Underlying Factor Structure Research Articles

Paper 75: Development and Validation of the KOOS-ACL: A Short-form Version of the KOOS for Young Patients with ACL Tears

Objectives:To develop and validate a short form, disease-specific version of the KOOS appropriate for the young active ACL deficient population: the KOOS-ACL.Methods:A baseline dataset of 605 young patients (< 25 years) with ACL tears was divided into a development and validation sample. Exploratory factor analyses were conducted in the development sample to identify the underlying factor structure and reduce the number of KOOS items based on statistical and conceptual indicators. Confirmatory factor analyses were conducted to check fit indices of the proposed KOOS-ACL model in both samples. Structural validity, reliability, and responsiveness to change were assessed in the full sample at five timepoints: baseline and 3 months, 6 months, 12 months and 24 months post-operatively.Results:Two factors were deemed most appropriate for the KOOS-ACL: Functionality and Sport. Fifteen items were removed from the full length KOOS based on discriminant validity (i.e., lack of distinctiveness between some proposed constructs) and another fifteen items were removed for repetitive content. The final KOOS-ACL model showed acceptable structural validity (CFI and TLI > 0.9, RMSEA and SRMR < 0.08), internal consistency reliability (a > 0.8), and responsiveness to change (effect size > 0.8) at all five timepoints in the dataset. The KOOS-ACL showed strong and significant correlations to the original KOOS and IKDC at all timepoints (r > 0.7).Conclusions:The new KOOS-ACL questionnaire contains 12 items and two subscales relevant to young active ACL patients. The KOOS-ACL would reduce patient burden by more than two thirds and provides improved structural validity compared to the full length KOOS while maintaining adequate psychometric properties and relatedness to other popular outcome measures currently used following ACL injuries. The KOOS-ACL may be a more relevant outcome to use with young active ACL patients within the two years of surgery.

Psychometrics of the SDQ-I for Palestinian Adolescent Students

The Self-description Questionnaire–I (SDQ–I) is a multidimensional instrument that measures eight self-concept facets hypothesized in Shavelson’s hierarchical model. This study investigated self-concept in a sample of Palestinian adolescent students using an Arabic version of the SDQ–I. Three-hundred sixty adolescents (163 girls and 197 boys) aged 13 to 16 years (M = 14.3, SD = .87) participated. The 72-item SDQ–I was administered in four Palestinian schools to assess the psychometric properties of the SDQ–I. This included the factor structure and the internal consistency reliability of the SDQ–I subscales and mean score responses of Palestinian self-concept. Factor analysis results, which accounted for the majority of the variance, supported an underlying general self-concept factor structure that demonstrated the eight factors that the SDQ–I is designed to measure. This is consistent with previous studies in similar age groups and the SDQ– I reliabilities were similar to those reported in the literature. Students perceived total self-concept positively (mean = 3.71). Three facets of self-concept (parent relations, reading, and general self-concept) indicated high positive selfconcept. Correlations among the different dimensions were consistent with the hierarchical structure in Shavelson’s model. Overall, the findings provided compelling support for Shavelson’s model, and the structure validity of Western self-concept measure. Interpretations were provided for the discrepancies regarding the Palestinian-Arab culture.

Predictors of expert providers' familiarity with intervention practices for school- and transition-age youth with autism spectrum disorder.

School-age children, adolescents, and young adults with autism spectrum disorder encounter many different types of providers in their pursuit of treatment for anxiety, behavior problems, and social difficulties. These providers may all be familiar with different types of intervention practices. However, research has not yet investigated patterns in expert providers' familiarity with different practices nor how these patterns are related to the characteristics of providers (years in practice, academic discipline, setting) and the youth (age and intellectual disability) they typically support. A panel of 53 expert transdisciplinary providers rated their familiarity with 55 intervention practices (derived from research and expert nominations) via an online Delphi poll. Advanced statistical methods were used to identify types of intervention practices with which providers were familiar, which included two approaches (cognitive and behavioral) and two strategies (engagement and accessibility). Providers who practiced outside a school setting or treated clients without intellectual disability were more familiar with cognitive approaches. Clinical psychologists, behavior analysts, and school-based providers were more familiar with behavioral approaches. Providers practicing outside school settings were also more familiar with engagement strategies, and providers with more years in practice were more familiar with accessibility strategies. These results may help families and researchers to better anticipate how services may vary depending on the types of autism spectrum disorder providers seen and work to reduce disparities in care that may result.

Validation of the Dyspnoea-12 and Multidimensional Dyspnea profile among older Swedish men in the population

BackgroundThe Dyspnoea-12 (D12) and Multidimensional dyspnea profile (MDP) are commonly used instruments for assessing multiple dimensions of breathlessness but have not been validated in older people in the population. The aim of this study was to validate the D12 and MDP in 73-years old men in terms of the instruments’ underlying factor structures, internal consistency, and validity.MethodsA postal survey was sent out to a population sample of 73-years old men (n = 1,193) in southern Sweden. The two-factor structures were evaluated with confirmatory factor analysis, internal consistency with Cronbach's alpha, and validity using Pearson´s correlations with validated scales of breathlessness, anxiety, depression, fatigue, physical/mental quality of life, body mass index (BMI), and cardiorespiratory disease.ResultsA total 684 men were included. Respiratory and cardiovascular disease were reported by 17% and 38%, respectively. For D12 and MDP, the proposed two-factor structure was not fully confirmed in this population. Internal consistency was excellent for all D12 and MDP domain scores (Cronbach's alpha scores > 0.92), and the instruments’ domains showed concurrent validity with other breathlessness scales, and discriminant validity with anxiety, depression, physical/mental quality of life, BMI, and cardiorespiratory disease.ConclusionsIn a population sample of 73-years old men, the D12 and MDP had good psychometrical properties in terms of reliability and validity, which supports that the instruments are valid for use in population studies of older men.

Perceived forcedness and perils of migration: Development and validation of a questionnaire for residents in receiving countries

ObjectivesFor refugees in receiving countries, integration is a growing challenge, and a core factor in this process is residents’ perceptions of refugees. This study examines whether perceived forcedness of migration affects residents’ reactions to new members of society. In doing so, we introduce a new questionnaire to assess forcedness and perils of migration as perceived by residents of receiving countries. The PMF-Res (Perceived Migration Forcedness – Residents) allows one to compare residents’ reactions to refugees and non-refugee migrants. MethodsIn Study 1 (N1 = 925; 39% male, 60% female, 1% non-binary; age: M = 45.44; SD = 16.30), we piloted theoretically derived items and examined their underlying factor structure. Study 2 (N2 = 1056; 41% male, 57% female, 1% non-binary, 1% no information; age: M = 50.69; SD = 14.54) replicated these results with an independent sample and further analyzed the psychometric properties of the new measure. ResultsStudy 1 supported the assumed four-dimensional factor structure (i.e., perceived locus of causality; perceived options for choice; perceived pre-migration perils; and perceived migration perils). Study 2 replicated this structure with an independent sample and an experimental design. Furthermore, results provided strong evidence for reliability, construct validity, and sensitivity of the new measure. ConclusionsThe new PMF-Res offers a reliable, valid, and efficient measure to assess forcedness and perils of migration from the perspective of receiving countries’ residents, and the PMF-Res may be used for both research and applied purposes.

User Preferences in Drone Design and Operation

Drones, which were first used in military applications, are now widely used by civilians for various purposes such as for deliveries and as cameras. There has been a lack of research into what drone users expect in terms of drone design and operation from a user perspective. In order to figure out what users want from drones, it is necessary to investigate the perception and design preferences of users with regard to drones. Surveys were conducted to collect data on preferences for various aspects of the design and operation of drone technology. Features relevant to the design and operation of drones were considered. We have identified the underlying factor structures of drone design and operation: outdoor mission type, user interface, military mission type, usefulness, risk, special mission type, and concern. The most important factors that contribute to all the dependent variables are the user interface and usefulness. The fact that drones will be increasingly used in the future is clear; however, the purpose of this study was to find out the areas on which to focus and pay further attention.

Psychometric evaluation of the Chinese version of social anxiety scale for social media users and cross-sectional investigation into this disorder among college students

BackgroundRecent years have seen an increased incidence of social anxiety due to increasing intensive use of social media, especially among young adults. ObjectiveThe present study aimed to translate the original English version of Social Anxiety Scale for Social Media Users (SAS-SMU) into Chinese, examine its applicability among Chinese College students via reliability and validity indexes, and investigate the influencing factors contributing to SAS-SMU. MethodsA cross-sectional study was conducted among a cohort of 1307 Chinese college students, 486 males and 821 females, aged 20.75 ± 3.13 years old. The original version of SAS-SMU was translated into Chinese using the backward and forward translation procedure. An exploratory factor analysis (EFA) and a confirmatory factor (CFA) analysis were used for construction of underlying factor structure. Criterion-related validity was assessed using Interaction anxiousness scale (IAS) and the “extraversion” domain of Eysenck Personality Short Scale (EPQ-R-S). Cronbach's alpha coefficient was computed for evaluation of internal consistency. A multivariate stepwise linear regression analysis was conducted for determining the potential correlates of SMU-related social anxiety. ResultsThe final Chinese version of SAS-SMU had 21 items. Item analysis, exploratory factor, EFA, and CFA jointly supported a three-factor structure of the translated version, defined as social recognition anxiety, interaction anxiety, and privacy concern anxiety, respectively. The three-factor structure of this scale showed configural, metric, scalar measurement invariance across gender. Cronbach's alpha coefficient of the scale and its three subscales were 0.96, 0.93, 0.94, and 0.91, respectively. The mean SAS-SMU overall score for each college student was 51.63 ± 16.32, with 21.64 ± 7.24 (recognition anxiety), 17.10 ± 6.30 (interaction anxiety), 12.90 ± 4.61 (privacy concern anxiety) for each subscale, respectively. IAS score, mobile phone addiction index (MPAI) score, EPQ-E score, time spent on social media per week, relationship with parents, childhood life status, whether being an only child, and cyber bullying experience can explain 51.1% of the variance of SMU related social anxiety. ConclusionBased on the data, the Chinese version of SAS-SMU has shown to be satisfactory in psychometric properties. Subjects prone to interaction anxiousness, addictive smartphone use, extraversion personality trait, bad relationship with parents, unfortunate childhood life, only-child status, and having cyberbullying experience tend to have a higher level of SMU related social anxiety.

Estimating Forward-Looking Stock Correlations from Risk Factors

This study provides fully mathematically and economically feasible solutions to estimating implied correlation matrices in equity markets. Factor analysis is combined with option data to receive ex ante beliefs for cross-sectional correlations. Necessary conditions for implied correlation matrices to be realistic, both in a mathematical and in an economical sense, are developed. An evaluation of existing models reveals that none can comply with the developed conditions consistently. This study overcomes this pitfall and provides two estimation models via exploiting the underlying factor structure of returns. The first solution reformulates the task into a constrained nearest correlation matrix problem. This method can be used either as a stand-alone instrument or as a repair tool to re-establish the feasibility of another model’s estimate. One of these properties is matrix invertibility, which is especially valuable for portfolio optimization tasks. The second solution transforms common risk factors into an implied correlation matrix. The solutions are evaluated upon empirical experiments of S&amp;P 100 and S&amp;P 500 data. They turn out to require modest computational power and comply with the developed constraints. Thus, they provide practitioners with a reliable method to estimate realistic implied correlation matrices.

The characteristics of occupational tuberculosis risk in healthcare workers.

Tuberculosis (TB) remains to be one of the most common causes of morbidity worldwide, but the discourse of its prevention has disproportionately singled out the occupational risks that affect healthcare workers. In this research, we aimed to: (1) investigate the underlying factor structure of Risk Characteristics (RC), specifically the risk of nosocomial TB transmission in health care facilities; (2) estimate the effects of work-related determinants and RC on risk perception; and (3) compare occupational risk perception of contracting TB with expert risk assessment. A paper-based questionnaire was administered to 179 health care workers (HCWs) working at 10 public health centres and two hospitals in Surabaya, Indonesia. We analysed our data using exploratory factor analysis (EFA) to unravel the latent structure of RC and structural equation modelling (SEM) to identify determinants of risk perceptions. EFA revealed a two-factor solution for nine qualitative RC: controllability of damage and knowledge-evoked dread. Our SEM analysis found evidence that the controllability aspect of the TB risk was a more profound determinant in predicting risk perception than knowledge-evoked dread, implying that HCWs might benefit from training aims to increase their beliefs on the controllability of TB risk despite its severity. Although further research is necessary, our study highlights the importance of addressing occupational risk perceptions in health facilities, encouraging HCWs to become more active in advocating for the necessary allocation of resources for their workplaces, and raising communities' awareness of TB transmissions.

Examining the Constructs of Burnout, Compassion Fatigue, Secondary Traumatic Stress in Physicians Using Factor Analyses.

BackgroundAdverse affective experiences have been well-documented in healthcare providers. Research describes them under a variety of terms, including burnout, secondary traumatic stress (STS), and compassion fatigue (CF). The present study evaluates conflicting models of STS, CF, and burnout constructs in physicians.MethodsSurveys were mailed to all allopathic physicians with active Rhode Island medical licenses. Three hundred and seventy-five complete responses were received. The survey included common measures of STS, CF, and burnout. Confirmatory Factor Analysis (CFA) was used to evaluate discriminant validity of the three constructs and test 5 a priori (1-, 2-, and 3-factor) theoretical models, and Exploratory Factor Analysis (EFA) was planned assess underlying factor structure in the case that CFA did not provide evidence supporting any existing model.ResultsBy CFA, all five a priori models of burnout, CF, and STS fail to demonstrate adequate model fit (Standardized Root Mean Square Residual >0.10, Tucker-Lewis Index <0.90). EFA with parallel analysis extracts four factors underlying the three burnout, STS, and CF measures. The four factors describe 54.3% of variance and can be described as (1) depressive mood; (2) primary traumatic stress-like symptoms; (3) responses to patients' trauma; and (4) sleep disturbances.ConclusionIn spite of abundant discussion surrounding burnout, CF, and STS in physicians, measures of these constructs did not uphold their theoretical factor structures in the present study. Future research might explore other constructs and measures that may describe adverse affective physician experiences.

Structural validity of the Eating Disorder Examination-Questionnaire: A systematic review.

ObjectiveThe main aim was to perform a systematic literature review of studies investigating the factor structure of the Eating Disorder Examination‐Questionnaire (EDE‐Q), a widely used measure of eating pathology. Secondary aims were to summarize the quality of reporting of latent variable (factor) analyses in these studies and review support for different factor solutions.MethodLiterature was identified through Scopus, Medline, PsycInfo, and ProQuest databases published up to February 23, 2022 and outreach via an international listserv. All studies published in English reporting factor analysis of the EDE‐Q were included with few restrictions. Sixty studies including 63,389 participants met inclusion criteria.ResultsThe originally proposed four‐factor solution received little empirical support, although few alternative models have been robustly evaluated. Items assessing shape and weight concerns frequently coalesce in factor solutions, suggesting that these constructs are closely related. Investigations of brief versions of the EDE‐Q have produced more consistent findings, suggesting that these measures, particularly a seven‐item version, might be useful alternatives to the full version. Quality of studies was reasonable, with important methodological elements of factor analysis often reported.DiscussionThe findings are of relevance to practitioners and researchers, suggesting that the “original” factor structure of the EDE‐Q should be reconsidered and that use of a seven‐item version is to be encouraged.Public SignificanceSelf‐report questionnaires are widely used in the assessment of disordered eating. The current study found that there is little consensus about the structure of a common measure of eating psychopathology. There is more consistent support for a brief, seven‐item, version assessing dietary restraint, body dissatisfaction, and overvaluation of weight and shape.

Preliminary Validation of the Pain-related Prayer Scale (PPRAYERS): An Exploratory Factor Analysis

Previous research on prayer as a pain coping strategy is mixed, with some studies associating prayer practices with greater pain and others with less. To date there is only one measure of pain-related prayer, the prayer subscale of the Coping Strategies Questionnaire-Revised (CSQ-R), which solely measures passive prayer, thus neglecting other types of petitionary prayer (i.e., active and neutral prayer). Therefore, to better understand the relationship between pain and prayer there is a need for a more comprehensive measure of petitionary prayer for pain. The aim of this study is to conduct a preliminary validation of the newly developed Pain-related Prayer Scale (PPRAYERS), a 22-item self-report questionnaire that asks participants to rate the frequency of their use of various petitionary prayer statements to God or a Higher Power in response to pain. Statements included active, passive, and neutral petitionary prayer statements. Two hundred and five adults with chronic pain completed a series of demographic, health, and pain-related questionnaires including the PPRAYERS. A maximum likelihood factor analysis with an oblimin rotation was used to examine the underlying factor structure of PPRAYERS. The scree plot and factor eigenvalues (>1) were evaluated. Factor loadings (>0.30) and cross-loadings were used to evaluate individual items. Congruent with theory, analysis yielded three factors, neutral, passive, and active prayer, that explained 40%, 15%, and 10% of the total variance, respectively. All but four items demonstrated primary loadings on one factor with primary loadings >0.5 and a difference between primary and secondary loadings >0.2. These results provide preliminary validation for PPRAYERS that measures active-, passive-, and neutral-style petitionary prayer. Additional research by the authors is ongoing to confirm the factor structure of the measure and provide evidence for convergent and discriminant validity by examining the associations between PPRAYERS and existing relevant measures. Grant support from 2021 Episcopal Church United Thank Offering Grant.

Measuring hope: psychometric properties of the children’s Hope Scale among South Sudanese refugee children

We investigated the psychometric properties of the Children’s Hope Scale among a sample of 1,118 South Sudanese refugee children (570 girls, 548 boys) aged 9 to 14 years displaced in Uganda. We assessed the underlying factor structure and model fit through exploratory and confirmatory factor analyses and measurement invariance by sex and developmental stage. Confirmatory factor analysis revealed good fit for a one-factor model with the error terms of items 1 and 3 and items 4 and 6 allowed to covary. There was no evidence of differential item functioning by group. Evidence from this study supports the use of a unidimensional model of hopefulness across groups and signifies the importance of confirming these properties for measures used to evaluate humanitarian interventions.

Ethnocentrism: A Short Form Measure (SFGENE-7)

The purpose of this investigation is to develop and validate a short form of the Generalized Ethnocentrism Scale (GENE). The GENE scale measures people’s tendency to consider their culture as the center of the world. A total of four studies were conducted using samples of college students. In the Study 1 has been examined the underlying factor structure of the GENE measure. Based on this study, the Short Form Generalized Ethnocentrism Scale is proposed (SFGENE-7). In the second study, the two-factor structure evidenced in Study 1, was supported by a confirmatory factor analysis (CFA). The psychometric properties of the short form of the GENE scale were also satisfactory. In the third study, the two-factor structure was submitted again to CFA. The investigation of the relationship between ethnocentrism and external variables was also examined. The results supported the convergent, discriminant and incremental validities. Finally, in the fourth study, temporal stability of the short form of the GENE scale has been assessed. The results demonstrated that the SFGENE-7 had adequate test-retest reliability. Overall, results reveal that the SFGENE-7 has adequate levels of reliability, convergent validity, discriminant validity, and incremental validity. We obtained a short, reliable, and valid instrument to assess ethnocentrism.

The Dutch 20 Item Centrality of Event Scale

Abstract: Event centrality is defined as the extent to which a memory of a traumatic event forms a reference point for people’s identity and attribution of meaning to other experiences in their life. Event centrality is typically measured with the Centrality of Event Scale (CES; Berntsen &amp; Rubin, 2006 ). The present study’s first aim was to investigate the underlying factor structure and construct validity of the Dutch 20-item CES (CES-20) in undergraduates ( N = 1,091). The second aim was to test whether the CES-20 could prospectively predict posttraumatic stress disorder (PTSD) symptoms four months later. The data supported a one-factor structure of the CES with a high internal consistency (α = .95), which is not in line with the theoretical model of event centrality but aligns with previous empirical research. Furthermore, high construct validity was evidenced by positive and significant relations between the CES and PTSD symptoms, depressive symptoms, DSM-5 trauma A criterion, and the number of experienced negative life events. Event centrality was not a significant predictor of PTSD symptoms four months later when controlling for PTSD symptoms at time 1, which questions the prospective relation between event centrality and later PTSD symptoms for those events.

Development of an Instrument to Measure Dietary Supplement Health Literacy

Background:Health literacy is one of the important social determinants of health.Objective:The aim of this study was to develop an instrument to measure Dietary Supplement Health Literacy (DSHL) of Iranian women.Methods:In this psychometrics study, an initial nine-factor instrument was developed. Face validity and content validity of the instrument were evaluated. The factor structure of the instrument was explored by the Exploratory Factor Analysis (EFA) among 400 women taking Dietary supplement. Confirmatory Factor Analysis (CFA) was done to determine the underlying factor structure of the instrument in this population. The internal and external reliability of the instrument was evaluated.Key Results:According to expert panel opinions, 16 items were deleted. The results of the EFA showed that the Kaiser-Meyer-Olkin and Bartlett's test of sphericity were significant. EFA showed that 30 items could be grouped into nine factors that accounted for 60.84% of the variance. Since two items in the ability to actively engage with health care providers factor were loaded in factor 1, this factor was labeled Engaging in receiving informational supports from health care providers. In addition, one item of the dimension was loaded in factor 3. Given that the one item of factor 5 and 1 item of factor 6 were loaded in a new factor 9, this factor was labeled Applying information to decision-making. The CFA indicated that the nine-factor structure of the DSHL instrument had a poor fit. To modify indices, factor 9 with 2 items and 1 item of factor 6 were deleted. The Cronbach's alpha and intraclass correlation coefficient of the instrument were acceptable. Finally, a 27-item instrument with 8 dimensions was confirmed.Conclusions:The results of the study showed that the instrument developed was a valid tool for identifying the DSHL of Iranian women. [HLRP: Health Literacy Research and Practice. 2022;6(2):e159–e166.]Plain Language Summary:This study sought to develop and validate a multidimensional instrument to measure the health literacy of Iranian women about dietary supplements that was performed from July 2019 to May 2020 in Iran. Findings showed that the 30-item instrument developed in this study is a valid instrument to be used for identifying the health literacy of Iranian women about dietary supplements.

The factor structure of the Barratt Impulsiveness Scale (BIS-11) and correlates of impulsivity among outpatients with schizophrenia and other psychotic disorders in Singapore

BackgroundImpulsivity has been linked to risky behaviours amongst patients with schizophrenia or other psychotic disorders. However, there is a dearth of studies examining impulsivity amongst this population in Singapore. Moreover, to date, scales to measure impulsivity have not been validated in this population. The present study seeks to examine the underlying factor structure of the Barratt Impulsiveness Scale (BIS-11) and explore sociodemographic and clinical correlates of impulsivity within this group.MethodsConfirmatory factor analyses (CFA) were conducted to test factor structures of the BIS-11 proposed in extant literature. However, due to poor fit statistics, the sample (n = 397) was split into two groups, with Exploratory Factor Analyses (EFA) conducted in the first subgroup (n = 200). The final model of the EFA was then tested within the second subgroup (n = 197) with CFA. Multivariable linear regressions were conducted to examine sociodemographic and clinical correlates of each underlying factor.ResultsCFA indicated a three-factor structure amongst 16-items of the BIS-11 with acceptable fit: i) Non-planning impulsivity (5-items; α = 0.94), ii) Motor impulsiveness (6-items α = 0.84), and iii) Lack of self-control (5-items, α = 0.85). Lower education was associated with higher non-planning impulsivity. While age, ethnicity, marital status, and general psychiatric symptom severity were significant correlates of motor impulsiveness, problematic alcohol use and general psychiatric symptom severity were related to a greater lack of self-control.ConclusionFactor structures of the BIS-11 suggested by extant literature were not applicable, and we propose an alternative factor structure for BIS-11. Significant correlates of impulsivity are highlighted, and avenues for future research are suggested.

Validity of the Greek NMP-Q and Sociodemographic Determinants of Nomophobia Among University Students

Nomophobia is defined as the fears caused to individuals by the lack of access or use their smartphone. The aim was to make a cultural adaptation and validation of the Greek version of the Nomophobia Questionnaire (NMP-Q) as well as to explore nomophobia’s association with several sociodemographic determinants among university students. The original NMP-Q was translated from English into Greek language using both backwards and forwards processes. The underlying factor structure of questionnaire was investigated through exploratory and confirmatory factor analysis. Multiple regression analyses were used to determine the associations between nomophobia scales and specific characteristics of the university students. Exploratory and confirmatory factor analysis revealed a four-factor structure. Moreover, a second-order factor was identified as a total nomophobia scale. All factors presented adequate psychometric properties in accordance to the original NMP-Q. Multiple regression models showed significant associations of nomophobia scales with sociodemographic characteristics as gender, age, father’s education and daily smartphone usage.

Hand hygiene compliance and its drivers in long-term care facilities; observations and a survey

BackgroundHand hygiene is an important measure to prevent healthcare-associated infections in long-term care facilities.ObjectivesTo evaluate compliance with hand hygiene recommendations by different nursing professionals in long-term care facilities and to investigate determinants potentially influencing hand hygiene and whether these differed between the different cadres of staff.MethodsWe conducted two sub-studies: we measured hand hygiene compliance of 496 professionals in 14 long-term care facilities (23 wards) through direct observation using World Health Organisation’s ‘five moments of hand hygiene’ observation tool. In addition, we performed a survey to examine determinants that may influence hand hygiene and to determine differences between different cadres of staff. We used a principal component analysis approach with varimax rotation to explore the underlying factor structure of the determinants.ResultsWe found an overall mean hand hygiene compliance of 17%. There was considerable variation between wards (5–38%) and between specific World Health Organization hand hygiene moments. In addition, hand hygiene compliance varied widely within and between different cadres of staff. The determinant analysis was conducted on 177 questionnaires. For all nursing professionals, we found multiple determinants in four domains: ‘social context and leadership’, ‘resources’, ‘individual healthcare professional factors’ and ‘risk perception’. In two domains, several barriers were perceived differently by nursing assistants and nurses. In the domain ‘social context and leadership’, this included (1) how the manager addresses barriers to enable hand hygiene as recommended and (2) how the manager pays attention to correct adherence to the hand hygiene guidelines. In the ‘risk perception’ domain, this included a resident's risk of acquiring an infection as a result of the nursing professional’s failure to comply with the hand hygiene guidelines.ConclusionHand hygiene compliance was low and influenced by multiple factors, several of which varied among different cadres of staff. When designing interventions to improve hand hygiene performance in long-term care facilities, strategies should take into account these determinants and how they vary between different cadres of staff. We recommend exploring hand hygiene determinants at ward level and among different cadres of staff, for example by using our exploratory questionnaire.Trial registrationRegistration number 50-53000-98-113, ‘Compliance with hand hygiene in nursing homes: go for a sustainable effect’ on ClinicalTrials.gov. Date of registration 28-6-2016.

Testing a Model for Measuring Organizational Learning: a Survey Study of the Opinions of a Sample of Employees in the Electoral Commission in Nineveh Governorate

The current study aimed to test a model for measuring organizational learning by adopting the eight dimensions of organizational learning based on Templeton et al., 2002 and included: awareness, communication, performance evaluation, intellectual nurturing, environmental adaptation, social learning, intellectual capital management, and organizational inoculation. Emphasis was placed on testing the underlying factor structure of organizational learning according to the first and second levels. The study sample included the employees of the High Electoral Commission / Nineveh Office, and a questionnaire was used as a tool for data collection, distributed electronically to the respondents who reached (523). Two hypotheses emerged from the study model and they were tested using the confirmatory factor analysis method. The statistical results showed that the selected underlying factor structure represents the dimensions of organizational learning in the investigated organization , and this is a clear indication of the availability of dimensions of organizational learning in the organization in question. The study recommends the need to pay attention to the dimensions of organizational learning, as they are important factors in the development of electoral work