Personal Dimensions in First Psychotic Episode Patients with Catatonia.

The study reports findings from an observational cross-sectional study involving patients experiencing their first psychotic episode with acute catatonia (n=82), compared to non-catatonic patients (n=74) and a group of healthy volunteers (n=47). Diagnostic procedures spanned two days: the first involved clinical interviews to assess psychosis structure and gather objective data (from relatives and medical records), while the second included psychometric evaluations using PANSS and BFCRS scales. Between these days, participants completed the Big Five Personality Factor Questionnaire (5PFQ) and Beck's Personality Beliefs Questionnaire (PBQ). Comparative analysis (H-test) across the three groups highlighted differences in the 5PFQ factor "expressiveness vs. practicality," predominantly influenced by the "sensitivity vs. insensitivity" parameter. Patients exhibiting catatonic symptoms demonstrated significantly lower scores compared to controls in this regard.

Risk Assessment Suicidality Scale (RASS)-Based On-Line Calculator Targeting Early Prevention of Suicides in General Population: from COMET-G Study Results Towards Integration of the Screening Tool into Routine Clinical Practice.

BACKGROUND: Suicide is a major global health concern, particularly among young people. This study evaluates an online suicide risk calculator based on the Risk Assessment of Suicidality Scale (RASS), which is designed to enhance accessibility and early detection of suicide risk. METHODS: The study involved 444 participants who completed the RASS via an online calculator. Results were compared with data from the COMET-G study's Russian sample (n=7572). Descriptive statistics, correlation analysis, and two-way ANOVA were used to analyze the data. RESULTS: The mean age of participants was 22.71 years (SD=7.94). The mean total RASS standardized score was 837.7 (SD=297.8). There was a significant negative correlation between age and RASS scores (r=-0.463, p<0.0001). The online calculator sample showed significantly higher RASS scores compared to the COMET-G sample, with 71% of online users scoring above the 90th percentile of the COMET-G sample. CONCLUSION: Our study demonstrated the advantage of the on-line suicidality risk calculator based on the RASS scale as a sensitive tool in detecting suicidal behaviours and measuring the severity of suicidality risks, offering a capability for broad reach and immediate assessment during clinical conversation between doctor and patient. Moreover, the RASS on-line psychometric instrument, when being freely distributed among the general population over internet sources, enabled to attract vulnerable groups of respondents with significantly higher suicidality risks. Future research should focus on integrating such tools into comprehensive suicide prevention programs and developing appropriate follow-up monitoring strategies for high risk-cases.

Critical Analysis of the Scales Assessing Assistance Provided by Family Caregivers.

BACKGROUND: While the literature on caregiver-assessment scales often focuses on the quantitative and psychometric aspects of the scales, we wished to examine the discourse on caregiving, caregivers and care-recipients (particularly, people with dementia) produced by these scales. What discourse does it help to crystallise and naturalise by dint of being used widely, with unresolved ethical and political issues? METHODS: We analysed two well-known scales that are widely used in both research and clinical settings and conceived among others for people with dementia: Zarit and, offering a sharp contrast, the CRA. We performed semantic network analysis using EVOQ software (https://www.evoq.be/) to visualise the links between the terms. RESULTS: Whereas the Zarit scale is entirely built around a view of caregiving and the care-recipient as a burden, the CRA offers a different discourse. Instead of considering the provision of help as an emotional load, the desire to help is highlighted. Rather than considering the care-recipient as a weight, the recognition of his or her contribution to the relationship with the caregiver is suggested. Moreover, the caregiver is presented as a relative who is capable of active strategies in order to cope with the reality of care without becoming exhausted. CONCLUSIONS: The comparison of our two analyses shows the extent to which the scales produce a discourse which needs to be examined before use, given its epistemological, ethical and political significance. Clinicians and researchers need to make choices between the many existing instruments and be able to justify them. Their reasons should include not only the psychometric qualities of the chosen tool, but also the discourse that it underpins, so as to avoid contributing to the promotion of a vision of care and its givers and recipients that would be reductive, moving us further away from a caring society.

On the Dimensional Approach to Adolescent Psychopathology: a Systematic Review.

In child and adolescent psychiatry, the clinical presentation of disorders in adolescents is complex, and categorical approaches have limitations by focusing on individual disorders. The intricate system of psychopathology during adolescence can be effectively modeled using network science, which integrates statistical and computational techniques through artificial intelligence tools. Network analysis of psychometric data from psychiatric disorder assessment tests has been extensively studied in both general psychiatry and child psychiatry. However, a comprehensive evaluation of existing network approaches that model multiple psychiatric or neurodevelopmental disorders encountered in adolescents remains necessary. We conducted a systematic literature review across two different databases - PubMed and Scopus - using the keywords "network analysis", "adolescent" and "psychiatry" to address this question. The selection of articles was based on age criteria and the number of pathological entities studied. Out of 406 articles, 69 were selected and analyzed. The results from some of these studies are described in this article. Notably, we observe significant heterogeneity in the findings, highlighting both the richness and complexity of adolescent psychopathology. Further research is needed to validate the already proposed results and standardize the models studied.

Development and validation of an instrument to evaluate the perspective of using the electronic health record in a hospital setting.

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

A multicountry study on the psychometric properties of the Arabic version of the Sleep Preoccupation Scale (SPS) using both classical testing theory and item response theory.

BACKGROUND: Sleep distrurbances involves daytime preoccupation about sleep, which plays a critical role in perpetuating sleep disturbances. Recent cognitive models highlight the importance of daytime processes, like processing sleep-related information and interpretations during waking hours, in influencing sleep quality and quantity. The Sleep Preoccupation Scale (SPS) quantifies this daytime cognitive activity related to sleep. This study aimed to translate and validate an Arabic version of the SPS for assessing sleep preoccupation among Arabic speakers. METHODS: 523 Arabic speakers (mean age 23.6 years, 75% female) from four countries completed the Arabic SPS alongside the Athens Insomnia Scale, Generalized Anxiety Disorder-7 Scale, and the Anxiety and Preoccupation about Sleep Questionnaire (APSQ). The sample repeated the SPS after two weeks for test-retest reliability. Confirmatory factor analysis evaluated the SPS's two-factor structure. Internal consistency, item response theory, and convergent validity with the other scales were examined. RESULTS: Confirmatory factor analysis supported the two-factor model's fit. Measurement invariance results suggest that the SPS exhibits a similar basic factor structure across both insomnia and non-insomnia groups. The Arabic SPS demonstrated good internal consistency (Cronbach's α = 0.92, McDonald's ω = 0.92) and two-way mixed effects, consistency, single rater/measurement intraclass correlation coefficient (ICC) test-retest reliability (ICC = 0.95). Most items exhibited satisfactory item response theory fit statistics and discrimination. The SPS total score showed strong positive correlations with insomnia severity (r = 0.48, p < 0.001), generalized anxiety (r = 0.57, p < 0.001), and sleep-related anxiety/preoccupation (r = 0.79, p < 0.001), demonstrating convergent validity. CONCLUSION: The Arabic version of the SPS demonstrated good psychometric properties and validity, supporting its use for assessing sleep preoccupation among Arabic speakers. This culturally-adapted version enhances sleep assessment capabilities for improving insomnia understanding and treatment within Arabic-speaking populations.

The validity and reliability of the Urostomy Education Scale: a methodological study.

BACKGROUND: There are no scales used by stoma and wound care nurses to evaluate the stoma care skills of individuals with a urostomy. PURPOSE: This study was conducted to investigate the Turkish validity and reliability of the Urostomy Education Scale (UES). METHODS: The study sample consisted of 66 patients who had undergone radical cystectomy, were in the 0- to 7-day postoperative period, were older than 18 years of age, had no physical or mental disabilities, had no urostomy complications, and agreed to participate in the study. This study used translation and back-translation to determine the linguistic validity of the UES in Türkiye. Expert opinion was consulted for content validity. Then, 2 competent and 2 experienced nurses evaluated the face validity of the scale with 5 individuals with urostomies. Reliability of the scale was assessed using internal consistency, interrater reliability, and intraclass correlation coefficients. RESULTS: The content validity index was 0.81 and α = 0.66 to 0.95 for the Cronbach's alpha of the competent nurse assessment and α = 0.68 to 0.96 in the expert nurse assessment. The intraclass correlation coefficient (ICC) results indicated sufficient and statistically significant agreement (ICC range: 0.6-1) between the evaluations made by the 2 evaluators for each skill. CONCLUSION: The Turkish version of the 7-item UES is a valid and reliable tool that can be used to determine the self-care levels of individuals with a urostomy.

Exploring the Utility of a Novel Approach of Evaluating Application of a Validated Violence Risk Assessment Instrument.

Mental health nurses are often responsible for assessment/management of inpatient aggression. Validated instruments such as the Dynamic Appraisal of Situational Aggression (DASA), can aid risk assessment. However, limited attention has been paid to evaluating nurses' ability to administer risk assessment instruments. An entrustable professional activity may offer way of evaluating risk assessment clinical activities. DASA trainers' perceptions of the value and utility of an EPA were explored via collection of data through focus groups, with 17 participants from six countries. Thematic analysis was conducted to analyze the data. Three themes were interpreted: (1) DASA trainers-a way of knowing and being (2) An EPA-something you did not know you need until you see it; (3) The DASA-EPA supports the need for training and importance of integrity in assessment. Trainers engaged in innovative ways to ensure training is suitable and responsive to needs of nurses and their setting. Participants understood how an EPA could be used to evaluate DASA administration, monitor DASA use, provide feedback, and highlight the importance of training to ensure best practice.

Development of an infertility perception scale for women (IPS-W).

PURPOSE: The purpose of this study was to develop an Infertility Perception Scale for Women (IPS-W). METHODS: Initial items were based on an extensive literature review and in-depth interviews with five infertile women and fifteen women not diagnosed with infertility. Forty-one items were derived from a pilot survey. Data were collected from 203 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale. RESULTS: Four factors containing 21 items were extracted from the exploratory factor analysis (EFA) to verify the construct validity. The four factors of infertility perception scale were perceived feelings, personal stigma, social stigma, and acceptance. These factors explained 59.3% of the total variance. The confirmatory factor analysis (CFA) confirmed a four-factor structure of the 21-item IPS-W. All fit indices were satisfactory (χ2/df ≤ 3, RMSEA < 0.08). These items were verified through convergent, discriminant, known group validity, concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α = 0.90). CONCLUSION: The scale reflects the perception of infertility within the cultural context of Korea. The findings can help nurses provide support that is appropriate for individual circumstances by examining how women experiencing infertility perceive infertility.

Violent attitudes in Portugal and Canada: Measurement invariance and psychometric properties of the Evaluation of Violence Questionnaire.

Theory and evidence suggest that attitudes toward violence are relevant for the explanation, prediction, and reduction of violent behavior. The purpose of the present study was to adapt a measure of violent attitudes-the Evaluation of Violence Questionnaire (EVQ)-for use in Portugal, test the cross-country equivalence, and test the validity of both versions. We found the expected one-factor structure, high internal consistency, and cross-country measurement invariance for the Portuguese and original EVQ with men in Portugal (N = 320) and Canada (N = 298). We also found the expected pattern of correlations with measures of more versus less theoretically relevant constructs: both versions of the EVQ showed the strongest correlations with overall aggression and reactive aggression; slightly lower correlations with proactive aggression; negative correlations with self-control; and the smallest correlations with self-esteem. Our results support the equivalence, reliability, and validity of the Portuguese and original versions of the EVQ.

The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women.

BACKGROUND: This study aims to examine whether the Edinburgh Postnatal Depression Scale (EPDS), excluding the self-harm item (EPDS-9), performs as effectively as the full EPDS in identifying depression among perinatal women. METHODS: A total of 3571 pregnant women and 3850 postpartum women participated in this observational study. Participants who scored ≥ 9 on the EPDS underwent further diagnostic evaluations by a clinical psychologist and/or psychiatrist. RESULTS: The EPDS-9 and full EPDS demonstrated a near-perfect correlation in both the antepartum (r = 0.996) and postpartum (r = 0.998) cohorts. EPDS-9 showed exceptional precision in identifying depression as screened by the full EPDS at cutoff points ranging 9-14, with areas under the curve ≥0.998. The sensitivity of EPDS-9 and full EPDS to detect depression that requires psychotropic medications was poor. The highest accuracy for both versions was at a cutoff score of 9: sensitivity of 0.579 for the full EPDS and 0.526 for the EPDS-9. At the cutoff point of 9, EPDS-9 performed adequately in predicting the response of the participants to the self-harm item. CONCLUSION: The EPDS-9 represents a solid and effective replacement for the full EPDS in clinical settings. If the presence of suicidal thoughts needs to be assessed, specialized scales should be used.

Navigating Ambiguity: Adapting and Validating the Personal Need for Structure Scale in Spanish.

The Personal Need for Structure (PNS) scale assesses individuals' tendency to seek out clarity and structured ways of understanding and interacting with their environment. The main aim of this study was to adapt the PNS scale to Spanish and assess its psychometric properties. There are two versions of the PNS scale being used, which vary in the number of dimensions (1 vs. 2), and in the number of items (12 vs. 11; because one version excludes Item 5). Therefore, an additional aim of this study was to compare the two existing versions of the PNS scale. This comparison aimed to address the debate regarding the inclusion of Item 5, and the number of dimensions that comprise the PNS scale. A sample of 735 individuals was collected. First, through an approach combining exploratory and confirmatory analyses, evidence was found in favor of the scale being composed of two related but distinguishable factors: Desire for Structure and Response to the Lack of Structure. Scores on these subscales showed acceptable internal consistency and test-retest reliability. Evidence supporting the invariance of the internal structure across sociodemographic variables such as gender and age was found. Validity evidence was also analyzed by examining the relationships with other relevant measures. The results indicated that Item 5 can be excluded without reducing scores validity or reliability, which supports preceding research in the literature. In conclusion, the PNS scale was satisfactorily adapted to and validated in Spanish and its use in this context is recommended.

A tale of two constructs: combined assessment of demoralization and subjective incompetence.

Demoralization comprises multiple dimensions. Among them, Subjective Incompetence (SI) is the perception of being incapable of appropriate action in demanding circumstances. SI may be an early sign of demoralization preceding hopelessness, thus we aimed at integrating items related to Subjective Incompetence into the clinical assessment of demoralization. We assessed 414 subjects from the general population with the Demoralization Scale, 24 items (DS24) and the Subjective Incompetence Scale, 12 items (SIS12). We used multiple approaches to detect the optimal number of factors and their item structure, then conducted Bayesian Item Response Theory analyses to study item psychometric properties. Item Response Theory models were used to extrapolate latent severity ratings of clinical dimensions. We modelled the DS24 with five factors (Disheartenment, Sense of Failure, Helplessness, Irritability, Loss of Purpose) and the SIS12 with three (Subjective Incompetence, Inability to plan, Inability to Deal). The more complex IRT model had the best predictive value and helped to identify the items with better discrimination properties across the different dimensions. Twenty items were retained and used to develop the combined Demoralization and Subjective Incompetence Scale (DSIS20), which maintained high correlation with raw and latent trait scores of the longer versions. We combined selected items of the DS24 and the SIS12 to develop the DSIS20, a shorter assessment instrument that includes Subjective Incompetence as well as other clinical dimensions of demoralization. Further study may clarify if DSIS20 may be helpful for the early detection of demoralization.

The role of subjective risk perception and self-esteem in the relationship between sensation seeking and aberrant behaviors on the road: A moderated-moderation model.

INTRODUCTION: Road crashes are still one of the main causes of death around the world. Risky behavior has been proposed as one of the foremost predictors, with the theoretical framework of aberrant behavior emerging as a predominant approach for its examination. Sensation seeking has been pointed out as one of the main personality predictors of aberrant behavior. The current research aimed to investigate the moderated-moderation effect of both risk perception and self-esteem in the relationship between sensation seeking and aberrant behavior. METHOD: Two studies were conducted. The first study aimed to analyze the psychometric properties of the Spanish version of the Risk Perception Scale (RPS), a 10-item self-report to assess risk perception. A sample composed of 471 Spanish drivers (319 female, Mage = 29.75) completed the RPS. In the second study, a different sample of 236 Spanish drivers (129 female, Mage = 38.49) completed a set of self-reports aiming both to analyze the concurrent and divergent validity of the RPS, and to test the main moderated-moderation hypothesis. RESULTS: With respect to the first study, the confirmatory factor analysis (CFA) supported a 7-item version which fitted in a single reliable factor (α = .74). Regarding the second study, the results supported both the concurrent and divergent validity of the RPS. Likewise, it was verified the moderated-moderation effect in the case of ordinary violations (R2 = .34), aggressive violations (R2 = .20), and lapses (R2 = .12). CONCLUSIONS: The RPS is a useful self-report to assess subjective risk perception in Spanish drivers. Both self-esteem and risk perception affect the relationship between sensation seeking and aberrant driving behavior. PRACTICAL IMPLICATIONS: Intervention programs aiming to reduce aberrant driving behavior should be focused on reducing sensation seeking tendencies while simultaneously enhancing both risk perception skills and self-esteem.

Cross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture.

OBJECTIVES: to adapt and validate the content of the Healthy Work Environment Assessment Tool for Brazilian culture, and evaluate the practical aspects of its application. METHODS: methodological study that followed six stages: translation; synthesis; back translation; content validation by a group of experts, pre-testing and approval of the process by the author of the original instrument. RESULTS: the first three stages were carried out by contracted companies. In the committee, two items and the title of a subscale were evaluated in a second round, when consensus was reached among experts. In the pre-test, more than 93% of professionals agreed that the tool was easy to understand. The average completion time was 8.53 minutes. The American Association of Critical-Care Nurses authorized publication of the results. CONCLUSIONS: the adaptation of the tool to Brazilian culture was completed following the adopted framework. In addition to the evidence of content validity, the tool appears promising for managerial use.

Translation, cultural adaptation and validation of the Tamil version of the Cardiff Acne Disability Index (CADI) in Sri Lanka.

BACKGROUND: Assessment of QoL has become an essential component in the holistic care of patients with acne. The Cardiff Acne Disability Index (CADI) is used globally to assess quality of life (QoL) in patients with acne. This study was done to validate CADI in Tamil, as 90 million of the global population are native speakers and Tamil is an official language of several countries. METHODS: CADI was translated and validated into Tamil according to published guidelines. The Tamil versions of both CADI and Dermatology Life Quality Index (DLQI), was administered to 150 Sri Lankan young adults with acne. The clinical severity was assessed using the Global Acne Grading System (GAGS). Discriminant validity was tested by comparing the results of CADI with those of GAGS and DLQI, using reliability, validity, Cronbach's alpha, and Spearman's correlation coefficient measurements. Construct validity was assessed by factor analysis. RESULTS: 70% were female, and the mean age was 25.1 (SD, 5.2). The majority (91.3%) had acne of mild to moderate severity when measured by GAGS. CADI-Tamil showed high internal consistency and reliability (Cronbach's alpha coefficient = 0.83). The CADI total score showed a strong correlation (0.86) with that of DLQI. The correlation between CADI and GAGS was low, whereas CADI had a high and significant correlations with the DLQI. The construct validity explained 61% of the variability. CONCLUSIONS: The CADI-Tamil is a reliable and valid tool for assessing the QoL of Tamil speaking patients with acne. This tool will help clinicians understand the patient's perspective on acne.

Peace, equanimity and acceptance in the cancer experience: validation of the German version (PEACE-G) and associations with mental health, health-related quality of life and psychological constructs.

BACKGROUND: Systematic reviews and meta-analyses reveal the importance of an accepting attitude towards cancer for mental health and functional coping. The aim of this study was to examine the psychometric properties of the German translation of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) questionnaire (Mack et al., 2008) and to investigate its associations with mental health, health-related quality of life (HRQoL) and related constructs. METHODS: The German version of the PEACE (PEACE-G) was created and validated with cancer patients in a cross-sectional two center questionnaire study. Construct validity was tested with confirmational factor analyses (CFA); Cronbach's alpha was used to determine internal consistency of items. We further examined associations with depression (PHQ-8), anxiety (GAD-7), distress (NCCN distress thermometer), HRQoL (SF-12), psychological flexibility (AAQ-II), resilience (RS-11) and acceptance scales, to evaluate concurrent and divergent validity. RESULTS: N = 213 cancer patients with different tumor entities participated in this study. Results of the CFA replicated the two-factor solution of the original PEACE (peaceful acceptance and struggle with illness) with satisfactory psychometric properties. Peaceful acceptance showed negative associations with depression, anxiety, distress, psychological inflexibility, and positive associations with HRQoL, acceptance, resilience, and mindfulness. Results of sensitivity analyses indicate a third factor (injustice/anger). CONCLUSIONS: The results demonstrate the validity and reliability of PEACE-G in cancer patients and point to the essential role of acceptance- and mindfulness-based interventions in psycho-oncology. Further studies are needed to investigate the different facets of struggle with the cancer illness.

New norm values of the brief resilience scale (BRS) from the German general population with new post-COVID-19 data.

BACKGROUND: The concept of psychological resilience has spurred extensive research across various fields, with the Brief Resilience Scale (BRS) emerging as a concise tool to measure an individual's ability to rebound from stress. It has been translated into multiple languages, including German, but the validation of the German version occurred prior to the COVID-19 pandemic. Therefore, the main objective of this study was to examine new norm values and psychometric properties of the BRS. METHODS: Norm values, the factor structure, reliability and validity of the BRS were examined using data from a representative survey of the German general population (N = 2522). RESULTS: The results indicated that the method-factor model showed the best fit, suggesting a nuanced understanding of resilience beyond a single-factor approach. The BRS demonstrated good convergent and discriminant validity based on both latent and manifest correlations. Moreover, the study revealed increasing postpandemic resilience scores. CONCLUSIONS: The results of this study provide support for the psychometric reliability and validity of the German version of the BRS after the COVID-19 pandemic and underscore the importance of assessing resilience amidst evolving societal challenges and highlight the need for further exploration in diverse populations.

Validation of Rosenberg self-esteem scale among Norwegian adolescents - psychometric properties across samples.

BACKGROUND: Self-esteem refers to the evaluative and affective dimensions of the self-concept and is important for positive mental health and overall functioning during adolescence. The Rosenberg Self-esteem scale (RSES) is one of the most frequently used and widely accepted instruments assessing self-esteem; however, the psychometric properties of the instrument have not been investigated in a Norwegian adolescent population. The present study's aim is to investigate the factor structure, construct validity and reliability of the RSES among adolescents 14-21 years. METHODS: The study was based on two cross-sectional samples (n = 1,233/ n = 1,816) of adolescents from rural and urban areas in Mid-Norway. Concerning the dimensionality of the RSES, two measurement models were tested using Principal Component Analysis and Confirmatory Factor Analysis: a one-factor model and a two-factor-model. RESULTS: The results show that a two-factor solution of positive and negative aspects of self-esteem representing "perceived personal competence" and "self-value" had the best fit across the two adolescent samples. The RSES also showed high reliability and correlated in expected directions with measures of life satisfaction, stress, and self-efficacy, supporting the convergent validity of the instrument. CONCLUSION: The psychometric properties of the RSES need to be further evaluated in Norwegian adolescent populations based on the dimensionality found in the present study; however overall, the results indicate that the instrument is appropriate for assessing self-esteem among Norwegian adolescents.

Developing and Validating a Self-Care Self-Efficacy Scale for Oral Anticoagulation Therapy in Patients With Nonvalvular Atrial Fibrillation: Protocol for a Mixed Methods Study.

BACKGROUND: Oral anticoagulation therapy (OAC) is the cornerstone treatment for preventing venous thromboembolism and stroke in patients with nonvalvular atrial fibrillation (NVAF). Despite its significance, challenges in adherence and persistence to OAC regimens have been reported, leading to severe health complications. Central to addressing these challenges is the concept of self-efficacy (SE) in medication management. Currently, there is a noticeable gap in available tools specifically designed to measure SE in OAC self-care management, while such tools are crucial for enhancing patient adherence and overall treatment outcomes. OBJECTIVE: This study aims to develop and validate a novel scale aimed to measure self-care self-efficacy (SCSE) in patients with NVAF under OAC, which is the patients' Self-Care Self-Efficacy Index in Oral Anticoagulation Therapy Management (SCSE-OAC), for English- and Italian-speaking populations. We also seek to assess patients' SE in managing their OAC treatment effectively and to explore the relationship between SE levels and sociodemographic and clinical variables. METHODS: Using a multiphase, mixed methods observational study design, we first conceptualize the SCSE-OAC through literature reviews, patient focus groups, and expert consensus. The scale's content validity will be evaluated through patient and expert reviews, while its construct validity is assessed using exploratory and confirmatory factor analyses, ensuring cross-cultural applicability. Criterion validity will be examined through correlations with clinical outcomes. Reliability will be tested via internal consistency and test-retest reliability measures. The study will involve adult outpatients with NVAF on OAC treatment for a minimum of 3 months, using both e-surveys and paper forms for data collection. RESULTS: It is anticipated that the SCSE-OAC will emerge as a reliable and valid tool for measuring SE in OAC self-care management. It will enable identifying patients at risk of poor adherence due to low SE, facilitating targeted educational interventions. The scale's validation in both English and Italian-speaking populations will underscore its applicability in diverse clinical settings, contributing significantly to personalized patient-centered care in anticoagulation management. CONCLUSIONS: The development and validation of the SCSE-OAC represent a significant advancement in the field of anticoagulation therapy. Validating the index in English- and Italian-speaking populations will enable personalized patient-centered educational interventions, ultimately improving OAC treatment outcomes. The SCSE-OAC's focus on SCSE introduces a novel approach to identifying and addressing individual patient needs, promoting adherence, and ultimately improving health outcomes. Future endeavors will seek to extend the validation of the SCSE-OAC across diverse cultural and linguistic landscapes, broadening its applicability in global clinical and research settings. This scale-up effort is crucial for establishing a universal standard for measuring SCSE in OAC management, empowering clinicians and researchers worldwide to tailor effective and culturally sensitive interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT05820854; https://tinyurl.com/2mmypey7. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51489.