Development and Psychometric Testing of the Existential Distress Scale for Palliative Care Cancer Patients.

OBJECTIVE: Existential distress is a common phenomenon in palliative care cancer patients. Developing a reliable and easy-to-use assessment scale for existential distress of palliative care cancer patients is crucial. The aim of this study was to develop a measurement of existential distress for palliative care cancer patients and test its properties. METHODS: The guidelines for developing a scale proposed by DeVellis were followed. Palliative care cancer patients were invited to test the draft scale. Two-hundred and nineteen valid questionnaires were included for the item analysis and exploratory factor analysis. Three-hundred and two valid questionnaires were included for confirmatory factor, convergent validity, discriminant validity, and internal consistency reliability analyses. Twenty repeated data were measured for test-retest reliability analysis. RESULTS: The Existential Distress Scale for Palliative Care Cancer Patients was developed with nine items and three dimensions, including meaninglessness, alienation, and death anxiety. The confirmatory factor analysis showed that the developed scale had a stable factor structure. The Cronbach's α for the whole scale was 0.81, and that for each dimension was 0.76, 0.67, and 0.70, respectively. The test-retest reliability of the scale was 0.79, and that of each dimension was 0.58-0.64. CONCLUSIONS: The Existential Distress Scale for Palliative Care Cancer Patients is a simple but reliable and valid tool.

Psychometric Testing of an Arabic Version of the Attitude Toward Skin-to-Skin Contact Instrument among Women in Saudi Arabia: A Cross-Cultural Validation Study.

BACKGROUND/OBJECTIVES: The World Health Organization recommends skin-to-skin contact immediately after birth, yet the practice rate remains low in Saudi Arabia, impacting the health and well-being of mother-baby dyads. No previous studies have explored Saudi women's attitudes toward skin-to-skin contact, a critical factor in developing strategies to increase its adoption. This study aimed to develop and evaluate an instrument to assess attitudes toward skin-to-skin contact among women in Saudi Arabia. METHODS: An instrument was developed by modifying the validated "Mother-Newborn Skin-to-Skin Contact Questionnaire". Psychometric testing was conducted to validate the instrument through a cross-cultural survey involving 383 participants recruited from two hospitals in Saudi Arabia using a convenience sampling method. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.885, indicating that the sample size was suitable for performing exploratory factor analysis. RESULTS: The overall Cronbach's alpha value was 0.85, reflecting adequate internal consistency of the questionnaire. The criteria of the two-factor confirmatory factor analysis were also met. The majority of women (85.6%) demonstrated a positive attitude towards skin-to-skin contact. A positive correlation was observed between higher educational levels and the total attitude score (r = 0.161, p = 0.002). CONCLUSIONS: The developed questionnaire is a reliable tool for measuring attitudes towards skin-to-skin contact among women in Saudi Arabia. The findings highlight the importance of educational interventions to improve the uptake of this practice.

Translating and validating the gay affirmative practice scale for nurses in mainland China.

Background: The gay affirmative practice (GAP) scale is an effective tool for evaluating the beliefs and behaviors of health care professionals toward gay and lesbian clients. Aim: This study aimed to examine the reliability and validity of the GAP scale among Chinese nurses. Methods: A quantitative cross-sectional study was conducted to evaluate the Chinese version of the GAP (C-GAP) scale after translation and cross-cultural adaptation and to examine its psychometric characteristics. The reliability and validity of the C-GAP scale were determined by item analysis, factor analysis, internal consistency, test-retest reliability, and discriminant construct validity. Outcomes: The GAP scale was translated and adapted specifically for China. A total of 1440 participants completed the C-GAP scale, sociodemographic questionnaire, and Marlowe-Crowne social desirability scale. Results: The C-GAP scale exhibited a Cronbach α of 0.95, with a high test-retest reliability coefficient of 0.92. Exploratory factor analysis identified 2 factors that accounted for 59.91% of the total variance. The results of the confirmatory factor analysis were as follows: χ2/df = 1.09, goodness-of-fit index = 0.98, adjusted goodness-of-fit index = 0.97, root mean square error of approximation = 0.01, Tucker-Lewis index = 1.00, comparative fit index = 1.00, incremental fit index = 1.00, parsimony goodness-of-fit index = 0.85, and parsimony normed fit index = 0.91. These findings confirm that all goodness-of-fit indices were satisfactory. Clinical Implications: The C-GAP scale can be an effective tool for health care professionals and managers and for education and research; it can also identify the beliefs and behaviors of health care professionals toward gay and lesbian clients, facilitating cultural competence development and enhancing care quality awareness and skills. Strengths and Limitations: The C-GAP scale demonstrates reliability and validity; however, because the sample consisted only of nurses, the findings may not be generalizable to other professional groups, such as counselors and therapists. Therefore, the occupational focus of the sample limited the broader applicability of the results. Conclusion: The C-GAP scale is a reliable and valid tool suitable for assessing the practice attitudes and behaviors of Chinese nurses toward gay and lesbian clients.

Psychometric validation of the Chinese version of the longer-term Unmet Needs after Stroke monitoring tool for stroke patients.

PURPOSE: This study aimed to translate, adapt, and test the psychometric properties of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool for Chinese stroke patients. MATERIALS AND METHODS: The LUNS monitoring tool was translated and cross-culturally adapted using the Functional Assessment of Chronic Illness Therapy translation methodology and two rounds of expert consultation. A cross-sectional study was conducted to test the validity and reliability of the Chinese version of the tool from April to October 2023 in Xi'an. RESULTS: The Chinese version of the LUNS monitoring tool had a Cronbach's alpha value of 0.702 and the ICC was 0.732 (p < 0.001). The I-CVIs were above 0.90 and the S-CVI/Ave was 0.983. The factor analysis extracted eight factors, collectively accounting for 66.283% of the data variance. The correlation coefficient between the LUNS and WSO needs assessment questionnaire was 0.105 (p = 0.019). CONCLUSIONS: The study confirmed good reliability and validity of the Chinese version of the LUNS monitoring tool in measuring the prevalence and level of unmet need in stroke patients. It will help identify the unmet needs of stroke patients, and to guide rehabilitation service response during individual patient consultations, facilitate service development, and inform commissioning decisions.

StrokeStroke patients often suffer from physical, psychological and social disabilities, leading to significant challenges and a spectrum of unmet needs.Assessing patients' unmet needs is crucial for their recovery.The Chinese version of the Longer-term Unmet Needs after Stroke monitoring tool has good reliability and validity.This tool will help identify the unmet needs of stroke patients, enabling healthcare professionals to provide more tailored interventions and ultimately improve patients' recovery.

Healthcare Professionals' Knowledge, Skills, and Information Needs Pertaining to Hearing Loss and Hearing Aids in Swedish Nursing Homes: A Cross-Sectional Study and Psychometric Evaluation.

Background: Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids. Objective: The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals' self-reported knowledge, experience, skills, competence, and information needs pertaining to residents' hearing loss and hearing aids in the Swedish context. Materials and Methods: A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned. Results: An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance. Conclusion: Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.

The gaming disorder test and gaming disorder scale for adolescents: translation and validation among Vietnamese young adults.

BACKGROUND: Previous studies have shown that the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) have promising validity and reliability when assessing symptoms of gaming disorder among young adults. However, validity and reliability properties of the two scales have not been established among a Vietnamese population. OBJECTIVE: The present study translated the GDT and GADIS-A into Vietnamese and examined their factor structures, measurement invariance, convergent validity, concurrent validity, and divergent validity among university students. METHODS: A total of 610 young adults (mean age = 21.09 years; 63.4% females) were recruited using convenience sampling and who completed a paper-and-pencil survey between April and June 2023. All participants completed a demographic questionnaire, GDT, GADIS-A, and six standardized scales related to gaming disorder, social media addiction, smartphone addiction, and psychological distress. Confirmatory factor analysis (CFA), internal consistency testing, and Pearson's correlations were performed. RESULTS: CFA showed that the GDT had a one-factor structure and the GADIS-A had a two-factor structure. The internal consistency was excellent for both scales among this population. Moreover, both GDT and GADIS-A showed convergent, concurrent, and divergent validity with other standardized scales. CONCLUSION: The Vietnamese versions of the GDT and GADIS-A have good psychometrics, which may be utilized in future research regarding gaming disorder among Vietnamese populations.

Psychometric Testing of an Instrument Assessing Family Knowledge, Contemplation, Confidence and Readiness for Engaging in Early Mobilisation of Critically Ill Patients: A Multi-Site Cross-Sectional Design.

BACKGROUND: Early mobilisation is beneficial to support recovery among critically ill patients. The literature highlights the benefits of family engagement in early mobilisation, yet this practice remains underutilised. Effective implementation depends on understanding the key antecedents that influence family engagement in early mobilisation, specifically families' knowledge, contemplation, confidence and readiness. However, no measurement tools currently exist to assess these. Therefore, developing a psychometrically supported instrument is essential to understanding and enhancing families' factors influencing their engagement in early mobilisation. AIM: To develop and evaluate the psychometric properties of an instrument to assess families' knowledge, contemplation, confidence and readiness to engage in early mobilisation. DESIGN: A multi-site cross-sectional survey design. METHODS: Based on established psychological theory (Social Cognitive Theories and Behaviour Change Theories), an item pool was developed to assess families' knowledge, contemplation, confidence and readiness to participate in early mobilisation. To psychometrically evaluate the new tool, a multi-site cross-sectional survey was undertaken from May 2020 to June 2022 across five intensive care units in Australia. Data from 370 families of critically ill patients were used to evaluate the structural, convergent and discriminant validity as well as the reliability of the new instrument. RESULTS: Confirmatory factor analysis indicated good model fit, supporting the proposed structure. All items displayed high standardised factor loadings except one, which improved upon freeing an error covariance. Positive inter-factor correlations were moderate to strong and were substantially lower than the square root of the average variance extracted, supporting both convergent and discriminant validity, respectively. Additionally, all subscales demonstrated well to excellent reliability. CONCLUSION: The findings provide preliminary support for the multiple types of validity evidence and the reliability of the instrument. This new instrument is suitable for use in clinical and research applications to assess families' knowledge, contemplation, confidence and readiness for their engagement in early mobilisation. IMPACT: Family engagement in early mobilisation activities may have multiple benefits but it is not commonly implemented in the ICU. Factors influencing family engagement in early mobilisation are poorly understood. Influential psychological theories highlight the likely importance of knowledge, contemplation, confidence and readiness. A readily available instrument designed to assess these constructs among family members is needed to deepen research understanding and guide clinical practice. The proposed instrument is designed to measure factors influencing family engagement in early mobilisation, which may support healthcare professionals and health services to identify and tailor strategies to support family engagement in early mobilisation. REPORTING METHOD: Recommendations for reporting the results of studies of instrument and scale development and testing was followed to report this study. PATIENT OR PUBLIC CONTRIBUTION: Family members of adult critically ill patients participated in this study, and they provided the data through the survey.

Development and psychometric testing of the nurses' core competencies for public health emergencies scale: A multicenter cross-sectional study.

BACKGROUND: The significance of addressing public health emergencies (PHEs) emphasizes the pivotal role of a skilled nursing workforce in effective preparedness and response. However, there's a lack of comprehensive assessments tailored to nurses' core competencies, serving as a standard for ongoing education in preparedness. OBJECTIVE: This study aimed to develop a psychometrically sound scale for identifying and measuring essential core competencies crucial for nurses during public health emergencies. DESIGN: A multicenter cross-sectional study was conducted. SETTINGS: Twelve tertiary hospitals in Shanghai. PARTICIPANTS: Affiliated nurses with prior experience and significant exposure to public health emergencies were recruited. METHODS: The study underwent development and validation in two stages, utilizing qualitative data analysis, a Delphi expert panel, and an empirical quantitative cross-sectional survey. The Nurses' Core Competencies for Public Health Emergencies (NCC-PHEs) scale and a demographic questionnaire were distributed between January 2023 and March 2023. Exploratory factor analysis, confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were employed to identify theoretical constructs, assess scale reliability, and establish validity. RESULTS: Analysis was conducted on valid data collected from 1481 nurses. Factor analysis identified 47 professional nursing competencies arranged within a four-factor high-order model: prevention competencies (9 items), preparation competencies (7 items), response competencies (comprising basic and advanced levels) (26 items), and recovery competencies (5 items). Structural equation modelling confirmed satisfactory factor loadings and a good model fit, validating construct integrity. The reliability of the total scale was confirmed. CONCLUSION: This study presents a valid scale that empirically measures nurses' core competencies crucial for preparedness and response during public health emergencies. The findings offer instrumental support for guiding the development of future courses and training programs in nursing research and practice.

Development and psychometric testing of the nursing practice difficulty scale for nurses caring for patients with dementia in general hospitals.

Objective: As aging in the Chinese population increases, the hospitalization rates of patients with dementia have also risen. Research on the difficulties of nurses who care for patients with dementia in Chinese general hospitals is limited. This study aimed to develop a scale to measure the difficulties nurses face in nursing patients with dementia in Chinese general hospitals and to verify its reliability and validity. Methods: Guided by the biopsychosocial theory, an initial scale was created through a literature review, qualitative interviews, and expert consultation. A web-based survey for psychometric testing was conducted with 394 nurses from 11 general hospitals during September to November 2021. Validity was verified using content validity, exploratory factor analysis, the known-groups method, and concurrent validity. Cronbach's α coefficient and split-half reliability were used to assess reliability. Results: The Item-level Content Validity Index was 0.833-1.000. The Scale-level Content Validity Index was 0.929. Twenty-one items with four factors were extracted from the item analysis and exploratory factor analysis. According to the known-groups method, the difficulty of the experienced group and the group with training experience was significantly lower than that of the less experienced group and the group without training experience. Based on external standards, the correlation coefficient was 0.387 with the Nursing Job Stress Scale and -0.239 with the Dementia Care Attitude Scale. Cronbach's α coefficient for each factor ranged from 0.889 to 0.905, and the total was 0.959. The split-half reliability for each factor ranged from 0.814 to 0.894, and the total was 0.911. Conclusion: This study discovered a four-factor structure related to the difficulty scale of dementia nursing practice, and the scale's reliability and validity were confirmed. The scale can be utilized to assess the difficulty of dementia nursing practice in general hospitals and may be employed in future research to improve dementia nursing practices.

Measuring mental wellbeing in clinical and non-clinical adolescents using the COMPAS-W Wellbeing Scale.

Introduction: Adolescence is a key period of vulnerability for poor mental health as the brain is still developing and may be more sensitive to the negative impacts of stress and adversity. Unfortunately, few measures comprehensively assess wellbeing in adolescents. Methods: The 26-item COMPAS-W Wellbeing Scale for adults was validated in a sample of 1,078 adolescents aged 13-17 years old (51.67% male, 79.13% non-clinical vs 20.87% psychiatric or developmental clinical cases). The six COMPAS-W sub-scales and total scale were examined in this sample using second-order confirmatory factor analysis, and psychometric testing. Results: The 23-item COMPAS-W demonstrated the best fit for this sample according to goodness-of-fit indices (χ 2 (220, 1078) = 1439.395, p < 0.001, CFI = 0.893, TLI = 0.877, RMSEA = 0.070, SRMR = 0.095). Internal reliability for the confirmed 23-item COMPAS-W model was run for the total scale (α = 0.912) and sub-scales (Composure, α = 0.735; Own-worth, α = 0.601; Mastery, α = 0.757; Positivity, α = 0.721; Achievement, α = 0.827; and Satisfaction, α = 0.867). Test-retest reliability over 6 weeks was also good for the total scale at r = 0.845 and the sub-scales: Composure (r = 0.754), Own-worth (r = 0.743), Mastery (r = 0.715), Positivity (r = 0.750), Achievement (r = 0.750), and Satisfaction (r = 0.812). Compared with non-clinical participants' wellbeing (M = 90.375, SE = 0.400), those with clinical diagnoses reported lower wellbeing, both for those with developmental diagnoses (M = 85.088, SE = 1.188), or psychiatric diagnoses (M = 78.189, SE = 1.758), or combined developmental and psychiatric diagnoses (M = 77.079, SE = 2.116). Yet, when wellbeing category scores were considered by diagnosis group, both non-clinical and clinical groups demonstrated incidence across all three categories of languishing, moderate and flourishing wellbeing, in support of the dual-continua model of mental health. On average, younger adolescents' (13-14 years) wellbeing did not differ from older adolescents' (15-17 years) wellbeing; however, for sex, males scored 1.731 points significantly higher in wellbeing compared with females (p = 0.028); and American participants scored 3.042 points significantly higher in wellbeing compared with Australian participants (p < 0.001). Discussion: In conclusion, the 23-item COMPAS-W is a reliable measure of wellbeing for adolescents, both for those with and without developmental and psychiatric diagnoses.

Psychometric Properties of the Teleprimary Care Oral Health Clinical Information System (TPC-OHCIS) Questionnaire Using the Rasch Model.

Background The Tele Primary Care Oral Health Clinical Information System (TPC-OHCIS) was implemented in Malaysia to digitalize health care and reduce numerous ground-level manual tasks. This study measures the psychometric properties of the TPC-OHCIS questionnaire among healthcare workers (HCWs) at primary healthcare clinics (PHC). Method A pilot study was conducted at PHC, which implemented the TPC-OHCIS application for service delivery. The questionnaire contained 65 items with four response categories, grouped into four scales: technology, organization, external support, and human resource. The questionnaire items were analyzed using the Rasch model in Winsteps 3.72.3. Results There were 319 respondents who participated (98.8%). The Cronbach alpha was 0.93. The construct validity was determined by a positive point measure correlation (PMC) value, with an infit and outfit mean square (MNSQ) range of 0.4-1.5 and a Z-standardized (ZSTD) range of -2.0 to 2.0. The person and item reliability were 0.93 and 0.97, respectively, indicating excellent reliability. The questionnaire was unidimensional, where the raw variance explained by measures was >40%. Conclusion The questionnaire was deemed fit for an actual survey after 18 items had been deleted. It has good psychometric properties and is practically applicable for evaluating HCWs on the TPC-OHCIS application implementation process monitoring using the local Malay language. High reliability and unidimensionality were achieved, supporting its use in digital healthcare. With this validated questionnaire, it will enhance digital healthcare implementation and streamline manual tasks.

The Night Eating Questionnaire through the lens of the Rasch model.

Previous research focused on the conventional approaches to test psychometric characteristics of the Night Eating Questionnaire (NEQ). The purpose of this research was to examine the psychometric properties of the Night Eating Questionnaire using the Rasch model in a sample of university students. The study was carried out from November 2018 to March 2019 on 300 students in health sciences at the University of Pristina temporarily seated in Kosovska Mitrovica, who completed the NEQ. A confirmatory factor analysis (CFA) suggested that the Serbian version mirrored the original NEQ structure: Goodness of fit index = 0.978, Comparative fit index = 0.996, Tucker-Lewis index = 0.995, Root Mean Square Error of Approximation = 0.011 and Standardized Root Mean Square Residual = 0.057. The Cronbach's alpha coefficient for the total scale was 0.627. The Rasch analysis showed that the item separation index classified the items into six groups based on their level of difficulty. The person reliability index separated well night eaters from day eaters. Few items did not fit the adequate range for the infit/outfit statistics. Overall, there were several groups of NEQ items that have a distinctive difficulty level, but the difference was not a remarkable one. This means that most students did not have night eating syndrome (NES), despite various levels of item difficulty. The NEQ performs well in the efforts to distinguish people who eat and do not eat at night. Most students reported conventional eating patterns and only a few had NES. The properties of the NEQ warrant its use in further night eating research.

Test-Retest Reliability of the Verran Professional Governance Scale©.

Background and Purpose: Stability testing, conducted using a test-retest protocol, measures an instrument's reliability by evaluating the consistency of participant responses to survey questions with repeated testing within a short interval. No studies have measured the stability of the Verran Professional Governance Scale© (VPGS). The purpose of this study was to evaluate the test-retest reliability of the VPGS. Methods: Volunteers from a parent study using the VPGS were sent a link to a retest version of the survey 14 days after taking the initial survey with a reminder email sent 5 days after the first request. Item-level and subscale comparisons were made between participants' initial and retest responses using intraclass correlation coefficients (ICCs) applying a two-way random-effects model. Results: VPGS subscales had ICC scores of 0.71 for decision-making, 0.73 for collateral relationships, and 0.86 for professional obligation. Conclusions: Findings suggest that the VPGS demonstrates test-retest reliability. Future research should evaluate the instrument's responsiveness.

Development and psychometric testing of the lymphedema self-management support scale for breast cancer survivors.

Objective: Effective self-management support should be tailored to the individual. To provide personalized and targeted self-management support, a rigorous assessment tool is needed to screen the actual degree of lymphedema self-management support received by breast cancer survivors. This study aims to develop and psychometrically test the Lymphedema Self-Management Support Scale for Breast Cancer Survivors (LSMS-BCs). Methods: This study involves two phases: scale development and psychometric testing. In the scale development phase, preliminary items and domains were identified through a qualitative meta-synthesis, a quantitative systematic review, and reference to previous similar scales. Expert consultation and pilot study were conducted to refine the scale and evaluate the content validity. The psychometric characteristics were tested with 447 participants using item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability assessments, as well as measurement invariance. Results: A preliminary 21-item scale with four domains, basic management support, management support for limb volume reduction, role management support, and emotional management support, was constructed in the scale development phase and well supported by EFA and CFA. The scale-level content validity index was 0.983. Cronbach's α coefficient for overall scale and subscales ranged from 0.732 to 0.949. McDonald's ω ranged from 0.848 to 0.955. Excellent known-groups validity, concurrent validity, predictive validity, and measurement invariance were demonstrated. Conclusions: The LSMS-BCs is psychometrically valid and reliable. It can serve as a valuable tool for assessing and understanding the lymphedema self-management support received by breast cancer survivors.

Translation and psychometric testing of the Persian Version of nurses' ethical decision-making in End-of-Life Care Scale.

BACKGROUND: Ethical decision-making in end-of-life care is one of the most challenging aspects of healthcare: providing ethical care to the society is one of the most important responsibilities of healthcare professionals. In order to assess nurses' ethical decision-making in end-of-life care, researchers need a specialized and comprehensive instrument which is sufficiently valid and reliable. The present study was conducted to translate and test the psychometric properties of the Persian version of Nurses' Ethical Decision-Making in End-of-Life Care Scale (NEDM-EOLCS). METHODS: This is a cross-sectional, multi-centric study with a methodological design The participants were selected via convenience sampling from five hospitals located in Iran. In total, 1320 nurses (660 for exploratory factor analysis and 660 for confirmatory factor analysis) participated in the study. The original NEDM-EOLCS was translated into Persian and subsequently the psychometric properties of the scale were assessed according to COSMIN criteria. RESULTS: Exploratory factor analysis (EFA) showed the factor loading of the 55 items to be between 0.62 and 0.88, all of which were significant. Also, exploratory factor analysis showed that 3 factors (perceived professional accountability, moral reasoning/moral agency and moral practice) explained 74.51% of the variance. Confirmatory factor analysis (CFA) results verified the good fit of the data (a chi-square of 21.74, df = 7, P = 0.001) RMSEA = 0.01, CFI = 0.96, NFI = 0.95, and TLI = 0.97). The reliability of the scale was measured in terms of its internal consistency and the Cronbach's alpha of the whole instrument was found to be 0.98. CONCLUSION: The Persian version of NEDM-EOLCS for nurses is sufficiently valid and reliable. Thus, this instrument can be used to measure nurses' ethical decision-making in end-of-life care and identify the most effective strategies, e.g. educational interventions, to improve ethical decision-making skills in end-of-life care in these healthcare professionals as necessary.

Psychometric testing of the Chinese version of the International Classification of Functioning, Disability, and Health Measure of Participation and Activities Screener in people with stroke.

BACKGROUND: Clinicians need a validated measure to assess the activity and participation of Chinese people with stroke. OBJECTIVES: To culturally adapt and psychometrically test the Chinese (Cantonese) version of the International Classification of Functioning, Disability and Health Measure of Participation and Activities (C-IMPACT-S) in community-dwelling people with stroke. METHODS: We followed the standard translation procedures to culturally adapt the C-IMPACT-S. Then we administered the C-IMPACT-S to 100 people with stroke and 50 healthy counterparts for psychometric testing, including the ceiling and floor effects, internal consistency, test - retest, measurement error, minimal detectable change, correlations with other outcome measures, known-group validity and optimal cutoff scores. RESULTS: The C-IMPACT-S has no floor effects but ceiling effects in item 5. It has poor to excellent (Cronbach's α = 0.56-95) internal consistency and fair to excellent (Intraclass correlation coefficients = 0.58-1.00) test-retest reliability. The overall C-IMPACT-S mean score and activity and participation component mean scores had statistically significant no to weak correlations with the Fugl-Meyer Assessment, the Chinese versions of Geriatric Depression Scale, Fatigue Assessment Scale, Lawton Instrumental Activities of Daily Living Scale and Community Integration Measure. The stroke participants had lower C-IMPACT-S scores then their health counterparts. The optimal cutoff scores of the overall C-IMPACT-S and activity and participation domains were 88.02% (sensitivity 72%, specificity 80%), 80.56% (sensitivity 86%, specificity 68%) and 91.67% (sensitivity 68%, specificity 80%), respectively. CONCLUSIONS: C-IMPACT-S is a reliable and valid measure for assessing the levels of activity and participation of people with chronic stroke.

Simulation to become a better neurosurgeon. An international prospective controlled trial: The Passion study.

Introduction: Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess. Research question: The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance. Material and methods: Seventy-two residents were randomized into the simulation group (SG) and control group (CG). The course spanned five days, commencing with assessment of technical skills in basic procedures within a wet-lab setting on day 1. Over the subsequent core days, the SG engaged in simulated procedures, while the CG carried out routine activities in an OR. On day 5, all residents' technical competencies were evaluated. Psychometric measures of all participants were subjected to analysis. Results: The SG demonstrated superior performance (p < 0.0001) in the brain tumour removal compared to the CG. Positive learning curves were evident in the SG across the three days of simulator-based training for all tumour removal tasks (all p-values <0.05). No significant differences were noted in other tasks, and no meaningful correlations were observed between performance and any psychometric parameters. Discussion and conclusion: A brief and intensive training regimen utilizing 3D virtual reality simulators enhances residents' microsurgical proficiency in brain tumour removal models. Simulators emerge as a viable tool to expedite the learning curve of in-training neurosurgeons.

Development, validation and reliability testing of the hospice care environment scale.

BACKGROUND: WHO stated the environment is an important factor affecting the development of hospice care. The environment is the sum of factors affecting behavior besides the individual factors. Currently, a scale to comprehensively assess the hospice environment of nurse is still lacking. This study aimed to develop an instrument to investigate the environmental factors affecting hospice care of nurses. METHODS: Literature review and a semi-structured interview were conducted to form the items pool of the Hospice Care Environment Scale. Two rounds of Delphi expert consultation were conducted by 16 experts to revise the scale dimensions and entries to form the Hospice Care Environment Scale. A psychometric evaluation was then performed among 530 oncology nurses in a large tertiary oncology hospital in Hubei Province. The 500 valid questionnaires were randomly divided into two groups in a 1:1 ratio, sample 1 (n1 = 250) for item screening and sample 2 (n2 = 250) for quality evaluation of the resulting scale. Item analysis, reliability analysis, validity analysis and acceptability analysis were performed. RESULT: The Hospice Care Environment Scale consists of two dimensions and 13 entries. The Cronbach's α coefficient of the Hospice Care Environment Scale was 0.970, and the Cronbach's α coefficient of the two dimensions were 0.952 and 0.969, respectively, with the Item-content validity index and average Scale- content validity index of the scale was both 1.000. The validation factor analysis showed the standardized path coefficients of each item were basically above 0.5, and the factor structure model was stable and suitable. The average completion time of the scale was about 3 min, which had good feasibility. CONCLUSION: The Hospice Care Environment Scale to assess the environment of hospice care services, has good content and construct validity and reliability. This scale can provide guidance to evaluate the hospice care environment.

Psychometric properties and criterion related validity of the Norwegian version of hospital survey on patient safety culture 2.0.

BACKGROUND: Several studies have been conducted with the 1.0 version of the Hospital Survey on Patient Safety Culture (HSOPSC) in Norway and globally. The 2.0 version has not been translated and tested in Norwegian hospital settings. This study aims to 1) assess the psychometrics of the Norwegian version (N-HSOPSC 2.0), and 2) assess the criterion validity of the N-HSOPSC 2.0, adding two more outcomes, namely 'pleasure of work' and 'turnover intention'. METHODS: The HSOPSC 2.0 was translated using a sequential translation process. A convenience sample was used, inviting hospital staff from two hospitals (N = 1002) to participate in a cross-sectional questionnaire study. Data were analyzed using Mplus. The construct validity was tested with confirmatory factor analysis (CFA). Convergent validity was tested using Average Variance Explained (AVE), and internal consistency was tested with composite reliability (CR) and Cronbach's alpha. Criterion related validity was tested with multiple linear regression. RESULTS: The overall statistical results using the N-HSOPSC 2.0 indicate that the model fit based on CFA was acceptable. Five of the N-HSOPSC 2.0 dimensions had AVE scores below the 0.5 criterium. The CR criterium was meet on all dimensions except Teamwork (0.61). However, Teamwork was one of the most important and significant predictors of the outcomes. Regression models explained most variance related to patient safety rating (adjusted R2 = 0.38), followed by 'turnover intention' (adjusted R2 = 0.22), 'pleasure at work' (adjusted R2 = 0.14), and lastly, 'number of reported events' (adjusted R2=0.06). CONCLUSION: The N-HSOPSC 2.0 had acceptable construct validity and internal consistency when translated to Norwegian and tested among Norwegian staff in two hospitals. Hence, the instrument is appropriate for use in Norwegian hospital settings. The ten dimensions predicted most variance related to 'overall patient safety', and less related to 'number of reported events'. In addition, the safety culture dimensions predicted 'pleasure at work' and 'turnover intention', which is not part of the original instrument.

Translation and validation of the Chinese version of the BCPT Eight Symptom Scale (BESS) in patients with breast cancer.

Objective: This study aimed to translate the Breast Cancer Prevention Trial Eight Symptom Scale (BESS) into Chinese and subsequently examine the latent constructs and psychometric properties of the Chinese BESS (C-BESS) among patients with breast cancer. Methods: In Phase 1, the BESS was translated from English into Chinese using the FACIT translation method. An expert panel was convened to assess the content validity, and pilot testing was performed with 20 patients with breast cancer. In Phase 2, a total of 427 patients with breast cancer from four Grade-A public hospitals in China were recruited to examine psychometric properties of the C-BESS. The internal consistency was evaluated based on the Cronbach's α, and the construct validity was tested using confirmatory factor analysis, convergent validity, and discriminant validity. Results: The C-BESS demonstrated satisfactory content validity index (item-level content validity index [I-CVI]: 0.8-1.0; scale-level content validity index [S-CVI]: 0.97). The Cronbach's α value for the entire C-BESS scale was 0.92. Confirmatory factor analysis indicated that eight-factor structure of the C-BESS was a good fit to the data (CFI = 0.959, AGFI = 0.904, RMSEA = 0.05, RMR = 0.029). The scale exhibited good convergent validity and discriminant validity. Conclusions: This study translated and validated the C-BESS for use in the Chinese population. The results demonstrate that the C-BESS exhibits good reliability and validity, with ideal psychometric properties for assessing the symptom burden in Chinese patients with breast cancer. This tool can be effectively integrated into the routine symptom monitoring of patients with breast cancer in China, helping Chinese clinical professionals in conducting comprehensive assessments of symptom burden.