Evidence for validity of the epidemic-pandemic impacts inventory (brief healthcare module): Internal structure and association with other variables.

The COVID-19 pandemic has subjected healthcare workers to enormous stress. Measuring the impact of this public health emergency is essential to developing strategies that can effectively promote resilience and wellness. The Epidemic-Pandemic Impacts Inventory Supplemental Healthcare Module-Brief Version (EPII-SHMb) was developed to measure impacts among occupational cohorts serving on the front lines of healthcare. While this instrument has been utilized in COVID-19 related studies, little is known about its psychometric properties. This study collects evidence for validity of the EPII-SHMb by evaluating its internal structure and how its scores associate with other variables. Physicians and nursing staff across a large New York health system were cross-sectionally surveyed using an online questionnaire between June and November 2020. Exploratory factor analysis resulted in a 3-factor solution, identifying factors Lack of Workplace Safety (7 items), Death/Dying of Patients (3 items), and Lack of Outside Support (2 items). Internal consistency was high overall and within physician/nursing and gender subgroups (Cronbach's alpha: 0.70 - 0.81). Median scores on Death/Dying of Patients were higher among those who directly cared for COVID-19 patients or worked in COVID-19 hospital units. These results are promising. Additional studies evaluating other dimensions of validity are necessary.

Psychometric properties of the Greek versions of the Pandemic-Related Pregnancy Stress Scale and the Pandemic-Related Postpartum Stress Scale and associated risk factors during the second year of the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has affected perinatal mental health. Reliable tools are needed to assess perinatal stress during pandemic situations. AIMS: To assess the psychometric properties of the Greek versions of the Pandemic-Related Pregnancy Stress Scale (PREPS) and the Pandemic-Related Postpartum Stress Scale (PREPS-PP) and to explore the associations between women's characteristics and perinatal stress during the second pandemic wave. METHODS: The PREPS and PREPS-PP were completed by 264 pregnant and 188 postpartum women, respectively, who also completed the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS). RESULTS: The internal consistency was similar for PREPS and PREPS-PP. It was good for preparedness stress (a = 0.77 and α = 0.71, respectively) and infection stress (α = 0.83 for both scales) but low for positive appraisal (α = 0.46 and α = 0.41, respectively). Of the pregnant women, 55.33% and 55.27%, respectively, reported scores of ≥40 on STAI-S and STAI-T, and the respective percentages for the postpartum women were 47.34% and 46.80%. In addition, 14.39% of the pregnant women and 20.74% of the postpartum women scored ≥13 on the EPDS. Higher preparedness stress on PREPS and PREPS-PP was associated with primiparity (P = 0.022 and P = 0.021, respectively) and disrupted perinatal care (P = 0.069 and P = 0.007, respectively). In postpartum women, higher infection stress was associated with chronic disease (P = 0.037), primiparity (P = 0.02) and perceived risk of infection (P = 0.065). Higher score on infection stress was associated with disrupted perinatal care in both groups (P = 0.107 and P = 0.010, respectively). CONCLUSIONS: The Greek versions of PREPS and PREPS-PP are valid tools for the assessment of women at risk of perinatal stress during a health crisis.

Developing and Evaluating a Measure of the Willingness to Use Pandemic-Related mHealth Tools Using National Probability Samples in the United States: Quantitative Psychometric Analyses and Tests of Sociodemographic Group Differences.

BACKGROUND: There are no psychometrically validated measures of the willingness to engage in public health screening and prevention efforts, particularly mobile health (mHealth)-based tracking, that can be adapted to future crises post-COVID-19. OBJECTIVE: The psychometric properties of a novel measure of the willingness to participate in pandemic-related screening and tracking, including the willingness to use pandemic-related mHealth tools, were tested. METHODS: Data were from a cross-sectional, national probability survey deployed in 3 cross-sectional stages several weeks apart to adult residents of the United States (N=6475; stage 1 n=2190, 33.82%; stage 2 n=2238, 34.56%; and stage 3 n=2047, 31.62%) from the AmeriSpeak probability-based research panel covering approximately 97% of the US household population. Five items asked about the willingness to use mHealth tools for COVID-19-related screening and tracking and provide biological specimens for COVID-19 testing. RESULTS: In the first, exploratory sample, 3 of 5 items loaded onto 1 underlying factor, the willingness to use pandemic-related mHealth tools, based on exploratory factor analysis (EFA). A 2-factor solution, including the 3-item factor, fit the data (root mean square error of approximation [RMSEA]=0.038, comparative fit index [CFI]=1.000, standardized root mean square residual [SRMR]=0.005), and the factor loadings for the 3 items ranged from 0.849 to 0.893. In the second, validation sample, the reliability of the 3-item measure was high (Cronbach α=.90), and 1 underlying factor for the 3 items was confirmed using confirmatory factor analysis (CFA): RMSEA=0, CFI=1.000, SRMR=0 (a saturated model); factor loadings ranged from 1.000 to 0.962. The factor was independently associated with COVID-19-preventive behaviors (eg, "worn a face mask": r=0.313, SE=0.041, P<.001; "kept a 6-foot distance from those outside my household": r=0.282, SE=0.050, P<.001) and the willingness to provide biological specimens for COVID-19 testing (ie, swab to cheek or nose: r=0.709, SE=0.017, P<.001; small blood draw: r=0.684, SE=0.019, P<.001). In the third, multiple-group sample, the measure was invariant, or measured the same thing in the same way (ie, difference in CFI [ΔCFI]<0.010 across all grouping categories), across age groups, gender, racial/ethnic groups, education levels, US geographic region, and population density (ie, rural, suburban, urban). When repeated across different samples, factor-analytic findings were essentially the same. Additionally, there were mean differences (ΔM) in the willingness to use mHealth tools across samples, mainly based on race or ethnicity and population density. For example, in SD units, suburban (ΔM=-0.30, SE=0.13, P=.001) and urban (ΔM=-0.42, SE=0.12, P<.001) adults showed less willingness to use mHealth tools than rural adults in the third sample collected on May 30-June 8, 2020, but no differences were detected in the first sample collected on April 20-26, 2020. CONCLUSIONS: Findings showed that the screener is psychometrically valid. It can also be adapted to future public health crises. Racial and ethnic minority adults showed a greater willingness to use mHealth tools than White adults. Rural adults showed more mHealth willingness than suburban and urban adults. Findings have implications for public health screening and tracking and understanding digital health inequities, including lack of uptake.

The hidden (overlooked) impact of living through a pandemic: How parents of children with disabilities fared during COVID-19?

ObjectiveThe purpose of this study was to investigate the impact of the COVID-19 pandemic on the quality of life of families of children with disabilities and the mediating roles of perceived social support, perceived parental self-efficacy, psychological health, psychological resilience, and perceived family burden on this relationship. BackgroundChildren with disabilities and their families are among the most affected populations from the restrictions imposed to prevent the spread of COVID-19 virus, as the special education and rehabilitation services they had been receiving were interrupted. MethodA correlational survey design was used to collect data from 824 parents of children with disabilities in Turkey. Path analysis was used to examine the direct and indirect effects of COVID-19 on family quality of life. ResultsResults indicated that COVID-19 had a significant total effect on family quality of life and perceived social support, parental self-efficacy and psychological resilience had a mediating role on the relationship between impact of the COVID-19 pandemic and family quality of life. Perceived social support was found to the strongest mediator of the relationship between the impact of COVID-19 and the family quality of life, while perceived family burden did not have a statistically significant association with these variables. ConclusionFamily quality of life for children with disabilities decreased as the impact of COVID-19 pandemic increased. Perceived social support, parental self-efficacy and psychological resilience had mediating roles in the relationship between the impact of the COVID-19 pandemic and family quality of life. ImplicationsCOVID-19 has resulted in disruption of special education and rehabilitation services for children with disabilities and their families. Changes in daily routines have brought up additional responsibilities to parents of children with disabilities. These additional responsibilities may adversely affect and increase the burden and stress families of children with disabilities experience. The high levels of stress in families negatively affect the welfare and quality of life and result in decreased parental attention to support their children. Findings of this study show the mediating link of perceived social support, parental self-efficacy and psychological resilience in the relationship between the impact of the COVID-19 pandemic and family quality of life. Policymakers and service providers should develop and implement specific care actions to support children with disabilities and their families during and after the pandemic.

Psychometric Validation of the Indonesian Version of Children's Revised Impact of Event Scale 13.

A psychometric evaluation of the Children's Revised Impact of Event Scale 13 (CRIES-13), which measures the posttraumatic stress disorder (PTSD) symptoms in children and adolescents caused by the coronavirus disease 2019 (COVID-19) pandemic, was conducted. We aimed to cross-culturally adapt and test the psychometric qualities of the CRIES-13 that was applied to Indonesian adolescents exposed to COVID-19 risk across gender groups. A cross-sectional study was conducted at a junior high school in Yogyakarta, Indonesia, in May 2022; 346 Indonesian adolescents aged 12 to 18 years completed the Indonesian version of the CRIES-13. The factorial validity results supported the scale's three-factor structure (intrusion, avoidance, and arousal), which satisfied all parameter index requirements and exhibited a favorable level of internal consistency reliability. Excellent results were obtained across genders for the four-level measurement of invariance (i.e., configural, metric, scalar, and full invariance), and they met the recommended criteria. Our Cronbach's alphas and composite reliability ratings were high (>0.7), indicating a strong correlation and reliability of the items for measuring each construct. We strongly support the use of the Indonesian CRIES-13, which was demonstrated to be valid and reliable for an adolescent population.

COVID-19 vaccine hesitancy scale and its association with actual COVID-19 vaccine uptake in Israel.

BACKGROUND: The public's willingness to get vaccinated continues to be a source of concern. In this study we assessed the psychometric properties of the COVID-19 vaccine hesitancy scale (C19-VHS) as well as the association between the scale and self-reported past COVID-19 vaccination, approximately two weeks after the national vaccine distribution plan was launched in Israel. METHODS: Participants were recruited via an online survey distributed through social media platforms and mailing lists. A total of 650 individuals completed the C19-VHS, the general vaccine hesitancy scale, and the fear of COVID-19 scale, and reported on demographic and pandemic-related characteristics. Principal component and Cronbach's alpha analyses were performed to assess the factor structure and reliability of the scale. Logistic regressions were employed to assess the scale's convergent and discriminative validity. RESULTS: Two factors pertaining to "lack of confidence" (Factor 1) and "risk perception" (Factor 2) emerged. Cronbach's alpha indicated good reliability of Factor 1 (0.93), with lower reliability of Factor 2 (0.72). Younger age was associated with higher risk perception, with women showing less confidence and perceiving greater risks. Lower hesitancy significantly predicted actual COVID-19 vaccine uptake after adjusting for demographic and pandemic-related factors (OR = 1.16, 95%CI 1.11-1.21, p <.001). Older age, being a woman, and receiving the flu vaccine in the past year were also predictive of COVID-19 vaccine uptake. DISCUSSION: The C19-VHS measure shows robust psychometric properties and is associated with actual vaccine uptake. Future studies assessing COVID-19 vaccination attitudes may utilize this scale to assess current COVID-19 vaccine hesitancy in different contexts and cultures.

The Thai version of the Nijmegen questionnaire.

Purpose: The Nijmegen questionnaire is a screening tool for detecting hyperventilation syndrome. The present study aimed to cross-culturally adapt the questionnaire to Thai language and test its psychometric properties for screening hyperventilation syndrome, in which the prevalence is increasing due to the impacts of the COVID-19 pandemic.Design/methodology/approach: The Thai version of the Nijmegen questionnaire (NQ-TH) was generated following a cross-cultural adaptation guideline including initial translation, synthesis of forward translation, back translation, expert committee review, and prefinal testing. Fifty control participants and one-hundred patients with symptoms related to hyperventilation syndrome were enrolled in this study for the determination of psychometric properties. Content validity, construct validity, internal consistency reliability, and test-retest reliability of the NQ-TH were assessed. Its discriminant ability and cutoff point for screening hyperventilation syndrome were also revealed. Findings: The obtained IOC and disappeared floor and ceiling effects indicated excellent content validity of the questionnaire. There were significant correlations between the total scores of the NQ-TH and other questionnaires and recorded respiratory measurements obtained from the patients, i.e., SF-36-TH (r = -0.257), HADS-TH (r = 0.331), RR (r = 0.377), and BHT (r = -0.444). This supported the construct validity of the NQ-TH. An acceptable internal consistency was also observed (Cronbach's alpha = 0.789). Test-retest repeatability of the questionnaire was high (ICC = 0.90). Moreover, the NQ-TH reliability was also ensured by calculated MDC (2.68). The cutoff point of the NQ-TH was at 20 with 98% sensitivity and 94% specificity.Originality/value: The NQ-TH established by the present study is a valid and reliable tool for screening hyperventilation syndrome among Thais.

Internal Structure of the Work-Family Conflict Questionnaire (WFCQ) in Teacher Teleworking.

The interference between family and work roles has led to the development of scales for their measurement. However, instrumental studies of work-family conflict have not been conducted in the context of teacher teleworking during the COVID-19 pandemic. For this reason, the objectives of this study were set to obtain evidence of the internal structure and fairness of the Blanch and Aluja Work-Family Conflict Questionnaire, as well as its association with job satisfaction and other sociodemographic variables. A total of 235 Peruvian school teachers between the ages of 24 and 72 years (M = 43.79 and SD = 9.67) responded to the scale using the online form. The analysis employed the non-parametric item response theory modeling (Mokken scaling analysis). The structure of two correlated factors was confirmed: work conflict in the family (WCF) and family conflict in the work (FCW). Both dimensions were invariant with respect to sex group and educational level. The association of both dimensions with job satisfaction was theoretically convergent, and the gender of the teachers slightly moderated this relationship. The reliability was adequate for group research. Finally, the instrument can be useful in the organizational context of teachers who telework.

Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings.

Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7−35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach's alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures.

Psychometric properties for measuring remote work factors: An exploratory analysis in student collaborators

The aim of this study was to analyze the psychometric properties of the scale of factors involved in remote work. A cross-sectional instrumental study was conducted, which involved a literature review process, construction of the instrument, and validation by specialists. A pilot test was conducted with 20 participants, followed by 148 student workers, whose responses allowed an item discrimination analysis, and finally an exploratory factor analysis was performed. The psychometric properties of the instrument were found to be relevant, consisting of three factors: technological work support, working hours, and social well-being. It is concluded that the proposed instrument can be applied to any work organization to identify the factors involved in remote work.

Teachers' perceptions of physical education teaching in post-pandemic Spain

The aim of this research was to analyse the changes that COVID-19 have caused in Physical Education during the 2020-2021 academic course in post-pandemic years in Spain. For this purpose, a descriptive study was carried out with the participation of 684 physical education teachers from all the autonomous communities. The teachers answered a questionnaire consisting of five approaches: technological, pedagogical, curricular, emotional and health and hygiene. The methodological procedure followed the ethical standards of research in education and sports science. The results obtained show how COVID-19 has conditioned the teaching of Physical Education in the first year back to the classroom. Compliance with the contingency protocols, the limitations of space and material, the institutional helplessness, and the uncertainty in the face of a totally new situation have generated stress and emotional exhaustion in the teaching staff. The COVID-19 pandemic has accelerated the use of technology, the promotion of student autonomy and the need to select curricular content in accordance with the contingency protocols. The use of active methodologies mediated by technolo-gy that promote self-regulation of learning, opens the door to new hybrid teaching models in Physical Education that should be studied.

Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Sample of Health Care Workers in Oman

BACKGROUND Despite its wide usage among healthcare workers (HCWs), Depression Anxiety Stress Scales 21 (DASS-21) has received scant attention in terms of its psychometric properties among HCWs. The present study examined the factor structure of DASS-21 among representative HCWs in Muscat Region, Oman. The related aim is to examine factorial invariance across samples of males and females. METHODS Confirmatory factor analyses were conducted to evaluate the latent structure of DASS-21. Factorial invariance between males and females was examined. The Cronbach alpha coefficients of DASS-21 were calculated to assess the internal consistency of the scale. RESULTS The CFA of the DASS-21 indicated that the three-factor solution best fits the data. The results also showed that DASS21 had overall good-to-excellent reliability. Multigroup analysis did not indicate gender differences. LIMITATIONS The present research study was limited as the accrued sample was drawn from HCWs working in the urban area, the Muscat region. As the study was conducted during the COVID-19 pandemic, this has the potential to constitute potential confounder to hamper the generalization of the present study. CONCLUSIONS The results supported the applicability of DASS-21 across cultures and sex. The present data provide initial support for the psychometric properties of Arabic DASS among HCWs.

Isolated and blocked adolescents: a study on the psychological effects of the COVID-19 outbreak

BACKGROUND: According to the most updated data children and adolescents are less affected by SARS-CoV-2 infection, but they may be among the most exposed to the psychosocial consequences of the pandemic. We investigated the immediate psychological consequences of the COVID-19 outbreak in a sample of Italian adolescents.METHODS: An online survey was administered to 204 adolescents during the country's nationwide lockdown. It was composed of a socio-demographic interview focused on how teenagers were experiencing the health emergency (e.g., sport practiced, school distance learning, media exposure), and questionnaires on pathological worry, impact of events, metacognitions, state and trait anxiety, and affectivity.RESULTS: Results of hierarchical regression analyses showed that specific individual dispositions and lifestyles during the emergency period predicted cognitive and emotional experiences of adolescents. Sport was directly related to positive affect, while media exposure was inversely related. Online learning was positively related to adolescents' state anxiety, while fear of being infected was positively related to state anxiety, excessive worry, and post-traumatic stress. Moreover, the comparison with a control group of adolescents tested in a period free from any health emergency showed that the current sample had higher worry, state anxiety, negative affect, and reduced positive affect.CONCLUSIONS: Our findings suggest that the pandemic and the containment measures have significantly affected adolescents' mental health. Lifestyles during the health emergency showed to have a predictive value on the cognitive and emotional experience of adolescents, therefore they must be seriously taken into consideration to counteract the effects (Cite this article as: Feruglio S, Matiz A, Cogo P, Vidal E, Paschetto A, Fabbro F, et al. Isolated and blocked adolescents: a study on the psychological effects of the COVID-19 outbreak. Minerva Psychiatry 2022;63:208-18. DOI: 10.23736/S2724

The Persian version of the psychological flexibility in sport scale: a psychometric study.

BACKGROUND: There is a growing body of research suggesting that psychological flexibility (PF) is an important psychological construct related to psychological health and human performance. The Psychological Flexibility in Sport Scale (PFSS) is the first general scale to assess sport-related PF. So far, the PFSS has not yet been validated in other contexts than Sweden. Therefore, the current study sought to investigate a Persian version of the PFSS (P-PFSS) and extend the investigation of the psychometric properties of the PFSS in Iranian athletes. METHODS: A total of 302 athletes from both team and individual sports (average age of 20.7 years, SD ± 7.5, 62.3% were female) were involved in the current study. Statistical analysis was performed on the data to test validity and reliability. The validity of the P-PFSS was tested through face and content validity, construct validity, criterion validity, and known-groups validity. The reliability of P-PFSS was verified through internal consistency and temporal stability of the scale. RESULTS: Results revealed that validity of the P-PFSS was satisfactory. The instrument was determined to have strong face and content validity. With modifications, the confirmatory factor analysis confirmed the scale's unidimensionality. The convergent validity of the P-PFSS was found to be acceptable (average variance extracted = 0.66) and satisfactory results were also found in the correlation matrix for the assessment of construct validity. The P-PFSS showed good criterion validity related to generic psychological flexibility and athletic-related variables. Also, the P-PFSS was able to differentiate PF between known groups. The P-PFSS was found to be reliable, with good internal consistency (Cronbach's alpha = 0.92; composite reliability = 0.92) and temporal stability on retest (intraclass correlation coefficient = 0.95). CONCLUSIONS: Overall, the Persian version of the PFSS showed good psychometric qualities in Iranian athletes. The current study provides additional support for the PFSS and extends the context-specific utility for practitioners and researchers in assessing sport-related PF.

Psychometric Properties of the Online International Physical Activity Questionnaire in College Students.

INTRODUCTION: Due to the restrictions imposed to control the COVID-19 pandemic, there has been an increase in studies based on online surveys. However, there are important concerns about the validity and generalizability of results from online surveys. Thus, we aimed to test the reliability and validity of the online version of the International Physical Activity Questionnaire short form (IPAQ-SF) among college students from low-income regions. METHODS: This was a methodological feasibility study with a random stratified sample from a college located in the state of Maranhão in the city of Imperatriz (Brazil). The sample consisted of 195 college students (at least 17 years of age) to evaluate the validity and 117 students to evaluate the reliability. All data were collected in a self-reported online format (via Google Forms) twice, with an interval of 2 weeks. We used Spearman's correlation analysis for the reliability study. Additionally, we applied exploratory and confirmatory factor analysis to evaluate the structural validity. RESULTS: The questionnaire showed acceptable (rho > 0.30) and significant (p < 0.05) reliability, except for the question about the duration of sitting time on a weekend day. When assessing the construct validity (exploratory analysis), we identified a single factor that explained 88.8% of the variance. The 1-factor model showed acceptable model fit (SRMR = 0.039; CFI = 0.96; TLI = 0.90) in confirmatory analysis. CONCLUSIONS: The online version of the IPAQ-SF has acceptable reliability among college students from low-income regions and maintains the structure of the construct regarding to physical activity.

The Difference of Invariance, Reliability of The Student Engagement Scale (ESE) In Distance-Learning During Covid-19 Pandemic in Light of Some Students' Characteristics

This study aimed to test the factor structure of the measure of student participation in distance education. The study population consisted of all teachers in public education and faculty members in higher education in the Kingdom of Saudi Arabia by applying it to a sample of bachelor's and graduate students at the college of Education at umm al-Qura University. The (ESE) was applied to a random sample representing the study population consisting of (216) respondents. The results of the study showed that the scale consists of three main factors, with showed a high degree of construct validity through fit indices of the confirmatory factor analysis. The results have shown a gradual consistency of the measure's invariance that reaches the high level of the Measurement Invariance across the gender and study groups variables.

Validation of the Mental Health Changes Indicators Scale against Rasch measurement theory

The Mental Health Changes Indicators Scale (MHCIS) is a brief instrument designed to assess changes in an individual's mental health that occur in response to a specific life event. Although adequate psychometric properties have been demonstrated for this instrument based on classical test theory, the MHCIS has not yet been validated against Rasch measurement theory (RMT). We applied RMT to examine the psychometric properties of the MHCIS using data from 807 Chinese university students. The nominated life event in this study was the COVID-19 pandemic. Despite modest violations of unidimensionality and misfit to the Rasch model, in general, the results supported the validity of the 10-item MHCIS. We recommend further exploration of the generalizability of these results in other populations and across a range of potentially adverse life events.

Validating the Five-Item World Health Organization Well-Being Index.

Purpose: Research on the psychological well-being of caregivers of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) suggests that the well-being of parents and caregivers has been negatively affected by the COVID-19 pandemic. Although the psychological well-being of caregivers is a major concern, few validated well-being measures exist for caregivers of children diagnosed with ADHD. Therefore, a valid self-report scale is needed to assess well-being during the pandemic. The brief Five-Item World Health Organization Well-Being Index (WHO-5) has previously been used in studies on caregivers. However, its validity in this population remains unknown. This study aimed to evaluate the reliability and construct validity of the WHO-5 with caregivers of children with ADHD. Methods: A cross-sectional anonymous online survey was conducted in Norway. The study recruited caregivers from a community sample during the COVID-19 pandemic. This was carried out to investigate the construct validity by exploring the relationship between well-being, quality of life, social support, self-reported psychological distress, and perceived stress. Results: The findings of unidimensionality and high internal consistency, together with the results from the hypothesis testing, demonstrate the reliability and construct validity of the Norwegian version of the WHO-5 in this population. Conclusions: This study provides the first empirical evidence of the validity and reliability of the WHO-5 from a sample of Norwegian caregivers of children diagnosed with ADHD, with excellent reliability and construct validity. The scale can be used to systematize the measurement of well-being in caregivers because of its brevity and good psychometric properties, making it a valuable resource in research settings and assisting healthcare professionals in their crucial work of caring for caregivers.

Psychometric Properties of the COVID-19 Pandemic Fatigue Scale: Cross-sectional Online Survey Study.

BACKGROUND: Pandemic fatigue is defined as feelings of demotivation to follow preventive measures against COVID-19, together with decreased trust in government and frequency of information-seeking behaviors. OBJECTIVE: This study aims to analyze the psychometric properties of the COVID-19-specific pandemic fatigue scale according to classical test theory (CTT) and Rasch model approaches in the general Spanish population. METHODS: This was a cross-sectional study in a representative sample of 1018 adults who completed an online survey in November 2020 in the framework of the COVID-19 Snapshot Monitoring (COSMO)-Spain project. The assessments included the 6-item COVID-19 Pandemic Fatigue Scale (CPFS) and other COVID-19-related variables: COVID-19 infection, adherence to preventive behaviors, information-seeking behavior, self-efficacy, worry, and cognitive and affective risk perception. Data quality, acceptability, reliability, and validity were analyzed according to CTT, and the fit to the Rasch model, unidimensionality, appropriateness of the response scale, item local independency, reliability (person-separation index [PSI]), and item-person distribution were also calculated. RESULTS: The mean CPFS score was 17.06 (SD 5.04, range 6-30), with higher scores for women, younger participants, participants who never seek information on COVID-19, those who think they would contract a mild disease in case of infection, those with higher level of worry about coronavirus/COVID-19, and those who felt depressed or felt the coronavirus/COVID-19 is spreading slowly (all P<.01). The Cronbach alpha for the CPFS was 0.74. In the confirmatory factor analysis, one factor was identified (root mean square error of approximation [RMSEA]=.02; comparative fit index [CFI]=.99; χ²₅=8.06, P=.15). The CPFS showed good fit to the Rasch model (χ ²₂₄=42.025, P=.01, PSI=.642), unidimensionality (binomial 95% CI -.005 to .045), and item local independency. CONCLUSIONS: Our results suggest that the CPFS has moderate reliability and internal consistency and it is composed of a single dimension. It is a useful tool to ascertain the level of pandemic fatigue in the general population, which may help to guide the communication and information strategies to face the COVID-19 pandemic.

Integrating Mindfulness and Acceptance Into Traditional Cognitive Behavioral Therapy During the COVID-19 Pandemic: A Case Study of an Adult Man With Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) can be chronic and impairing, highlighting the need for effective treatments. Although Cognitive Behavior Therapy (CBT) is an effective treatment for GAD, a number of patients continue to report GAD symptoms treatment. Integrating evidenced-based treatment components into CBT treatments, such as mindfulness- and acceptance-based treatment components found in Acceptance and Commitment Therapy (ACT), may help improve the efficacy of treatment. Emerging interventions and research suggest that the cognitive restructuring aspect of CBT and acceptance stance of ACT (e.g., cognitive defusion) can be implemented into treatment concurrently from a stance of increasing a patient's coping skills repertoire and psychological flexibility. This systemic case analysis examined the efficacy and clinical utility of integrating ACT into a manualized CBT treatment for GAD. Furthermore, this study examined treatment efficacy and therapeutic alliance as the treatment rapidly and unexpectedly transitioned from in-person to telehealth due to the COVID-19 pandemic. Pre- to post-treatment and time-series analyses showed significant decreases in anxiety symptoms, worry, depressive symptoms, and emotion dysregulation. Although there was an initial increase in depressive and anxiety symptoms, worry, and emotion dysregulation following the switch from in-person to telehealth services, these quickly subsided and resumed a downward trend. The therapeutic relationship did not deteriorate during the transition to telehealth. This case study provides evidence of feasibility and efficacy of an integrated CBT/ACT approach in treating GAD. It also suggests that despite some temporary increase in symptoms, therapeutic alliance and treatment efficacy were not impacted by the switch to telehealth.