Inflammatory bowel disease patients' perspectives of non-medical needs.

BACKGROUND: Inflammatory bowel disease (IBD) imposes a huge burden on the healthcare systems and greatly declines the patient's quality of life. However, there is a paucity of detailed data regarding information and supportive needs as well as sources and methods of obtaining information to control different aspects of the disease from the perspectives of the patients themselves. This study aimed to establish the IBD patients' preferences of informational and supportive needs through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). METHODS: IBD patients were recruited from different centers. Considering inclusion and exclusion criteria, 521 participants were filled a predefined questionnaire. This questionnaire was prepared through literature review of the recent well-known guidelines on the needs of IBD patients, which was further approved by the experts of IBD area in three rounds of Delphi consensus. It includes 56 items in four sections of informational needs (25), supportive needs (15), sources of information (7), and methods of obtaining information (9). RESULTS: In particular, EFA was used to apply data reduction and structure detection. Given that this study tries to identify patterns, structures as well as inter-relationships and classification of the variables, EFA was utilized to simplify presentation of the variables in a way that large amounts of observations transform into fewer ones. Accordingly, the EFA identified five factors out of 25 items in the information needs section, three factors out of 15 items in the supportive needs section, two factors out of 7 items in the information sources section, and two factors out of 9 items in the information presentation methods. Through the CFA, all 4 models were supported by Root Mean Squared Error of Approximation (RMSEA); Incremental Fit Index (IFI); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); and SRMR. These values were within acceptable ranges, indicating that the twelve factors achieved from EFA were validated. CONCLUSIONS: This study introduced a reliable 12-factor model as an efficient tool to comprehensively identify preferences of IBD patients in informational and supportive needs along with sources and methods of obtaining information. An in-depth understanding of the needs of IBD patients facilitates informing and supporting health service provision. It also assists patients in a fundamental way to improve adaptation and increase the quality of life. We suggest that health care providers consider the use of this tool in clinical settings in order to precisely assess its efficacy.

War-related stress scale.

BACKGROUND: The current war in Ukraine has affected the well-being of people worldwide. In order to understand how difficult the situation is, specific stressors associated with war need to be measured. In response, an inventory of war-related stressors including its short form, has been developed. METHODS: A list of potential war-related stressors was created, and the content validity of each item assessed. The list, along with other validated scales, was administered to a representative sample of the Slovak population (effective N = 1851). Exploratory factor analysis, confirmatory factor analysis, convergent validity analysis and network analysis were carried out to determine the optimal scale (long and short form) focused on war-related stressors. RESULTS: The full version of the scale consists of 21 items, further divided into three factors: society-related stressors, person-related stressors, and security-related stressors. The short version of the scale comprises nine items loaded onto one factor. These items cover concerns for one's safety and future, access to necessities, potential worsening of the economic situation, and the risk of conflict escalation, including a nuclear threat. The results of the network analysis indicate that concern about escalation and fear of an economic crisis play a central role. CONCLUSIONS: The scale attempts to encompass a wide spectrum of areas that are affected by war and its potential consequences on individuals who reside outside the conflict zone. Given the complexity of the issue, researchers are invited to modify the scale, tailoring it to specific cultural, geographical, and temporal contexts.

Validation of the internal structure of the Brazilian Dental Vulnerability Scale.

OBJECTIVE: This study aimed to evaluate evidence of validity of internal structure of the Brazilian Dental Vulnerability Scale (EVO-BR) when applied in Brazil. METHODS: This is a psychometric study that seeks to validate a scale elaborated by evidence of internal structure. Data collection was conducted in 18 basic health units that implement the Brazilian Healthcare Planning (PAS) methodology, across the five regions of Brazil. The initial version of the EVO-BR contained 41 items that measured dental vulnerability and was applied to users of the Brazilian Unified Health System (SUS) aged 18 years or older who were in basic health units for consultation with higher education professionals. To evaluate the evidence, the following statistical analyses were performed: exploratory factor analysis, confirmatory factor analysis, and network analysis. RESULTS: A total of 1,753 users participated in the study. To adjust the sample, we considered the factorability obtained from Kaiser-Meyer-Olkin (KMO) test = 0.65, Bartlett sphericity test = 8019.7, and a matrix determinant of 0.008. The initial parallel analysis indicated a four-dimensional model and had the items adjusted according to factor loading (ranging from 0.38 to 0.99), common factors (0.13 to 0.89), and Pratt's measure, until the model presented congruence in the statistical and interpretative principles simultaneously. The final model contained 15 items, maintaining the four dimensions indicated by the parallel analysis, and held an explained variance of 68.56%. CONCLUSIONS: The EVO-BR is a validated scale to measure dental vulnerability and, thus, can contribute to the organization of access to the oral health team in primary health care (PHC) by stratifying the population, as recommended in the Brazilian Healthcare Planning.

Family Vulnerability Scale: validity evidence in primary health care.

OBJECTIVE: Investigate evidence of validity of the Family Vulnerability Scale (EVFAM-BR) as an instrument to support population-based management in primary health care (PHC), in the scope of Health Care Planning (PAS). METHODS: This is a psychometric study to assess any additional evidence of the internal structure of EVFAM-BR using confirmatory factor analysis (CFA) and network analysis (NA). A preliminary version of the scale with 38 items was submitted to patients of PHC facilities that use the PAS methodology, distributed across the five regions of Brazil. For the primary CFA data, factor loadings and predictive power (R2) of the item were used. Seven model adjustment indices were adopted and reliability was measured by three indicators, using Bayesian estimation. RESULTS: The preliminary version of the scale was applied to 1,255 patients. Using the AFC, factor loadings ranged from 0.66 to 0.90 and R2 from 0.44 to 0.81. Both the primary indicators and the model adequacy indices presented satisfactory and consistent levels. According to the NA, the items were appropriately associated with their peers, respecting the established dimensions, thus demonstrating sustainability and stability of the proposed model. CONCLUSIONS: The evidence of validity presented by EVFAM-BR indicates, for the first time in Brazil, a concise instrument that is able to assertively measure family vulnerability, potentially supporting population-based management.

The Construction of a Multi-Gene Risk Model for Colon Cancer Prognosis and Drug Treatments Prediction.

In clinical practice, colon cancer is a prevalent malignant tumor of the digestive system, characterized by a complex and progressive process involving multiple genes and molecular pathways. Historically, research efforts have primarily focused on investigating individual genes; however, our current study aims to explore the collective impact of multiple genes on colon cancer and to identify potential therapeutic targets associated with these genes. For this research, we acquired the gene expression profiles and RNA sequencing data of colon cancer from TCGA. Subsequently, we conducted differential gene expression analysis using R, followed by GO and KEGG pathway enrichment analyses. To construct a protein-protein interaction (PPI) network, we selected survival-related genes using the log-rank test and single-factor Cox regression analysis. Additionally, we performed LASSO regression analysis, immune infiltration analysis, mutation analysis, and cMAP analysis, as well as an investigation into ferroptosis. Our differential expression and survival analyses identified 47 hub genes, and subsequent LASSO regression analysis refined the focus to 23 key genes. These genes are closely linked to cancer metastasis, proliferation, apoptosis, cell cycle regulation, signal transduction, cancer microenvironment, immunotherapy, and neurodevelopment. Overall, the hub genes discovered in our study are pivotal in colon cancer and are anticipated to serve as important biological markers for the diagnosis and treatment of the disease.

Clusters in Infant Environmental Factors Influence School-Age Children's Vegetable Preferences in Japan.

It remains unclear how the various environmental factors are combined in practice to influence vegetable preferences in school-aged children. This study aimed to clarify the environmental factors during infancy and their association with vegetable preference in school-aged children. To find clusters of early childhood environmental factors, we conducted a factor analysis on 58 items related to early childhood environmental factors and a k-means cluster analysis using the factors obtained. The association of the extracted factors and clusters with vegetable preferences was assessed by multiple regression analysis. Twelve factors relating to vegetable eating, cooking and harvesting experience, and parental attitudes were extracted by factor analysis. Three clusters, "low awareness of experiences", "high awareness" and "low positive encouragement", were then extracted. In the multiple regression analysis, all 12 factors were found to be associated with vegetable preferences. Furthermore, it was found that the "high awareness" group had a significantly higher score for vegetable preference than the "low awareness of experiences" group (ß = 0.56, 95% CI: 0.37-0.74). Thus, the study found that environmental factors during infancy, in isolation and combination, influenced vegetable preferences in school-aged children. Assessing the combination of various environmental factors during infancy may contribute to a better understanding of future vegetable preferences.

Development and validation of a Context-sensitive Positive Health Questionnaire (CPHQ): A factor analysis and multivariate regression study.

BACKGROUND: The concept of Positive Health (PH) has gained increasing attention as a way of measuring individuals' ability to adapt in the face of contextual challenges. However, a suitable measurement instrument for PH that encompasses contextual factors has not yet been developed. This paper responds to this need by developing a Context-specific Positive Health (CPH) measurement instrument that aligns with the Capability Approach (CA). METHODS: The measurement instrument was developed and tested among a representative sample of 1002 Dutch internet survey panel members with diverse sociodemographic backgrounds. The instrument was developed in two stages: a preparation phase consisting of focus groups and expert consultations, and a validation among a representative panel of Dutch citizens. The goal of the preparation phase, was to pilot test and refine previously proposed Positive Health questionnaires into an initial version of the CPHQ. The validation phase aimed to examine the initial CPHQ's factorial validity using Factor Analysis, and its concurrent validity using Multivariate Regression Analysis. RESULTS: The developed questionnaire demonstrated adequate factorial and concurrent validity. Furthermore, it explicitly includes an assessment of resilience, this being a key component of PH. CONCLUSIONS: The introduced measurement tool, the CPHQ, comprises 11 dimensions that we have labeled as follows: relaxation, autonomy, fitness, perceived environmental safety, exclusion, social support, financial resources, political representation, health literacy, resilience, and enjoyment. In this article, we present four major contributions. Firstly, we embedded the measurement in a theoretical framework. Secondly, we focused the questionnaire on a key concept of Positive Health - the "ability to adapt." Thirdly, we addressed issues of health inequality by considering contextual factors. Finally, we facilitated the development of more understandable measurement items.

The development and validation of tour guides internalized occupational stigma scale (TIOSS).

BACKGROUND: Tour guides' identification and internalization of occupational stigma may exacerbate their career development, perceived professional reputation and status, and mental health. The current study aimed to develop and verify the Tour guides Internalized Occupational Stigma Scale (TIOSS) to provide an effective tool for relevant quantitative research. METHODS: The study developed an initial questionnaire through literature analysis, expert review, and semi-structured surveys. We conducted item analyses and exploratory factor analyses among 326 tour guides, and confirmatory factor analysis and reliability and validity tests among 315 tour guides. RESULTS: The TIOSS consists of 21 items and is formed in three dimensions referring to Stigma Perception (SP), Status Loss (SL), and Career Denial (CD). The correlation coefficient values of the TIOSS total scale and dimension scores with the criterion instruments ranged from 0.17 to 0.68. In addition, the Cronbach's α coefficients for the TIOSS and its dimensions ranged from 0.837 to 0.928, and the split-half reliability coefficients ranged from 0.843 to 0.916. The study also revealed that the TIOSS was consistent across genders. CONCLUSION: The TIOSS performed favorable reliability and validity to be a valid instrument to assess tour guides' internalized occupational stigma.

Measuring job stress of dental workers in China during the COVID-19 pandemic: reliability and validity of the hospital consultants' job stress questionnaire.

BACKGROUND: The Hospital Consultants' Job Stress Questionnaire (HCJSQ) has been widely used to assess sources and levels of job stress. However, its reliability and validity among Chinese dental workers have not been extensively studied. The objective of this study was to assess the reliability and validity of the HCJSQ specifically in Chinese dental workers. METHODS: The HCJSQ was used to explore the sources and the global ratings of job stress among Chinese dental workers. To assess the reliability and validity of the HCJSQ, various statistical measures were employed, including Cronbach's alpha coefficient, Spearman-Brown coefficient, Spearman correlation coefficient, exploratory factor analysis, confirmatory factor analysis, convergent validity, and discriminant validity. RESULTS: Of the participants, 526 (17.4%) reported high levels of stress, while 1,246 (41.3%) and 1,248 (41.3%) reported moderate and low levels of stress, respectively. The Cronbach's alpha coefficient for the modified HCJSQ was 0.903, and the Spearman-Brown coefficient was 0.904. Spearman correlation coefficient between individuals' items and the total score ranged from 0.438 to 0.785 (p < 0.05). Exploratory factor analysis revealed that three factors accounted for 60.243% of the total variance. Confirmatory factor analysis demonstrated factor loadings between 0.624 and 0.834 on the specified items. The fit indices of the confirmatory factor analysis indicated good model fit, with a Root Mean Square Error of Approximation of 0.064, Normative Fit Index of 0.937, Comparative Fit Index of 0.952, Incremental Fit Index of 0.952, Tucker-Lewis index of 0.941, and Goodness of Fit Index of 0.944. Additionally, the convergent validity and discriminant validity showed a good fit for the three-factor model. CONCLUSION: The results of this study confirm that Chinese dental workers experience high levels of stress, and the three-factor model of the HCJSQ proves to be a suitable instrument for evaluating the sources and levels of job stress among Chinese dental workers. Therefore, it is imperative that relevant entities such as hospitals, medical associations, and government take appropriate measures to address the existing situation.

Psychometric Properties of the Spanish Clance Impostor Scale (S-CIPS) / Propiedades psicométricas de la adaptación española de la Clance Impostor Phenomenon Scale (S-CIPS)

El objetivo del presente estudio fue el de examinar la fiabilidad, validez y estructura factorial de la adaptación española de la Clance Impostor Phenomenon Scale (CIPS). Para ello, un total de 271 estudiantes españoles completaron una versión traducida de la escala original de 20 ítems. En nuestra muestra, el instrumento mostró una alta fiabilidad, medida como consistencia interna, (ωTotal =.90) y correlaciones moderadas-altas con medidas de depresión (r =.633), autoestima (r = -.754) y miedo a las evaluaciones negativas (r = .666), lo cual sugiere tanto una validez nomológica como discriminante. Aunque en la validación original se propuso una estructura de tres factores, otros estudios han encontrado ajuste a estructuras de uno y dos factores. Aquí, utilizamos un análisis factorial confirmatorio (AFC) para probar el ajuste de estos tres modelos. Nuestros resultados muestran que, en la adaptación a español, el modelo con dos factores es el preferido. Esta adaptación al español de la CIPS provee a los profesionales clínicos una de una nueva herramienta para poder investigar los mecanismos que subyacen al síndrome del impostor, así como futuros tratamientos.(AU)

The aim of this study was to examine the reliability, validity, and factorial structure of the Spanish version of the Clance Impostor Phenom-enon Scale (CIPS). A sample of 271 Spanish students was recruited to complete a translated version of the original 20-item CIPS. In our sample, the instrument showed high internal consistency reliability (ωTotal=.90) and a moderate-to-strong correlation with measures of depression (r= .633), self-esteem (r= -.754) and fear of negative evaluation (r= .666), suggesting both nomological and discriminant validity. Althoughthe original valida-tion of the CIPS proposed a factorial structure with three factors, subse-quent validations also revealed adjustment to two-and one-factor struc-tures. Here, we used confirmatory factor analysis (CFA) to test the three different models. The results showed that in our adaptation, a 2-factor structure might be preferred. This adaptation of the CIPS to Spanish pro-vides clinicians with a new method to gain insight into the psychological mechanisms behind the Impostor phenomenon and suitable treatments.(AU)

Authenticity Scale: Validity and Reliability Evidence in a Sample from Brazil and Portugal / Escala de autenticidad: evidencia de validez y confiabilidad en una muestra de Brasil y Portugal

Este estudio presenta distintos tipos de evidencias de validez y confiabilidad de la Escala de Autenticidad (AS) en una muestra de Brasil y Portugal. El estudioconsiste en una encuesta con 1.077 brasileños y 622 portugueses. Se testó el modelo con tres factores correlacionados (autoalienación, vivir auténtico y aceptación de la influencia externa), el modelo unidimensional y el modelo bifactorial. Se retuvo el modelo con tres factores correlacionados, con las tres subescalas alcanzando confiabilidad moderada a buena. Análisis factorial confirmatorio multigrupo sugirió invariancia escalar para cultura, género, edad, educación, ocupación y preocupación e impacto relacionados con Covid. Los ítems fueron evaluados por graded response model(GRM), sugiriendo que las tres subescalas no discriminan las personas con altos rasgos de autenticidad. GRM y estadísticas descriptivas indican que la escala de puntuación es inapropiada, particularmente para la subescala vivir auténtico, que es afectada por efecto techo. Las asociaciones con presencia de sentido mostraron evidencia adicional de validez. A pesar de las limitaciones, la AS es una medida adecuada para evaluar la autenticidad en diferentes grupos. Se discuten posibles modificaciones para el aprimoramiento de la AS.(AU)

This study introduces distinct types of validity and reliability evidence of the Authenticity Scale (AS) in a sample from Brazil and Portugal. It consists of an online survey with 1,077 Brazilian citizens and 622 Portuguese citizens. The study tested the model with three correlated factors (self-alienation, authentic living, and accepting external influence), the unidimensional model, and the bifactor model. The model with three correlated factors was retained, with the three subscales demonstrating moderate to good reliability. Multigroup confirmatory factor analysis suggested scalar invariance across culture, gender, age, education, occupation, and Covid-related concern and impact. The items were assessed by graded response model (GRM), which suggested that the three subscales are not able to distinguish respondents with high authenticity traits. GRM and descriptive statistics indicated that the rating-scale is inappropriate, particularly for authentic living subscale, which is affected by ceiling effect. Associations with presence of meaning showed additional validity evidence. Despite the limitations, the AS is an effective measure to assess authenticity across different groups. Potential modifications for the improvement of the AS are discussed.(AU)

Validation of Psychometric Instrumentswith Classical Test Theory in Social and Health Sciences: A practical guide / Validación de instrumentos psicométricos en ciencias sociales y de la salud: una guía práctica

Recientemente se ha incrementado significativamente el número de estudios psicométricos junto a avances estadísticos cruciales para evaluar las evidencias defiabilidad y validez de los testsy escalas de medida. Dada la importancia de proporcionar procedimientos más exactos tanto en la metodología como en la interpretación de las puntuaciones, los editores de la revista Anales de Psicología proponen esta guía para abordar los tópicos más relevantes en el campo de la psicometría aplicada. Con esta finalidad, el presente manuscrito analiza los tópicos principales de la TeoríaClásica de Tests (e.g., análisis factorial exploratorio/confirmatorio, fiabilidad, validez, sesgo, etc.) con vistas a sintetizar y clarificarlas aplicaciones prácticas, y mejorar los estándares de publicación de estos trabajos.(AU)

In recent years,there has been a significant rise in the number of psychometric studies, together with crucial statistical advances for validity and reliability measures. Given the importance of providingaccurate procedures both in methodology and score interpretationof tests and/or measurement scales, the editors-in-chie fof the journal Annals of Psychology have draftedthis guide to address the most relevant issues in the field of applied psychometry. To this end, the present manuscript analyses the main topics under the Classical Test Theory framework (e.g., exploratory/confirmatory factor analysis; reliability, bias, etc.) aimingto synthesizeand clarifythe best practical applications;and improve publication standards.(AU)

Development of the What Matters 2 Adults (WM2A) wellbeing measure for Aboriginal and Torres Strait Islander adults.

PURPOSE: As wellbeing is culturally bound, wellbeing measures for Aboriginal and Torres Strait Islander peoples must be culturally relevant and grounded in Aboriginal and Torres Strait Islander values and preferences. We describe the development of a nationally-relevant and culturally grounded wellbeing measure for Aboriginal and Torres Strait Islander adults: the What Matters to Adults (WM2A) measure. METHODS: We used a mixed methods approach to measure development, combining Indigenist methodologies and psychometric methods. Candidate items were derived through a large national qualitative study. Think-aloud interviews (n = 17) were conducted to assess comprehension, acceptability, and wording of candidate items. Two national surveys collected data on the item pool (n = 312, n = 354). Items were analysed using exploratory factor analysis (EFA), and item response theory (IRT) to test dimensionality, local dependence and item fit. A Collaborative Yarning approach ensured Aboriginal and Torres Strait Islander voices were privileged throughout. RESULTS: Fifty candidate items were developed, refined, and tested. Using EFA, an eight factor model was developed. All items met pre-specified thresholds for maximum endorsement frequencies, and floor and ceiling effects; no item redundancy was identified. Ten items did not meet thresholds for aggregate adjacent endorsement frequencies. During Collaborative Yarning, six items were removed based on low factor loadings (<0.4) and twelve due to conceptual overlap, high correlations with other items, endorsement frequencies, and/or low IRT item level information. Several items were retained for content validity. The final measure includes 32 items across 10 domains (Balance & control; Hope & resilience; Caring for others; Culture & Country; Spirit & identity; Feeling valued; Connection with others; Access; Racism & worries; Pride & strength). CONCLUSIONS: The unique combination of Indigenist and psychometric methodologies to develop WM2A ensures a culturally and psychometrically robust measure, relevant across a range of settings and applications.

Exploratory factor analysis of shared trauma in psychiatric-mental health nurses using the Shared Trauma Professional Posttraumatic Growth Inventory (STPPG).

INTRODUCTION: The Shared Trauma Professional Post Traumatic Growth Inventory (STPPG) was developed by Tosone et al. (2014) to help understand shared trauma (ST) in social workers. ST occurs when the healthcare professional and client both experience the same collective traumatic event. This inventory has been adapted for use with mental health nurses. A cross-sectional study of N = 552 mental health nurses was completed in the spring of 2023 to assess the feasibility of using the STPPG to explore shared trauma in mental health nurses. METHODS: An exploratory factor analysis was run for the STPPG using squared multiple correlations with the maximum likelihood method. RESULTS: The alpha coefficient ranged from 0.82 to 0.89 for 2-factors and 0.73 to 0.89 for 3-factors. The results indicated that all correlations were significant among the total scales and subscales. All correlations were positive, ranging from 0.81 to 0.95 for two factors and 0.58 to 0.89 for three factors. CONCLUSION: The STPPG has confirmed a two-factor analysis for mental health nurses. The STPPG is a valid inventory to measure ST in mental health nurses and will allow the concept to be further studied.

Development and psychometric evaluation of uncertainty about disease and treatment scale in hemodialysis patients: a sequential-exploratory mixed-method study.

BACKGROUND AND OBJECTIVE: The need for long-term treatment and frequent visits to treatment centers for hemodialysis can lead to psychological problems such as Uncertainty about Disease and Treatment (UC about D&T) in patients with chronic kidney failure. In order to understand uncertainty about disease and treatment and to plan for preventive measures and care interventions in various dimensions, there is a need for reliable and valid tools. The present study was conducted to design and psychometrically evaluate the Uncertainty about Disease and Treatment Scale (UC about D&TS) in patients undergoing hemodialysis. METHODS: This study is of a methodological type and conducted in two stages. The first stage included a deductive (literature review) and an inductive approach (face-to-face interviews). In the second stage, psychometric indices of the UC about D&TS, including face validity (qualitative-quantitative), content validity (qualitative-quantitative), construct validity (exploratory factor analysis), and reliability (using Cronbach's alpha and McDonald's omega) were examined. RESULTS: In the literature review stage, 66 items were extracted, and in the qualitative stage, 48 items were extracted. After merging similar items, 29 items were entered into the psychometric process. No items were removed in the face and content validity stages. In the construct validity stage, five factors were extracted, including self-uncertainty, uncertain situation, uncertain future, uncertainty of treatment outcomes, and information uncertainty, which constituted a total of 82.16% of the total variance. In this stage, five items were removed from the study due to a corrected item-total correlation below 0.32, and four items were removed due to cross-loading. The α and Ω were calculated as 0.828 and 0.818, respectively. The measurement stability and standard error of measurement were estimated at 0.977 and 2.019, respectively. CONCLUSION: The results showed that the UC about D&TS is a valid and reliable measure for patients undergoing hemodialysis. This scale is specifically designed to measure UC about D&T in hemodialysis patients, and it is recommended that healthcare providers (Hcps) use this scale in follow-up visits.

Psychometric properties of a modified health belief model for cervical cancer and visual inspection with acetic acid among healthcare professionals in Ethiopia.

PURPOSE: Evidence supports that the Health Belief Model (HBM) can explain and predicts certain health behaviors, including participation in cervical cancer (CC) screening. The purpose of this study was to evaluate the psychometric properties of a modified HBM for CC and visual inspection with acetic acid (VIA) in female healthcare professionals in Addis Ababa, Ethiopia, 2020. METHODS: Psychometric properties related to CC and VIA were tested using 42-item modified HBM self-administered questionnaire and a cross-sectional study design with simple random sampling. Kaiser-Meyer-Olkin and Bartlett's sphericity test indicated that data sampling adequacy for exploratory factor analysis was 0.792 (χ2 = 3189.95, df = 351, p < .001). Items with cross-loading and factor loadings ≥ 0.5 were retained. Confirmatory factor analysis (CFA) was conducted to determine model fit. RESULTS: The final analysis included 194 women, (mean age 30±4.34). Twelve items with ≤ 0.5 were removed and 30 retained items loaded into 6 factors; (benefits of VIA, perceived seriousness of CC, barrier (fear of negative outcome), self-efficacy, susceptibility to CC, and barriers (health system delivery)) explained 65% of the total variance. Cronbach's alpha for the total instrument was 0.8 and reliability for the 6 subscales was 0.76-0.92. Composite reliability and average variance extracted indicated good internal consistency and convergent validity. CFA identified 6 additional items to be removed with high residual covariance. The final 24 items of the modified HBM had an acceptable model fit (goodness-of-fit index (GFI) = 0.861, adjusted GFI = 0.823, comparative fit index = 0.937, root mean square error of approximation = 0.059). CONCLUSION: The modified HBM for CC and VIA with 24 items had adequate psychometric properties and may be used by Ethiopian healthcare professionals for research or clinical purposes. To support external validity the updated 24 items tool is suggested for application in further study in different populations in Ethiopia.

Measuring remote working skills: Scale development and validation study.

Remote work, one of the most significant working arrangements of today, requires certain employee skills. Although there are some hints, there is not much information in the literature on this subject. This study aims to identify the skills required for productive remote working activities and to develop a scale for measuring these skills. For this purpose, a thorough review of the literature, consultation with experts, and analysis of data obtained from four samples with remote working experience were all conducted. Within this context, item generation and content validation, initial factor structure analysis, and factor structure confirmation and construct validity examination were performed. Consequently, the Remote Working Skills Scale was developed, which has 36 items and five dimensions (cybersecurity, problem-solving, time management, verbal communication, and written communication).

The vulnerability assessment and obstacle factor analysis of urban agglomeration along the Yellow River in China from the perspective of production-living-ecological space.

Urban agglomerations are sophisticated territorial systems at the mature stage of city development that are concentrated areas of production and economic activity. Therefore, the study of vulnerability from the perspective of production-living-ecological space is crucial for the sustainable development of the Yellow River Basin and global urban agglomerations. The relationship between productivity, living conditions, and ecological spatial quality is fully considered in this research. By constructing a vulnerability evaluation index system based on the perspectives of production, ecology, and living space, and adopting the entropy value method, comprehensive vulnerability index model, and obstacle factor diagnostic model, the study comprehensively assesses the vulnerability of the urban agglomerations along the Yellow River from 2001 to 2020. The results reveal that the spatial differentiation characteristics of urban agglomeration vulnerability are significant. A clear three-level gradient distribution of high, medium, and low degrees is seen in the overall vulnerability; these correspond to the lower, middle, and upper reaches of the Yellow River Basin, respectively. The percentage of cities with higher and moderate levels of vulnerability did not vary from 2001 to 2020, while the percentage of cities with high levels of vulnerability did. The four dimensions of economic development, leisure and tourism, resource availability, and ecological pressure are the primary determinants of the urban agglomeration's vulnerability along the Yellow River. And the vulnerability factors of various urban agglomerations showed a significant evolutionary trend; the obstacle degree values have declined, and the importance of tourism and leisure functions has gradually increased. Based on the above conclusions, we propose several suggestions to enhance the quality of urban development along the Yellow River urban agglomeration. Including formulating a three-level development strategy, paying attention to ecological and environmental protection, developing domestic and foreign trade, and properly planning and managing the tourism industry.

Cultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil.

OBJECTIVES: to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil. METHODS: psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω). RESULTS: EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86. CONCLUSIONS: the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.

Improving the measurement properties of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R): deriving a valid measurement total for the calculation of change.

BACKGROUND: The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) total score is a widely used measure of functional status in Amyotrophic Lateral Sclerosis/Motor Neuron Disease (ALS), but recent evidence has raised doubts about its validity. The objective was to examine the measurement properties of the ALSFRS-R, aiming to produce valid measurement from all 12 scale items. METHOD: Longitudinal ALSFRS-R data were collected between 2013-2020 from 1120 people with ALS recruited from 35 centers, together with other scales in the Trajectories of Outcomes in Neurological Conditions-ALS (TONiC-ALS) study. The ALSFRS-R was analyzed by confirmatory factor analysis (CFA), Rasch Analysis (RA) and Mokken scaling. RESULTS: No definite factor structure of the ALSFRS-R was confirmed by CFA. RA revealed the raw score total to be invalid even at the ordinal level because of multidimensionality; valid interval level subscale measures could be found for the Bulbar, Fine-Motor and Gross-Motor domains but the Respiratory domain was only valid at an ordinal level. All four domains resolved into a single valid, interval level measure by using a bifactor RA. The smallest detectable difference was 10.4% of the range of the interval scale. CONCLUSION: A total ALSFRS-R ordinal raw score can lead to inferential bias in clinical trial results due to its non-linear nature. On the interval level transformation, more than 5 points difference is required before a statistically significant detectable difference can be observed. Transformation to interval level data should be mandatory in clinical trials.