An Item Response Theory Analysis of the Psychosis Screening Questionnaire in Ethiopia.

AIM: Few psychosis screening instruments have been tested for use in Africa, yet appropriate tools can increase the detection of self-reported psychotic symptoms, improve the detection of psychosis and impact its prognosis. METHOD: The construct validity and factor structure of Psychosis Screening Questionnaire (PSQ) were tested with confirmatory factor analysis (CFA) and item response theory (IRT) in a sample of 1928 Ethiopian adults without any history of psychosis. We tested a unidimensional model with and without an item on mania. For IRT, unidimensional latent structure one-parameter logistic (1PL) and two-parameter (2PL) logistic models were tested and compared for relative fit using a likelihood-ratio test. RESULT AND DISCUSSION: The prevalence of lifetime positive screens was 2.8% in an Ethiopian sample of adults from a general medical setting. A unidimensional model demonstrated good fit for the PSQ, (CFI = 0.993, TLI = 0.986 and RMSEA = 0.025). For IRT, a 2PL model was the best fitting one. IRT tests of item difficulty and discrimination parameters showed that paranoia had the highest discrimination α = 4.59 $$ \left(\alpha =4.59\right) $$ and lowest difficulty ( ß = 2.53 $$ \beta =2.53 $$ ), likely to be endorsed at low levels of psychotic features. Thought insertion had the highest item difficulty ( ß = 2.98 $$ \beta =2.98 $$ ). Overall, the measure captures the psychosis construct at higher levels of the latent trait and may be suited for detecting moderate to severe levels of psychosis. CONCLUSION: The PSQ is found to have good construct validity in screening for psychosis among Ethiopian adults. Future studies may focus on the diagnostic validity of the PSQ comparing it with a structured clinical interview.

Patient Safety Climate in Danish Primary Care: Adaption and Validation of the Danish Safety Attitudes Questionnaire (SAQ-DK-PRIM).

Background: A lack of instruments to assess patient safety climate within primary care exists. The objectives of this study were as follows: 1) To adapt the Danish hospital version of the Safety Attitudes Questionnaire (SAQ-DK) for use in primary care; 2) Test the internal consistency and the construct validity of this version; 3) Present benchmark data; and 4) Analyze variance. Methods: The SAQ-DK was adapted for use in Danish primary care settings (SAQ-DK-PRIM) and distributed to healthcare staff members from nursing homes (N = 11), homecare units (N = 4) and healthcare units (N = 2), within the municipality of Aarhus, Central Denmark Region, Denmark. Face- and content validity were assessed. The construct validity was evaluated by a set of goodness-of-fit indices. The internal reliability was evaluated using the item-rest correlations, the inter-item correlations, and Cronbach's alpha (α). Results: The adaptation process resulted in a questionnaire of 10 items. Eight hundred and thirty healthcare staffs participated (78% of the eligible respondents). In total 586 (70.6%) responses were complete and were included in the analysis. Goodness-of-fit indices from the confirmatory factor analysis showed: Chi2=46.90CFI=0.97, RMSEA = 0.063 (90% CI: 0.044-0.084), Probability RMSEA (p close)=0.12. Internal reliability was high (Cronbach's α=0.76). Proportions of participants with a positive attitude was 41.1% and did not differ between the healthcare services. Scale mean score was 70.19 (SD: 18.05) and differed between healthcare services. The safety climate scale scores did not vary according to healthcare service type. ICC was 0.68% indicating no clustering of scores by healthcare service type. Conclusion: Considering the questionnaire's applicability, short length, strengthened focus on one area of interest and validity, the SAQ-DK-PRIM can serve as a valuable tool for measuring patient safety climate within primary care settings in Denmark.

An indicator of the view of time passing: the development and validation of the metacognitive knowledge of time passing scale (MKTPS) in Chinese college students.

How we view the passage of past time determines how we face time itself as well as our futures, which has a strong impact particularly during the highly creative and malleable college years. Chinese culture cherishes time deeply, and for centuries there has been a tradition of "educating children and youth to inspect the passage of time." However, in today's age of information and intelligence, time has shown a trend toward fragmentation. How do contemporary Chinese college students view the passage of time, and what structures or content does it contain? The answer to this question remains uncertain, necessitating further exploration. Following Flavell's theory of metacognitive knowledge (MK), we adopted a semi-structured interview method and used the results to first outline the basic structure of Chinese college students' view of time passing, identifying four major aspects: priming aftereffect, life touching, positive promotion, and negative inhibition. Then, using the initial four-dimensional structure as a starting point, we developed the Metacognitive Knowledge of Time Passing Scale (MKTPS), and carried out exploratory factor analysis and confirmatory factor analysis to test its fit. The results showed that the four-factor scale and its 22 items had a good fit to the data. Third, the reliability and validity of the self-developed scale were tested. The results show that the internal consistency, split-half, and retest reliability of the MKTPS are good (all rs > 0.60). The construct validity of the MKTPS is also good (r between subscales is 0.33-0.60, r between subscales and total scale is 0.64-0.87), the convergent validity with Zimbardo's negative past time perspective is high (r = 0.37), and the discriminant validity with Zimbardo's future time perspective is significant (r = 0.18). Regarding criterion correlation validity, the total scores of the MKTPS have a significantly higher positive correlation with those of the time management disposition (TMD) scale (r = 0.45). Future points for studying the view of time passing in adults of all ages and across cultures field and shortcomings of the current study are also discussed.

Polish translation, cultural adaptation, and validity confirmation of the Scored Patient-Generated Subjective Global Assessment.

PURPOSE: The Scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated nutritional screening, assessment, triage, and monitoring tool. The aim of this study was to perform translation, cultural adaptation, linguistic, and content validation of the translated and culturally adapted version of the PG-SGA for the Polish setting. METHODS: The study was performed in concordance with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles. Patients (n = 174) and healthcare professionals (HCPs, n = 188) participated in the study. Comprehensibility and difficulty were assessed by patients for the PG-SGA Short Form, and by HCPs for the professional component. Content validity was assessed for the full PG-SGA by HCPs only. Evaluations were operationalized by a 4-point scale. Item and scale indices were calculated using the average item ratings divided by the number of respondents. Item indices < 0.78 required further analysis of the item, while scale indices ≥ 0.90 were defined as excellent and 0.80-0.89 as acceptable. RESULTS: The PG-SGA Short Form was rated as excellent for content validity (Scale-CVI = 0.90) by HCPs and easy to comprehend (Scale-CI = 0.96) and use (Scale-DI = 0.94) by patients. The professional component of the PG-SGA was perceived as acceptable for content validity (Scale-CVI = 0.80), comprehension (Scale-CI = 0.87), and difficulty (Scale-DI = 0.80). The physical exam was rated the least comprehensible and the most difficult, and with the lowest content validity. We found significant differences in scale indices (p < 0.05 for all) between HCPs with different professions and between those being familiar with PG-SGA and not. CONCLUSION: Translation and cultural adaptation of the PG-SGA for the Polish setting preserved the purpose and conceptual meaning of the original PG-SGA. Validation revealed that the Polish version of PG-SGA is well understood and easy to complete by patients and professionals, and is considered relevant by professionals. However, detailed results indicate the need for appropriate training of the Polish HCPs, especially physicians and nurses, mainly in the worksheets related to the metabolic demand and physical exam.

A quick balance assessment tool for all clinical settings: validity and reliability of the Hungarian version of the activities-specific balance confidence scale.

BACKGROUND: The Activities-specific Balance Confidence Scale was developed for testing the balance confidence of elderly individuals, and it has been used extensively for evaluating various patients. No such scale has been adapted for the Hungarian population. OBJECTIVE: To translate and culturally adapt the Activities-specific Balance Confidence Scale and test the reliability and validity of the Hungarian version. METHODS: The study included 167 independently mobile subjects, of whom 39 filled in the questionnaire twice, 1 week apart. Beaton's six-step principle was applied for cross-cultural adaptation. Reliability was assessed by internal consistency measured by Cronbach's alpha and through test-retest analysis. Types of validity evaluated were concurrent validity using the Berg Balance Scale and cross-cultural validity. RESULTS: Excellent internal consistency was shown by Cronbach's alpha = 0.977. Test-retest analysis resulted in an Intra-Class Correlation Coefficient of 0.962 (0.865-0.961, 95% CI, p < .001) for the whole test; no floor or ceiling effects were found. The convergent validity of the scale was tested by Spearman's rank correlation analysis using the Berg Balance scale for external validation and showed a strong positive correlation (Rho = 0.755, p < .001). Receiver Operating Characteristic curve analysis showed an Area Under the Curve of 0.821 (CI 95% 0.75, 0.892). Mean detectable change based on the 95% confidence interval was 10.49% on the scale ranging from 0 to 100%. CONCLUSIONS: The Hungarian version of the Activities-Specific Balance Confidence Scale provides a valid and reliable picture of the patients' self-assessed balance. It is recommended both for clinicians and for clinical studies.

Reliability and Validity of Turkish version of DSM-5 Substance Use Scale. / DSM-5 Madde Kullanimi Ölçegi'nin Türkçe Formunun Geçerligi ve Güvenilirligi.

OBJECTIVE: This study aims to evaluate the severity of substance use disorders according to the DSM-5 criteria and to show the reliability and validity of the Turkish version of the DSM-5 Substance Use Scale that improved to learn what kind of substances are used. METHODS: In this study,54 in or out-patients who met the criteria for any substance use disorder according to DSM-5 and who are receiving treatment in Psychiatry Department of Celal Bayar University Faculty of Medicine and AMATEM department of Bakirköy Prof. Dr. Mahzar Osman Mental Health and Neurology Training and Research Hospital, were included. One hundred volunteers without any mental or physical disease were also recruited as the control group. Beside the DSM-5 Level 2 substance use scale, Addiction Profile Index was used for concurrent validity. Internal consistency coefficient and item-total correlation analysis were performed for reliability analysis. ROC Analysis was used in the validity analysis. RESULTS: Mean age was 26.97±10.20 years in the study group and 39% of the sample (n=60) were female. 5.6% (n=3) of the patient group were female and 94.4% (n=51) were male. In the control group, 57% (n=57) were female and 43% (n=43) were male. Of the patients diagnosed with substance use disorder (n=54), 88.7% had opiate use disorder, 5.6% had polysubstance use disorder, 5.6% had other (unknown) substance (synthetic cannabinoid) use disorder and 1.8% of patients have cannabis use disorder. The internal consistency of the substance use scale was 0.80 and itemtotal correlation coefficients were between 0,196- 0,643 (p<0.0001). Coefficient of correlation analysis with API was calculated as r=0.806 (p<0.0001). CONCLUSION: The results showed that DSM-5 Substance Use Scale is a valid and reliable questionnaire that can be used to measure the progress of different dimensions of alcohol and substance use.

Cross-Cultural Adaptation and Psychometric Evaluation of the Brazilian Portuguese Version of the Nocturia Quality-of-Life Questionnaire.

INTRODUCTION AND HYPOTHESIS: The objective was to cross-culturally adapt and check for the reliability, internal consistency, and validity of the Nocturia Quality of Life Questionnaire (N-QoL) in Brazilian Portuguese (N-QoL-Br). METHODS: The questionnaire was translated according to international guidelines, included forward-translation, back-translation, and consensus among an expert committee. Participants with nocturia completed the Pittsburgh Sleep Quality Index, International Consultation on Incontinence Questionnaire Overactive Bladder, and the General Quality of Life Assessment Questionnaire SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey), in addition to the N-QoL-Br. The Brazilian version was applied in men and women with nocturia twice within a range of 4 weeks. Psychometric properties such as content validity, construct validity, internal consistency, and test-retest reliability were tested. RESULTS: Content validity was considered adequate. Eighty-four men and women participated in the study. Good internal consistency in the domains and final score of the N-QoL-Br was observed, with Cronbach α greater than 0.9. The test-retest reliability was also high, with an intraclass correlation coefficient greater than 0.9 for the domain sleep/energy, bother/concern, and total score (0.98, 0.98, and 0.97 respectively). CONCLUSIONS: The Portuguese version of the N-QoL-Br presents good internal consistency and reproducibility and it can be considered adequate and valid for evaluating the impact of nocturia on the quality of life of men and women in the Brazilian population.

Assessing the reliability of a novel cancer-specific multi-attribute utility instrument (FACT-8D) and comparing its validity to EQ-5D-5L in colorectal cancer patients.

OBJECTIVE: To examine the test-retest reliability of the Functional Assessment of Cancer Therapy - 8 Dimension (FACT-8D) for the first time, and to conduct a head-to-head comparison of the distribution properties and validity between the FACT-8D and EQ-5D-5L in Colorectal Cancer (CRC) Patients. METHODS: We conducted a longitudinal study on Chinese CRC patients, employing Functional Assessment of Cancer Therapy-General (FACT-G) and EQ-5D-5L at baseline, and FACT-G during follow-up (2-7 days from baseline). Utility scores for FACT-8D were derived from all available value sets (Australia, Canada and USA), while EQ-5D-5L scores were obtained from corresponding value sets for various countries. We assessed convergent validity using pairwise polychoric correlations between the FACT-8D and EQ-5D-5L; known-groups validity by discriminating participants' clinical characteristics, and effect size (ES) was tested; test-retest reliability for FACT-8D using kappa and weighted Kappa for choice consistency, and intraclass correlation coefficient (ICC) and Bland-Altman method for utility consistency. RESULTS: Among the 287 patients with CRC at baseline, 131 were included in the retest analysis. The utility scores of FACT-8D were highly positively correlated with EQ-5D-5L across various country value sets (r = 0.65-0.77), and most of the dimensions of FACT-8D and EQ-5D-5L were positively correlated. EQ-5D-5L failed to discriminate known-groups in cancer stage across all value sets, whereas both were significant in FACT-8D (ES = 0.35-0.48, ES = 0.38-0.52). FACT-8D showed good test-retest reliability (Cohen's weighted Kappa = 0.494-0.722, ICC = 0.748-0.786). CONCLUSION: The FACT-8D can be used as a valid and reliable instrument for clinical evaluation of patients with CRC, outperforming EQ-5D-5L in differentiating clinical subgroups and showing promise for cancer practice and research.

Recently, the Multi-Attribute Utility in Cancer Consortium developed the Functional Assessment of Cancer Therapy − 8 Dimension (FACT-8D), a new cancer-specific multi-attribute utility instrument based on the Functional Assessment of Cancer Therapy - General (FACT-G). This addresses the FACT-G's limitation in directly generating utility values, which has broad application prospects in cost-utility analysis within the field of oncology. To our knowledge, this is the first study to examine the test-retest reliability of FACT-8D and to conduct a head-to-head comparison of its distribution properties and validity against the EQ-5D-5L in colorectal cancer (CRC) patients. The results indicate that FACT-8D is a valid and reliable instrument for clinical evaluation of CRC patients, demonstrating superior performance in differentiating between known clinical groups compared to the generic MAUI EQ-5D-5L, and is a promising instrument for use in cancer practice and research.

Validating a brief measure of four facets of social evaluation.

Five studies (N = 7972) validated a brief measure and model of four facets of social evaluation (friendliness and morality as horizontal facets; ability and assertiveness as vertical facets). Perceivers expressed their personal impressions or estimated society's impression of different types of targets (i.e., envisioned or encountered groups or individuals) and numbers of targets (i.e., between six and 100) in the separate, items-within-target mode or the joint, targets-within-item mode. Factor analyses confirmed that a two-items-per-facet measure fit the data well and better than a four-items-per-dimension measure that captured the Big Two model (i.e., no facets, just the horizontal and vertical dimensions). As predicted, the correlation between the two horizontal facets and between the two vertical facets was higher than the correlations between any horizontal facet and any vertical facet. Perceivers' evaluations of targets on each facet were predictors of unique and relevant behavior intentions. Perceiving a target as more friendly, moral, able, and assertive increased the likelihood of relying on the target's loyalty, fairness, intellect, and hubris in an economic game, respectively. These results establish the external, internal, convergent, discriminant, and predictive validity of the brief measure and model of four facets of social evaluation.

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study.

Background: Controlling saturated fat and cholesterol intake is important for the prevention of cardiovascular diseases. Although the use of mobile diet-tracking apps has been increasing, the reliability of nutrition apps in tracking saturated fats and cholesterol across different nations remains underexplored. Objective: This study aimed to examine the reliability and consistency of nutrition apps focusing on saturated fat and cholesterol intake across different national contexts. The study focused on 3 key concerns: data omission, inconsistency (variability) of saturated fat and cholesterol values within an app, and the reliability of commercial apps across different national contexts. Methods: Nutrient data from 4 consumer-grade apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa FoodApp) were compared against 2 national reference databases (US Department of Agriculture [USDA]-Food and Nutrient Database for Dietary Studies [FNDDS] and Taiwan Food Composition Database [FCD]). Percentages of missing nutrients were recorded, and coefficients of variation were used to compute data inconsistencies. One-way ANOVAs were used to examine differences among apps, and paired 2-tailed t tests were used to compare the apps to national reference data. The reliability across different national contexts was investigated by comparing the Chinese and English versions of MyFitnessPal with the USDA-FNDDS and Taiwan FCD. Results: Across the 5 apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fats, with errors ranging from -13.8% to -40.3% (all P<.05). All apps underestimated cholesterol, with errors ranging from -26.3% to -60.3% (all P<.05). COFIT omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. The coefficients of variation of beef, chicken, and seafood ranged from 78% to 145%, from 74% to 112%, and from 97% to 124% across MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, respectively, indicating a high variability in saturated fats across different food groups. Similarly, cholesterol variability was consistently high in dairy (71%-118%) and prepackaged foods (84%-118%) across all selected apps. When examining the reliability of MyFitnessPal across different national contexts, errors in MyFitnessPal were consistent across different national FCDs (USDA-FNDSS and Taiwan FCD). Regardless of the FCDs used as a reference, these errors persisted to be statistically significant, indicating that the app's core database is the source of the problems rather than just mismatches or variances in external FCDs. Conclusions: The findings reveal substantial inaccuracies and inconsistencies in diet-tracking apps' reporting of saturated fats and cholesterol. These issues raise concerns for the effectiveness of using consumer-grade nutrition apps in cardiovascular disease prevention across different national contexts and within the apps themselves.

Content validity of the Leicester Cough Questionnaire in adults with refractory or unexplained chronic cough: a qualitative interview study.

BACKGROUND: Chronic cough, a cough lasting >8 weeks, includes refractory chronic cough (RCC) and unexplained chronic cough (UCC). Patient-reported outcome (PRO) measures are needed to better understand chronic cough impacts that matter most to patients. The 19-item Leicester Cough Questionnaire (LCQ), an existing PRO measure of chronic cough, assesses impacts of cough across physical, psychological, and social domains. However, the content validity of the LCQ evaluating these concepts in patients with RCC/UCC had not been established. OBJECTIVES: To evaluate the content validity of the LCQ in patients with RCC/UCC. DESIGN: A cross-sectional, qualitative interview study. METHODS: First, previously completed qualitative interview results in adults with RCC/UCC (N = 30) were evaluated and mapped to LCQ concepts. Next, a clinical cough expert reviewed each LCQ item and assessed the salience of its concepts for patients with RCC/UCC. Finally, semistructured interviews-including both concept elicitation and cognitive debriefing-were conducted in adults with RCC/UCC (N = 20) to elicit a comprehensive set of participant experiences and to assess the appropriateness of using the LCQ in this population. RESULTS: Concepts reported in the past and present qualitative interviews were included across all LCQ items, and most impacts reported to be the "most bothersome" were assessed in the LCQ. In the current study, all participants indicated that reduced cough frequency would be an important treatment target. During cognitive debriefing, each LCQ item was endorsed by ⩾70% of participants. Additionally, participants were generally able to understand, recall, and select a response for each LCQ item. All participants and the clinical expert indicated that the LCQ was appropriate and assessed the impacts most relevant to patients with RCC/UCC. CONCLUSION: Our findings support the content validity of the LCQ and demonstrate that this measure is fit-for-purpose and includes important cough impacts in adults with RCC/UCC.

Further validation of the visceral sensitivity index: Psychometric properties and utility for predicting disordered eating in a diverse university sample.

Gastrointestinal (GI) visceral sensitivity (i.e., anxiety/worry over GI sensations) may be a key maintaining factor for disordered eating; however, it is unknown whether GI visceral sensitivity predicts the range of disordered eating behaviors in nonclinical samples. The current preregistered study aimed to replicate previous construct validity findings of the Visceral Sensitivity Index (VSI; i.e., factor structure, convergent and discriminant validity) and examine its criterion-related validity for predicting a range of disordered eating attitudes and behaviors in a diverse undergraduate sample. A total of 591 university students were retained in the final analytic sample (53 % women; 23 % Hispanic [Any Race], 10 % Asian, 9 % Black) and completed the VSI, disordered eating, and additional validity measures. A confirmatory factor analysis tested the factor structure of the VSI, and correlations were used to examine convergent and discriminant validity. Hierarchical regressions and t-tests were used to examine criterion-related validity. Results replicated previous construct validity findings in a diverse undergraduate sample. Exploratory analyses supported invariance of the VSI across gender and the VSI discriminated between individuals at high- versus low-risk for an eating disorder and predicted a range of disordered eating attitudes (e.g., body dissatisfaction) and behaviors (e.g., restricting, binge eating, purging, compulsive exercise). GI-specific anxiety appears to be transdiagnostic across disordered eating behaviors and relevant across the spectrum of disordered eating severity. Future work may include developing transdiagnostic models of GI visceral sensitivity in disordered eating and investigating inclusion of the VSI in university screening efforts.

Turkish Validation and Cultural Adaptation of the Family Care Ability Assessment Scale for Pediatric Oncology Caregivers.

OBJECTIVES: This study aimed to investigate the psychometric properties of the Turkish version of the "Caring Ability of Family Caregivers of Patients with Cancer Scale" in parents of children with cancer". METHODS: The current study has a methodological design. The study group consisted of 493 parents of children with oncological problems who were followed in the pediatric hematology-oncology departments of three university hospitals. Data were collected between January and December 2021 through convenience sampling. The face, content construct validity, internal consistency, and scale stability were evaluated. SPSS 26.0 and LISREL 8.80 package programs were used to analyze the data. RESULTS: In the confirmatory factor analysis; root mean- mean square error of approximation, comparative fit index, normed fit index, and non-normed fit index were determined to be 0.08, 0.93, 0.91, and 0.92, respectively. Cronbach's alpha reliability coefficient obtained from the entire scale was calculated to be 0.88, the stability correlation coefficient was 0.84 (p < .005) and the item-total correlation coefficient was calculated between 0.249 and 0.716. CONCLUSIONS: The scale adapted to Turkish culture can be considered a valid and reliable tool for the assessment of the caring ability of family caregivers of patients with cancer. IMPLICATIONS FOR NURSING PRACTICE: The scale can be used to assess parents' caregiving abilities, to determine their strengths and weaknesses. In this respect, it can contribute to the creation of an education plan, the development of parents' caregiving abilities and the increase in the quality of care.

Development of a Scale to Assess Cancer Attitude in the Community.

AIM: The aim of this study was to develop the Cancer Attitude Scale (CAS) and to evaluate its psychometric properties. METHODS: The study was conducted in a mixed-methods study. The preliminary version of the CAS was created by developing an item pool, and qualitative interviews. The items' content validity ratio was calculated to assess content validity. Construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Internal consistency and test-retest methods were used to determine the reliability of the scale. The Cancer Information Burden Scale was used to evaluate the convergent validity of the scale. Three hundred twenty-five healthy individuals selected by convenience sampling method were included in this study. RESULTS: The CAS sub-dimensions were determined as cancer diagnosis, cancer prevention, stigmatization of individuals with cancer, and personal empowerment after cancer. The content validity of the 22-item scale was 0.94 and four factors explaining 56% of the variance. The model fit indices were χ2/df = 1.968, RMSEA = 0.055, SRMR = 0.085, and GFI = 0.904. . Cronbach's α and test-retest reliability coefficients of the total scale are 0.76 and 0.936, respectively. The CAS and Cancer Information Overload Scale showed acceptable convergent validity (r = 0.435, P < .001). CONCLUSIONS: The Cancer Attitude Scale is a valid and reliable tool that can be applied to assess the attitudes of individuals in the community toward cancer in a multidimensional way. IMPLICATIONS FOR PRACTICE: Nurses play crucial roles in society, including enhancing cancer awareness, delivering counseling services, and providing health education. Cancer nursing should plan cancer awareness training in line with individuals' attitudes toward cancer and encourage positive attitudes that increase participation in screening programs.

Psychometric properties of the Depression Anxiety Stress Scales (DASS-21) in women with breast cancer.

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald's omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Functional fitness and physical independence in later years: cut-off values and validation.

BACKGROUND: To establish and validate the criterion-referenced standards of functional fitness in predicting physical independence in 80 + years. METHODS: A group of 2,749 older community dwellers (60-84 years) were recruited, and 2,050 were identified with moderate-to-high independent living ability according to the proposed minimum composite physical function score. The Senior Fitness Test battery was applied to measure functional fitness at five-year intervals. The declining rate for each fitness dimension was calculated based on the differences between any two adjacent age groups and was adjusted according to the reported degradation rate differences between the cross-sectional and longitudinal studies. RESULTS: The age-and-sex-specific criterion-referenced standards were identified for muscle strength, cardiovascular endurance, and dynamic balance that older adults should possess at 60-79 to maintain independent living abilities. Moderate to high consistency (k = 0.622-0.650) and associations (φ = 0.641-0.694) were found between the predicted physical independence by criterion-referenced standards of functional fitness and the results from the composite physical function scale. Moreover, the predicted independent living abilities in later years from the criterion-referenced standards of functional fitness showed high test-retest reliability (Pa = 0.90-0.96). CONCLUSION: The criterion-referenced standards for functional fitness are valid and reliable to predict independent living abilities in later years, and provide the threshold to identify the limitations in physical fitness and detect the risks of functional disabilities among older adults in an early stage.

Self-concealment scale (SCS) in middle-aged people: psychometric features and cross-age equivalence test.

BACKGROUND: Individuals' concealment of negative information and privacy may lead to impaired social interactions and threatened health conditions. This study aimed to investigate the effectiveness of the Self-Concealment Scale (SCS) in the middle-aged Chinese population and to examine the equivalence of the SCS among different age groups. METHODS: The current research adopted the SCS, Distress Disclosure Index (DDI), Revised Cheek and Buss Shyness Scale (RCBS), Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), UCLA Loneliness Scale (ULS-8), and Kessler Psychological Distress Scale (K10) to survey 1124 middle-aged people. To explore the factor structure of the SCS, the study employed exploratory factor analysis and confirmatory factor analysis. The reliability of the SCS was measured based on Cronbach's α coefficients, McDonald's Omega coefficients, and split-half reliability. Correlation analysis was applied to examine the relationship between SCS and RCBS, SIAS, SPS, ULS-8, and K10. Moreover, this study recruited 1458 emerging adults and 1104 older adults to identify the cross-age invariance of the SCS. RESULTS: Exploratory factor analysis of the middle aged adults' data supported a single factor model. The factor loadings of SCS items ranged from 0.62 to 0.73, the commonality ranged from 0.39 to 0.53, and the single-factor model fitted well. The scale showed a Cronbach's α coefficient value of 0.895, McDonald's Omega coefficient of 0.893, and a split-half reliability coefficient value of 0.861. In addition, the SCS demonstrated invariance in emerging adults, middle-aged adults, and older adults. Further analysis showed that the scores of the SCS (F = 3.55, p = 0.029) among emerging adults (M = 26.43, SD = 7.96) were significantly higher than among middle-aged (M = 25.77, SD = 7.79), and older cohort (M = 25.69, SD = 7.91). CONCLUSION: The SCS revealed favorable psychometric characteristics among the middle-aged Chinese population. The degree of self-concealment among emerging adults was higher than that of middle-aged and older people.

Psychometric properties of computerized adaptive testing for chronic obstructive pulmonary disease patient-reported outcome measurement.

BACKGROUND: Computerized adaptive testing (CAT) is an effective way to reduce time, repetitious redundancy, and respond burden, and has been used to measure outcomes in many diseases. This study aimed to develop and validate a comprehensive disease-specific CAT for chronic obstructive pulmonary disease (COPD) patient-reported outcome measurement. METHODS: The discrimination and difficulty of the items from the modified patient-reported outcome scale for COPD (mCOPD-PRO) were analyzed using item response theory. Then the initial item, item selection method, ability estimation method, and stopping criteria were further set based on Concerto platform to form the CAT. Finally, the reliability and validity were validated. RESULTS: The item discrimination ranged from 1.05 to 2.71, and the item difficulty ranged from - 3.08 to 3.65. The measurement reliability of the CAT ranged from 0.910 to 0.922 using random method, while that ranged from 0.910 to 0.924 using maximum Fisher information (MFI) method. The content validity was good. The correlation coefficient between theta of the CAT and COPD assessment test and modified Medical Research Council dyspnea scale scores using random method was 0.628 and 0.540 (P < 0.001; P < 0.001) respectively, while that using MFI method was 0.347 and 0.328 (P = 0.007; P = 0.010) respectively. About 11 items (reducing by 59.3%) on average were tested using random method, while about seven items (reducing by 74.1%) on average using MFI method. The correlation coefficient between theta of the CAT and mCOPD-PRO total scores using random method was 0.919 (P < 0.001), while that using MFI method was 0.760 (P < 0.001). CONCLUSIONS: The comprehensive disease-specific CAT for COPD patient-reported outcome measurement is well developed with good psychometric properties, which can provide an efficient, accurate, and user-friendly measurement for patient-reported outcome of COPD.

Development and validation of Tamil version of CARIES-QC questionnaire among socially marginalized school children in Chennai City.

BACKGROUND: The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), which was developed to assess dental caries-specific Child Oral Health Related Quality of Life (COHRQoL), has been translated into few world languages. AIM: To develop and validate the Tamil version of Caries Impacts and Experience Questionnaire for Children (CARIES-QC). DESIGN: This cross-sectional study was conducted among socially marginalized school children in Chennai City. The initial translation of the English CARIES-QC questionnaire to Tamil was made by two independent translators followed by an expert committee discussion to derive a prefinal version of the Tamil questionnaire. Subsequently, content validation was performed by bilingual subject experts followed by preliminary pilot testing among 30 school children aged 8-10 years studying in Adidravidar Welfare High School, Chennai, to produce the final version of the questionnaire. Convergent validity, discriminant validity, and test-retest reliability of the translated questionnaire were tested among 191 children. RESULTS: The content validation process revealed that the translated version had relevant questions and content coverage (Scale-wise Content Validity Index score = .91). The children with and without dental caries had mean CARIES-QC scores of 5.39 + 3.7 and 3.71 + 5.1, respectively, and their statistically significant difference (p-value = .04) between them indicates the scale's satisfactory discriminant validity. The Cronbach's alpha was .87 indicating the questionnaire's good internal consistency. CONCLUSION: The newly developed Tamil CARIES-QC questionnaire is a valid and reliable tool for assessing COHRQoL among Tamil-speaking school children.

Validity and reliability of the translated Marathi version of the 14-item health literacy scale.

Introduction: Various tools for measuring health literacy are designed to assess reading comprehension and numeracy in English speakers. There is a need to develop a tool in the vernacular language and estimate health literacy levels in Indian settings. The present study was conducted with the objectives to develop a Marathi version of a 14-item health literacy scale (HLS-14) to test the reliability and validity of its Marathi version and to estimate the health literacy among patients attending the out-patient department at a tertiary care centre. Methodology: The present study was conducted among 50 adult patients attending the out-patient department of a tertiary hospital from July 2022 to December 2022. The 14-Item Health Literacy Scale available in English was translated into Marathi and back-translated to English, and the final version was developed. Bilingual study subjects were asked to fill the scales on day 0 and on day 7. Cronbach's alpha was calculated for internal validity, and the correlation coefficient was calculated for the reliability of the tool and health literacy was estimated. Results: When items of the Health Literacy Scale were analysed, all the items barring 2, 6, and 10 gave an r-value of more than 0.70, which shows good reliability of each translated item. The Cronbach's alpha value found for the current translated Marathi questionnaire is 0.66. Internal consistency is good. The mean total health literacy score was 51.16 ± 6.81. Conclusions: A translated Marathi version of HLS-14 is developed, which is valid and reliable. The health literacy among the study participants is marginal.