A hindrance to proper health care: psychometric development and validation of opiophobia questionnaire among doctors in Pakistan

Purpose There is an ever-increasing number of patients suffering from various forms of acute and chronic pain and getting treatment for such ailments is a basic human right. Opioid analgesics remain one way of managing and attending to such patients. However, due to the prevalence of opiophobia, many doctors avoid prescribing opioid-based medicines, even at the cost of patients suffering leading to a hindrance in providing optimal health care. Up till now, there has been no reliable and valid instrument to measure the severity of opiophobia in doctors. For this reason, the purpose of this study is to represent the construction of a precise and reliable instrument for measuring opiophobia along with its validation for doctors in Pakistan. Design/methodology/approach Interviews and theoretical knowledge relating to opiophobia were used as the basis for the purpose of generating an item pool. The generated item pool was evaluated by subject matter experts for content validity and inter-rater reliability, followed by Velicer’s minimum average partial method and maximum likelihood factor analysis for establishing the factorial structure of the scale. As opiophobia in doctors prevails the most and causes a lower ratio of prescription of opioid analgesics. The present sample selected for the study was that of n = 100 doctors (men = 50; women = 50) from various hospitals, treating patients with chronic pain, in Rawalpindi and Islamabad. Findings A two-factor structure was suggested by Velicer’s minimum average partial method and maximum likelihood factor analysis, which were labeled as fear of opioid analgesics and justified acceptance of opioids. The developed opiophobia questionnaire along with its subscales displayed appropriate levels of reliability α = 0.733, α = 0.760 and α = 0.725, respectively, suggesting the scale to be reliable. Research limitations/implications Like any other study, this study also tried to address every essential aspect, but still lacked at some places which should be considered and catered for in future studies. In the first place the sample size was very limited which was due to the fact, the study was conducted during a pandemic and physically going for data collection was unavailable, thus leading to consequent sample size. It is recommended a correspondent study can be conducted with larger sample size, so they can get more reliable results with greater precision and power. Then, they will have the advantage of a small margin of error. The second limitation was the study involved only doctors as that was the main focus of the present study. However, other hospital staff such as nurses should also be incorporated to assess their level of opiophobia. The current scale suggests the severity of opiophobia with higher scores though no cutoff point has been suggested. Future studies should try and incorporate a cutoff point to assess the difference between doctors who have conventional levels of reservations against opioids and those suffering from opiophobia. Another limitation was that the present scale did not establish additional validities such as convergent and divergent validity. Future studies should collect data from a larger sample to establish these validities to further refine the scale. Practical implications This instrument can be immensely effective in identifying doctors who have concerns and fears about prescribing opioids to patients with chronic pain. The findings acquired on such a scale can help in developing appropriate academic and psychological interventions which can help such doctors to overcome their opiophobia. This can enable more doctors to prescribe appropriate medicine to their patients instead of letting them suffer from pain. Additionally, researchers can equally benefit from the instrument as it can enable them to investigate opiophobia with other possible variables. Social implications Developing such a scale about the fear faced by doctors while treating patients would be very useful as it is not possible to take such fear when it comes to a patient’s life. This fear is also common among patients where they have a fear about the undesirable effects, addiction of drugs and fear of dying. Better awareness should be given to them which will be helpful for successful and less painful treatment in hospitals. Originality/value This scale is an original work with the aim of accessing opiophobia among doctors toward (chronic) patients with severe pain. There was a lot of research work that has been done on opiophobia in developed countries and few Pakistani researchers have also worked on opiophobia and its impact on pain management but still, no scale has been developed to measure the extent or tendency of opiophobia among doctors or patients. This scale can be used globally on both men and women doctors to access the tendency of opiophobia among them.

Psychometric development and validation of ostracism experience scale (OES): across sample of young adults from Pakistan

Purpose Ostracism is being socially ignored or excluded by others. Ostracism leads to serious psychological distress and health issues in the young adults being ostracized. However, there are no psychometrically designed instruments to measure this phenomenon in young adults. This study aims to develop a scale that measures ostracism efficiently and establishes the scale’s psychometric properties. Design/methodology/approach The research design used for the study is “a mixed-method study using non-experimental research with an exploratory sequential approach and instrument development design.” For the formation of the item pool, theoretical evidence was collected and focus group discussions were conducted. Afterward, content validity was established with the help of subject matter experts, followed by Velicer’s minimum average partial method and maximum likelihood factor analysis to form the instrument’s factorial structure. Findings Velicer’s minimum average partial method and maximum likelihood factor analysis made two factors as follows: ostracism experience and psychological effect. The instrument developed has a high value of alpha reliability i.e. a = 0.97 and a = 0.96, a = 0.92 for the subscales, respectively. Research limitations/implications The sample used for the research was enough to run the analysis, but future studies can go for a more extensive and more diverse sample. The sample was based solely on university students. The current research focused only on the target of the phenomenon, and the whole research process was conducted online because of the Covid-19 pandemic going on. The scale developed can be used in several settings to find out if the individual is being ostracized or not. Practical implications The scale’s most important implication is in the colleges and universities where young adults are found and face this problem daily. Likewise, psychologists can also use it in clinical settings. The other important implication of this scale is that it is opening a route to future research as different variables can be studied in ostracism such as depression, physical health and anxiety. Social implications Ostracism is a hidden evil in societies that is not usually talked about. When people are not given equal importance in groups or settings, it leads to serious psychological issues in those individuals. This scale will in the identification of the problem that will lead to a proper solution to this evil. Originality/value This work is original and not copied from anywhere. The research was conducted with the sole purpose of developing a scale on the ostracism experiences in young adults. The data is collected in the form of online surveys. The current scale is an attempt at developing a more reliable and valid scale that can be used in social settings.

The Performance of Maximum Likelihood Factor Analysis on South African Stock Price Performance

The purpose of this paper is to explore the effectiveness and applicability of Maximum Likelihood Factor Analysis (MLFA) method on stock price performance. This method identifies the variables according to their co-movement and variability and builds a model that can be useful for prediction and ranking or classification. The results of factor analysis in this study provide a guide as far as investment decision is concerned. Stock price performance of the seven well-known and biggest companies listed in the Johannesburg stock exchange (JSE) was used as an experimental unit. Monthly data was available for the period 2010 to 2014.Details of a trivariate factor model is: Factor 1 comprises of Absa and Standard Bank (Financial sectors), Factor 2 has Shoprite and Pick ‘n Pay (Retail sectors) while Factor 3 collected Vodacom MTN and Sasol (Industrial sectors). The companies contribute 46.9%, 12.7% and 10.8% respectively to the three sectors and these findings are confirmed by a Chi-square and the Akaike information criterion to be valid. The three factors are also diverse and reliable according to Tucker and Lewis and Cronbach’s coefficients. The findings of this study give economic significance and the study is relevant as it gives investors and portfolio manager’s sensible investment reference.Keywords: Maximum Likelihood Factor Analysis, stock prices

Psychopathic Traits and the Cheater–Hawk Hypothesis

The present study was a direct test of the cheater–hawk hypothesis which argues that psychopathy is related to two potentially adaptive interpersonal strategies: cheating and aggression. As expected, the measures of cheater and hawk behaviors comprised a single factor, according to a maximum-likelihood factor analysis. As hypothesized, psychopathic traits exhibited large positive correlations with measures of both cheater (entitlement, exploitiveness, and short-term mating orientation) and hawk (vengeance and aggression) behaviors. Furthermore, psychopathic traits were associated with the tendency of using individualistic and competitive tactics in an altruism game and being less likely to act in a prosocial manner. Finally, scores on the combined–cheater hawk variable were significantly correlated with psychopathic traits. As hypothesized, individuals scoring high on Factor 1 of psychopathy were more likely to utilize behaviors and strategies associated with the cheater–hawk designation, whether or not they scored high on Factor 2 of psychopathy. In general, the findings support the conceptualization that psychopathy represents a fast life-history strategy characterized by seeking personal gain over others, including exploitiveness (cheater), aggression (hawk), and risk taking. Results also indicate that cheater and hawk behaviors are part of a single strategy more often employed by those higher on psychopathic traits. Implications for treatment success are discussed.

Dimensionality and Reliability of a Modified Version of Norton's 1983 Quality Marriage Index among Expectant and New Canadian Mothers

A slightly modified version of Norton's 1983 Quality Marriage Index was administered to 61 expectant mothers prior to giving birth and within 3 mo. after giving birth. Mothers' ages ranged from 19 to 43 years ( M = 30, SD = 5.01) and their partners' ages ranged from 21 to 48 years ( M = 32, SD = 6.02). Mothers were presented an opportunity to participate in this study during prenatal classes held at hospital and community health centers. The only requirement for participation was that the mother be residing with her child's father for the duration of the study. The six items of the modified index showed high internal consistency (α>.90) and substantial test-retest reliability with a Pearson zero-order correlation of .65 across the two administrations. Maximum likelihood factor analysis indicated moderate support for unidimensional factor structure for the modified index, but removing one item from the pre- and postnatal administration improved the factor structure. In the first administration, the last item (overall current satisfaction with partner) fit poorly with the factor structure, while at the second administration, the second item (our relationship is very stable) fit poorly. Possible implications of the results are discussed.

Psychometric Properties of the Brief Verision of the Fear of Negative Evaluation Scale in a Turkish Sample

The purpose of the study was to report initial data on the psychometric properties of the Brief Fear of Negative Evaluation Scale. The scale was applied to a nonclinical sample of 250 (137 women, 113 men) Turkish undergraduate students selected randomly from Middle East Technical University. Their mean age was 20.4 yr. ( SD= 1.9). The factor structure of the Turkish version, its criterion validity, and internal reliability coefficients were assessed. Although maximum likelihood factor analysis initially indicated that the scale had only one factor, a forced two-factor solution accounted for more variance (61%) in scale scores than a single factor. The straightforward items loaded on the first factor, and the reverse-coded items loaded on the second factor. The total score was significantly positively correlated with scores on the Revised Cheek and Buss Shyness Scale and significantly negatively correlated with scores on the Rosenberg Self-Esteem Scale. Factor 1 (straightforward items) correlated more highly with both Shyness and Self-esteem than Factor 2 (reverse-coded items). Internal consistency estimate was .94 for the Total scores, .91 for the Factor 1 (straightforward items), and .87 for the Factor 2 (reverse-coded items). No sex differences were evident for Fear of Negative Evaluation.