Validity and reliability of the Polish version of the Michigan Neuropathy Screening Instrument

BACKGROUND Diabetic sensorimotor polyneuropathy is an important risk factor for foot ulceration and amputation.Thus,patients with diabetes should be screened for this disorder according to local guidelines.An obstacle to the diagnosis of this disease may be the lack of unified diagnostic criteria due to the lack of properly validated scales used for assessment.AIM To validate both sections(A and B)of the Michigan Neuropathy Screening Instrument(MNSI)in Polish(PL)patients with diabetes.METHODS A cross-sectional study using a test(A1,B1)and re-test(A2,B2)formula was performed in 80 patients with diabetes.The gold standard used for neuropathy detection was a nerve conduction study(NCS)which was performed in all participants.Reliability of the MNSI-PL was assessed using the Cronbach’s alpha,Kuder-Richardson formula 20(KR-20),split-half reliability,the Gottman split-half tests,and correlation between first and second half was accessed.Stability was assessed using an intraclass correlation coefficient(ICC).For external validation,we used simple linear correlation,binomial regression,and agreement between two different tools using a Bland-Altman plot analysis.RESULTS The scale was internally consistent(Cronbach’s alpha for the full scale:0.81 for A and 0.87 for B).MNSI-PL scores in test/retest showed high stability(ICC=0.73 for A and ICC=0.97 for B).The statistically important correlations between MNSI-PL and NCS were found for B1,B2,and A1(P<0.005).The cut-off points of≥3 for section A(sensitivity of 90%-100%;specificity of 33%-40%)and≥2 for section B(sensitivity of 81%-84%;specificity of 60%-70%)were obtained during neuropathy detection.CONCLUSION The MNSI-PL is a reliable and valid instrument in screening for diabetic neuropathy.

Testing Reliability and Validity of the Oulu Patient Classification Instrument—The First Step in Evaluating the RAFAELA System in Norway

Objective: To study reliability and validity of the Finnish Oulu Patient Classification instrument in Norway. Background: The Finnish patient classification system RAFAELA consists of three parts: 1) daily patient classification of nursing intensity using the Oulu Patient Classification instrument, 2) calculation of nursing resources providing bed side care per 24 hours, and 3) Professional Assessment of Optimal Nursing Care Intensity Level. The RAFAELA system has not been tested outside of Finland. Methods: A prospective, descriptive study was performed at 5 clinical units at Oslo University Hospital during 2011-2012. The interrater reliability of the Oulu Patient Classification instrument was tested by parallel classification including 100-167 patient classifications pr. unit, and analyzed by consensus in % and using Cohen’s Kappa. Convergent validity was tested by using the average Oulu Patient Classification instrument value to predict the average Professional Assessment of Optimal Nursing Care Intensity Level for the same calendar day by linear regression analysis. Results: The Oulu Patient Classification instrument consensus of parallel classifications varied between 70.1%-89%. Cohen’s Kappa within patient classes varied between 0.57 and 0.81, representing substantial interrater reliability. The Oulu Patient Classification instrument was valid as the instrument in average explained about 38% of the variation of the Professional Assessment of Optimal Nursing Care Intensity Level. Conclusions: Patient classification systems tested for psychometric properties are needed and this study provides evidence of satisfactory reliability and validity of the Oulu Patient Classification instrument as tested outside Finland, demonstrating that this instrument has international relevance within nursing.

A Scale of Parental Anxiety about Pediatric Emergency Medical Care Services of Japan: Development, Reliability, Validity, Generalizability and Usefulness

Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.

Development and validation of an instrument to assess knowledge,attitudes,and practices on digital health among nursing officers

Objective:Validation is an important aspect of an instrument,and it ensures the confidence of researchers to employ the instrument in their studies.This study was conducted to develop and validate an instrument to assess knowledge,attitudes,and practices(KAP) on digital health among nurses since digital health capacity is a major concern in health care that needs to be assessed.Methods:We conducted a methodological study to assess the content validity and reliability of the instrument.First,items were generated through a comprehensive literature review and by obtaining an expert opinion.Second,content and face validity were assessed by a panel of 7 experts.Both the item-level content validity index(I-CVI) and the scale-level content validity index(S-CVI) were established.Moreover,test–retest reliability and internal consistency of the instrument were assessed.Data were analyzed using SPSS version 25.Results:The initial pool consisted of 60 items and after obtaining content,face,and construct validity,51 items remained.Items with an I-CVI <0.78 were considered relevant.The S-CVI for relevancy,clarity,ambiguity,and simplicity were 0.93,0.91,0.94,and 0.92,respectively.Five subcomponents were constructed in each knowledge and attitudes domain,and the test–retest reliability test revealed that the instrument has good reliability,showing correlation coefficient values for the KAP domains and the total questionnaire of 0.76,0.98,0.99,and 0.99,respectively.The independent Cronbach's α for all items was 0.76,indicating good internal consistency.Conclusions:The present study established the acceptable validity and ensured the good reliability and internal consistency of the instrument,which can serve as an assessment tool of KAP on digital health among healthcare professionals.

Development and validation of a screening instrument for cognitive fluctuation in patientswith neurocognitive disorder with Lewy bodies(NCDLB):the Mayo Fluctuations Scale-Thai version

Background Prevalence of neurocognitive disorder with Lewy bodies （NCDLB） is low in Asian populations, which may partially refect its diagnostic diffculty. The Mayo Fluctuations Scale, a short questionnaire that evaluates cognitive fuctuation, has been shown to signifcantly differentiate NCDLB from Alzheimer＇s disease.Aim This study aimed to develop the Mayo Fluctuations Scale-Thai version and assess its validity to screen NCDLB in an elderly population.Methods The Mayo Fluctuations Scale was translated into Thai. The process involved back-translation, cross-cultural adaptation, feld testing of the prefnal version, as well as fnal adjustments. From all patients attending the Psychiatric and Memory Clinic at Ramathibodi Hospital, 135 patients accompanied by their primary caregivers were included. Caregivers were interviewed by research assistants using a four-item scale, and psychiatrists determined patients＇ diagnosis based on the diagnostic and statistical manual of mental disorders （DSM）-5 criteria. Evaluations performed by psychiatrists and research assistants were blinded.Results Seventeen participants had been diagnosed with major NCDLB. At a cut-off score of 2 or over, the Mayo Fluctuations Scale exhibited excellent performance to differentiate major NCDLB from other major neurocognitive disorders （NCDs）, with a sensitivity of 94.1% and a specifcity of 71.4%, and acceptable performance to differentiate mild NCDLB from other mild NCDs, with a sensitivity of 60% and a specifcity of 93.1%.Conclusion The Mayo Fluctuations Scale-Thai version is an excellent screening tool for major NCDLB and an acceptable tool that may be used with other additional tests for mild NCDLB. The tool is practical for use in memory and psychiatric clinics. Further validation studies in participants with other specifc clinical conditions are required.

Development and validation of the perioperative recovery scale for integrative medicine

Purpose: The aim of this study is to develop and validate a scale for perioperative recovery with integrative medicine. Methods: The procedures for developing the scale included a review of both modern and ancient literature, other perioperative scales or questionnaire references, an expert consultation, and interviews with patients and surgeons following standard procedures. Primary face and content validity were assessed through a small-scale patient survey of 50 patients. A final evaluation based on the patient survey was conducted among 354 patients (age range 16-75) from the same hospital. This included testing the perioperative recovery scale for integrative medicine (PRSIM) for scaling properties, reliability, validity and responsiveness. Results: The PRSIM, a 20-item scale, was modified from an initial version transcript which included 122 items. The 20 items in the PRSIM covered five domains: direct influence, indirect influence, activity, mental function and general health perceptions. Five factors extracted from an exploratory factor analysis demonstrated a desirable model fit. A confirmatory factor analysis further indicated that the PRSIM had a good fit with the same sample. A data analysis of the PRSIM with 349 patients showed that it had good internal consistency (α> 0.7), test-retest reliability (ICC > 0.4) and split half reliability (α= 0.66). Conclusions: The PRSIM can serve as a valuable instrument for assessing patient perioperative recovery in integrative medicine. It is acceptable for patients in the perioperative period undergoing treatment by either Chinese or integrative medicine, and has good psychometric properties. Registration number: ChiCTR-TRC-09000527.

Development of a frailty scale for elderly people in China

Objective：The aim of this study was to develop a frailty scale for the elderly in China and to examine its reliability and validity.Methods：The method of convenient sampling was used to select 375 elderly individuals in different communities of Tianjin,China.EuroQpl-5D was used to evaluate the criterion validity.Cronbach＇s αcoefficients,correlation analysis,exploratory factor analysis,criterion-related validity,and internal consistency were used to evaluate the reliability and validity of the scale.To evaluate the test—retest reliability,30 old people were re-evaluated after 2 weeks.Results：The final version of the frailty scale（FI-35） consisted of 35 items.Eleven factors were extracted by a principal factor analysis and varimax rotation,with a cumulative contribution of 86.00%.Eleven dimensions were positively correlated（r = 0.130-0.541,P 〈 0.01）.Cronbach＇s α coefficient was 0.952,and the alpha coefficients of 11 dimensions ranged from 0.730 to 0.992.The test-retest reliability was0.874 for the total scale.The split-half reliability of the scale was 0.808.Structural equation modeling was used to perform a confirmatory factor analysis,and various parameters were all acceptable.Conclusions：FI-35 met the requirement of scale development and showed good reliability and validity;thus,it can be used as an efficient frailty measurement tool for Chinese elderly.

Development of Elementary School Teachers＇ Self-Regulated Learning Exploratory Factor Scale

Self-regulated learning （SRL） is one of the precious ways in teachers＇ professional development, and its operation level includes different factors. With studies abroad and our preliminary investigation as base, this study developed a scale to test the factors SRL includes. According to the result of 905 teachers working in elementary school by exploratory factor analysis, the SRL for elementary teachers is consisted of its sociality （it included selecting leads and seeking for instructing）, its motivation（it included self-improvement and self-excelling）, its methods（it included strategy use and habitual behavior）, and its outcomes（it included extensive reading and teachers＇ professional development）. All the result indicated Teachers＇ SRL Scale had clear factor structure, good reliability and validity. It can be used to test the current operating situation of SRL for teachers working in elementary school.

Cost Climate Survey Scale in Construction:Development and Empirical Research

To develop the cost climate survey scale( CCSS) used in construction enterprises,the design concepts,principles and the process diagrams of CCSS are proposed.Through questionnaire investigation and expert interviews,314 projects are established and the CCSS that is made up of 7 dimensions framework and 30 levels is preliminarily determined.After categorized merger,pre-test analysis and multiple items refining,16 projects of CCSS are eventually compiled.In order to verify the credibility and validity of the CCSS,200 employees in Qinhuangdao construction company as the samples are tested.SPSS 21.0 is used to analyze the reliability,validity and rationality of level divisions,and Amos 22.0 is for analyzing the degree of model adaptation in this survey.Finally,the current cost climate situation of the construction site in the company is evaluated,the deficiencies of the cost culture of the construction site are pointed out.This study shows that strengthening the cost knowledge training has a significant positive effect on the cost climate cognition of the employees.Nevertheless,accumulation of work experience has a dual impact on that.The CCSS is not only an important foundation for the cost climate research and its theoretical development,but also the premise of the cost climate quantitative research.An appropriate CCSS,to some extent,can reflect the cognitive level of all kinds of employees in one enterprise and cost savings degree of the enterprise in a certain time.The development of CCSS reflects the originality and interactivity,and fills a blank of the CCSS in construction,which is considered to be an effective tool for cost climate research in construction.

高中生心理健康素养量表的编制

通过借鉴国内外心理健康素养量表的概念框架与设计理念,编制符合我国当代高中生心理健康教育发展现状,且便于在学校开展测量的心理健康素养量表。采用基于前人研究编制的52项条目的高中生心理健康素养量表和作为效标的中国中学生心理健康量表对接近全国普通高中水平的两所学校的高中生开展调查并回收有效问卷798份,经探索性因素分析、验证性因素分析和信效度分析,该量表最终条目为23项,分为知识、态度、行为/技能与表现三个维度,且信效度良好,可以较好地评估我国高中生的心理健康素养水平。

妊娠相关静脉血栓风险评估量表的编制及信效度检验

目的:编制适合我国孕产妇妊娠相关静脉血栓风险的评估量表,并验证其信效度。方法:通过文献研究法和2轮专家函询形成预试量表。选取202名孕产妇进行调查,对预试量表进行项目分析和信效度检验。结果:妊娠相关静脉血栓风险评估量表包含非手术相关因素、血液相关因素、手术相关因素、妊娠相关因素、人工辅助生殖5个维度,共16个条目,探索性因子分析共提取6个公因子,累计方差贡献率为60.832%,受试者工作特征(ROC)曲线下面积为0.836,总量表的Cronbach’s α系数为0.852,2周后重测信度为0.920。结论:编制的妊娠相关静脉血栓风险评估量表具有良好的信效度,可有效评估孕产妇妊娠相关静脉血栓的风险。

国家卫生城市主观建成环境满意度评价量表的编制及信效度评价

目的初步编制国家卫生城市主观建成环境满意度评价量表,并进行信度和效度评价。方法基于政策梳理、专家咨询确定量表的初始条目,通过居民个人访谈结合统计分析方法确定量表的最终条目,利用探索性因子分析主成分分析确定量表的维度,最后使用克朗巴赫系数和分半系数以及验证性因子分析对量表进行信度和效度评价。结果本研究建立了包括20个条目的4维度量表,分别代表城市生活方式、城市基础功能、城市环境卫生和城市治理四个方面的评价。问卷的克朗巴赫系数为0.910,分半系数为0.851;验证性因子分析结果显示各检验量均处于标准范围。结论本研究初步编制的国家卫生城市建成环境满意度评价量表信度和效度良好,应开展量表在人群中的实证研究,进一步验证量表的实际应用价值。

护理学专业学生职业认同量表的编制与信效度检验

目的构建一个信效度良好的护理学专业学生职业认同量表。方法以认同理论为理论框架,通过文献分析、质性访谈结果构建量表条目池,使用德尔菲法筛选和优化构建量表初稿,通过预调查、条目筛选和量表信效度评价形成量表终稿。结果构建的护理学专业学生职业认同量表包括3个维度28个条目。量表总Cronbach’sα系数为0.971,折半信度为0.946,重测信度是0.832。探索性因子分析提取3个公因子,累积贡献率为64.23%;验证性因子分析显示,结构模型整体拟合度良好。结论护理学专业学生职业认同量表研制过程严谨、科学,量表结构合理,具有良好的信效度,可用于测评护理学专业学生的职业认同水平。

ICU患者暴露性角膜炎风险评估量表的编制及信效度检验

目的编制ICU患者暴露性角膜炎风险评估量表,并检验其信度和效度。方法基于循证系统查阅文献编制量表初始条目池;通过2轮德尔菲专家函询,形成初始版量表;采用方便抽样法选取298例ICU患者,采用暴露性角膜炎风险评估量表进行调查,对量表信效度进行检验,并绘制受试者工作特征曲线确定最佳临界值。结果ICU患者暴露性角膜炎风险评估量表包括3个维度、12个条目;2轮函询专家积极系数分别为100%和80.95%,权威系数为0.892、0.888,肯德尔和谐系数为0.364和0.492;量表整体的Cronbach′sα系数为0.834,折半信度为0.795,评定者间信度0.841,内容效度为0.917;最佳临界值为8.5分,受试者工作特征曲线下面积为0.925。结论ICU患者暴露性角膜炎风险评估量具有良好的信效度,可用于ICU患者暴露性角膜炎的风险评估。

中国居民健康获得感问卷编制及信效度评价

目的:初步编制居民健康获得感测量问卷,评价其信度和效度。方法:通过文献研究法、访谈法、专家咨询法探索居民健康获得感的内涵和结构并编制初始测量问卷。通过问卷星平台发放和回收问卷,利用SPSS 21.0软件进行项目分析、信度检验和探索性因子等多种统计分析;利用AMOS 21.0软件进行验证性因子分析,评价构建的模型与实测数据的拟合程度。结果:居民健康获得感问卷包括支持条件、健康基础、自我认知3个维度共12个条目。研究编制的居民健康获得感测量问卷信效度良好,各分维度的克朗巴赫α系数在0.832~0.870之间,整体问卷的克朗巴赫α系数为0.850;结构模型拟合指标良好,χ^(2)/df为2.214,CFI、NFI、TLI等拟合数据基本在0.9以上,RMSEA值为0.051,所有测量题项的因子载荷均在0.7以上,各维度的组合信度CR值都在0.8以上、AVE值均在0.5以上,居民健康获得感与校标变量生活满意度之间存在显著正向相关关系(r=0.289,P<0.01)。结论:编制的3维度12题项测量问卷有良好的信效度,能较好反映居民健康获得感的内涵和结构,可作为测量我国居民健康获得感的有效工具。

脑卒中患者营养风险筛查工具的编制及信效度检验

目的:编制适用于脑卒中患者的营养风险筛查工具并对其信效度进行检验,为临床评估脑卒中患者潜在营养风险提供参考。方法:通过文献归纳总结、研究小组讨论和德尔菲法专家函询编制脑卒中患者营养风险评估量表。采用便利抽样法,选取2022年6月—2023年4月于安阳市人民医院住院的170例脑卒中患者作为研究对象,对其进行问卷调查,并对量表的信效度进行检验。结果:脑卒中患者营养风险评估量表内容效度指数(S-CVI)为0.925,各条目内容效度指数(I-CVI)为0.841~1.000。经探索性因子分析共提取出营养状态、认知水平、行为能力及知识获取4个公因子,其共解释方差变异值为55.897%。量表Cronbach’s α系数为0.819,各维度Cronbach’s α系数为0.798~0.856,重测信度为r=0.716,差异有统计学意义(P<0.05)。结论:编制的脑卒中患者营养风险评估量表具备较好的信效度,可以较为全面地评估脑卒中患者营养风险。

乳腺癌术后淋巴水肿患者自我护理问卷的编制及信度、效度检验

目的编制乳腺癌术后淋巴水肿患者自我护理问卷,并进行信度、效度检验,为临床提供一种评估工具。方法2022年7月—2023年4月以知信行理论为指导框架,通过文献研究、半结构式访谈确定问卷条目池,选择全国8个省市临床护理、护理管理、护理教育3个领域的15名专家,采用德尔菲法对该问卷进行2轮专家函询构建了问卷初稿;2023年5月—7月采用便利抽样法,分别选取湖北省和河南省7所三级甲等综合医院的444例乳腺癌术后淋巴水肿患者进行2次问卷调查,测评其信度与效度。结果两轮专家函询的积极性系数分别为93.75%和93.33%,权威程度系数分别为0.86和0.90,Kendall协调系数W分别为0.130和0.379,第1轮函询各条目的重要性均数为4.33~4.93,变异系数为0.05~0.19,满分率为53.33%~93.33%;第2轮函询各条目的重要性均数为2.86~4.93,变异系数为0.05~0.36,满分率为7.14%~92.86%。2次调查421例患者完成研究,问卷总的Cronbachα系数为0.943,折半信度为0.824;问卷总体水平的内容效度指数(scale-level content validity index,S-CVI)为0.912,问卷条目水平的内容效度指数(item-level content validity index,I-CVI)为0.857~1.000;探索性因子分析KMO值为0.919,Bartlett’s球形检验值为4671.724(P<0.001),累计方差贡献率为64.155%;验证性因子分析显示修正后模型适配良好。经信度、效度检验后形成包含知识维度9个条目、态度维度6个条目、行为维度18个条目共33个条目的正式版问卷。结论乳腺癌术后淋巴水肿患者自我护理问卷具有良好信度、效度,适用于评估我国乳腺癌术后淋巴水肿患者的自我护理水平。

成人癌症生存者延续护理服务需求量表编制及信效度检验

目的编制成人癌症生存者延续护理服务需求量表,并检验其信效度。方法以新人本主义需要理论为指导,通过回顾文献、进行半结构式访谈及Delphi专家函询、预调查形成量表初稿。2022年6月选取云南省、四川省、河南省、河北省、辽宁省7所三级甲等医院531例患者对量表进行项目分析及探索性因子分析,形成正式量表;2022年8月选取浙江省、云南省、河南省、辽宁省6所三级甲等医院784例患者正式调查,评价量表的信度和效度。结果成人癌症生存者延续护理服务需求量表包括症状控制/缓解需求、健康服务需求、情感心理需求及家庭/社会支持需求4个维度,25个条目。量表总的内容效度为0.940,各条目内容效度为0.875~1;探索性因子分析提取4个公因子,累计方差贡献率为64.619%。验证性因子分析量表模型适配度良好;聚敛效度理想,各维度平均方差提取量(AVE)均>0.5,组合信度(CR)均>0.8;量表区分效度理想,各维度间有显著相关性(P<0.01),相关性系数均小于所对应的AVE平方根。量表Cronbach'sα系数为0.945,折半信度为0.867,重测信度为0.726。结论成人癌症生存者延续护理服务需求量表具有良好的信效度,可作为成人癌症生存者延续护理服务需求的测量工具。