Structural Validity Research Articles

Development and Validation of the Participation Questionnaire for Preschoolers with Autism Spectrum Disorder: Structural Validity, Internal Consistency, and Construct Validity

Aim This study aimed to develop the Participation Questionnaire for Preschoolers (PQP) and validate its psychometric properties as a disability-specific tool designed to assess participation in preschool-aged children with autism spectrum disorder (ASD). Methods This cross-sectional study recruited caregivers of 412 children, including those diagnosed with ASD and those at risk for neurodevelopmental disorders. Participants were recruited from child development facilities, medical institutions, and developmental support websites across Japan. Data from 287 children diagnosed with ASD were analyzed for item reduction, followed by exploratory factor analysis and the calculation of Cronbach’s alpha to evaluate internal consistency. Five hypotheses were tested to assess construct validity. Results Item reduction resulted in the removal of seven items and the identification of four factors: Friendship and Education, Family Satisfaction, Daily Living and Independence, and Leisure and Community Life. Cronbach’s alpha values for these factors ranged from 0.74 to 0.88, indicating acceptable internal consistency. Three of the five hypotheses related to construct validity were supported, aligning with expectations. Conclusion The PQP exhibited structural validity, internal consistency, and construct validity. However, further longitudinal studies are needed to validate its measurement properties over time.

Persian version of the McHale co‐parenting scale: The evaluation of the psychometric properties

AbstractValidation of the MacHale Co‐parenting Scale (1997) was examined in a sample of 192 Persian‐speaking parents who had children in primary school. Translation of this scale was performed using the forward–backward method. To assess reliability, internal consistency was used after translating the items into Persian. Face validity, content validity and structural validity were also applied to ensure tool validity. The results indicated that Ballit's sphericity test yielded a value of 1153.138 at a significance level of p < .05. Using varimax rotation, three factors (Family Integrity, Consistency and Conflict) were identified with eigenvalues greater than 1 and factor loadings higher than 0.5. The total factors explained 58.18 per cent of the variance in the data. Additionally, the Cronbach's alpha coefficient for the entire questionnaire was 0.84. The Persian version of the co‐parenting questionnaire has satisfactory psychometric properties with acceptable reliability and validity for measuring joint parenting among Iranian parents in terms of family integrity, consistency and conflict dimensions.

A validation of the Flemish School Burnout Assessment Tool for students between 17 and 21 years old (FS-BAT)

IntroductionThe present study assessed the factor structure, reliability, and convergent validity of the Flemish school burnout assessment tool (FS-BAT) for students between 17 and 21 years old. MethodThe sample consisted of 570 secondary and higher education students between 17 and 21 years old (Mage = 19.14, SDage = 1.11, 81% female). Confirmatory factor analysis (CFA), reliability scores, and the convergent validity were assessed. ResultsCFA revealed four distinguishable but strongly related school burnout core symptoms (i.e., exhaustion, mental distance, cognitive impairment and emotion impairment), referring to one underlying construct ‘school burnout’. The psychological stress complaints and psychosomatic complaints are two separate but positively correlated aspects of the secondary symptoms. The internal consistency of the scales ranged between excellent (.94; total core symptoms scale) and acceptable (.77; psychosomatic complaints scale). The test-retest reliability after five months varied between excellent (the total core scale and secondary symptoms subscales) and good (core symptoms subscales), indicating good stability over time. The convergent validity showed moderate positive correlations with the Perceived Stress Scale and the Perceptions of Academic Stress scale. ConclusionThe current findings illustrate that the FS-BAT can be used as a reliable and valid instrument to assess school burnout symptoms in secondary and higher education students between 17 and 21 years old. Further research to assess the discriminant validity and the relation to other school burnout measures is needed.

Rasch Analysis Of The Dermatology Life Quality Index.

Previous results of the Dermatology-Life-Quality-Index (DLQI) validation in Colombia based on the classical test theory (CTT) perspective have showed the need to delve into its measurement properties. Therefore, we aimed to assess the structural validity, internal consistency and item response analysis of the DLQI through the item response theory (IRT) or the Rasch model. We assessed the dimensionality of the DLQI, determined its difficulty, discrimination and differential functioning and went on to evaluate its internal consistency and discriminative validity among patients with inflammatory and non-inflammatory skin disease. We recruited Colombian patients with different skin diseases. Data of 865 patients (mean age, 49.3 years; 61% females) were included. DLQI-scores ranged from 0 up to 30. Internal consistency for dichotomous item #7 showed a McDonald's Omega coefficient of 0.85 (95%CI, 0.84-0.87) and a Cronbach's α coefficient of 0.86 (95%CI, 0.84-0.88). For ordinal item #7, the McDonald's Omega coefficient was 0.87 (95%IC:0.85-0.89) and Cronbach's α coefficient, 0.84 (95%CI, 0.82-0.87). Horn's parallel analysis revealed the presence of DLQI unidimensionality with a 1-factor solution. Only item #1 fitted the PCM model. The remaining items, including item #9, did not show adequate fit due to overlapping responses and order changes. The validity of DLQI-COL based on Rasch analysis proved not to be a suitable instrument to evaluate QoL in our dermatologic population. A refined version of the scale with an adequate cross-cultural adaptation and validation process is needed to obtain an appropriate and reliable version of the instrument for QOL measuring in Colombian patients with skin diseases.

A validated simulation methodology for determining single lap shear allowable strength in thermoplastic polymer composites

While several modeling approaches exist to simulate the strength of single lap shear configurations, their application to obtaining design allowables for thermoplastic composites remains underexplored. This paper addresses this gap by presenting a novel methodology for the forward propagation of parameter uncertainty using advanced finite element models specifically tailored for thermoplastic carbon fiber composites. The proposed approach goes beyond traditional methods by integrating advanced damage models and a structured validation process, supported by an extensive experimental test campaign.We demonstrate the feasibility of determining design allowables through simulation by examining the influence of batch size on both the validation process and the prediction of allowable strength. Our findings provide new insights into the propagation of uncertainties in the context of composite material design, showing that it is possible to achieve reliable design allowables through simulation, which can significantly accelerate the development of new components while maintaining high safety standards.

The Complex Nature of Ecotourist Experience and its Relationship with Pro-Environmental behavior in a National Park

Background and objective: Despite the increase in the number of studies related to visitor experiences and behavior in ecotourism and outdoor recreation settings, little empirical research has concentrated on how to identify the nature of ecotourists’ experiences within national park settings. Thus, the purpose of this study was to explore the complex nature of ecotourists’ experiences through personal, social, and environmental conditions, and to examine its relationship with pro-environmental behavior in natural environmental settings.Methods: For visitors, a questionnaire survey was administered to 396 adults who visited a national park in South Korea. Cronbach’s alpha coefficient scores were assessed to examine the reliability of ecotourist experiences. The confirmatory factor analysis (CFA) was utilized to explore the construct validity of the factor structure in the measurement variables. Pearson’s correlation coefficients were analyzed to examine the relationships between independent variables. Path analysis was used to examine the contributions of ecotourist experiences to satisfaction and pro-environmental behavior.Results: One of the most important findings is that ecotourist experiences scale shows relatively acceptable measurement properties and reasonable levels of fit. The results in the path model represented that ecotourist satisfaction had large effects on pro-environmental behavior. Based on the fit statistics in the proposed model, the relationship between the measurement variables provides a relatively good fit to the data and verify the convergent validity of the measures. Personal factor of ecotourist experience had significant effects on satisfaction. Additionally, satisfaction had a significant effect on pro-environmental behavior for ecotourists.Conclusion: The findings of the study provide empirical evidence that three dimensions of ecotourist experiences were significantly related to pro-environmental behavior through visitor satisfaction in natural environmental settings. Further study may need to explore the nature of visitor experience and its relationship with behavior of man-made structures in different settings.

Validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale.

Stigma against people who have alcohol and drug problems severely affects their health and well-being. An instrument based on stigma theory assessing individual-level stigma is essential for a comprehensive understanding of their stigma. We evaluated the validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale (SU-SMS-J) among a population who had alcohol or drug use problems. Adults with experience in substance use disorders from psychiatry outpatient departments and rehabilitation facilities participated in the self-administered questionnaire survey. Confirmatory factor analysis was conducted to test the structural validity of the 5-factor model proposed in other language versions, and factor loadings and correlation between the subscales were confirmed. The correlations between the SU-SMS-J and psychometric properties related to substance use (e.g., severity of substance use, motivation to change) were investigated to assess concurrent validity. Internal consistency was assessed using Cronbach's alpha coefficients. Data from 126 participants were analyzed. The 5-factor model was acceptable with good or reasonable model fit indices. The correlations between subscales were weak to moderate, and this result suggested the SU-SMS-J assessed different but related components of stigma: enacted, anticipated, and internalized stigma from different stigma sources (family and healthcare workers). The SU-SMS-J and subscales showed moderate concurrent validity. Internal consistency was mostly sufficient, with Cronbach's alpha coefficients of 0.86 for all items and 0.66-0.93 for subscales. The SU-SMS-J is valid and reliable for use among populations with substance use problems in various settings in Japan.

Measuring depressive symptoms among Latinos in the US: a psychometric evaluation of the CES-D Boston form.

We present a psychometric evaluation of the Center for Epidemiologic Studies Depression Boston Form (CES-D-B) for use with different Latino subgroups as there is inconsistency regarding its performance across subgroups of Latinos, a large and rapidly growing cultural group in the United States. We evaluated the reliability and structural validity of the scores generated by the CES-D-B using four distinct Latino samples residing in US: Mexicans, Venezuelans, Cubans, and "other Latinos" (total N = 1033). To further explore structural validity of CES-D-B scores, we conducted measurement invariance analyses across different countries of origin, gender groups, educational levels, and languages of assessment (English, Spanish). For all four samples, CES-D-B scores were highly reliable as indicated with the coefficients ranging from 0.82 to 0.88, and the factor structure provided an adequate fit to the data with the fit indices CFI/TLI ranging from 0.96 to 0.99, RMSEA estimates between 0.02 and 0.07, and SRMR estimates between 0.02 and 0.04. While measurement invariance analyses for different educational levels indicated scalar invariance across all samples, the same level of measurement equivalency was achieved only for Mexicans and Venezuelans with varying gender and languages of assessment. The findings indicated that CES-D-B scores are internally consistent, possess a strong four-factor structure, and have somewhat equivalent psychometric properties across diverse Latino groups. Findings from this study highlight the importance of considering gender and languages of assessment when assessing depressive symptoms of various Latino subgroups.

Cross-cultural adaptation and validation of the Chinese version of the Trauma Resiliency Scale (tRS-18)

BackgroundTrauma is a prevalent issue in public health, where individuals who experience physical injuries are also at risk of compromised mental health. Psychological resilience is considered a positive indicator that can predict the prognosis of trauma patients throughout their traumatic experiences. Currently, there is a lack of tools in China for measuring the psychological resilience of trauma patients. The aim of this study was to translate and cross-culturally adapt the Trauma Resiliency Scale (tRS-18) into Chinese and to test its reliability and validity in China.MethodsThe Trauma Resiliency Scale (tRS-18) was translated into a Chinese version suitable for the Chinese language environment using the Brislin translation model. A convenience sampling method was used to select 588 trauma patients as study subjects. Reliability was assessed using Cronbach’s alpha coefficient, 14-day test-retest reliability, and split-half reliability. Validity was examined through the content validity index, structural validity, and convergent validity. Structural validity was specifically evaluated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).ResultsThe total variance explained by the single-factor model in the exploratory factor analysis (EFA) of the Chinese version of the tRS-18 was 62.048%, and the factor loading of each item exceeded 0.4. The results of the CFA indicated that the model demonstrated a favorable fit index (X2/df = 1.620; RMSEA = 0.046; SRMR = 0.026; NFI = 0.945; CFI = 0.978; GFI = 0.927; TLI = 0.975; IFI = 0.978). The Cronbach’s alpha coefficient of the reliability index was 0.963, the test-retest reliability was 0.970, and the split-half reliability was 0.964, which were all within the reference value range.ConclusionThe Chinese version of the tRS-18 has good validity and reliability and can be used as an assessment tool for trauma resilience in trauma patients.

Longitudinal validity of the Hyperhidrosis Quality of Life Index (HidroQoL©) in a phase IIIb clinical trial population with hyperhidrosis: responsiveness and meaningful change.

The Hyperhidrosis Quality of Life Index (HidroQoL ©) is a well-developed patient-reported outcome measure assessing the quality of life (QoL) impacts in hyperhidrosis, which has proven very good measurement properties, such as structural validity and internal consistency. We aimed to investigate responsiveness over time and estimate values for meaningful within-person change (MWPC) towards symptom improvement for different measurement time points (4 and 12 weeks), extending the existing validity evidence in patients with primary axillary hyperhidrosis. Data (from a phase IIIb clinical trial) was collected at baseline, week 4, week 8, week 12, week 28, week 52, and week 72. For the assessment of responsiveness, HidroQoL change scores were correlated with corresponding change scores of the Hyperhidrosis Disease Severity Scale (HDSS), the Dermatology Life Quality Index (DLQI), and the gravimetric sweat production based on a-priori formulated hypotheses. Furthermore, it was tested whether the different HDSS change score groups differed significantly from each other over time and whether the HidroQoL was sensitive towards these group differences over time. This was extended by the calculation of matched-pair tests and effect sizes to test significance for each change group separately. For the estimation of MWPC thresholds towards symptom improvement, different anchor-based and integrated approaches were used. In total, the sample was composed of 357 patients with primary axillary hyperhidrosis. For the assessment of responsiveness, 5 out of 14 a-priori hypotheses regarding the correlation of the change scores could be confirmed, whereas the rejected hypotheses only marginally differed from the expected values. Furthermore, regarding responsiveness, the HidroQoL showed sensitivity towards symptom improvement at each measurement time point. Effect sizes were large as expected (d ≥ 0.806). MWPC thresholds towards symptom improvement were proposed for two measurement time points: 5 (week 4) and 6 (week 12). Increasing MWPC values over time were observed. This study extends the evidence for the longitudinal validity of the HidroQoL up to 72 weeks and proposed MWPC thresholds for different time intervals (4 and 12 weeks) after baseline, aiding interpretability. Results concur with findings from previous validation studies.

Enhancing the Precision of the Self-Compassion Scale Short Form (SCS-SF) with Rasch Methodology

Abstract Objectives Precise measurement of self-compassion is essential for informing well-being–related policies. Traditional assessment methods have led to inconsistencies in the factor structure of self-compassion scales. We used Rasch methodology to enhance measurement precision and assess the psychometric properties of the Self-Compassion Scale Short Form (SCS-SF), including its invariance across Ghana, Germany, India, and New Zealand. Method We employed the Partial Credit Rasch model to analyse responses obtained from 1000 individuals randomly selected (i.e. 250 from each country) from a total convenience sample of 1822 recruited from the general populations of Germany, Ghana, India, and New Zealand. Results The initial identification of local dependency among certain items led to a significant misfitting of the SCS-SF to the Rasch model (χ2 (108) = 260.26, p < 0.001). We addressed this issue by merging locally dependent items, using testlets. The solution with three testlets resulted in optimal fit of the SCS-SF to the Rasch model (χ2 (27) = 23.84, p = 0.64), showing evidence of unidimensionality, strong sample targeting (M = 0.20; SD = 0.72), and good reliability (Person Separation Index = 0.71), including invariance across sociodemographic factors. We then developed ordinal-to-interval conversion tables based on the Rasch model’s person estimates. The SCS-SF showed positive correlations with measures of compassion towards others, optimism, and positive affect, alongside negative associations with psychological distress and negative affect. Conclusions The current study supports the reliability, as well as the structural, convergent, and external validity of the SCS-SF. By employing the ordinal-to-interval conversion tables published here, the precision of the measure is significantly enhanced, offering a robust tool for investigating self-compassion across different cultures.

Development and Measurement Properties of the Danish Translation of the Groin Hernia-Q: Protocol for a Validation Study

Background: The patient reported outcome questionnaire Abdominal Hernia-Q is probably the most thoroughly validated patient-reported outcome measure specifically developed for patients undergoing ventral hernia repair. The present study aims to adapt and validate the Danish translation of the Abdominal Hernia-Q for patients undergoing groin hernia repair: the Groin Hernia-Q. Methods: This validation study will involve a total of 250 participants and it is divided into two substudies. Substudy 1 will focus on adapting the Abdominal Hernia-Q into the Groin Hernia-Q and assessing its content validity using the QQ-10 questionnaire. Substudy 2 will evaluate the structural validity, internal consistency, test-retest reliability, measurement error and construct validity of the Groin Hernia-Q, while also utilizing and comparing the results to the Carolinas Comfort Scale and Short-Form 12. Participants will be recruited both in a clinical setting and electronically. Data collection will be conducted through the platform Research Electronic Data Capture (REDCap). In addition to questionnaire data, this study will also involve perioperative and patient-related data extracted from the Danish National Patient Registry and the Danish Hernia Database. This study is part of the AFTERHERNIA Project. Conclusion: This study will provide a comprehensive validation of the Groin Hernia-Q, ensuring it becomes a valuable tool for assessing patient-reported outcomes in patients undergoing groin hernia repair. The questionnaire will contribute significantly to improved patient care through the AFTERHERNIA Project.

Catalytic function of the laccase enzyme in response to chlorpyrifos and 2,4-dichlorophenoxyacetic acid: behavior in controlled and simulated environments.

Enzymes secreted by white-rot fungi, such as laccase, offer a promising solution for treating xenobiotic compounds dangerous to the environment and human health. This study aimed to perform a comprehensive analysis of the tolerance of Pleurotus pulmonarius LBM 105 and its laccase activity toward the pesticides 2,4-D and chlorpyrifos both in vitro and in silico. The fungal strain was able to grow in different concentrations of the pesticides, showing evident morphological alterations. Laccase activity and a 53kDa electromorph were present in all treatments, showing significant stability with peak activity achieved at a pH of 5.6 and within a temperature range of 50-60°C. Three laccase genes were mapped, annotated, and characterized from the genome. PplacI obtained better structural validation and affinity energy of - 5.05 and - 7.65kcalmol-1 with 2,4-D and chlorpyrifos, respectively. The Molecular Mechanics/Poisson-Boltzmann Surface Area analysis at 250ns confirmed the docking results, revealing the existence of stronger hydrophobic interactions between laccase and chlorpyrifos and highlighting the importance of the Phe341 residue in stabilizing both complexes. Understanding the impact of pesticides on laccase's catalytic function is key to formulating and applying future biotechnological strategies with this enzyme.

Design and development of dual targeting CAR protein for the development of CAR T-cell therapy against KRAS mutated pancreatic ductal adenocarcinoma using computational approaches

Mutant KRAS promotes the proliferation, metastasis, and aggressiveness of various cancers including pancreatic ductal adenocarcinoma (PDAC), non-small cell lung cancer (NSCLC), and colorectal adenocarcinoma (CRC) respectively. Mutant KRAS therapeutics are limited, while Sotorasib and Adagrasib were the only FDA-approved drugs for the treatment of KRASG12C mutated NSCLC. Chimeric antigen receptor (CAR) T-cell therapy has been emerged as an effective strategy against hematological malignancies and being extended towards solid cancers including PDAC. mesothelin (MSLN) and Carcinoembryonic Antigen (CEA) were reported to be highly overexpressed in KRAS-mutated PDAC. Meanwhile, in clinical trials, several CAR T-cell therapy studies are mainly focused towards these two cancer antigens in PDAC, however, the dual targeting of these two neoantigens is not reported. In the present study, we have designed and developed a novel dual-targeting CAR protein by employing various bioinformatics approaches such as functional analysis (antigenicity, allergenicity, antigen binding sites & signalling cascades), qualitative analysis (physicochemical, prediction, refinement & validation of 2D and 3D structures), molecular docking, and in silico cloning. Our results revealed that the designed CAR protein specifically binds with both MSLN & CEA with significant binding affinities, and was predicted to be stable & non-allergenic. Additionally, the protein–protein interaction network reveals the T-cell mediated antitumor responses of each domain in the designed CAR. Conclusively, we have designed and developed a dual targeting (MSLN & CEA) CAR protein towards KRAS-mutated PDAC using computational approaches. Alongside, we further recommend to engineer this designed CAR in T-cells and evaluating their therapeutic efficiency in in vitro and in vivo studies in the near future.

The French Version of the Academic Major Satisfaction Scale: Structural, Convergent, and Divergent Validity

The French Version of the Academic Major Satisfaction Scale: Structural, Convergent, and Divergent Validity

Validating an Internalizing Psychopathology Screener for Use with College Students

Objective College students experience high levels of internalizing psychopathology. The current study evaluated multiple sources of validity evidence for using the Youth Internalizing Problems Screener (YIPS) to identify college students with these concerns. Method We evaluated responses to the YIPS and criterion measures with a sample of N = 454 young adults enrolled in a large public university in the USA (M age = 20.02, female = 74%, White = 60%). Analyses addressed structural and criterion validity evidence. Results Results showed strong levels of validity evidence for the YIPS factor structure and theory-consistent correlations with criterion variables. YIPS scores had moderate to strong accuracy for estimating symptom severity levels for both anxiety and depression. Conclusions Results suggest the YIPS is a psychometrically sound screener for internalizing psychopathology among college students, supported by multiple sources of validity evidence. Significance statement Our findings suggest mental health professionals might use the YIPS in college settings for identifying young adults presenting with varying levels of anxiety and depression symptoms. Given the YIPS is brief, free, and publicly available, it may be more feasible than alternative internalizing screeners available for this purpose.

Negative Beliefs About Working with Health Problems and Support at Work as Predictors for Return to Work for People Struggling with Common Mental Disorders.

The purpose of this study was to investigate predictors for return to work for people struggling with common mental disorders on sick leave or at risk of sick leave. The first aim of this study was to evaluate the psychometric properties of a set of statements exploring different conditions at the workplace and assumptions about working with health problems, by investigating the factor structure, reliability and construct validity of these statements. The second aim of this study was to investigate the predictive value of the identified factors. A total of 797 patients from an outpatient mental health clinic were included in a naturalistic observational study. The study design was longitudinal. The participants filled out self-report questionnaires pre- and post-treatment. A principal component factor analysis with a varimax rotation identified two factors, Negative beliefs about working with health problems and Support at work, displaying high internal consistency, 0.83 and 0.84, respectively. Separately, both factors were significant predictors of full return to work after treatment. The final multivariable analysis including both factors left Negative beliefs about working with health problems as a significant predictor explaining unique variance. Negative beliefs about working with health problems and Support at work are important predictors for work status after treatment and should therefore be addressed during treatment for common mental disorders to assist people return to work.

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

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

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

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

Validation of the CRAVE-C scale in Chinese adults: a four-study examination of competing motivations for physical activity versus rest.

The study aimed to validate the Cravings for Rest and Volitional Energy Expenditure (CRAVE) scale among Chinese adults with different health conditions (healthy control, chronic illnesses, and psychiatric disorders) and skill levels (athletes vs. non-athletes). In Study 1, a confirmatory factor analysis (CFA) using the Maximum Likelihood Method (MLM) was performed on a Chinese sample of emerging adults (N = 481) to evaluate the structural validity of the Cravings for Rest and Volitional Energy Expenditure-Chinese version (CRAVE-C). In Study 2, differences in "Move" and "Rest" desires were examined among patients with psychiatric disorders, patients with chronic illnesses, and healthy controls. In study 3, investigated the relationship between cardiorespiratory fitness and exercise motivation using the CRAVE-C (N = 83). In Study 4, the changes in "Move" desire from baseline to post-training were compared between athletes and non-athletes. Results from Study 1 indicated that the 10-item CRAVE-C showed good fit indices ( Chi2 (34) = 118.769, CFI = 0.95, TLI = 0.934, SRMR = 0.053, RMSEA = 0.072). "Move" positively correlated with various factors of the Affective Exercise Experiences Questionnaire-Chinese and the Physical Effort Scale-Chinese, while "Rest" correlated negatively. In Study 2, Patients with psychiatric disorders had a significantly higher "Move" desire than healthy controls. Patients with chronic illnesses had a significantly higher "Rest" desire than healthy controls. In Study 3, higher cardiorespiratory fitness was associated with a slight increase in "Move" desire (3.26% ± 37.35%) and a decrease in "Rest" desire (18.94% ± 66.99%). Lower fitness was linked to a significant decline in "Move" desire (-54.61% ± 111.33%) and an increase in "Rest" desire (43.62% ± 63.64%). In Study 4, the athlete group demonstrated a significant increase in "Move" desire from baseline to post-training, whereas the non-athlete group reported a significant decrease in "Move" desire from baseline to post-training. The 10-item CRAVE-C has good reliability and validity in the Chinese cultural context and can be used among Chinese adults with different health conditions and skill levels.