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Objectives: Following a user‐centred redesign and refinement process of an electronic delirium screening tool (eDIS‐MED), further accuracy assessment was performed prior to anticipated testing in the clinical setting. Methods: Content validity of each of the existing questions was evaluated by an expert group in the domains of clarity, relevance and importance. Questions with a Content Validity Index (CVI) <0.80 were reviewed by the development group for potential revision. Items with CVI <0.70 were discarded. Next, face validity of the entirety of the tests was conducted and readability measured. Results: A panel of five clinical experts evaluated the test battery comprising eDIS‐MED. The content validity process endorsed 61 items. The overall scale CVI was 0.92. Eighty‐eight per cent of the responses with regard to question relevancy, usefulness and appropriateness were positive. The questions were deemed fifth grade level and very easy to read. Conclusions: A revised electronic screening tool was shown to be accurate according to an expert group. A clinical validation study is planned. [ABSTRACT FROM AUTHOR]

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]

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]

Aim: The aim of this study was to translate the Nursing Clinical Reasoning Scale (NCRS) into Persian and evaluate its psychometric properties. Design: This study was a methodological and cross‐sectional study. Methods: This methodological study was conducted in 2020 in a teaching hospital. After obtaining necessary permission from its developers, NCRS was translated into Persian through the method proposed by the World Health Organization. Then, its face, content, and construct validity and reliability were assessed. For construct validity assessment through exploratory and confirmatory factor analyses, 300 nurses (two 150‐nurse samples), who had randomly been selected, completed the instrument. Reliability also assessed through the internal consistency and the stability methods. Data were analysed using the SPSS (v. 20.0) and the AMOS (v. 5.0) software. Results: The content validity indices of NCRS and its items were 0.97 and more than 0.79, respectively. Exploratory factor analysis revealed an assessment and confirmation factor and an implementation and reflection factor for the scale which together explained 57.30% of the total variance. Confirmatory factor analysis also confirmed this two‐factor structure (χ2/df = 2.11, NNFI = 0.952, RMSEA = 0.053, CFI = 0.91, GFI = 0.94, IFI = 0.95, and NFI = 0.96). The Cronbach's alpha and the intraclass correlation coefficient values of the scale were 0.96 and 0.94, respectively. Public Contribution: The Persian NCRS can help nursing policy makers and mentors identify the need for developing nurses' and nursing students' CR skills and implement need‐based educational courses to improve these skills. Moreover, it helps determine whether the educational programmes are effective in improving nurses' CR skills and clinical competence. [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: 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]

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]

Aim: To evaluate the psychometric properties of the Persian version of the Cambodian Nursing Care Quality Scale. Design: Methodological design. Methods: This study was carried out in several steps: a forward‐backward translation was done, face and construct validity was measured using exploratory and confirmatory factor analysis and the reliability was evaluated. A convenience sampling method was employed to recruit 350 nurses from May 2021 to March 2022. Results: The exploratory factor analysis extracted six factors that explained 60.76% of the total variance. The six‐factor model is supported by confirmatory factor analysis. The Cronbach's alpha and the intra‐class correlation coefficient were 0.94 and 0.85, respectively. Patient or Public Contribution: Evaluation of the quality of care can lead to the enhancement of the quality of nursing services and patient safety. This will subsequently increase the patients' and community satisfaction. [ABSTRACT FROM AUTHOR]

Aim and Objectives: This study aimed to develop and examine psychometric properties of the safety feeling scale (SFS) in adult patients to assess their sense of safety during a hospital stay. Design: Mixed methods design. A SQUIRE checklist was used. Methods: This is a study with two phases of scale development and evaluation of the psychometric properties of the scale. In the first phase, the concept of 'safety feeling' was analysed using a hybrid model. Thus, a systematic review and then a qualitative study with hospitalized patients (n = 31) were conducted by conventional content analysis. In the psychometric phase, factorial validity, reliability, feasibility, and responsiveness of the scale were evaluated by different tests in various samples. Results: After integrating the results of the systematic review and qualitative study, a scale item pool with 84 items was developed. In the psychometric phase, 12 items with four factors were specified; 'effective care,' 'confidence in the healthcare team,' 'emotional enrichment' and 'hygienic facilities,' explaining 51% of the total variance of the scale. They were confirmed by confirmatory factor analysis. Internal consistency and stability of the scale were satisfactory. Feasibility and responsiveness were also acceptable. [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]

How can nurses assess the self‐management of lower urinary tract symptoms (LUTS) in patients with cancer after radical prostatectomy (RP)? Patients with prostate cancer who have undergone RP experience multiple LUTS. This study aimed to develop a self‐management scale for LUTS in patients with cancer following RP (SMS‐LUTS‐RP), as well as to verify its reliability and validity. LUTS has physical, social, and psychological consequences for patients. As a result, patients are forced to self‐manage their LUTS and LUTS‐related issues. However, no indicators exist to assess self‐management of LUTS. A total of 246 individuals were surveyed. A 49‐item scale draft, whose content validity and face validity were confirmed, was used to develop a questionnaire for patients with LUTS after RP. The reliability and validity were determined using by item analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α coefficient. The exploratory factor analysis produced the following 18 items on five extracted factors: 'monitoring of urinary status,' 'coping with daily life difficulties due to LUTS,' 'collaboration with medical professionals,' 'continued training to improve LUTS,' and 'living with LUTS.' The goodness‐of‐fit‐index (GFI) for confirmatory factor analysis was 0.876, and the root mean square error of approximation was 0.075. Cronbach's α coefficient was 0.754–0.820. SMS‐LUTS‐RP has desirable psychometric properties and can assess the cognitive and behavioural aspects of self‐management of LUTS in patients with cancer who have undergone a RP. This scale can be used to provide individualized self‐management support according to living conditions. [ABSTRACT FROM AUTHOR]

Background: The older person care home population is increasing. As skin ages, it becomes vulnerable to dryness, itching, cracks and tears. These are experienced by most older people, they impair quality of life and can lead skin breakdown, increased dependency, hospital stays and greater financial and human costs. Dryness, itching, cracks and tears can be prevented, but despite best practice guidance, concordance is suboptimal. Objectives: (i) develop and test a theory‐based diagnostic instrument to accurately and prospectively assess barriers and facilitators and (ii) survey barriers and facilitators to care home staff in the delivery of skin hygiene care. Methods: Instrument development and survey. Barriers and facilitators identified from the literature and pilot study were categorised in a Delphi survey of experts (n = 8) to the Theoretical Domains Framework. This model was tested in three rounds for face validity (n = 38), construct validity (n = 235) and test–retest reliability (n = 11). Barriers and facilitators were surveyed in Round 2 and reported in accordance with TRIPOD. Results: A 29‐item valid and reliable instrument (SHELL‐CH) resulted (χ2/df = 1.539, RMSEA = 0.047, CFA = 0.872). Key barriers were delivering skin hygiene care to agitated or confused residents, pressure to rush or engage in other tasks from colleagues, being busy and the unrealistic expectations of relatives. Knowledge of skin hygiene care was a facilitator. Conclusion: This study has international significance having identified barriers and facilitators to skin hygiene care including barriers previously unreported. [ABSTRACT FROM AUTHOR]

Background: Existing gerontological nursing competencies include the requisite knowledge and skills required for aged care nursing. What were not previously considered were legal and ethical aspects and access to technology, e‐health and social media. Objectives: This study aimed to validate an Australian gerontological nursing competencies scale and assess the factors associated with for aged care nurses in Taiwan. Methods: A methodological study design was used to validate the scale with a sample of 369 aged care nurses from aged care settings including nursing homes, long‐term care facilities and aged care wards in Taiwan. The cultural adaptation and psychometric validation were evaluated. The content validity, construct validity through exploratory factor analysis and the internal consistency of the scale were assessed. Results: The exploratory factor analysis extracted two levels of gerontological nursing practice, 'essential' and 'enhanced', which accounted for 80.8% of the total variance. The internal consistency, split‐half reliability and test–retest reliability were excellent. Aged care nurses with higher levels of education, aged care education as their highest degree and continued education within 6 months, and certified long‐term care education had higher gerontological nursing competencies scores than those who did not. Conclusions: This validated gerontological nursing competencies scale is a reliable and valid tool that can be implemented in future workforce planning, research and postgraduate and undergraduate curriculum and education in Taiwan and other Mandarin‐speaking locales. Implications for practice: Using validated gerontological nursing competencies scales to explain different levels of specialist practice is crucial for addressing negative views about aged nursing and explicitly demonstrate the possibilities for career pathways in gerontological nursing. [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]

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]

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: 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]

Background: Poor sleep quality predicts poor quality of life, poor self‐rated health, and chronic diseases and mental disorders among older adults. The Pittsburgh Sleep Quality Index (PSQI) is the most widely used self‐report measure of sleep quality in older adults. Objectives: This study aimed to assess internal reliability, face validity, content validity and internal consistency of the Slovenian version of the PSQI (PSQI‐SLO) for sleep quality in older adults. Methods: A cross‐sectional study was used to evaluate content and face validity as well as reliability (ɑ, ω and item‐total correlations). Residents of 13 nursing homes and community‐dwelling older adults from all regions of Slovenia were sampled. A total of 831 participants aged 65 years and older participated in the study between March and August 2019. Results: All items were successfully translated to Slovenian. A minor cultural adaptation was made to improve the clarity of the meaning of all items. None of the items had an item content validity index (I‐CVI) score lower than 0.50. Kappa indices were excellent for half of the items and good for the remainder. Internal consistency agreed with prior research (ɑ = 0.74). Intraclass correlation coefficient for global PSQI‐SLO was 0.62 (p < 0.001). The total score of PSQI‐SLO (8.09 ± 3.64 (95%, CI = 7.85–8.34)) was expected and comparable. Fifty‐eight and four tenths' per cent (95%, CI = 55%–62%) had at least one chronic disease and 40% (95%, CI = 37%–42%) lived in a nursing home. Conclusions: PSQI‐SLO showed adequate internal consistency and test–retest reliability, and adequate construct and criterion validity. The instrument can be important in assessing older adults' subjective sleep quality in nursing homes, home environment and clinical settings. [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]

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]

Those using intermittent catheterization (IC) have many catheter types and styles to select from; including what manufacturers refer to as discreet catheters. Discreet catheters are often manufactured to be smaller in length, coiled in design, or foldable, thus allowing for easier concealment or discretion when carried in public and offering a degree of personal privacy. This study explores discreet catheter use and its alignment with the lifestyle experience of those who use such catheters. This study assesses the user and user experience with discreet catheters. User experience is defined as catheter choice, associated activities, and urinary tract health. A cross‐sectional survey investigated life and health status of individuals in the Netherlands requiring IC. The study enrolled 1892 individuals of which 784 use a discreet catheter as their primary catheter. Catheter choice: 82% of study respondents state they have the ability to choose the type of catheter they use. Of those indicating not having the ability to choose their catheter, they state their health care professional did not inform them of different catheters, brands, or options. Catheter associated activities: Those employed full or part time are satisfied with their discreet catheter (95.1%) claiming it is discreet, and gives them confidence to live their life the way they choose; that the catheter did not interference with social activities (72.6%), and had little to no interference with work outside of the home (76.1%). Urinary tract infections (UTI): 39.4% report a clinician diagnosed UTI within 6 months prior to the survey. The data indicates that 18.3% of the sample are deficient in UTI knowledge stating they do not know what a UTI is, or what associated symptoms are; 41% followed a clinician suggested regimen for catheterizing; 25.5% altered catheterization schedules to fit daily activities; 33.3% stated they did not follow a regimen, but catheterized when convenient The data supports positive experiences for individuals who use discreet catheters as their primary method of bladder voiding, particularly socially active individuals requiring an element of personal privacy in their life. However, UTI's are a matter of concern due to a reported deficit in knowledgeable about UTI's and symptomology. [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 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]

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: This study aimed to develop and psychometrics a questionnaire for assessing childbirth experience in Iranian women. Design: Cross‐sectional study. Methods: This cross‐sectional study was done in women who experienced childbirth within the last 12 hr to 2 months from May to December 2018. Questionnaire items were extracted from a comprehensive review of the available studies and questionnaires on childbirth experiences and definitions implied by qualitative interviews. The designed questionnaire was validated in three stages: face, content and construct. Cronbach's alpha was used to determine the reliability of the instrument. Result: Iranian women childbirth experience questionnaire contained seven factors with 52 items which were called professional support, husband's and other important support, baby, preparation, fear, positive perception and control were extracted. The Cronbach's alpha coefficient after factor analysis was 0.62–0.92 and for the whole instrument was 0.91. The findings showed that Iranian women childbirth experience questionnaire was valid and reliable. [ABSTRACT FROM AUTHOR]

Aim: To develop and evaluate the psychometric properties of postgraduate nursing student academic satisfaction scale (PNSASS). Design: The mixed‐method study was carried out in two phases; (a) item generation by hybrid concept analysis and (b) item reduction by psychometric evaluation of the developed scale. Methods: The initial item pool (N = 209) was prepared based on concept analysis results and similar instruments. A total of 402 postgraduate nursing students willingly participated in online data gathering from August 2019 to May 2020. The validity (face, content and construct) and reliability (stability and internal consistency) of the scale were assessed. Results: Exploratory factor analysis identified that the scale had four factors which explained 64.80% of the total extracted variance. The results of confirmatory factor analysis showed a good model fit. The reliability of scale was strong to excellent. The results showed that the PNSASS has suitable validity and reliability properties, which can be used to measure the academic satisfaction of postgraduate nursing students. [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]

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: 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]

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]

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: 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]

Rationale: Low mood may affect developing relationships with a new baby, partner and family. Early identification of mood disturbance is crucial to improve outcomes for women perinatally. Instruments such as the Edinburgh Postnatal Depression Scale (EPDS) are used routinely, with evidence that some women do not feel comfortable with how they are asked about their mental health. Objective: To develop a mood checklist as a user‐friendly, effective measure of well‐being in post‐partum women, for use by health professionals. Methods: Cognitive interviews with women who had recently given birth assessed response format and face validity of a prototype measure. A cross‐sectional survey followed. A random split‐half instrument development protocol was used. Exploratory factor analysis determined factor structure with the first sample,. The second sample confirmed factor structure and evaluationof key psychometric variables and known‐groups discriminant validity (KGDV), requiring a supplementary between‐subjects design with stratification based on case negative/case positive classification using EPDSscreening cut‐off criteria. Results: Cognitive interview data confirmed the face validity of the measure. Exploratory factor analysis indicated an 18 item two‐factor model with two (negatively) correlated factors. Factor 1 loaded with items reflecting positive mood and factor 2 negative items. Confirmatory factor analysis showed a good fit to the two‐factor model across the full spectrum of fit indices. Statistically significant differences between groups were observed in relation to as EPDS caseness classification. Cronbach alpha coefficients for the positive and negative subscales revealed acceptable internal consistency of 0.79 and 0.72, respectively. Conclusion: The outcome checklist may be appropriate for use in clinical practice. It demonstrated effective psychometric properties and clear cross‐validation with existing commonly used measures. [ABSTRACT FROM AUTHOR]

The aim of this study was to translate into Mexican Spanish, cross‐culturally adapt and validate the wound‐specific quality of life (QoL) instrument Cardiff wound impact schedule (CWIS) for Mexican patients. This instrument went through the full linguistic translation process based on the guidelines of Beaton et al (Beaton DE, Bombardier C, Guillemin F, Ferraz MB, Guidelines for the process of cross‐cultural adaptation of self‐report measures, Spine Phila Pa, 1976, 2000, 318‐391). We included a total of 500 patients with chronic leg ulcers. The expert committee evaluated the Face validity and they agreed unanimously that the instrument was adequate to assess the QoL of these patients, covering all relevant areas presented by them. The content validity index obtained was of 0.95. The construct validity demonstrated moderately significant correlations between related sub‐scales of CWIS and SF‐36 (P =.010 to P <.001). The instrument was able to discriminate between healed and unhealed ulcers. The instrument obtained an overall Cronbach's alpha of.952, corresponding to an excellent internal consistency (.903‐.771 alpha range for domains). The CWIS can be appropriately used to assess the health‐related QoL of Mexican patients with chronic leg ulcers. [ABSTRACT FROM AUTHOR]

Health literacy, or the ability to read and understand health information, is critical to the health of children. In this study, we compared the fever management knowledge of parents attending the emergency department with a child with fever. A cross‐sectional survey of 33 parents/carers with limited health literacy and 122 with functional health literacy was undertaken. There were no differences in the overall proportion of correct responses to knowledge or management questions posed by the two scales between the two groups. Both groups presented with limited knowledge and poor practices (<60% correct in both scales) in relation to fever knowledge and management in their children. Although health literacy impacts health utilization, we did not find any differences in these groups. Inappropriate practices, such as when to give medications, were evident. Educational programs, responsive to health literacy, are urgently needed to address these information needs for parents. An assessment of parents' health literacy level can guide the selection of information that can be easily read, understood, and acted upon to deliver the best health outcomes for children. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: To validate clinically the nursing outcome "Swallowing status". METHODS: The adjustment of the nursing outcome was investigated according to the Classical and Item Response Theories. The models were compared regarding information loss, goodness‐of‐fit, and differential item functioning. Stability and internal consistency were examined. RESULTS: The nursing outcome has the best fit in the generalized partial credit model with different discrimination parameters. Strong correlations among the scores of each indicator were observed. There was no differential item functioning of the outcome indicators. The scale presented high internal consistency (Cronbach's α =.954) and stability (and >.800). CONCLUSIONS: This study presents a valid nursing outcome. RELEVANCE TO CLINICAL PRACTICE: Most accurate monitoring of sensitivity to an intervention. OBJETIVO: Validar clinicamente o resultado de enefermagem "Estado da Deglutição". MÉTODOS: O ajustamento do resultado foi investigado de acordo com as teorias Clássica e de Resposta ao Item. Os modelos foram comparados assumindo parâmetros de itens cruzados de igual discriminação. Investigaram‐se as propriedades de bondade do ajuste, funcionamento diferencial dos itens, estabilidade e consistência interna. RESULTADOS: O resultado se ajustou melhor a partir do Modelo de crédito parcial generalizado, o qual demonstrou unidimensionalidade do resultado e forte correlação entre os escores de cada indicador. Não houve funcionamento diferencial dos indicadores. A consistência interna para a escala global (Cronbach's α =.954) e a estabilidade (>.800) mantiveram‐se elevadas. CONCLUSÃO: O estudo apresenta um resultado de enfermagem válido. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: Maior acurácia para monitorar a sensibilidade da intervenção. [ABSTRACT FROM AUTHOR]

Aim: Children's intake of discretionary choices is excessive. This study aimed to develop a questionnaire measuring parents’ attitudes and beliefs towards limiting provision of discretionary choices, using the Health Action Process Approach model. Methods: The questionnaire items were informed by the Health Action Process Approach model, which extends the Theory of Planned Behaviour to include both motivational (intention) and volitional (post‐intention) factors that influence behaviour change. The questionnaire was piloted for content and face validity (expert panel, n = 5; parents, n = 4). Construct and predictive validity were examined in a sample of 178 parents of 4–7‐year‐old children who completed the questionnaire online. Statistical analyses included exploratory factor analyses, Cronbach's alpha and multiple linear regression. Results: Pilot testing supported content and face validity. Principal component analyses identified constructs that aligned with the eight constructs of the Health Action Process Approach model. Internal consistencies were high for all subscales, in both the motivational (Cronbach's alpha 0.77–0.88) and volitional phase (Cronbach's alpha 0.85–0.92). Conclusions: Initial results from validation tests support the development of a new questionnaire for measuring parent attitudes and beliefs regarding provision of discretionary choices to their 4–7‐year‐old children within the home. This new questionnaire can be used to gain greater insight into parents’ attitudes and beliefs that influence ability to limit discretionary choices provision to children. Further research to expand understanding of the questionnaires’ psychometric properties would be valuable, including confirmatory factor analysis and reproducibility. [ABSTRACT FROM AUTHOR]

Background/aim: A review of the literature related to in‐hand manipulation (IHM) revealed that there is no assessment which specifically measures this construct in the adult population. This study reports the face and content validity of an IHM assessment for adults with impaired hand function based on expert opinion. Methods: The definition of IHM skills, assessment tasks and scoring methods identified from literature was discussed in a focus group (n = 4) to establish face validity. An expert panel (n = 16) reviewed the content validity of the proposed assessment; evaluating the representativeness and relevance of encompassing the IHM skills in the proposed assessment tasks, the clarity and importance to daily life of the task and the clarity and applicability to clinical environment of the scoring method. The content validity was calculated using the content validity index for both the individual task and all tasks together (I‐CVI and S‐CVI). Feedback was incorporated to create the assessment. Results: The focus group members agreed to include 10 assessment tasks that covered all IHM skills. In the expert panel review, all tasks received an I‐CVI above 0.78 and S‐CVI above 0.80 in representativeness and relevance ratings, representing good content validity. With the comments from the expert panel, tasks were modified to improve the clarity and importance to daily life. A four‐point Likert scale was identified for assessing both the completion of the assessment tasks and the quality of IHM skills within the task performance. Conclusion: Face and content validity were established in this new IHM assessment. Further studies to examine psychometric properties and use within clinical practice are recommended. [ABSTRACT FROM AUTHOR]

Introduction Child's illness and hospitalisation are difficult and stressful situations both for the patients themselves and for their parents. Supporting the ill child and their guardians is an indispensable element of caring for ill children. The Nurse-Parent Support Model developed by Margaret Miles is based on four elements, namely emotional support, appraisal support, informational support and instrumental support. Aim The aim of the research was (i) cultural adaptation and validation of The Nurse-Parent Support Tool into Polish and (ii) initial assessment of parents' perception of nursing support given to the parents of children hospitalised in five paediatric wards in Poland. Material and method Quantitative cross-sectional study was conducted in a group of 195 parents of children hospitalised in five different hospital wards in eastern Poland. Results and conclusions Theoretical validity of the four-factor version of NPST is proved by the correlation matrix analysis and inter-correlation between the dimensions of the described tool as well as the analysis of the internal structure of the test verified on the basis of its internal validity which also confirms its reliability. However, theoretical validity of the test is not confirmed by the factor analysis whose results indicate that the tool encompasses two factors that explain 58.5% of variances. Respondents rated instrumental support provided by the nurses the highest, appraisal and informational support were rated slightly lower, and emotional support was rated the lowest. Negative correlation between the level of stress and emotional support (r = −0.35), informational support (r = −0.29) and support in general (r = −0.30) was demonstrated. Polish four-factor version of NPST is recommended only for international comparative analyses, whereas the use of two-factor version of NPST is recommended for national research programmes. The level of support given to the parents of children hospitalised in Poland seems to be unsatisfactory. [ABSTRACT FROM AUTHOR]

Aim: To develop a nutritional screening tool and examine its reliability and validity in elementary school children with malnutrition based on PRECEDE--PROCEED model, in Shiraz, Iran. Methods: A questionnaire was designed and its reproducibility was analysed via test--retest design among students with malnutrition. The students were in the fourth to sixth grades. Validity was assessed using face validity, content validity, construct validity, item difficulty and item discrimination. Reliability was measured by Cronbach's alpha (internal consistency), the intra-class correlation coefficient (ICC) and κ statistics (test--retest reliability). Results: A total of 165 primary school students (mean age of 11.21 ± 1.08 years, 65.5% females) participated in the study. The PRECEDE--PROCEED theoretical model for health education was adapted for this questionnaire. The questionnaire was divided into four main sections: predisposing, reinforcing, enabling factors and behaviour. Coefficient κ reliability estimate was above 0.9 for most scales. The ICCs for different scales of the questionnaire were within the range of 0.402-0.800. Values for κ ranged from 0.412 to 0.785 for most scales. Conclusions: The results showed reasonable validity, excellent reliability and moderate to substantial reproducibility for all scales of the questionnaire except two questions for κ statistics. The present study is of great importance, as there are no psychometrically evaluated tools (based on health behaviour models) with accepted validity and reliability for the evaluation of such factors in children with malnutrition. The questionnaire developed in the present study can be used to assess the effect of intervention among primary school students with malnutrition. [ABSTRACT FROM AUTHOR]

ABSTRACT Can voiding diary be a primary tool to assess urinary symptoms, being accessible and easier to fit into patients' lives and their family or caregiver? The nursing care to neurogenic bladder patients reveals the daily need for standardized patient assessment tools that support the treatment process. The aim of this study is to propose and assess a voiding diary for use with intermittent bladder catheter users and their caregivers. Voiding diary is important tool for patients and their caregivers to use to help both parties understand the functioning of the urinary tract and identify urinary symptoms. Research developed at a Rehabilitation Center of a university hospital. After characterizing the population, the voiding diary was constructed based on the literature review and then subject to expert face and content validation. Each participant received a diary, a graded plastic flask and a data collection instrument, between June and October 2013. The data were analysed using descriptive statistics. Among the 44 (100.0%) participants, 28 (63.6%) were caregivers and 16 (36.4%) patients. The best assessed items regarding the diary were 'Importance of the tool,', 'Explanation of the orientations' and 'Clarity of the Figures.' The good adherence level to the tool was highlighted, as well as the importance of appropriate orientations before completing the diary. [ABSTRACT FROM AUTHOR]