Standardized Root Mean Square Residual Research Articles

Cultural Spanish adaptation, factor structure, and reliability of implementation science instruments for suicide prevention.

Research on the implementation of community gatekeeper training interventions for suicide prevention in Spanish-speaking countries is limited. Gatekeepers identify warning signs of suicidal behavior in at-risk population and refer them to specialized mental health care. To identify factors that influence the implementation of evidence-based practices, standardized measures are needed in Spanish. We culturally adapted and evaluated the factor structure and reliability of two measures for use in the Mexican population: the final version of Acceptability, Appropriateness, and Feasibility of the Intervention (Weiner et al., 2017), and the Organizational Readiness for Implementing Change (ORIC; Shea et al., 2014). Our study consisted of two consecutive phases. The first addressed the cross-cultural adaptation. In the second phase, we administered an online survey to a nonrandom sample of 453 middle school personnel and performed a confirmatory factor analysis (CFA). Participants were 73.95% female, 25.17% male, and 0.88% nonbinary/other and came from the 32 Mexican states. CFA indices for the Mexican Spanish version of the acceptability, appropriateness, and feasibility measure yielded values of comparative fit index (CFI) = 0.96, Tucker-Lewis fit index (TLI) = 0.94, root-mean-square error of approximation (RMSEA) = 0.05, and standardized root-mean-square residual (SRMR) = 0.03. Internal consistency was Ω = 0.95. CFA indices of the Mexican Spanish version of the ORIC were CFI = 0.95, TLI = 0.93, RMSEA = 0.08, and SRMR = 0.03, and internal consistency was Ω = 0.94. We conclude that both instruments show preliminary psychometric properties that support their validity and reliability in the Mexican Spanish-speaking context. These findings promise to drive research on the implementation of gatekeeper interventions and other evidence-based practices in Spanish-speaking school settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-Care and Quality of Life of Ostomy Patients: A Structural Equation Modeling Analysis

Background. Previous research has shown that patients with ostomy frequently exhibit a low health-related quality of life (HRQoL). Self-care is a key element that influences their HRQoL. However, the evidence regarding the relationship between these two constructs in patients with ostomy is still not clear. Materials and Methods. This was a secondary analysis of an Italian multicenter, observational, longitudinal study. Participants were recruited from seven outpatient ostomy care clinics in central and northern Italy. The Stoma-Specific Quality of Life Questionnaire (Stoma QoL) and the Ostomy Self-Care Index (OSCI) were administered to the participants. The relationship between self-care and HRQoL was analyzed using structural equation modeling. Results. A total of 521 patients were enrolled. Our results emphasized that self-care is a predictor of HRQoL among people with ostomy. Self-care maintenance and self-care monitoring had a positive effect on HRQoL (self-care maintenance: β = 0.506, p < 0.001; self-care monitoring: β = 0.303, p < 0.001). The model exhibited acceptable fit indices: χ2 (151, n= 521) = 516.447, p ≤ 0.001, comparative fit index (CFI) = 0.97, Tucker–Lewis index (TLI) = 0.96, root mean square error of approximation (RMSEA) = 0.068 (90% CI, 0.062–0.075), p < 0.001, and standardized root mean square residual (SRMR) = 0.038. Conclusions. The structural equation model tested the causal relationship between self-care and HRQoL in people with a stoma, demonstrating for the first time that inadequate self-care in patients with ostomy may lead to lower HRQoL. Thus, to enhance HRQoL, interventions should be designed to improve self-care behaviors. Future research should investigate potential mediating variables in the relationship between self-care and HRQoL.

Development and validation of Parents’ Health Literacy Scale on Preventing Road Traffic Injuries for children aged 0–6 years in China

BackgroundRoad traffic injuries are the leading cause of death in children. Parents’ health literacy (HL) is closely related to child safety, especially for the young children. This study aimed to...

Psychometric Properties of the Serbian Version of the Arm, Shoulder, and Hand Disability Self-Assessment Questionnaire: Criterion Validity, Construct Validity, and Internal Consistency.

Background/Objectives: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a widely employed self-report tool for assessing upper extremity function. The aim of this study was to assess the psychometric properties of the Serbian version of the DASH by determining its criterion and construct validity, as well as internal consistency. Methods: This cross-sectional study was conducted among patients with hand and wrist disabilities at the Institute for Orthopedics "Banjica", Serbia. The psychometric properties of the Serbian version of the DASH were analyzed through an examination of its factorial structure and internal consistency. The DASH consists of 30 items, 24 of which assess function, 21 of which focus on physical function and three on social/role function. The remaining six items evaluate symptoms related to pain, tingling/numbness, weakness, and stiffness. Results: A total of 297 patients were included in the study. The mean age was 47.4 ± 16.8 years, with 50.5% males. Three models were assessed to determine the reliability and validity of the questionnaire across different domains. Model 1 examined a single-factor structure. In Model 2, the items were divided into two domains: Physical Function and Psychosocial/Symptoms. In Model 3, items were subdivided into three domains: Physical Function, Symptoms, and Psychosocial. All models demonstrated an excellent internal consistency with a Cronbach's alpha > 0.9 for most domains. The values for the fit indices Tucker-Lewis index (TLI) and Comparative-Fit Index (CFI) were above their cut-off criteria of 0.9, while the Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) were below the suggested value of 0.06, indicating an excellent level of models fit. Standardized factor loadings were statistically significant (p < 0.05). Conclusions: The present study provided the evidence for the appropriate metric properties of the Serbian version of the DASH. Results support both the unidimensional and multidimensional structures of the DASH.

Validity and Reliability of a Simplified Chinese Version of Cancer Survivors' Unmet Needs Scale (CaSUN).

To translate Cancer Survivors' Unmet Needs scale (CaSUN) into Simplified Chinese, and to assess the validity and reliability of this translated version among Chinese cancer survivors. Following the cross-cultural adaptation guidelines, the original CaSUN scale was translated from English into Simplified Chinese. To enhance the readability and comprehension of each item, a pilot study involving 40 cancer patients was carried out. Subsequently, 324 cancer survivors participating in follow-up appointments at a cancer hospital in Beijing, China completed the Simplified Chinese version of the CaSUN. The scale's validity was assessed through factor analysis. Indices including Satorra-Bentler scaled chi-square to degree of freedom ratio (χ2/df), comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean squared residual (SRMR) were employed for construct validity. Average variance extracted (AVE) of each category reflected the convergent validity. Reliability was confirmed with both Cronbach's α and Guttman split-half coefficient. Factor analysis suggested that a three-level hierarchical structure of the CaSUN with four first-order factors, nine second-order factors and all the 35 items assessing unmet need could fit our data well (χ2/df=2.833, CFI=0.902, RMSEA=0.076, SRMR=0.066), indicating sufficient construct validity for this model. For convergent validity, AVE of each second-order category were greater than 0.5. Regarding reliability, Cronbach's α of the 35 items was 0.968, and the Guttman split-half coefficient was 0.984. Both of these coefficients were higher than 0.8. The present Simplified Chinese version of CaSUN had good cultural adaptability, appropriate validity and reliability for assessing unmet needs in different cancer survivor groups in Chinese mainland. This Simplified Chinese version of CaSUN can assist health professionals in addressing individual survivor needs and bridge the gap between patients' experiences and their expectations, thereby improving the quality of cancer survivorship care.

Socioeconomic status, reserve capacity, and depressive symptoms predict pain in Rheumatoid Arthritis: an examination of the reserve capacity model

BackgroundGuided by the reserve capacity model, we evaluated the unique relationships between socioeconomic status (SES), reserve capacity (helplessness, self-efficacy, social support), and negative emotions on pain in patients with Rheumatoid Arthritis (RA).MethodsThe secondary analysis used baseline, cross-sectional data from 106 adults in a clinical trial comparing behavioral treatments for RA. Patients were eligible if they were ≥ 18 years old, met the ACR criteria for RA (determined by study rheumatologist), had stable disease and drug regimens for 3 months, and did not have a significant comorbid condition. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness- Arthritis Helplessness Index, self-efficacy -Personal Mastery Scale, social support- Social Provisions Scale) and negative emotions (stress and depressive symptoms- Perceived Stress Scale and Hamilton Depression Rating Scale) on pain (Rapid Assessment of Disease Activity in Rheumatology-RADAR & visual analog scale-VAS), and the indirect effects of SES as mediated by reserve capacity and negative emotions. The SEM model was evaluated using multiple fit criteria: χ2 goodness-of-fit statistic, the comparative fit index (CFI), the standardized root mean square residual (SRMR), and the root mean square error of approximation (RMSEA).ResultsParticipants were mostly female (85%), 55.45 years old on average, self-identified as white (61%), Hispanic (16%), black (13%), and other (10%), and had RA for an average of 10.63 years. Results showed that low SES contributed to worse pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain. The final model explained 39% of the variance in pain.ConclusionsThe findings indicate that lower SES was related to worse clinical pain outcomes and negative emotions and reserve capacity (helplessness, social support, and self-efficacy) mediated the effect of SES on pain. A primary limitation is the small sample size; future studies should evaluate this model further in larger, longitudinal approaches. Interventions that target negative emotions in patients with low SES may facilitate better pain control with RA.Trial registrationclinicaltrials.gov NCT00072657 01/02/2004 20/03/2009.

Validation of the Jamaican version of the Oral Health Impact Profile (OHIP-14) in adults: JAM-OHIP study

Background: The Oral Health Impact Profile (OHIP-14) is a widely used tool for measuring the effects of oral health-related quality of life (OHRQoL). However, the validity of the OHIP-14 in the Jamaican context, referred to as the Jamaican Oral Health Impact Profile (JAM-OHIP), has yet to be established. Purpose: To determine the validity of the Jamaican language version of the OHIP in evaluating the OHRQoL of Jamaican adults. Methods: The original English version of the Oral Health Impact Profile (OHIP-14) was translated into the Jamaican language using forward and backward translation. The JAM-OHIP was used to evaluate the OHRQoL of 236 individuals at the University of the West Indies Dental Polyclinic. The overall fit was checked using a chi-square test (p &gt; 0.05), comparative fit index (CFI), Tucker–Lewis index (TLI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). Results: More DMFT (p &lt; 0.01) was associated with high JAM-OHIP scores, and the most impacted domain was physical pain. Cronbach’s alpha and the standardized item alpha for the JAM-OHIP were 0.82. The overall fitting results for the CFA were χ²(68) = 80.558, p = 0.142, and χ²/g.l. = 1.185. The CFI and TLI were 0.996 and 0.994, respectively. The SRMR was 0.072 and the RMSEA was 0.028 (CI95% = [0.000; 0.050]) p = 0.953. Conclusions: The JAM-OHIP instrument was shown to be reliable and valid for the assessment of OHRQoL in the Jamaican adult population.

Psychometric analysis and validation of the SF-34 PREG: An adaptation of the SF-36 for assessing quality of life in pregnant women.

This study aims to perform a psychometric analysis of the 36-item short form health survey (SF-36) in a population of pregnant women and validate an adapted version of the instrument to measure health-related quality of life specific to pregnancy. A cross-sectional study design was carried out with data collection between 7 and 36 weeks of gestation, with a total sample of 547 pregnant women divided into two randomized subsamples. Data were collected between September 2021 and April 2023. An exploratory factor analysis was initially performed on one subsample, followed by a confirmatory factor analysis on the other. Internal consistency was assessed using Cronbach's alpha and McDonald's omega, and correlations between factors were analyzed. Results from the exploratory factor analysis proposed a seven-factor model explaining 56% of the variance. All proposed dimensions achieved Cronbach's alpha scores above 0.75, with a total test score of 0.92. Furthermore, all dimensions exhibited positive and statistically significant correlations. Bartlett's test of sphericity and the Kaiser-Meyer-Olkin test yielded values of 5599 (P < 0.001) and 0.871, respectively. The confirmatory factor analysis reaffirmed this model with good fit indices: χ2 792 (P < 0.001), comparative fit index (CFI) and Tucker-Lewis index (TLI) >0.90, and standardized root mean square residual (SRMR) and root mean square error of approximation (RMSEA) <0.06. This study developed and validated the "SF-34 PREG," an adapted version of the SF-36, specifically designed for pregnant women. The SF-34 PREG demonstrated high reliability and a robust factorial structure, making it a more precise and relevant tool for assessing health-related quality of life during pregnancy. Although it does not include the social functioning dimension of the original SF-36, the SF-34 PREG offers improved relevance and accuracy for this specific population. Further research and clinical use of the SF-34 PREG are recommended.

Development and validation of the mpox stigma scale (MSS) and mpox knowledge scale (MKS)

BackgroundFew validated brief scales are available to measure constructs that may hinder mpox-related prevention and care engagement, such as knowledge and stigma. Both are highly salient barriers to infectious disease care and disease understanding, precursors to evaluating one’s risk and need to, for example, accept vaccination. To address this gap, we developed and validated the Mpox Stigma Scale (MSS) and Mpox Knowledge Scale (MKS).MethodsAs part of a full-scale clinical trial, we offered an optional mpox survey to participants who self-identified as African American or Black, were 18–29 years old, and lived in Alabama, Georgia, or North Carolina (2023, N = 330). We calculated psychometric properties through confirmatory factor analyses (CFA) and applied Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Tucker-Lewis Index (TLI) values equal to or exceeding 0.90 and Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) values less than 0.08 to determine adequate model fit. We computed internal reliability using Cronbach’s alpha and calculated Pearson or Spearman correlation coefficients between the MSS and MKS and related variables.ResultsFor the MSS, CFA results showed that the one-factor model fit the data well (χ2(df = 5, N = 330) = 34.962, CFI = 0.97, GFI = 0.99, TLI = 0.94, RMSEA = 0.13, SRMR = 0.03). For the MKS, the one-factor model provided a good fit to the data (χ2(df = 6, N = 330) = 8.44, CFI = 0.99, GFI = 0.99, TLI = 0.95, RMSEA = 0.15, SRMR = 0.02). Cronbach’s alphas were MSS = 0.91 and MKS = 0.83, suggesting good to excellent reliability. The MSS was correlated with the MKS (r = .55, p < .001), stigmatizing attitudes (r = .24, p < .001), attitudes towards mpox vaccination (r=-.12, p = .030), and worry about contracting mpox (r = .44, p < .001). The MKS was correlated with worry about contracting mpox (r = .30, p < .001) and mpox disclosure (r=-.16, p = .003).ConclusionsThe MSS and MKS are reliable and valid tools for public health practice, treatment and prevention research, and behavioral science. Further validation is warranted across populations and geographic locations.Trial RegistrationClinicalTrials.gov NCT05490329.

Omissions by Design in a Survey: Is This a Good Choice when using Structural Equation Models?

Abstract Missing observations can arise due to the effort required to answer many questions in long surveys and the cost required to obtain some responses. Implementing a planned missing design in surveys helps reduce the number of questions each respondent needs to answer, thereby lowering survey fatigue and cutting down on implementation costs. The three-form and the two-method design are two different types of planned missing designs. An important consideration when designing a study with omissions by design is to know how it will affect statistical results. In this work, a simulation study is conducted to analyze how the usual fit measures, root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), comparative fit index (CFI), and Tucker-Lewis index (TLI) perform in the adjustment of a Structural Equation Model. The results revealed that the CFI, TLI, and SRMR indices exhibit sensitivity to omissions with small samples, low factor loadings and large models. Overall, this study contributes to our understanding of the importance of considering omissions by design in market research.

Psychometric Properties of the Turkish Form of a New Scale for Nurse Leaders: Coaching-Based Leadership Scale.

Background: In the current literature, no existing scale that can measure nurse specific coaching-based leadership has been found. Purpose: The study was conducted to determine the Turkish validity and reliability of the Coaching-Based Leadership Scale (CBLS). Methods: The research is methodological. The study was conducted in two sample groups for the employees' and leaders' versions of the scale. Results: The confirmatory factor analysis of the scale revealed that both the employees' and leaders' versions have a 16-item, four-factor structure, and the fit indices were confirmed as follows: for the employees' version: Chi-square (χ2) = 361.948, χ2/degrees of freedom (df) = 4.022, root mean square error of approximation (RMSEA) = 0.133, goodness of fit index (GFI) = 0.808, comparative fit index (CFI) = 0.941, Tucker-Lewis index (TLI) = 0.821, and standardized root mean square residual (SRMR) = 0.0317, and for the leaders' version: χ2 = 180.121, χ2/df = 1.896, RMSEA = 0.104, GFI = 0.809, CFI = 0.970, TLI = 0.962, and SRMR = 0.0177. The obtained fit indices indicated a good fit. The scale-item-total score correlations were found to range from r = 0.816 to r = 0.952 for the employees' version and from r = 0.922 to r = 0.968 for the leaders' version, which were determined to be at an acceptable level. It was determined that the Cronbach's alpha (α) reliability coefficient of the scale was 0.98 in the employees' version and the Cronbach's α coefficients of its subdimensions were 0.93 for working alliance, 0.96 for open communication, 0.97 for learning and development, and 0.96 for progress and results. In the leaders' version, the Cronbach's α reliability coefficient was 0.99, while the Cronbach's α coefficients of its subdimensions were found to be 0.93 for working alliance, 0.96 for open communication, 0.97 for learning and development, and 0.96 for progress and results. Conclusion: It has been determined that the CBLS is a valid and reliable measurement tool for Turkish nursing employees and managers.

Adapting to AI: exploring the implications of AI integration in shaping the accounting and auditing profession for developing economies

The study investigates the adaptability of the accounting and auditing profession in the face of rapid AI integration, focusing on developing economies with Ghana as a case study. It employs a quantitative approach, using a cross-sectional survey design to collect data from accounting and auditing professionals across various sectors in Ghana. A stratified random sampling technique ensures diverse representation, and the data is analysed using structural equation modelling (SEM) tools. The research identifies six key domains and twelve adaptability attributes, including forces of change, leadership qualities, readiness, approach, and resistance to change, which are critical for the profession’s response to disruptive AI technologies. The extracted model, based on these attributes, was validated through a survey, revealing a good model fit with the Standardized Root Mean Square Residual (SRMR) below 0.08 and a Normed Fit Index (NFI) within an acceptable range. The findings suggest that to remain relevant in the AI era, accounting professionals in developing economies must continuously upskill and reskill, alongside cultivating strong business acumen, interpersonal skills, critical thinking, value-added services, and communication abilities. The study emphasizes the importance of policymakers, professional bodies, and leadership within the profession aligning their strategies with these adaptability attributes to enhance resilience and competitiveness in an AI-driven landscape. This research significantly contributes to the understanding of how the accounting and auditing profession in developing economies can navigate the challenges and opportunities presented by AI.

Problematic use of the internet as a predictor of oral health-related quality of life: the mediating role of lifestyles in Peruvian schoolchildren

BackgroundThe pervasiveness of the Internet in everyday life, especially among young people, has raised concerns about its effects on mental health, education, and, recently, oral health. Previous research has suggested a complex relationship between Problematic Internet Use (PIU), lifestyles, and oral health-related quality of life, highlighting the need to examine these interactions further. This study seeks to explore the PIU as a predictor of oral health-related quality of life and examine the mediating role of lifestyles between both in a sample of Peruvian schoolchildren.MethodsA cross-sectional study was carried out with 293 Peruvian students aged 12 to 17 years (M = 14.42, SD = 1.5), using structural equations to analyze the relationship between PIU, lifestyles, and quality of life related to oral health. The data collection procedure was through a face-to-face survey. Validated instruments measured PIU, lifestyles, and oral health-related quality of life. The study’s theoretical model was analyzed through structural equation modeling with the MLR estimator. The fit assessment was performed using the comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR).ResultsThey indicated significant correlations between PIU, lifestyles, and oral health-related quality of life. A negative influence of PIU on lifestyles (β = -0.30, p < .001) and on oral health-related quality of life (β = -0.35, p < .001) was observed, as well as a positive relationship between PIU and oral health-related quality of life (β = 0.29, p < .001). The mediation of lifestyles was statistically significant, suggesting that they mediate the relationship between PIU and oral health-related quality of life.ConclusionsThe study confirms that PIU can negatively affect adolescents’ oral health-related quality of life, mediated by unhealthy lifestyles. It underlines the importance of promoting balanced Internet use and healthy lifestyles among young people to improve their oral well-being.

The Chinese version of patient experience with treatment and self-management (PETS vs. 2.0): translation and validation in patients with multimorbidity in primary care in Hong Kong

BackgroundValidated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care.MethodologyThe translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach’s alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity.ResultsThe mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ2/df = 1.741; root mean square error of approximation (RMSEA) = 0.038; standardized root mean square residual (SRMR) = 0.058; comparative fit index (CFI) = 0.911; Tucker-Lewis Index (TLI) = 0.903). All standardized factor loadings were 0.30 or above. Significant positive correlations between the latent factors were found for all factor pairs (correlation coefficient < 0.8).ConclusionsThe Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained.

Development and Validation of a Malay Version Questionnaire to Evaluate Remote Health Monitoring of COVID-19 via Telehealth Applications: Navigating Telehealth Evolution.

Introduction The rapid adoption of telehealth services due to the COVID-19 pandemic has highlighted the necessity for effective tools to evaluate patient experiences. This study developed and validated the Telehealth Usability, Acceptability, and Satisfaction Questionnaire (TUASQ) for virtual COVID-19 Assessment Centres (CACs) in Malaysia, aiming to comprehensively measure usability, acceptability, and satisfaction. Methodology The TUASQ was developed in two phases. Initially, the questionnaire development phase included item generation guided by the Technology Acceptance Model (TAM) and the Health Belief Model (HBM), with feedback from a panel of six experts. Items were refined through Content Validity Index (CVI) - Item-Level Content Validity Index (I-CVI) ≥ 0.82, Scale-Level Content Validity Index (S-CVI) ≥ 0.82, and Content Validity Ratio (CVR ≥ 0.78); and Face Validity Index (FVI) by 10 respondents - Item-Level Face Validity Index (I-FVI) ≥ 0.82and Scale-Level Face Validity Index (S-FVI ≥ 0.82). The psychometric validation phase involved a cross-sectional study of 705 respondents, recruited through convenience sampling from March to July 2024, to perform Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), followed by reliability testing using Cronbach's alpha, Composite Reliability (CR), and Average Variance Extracted (AVE). Results Content validation showed that most items' I-CVI exceeded 0.82, indicating significant expert consensus on relevance and clarity. The CVR also surpassed the 0.78 threshold, affirming their essential role. Face validation indices generally exceeded 0.80, confirming the questionnaire's clarity and comprehensiveness from the users' perspective. EFA with 250 participants indicated a high Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) of 0.933 and significant Bartlett's test (χ² (136) = 3752.698, p < 0.001), supporting the factorability of the data and extracting three distinct factors. CFA with 455 participants initially showed a poor fit, prompting model adjustments that subsequently improved the fit indices (Root Mean Square Error of Approximation (RMSEA) = 0.076, Standardized Root Mean Square Residual (SRMR) = 0.045, Goodness of Fit Index (GFI) = 0.94, Tucker-Lewis Index (TLI) = 0.96, Comparative Fit Index (CFI) = 0.97). Reliability testing revealed a high internal consistency with Cronbach's alpha of 0.975. CR for each factor exceeded the 0.70 threshold, and the AVE for each factor was above 0.50, indicating good convergent validity. Conclusion The validated TUASQ is a reliable and effective instrument for assessing the experiences of Malaysian patients using virtual CAC. Demonstrating robust psychometric properties through comprehensive validation processes, the TUASQ accurately measures usability, acceptability, and satisfaction, identifying strengths and areas for improvement in telehealth services. This contributes to enhanced care quality and patient satisfaction in the evolving healthcare landscape.

Equivalence Testing Based Fit Index: Standardized Root Mean Squared Residual

A popular measure of model fit in structural equation modeling (SEM) is the standardized root mean squared residual (SRMR) fit index. Equivalence testing has been used to evaluate model fit in structural equation modeling (SEM) but has yet to be applied to SRMR. Accordingly, the present study proposed equivalence-testing based fit tests for the SRMR (ESRMR). Several variations of ESRMR were introduced, incorporating different equivalence bounds and methods of computing confidence intervals. A Monte Carlo simulation study compared these novel tests with traditional methods for evaluating model fit. The results demonstrated that certain ESRMR tests based on an analytic computation of the confidence interval correctly reject poor-fitting models and are well-powered for detecting good-fitting models. We also present an illustrative example with real data to demonstrate how ESRMR may be incorporated into model fit evaluation and reporting. Our recommendation is that ESRMR tests be presented in addition to descriptive fit indices for model fit reporting in SEM.

Psychometric Testing of the Korean Version of the Self-Care of Coronary Heart Disease Inventory Version 3

PurposeThis methodological study evaluated the psychometric properties of the Self-Care of Coronary Heart Disease Inventory version 3 (SC-CHDI v3) in a Korean context. MethodsThe SC-CHDI v3 was translated into Korean following a rigorous translation process. Participants were 452 patients who had experienced coronary heart disease (CHD), all recruited from a tertiary hospital in Korea. Exploratory and confirmatory factor analyses were performed to test construct validity. Concurrent validity was examined by correlating scores from the Korean version of the SC-CHDI v3 with those from the Cardiac Self-Efficacy Scale. Internal consistency was analyzed using Cronbach’s alpha and McDonald’s omega. ResultsThe Korean version of the SC-CHDI v3 consists of 21 items, excluding two from the original instrument. The self-care maintenance subscale identified a two-factor structure: “treatment adherence” and “health-promoting behaviors.” The goodness-of-fit indices were satisfied: χ2 = 18.19, p = .110, comparative fit index (CFI) = .97, Tucker-Lewis Index (TLI) = .95, and standardized root mean square residual (SRMR) = .04. The self-care monitoring subscale consisted of a one-dimensional structure (“monitoring behaviors”) and the goodness-of-fit indices were satisfied: χ2 = 19.19, p = .059, CFI = .99, TLI = .99, and SRMR = .04. The self-care management subscales had a two-factor structure of “consulting behaviors” and “problem-solving behaviors.” The goodness-of-fit indices were satisfied: χ2 = 16.44, p = .037, CFI = .99, TLI = .98, and SRMR = .03. Scores from the Cardiac Self-Efficacy Scale showed a positive correlation with the Korean version of SC-CHDI v3 subscales. Reliability estimates were ≥ .80 for all subscales except for the self-care maintenance subscale. ConclusionsThe Korean version of the SC-CHDI v3 consists of 21 items in 3 subscales and is a valid and reliable instrument. Therefore, healthcare providers can effectively utilize it to assess the self-care levels of patients with CHD.

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.

Structural Model of the Effect of Organizational Climate on Life Satisfaction with the Mediating Role of Job Satisfaction among Employees of Emergency Medical Centers in Ahvaz

Background: Today, human power has a deep connection with organization, and the dimensions of personal and organizational life of people are intertwined in a complicated way. The present study was conducted with the aim of designing a structural model of the effect of organizational climate on life satisfaction with the mediating role of job satisfaction among employees of emergency medical centers. Methods: The present descriptive-analytical study was conducted cross-sectionally in 2021. The statistical population of the research included 270 employees of emergency medical centers in Ahvaz city, including the headquarters, urban and road bases, who were all included in the study using the census method. Data collection tools consisted of Halpin and Croft's organizational climate questionnaires, life satisfaction and Spector's job satisfaction. Data were analyzed using structural equation modeling technique in Smart PLS 3 software. Results: The findings showed that there was a significant and positive relationship between organizational climate and job satisfaction and job satisfaction and life satisfaction in emergency medical workers in Ahvaz city. Organizational climate has a significant and positive effect on life satisfaction through the mediation of job satisfaction. According to the path coefficients, the job satisfaction variable plays a mediating role in the relationship between organizational climate and life satisfaction with 0.51 units (0.776 x 0.663). The values of Standardized Root Mean Square Residual (SRMR) and Normed Fit Index (NFI) index were 0.089 and 0.571, respectively, which indicated the suitability of the presented model regarding the relationship between organizational climate, life satisfaction, and job satisfaction. Conclusion: Considering the effect of organizational climate on life satisfaction and the mediating role of job satisfaction, it is possible to increase employees' life satisfaction by providing a favorable environment in the organization and improving job satisfaction.

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.