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There are few short, validated tools to assess young children's obesity‐related dietary behaviours, limiting the rapid screening of dietary behaviours in research and practice‐based early obesity prevention. This study aimed to develop and assess the reliability and validity of a caregiver‐reported short dietary questionnaire to rapidly assess obesity‐related dietary behaviours in children aged 6 months to 5 years. The Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH‐DQ) was developed using a rigorous process to determine content and structural validity. Three age‐appropriate versions were developed for (1) infants, aged 6–12 months, (2) toddlers, aged 1–2.9 years and (3) pre‐schoolers, aged 3–5 years. The questionnaire (7–15 items) measures dietary behaviours, including diet risk from non‐core food and beverage intake, diet quality from vegetable frequency, bread type and infant feeding practices. Test–retest reliability was assessed from repeated administrations 1 week apart (n = 126). Internal consistency, concurrent validity (against a comparison questionnaire, the InFANT Food Frequency Questionnaire), construct validity and interpretability were assessed (n = 209). Most scores were highly correlated and significantly associated (p < 0.05) for validity (rs: 0.45–0.89, percentage agreement 68%–100%) and reliability (intraclass correlation coefficient: 0.61–0.99) for diet risk, diet quality and feeding practice items. The EPOCH‐DQ shows acceptable validity and reliability for screening of obesity‐related behaviours of children under 5 years of age. The short length and, thus, low participant burden of the EPOCH‐DQ allows for potential applications in various settings. Future testing of the EPOCH‐DQ should evaluate culturally and socio‐economically diverse populations and establish the predictive validity and sensitivity to detect change. Key messages: Accurate measurement of obesity‐related dietary behaviours is essential for the evaluation of early obesity prevention programmes and monitoring population trends.The 7–15 item Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH‐DQ) was shown to have acceptable validity and reliability for assessing obesity‐related behaviours of children aged 6 months to 5 years of age.The short length and thus low participant burden of the EPOCH‐DQ allows for potential applications in various settings, including research, population health monitoring and use by health professionals.Future testing of the EPOCH‐DQ should include evaluation across culturally and socio‐economically diverse populations and determine the predictive validity and sensitivity to detect change of the EPOCH‐DQ. [ABSTRACT FROM AUTHOR]

Background: In order to evaluate interventions aimed at reducing cesarean births, care practitioners' attitudes are important to measure. The Labor Culture Survey (LCS) is a scale that measures individual and unit attitudes towards supporting vaginal birth. As no equivalent scale exists in Sweden, the aim was to translate, adapt, and validate the LCS and to investigate whether there were differences in attitudes toward supporting vaginal birth between maternity care practitioners. Methods: A cross‐sectional study including midwives, physicians, and nurse assistants working with intrapartum care in five labor wards in Sweden. The original LCS was translated into Swedish, and six context‐specific items were developed for the Swedish setting (SLCS). The translation was tested for face validity. Psychometric analysis was conducted using exploratory factor analysis with principal component analysis, parallel analysis, and principal axis factoring. Reliability was estimated using Cronbach's alpha. One‐way ANOVA and Tukey HSD were calculated to analyze differences in attitudes between professions on the subscales of the S‐LCS. Results: A total of 539 midwives, physicians, and nurse assistants participated. The final S‐LCS showed a five‐factor solution with the following subscales: Best Practices to reduce cesarean overuse, Unpredictability of vaginal birth, Unit Microculture, Maternal Agency, and Organizational Oversight. Chronbach alpha values varied from 0.60 to 0.83. Midwives were more supportive towards vaginal birth and less fearful of potential consequences of vaginal birth compared with physicians. Conclusions: The S‐LCS demonstrated satisfactory psychometric properties for use in Swedish maternity care. Further work to improve the scale should include additional items reflecting the subscale Maternal Agency. [ABSTRACT FROM AUTHOR]

Background: Reliable dietary data for children are necessary to investigate associations with health outcomes. The present study aimed to develop and validate a questionnaire to determine the frequency of intakes of specific healthy and unhealthy food groups in young children. Methods: Participants were 5–9‐year‐old South African children (n = 920) from 10 urban schools. Their parents completed a demographic questionnaire and the food intake questionnaire with food pictures. Based on the literature, four healthy food groups (fruits, vegetables, milk, meat/fish/poultry/eggs) and six unhealthy food groups (hot and cold sugar‐sweetened beverages, candy, salty snacks, cakes and fast foods) were included, with five different frequency responses. Six experienced nutritionists assessed the face validity and content validity. After pilot testing, construct validity and homogeneity were determined in the participants. Convergent validity was determined using urinary sodium and potassium concentrations as biological intake markers. Results: Nutritionists confirmed face and content validity. Caregivers confirmed understanding of the questionnaire. Three factors explained 50.2% of the variance, with most unhealthy food groups as factor 1, fruits and vegetables as factor 2, and animal source protein and milk groups clustered with sugar‐sweetened beverages as factor 3. The frequency of milk group, fruits and vegetables intake correlated negatively, whereas the frequency of salty snacks and fast foods intakes correlated positively with the urinary sodium:potassium ratio. Conclusions: The healthy and unhealthy food group questionnaire has advantages of low respondent burden, as well as acceptable content and convergent validity in South African children. The questionnaire may be used to investigate associations between food intakes and health outcomes. Key points: Simplified methods to collect data on the food consumption of children are required in epidemiological studies.Intakes from specific food groups, namely fruits, vegetables, sugar‐sweetened beverages and snacks, salty snacks, and fast foods, are important.A healthy and unhealthy food group questionnaire was validated and showed acceptable content and convergent validity in South African children.The food group questionnaire has a low respondent burden. [ABSTRACT FROM AUTHOR]

Objective: To develop a scale to determine parents' attitudes and beliefs regarding fluoride varnish. Design and methods: This study had a cross‐sectional design and was conducted between 2019 and 2021. A total of 810 parents were included in the study sample. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), discriminant validity, and convergent validity methods were used to estimate the scale validity. For reliability, the Cronbach alpha coefficient, item‐total correlation coefficients, and test–retest method were used. Results: As a result of psychometric analysis, the scale was found to have a three‐factor structure. The factor loads of the items were between 0.838 and 0.715. The three‐factor construct showed a good fit in confirmatory factor analysis (X2(41): 110.06, p <.001; RMSEA: 0.065; RMSR, 0.02; GFI, 0.95; and NFI, 0.94). Cronbach's α coefficient on the scale was 0.85. The item‐total correlation of the scale was found to be between 0.355 and 0.626. The test–retest intra‐class correlation coefficient of the scale was 0.72. Conclusions: This study suggests that the developed scale is a reliable tool to evaluate the attitudes and beliefs of parents toward fluoride varnish. It is thought that the scale will make a contribution to public health. [ABSTRACT FROM AUTHOR]

Background: Professionals providing self‐management support to parents regarding the care for their child with a chronic condition nowadays is an important aspect of child healthcare. This requires professionals to orient themselves towards partnership and collaboration with parents. The aims of the current study were the development and validation of the S‐Scan‐Parental self‐management Support (S‐scan ‐ PS) as a tool for healthcare professionals to reflect on their attitude and practices regarding the support for parental self‐management. Methods: An existing instrument was adapted together with field experts for professionals to self‐evaluate their support for self‐management of parents. The resulting 36‐item self‐report questionnaire was filled in by healthcare professionals in the Netherlands working with children and their parents. Cognitive interviews, exploratory and confirmatory factor analysis (CFA), and test–retest reliability analysis were part of the development and validation process. Results: In total, 434 professionals, including physicians, physiotherapists, occupational therapists, and nurses, from 13 rehabilitation institutes and 5 medical centres participated. The cognitive interviews with child healthcare professionals indicated adequate face and content validity. The S‐scan ‐ PS scale had acceptable internal consistency (0.71 ≤ α ≤ 0.91) for the total score as well as the domain scores. CFA showed acceptable root mean square error of approximation (RMSEA) model fit (0.066), though not on other tested goodness‐of‐fit indices. Test–retest reliability of the instrument was moderate with an average intraclass correlation coefficient (ICC) = 0.61. Conclusions: The S‐scan ‐ PS fulfils important psychometric criteria for use by child healthcare professionals to reflect on parental self‐management support. Such self‐reflection might help to improve their approach towards supporting self‐management of parents in the care for their child with a chronic condition. Further research is needed into the construct validity and test–retest reliability of the instrument. [ABSTRACT FROM AUTHOR]

Diagnosing autism or ID using a gold‐standard tool can be time‐consuming, costly, and requires training, which is generally limited in Nigeria, and the rest of Africa. Screening, on the other hand, can be quick and effective, with minimal training depending on the tool (Iragorri & Spackman, Public Health Reviews, 2018;39(1):17), thus making the availability of short screeners a necessity in Nigeria, and the rest of Africa. We identified four screening tools through a previously completed systematic review (Nwokolo et al., Review Journal of Autism and Developmental Disorders, 2022;1–23.), two (SCQ and AQ‐10) for autism and two (SCIL and CAIDS‐Q) for ID, which appeared appropriate for validation for use within African nations. The Nominal Group Technique was used with a purposive group of professionals, parents, and laypersons to select and adapt the existing screening tools for autism and ID for use with older children and adolescents in Nigeria. The group examined the screening tools for cultural relevance, face and content validity. Following the discussions, items were either (1) accepted in the original form or (2) more culturally appropriate examples chosen if at least 75% of participants agreed. The group selected the SCQ for autism and the SCIL for ID. The minimum agreement on all autism and ID measures items was 84%, and this indicated the measures had face and content validity for use within Nigeria. Following the recommendations and consensus of the group, the SCQ and the SCIL 14–17 were agreed on as measures to be validated with the Nigerian adolescents, with only a small number of adjustments needed to allow for different use of language, customs and environment in the Nigerian context. [ABSTRACT FROM AUTHOR]

Background: This study examined the impacts of an educational intervention based on the Progressively Lowered Stress Threshold (PLST) extended model on caregiving for people with dementia (PWD). Method: This study was conducted in Isfahan, Iran, from May 2016 to June 2018, with 38 caregivers of PWD as participants assigned to an intervention group. Data were collected using a multi‐sectional, researcher‐developed questionnaire that recorded the demographic characteristics, and measured the dementia‐related knowledge and caregiving practices of the participants. The questionnaire and an educational program were designed in three parts according to the educational needs of caregivers to enhance their practice, skills, and ability to handle challenging behaviours in PWD. The questionnaire's face validity was confirmed by expert review, and its reliability was assessed with Cronbach's alpha coefficient (knowledge section, 0.838; practice section, 0.802). The sampling method used was convenience sampling, and none of the caregivers refused to receive the educational content. Therefore, the evaluation of the program lacks a randomized controlled group. To tailor the intervention program to the participants' needs, the educational content was based on the PLST extended model. Results: The mean scores for knowledge and practice increased following the intervention (P < 0.05). An educational intervention, using the PLST extended care model, thus produced positive impacts in improving the knowledge and practice of caregivers of PWD. Conclusion: Educating caregivers with the PLST extended model, with a specific focus on the cultural and religious backgrounds of societies, is recommended. [ABSTRACT FROM AUTHOR]

Purpose: Adults born with intellectual disabilities (ID) and motor disabilities (MD) have higher risk of dysphagia and should be assessed to decrease risk of severe complications. However, standardised assessment tools in Swedish are lacking. Methods: The Dysphagia Assessment Package (DAP) was cross‐culturally translated from English to Swedish (DAP‐SE) and tested for content validity by an expert group. Face validity was assessed by five speech and language therapist (SLT) during meal observations (n = 10), and the clinical relevance was reported in a study‐specific questionnaire. Results: The DAP‐SE was culturally adapted within the process of translation and was found to contain clinically relevant aspects to assess and suggest further interventions for adults with ID and MD. Face and content validity was confirmed by the expert group. Conclusion: This study, in which the DAP‐SE was tested in a small sample size, provides the first indications of the instrument's validity with respect to evaluating mealtimes, swallowing function and swallowing safety in adults born with ID and MD. The study adds to the knowledge on how to translate and culturally adapt an assessment tool to clinically assess dysphagia on a complex and vulnerable patient group. [ABSTRACT FROM AUTHOR]

Aims: Improving hospital nutrition and mealtime care is complex and often requires multifaceted interventions and implementation strategies to change how staff, wards and systems operate. This study aimed to develop and validate a staff questionnaire to identify multilevel barriers and enablers to optimal nutrition and mealtime care on hospital wards, to inform and evaluate local quality improvement. Methods: Literature review, multidisciplinary focus groups and end‐user testing informed questionnaire development and establishment of content and face validity. To determine the construct validity, the questionnaire was administered to ward staff working in five wards across two facilities (acute hospital, rehabilitation unit). Exploratory factor analysis was used to estimate the number of factors and to guide decisions about whether to retain or reject individual items. Scale reliability was assessed using Cronbach's alpha. Results: The questionnaire was completed by 138 staff, with most respondents being nurses (57%) and working in the acute care facility (76%). Exploratory factor analysis supported construct validity of four of the original seven subscales. The final questionnaire consisted of 17 items and 4 sub sub‐scales related to (1) Personal Staff Role; (2) Food Service; (3) Organisational Support, and (4) Family Involvement; each sub‐scale demonstrated good reliability with Cronbach's alpha values all >0.70. Conclusion: This novel and brief questionnaire shows good reliability and preliminary evidence of construct validity in this small sample. It provides a potentially useful instrument to identify barriers and enablers to nutrition and mealtime care from the staff perspective and inform where improvement efforts should be focused. [ABSTRACT FROM AUTHOR]

Aim: To develop and pilot a tool to evaluate Australian dietitians' and student dietitians' ethical and professional practice using social media. Methods: A Social Media Evaluation Checklist was developed based on checklist development literature with a four‐staged process. Stage one included a literature review and input from an expert panel to ensure content validity. Stages two and three were to ensure face validity by categorising the checklist and pilot testing the tool. Instagram profiles and posts were audited by two authors using the checklist in the final stage to analyse ethical and professional use. An account purposely created for this study was used, and the first 25 dietitian and first 25 student dietitian profiles identified using the key words 'dietitian', 'student dietitian' and 'dietitian student' and the hashtag '#australiandietitian' were reviewed. Results: A total of 50 Instagram profiles and 250 posts were audited based on seven categories; (1) financial disclosure, (2) cultural awareness, (3) evidence‐based information, (4) transparency, (5) privacy/confidentiality, (6) professionalism and (7) justifiability. Areas for improvement included advertising transparency which was met in only 12% of dietitian posts, and the provision of evidence‐based information, which was met in 56% of dietitian posts and 72% of student dietitian posts. Conclusions: This study provides insight into the ethical and professional use of social media by Australian dietitians and dietetics students. With the evolving nature of social media, guidance is required. This will ensure dietitians remain, now and in the future, the credible source of nutrition information for the public. [ABSTRACT FROM AUTHOR]

Maladaptive daydreaming (MD) defines excessive use of fantasy, which replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning. This study tests psychometric properties of the Polish version of the Maladaptive Daydreaming Scale (PMDS‐16) and a short 5‐item version derived from it (PMDS‐5), and their capacity to screen for MD. The relationship between MD, resilience and the quality of life was also explored. Validity and reliability were examined in a sample of 491 participants in nonclinical (n = 315) and mixed‐clinical (n = 176) groups who completed the tests online. The exploratory factor analysis with principal component analysis method of parameter estimation without rotation confirmed a one‐factor solution of both instruments. Reliability of both versions was corroborated by Cronbach's alpha coefficient (PMDS‐16: >.941; PMDS‐5: >.931). The cutoff score maximizing sensitivity and specificity for MD was 42 in both instruments, but the short version had better discriminating properties. People who identified themselves as maladaptive daydreamers in comparison to those who did not had significantly higher scores in both instruments. Maladaptive daydreamers also had lower quality of life in the psychological and social relationships domains and poorer resilience. Both PMDS‐16 and PMDS‐5 proved to have satisfactory psychometric properties. They have similar psychometric properties, although PMDS‐5 has better discriminating power and can be used effectively for the screening of MD. [ABSTRACT FROM AUTHOR]

Background: Personality traits are associated with pain‐related beliefs and coping strategies, and different chronic conditions are linked through specific personality profiles. This highlights the importance of having valid and reliable measures of personality traits for use in clinical and research settings when assessing patients in chronic pain. Purpose: To translate and cross‐culturally adapt the 10‐item Big Five Inventory (BFI‐10) into Danish. Methods: A bilingual expert panel (N = 4) and a panel of laymen (N = 8) translated and culturally adapted the questionnaire into Danish. Face validity was evaluated in a group of persons suffering from recurring or ongoing painful conditions (N = 9). Data were collected to evaluate the internal consistency, test–retest reliability and factor structure (N = 96). Results: Some of the participants in the lay panel considered the questionnaire too short, considering its aim of assessing personality. Acceptable internal consistency was found for two out of five subscales (0.78 for both Extraversion and Neuroticism), while the internal consistency was non‐acceptable for the remaining subscales (0.17–0.45). Test–retest reliability was acceptable for three subscales (0.80 for Neuroticism, 0.84 for Conscientiousness, and 0.85 for Extraversion). Assumptions for determining the factor structure were not met and therefore was this analysis omitted. Discussion: Although face valid, only two out of five subscales had acceptable internal consistency and only three subscales had acceptable test–retest reliability. These findings indicate that interpreting findings regarding personality using the Danish BFI‐10 should be done with caution. [ABSTRACT FROM AUTHOR]

Background: Patients in intensive care units require comprehensive care. Hence, improving health care quality depends on accurate assessment and documentation. Aim: To develop and validate the content of an assessment sheet for critically ill patients. Study Design and Methods: A Delphi design study was conducted between January and March 2020. The content validity index (CVI) was used to calculate the degree of agreement among the experts to analyse the instrument and the entire set of items. Content validity was determined by seven experts (three critical care nursing professionals, two critical care doctors, and two anaesthesiologists) using a four‐point Likert scale. They evaluated the items in terms of the following: 1 = "irrelevant," 2 = "somewhat relevant if the phrasing is profoundly adjusted," 3 = "relevant with some adjustment as to phrasing," and 4 = "very relevant." The CVI was applied, and the accepted value was ≥0.50. Results: Three rounds of evaluation were required to achieve the minimum index. The items were reviewed for content and face validity. The instrument was validated with 86 items with a total CVI of 0.90, a face validity of 1, and a scale‐level content validity index/universal agreement calculation method (S‐CVI/UA) value of 0.813. Conclusion: This instrument can help nurses, doctors, academics, and students assess patients in intensive care units. Relevance to Clinical Practice: The daily assessment tool may provide a systematic and consistent approach to critically ill patients' assessment to guide interventions. [ABSTRACT FROM AUTHOR]

Purpose: To translate and validate the Italian version of the Spirituality and Spiritual Care Rating Scale (SSCRS‐ita). Methods: A single‐center cross‐sectional study was performed from October 15 to November 15, 2019 in a public hospital in Milan, Italy. The scale was drafted using the back‐translation method. Prior to administration, the Italian version of the scale was assessed for content validity and retest stability by calculating the content validity index. Internal consistency was investigated by calculating Cronbach's alpha coefficient, test‐retest stability by Spearman's rho coefficient. Findings: A total n = 337 nurses participated in the survey by correctly completing the scale. The Kaiser–Meyer–Olkin test (0.81) and Bartlett's test of sphericity (p < 0.001) confirmed the adequacy of the sample to conduct exploratory factor analysis (EFA). The factorial model of EFA without rotation and then with nonorthogonal Promax rotation confirmed the presence of the four constructs identified by the original author. Conclusions: SSCRS‐ita showed promising psychometric properties in terms of validity and reliability. The results of this study, together with the lack of in‐depth studies in the Italian health and educational panorama, suggest the need to develop an educational pathway which, starting from the curricula of basic training and continuing with the updating of nursing staff, is dedicated to the detection of the spiritual needs of the patient. Implications for nursing practice: The SSCRS‐ita is the first validated Italian tool concerning the consideration of the needs of spirituality and spiritual care in healthcare contexts; the possibility to use this tool is the first step towards a better integration of the mentioned dimensions of care in a nursing care qualitative perspective in Italy. [ABSTRACT FROM AUTHOR]

Background: There is a lack of a valid and reliable instrument that measures objective and subjective knowledge of evidence‐based dietetic practices (EBDP) among registered dietitian nutritionists (RDNs). The present study aimed to develop and assess the validity and reliability of an EBDP Questionnaire (EBDPQ) with objective knowledge items (i.e., quiz items) among RDNs in the USA. Methods: Subscales from four existing evidence‐based practice (EBP) instruments were combined and modified for dietetics. Content and face validity and internal consistency were used to assess the full survey. Survey responsiveness and test–retest reliability were evaluated within the objective knowledge subscale. Content experts (n = 11) and nutrition professionals (n = 16) completed validation reviews. Doctoral students enrolled in a research course (n = 12) were used to analyse survey responsiveness. Internal and test–retest relability analyses utilised RDN participants (time point 1, n = 482; time point 2, n = 335). Results: Content validation resulted in a 38‐item questionnaire. Average percent agreement among face validity reviewers was 95.1%. Only the pre‐validation version of the objective knowledge subscale resulted in significantly higher post‐course scores (Mdn = 11.50) compared to the pre‐course (Mdn = 9.75, p = 0.05). The validated instrument had excellent internal consistency (Cronbach's α = 0.91); however, the objective knowledge subscale was low (Cronbach's α = 0.41). A good degree of reliability was found between the two time points (intraclass correlation coefficient = 0.71). Conclusions: The EBDPQ demonstrated adequate validity and reliability among RDNs. Future research should assess construct validity, with the responsiveness and objective knowledge subscale requiring additional evaluation through an EBDP course. Key points: Subjective measures may not adequately estimate the knowledge of evidence‐based dietetic practices (EBDPs) among dietitians.Subscales from four evidence‐based practice instruments, including both subjective and objective (i.e., quiz items) measures, were adapted for the dietetics practitioner.This instrument demonstrated adequate validity and reliability among dietitians; however, the objective knowledge subscale was low (Cronbach's α = 0.41), likely as a result of too few items and variation in EBDP exposure and training among participants.Future research should assess construct validity and further evaluate the reliability and responsiveness of the objective knowledge subscale. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a tool to evaluate the NANDA International, Inc. diagnostic classification. Methods: The tool, EVALUAN‐I, was validated in a non‐probabilistic sample (N = 460) on Spanish Registered Nurses (September–December 2019) in two phases. First, design and construct the instrument in three steps: (1) literature review to define the construct focusing on the orientation toward nursing concepts and theoretical foundations, the level of scientific evidence, the structural configuration, the applicability, the nurses' clinical reasoning skills, and the attitudes toward nursing diagnosis, (2) substantiation of the questionnaire items and design according to the criteria for a diagnostic classification, (3) expert test to establish the face validity and content validity. The second phase revolved around (4) conducting a pilot test and measuring the temporal stability (test‐retest) and Cohen's kappa coefficient; assessing psychometric properties by measuring (5) reliability (internal consistency using Cronbach alpha and interfactor correlation) and (6) construct validity (exploratory and confirmatory factor analysis). The manuscript follows the STROBE checklist. The study was approved by the Research Ethics Committee with registration number 2019‐190‐1. Findings: EVALUAN‐I displayed moderate test‐retest stability, adequate construct validity, and excellent reliability. The confirmatory factor analysis provided evidence about the configuration of EVALUAN‐I in relation to nine analytical dimensions: clinical competence, nurses' reasoning skills, attitudes towards nursing diagnosis, discipline's central concepts, classification's contents, physiopathological attributes, level of scientific evidence, diagnostic precision, and conceptual correspondence between terminologies. Conclusions: EVALUAN‐I is a valid and reliable instrument, which can be used to improve the epistemological, normative, and intuitive configuration of NANDA International, Inc. in a structured, systematic manner. Implications for Nursing Practice: Comprehensive evaluation of NANDA International, Inc. in different clinical settings around the world using a validated instrument, like EVALUAN‐I, would allow strengths and weaknesses to be identified and contribute to the classification's development and practical application. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe the preliminary development and validation of an instrument to measure the extent that a population health approach was applied in sexual health by public health units in Ontario, Canada. Design: Preliminary scale development and administration occurred in two phases that included item development and validity testing. Measurement and Sample: Two phases of development included: (1) using literature and expert input (n = 6) to develop items; and (2) validation of items by content experts (n = 5) and pre‐testing (n = 3). Results: The validated scale consisted of 69 items across the eight key elements of a population health approach. 15 out of 35 health units completed the survey, representing 43% of health units. Instrument administration revealed that Focus on the Health of Populations and Address the Determinants of Health and their Interactions were implemented more frequently compared to Collaborate Across Sectors and Levels and Employ Mechanisms for Public Involvement, which were infrequently implemented. Conclusion: This preliminary scale is a way for sexual health programs to measure the extent that a population health approach is implemented by their organization. Further testing with a broader sample is needed to strengthen generalizability and address reliability. [ABSTRACT FROM AUTHOR]

Introduction: The global prevalence of diabetes in 2019 in adults was estimated to be 9.3%. This study developed in Ecuador, for the first time, instruments to assess patient‐reported outcomes and experiences. Methods: The Experiences of the Person with Diabetes (EPD) Questionnaire is a diabetes‐specific instrument. A mixed‐methods study was conducted. First, a qualitative item development phase that included four focus groups and six semi‐structured interviews with patients was conducted in different rural and urban areas of Ecuador to obtain information on culture, beliefs, demographics, diet and social perspectives. A second quantitative phase for psychometric validation was carried out in primary care settings of rural and urban areas of Ecuador. Results: Forty‐two and four hundred and eighty‐nine participants were included in each phase, respectively. The item development phase resulted in a questionnaire of 44 items (23 for perceived outcomes and 21 for experiences). In the validation study, most participants were women (58%) and from urban areas (57%). Exploratory factor analysis revealed three dimensions for each instrument. Outcomes instrument dimensions were symptoms and burnout, worries and fears and social limitations. Experiences instrument dimensions were information, patient‐centred care and care delivery. Cronbach's α values of the total score and dimensions were high, ranging between.81 and.93 in both instruments. Confirmatory factor analysis showed an acceptable fit of the data. Conclusion: The EPD Questionnaire is probably the first instrument developed to assess patient‐reported experiences and perceived outcomes in a middle‐income country that included patients to capture all dimensions relevant for the intended population. Its psychometric properties are robust and could provide valuable information for clinicians and policymakers in the region. Patient or Public Contribution: The development of these instruments has taken into consideration patients and the public since their conception. A qualitative approach gathered relevant information related to the cultural, social and economic burden of different populations in Ecuador. Before validation, a pilot test was carried out with users of the National Health Services to obtain their perspectives and insights of the developed instrument. Finally, during the data analysis, we have given special consideration to social variables such as rural and urban populations. [ABSTRACT FROM AUTHOR]

Background: Learners in a given massive open online course (MOOC) are usually provided with the same learning materials, guided by the same syllabus, and assessed in the same format. This "one‐size‐fits‐all" approach constrains learners' ability to reap the optimal benefits from online learning. Objectives: This study aims to characterize learners' differences in MOOC learning. Specifically, it examines how learners might vary in their enrolment motivation and the development of continuance intention to learn in a MOOC because of their gender and employment status. Methods: Data were collected via a questionnaire survey. Quantitative and qualitative methods were used to analyse data from 664 learners in a Chinese MOOC. Results and Conclusion: The research revealed significant differences in learners' enrolment motivation across groups defined by employment status, but not for gender groups. Learner groups defined by gender and employment status experienced variant psychological processes when deciding to continue to learn in the MOOC. Major Takeaways: Working adults stressed the instrumental values derived from MOOC learning; therefore, it is vital to design and integrate additional features into the MOOC to satisfy their needs. Besides, it would be critical to understand female learners' and working adults' expectations of MOOC learning, as they are more sensitive to confirmation in determining their attitudes toward learning in a MOOC. A short pre‐course survey of learners' expectations would serve the purpose. Lay Description: What is already known about this topic?: Gender and employment status are associated with varied learning outcomes in MOOCs.Motivation and continuance intention are two critical psychological mechanisms.Confirmation, satisfaction, and attitude are determinants of continuance intention. What this paper adds?: Students' enrolment motivation is significantly different from that of working adults.No significant difference was found in motivation across gender.Working adults' and female learners' attitudes were more determined by confirmation.Students and male learners depended more on satisfaction in forming their attitudes. Implications for practitioners: Working adults stressed the instrumental value derived from MOOC learning.Extra features should be integrated into MOOCs to satisfy working adults' needs.It is critical to understand female learners' and working adults' expectations.A short pre‐course survey could shed light on learners' expectations [ABSTRACT FROM AUTHOR]

Background: In view of the widespread use of digital technologies in English as a foreign language (EFL) learning and the importance of students' approaches to learning (SAL) and digital competence, as well as the threats of technostress in digital settings, digital EFL learning requires a critical examination. Objectives: This study sought to investigate the interrelationships among of SAL, students' digital competence, and the emerging technostress in digital learning of EFL. Methods: Survey and EFL test data of 477 university students taking EFL courses were collected. Partial least square structural equation modelling and cluster analysis were employed to analyze these data. Results and Conclusions: The results indicate that a surface approach to learning was significantly positively associated with technostress while negatively associated with digital competence. The deep and organized learning approaches positively predicted digital competence, which further negatively predicted technostress and burnout in digital learning of EFL. Technostress was found to be positively related to exhaustion and cynicism, with cynicism being negatively related to EFL learning outcomes. The cluster analysis identified three clusters of EFL learners and revealed that, overall, high scores in the deep and organized approaches to learning were generally aligned with strong digital competence, low technostress, low burnout, and high EFL learning outcomes. Takeaways: The findings of this study carry important implications for practitioners of EFL learning and teaching in the design of strategies, pedagogies, and EFL learning technologies that improve EFL learning in digital settings while maintaining learners' wellbeing. Lay Description: What is already known about this topic?: Computer‐assisted language learning (CALL) is often perceived as rote learning through a surface approach such as memorization and repetition.Technostress may arise if learners cannot manage their approaches to digital learning properly, but has rarely been studied in CALL.Digital competence enables learners to leverage digital technologies for maximal learning prospects. However, little is known whether and how students' approaches to learning are related to digital competence in CALL. What this paper adds?: A surface approach to CALL was significantly positively related to technostress while negatively related to digital competence.The deep and organized learning approaches positively predicted digital competence.Digital competence negatively predicted technostress and burnout in CALL.High scores in the deep and organized approaches to learning were generally aligned with strong digital competence, low technostress, low burnout, and high CALL outcomes. Implications for practitioners: Authentic and safe CALL environments should be created for students to flourish.Deep and organized approaches to CALL are conducive to digital competence and help reduce technostress. [ABSTRACT FROM AUTHOR]

The original 26‐item Self‐Compassion Scale (SCS; Neff, 2003) and 12‐item Short‐Form Self‐Compassion Scale (SF‐SCS; Raes et al., 2011) are scales commonly used in cross‐sectional and longitudinal research to assess the global self‐compassion construct and its six facets. We introduce the Single‐Item Self‐Compassion Scale (SISC; 'I have high self‐compassion') to measure the global self‐compassion construct in time‐, space‐ and resource‐limited contexts (e.g., daily diaries, experience sampling and nationally representative surveys). Additionally, the SISC will expand knowledge about self‐compassion by providing researchers whose primary interest is not self‐compassion with a convenient, face‐valid option to measure self‐compassion. Across 10 samples (four cross‐sectional, four longitudinal and two 7‐day daily diary; N = 2,477), we demonstrated that the SISC has acceptable psychometric properties. Specifically, the SISC was temporally consistent, correlated adequately with the SCS and SF‐SCS, exhibited nearly identical correlational patterns when compared with the SCS and SF‐SCS with a wide range of criterion measures (e.g., self‐esteem, personality, affective and social functioning, mental health and demographic variables) and saved 12 min over a 7‐day diary. Results replicated among students, community samples and across the United States, Turkey and Malaysia. Thus, we provide the field with an alternative measure of the global self‐compassion construct that complements the SCS and SF‐SCS. [ABSTRACT FROM AUTHOR]

Background: There is a lack of critical or empirical work interrogating the nature and purpose of evaluating technology use in education. Objectives: In this study, we examine the values underpinning the evaluation of technology use in education through field specialist perceptions. The study also poses critical reflections about the rigour of evaluation instruments development in the educational technology field. Method: A total of 48 domain specialists were surveyed to investigate the face and content validity of 39 items under eight constructs, with both qualitative and quantitative data from the survey analysed. Results: There was an alignment between the constructs that the specialists felt were important and the constructs that have typically been the focus of empirical studies, with field specialists indicating high relevance scores for technology (M = 3.24/4), learning outcomes (M = 3.20/4), affective elements (M = 3.19/4), behaviour (M = 3.15/4), presence/community (M = 3.07/4), teaching/pedagogy (M = 3.01/4), design (M = 2.96/4), and institutional environment (M = 2.86/4). Only a minority of other studies were found to perform face and content validity checks and even then only with small samples of respondents (usually n ≤ 5). Implications: Specialists in educational technology research confirm that all eight dimensions are important to consider when evaluating the use of technology in education. Thorough face and content validity processes should be adopted when developing educational technology evaluation instruments. Further work has validated an eight factor 28 item instrument for evaluating the use of technology in education using a large sample of students from a global open learning online course. Lay Description: What is already known about this topic: Comprehensive evaluation of technology use is essential to make decisions on learning technology strategies.There is a lack of critical work interrogating how technology use is evaluated in education.There is a need for developing evaluation instruments in the educational technology field. What this paper adds: An examination of 48 field specialist perceptions of important constructs when evaluating technology use in education.Field specialists agreed that eight constructs identified in empirical studies were relevant to educational technology evaluation.Evidence of limited face and content validation processes based on previous empirical work.A comprehensive 39‐item instrument for evaluating technology use in education. Implications of study findings for practitioners: Adopt a broad range of constructs when evaluating the use of technology in education.Apply face and content validation processes involving a large sample of experts.Consider using the 39‐item instrument to evaluate educational technology use. [ABSTRACT FROM AUTHOR]

Aims: To develop a questionnaire to identify Intensive Care survivor needs at key transitions during the recovery process, and assess its validity and reliability in a group of ICU survivors. Methods: Development of the Support Needs After ICU (SNAC) questionnaire was based on a systematic scoping review, and analysis of patient interviews (n = 22). Face and content validity were assessed by service users (n = 12) and an expert panel of healthcare professionals (n = 6). A pilot survey among 200 ICU survivors assessed recruitment at one of five different stages after ICU discharge [(1) in hospital, (2) < 6 weeks, (3) 7 weeks to 6 months, (4) 7 to 12 months, or (5) 12 to 24 months post‐hospital discharge]; to assess reliability of the SNAC questionnaire; and to conduct exploratory data analysis. Reliability was determined using Cronbach's alpha for internal consistency; intraclass correlation coefficients for test–retest reliability. We explored correlations with sociodemographic variables using Pearson's correlation coefficient; differences between questionnaire scores and patient demographics using one‐way ANOVA. Results: The SNAC questionnaire consisted of 32 items that assessed five categories of support needs (informational, emotional, instrumental [e.g. practical physical help, provision of equipment or training], appraisal [e.g. clinician feedback on recovery] and spiritual needs). ICU survivors were recruited from Northern Ireland, England and Scotland. From a total of 375 questionnaires distributed, 202 (54%) were returned. The questionnaire had high internal consistency (0.97) and high test–retest reliability (r = 0.8) with subcategories ranging from 0.3 to 0.9. Conclusions: The SNAC questionnaire appears to be a comprehensive, valid, and reliable questionnaire. Further research will enable more robust examination of its properties e.g. factor analysis, and establish its utility in identifying whether patients' support needs evolve over time. Relevance to clinical practice: The SNAC questionnaire has the potential to be used to identify ICU survivors' needs and inform post‐hospital support services. [ABSTRACT FROM AUTHOR]

Accessible summary: Barriers make it hard for pupils to learn. We wanted to assess barriers to learning. We made an assessment called the Assessment of Barriers to Learning in Education‐Autism (ABLE‐Autism).We asked teachers to tell us about the barriers to learning. They told us about lots of barriers. We wanted to include the most important barriers.We used the Delphi method with teachers. The Delphi method helps people to agree what is important.Teachers told us about the most important barriers to learning. We included the most important barriers to learning in our assessment. Background: This study outlines how a modified Delphi procedure was used with special educational needs teachers to select skills and behaviours for inclusion in the Assessment of Barriers to Learning in Education‐Autism (ABLE‐Autism). The ABLE‐Autism is a new teacher assessment to show progress in barriers to learning for pupils on the autism spectrum with coexisting intellectual disabilities in special schools. The research aim was to select items for inclusion in the assessment based on teacher ratings of relevance, comprehensibility and comprehensiveness. Method: Following a review of the literature and teacher focus groups, a list of 86 items was developed and a modified two‐round Delphi exercise was conducted with special needs teachers. Items were selected for inclusion if at least 80% of teachers agreed that the item was (a) able to be understood, (b) important to assess and (c) the median score associated with whether the item was able to be understood and important to assess was 1 (the highest score possible). Results: In the first round, 56 items met the criteria for inclusion and were retained. Thirty items were amended, and, after three items were amalgamated with other items, 27 amended items were included in the second round. After the second round, 14 additional items met the threshold to be included in the final assessment. Conclusions: After both rounds, 70 items were endorsed by teachers and included in the ABLE‐Autism. The input of special needs teachers provided initial face and content validity for the new outcome measure. [ABSTRACT FROM AUTHOR]

Counseling researchers and practitioners use screening tools and assessments to measure, treat, and improve their clients' overall (mental and physical) wellness, which creates a need for screening tools that appraise overall wellness. The author of this study first tested the convergent validity of scores on the Lifestyle Practices and Health Consciousness Inventory (LPHCI), a screening tool for simultaneously appraising global wellness (mental and physical) using a large (N = 796) national stratified random sample of adults living in all 50 of the United States. The author then investigated the capacity of global wellness for predicting symptoms of anxiety and depression and explored demographic differences in global wellness. Findings support the convergent validity of scores on the LPHCI and reveal that global wellness is a significant negative predictor of the symptomology of mental and physical distress. Implications for the potential utility of incorporating global wellness into counseling practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Oral epithelial dysplasia (OED) can lead to significant information needs (IN) related to the risk of cancer development, the need for long‐term monitoring and potential intervention. The present study aimed to develop and perform preliminary psychometric testing for a novel IN instrument specific to OED. Subjects and methods: Patients diagnosed with OED were invited to complete the Oral Epithelial Dysplasia Informational Needs Questionnaire (ODIN‐Q), which was developed based on a known theoretical framework and with items generated via expert input and the literature. Face validity and content validity were initially assessed prior to finalisation of the tool. ODIN‐Q was tested for internal consistency and test–retest reliability along with construct validity. Results: ODIN‐Q consists of 35 items, categorised under six domains, and rated by dual 4‐point Likert scales (amount of information received and degree of importance). Internal consistency (Cronbach's alpha) was rated "excellent" for the scale (0.93) and both subscales (0.92/0.94). For test–retest reliability, moderate agreement was found (κ = 0.49–0.53). Regarding construct validity, a significant but limited relationship was found between ODIN‐Q and the Krantz Health Opinion Survey. Conclusion: ODIN‐Q showed adequate psychometric properties of reliability and validity. Further validation is, however, needed to assess its structural validity and responsiveness. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff related shoulder pain (RCRSP) knowledge is an important contributor to compliance with clinical practice guidelines and providing best practice care. However, there are no validated instruments for measuring health literacy levels among people with RCRSP. This study aimed to design a valid and reliable instrument to measure RCRSP health literacy and use it to evaluate an education intervention for people with RCRSP. Methods: Development of the patient knowledge questionnaire (PKQ‐RCRSP) included three phases. Phase 1 was developed based on available literature and input from expert clinicians, researchers and patients. Face validity, pilot testing and readability assessment were also undertaken. In Phase 2, internal consistency and predictive validity were assessed in people with RCRSP and other shoulder pain diagnoses. In Phase 3, RCRSP health literacy was assessed. Result: Face validity was acceptable and pilot testing identified minor accuracy issues that were corrected. Literacy level was rated as 'difficult to read' which reflects the medical terminology within the questionnaire. Internal consistency was very good and 81% of questions demonstrated acceptable predictive validity. Health literacy was heterogeneous depending on the question with less than 40% of respondents answering correctly for questions related to the indications, process and the known benefits of RCRSP surgery. Conclusion: The PKQ‐RCRSP demonstrated acceptable face validity, predictive validity and reliability (internal consistency) in assessing RCRSP health literacy. Health literacy among our small sample was poor for questions related to surgery for RCRSP. [ABSTRACT FROM AUTHOR]

Rationale: To maintain patients' dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers' non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients. Aim: The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson's Theory of Caring. Method: An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient. Result: The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson's Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson's Theory of Caring were observed and coded in the interaction. Discussion/Conclusion: The CBCS is a theory-based instrument that contributes to research on healthcare providers' behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers' caring behaviour with the intended outcome of patient well-being. [ABSTRACT FROM AUTHOR]

Aim: To describe the process of linguistic and content validity of the Swedish version of the PedsQL™ Gastrointestinal Symptoms Scales and Symptoms Module, measuring health-related quality of life (HRQOL) in children with gastrointestinal (GI) disorders.Methods: The establishment of linguistic and content validity was carried out in compliance with international standards on patient-reported outcome measurements. The process included forward translation, expert review and reconciliation, backward translation, backward translation review and interviews with 15 children aged 5-18 years with GI tract symptoms and 20 parents of children with GI tract symptoms aged 2-18 years.Results: The Swedish version of the PedsQL™ Gastrointestinal Symptoms Scales and Symptoms Module (child report 5-18 years, parent report for children 2-18 years) was achieved without major difficulties. Eight issues needed discussion after forward translation, and there was one change after backward translation and three revisions following patient and parent testing.Conclusion: A conceptually equivalent Swedish language version of PedsQL™ Gastrointestinal Symptoms Scale and Symptoms Module for children aged 2-18 years old was developed. This enables improved HRQOL evaluations in children with GI disorders in Sweden. Future research using a larger sample is recommended to evaluate validity and reliability of the Swedish language version of the module. [ABSTRACT FROM AUTHOR]

Background: Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics. Aims and objectives: This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics. Design A cross‐sectional design was conducted. Methods: All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t‐test, one‐way analysis of variance, and multivariable linear regression analysis. Results: The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score. Conclusion: This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics. Relevance to clinical practice: The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units. [ABSTRACT FROM AUTHOR]

Objective: Medication errors are a concern in overall the world. Although there are studies that investigate what may be the main causes that lead to the genesis of the medication error in the home care setting, there is no tool that correlates knowledge, attitudes, and behavior to medication errors in the context of home care. This study aimed to psychometrically test to the questionnaire on knowledge, attitudes, and behaviors in the administration of medication in the new setting: home care setting. Design: This observational study was reported according to the STROBE checklist. Sample: Sixty two nurses working in home care setting responded to the online survey. Measurement: The face and content validity of the items generated was assessed. An Exploratory Factorial Analysis descriptive statistical analysis was conducted. The final questionnaire is composed of 20 items. Results: The results of the statistical analyses allowed to validate the questionnaire, ensuring good internal consistency and reliability. Most of the sample pointed out that the use of electronic health record, medication reconciliation and the pharmacist's figure are all useful strategies for reducing the risk of medication errors. Conclusion: The questionnaire is reliable to measure knowledge, attitude, and behavior about medication errors prevention in home care settings. [ABSTRACT FROM AUTHOR]

Context: Partnership between patients and health‐care professionals (HCPs) is a concept that needs a valid, practical measure to facilitate its use by patients and HCPs. Objective: To co‐construct a tool for measuring the degree of partnership between patients and HCPs. Design: The CADICEE tool was developed in four steps: (1) generate key dimensions of patient partnership in clinical care; (2) co‐construct the tool; (3) assess face and content validity from patients' and HCPs' viewpoints; and (4) assess the usability of the tool and explore its measurement performance. Results: The CADICEE tool comprises 24 items under 7 dimensions: 1) relationship of Confidence or trust between the patient and the HCPs; 2) patient Autonomy; 3) patient participation in Decisions related to care; 4) shared Information on patient health status or care; 5) patient personal Context; 6) Empathy; and 7) recognition of Expertise. Assessment of the tool's usability and measurement performance showed, in a convenience sample of 246 patients and relatives, high face validity, acceptability and relevance for both patients and HCPs, as well as good construct validity. Conclusions: The CADICEE tool is developed in co‐construction with patients to evaluate the degree of partnership in care desired by patients in their relationship with HCPs. The tool can be used in various clinical contexts and in different health‐care settings. Patient or Public Contribution: Patients were involved in determining the importance of constructing this questionnaire. They co‐constructed it, pre‐tested it and were part of the entire questionnaire development process. Three patients participated in the writing of the article. [ABSTRACT FROM AUTHOR]

Aim: To validate a semi‐quantitative food frequency questionnaire (SFFQ) and assess the dietary intake of Iranian adults. Methods: This study was conducted among 113 healthy adults in Iran. We administered twelve 24‐hour dietary recalls (24DRs) during a year as a reference method. The 165‐item SFFQ was administered twice, along with the first and last 24DRs. To examine validity and reproducibility of SFFQ, the correlation coefficients (r) and de‐attenuated correlation coefficients and intra‐class correlation coefficient (ICC) between 24DRs and SFFQ were calculated. The Bland‐Altman method was used to assess agreement between the two methods. Results: De‐attenuated correlations varied from 0.42 (polyunsaturated fatty acids) to 0.62 (energy) (all P <.001) for nutrients and from 0.48 (oils and fats) to 0.65 (sweets) for food groups (all P <.05). We found reasonable reproducibility of SFFQ for both nutrients and food groups. ICC (95%CI) varied from 0.47 (0.15‐0.74) for saturated fatty acids to 0.64 (0.47‐0.76) for energy and from 0.43 (0.15‐0.62) for oils and fats to 0.58 for grains (0.31‐0.69). According to the Bland‐Altman plots, we observed an acceptable level of agreement between the two methods. Conclusions: We found reasonable relative validity and acceptable reproducibility of SFFQ. This SFFQ can be used to classify individuals based on their dietary intake in our population. [ABSTRACT FROM AUTHOR]

Aim: To develop and validate a questionnaire investigating endurance athletes' carbohydrate beliefs, knowledge, information sources, and other dietary and non‐dietary practices related to exercise‐associated gastrointestinal symptoms. Methods: A questionnaire was developed by a review of relevant literature and sports‐related questionnaires, and input from five experienced sports dietitians. Item construct and format was adapted and modified from a previous questionnaire. The modified questionnaire sought information on demographics, nutrition knowledge, beliefs, intended practices, information sources and exercise‐associated gastrointestinal symptoms. A five‐phase validity process was conducted to determine content, face and construct validity, item difficulty and internal reliability of the questionnaire. The Delphi technique was applied with experts over three anonymous rounds. Items were reviewed to determine whether to keep, modify, or delete, rate the relevance of each item using a content validity index (CVI), and provide comments. A content analysis was conducted on all comments after each round. Online interviews were conducted with a pilot group of endurance athletes (n = 15) to assess item difficulty and feasibility. Nutrition knowledge was compared between pilot group of athletes and experts to determine construct validity and internal consistency. A test‐retest process was applied to a second pilot group (n = 8) to verify questionnaire reliability. Results: High CVI (≥.83) and agreement scores were obtained through the Delphi technique. High reliability (r =.942) and acceptable internal consistency (α =.53‐.78) of the questionnaire were obtained. Conclusions: The questionnaire was shown to be a valid and reliable tool that will be of use for clinicians and research purposes. [ABSTRACT FROM AUTHOR]

Developing new patient‐reported outcome measures (PROMs) for application in clinical studies can be necessary if an adequate PROM does not exist. For adequate measurement, it is essential that the PROM has face validity (ie, is perceived to be relevant by clinicians and researchers) and has high content validity (ie, content relevance and content coverage for the targeted patient group). The steps needed to create PROMs that possess face and content validity for a specific condition are described in this paper. Face validity is achieved by item identification and generation through literature review. Content validity is confirmed through repetitive cognitive interviews of patients from the targeted patient group in order to generate a consensus‐based pilot‐version of the new PROM. This qualitative process ensures that items are appropriately worded, understandable, and minimizes doubts about how items should be answered. A practical example of this process is presented, which shows the development of the Knee Numeric‐Entity Evaluation Score (KNEES‐ACL), a condition‐specific PROM for patients with deficiency of the anterior cruciate ligament (ACL). [ABSTRACT FROM AUTHOR]

Background: Patients need medication and medical condition‐related information to better self‐manage their health. Health‐care professionals (HCPs) should be able to actively provide information outside of one‐on‐one consultations; however, patient consent may be required. Objective: To investigate the Australian public's preferences, and factors that may influence their preferences, towards an opt‐in versus an opt‐out approach to health communication. Design: A cross‐sectional study using a structured questionnaire administered via Computer‐Assisted Telephone Interviewing. Setting and participants: Participants across Australia who were adults, English‐speaking and had a long‐term medical condition. Main outcome measures: Preferences for opt‐in vs opt‐out approach to receiving follow‐up tailored information. Results: A total of 8683 calls were made to achieve the required sample size of 589 completed surveys. Many (346/589; 58.7%) indicated that they were interested in receiving tailored, ongoing follow‐up information from their HCP. Nearly half (n = 281; 47.7%) preferred an opt‐in service and 293/589 (49.7%) an opt‐out service for receiving follow‐up information. Reasons for preferring an opt‐in service were being in control of the information received (n = 254); able to make a decision that is best for them (n = 245); opt‐in service would save time for HCPs (n = 217); they may not want or need the information (n = 240). Many (n = 255) felt that an opt‐out service should be part of the normal duty of care of their HCP and believed (n = 267) that this approach would ensure that everyone has access to information. Conclusions: Respondents were interested in receiving tailored information outside of consultation times. However, preferences for an opt‐in or opt‐out approach were divided. [ABSTRACT FROM AUTHOR]

Background: Lack of evidence regarding whether a useful examination instrument such as an multiple choice question (MCQ) quiz is reliable for assessing delirium care knowledge. Aim: To develop and psychometrically test a MCQ‐based quiz for assessing the delirium care knowledge in critical care nurses. Design Instrument development and psychometric evaluation study. Methods: The development and validation process consisted of two phases. The first Phase focused on the quiz development, which was achieved through the following steps: (a) generation of an initial 20‐item pool; (b) assessment of content validity; (c) assessment of face validity; (d) conduction of a pilot test, involving the collection of data from 217 critical care nurses through an online survey; and (e) item analysis and item elimination according to item difficulty and discrimination indices. The MCQ quiz was finalized through the development process. The second phase emphasized quiz validation through estimation of the internal consistency, split‐half and test–retest reliability, and construct validity using parallel analysis with exploratory factor analysis (EFA). Results: A final 16‐item MCQ quiz was emerged from the item analysis. The Kuder–Richardson formula 20 coefficient for the overall quiz indicated good internal consistency (0.85), and the intraclass correlation coefficient with a 30‐day interval also indicated that the questionnaire had satisfactory stability (0.97). EFA confirmed that the quiz had appropriate construct validity, and four factors could explain 60.87% of the total variance. Conclusion: In this study, the MCQ, and single best answer quiz for assessing delirium care knowledge was developed, and its reliability and validity for this purpose were demonstrated. Relevance to clinical practice: This study introduced an evidence‐based quiz designed for future use in delirium care research and education that has significant implications for MCQ‐based knowledge assessment in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To verify the reliability and validity of a Japanese translation of the Satter eating competence Inventory‐2.0™ (ecSI‐2.0™) for parents of fifth and sixth grade elementary school students. Methods: Participants were parents who prepared meals for their children aged 10–12 years. A preliminary study was conducted with 11 parents using semi‐structured interviews and questionnaires, followed by a main study of 2,825 parents. Internal consistency and test–retest methods were used to verify reliability. Face and content validity were confirmed in the preliminary study, and feasibility was examined by the valid response rate and response time. Construct validity was verified using factor validity and known population validity. Results: Of the 2,825 persons surveyed, 626 returned valid responses, and among the 60 persons who received the re‐survey, 48 returned valid responses. The average score of the Japanese translation of the ecSI‐2.0™ was 33.1 (SD ± 7.8) points. Cronbach's alpha coefficient for the whole scale was.87 and ranged from.67–.79 for the four subscales. The test–retest method confirmed the scale's stability. Factor analysis confirmed that reproducibility of the four factors was similar to the original version. In the examination of known population validity, the same correlation as the original edition was confirmed. Conclusions: The Japanese translation of the ecSI‐2.0™ may be reliable and valid for understanding eating competence related to behavior of parents of school‐age children. [ABSTRACT FROM AUTHOR]

Background: Patient empowerment can improve health‐related outcomes and is important in chronic conditions, such as arthritis. This study aimed to validate the Health Care Empowerment Questionnaire (HCEQ), a patient‐reported experience measure of empowerment, for use with patients with arthritis and other rheumatic diseases. Methods: The HCEQ measures Patient Information Seeking (or Involvement in Decisions) and Healthcare Interaction Results (or Involvement in Interactions) and asks respondents to answer questions in two ways: whether they feel something happened and its importance to them. Face validity was assessed through qualitative data (n = 8, nominal group technique; n = 55, focus groups). Measure structure was assessed through confirmatory factor analysis (CFA); internal consistency was also assessed (n = 9226). Test‐retest reliability was assessed with sub‐sample of participants (n = 182). Results: We found adequate face validity of the HCEQ for patients with arthritis. The CFA indicated good fit to the data for the two‐factor structure of the HCEQ (RMSEA = 0.075; CFI = 0.987; TLI = 0.978; SRMR = 0.026). Internal consistency was strong (α=0.94 for both subscales). Test‐retest reliability was moderate for Patient Information Seeking (ICC=0.67) and good for Healthcare Interaction Results (ICC=0.77). Conclusions: The HCEQ, with modifications, demonstrated promising psychometric properties within this sample, laying the foundation for further assessment. This work supports the HCEQ as an appropriate instrument for examining experiences with and perceived importance of empowerment in individuals with arthritis and other rheumatic conditions. Patient Contribution: Patients contributed to the assessment of face validity. As a measure of patient empowerment, the HCEQ's use can enable further participation of patients in health care. [ABSTRACT FROM AUTHOR]

Aims: Educating women regarding breast cancer and increasing breast self‐examination uptake continues to remain a major challenge despite the intensive campaigns. An innovative, cost‐effective and easily customised intervention is needed especially in under‐resourced and hard to reach communities. This paper is a report examining the effects of mobile text messaging on women's knowledge of breast cancer and BSE, BSE self‐efficacy and frequency of BSE. Methods: A randomised controlled trial design was used. The study sample consisted of 128 women of reproductive age (WRA) (64 in the experimental group and 64 in the control group) from two communities in the Philippines during the months of August to October 2018. Three to five short messages were sent to the participants in the experimental group daily for one month while the control group did not receive the messages. Results: Women who received mobile text messages had higher knowledge of breast cancer (F = 21.756, p = 0.001) and breast self‐examination (F = 6.776, p = 0.010) than the control group. However, no significant improvements were seen in the BSE self‐efficacy (F = 1.446, p = 0.232) and frequency of BSE (F = 3.374, p = 0.69). Conclusion: Mobile text messaging significantly improved the knowledge on breast cancer and breast self‐examination among women; however, it did not affect their breast self‐examination self‐efficacy and frequency. Mobile text messaging can be a viable tool that can be used by healthcare workers in order to educate women regarding breast cancer and breast self‐examination. [ABSTRACT FROM AUTHOR]

Aim: We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN‐J). Background: Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses' professional attitudes. Introduction: This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. Methods: Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59‐item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59‐item draft scale, and a self‐report scale of nurses' professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion‐related, concurrent, and known‐groups validity, and reliability of the PASN‐J. Results: Data from 1716 participants were analysed. The analyses yielded a 38‐item, 3‐factor scale that adequately fit the data. PASN‐J scores were positively correlated with nurses' professional behaviour and nursing practice ability. Conclusion: The 38‐item PASN‐J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses' professionalism. The PASN‐J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN‐J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN‐J enhances nurses' professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Healthcare providers involved in an unexpected adverse patient safety event are affected by negative outcomes of the event and are called 'second victims'. The Second Victim Experience and Support Tool has been introduced as a reliable and valid measure to assess the second victim responses and to support recourses of healthcare professionals. Aim: The core objective of this survey was to assess the psychometric attributes of the scale within Iranian nurse. Methods: Having translated the scale based on the WHO guidelines and assessing its face validity, a board of 8 specialists assessed the content validity of the measure. In order to assess the psychometric characteristics of the questionnaire, a survey was conducted in 5 university‐affiliated hospitals of Urmia. Confirmatory factor analysis is adopted to assess the construct validity. The internal consistency and test–retest reliability of the scale were determined. Results: The Persian version of the scale consists of 29 items and 9 subscales. Confirmatory factor analysis illustrated that the scale reflects a foolproof construct validity. Cronbach α coefficients revealed the reliability of the scale (0.68–0.88). Conclusions: The survey proves to be a reliable and valid measure to evaluate the second victim responses and conceivable support resources of Iranian nurses or other Persian‐speaking healthcare professionals of the region. Implications for health policy and practice: Health policymakers ought to build up large‐scale surveys to determine the degree of second victimization of healthcare professionals so as to offer suitable support systems. Taking the scale into account would improve evaluation of the benefits of second victim support initiatives in nursing practice. [ABSTRACT FROM AUTHOR]

Background: Stress can threaten the health and recovery of patients, and determining the level of stress can be an important factor in curing illnesses. The aim was to adapt the Hospitalisation‐Related Stressors Questionnaire for Elderly Patients (HRSQ‐EP) and perform its psychometric evaluation. Methods: In the study, the method of developing a scale and determining the construct validity and reliability of this scale was used. The research was carried out with elderly patients who were hospitalised. The research was conducted in two main phases; in the first phase, after providing expert opinion for the language validity of the scale, the content and face validity were confirmed and then confirmatory and exploratory factor analyses were applied for content validity and reliability in the second phase. Results: The new scale, which was formed as a result of evaluating the construct validity, consisted of three factors and 15 items, and all factors explained 67.1% of the total variance. Kaiser‐Meyer‐Olkin, which determined the suitability of the measurement tool for factor analysis, was determined as 0.901 and Bartlett test 0.000. The adapted short form is a simple and easy‐to‐understand tool for determining the stress levels of hospitalised elderly individuals. HRSQ‐EP provided evidence that it demonstrates adequate internal consistency, reliability and construct validity. Conclusion: The results suggested that the adapted measurement tool will be useful. The scale is recommended to be evaluated in different populations to determine cultural differences. [ABSTRACT FROM AUTHOR]

Aim: Family caregivers have limited abilities that make them vulnerable to the care needs of patients. Therefore, it seems necessary to evaluate their caring ability. The aim of this study was to design an instrument for assessing the caring ability of family caregivers of cancer patients. Methods: This was a sequential exploratory mixed‐method study, carried out in two qualitative and quantitative phases. The concept of caring ability and its dimensions were explained using conventional content analysis in the qualitative phase. The research participants included 41 family caregivers of cancer patients and professional caregivers who were selected using purposeful sampling method until reaching data saturation. The scale items were designed using the results of the qualitative phase of the study, as well as the review of relevant literature. In the quantitative phase, the scale was validated using content and face validity, construct validity, as well as internal consistency and stability. Results: The primary item pool was prepared in 108 items. Content validity was determined using CVR with a cut‐off point (0.62), CVI with a cut‐off point (0.8) and kappa coefficient (κ) (>0.75). The validity of 72 items was confirmed. Then, the overlapping items were merged and eventually the 45‐item scale entered the face validity stage and five items with an impact factor < 1.5 were omitted. Results of KMO = 0.904 and Bartlett = 6184.012 (p < 0.001) justified the need for factor analysis. Scree plot indicates five factors with eigenvalues above 1 and 67.7% of the total variance, including 'Effective role play, Fatigue and Surrender, Trust, Uncertainty, and Caring ignorance'. Reliability of the 31‐item instrument indicated a Cronbach's alpha coefficient of 0.93 and ICC of 0.94. Conclusions: Caring abilities scale (CAI) of family caregivers of patients with cancer is a valid and reliable instrument that can assess caregivers' caring ability. [ABSTRACT FROM AUTHOR]

Background: Feeding practices adopted by parents play a critical role in the development of children's taste preferences, eating habits, nutrition and eventual weight status. Many scales have been developed to assess feeding practices among children of various age groups. This paper aimed to construct and validate a robust scale for the comprehensive assessment of sleep‐time feeding practices for children aged 0‐3 years and to establish the risk of developing Early Childhood Caries (ECC). Methods: There were multiple phases to the development of the scale: (a) formation of a conceptual framework, (b) systematic development of an item pool, (c) refinement of the item pool by focus group discussion, cognitive interviewing and pretesting, (d) validity testing and (e) reliability testing. The conceptual framework was built based on four broad constructs: breastfeeding, bottle‐feeding, other feeding modes and 'tooth and diet' constructs. Reviews of existing scales in related areas were instrumental in scale development and helped to generate an initial pool of 45 items, which was finally refined to 28 items. Results: Cognitive interviews by the 'think‐aloud protocol' helped to reduce ambiguity and maximize clarity of the questions. Pretesting the scale aided increased comprehension and specificity. Face and content validity were corroborated by 'subject matter experts' who endorsed the suitability and appropriateness of items. Reliability was assessed by test‐retest, and a near‐perfect agreement was obtained in 96% of the items. Conclusions: This is the first validated scale currently available for recording sleep‐time feeding practices of children less than three years of age. This 28‐item scale can be applied as a potential clinical scale to record sleep‐time feeding history and the risk of developing ECC as well as a research scale to investigate the association of sleep‐time feeding practices with ECC. [ABSTRACT FROM AUTHOR]

Background: The patient's right to be involved in treatment decisions is anchored in guidelines and legislation in many countries. Previous research suggests challenges in the implementation of user involvement across different areas of health care, including mental health. However, little is known about psychiatric outpatients' experiences of being involved in their treatment. Objective: To investigate how psychiatric outpatients after treatment rate the degree to which they were included in the treatment and explore the associations between perceived user involvement, demographic characteristics of the sample and patient satisfaction. Design: Cross‐sectional. Setting and participants: The sample consisted of 188 psychiatric outpatients (67% female, mean age 42.2 years) who were discharged in the two years prior to data collection. Main variables studied: Perceived user involvement in psychiatric outpatient treatment and patient satisfaction as measured by the Psychiatric Out‐Patient Experiences Questionnaire. Results: About half of the participants rated the overall degree of involvement in their treatment as high or very high. The lowest percentage of participants reporting high or very high involvement was found for sufficient information to contribute to treatment decisions (36%). Female gender, higher education and, to a small degree, younger age were associated with more involvement. Perceived user involvement was strongly associated with treatment satisfaction. Discussion and conclusion: The findings suggest that user involvement in psychiatric outpatient treatment can be improved. Patient information that facilitates user involvement should be given more attention. Patient or Public Contribution: The hospital's user panel was involved in the development of items assessing user involvement. [ABSTRACT FROM AUTHOR]

The anorexic voice (AV) is defined as a critical internal dialogue, which has been implicated in the development and maintenance of anorexia nervosa (AN). Systematic research to explore this further requires a valid and reliable measurement tool. This study aimed to develop and assess the validity of the Experience of an Anorexic VoicE Questionnaire (EAVE‐Q). EAVE‐Q items were developed and checked for face and content validity through cognitive interviews with seven individuals diagnosed with AN. Participants with a diagnosis of AN (N = 148) completed the EAVE‐Q, sociodemographic questions and measures of mood and quality of life to assess internal consistency and construct validity. Forty‐nine participants completed the EAVE‐Q twice more to assess test–retest reliability. The EAVE‐Q had good face and content validity and good acceptability. Principal axis factoring resulted in an 18‐item scale organized into five domains with high internal consistency (α = 0.70 to α = 0.85). Domains correlated significantly with eating disorder symptoms, psychological distress, and quality of life. The EAVE‐Q did not discriminate between participants on the basis of body mass index. Test–retest reliability was moderate. Although the factor structure of the EAVE‐Q requires replication in other AN samples, the EAVE‐Q is the first measure of a critical internal dialogue in AN. It is hoped that it will aid future research to increase understanding of AN and the continued development of person‐centred treatments. [ABSTRACT FROM AUTHOR]

Background: Experiences of people with intellectual disability are often reported by proxy, excluding the person's own perception. To assist people with intellectual disabilities ability to communicate their own experiences, the current study explored the feasibility, reliability and validity of experience sampling methods (ESMs) for people with intellectual disability. Method: After a training session, 19 participants carried a mobile device for 7 consecutive days, answering a survey when prompted 7 times daily. Participants were interviewed at the end of data collection. Results: Excluding incomplete entries, the response rate was 33.8%, varying by living arrangement and employment. Split‐half reliability and correlations among logically linked internal experiences demonstrated strong reliability and validity. Illustration of the context of responses supported face validity. Technological and content difficulties were discussed in interviews. Conclusions: Experience sampling methods is feasible for some people with intellectual disability, providing valid and reliable information. Future research is needed to further improve feasibility. [ABSTRACT FROM AUTHOR]

The Family Adaptability and Cohesion Scale IV (FACES-IV) was developed to capture the balanced and unbalanced levels of cohesion and flexibility in families. Although this measure has been shown to be valid and reliable, its length at 62 items limits utility and uptake in clinical and research settings. This paper details the development of a shorter form of the FACES-IV (the FACES-IV Short Form) using two studies. In the first study, three item-level analyses were used to identify 24 items that provided the best measurement of each of the scales of the FACES-IV. In the second study, the reliability, and convergent and divergent validity of the short form was tested. Results suggest that the FACES-IV-SF is a valid and reliable measure that adheres to the theory underlying the original FACES-IV but may be better utilized in clinical and research settings due to its brevity. [ABSTRACT FROM AUTHOR]

Background: Health care providers should be able to provide good quality end‐of‐life care. A tool to evaluate the positive and negative consequences of caring for dying patients is warranted. Aim: The aim of this study was to evaluate the psychometric properties of the Persian version of the End‐of‐Life Caregiving Experience Appraisal Scale (EOLCAS). Methods: This research was conducted in two phases. Phase I: The World Health Organization Protocol of forward‐backward translation and an expert panel in order to determine face and content validity. Phase II: Survey development with 310 nurses who worked in critical care units, construct validity (construct, convergent and divergent validity), internal consistency (average inter‐item correlation, Cronbach's alpha and McDonald's omega) and construct reliability were evaluated. Results: The exploratory factor analysis showed that the present scale (Persian version) has four factors: Negative physical‐emotional and social consequences, transcendental communication, information deficits and future rumination, which explained 83.92% of the overall extracted variance. Convergent and divergent validity were confirmed for all factors. The internal consistency and construct reliability were acceptable. Conclusion: The scale has a multidimensional concept that is sufficiently reliable and the use of the scale would be helpful in measuring consequences of caring for dying patients. Relevance to clinical practice: This scale makes a significant contribution in that it helps in the recognition of positive and negative consequences of critical care nurses' caring for dying patients. [ABSTRACT FROM AUTHOR]