Development of a Readiness for Hospital Discharge assessment tool in Thai patients with stroke

Background: The transition from hospital to home among patients with stroke is quite challenging. If the patients are not ready for hospital discharge, their condition may worsen, which also causes a high rate of readmission. Although instruments to measure readiness for hospital discharge exist, none of them fit with the Thailand context. Objective: This study aimed to develop a Readiness for Hospital Discharge assessment tool in Thai patients with stroke. Methods: The study was conducted from February to September 2020, which consisted of several steps: 1) conducting an extensive literature review, 2) content validity with five experts, 3) pilot testing with 30 samples, and 4) field testing with 348 participants. Content validity index (CVI) was used to measure the content validity, Cronbach’s alpha and inter-item correlation to evaluate reliability, and multiple logistic regression analysis to measure the construct validity. Results: The findings showed good validity and reliability, with I-CVI of 0.85, Cronbach’s alpha of 0.94, and corrected item-total correlation ranging from 0.43 to 0.86. The construct validity was demonstrated through the results of regression analysis showing that the nine variables include level of consciousness (OR = 0.544; CI 95% = 0.311 - 0.951), verbal response (OR = 0.445; 95% CI 0.272- 0.729), motor power right leg (OR = 0.165; 95% CI 0.56- 0.485), visual field (OR = 0.188; 95% CI 0.60-0.587), dysphagia (OR = 0.618; 95% CI 0.410-0.932), mobility (OR = 0.376; 95% CI 0.190 - 0.741), self-feeding (OR = 0.098; 95% CI 0.036 -0.265), bathing (OR = 0.099; 95% CI 0.026-0.378), and bladder control (OR = 0.589; 95% CI 0.355-0.977) that significantly influenced the hospital readmission within 30 days in patients with stroke. Conclusion: The Readiness for Hospital Discharge assessment tool is valid and reliable. Healthcare providers, especially nurses, can use this tool to assess discharge conditions for patients with stroke with greater accuracy in predicting hospital readmission.

Development and validation of a multi-lingual online questionnaire for surveying the COVID-19 prevention and control measures used in global workplaces

Background Despite widespread COVID-19 vaccination programs, there is an ongoing need for targeted disease prevention and control efforts in high-risk occupational settings. This study aimed to develop, pilot, and validate an instrument for surveying occupational COVID-19 infection prevention and control (IPC) measures available to workers in diverse geographic and occupational settings. Methods A 44-item online survey was developed in English and validated for face and content validity according to literature review, expert consultation, and pre-testing. The survey was translated and piloted with 890 workers from diverse industries in Canada, Ireland, Argentina, Poland, Nigeria, China, the US, and the UK. Odds ratios generated from univariable, and multivariable logistic regression assessed differences in ‘feeling protected at work’ according to gender, age, occupation, country of residence, professional role, and vaccination status. Exploratory factor analysis (EFA) was conducted, and internal consistency reliability verified with Cronbach’s alpha. Hypothesis testing using two-sample t-tests verified construct validity (i.e., discriminant validity, known-groups technique), and criterion validity. Results After adjustment for occupational sector, characteristics associated with feeling protected at work included being male (AOR = 1.88; 95% CI = 1.18,2.99), being over 55 (AOR = 2.17; 95% CI = 1.25,3.77) and working in a managerial position (AOR = 3.1; 95% CI = 1.99,4.83). EFA revealed nine key IPC domains relating to: environmental adjustments, testing and surveillance, education, costs incurred, restricted movements, physical distancing, masking, isolation strategies, and areas for improvement. Each domain showed sufficient internal consistency reliability (Cronbach’s alpha ≥0.60). Hypothesis testing revealed differences in survey responses by country and occupational sector, confirming construct validity (p < 0.001), criterion validity (p = 0.04), and discriminant validity (p < 0.001). Conclusions The online survey, developed in English to identify the COVID-19 protective measures used in diverse workplace settings, showed strong face validity, content validity, internal consistency, criterion validity, and construct validity. Translations in Chinese, Spanish, French, Polish, and Hindi demonstrated adaptability of the survey for use in international working environments. The multi-lingual tool can be used by decision makers in the distribution of IPC resources, and to guide occupational safety and health (OSH) recommendations for preventing COVID-19 and future infectious disease outbreaks.

Development and validation of preconception care improvement scale (PCIS) in a resource-limited setting

Background Preconception care helps to close the gaps in a continuum of care. It is of paramount importance to reduce maternal and child adverse pregnancy outcomes, increase the utilization of services such as antenatal care, skilled delivery care, and post-natal care, and improve the lives of future generations. Therefore, a validated instrument is required. The purpose of this study was to develop and validate the preconception care improvement scale (PCIS) in a resource-limited setting. Methods A mixed-method study was carried out from 02, March to 10, April 2019 in Manna district, Oromia region, Ethiopia to test the reliability and validity of the scale. Items were generated from literatures review, in-depth interviews with different individuals, and focused group discussions with women of reproductive age groups. A pretested structured questionnaire was used and a survey was conducted among 623 pregnant women in the district. The collected data were entered into EPI-data version 3.1 software and exported to SPSS version 23 software and data were analyzed for internal consistency and validity using reliability analysis and factor analysis. Results The PCIS has 17 items loaded into six factors: Substance-related behaviors, screening for common non-communicable and infectious diseases, micronutrient supplementation and vaccination, seeking advice, decision and readiness for conception, and screening for sexually transmitted diseases. Factor analysis accounted for 67.51% of the observed variance. The internal consistency (Cronbach’s alpha) of the scale was 0.776. Diversified participants of the qualitative study and experts’ discussions assured the face and content validity of the scale. Factor loading indicated the convergent validity of the scale. Three of the PCIS subscale scores had a positive and significant association with the practice of preconception care and antenatal care visits, which confirmed the predictive validity of the scale. Conclusion The PCIS exhibited good reliability, face validity, content validity, convergent validity, and predictive validity. Thus, the scale is valid and helps to improve preconception care, especially in resource-limited settings.

Validation of Acromegaly Quality of Life Questionnaire (AcroQol) for the Iranian Population

Background Acromegaly is a chronic disease seriously impacting the patients' quality of life. This study aimed to validate the Acromegaly Quality of Life Questionnaire (AcroQoL) for the Persian-speaking population. Methods This cross-sectional study recruited 73 Iranian patients with a confirmed diagnosis of acromegaly. The content validity of the scales was evaluated by an expert panel of eight endocrinologists. Construct validity was assessed by using confirmatory factor analysis. Internal consistency was assessed on the basis of Cronbach’s alpha, and a goodness-of-fit (GoF) index was calculated to display whether the model fitted the data. Results The content validity index (CVI) and content validity ratio (CVR) yielded values of 0.85 and 0.80, respectively. The average variance extracted (AVE) from physical and psychological dimensions was 0.520 and 0.462, respectively, exceeding the minimum criterion of 0.40. Cronbach’s alpha for physical and psychological dimensions equaled 0.868 and 0.866, respectively, indicating the adequate internal consistency of multiple items for each construct. The subscales’ R square and path coefficient were greater than the recommended threshold (physical dimension: 0.778, psychological dimension: 0.873), demonstrating the suitability of this criterion. Finally, the GoF value of 0.29 indicated the model's moderate fit. Conclusions The findings revealed that the Persian version of AcroQoL is of adequate validity and reliability for evaluating the quality of life of Iranian people with acromegaly.

Development of tool for assessment of performance motivation and job satisfaction among the Community Health Workers of Central India.

Introduction: Among the various factors influencing the performance of Community health workers, motivation and job satisfaction serves as a potential drive to perform better. Hence, this study aimed at constructing a motivation and job satisfaction tool in a systematic method that would serve as a potential tool for further research considering the heterogeneity in the study population. Objective: To develop a tool to measure how well the CHWs are motivated and satisfied pertaining to individual, community and health system determinants. Methods: This cross-sectional study from rural block of Madhya Pradesh in Central India included relatively high performing and low performing CHWs based on their annual performance-based incentives for the year (April 2017- March 2018). The CHWs were administered a self-reported questionnaire that contained a 5-point Likert scale with individual, health system and community determinants of motivation and job satisfaction. Results: The performance motivation scale with 18 items and job satisfaction scale with 15 items were administered to the 92 CHWs. Their item content validity index was 0.66 and 0.83 respectively. The finalized tool consisted of 11 items in motivation scale and all the 15 items in job satisfaction scale following the Explanatory factor analysis. All the individual constructs in both the scales showed good internal consistency with Cronbachs alpha ranging from 0.62-0.88. The overall median (IQR) score of both RLP and RHP CHWs were 4(4-5) in both the questionnaires. Conclusion: The CHWs in our study were intrinsically motivated and were satisfied with their performance as voluntary village health workers. Further research would be planned to validate the constructs using confirmatory factor analysis. Keywords: Community Health workers, Motivation, Job satisfaction, Content validity

Reliability, Validity, and Psychometric Properties of the Persian Version of the Tayside Children's Sleep Questionnaire

Background: Tayside children's sleep questionnaire (TCSQ) is a simple tool for screening the Disorders of Initiating and Maintaining Sleep among children aged between one and five years. In this study, we aimed to translate TCSQ into Persian and evaluate the validity and reliability of TCSQ among Persian speakers.Methods: A cross-sectional study was conducted among 311 children aged 1-5 years in Isfahan. After permission, the forward-backward translation method is used to develop the Persian version. Finally, 311 children participated in this survey, and 30 were repeated for a second time. Google Form, SPSS16, and STATA14 were used for data collection, descriptive statics, and factor analysis. BEARS questionnaire is used for convergent validity. Three expert opinions were used for content validity.Results: In this study, 404 mothers of children in Isfahan volunteered to participate in the survey, of which 311 remained. The mean and standard deviation age of their children was 3.47±1.91 years. Cronbach Alpha of the Persian version of TCSQ was 0.76 CI (0.78-0.66). The intra-class correlation coefficient was 0.67 CI (0.60-0.74). The content validity index was 0.88, and three factors (Disturbance, nighttime, parents) with a specific value greater than 0.4 is determined by factor analysis.Conclusions: The current study results indicate that TCSQ has good reliability and validity among Persian speakers.