Development and validation of the geriatrics health behavior questionnaire (GHBQ)

Development and validation of an information-motivation-behavioral skills questionnaire for colorectal cancer prevention in a high-risk population

BACKGROUND

Colorectal cancer (CRC) is one of the most prevalent cancers, and the risk of CRC is substantially greater in a high-risk population than in the general population. However, no existing assessment instruments have been specifically designed to evaluate CRC prevention behaviors in a high-risk population. The aim of this study was to develop and psychometrically validate an information-motivation-behavioral skills (IMB) questionnaire tailored for the population at high risk for CRC (IMB-CRC) to assess the factors influencing prevention behaviors.

METHODS

This cross-sectional study was conducted in northeastern China. The initial questionnaire items were derived from a comprehensive literature review, semistructured interviews analyzed via content analysis, and expert focus group discussions. Content validity was assessed through expert consultation using the Delphi method, and face validity was evaluated in the high-risk population for CRC. Explanatory factor analysis (EFA) was performed on Sample 1 (N = 287) to identify underlying factors, and confirmatory factor analysis (CFA) was performed on Sample 2 (N = 224) to validate the model. Internal consistency and test-retest reliability were also examined to ensure the stability and consistency of the questionnaire.

RESULTS

The final IMB-CRC comprises 21 items distributed across four dimensions: prevention information (7 items), objective skills (5 items), self-efficacy (5 items), and motivation (4 items), collectively accounting for 61.99% of the variance. CFA indicated that the proposed model fit the data well (χ2/df = 1.779, RMSEA = 0.059, AGFI = 0.852, GFI = 0.883, CFI = 0.950, IFI = 0.951, TLI = 0.943, and NFI = 0.894). The item content validity index (I-CVI) for individual items ranged from 0.905 to 1, and the scale content validity index (S-CVI) was 0.952, suggesting good content validity. The IMB-CRC demonstrated high reliability, with a Cronbach's alpha of 0.937, McDonald's omega of 0.939, and test-retest reliability of 0.919. Significant positive correlations were observed between the IMB-CRC and each of its four dimensions, indicating that higher IMB-CRC scores were associated with greater engagement in cancer prevention behaviors among the high-risk population.

CONCLUSION

The IMB-CRC exhibited appropriate validity and reliability, indicating that this questionnaire is a robust tool for assessing behavioral components essential for CRC prevention in the high-risk population. Health care professionals and policymakers can use the IMB-CRC to develop targeted CRC risk communication and behavioral education strategies, thereby improving the preventive abilities of a high-risk population.

COPD-ES Questionnaire Based COPD Patients Management in Stable Phrase Improves Disease Group Classification

Introduction

Chronic obstructive pulmonary disease (COPD) is a prevalent, incurable condition requiring lifelong management. Inadequate daily management exacerbates COPD, leading to increased healthcare utilization and reduced quality of life.

Methods

This study aimed to design and validate a 10-item COPD self-evaluation (COPD-ES) questionnaire and apply it in the education of stable COPD patients. Participants were recruited from the Third Xiangya Hospital of Central South University and randomly assigned to control and intervention groups. The intervention group received monthly disease education using the COPD-ES questionnaire during a 6 months observation period.

Results

Significant improvements in smoking cessation, medication adherence, and disease knowledge in the intervention group were found. The intervention also led to a reduction in COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) grades and acute exacerbation frequency. The COPD group classification improved accordingly.

Conclusion

The study highlights the importance of patient-centered education with our COPD-ES questionnaire in improving COPD management outcomes.

Lifestyle Profile Scale for Gravida with Urinary Incontinence: scale development and psychometric testing in Chinese Mainland

OBJECTIVES

A significant number of women may experience urinary incontinence (UI) during pregnancy. While lifestyle modifications are recommended as important measures for preventing and treating UI, little is known about the lifestyle status of gravida with UI. This study aimed to develop the Lifestyle Profile Scale for Gravida with Urinary Incontinence (LPG-UI) and to evaluate its psychometric properties.

DESIGN

It was an instrument design study carried out in two stages. In stage 1, a literature review was conducted to generate the initial item pool. Subsequently, a Delphi survey was conducted to obtain expert consensus and reduce the items. In stage 2, further item reduction was performed through item analysis. Then, psychometric properties of the instrument were evaluated, including structural validity, internal consistency, split-half reliability, test-retest reliability and criterion validity.

SETTING

This study was conducted in obstetric clinics of a tertiary maternity hospital in Zhejiang Province, mainland China.

PARTICIPANTS

A sample of 447 pregnant women with UI were enrolled in stage 2.

RESULTS

A 24-item, 7-dimension lifestyle profile scale was ultimately obtained. The content validity was satisfactory. The split-half reliability and total-scale Cronbach's alpha coefficient were 0.890 and 0.819, respectively. The criterion validity was 0.598. The seven-factor model, which accounted for 63.667% of the total item variance, demonstrated a good fit with the data ([Formula: see text] =1.672, root mean square error of approximation=0.053, goodness of fit=0.884).

CONCLUSIONS

The LPG-UI has sufficient validity and reliability for assessing the lifestyle status of pregnant women with UI.

Determining the minimum data set of geriatric assessment at the Iran primary health care referral system: shifting from fragmentation to integration care for older people

BACKGROUND

Geriatric assessment (GA) is a multidimensional process that disrupts the primary health care (PHC) referral system. Accessing consistent data is central to the provision of integrated geriatric care across multiple healthcare settings. However, due to poor-quality data and documentation of GA, developing an agreed minimum data set (MDS) is required. Therefore, this study aimed to develop a GA-MDS in the PHC referral system to improve data quality, data exchange, and continuum of care to address the multifaceted necessities of older people.

METHODS

In our study, the items to be included within GA-MDS were determined in a three-stepwise process. First, an exploratory literature search was done to determine the related items. Then, we used a two-round Delphi survey to obtain an agreement view on items to be contained within GA-MDS. Finally, the validity of the GA-MDS content was evaluated.

RESULTS

Sixty specialists from different health geriatric care disciplines scored data items. After, the Delphi phase from the 230 selected items, 35 items were removed by calculating the content validity index (CVI), content validity ratio (CVR), and other statistical measures. Finally, GA-MDS was prepared with 195 items and four sections including administrative data, clinical, physiological, and psychological assessments.

CONCLUSIONS

The development of GA-MDS can serve as a platform to inform the geriatric referral system, standardize the GA process, and streamline their referral to specialized levels of care. We hope GA-MDS supports clinicians, researchers, and policymakers by providing aggregated data to inform medical practice and enhance patient-centered outcomes.

The Indian Geriatrics Quality of Life Inventory Scale (IGQOLI): Development and Validation of a Scale to Evaluate the Quality of Life among Geriatric Population of India

Background

Quality of life (QOL) refers to an individual's perception of their overall life and well-being. As people age, their QOL often deteriorates. Although various outcome measures exist to assess QOL, most are limited in scope and not specific to the Indian ethnicity of geriatrics. Therefore, a new outcome measure was developed and validated to more accurately evaluate the QOL for the geriatric population in India.

Methods

The outcome measure was developed in three stages, followed by validation. Data was collected using multistage cluster sampling from 13 subdivisions of Jaipur district. A total of 423 participants were interviewed face-to-face. The collected data was analyzed using SPSS version 20, and the reliability and validity of the outcome measure were assessed.

Results

The Indian Geriatrics Quality of Life Inventory (IGQOL) scale demonstrated excellent reliability, with a Cronbach's alpha (α) of 0.95 and an intraclass correlation coefficient of 0.93. The measure also exhibited excellent face and content validity, with a K value of 1. Correlation analysis revealed a significant relationship with other outcome measures, with a Pearson correlation coefficient value of > 7 and a p-value of < 0.05.

Conclusion

The study concludes that the IGQOLI scale is a reliable and valid outcome measure for evaluating the QOL in the geriatric population in India.

Development and validation of the Women's Self-care Knowledge and Attitude Questionnaire (WSKAQ)

BACKGROUND

Menopausal women should learn self-care practices to enjoy a healthy lifestyle, positive health behaviors, and health status. In addition, the lack of self-care knowledge can lead to unhealthy attitudes and lifestyles, resulting in many complications. Improved self-care knowledge can foster positive attitudes, leading to healthier lifestyles as a beneficial cycle. However, menopausal women have limited knowledge about self-care and evaluation tools. Therefore, this study aimed to develop and investigate the validity and reliability of the Women's Self-care Knowledge and Attitude Questionnaire (WSKAQ) in Iranian menopausal women.

METHODS

This cross-sectional study was conducted on 249 menopausal women, aged between 45 and 65 years and at least one year post-menopause, with a minimum literacy level of elementary education. Validation properties included construct validity, exploratory (EFA), and discriminant validity. Reliability was further established through Cronbach's α and McDonald's Omega. PASS 15 and SPSS 27 software were used to select centers, calculate sample size and analyze the data, respectively.

RESULTS

The initial stage of construct validity involved the Kolmogorov-Smirnov test and EFA, resulting in a 6-item self-care knowledge subscale, 47.29% of the total data variance, and 7-item self-care attitude subscale, 55.50% of the total data variance. Independent t-test indicated that menopausal women with education level equal to or higher than diploma have significantly higher self-care attitude scores than those with lower than diploma (p = 0.007). Additionally, significant correlations were observed between self-care knowledge and attitude (r:0.30). Cronbach's α and McDonald's Omega coefficients of the 13-item WSKAQ were 0.77 and 0.78, respectively.

CONCLUSIONS

Based on the results, the WSKAQ, consisting of 13 items, was validated and reliable for assessing the self-care knowledge and attitude of Iranian menopausal women.

Psychometric evaluation of the translated arabic version of the geriatrics health behavior questionnaire (GHBQ) for geriatric nurses: a cross-sectional study

BACKGROUND

The Geriatrics Health Behavior Questionnaire (GHBQ) is essential for assessing health-related behaviors among older adults populations. This study focuses on the translation, cultural adaptation, and psychometric evaluation of the Arabic version of the GHBQ to ensure its relevance and accuracy for Arabic-speaking older adults individuals.

METHODS

This cross-sectional study was conducted at the Cairo University Educational Hospital's outpatient clinic. The GHBQ was translated and culturally adapted through a systematic process, including initial translation, back-translation, expert review, and pilot testing. The psychometric properties of the Arabic-translated GHBQ were evaluated using a sample of 200 older adults Arabic-speaking participants. Reliability was assessed using Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC). Validity was evaluated through Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA).

RESULTS

The Arabic GHBQ demonstrated excellent reliability with Cronbach's alpha values ranging from 0.74 to 0.87 across subscales and ICC values confirming reproducibility (ICC = 0.82). The CVI indicated strong content validity (average CVI = 0.91). EFA revealed a five-factor structure, explaining 72% of the variance, with all factor loadings exceeding 0.60. CFA supported the questionnaire's structure with fit indices meeting recommended criteria: χ²/df = 2.05, NFI = 0.92, TLI = 0.94, GFI = 0.90, SRMR = 0.05, AIC = 140.35, and BIC = 160.22. Criterion validity was confirmed through significant correlations with established health behavior measures (r = 0.63, p < 0.001).

CONCLUSIONS

The culturally adapted Arabic version of the GHBQ is a reliable and valid tool for assessing health behaviors in the older adults population in Egypt. This instrument can aid healthcare providers in identifying and addressing health behaviors, ultimately improving the well-being of this demographic. Future research should focus on expanding the sample and comparing the GHBQ with other similar tools used in Arabic-speaking populations.

Development and Validation of a Health Behaviour Scale: Exploratory Factor Analysis on Data from a Multicentre Study in Female Primary Care Patients

Health behaviours are the most important proximal determinants of health that can be either promoting or detrimental to the health of individuals. To assess and compare health behaviours in different socioeconomic groups within the population, a comprehensive, valid, reliable, and culturally appropriate measure is needed. This study aimed to develop a health behaviour questionnaire and validate it in a sample of female patients over 45 years of age with cardiovascular disease (CVD). The development procedure encompassed the following stages: literature search and item generation, content validity testing (focus group and expert evaluation), and field testing. A preliminary 38-item Health Behaviour Scale (HBS) was developed and tested in a group of 487 female primary care patients over 45 years of age. An exploratory factor analysis (EFA) yielded a four-factor structure. Factors jointly accounted for 47% of the variance observed. The results confirmed very good internal consistency of the questionnaire. The Cronbach's alpha and McDonald's omega coefficients for the entire scale were 0.82 and 0.84, respectively. The factor and item structure of the final 16-item HBS reflects the specificity of the studied sample. This measure can be a useful tool for primary care practitioners and public health researchers by helping them to develop interventions and strategies to reinforce health-promoting behaviours.