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Background: Adequate sleep and rest are essential for patient recovery; however, lack of sleep has become a common problem faced by Chinese patients during hospital stays. Reduced sleep is often associated with a higher risk of disease progression and is strongly associated with increased hospital stay. However, there is no specific tool in China to assess short-term insomnia caused by hospitalization. This study aimed to translate the Hospital-acquired Insomnia Scale (HAIS) into Chinese, test its applicability to Chinese inpatients through reliability and validity indicators, and investigate the potential influencing factors of hospital-acquired insomnia. Methods: Psychometric analysis from a sample of 679 hospitalized patients to whom the HAIS questionnaire was applied. The structural validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity of the scale was assessed using the content validity index. Cronbach's alpha coefficient, split-half reliability and test–retest reliability were calculated to evaluate the internal consistency of the scale. Multiple stepwise linear regression analysis was conducted to determine the potential correlates of hospital-acquired insomnia. Results: EFA supported a four-factor structure with factor loadings for all dimensions greater than 0.40. CFA showed good indicators of model fit. The content validity index of the scale was 0.94. the Cronbach's alpha of the scale was 0.915, the split-half reliability coefficient was 0.819, and the retest reliability was 0.844. Gender, age, total hours of sleep during the night, medical insurance, length of hospital stay, perceived stress level, and perceptions about sleep explained 46.2% of the variance in hospital-acquired insomnia. Conclusion: The Chinese version of HAIS has good psychometric characteristics and is an effective instrument for evaluating hospital-acquired insomnia. In addition, hospital-acquired insomnia is more common in women, of younger age, less than 5 h of sleep a night, without medical insurance, stressed, and patients with more misconceptions about sleep. [ABSTRACT FROM AUTHOR]

Background: Reasonable instruction and promotion of appropriate exercise are crucial to improving the exercise status of pregnant women and safeguarding the health of both mother and fetus. However, there is a lack of validated Pregnancy Exercise Attitude Scales with a complete evaluation system in China. This study aims to assess the validity and reliability of the Pregnancy Exercise Attitude Scale (C-PEAS) in Chinese to give medical professionals a reference for carrying out pregnancy care services and promoting the health of the mother and fetus. Methods: In this study, the scale was translated, back-translated, and cross-culturally adapted using the Brislin translation model to form the C-PEAS. 528 pregnant women were conveniently selected for the questionnaire survey to evaluate the scale's reliability. The scale's content validity was assessed by the content validity index, while its structural validity was investigated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha coefficient, McDonald's omega coefficient, split-half reliability, and retest reliability were used to evaluate the scale's internal consistency. Results: The C-PEAS contains two dimensions with 37 entries. The EFA supports a two-factor structure with a cumulative variance contribution of 62.927%. The CFA model was well fitted (χ2/df = 1.597, RMSEA = 0.048, IFI = 0.955, TLI = 0.952, and CFI = 0.955). The C- PEAS' Cronbach's alpha coefficient was 0.973, and the range of Cronbach's alpha values for the dimensions was 0.976, 0.944. McDonald's omega coefficient was 0.971, the half-point reliability of the scale was 0.856, and the retest reliability was 0.966. Conclusions: The Chinese version of C-PEAS has good psychometric properties. It can be used as an effective measurement tool to evaluate the attitude of pregnant women to exercise during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Social and emotional development are important aspects of young children's well-being but can be difficult to assess during the first years of life. The Ages and Stages Questionnaire: Social-Emotional Second Edition (ASQ:SE-2) is a parent-rated assessment tool for child socioemotional development between 1 and 72 months of age. In this study, we examined the psychometric properties of this instrument in 18-month-old Swedish children. Methods: Data from 586 Swedish-speaking parents of 18-month-old children were included. In addition to the ASQ:SE-2, parents also completed the Social-Emotional Assessment/Evaluation Measure (SEAM), and the child's socioemotional development was assessed by a nurse at the Child Health Services. We used exploratory factor analysis and Rasch methodology to explore dimensionality and item properties of the ASQ:SE-2. Furthermore, we used Pearson and Spearman rank correlations to study associations with the SEAM and the nurse assessment. Results: An exploratory factor analysis suggested a one-factor model for the ASQ:SE-2 items. However, several items showed weak factor loadings, and a final scale including 18 of the original 29 items was further explored. The Rasch analysis revealed problems with targeting, and the final scale showed acceptable reliability only in the 22% with the highest levels of socioemotional difficulties. The total score of the final version showed a strong association with the parent-rated SEAM but a weak association with the nurse observations. We labeled the reduced 18-item scale Social Interaction. Conclusions: The results of this study highlight that the original Swedish version of the ASQ:SE-2 for 18-month-old children may not be an adequate tool for assessing social and emotional competencies in a normal population since acceptable reliability was reached only in children with the greatest difficulties (above the 78th percentile). In conclusion, the suggested 18-item version works best either as a screening instrument for problems with social interaction or as a continuous measure of such problems in children with high levels of social interaction difficulties. [ABSTRACT FROM AUTHOR]

Background: Evidence-based medicine is defined as searching for medical information, reviewing and comparing it to each patient's situation, and then judging the optimal decision. We aimed to measure the psychometric properties of the Evidence-Based Performance Profile (EBP2) Questionnaire among the students of health-related fields at Shiraz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2021. The EBP2 questionnaire, which includes 74 five-Likert-scale items, was translated into the Persian language using the forward-backward translation method. A panel of five experts approved the face, content, and structural validity of the questionnaire. The Cronbach's alpha and McDonald's Omega coefficients were utilized to assess the questionnaire's internal consistency. Furthermore, both confirmatory and exploratory factor analyses were used to assess the questionnaire's construct validity. SPSS software version 25 and LISREL software version 8.8 were used for statistical analysis. Results: Overall, 339 students participated in this study. The cultural adaptability, linguistic equivalence, and content validity of the Persian version of the EBP2 questionnaire were approved by a five-member team of medical experts. In addition, the results showed excellent internal consistency of the Persian version of the EBP2 questionnaire (Cronbach's alpha = 0.962, McDonald's Omega (ML) = 0.963). Moreover, all domains had acceptable reliability (> 0.7), except the Practice domain which had a marginally acceptable Cronbach's alpha coefficient equal to 0.686. Exploratory factor analysis discovered six domains for the questionnaire. Moreover, the confirmatory factor analysis demonstrated that all indices except the comparative fit index (CFI) and adjusted goodness of fit (AGFI) confirmed the validity of the EBP2 questionnaire. Conclusion: The study's findings indicate that the Persian translated of the EBP2 questionnaire exhibited satisfactory validity and reliability for assessing students' evidence-based performance in health-related fields. [ABSTRACT FROM AUTHOR]

Introduction: The Fear of Pain Questionnaire (FOPQ) is a self-report tool designed to measure an individual's fear of pain (FOP). While the Persian version of the FOPQ (FOPQ-P) has been developed, its validity and reliability have not yet been assessed in the Iranian context. This study aims to evaluate the psychometric properties of the FOPQ-P among Iranian patients after surgery. Methods: A methodological study was conducted in 2023 involving 400 post-surgery patients selected with a convenience sampling. The FOPQ was translated into Persian, and its psychometric properties were analyzed using network analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), as well as assessments of convergent and discriminant validity. Internal consistency was measured using Cronbach's alpha, McDonald's Omega, average inter-item correlation coefficient, Composite Reliability, and Maximal Reliability. Results: The EFA results with Promax and Kaiser Normalization rotation identified two factors that explained 54.32% of the variance, comprising seven items. The CFA confirmed the model's validity. Both convergent and discriminant validity were established. The reliability analyses showed that Cronbach's alpha, McDonald's omega, composite reliability, and MaxR for all constructs were above 0.7. Additionally, the average inter-item correlation coefficient was greater than 0.5, indicating strong internal consistency and construct reliability. Conclusion: The findings suggest that the FOPQ-P possesses a valid structure and was acceptable reliability in patients cultural context of Iran post-surgery, making it a suitable instrument for measuring fear of pain in this population. [ABSTRACT FROM AUTHOR]

Background: Motivation is a critical factor in the success of nursing students, as it significantly influences their ability to acquire the necessary knowledge and skills for the nursing profession. Insufficient motivation can result in a lack of engagement with learning activities, thereby impeding the development of essential competencies. Aim: This study aimed to translate the Motivation for Nursing Student Scale (MNSS) into Persian and evaluate its psychometric properties within the context of nursing students in Iran. Method: This methodological cross-sectional study involved a sample of 542 nursing students selected through convenience sampling. The MNSS was translated into Persian following the guidelines recommended by the World Health Organization. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of internal consistency were conducted to evaluate the validity and reliability of the instrument. Results: The EFA and CFA validated the structure of the instrument, identifying four factors and 20 items, which explained 58.68% of the total variance. The CFA results indicated a well-fitting model with the following indices: CFI = 0.91, GFI = 0.93, IFI = 0.946, TLI = 0.92, RMSEA = 0.061, and SRMR = 0.049. The Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) for the scale were 0.882 and 0.802, respectively. Conclusion: The Persian version of the MNSS demonstrates satisfactory reliability and validity, making it a dependable instrument for measuring the academic motivation of nursing students. This tool can be effectively used to assess the motivation of nursing students in Iran. [ABSTRACT FROM AUTHOR]

Background: Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions. Methods: An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma. Results: Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1–7 rating scale was determined to indicate clinically meaningful levels of internalized stigma. Conclusions: The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions. Study pre-registration: https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f. [ABSTRACT FROM AUTHOR]

Background: Evaluating healthcare information systems, such as the Electronic Health Records (EHR), is both challenging and essential, especially in resource-limited countries. This study aims to psychometrically develop and validate an instrument (questionnaire) to assess the factors influencing the successful adoption of the EHR system by healthcare professionals in Moroccan university hospitals. Methods: The questionnaire validation process occurred in two main stages. Initially, data collected from a pilot sample of 164 participants underwent analysis using exploratory factor analysis (EFA) to evaluate the validity and reliability of the retained factor structure. Subsequently, the validity of the overall measurement model was confirmed using confirmatory factor analysis (CFA) in a sample of 368 healthcare professionals. Results: The structure of the modified HOT-fit model, comprising seven constructs (System Quality, Information Quality, Information technology Service Quality, User Satisfaction, Organization, Environment, and Clinical Performance), was confirmed through confirmatory factor analysis. Absolute, incremental, and parsimonious fit indices all indicated an appropriate level of acceptability, affirming the robustness of the measurement model. Additionally, the instrument demonstrated adequate reliability and convergent validity, with composite reliability values ranging from 0.75 to 0.89 and average variance extracted (AVE) values ranging from 0.51 to 0.63. Furthermore, the square roots of AVE values exceeded the correlations between different pairs of constructs, and the heterotrait-monotrait ratio of correlations (HTMT) was below 0.85, confirming suitable discriminant validity. Conclusions: The resulting instrument, due to its rigorous development and validation process, can serve as a reliable and valid tool for assessing the success of information technologies in similar contexts. [ABSTRACT FROM AUTHOR]

Background: Research suggests that a two-factor model of impulsivity predicts Substance Use Disorder and Gambling Disorder. We aimed to determine whether a similar factor structure was present for Gaming Disorder (GD) and Internet Gaming Disorder (IGD). Methods: Secondary data analysis was conducted on survey responses from 372 participants who had completed a series of questions on facets of impulsivity and their involvement in gaming. Participants were sampled from gaming forums and an online recruitment website. Exploratory factor analysis was conducted on the measures of trait impulsivity, and the identified factors were then analyzed against measures of Gaming Disorder and Internet Gaming Disorder. A confirmatory factor analysis was then run to confirm the model. Results: The exploratory results suggested a five-factor model of impulsivity, with gaming being related to all five factors. Interestingly, only two of those factors (Urgency (Positive Urgency, Negative Urgency, Delay Discounting) and (Impaired) Inhibitory Control (False Button Presses on Go/No-Go Tasks)) predicted symptom counts above the clinical cut-off for IGD. In addition, Urgency was related to symptom counts above 7/9 criteria for IGD, as well as symptom counts above the suggested clinical cut-off for GD. The confirmatory factor analysis suggested that this two-factor model of impulsivity had 'good fit.' Conclusions: This two-factor model of impulsivity is similar to those found in established addiction disorders, in that one factor appears to predict more problematic involvement than the other. However, the results indicate that Urgency predicts higher symptom counts than (Impaired) Inhibitory Control. This contrasts with previous findings on substance use and gambling, where (Impaired) Inhibitory Control was the factor predicting problematic use. However, there was evidence to suggest that gaming is similar to alcohol consumption, where socially acceptable, "healthy," use is related to impulsivity at some level, but Urgency is key in the transition from recreational to disordered behavior. [ABSTRACT FROM AUTHOR]

Background: Quantifying the professional ethical challenges that nurses encounter is crucial for both theoretical insights and practical outcomes. The objective of this research is to assess the psychometric properties of the Chinese adaptation of the Moral Distress Scale for Healthcare Professionals (MD-APPS). Methods: In 2024, a survey approach was utilized to engage with several tertiary-level healthcare institutions throughout China. A cohort of 448 nursing professionals who satisfied the specified selection benchmarks was consequently incorporated into the study. To evaluate the scale's reliability and validity, methods including the Content Validity Index (CVI), Factor Analysis—both Exploratory (EFA) and Confirmatory (CFA)—alongside assessments of internal consistency and test-retest reliability were employed. Results: Expert evaluations yielded an I-CVI of 0.90, suggesting good content validity for the MD-APPS's Chinese adaptation. Exploratory Factor Analysis (EFA) revealed a bi-dimensional framework with 7 components, explaining 56.34% of the cumulative variance. Confirmatory Factor Analysis (CFA) outcomes displayed a χ-square/df ratio of 1.542. The estimate for Robust RMSEA was 0.054, and the SRMR was ascertained to be 0.041. Indices for both Robust TLI and Robust CFI surpassed the 0.9 threshold, indicating an acceptable fit; this aspect was supported by a P-value (Chi-square) of 0.094. The internal consistency, measured by Cronbach's α, was found to be 0.74, while the test-retest reliability over a two-week period reached 0.964. These findings provide initial evidence for the psychometric properties of the Chinese MD-APPS. Conclusion: The Chinese adaptation of the MD-APPS demonstrates promising initial psychometric properties, suggesting its potential suitability for exploring nurses' professional ethical challenges within the Chinese cultural context. This scale may facilitate the identification of diverse elements influencing nurses' professional ethics and the assessment of the ethical climate in nursing practices. However, further validation studies are needed to fully establish its psychometric robustness across various healthcare settings in China. [ABSTRACT FROM AUTHOR]

Background: Multiple trauma injuries are the leading cause of death and disability in people under the age of 45 and require prompt and specialised care. However, medical and nursing education programmes do not always include specific training in emergency pre-hospital care, resulting in a lack of basic practical skills in trauma management. Objective: To develop and validate two instruments for assessing nursing students' competence in cervical collar and spinal board application in simulated pre-hospital emergency scenarios. Method: This is an instrumental study that involves the development of two assessment instruments and the evaluation of their psychometric properties in a sample of 392 nursing students. Content validity was assessed using expert judgement, by calculating the content validity ratio (CVR) for each item and the scale level content validity index average (S-CVI/Ave) for the instruments. Exploratory factor analysis using the MINRES extraction method and Promax rotation was performed to analyse the performance of the items and structure of the rubrics. Internal consistency was analysed using the Omega coefficient and inter-rater agreement was assessed using Cohen's Kappa coefficient. Results: Initially, two rubrics were obtained: one with six items for cervical collar placement (S-CVI/Ave = 0.86) and one with nine items for spinal board placement (S-CVI/Ave = 0.81). Both had a single-factor structure, with all items having factor loadings greater than 0.34 for the cervical collar rubric and 0.56 for the spinal board rubric, except for item 2 of the cervical collar rubric (λ = 0.24), which was subsequently removed. The final cervical collar rubric (five items) had an overall internal consistency of 0.84 and the spinal board rubric had an overall internal consistency of 0.90, calculated using the Omega statistic. The weighted Kappa coefficient for each item ranged from acceptable (0.32) to substantial (0.79). These results show that we have successfully developed two sufficiently valid instruments to assess the immobilisation competencies proposed in the objective of the study. Conclusion: Whilst further research is needed to fully establish their psychometric properties, these instruments offer a valuable starting point for evaluating nursing students' competence in cervical collar and spinal board application in simulated pre-hospital scenarios. [ABSTRACT FROM AUTHOR]

Background: This study examines the structural validity of the Chinese version of the Abbreviated Profile of Mood States (POMS) among Chinese athletes and analyzes potential profiles to provide evidence for its effective use and recommendations for its application. Methods: A total of 340 Chinese athletes completed the Chinese version of the Abbreviated POMS. Initially, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to identify and verify the extractable dimensions of the Abbreviated POMS. Subsequently, the fit of the six-factor and seven-factor models of POMS was tested directly based on their theoretical structures. Finally, latent profile analysis was used to examine profiles based on the four-factor model derived from the factor analysis, six-factor model, and seven-factor model. Results: The Abbreviated POMS was refined to a four-factor model, consisting of 27 items across four factors: positive mood, anger, fatigue, and confusion. The hypothesized six-factor and seven-factor models did not demonstrate satisfactory fit, suggesting that the seven dimensions function better as independent subscales. Iceberg and inverse iceberg profiles were observed across the four-factor model, six-factor model, and seven-factor model. Conclusion: The Abbreviated POMS does not support its initial hypothesized structure among Chinese athletes. Caution is advised when using the Abbreviated POMS with athletes; it is recommended to use the four-factor model or evaluate each emotion as an independent subscale. The iceberg and inverse iceberg profiles can be used to categorize athletes' emotional characteristics. [ABSTRACT FROM AUTHOR]

Background: Valid and reliable measures for assessing health activation in school-aged children are currently lacking. This study aimed to develop a scale to measure health activation and evaluate its psychometric properties among English-speaking primary school children in Singapore. Methods: The development of the Health Activation Scale for Children (HAS-C) involved an extensive literature review, expert consultations, cognitive interviews with primary school children, and thorough discussions for dimension and item refinement. A cross-sectional study was conducted with 597 children aged 8 to 12 years, recruited from four mainstream primary schools, comprising 50.1% boys and 64.8% Chinese students. The potential scale, along with other measures, was independently completed by the children. Descriptive statistics were provided for individual scale items. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess factorial validity. Convergent validity was examined by correlating the scale scores with scores of health confidence and self-efficacy measures. Hypothesis-testing validity was evaluated by assessing the scale's correlation with self-reported health behaviours, including daily consumption of vegetables and fruits, time spent on sedentary activities and physical activities. Internal consistency reliability was measured using Cronbach's alpha. Results: EFA suggested a three-factor structure for the 12-item HAS-C, which was subsequently confirmed by CFA with a good model fit. All three HAS-C dimension scores demonstrated moderate correlations (rho = 0.34–0.52) with health confidence and self-efficacy measures, indicating good convergent validity. They were positively correlated with more vegetable and fruit intakes, more time spent on exercises, and negatively correlated with time spent on sedentary activities, supporting hypothesis-testing validity. Internal consistency reliability for individual HAS-C dimensions was generally acceptable, with Cronbach's alpha values of 0.70 or above. Conclusion: The 12-item multi-dimensional HAS-C exhibited good validity and reliability, making it a valuable tool for assessing health activation in primary school-aged children. [ABSTRACT FROM AUTHOR]

Background: Alcohol use is one of the leading public health concerns in the Czech Republic. Drinking motives play a vital role in both initiation and subsequent alcohol use. A revised version of the self-report Drinking Motives Questionnaire (DMQ-R) has been proposed to assess these motives. The present study aims to validate the DMQ-R in the Czech general population. Methods: A total sample of 1,784 Czech participants completed a national survey. For the analysis, only a sub-sample of the past 12 months alcohol users was used: N = 1,123; 52.8% male; mean (SD) age = 40.2 (13.3). Drinking motives were assessed by the adopted Czech version of the DMQ-R. Both confirmatory (CFA) and exploratory factor analysis (EFA) were conducted to examine the factorial structure of the instrument. The age of the participant was additionally considered in the analysis (15–24 years as opposed to 25–64 years). Results: The CFA supported the four-factor model in the 25–64 age group. The analysis supported the construct validity of the Social, Conformity, and Coping factors. The Enhancement factor retained only two items and was found to refer more to a domain of 'Pleasant Feeling'. For the 15–24 age group, the hypothesised four-factor structure was not corroborated. Conclusions: The Czech version of the DMQ-R was found to be a reliable measurement tool of the Social, Conformity, and Coping motives. Future research should investigate the dimensionality of the instrument items presumed to correspond to the Enhancement motives. This should be conducted particularly among adolescents and young adults aged 15–24 years, where administering the DMQ-R with a large enough sample is also needed. [ABSTRACT FROM AUTHOR]

Background: The rapid adoption of ChatGPT in academic settings has raised concerns about its impact on learning, research, and academic integrity. This study aimed to develop and validate a comprehensive ChatGPT Usage Scale specifically tailored to postgraduate students, addressing the need for a psychometrically sound instrument to assess the multidimensional nature of ChatGPT usage in higher education. Methods: A cross-sectional survey design was employed, involving 443 postgraduate students from two Egyptian universities. The initial 39-item scale underwent Exploratory Factor Analysis (EFA) using principal component analysis with Varimax rotation. Confirmatory Factor Analysis (CFA) was conducted to assess the model fit and psychometric properties of the final 15-item measure. Internal consistency reliability was evaluated using Cronbach's alpha and McDonald's omega. Results: EFA revealed a three-factor structure explaining 49.186% of the total variance: Academic Writing Aid (20.438%), Academic Task Support (14.410%), and Reliance and Trust (14.338%). CFA confirmed the three-factor structure with acceptable fit indices (χ2(87) = 223.604, p <.001; CMIN/DF = 2.570; CFI = 0.917; TLI = 0.900; RMSEA = 0.060). All standardized factor loadings were statistically significant (p <.001), ranging from 0.434 to 0.728. The scale demonstrated good internal consistency (Cronbach's α = 0.848, McDonald's ω = 0.849) and composite reliability (CR = 0.855). The average variance extracted (AVE) was 0.664, supporting convergent validity. Conclusions: The validated ChatGPT Usage Scale provides a reliable and valid instrument for assessing postgraduate students' engagement with ChatGPT across multiple dimensions. This tool offers valuable insights into AI-assisted academic practices, enabling more nuanced investigations into the effects of ChatGPT on postgraduate education. [ABSTRACT FROM AUTHOR]

Background: Disordered thinking is a condition that can manifest in not only clinical cases (e.g., psychotic disorders), but also the wider general population. However, there is no current method to measure the specific cognitive processes experienced during such a condition. Therefore, this study aimed to develop a new self-report measure, the Disorganised Thoughts Scale (DTS), that can assess disorganised thinking in the general population. Methods: To achieve this aim, a survey was developed and shared online with four independent samples, including a sample of Australians in the general population (N = 321) and three samples (N = 200 each) that were controlled for their substance use (i.e., frequent alcohol and cannabis use; non-frequent substance use). Exploratory and confirmatory factor analyses, and reliability analyses, were used to test the internal validity, whilst correlational analyses were implemented to examine the external validity. Results: The exploratory factor analysis revealed a two-factor structure (10 items each) measuring Positive thought disorder (i.e., accelerated, uncontrollable, and incongruent thinking) and Negative thought disorder (i.e., inhibited, disjointed, and disorientated thinking). This internal structure was confirmed with subsequent confirmatory factor and reliability analyses (α = 0.90 to 0.97) in the three substance-controlled groups. Concurrent validity was also supported, as the DTS exhibited strong correlations with established measures of general cognitive difficulties, specific self-regulatory dysfunctions, and psychopathological symptomology. Finally, the measure was also shown to be significantly higher in cohorts who exhibited a higher degree of psychological distress and who frequently used substances (i.e., alcohol and cannabis). Conclusions: Overall, this study provided preliminary evidence to suggest that the DTS is a sound measure of disorganised thought that is linked to psychopathology and substance use in non-clinical populations. The measure could be used in future research which seeks to better understand how thinking effects, and is affected by, various psychological conditions. [ABSTRACT FROM AUTHOR]

Background: Physical, mental and social components of well-being are known to be important to health. However, research on well-being often focuses on physical and mental well-being with little attention paid to social well-being. This research aims to develop and preliminarily validate the South Wales Social Well-being Scale (SWSWBS) to measure social well-being. Methods: A non-experimental and cross-sectional design was applied with two phases: scale development and preliminary validation. Initially, 24 items were drawn from a Group Concept Mapping study exploring the concept of social well-being. These items were reviewed and reduced to 14 for preliminary validation among 103 university students and staff in health and social care disciplines. Construct validity (exploratory factor analysis and convergent validity) were tested. Reliability was demonstrated by internal consistency. Floor and ceiling effects were also evaluated. Results: A 3-factor structure was identified and explored, which highlight the most important features of the social world a person inhabits: "Safe and inclusive interaction with others" (6 items), "Learning, helping, and feeling useful" (4 items), and "Security, worthwhile activities, family and friends" (4 items). The SWSWBS was correlated to the Warwick Edinburgh Mental Well-being Scale and the Four measures of Personal Well-being Scale to some extent. The Cronbach alpha coefficient was 0.85 for the sum score and 0.83–0.86 for individual items. The item-total correlation coefficients ranged between 0.08 and 0.65. The split half reliability coefficient was 0.78. There is absence of a floor effect, but most items had a ceiling effect. Conclusions: Preliminary validation of the SWSWBS shows the scale has satisfactory psychometric properties with good validity, reliability, and reasonable variability. This study needs to be replicated with larger and representative populations to explore how the scale can be used alongside the Warwick Edinburgh Mental Well-being Scale to capture a holistic/multi-dimensional understanding of well-being. [ABSTRACT FROM AUTHOR]

Background: The influence of social determinants of health (SDH) on sustainable development goals (SDG) has gained attention in recent years. However, there is a scarcity in the availability of valid and reliable instruments to assess the multiple aspects of SDH. Hence, this study was conducted to develop a brief self-reported measure for assessing SDH. Method: A cross-sectional survey was conducted among university undergraduate students in Nigeria. The study consisted of 300 participants in the EFA (males 55.7%, females 44.3%) and 430 participants in the CFA (males 54.0%, females 46.0%). Participants were selected using a convenience sampling approach to assess their perceptions regarding SDH. Content Validity Index (CVI), Face Validity Index (FVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Composite Reliability (CR), Average Variance Extracted (AVE), Cronbach's alpha, and Intraclass Correlation Coefficient (ICC) were computed to determine the psychometric properties of the newly developed SDH scale. Results: In the EFA, two factors were extracted (structural determinants of SDH and intermediary determinants of SDH), with all 20 items retained. The total variance explained by the EFA model was 61.8%, and the factor correlation was 0.178. The Cronbach's alpha values of the two factors were 0.917 and 0.939. In the CFA, the initial model did not fit the data well based on fit indices. After several re-specification of the model, the final re-specified measurement model demonstrated adequate fit factor structure of the SDH scale with two factors and 20 items (CFI = 0.943, TLI = 0.930, SRMR = 0.056, RMSEA = 0.053, RMSEA p-value = 0.220). The CR was 0.797 for structural determinants of SDH and 0.794 for intermediary determinants of SDH. The ICC was 0.938 for structural determinants of SDH and 0.941 for intermediary determinants of SDH. Conclusion: The findings indicate that the SDH scale has adequate psychometric properties and can be used to assess the perceived level of SDH. We recommended that this tool be tested in other populations with diverse age groups and other demographic characteristics. [ABSTRACT FROM AUTHOR]

Background: Patient Organizations (POs) are an important support factor in helping chronically ill patients cope with their illness. Patient involvement in the management of their disease helps to achieve the best possible care for the patient, streamline the work of healthcare providers, shape healthcare policy, and even influence the structures of healthcare systems. The perspective of chronically ill patients on the activities and services provided by patient organizations has not been evaluated yet. This study aimed to identify and map the services and activities of all types of non-profit patient organizations from the perspective of chronically ill patients so that they can be integrated as an integral part of the healthcare system. Methods: Nineteen services and activities of patient organizations were sampled from Israeli patient organizations and scientific literature. These services and activities were evaluated by chronically ill patients in Israel. Patient-Oriented Questionnaires (POQ) were distributed among patients with chronic diseases (N = 1395) using snowball sampling. Results: Exploratory factor analysis (EFA) was performed, followed by confirmatory factor analysis (CFA) for convergent and discriminant validity. Findings showed that twelve services and activities suggested by patient organizations were found to represent chronically ill patients' needs and categorized into three groups: Interpersonal support (five items), patients' rights (four items), and medical information (three items). CFA showed a good fit for the observed data. CFI = 0.98, NFI = 0.97, TLI = 0.96, RMSEA = 0.058. Conclusions: Well-organized patient organizations are an important pillar in reformed healthcare systems. They can serve as the social arm of the healthcare system and as an intermediary between patients and healthcare institutions. We narrowed down twelve services and activities given by patient organizations that were important to chronically ill patients in Israel. patient organizations can utilize patient needs or preferences into clinical practice and influence health policy planning, patient-caregiver relationships, research and even healthcare costs. patient organizations recognition by the healthcare system, and establishment of a national patient council will help to realize these processes. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the usefulness of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire in the South-African context and to validate it as an appropriate tool for measuring health-related quality of life (HRQoL). Method: The ExAMIN Youth SA study was designed to investigate lifestyle behaviours, including psychosocial factors that may adversely impact on cardiovascular health of children. Construct validity was examined by using exploratory and confirmatory factor analysis, while internal consistency was tested by Cronbach's alpha. The final factor structure was confirmed by model fit indices. Results: The study included children (n = 1088) aged between 5 and 10 years in North-West, South Africa. The reliability coefficients of the original factors could not be reproduced in this data set, with the Cronbach's alphas ranging between 0.46 and 0.78. With exploratory factor analysis, including the additional items, our data supported a 7-factor structure with acceptable internal consistency (Cronbach's alpha: 0.68–0.79; Omega: 0.75–0.85) and acceptable model fit indices (CFI: 0.91; TLI: 0.90; RMSEA: 0.05; SRMR: 0.07). Two factors (emotional wellbeing and everyday functioning) further split into separate factors for positive and negative experiences related to each of these dimensions. Conclusion: We confirmed a new factor structure of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire, which can be used in the African context. Although the new factor structure has great overlap with the original structure, some items did not contribute to the factors as expected. Language and cultural differences between the original German group and the current South African study group resulted in a different factor structure. [ABSTRACT FROM AUTHOR]

Objective: To compile a scale of Chinese college students' perception of teachers' differential behavior and to provide a reference for college students to establish correct life values, promote college students' physical and mental health, and reduce teachers' differential treatment. Methods: Open-ended questionnaires and expert interviews were used to conduct interviews and correspondence with 58 college students, ten psychologists, and six psychologists to form an initial questionnaire. Then, the scale's exploratory factor analysis, confirmatory factor analysis, and reliability and validity test were conducted on 7053 college students from 18 universities in 6 provinces (municipalities directly under the Central Government). Results: The Chinese college students' perception of teachers' differential behavior scale has two dimensions: teacher prejudice and preference. Each dimension includes three aspects: emotional feedback, behavior orientation, and opportunity privilege, and each aspect have a total of 4 items. The consistency test coefficients of each dimension and each factor of the prepared scale are all above 0.7, and the split-half reliability is above 0.6. Confirmatory factor analysis shows that the six-factor structural model fits well (χ2/df = 4.287, RMSEA = 0.066, CFI = 0.950, TLI = 0.919). Using the generalized anxiety disorder scale and the patient health questionaire-9items as empirical criteria, each factor in the scale demonstrated significant correlations with both the GAD scale and the patient health questionaire-9items. Conclusions: The Chinese college students' perception of teachers' differential behavior scale has a two-dimensional six-factor structure and has good reliability and validity. It can be used as an effective tool to measure Chinese college students' perceived teacher differential behavior. [ABSTRACT FROM AUTHOR]

Aim: This study aims to develop the Quality of Life in Pregnancy Scale (PREG-QOL) as a new instrument to evaluate the quality of life during pregnancy and test its psychometric properties. Design: An instrument development study and psychometric testing of the content and construct validity, factor structure and reliability. Methods: The study was conducted in three stages: (1) creating an item pool, (2) preliminary evaluation of items, and (3) refining the scale and evaluating psychometric properties. Instrument development guidelines were used to evaluate content validity, construct validity, internal consistency and stability of the instrument over time. Data to evaluate psychometric properties of the PREG-QOL were collected between April and August 2021. Results: Items were developed using in-depth interviews with pregnant women and extensive literature review. Scale-content validity index was 0.98. Exploratory factor analysis revealed a 26-item instrument with 6 factors, which explained % 56.2 of variance. Confirmatory factor analysis (CFA) showed that factors 3 and 5 should be combined into the factor of physical domain since they included items about the same theme. Fit indices obtained by CFA were at sufficient levels. Parallel test method was employed to evaluate the correlation of the PREG-QOL with the SF-36. The findings indicated that the PREG-QOL had high internal inconsistency and stability over time. Conclusion: The PREG-QOL is a valid and reliable instrument in terms of its psychometric characteristics. The 26-item instrument was composed of the five factors of perception of general satisfaction, emotional domain, physical domain, health support systems and social domain. Impact: Displaying good psychometric properties, the PREG-QOL may be used to evaluate multiple dimensions of the quality of life during pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop a Quality of Life (QOL) assessment scale for older patients with Neuro-co-Cardiological Diseases (NCCD) and to evaluate the reliability and validity of the scale. Method: The study participants were derived from the Elderly Individuals with NCCD Registered Cohort Study (EINCCDRCS), a multicenter registry of patients with NCCD. The preliminary testing of the questionnaire was conducted among 10 older individuals aged 65 years and older who had NCCD and were recruited from the registry. Other patients who met the inclusion criteria participated in the field testing. After verifying the unidimensionality, local independence, and monotonicity assumptions of the scale, we employed the Rasch model within Item Response Theory framework to assess the quality of the scale through methods including internal consistency, criterion validity, Wright map, and item functioning differential. Subsequently, we assessed the construct validity of the scale by combining exploratory factor analysis with confirmatory factor analysis. Results: Based on well-validated scales such as the short-form WHOQOL-OLD, HeartQOL, IQCODE, and SF-36, an original Neuro-co-Cardiological Diseases Quality of Life scale (NCCDQOL) was developed. 196 individuals from the EINCCDRCS were included in the study, with 10 participating in the preliminary testing and 186 in the field testing. Based on the results of the preliminary testing, the original questionnaire was refined through item deletion and adjustment, resulting in an 11-item NCCDQOL questionnaire. The Rasch analysis of the field testing data led to the removal of 21 misfitting individuals. The NCCDQOL demonstrated a four-category structure, achieved by combining two response categories. This structure aligned with the assumptions of unidimensionality, local independence, and monotonicity. The NCCDQOL also exhibited good validity and reliability. Conclusion: The revised NCCDQOL questionnaire demonstrated good reliability and validity in the Rasch model, indicating promising potential for clinical application. [ABSTRACT FROM AUTHOR]

Background: Incorporating principles of family-centered care into pediatric weight management interventions can improve the effectiveness and quality of treatment and reduce attrition rates. To assess the family-centeredness of interventions, reliable, valid, and easy-to-administer scales are needed. The purpose of the study was to develop a shortened version of the modified Family Centered Care Assessment (mFCCA) and assess its psychometric properties. Methods: The mFCCA, a scale to assess the family-centeredness of interventions for childhood obesity, was administered to families following the Connect for Health randomized control trial evaluating the effectiveness of a primary care-based pediatric weight management intervention. We iteratively removed items from the mFCCA and used Rasch modeling to examine the reliability and validity of the shortened scale. Results: We included data from 318 parents and the exploratory factor analysis showed the presence of a single factor. The results of the Rasch modeling demonstrated acceptable internal consistency of the scale (0.7) and strong validity as evidenced by the overall model fit and range of item difficulty. Following the psychometric analyses, we reduced the number of items from 24 to 8 items. Conclusion: The mFCCA short version demonstrates good psychometrics and can be used to evaluate the family-centeredness of childhood obesity interventions with reduced participant burden, thereby improving outcomes for children with obesity. Trial registration: Clinicaltrials.gov NCT02124460 registered on April 24, 2014. [ABSTRACT FROM AUTHOR]

Background: Students' physical fitness has always been the focus of attention of the Chinese government, and the school as an important way to improve students' physical fitness, there are many studies on the current status of the implementation of physical education in schools, and there are many studies that use self-made questionnaires to investigate the implementation of physical education in schools, but most of the studies do not adequately validate the self-made questionnaires, so the purpose of this study was to develop a questionnaire to assess the level of implementation of physical education programmes in Chinese junior secondary schools and to test its reliability and validity. Method: The content of the questionnaire was developed based on the content of Annex 1 of the Assessment Measures for Physical Education in Primary and Secondary Schools issued by the Ministry of Education of China in 2014 and was modified based on feedback from the expert panel and pre-test participants. The questionnaire was initially tested for validity by 5 expert reviewers, and then we collected data information from 350 participants and conducted exploratory factor analysis (EFA) to explore the factor structure of the initial version. One week later, 40 of the 350 participants were randomly selected to assess test-retest reliability. Results: The I-CVI and KAPPA value analysis results of the expert review results show that the questionnaire has extremely high reliability and consistency among experts. EFA results indicate that the five dimensions of this questionnaire are highly reliable. In the test-retest reliability, the Pearson correlation coefficients of the initial test data and the retest data of each dimension are all greater than 0.7, and the significance probability values are all less than 0.05, reaching the significance level, the results show that the questionnaire has good stability. Conclusions: This study concluded that the 5 dimensions and 38 items of this questionnaire had high reliability and validity and could be used as a preliminary tool to measure the implementation level of physical education programs in junior high schools in China. However, future research should explore the potential need for adjustment to suit different regions and cultures. [ABSTRACT FROM AUTHOR]

Background: Individuals' concealment of negative information and privacy may lead to impaired social interactions and threatened health conditions. This study aimed to investigate the effectiveness of the Self-Concealment Scale (SCS) in the middle-aged Chinese population and to examine the equivalence of the SCS among different age groups. Methods: The current research adopted the SCS, Distress Disclosure Index (DDI), Revised Cheek and Buss Shyness Scale (RCBS), Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), UCLA Loneliness Scale (ULS-8), and Kessler Psychological Distress Scale (K10) to survey 1124 middle-aged people. To explore the factor structure of the SCS, the study employed exploratory factor analysis and confirmatory factor analysis. The reliability of the SCS was measured based on Cronbach's α coefficients, McDonald's Omega coefficients, and split-half reliability. Correlation analysis was applied to examine the relationship between SCS and RCBS, SIAS, SPS, ULS-8, and K10. Moreover, this study recruited 1458 emerging adults and 1104 older adults to identify the cross-age invariance of the SCS. Results: Exploratory factor analysis of the middle aged adults' data supported a single factor model. The factor loadings of SCS items ranged from 0.62 to 0.73, the commonality ranged from 0.39 to 0.53, and the single-factor model fitted well. The scale showed a Cronbach's α coefficient value of 0.895, McDonald's Omega coefficient of 0.893, and a split-half reliability coefficient value of 0.861. In addition, the SCS demonstrated invariance in emerging adults, middle-aged adults, and older adults. Further analysis showed that the scores of the SCS (F = 3.55, p = 0.029) among emerging adults (M = 26.43, SD = 7.96) were significantly higher than among middle-aged (M = 25.77, SD = 7.79), and older cohort (M = 25.69, SD = 7.91). Conclusion: The SCS revealed favorable psychometric characteristics among the middle-aged Chinese population. The degree of self-concealment among emerging adults was higher than that of middle-aged and older people. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to translate and validate the reliability and validity of the Falls Health Literacy Scale (FHLS). Methods: A total of 509 elderly hospitalized patients were recruited from Wuhan, China. The reliability of the scale was validated using internal consistency, split-half reliability and retest reliability. The validity of the scale with content validity index, exploratory factor analysis and validation factor analysis. Results: The Chinese version of the FHLS consists of 3 dimensions, falls prevention experience, general health and staying active, and seeking health advice and services, with a total of 25 entries. The Cronbach's α coefficient of the scale was 0.949, the range of Cronbach's α values for each dimension was 0.911 to 0.927, the split-half reliability was 0.800, and the retest reliability was 0.801. The I-CVI of the scale ranged from 0.833 to 1.000, and the S-CVI was 0.973. The KMO value was 0.925, and the χ2 value of Bartlett's sphericity test was 5,784.223 (P < 0.001). Exploratory factor analysis extracted four metric factors, which were discussed and combined into three metric factors explaining 56.361% of the total variance. The results of validation factor analysis showed that the model indicators were: χ2/df = 2.182, CFI = 0.928, GFI = 0.820, NFI = 0.875, IFI = 0.928, RFI = 0.862, TLI = 0.920, RMSEA = 0.076, MRM = 0.021, which met the criteria, and the model fitting of the indicators were all in good. Conclusions: The Chinese version of the FHLS has good reliability and validity for elderly patients and is suitable for assessing the falls health literacy level of elderly patients. The assessment of fall health literacy in elderly patients can help healthcare professionals to provide individualized health education to them, so as to improve the awareness of fall prevention in elderly patients. [ABSTRACT FROM AUTHOR]

Background: Considering the vital role of nurses in responding to disasters, it is essential to measure their readiness with a valid and reliable tool. The present study aimed to assess the psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI). Methods: This cross-sectional study was conducted between 2023 and 2024 among 200 nurses working at educational hospitals affiliated with one of the medical universities in Tehran, Iran. The Disaster Nursing Readiness Evaluation Index was translated into Persian. The face, content, and construct validity, as well as internal consistency, were analyzed. Results: In the exploratory factor analysis, five factors were extracted: practical skills for disaster response, adaptability to stressful situations at the disaster site, communication and cooperation skills for teamwork, emergency nursing skills, and effective coping with daily stress. Together, these factors accounted for 39.7% of the total variance. The results of the confirmatory factor analysis indicated that the extracted model fit well: CMIN/DF = 1.519, CFI = 0.889, RMSEA = 0.051. The Cronbach's alpha and McDonald's omega coefficients for the entire questionnaire were 0.890 and 0.891, respectively. Conclusions: Given that Iran is frequently exposed to disasters, it becomes essential to assess the preparedness of Iranian nurses using a valid and reliable scale. The availability of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI), which has undergone validation and reliability testing, facilitates accurate measurement of this concept. [ABSTRACT FROM AUTHOR]

Introduction: Falls in older adults are a common and serious threat to health and functional independence. It can cause psychological distress, inability to participate in activities of daily living, brain injury, fractures, and even death. The aim was to analyze the psychometric properties of the self-assessed fall risk scale (FRS) that measures the risk of falls in older adults in a central region of Chile, as well as to verify the concurrent validity against functional fitness tests. Materials and methods: A descriptive cross-sectional study was carried out in 222 older adults (OA) [34 males and 188 females] with an age range of 65 to 85 years. The 13-item self-perceived fall risk scale (FRS) was validated. Anthropometric measures (weight, height and waist circumference) were assessed. Five functional fitness tests were measured (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test). Validation was performed by construct validation [(exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)] and concurrent validity. Results: The EFA revealed 4 factors in the FRS scale [1: fear of falling (variance 27.1%), 2: use of assistive devices (variance 10.6%), 3: loss of sensation (variance 9.3%), and 4: limited mobility (variance 8.3%)]. Factor loadings ranged from ∼ 0.50 to 0.83 across the 4 components. The Kaiser-Meyer Olkin sample adequacy test (KMO) reflected adequate adequacy (KMO = 0.79, chi-square (X2) = 498.806, gl = 78, p = 0.00). The CFA showed a satisfactory final fit [chi-square (X2) = 126.748, Root mean squared error of approximation (RMSEA) = 0.042, Tucker-Lewis Index (TLI) = 0.946, Comparative fit index (CFI) = 0.935 y Normed fit index (NFI) = 0.90. The relationships between the FRS scale and functional fitness tests (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test) ranged from low to moderate (r= -0.23 to 0.41). Conclusion: The FRS scale showed acceptable validity and reliability in older adults in central region of Chile. It is expected that this scale will be useful for assessing fall risk in clinical and epidemiological settings in the aging Chilean population. [ABSTRACT FROM AUTHOR]

Background: Ensuring the wellness of older individuals with disabilities requires prioritising the care needs of their carers. However, current practice lacks validated tools to measure the needs of carers in home environments. Thus, this study aimed to create and test a questionnaire on the care needs of family carers of older people with disabilities in China. Methods: We used a standard development process to generate the questionnaire. The pilot testing included cognitive interviews to ensure interpretation as intended. Furthermore, we used a cross-sectional study method to conveniently select 640 Chinese family carers of older people with disabilities from August 1, 2022, to June 11, 2023, for face-to-face investigation. Exploratory factor analysis (EFA) aided in project reduction and factor estimation, with 30 participants undergoing retest evaluations every two weeks. Confirmatory factor analysis (CFA) assessed the model's structural validity, while internal consistency and retest reliability validated its accuracy. Results: These tests established the model: content validity, item analysis and EFA. Six factors extracted from the initial analysis explained 62.891% of the observation variance. CFA showed good model fit, and the questionnaire had good reliability and validity. The final questionnaire included 21 items focusing on six dimensions: care assistance (three items), care environment (three items), care information (three items), formal support (four items), care ability (six items) and self-development (two items). Conclusion: The care needs questionnaire effectively evaluates the needs of family carers in their caring activities. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to explore the extent to which faculty members in undergraduate medical education apply cognitive psychology principles in their teaching practices, and to evaluate the perceived effectiveness of these principles in enhancing student learning. Methods: This mixed method study was conducted on faculty members of public and private sector universities. Focused group discussions were conducted, and the responses of the participants were measured on a 5-point- Likert Scale. The instrument was tested for validity and reliability by measuring Cronbach's alpha and performing exploratory factor analysis. Mann–Whitney U test was applied on the attributes scores to compare 13 attributes by institutions, designations and domains. Results: One theme, 7 sub-themes and 19 categories were identified from the focused group discussion. as Kaiser- Meyer-Olkin index was 0.88 and Bartlett's test of sphericity was significant. Reliability was established at 0.95. The faculty self-perceived practicing psychology principles mostly scored in the middle level, where they think they apply less strategies. While highly significant results were noted for using Meyer's multimedia principles. Conclusion: Faculty members followed the principles of cognitive psychology to some extent. However, they all felt that using these principles can transform the teaching and learning of medical education. [ABSTRACT FROM AUTHOR]

Background: Fully online learning has become a common option in many universities worldwide in the post-COVID-19 era. The study aimed to evaluate the dimensions and characteristics of the fully online learning self-efficacy among Chinese undergraduate medical and nonmedical students. Methods: A cross-sectional study was conducted from January to August 2023 at Xihua University in China. A stratified cluster sampling method was used to enroll participants of undergraduate students. The Chinese version of the online learning self-efficacy scale (OLSES) was used to collect the demographic information. Cronbach's alpha coefficient, exploratory factor analyses, confirmatory factor analyses, and linear regression analyses were conducted in the study. Results: A total of 203 college students were included in the study. One hundred and twenty (59.1%) of the participants were medical students and 83 (40.9%) were nonmedical students, and most of them (64.5%) were from rural areas. The Cronbach's alpha coefficients were determined to be 0.90, 0.86, 0.87, and 0.95 for the learning in a fully online environment, time management, technology use subscales, and the whole scale, respectively. Exploratory factor analysis revealed the justifiability of factor analysis. In the confirmatory factor analysis, the majority of the goodness-of-fit indices reached an acceptable threshold (χ2/df = 3.14, RMR = 0.06, RMSEA = 0.10, NFI = 0.84, RFI = 0.80, IFI = 0.89, TLI = 0.85, CFI = 0.90). More than half of the students reported insufficient self-efficacy for learning in a fully online environment and time management, whereas 55.7% showed good self-efficacy for technology use. Although more medical students than non-medical students had higher self-efficacy scores in the three domains of self-efficacy, the proportion of students with good self-efficacy was slightly lower among medical students than non-medical students, with no significant differences between the medical students and nonmedical students. Conclusions: Most Chinese university students' that participated to our study found self-efficacy for fully online learning as insufficient (results on the three domains, ranging from 36.5 to 55.7%) and had a good level of fully online learning self-efficacy. Medical students and nonmedical students are not differences in the self-efficacy of fully online learning. Thus, pedagogues should take measures to help students including medical and nonmedical improve their self-efficacy in online environment learning, time management and technology use, ultimately enhancing their academic success. [ABSTRACT FROM AUTHOR]

Background: Empowerment is a comprehensive concept involving intrapersonal, interactional, and behavioral aspects. However, there is a lack of a specific empowerment scale for Coronary artery disease (CAD) related to knowledge and skills in China. The reliability and validity of the Coronary Artery Disease Empowerment Scale (CADES) need to be tested. This study aimed to assess the reliability and validity of the Chinese version of CADES among patients with CAD in China. Methods: The study adopted a cross-sectional design. After obtaining the copyright by contacting the author, the original English CADES was developed into Chinese by forward translation, back-translation, cross-cultural adaptation, and a pretest (30 patients). The Chinese version of CADES was administered to 391 CAD patients between September 2022 and June 2023, with the reliability and validity of the version evaluated. Exploratory factor analysis and confirmatory factor analysis were performed to examine the underlying factor structure of the translated questionnaire. The Cronbach's α coefficient, Guttman's split-half coefficient, and McDonald's omega coefficient were calculated to verify the scale's reliability. Results: For the Chinese version of CADES, the scale-content validity index was 0.972, with the item-content validity index ranging from 0.86 to 1.00. The questionnaire comprised 25 items, and exploratory factor analysis extracted four factors with loadings > 0.40, explaining 62.382% of the total variance. An acceptable model fit was achieved (χ2/df = 1.764, RMSEA = 0.060, TLI = 0.901, CFI = 0.912, IFI = 0.913). The Cronbach's α coefficient of the total questionnaire was 0.928, with coefficients for the four factors ranging from 0.683 to 0.913. The split-half reliability coefficient was 0.777, and the McDonald's omega reliability coefficient was 0.926. Conclusions: The Chinese version of CADES is reliable and valid among CAD patients in China. This instrument can serve as a valuable reference for guiding the implementation of targeted intervention strategies tailored to the empowerment status of CAD patients in clinical practice. [ABSTRACT FROM AUTHOR]

Background: The concept of quality in health care has evolved, placing greater importance on the patient's needs, culture, and social context, as well as their participation in clinical decision-making, as highlighted by Mead and Bower's Person-Centered Care Model. The aim of the present study was to design and validate an instrument to assess the extent to which healthcare services provided by PEMEX (Petróleos Mexicanos) offer person-centered care according to user perceptions. Methods: The first phase comprised the development of 57 items based on the analysis of responses from an open-ended questionnaire administered to 30 users of Pemex healthcare services. This questionnaire was designed considering the four factors of the person-centered care model, however, the high correlation between the 4 factors (i.e., r ≥.80) indicated an overfactoring effect and consequently an increase in the risk of overfitting. Therefore, an exhaustive analysis of the instrument was performed, starting with the review of the individual behavior of each item, and carrying out exploratory and confirmatory factor analysis. Using a sample of 330 individuals, an exploratory factor analysis was perfomed. Afterward, a confirmatory factorial analysis was carried out with 335 participants. Finally, a new confirmatory factorial analysis included 130 participants due to the refinements made in the previous phase. Internal consistency was assessed using Cronbach's α and McDonald's ω at every phase. Results: The exploratory factor analysis retained 35 items in a single factor that accounted for 49% of the variance with an internal consistency of Cronbach's α and McDonald's ω = 0.97. Because the factorial structure by confirmatory factorial analysis was unsatisfactory, the initial model was refined, leading to the retention of 11 items and a final model with adjustment index of χ2 = 127.53, χ2/gl = 2.89, RMSEA = 0.07, IC RMSEA 0.06 to 0.09, TLI = 0.95 and CFI = 0.96, with an internal consistency of Cronbach's α and McDonald's ω = 0.93. Due to the refinements, a new confirmatory factorial analysis was conducted with suitable goodness-of-fit criteria in most items (χ2 = 151.44, χ2/gl = 3.43, RMSEA = 0.13, IC RMSEA 0.11 to 0.16, TLI = 0.93 and CFI = 0.94), resulting in a Cronbach's α and McDonald's ω = 0.98. Conclusions: The instrument exhibits suitable psychometric properties to be employed to measure the degree to which medical care is patient centered. This instrument represents a strategy for promoting an innovative healthcare model. [ABSTRACT FROM AUTHOR]

Background: Given increases in China's aging population, the growing demand for public health services and the shortage of human resources among nurses have become more prominent. Under such a background, "Internet + Nursing Services" have received more attention. Thus, exploring the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective: This study aimed to develop a scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and to test the validity and reliability of the scale. Methods: A preliminary scale was developed based on a literature review, theoretical research, semistructured qualitative interviews, and two rounds of Delphi expert inquiry. A convenient sampling method was used for the questionnaire survey. A 5-point Likert scale was used to evaluate the importance of the items. The survey data of 659 clinical nurses obtained from February to March 2023 were used for item analysis, exploratory factor analysis (EFA), and reliability and validity tests of the scale. The survey data of 538 clinical nurses obtained in April 2023 were used for confirmatory factor analysis (CFA) of the final scale. Results: The final scale consists of 25 items and 4 dimensions (performance expectations, perceived risk, need for professional knowledge training, and nonprofessional knowledge training). The scale showed good structural validity and content validity: the Cronbach's α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the kaiser-meyer-olkin(KMO) value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The scale content validity index(S-CVI) was 0.914. The confirmatory factor analysis model had favorable fit indices: χ2/df = 4.234, RMSEA = 0.078, NFI = 0.940, IFI = 0.953, TLI = 0.947, and CFI = 0.953. Conclusion: The scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" has good reliability and validity, and provides a reference for evaluating nurses' willingness to participate in "Internet + Nursing Services". [ABSTRACT FROM AUTHOR]

Background: Farming is a stressful occupation, and a growing body of research shows that farm stressors are associated with poor mental health. To date, there are few methodologically sound surveys that assess farm stressors, and none have been validated for the Canadian context. Our study aimed to: (a) investigate the types of stressors experienced by farmers, (b) develop a farm stress assessment tool and test its factor structure and internal consistency, and (c) assess its criterion-related validity to self-reported levels of anxiety, depression, burnout, and resilience among farmers. Methods: We developed a 20-item survey based on a review of the literature, examining existing farm stress surveys, and consulting 10 farmers and agricultural industry experts. Then, a convenience sample of farmers living in Alberta, Canada (Sample 1, N = 354) completed a questionnaire containing the 20-item farm stress survey and four validated measures that assessed depression, anxiety, burnout, and resilience. Sample 1 was used to assess the factor structure using exploratory factor analysis (EFA), internal consistency, and criterion-validity of the survey. Next, a convenience sample of farmers living outside of Alberta (Sample 2, N = 138) was used to evaluate the factor structure of the survey using confirmatory factor analysis (CFA). Results: The results of the EFA revealed five underlying dimensions of farm stressors: Unexpected work disruptions, Agricultural hazards, Farm and financial planning, Isolation, and Regulations and public pressure. The subscales accounted for 61.6% of the variance, and the internal consistency (Cronbach's alpha) ranged from 0.66 to.75. Subscale correlations were below 0.44, indicating evidence of discriminant validity. Correlations between the five subscales and the four mental health outcome variables supported the criterion-related validity of the survey. The results of the CFA indicated that the data fit the model, and fit was further improved by correlating one pair of error terms. Conclusions: Preliminary analysis of our Farmer Stress Assessment Tool (FSAT) suggests it is a reliable and valid instrument for measuring a range of stressors farmers face. Implications for policy and community-based mental health interventions that help farmers manage the enduring stressors of agriculture is discussed. [ABSTRACT FROM AUTHOR]

Background: The purpose of the article was to assess students' perception of the learning environment at the College of Medicine and Health Sciences, United Arab Emirates University using the 'Medical School Learning Environment Survey' (MSLES). Evaluating the learning environment and working towards its improvement is crucial for the physical and mental well-being of medical students, as it contributes to fostering an optimal learning environment. Methods: Students participated in four groups: Year-1 (pre-medical), Year-2 (pre-medical), Year-3/Year-4 (pre-clinical), and Year-5/Year-6 (clinical). MSLES data was collected from each group using an online survey tool (Qualtrics XM). Latent factor structures in the learning environment constructs were assessed using 'exploratory factor analysis'; and reliability was measured by Cronbach's alpha. Differences among groups were assessed by 'single factor ANOVA'. Results: Three hundred seventy-seven (65%) of the 584 eligible students completed the survey. Exploratory factor analysis revealed four factors: (Genn J. AMEE Medical Education Guide 23 (Part 1): Curriculum, environment, climate, quality and change in medical education–a unifying perspective. Med Teach. 2001;23(4):337–44.) Learning experience (∝=0.71), (Maudsley RF. Role models and the learning environment: essential elements in effective medical education. Acad Med. 2001;76(5):432–4.) Student-student interaction (∝=0.69), (Gruppen LD, Irby DM, Durning SJ, Maggio LA. Conceptualizing learning environments in the health professions. Acad Med. 2019;94(7):969–74.) Student-faculty interaction (∝=0.62), and (Soemantri D, Herrera C, Riquelme A. Measuring the educational environment in health professions studies: A systematic review. Med Teach. 2010;32(12):947–52.) Academic support (∝=0.62). Students in Y3-Y6 rated the learning environment statistically significantly lower than that in Y1-Y2. Student-student interaction in Y2 was significantly lower than that in other years. Student-faculty interaction in Y1 was significantly higher than that in Y2. Academic support was significantly higher in Y1 than that in Y2-Y6. Conclusion: The MSLES revealed variabilities in learning domains across the years. Improvement efforts should foster student-student collaboration in Y2 and improve academic support approaches for Y2-6. These findings provide valuable insights for medical educators to enhance the medical school learning environment and foster an optimal learning environment in lifelong medical education. [ABSTRACT FROM AUTHOR]

Background: Occupational stress is a serious problem in veterinary medicine; however, validated instruments to measure this problem are lacking. The aim of the current study was to address this literature gap by designing and validating a questionnaire and establishing the cut-off points for identifying veterinarians with high and low levels of stress. Methods: The study involved two sub-studies with two Spanish samples. The first study (N = 30 veterinarians; 66.7% women; 63.33% from small animal clinics) investigated the factors related to the work environment that caused the most stress; the results were analyzed using thematic content analysis. The second study (N = 1082; 70.8% women; 71.4% from small animal clinics) involved designing and validating a questionnaire to measure sources of stress in veterinary medicine, as well as establishing the cut-off points for interpreting the results using receiver operating characteristics (ROC) curve analysis. Results: The first study showed the main sources of stress and allowed items to be defined for the questionnaire. The second study validated the Sources of Stress in Veterinarian Medicine (SOS-VetMed) questionnaire and confirmed five sources of stress with adequate reliability and validity indices: "work overload," "work–family conflict," "emotional burden of work," "organizational factors," and "emergency problems." Exploratory and confirmatory factor analyses verified a structure of five factors (Cronbach's alpha values ranging between 0.92 and 0.69). The five subscales of the SOS-VetMed questionnaire were positively correlated with two indicators of distress: "psychological complaints" and "psychosomatic complaints." The cut-off points indicated that 45.83% and 19.95% of the veterinarians surveyed had high and low levels of stress, respectively. Conclusions: The results confirmed that the SOS-VetMed questionnaire could be used to determine the stress levels of veterinarians and to design intervention programs to improve their workplace health. [ABSTRACT FROM AUTHOR]

Background: The Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV). Methods: A total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8). Results: The results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the "general nightmare distress and coping" while the second was named "nightmare impact and perception". The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity. Conclusion: In conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop a culturally adapted Chinese version of the Value-based Stigma Inventory (VASI) and to evaluate its psychometric properties, including reliability and validity, among the general Chinese population. Methods: This study is a cross-sectional study. Convenience sampling was used to recruit 708 general citizens from Shenyang City, Liaoning Province, China. The VASI's internal consistency, split-half reliability, and test–retest reliability were tested to assess the translated scale's reliability. Several validity tests were performed, including expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States). Results: The Chinese version of the VASI showed good reliability, with a Cronbach's α value of 0.808, and the dimensions ranged from 0.812 to 0.850. Test–retest reliability showed good temporal stability with a value of 0.855, and the split-half reliability value was 0.845, indicating a high degree of consistency. The scale also demonstrated good content validity with a content validity index of 0.952. After conducting exploratory factor analysis, a five-factor structure was identified, including factors of self-realization, personal enrichment, reputation, meritocratic values, and security. In the confirmatory factor analysis, all recommended fit indicators were found to be within the acceptable range, including χ2/DF = 1.338, GFI = 0.960, AGFI = 0.940, RMSEA = 0.031, TLI = 0.985, CFI = 0.989, IFI = 0.989, PGFI = 0.640, and PNFI = 0.729. Conclusion: The Chinese version of the VASI is valid and reliable among the Chinese general public. The five-factor structured scale effectively assessed public stigma against mental illness, including the value orientations associated with personal stigma. Given the harsh and widespread public stigma against mental illness, the findings from the questionnaire may inform the development of future public health education programs. Public health education is needed to reduce the stigma of mental illness, increase public awareness of mental health issues, and mitigate the continued stigmatization of mental illness. [ABSTRACT FROM AUTHOR]

Background: Due to the high prevalence of multimorbidity and realistic health service demands for fall prevention, there is growing interest in the association between multimorbidity and falls. Our study aimed to identify multimorbidity patterns among Chinese older adults and explore the association between multimorbidity patterns and falls. Methods: Data from 4,579 Chinese community-dwelling older adults was included in this analysis. Information regarding falls and 10 chronic conditions was collected. An exploratory factor analysis was performed to determine multimorbidity patterns. Regression models were fitted to explore the associations of individual chronic disease or multimorbidity patterns with falls. Results: Among 4,579 participants, 368 (8.0%) were defined as fallers, including 92 (2.0%) frequent fallers, and multimorbidity affected 2,503 (54.7%) participants. Older adults with multimorbidity were more likely to be fallers [odds ratio (OR) = 1.3, P = 0.02] and frequent fallers (OR = 1.7, P = 0.04). Three multimorbidity patterns were identified (i.e., cardiovascular-metabolic diseases, psycho-cognitive diseases and organic diseases), and the associations between psycho-cognitive diseases/organic diseases and prevalent falls or frequent falls were found to be significant. Conclusions: The psycho-cognitive disease pattern and organic disease pattern are significantly associated with falls. Therefore, more attention should be paid to patients with psycho-cognitive diseases and timely, targeted diagnostic and treatment services should be provided in fall prevention. [ABSTRACT FROM AUTHOR]

Background: Assessment of eating disorders (ED) in youth relies heavily on self-report, yet persistent lack of recognition of the presence and/or seriousness of symptoms can be intrinsic to ED. This study examines the psychometric properties of a semi-structured interview, the parent version of the Eating Disorder Examination (PEDE), developed to systematically assess caregiver report of symptoms. Methods: A multi-site, clinical sample of youth (N = 522; age range: 12 to 18 years) seeking treatment for anorexia nervosa (AN) and subsyndromal AN were assessed using the Eating Disorder Examination (EDE) for youth and the PEDE for collateral caregiver report. Results: Internal consistencies of the four PEDE subscales were on par with established ranges for the EDE. Significant medium-sized correlations and poor to moderate levels of agreement were found between the corresponding subscales on each measure. For the PEDE, confirmatory factor analysis of the EDE four-factor model provided a poor fit; an exploratory factor analysis indicated that a 3-factor model better fits the PEDE. Conclusions: Findings suggest that the PEDE has psychometric properties on par with the original EDE. The addition of the caregiver perspective may provide incremental information that can aid in the assessment of AN in youth. Future research is warranted to establish psychometric properties of the PEDE in broader transdiagnostic ED samples. Plain English summary: Assessments for eating disorders rely primarily on self-report; yet, the denial of symptoms or symptom severity among adolescents with anorexia nervosa can complicate assessment and delay treatment in this population. The Parent Eating Disorder Examination (PEDE) is the first semi-structured interview formally developed to improve childhood eating disorder assessment by including caregiver perspectives. In this study, a large sample of adolescents with anorexia nervosa completed a self-report interview (the Eating Disorder Examination or EDE) and their parents completed the PEDE. The PEDE appeared to measure parents' report of their child's eating disorder symptoms consistently. Results from both interviews were related to one another but did not completely agree. This suggests that in an eating disorder assessment, the PEDE can provide additional information from caregivers that might reduce diagnostic confusion and lead to earlier intervention for youth with anorexia nervosa. [ABSTRACT FROM AUTHOR]

Introduction: Fear-avoidance beliefs (FAB) play a crucial role in the treatment outcomes of post-surgery patients. These beliefs can lead to activity avoidance, increased pain, and decreased quality of life. Therefore, accurately measuring these beliefs in Iranian patients is of significant importance. The Fear-Avoidance Belief Questionnaire (FABQ) is a patient-reported questionnaire that evaluates individuals' FAB. Since the validity and reliability of the Persian version of FABQ (FABQ-P) have not been assessed based on the Iranian population and sociocultural contexts, the current study has been implemented to determine the reliability and validity of the FABQ-P among Iranian post-operative patients by translation and psychometric properties. Methods: This methodological study conducted in 2023, a sample of 400 patients who had undergone surgery were selected using a convenience sampling method. The scale used in the study was translated and its psychometric properties were evaluated through network analysis and assessments of construct validity (including exploratory and confirmatory factor analysis), convergent validity, and discriminant validity. Additionally, the study assessed the internal consistency of the scale. Results: The MLEFA results with Promax and Kaiser Normalization rotation yielded two factors explaining 57.91% of the variance, encompassing 13 items. Also, the model was approved by CFA. Convergent and discriminant validity have been confirmed through the following criteria: Average Variance Extracted (AVE) exceeding 0.5, Composite Reliability (CR) surpassing 0.7, and Heterotrait-Monotrait Ratio of Correlations (HTMT) equating to 0.597. As for reliability, Cronbach's alpha, composite reliability (CR), and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency. Conclusion: As demonstrated by the results, the FABQ-P has a satisfactory level of reliability along with authentic validity according to the sociocultural contexts of Iranian post-operative patients. [ABSTRACT FROM AUTHOR]

Background: A healthy diet is a critical factor in maintaining long-term health. In addition to a health-promoting food environment, the nutrition health literacy (NHL) and food literacy (FL) of the population are important in this context. This paper describes the development and validation of two short instruments to measure the nutrition literacy of the population, used in the Austrian Nutrition Literacy Survey 2021. Methods: An instrument to measure NHL (Nutrition Health Literacy Scale; NHLS) has been adapted and further developed. To measure FL, the Self-perceived Food Literacy Scale by Poelman et al. has been modified and shortened (SPFL-SF). Validation of the instruments was based on data from a web survey conducted in Austria in 2021 with almost 3,000 participants aged 18 years and older. Exploratory and confirmatory factor analyses were performed to assess the factorial validity/dimensionality of the instruments. Additionally, internal consistency was assessed using Cronbach's alpha, ordinal alpha, and McDonald's omega. Results: Both instruments demonstrate excellent data-model fit. The NHLS also shows excellent internal consistency (α = 0.91), while the SPFL-SF displays a sufficient internal consistency for all (α between 0.70 and 0.89) but one sub-dimension (resisting temptation α = 0.61). Furthermore, the distribution of the items indicates that the measures are understandable and suitable, as evidenced by the absence of missing values in the sample. In addition, the items of both instruments differ in their level of difficulty or agreement. Conclusions: The NHLS and SPFL-SF are reliable and valid instruments for measuring NHL and FL in the general adult population. The brief instruments measuring the different aspects of nutrition literacy can be easily used in nutritional or evaluation studies. Further work is required to investigate other aspects of validity. [ABSTRACT FROM AUTHOR]

Introduction: Increasing numbers of ambulance calls, vacant positions and growing workloads in Emergency Medicine (EM) are increasing the pressure to find adequate solutions. With telemedicine providing health-care services by bridging large distances, connecting remote providers and even patients while using modern communication technologies, such a technology seems beneficial. As the process of developing an optimal solution is challenging, a need to quantify involved processes could improve implementation. Existing models are based on qualitative studies although standardised questionnaires for factors such as Usability, Acceptability and Effectiveness exist. Methods: A survey was provided to participants within a German county. It was based on telemedical surveys, the System Usabilty Scale (SUS) and earlier works describing Usability, Acceptability and Effectiveness. Meanwhile a telemedical system was introduced in the investigated county. A comparison between user-groups aswell as an exploratory factor analysis (EFA) was performed. Results: Of n = 91 included participants n = 73 (80,2%) were qualified as emergency medical staff (including paramedics n = 36 (39,56%), EMTs n = 28 (30,77%), call handlers n = 9 (9,89%)) and n = 18 (19,8%) as emergency physicians. Most participants approved that telemedicine positively impacts EM and improved treatment options with an overall Usabilty Score of 68,68. EFA provided a 3-factor solution involving Usability, Acceptability and Effectiveness. Discussion: With our results being comparable to earlier studies but telemedicine only having being sparsely introduced, a positive attitude could still be attested. While our model describes 51,28% of the underlying factors, more research is needed to identify further influences. We showed that Usability is correlated with Acceptability (strong effect), Usability and Effectiveness with a medium effect, likewise Acceptability and Effectiveness. Therefore available systems need to improve. Our approach can be a guide for decision makers and developers, that a focus during implementation must be on improving usability and on a valid data driven implementation process. [ABSTRACT FROM AUTHOR]

Objective: Caring for a child, particularly one with special healthcare needs, is a demanding task that can lead to the experience of caregiver strain. This in turn has an effect on the caregiver's mental health, as well as on the child and his or her treatment. To enable the identification of afflicted parents, this study aims to provide a German version of the Caregiver Strain Questionnaire–Short Form 11 (CGSQ-SF11) and to examine its factor structure and psychometric properties. Methods: Data from 698 caregivers were included in the analyses. Caregivers completed the CGSQ-SF11 along with measures of parenting stress (PSI-SF), stress (PSS-10), anxiety (GAD-7), depression (PHQ-8), family-related quality of life (FLQ), and social desirability (SES-17) as additional instruments for validation. A two-week follow-up questionnaire included only the CGSQ-SF11. Exploratory factor analysis followed by a confirmatory factor analysis was conducted for parents of children with and without special healthcare needs, separately. Further analyses examined the validity and reliability of the instrument. Results: For parents of children with special healthcare needs, a three-factor structure (objective, internalized subjective, externalized subjective strain) with a second-order factor (caregiver strain) was supported. For parents of children without special healthcare needs, a similar three-factor structure was found, although the second-order factor was not supported. Measurement invariance between the two groups was not confirmed. Internal consistency, test-retest reliability, and validity were largely supported in both groups. Conclusions: The results indicate that the German version of the CGSQ SF-11 is a valid and reliable questionnaire for measuring caregiver strain. [ABSTRACT FROM AUTHOR]

Background: The prevalence of metabolic syndrome (MetS) in American adults increased from 37.6% in the 2011–12 period to 41.8% in 2017–2018. Environmental exposure, particularly to common compounds such as glyphosate, has drawn increasing attention as a potential risk factor. Methods: We employed three cycles of data (2013–2018) from the National Health and Nutrition Examination Survey (NHANES) in a cross-sectional study to examine potential associations between urine glyphosate measurements and MetS incidence. We first created a MetS score using exploratory factor analysis (EFA) of the International Diabetes Federation (IDF) criteria for MetS, with data drawn from the 2013–2018 NHANES cycles, and validated this score independently on an additional associated metric, the albumin-to-creatinine (ACR) ratio. The score was validated via a machine learning approach in predicting the ACR score via binary classification and then used in multivariable regression to test the association between quartile-categorized glyphosate exposure and the MetS score. Results: In adjusted multivariable regressions, regressions between quartile-categorized glyphosate exposure and MetS score showed a significant inverted U-shaped or saturating dose‒response profile, often with the largest effect for exposures in quartile 3. Exploration of potential effect modification by sex, race, and age category revealed significant differences by race and age, with older people (aged > 65 years) and non-Hispanic African American participants showing larger effect sizes for all exposure quartiles. Conclusions: We found that urinary glyphosate concentration is significantly associated with a statistical score designed to predict MetS status and that dose–response coefficient is nonlinear, with advanced age and non-Hispanic African American, Mexican American and other Hispanic participants exhibiting greater effect sizes. [ABSTRACT FROM AUTHOR]

Measures such as education, improving knowledge, attitude and taking preventive action to protect against COVID-19 are vital strategies for prevention. The aim of this study was to determine the predictability of Health Belief Model (HBM) constructs in performing preventive behaviors against COVID-19 among secondary school students in Chabahar, Iran. In this cross-sectional-analytical study, 400 secondary school students of Chabahar city were investigated by simple random sampling. The data collection tool was a questionnaire including demographic characteristics, knowledge, behavior, and Health Belief Model constructs' questions. Exploratory Factor Analysis (EFA) was used to evaluate the validity of HBM constructs, and the structural equation modeling (SEM) method was used to evaluate the direct and indirect effects of the relationship between knowledge, HBM constructs, and preventive behavior against COVID-19 based on the conceptual model. Based on the results of the structural modeling, the direct effect of knowledge on the constructs of the health belief model was positive and significant (β = 0.34, P-value < 0.001), and on the preventive behavior of students was insignificant (β = 0.12, P-value = 0.07) while the indirect effect of knowledge through increasing the constructs of the HBM on student behavior was positive and significant (β = 0.30, P < 0.001). The relationship between the constructs of the HBM constructs and student behavior was also positive and significant (β = 0.89, P-value < 0.001).Due to the fact that knowledge and HBM structures played a role in predicting the adoption of preventive behavior from COVID-19, it is possible to design appropriate interventions to increase knowledge, sensitivity, perceived severity, and self-efficacy, in order to recover from COVID-19 by adopting preventive behaviors. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. Methods: The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. Results: The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. Conclusions: The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors. [ABSTRACT FROM AUTHOR]

Background: Given the increasing prevalence of the physician burnout, this study provides new insights into the antecedents driving burnout and turnover intent. By introducing the concept of physician fortitude, we develop a valid and statistically-reliable measure that increases our understanding of these issues. Methods: A two-sample design was employed. Using a sample of 909 physicians, Advanced Practice Providers (APPs) and healthcare leaders, exploratory factor analysis was employed to create a 12-item fortitude scale. In the second study, using a sample of 212 of practicing physicians, APPs and healthcare leaders, bivariate and tetrachoric correlations, and ordinary least square regression modeling were able to establish reliability and validity. Results: The fortitude scale shows sufficient reliability. Moreover, we found significant support for convergent and criterion-related validity. Fortitude was significantly related to all three subdimensions of burnout, including emotional exhaustion (r = -.62, p <.01), depersonalization (r = -.70, p <.01) and personal accomplishment (r =.65, p <.01), and turnover intent (r = -.55, p <.01). Moreover, the fortitude measure explained more variance in all three subdimensions of burnout and turnover intent compared to common measures, including grit, hardiness, mental toughness and resilience (p <.01). Conclusions: Results from this study empirically demonstrate that fortitude is significantly related to burnout, and turnover intent. This new fortitude measure adds a new perspective to assist in the development of more effective interventions. Opportunities for future research are discussed. [ABSTRACT FROM AUTHOR]