Exploratory factor analysis with small sample sizes: a comparison of three approaches

Differences in symptom clusters based on multidimensional symptom experience and symptom burden in stroke patients

In the study of stroke symptoms, a significant unresolved issue remains: What are the similarities and differences in the use of three symptom dimensions-occurrence, severity, and distress-and symptom burden to identify symptom clusters, and which level is recommended for constructing symptom clusters? This study aimed to identify the number and types of symptom clusters in stroke patients on the basis of these dimensions and to determine the most suitable dimension for extracting symptom clusters. Data were collected from 656 stroke patients via a convenience sampling method at a tertiary-level hospital in Wuhan, China, between August 2023 and March 2024. Exploratory factor analysis was conducted to extract symptom clusters on the basis of the three dimensions of the symptom experience scale and symptom burden. Four similar symptom clusters were identified: the mood disturbance symptom cluster, the physical symptom cluster, the cognitive dysfunction symptom cluster, and the slurred speech and choking cough symptom cluster. The symptom of "fatigue" within the physical symptom cluster was not identified only in the dimension of distress (with a percentage agreement of 83.3%), whereas the symptom composition of other clusters remained consistent across all three symptom dimensions (with a percentage agreement of 100%). Moreover, all four symptom clusters exhibited high consistency in terms of both occurrence and symptom burden, regardless of whether the symptom with the highest factor loading or the overall symptom composition was considered. The use of symptom occurrence and symptom burden is recommended for identifying symptom clusters in stroke patients. Subsequently, trajectory studies of symptom clusters and symptom network analyses should be conducted on the basis of these two dimensions to establish a solid theoretical foundation for future clinical interventions and related scientific research.

A Novel and Comprehensive Wellness Assessment for Lifestyle-Based Interventions

Objective

While weight status and clinical laboratory measures are important in assessing obesity-related disease severity and chronic disease risk, including a broader range of emotional, psychosocial, and behavioral factors would provide greater context of an individual's overall state of wellness and could be used to better guide treatment decisions. The purpose of this research was to develop a comprehensive Lifestyle Wellness assessment for use in lifestyle-based wellness interventions and programs.

Methods

A cross-sectional exploratory factor analysis (EFA) was conducted using baseline data from N = 138 adults participating in behavioral weight loss trials. An unweighted least squares extraction method with oblique rotation was used. Twenty-one putative measures spanning constructs related to metabolic health, emotional health/wellbeing, body weight and composition, diet quality, and fitness were analyzed for retention.

Results

Mean body mass index (BMI) was 38.0 ± 6.6 kg/m2, mean age was 57.3 ± 11.1 years, and 77.5% of participants were female. The EFA produced a five-factor model with 13 items that explained 80.3% of the variance. The retained factors included: (1) Psychosocial State: mindfulness, resilience, quality of life, and happiness; (2) Blood Pressure State: systolic and diastolic blood pressure; (3) Lipid State: total cholesterol and LDL-cholesterol; (4) Fitness State: grip strength, jump height, and percent body fat; and (5) Body State: BMI and waist circumference.

Conclusions

Lifestyle Wellness is a comprehensive assessment that enables innovative wellness-related research such as metabolically healthy obese phenotypes and weight-neutral interventions. Future research should include investigations in additional populations with greater age, sex/gender, and body size diversity.

Sustaining the mobile medical units to bring equity in healthcare: a PLS-SEM approach

BACKGROUND

Equitable access to healthcare for rural, tribal, and underprivileged people has been an emerging area of interest for researchers, academicians, and policymakers worldwide. Improving equitable access to healthcare requires innovative interventions. This calls for clarifying which operational model of a service innovation needs to be strengthened to achieve transformative change and bring sustainability to public health interventions. The current study aimed to identify the components of an operational model of mobile medical units (MMUs) as an innovative intervention to provide equitable access to healthcare.

METHODS

The study empirically examined the impact of scalability, affordability, replicability (SAR), and immunization performance on the sustainability of MMUs to develop a framework for primary healthcare in the future. Data were collected via a survey answered by 207 healthcare professionals from six states in India. Partial least squares structural equation modeling (PLS-SEM) was conducted to empirically determine the interrelationships among various constructs.

RESULTS

The standardized path coefficients revealed that three factors (SAR) significantly influenced immunization performance as independent variables. Comparing the three hypothesized relationships demonstrates that replicability has the most substantial impact, followed by scalability and affordability. Immunization performance was found to have a significant direct effect on sustainability. For evaluating sustainability, MMUs constitute an essential component and an enabler of a sustainable healthcare system and universal health coverage.

CONCLUSION

This study equips policymakers and public health professionals with the critical components of the MMU operational model leading toward sustainability. The research framework provides reliable grounds for examining the impact of scalability, affordability, and replicability on immunization coverage as the primary public healthcare outcome.

Beyond the Dichotomy: Creation and Validation of a Continuous Statewide Index of U.S. Honor Culture

Honor cultures are characterized by a heightened sensitivity to reputation threats and strong expectations for the defense of honor. U.S. states vary in the extent to which they express the cultural norms of honor, but researchers have frequently relied upon a dichotomous classification that differentiates states as honor or dignity states. We created and validated a continuous, six-item index of honor norms and values across all U.S. states (Study 1). In Study 2, our honor index was correlated with historical variables theoretically associated with the genesis of honor cultures. In Study 3, we validated our honor index further by showing that it predicted several race-/ethnicity-specific outcomes that prior research has connected with honor (e.g., homicide rates, suicide rates). This new index equips researchers with a more nuanced understanding of U.S. honor cultures and a measure that can be used in future investigations.

Psychometric properties of the Arabic translation of the Dark Future Scale questionnaire in a non-clinical sample of Arabic-speaking young adults

BACKGROUND

Through the years, studying negative behaviors of the worldwide population seized the spotlight from many researchers who focused on building scales in order the measure the level of worries, fear and even depression of such stressed individuals. By definition, "Future anxiety" (FA) is fueled by negative thoughts leading to intense fear of unknown future events. The Dark Future scale (DFS) measures the level of anxiety experienced towards the future. Our aim was to examine the psychometric properties of a novel Arabic translation of the DFS.

METHODS

A sample of 684 Arabic-speaking young adults (65.6% women) filled the DFS, TEMPS-M (temperaments) and DASS-8 (psychological distress).

RESULTS

Confirmatory factor analyses (CFA) supported a unidimensional model of the DFS score, with all 5 items retained. This scale had good reliability. Moreover, concurrent validity demonstrated significant associations between DFS scores and psychological distress, depressive, cyclothymic, irritable and anxious temperament. Scores achieved scalar invariance across gender, with women having greater exposure to anxiety about the future.

CONCLUSION

Overall, these findings led to the conclusion that the Arabic DFS is a psychometrically valid tool for the assessment of FA. The DFS is a brief, reliable and easy to apply scale that would help researchers in psychology and psychiatry in assessing anxiety about future.

Sleep and the Social Profiles of Individuals With Rett Syndrome

BACKGROUND

This study investigates the distinctive social behaviors observed in individuals with Rett syndrome (RTT), characterized by the loss of spoken language, impaired eye gaze communication, gait abnormalities, and sleep issues. The research aims to identify social profiles in RTT and explore their correlation with sleep, sleep-disordered breathing (SDB), and daytime sleepiness.

METHODS

Standard overnight sleep macrostructure and respiratory parameters were assessed. Extracting 25 social-related items and one for daytime sleepiness from the Rett Syndrome Behavioral Questionnaire, factor analysis was applied to establish latent social profiles. These profiles were then correlated with sleep parameters. The nonparametric Mann-Whitney U test compared social profiles based on the presence of SDB (defined by an apnea-hypopnea index greater than one per hour) and daytime sleepiness.

RESULTS

The study involved 12 female subjects with confirmed RTT diagnoses and MECP2 mutations, aged 8.54 ± 5.30 years. The Rett Syndrome Behavioral Questionnaire revealed a total average score of 25.83 ± 12.34, indicating varying degrees of social impairments. Comprising 25 social-related items, factor analysis yielded four social profiles: "interactive motricity," "mood change," "anxiety/agitation," and "gazing." Longer sleep onset latency correlated with increased socio-behavioral impairments, particularly in interactive motricity reduction. Conversely, higher rapid eye movement sleep was associated with fewer interactive socio-motor behaviors. No significant differences in social profiles were found concerning the presence of SDB or daytime sleepiness.

CONCLUSIONS

The findings suggest four distinct social profiles in RTT individuals, hinting at shared disrupted circuits between sensorimotor functioning and sleep-related neuronal pathways. Despite the absence of differences in SDB or daytime sleepiness, the study highlights the relationship between sleep parameters, such as sleep onset latency and rapid eye movement sleep, and socio-behavioral outcomes in RTT with MECP2 mutations.

Cross-Cultural Adaptation and Psychometric Properties of the Chinese Version of the Knee Osteoarthritis Fears and Beliefs Questionnaire

This study aimed to adapt and validate the Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ) for Chinese patients, thereby advancing the understanding of fear-avoidance behaviors. Adopting a cross-sectional design, data were collected for 241 subjects (78.8% women; mean age 68.0 ± 7.8 years) across various healthcare settings in Hong Kong. Exploratory factor analysis resulted in an 11-item questionnaire with three distinct subscales, covering fears and beliefs related to physicians and disease (six items), daily living activities (three items), and sports and leisure activities (two items). The overall Cronbach's α coefficient was 0.86, indicating strong internal consistency. The questionnaire exhibited favorable convergent validity. Confirmatory factor analyses confirmed a good model fit. Test-retest reliability analysis indicated a high intraclass correlation coefficient of 0.93 (95% confidence interval: 0.88, 0.96), and a Bland-Altman plot revealed a slight bias in two measurements (0.97 [0.19]) without a systematic trend. The adapted Chinese version of the KOFBeQ demonstrated robust psychometric properties in terms of validity and reliability, providing an effective tool for surveying Chinese patients with knee osteoarthritis. These findings offer valuable insights for clinicians and patients, aiding in informed decision-making and improved rehabilitation strategies.

Assessing Eysenck's PEN model to describe personality in chimpanzees

Questionnaires adapted from human models can be used to reliably assess personality also in non-human primates. In this study, we used an adapted version of Eysenck's Psychoticism-Extraversion-Neuroticism (PEN) model that focuses on three higher-order personality traits. Extending previous work on a small group of chimpanzees (Pan troglodytes), we tested 37 chimpanzees housed at Fundació Mona (Girona, Spain) and the Leipzig Zoo (Germany). We assessed personality with a 12-item questionnaire, which raters scored using a 7-point Likert scale. To identify the personality traits, we conducted data reduction with Principal Components Analysis and Robust Unweighted Least Squares. The ICCs for the single (3, 1) and average (3, k) ratings indicated substantial agreement between raters. Parallel analyses identified two factors to retain, whereas the scree plot inspection and eigenvalues larger than one rule identified three factors. Factor 1 and 2 in our study were identical to the ones previously described for this species (labelled Extraversion and Neuropsychoticism, respectively) and we also obtained a third factor that could be related to Dominance (Fearless Dominance). Thus, our results confirm the potential of the PEN model to describe chimpanzee personality structure.

Examining the Impact of Key Factors on COVID-19 Vaccination Coverage in India: A PLS-SEM Approach

During the coronavirus disease 2019 (COVID-19) pandemic, numerous factors determined the performance of COVID-19 vaccination coverage. The purpose of this study is to examine the influence of factors such as government stewardship, planning and implementation, and community participation on COVID-19 vaccination coverage. This study applied partial least square structured equation modeling (PLS-SEM) by analyzing 187 responses from the stakeholders involved in vaccination programs in four select states of India. This study empirically validates a framework for improving vaccination coverage by confirming the significant impact of planning and implementation on vaccination coverage followed by government stewardship and community participation. Additionally, this study highlights the individual impact of each factor on vaccination coverage. Based on the findings, strategic recommendations were proposed that can be utilized for formulating policy-level actions to facilitate the vaccination program.

Cross-cultural adaptation of the Job Insecurity Scale (JIS) in Brazil and cross-national analysis of Job Insecurity effects in Brazil and Spain

BACKGROUND

Job flexibilisation has increased interest in job insecurity and its consequences. Job insecurity, understood as a fear of losing employment, is linked to a deterioration of mental health, social relations or job satisfaction. Its study has been developed primarily in Europe, in the absence of validated psychometric scales in the Latin American context. To bridge this knowledge gap, the aim of this study is to cross-culturally adapt the Job Insecurity Scale (JIS) in Brazil, and secondly, to establish a cross-national analysis between people employed in Brazil and Spain.

METHODS

As criteria for the sample, people with formally established employment in Brazil and Spain were selected. For the scale adaptation process, a sequence of EFA, CFA and validity tests are carried out, as well as a multigroup invariance according to the gender variable. The cross-national comparison compares the effect sizes of affective and cognitive job insecurity on the mental health variable measured with the GHQ-28 scale in both countries.

RESULTS

1165 employed people participate in the study, of whom 573 reside in Brazil and 592 in Spain. The results of the scale adaptation show that the JIS is suitable for use in the Brazilian employment context. The scale offers a factorialisation in two dimensions (affective and cognitive) (CFI = 0.993; TLI = 0.987; RMSEA = 0.04; SRMR = 0.049; GFI = 0.999; NFI = 0.980) with good reliability (ω > 0.84). The cross-national comparison shows that job insecurity has a greater weight in explaining the mental health of the employed population in Brazil than in Spain, which is related to higher indicators of job insecurity in the Brazilian context.

CONCLUSIONS

With this validation we now have a validated scale of job insecurity validated for the Brazilian context. The comparison between countries shows the need to establish these analyses, since the behaviour of the phenomenon is different in the contexts studied.

Defining the Characteristics of Successful Biosecurity Scent Detection Dogs

To perform their role effectively, scent detection dogs require certain characteristics. Identifying these characteristics will inform the selection of prospective dogs and preferred approaches to their training. The current study drew upon the perspectives of industry stakeholders to identify the behavioural traits considered relevant for detection dogs in biosecurity screening roles. Dog handlers, trainers, and supervisors (n = 25) in Australian biosecurity operations participated in focus group interviews to determine the perceived characteristics that, in their experience, influence detection performance. Their descriptions were used to create a questionnaire which was then administered to handlers to assess the working behaviours of current biosecurity dogs. Responses were collected for 88% of the operational dogs (n = 36). An exploratory factor analysis revealed seven tentative dimensions: search motivation, emotional stability, search arousal, food motivation, play motivation, search independence, and search focus. Search motivation and search arousal were both positively associated with handler ratings of detection performance (p ≤ 0.006). In general, biosecurity dogs were scored consistently high in ratings of search motivation, emotional stability, and food motivation. Our approach has advanced our understanding of the working behaviours and characteristic profile of biosecurity detector dogs and will be used to inform candidate selection processes.

Assessing the Compliance of Dental Clinicians towards Regulatory Infection Control Guidelines Using a Newly Developed Survey Tool: A Pilot Cross-Sectional Study in India

Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.

Validation of Tools to Assess Predictors of Successful Weight Loss Outcome in Individuals With Overweight and Obesity

OBJECTIVE

To develop and validate questionnaires to assess the behavioral, psychosocial, and environmental predictors of successful weight loss outcomes.

DESIGN

Mixed method study. Questionnaires were developed using 5 steps: item generation by literature review and preexisting questionnaires, expert evaluation, pilot testing, factor analysis, and internal consistency.

SETTING

Adults with obesity recruited via web-based survey hyperlink.

PARTICIPANTS

One hundred participants with a mean body mass index of 28.7 ± 4.4 kg/m².

VARIABLES MEASURED

The questionnaires were generated using 221 items. Establishing content, face and construct validity, and internal consistency.

ANALYSIS

Content validity was analyzed using content validity index and content validity ratio, internal consistency through Cronbach α (CA), and structural validity by factor analysis via principal varimax rotation.

RESULTS

All three questionnaires had good content validity. The Behavioral Predictor Questionnaire had good internal consistency (CA, 0.7) and excellent structural validity (69.7%). Psychosocial Predictors Questionnaire (CA, 0.8, 67.5%) and Environmental Predictors Questionnaire (CA: 0.8, 72.2%) had excellent internal consistency and structural validity.

CONCLUSION AND IMPLICATION

Questionnaires seem to be practical, valid, and reliable tools for baseline assessment of individual-specific factors related to weight loss success.

Translation, cross-cultural adaptation and validation of the Computer Vision Syndrome Questionnaire into Persian (CVS-Q FA©)

Purpose

To translate, cross-culturally adapt and validate the Computer Vision Syndrome Questionnaire (CVS-Q^©) into Persian.

Methods

This study was carried out in 2 phases: (1) the CVS-Q^© was translated and cross-culturally adapted into Persian and (2) the validity and reliability of CVS-Q FA^© were assessed in a cross-sectional validation study. An expert committee composed of 15 optometrists evaluated content validity (item-level (I-CVI) and scale-level (S-CVI) content validity index were calculated). A pretest was performed (n = 20 participants) to verify the comprehensibility of the questionnaire. A total of 102 computer users completed the final questionnaire. Criterion validity and diagnostic performance of the CVS-Q FA^© were assessed by calculating sensitivity, specificity and receiver characteristic operator curve. Cronbach's alpha was calculated for the assessment of internal consistency and 46 participants refilled the questionnaire for the second time and the interclass correlation coefficient (ICC) and Cohen's kappa (κ) were evaluated for test–retest reliability.

Results

The translation and cross-cultural adaptation process was performed successfully according to accepted scientific recommendations without any major difficulties. The I-CVI was above 0.80 for all items (symptoms) except item 15 (feeling that sight is worsening) and the S-CVI was 0.92. The CVS-Q FA^© showed good sensitivity (81.1%) and acceptable specificity (69.2%). Also, it achieved good internal consistency (Cronbach's alpha = 0.80) and test–retest reliability (ICC = 0.81 and κ = 0.65).

Conclusion

The CVS-Q FA^© was successfully translated, cross-culturally adapted, and validated into Persian. This study provides a valid and reliable tool for the assessment of computer vision syndrome among the Iranian working population.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10792-022-02340-3.

Evening chronotype as a bipolar feature among patients with major depressive disorder: the results of a pilot factor analysis

Objectives:

The bipolar spectrum concept has resulted in a paradigm shift that has affected both the diagnosis and therapy of mood disorders, with bipolarity becoming an indicator of treatment resistance in depression. Evening circadian preference has also been linked to affective disorders. The aim of our study was to confirm the relationship between the severity of depressive symptoms, bipolar features, chronotype, and sleep quality among patients with major depressive disorder.

Methods:

A group of 55 individuals who were recruited from a mental health outpatient clinic completed the following psychometric tools: a Chronotype Questionnaire comprising morningness-eveningness (ME) and subjective amplitude of the rhythm (AM) scales, the Hypomania Checklist 32 (HCL-32), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI).

Results:

Factor analysis identified two latent components, accounting cumulatively for 58% of variables: depressive symptoms (BDI and PSQI) and bipolarity (ME, AM, and HCL-32). After rotation, ME loading in the first factor increased the result to a significant level. The correlation between the two components was very low.

Conclusions:

Evening chronotype appears to be a bipolarity-related marker, with this relationship being independent of its link to depressive symptoms and sleep quality. Eveningness and high circadian rhythm amplitude may offer promise as diagnostic, prognostic, and therapeutic predictors.

Measuring behavioral coping style and stress reactivity experimentally in wild olive baboons

Many nonhuman animals have been used as subjects to elucidate intra-individual variation in the stress response - understood via coping styles and stress reactivity. Given the evidence and theory supporting evolutionary trade-offs associated with such differences, it is surprising, then, how few studies have used wild nonhuman primates to develop this theoretical framework. In the current study, we evaluated this framework using a combination of behaviours from focal follows and an experimental method, novel to the field - collected during a 17 month project on olive baboons (Papio anubis) in Laikipia, Kenya. Our experimental design simultaneously introduces a risk with an incentive: a model snake with a real chicken egg, respectively. Such an approach facilitates multiple solutions to a stressor, a key element of coping style theory. General behavioral tendencies did not associate with the experimental measures of coping style and stress reactivity. These results, however, demonstrated the utility and validity of this experimental approach for measuring coping style and stress reactivity in wild nonhumans. Fear grimaces represented stress reactivity. A factor solution represented coping style - summarizing decision making under stress. The treatment experiment, with a snake and egg, elicited a behavioral stress response, relative to control trials with just an egg.

Individual differences in proactive interference in rats (Rattus Norvegicus)

Individual differences in behaviors are seen across many species, and investigations have focused on traits linked to aggression, risk taking, emotionality, coping styles, and differences in cognitive systems. The current study investigated whether there were individual differences in proactive interference tasks in rats (Rattus Norvegicus), and tested hypotheses suggesting that these tasks should load onto a single factor and there should be clusters of rats who perform well or poorly on these tasks. The performance of 39 rats was tested across three learning tasks that all involved disengagement from an irrelevant previously learned stimulus to a relevant stimulus: latent inhibition (LI), partial reinforcement extinction effect (PREE), and reversal learning (RL). An exploratory factor analysis revealed the existence of one factor underlying performance. A cluster analysis revealed the existence of sets of rats displaying either weak LI and strong PREE and RL effects, or vice versa. These findings suggest that proactive interference may be based on a single underlying psychological system in rats.

The Father in Youth Baseball: A Self-Determination Theory Approach

This study based on the self-determination theory aims to examine the relationship among the aspirations that fathers have about their children's youth baseball practice, the children's basic psychological needs (satisfaction and frustration), and their intentions to either continue or drop out of baseball practice in a sample of children from Hermosillo, Mexico. A cross-sectional study was carried out involving 533 fathers (M = 44.30, SD = 5.18) and 533 children (M = 13.09, SD = 1.68). The results showed that the intrinsic aspirations of fathers were positively correlated to the satisfaction of the children's psychological needs, whereas the extrinsic aspirations of fathers were positively correlated with the frustration of the children's psychological needs. Satisfaction of basic psychological needs was positively correlated with the intention to continue and negatively correlated with dropout; on the contrary, frustration of basic psychological needs was negatively correlated with the intention to continue and positively with dropout. In conclusion, the fathers' pursuit of intrinsic aspirations for their children in the youth baseball context satisfies the children's basic psychological needs, and in turn, their intention to continue practicing increases. Conversely, when a father pursues extrinsic aspirations for his son in youth baseball, the child will feel his basic psychological needs frustrated, and he will have a greater intention to drop out. Overall, this study extends the existing sport-scientific literature by confirming the impact of parents' aspirations on their children's basic psychological needs and intention to continue being baseball players.

Temporal consistency and ecological validity of personality structure in common marmosets (Callithrix jacchus): A unifying field and laboratory approach

Personality in animals has been extensively researched in recent decades. Temporal consistency of behaviors is almost always part of the personality definition and is usually explored in several different testing sessions or observation periods. However, it is still unclear whether the obtained personality constructs are stable across several years, which might be especially important for long-living animals, such as primates. Further, little is known on whether the personality structures obtained in the laboratory reflect the structures obtained under ecologically relevant conditions in the wild. Therefore, we conducted a battery of personality tests on common marmosets (Callithrix jacchus) (N = 27), compared it with a test battery conducted 4 years beforehand on a subset of animals in captivity (N = 13) and ran an adapted version under field conditions at Baracuhy Biological Field Station, Brazil (N = 18). Under captive conditions, we found a remarkably similar personality structure across 4 testing years. Further, we found high long-term temporal consistency in the first two personality components, Boldness and Exploration; however, monkeys that changed their social (i.e., breeding) status between the two testing periods showed a significant increase in Boldness scores. Under field conditions, we found a somewhat similar personality structure as compared to the laboratory, which to some extent corroborates ecological validity of our personality test design. Nevertheless, whether the structure in the wild is suppressed or expanded in comparison to captivity, and in which way the social setting influences personality structure, should be further explored. Taken together, our results contribute to the discussion about the reliability and ecological validity of personality structures in nonhuman primates.

Validation of the functional component of the Halliwick-ICF assessment scale

Introduction: Aquatic rehabilitation therapy can improve strength and functional ability. Previous studies measured outcomes on land but did not measure underwater functional ability.Purpose: This study aimed to validate the functional component of the Halliwick-ICF assessment scale, and to compare the scale between underwater and on-land activities.Methods: Rehabilitation and medical charts of individuals with brain lesions and/or spine injuries who underwent aquatic therapy were retrospectively reviewed. Twenty-one functional components of the Halliwick-ICF assessment scale items were categorized through exploratory factor analysis: center of gravity alteration, basic functional activity, and progressive basic functional activity. Confirmatory factor analysis was performed to evaluate the validity of the functional components of the Halliwick-ICF assessment scale. Spearman's correlation analyses were conducted using Medical Research Council sum and modified Barthel index scores.Results: Ninety-five participants (mean age: 53.4 years, range: 27-73 years) were included in the analysis. Convergence and discrimination validity for all three factors were established. Total scores of the scale showed correlations with the modified Barthel index (r = 0.636, p < .001) and Medical Research Council sum (r = 0.298, p = .01) scores.Conclusion: The functional components of the Halliwick-ICF assessment scale demonstrated validity with physical function on land, suggesting its usefulness in aquatic therapy.

Regularized Exploratory Bifactor Analysis With Small Sample Sizes

Several methods of factor extraction have recently gained popularity as a procedure for dealing with estimation problems associated with small sample sizes, which can be found in the various behavioral science disciplines, such as comparative psychology and behavior genetics. Two popular approaches for particularly small samples (below 50) include unweighted least squares factor analysis (ULS-FA) and regularized exploratory factor analysis (REFA). However, it is unclear how well each of the approaches performs with small samples in the context of exploratory bifactor modeling. In the current study, a comprehensive simulation study was conducted to evaluate the small sample behavior of the two approaches in terms of bifactor structure recovery under different sample size, factor loading, number of variables per factor, number of factors, and factor correlation experimental conditions. The results show that REFA is recommended for use over ULS-FA, particularly in the conditions involving low factor loadings, few group factors, or a small number of variables per factor.

Strategies used by families to cope with chronic mental illnesses: Psychometric properties of the family crisis oriented personal evaluation scale

PURPOSE

This study was aimed at investigating the psychometric properties of the Family Crisis Oriented Personal Evaluation Scale (F-COPES) for Turkish society, which assesses the coping skills of caregivers of individuals with chronic mental illnesses.

DESIGN AND METHODS

The study was conducted with 153 family caregivers of patients with a chronic mental illness admitted to the inpatient and outpatient units of two university hospitals and İzmir Schizophrenia Solidarity Association. For the language validity, the translation-back translation method was performed, for the content validity, expert opinions were obtained, for the construct validity, exploratory and confirmatory factor analysis was performed. For the reliability analysis, Cronbach α reliability coefficient was calculated and the test-retest reliability analysis was performed.

FINDINGS

The content validity index of the scale was 0.96. The Cronbach's α reliability coefficient for the overall scale was .80. Factor loadings of the subscales ranged between 0.56 and 0.69 for the Acquiring Social Support subscale, between 0.43 and 0.74 for the Reframing subscale, between 0.53 and 0.74 for the Seeking Spiritual Support subscale. The model fit indexes were as follows: χ² = 176.369, df = 116, χ² /df = 1.52, RMSEA = 0.059, CFI = 0.90, IFI = 0.91, GFI = 0.88.

PRACTICE IMPLICATIONS

The results of the present study show that the levels of psychometric properties of F-COPES in Turkish society are acceptable. It is thought that it would be useful to use the F-COPES in the assessment of coping behaviors of individuals who give care to patients with a chronic mental illness and that it can be used as measurement tool in studies to be conducted with caregivers of patients with a chronic mental illness to assess their coping skills.

Assessing the maturity of the healthcare system for integrated care: testing measurement properties of the SCIROCCO tool

Background

The Scaling Integrated Care in Context (SCIROCCO) tool has been developed to facilitate knowledge transfer and learning about the implementation and scaling-up of integrated care in European regions. To adequately test the functionality of the tool in assessing the maturity for integrated care within regions, this study evaluated its structural validity, internal consistency and convergent validity.

Methods

Exploratory factor analysis was used to investigate the structural validity of the 12-items of the SCIROCCO tool. Hereafter, the internal consistency was assessed by calculating Cronbach’s and ordinal alpha. The convergent validity was explored by testing 23 pre-hypothesized relationships between items of the SCIROCCO tool and items of an instrument measuring a similar construct.

Results

Factor analysis revealed a one-factor structure. Cronbach’s alpha of the overall instrument was 0.92, ordinal alpha was 0.94. Only 30.34% of the hypotheses for testing the convergent validity were met.

Conclusion

The one-factor structure is considered relevant in representing the structural validity of the SCIROCCO tool. The scale of the SCIROCCO tool shows good internal consistency. The tool (DMIC Quickscan) used to assess the convergent validity might measure a different aspect of integrated care than the SCIROCCO tool. Further research is needed to continue investigating the validity and reliability of the tool.

Electronic supplementary material

The online version of this article (10.1186/s12874-019-0704-1) contains supplementary material, which is available to authorized users.

Adaptation of a scale to measure coping strategies in informal primary caregivers of psychiatric patients

WHAT IS KNOWN ON THE SUBJECT?: Informal caregivers of psychiatric patients are vulnerable to many disturbances associated with the stress related to their activity. Caregivers who show a coping style focused on problem-solving report less psychological distress, and this approach positively influences the recovery process of the psychiatric patient. There are some questionnaires to measure coping styles in caregivers of psychiatric patients, but most of them do not have the minimum psychometric properties that a scale must fulfil. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The authors present an adapted and validated scale for measuring both active and passive coping strategies used by informal caregivers to face daily stressful situations with psychiatric patients. The study is an example of how scales can be adapted to small samples (n < 200). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The scale could be helpful for generating strategies to support the family caregiver, as well as for measuring the results of interventions. The scale could also be used to identify how coping styles of informal caregivers are related to recovery process of psychiatric patients.

ABSTRACT

Background The recovery process of a psychiatric patient is related to his primary informal caregiver's style of coping with stress. There is insufficient literature on validations of instruments that measure coping styles in this population. Objective To adapt and validate a scale to measure coping strategies in primary informal caregivers. Method The adapted scale was based on the Extreme Coping Scale of López-Vázquez and Marván. Items from that scale were adapted for application to informal caregivers. The scale was administered to 122 primary informal caregivers of patients from two psychiatric institutions in Mexico. Psychometric analyses were performed to determine the scale's properties. Results The scale was composed of 20 items (six less than in the original scale) and two factors: (i) active coping (Cronbach's alpha = .837) and (ii) passive coping (Cronbach's alpha = .718). Discussion The findings are discussed in the light of the importance of studying the relationship between coping styles and the well-being of both informal caregivers and psychiatric patients. Implications for practice The scale could be used by health practitioners and researchers to generate strategies to support the family caregiver, as well as to measure the results of interventions.

Evaluation of a conceptual framework for predicting navigation performance in virtual reality

Previous research in spatial cognition has often relied on simple spatial tasks in static environments in order to draw inferences regarding navigation performance. These tasks are typically divided into categories (e.g., egocentric or allocentric) that reflect different two-systems theories. Unfortunately, this two-systems approach has been insufficient for reliably predicting navigation performance in virtual reality (VR). In the present experiment, participants were asked to learn and navigate towards goal locations in a virtual city and then perform eight simple spatial tasks in a separate environment. These eight tasks were organised along four orthogonal dimensions (static/dynamic, perceived/remembered, egocentric/allocentric, and distance/direction). We employed confirmatory and exploratory analyses in order to assess the relationship between navigation performance and performances on these simple tasks. We provide evidence that a dynamic task (i.e., intercepting a moving object) is capable of predicting navigation performance in a familiar virtual environment better than several categories of static tasks. These results have important implications for studies on navigation in VR that tend to over-emphasise the role of spatial memory. Given that our dynamic tasks required efficient interaction with the human interface device (HID), they were more closely aligned with the perceptuomotor processes associated with locomotion than wayfinding. In the future, researchers should consider training participants on HIDs using a dynamic task prior to conducting a navigation experiment. Performances on dynamic tasks should also be assessed in order to avoid confounding skill with an HID and spatial knowledge acquisition.

Three-factor structure for Epistemic Belief Inventory: A cross-validation study

Research on epistemic beliefs has been hampered by lack of validated models and measurement instruments. The most widely used instrument is the Epistemological Questionnaire, which has been criticized for validity, and it has been proposed a new instrument based in the Epistemological Questionnaire: the Epistemic Belief Inventory. The Spanish-language version of Epistemic Belief Inventory was applied to 1,785 Chilean high school students. Exploratory and confirmatory factor analyses in independent subsamples were performed. A three factor structure emerged and was confirmed. Reliability was comparable to other studies, and the factor structure was invariant among randomized subsamples. The structure that was found does not replicate the one proposed originally, but results are interpreted in light of embedded systemic model of epistemological beliefs.

Psychometric properties of the Management of Aggression and Violence Attitude Scale in Hong Kong's emergency care setting

BACKGROUND

Emergency unit is one of the most high-risk areas for patient violence. However, in Hong Kong, little research has been test psychometric properties of assessment tool of Emergency unit nurses' attitude toward violence.

METHODS

The Management of Aggression and Violence Attitude Scale's (MAVASs) Scale- and Item-Content Validity Index were established by 5-experts panel. A convenience sample of 123 nurses working in 4 public Emergency Department in Hong Kong was recruited. The construct validity was tested using exploratory factor analysis and the reliability was assessed by Cronbach's alpha and test-retest reliability.

RESULTS

The Scale-Content Validity Index was 97.0% and the Item-Content Validity Indexes ranged from 80.0% to 100.0%. Exploratory factor analysis indicated 4-factors solution (i.e., "importance of communication with patients", "perceived effectiveness of interventions", "pitfalls of interventions" and "perceived need for intervention"). Its' internal consistency was satisfactory (Cronbach's alphas=0.40-0.77) across the 4 subscales and test-retest reliability over 4-week interval was satisfactory (Pearson's coefficient=0.85).

CONCLUSION

MAVAS was found to be a valid and reliable tool to examine nurses' attitudes towards patients' violence in emergency care setting, and provides useful information to those developing training and intervention programmes for management of aggression.

Psychometric testing of a person-centred care scale the Eden Warmth Survey in a long-term care home in New Zealand

BACKGROUND

Traditional nursing homes have been viewed as dominated by the medical model. Since the 1990s, the Eden Alternative(TM) has become a significant model in systemic transformations in nursing homes. The purpose of this study was to evaluate the psychometric performance of the 20 items of the Eden Warmth Survey - Residents (EWS-R) in an aged-care home.

DESIGN

A resident's satisfaction survey was used to collect a sample of 85 long-term care home residents.

METHODS

Psychometric evaluation included item analyses, reliability including internal consistency and stability, criterion-related validity and construct validity.

RESULTS

The reduced 13 items demonstrated adequate reliability (α = 0.82) with two factors, Trust and Connectedness with Others and Care Practices, extracted and contributed to 57.9% of the total variance.

CONCLUSIONS

The 13-item of EWS-R can be considered as a reliable and predictive scale for assessing quality of life and overall satisfaction on people living in long-term care facilities.

Factors Associated with Comfort Level of School-Based Occupational Therapists in Providing Low-Vision Services

This study identified factors associated with the comfort level of school-based occupational therapists in providing services to children with visual impairments. Sixty-one school-based occupational therapists completed an on-line survey. Fifty-four percent of respondents were comfortable or somewhat comfortable when choosing assessments and 84% were comfortable or somewhat comfortable in providing occupational therapy services for children with visual impairments. Multivariable linear regression analyses indicated years of professional experience, history of a caseload of children with visual impairments, and training received in treating children with visual impairments from continuing education were uniquely and significantly associated with the respondents' comfort level. Though not included in the final model, collaboration with other low vision service providers (e.g., teachers, optometrists, ophthalmologists, and orientation/mobility specialists) was also significantly associated with respondents' comfort level in the univariate analysis. Findings provide an initial direction and strategies to improve occupational therapists' comfort level in providing services to children with visual impairments in school settings.

Personality variation in little brown bats

Animal personality or temperament refers to individual differences in behaviour that are repeatable over time and across contexts. Personality has been linked to life-history traits, energetic traits and fitness, with implications for the evolution of behaviour. Personality has been quantified for a range of taxa (e.g., fish, songbirds, small mammals) but, so far, there has been little work on personality in bats, despite their diversity and potential as a model taxon for comparative studies. We used a novel environment test to quantify personality in little brown bats (Myotis lucifugus) and assess the short-term repeatability of a range of behaviours. We tested the hypothesis that development influences values of personality traits and predicted that trait values associated with activity would increase between newly volant, pre-weaning young-of-the-year (YOY) and more mature, self-sufficient YOY. We identified personality dimensions that were consistent with past studies of other taxa and found that these traits were repeatable over a 24-hour period. Consistent with our prediction, older YOY captured at a fall swarming site prior to hibernation had higher activity scores than younger YOY bats captured at a maternity colony, suggesting that personality traits vary as development progresses in YOY bats. Thus, we found evidence of short-term consistency of personality within individuals but with the potential for temporal flexibility of traits, depending on age.