Reliability and validity of the Chinese version of the Information Security Attitude Questionnaire for nurses.

AIM: Nurses play a crucial role within medical institutions, maintaining direct interaction with patient data. Despite this, there is a scarcity of tools for evaluating nurses' perspectives on patient information security. This study aimed to translate the Information Security Attitude Questionnaire into Chinese and validate its reliability and validity among clinical nurses. DESIGN: A cross-sectional design. METHODS: A total of 728 clinical nurses from three hospitals in China participated in this study. The Information Security Attitude Questionnaire (ISA-Q) was translated into Chinese utilizing the Brislin two-way translation method. The reliability was assessed through internal consistency coefficient and test-retest reliability. The validity was determined through the Delphi expert consultation method and factor analysis. RESULTS: The Chinese version of ISA-Q consists of 30 items. Cronbach's α coefficient of the questionnaire was 0.930, and Cronbach's α coefficient of the six dimensions ranged from 0.781 to 0.938. The split-half reliability and test-retest reliability were 0.797 and 0.848, respectively. The content validity index (S-CVI) was 0.962. Exploratory factor analysis revealed a 6-factor structure supported by eigenvalues, total variance interpretation, and scree plots, accounting for a cumulative variance contribution rate of 69.436%. Confirmatory factor analysis further validated the 6-factor structure, demonstrating an appropriate model fit. CONCLUSION: The robust reliability and validity exhibited by the Chinese version of ISA-Q establish it as a dependable tool for evaluating the information security attitudes of clinical nurses. IMPLICATIONS FOR NURSING PRACTICE: The Chinese iteration of the ISA-Q questionnaire offers a profound insight into the information security attitudes held by clinical nurses. This understanding serves as a foundation for nursing managers to develop targeted intervention strategies aimed at fortifying nurses' information security attitudes, thereby enhancing patient safety.

Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals.

PURPOSE: Patients' perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients. METHODS: For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald's omega coefficient was used to examine the internal consistency of reliability. RESULTS: In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald's omega coefficient was .90. CONCLUSION: The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.

Events related to medication errors and related factors involving nurses' behavior to reduce medication errors in Japan: a Bayesian network modeling-based factor analysis and scenario analysis.

PURPOSE: This study aimed to identify the relationships between medication errors and the factors affecting nurses' knowledge and behavior in Japan using Bayesian network modeling. It also aimed to identify important factors through scenario analysis with consideration of nursing students' and nurses' education regarding patient safety and medications. METHODS: We used mixed methods. First, error events related to medications and related factors were qualitatively extracted from 119 actual incident reports in 2022 from the database of the Japan Council for Quality Health Care. These events and factors were then quantitatively evaluated in a flow model using Bayesian network, and a scenario analysis was conducted to estimate the posterior probabilities of events when the prior probabilities of some factors were 0%. RESULTS: There were 10 types of events related to medication errors. A five-layer flow model was created using Bayesian network analysis. The scenario analysis revealed that "failure to confirm the 5 rights," "unfamiliarity with operations of medications," "insufficient knowledge of medications," and "assumptions and forgetfulness" were factors that were significantly associated with the occurrence of medical errors. Conclusion: s: This study provided an estimate of the effects of mitigating nurses' behavioral factors that trigger medication errors. The flow model itself can also be used as an educational tool to reflect on behavior when incidents occur. It is expected that patient safety education will be recognized as a major element of nursing education worldwide and that an integrated curriculum will be developed.

Chemiluminescence data modeling using parallel factor analysis for the simple and sensitive determination of diphenoxylate in human plasma and tablets.

In this study, a chemiluminescence (CL) method was developed to determine diphenoxylate in tablets and human plasma. This is the first CL method proposed to determine diphenoxylate. Creating three-dimensional data caused the parallel factor analysis algorithm (PARAFAC) to be used for the first time in CL methods. The method is based on the fact that diphenoxylate enhances the weak CL produced in the reaction of Ru(phen)3 2+ and acidic Ce(IV), and the concentration of Ce(IV) solution has a different effect on the CL response of diphenoxylate and the blank plasma. The calibration curve was linear from 4.0 × 10-8 to 1.6 × 10-6 mol L-1 (R2 = 0.9954), and the detection limit was 1.3 × 10-8 mol L-1 (S/N = 3). The sampling rate was about 30 samples per hour, and the % RSD for 10 repeated measurements of 4 × 10-7 mol L-1 diphenoxylate was 5.4%. The interference effects of some ions, amino acids, and common additives were also investigated. The CL method was successfully used to determine diphenoxylate in tablets, and the results were statistically confirmed by the reference method. The proposed CL method and the PARAFAC algorithm were successfully used to determine the concentration of diphenoxylate in human blood plasma samples.

Seasonal studies of aquatic humic substances from Amazon rivers: characterization and interaction with Cu (II), Fe (II), and Al (III) using EEM-PARAFAC and 2D FTIR correlation analyses.

Aquatic humic substances (AHS) are defined as an important components of organic matter, being composed as small molecules in a supramolecular structure and can interact with metallic ions, thereby altering the bioavailability of these species. To better understand this behavior, AHS were extracted and characterized from Negro River, located near Manaus city and Carú River, that is situated in Itacoatiara city, an area experiencing increasing anthropogenic actions; both were characterized as blackwater rivers. The AHS were characterized by 13C nuclear magnetic ressonance and thermochemolysis GC-MS to obtain structural characteristics. Interaction studies with Cu (II), Al (III), and Fe (III) were investigated using fluorescence spectroscopy applied to parallel factor analysis (PARAFAC) and two-dimensional correlation spectroscopy with Fourier transform infrared spectroscopy (2D-COS FTIR). The AHS from dry season had more aromatic fractions not derived from lignin and had higher content of alkyls moities from microbial sources and vegetal tissues of autochthonous origin, while AHS isolated in the rainy season showed more metals in its molecular architecture, lignin units, and polysacharide structures. The study showed that AHS composition from rainy season were able to interact with Al (III), Fe (III), and Cu (II). Two fluorescent components were identified as responsible for interaction: C1 (blue-shifted) and C2 (red-shifted). C1 showed higher complexation capacities but with lower complexation stability constants (KML ranged from 0.3 to 7.9 × 105) than C2 (KML ranged from 3.1 to 10.0 × 105). 2D-COS FTIR showed that the COO- and C-O in phenolic were the most important functional groups for interaction with studied metallic ions.

When income meets faith: the development and application of the Chinese generation Z unconventional religious orientation scale.

This study seeks to analyze the psychological construction of Unconventional Religious Orientations and their association with individual income level satisfaction within Generation Z. Generation Z, individuals born between 1995 and 2010, grew up in a socio-cultural context marked by digitization and globalization. This study identifies three key dimensions of Unconventional Religious Orientations: religious spiritual dependence, religious instrumental tendencies, and religious uniqueness identity. By combining rootedness theory, semi-structured interviews, and literature review, we constructed and refined a set of relevant scales. Using exploratory and validation factor analyses (EFA and CFA), we verified the structural validity of the scale. The results of the analyses revealed significant negative correlations between satisfaction with income level and all dimensions of Unconventional Religious Orientation for Generation Z, suggesting that Unconventional Religious Orientation tends to diminish as income satisfaction increases. In addition, the significant positive correlations between these dimensions of religious inclination imply that they may share certain underlying factors in their psychological structure. This study not only successfully developed a set of psychometric instruments for Unconventional Religious Orientations, but also provided a new psychological perspective for understanding the dynamic interaction between economic satisfaction and religious psychological attitudes in Generation Z.

The significant others' responses to trauma scale (SORTS): applying factor analysis and item response theory to a measure of PTSD symptom accommodation.

Background: Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs' participation in patients' avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients' symptoms. The Significant Others' Responses to Trauma Scale (SORTS) is the only existing measure of accommodation in PTSD but has not been rigorously psychometrically tested.Objective: We aimed to conduct further psychometric analyses to determine the factor structure and overall performance of the SORTS. Method: We conducted exploratory and confirmatory factor analyses using a sample of N = 715 FMs (85.7% female, 62.1% White, 86.7% romantic partners of individuals with elevated PTSD symptoms).Results: After dropping cross-loading items, results indicated good fit for a higher-order model of accommodation with two factors: an anger-related accommodation factor encompassed items related largely to minimising conflict, and an anxiety-related accommodation factor encompassed items related primarily to changes to the FM's activities. Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction, although the factors showed somewhat distinct associations. Item Response Theory analyses indicated that the scale provided good information and robust coverage of different accommodation levels.Conclusions: SORTS data should be analysed as both a single score as well as two factors to explore the factors' potential differential performance across treatment and relationship outcomes.

We examined the Significant Others' Responses to Trauma Scale (SORTS), a measure of symptom accommodation in PTSD, among a large sample of family members.As measured by the SORTS, accommodation in PTSD could be broken down into two aspects: anger-related accommodation and anxiety-related accommodation.Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction.

Measuring intangible cultural heritage image: A scale development.

Although an increasing number of studies have examined issues relating to the preservation and development of intangible cultural heritage (ICH), there has been limited research on how tourists perceive ICH. Moreover, UNESCO asserts that the concept of "authenticity" is not applicable to ICH, and so far, no valid instrument for measuring tourists' subjective perceptions of ICH has been developed, even though their perceptions play a very important role in the preservation and development of ICH. Therefore, this paper aims to develop a measurement scale for ICH image, using both qualitative and quantitative research methods. Participant observation, semi-structured in-depth interviews, secondary data collection, and a literature review were conducted to generate the initial scale items, and then the main surveys were conducted to collect data for the model tests. Four dimensions were extracted by exploratory factor analysis: transmission, localization, vitality, and association. The reliability and validity of the measurement model were demonstrated through confirmatory factor analysis. We further determined that the transmission, vitality, and association of ICH image have a positive impact on tourists' revisit intention. The paper highlights the crucial role of ICH image in sustainable tourism development. The theoretical and managerial implications of the study are discussed, followed by suggestions for future research.

Factor analysis of lifetime psychopathology and its brain morphometric and genetic correlates in a transdiagnostic sample.

There is a lack of knowledge regarding the relationship between proneness to dimensional psychopathological syndromes and the underlying pathogenesis across major psychiatric disorders, i.e., Major Depressive Disorder (MDD), Bipolar Disorder (BD), Schizoaffective Disorder (SZA), and Schizophrenia (SZ). Lifetime psychopathology was assessed using the OPerational CRITeria (OPCRIT) system in 1,038 patients meeting DSM-IV-TR criteria for MDD, BD, SZ, or SZA. The cohort was split into two samples for exploratory and confirmatory factor analyses. All patients were scanned with 3-T MRI, and data was analyzed with the CAT-12 toolbox in SPM12. Psychopathological factor scores were correlated with gray matter volume (GMV) and cortical thickness (CT). Finally, factor scores were used for exploratory genetic analyses including genome-wide association studies (GWAS) and polygenic risk score (PRS) association analyses. Three factors (paranoid-hallucinatory syndrome, PHS; mania, MA; depression, DEP) were identified and cross-validated. PHS was negatively correlated with four GMV clusters comprising parts of the hippocampus, amygdala, angular, middle occipital, and middle frontal gyri. PHS was also negatively associated with the bilateral superior temporal, left parietal operculum, and right angular gyrus CT. No significant brain correlates were observed for the two other psychopathological factors. We identified genome-wide significant associations for MA and DEP. PRS for MDD and SZ showed a positive effect on PHS, while PRS for BD showed a positive effect on all three factors. This study investigated the relationship of lifetime psychopathological factors and brain morphometric and genetic markers. Results highlight the need for dimensional approaches, overcoming the limitations of the current psychiatric nosology.

Development and validity evidence on the scale of perceived social support for university students (EPSSEU) during the period of social restrictions.

AIM: This study aims to validate a Perceived Social Support Scale for University Students (EPSSEU) during periods of social restrictions, by focusing on family and university support. SUBJECT AND METHODS: This cross-sectional study was conducted with undergraduate students from a public higher education institution. The college students who participated in the study-1353 at baseline and 378 after 6 months-answered a virtual questionnaire containing questions on: sociodemographic and lifestyle data, items proposed for the EPSSEU, Satisfaction with Social Support Scale (ESSS), and Depression, Anxiety and Stress Scale (DASS-21). Exploratory factor analysis, Cronbach's alpha reliability analysis, as well as discriminant, convergent, and known-group validations were performed. RESULTS: The results showed two factors support from: i) the university and ii) friends and family- which explained 61.82% of the variance in the data. The EPSSEU showed good reliability (Cronbach's alpha = 0.796) as well as validity, with higher scores among individuals without depression, anxiety, or stress. CONCLUSION: The EPSSEU shows adequate psychometric qualities and may be a useful instrument for assessing university students' social support in pandemics, social distancing, and remote teaching contexts.

Development and evaluation of the psychometric properties of a new measure of athlete insomnia: Insomnia in Response to Sports-related Stress Test questionnaire.

To develop and validate the Insomnia in Response to Sports-related Stress Test (IRSST) questionnaire, a new specific instrument with the goal of sensitively measuring vulnerability to sport-specific stressful situations among elite athletes. Five hundred and thirty-one competitive elite athletes (mean age = 17.6 ± 4.4 years) completed the Ford Insomnia Response to Stress Test (FIRST) questionnaire and the IRSST, a six-item questionnaire developed to assess the level of sleep disturbance in response to the commonly experienced sport-specific stressful situations. A development and validation process including substantive, structural, and external stages was used in the present study. One eigenvalue of the exploratory factor analyses was greater than 1.0 (i.e., 2.91, 48.52% of explained variance) whereas the scree test provided evidence for a one-factor solution, with all the six items achieving a loading of 0.40 or higher on the factor. Cronbach alpha was 0.77 and provided evidence for the reliability of the IRSST score. The correlation between IRSST and FIRST scores was 0.47 (p < 0.001, moderate effect size). These results provide strong evidence for construct validity, indicating that the IRSST is a promising scale for assessing the likelihood of sleep disruption due to sports-related stressful situations. The results of reliability and correlational analyses provided further evidence of the promising psychometric properties of the IRSST. We believe that the IRSST could provide to the sport and sleep science communities a sleep screening tool for use in this unique population.

Psychometric Properties of the Family Adaptability and Cohesion Evaluation Scale III in Latin American University Dental Students.

OBJECTIVE: The Family Adaptability and Cohesion Evaluation Scale III (FACES III) is a self-report instrument that enables the assessment of the dimensions of adaptability and cohesion within a family, establishing whether or not that family is functional and classifying it according to categories within those dimensions. The objective of this research was to determine the psychometric properties of this instrument using a sample of dental students from 5 Latin American countries. MATERIALS AND METHODS: The FACES III was administered to a sample of 2888 university dental students from Colombia (35.3%), Chile (34.6%), the Dominican Republic (19%), Argentina (6%), and El Salvador (5.1%). Confirmatory factor analysis was used to examine the factorial structure of the scale, comparing 3 models proposed in the Latin American literature, establishing a multigroup analysis to examine invariance among countries. RESULTS: The results revealed a structure composed of 2 dimensions: cohesion and adaptability. These dimensions showed adequate structure and internal consistency. The invariance of the measurement model in the participating countries was confirmed. CONCLUSION: In general, this study offers evidence of the adequacy of the psychometric properties of FACES III in Colombian, Chilean, Dominican, Argentine, and Salvadoran dental students.

Construction and validation of a new Generational Time Perspective Questionnaire.

The article presents a proposal for a new diagnostic tool-the Generational Time Perspective Questionnaire. The Generational Time Perspective was defined as a cognitive-affective representation of the future in relation to the lives of a generation of people that the current generation of people will not live to see. This definition was the starting point for the construction of the Generational Time Perspective Questionnaire. The results of exploratory and confirmatory factor analyses indicate a two-factor structure of the Generational Time Perspective Questionnaire. The first factor includes items about the cognitive representation of the future in the next generations. The second factor describes negative emotions towards the problems that humanity may face in future generations. The reliability of the particular dimensions of the questionnaire is satisfactory. The Generational Time Perspective Questionnaire correlates with other constructs that diagnose different aspects of an individual's temporality.

Psychometric assessment of the 10-item Thai version of the Experience in Close Relationship-Revised for Adolescents (ECR-R-10-AD).

The 18-item version of the Experiences in Close Relationships-revised (ECR-R-18) is a valid and reliable scale used among Thai adolescents. However, it revealed problematic items that impacted the scale's internal consistency. The study aimed to achieve two objectives: (1) develop a new, shorter scale by retaining only highly loaded items equally between attachment anxiety and attachment avoidance, and (2) evaluate the psychometric properties of the shorter ECR-R version compared to the existing 18-item scale. Objective 1 was achieved through Study 1, involving 204 youths aged 16-18 years (64% female). All participants completed the 18-item ECR-R, and exploratory factor analysis was conducted to identify suitable items for the new ECR-R-AD. Objective 2 was fulfilled in Study 2, which included a total of 443 students in grades aged 15-18 years old (88% female) from Thai boarding schools in Northern Thailand. All participants completed both the 18-item ECR-R, and confirmatory factor analysis of both the existing 18-item and the new shorter scale was performed and compared. Additional measures including the Rosenberg Self-Esteem Scale, Perceived Stress Scale-10, and Relationship Questionnaire were completed alongside the ECR-R to assess convergent, discriminant, and criterion validity. The invariance test for the new ECR-R across genders was conducted using multigroup confirmatory factor analysis. For objective 1, Study 1 developed a new scale called "ECR-R-10-AD" with 10 items, comprising 5 for attachment anxiety and 5 for attachment avoidance. The McDonald's omega values were 0.866 for avoidance and 0.823 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10-AD was significant. For objective 2, Study 2 found that the first-order two-factor solution model fit the data best for the ECR-R-10-AD. Convergent, discriminant, and criterion validity with other measurements and invariance tests based on sex were established for the ECR-R-AD. The ECR-R-10-AD provided sufficient psychometric properties among Thai adolescents. Factorial validity, convergent validity, and measurement invariance were established. As the ECR-R-10-AD is brief, it can be administered with less burden. Limitations and future research were discussed.

Causal analysis of radiotherapy safety incidents based on a hybrid model of HFACS and Bayesian network.

Objective: This research investigates the role of human factors of all hierarchical levels in radiotherapy safety incidents and examines their interconnections. Methods: Utilizing the human factor analysis and classification system (HFACS) and Bayesian network (BN) methodologies, we created a BN-HFACS model to comprehensively analyze human factors, integrating the hierarchical structure. We examined 81 radiotherapy incidents from the radiation oncology incident learning system (RO-ILS), conducting a qualitative analysis using HFACS. Subsequently, parametric learning was applied to the derived data, and the prior probabilities of human factors were calculated at each BN-HFACS model level. Finally, a sensitivity analysis was conducted to identify the human factors with the greatest influence on unsafe acts. Results: The majority of safety incidents reported on RO-ILS were traced back to the treatment planning phase, with skill errors and habitual violations being the primary unsafe acts causing these incidents. The sensitivity analysis highlighted that the condition of the operators, personnel factors, and environmental factors significantly influenced the occurrence of incidents. Additionally, it underscored the importance of organizational climate and organizational process in triggering unsafe acts. Conclusion: Our findings suggest a strong association between upper-level human factors and unsafe acts among radiotherapy incidents in RO-ILS. To enhance radiation therapy safety and reduce incidents, interventions targeting these key factors are recommended.

The Patient Activation Measure-13 (PAM-13) in an oncology patient population: psychometric properties and dimensionality evaluation.

BACKGROUND: Accurate assessment and enhancement of health-related skills among oncology patients are pivotal for optimizing cancer care. The Patient Activation Measure (PAM-13), a questionnaire designed to reflect an individual's knowledge, skills, and confidence in self-healthcare management, has been validated across diverse countries and settings. Concerns have been raised regarding the cross-situational applicability, as patients with specific diseases and cultural backgrounds interpret questionnaire items differently. This study aimed to examine the structural validity and psychometric properties of the PAM-13 in an oncological patient cohort. METHODS: Baseline data from a longitudinal non-randomized controlled study involving cancer out-patients (n = 1,125) from Comprehensive Cancer Centres in Southern Germany were analysed. The German version of the PAM-13 was employed. With classical test and item response theory methods data quality, reliability, convergent and structural validity, as well as psychometric properties were assessed. Exploratory (EFA) and confirmatory factor analyses (CFA) were employed to investigate the postulated unidimensionality of the underlying construct. With a partial credit model (PCM) we examined item fit, targeting, local independence and differential item functioning. RESULTS: Participants were predominantly female (73.0%) with a breast cancer diagnosis (41.3%). While items were generally well-accepted, ceiling effects were observed and a high mean PAM-13 score (69.7, SD = 14.2) was noted, potentially compromising responsiveness to interventions. Reliability was adequate (Cronbach's α = 0.81), person and item separation reliability were good to excellent (0.81 and 0.99, respectively). Explorations of the unidimensionality of the construct (EFA, CFA, PCM) yielded inconclusive results, hinting towards a two-factor solution. Item difficulty rankings deviated from the original. No differential item functioning was identified, and local independence was confirmed. CONCLUSIONS: While the PAM-13 serves as a valuable instrument for comprehending and promoting health-related skills in cancer patients, the identification of ceiling effects, disordered item-difficulty rankings, and inconclusive findings regarding unidimensionality contribute to the expanding body of evidence, emphasizing the dependency of PAM-13's validity and reliability on distinctive characteristics within the population under investigation. Future research should prioritize refining or adding PAM-13 items to better capture the specific health-related challenges within diverse populations, paving the way for more effective patient engagement strategies in oncology. TRIAL REGISTRATION NUMBER: DRKS00021779.

Measuring sociocultural engagement of health professions education students: a psychometric study.

BACKGROUND: Sociocultural engagement of students refers to broadening viewpoints and providing awareness of, and respect for, diverse backgrounds and perspectives. However, there are no existing validated instruments in the literature for measuring sociocultural engagement of health professions education (HPE) students. Therefore, the aim of this study is to develop and validate a questionnaire designed to assess sociocultural engagement among HPE students. METHODS: The study included undergraduate HPE students (n = 683) at Gulf Medical University. The initial version of the sociocultural engagement of students' questionnaire (SESQ) was developed after extensive literature review and guided by the Global Learning Qualifications Framework. We then tested the content validity of the questionnaire by using focus group discussion with subject experts (n = 16) and pilot testing with students (n = 20). We distributed the content-validated version of the SESQ (16 items) to undergraduate students in six HPE colleges. To examine the construct validity and construct reliability of the questionnaire, we conducted exploratory factor analysis, followed by confirmatory factor analysis. RESULTS: Confirmatory factor analysis supported the two-factor structure which consists of 13 items with good fitness indices (χ2 = 214.35, df = 61, χ 2/df = 3.51, CFI = 0.98, RMSEA = 0.06, SRMR = 0.025, and AIC = 208.00). The two factors were sociocultural interactions (8 items) and sociocultural adaptation (5 items). The construct reliability of the total questionnaire is 0.97 and the two factors were 0.93 and 0.92 for sociocultural interactions and sociocultural adaptation, respectively. In addition, there were significant weak correlations between both factors of sociocultural engagement scores and student satisfaction with the university experience (r = .19 for each, P = .01). CONCLUSIONS: The sociocultural engagement of students' questionnaire exhibits good evidence of construct validity and reliability. Further studies will be required to test the validity of this questionnaire in other contexts.

Substantial Increases in Healthcare Students' State Empathy Scores Owing to Participation in a Single Improvisation Session.

PURPOSE: To determine whether the 12-item state empathy scale could be modified reliably to measure empathy in healthcare professions students and to detect changes in their empathy owing to a single improvisation (improv) session. METHODS: Three cohorts of students from two healthcare professions programs (total = 165 students) participated in an improv session. During the session, one of the researchers (BS) tasked the students with several improv activities. Participants' self-reported state empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester) using revised, in-class paper versions of the State Empathy Scale. RESULTS: The exploratory factor analysis revealed a single factor solution for the revised scale, justifying the creation of an overall state empathy score from the questionnaire. Cronbach's alpha reliability values averaged 0.87. Students' mean empathy scores were higher directly after the improv session than directly prior to the session (p < 0.0001; effect size = r = 0.67, 0.55, and 0.79 for cohorts 1, 2, and 3, respectively). CONCLUSIONS: These findings show that a single one- or two-hour improv session can foster substantial increases in healthcare professional students' state empathy for one another. Greater healthcare professional empathy and compassion foster better healthcare team cooperation and patient outcomes, so healthcare professionals and their students should engage in such empathy-enhancing activities at regular intervals throughout their training and careers.

The Flourishing Scale: Psychometric Properties in Breast Cancer Patients.

BACKGROUND/OBJECTIVE: Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context. METHOD: Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage. RESULTS: The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress. DISCUSSION: The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.

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.