Psycho-emotional intervention with parents of very preterm babies during the first year: A single-arm pilot study.

Studies of intervention programs that aim to improve the emotional state of parents of children admitted to the neonatal intensive care units (NICU) are scarce in Spain. The aims of this single-arm pilot study are to get to know the emotional profile of parents of high-risk preterm newborns, and to explore parents' patterns of emotional well-being before and after a psychological program called the Parental Empowerment Program, to increase parental readiness levels. The sample was made up of 100 parents (50 couples) who participated in the program. Measurements were taken of post-traumatic stress, depression, and resilience at 1 month and 12 months. Repeated measurements and dyadic data analyses were performed. One month after the birth of the baby and prior to the start of the program, mothers show more symptoms of stress and depression than fathers. After the intervention, both parents experienced improvements in their mood levels. The evidence obtained seems to show that high resilience levels and low post-traumatic stress symptoms are associated with reduced depression levels after implementing the program. However, the heterogeneity of the responses obtained, the observed associations between stress, resilience, and maternal depression, along with the reciprocal influence between maternal and paternal depression 1 year after the intervention, highlight the need for a more in-depth exploration of the interplay between risk and protective factors in this population. Despite the identified potential threats to validity, further work in this direction is recommended, including the implementation of clinical trials to demonstrate intervention efficacy. The adaptation of the parents' mutual emotional adjustment at each stage would allow them to participate more actively in the baby's care.

The Methodological Quality Scale (MQS) for intervention programs: validity evidence.

Introduction: A wide variety of instruments are used when assessing the methodological quality (MQ) of intervention programs. Nevertheless, studies on their metric quality are often not available. In order to address this shortcoming, the methodological quality scale (MQS) is presented as a simple and useful tool with adequate reliability, validity evidence, and metric properties. Methods: Two coders independently applied the MQS to a set of primary studies. The number of MQ facets was determined in parallel analyses before performing factor analyses. For each facet of validity obtained, mean and standard deviation are presented jointly with reliability and average discrimination. Additionally, the validity facet scores are interpreted based on Shadish, Cook, and Campbell's validity model. Results and discussion: An empirical validation of the three facets of the MQ (external, internal, and construct validity) and the interpretation of the scores were obtained based on a theoretical framework. Unlike other existing scales, MQS is easy to apply and presents adequate metric properties. In addition, MQ profiles can be obtained in different areas of intervention using different methodologies and proves useful for both researchers doing meta-analysis and for evaluators and professionals designing a new intervention.

Methodological procedure based on quantitizing/liquefying: a case study to assess work climate in an emergency department.

Introduction: In the assessment of health organizations, results-based indicators are mainly used, with no consideration of internal work dynamics. This type of assessment forfeits much of the rich, useful information needed to make decisions on improving the organization. In order to address this, a rigorous procedure based on mixed methods is laid out here on gathering, analyzing, and interpreting data associated with the implementation process. Methods: A 55-year-old doctor was selected at random from among the staff who volunteered to be interviewed at the emergency department at a public hospital located in southern Spain for an interview. Qualitative data obtained from the in-depth interview (indirect observation) were progressively systematized (liquefied and quantitized) based on a theoretical framework until a code matrix was obtained, without losing or distorting any information. Afterwards, data quality was controlled using Cohen's kappa (κ) coefficient. A quantitative polar coordinate analysis was then carried out using the free software HOISAN (v. 1.6.3.3) to obtain robust results, vectorizing the relationships between codes and specifying whenever such relationships were statistically significant (and if they resulted in behavior activation or inhibition). Finally, a supplementary quantitative and qualitative assessment was carried out. Results and discussion: The proposed method was applied to the needs assessment of teams in order to evaluate that work climate in the hospital's emergency department Health Services of a hospital. Data quality control yielded an adequate result (κ = 0.82). Significant activation and inhibition of behaviors occurred, both prospectively and retrospectively. For instance, We seek to understand the needs of our clients and We readily adapt to new circumstances showed a significant activation (vector length = 3.43, p < 0.01) both prospectively (Zsum = 0.48) and retrospectively (Zsum = 3.4).An adequate method to obtain detailed information about group dynamics in a work environment is presented, based on an in-depth interview. Practical applications for implementations to improve the functioning of organizations are presented.

Emotional Self-Regulation in Everyday Life: A Systematic Review.

Emotional self-regulation in childhood and adolescence constitutes a growing interest in the scientific community, highlighting in recent years the need to observe its development in their daily life. Therefore, the objective of this systematic review is to characterize publications referring to the development of emotional self-regulation of people under 18 years-old, in natural contexts. Based on the PRISMA guidelines, searches are carried out in the Web of Science, Scopus and PsycINFO databases, and in Google Scholar until May 2020. After reviewing the full text of 376 publications, 14 works are selected that are observed in their extrinsic, substantive and methodological characteristics based on the GREOM and MQCOM guidelines, by two independent evaluators. Most of the studies correspond to the last 20 years, increasing the interest in observing older children, in interaction with adults and/or in different cultures. They apply mixed methodologies, not always ascribing to a low intensity design. Strengths are observed regarding the collection and analysis of the quality of the data; and weaknesses related to the failure to record the duration and sequence of behaviors, highlighting the use of guidelines as guides for future research.

Predictive Factors of Mental Health in Survivors of Intimate Partner Violence in Chile.

Studies about violence against women specific to the Chilean population are scarce. As a result, government treatment programs lack a local perspective. Predictor variables were analyzed in the mental health of Chilean women who have survived intimate partner abuse. Two hundred and two women who made regular visits to public Women's Centers participated in the study; on average, they had survived 11 years of abuse. Logistic regression analyses were conducted to determine what variable/s in the history of violence best predicted the mental health variables. Among other protective factors, an increase in both resilience and the time since the last violent episode yielded a reduction in levels of general psychological distress (B = -1.836, p < .001 and B = 1.117, p < .001 respectively), post-traumatic stress disorder (B = -1.243, p = .002 and B = 1.221, p < .001 respectively), and depression (B = -1.822, p < .001 and B = 1.433, p < .001 respectively). The study also noted risk factors such as a high level of additional stressors, which in turn led to increased levels of general psychological distress (B = 1.007, p = .005), post-traumatic stress disorder (B = 0.928, p = .013), and depression (B = 1.061, p = .016). The Women's Center is the place where women feel most supported. To improve the effectiveness of treatments at these centers and aid in the recovery of women who have suffered from intimate partner violence, the predictive factors significantly related to mental health should be taken into account. This means prioritizing cases where the last episode of violence was more recent, addressing additional stressors, and promoting resilience.

From randomized control trial to mixed methods: a practical framework for program evaluation based on methodological quality / Del ensayo controlado aleatorizado a los métodos mixtos: un marco práctico para la evaluación de programas basado en la calidad metodológica

The evidence used when making decisions about the design, implementation and evaluation in intervention programs should be methodologically sound. Depending on the context of the intervention, different methodologies may apply. Nonetheless, the intervention context is often unstable and, to adapt to changing circumstances, it sometimes becomes necessary to modify the original plan. The framework proposed herein draws on approaches that can be considered two extremes of a continuum (experimental/quasi-experimental designs and studies based on observational methodology). In unstable intervention context conditions, this enables decisions from a methodological quality approach regarding design, measurement, and analysis. Structural dimensions, i.e., units (participants, users), treatment (program activities), outcomes (results, including decisions about the instruments to use and data gathering), setting (implementation context) and time will be detailed as part of the practical framework. The present study aims to specify the degree of correspondence/complementarity between components in these structural dimensions of a program evaluation from a practical complementarity perspective based on methodological quality.(AU)

La evidencia utilizada al tomar decisiones sobre el diseño, implementación y evaluación en los programas de intervención debe ser metodológicamente sólida. Dependiendo del contexto de la intervención, se pueden aplicar diferentes metodologías. Sin embargo, el contexto de la intervención es a menudo inestable y, para adaptarse a las circunstancias cambiantes, en algunas ocasiones se hace necesario modificar el plan original. El marco propuesto en este documento se basa en enfoques que pueden considerarse dos extremos de un continuo (diseños experimentales / cuasiexperimentales y estudios basados ​​en metodología observacional). En condiciones de contexto de intervención inestable, esto permite tomar decisiones desde un enfoque de calidad metodológica en cuanto a diseño, medición y análisis. Las dimensiones estructurales, i.e., las unidades (participantes, usuarios), el tratamiento (actividades del programa), los resultados (incluidas las decisiones sobre los instrumentos a utilizar y la recopilación de datos), el entorno (contexto de implementación) y el tiempo se detallarán como parte del marco práctico. El presente estudio tiene como objetivo especificar el grado de correspondencia / complementariedad entre componentes en estas dimensiones estructurales de la evaluación de un programa desde una perspectiva de complementariedad práctica basada en la calidad metodológica.(AU)

Effect of a Ketogenic Diet on the Nutritional Parameters of Obese Patients: A Systematic Review and Meta-Analysis.

The effect of a ketogenic diet (KD) on biochemical parameters and nutritional status has been the subject of debate over the years, as several randomized clinical trials (RCTs) obtained different results. METHOD: A systematic review and random-effects meta-analysis of RCTs comparing KD with a balanced diet was performed by means of a search of PubMed, Cochrane Library, Scopus, and Web of Science. Trials where the method for measuring the response variables was unclear, those that considered pathologies other than chronic non-communicable diseases and those with participants receiving pharmacological treatment for obesity were excluded from the comparison. RESULTS: Of the studies included in the meta-analysis, no statistically significant standardized mean differences were observed for body mass index (BMI) (d = -0.457, p = 0.359), total cholesterol, COL-T (d = 0.230, p = 0.591), high-density lipoprotein, HDL (d = -0.028, p = 0.934), low-density lipoprotein, LDL (d = 0.528, p = 0.173), or triglycerides, TG (d = -0.283, p = 0.222), with high values of heterogeneity. The percentage of women included in the studies is a significant moderating variable in terms of BMI ratio (z = -6.68, p < 0.001) and TG (z = -2.27, p = 0.023). CONCLUSION: A KD shows no more benefits on nutritional parameters than a balanced diet, and adverse effects of being on the diet are sometimes reported.

A Training Intervention through a 360° Multisource Feedback Model.

Physicians and other health sciences professionals need continuous training, not only in technical aspects of their activity but also in nontechnical, transversal competencies with a cost-efficient impact on the proper functioning of healthcare. The objective of this paper is to analyze the behavioral change among health professionals at a large public hospital following a training intervention on a set of core nontechnical competencies: Teamwork, Adaptability-Flexibility, Commitment-Engagement, Results Orientation, and Leadership Skills for Supervisors. The 360° Multisource Feedback (MSF) model was applied using three sources of information: supervisors, co-workers, and the workers themselves (self-assessment). A quasi-experimental pretest-post-test single-group design with two points in time was utilized. The training intervention improved the scores of only one of the trained competencies-the "Results Orientation" competency-although the scores were slightly inflated. Moreover, significant discrepancies were detected between the three sources, with supervisors awarding the highest scores. The magnitude of behavioral change was related to certain sociodemographic and organizational variables. The study was not immune to the ceiling effect, despite control measures aimed at avoiding it. The empirical evidence suggests that the 360° MSF model must be maintained over time to enhance and reinforce an evaluation culture for better patient care.

Spanish Adaptation of the Inventory Brief Child Abuse Potential and the Protective Factors Survey.

Child maltreatment is a public health problem with different consequences depending on the form of abuse. Measuring risk and protective factors has been a fertile ground for research, without involving instruments with sufficient evidence of validity. The aim of the study was to gather evidence of validity and reliability of the Inventory Brief Child Abuse Potential (IBCAP) and Protective Factors Survey (PFS) in the Mexican population. The instruments were translated into Spanish. In a non-probabilistic sample of 200 participants, the 7-factor model for the IBCAP [comparative fit index (CFI) = 0.984; root mean square error of approximation (RMSEA) = 0.067] and the 4-factor model for the PFS (CFI = 0.974; RMSEA = 0.061) were confirmed, showing adequate fit indices. Reliability was estimated and evidence of convergent, divergent, and discriminant validity was collected, controlling for effects of social desirability. We also report interpretability statistics of the scores. We achieved solid progress in the development of instrumentation that allows determining the presence or absence of protective and risk factors for child abuse.

Work Climate Scale in Emergency Services: Abridged Version.

This study is based on a 40-item work climate scale in hospital emergency services (WCSHES). Teams working in these emergency services experience a heavy workload and have a limited amount of time with each patient. COVID-19 has further complicated these existing issues. Therefore, we believed it would be helpful to draft an abridged version of the 40-item WCSHES, considering both validity and reliability criteria, but giving greater weight to validity. One hundred and twenty-six workers between the ages of 20 to 64 (M = 32.45; standard deviation (SD = 9.73)) years old participated voluntarily in the study. The validity, reliability, and fit model were evaluated in an iterative process. The confirmatory factor analysis yielded appropriate global fit indices in the abridged 24-item version (Χ2(248) = 367.84; p < 0.01, RMSEA = 0.06 with an interval of 90% from 0.05 to 0.07, SRMR = 0.08, GFI = 0.9, AGFI = 0.96, CFI = 0.98, NFI = 0.95, and NNFI = 0.98), along with test criteria validity (ρXY = 0.68, p < 0.001) and excellent reliability (α = 0.94 and ω = 0.94), maintaining the same conceptualization and usefulness of the original scale. The abridged 24-item version was used to measure four work climate factors (work satisfaction, productivity/achievement of aims, interpersonal relations, and performance at work). Evidence of the usefulness of the new abridged scale is provided along with a description of our study limitations and future areas for development.

Couples extrinsic emotion regulation questionnaire: Psychometric validation in a Chilean population.

The way couples regulate their emotions affects the quality of their relationship. Despite this, no evidence-based scales of validity and reliability can measure the intention to regulate emotions in the romantic dyad. In order to address this gap, we developed the Couples Extrinsic Emotion Regulation (CEER) questionnaire. First, we adapted the "Others" subscale from the Emotion Regulation of Others and Self questionnaire (EROS) for any close relationship to measure the intention to regulate emotions in couples; second, the psychometric properties of the CEER questionnaire were studied. For the content validity assessment, 23 experts (47.8% of whom worked in social and health psychology and the psychology of emotions, 17.4% in couples' therapy, and 34.8% in social science methodologies) participated. A total of 528 Chileans completed the online CEER questionnaire, the relationship satisfaction scale (RAS) and dyadic adjustment scale (DAS): 27.8% were male, age M = 38.7, SD = 10.05, and time of the relationships M = 11.27, SD = 9.82. The content-based validity study made it possible to determine which items to include in the final version. Two unrelated first-order factors structure of the original test fit (RMSEA = .052, GFI = .97, AGFI = .95; CFI = .99; NFI = .98; and NNFI = .98). The CEER+ and CEER- factors presented adequate internal consistency (α = .79; ω = .80 and α = .85; ω = .85, respectively). The discrimination index of the factors were excellent (CEER+ = .55 and CEER- = .63). Validity evidence based on the relations to other variables showed a direct positive relation between CEER+, RAS and overall DAS, as well as their factors; and a negative relation between CEER-, RAS overall DAS, as well as their factors. The use of this instrument is recommended for the identification of Chilean couples where at least one of the partners has a less favorable opinion of their relationship, providing relevant data for couple's therapy.

Profile of Mood States Factor Structure Does Not Accurately Account for Patients with Chronic Pain.

OBJECTIVE: The need for measuring emotional functioning in patients with chronic pain was recognized decades ago. The Initiative on Methods, Measures, and Pain Assessment in Clinical Trials (IMMPACT) proposed the Profile of Mood States for this purpose. However, to date, its factor structure has not been confirmed in these patients. METHODS: We set out to use confirmatory factor analysis to test the theoretical structure of seven factors: Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor-Activity, Fatigue-Inertia, Confusion-Bewilderment, and Friendliness. PARTICIPANTS: The sample consisted of 588 Spanish adult patients with chronic pain. RESULTS: The original structure could not be verified according to the obtained fit indices (e.g., root-mean-square error of approximation = 0.11). For this reason, we carried out a second study that relied on exploratory factor analysis to evaluate the structure in half of the cases and confirmatory factor analysis to validate it in the other half. The factor structure detected in the exploratory factor analysis was not satisfactory, nor could it be validated with confirmatory factor analysis (e.g., normed fit index between 0.54 and 0.56). CONCLUSIONS: The factor structure of the Profile of Mood States could not be satisfactorily confirmed. Consequently, other mood measures and shorter, optimized versions of the POMS are discussed as possible alternatives.

The Impact of Family Environment on Language Development of Children With Cochlear Implants: A Systematic Review and Meta-Analysis.

OBJECTIVES: The authors conducted a systematic review of the literature and meta-analyses to assess the influence of family environment on language development in children with cochlear implants. DESIGN: The Pubmed, excerpta medica dataBASE (EMBASE), Education Research Information Center, cumulative index to nursing and allied health literature (CINAHL), Healthcare Literature Information Network, PubPsych, and Social SciSearch databases were searched. The search strategy included terms describing family environment, child characteristics, and language development. Studies were included that (a) assessed distal family variables (such as parental income level, parental education, family size, and parental stress) with child language outcomes, and/or more proximal correlates that directly affect the child (such as family engagement and participation in intervention, parenting style, and more specifically, the quantity and quality of parental linguistic input) on child language; (b) included children implanted before the age of 5 years; (c) measured child language before the age of 21 years with standardized instruments; (d) were published between 1995 and February 2018; and (e) were published as peer-reviewed articles. The methodological quality was assessed with an adaptation of a previously validated checklist. Meta-analyses were conducted assuming a random-effects model. RESULTS: A total of 22 study populations reported in 27 publications were included. Methodological quality was highly variable. Ten studies had a longitudinal design. Three meta-analyses on the correlations between family variables and child language development could be performed. A strong effect of the quality and quantity of parental linguistic input in the first 4½ years postimplantation on the child's language was found, r = 0.564, p ≤ 0.001, 95% confidence interval (CI) = 0.449 to 0.660, accounting for 31.7% of the variance in child language outcomes. Results demonstrated high homogeneity, Q(3) = 1.823, p = 0.61, I = 0. Higher-level facilitative language techniques, such as parental expansions of the child's utterances or the use of open-ended questions, predicted child language skills. Risk of publication bias was not detected. The results on the impact of family involvement/participation in intervention on child language development were more heterogeneous. The meta-analysis included mainly cross-sectional studies and identified low to moderate benefits, r = 0.380, p ≤ 0.052, 95% CI = -0.004 to 0.667, that almost attained significance level. Socioeconomic status, mainly operationalized by parental level of education, showed a positive correlation with child language development in most studies. The meta-analysis confirmed an overall low and nonsignificant average correlation coefficient, r = 0.117, p = 0.262, 95% CI = -0.087 to 0.312. A limitation of the study was the lack of some potentially relevant variables, such as multilingualism or family screen time. CONCLUSIONS: These data support the hypothesis that parental linguistic input during the first years after cochlear implantation strongly predicts later child language outcomes. Effects of parental involvement in intervention and parental education are comparatively weaker and more heterogeneous. These findings underscore the need for early-intervention programs for children with cochlear implants focusing on providing support to parents for them to increase their children's exposure to high-quality conversation.

Methodological quality checklist for studies based on observational methodology (mqcom) / Checklist de calidad metodológica para estudios basados en metodología observacional

BACKGROUND: No existing instrument addresses the minimum number of items that guarantee methodological quality in studies based on observational methodology. Consequently, professionals who are not experts in observational methodology do not have a basic framework to guide their practice in this type of study. This study developed a checklist to measure the minimum number of items for methodological quality that studies based on observational methodology should consider and provided evidence of their validity based on test content and intercoder reliability. METHOD: Fifty-four judges with at least 1 year of experience in observational methodology and research based on this methodology evaluated the items of the developed checklist in terms of relevance, usefulness, and feasibility. Items were selected if they obtained at least .5 in the Osterlind indexes of the three aspects evaluated. Two coders applied the selected items to a random selection of articles that used observational methodology to investigate soccer, and intercoder reliability was examined using Cohen's kappa (k) coefficients. RESULTS: The final checklist included 16 items grouped into 11 criteria/dimensions, with adequate reliability coefficients. CONCLUSIONS: This study developed a useful instrument for non-expert professionals to enhance the methodological quality of studies based on observational methodology

ANTECEDENTES: no existen instrumentos referidos a los ítems mínimos que garanticen la calidad metodológica en estudios basados en metodología observacional. En consecuencia, los profesionales no expertos en metodología observacional no disponen de una guía básica que oriente su práctica en este tipo de estudios. Se desarrolló una escala para medir los ítems mínimos de calidad metodológica que deben considerar los estudios basados en metodología observacional aportando evidencias de su validez basada en el contenido de la prueba y fiabilidad intercodificadores. MÉTODO: cincuenta y cuatro jueces con al menos un año de experiencia en metodología observacional y su aplicación evaluaron los ítems del checklist elaborado respecto a su relevancia, utilidad y viabilidad. Se seleccionaron aquellos ítems que obtuvieron al menos ,5 en los índices de Osterlind en los tres aspectos evaluados. Dos codificadores los aplicaron a una selección aleatoria de artículos que utilizaron metodología observacional en fútbol y se estudió la fiabilidad intercodificadores mediante coeficientes kappa (k) de Cohen. RESULTADOS: la escala resultante constó de 16 ítems agrupados en 11 criterios/dimensiones, con coeficientes de fiabilidad adecuados. CONCLUSIONES: se desarrolló un instrumento útil dirigido a profesionales no expertos para potenciar la calidad metodológica de estudios basados en metodología observacional

Methodological quality checklist for studies based on observational methodology (MQCOM).

BACKGROUND: No existing instrument addresses the minimum number of items that guarantee methodological quality in studies based on observational methodology. Consequently, professionals who are not experts in observational methodology do not have a basic framework to guide their practice in this type of study. This study developed a checklist to measure the minimum number of items for methodological quality that studies based on observational methodology should consider and provided evidence of their validity based on test content and intercoder reliability. METHOD: Fifty-four judges with at least 1 year of experience in observational methodology and research based on this methodology evaluated the items of the developed checklist in terms of relevance, usefulness, and feasibility. Items were selected if they obtained at least .5 in the Osterlind indexes of the three aspects evaluated. Two coders applied the selected items to a random selection of articles that used observational methodology to investigate soccer, and intercoder reliability was examined using Cohen's kappa (k) coefficients. RESULTS: The final checklist included 16 items grouped into 11 criteria/dimensions, with adequate reliability coefficients. CONCLUSIONS: This study developed a useful instrument for non-expert professionals to enhance the methodological quality of studies based on observational methodology.

Causal attributions of potentially traumatic life events in fibromyalgia patients.

AIM: In common clinical practice, potentially traumatic life events and the possible attribution of such events to fibromyalgia often go undetected. Having demonstrated in a previous study that hypnosis facilitates the exploration of such events, we now aim to explore and classify the content of these events and to determine whether there is an association between the type of event, the state of consciousness in which the patient verbalized it, and possible causal attributions of the disorder. METHOD: Thirty-two women (age 52 ± 7 years) suffering from fibromyalgia and receiving care in a primary healthcare center participated in the same semi-structured interview twice: once in a wakeful state and once under hypnosis. They answered two questions: what other events in your life coincided with the onset of fibromyalgia? Are those events related to your fibromyalgia in any way? To counteract biases related to order or recall, the order of the two interviews was randomized with a 3-month period in between. RESULTS: The patients verbalized 23 different types of events, which we classified into eight categories, mostly psychosocial events. Although the relationship between the three variables was not statistically significant, two of the bivariate associations predicted (type of event and state of consciousness; and state of consciousness and causal attribution) were confirmed (χ2 , P values of .01 and <.001 respectively). CONCLUSION: Potentially traumatic life events could remain undetected in primary healthcare consultations and hypnosis could prove a useful tool for their detection.

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity.

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of its psychometric properties. For this reason, as relevant actions for further development, we encourage expert readers to use it and provide feedback; we plan to apply it to different sport areas.

Development of a Work Climate Scale in Emergency Health Services.

An adequate work climate fosters productivity in organizations and increases employee satisfaction. Workers in emergency health services (EHS) have an extremely high degree of responsibility and consequent stress. Therefore, it is essential to foster a good work climate in this context. Despite this, scales with a full study of their psychometric properties (i.e., validity evidence based on test content, internal structure and relations to other variables, and reliability) are not available to measure work climate in EHS specifically. For this reason, our objective was to develop a scale to measure the quality of work climates in EHS. We carried out three studies. In Study 1, we used a mixed-method approach to identify the latent conceptual structure of the construct work climate. Thus, we integrated the results found in (a) a previous study, where a content analysis of seven in-depth interviews obtained from EHS professionals in two hospitals in Gibraltar Countryside County was carried out; and (b) the factor analysis of the responses given by 113 EHS professionals from these same centers to 18 items that measured the work climate in health organizations. As a result, we obtained 56 items grouped into four factors (work satisfaction, productivity/achievement of aims, interpersonal relationships, and performance at work). In Study 2, we presented validity evidence based on test content through experts' judgment. Fourteen experts from the methodology and health fields evaluated the representativeness, utility, and feasibility of each of the 56 items with respect to their factor (theoretical dimension). Forty items met the inclusion criterion, which was to obtain an Osterlind index value greater than or equal to 0.5 in the three aspects assessed. In Study 3, 201 EHS professionals from the same centers completed the resulting 40-item scale. This new instrument produced validity evidence based on the internal structure in a second-order factor model with four components (RMSEA = 0.079, GFI = 0.97, AGFI = 0.97, CFI = 0.97; NFI = 0.95, and NNFI = 0.97); absence of Differential Item Functioning (DIF) in 80% of the items; reliability (α = 0.96); and validity evidence based on relations to other variables, specifically the test-criterion relationship (ρ = 0.680). Finally, we discuss further developments of the instrument and its possible implications for EHS workers.