convergent validity, discriminant validity, content validity, and internal consistency reliability after the items screening.ResultsThe reliability and validity of MANJS were validated in 1127 mothers of jaundiced neonates. After the item with cross-loadings was removed using exploratory factor analysis, MANJS consisted of two dimensions and 10 items, with a cumulative variance contribution of 74.36% and factor loadings above 0.6 for all items. The confirmatory factor analysis identified three items with cross-factor loading or error correlation and then they were removed orderly. The further confirmatory factor analysis showed a good construct validity for the 7-item MANJS, with standardized root mean square residual (SRMR) = 0.029, root mean square error of approximation (RMSEA) = 0.068, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.937, incremental fit index (IFI) = 0.961, normed fit index (NFI) = 0.954, goodness of fit index (GFI) = 0.998, adjusted goodness of fit index (AGFI) = 0.996, respectively. The average variance extracted values (AVE) of the two factors were 0.80 and 0.72, and the combined reliability (CR) were 0.94 and 0.88, respectively. Cronbach’s alpha was 0.90 for the MANJS, and split-half reliability was 0.72.ConclusionsMANJS was demonstrated to have satisfactory reliability and validity in evaluating maternal anxiety caused by neonatal jaundice among Chinese postpartum women.

Development of shortened HIV-related stigma scales for young people living with HIV and young people affected by HIV in India

BackgroundHIV-related stigma is associated with poor quality of life and poor healthcare-seeking behaviours in young people living with HIV (YPLHIV) and young people affected by HIV (YPAHIV). India has an estimated 120,000 YPLHIV and 4 million YPAHIV, but efforts to measure HIV-related stigma in them are sparse, impeded by the lack of measuring instruments. Here, we describe the development of the Pune HIV-Stigma Scale (PHSS) and modified-PHSS to measure HIV-related stigma among YPLHIV and YPAHIV, respectively, in India.MethodsWe used data from a mental health study for YPLHIV and YPAHIV aged 15–25 years, conducted at Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospitals, Pune, India, between August 2018 and June 2021. Findings from multiple confirmatory factor analyses and cognitive interviews guided the development of the 12-item PHSS. The modified-PHSS was developed by confirming the structure of the PHSS for YPAHIV. Convergent validity with Center for Epidemiological Studies Depression (CES-D) and UCLA Loneliness scales was assessed using Spearman’s correlation coefficients.ResultsModel fit indices were good for both the PHSS (χ2 = 65.0, df = 48, p value: 0.052; root mean square error of approximation (RMSEA): 0.054; comparative fit index (CLI): 0.980; Tucker–Lewis index (TLI): 0.972; and standardized root mean square residual (SRMR): 0.067), and the modified-PHSS (χ2 = 56.9, df = 48, p value: 0.176; RMSEA: 0.045; CLI: 0.983; TFI: 0.976, and SRMR: 0.078). Spearman’s correlation coefficients indicated low to moderate convergent validity (ρ: 0.03–0.52) across different subscales of the PHSS and modified-PHSS. Cronbach’s alpha for the PHSS was 0.82 and for the modified-PHSS 0.81.ConclusionWe developed the first scales to measure HIV-related stigma among YPLHIV and YPAHIV in India. These concise scales can facilitate measurement of HIV-related stigma more frequently in research studies. We recommend that they be tested in different Indian languages.

Translation and validation of the EORTC QLQ-BR45 among Ethiopian breast cancer patients

This study aimed to examine the validity and reliability of the EORTC QLQ-BR45 questionnaire among breast cancer patients in Ethiopia. This study included 248 breast cancer patients who completed the QLQ-BR45 and QLQ-C30 questionnaires. The internal reliability, test–retest reliability, and the content, concurrent, convergent, divergent, and clinical validity of the tool were examined. The statistical analyses included Cronbach’s α coefficient, Pearson’s correlation coefficient, standardised root mean square residual (SRMR), comparative fit index (CFI), t-test, and root mean square error of approximation (RMSEA). All items were marked as relevant, and item-level content validity index (I-CVI) scores ranged from 0.83 to 1. The S-CVI/Ave was calculated by dividing the sum of I-CVI values by the total number of items, which was found to be 0.94. The average CVR value was 0.76. The Cronbach’s α coefficient was 0.80 for all domains. All subscales met the minimal standards of reliability except the arm symptom scale (0.66). The test–retest reliability coefficient was 0.77 for all domains. Seven out of the 12 hypothesised scales showed positive correlations (r > 0.40) between the QLQ-BR45 and QLQ-C30 scales. Multitrait scaling analysis showed that the item-scale correlations exceeded the 0.40 criterion for item-convergent validity for 11 of the 12 hypothesised scales. The correlation coefficients between an item and its own subscale were significantly higher than with other subscales. The EORTC QLQ-BR45 had good reliability and validity, and it can be used to measure the quality of life of breast cancer patients in Ethiopia.

The Turkish version of the Camberwell Assessment of Need for the Elderly: A validity and reliability study.

The present study attempted to adapt and validate the Turkish version of the Camberwell Assessment of Need for the Elderly (CANE-T). The data of this methodological study were collected from 610 older people who volunteered between September 10 and December 15, 2019. The SPSS 20 and LISREL software were used to perform reliability (internal reliability, parallel forms reliability/equivalent forms, and test-retest reliability) and validity (exploratory factor analysis and confirmatory factor analysis) analyses for the CANE-T. The Kaiser-Meyer-Olkin test revealed the sampling adequacy to be 0.72. After deleting four items (psychological distress, behavior, alcohol, and money) with a factor loading below 0.30 from the dataset, it was found that the scores on the scale explained 55% of the total variance. Besides, the confirmatory factor analysis revealed the following fit indices: p < 0.05, root mean square error of approximation (RMSEA)=0.08, root mean square residuals (RMR)=0.07, standardized root mean square residual (SRMR)=0.07, goodness-of-fit index (GFI)=0.88, and adjusted goodness-of-fit index (AGFI)=0.84. Concerning reliability, Cronbach's α values were calculated to be 0.78 for 'Physical Needs', 0.74 for 'Psychophysiological Needs', 0.75 for 'Security Needs', 0.75 for 'Social Needs', and 0.75 for 'Health Needs'. Overall, it was concluded that the 20-item five-factor CANE-T is a valid and reliable tool to measure the needs of older adults in the Turkish context.

Exploring the complex pathways between somatosensory impairment, physical ability and affective symptoms following stroke: mediation analyses.

Based on the theory of postural control and the role of cognitive capacity, this study analyses how physical ability and somatosensory impairment influence affective symptoms in patients with stroke. The cross-sectional study with a consecutive sampling approach was conducted in 10 different rehabilitation departments in Yunnan Province, China between August 2019 and February 2021. A total of 1,058 patients with stroke were included according to the inclusion criteria and exclusive criteria. Their important functions were evaluated including somatosensory measurement, Brunnstrom recovery stage, manual muscle testing (MMT), Barthel index (BI), mini-balance evaluation systems test (Mini-BEST), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAM-A), and Hamilton Depression Scale (HAM-D). Exploratory Factor Analysis was used to construct the measure models. A path analysis was performed to estimate the role of balance impairment and cognitive capacity as mediators in the relationships between somatosensory impairment, physical ability and affective symptoms. By comparing two models, the final model indicated a good global model fit to the data [χ2=243.5, χ2/df=5.181, goodness-of-fit index (GFI) =0.977, comparative five index (CFI) =0.944, Tucker-Lewis index (TLI) =0.922, standardized root mean square residual (SRMR) =0.063, and root mean square error of approximation (RMSEA) =0.063, Akaike information criterion (AIC) =303.51, Bayesian information criterion (BIC) =304.26], although Chi-square test was not significant due to the large sample size. In the path analysis, somatosensory impairment significantly negative influenced balance impairment (P<0.05, β=-0.061), and physical ability significantly positively affected balance impairment (P<0.001, β=0.893). A mediation analysis was conducted to show that balance impairment mainly mediated the relationship between physical ability and affective symptoms (R2=0.996), while the relationship between physical ability and affective symptoms was mediated slightly by cognitive capability (R2=0.108). These results suggest that balance impairment mainly mediates the relationship between physical ability and affective symptoms, while cognitive capacity slightly medicates this relationship. Rehabilitation professionals and family caregivers should pay more attention to balance function, which will help to strengthen the physical ability and improve post-stroke mood disorders.

Bi-Directionality between Physical Activity within School and Fundamental Movement Skills in School-Aged Students: A Cross-Lagged Study.

Background: Evidence has indicated the health importance of fundamental movement skills (FMS) and physical activity (PA) in children and their relationships seems bidirectional. However, their bidirectional relationship has not yet been fully answered in the literature. Aim: This study sought to determine bidirectional relationship between FMS and PA in children using cross-lagged study design. Methods: A total of 183 second-level students (8.8 ± 1.1 years old) from three primary schools in Henan Province, China were selected as subjects. The average number of steps per school day was used as the amount of PA in the school environment; the third edition of the test of gross motor development was used for FMS testing. The baseline data (T1) and tracking data (T2) were collected at the beginning and end of the fall semester, respectively. The two tests were separated by 3 months (11 weeks), and a cross-lag model analysis was performed. Based on the hypothetical model, we tested the cross-lag effect of children’s PA and FMS. Results: The model fit index was χ2/df = 2.861 (p < 0.001, n = 183); goodness of fit index GFI = 0.900; NFI = 0.909; CFI = 0.931 and the 95%CI was between 0.071–0.192. The RMSEA = 0.063, and the standardized residual root mean square SRMR = 0.029. The T1 FMS can be used to predict the number of steps in the T2 teaching days with statistical significance (β = 0.22, 95% CI: 0.07–0.38, p = 0.003). However, the T1 steps cannot be used to predict the T2 FMS (β = 0.05, 95% CI: 0.07–0.13, p = 0.475). Further analysis shows that the main contributor to these relationships are ball skills in the FMS. Conclusions: The relationship between children’s fundamental movement skills and PA is not two-way. Students with higher FMS are expected to reach higher levels of PA after undergoing school PA in a teaching cycle. The PA of the students can be improved by improving their motor skills, which further improves their physical and mental health.

ADAPTING THE OLDENBURG BURNOUT INVENTORY INTO BAHASA INDONESIA FOR MEASURING BURNOUT IN MEDICAL RESIDENTS

Background: Burnout is common among medical residents, and a non-commercial tool for assessing burnout for medical residents is needed. This study aimed to adapt the Oldenburg Burnout Inventory (OLBI) in Bahasa Indonesia for medical residents and to analyze its validity and reliability.Case Discussion: The English version of OLBI was forward and backward translated to and from Bahasa Indonesia by English-language translation experts, and was appropriately modified by the authors. The respondents of the questionnaire were taken from pediatric residents in the first trial (48 subjects), and from internal medicine, pediatric, dermatology, surgery, and neurology residents in the second trial (109 subjects). The item-test correlation to measured construct validity was good for both trials. A confirmatory factor analysis was then undertaken to evaluate the goodness of fit (GOF), the root mean squared error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean squared residual (SRMR), and coefficient of determination (CD) in the second trial. The results of the one-factor model and multidimensional GOF of the 16 items were unsatisfactory (χ2&lt;0.05 and RMSEA&gt;0.08). The GOF of the two-factor analysis of burnout with 8 items (3 exhaustion items and 5 disengagement items) created the following results: χ2=0.378; RMSEA=0.025; CFI=0.995; TLI=0.993; SRMR=0.036; and CD=0.898. The Cronbach’s alphas, for internal consistency reliability, in the first trial, second trial, and final model were 0.73, 0.87, 0.83, and 0.79, respectively.Conclusion: An 8-items modified Bahasa Indonesia translation of the OLBI for medical residents to measure burnout has good reliability and validity.

Validity and reliability of the Patient Health Questionnaire scale (PHQ-9) among university students of Bangladesh.

This study investigated the reliability and factorial validity of Patient Health Questionnaire-9 (PHQ-9) in the context of university students in Bangladesh. The research aimed to assess whether the original one-dimensional model or a model containing both somatic and cognitive-emotional factors is appropriate in the case of a sample of university students. A repeated cross-sectional survey design based on convenience sampling was used to collect data from 677 university students from both public and private universities. The factor structure of the PHQ-9 was assessed using confirmatory factor analysis (CFA). Measurement invariances were assessed across gender, type of university, level of education and victim of domestic violence. Its convergent validity was determined by investigating its correlations with Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS). Results showed excellent reliability of PHQ-9 as measured by both Cronbach’s α and McDonald’s ω. CFA suggested that a modified one-factor model where the error variances between item-3 (‘sleeping difficulties’) and item-6 (‘feeling as a failure’), item-6 and item-9 (‘suicidal thoughts’), item-4 (‘feeling tired’) and item-9, item-3 and item-9 were allowed to covary is appropriate for the sample. This model provided high values of comparative fit index (CFI), goodness of fit index (GFI), and Tucker Lewis Index (TLI), low value of standardized root mean square residual (SRMR) and a non-significant root mean square error of approximation (RMSEA) as well as a high Factor Determinacy Score Coefficient. Correlation between PHQ-9 and GAD-7 was 0.751 and 0.934 between PHQ-9 and PHQ-ADS. Finally, the model is strictly invariant across gender and university type. Overall, the study provided support for modified unidimensional structure for PHQ-9 and showed high internal consistency along with good convergent validity.

Instrument evaluation of conspiracy theory about COVID-19: Exploratory factor analysis and confirmatory factor analysis

&lt;span&gt;Students’ beliefs toward conspiracy theory (CT) of COVID-19 can be the indication of science education quality. However, a validated instrument to measure the level of students’ acceptance on the CT about COVID-19 still remains unexplored. This study aimed to evaluate the questionnaire of CT about COVID-19. The questionnaire consisted of 14 items and delivered online to the 400 students of Biology education in Indonesia. The data was analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). All items have standard deviation between 1.60 and 2.63, but one item was revealed to have insignificant correlation. The EFA result indicated that the other 13 items had loading factor 0.5 and were categorized into three dimensions. The third dimension was eliminated after the administration of CFA due to only one item in the dimension (λ&amp;gt;0.5). There were three items in the first dimension and two items in the second dimension resulted in λ&amp;lt;0.5. The correlated model from CFA disclosed good values of goodness of fit (GOF), χ&lt;sup&gt;2&lt;/sup&gt;/df=2.527, root mean square error of approximation (RMSEA) standardized root mean square residual (SRMR)=0.014, comparative fit index (CFI)=0.964, goodness-of-fit index (GFI)=0.969, adjusted goodness of fit (AGFI)=0.940, Tucker-Lewis index (TLI)=0.947, and normed fit index (NFI)=0.943. Therefore, the questionnaire is strongly recommended to measure the level of students’ beliefs toward the CT of COVID-19. &lt;/span&gt;

Psychometric properties and measurement invariance of Short-Form Life Attitude Inventory for hospital staff

BackgroundThe life attitude of health care workers can deeply influence the quality of care. Examining the performance of the Short-Form Life Attitude Inventory (SF-LAI), this study analyzes the factorial structure, reliability, and invariance of the revised SF-LAI across genders and professions among the staff of a teaching medical center.MethodsThe SF-LAI was developed for university students in Taiwan. From January to February 2019, we administered a cross-sectional survey of life attitudes by distributing the SF-LAI to all staff members of a medical center in Taiwan. The construct validity was evaluated using a confirmatory factor analysis (CFA). Model fit was assessed in terms of the comparative fit index (CFI), Tucker–Lewis index (TFI), standardized root mean square residual (SRMR), and root mean square of error of approximation (RMSEA). Internal consistency was calculated using Cronbach’s alpha and McDonald’s omega. We also performed the CFA invariance analysis for the SF-LAI-R across genders and professions (physician, nurse and other hospital staff).ResultsOf 884 (24.62%) responses, 835 were valid. The participants had a mean age of 47.8 years, and 20.12% were male. In a comparison of multiple CFAs, a second-order model with six factors outperformed other models. The goodness of fit indices revealed the CFI was 0.955, TFI was 0.952, RMSEA was 0.071, and SRMR was 0.038. The Cronbach’s alphas, McDonald’s omega coefficients for internal consistency were all greater than 0.8. The first and second-order model had metric and scalar invariance across genders and professions.ConclusionsAs health care demands evolve, humanities are becoming more important in medical education. Life attitude of hospital care worker is a crucial indicator of whether one embodies the ideals of a humanistic education. The revised SF-LAI has acceptable structural validity, internal consistency, and invariance across genders and professions among staff members of a teaching medical center.

Parenting practices during early childhood: validity evidence of a Brazilian scale

ObjectiveThe present study aims to analyze the validity of evidence and internal consistency of an inventory for assessing parenting practices during early childhood. MethodParticipants were 857 mothers of one-to-42-months children recruited in three cities in the Southeast region and one city in the Midwest region of Brazil. The participants answered a sociodemographic questionnaire with maternal and child data, and the Parenting Styles Inventory for Mothers of Babies (IEPMB). The IEPMB includes 25 questions about positive and negative parenting practices that mothers use to raise their children. An exploratory and confirmatory factor analysis was conducted using the following criteria to indicate adequate model fit: root-mean-square error of approximation (RMSEA) < .08; standardized root mean square residual (SRMR) < .09; comparative fit index (CFI) > 0.90. For the hypothesis-testing method, a comparison between groups using a student's t-test based on the child's age (infants vs. toddlers) and mother's age (adolescents vs. adults) was carried out. ResultsThe final 11 items model of the measure revealed an adequate overall model fit (RMSEA = 0.04; SRMR = 0.04; CFI = 0.94). The items were grouped into three constructs: Aggressiveness and Emotional Dysregulation, Relaxed Discipline, and Positive Monitoring. Adolescent mothers reported less positive monitoring than adult mothers (p < 0.001). Mothers of toddlers reported more aggressiveness/emotional dysregulation (p < 0.001) and relaxed discipline (p = 0.05) than mothers of infants. ConclusionsThe instrument named from this study as the Parenting Practices Inventory for Mothers of Babies showed evidence for measuring mothers’ parenting practices in early childhood and allows the identification of parents who need support.

Cognitive and behavioural factors contributing to distress in LGBTQ+students: a prospective mediation study

We applied a cognitive behavioural therapy (CBT) model of psychological distress and examined cognitive and behavioural predictors and mediators of depression, anxiety and suicidality among lesbian, gay, bisexual, trans, queer and other sexual or gender minority (LGBTQ+) students. LGBTQ + university students (N = 385) completed questionnaires at baseline, 1 and 2 months. Structural equation modelling (SEM) was used to test the relationship between baseline negative beliefs (about the self, others and the future) and depression, anxiety and suicidality 2 months later, via cognitive and behavioural response mediators (perseverative thinking, avoidance and self-compassion) assessed at 1 month. The final model demonstrated acceptable fit: χ 2 (16) = 73.36, p < .001, comparative fit index (CFI)=0.96, Tucker–Lewis index (TLI)=0.93, root-mean-square error of approximation (RMSEA) = 0.09 (90% CI [0.07–0.12]), standardized root-mean-square residual (SRMR) = 0.04, accounting for significant variance in depression/anxiety (48%) and suicidality (27%). For depression/anxiety, negative beliefs had a direct effect and an indirect effect via perseverative thinking and avoidance. For suicidality, negative beliefs had a direct effect. A cognitive behavioural conceptualization may improve our knowledge of the psychological mechanisms involved in depression, anxiety and suicidality in LGBTQ + students. Negative beliefs about the self, others or the future, perseverative thinking, and avoidance are promising targets for prevention and treatment.

Application of Item Response Theory (IRT)-Graded Response Model (GRM) to Entrepreneurial Ecosystem Scale

The scale of entrepreneurial ecosystems (EE) assesses the perceptions about entrepreneurial ecosystem domains, finances, capital finances, support, support professions, policies, markets, human resources, and culture. The scales are always error-prone—these scales must possess properties that enable them it to provide maximum information and validity reliability. Convenient sampling data from (n = 474) founders, co-founders, and entrepreneurs were collected. The IRT-GRM model is used to validate and test the instrument-based on polytomous scales. IRT yields discriminating power—the level of difficulty of the items of the scale. The scale consists of 48 items. The item Pol5 (4.13) was found to have the highest discriminating value (4.13), the item mar5 had the lowest discriminating value (1.57), and all items had discriminating values greater than the threshold value of 0.60. The EE Scale showed good reliability based on McDonald’s omega and Cronbach’s alpha (0.80 and 0.88). The parallel and factor analysis showed good agreement of the one-dimesnionality of the scale. The model goodness of fit statistics based on the comparative fit index (CFI) and the Tucker–Lewis index, (TLI) and the standardized root mean square residual (SRMR) showed a satisfactory level of fit; however, the root mean square error of approximation (RMSE) showed a poor fit. The item characteristic curves showed that the all item responses were properly ordered. The items of the scale showed a satisfactory level of discrimination power and level of difficulty, and it was found to have three levels of agreement about entrepreneurial ecosystem scale. It is concluded that the EE scale possesses good psychometric properties and that it is reliable and valid instrument to measure the entrepreneurial ecosystem of the given region.

Structural equation model of psychological constructs of transtheoretical model, motives for physical activity, and amount of physical activity among people with type 2 diabetes mellitus in Malaysia.

This study aimed determine the structural relationship between psychological constructs of the transtheoretical model (TTM; processes of change, decisional balance, and exercise self-efficacy), motives for physical activity (PA), and amount of PA among Malaysians with type 2 diabetes mellitus (T2DM). All participants were recruited from the Hospital Universiti Sains Malaysia using a cross-sectional study design with purposive) sampling method. A total of 331 participants were recruited for the present study. Before participation in the study, they were informed that participation in the study was totally voluntary. Those who agreed to participate voluntarily were required to complete the self-administered questionnaire set, which included the processes of change, decisional balance, exercise self-efficacy, physical activity and leisure motivation, and international physical activity questionnaires. Data analysis of structural equation modeling was performed using Mplus 8. From the 331 participants, most of whom were male (52%) and Malay (89.4%), with a mean age of 62.6 years (standard deviation = 10.29). The final structural equation model fit the data well based on several fit indices [Root Mean Square Error of Approximation (RMSEA) = 0.059, Comparative Fit Index (CFI) = 0.953, Tucker-Lewis Index (TLI) = 0.925, Standardized Root Mean Square Residual (SRMR) = 0.031]. A total of 16 significant path relationships linked between the TTM, motives for PA, and amount of PA. The pros of decisional balance, others' expectations, and psychological condition were constructs that directly affected PA, whereas the other constructs had a significant indirect relationship with the amount of PA. A positive mindset is crucial in deciding a behavioral change toward an active lifestyle in people with T2DM.