The working alliance inventory - short version: psychometric properties of the patient and therapist form in youth mental health and addiction care.

The therapeutic alliance is considered to play an important role in youth treatment. The commonly used versions of the Working Alliance Inventory (WAI) are based on Bordin's three-dimensional alliance model. However, previous psychometric studies of the WAI did not find this three-dimensional structure in youth psychotherapy. These earlier findings may indicate different perceptions of the alliance by adolescent versus adult patients, but may also be due to methodological shortcomings. The current study aims to address previous study limitations by evaluating the factor structure of the short version of the WAI (WAI-S) in youth treatment in multilevel analysis to address the hierarchical structure of the alliance data. We examined the psychometric properties of the patient (n = 203) and therapist (n = 62) versions of the WAI-S in youth mental health and addiction care and tested four multilevel models of alliance at start of treatment and 2-month follow-up. Our results suggests a two-factor model for youth and a three-dimensional model for their therapist at both time points. Since this is the first study that finds a best fit for a two-dimensional construct of alliance in youth, more research is needed to clarify whether the differences in alliance dimensions are due to measurement differences between the WAI-S for youth and therapists or whether youth and their therapists truly differ in their perceptions of the concept of alliance.

The Ottawa clinical fear of recurrence instruments: A screener, self-report, and clinical interview.

OBJECTIVE: Clinical fear of cancer recurrence (FCR) was recently defined by a group of experts during a Delphi study. Five criteria were agreed upon, namely: (a) high levels of preoccupation, (b) high levels of worry, (c) that are persistent, (d) hypervigilance and hypersensitivity to physical sensations that e) may result in functional impairment. No existing instruments comprehensively capture all these criteria for clinical FCR. METHODS: To remedy this gap, a set of three patient-reported outcome instruments including a one-item screener, self-report questionnaire, and semi-structured clinical interview, named the Ottawa Clinical Fear of Recurrence instruments, were developed. To do so, the research team first conducted a literature review of potential items. Additional FCR experts discussed the content of the screener and interview. The self-report's items were assessed for content validity by the same expert panel using Likert ratings and the Content Validity Index to narrow down the number of items. The three instruments were piloted with a group of cancer survivors to assess face validity following the European Organization for Research and Treatment of Cancer recommendations. RESULTS: The literature review and content validity assessment led to a final draft pre-pilot of 23 potential items for the self-report questionnaire. The instruments were piloted. Pilot study participants suggested changing wording and response options (particularly for the self-report) for greater clarity. CONCLUSIONS: Based on the feedback received, minor modifications were made, mostly for the self-report. In general, content and face validity for the three instruments were good for both experts and cancer survivors.

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 a food literacy questionnaire for schoolchildren in France.

Food literacy is gaining importance in nutrition education programs for children. To date, food literacy assessment tools have been developed in many countries, however, none exist in France. The objectives of this study were to develop a questionnaire and to evaluate its measurement properties among French schoolchildren aged 8-11 years. The questionnaire was developed in three phases: i) item selection (literature review and adaptation or creation of items) and content validity (submission to an expert panel), ii) questionnaire development including a pre-test in a small sample of children (n = 41) and item reduction and dimensionality based on the responses of children who completed the questionnaire in 31 schools between December 2022 and March 2023, and iii) questionnaire evaluation in terms of reliability, validity and acceptability. In total, 1187 responses were included in the analysis. The mean age of the children was 9.6 ± 0.7 years (girls: 51.2%, boys: 48.8%). The development process resulted in a 25-item questionnaire with good acceptability and satisfactory estimated reliability (McDonald omega coefficient = 0.73). Factor evaluation revealed a three-dimensional structure encompassing food and nutrition knowledge, participation in food preparation activities and food habits. To our knowledge, this study was the first to assess food literacy for schoolchildren in France. Our questionnaire can contribute to assess the factors that make food literacy vary, especially regarding socioeconomic variables to target priority populations for nutrition education actions and to describe changes in food literacy scores from a longitudinal perspective.

Initial evaluation of measurement properties of the Work Environment Impact Questionnaire (WEIQ) - using Rasch analysis.

BACKGROUND: To provide both preventive and rehabilitative conditions in a workplace, one must understand how employees experience work demands. Such an understanding can be obtained from each individual with valid and quality-assured questionnaires. The Work Environment Impact Questionnaire (WEIQ) is a new questionnaire for measuring employees' self-perceived work ability in relation to their specific workplace environment. The purpose of this study was to assess the measurement properties in terms of construct validity of the WEIQ. METHODS: A cross-sectional survey study was conducted with 288 respondents from three different workplaces involving assisted living personnel, vocational rehabilitation personnel and personnel at a research institute. The measurement properties of the WEIQ were assessed according to Rasch Measurement Theory (RMT), including assessment of item-to-sample targeting, threshold ordering, item fit statistics, unidimensionality and reliability. RESULTS: Item fit, i.e., fit residuals, item characteristic curves (ICC) and chi square values, were all satisfactory, and no disordered thresholds were present after collapsing the lowest response categories. However, issues with local dependent (LD) item correlations was present in 7.6% cases, four items showed statistically significant differential item functioning (DIF), where 11% of the respondents had person fit residuals outside the recommended range of ± 2.5 and the t-test for unidimensionality did not meet the criterion of 5%. Scale-to-sample targeting and reliability (0.92) were good. LD could be resolved with testlets and at the same time maintaining fit and improving dimensionality, but then the reliability decreased to 0.82. CONCLUSIONS: This study provides an initial validation of the WEIQ to be used for assessing employees' self-perceived work ability. Most measurement properties were acceptable, but further exploration of LD, DIF and unidimensionality in additional work settings and with larger sample sizes is warranted. TRIAL REGISTRATION: Not applicable.

Psychometric testing of the Chinese version of the Perceived Maternal Parenting Self-Efficacy Scale among postpartum women.

BACKGROUND: Maternal parenting self-efficacy plays a critical role in facilitating positive parenting practices and successful adaption to motherhood. The Perceived Maternal Parenting Self-Efficacy Scale (PMPS-E), as a task-specific measure, confirms its psychometric properties in cultural contexts. Compared with other tools, the advantages of the PMPS-E are as follows: (i) specific context or time period during the lifespan of a child, (ii) explicitly assess parenting self-efficacy across a diverse enough range of parenting tasks or activities during the perinatal/postnatal period and (iii) having robust psychometric properties. The aim of this study was to translate and determine the psychometric properties of the PMPS-E among Chinese postpartum women (C-PMPS-E). METHOD: The cross-cultural adaptation process followed Beaton et al.'s intercultural debugging guidelines. A total of 471 women were included to establish the psychometric properties of the C-PMPS-E. Mothers were asked to complete the C-PMPS-E, Edinburgh Postnatal Depression Scale (EPDS), the Generalized Anxiety Disorder-7 (GAD-7) and several demographic questions. The psychometric testing of the C-PMPS-E was established through item analysis, construct validity and internal consistency reliability. RESULTS: Item analysis showed that the critical ratios of all items were greater than 3 between the low-score group and high-score group, and all item-total correlation coefficients were greater than 0.4. The fit indices showed that the original correlated four-factor model of C-PMPS-E was observed to be an excellent fit to the data. The PMPS-E was negatively correlated with the EPDS and GAD-7 demonstrating its discriminant validity. As expected, no significant correlation was found between PMPS-E total or subscale scores and mothers' age. In addition, statistically significant differences for parity were detected for C-PMPS-E total and subscale scores with multipara having higher scores. This was taken as further evidence of the scale known-groups discriminant validity. In terms of internal consistency, the Cronbach's alpha of the C-PMPS-E total scale was 0.950, and subscales ranged from 0.76 to 0.89. Furthermore, a ROC curve analysis was conducted to establish the ability of the C-PMPS-E to distinguish between symptoms of depression and symptoms of anxiety. A cut-off value of 55 was identified that resulted in good specificity and fair sensitivity. CONCLUSION: The C-PMPS-E is a reliable and valid tool to assess maternal parenting self-efficacy in a Chinese context.

Pediatric psychoSocial Risk Index: Factor Analysis and Item Reduction Study.

OBJECTIVES: The Pediatric psychoSocial Risk Index (PSRI) is psychosocial risk screening instrument for health practitioners. The objective of this study was to confirm validity evidence of a truncated version of PSRI. METHODS: PSRI was completed initially by 100 parents of children aged 0 to 18 years admitted to a tertiary hospital; 50 parents repeated the PSRI 3 days later. Analysis includes principal component analysis (PCA) to include the least number of items that explain the most variance in a shortened version of PSRI as well as confirming test-retest reliability and internal consistency of the shortened instrument. RESULTS: PSRI originally had 86 items, 85 close-ended items were analyzed. Three items were excluded because of missing test-retest data. Item reduction resulted in truncation of 16 items; 66 items remained. A Kaiser-Mayer-Orkin test of sampling adequacy resulted in reduction of 14 items; 52 items remained. Initial PCA led to reduction of 26 items. The PCA was rerun on remaining items, resulting in reduction of 6 further items; 18 items remained. Two items with >10% missingness were removed leaving 16 items in the final PSRI. Test-retest reliability was 0.98 and mean within-person across-item reliability was 0.95. Cronbach α was 0.9. Remaining items represented 9 social risk themes: food insecurity, medical complexity, home environment, behavioral issues, financial insecurity, parenting confidence, parental mental health, social support, and unmet medical needs. CONCLUSIONS: PSRI was reduced from 86 to 16 items with high internal consistency and reliability. PSRI demonstrates adequate validity supporting practitioners to screen families about their psychosocial risk.

Psychometric properties of the experiences of maternity care scale among Iranian women.

BACKGROUND: Assessing women's perceptions of the care they receive is crucial for evaluating the quality of maternity care. Women's perceptions are influenced by the care received during pregnancy, labour and birth, and the postpartum period, each of which with unique conditions, expectations, and requirements. In England, three Experience of Maternity Care (EMC) scales - Pregnancy, Labour and Birth, and Postnatal - have been developed to assess women's experiences from pregnancy through the postpartum period. This study aimed to validate these scales within the Iranian context. METHODS: A methodological cross-sectional study was conducted from December 2022 to August 2023 at selected health centers in Tabriz, Iran. A panel of 16 experts assessed the qualitative and quantitative content validity of the scales and 10 women assessed the face validity. A total of 540 eligible women, 1-6 months postpartum, participated in the study, with data from 216 women being used for exploratory factor analysis (EFA) and 324 women for confirmatory factor analysis (CFA) and other analyses. The Childbirth Experience Questionnaire-2 was employed to assess the convergent validity of the Labour and Birth Scale, whereas women's age was used to assess the divergent validity of the scales. Test-retest reliability and internal consistency were also examined. RESULTS: All items obtained an impact score above 1.5, with Content Validity Ratio and Content Validity Index exceeding 0.8. EFA demonstrated an excellent fit with the data (all Kaiser-Meyer-Olkin measures > 0.80, and all Bartlett's p < 0.001). The Pregnancy Scale exhibited a five-factor structure, the Labour and Birth Scale a two-factor structure, and the Postnatal Scale a three-factor structure, explaining 66%, 57%, and 62% of the cumulative variance, respectively, for each scale. CFA indicated an acceptable fit with RMSEA ≤ 0.08, CFI ≥ 0.92, and NNFI ≥ 0.90. A significant correlation was observed between the Labour and Birth scale and the Childbirth Experience Questionnaire-2 (r = 0.82, P < 0.001). No significant correlation was found between the scales and women's age. All three scales demonstrated good internal consistency (all Cronbach's alpha values > 0.9) and test-retest reliability (all interclass correlation coefficient values > 0.8). CONCLUSIONS: The Persian versions of all three EMC scales exhibit robust psychometric properties for evaluating maternity care experiences among urban Iranian women. These scales can be utilized to assess the quality of current care, investigate the impact of different care models in various studies, and contribute to maternal health promotion programs and policies.

Measuring psychotherapeutic processes in the context of psychedelic experiences: Validation of the General Change Mechanisms Questionnaire (GCMQ).

BACKGROUND: Therapeutic and salutogenic effects of psychedelic drugs have been attributed to psychotherapeutic or psychotherapy-like processes that can unfold during the acute psychedelic experience and beyond. Currently, there are no psychometric instruments available to comprehensively assess psychotherapeutic processes (as conceptualized by empirical psychotherapy research) in the context of psychedelic experiences. AIMS: We report the initial validation of the General Change Mechanisms Questionnaire (GCMQ), a self-report instrument designed to measure five empirically established general change mechanisms (GCMs) of psychotherapy-(1) resource activation, (2) therapeutic relationship, (3) problem actuation, (4) clarification, and (5) mastery-in the context of psychedelic experiences. METHODS: An online survey in a sample of 1153 English-speaking and 714 German-speaking psychedelic users was conducted to evaluate simultaneously developed English- and German-language versions of the GCMQ. RESULTS: The theory-based factor structure was confirmed. The five GCMQ scales showed good internal consistency. Evidence for convergent validity with external measures was obtained. Significant associations with different settings and with therapeutic, hedonic, and escapist use motives confirmed the hypothesized context dependence of GCM-related psychedelic experiences. Indicating potential therapeutic effects, the association between cumulative stressful life events and well-being was significantly moderated by resource activation, clarification, and mastery. Factor mixture modeling revealed five distinct profiles of GCM-related psychedelic experiences. CONCLUSION: Initial testing indicates that the GCMQ is a valid and reliable instrument that can be used in future clinical and nonclinical psychedelic research. The five identified profiles of GCM-related experiences may be relevant to clinical uses of psychedelics and psychedelic harm reduction.

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.

Validation of the Chinese version of the coping strategies for victims of cyberbullying scale.

BACKGROUND: Although abundant evidence has confirmed cyberbullying as a global online risk, little is known about the coping strategies employed by victims and those who experiencing bullying. A validated scale for coping with cyberbullying could inform evidence-based social services and enable comparative studies of this phenomenon among victims from different backgrounds. This study aims to validate the Coping Strategies for Victims of Cyberbullying (CSVC) scale among Chinese adolescents and to compare its effectiveness between victims and bully-victims (individuals with dual roles). METHODS: A 25-item CSVC scale was translated and adapted for cultural relevance in the Chinese context. A sample of 1,716 adolescents, aged 13-18 years, from two middle schools and one high school in China, was recruited. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. RESULTS: The EFA revealed that the Chinese version of the CSVC scale had satisfactory validity. The CFA demonstrated a good fit for the eight-factor model in assessing different coping strategies for cyberbullying. Differences in the selection of coping strategies were observed between the general adolescent population and sexual and gender minorities. CONCLUSIONS: Future intervention studies may use this validated scale to educate adolescents, both those affected by cyberbullying and those who are not, to learn a broader range of coping strategies and to choose more effective ones.

Psychological well-being for cognitively impaired people scale: Assessing reliability and validity of Turkish version.

PURPOSE: The aim of the present study was to evaluate the psychometric properties of the Psychological Well-Being of Cognitively Impaired People (PWB-CIP) scale in people with dementia in nursing homes. METHOD: It was conducted with 70 people with dementia and 12 formal caregivers in two nursing homes. This study used translation and back translation for the scale's language equivalence and expert opinion for content validity. The reliability and validity were tested by exploratory and confirmatory factor analysis, test-retest correlation analyses, and internal consistency. RESULTS: The PWB-CIP was clustered under two factors. Cronbach's alpha scores for positive affect (α = 0.624), and negative affect (α = 0.822) factors were satisfactory. Confirmatory factor analysis revealed an acceptable level of fit (GFI = 0.905, p < 0.001, CFI = 0.94, RMSEA = 0.067). The test, retests were positively correlated (r: 0.756, p < 0.001). CONCLUSION: The 9-item PWB-CIP is a valid and reliable instrument for the examined Turkish sample. The PWB-CIP demonstrated robust psychometric properties in the context of nursing homes, indicating its suitability for assessing the well-being of individuals with dementia. NURSING IMPLICATIONS: The validated PWB-CIP can serve as a valuable tool for nurses and caregivers in evaluating the psychological well-being of cognitively impaired individuals in nursing home settings, enabling targeted interventions to enhance their overall quality of life.

Assessment of Voice Content for Voice Hearers: Psychometric Evaluation of the Perth Voice Content Questionnaire.

The experience of hearing voices is common to an estimated 7% of the general population, with the presence of negative content being the best predictor of whether individuals will require clinical support. Whilst largely neglected in the literature to date, there are calls to consider the significance of voice content for reducing voice-related distress. However, no quantitative and comprehensive measure of voice content with suitability for research and clinical use exists. This pilot study aimed to demonstrate preliminary psychometric properties of a newly developed measure, the Perth Voice Content Questionnaire (PVCQ), designed to measure the intensity and themes of positively and negatively valenced voice content, primarily of the dominant voice. The PVCQ and measures of voice severity and related beliefs were completed by 47 voice-hearing participants. The measure was found to be internally consistent, loaded onto two distinct factors of positive and negative content, and these factors were associated with voice-related distress and negative beliefs about voices and positive beliefs about voices, respectively, indicating good validity. The PVCQ offers the first self-report measure of voice content, with preliminary psychometric properties indicating its suitability for clinical and research use.

Development and initial testing of a brief, generic self-reported disability questionnaire: The Universal Disability Index.

BACKGROUND: Disability is an important multifaceted construct. A brief, generic self-reported disability questionnaire that promises a broader and more comparable measure of disability than disease-specific instruments does not currently exist. The aim of this study was to develop and evaluate such a questionnaire: the Universal Disability Index (UDI). METHODS: An online survey was used to collect general population data. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency and discriminant validity were also assessed. Bootstrapping was used to evaluate model stability and generalisability. RESULTS: 403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α > 0.90), were strongly correlated (Pearson's r > 0.7) with both GARS and GCPS disability scores, indicating concurrent validity, and could accurately discriminate between upper and lower quartiles of these comparators. Confidence intervals of estimates were narrow, suggesting model stability and generalisability. CONCLUSIONS: A brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted.

Cross-cultural translation and validation of the Chinese version Distress Tolerance Scale for adolescents with chronic physical disease.

INTRODUCTION: Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15-item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. METHODS: The 15-item English version DTS was translated into a Chinese version using the translation guidelines for cross-cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item-total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. RESULTS: The two-factor nine-item Chinese version DTS for Adolescents with CPD (C-DTS-A) was developed. Lower scores of the C-DTS-A were significantly associated with higher diabetes distress, poorer self-management, and worse glycaemic control; their correlation coefficients sequentially were -.40, .17 and -.23. Cronbach's α and the test-retest reliability of the two-factor C-DTS-A ranged from .81 to .87 and from .79 to .89, respectively. CONCLUSION: The two-factor nine-item C-DTS-A with good cross-cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD.

Psychometric Properties of the Spanish Motives for Online Gaming Questionnaire in a Sample of College Students.

This study investigates the psychometric properties of the Spanish version of the Motives for Online Gaming Questionnaire (MOGQ). We explored the factor structure and construct validity of the MOGQ through its relationships with gaming disorder symptoms (IGD-20) and impulsivity traits. We also analyzed if sociodemographic variables and gaming habits were related to gaming motives. An online cross-sectional survey was completed by 845 college students. Structure validity was examined using a combination of exploratory and confirmatory factor analyses, which supported a bifactor model composed of a general motivation factor and six uncorrelated factors (a mixed factor composed of escape and coping, competition, recreation, skill, social, and fantasy). Omega-hierarchical and omega coefficients were used to determine reliability of the MOGQ. The scale presented acceptable reliability for the general factor (ωh = .79) and the specific factor scores (social ω = .79, escape/coping ω = .81, competition ω = .79, skill ω = .84, fantasy ω = .82, and recreation ω = .70). Positive associations were observed between the MOGQ and the IGD-20 symptoms, with escape/coping (r = .48) and fantasy (r =.40) showing the strongest ones. Null or low correlations were observed with impulsivity traits. Motives to play varied significantly across genders. These findings provide evidence that the Spanish version of the MOGQ is a reliable and valid tool to assess motives to play online games.

Validation of Tunisian Arabic version of Pittsburgh Sleep Quality Index in non-clinical adolescents.

INTRODUCTION: Sleep quality is a complex phenomenon with quantitative and subjective aspects that vary during adolescence. The prevalence of sleep disorders is not known in Tunisia due to the lack of validated tools. AIM: To translate and validate the questionnaire Pittsburgh Sleep Quality Index (PSQI) into Tunisian Arabic in middle school students. METHODS: We translated the PSQI into Tunisian Arabic based on the translation back-translation method. We conducted a cross-sectional study on a sample of 560 adolescents. Exploratory factor analysis was performed to study construct validity. To test reliability, the global internal consistency of the scale was computed. RESULTS: The construct validity was verified by factor analysis, proving that a single factor explained 30.3% of the overall variance. This model produced a good factor load for all the components. The analysis of the reliability showed an acceptable internal consistency (Cronbach's alpha=0.6). CONCLUSION: The Arabic Tunisian version of the PSQI is a psychometrically valid measure. The PSQI could be useful for the detection and evaluation of symptoms of sleep disorders, as well as for further studies and researches about associated factors with poor sleep quality in adolescent and youth.

Validation of an Instrument That Measures Factors Affecting Saudi Parents' Tolerance of Risky Play: A Rasch Analysis.

IMPORTANCE: Benefits of children's participation in risky play are broadly recognized. However, most related research originates in Western countries; none focuses on outdoor play in Eastern countries, including Saudi Arabia. Furthermore, although the literature identifies varying perspectives on risky play among parents, there is no objective measure to assess personal, situational, and cultural factors shaping their risk tolerance. OBJECTIVE: To establish the construct validity and internal reliability of data gathered with the newly developed Factors Affecting Tolerance for Risk in Play Scale (FAC-TRiPS). DESIGN: Instrument development. SETTING: Online survey. PARTICIPANTS: Ninety Saudi parents with children ages 7 to 10 yr. OUTCOMES AND MEASURES: The FAC-TRiPS, a 17-item, self-report measure. We used Rasch analysis (Winsteps 4.4.4) to establish evidence for construct validity (item fit, match of item difficulty and parent tolerance, principal-components results) and internal reliability (person reliability index). RESULTS: Item fit analysis revealed that data from 15 of 17 items (88%) conformed to Rasch model expectations. Item difficulty closely matched parents' risk tolerance level. The principal-components analysis of residuals demonstrated that observed variance (49.6%) closely matched expected variance (49.7%). The first contrast's unexplained variance had an eigenvalue slightly greater than 2.5, suggesting possible multidimensionality. The person reliability index was .90. CONCLUSIONS AND RELEVANCE: Preliminary analysis suggests that the FAC-TRiPS yields valid, reliable data measuring factors that influence parents' risk tolerance. Further research is needed. Plain-Language Summary: This study contributes to the knowledge of how parents in Eastern countries perceive risky play. The Factors Affecting Tolerance for Risk in Play Scale (FAC-TRiPS) is a newly developed tool that occupational therapy practitioners can use to understand parents' beliefs about and tolerance for their children's participation in risky play. The findings facilitate an understanding of the complex nature of parenting when determining whether to allow children to participate in risky play activities.