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Abstract Cyberchondria is a hybrid term signifying a state in which individuals compulsively search for health-related information online because of health distress or anxiety, further aggravating their worries. This study develops a Cyberchondria Severity Scale (CSS) to assess the current situation of university students. Exploratory factor analysis (EFA) was conducted using 145 valid questionnaires. Subsequently, a nationwide survey was conducted at various universities in Taiwan, and 802 questionnaires were used for confirmatory factor analysis (CFA). The EFA led to the development of a CSS for college students with four constructs: increased anxiety (α = 0.91), obsessive-compulsive hypochondria (α = 0.87), perceived controllability (α = 0.88), and online physician-patient interaction (α = 0.86), with a Cronbach’s alpha of 0.92 and variance of 66.81%. The CFA indicated that item reliability ranged from 0.50 to 0.86, factor loadings ranged from 0.71 to 0.93, and the composite reliability for latent variables ranged from 0.83 to 0.90 (p

Background Graded diagnosis and treatment is one of the main goals of medical reform. In 2015, the General Office of the State Council issued the"Guiding Opinions on Promoting the Construction of Graded Diagnosis and Treatment System" (Guo Ban Fa[2015]No. 70), which stated that in 2017, the proportion of diagnosis and treatment in grassroots medical institutions was over 65.0%, but that proportion was 54.2% that year, and in recent years, it has shown an overall downward trend. Previous literature has mostly focused on the demand side (patients) for research, while as one of the suppliers of graded diagnosis and treatment, there have been few surveys on the willingness of general practitioners to participate in graded diagnosis and treatment. Objective This article aims to take Suzhou City as an example to investigate and study the willingness of general practitioners to participate in graded diagnosis and treatment, analyze its influencing factors, and provide suggestions to improve the willingness of general practitioners to participate in graded diagnosis and treatment, providing reference for formulating policies related to graded diagnosis and treatment. Methods In June 2022, a multi-stage convenient sampling method was adopted to select 1 451 general practitioners from 175 grassroots medical and health institutions (hereinafter referred to as grassroots institutions) in 4 counties and 6 districts of Suzhou City. A self-developed survey questionnaire was used to conduct the survey. The questionnaire includes the survey of general practitioners' basic situation (demography characteristics), survey of general practitioners' willingness to participate in hierarchical diagnosis and treatment (this part of the questionnaire is based on the expanded model of influencing factors of general practitioners' willingness to participate in hierarchical diagnosis and treatment, which is a fusion model of theory of planned behavior (TPB) and technology acceptance model (TAM) combined with Document retrieval and interview collection content). According to the survey results, use structural equation model SEM analysis to test the influencing factors of general practitioners' willingness to participate in graded diagnosis and treatment, expand the model's fit, and determine the model's fit effect. Exploratory factor analysis was used to calculate the weight (influence) of each influencing factor of general practitioners' willingness to participate in graded diagnosis and treatment, and to build a Relational model of influencing factors of general practitioners' willingness to participate in graded diagnosis and treatment. Results One thousand four hundred and fifty-one general practitioners participated in this questionnaire survey, and 1 302 valid questionnaires were collected, with an effective rate of 89.73%. The expanded model of influencing factors on the willingness of general practitioners to participate in graded diagnosis and treatment is well fitted. In the influencing factors of general practitioners' willingness to participate in graded diagnosis and treatment, participation attitude, subjective norms, and perceived behavioral control jointly affect the willingness of general practitioners to participate in graded diagnosis and treatment, with weights of 46.22%, 9.75%, and 44.02%, respectively. Perceived benefits and perceived usefulness jointly explain participation attitudes, with weights of 15.14% and 31.08% respectively. Disposable resources and expected resistance jointly explain perceptual behavioral control, with weights of 27.07% and 16.95%, respectively. Conclusion The degree of recognition of the medical service capabilities of higher-level hospitals by general practitioners, the complexity of referral procedures, and the degree of openness of medical resources from higher-level hospitals to general practitioners have a significant impact on the willingness of general practitioners to participate in graded diagnosis and treatment. It is recommended to strengthen communication and interaction among personnel within the medical association at the administrative, organizational, and personal levels, and use information technology to simplify referral processes and procedures Encourage higher-level hospitals to provide targeted and quantitative access to medical resources such as outpatient number sources and ward beds for general practitioners, and take various measures to increase their willingness to participate in graded diagnosis and treatment.

Abstract Over the last two decades, awe has attracted the attention of an increasing number of researchers. The use of virtual reality has been identified as one of the most effective techniques for eliciting awe, in addition to more personalized methods for inducing emotion, such as autobiographical recall. However, previous measures of awe were unable to uncover the hidden structure of this experience. Awe experience scale (AWE-S) has been validated as a comprehensive measure of contingent awe in English, providing new opportunities for analysis. In this two-phases study, we investigated whether the latent structure of the experience of awe evoked by the autobiographical recall technique (Study 1) overlapped with that induced by exposing participants to a validated virtual reality awe-eliciting training (Study 2). The original English AWE-S structure held both in autobiographical recall induction and virtual reality-based elicitation. Despite evidence of overlap between English and Italian structures, low correlations were found between Italian trait measures used to test the concurrent validity of the AWE-S in the Italian sample and AWE-S state dimensions. This study highlights cultural differences in awe experience, trait, and state variations, and provides new insights into the standardized induction of this emotion through simulated environments.

Objective To explore the composition of symptom clusters in the acute phase of patients with hypertensive cerebral haemorrhage and to analyse their correlation with prognostic quality of life. Methods From July 2021 to June 2022, 396 patients with hypertensive cerebral haemorrhage hospitalised in neurosurgery departments of two tertiary care hospitals in Tangshan City were selected and surveyed using the General Information Questionnaire, the Memory Symptom Assessment Scale and the Stroke-Specific Quality of Life Scale. An exploratory factor method was used to extract symptom clusters and Biased correlation analysis was applied to analyse the correlation between symptom clusters and quality of life. Results Symptoms with a higher incidence in the acute phase in patients with hypertensive cerebral hemorrhage included loss of appetite (77.3%), low energy/weakness (74.0%), pain (72.9%), weight loss (71.5%), and feeling nervous (70.7%); symptoms with a higher degree of severity included loss of appetite (2.01±1.22), low energy/weakness (2.00±1.32), pain (1.97±1.30), vomiting/nausea (1.83±1.21), difficulty concentrating (1.81±1.30); symptoms with higher levels of distress included pain (2.27±1.53), vomiting/nausea (2.20±1.48), vomiting (1.98±1.59), low energy/weakness (1.96±1.30), dizziness (1.81±1.40). A total of six symptom clusters were extracted by the exploratory factor method, namely digestive symptom cluster, psychological symptom cluster, pain-fatigue related symptom cluster, physical-cognitive impairment symptom cluster, speech-swallowing disorder symptom cluster and pneumonia related symptom cluster, all of which were negatively correlated with prognostic quality of life with correlation coefficients of-0.261,-0.388,-0.335,-0.513,-0.304,-0.273. Conclusion The presence of six symptom clusters in the acute phase of hypertensive cerebral haemorrhage patients, all of which were negatively associated with prognosis of quality of life, suggests that medical staff should identify or predict symptom clusters in a timely and accurate manner and optimise symptom management strategies to improve patients ‘ prognosis of quality of life.

Abstract The Health Action Process Approach (HAPA) is a two-stage (pre-intentional and post-intentional) behavioral change model that distinguishes between motivation and volition in behavior change process. This study aims to develop HAPA-based assessments for smoking cessation among current smokers. The HAPA-based measures were developed and the draft measures included nine constructs, namely, risk perception in smoking-induced cancer, risk perception in smoking-induced systemic disease, positive outcome expectancy, negative outcome expectancy, self-efficacy in quitting smoking, self-efficacy in maintaining, self-efficacy in re-initiating, quitting planning and coping planning in smoking cessation, with a total of 26 items. A cross-sectional survey was conducted in China in 2022. Principal Component Analysis was used for Exploratory Factor Analysis (EFA). Cronbach’s α coefficient was calculated to evaluate the internal consistency. Variables such as severity of smoking addiction were selected to evaluate the correlation between the HAPA scale and these variables. Of the 928 participants, 76.4% (709/928) were male and the median age was 35 years. Five factors were extracted by EFA. The factor loadings of each item were all greater than 0.60, and the cumulative variance contribution rate was 90.15%. The Cronbach’s α coefficient of each HAPA-based subscales was 0.929–0.986. The HAPA-based measurements are comprehensive, reliable and valid in the assessment of smokers’ smoking cessation cognition, which can be used to guide the design and implementation of intervention and the development of theory.

Background: Regulation can improve professional practice and patient care, but is often weakly implemented and enforced in health systems in low- and middle-income countries (LMICs). Taking a de-centred and frontline perspective, we examine national regulatory actors' and health professionals' views and experiences of health professional regulation in Kenya and Uganda and discuss how it might be improved in LMICs more generally. Methods: We conducted large-scale research on professional regulation for doctors and nurses (including midwives) in Uganda and Kenya during 2019–2021. We interviewed 29 national regulatory stakeholders and 47 subnational regulatory actors, doctors, and nurses. We then ran a national survey of Kenyan and Ugandan doctors and nurses, which received 3466 responses. We thematically analysed qualitative data, conducted an exploratory factor analysis of survey data, and validated findings in four focus group discussions. Results: Kenyan and Ugandan regulators were generally perceived as resource-constrained, remote, and out of touch with health professionals. This resulted in weak regulation that did little to prevent malpractice and inadequate professional education and training. However, interviewees were positive about online licencing and regulation where they had relationships with accessible regulators. Building on these positive findings, we propose an ambidextrous approach to improving regulation in LMIC health systems, which we term deconcentrating regulation. This involves developing online licencing and streamlining regulatory administration to make efficiency savings, freeing regulatory resources. These resources should then be used to develop connected subnational regulatory offices, enhance relations between regulators and health professionals, and address problems at local level. Conclusion: Professional regulation for doctors and nurses in Kenya and Uganda is generally perceived as weak. Yet these professionals are more positive about online licencing and regulation where they have relationships with regulators. Building on these positive findings, we propose deconcentrating regulation as a solution to regulatory problems in LMICs. However, we note resource, cultural and political barriers to its effective implementation. [ABSTRACT FROM AUTHOR]

Introduction: Non-adherence to medication in HIV-positive patients leads to the occurrence of HIV-related diseases and ultimately reduces the quality of life and immune system function of these patients. Therefore, the present study was conducted to identify and explain the factors that influence medication non-adherence in HIV-positive Iranian patients. Material & Methods: The present applied study was conducted in 2020-2021 using the descriptive method. First, by reviewing the research literature and interviewing experts in the field of HIV treatment, the main factors influencing medication non-adherence in HIV-positive patients were identified, based on which the research questionnaire was designed. Data were collected from 590 HIV-positive patients and analyzed using exploratory factor analysis and SPSS23 and LISREL software. Findings: Four factors, namely organizational factors (16 items), individual factors (19 items), educational factors (7 items), and communication factors (7 items) were identified as effective factors for medication non-adherence in HIV-infected patients. Communication factors, individual factors, educational factors, and organizational factors with factor loadings of 0.76, 0.74, 0.73, and 0.71, respectively, had an impact on medication non-adherence in HIV-positive patients. Discussion & Conclusion: To improve medication adherence among HIV patients, behavioral disease counseling experts and therapists should pay more attention to communication factors (improving patients social support from family and friends) and individual factors (not coping with the disease state and the effects of stigma and disclosing the disease).

Background and objectives: Automated drug dispensing systems (ADDs) have been introduced to improve the efficiency of dispensing and patient safety. The available questionnaires measure patient satisfaction with particular aspects of ADDs. Also, the level of patient satisfaction with ADDs is not widely established. This study aimed to develop and validate a novel questionnaire to assess patient satisfaction with ADDs. Methods: Content and construct validity procedures were used to validate the 20-item questionnaire with four domains, including pharmacy administration, dispensing practice, patient education, and the dispensing system. Two hundred consenting participants took part in this study, from those who visited the outpatient pharmacy in a government hospital. Results: The internal consistency of all four scale items shows acceptable reliability (>0.7). In the exploratory factor analysis, three items were removed due to poor factor loading and cross-loading. In the confirmatory factor analysis, the model has acceptable fit indices, including the comparative fit index (0.937), Tucker–Lewis’s index (0.924), standardized root mean square residual (0.051), root mean square error of approximation (0.057), and χ2/df (1.67). The convergent and discriminant validity were established, since the average variance extracted (AVE) was ≥0.5 and the squared correlation (SC) values of one construct with other constructs were less than the AVE of the specific construct. Conclusion: This study offered a reliable and valid 17-item questionnaire incorporating a multi-dimensional four-factor model to evaluate patient satisfaction with ADDs. The validated questionnaire can be utilized to explore patients’ perspectives on ADDs.

Background The perception of teledentistry use among dental practitioners in various contexts was assessed using the Teledentistry Survey (the TDS-24). However, this survey’s psychometric analyses have not yet been analysed. This present study aims to examine the validity and reliability of the TDS-24 in a sample of dental practitioners in Saudi Arabia. Methods A self-administered questionnaire, including sociodemographic characteristics and the TDS, was distributed as a cross-sectional survey to 800 current dental practitioners in Saudi Arabia recruited via convenience and snowball sampling. The construct validity and reliability of the TDS were assessed using exploratory factor analysis (EFA) and Cronbach’s alpha. Results The EFA of the survey yielded 20 items supporting a four-factor structure as follows: factor I (10 items), factor II (four items), factor III (three items) and factor IV (three items). The overall Cronbach’s alpha was 0.85, while it was 0.86 for the first factor, 0.70 for the second factor, 0.52 for the third factor and 0.57 for the fourth factor. Conclusions The TDS-20, after excluding four items, revealed four factors with adequate psychometric properties, making it a valid and reliable tool in assessing teledentistry perceptions among dental practitioners in this study sample.

Background: One of the most frequent medical mistakes that lower patient safety and mortality is medication errors in HIV/AIDS patients. A structured reporting system is necessary for the efficient avoidance of these kinds of mistakes. In order to discover parameters influencing the management of medication mistake reporting in HIV-infected patients, the current research was carried out. Methods: The current research is an example of an applied study that was carried out between 2010 and 2019 utilizing a hybrid (quantitative-qualitative) methodology. First, the primary factors impacting the management of medication mistake reporting in HIV positive patients were collected from a study of the research literature and 35 interviews with experts in the area of treating HIV patients, and a research questionnaire was created utilizing them. Using the Lawshe approach, the questionnaire was sent to and collected from 31 experts in order to assess its content validity. SPSS23 was then used to determine the questionnaire's reliability, which resulted in a Cronbach's alpha value of 0.920. 400 workers who treated HIV/AIDS patients provided information for the data collection. Exploratory factor analysis was used to analyze the data, together with SPSS23 and Lisrel software. Results: Four factors were found to be important in managing medication mistake reporting in HIV patients, including organizational factors (18 variables), person factors (9 variables), educational factors (10 variables), and communication factors (6 variables). The management of medication mistake reporting in HIV patients was impacted most and least by personal and educational variables, with factor loadings of 0.784 and 0.754, respectively. Conclusion: It is preferable to concentrate on individual variables (employee-related hurdles, fear of the repercussions of reporting, and others' reactions) rather than addressing all four aspects at once in order to manage medication mistake reporting in HIV positive patients (managers, colleagues, patients). Managers, policymakers, specialists from behavioral disease counseling centers, and attending physicians should pay greater attention to both the individual (application and development of the integrated HIV management system).

Abstract Background Interprofessional collaboration ensures that high-quality health care is provided leading to improved health outcomes and provider satisfaction. Assessing the attitudes of health care professionals towards teamwork in Ghana is novel. Objective To examine the attitudes of health care professionals towards interprofessional teamwork and assess specific attributes influencing these attitudes in the Ashanti region, prior to implementing an in-service interprofessional HIV training programme. Methods A cross-sectional pre-training online survey using a modified Attitudes Toward Health Care Teams Scale was conducted among health care practitioners undergoing a two-day interactive interprofessional HIV training in Kumasi and Agogo from November 2019 to January 2020. Trainees were diverse health professional cadres selected from five hospitals in the Ashanti region of Ghana. Data was summarised using the mean and standard deviation for continuous variables, and frequencies and percentages for categorical variables. An exploratory factor analysis was conducted to categorise the 14 items of the modified attitudes scale. The Wilcoxon rank-sum (Mann–Whitney) and Kruskal–Wallis tests were used to test the mean attitude difference among the demographic characteristics. Statistical significance was set at p

Interprofessional collaborative practice is a core competency and is the key to strengthening health practice systems in order to deliver safe and high-quality nursing practice. However, there is no Interprofessional Collaboration Practice Competency Scale (IPCPCS) for clinical nurses in Taiwan. Therefore, the purposes of this study were to develop an IPCPCS and to verify its reliability and validity. This was a psychometric study with a cross-sectional survey using convenience sampling to recruit nurses from the seven hospitals of a medical foundation. A self-designed structured IPCPCS was rolled out via a Google survey. The data were analyzed using descriptive statistics, principal-axis factoring (PAF) with Promax rotation, Pearson correlation, reliability analysis, and one-way ANOVA. PAF analysis found that three factors could explain 77.76% of cumulative variance. These were collaborative leadership and interprofessional conflict resolution, interprofessional communication and team functioning, and role clarification and client-centered care. The internal consistency of the three factors (Cronbach’s α) was between 0.970 to 0.978, and the Pearson correlation coefficients were between 0.814 to 0.883. Significant differences were presented in the IPCPCS score by age, education level, total years of work experience, position on the nursing clinical ladder, and participation in interprofessional education. In conclusion, the three factors used in the IPCPCS have good reliability and construct validity. This scale can be used as an evaluation tool of in-service interprofessional education courses for clinical nurses.

Objective To further determine the relationship between blood donor role cognition and blood donation behavior, then prepare of blood donor role identity scale(BDRIS). Methods The preparation of the scale was divided into five stages. It includes literature retrieval, expert interview, construction of the basic framework of the scale, scale test and statistical index test. The study focused on items selection, dimensions identification, measurement reliability, content and structural validity. Results The blood donor role identity scale consisted of 35 items. Exploratory factor analysis divided the items into six common factors, including role identity, role expectation, current situation of blood collection and supply, role conflict, external reward and blood donation experience. The α of scale was 0.840. Conclusion The reliability and validity of the scale meet the basic measurement requirements, and the framework of the blood donor role scale is basically formed. It can be used as one of the means to explore the ways and mechanisms of the role identity of blood donors in blood donation behavior.

Objective: To develop an indigenous Caregiver Social Isolation Scale (CSIS) in Urdu for caregivers of mental and physical disorders in Pakistan. Study Design: Mixed method study. Place and Duration of Study: Department of Psychology, University of Gujrat, Pakistan, from Jan to Jun 2021. Methodology: An item pool of 48 was generated based on a thematic analysis of structured interviews with six experts and nine caregivers. The content validity was evaluated by three PhDs in Psychology and two Physicians. The reliability calculated on thirty participants for a tryout was 0.95. Item total correlation of item tool was in the acceptable range. A pilot study was done on three hundred individuals. The value of the KMO was 0.952, which showed the adequacy of the data, with the value of Bartlett’s test significant. No item was deducted. The reliability of 48 items on 300 individuals was 0.976, with two factors. First, for the validity of CSIS, data was collected from 120 individuals with standardized Ryff’s psychological well-being scale, Scale of Social Support and Delong Loneliness Scale. Second, confirmatory factor analysis was conducted on 200 caregivers of children with cleft lip and palate. Results: Exploratory factor analysis yielded two factors, mental agony and lack of social cohesion, with 48 items. Model fit indices of CFA on caregivers...... Conclusion: CSIS is a reliable and valid scale for assessing the social isolation experiences of caregivers of either mental or physical diseases in Urdu. Keywords: Cleft lip, Cleft palate, Caregiver social isolation scale, Exploratory factor analysis.

Objective: To develop a reliable scale to measure stress among parents with only daughters. Study Design: Cross-sectional study. Place and Duration of Study: Department of Psychology, University of Gujrat, Gujrat Pakistan, from May to Jul 2019. Methodology: The study was conducted on parents who have only daughters. A pool of 59 items was created through brainstorming sessions and an intensive literature review. Afterwards, 42 items were retained through meticulous evaluation and assessment of experts. Subsequently, a scale was administered to 242 respondents who were selected through a purposive sampling technique. All the items were retained because of their high correlation with item total (r≥0.5). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) proceeded for structure exploration and confirmation. Furthermore, the reliability of the scale was established. Results: EFA led to five factors encompassing 36 items. Moreover, CFA was carried out, and the model fit summary showed some indices in good ranges (RFI=0.923, NFI=0.940, GFI=0.928) while some in excellent ranges (CFI=0.970, IFI= 0.971, TLI=0.962) after the deletion of 22 items with significance p-value (0.001). The reliability of the scale was 0.93, while the reliability of the subscale ranges from 0.81 to 0.88. Conclusion: A reliable scale to measure Stress among parents having only daughters was successfully developed with 14 items casing four subscales.

Aim. With the advent of an aging society and the development of end-of-life care, there is an increasing need to understand the older generation’s attitude toward end-of-life resuscitation. The study aimed to develop and validate a novel attitude scale toward end-of-life resuscitation in older inpatients. Method. Instrumental development and a psychometric evaluation were used. First, a new attitude scale toward end-of-life resuscitation was formulated from literature views, expert content validity, and face validity. Next, the new scale was evaluated using a principal component analysis and internal consistency reliability in a sample from 106 medical–surgical inpatients in a southern Taiwan hospital 1 enrolled through convenience sampling. Serving as an indicator of concurrent validity, a logistic regression analysis was performed to analyze the association between scores on the scale and intention to discuss end-of-life CPR issues. Results: After being validated by the expert content validity and face validity, a draft of a 20-item scale was created. Throughout the exploratory factor analysis, two items with low factor loadings were removed from the draft scale and an 18-item scale of attitude was generated. This 18-item scale had a three-factor structure that accounted for 64.1% of the total variance; the three components were named ‘stress, avoidance, and ignorance’, ‘a peaceful death’, and ‘self-determination and ambivalence’. The Cronbach’s alpha of the total scale and three components were 0.845, 0.885, 0.879, and 0.857, respectively, which indicated a favorable reliability. Scores on the scale were significantly associated with the intention to discuss end-of-life CPR issues, which also indicated a favorable concurrent validity. Conclusions: A 18-item attitude scale with three factors is a valid scale to measure the attitude toward end-of-life resuscitation. The result provides preliminary evidence of the psychometric properties of the scale. Further research with larger samples or other populations is required.

Purpose: Shortage and maldistribution of medical specialists hamper healthcare quality. The specialist career choices of house officers determines the future composition of healthcare systems. We studied house officers" specialist career choices and motivators for their choice. Participants and methods: We conducted online in-depth interviews among seven house officers using an interview guide developed based on a literature review. The transcripts were analyzed. Major themes were identified. A 33-item questionnaire was developed, and the main and sub-themes were identified as motivators for specialist career choice. An online survey was done among 185 house officers. Content validation of motivators for specialist choice was done using exploratory factor analysis. First, second and third choices for a specialist career were identified. Multinomial logistic regression analyses were done to determine the socio-demographic factors and motivators associated with the first choice. Results: HOs perceived that specialist training opportunities provide a wide range of clinical competencies through well-structured, comprehensive training programs under existing specialist training pathways. Main challenges were limited local specialist training opportunities and hurdles for 'on-contract' HO to pursue specialist training. Motivators for first-choice specialty were related to 'work schedule', 'patient care characteristics', 'specialty characteristics', 'personal factors', 'past work experience', 'training factors', and 'career prospects.' House officers' first choices were specialties related to medicine (40.5%), surgery (31.5%), primary care (14.6%), and acute care (13.5%). On multivariate analysis, "younger age", "health professional in the family", "work schedule and personal factors", "career prospects" and "specialty characteristics" were associated with the first choice. Conclusions: Medical and surgical disciplines were the most preferred disciplines and their motivators varied by individual discipline. Overall work experiences and career prospects were the most important motivators for the first-choice specialty. The information about motivational factors is helpful to develop policies to encourage more doctors to choose specialties with a shortage of doctors and to provide career specialty guidance. [ABSTRACT FROM AUTHOR]

(1) Background: In response to the impact of religious intervention on health outcomes and the importance of documenting how nurses experience the spiritual need of 392 hospitalized patients, it is vital to provide the nursing profession with instruments to evaluate these spiritual aspects. This study describes the development and validation of the Nursing Care and Religious Diversity Scale (NCRDS); (2) Methods: A two-step design was used for NCRDS translation and psychometric validation. The tool design was developed in the first step, while the psychometric characteristics were tested in the second step. An inductive study was conducted to test the validity and reliability of the NCRDS tool. The overall sample consisted of 317 nurses; (3) Results: The final instrument comprised 25 items in five dimensions. The construct validity indicated five dimensions. The face and content validity were adequate. Test-retest reliability displayed good stability, and internal consistency (Cronbach’s α) was acceptable (0.83); (4) Conclusions: Initial testing of the NCRDS suggested that it is a valid and reliable instrument to evaluate individuals in religious diversity, with five dimensions for evaluating the meaning of spirituality and individual belief, the religious healthcare environment, educational adequacy, spiritual and religious needs, and religious plurality.

Abstract Background Despite multi-professional collaboration via consultation being increasingly important given the variety of disease diagnoses and treatment, the key elements as consultants remain unclear. The study aimed to identify the skills and attitudes that are important for consultants from the residents’ perspective so that they can be targeted as priority goals in subsequent educational interventions. Methods We conducted our research in two phases: a preliminary survey (May 1 to 14, 2020) and a main survey (June 1 to 14, 2020). As a preliminary survey, first-year postgraduate residents at St. Luke’s International Hospital in Tokyo, Japan, were first asked an open-ended question about the types of skills and attitudes that are important for consultants. After eliminating duplicate answers, there were 19 skills and attitudes in total. In the main survey with residents who completed their residency training at our institute, from 2014 to 2018 and current residents (2019–2020), we first asked them about their demographic characteristics (gender, years of postgraduate education, and type of specialty). Then, they answered how important each skill and attitude are for consultants. All 19 items were scored on a seven-point Likert scale that ranged from 0 (completely disagree) to 6 (totally agree). Cronbach’s alpha confirmed the internal consistency of the questionnaire items. Principal component analysis and exploratory factor analysis were performed. Results The survey included 107 individuals (61.1 %, 175 potential participants). The median postgraduate years of education was four (interquartile range: 2–5), and 64.5 % were men (n = 69). Seven key elements for consultants were identified and termed Willing CONSULT. These included (1) willingness (willingness to accept consultation requests), (2) contact (easy access to consultants), (3) needs (consideration of consulters’ needs), (4) suggestions and support (providing clear recommendations and suggestions, following up on the patients, and supporting the consulters continuously), (5) urgency (considering the situation’s urgency and responding appropriately), (6) learning opportunities (providing teaching points), and (7) text (writing medical records). Conclusions We propose Willing CONSULT, which are important skills and attitudes for consultants.

Midwifery empowerment is an important topic. The most widely used instrument to measure the perceived empowerment of midwives is the Perceptions of Empowerment in Midwifery Scale (PEMS), which has not been validated in Spain. The aim of this study was to translate and adapt the PEMS to the Spanish context. This research was carried out in two phases; Phase 1: Methodological study; translation, backtranslation and cross-cultural adaptation of the PEMS and pilot study on the target population (10 midwives) for evaluation of face validity. Phase 2: Cross-sectional observational study to obtain a sample for construct validation by Exploratory Factor Analysis and measurement of PEMS-e reliability. Additionally, an inferential analysis was carried out to study the possible association between several collected variables and PEMS-e subscale-scores. A total of 410 midwives from 18 Spanish regions participated in the study through an online questionnaire. An initial Spanish version of the PEMS scale was produced, demonstrating adequate face validity. A final model was produced for the PEMS-e, which included 17 items classified into two subscales (“Organizational support” and “Own skills and teamwork”) with fit indexes RMSEA = 0.062 (95%CI: 0.048–0.065) and AGFI = 0.985 (95%CI: 0.983–0.989) and Cronbach’s alpha 0.922 for the total scale. Results showed that one in four midwives had considered abandoning the profession in the last 6 months (p ≤ 0.001). This research suggests that Spanish midwives perceive their empowerment level as low. The PEMS-e is a valid tool with solid psychometric properties that can be used in future research to identify factors that contribute to increased empowerment among Spanish midwives and inform strategies to improve job satisfaction and retention in the profession.

The prevalence of eating disorders (EDs) is growing, and early screening is important to prevent related health complications. The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a diagnostic tool to identify cases of EDs; however, a validated Arabic version of the tool is needed to help in the screening process of EDs. The aim of this study was to validate the Arabic version of EDE-Q. A cross-sectional study included a sample of 549 adults, who were recruited mainly from the four major provinces in Saudi Arabia. A forward–backward translation method was conducted, and then the tool was validated using the confirmatory factor analysis (CFA). The dataset was split for further convergent analysis using exploratory factor analysis (EFA) and CFA. The results of CFA from the main dataset did not support the four-factor original EDE-Q. The results of EFA from the first data-split suggested a three-factor EDE-Q-14 Arabic version. This was supported by the results of CFA of the second data-split. A total of five items were allocated in each shape and weight concern, and restraint component, with correlations ranging from 0.969 and 0.462 and from 0.847 to 0.437, respectively. A total of four items were allocated in eating concern, with correlations ranging from 0.748 to 0.556. The internal consistency of the global and the three subscales were high, with Cronbach’s α ranging from 0.762 to 0.900. Findings of the current study suggest that the Arabic version of the EDE-Q-14 is a valid and reliable tool to screen for EDs among adults in Saudi Arabia.

OBJECTIVES: To develop and examine reliability of dependent personality disorder scale for adults. METHODS: This cross-sectional analytical study design was used to develop a scale, which will measures dependent personality disorder. The data was collected by using purposive sampling technique from different government and private colleges, universities and community of Sialkot. A total of 140 participants, between 19-75 years were enrolled in this study. The item pool of 134 items was generated from literature reviews and people’s opinions. Among the 125 items retained by experts, and after a pilot study only 36 statements were retained. The data was analyzed by using exploratory factor analysis, confirmatory factor analysis and reliability. RESULTS: The final administration of 36 items was handed over to 180 participants. The model fit showed a P-value of

Objective: To develop a scale and establish psychometric properties to measure Adverse Childhood Experiences of Adolescents in Urdu language. Study Design: Cross sectional analytical study. Place and Duration of Study: Department of Psychology, University of Gujrat, from Dec 2019 to Oct 2020. Methodology: After the approval of proposal initial item pool of 145 items was generated with the help of DSM-5, extensive literature review and focus group interviews (Girls=25, Boys=25). Expert evaluation shortens it into 137 items whereas pilot study retained 132 items for final administration. Data was obtained from 1331 adolescents with age range of 12-19 from educational institutions and community in district Gujrat. Exploratory Factor Analysis, Confirmatory Factor Analysis and reliability analysis were carried out to analyze the data. Results: Exploratory factor analysis explored 38 reliable items for Adverse Childhood Experiences scale under four sub factors; Sexual Abuse, Neglect, Physical Abuse, and Psychological Abuse whereas 12 items were confirmed for final scale through model fit (p-value=0.000, CFI=0.968, GFI=0.975, AGFI=0.959, RMSEA=0.049) of Confirmatory Factor Analysis. Conclusion: A scale to estimate Adverse Childhood Experiences of adolescents in Urdu language is competently developed and established with 12 questions and four sub-scales.

This study seeks to verify the psychometric properties of the Major Depression Inventory (MDI) in a sample of Colombian university students, including a new item, due to the need to adapt and validate instruments for this population. 341 Medicine and Health Promotion students with ages between 18 to 38 years participated (M = 21.3; SD = 3.04; 65.7% women). Evidence of content validity was found by expert judgment and pilot test, that of construct validity with exploratory and confirmatory factor analysis, and that of compared validity with the Positive and Negative Suicidal Ideation (PANSI) test. The psychometric quality of the test was confirmed, including one more item to update its unifactorial structure in coherence with the DSM-5. [ABSTRACT FROM AUTHOR]

BACKGROUND: The original structure of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been contested in several languages. OBJECTIVE: To assess the structural validity of the Brazilian version of WOMAC among patients with knee osteoarthritis. DESIGN AND SETTING: Structural validity study conducted at physiotherapy clinics and primary healthcare units. METHODS: The study included males and females aged 40 to 80 years who were all native Brazilian Portuguese speakers, with knee pain in the previous six months and a diagnosis of knee osteoarthritis. We used exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) with implementation of a polychoric matrix and the robust diagonally weighted least squares (RDWLS) extraction method. The adequacy of the model was assessed using the following fit indices: root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean square residual (SRMR) and chi-square/degree of freedom (DF). RESULTS: 203 patients with knee osteoarthritis were included. The model proposed in this study with two factors, i.e. “pain” (items 1, 2, 3 and 4) and “physical function” (items 10, 11, 16, 17, 18, 19, 21 and 22), showed adequate fit indices in CFA: chi-square/DF = 1.30; CFI = 0.976; TLI = 0.970; RMSEA = 0.039; and SRMR = 0.070. The factorial loads ranged from 0.68 to 0.76 for the “pain” domain and 0.44 to 0.62 for the “physical function” domain. CONCLUSION: The Brazilian version of WOMAC with two domains, i.e. “pain” (four items) and “physical function” (eight items), presents the best structure.

Objective (s): The basic health services package is the minimum set of essential health services that all people should have access to it, but there is no consensus on the services included in a package or the services to be included. The aim of this study was to identify the dimensions and components for designing a basic package in Iran. Methods: This was a mixed method study. In qualitative phase 25 in-depth individual interviews were conducted with experts from the Ministry of Health, incurrence organization and the Planning and Budget Organization, and the data were analyzed using content analysis method. In the quantitative phase 285 managers and faculty members were selected from the Ministry of Health, insurance organizations, and 12 universities of medical sciences. Data were collected using a two-part questionnaire, including demographic characteristics and evaluation of 58 criteria, and analyzed using SPSS.23 and Smart-pls.3.2.8 software for exploratory and confirmatory factor analyses. Results: 8 Dimensions of community health priority, structure and potential capacity of service delivery system, peoplechr('39')s demands, cost effectiveness, benefits, funding, social acceptance of service, and governance obligations and requirements for designing a basic health services package were identified, of which 57 components were classified under these eight factors. According to the goodness of fit index in factor analysis, the overall performance of the model was strong (GOF = 0.8). Conclusion: It is important to design a basic health service package. The basic health services package needs to be comprehensive and accessible so that all individuals are willing and satisfied to use the services.

Objectives: Parenting is a difficult task. Factors like social support, sense of coherence, self-esteem, hardiness, optimism, internal locus of control, and religious coping play a vital role in this area. This study aimed to develop a religious coping measure for parents of differently-abled children. It also aimed to explore the factor structure and reliability of a religious coping scale. Methods: Two hundred parents of differently-abled children completed the research measure. The mean age and standard deviation of the parents were 40.04 and 5.31 years, respectively. Exploratory factor analysis was employed to identify the potential factor structure of the religious coping scale. Results: The findings of this study demonstrated that the religious coping scale had 5 factors comprising “divinely seeking”, “coping attitude”, “religious faith”, “sense of possibility”, and “spiritual and social support”. Discussion: The study showed that the scale had good internal consistency, factorial, and content validity. Furthermore, a significant positive association was found between the dimensions of the religious coping scale. The results suggest that this scale is a reliable and valid tool for measuring religious coping among parents of differently-abled children.

Background and Aim: Coping with stress is one of the most important research areas in health psychology. Researching in this regard requires a tool with strong psychometric properties and validation in Iranian culture. The purpose of this study was to investigate the most commonly used short-scale factor structure, the Carver’s Brief Cope. Methods & Materials: This study was a cross-sectional and methodological study of test type. The statistical population consisted of all students studying at Birjand University in 1977-98. Sampling was available by the method. The condition for entry into the study was the experience of a stressor for at least 6 months. After receiving a medium or high score on the perceived stress level, 629 students completed the 28-question form. Data was analyzed using SPSS V. 15 and laser software V. 8.8. Exploratory factor analysis was performed to determine the factor structure of the questionnaire. A confirmatory factor analysis was used to confirming the factors. Reliability was established through retesting and internal consistency. Ethical Considerations: This study is part of a PhD. thesis, registered (Code: IR.UM.REC. 3/50099) at Ferdowsi University of Mashhad. Before entering the study, an informed consent was obtained from the subjects. Results: After confirming the face and content validity quantitatively and qualitatively, the exploratory factor analysis results after varimax rotation showed 55.139% of the total variance explained by the first eight factors with a higher than one specific value. However, in confirmatory factor analysis, the first two factors, 4 and 7, were omitted due to insufficient power to explain the present variables. Finally, the goodness-of-fit indices of the RMFIA, PFI, GFI, IFI, IFI, CFI, AGFI confirmed the fit of the six-factor structure with the data. Reliability of the instrument was also confirmed by internal consistency (α=0.73) and test-retest reliability (r=0.59). Conclusion: The highly abbreviated 6-item form of Carver’s Brief Cope showed good validity and reliability in the student sample and can be used in health psychology studies.

Objective: To revise the psychological well-being scale for cancer patients and development of psychometric properties of revised measure. Study Design: Cross-sectional study. Place and Duration of Study: Study was carried out at department of Psychology, University of Gujrat, Pakistan over duration of seven months started from Aug 2017 to Feb 2018. Data collected from three different cancer hospitals of Lahore including Shaukat Khanum Memorial Cancer Hospital and Research Centre and Mayo Hospital Oncology department and Institute of Nuclear Medicine & Oncology. Total 255 cancer patients were included in this phase. Methodology: Sample was selected through the purposive non-probability sampling. Initially, 53 items scale in Urdu language was qualitatively evaluated by 7 subject experts that turned into 51 items after evaluation. Amended scale of 51 items administered on targeted population. Data was analyzed through the descriptive and inferential statistics. Item total correlation method was used to figure out the most correlated items with the following administration of exploratory factor analysis. Scale reliability was explored through Alpha Reliability measure and through the Split half Reliability. Results: Exploratory factor analysis was carried out for structure detection and data reduction and resulted in to 37 items with four subscales (Familial Support, Feeling of Worry, Cognitive Functioning, and Learned Helplessness). Further item-total correlation was computed to figure out the internal consistency of scale. Alpha reliability coefficient and split half reliability was 0.90 and 0.70 respectively. Conclusion: After revision, 53 items psychological wellbeing scale turned into 37 items scale with categorization of mild, moderate and severe level of psychological wellbeing in cancer patients.

The present study explored whether motivational constructs for diet and physical activity (PA) cluster and how these motivational constructs relate to dietary and PA behaviour. Data of 1142 participants were used from a randomised controlled trial examining the effects of a web-based diet and PA promotion intervention based on self-determination theory and motivational interviewing. Motivation was assessed using the Treatment Self-Regulation Questionnaire and Behavioural Regulation in Exercise Questionnaire. The dietary outcomes were measured using an adapted Food Frequency Questionnaire. PA was assessed using the Short QUestionnaire to ASsess Health. Spearman rank-order correlations showed large correlation coefficients (rs ≥ 0⋅63) between similar motivational constructs between the two lifestyle domains, except for intrinsic motivation where a medium correlation coefficient was found (rs = 0⋅41). Furthermore, the exploratory factor analysis illustrated that more self-determined forms of motivation seem to be more domain-specific. In contrast, non-self-determined forms of motivation seem to be domain-independent. Last, regression analyses demonstrated that intrinsic motivation towards PA was the only motivational construct significantly positively associated with all PA sub-behaviours (standardised regression coefficients ranging from 0⋅17 to 0⋅28, all P < 0⋅0125). Intrinsic motivation to eat healthily was significantly positively associated with fruits, vegetables and fish intake (standardised regression coefficients ranging from 0⋅11 to 0⋅16, all P < 0⋅0125), but not with unhealthy snacks. Insight of this exploratory study is useful for understanding the interrelationships of motivational induced behaviours, the development of interventions targeting multiple behaviours, and the construction of questionnaires.

Objective (s): Motorcyclists are vulnerable to traffic accidents. The purpose of this research was to evaluate the psychometric properties of the Persian version of Brief Scale of Unsafe Behaviors of motorcyclists. Methods: This was a cross sectional study of 110 motorcyclists referred to the Persian Gulf clearance headquarters Tehran, Iran in year 2017. Demographics and Persian version of the motorcycle unsafe behavior data was used from Zamani F., et al. studies. The exploratory factor analysis and Cronbachchr('39')s alpha coefficient were used to assess the validity and reliability using SPSS 25 software. Results: The result of KMO test after deleting 4 out of 11 questions indicated the adequacy of sample size (0.824). The results of Bartlettchr('39')s test of sphericity showed that the data were appropriate (p

There are few tools to ascertain self-efficacy, which is a valuable component of nursing skills. This study has tested the psychometric properties of an Albanian translation of the Nursing Profession Self-Efficacy Scale (NPSES), which is based on Bandura’s theory of social cognition. Data were collected using questionnaires which were filled out by 423 nurses from the twelve provinces of the Albanian health system. The scale’s content, face, and construct validity were evaluated. Reliability was verified using Cronbach’s α and test–retest and by calculating the intraclass correlation coefficients. The original NPSES has two factors; for the A-NPSES analyzed in this study, four factors emerged from the factorial analysis of our reference sample: nursing care procedure situation, nursing research situation, nursing ethics situation, and nursing practice situation. Cronbach’s α was 0.91, indicating that the tool is reliable. The results of this study demonstrate the validity and reliability of the Albanian version of the NPSES. This scale is a valuable tool for self-assessing nurses’ self-efficacy. An adequate scale for measuring nurses’ self-efficacy can be used to improve the quality of clinical nursing care.

Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.

Abstract Objectives This paper describes the development and translation of a questionnaire purported to measure (1) the perception of the placement strategy of automated external defibrillator, (2) the perception on the importance of bystander cardiopulmonary resuscitation and automated external defibrillator (3) the perception on the confidence and willingness to apply these two lifesaving interventions as well as (4) the fears and concerns in applying these two interventions. For construct validation, exploratory factor analysis was performed using principal axis factoring and promax oblique rotation and confirmatory factor analysis performed using partial least square. Results Five factors with eigenvalue > 1 were identified. Pattern matrix analysis showed that all items were loaded into the factors with factor loading > 0.4. One item was subsequently removed as Cronbach’s alpha > 0.9 which indicates redundancy. Confirmatory factor analysis demonstrated acceptable factor loadings except for one item which was subsequently removed. Internal consistency and discriminant validity was deemed acceptable with no significant cross-loading.

AbstractIntroduction:There is a clear need to educate and train the clinical research workforce to conduct scientifically sound clinical research. Meeting this need requires the creation of tools to assess both an individual’s preparedness to function efficiently in the clinical research enterprise and tools to evaluate the quality and effectiveness of programs that are designed to educate and train clinical research professionals. Here we report the development and validation of a competency self-assessment entitled the Competency Index for Clinical Research Professionals, version II (CICRP-II).Methods:CICRP-II was developed using data collected from clinical research coordinators (CRCs) participating in the “Development, Implementation and Assessment of Novel Training In Domain-Based Competencies” (DIAMOND) project at four clinical and translational science award (CTSA) hubs and partnering institutions.Results:An exploratory factor analysis (EFA) identified a two-factor structure: the first factor measures self-reported competence to perform Routine clinical research functions (e.g., good clinical practice regulations (GCPs)), while the second factor measures competence to perform Advanced clinical functions (e.g., global regulatory affairs). We demonstrate the between groups validity by comparing CRCs working in different research settings.Discussion:The excellent psychometric properties of CICRP-II and its ability to distinguish between experienced CRCs at research-intensive CTSA hubs and CRCs working in less-intensive community-based sites coupled with the simplicity of alternative methods for scoring respondents make it a valuable tool for gauging an individual’s perceived preparedness to function in the role of CRC as well as an equally valuable tool to evaluate the value and effectiveness of clinical research education and training programs.

Background and purpose: Stressful life events can lead to psychological problems, heart disease, stroke, etc. Multidimensional nature of stress calls for advanced statistical methods that could evaluate these dimensions based on symptoms of stress. Therefore, current study aimed at identifying and redefining the dimensions of the stressful life events (SLE) questionnaire using a higher order factor model. Materials and methods: This cross-sectional study was done in 4763 people participating in a project called SEPAHAN in Isfahan, Iran 2010. The perceived stress level was evaluated by the Iranian version of SLE questionnaire. First and second order exploratory and confirmatory factor models were applied for data analysis using AMOS V20. Results: According to exploratory factor analysis, 11 domains of stress (first order factors) were extracted from 44 items, which explained 51.42% of the total variance. Based on these domains, two dimensions were identified as second-order factors (stressors), including individual and social stressors that explained 17.3% and 25.6% of total variance, respectively. The similar structure was identified both in total sample and in men and women separately. Also, the results in exploratory factor analysis were confirmed by confirmatory factor analysis (CFI =0.78, GFI =0.89, RMSEA =0.05). It was found that the second-order factor model well fitted to the dimensions of the questionnaire identified. Conclusion: SLE questionaire has11 domains and two higher dimensions (individual and social stressors). Studying the types of stressors could be used in preventive strategies against mental health problems and also in training useful copying styles.

Introduction: The demanding nature of medical and health sciences studies can cause stress among students in these disciplines affecting their wellbeing and academic performance. The Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress among medical students and healthcare professionals that has not yet been validated among medical and health sciences students in Hong Kong. The aim of this study is to establish the construct validity and reliability of the PSS-10 in this context. Methods: 267 final year medical and health sciences students were surveyed using the PSS-10. The data were analysed using exploratory factor analysis for construct validity and Cronbach's alpha coefficient and corrected item-total correlations for reliability. Results: Exploratory factor analysis revealed a two-factor structure for PSS-10, with Cronbach's alpha of 0.865 and 0.796, indicating good internal consistency. Corrected item-total correlations showed satisfactory correlation ranged from 0.539 to 0.748 for all items and their respective subscale. Both tests supported PSS-10 as a two-factor scale. Conclusion: The PSS-10 is a valid measure for assessing perceived stress in Hong Kong medical and health sciences students. [ABSTRACT FROM AUTHOR]

Background: It is unlikely that applications of artificial intelligence (AI) will completely replace physicians. However, it is very likely that AI applications will acquire many of their roles and generate new tasks in medical care. To be ready for new roles and tasks, medical students and physicians will need to understand the fundamentals of AI and data science, mathematical concepts, and related ethical and medico-legal issues in addition with the standard medical principles. Nevertheless, there is no valid and reliable instrument available in the literature to measure medical AI readiness. In this study, we have described the development of a valid and reliable psychometric measurement tool for the assessment of the perceived readiness of medical students on AI technologies and its applications in medicine. Methods: To define medical students' required competencies on AI, a diverse set of experts' opinions were obtained by a qualitative method and were used as a theoretical framework, while creating the item pool of the scale. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were applied. Results: A total of 568 medical students during the EFA phase and 329 medical students during the CFA phase, enrolled in two different public universities in Turkey participated in this study. The initial 27-items finalized with a 22-items scale in a four-factor structure (cognition, ability, vision, and ethics), which explains 50.9% cumulative variance that resulted from the EFA. Cronbach's alpha reliability coefficient was 0.87. CFA indicated appropriate fit of the four-factor model (χ2/df = 3.81, RMSEA = 0.094, SRMR = 0.057, CFI = 0.938, and NNFI (TLI) = 0.928). These values showed that the four-factor model has construct validity. Conclusions: The newly developed Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) was found to be valid and reliable tool for evaluation and monitoring of perceived readiness levels of medical students on AI technologies and applications. Medical schools may follow 'a physician training perspective that is compatible with AI in medicine' to their curricula by using MAIRS-MS. This scale could be benefitted by medical and health science education institutions as a valuable curriculum development tool with its learner needs assessment and participants' end-course perceived readiness opportunities. [ABSTRACT FROM AUTHOR]

Introduction: The methodological tutor is conceived as a person with research experience, contribution of constructive ideas, knowledge and inclined to collaborate with other people. He or she should facilitate the carrying out of relevant research, of high academic level and social commitment, without losing sight of interpersonal relationships in various settings and contexts. Having an instrument that allows evaluating the perception of methodological tutoring can benefit not only tutors in the objective evaluation of their work, but also education coordinators to identify areas of opportunity to strengthen this process. The purpose of this research is to determine the validity and reliability of the questionnaire to assess the perception of methodological tutoring in Medical Specialization courses. Method: A quantitative study with an analytical cross-sectional design was carried out at the Center for Educational Research and Teacher Training of the Instituto Mexicano del Seguro Social, Guanajuato Delegation. For content validity, five experts participated. For the pilot test, a nonprobabilistic sample of 94 resident physicians who were in the last year of the medical specialty and who had their research project concluded and registered were selected. The content validity was determined qualitatively by expert round and quantitatively, using the Lowshe index. Construct validity was performed using exploratory factor analysis (EFA) and reliability, with the Cronbach's Alpha coefficient. The research is attached to the ethical principles established in the General Health Law and its regulations, as well as in the Declaration of Helsinki in its latest revision. It was registered in the IMSS Local Research Committee 1008. Results: The content validity was determined by expert judgment, considering that the questionnaire is clear, sufficient, coherent and relevant. Likewise, a Lowshe Index of 0.99 was obtained. Cronbach's alpha coefficient was 0.97 overall (0.92 for personal and socio-emotional competencies and 0.96 for competencies to socialize and facilitate the research process). The EFA allowed the identification of a two-factor structure (with a KMO sample size adequacy measure of 0.876, a significant Bartlet sphericity test [p = 0.001] and a correlation between variables > 0.6). The questionnaire was made up of 21 items, with two factors: Personal and socio-emotional skills of the tutor and skills to socialize and facilitate the research process, with 6 and 15 items respectively. The competences for tutoring were grouped into two dimensions that explained 76.78% of the variance. Discussion or Conclusion: The psychometric of the questionnaire is adequate, so, it has content and construct validity, and internal consistency, which makes it possible to evaluate the perception of methodological tutoring. [ABSTRACT FROM AUTHOR]

Aim of the study: Identification of factors which determine effective communication between a doctor and a patient. Development of a tool for the evaluation of doctors’ skills of breaking bad news to patients’ relatives. Material and methods: The study was conducted with the survey method, and covered a group of 94 doctors of medicine from three hospitals in the Małopolska region in Poland. The Breaking Bad News Skills questionnaire, developed by Wioletta Szwed-Łopata and Jakub Lickiewicz, describes a doctor’s behaviour in contact with a patient’s family. Results: Exploratory factor analysis was conducted to establish the factor structure of Breaking Bad News Skills questionnaire. The scree plot was used prior to determining the number of factors. Internal consistency was evaluated with Kaiser–Meyer–Olkin (KMO) measure, which should be above 0.6, and Bartlett’s test of sphericity. The factor analysis identified five factors referring to the most characteristic types of doctors’ behaviour. These are: Communication (COM), Emotional Barriers (EMO), Partnership (PAR), Support (SUP) as well as Empathy and Compassion (EMP). The first of the constructed factors (8 items) focuses on statements concerning a doctor’s communication with a patient (COM), while the second factor (8 items) pertains to statements connected with the emotional context of breaking bad news by the physician (EMO). Next factor (5 items) includes statements about partnership (PAR). The fourth factor (5 items) concerns the ability to build a supportive environment (SUP). The last factor (8 items) comprises statements concerning partnership, refers to building a supportive environment and the doctor’ s empathy and compassion (SUP). Conclusions: Results of the Breaking Bad News Skills tool analyses indicate that it should be recommended for further scientific research and used in many areas of psychological and social practice.

Abstract Background Various individual biomarkers of inflammation and micronutrient status, often correlated with each other, are associated with adverse treatment outcomes in human immunodeficiency virus (HIV)-infected adults. The objective of this study was to conduct exploratory factor analysis (EFA) on multiple inflammation and micronutrient biomarkers to identify biomarker groupings (factors) and determine their association with HIV clinical treatment failure (CTF) and incident active tuberculosis (TB). Methods Within a multicountry randomized trial of antiretroviral therapy (ART) efficacy (PEARLS) among HIV-infected adults, we nested a case-control study (n = 290; 124 cases, 166 controls) to identify underlying factors, based on EFA of 23 baseline (pre-ART) biomarkers of inflammation and micronutrient status. The EFA biomarker groupings results were used in Cox proportional hazards models to study the association with CTF (primary analysis where cases were incident World Health Organization stage 3, 4 or death by 96 weeks of ART) or incident active TB (secondary analysis). Results In the primary analysis, based on eigenvalues> 1 in the EFA, three factors were extracted: (1) carotenoids), (2) other nutrients, and (3) inflammation. In multivariable-adjusted models, there was an increased hazard of CTF (adjusted hazard ratio (aHR) 1.47, 95% confidence interval (CI)1.17–1.84) per unit increase of inflammation factor score. In the secondary incident active TB case-control analysis, higher scores of the high carotenoids and low interleukin-18 factor was protective against incident active TB (aHR 0.48, 95% CI 0.26–0.87). Conclusion Factors identified through EFA were associated with adverse outcomes in HIV-infected individuals. Strategies focused on reducing adverse HIV outcomes through therapeutic interventions that target the underlying factor (e.g., inflammation) rather than focusing on an individual observed biomarker might be more effective and warrant further investigation.

Abstract Objective The present study was aimed at assessing the validity and the reliability of the Sinhala version of the Utrecht Work Engagement Scale-Student Version (UWES-S) among collegiate cycle students in Sri Lanka. Results The 17-item UWES-S was translated to Sinhala and the judgmental validity was assessed by a multi-disciplinary panel of experts. Construct validity of the UWES-S was appraised by using multi-trait scaling analysis and exploratory factor analysis (EFA) on data obtained from a sample of 194 grade thirteen students in the Kurunegala district, Sri Lanka. Reliability of the UWES-S was assessed by using internal consistency and test–retest reliability. Except for item 13, all other items showed good psychometric properties in judgemental validity, item-convergent validity and item-discriminant validity. EFA using principal component analysis with Oblimin rotation, suggested a three-factor solution (including vigor, dedication and absorption subscales) explaining 65.4% of the total variance for the 16-item UWES-S (with item 13 deleted). All three subscales show high internal consistency with Cronbach’s α coefficient values of 0.867, 0.819, and 0.903 and test–retest reliability was high (p

Introduction: The Uniformed Services University of the Health Sciences coordinates a 2-week Summer Operational Experience (SOE) during the first year of medical school. The SOE aims to provide students with operational context and enhance familiarity with service-specific operational environments, the services' medical department capabilities, and/or general warfighter skills. One overarching goal of the SOE is to provide an experience that may motivate students to pursue an operational medicine assignment at some point in their military career. However, to date, little evaluation data have been collected regarding the effectiveness of the SOE in encouraging medical students to pursue operational medicine assignments. The purpose of this project was to develop and collect initial validity evidence for a survey instrument designed to assess various aspects of students' attitudes and behavioral intentions to pursue an operational medicine assignment at some point in their military career.Materials and Methods: Using the theory of planned behavior as a framework, we developed a survey that focused on three distinct constructs: attitude, subjective norms, and perceived behavioral control. We followed a systematic, seven-step design process to develop the survey and collect initial validity evidence. Students completed the 20-item survey prior to their operational experience to evaluate their intentions to pursue an operational medicine assignment at some point in their military career. An exploratory factor analysis (EFA) and reliability analysis were performed to examine the internal structure of the instrument. In addition, bivariate correlation and multiple linear regression analyses were used to explore the relationships between the identified factors and students' intentions to pursue operational medicine.Results: Results from the expert reviews and cognitive interviews suggested the instrument was clear and interpretable. We then invited the entire class of 2020 who participated in the SOE (149 students) to take the survey; in total, 122 students (response rate = 82%) completed the entire survey. Findings from the EFA suggested four underlying factors with satisfactory internal consistency reliability, and the regression analysis revealed that three factors statistically significantly predicted students' intentions to pursue operational medicine: Attitude: Personal Growth (b = 0.67, β = 0.42, P < 0.001); Behavioral Control (b = 0.20, β = 0.15, P < 0.05); and Attitude: Career Progression (b = 0.36, β = 0.30, P < 0.001). The factor related to student's perception of the importance that others placed on an operational medicine assignment was not a statistically significant predictor of intention.Conclusions: Findings from this study suggest the developed survey yields scores that can reliably assess students' attitudes, subjective norms, perceived behavioral control, and intentions to pursue operational medicine. Using this survey, course leaders have a tool for evaluating the success of the SOE and identifying potential areas for improvement within the curriculum. More broadly, other educators can use the theoretical framework and instrument design process described here to evaluate students' behavioral intentions in their own contexts. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop the Medical Ethics Assessment Scale for Sports (MEASS) and to asses the vison of amateur level competitor athletes, using this scale, about level of compliance with professional ethical principles of their health professionals and the sports medicine organisations with which they come in contact. The study was conducted on 400 participants (nfemale =145; nmale =255) aged 16-35 from different sports. MEASS was constructed with 13 items and three factors: 'Not harming the patient's body', 'Informing the patient', and 'Maintaining patient's privacy and right to choose care'. The validity value was found to be 0.795. The exploratory factor analysis showed all three factors had eigenvalues greater than 1.0 (55.7% variance). Cronbach's Alpha reliability (α) correlation coefficient was 0.725. These results showed that the scale is suitable for factor analysis and reliable. The MEASS can be used as a new measurement tool to evaluate the ethics of health professionals and organisations. The results also demonstrated that athletes feel well-informed and unharmed by their physicians, but would prefer more control over their care choices and how their personal information is used. [ABSTRACT FROM AUTHOR]

Aim: In the past few years, the concept of self-efficacy in children with epilepsy has become increasingly important. This study aimed to analyze the psychometric aspects of the Turkish version of the Seizure Self-Efficacy Scale for Children. Materials and Methods: This is a cross-sectional survey. The study data were collected using the Seizure Self-Efficacy Scale for Children and Child Introduction Form. The study sample included 166 children who were between 9 and 17 years of age. The authors assessed the reliability and construct validity of the study data using exploratory and confirmatory factor analyses (CFA). Results: The original model was not confirmed by the CFA. The analysis tool included 15 items in two factors. Reliability analysis showed that the two factors were acceptable and valid. The tool was valid and reliable for measuring the self-efficacy of epileptic children. The factor structure was derived from and confirmed by the original tool. It was found that the Turkish version of the modified Seizure Self-Efficacy Scale for Children had excellent satisfactory psychometric aspects for a Turkish population. Conclusion: Health professionals can present a more effective drug process and nursing care by identifying and assessing seizure self-efficacy levels in children with epilepsy, and they can make a positive contribution to disease management and the way the child deals with the disease.

Background: There has been no a specific scale to measure quality of life (QOL) for prostate cancer patients receiving androgen deprivation therapy (ADT) to date. This study aimed to develop and initially validate the scale to evaluate QOL for prostate cancer patients receiving ADT. Methods: The scale was developed following international recommendations. Moreover, the items were all generated through literature review and referenced questionnaires. After being reviewed by expert panelists, the revised scale was formed and then completed by a convenience sample of 200 prostate cancer patients from our hospital. Explore factor analysis (EFA) was applied to test the construct validity, then split-half reliability, Cronbach's alpha, and test-retest reliability were applied to assess the reliability and stability of the scale. Results: The revised scale contained 22 items and a total of 200 participants had completed the scale. One hundred participants were randomly selected from the total 200 participants to perform EFA with varimax rotation on the revised scale, and “hot flashes” item was deleted for low factor loading. We selected only 3 items from each factor, then, the final scale was formed with 18-items. We selected another 100 participants to perform the EFA again on the final scale. It was demonstrated that the structure with 6 factors explained 72.5% of total variance and factor loading value was above 0.40 in all items of the factors. Moreover, the split-half reliability coefficient, Cronbach's alpha, and test-retest reliability coefficient were calculated to be 0.74, 0.63, and 0.89, respectively, exhibiting good reliability on the whole. Conclusions: The scale was identified to be a valid and reliable instrument to measure QOL for prostate cancer patients receiving ADT. Moreover, further research is needed to overcome the potential drawbacks.