Development and psychometric validation of caring leadership scale in nursing.

Background Young people’s expectations regarding the consequences of vaping are critical determinants of their vaping behavior; therefore, valid and reliable instruments are essential for accurately assessing these expectations. The aim of this study was to adapt the “Short Form Vaping Consequences Questionnaire” to Turkish culture and to evaluate its psychometric properties. Methods This methodological study included 840 university students. Data were collected face-to-face via Google Forms and analyzed using SPSS 22.0 and AMOS 25. The internal structure of the scale was examined. To evaluate the cultural and psychometric adaptation of the scale, validity was assessed through content and construct analyses (exploratory and confirmatory factor analyses), while reliability was evaluated using item-total correlations, Cronbach’s alpha, and test-retest. Results For the Turkish version, item-level content validity index values ranged from 0.83 to 1.00, scale-level content validity index was 1.00, and average scale-level content validity index was 0.95. Confirmatory factor analysis confirmed the original four-factor structure, with standardized loadings between 0.786 and 0.967. Cronbach’s alpha values ranged from 0.921 to 0.982. Test-retest results showed no significant differences (p > 0.05), and intraclass correlation coefficients values ranged from 0.801 to 0.979 (p < 0.001). Conclusions The findings of this study provide evidence of validity and reliability for the Turkish version of the Short Form Vaping Consequences Questionnaire in assessing vaping outcome expectancies among both users and non-users in university students.

BackgroundThe Patient readiness to engage in health information technology (PRE-HIT) is a conceptually and psychometrically validated questionnaire survey tool to measure willingness of patients with chronic conditions to use health information technology (HIT) resources.ObjectivesThis study aimed to translate and validate a health information technology readiness instrument, the PRE-HIT instrument, into the Persian language.MethodsA rigorous process was followed to translate the PRE-HIT instrument into the Persian language. The face and content validity was validated by impact score, content validity index (CVI) and content validity ratio (CVR). The instrument was used to measure readiness of 289 patients with chronic diseases to engage with digital health with a four point Likert scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used to check the validity of structure. The convergent and discriminant validity, and internal reliability was expressed by average variance extracted (AVE), construct reliability (CR), maximum shared squared variance (MSV), average shared square variance (ASV), and Cronbach's alpha coefficient. Independent samples, t-test and one-way ANOVA were used respectively to compare the impact of sex, education and computer literacy on the performance of all PRE-HIT factors.ResultsEight factors were extracted: health information needs, computer anxiety, computer/internet experience and expertise, preferred mode of interaction, no news is good news, relationship with doctor, cell phone expertise, and internet privacy concerns. They explained 69% of the total variance and the KMO value was 0.79; Bartlett's test of sphericity was also statistically significant (sig < 0.001). The communality of items was higher than 0.5. An acceptable model fit of the instrument was achieved (CFI = 0.943, TLI = 0.931, IFI = 0.944, GFI = 0.893, RMSEA ≤ 0.06, χ2/df = 1.625, df = 292, P-value ≤ 0.001). The Cronbach's alpha coefficient achieved a satisfactory level of 0.729. The AVE for all factors was higher than 0.50 except for PMI (0.427) and CIEE (0.463) and also the CR for all factors was higher than 0.7, therefore, the convergent validity of the instrument is adequate. The MSV and ASV values for each factor were lower than AVE values; therefore, the divergent validity was acceptable.ConclusionThe Persian version of the PRE-HIT was empirically proved for its validity to assess the level of readiness of patients to engage with digital health.

The prevalence of psychosomatic disorders associated with emotional instability has risen considerably in recent years. Among the different negative emotions, anger stands out as the most intense and prototypical. When excessive and poorly regulated, it serves as a significant contributing factor in the pathogenesis of various psychosomatic disorders. This study aims to develop and systematically validate an integrated Ayurvedic Anger Assessment Scale (AAAS) for the adult population based on Ayurvedic, Indian philosophical, and contemporary psychological concepts, and this manuscript discusses its psychometric validation. An extensive literature review and expert consultations were conducted for item generation. A panel of 10 experts evaluated content and face validity. Subsequently, pre-testing was carried out with 15 healthy individuals to assess internal consistency and test-retest reliability. Construct validity was further assessed by administering the questionnaire to a sample of 105 individuals. Content Validity Index (I-CVI) of the items ranged from 0.50 to 1.00. Given that the panel consisted of ten experts, a minimum acceptable CVI value of 0.78 was applied. Accordingly, seven items with CVI values below this threshold were excluded, and the Scale-level Content Validity Index (S-CVI) was subsequently calculated, yielding a value of 0.91. The Content Validity Ratio (CVR) across items ranged from 0.20 to 1.00. Reliability analysis demonstrated strong internal consistency, with a Cronbach's alpha of 0.944. Test-retest reliability, assessed using the Pearson correlation coefficient, produced values ranging from 0.70 to 1.00 (p<0.01) across all items. Exploratory factor analysis (EFA) using principal component analysis extracted nine components with eigenvalues >1. This scale adopts an integrative approach to assessing the intensity of expressed anger, including negative consequences in the form of anger rumination. The development and validation process has been comprehensive, with significant psychometric properties inspiring future researchers to undertake similar studies.

BackgroundThere is currently no dedicated measurement for assessing nursing students’ study interest in China. Considering the good reliability, validity, and widespread applicability of the Study Interest Questionnaire-Short Form (SIQ-SF), the objective of this study was to validate its usage among Chinese nursing students.MethodsThe translation and cross-cultural adaptation rigorously followed the modified Brislin model. A cross-sectional survey was conducted using the Chinese version of the SIQ-SF and convenience sampling was employed to select nursing students. The Psychometric evaluation of the Chinese version of the SIQ-SF was conducted based on Classical Test Theory and Item Response Theory.ResultsA total of 1158 participants were included in the analysis. The item-level content validity index (CVI) ranged from 0.9 to 1.0, and the scale-level CVI was 0.98. In the Exploratory factor analysis, three factors with eigenvalues above 1 were identified, accounting for 62.554% of the cumulative variance. In the confirmatory factor analysis, the CMIN\\DF was 5.639, the GFI was 0.953, the CFI was 0.902, and the IFI was 0.904. The Cronbach’s α coefficient of the Chinese version of the SIQ-SF was 0.70. Thirty-one participants were invited to sign the scale after two weeks. The intraclass correlation coefficient was 0.784, and that of items ranged from 0.70 to 0.819. The infit MnSQ values ranged between 0.76 and 1.51, and the outfit MnSQ values ranged between 0.72 and 1.76. The point-measure correlation value ranged between 0.30 and 0.68. The item difficulty measures ranged from − 0.66 to 1.44 logit and the individual learning interest estimations ranged from − 4.22 to 4.97 logit. DIF contrast ranged from 0.00 to 0.33 logits, with all p values greater than 0.05.ConclusionsThe Chinese version of the SIQ-SF demonstrated acceptable reliability and validity among Chinese nursing students and could be used to assess nursing students’ study interest in China. With the aid of this scale, teachers can gain a better understanding of nursing students’ study interests, thereby maximizing their learning effects through appropriate content and methods.

Marian K. Shaughnessy, DNP, RN

The Craig Hospital Inventory of Environmental Factors (CHIEF) is a tool designed to assess and quantify the impact of environmental factors on an individual's functioning and social participation. In this study, we aim to culturally adapt the CHIEF from its original English version into the Malay language (M-CHIEF) and examine its validity and reliability among older adults in Malaysia. The original CHIEF was cross-culturally adapted into the Malay language following the published guidelines on cross-cultural adaptation of health questionnaires. Its content and convergent validity were assessed using the content validity index and correlation with participants' gait speed, respectively. The reliability of M-CHIEF was assessed for its internal consistency using Cronbach's coefficient alpha and Cohen's kappa and its test-retest reliability was assessed using intraclass correlation coefficients (ICCs). The M-CHIEF was rated with excellent content validity with a scale-level content validity index (S-CVI) of 0.86. Its internal consistency was demonstrated to be high with Cronbach's alpha of 0.84. The test-retest reliability at a two-week interval showed a stable score of the M-CHIEF and its subscales with an ICC value of 0.89. The M-CHIEF is deemed relevant for use among Malay speakers. It can function as an instrument to quantify the environmental barriers of an individual while considering broad environmental factors including policy, physical/ structural, work/school, attitude/support, and services/assistance.

Background: The Disaster Preparedness Evaluation Tool (DPET) with 47 items was developed to assess the disaster preparedness level among nurses in the USA. Aim: This study aimed (1) to adapt and validate the DPET for the nursing context in Germany and (2) to perform its psychometric evaluation. Methods: The DPET items were translated to German (DPET-GER). Adaptation was performed to identify irrelevant items and content validity was estimated using the scale-level content validity index (S-CVI) based on expert ratings. Psychometric evaluation was performed based on data from an online survey of 317 nurses. Internal consistency (Cronbach's alpha) and factor structure were assessed with an exploratory factor analysis. Results: Ten items were unanimously rated as irrelevant by four experts and removed. Based on ratings by further seven experts, the content validity of DPET-GER was low for all 37 items (S-CVI of 0.53) or moderate for 19 items rated as relevant (S-CVI of 0.74). The internal consistency of DPET-GER was high (Cronbach's alpha of 0.94) and 37 items were reduced to five factors that explain 55% of variance in all items. Conclusions: The DPET-GER has acceptable psychometric properties (internal consistency and factor structure). However, low content validity indicates that further adaptation of the DPET-GER is required before it could be used to assess disaster preparedness among nurses in Germany. More research is also needed to contextualize the construct of disaster preparedness.

Background Mental health problems among the health workforce are a significant concern worldwide, including in Malaysia. Unfortunately, some health workforce may perceive various barriers or challenges that prevent them from seeking help. Identifying and addressing these barriers is crucial for enhancing mental health services and support. The Barriers to Access to Care Evaluation (BACE-3) questionnaire is a valuable tool that can be used for assessing these barriers among health workers. However, a validated Malay version is needed. Therefore, this study aims to translate, adapt, and validate the original version of Barriers to Access to Care Evaluation (BACE-3) into the Malay version (MBACE). Methods A rigorous process of translation and adaptation was followed to develop the Malay version of the BACE-3 questionnaire (MBACE). A cross-sectional study was conducted to assess the psychometric properties of the questionnaire, with purposive sampling employed to recruit 188 participants from various job categories, including doctors, nurses, pharmacists, and non-clinical staff, such as health assistants and clerks. The analysis was conducted using the R software version 4.2.2 (R Foundation, Vienna, Austria). Construct validity was determined using confirmatory factor analysis (CFA). To assess the convergent validity, internal consistency, and reliability of the instrument, measures such as the average variance extracted (AVE), composite reliability (CR), and Cronbach's alpha values were calculated. Results During the CFA process, two items with a factor loading less than 0.5 (items 15 and 16) were removed to improve the convergent validity and model fit. The CFA results revealed that the 2-factor model MBACE had good construct validity (root mean square error of approximation (RMSEA) = 0.053; comparative fit index (CFI) = 0.939; Tucker-Lewis fit index (TLI) = 0.934). The internal consistency was supported by Cronbach's alpha values ranging from 0.92 to 0.94 for the stigma factor and non-stigma factor. The average variance extracted (AVE) and composite reliability (CR) values further supported the questionnaire's reliability and convergent validity. Conclusion The translated and adapted 28-item MBACE questionnaire is a valid and reliable tool for assessing the barrier to seeking professional mental health care among the Malaysian health workforce. This instrument has the potential to aid in the development of targeted interventions to promote mental health help-seeking behavior and enhance the well-being of the Malaysian health workforce.

The purpose of this study was to develop the Avoidance of Daily Activities Photo Scale (ADAP Shoulder Scale) to measure shoulder pain-related avoidance behavior in patients with shoulder pain and evaluate and report the structural validity and internal consistency of the scale. Potential daily activities involving the shoulder were selected from the activities and participation domain of the International Classification of Functioning, Disability and Health. The selected activities were presented to an expert panel, health care professionals, and patients with shoulder pain with the question "How much do you think it is important to ask patients with shoulder pain about this activity?" Activities attaining a content validity index (CVI) ≥ 0.8 were represented using a digitally colored photograph. Activity photographs were evaluated by health care professionals and patients with shoulder pain. Photographs with a CVI ≥ 0.8 were included in the scale. To evaluate structural validity and internal consistency of the scale, exploratory factor analysis was performed to determine the presence of any scale domain. Cronbach alpha was calculated to indicate the internal consistency of each domain. Of the 107 preselected activities, 21 attained a CVI ≥ 0.8. Eighteen photographs (CVI ≥ 0.8) were included in the scale after being analyzed by 120 health care professionals and 50 patients with shoulder pain. Exploratory factor analysis (N = 156) showed that the ADAP Shoulder Scale consists of 3 domains: free movement, high effort, and self-care. The internal consistencies of the domains were 0.92, 0.89, and 0.92, respectively. The ADAP Shoulder Scale included 15 photographs distributed in 3 domains. All domains had a high internal consistency. The scale is easily applicable, well understood, and relevant for shoulder pain. The ADAP Shoulder Scale can be used to rate shoulder pain-related avoidance behaviors.

BackgroundRFL (The Reasons for Living) is the reason why individuals still choose to live actively in the face of setbacks. It can buffer against suicide. Suicide among the older adults has become a major public health issue in many countries. SRFL-OA(The shortened version of the RFL-OA scale) is of great significance in identifying the reasons for living among the older adults, thus preventing suicidal ideation and reducing the risk of suicide. China lacks tools to assess the reasons for living among the older adults. The aim of this study is to translate the SRFL-OA scale into Chinese and evaluate its psychometric properties among the older adults in China.MethodsThis study included 200 older adults. Item screening was performed using the critical ratio and correlation coefficient methods. Internal consistency and test-retest reliability were used for reliability analysis, and validity was assessed through content validity and exploratory factor analysis.ResultsAfter rigorous translation and cross-cultural adaptation, a shortened Chinese version of the Reasons for Living - Older Adults (SRFL-OA), comprising 3 dimensions and 22 items, was developed. In terms of reliability, the correlation coefficients between individual items and the total questionnaire score ranged from 0.453 to 0.679. The overall Cronbach’s α coefficient of the scale was 0.914, with subscale coefficients ranging from 0.838 to 0.886. The McDonald’s ω coefficient for the total scale was 0.923, and the ω coefficients for each subscale range from 0.854 to 0.901. The test-retest reliability of the scale was 0.734, with individual subscale values of 0.729–0.841. For validity, the item-level content validity index (I-CVI) was 0.83–1.00, and the average scale-level content validity index (S-CVI) was 0.93. Exploratory factor analysis revealed a three-factor structure that explained 55.468% of the total variance.ConclusionThe SRFL-OA scale has been successfully adapted for use in China and demonstrates good psychometric properties among Chinese community-dwelling old people. The scale evaluates the reasons for living among older adults from a positive psychological perspective and effectively identifies older individuals with suicidal ideation. SRFL-OA scale provides scientific reference and is a valuable tool for evaluating the reasons for living among the older population in China.

Turkish Validation of the MISSCARE Survey – Pediatric Version

Exercise craving refers to an uncontrollable urge to engage in exercise, accompanied by cognitive and emotional responses when deprived of it. Although several instruments exist to measure exercise addiction, there is no valid and reliable tool specifically designed to assess exercise craving. Addressing this gap is essential to better understand the psychological and behavioral outcomes of exercise deprivation. This study aimed to develop a valid and reliable scale to evaluate exercise craving levels in individuals unable to exercise. The research was conducted with a survey model in five stages. First, a comprehensive literature review and expert evaluations were used to generate an item pool. The preliminary version was piloted with 30 participants and revised. The finalized version was then applied to a sample of 222 volunteers. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to examine validity. Reliability was assessed using test-retest, Cronbach's alpha, composite reliability (CR), and average variance extracted (AVE). EFA revealed a two-factor structure, and one item was removed due to low loading, resulting in an eight-item scale that explained 74.628% of the variance. The first factor, exercise obsession, captured cognitive and emotional reactions to deprivation, while the second factor, effects of deprivation, reflected its negative influence on mood and daily functioning. CFA results confirmed a good model fit (χ²/df = 2.327, RMSEA = 0.077, SRMR = 0.030, CFI = 0.995, TLI = 0.990). Reliability analyses showed strong internal consistency (Cronbach's alpha = 0.897). The exercise craving scale is proposed as a valid and reliable tool for assessing the psychological and cognitive consequences of exercise deprivation.

Introduction The increase in the prevalence of obesity is one of the major public health problems. There is a weak relationship between nutritional knowledge and feeding practices. Studies have evaluated that the associations between obesity and the level of nutritional knowledge and feeding practices in children are scarce. The evaluation of nutritional knowledge and feeding practices should be carried out using validated instruments. Study showed the need to improve the instruments of habit research and feeding practices in children for better evaluation. Objectives: To develop and validate an instrument about nutritional knowledge and feeding practices for use in children from 7 to 11 years, based on the Food Guide for the Brazilian Population. Methods The study filled all the steps expected to validate an instrument: review on the subject, instrument elaboration, Content's Validity (Content Validity Index – CVI) with two groups of judges: 1° – nutritionists and, after adjustments, 2° – multidisciplinary group), FACE Validity, reliability analysis [Intraclass Correlation Coefficient (ICC) and Kappa (K), Internal Consistency Analysis - Cronbach's Alpha] and Validity of Construct (Exploratory Factorial Analysis - EFA) The sample was calculated, considering, at least, 10 subjects for each question of the questionnaire. Results Validation occurred in a final sample of 453 children, 46.4% boys and 53.6% girls, mean age 9.45 (SD = 1.44). The validity of the content presented CVI ≥0.80 for relevance in 62.3% of items for nutritionist group and 100% of items for multidisciplinary group), clarity (49.4%, 91.8%), Pertinence (58.8%, 98.4%), respectively. The test-retest had a level of agreement of 84.3% and K=0.740 for the Knowledge Dimension; and the ICC=0.754 for the Practices Dimension. Cronbach's Alpha, for internal consistency analysis, was α=0.589 for the Knowledge Dimension and α=0.618 for the Practices Dimension. The EFA with variance of 47.01% (7.81% at 10.85%), with varimax rotation, it defined five factors for the Practices Dimension: Involvement; Healthy Eating and drinking; Unhealthy eating and drinking; Basic food consumption; Attitudes during the meal. Conclusion The instrument QCPA demonstrated validity and reliability to evaluate nutritional knowledge and practices in children aged 7 to 11 years.

BackgroundAssessing or measuring adherence is the initial step toward comprehending it, or the lack thereof.ObjectiveThis study aims to translate and validate the Treatment Adherence Questionnaire TAQ among Yemeni dialysis patients with cardiorenal syndrome.MethodsThis cross-cultural adaptation study was conducted at two dialysis centers in Hadhramout Governorate, Yemen, between January 10 and February 15 of 2021. The English version of TAQ was translated into Arabic using the Beaton translation process. Psychometric tests of the TAQ were performed on 100 patients with cardiorenal syndrome. For face and content validity, the pre-final version of the TAQ Arabic was tested using a convenience sample of 10 patients. Individual interviews were used to investigate the meaning, comprehensibility, and acceptability. To evaluate the factor loadings, discriminant validity, and internal consistency of the TAQ Arabic version (the TAQ-Ar), one hundred patients were selected in the same manner and using the same inclusion criteria. Exploratory Factor Analysis (EFA) was utilized to ascertain the underlying factor structure of the Arabic version of the questionnaire, as its dimensionality had not been previously determined in this group. We employed principal component extraction with promax rotation to produce a clear and understandable factor solution. To assess reproducibility, 30 patients were chosen randomly from 100 to resubmit the questionnaire 2 weeks after the initial administration and under the same conditions.ResultsThe transcultural adaptation process revealed that all TAQ-Ar items and patient descriptions exhibited full semantic equivalence. During the psychometric validation phase, the scale-level Content Validity Index was 0.88, and cognitive interviews (n = 30) confirmed patient clarity. Exploratory factor analysis identified four variables, aligning with the structure suggested by the original instrument inventor. Based on Bandalos' standards, factors were kept if their eigenvalues were more than 1 and their factor loadings were higher than 0.30. The overall average factor loading was 0.683, which shows that the test was valid. Internal consistency was very good (Cronbach's alpha = 0.948), and test-retest repeatability showed significant stability (ICC = 0.776).ConclusionWe confirm that the TAQ-Ar is suitable for assessing treatment adherence in individuals with Arabic as their first language for cardiorenal syndrome disease.

BackgroundSince the emergence of the COVID-19 pandemic, vaccines have been developed to tackle the disease. However, many people worldwide were not confident enough to take the vaccines. Developing a questionnaire to measure COVID-19 vaccine hesitancy will give the health authorities and policymakers a clear picture to establish appropriate interventions addressing vaccine hesitancy among the community. MethodsIn this study, we used a mixed-method design over two phases. Phase 1 entailed a qualitative approach to developing the questionnaire, including a literature search, expert panel review, and focus group discussion. Phase 2 used a quantitative method for establishing the content and construct validity of the questionnaire via exploratory and confirmatory factor analysis (EFA & CFA). Internal consistency was checked using Cronbach's Alpha and intraclass correlation coefficient. ResultsWe developed a 50-item instrument designed to measure COVID-19 vaccine hesitancy among adults in the state of Qatar. The study involved 545 adult participants. In terms of content validity, our study showed a value of 0.92 for the scale-level content validity index based on the average and a value of 0.76 for the scale-level content validity index - universal agreement. In the EFA, the Kaiser-Meyer-Olkin measure of sampling adequacy was calculated at 0.78, with statistical significance (P = 0.001). Regarding model fit indices of the seven-factor model, our findings showed an acceptable model-data-fit, with a relative chi-square: 1.7 (<3), Root mean square error of approximation: 0.05 (<0.08), PCLOSE = 0.41, Comparative fit index: 0.909, Tucker-Lewis index: 0.902, Incremental Fit Index: 0.910 and, Standardized Root mean square residual: 0.067 (<0.08). The seven-factor model of the questionnaire met the criterion of good internal consistency (Cronbach's alpha = 0.73). ConclusionThis tool is deemed of methodological merits in terms of validity, reliability, and determining the underlying conceptual structure of COVID-19 vaccine hesitancy and its associating factors.