The Holland Sleep Disorders Questionnaire: Factorial structure and measurement invariance in a psychiatric sample relative to the general population.

OBJECTIVES: Although common, sleep disorders often remain undiagnosed in psychiatric patients. A screening instrument, like the Holland Sleep Disorders Questionnaire (HSDQ) could improve this. Previous work indicated a 6-factor structure for the HSDQ, but this hasn't been investigated in psychiatric patients. METHODS: HSDQ data was collected in a psychiatric-outpatient sample (n = 1082) and general-population sample (n = 2089). Internal reliability of the HSDQ was investigated and Confirmatory Factor Analyses (CFA) were used to compare 1-, 6-, and second-order 6-factor models in both samples. Next, multigroup-CFA was used to investigate measurement invariance. RESULTS: Except for one subscale, internal reliability was acceptable in both samples. The 6-factor structure model fitted best in both samples and investigation of measurement invariance showed evidence for equality of the overall factor structure (configural invariance). Addition of equality constraints on factor loadings (metric invariance) and item thresholds (scalar invariance) showed good fit for all fit statistics, except for one. Exploratory analyses identified three items for metric and three different items for scalar invariance explaining this non-invariance. CONCLUSION: The HSDQ has a 6-factor structure in psychiatric patients, which is comparable to the general population. However, due to the observed non-invariance, users should be cautious with comparing HSDQ scores between psychiatric and general populations.

Development of a new perceived injustice scale for Bangla speaking population.

BACKGROUND: Perceived injustice is a relatively novel psychosocial construct starting to get some attention among researchers studying health and mental health outcomes. In the context of the widespread perception of being a victim of injustice in Bangladesh, a gap in instruments measuring perceived injustice was evident. The novelty of the construct and lack of similar instruments necessitated the development of a new Perceived Injustice Scale for Bangla speaking population. METHOD: A three-stage approach was used to develop the instrument. A thorough review of literature coupled with interviews with the general population as well as professionals contributed to the conceptualization of the construct. A rigorous process of expert evaluation and item analysis resulted in the identification of the most suitable items. RESULTS: The scale demonstrated a single-factor structure with adequate evidence of its reliability and validity. Reliability of the scale was assessed using internal consistency method (Cronbach alpha = .931; p< .01) and test-retest method (r = .837; p< .01). While validity was assessed using criterion-related validity (correlation with the Steel Injustice Inventory at r = .428; p< .01) and construct validity (correlation with the Perceived Stress Scale at r = .332; p< .01; and with the WHO Wellbeing Index at r = -.361; p< .01). CONCLUSION: The strong evidence of reliability and validity suggests the suitability of the scale for measuring perceived injustice in Bangladesh. Researchers and clinicians can use this 10-item scale with confidence in assessing perceived injustice among the general population.

Validation of the Argentine version of the epistemic trust, mistrust, and credulity questionnaire.

Epistemic trust refers to the trust in communicated knowledge, specifically an individual's ability to regard knowledge conveyed by others as meaningful, relevant to oneself, and applicable to other contexts. This area has received considerable attention in recent psychological literature, though predominantly from a theoretical perspective. The main objective of this study was to test the factorial validity of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) on an Argentine setting. Based on two studies (Study 1, n = 1018; Study 2, n = 559), the factorial structure of the instrument and its internal consistency were examined (S1 Appendix). In the second study, the factorial structure was confirmed, test-retest reliability was analysed, and associations between epistemic stances and sociodemographic variables, hypomentalisation, attachment styles, childhood traumatic experiences, and anxious-depressive symptomatology were explored. A satisfactory three-factor solution with 15 items and residual correlations was found in both studies, with stable scores over time. Significant positive correlations were found with anxious and fearful-avoidant attachment, hypomentalisation, childhood traumatic experiences, and psychopathological symptomatology. Post-hoc analysis revealed that, on the one hand, gender acts as a moderator in the relationship between hypomentalisation and epistemic mistrust. On the other hand, economic level and educational level moderate the relationship between hypomentalisation and epistemic credulity. Measurement invariance across gender was tested and found satisfactory, with significant differences subsequently observed in the epistemic trust factor. In conclusion, the Argentine version of the ETMCQ provides an empirical measure for use in non-clinical samples. Its application could facilitate clinically and theoretically relevant findings.

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.

Rasch validation of the revised body awareness rating questionnaire (BARQ-R) in adults with and without musculoskeletal pain.

BACKGROUND: The Revised Body Awareness Rating Questionnaire (BARQ-R) is a self-report measure of body awareness. First aim: evaluate the structural validity of BARQ-R with Rasch analysis in community-dwelling Americans with and without musculoskeletal pain. Subaim: validate a Rasch analysis of BARQ-R done in Norwegian adults with musculoskeletal pain, through a secondary analysis in our sample of Americans with musculoskeletal pain. METHODS: BARQ-R has 12 items with scores ranging from 0 (completely disagree) to 3 (completely agree), with higher total scores reflecting lower degrees of body awareness. Through Rasch analysis, we evaluated unidimensionality, item hierarchy, and structural validity with item and person fit, targeting, person separation reliability (PSR), local item dependence (LID), differential item functioning (DIF), and principal components analysis of residuals (PCAR). RESULTS: We recruited 623 adults with and without musculoskeletal pain (average age = 50.27 ± 17.25 years). After rescoring 1 item and deleting 3 items, the 9-item Rasch-based BARQ-R had no misfitting items, the hierarchical ordering of the items followed clinical expectations, 3 (0.48%) misfitting persons, person mean location: -0.62 ± 1.03 logits (max -0.53, min 0.72 logits), minimal floor effect (1.93%) and ceiling effect (0.48%), no DIF, and PSR = 0.72. LID was found in 5 item pairs. The PCAR's eigenvalue was 2.18. The secondary Rasch analysis in 152 adults with musculoskeletal pain (average age = 52.26 ± 16.13 years), demonstrated that, after rescoring 2 items, BARQ-R had no misfitting items and only 2 (1.32%) misfitting persons, good targeting (person mean location: -0.36 ± 0.88 logits), minimal floor effect (0.01%), no ceiling effect (0.00%), and PSR = 0.75. LID was found in 6 item pairs. The PCAR's eigenvalue was 2.47. CONCLUSIONS: BARQ-R had good item and person fit. PSR with items covering a limited logit range suggests that differing levels of body awareness are measured with only modest precision. Adding and revising items to cover a wider range of body awareness and to better address concepts of internal body awareness and body movements would improve BARQ-R's utility. Further analyses are needed before BARQ-R's use for research or in the clinic. In addition, future BARQ-R Rasch validation is needed in other populations with body awareness deficits, such as stroke or spinal cord injury.

Microsaccadic suppression of peripheral perceptual detection performance as a function of foveated visual image appearance.

Microsaccades are known to be associated with a deficit in perceptual detection performance for brief probe flashes presented in their temporal vicinity. However, it is still not clear how such a deficit might depend on the visual environment across which microsaccades are generated. Here, and motivated by studies demonstrating an interaction between visual background image appearance and perceptual suppression strength associated with large saccades, we probed peripheral perceptual detection performance of human subjects while they generated microsaccades over three different visual backgrounds. Subjects fixated near the center of a low spatial frequency grating, a high spatial frequency grating, or a small white fixation spot over an otherwise gray background. When a computer process detected a microsaccade, it presented a brief peripheral probe flash at one of four locations (over a uniform gray background) and at different times. After collecting full psychometric curves, we found that both perceptual detection thresholds and slopes of psychometric curves were impaired for peripheral flashes in the immediate temporal vicinity of microsaccades, and they recovered with later flash times. Importantly, the threshold elevations, but not the psychometric slope reductions, were stronger for the white fixation spot than for either of the two gratings. Thus, like with larger saccades, microsaccadic suppression strength can show a certain degree of image dependence. However, unlike with larger saccades, stronger microsaccadic suppression did not occur with low spatial frequency textures. This observation might reflect the different spatiotemporal retinal transients associated with the small microsaccades in our study versus larger saccades.

The Persian version of the fear of pain questionnaire mong Iranian post-surgery patients: a translation and psychometrics.

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

Cultural adaptation and psychometric evaluation of the Persian version of the motivation for nursing student scale (MNSS).

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

Development and psychometric validation of an age-friendly health system assessment tool in the Iranian context.

Evaluating health system interventions for elderly care necessitates a context-specific, credible and dependable instrument. This research was dedicated to creating and validating a tool to assess the health system's age-friendliness. The study unfolded in two pivotal stages: the generation of items utilizing a hybrid model and the psychometric appraisal of the tool, encompassing both validity and reliability assessments. From an initial pool of 522 items derived from a systematic scoping review and qualitative analysis, a concise assessment tool emerged, featuring 52 items across 6 domains: governance, information, resources, service delivery, community engagement and outcomes. The 52-item tool offers a straightforward, substantiated and robust means to gauge age-friendliness, pinpoint health system deficiencies and facilitate strategic planning on the basis of its insights.

Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa: systematic review.

Introduction: In sub-Saharan Africa, pregnant and postpartum women with mental health problems are often missed in healthcare systems. To address this, a practical and simple screening tool for maternal mental health should be available to primary healthcare workers. An important step toward having such a tool is to assess the existing tools and their effectiveness in primary care settings. Methods: We systematically searched PubMed, LILAC, CINAHL, Google Scholar, African Index Medicus, HINARI, and African Journals Online from inception to 31 January 2023, without language restriction. Reference lists of retrieved articles were reviewed and experts in the field were contacted for studies not captured by our searches. All retrieved records were collated in Endnote, de-duplicated, and exported to Rayyan for screening. Study selection and data extraction were done by at least two reviewers using a pre-tested flow chart and data extraction form. Disagreements between reviewers were resolved through discussion. We contacted primary authors for missing or insufficient information and conducted a content analysis of the psychometric properties of the tools. Results: In total, 1,181 studies were retrieved by our searches, of which 119 studies were included in this review. A total of 74 out of 119 studies (62%) were screened for depression during pregnancy and or the postpartum period. The Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) were the most commonly used tools. In total, 12 studies reported specificity and sensitivity for tools for measuring depression (EPDS, PHQ-9, and Whooley) and psychological distress [Self Report Questionnaire (SRQ) and Kessler Psychological Distress Scale (KPDS)]. The average sensitivity and specificity of the EPDS reported were 75.5 and 76.5%, respectively, at a cut-off of ≥13. The EPDS appears to be the most acceptable, adaptable, user-friendly, and effective in screening for maternal mental health conditions during pregnancy and postpartum. However, the methodological approach varied for a particular tool, and documentation on the attributes was scanty. Conclusion: The EPDS was the most commonly used tool and considered as most acceptable, adaptable, user-friendly, and effective. Information on the performance and psychometric properties of the vast majority of screening tools was limited. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022323558, identifier CRD42022323558 (PROSPERO).

Cross-cultural adaptation and psychometric properties of the Chinese version of the Intermittent Self-Catheterization Questionnaire (ISC-Q).

Background: The intermittent self-catheterization questionnaire (ISC-Q) is a valid and reliable tool to assess the quality of life (QOL) in patients with neurogenic lower urinary tract dysfunction (NLUTD) who engage in ISC. The aim of this research is to culturally adapt the ISC-Q and evaluate its psychometric properties within the Chinese patient population. Methods: The cross-sectional research was meticulously conducted in two pivotal stages: initially, the focus was on cross-cultural adaptation, followed by an extensive phase of psychometric testing. This comprehensive analysis involved 405 Chinese patients with NLUTD who use ISC. Various analyses, including evaluations of the floor and ceiling effects, item analysis, content validity, exploratory and confirmatory factor analysis (EFA and CFA), assessments of convergent, discriminant, and criterion validity. Additionally, Cronbach's alpha was utilized to determine internal consistency, and test-retest reliability was measured using the intraclass correlation coefficient (ICC). Results: No floor and ceiling effects were observed. The content validity index was 0.967. The EFA identified four factors, accounting for 64.953% of the total variance, and this four-factor structure was confirmed by the CFA. The fit indices in CFA were favorable, with χ2/df = 1.999, root mean square error of approximation = 0.070, comparative fit index = 0.916, Tucker-Lewis index = 0.900, goodness-of-fit index = 0.863, and incremental fit index = 0.917. The average variance extracted for the four factors ranged from 0.466 to 0.565, with composite reliability values ranging from 0.776 to 0.859. The ISC-Q showed a positive correlation with the intermittent self-catheterization acceptance questionnaire (r = 0.557, P < 0.001). The ICC overall Cronbach's alpha coefficient for the questionnaire was 0.821, and the for test-retest reliability was 0.951 (95% CI [0.900-0.976] P < 0.001). Conclusion: The validity and reliability of the Chinese version of the ISC-Q have been verified, making it suitable for measuring the QOL in NLUTD patients who practice ISC.

Development and validation of the Upstream Social Interaction Risk Scale (U-SIRS-13): a scale to assess threats to social connectedness among older adults.

Background: Social interactions are essential to social connectedness among older adults. While many scales have been developed to measure various aspects of social connectedness, most are narrow in scope, which may not be optimally encompassing, practical, or relevant for use with older adults across clinical and community settings. Efforts are needed to create more sensitive scales that can identify "upstream risk," which may facilitate timey referral and/or intervention. Objective: The purposes of this study were to: (1) develop and validate a brief scale to measure threats to social connectedness among older adults in the context of their social interactions; and (2) offer practical scoring and implementation recommendations for utilization in research and practice contexts. Methods: A sequential process was used to develop the initial instrument used in this study, which was then methodologically reduced to create a brief 13-item scale. Relevant, existing scales and measures were identified and compiled, which were then critically assessed by a combination of research and practice experts to optimize the pool of relevant items that assess threats to social connectedness while reducing potential redundancies. Then, a national sample of 4,082 older adults ages 60 years and older completed a web-based questionnaire containing the initial 36 items about social connection. Several data analysis methods were applied to assess the underlying dimensionality of the data and construct measures of different factors related to risk, including item response theory (IRT) modeling, clustering techniques, and structural equation modeling (SEM). Results: IRT modeling reduced the initial 36 items to create the 13-item Upstream Social Interaction Risk Scale (U-SIRS-13) with strong model fit. The dimensionality assessment using different clustering algorithms supported a 2-factor solution to classify risk. The SEM predicting highest risk items fit exceptionally well (RMSEA = 0.048; CFI = 0.954). For the 13-item scale, theta scores generated from IRT were strongly correlated with the summed count of items binarily identifying risk (r = 0.896, p < 0.001), thus supporting the use of practical scoring techniques for research and practice (Cronbach's alpha = 0.80). Conclusion: The U-SIRS-13 is a multidimensional scale with strong face, content, and construct validity. Findings support its practical utility to identify threats to social connectedness among older adults posed by limited physical opportunities for social interactions and lacking emotional fulfillment from social interactions.

An international field study for the reliability and validity of the EORTC communication questionnaire EORTC QLQ-COMU26.

BACKGROUND: The EORTC Quality of Life Group has developed a questionnaire to evaluate cancer patients' perception of their communication with healthcare professionals (HCPs): the EORTC QLQ-COMU26. In this study we test the validity and reliability of this novel measure in an international and culturally diverse sample of cancer patients. METHODS: Cancer patients completed the following EORTC questionnaires at two time points (before and during treatment): the QLQ-COMU26 (including a debriefing questionnaire), the QLQ-C30, and specific IN-PATSAT32 scales. These data were used to assess: the cross-cultural applicability, acceptability, scale structure, reliability, convergent/divergent validity, known-groups validity, and responsiveness to change of the QLQ-COMU26. RESULTS: Data were collected from 498 patients with various cancer diagnoses in 10 European countries, Japan, Jordan and India (overall 5 cultural regions). At most, only 3% of patients identified an item as confusing and 0.6% as upsetting, which indicates that the questionnaire was clear and did not trigger negative emotional responses. Confirmatory factor analysis and multi-trait scaling confirmed the hypothesised QLQ-COMU26 scale structure comprising six multi-item scales and four single items (RMSEA = 0.025). Reliability was good for all scales (internal consistency > 0.70; test-retest reliability > 0.85). Convergent validity was supported by correlations of ≥ 0.50 with related scales of the IN-PATSAT32 and correlations < 0.30 with unrelated QLQ-C30 scales. Known-groups validity was shown according to sex, education, levels of anxiety and depression, satisfaction with communication, disease stage and treatment intention, professional evaluated, and having a companion during the visit. The QLQ-COMU26 captured changes over time in groups that were defined based on changes in the item of satisfaction with communication. CONCLUSION: The EORTC QLQ-COMU26 is a reliable and valid measure of patients' perceptions of their communication with HCPs. The EORTC QLQ-COMU26 can be used in daily clinical practice and research and in various cancer patient groups from different cultures. This questionnaire can help to improve communication between patients and healthcare professionals.

The validity and reliability of the Arabic version of the EQ-5D in atrial fibrillation patients in a conflict country: a study from Syria.

BACKGROUND: The EQ-5D is one of the most commonly used tools to establish health-related quality of life (QoL). EQ-5D data in atrial fibrillation (AF) patients in the Middle East are lacking. OBJECTIVES: This study aims to evaluate the reliability and validity of the Arabic version of the EQ-5D in AF inpatients in Syria. METHODS: The study involved patients admitted to the emergency department of Tishreen's University Hospital in Latakia with AF as the primary diagnosis between the 1st of June 2021 and the 1st of June 2023. Arabic versions of the EQ-5D, EQ-VAS and SF36 questionnaires were administered to patients. Validation was done using convergent, discriminant, and known-groups validity, while reliability was conducted using EQ-5D retesting within 2-4 weeks. RESULTS: 432 participants were included in the study with a mean ± standard deviation of 63 ± 15. Males represented 242 (56%) of the participants. All hypotheses relating EQ-5D responses to external variables were satisfied. All three validation hypotheses demonstrated that the EQ-5D had the convergent, discriminant and known group validity to assess QoL in this cohort. The intraclass correlation coefficient (ICC) for test-retest reliability ranged between 0.74 and 0.88, while Cohen's κ ranged between 0.72 and 0.86. Cronbach's α value for internal consistency was 0.73. CONCLUSION: The Arabic version of EQ-5D was valid and reliable in measuring QoL in AF inpatients in Syria. This validation opens the door for more widespread use of the EQ-5D in Arabic-speaking regions, facilitating better-informed healthcare decisions and improving patient care strategies in Syria and other Middle Eastern countries.

Development and validation of the Thai Halitosis Associated Life-Quality Test (T-HALT): an evaluation of psychometric properties.

BACKGROUND: Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component. MATERIALS AND METHODS: This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure. RESULTS: T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings. CONCLUSION: T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity.

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.

Measuring internalized health-related stigma across health conditions: development and validation of the I-HEARTS Scale.

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