A scale for measuring nursing digital application skills: a development and psychometric testing study.

BACKGROUND: The adoption of digitization has emerged as a new trend in the advancement of healthcare systems. To ensure high-quality care, nurses should possess sufficient skills to assist in the digital transformation of healthcare practices. Suitable tools have seldom been developed to assess nurses' skills in digital applications. This study aimed to develop the Nursing Digital Application Skill Scale (NDASS) and test its psychometric properties. METHODS: The Nursing Digital Application Skill Scale was developed in three phases. In Phase 1, an item pool was developed based on previous literature and the actual situation of nursing work. Phase 2 included 14 experts' assessment of content validity and a focus group interview with 30 nurses to pretest the scale. In phase 3, 429 registered nurses were selected from March to June 2023, and item analysis, exploratory factor analysis, and confirmatory factor analysis were used to refine the number of items and explore the factor structure of the scale. Additionally, reliability was determined by internal consistency and test-retest reliability. RESULTS: The final version of the NDASS consisted of 12 items. The content validity index of NDASS reached 0.975 at an acceptable level. The convergent validity test showed that the average variance extracted value was 0.694 (> 0.5) and the composite reliability value was 0.964 (> 0.7), both of which met the requirements. The principal component analysis resulted in a single-factor structure explaining 74.794% of the total variance. All the fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the single-factor structure contributed to an ideal model fit. The internal consistency appeared high for the NDASS, reaching a Cronbach's alpha value of 0.968. The test-retest reliability was 0.740, and the split-half coefficient was 0.935. CONCLUSION: The final version of the NDASS, which possesses adequate psychometric properties, is a reliable and effective instrument for nurses to self-assess digital skills in nursing work and for nursing managers in designing nursing digital skill training.

Development and psychometric testing of the narrative nursing teaching effectiveness scale: A methodological study.

BACKGROUND: Narrative teaching is widely used in nursing education. However, there is currently a lack of valid and reliable tool to assess the effectiveness of narrative nursing teaching from the perspective of nursing students. OBJECTIVES: This study developed a Narrative Nursing Teaching Effectiveness (NNTE) scale and evaluated its psychometric properties. DESIGN: A methodological design was used to develop and validate the instrument. SETTINGS: The study took place at a university in southern China. PARTICIPANTS: The study involved 283 nursing students enrolled at a medical university in Fujian Province, China. METHODS: The researchers conducted literature reviews, held focus groups and individual interviews, and utilized the Delphi method to create a pool of indicators for a narrative nursing teaching evaluation system. A pretest was administered to 150 nursing students. Next, the primary study involved 283 nursing students, chosen through cluster sampling, completed a general information questionnaire along with the NNTE scale. Data analysis was performed using SPSS 26.0, Mplus 6.1, and STATA 16.0, and included general statistical analysis, critical test theory, and item response theory analyses. RESULTS: The researchers created a 42-item scale with four subdomains, explaining 60.32 % of the total variance. Confirmatory factor analysis proved the four-factor model's validity. Cronbach's alpha values for the four subscales ranged from 0.869 to 0.949. The average content validity index of the scale was 0.923 and the item content validity index ranged from 0.872 to 1. In addition, all item characteristic curves displayed desirable shapes, and the test information functions provided precise information. CONCLUSIONS: The NNTE scale exhibits good psychometric properties, providing a scientifically sound and effective instrument to evaluate the effectiveness of the narrative nursing teaching approach to nursing education.

Assessing HIV knowledge in Mexican people living with HIV: development and validation of CC-VIH questionnaire.

The level of knowledge that people living with human immunodeficiency virus (HIV) have about their disease can impact their adherence to treatment. The aim of this study was to develop a tool to assess the knowledge about HIV among people receiving treatment at a specialized clinic in Mexico City. To establish content validity, expert judges were invited to conceptualize the tool and propose items for the defined dimensions. A total of 490 individuals living with HIV completed the 91-item questionnaire, with 82.2% being male and a mean age of 36.1 years. We conducted an exploratory factor analysis, resulting in a reduced questionnaire of 45 questions. A three-factor solution explained 36.2% of the variance in HIV knowledge. The total scale had a reliability coefficient of 0.937, and each subscale had reliabilities of 0.828, 0.856 and 0.859. Lower educational level (F(336) = 8.488, p < 0.001) and female gender (t(399) = 2.003, p = 0.046) were associated with lower scores on the HIV knowledge questionnaire. This tool appears suitable for measuring HIV knowledge in people living with HIV, although future studies are required to confirm its structure and reduce its extension.

Developing conceptually sound items for a clinical courage questionnaire.

INTRODUCTION: Clinical courage can be described as a rural doctor's adaptability and willingness to undertake clinical work at the limits of their training and experience to meet the needs of their patients. This article describes the in-house development of survey items to include in a quantitative measure of clinical courage. METHODS: The questionnaire development involved two key concepts: a second-order latent factor model structure and a nominal group technique, used to develop consensus among the research team members. RESULTS: The steps taken to develop a sound clinical courage questionnaire are described in detail. The resulting initial questionnaire is presented, ready for testing with rural clinicians and refinement. CONCLUSION: This article outlines the psychometric process of questionnaire design and presents the resultant clinical courage questionnaire.

Condom-Related Stigma Scale among Men Who Have Sex with Men in China: Development and Psychometric Tests.

Condom-related stigma is a frequently mentioned barrier to consistent condom use among men who have sex with men (MSM). Based on the concept and operational definition of condom-related stigma recently defined by our team, we developed the 20-item condom-related stigma scale (CRSS) and examined its psychometric properties among 433 MSM in China, following DeVellis's scale development guidelines. The content validity, convergent validity, empirical validity, factorial validity, scale score reliability, split-half reliability, and test-retest reliability for the CRSS were all assessed. The scale consists of four domains: perceived distrust, perceived potential HIV/STI risk, perceived embarrassment, and perceived violation of the traditional understanding of sexual intercourse. The CRSS has good validity (the scale-level content validity index was 0.99; the empirical validity was greater than 0.70) and high reliability (the Cronbach's alpha coefficient overall was 0.926; the split-half reliability overall was 0.795; the test-retest reliability overall was 0.950). This scale is recommended for assessing the level of condom-related stigma among Chinese MSM, which can serve as an evaluating indicator for safer-sex interventions to prevent HIV infection among the MSM population in a Chinese cultural context.

Development and validation of two versions of the Nurse-Patient Mutuality in Chronic Illness scale.

AIMS: The aim of the study was to develop and psychometrically test the Nurse-Patient Mutuality in Chronic Illness (NPM-CI) scale in two versions, one for nurses and one for patients. METHOD: A multiphase methodological study was conducted. In the first phase, a qualitative investigation was conducted through interviews and an analysis of the content; inductively, the items of two instruments were generated, one for nurses and one for patients. In the second phase, the content and face validity were assessed through the expert consensus method. In the third phase, exploratory factor analysis (EFA), Cronbach's alpha test, intraclass correlation and Pearson correlation coefficients were conducted to estimate construct, criterion validity and instrument reliability. For each phase, the sample included nurses and patients recruited from a large hospital in Northern Italy. Data collection was conducted between June and September 2021. RESULTS: Nurse and patient versions of the NPM-CI scale were developed. Two rounds of consensus reduced the items from 39 to 20; content validity index ranged between 0.78 and 1, content validity ratio was 0.94. Face validity indicated clarity and comprehensibility of the items. EFA identified three latent factors for both the scales. Internal consistency was satisfactory, with Cronbach's alphas ranging between .80 and .90. Test-retest stability was suggested, with an intraclass correlation coefficient of .96 (nurse scale) and .97 (patient scale). Predictive validity was established, with a Pearson correlation coefficient of .43 (nurse scale) and 0.55 (patient scale) between the mutuality scales and satisfaction in providing and receiving care. CONCLUSION: The results suggest that the NPM-CI scales are sufficiently valid and reliable for the clinical practice among chronic illness patients and the nurses caring for them. A more in-depth exploration of this construct in the context of nursing and patient outcomes is warranted. PATIENT OR PUBLIC CONTRIBUTION: Patients were involved in all study phases. IMPACT: Mutuality is fundamental in the relationship between nurse and patient, based on trust, equality, reciprocity, and mutual respect. The NPM-CI scale was developed and psychometric estimated through a multiphase study in both nurse and patient versions. The NPM-CI scale measures the factors of 'developing and going beyond', 'being the point of reference' and 'deciding and sharing care'. The NPM-CI scale allows us to measure mutuality in clinical practice and research. Expected outcomes and influencing factors for patients and nurses could be associated.

Reliability and Validity Testing of the Caregiver-Centered Communication Questionnaire.

Objective: The purpose of this study is to test the reliability and construct validity of a new instrument, the Caregiver-Centered Communication Questionnaire (CCCQ), designed to assess the extent to which family caregivers feel their perspectives and needs are appropriately acknowledged and addressed by the healthcare team. Methods: We administered the CCCQ to adult family caregivers of hospice patients. We calculated Cronbach's alpha and performed structural equation modeling. Following the estimation of the congeneric model, modification indices (MI) were examined to establish cross-loading. We used RMSEA, CFI and TLI, and SRMR to determine the quality of model fit. Results: A total of 525 caregivers completed the CCCQ instrument. The Cronbach's alpha was α = 0.98, indicating good reliability. Our final model demonstrated good fit to our data, χ2(354) = 711.653, RMSEA = 0.044(0.039, 0.049), CFI = 0.99, TLI = 0.99, SRMR = 0.029. Conclusion: Caregivers are asked to play an ever-increasing role in managing aspects of care. This role is not fully reflected in available toolkits to assess processes of care, and the CCCQ, designed to address this gap, was found to be reliable and valid. Assessing caregiver centered communication should and can be integrated into the evaluation of health care services delivered to patients and families.

Risk assessment scale for pressure ulcers in pediatric patients: French translation, internal consistency, convergent validity, feasibility, and clinical utility of the Braden QD Scale / Échelle d'évaluation des risques d'escarres en pédiatrie : traduction en langue française, cohérence interne, validité convergente, faisabilité et utilité clinique de l'échelle Braden QD

Introduction: Pediatric patients are particularly vulnerable to pressure ulcers. Structured evaluation with a risk assessment tool is recommended in order to identify patients at risk. The Braden QD Scale integrates the risks of both immobility-related and medical device-related pressure ulcers in pediatric patients. Objectives: To translate and pretest the Braden QD Scale into French (Swiss-French version), and to evaluate its consistency, convergent validity, feasibility, and clinical utility. Method: Over five prevalence surveys, the Braden QD Scale was used on all hospitalized pediatric patients. Convergent validity and internal consistency were tested. A self-administered questionnaire on feasibility and clinical utility was completed by nurses. Results: The translated version of the Braden QD Scale was pretested on 352 children. The prevalence surveys showed that 5.1% were at risk of developing pressure ulcers. Medical devices were present in 85.8% of cases. A Cronbach's alpha of 0.710 and a high convergent validity were measured. High scores of feasibility and clinical utility were found. Discussion and conclusion: This study suggests that the Swiss-French version of the Braden QD Scale is reliable, valid, feasible, and has clinical utility.

Introduction: La population pédiatrique est particulièrement vulnérable aux escarres. Afin d'identifier les patients à risques, une évaluation structurée est recommandée. L'utilisation de l'échelle Braden QD permet d'intégrer les risques liés à l'immobilité et à la présence de dispositifs médicaux. Objectifs: Réaliser une traduction en langue française (suisse francophone), un test de l'échelle Braden QD, évaluer sa cohérence interne, sa validité convergente, sa faisabilité et son utilité clinique. Méthode : lors de cinq enquêtes de prévalence, l'échelle Braden QD a été utilisée auprès de tous les enfants hospitalisés. Des tests psychométriques ont été mesurés. Un questionnaire de faisabilité et d'utilité clinique a été distribué aux enquêtrices. Résultats: L'échelle traduite a pu être testée auprès de 352 enfants. Les enquêtes ont montré que 5,1 % étaient à risques de développer une escarre et 85,8 % étaient porteurs de dispositifs médicaux. Un alpha de Cronbach à 0,710, avec une validité convergente élevée, de hauts scores de faisabilité et d'utilité clinique ont été retrouvés auprès des infirmières. Discussion et conclusion: Cette étude suggère que la version suisse francophone de la Braden QD est faisable, fiable et valide. Les infirmières ont estimé qu'elle était facile à utiliser et utile pour leur pratique.

Self-compassion and professional quality of life among midwives and nurse assistants: A cross-sectional study.

INTRODUCTION: Self-compassion and satisfaction derived from helping others is part of healthcare providers' professional quality of life. The aim of this study was to explore and psychometrically test two instruments measuring self-compassion and professional quality of life among midwives and nurse assistants. METHODS: This was a cross-sectional study with midwives and nurse assistants working with intrapartum care at five different labor wards in Sweden. The Self-Compassion Scale (SCS) and the modified Professional Quality of Life Measurement (ProQOL) were validated and correlation analyses were calculated between the different subscales. Descriptive statistics, t-test, were calculated to analyze associations between the subscales of the SCS, the ProQOL and the background variables. RESULTS: Midwives were more self-critical than nurse assistants, and the midwives who were negative towards the new clinical practice scored higher for compassion fatigue. The principal component analysis showed a two-factor solution for both the SCS and the modified ProQOL. The two SCS subscales were named 'self-criticism' (α=0.85) and 'self-kindness' (α=0.87). The two ProQOL subscales were named 'compassion satisfaction' (α=0.83) and 'compassion fatigue' (α=0.78). A negative correlation was found between self-kindness and compassion fatigue subscales, between compassion satisfaction and compassion fatigue, and between self-kindness and self-criticism. CONCLUSIONS: The SCS and modified ProQOL are considered as valid questionnaires for use in a Swedish maternity setting and a correlation between the scales was found. Midwives are more self-critical than nurse assistants. Understanding and identifying compassion fatigue among midwives is important to managers responsible for quality improvement and practice changes.

Personal statement versus psychological test as admission to the nursing degree: an evaluation.

BACKGROUND: A review of admissions to nursing in Northern Ireland was prompted by the growing number of applications and a desire to ensure that the applicants had the right values for a career in nursing. Concerns regarding authorship, plagiarism and reliability of personal statements used to select applicants to interview was the focus of this research. This study evaluates the psychometric properties of a Personal Statement (PS) as a method for admission to a nursing programme and a values-based psychological screening tool, Nurse Match (NM). METHODS: A self-selecting, purposive sample (n = 228; 9.7%) was drawn from applicants to Schools of Nursing in the United Kingdom (n = 2350). Participants all of whom had completed a Personal Statement were asked to complete a psychological tool and the scoring outcomes and psychometric properties of both tests were investigated. Statistical analysis was conducted using Minitab 17. RESULTS: Applicants from 18 schools and five colleges responded. The majority (72.4%) were aged 18-19. Findings provide practical, theoretical, statistical, and qualitative reasons for concluding that the Personal Statement has substantial limitations as a measure of suitability. It does not compare well with international test standards for psychometric tests. In contrast, NM is a valid and reliable measure with good discriminatory power, standardised administration and consistent marking. CONCLUSION: NM is a viable alternative to the PS for shortlisting applicants for nursing interviews.

Propiedades psicométricas del Inventario de Sexismo Ambivalente (ASI) en población adulta ecuatoriana

Objetivo. El objetivo del estudio fue realizar la validación del Inventario de Sexismo Ambivalente (ASI) en el contexto ecuatoriano, así como analizar su consistencia interna y validez convergente con el Inventario de Ambivalencia hacia Hombres (AMI). Método. Participaron en el presente estudio, cuantitativo e instrumental, hombres (44.1%) y mujeres (55.9%) de la ciudad de Quito (N = 965) entre los 20 y los 60 años. Resultados. El ASI presenta un ajuste factorial adecuado al modelo original de dos factores; existe además consistencia interna en la escala total (w = .72) y en los dos factores (sexismo hostil: w = .71; sexismo benevolente: w = .53), y una validez convergente estadísticamente significativa con el AMI (r = .652). Se concluye que el instrumento es válido para uso en el contexto ecuatoriano.

Objective. The aim of the study was to validate the Ambivalent Sexism Inventory (ASI) in the Ecuadorian context, as well as to analyze its internal consistency and convergent validity with the Ambivalence Inventory towards men (AMI). Method. Men (44.1%) and women (55.9%) from the city of Quito (N = 965), aged from 20 to 60 years old, participated in this quantitative and instrumental study. Results. The ASI presents an adequate factorial fit to the original two-factor model; there is internal consistency in the total scale (w = .72) and in the two factors (hostile sexism: w = .71; benevolent sexism: w = .53), and statistically significant convergent validity with the AMI (r = .652). It is concluded that the instrument use in the Ecuadorian context is valid.

Assessment of anxiety in Mexican persons living with HIV using a culturally-adapted version of the GAD-7 test.

Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.

Psychometric Evaluation of the Chinese Version of Mild Cognitive Impairment Questionnaire among Older Adults with Mild Cognitive Impairment.

BACKGROUND: There is a lack of instruments for measuring quality of life (QOL) in Chinese patients with mild cognitive impairment (MCI). This study aimed to translate the Mild Cognitive Questionnaire (MCQ) into the Chinese language and to evaluate the reliability and construct validity of the MCQ-Chinese among older adults with MCI. METHODS: Linguistic translation and validation of the questionnaire were conducted according to the MCQ developer and Oxford University Innovation guidelines. After a pilot test, the final version of the MCQ-Chinese was applied to a convenience sample of older adults with MCI (n = 186). Cronbach's alpha and confirmatory factor analyses were used to assess the reliability and construct validity of the MCQ-Chinese. In addition, non-parametric analysis was used to assess convergent and discriminant validity. RESULTS: The total scale and all the factors had good internal consistency, with Cronbach's alpha values ranging from 0.90 to 0.92. Confirmatory factor analysis indicated satisfactory goodness of fit for the 2-factor MCQ. The MCQ-Chinese had a good convergent validity, and the discriminant validity was confirmed with a significant difference in MCQ scores in different health conditions. CONCLUSIONS: MCQ-Chinese is a reliable tool for assessing QOL among Chinese older adults with MCI.

Translation, Cultural Adaptation, and Psychometric Properties of the Life Satisfaction Index for the Third Age-Short Form (LSITA-SF12) for Use among Ethiopian Elders.

(1) Background: Self-reported measures play a crucial role in research, clinical practice, and health assessment. Instruments used to assess life satisfaction need validation to ensure that they measure what they are intended to detect true variations over time. An adapted instrument measuring life satisfaction for use among Ethiopian elders was lacking; therefore, this study aimed to culturally adapt and evaluate the psychometric properties of the Life Satisfaction Index for the Third Age-Short Form (LSITA-SF12) in Ethiopia. (2) Methods: Elderly people (n = 130) in Metropolitan cities of northwestern Ethiopia answered the LSITA-SF12 in the Amharic language. Selected reliability and validity tests were examined. (3) Result: The scale had an acceptable limit of content validity index, internal consistency, test-retest, inter-rater reliabilities, and concurrent and discriminant validities. (4) Conclusion: The Amharic language version of LSITA-SF12 appeared to be valid and reliable measures and can be recommended for use in research and clinical purposes among Amharic-speaking Ethiopian elders.

Exploring safety culture in the Finnish ambulance service with Emergency Medical Services Safety Attitudes Questionnaire.

BACKGROUND: Emergency Medical Services (EMS) is, by its nature, a challenging context that may create risks for both patients and employees. It is also known that an organisation's safety culture has an influence on both patient and employee safety. Finnish EMS organisations lack knowledge of how their safety culture is perceived by their employees. AIM: This study aims to test the psychometric properties of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) in a Finnish EMS setting. We also explore the connections between individual- and organisation-based characteristics and safety attitudes in the Finnish EMS. METHODS: A cross-sectional survey study design was used. The EMS-SAQ was used to collect data via social media. The instrument measures six domains of workplace safety culture: safety climate, teamwork climate, perceptions of management, job satisfaction, working conditions and stress recognition. The 5-point Likert scale was converted to a 100-point scale and mean ≥ 75 was dichotomized as a positive. Confirmatory factor analysis (CFA) was carried out to validate the EMS-SAQ in a Finnish setting. Other results were analysed by using non-parametric tests. RESULTS: 327 responses were included in the analysis. CFA showed that the total EMS-SAQ model had acceptable goodness-of-fit values in the Finnish EMS setting. Total mean scores for each safety culture domain were identified non-positively (mean score < 75); safety climate 60.12, teamwork climate 60.92, perceptions of management 56.31, stress recognition 64.55, working conditions 53.43 and job satisfaction 70.36. Higher education was connected to lower job satisfaction and the teamwork climate within the individual characteristics. All organisation-based characteristics caused at least one significant variation in the safety culture domain scores. Working area significantly affected (p < 0.05) five out of the six safety culture domain scores. CONCLUSIONS: The EMS-SAQ is a valid tool to evaluate safety culture among the Finnish EMS organisations; it offers a novel method to evaluate safety and patient safety within the Finnish EMS organisations. According to the findings, the organisation-based characteristics more likely had an impact on safety attitudes than did the individual-based characteristics. Therefore, it is suggested that the Finnish EMS organisations undertake safety culture development at the organisational level.

Corrigendum: Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.3389/fnins.2021.579263.].

Minimal hepatic encephalopathy may be present despite the absence of non-invasive and elastography evidence of cirrhosis in patients with primary biliary cholangitis.

PURPOSE: Minimal hepatic encephalopathy (MHE) is an important complication of chronic liver disease (CLD); however, MHE burden in patients with primary biliary cholangitis (PBC) has not been determined yet. Therefore, our study aimed to assess the prevalence of MHE in a typical cohort of middle-aged, patients with PBC suspicion of liver fibrosis and to investigate the relationship between MHE, basic laboratory tests and the stage of liver fibrosis. PATIENTS AND METHODS: Fifty-one patients (38 with PBC and 13 controls), were prospectively enrolled. Portosystemic Encephalopathy-Syndrome test was used to diagnose MHE. Elastography point qualification (ElastPQ) and non-invasive markers (APRI and FIB-4) were used to assess liver fibrosis. The severity of CLD was assessed using the Model of End-Stage Liver Disease (MELD) and Child-Pugh score. RESULTS: MHE was diagnosed in 9 patients (24.3%) with PBC and none in the control group. As many as 44.4% of the patients with MHE had neither advanced fibrosis nor cirrhosis, as demonstrated using non-invasive markers of liver fibrosis or ElastPQ. The MELD score was the only predictor of MHE with cut-off value 8.5 [AUC â€‹= â€‹0.753, CI95% â€‹= â€‹0.569 to 0.938)] with sensitivity of 56%, specificity of 85% and accuracy of the test of 78%. Non-invasive markers of liver fibrosis and ElastPQ did not predict MHE. CONCLUSIONS: MHE may occur in PBC despite no evidence of advanced liver fibrosis or cirrhosis. The slightly elevated MELD score may indicate a substantially increased risk of MHE in patients with PBC.

Técnica estadística multivariada para validar instrumento de evaluación del clima organizacional en empresas ganaderas de leche / Multivariate statistical technique to validate an instrument for evaluating the organizational climate in dairy farming companies

RESUMEN Uno de los temas que poco se ha profundizado es la evaluación del clima organizacional en empresas del sector agropecuario bajo análisis de estadísticas multivariadas, es así que el propósito del presente estudio es construir y validar un instrumento para medir el clima organizacional de las empresas tecnificadas de ganadería de leche, bajo un enfoque mixto, con un alcance exploratorio de tipo tecnológico psicométrico, desarrollando un análisis de variables categóricas. La muestra de estudio fueron 45 fincas, las cuales, se analizaron bajo 9 dimensiones, soportadas en 97 ítems, bajo la escala Likert, donde el alfa de Cronbach obtenido fue de 0.9044395, lo que evidencia que los datos son confiables y que existe consistencia interna entre las preguntas del cuestionario. El análisis de resultados, se hizo mediante técnicas multivariadas de correspondencia simple para cada una de las dimensiones establecidas, permitiendo analizar la problemática desde un enfoque psicosocial. La dimensión de mayor preocupación fue la de Contexto social, que evidenció problemas relacionados con la escasa oportunidad de interacción social, pocos espacios de recreación y esparcimiento familiar; la dimensión mejor evaluada fue la de liderazgo y participación, demostrando una muy buena relación con el jefe. En general, se pude decir que el mayor porcentaje de agrupamiento de las respuestas está alrededor de la opción siempre, correspondiente a la calificación ideal para cada ítem, representado en el 57,32%, lo que indica un comportamiento cercano a lo óptimo, en determinadas variables analizadas.

ABSTRACT One of the topics that have not been studied in depth is the evaluation of the organizational climate in companies of the agricultural sector under multivariate statistical analysis. Thus, the purpose of this study is to construct and validate an instrument to measure the organizational climate of technified dairy cattle raising companies, under a mixed approach, with an exploratory scope of psychometric technological type, developing an analysis of categorical variables. The study sample consisted of 45 farms, which were analyzed under 9 dimensions supported by 97 items under the Likert scale, where the Cronbach's alpha obtained was 0.9044395, which shows that the data are reliable and that there is internal consistency among the questions of the questionnaire. The analysis of the results was carried out using multivariate techniques of simple correspondence for each of the established dimensions, allowing the analysis of the problem from a psychosocial approach. The dimension of greatest concern was the social context. This showed problems related to the scarce opportunity for social interaction, few spaces for recreation, and family recreation; the best-evaluated dimension was that of Leadership and participation, showing a very good relationship with the boss. In general, it can be said that the highest percentage of the grouping of responses is around option always, that correspond to the ideal qualification for each item, represented in 57.32%, which indicates a behavior close to the ideal in certain variables analyzed.

Experiences from Two Ways of Integrating Pre- and Post-course Multiple-choice Assessment Questions in Educational Events for Surgeons.

To examine how to optimise the integration of multiple-choice questions (MCQs) for learning in continuing professional development (CPD) events in surgery, we implemented and evaluated two methods in two subspecialities over multiple years. The same 12 MCQs were administered pre- and post-event in 66 facial trauma courses. Two different sets of 10 MCQs were administered pre- and post-event in 21 small animal fracture courses. We performed standard psychometric tests on responses from participants who completed both the pre- and post-event assessment. The average difficulty index pre-course was 57% with a discrimination index of 0.20 for small animal fractures and 53% with a discrimination index of 0.15 for facial trauma. For the majority of the individual MCQs, the scores were between 30%-70% and the discrimination index was >0.10. The difficulty index post-course increased in both groups (to 75% and 62%). The pre-course MCQs resulted in an average score in the expected range for both formats suggesting they were appropriate for the intended level of difficulty and an appropriate pre-course learning activity. Post-course completion resulted in increased scores with both formats. Both delivery methods worked well in all regions and overall quality depends on applying a solid item development and validation process.

Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis.

Hepatic encephalopathy (HE) is one of the most disabling metabolic diseases. It consists of a complication of liver disease through the action of neurotoxins, such as excessive production of ammonia from liver, resulting in impaired brain function. Its prevalence and incidence are not well known, although it has been established that up to 40% of cirrhotic patients may develop HE. Patients with HE episodes display a wide range of neurological disturbances, from subclinical alterations to coma. Recent evidence suggests that the resolution of hepatic encephalopathy does not fully restore cognitive functioning in cirrhotic patients. Therefore, the aim of this review was to evaluate the evidence supporting the presence of lingering cognitive deficits in patients with a history of HE compared to patients without HE history and how liver transplant affects such outcome in these patients. We performed two distinct meta-analysis of continuous outcomes. In both cases the results were pooled using random-effects models. Our results indicate that cirrhotic patients with a history of HE show clear cognitive deficits compared control cirrhotic patients (Std. Mean Difference (in SDs) = -0.72 [CI 95%: -0.94, -0.50]) and that these differences are not fully restored after liver transplant (Std. Mean Difference (in SDs) = -0.72 [CI 95%: -0.94, -0.50]).