Burden and Cognitive Appraisal of Stroke Survivors' Informal Caregivers: An Assessment of Depression Model With Mediating and Moderating Effects.

This study proposes and evaluates a model of depression that concerns the role of burden and cognitive appraisal as mediators or moderators of outcomes among stroke survivor caregivers. A total of 105 informal caregivers of stroke survivor completed the self-report measures of Caregiver Burden Inventory, Center for Epidemiologic Studies Depression Scale, and Cognitive Impact of Appraisal Scale. The Glasgow Coma Scale and Barthel Index were used by the researcher to examine the physical functional status of the survivor. Partial least squares (PLS) path modeling was used to estimate the parameters of a depression model that included mediating or moderating effects. The model shows that burden and impact of cognitive appraisal have a significant direct and indirect impact on depression, while survivor physical functional status does not have a direct impact. The model also demonstrates that burden and impact of cognitive appraisal separately play a mediating role between survivor physical functional status and caregiver depression. In addition, cognitive appraisal has a moderating influence on the relationship between burden and depression. Overall, survivor physical functional status, burden, and cognitive appraisal were the predictors of caregiver depression, explaining 47.1% of the variance. This study has shown that burden and cognitive appraisal are mediators that more fully explain the relationship between patient severity and caregiver depression.

Testing of the factor structure of the Sexual Health Knowledge Measure with young adolescent Taiwanese girls.

Knowledge of sexual health is an important indicator of the development of healthy adolescent sexuality. An evaluation instrument in nursing school practice, whose results can lead to improved sexual health in adolescents, is needed. We conducted this study to undertake rigorous testing of the Sexual Health Knowledge Scale (SHKS) as a means to ensure a reliable and valid quantitative measure of sexual health knowledge among young adolescent females. A panel of experts assessed the content validity of the 40-item measure. Initial testing involved 481 female adolescents (12-14 years old), using principal component factor analysis with varimax rotation and the determination of Cronbach's alpha coefficients. Confirmatory factor analysis (CFA) was conducted using data from an additional sample of 234 female adolescents (12-14 years old). Principal component factor analysis yielded a four-factor solution with eigenvalues greater than 1 that explained 43.40% of the variance. As a result of the analysis of the scale, 22 items were deleted, resulting in an 18-item scale. The CFA identified a second-order factor termed "sexual health knowledge." Goodness-of-fit indices showed an acceptable fit overall with the full model (χ(2)/df (131) = 1.69, RMSEA = 0.054, RMR = 0.013, CFI = 0.92, and GFI = 0.99). We determined that the SHKS is a reliable and valid measure, with good composite reliabilities and goodness-of-fit indices.