OBJECTIVE: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses.
RESEARCH DESIGN: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised.
ETHICAL CONSIDERATIONS: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered.
FINDINGS: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress.
DISCUSSION AND CONCLUSION: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.
METHODS: This was a cross-sectional validation study among 159 T2DM patients attending a public primary care clinic in Selangor. The DMOQ English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using Exploratory Factor Analysis, internal consistency and testretest reliability.
RESULTS: The DMOQ domains were conceptually equivalent between English and Malay language. A total of 13 items and two domains were removed during the validation process (three items during the content validation, three items due to poor factor loadings, five items as they loaded onto two domains which were not interpretable, one item as it did not fit conceptually into the factor it loaded onto and one openended question as it did not fit into the retained domains). Therefore, the final DMOQ Malay version consisted of 21- items within five domains. The Cronbach alpha was 0.714 and the intraclass-correlation coefficient was 0.868.
CONCLUSION: The DMOQ Malay version is a valid and reliable tool which is consistent over time. It can be used to examine the perception of T2DM patients towards the risk of their offspring developing diabetes and possibility of intervention in Malay-speaking patients.
METHODS: We analysed data from the previously published, cross-sectional, WONDERS study and used linear regression models to adjust for potential confounding variables. Based on equivalence clinical trial methods, measurement equivalence was assessed by comparing 90% confidence interval (CI) of differences in scores across language versions with a predefined equivalence margin of 0.3 SD. Equivalence was achieved if the 90% CI fell within 0.3 SD. Data from 1203 participants, aged above 21 years, were analysed.
RESULTS: Participants who completed the different language versions of WHOQOL-BREF expectedly differed in age, ethnicity, highest education level, marital status, smoking status and Body Mass Index (BMI). The English and Malay language versions were definitely equivalent for all domains. The English and Chinese language versions were definitely equivalent for physical and environmental domains but inconclusive for psychological and social domains. Likewise, for Chinese and Malay versions.
CONCLUSION: The English, Chinese and Malay language versions of the WHOQOL-BREF questionnaire may be considered equivalent, with evidence being more robust for some domains than the others. Given the large number of people who speak/ read Chinese and Malay, this study has widespread relevance.
DESIGN: Descriptive, cross-sectional survey.
METHODS: The research method employed in this study is characterized as a methodological study. Self-reported survey data were collected among community-dwelling older adults with chronic diseases residing in suburban counties in China. Including the following psychometric characteristics, item analysis was performed using the decision value method and Pearson's correlation analysis. Content validity was assessed through expert panel evaluation. The internal consistency of the questionnaire was determined by calculating Cronbach's alpha coefficient and corrected item-total correlation. Additionally, confirmatory factor analysis (CFA) was utilized to assess the construct validity of the ACPRS-C.
RESULTS: A total of 228 older adults participated in this psychometric study from August to October 2023. The item content validity index ranged from 0.80 to 1.00, while the scale content validity index was 0.945. The scale demonstrated excellent internal consistency (Cronbach's alpha = 0.931), and the correlation between items and total score was satisfactory. The structural validity was deemed robust (CFA model fit: chi-square/df = 1.121, comparative fit index = 0.992).
CONCLUSION: The ACPRS-C is a scale with strong psychometric properties to assess the ACP readiness within the context of community-dwelling older adults with chronic diseases residing in suburban counties in China. Its reliability and validity hold considerable significance for both research and clinical practice.
METHODS: A total of 218 undergraduate medical students at the Health Campus, Universiti Sains Malaysia, participated in a cross-sectional study that involved an online survey. Environmental factor scales were assessed with the nine-item lighting, noise, and temperature (LNT) scale and the six-item technology scale. Analysis was performed using confirmatory factor analysis (CFA).
RESULTS: The English version of the LNT scale with nine items and three factors showed a good fit to the data, with no item deleted. For LNT, the composite reliability (CR) was 0.81, 0.81, and 0.84, respectively, while the average variance extracted (AVE) was 0.61, 0.59, and 0.6, respectively. The English version of the technology scale, with six items and one factor, also showed a good fit to the data, with no item deleted. The CR was 0.84, and the AVE was 0.51.
CONCLUSIONS: The results provide psychometric evidence for environmental questionnaire scales in evaluating the factors associated with online learning among Malaysian university medical students. All items were retained and confirmed to fit the sample data.
METHODS: In a cross-sectional study, the Malay version of the Perceived Stress Scale (PSS) was administered to 227 caregivers of children with ASD. The caregivers were recruited from ASD databases in four tertiary hospitals in Kelantan and a meeting was set up during the child's follow-up in the clinic. Multiple linear regression analyses were applied to determine the predictors of perceived stress.
RESULTS: The mean total perceived stress score was 20.84 (4.72). This was considered higher than average. Higher perceived stress was significantly predicted among caregivers who live far from the health institution, caregivers who do not own transportation to bring the child to the treatment center, and caregivers who have an ASD child with a learning disability.
CONCLUSION: Caregivers of an ASD child perceived significant stress while taking care of their children. Institutions should alleviate the factors that were predicted to increase the caregivers' perceived stress to improve the quality of the lives of children and ASD families as a whole.
EVIDENCE ACQUISITION: Qualitative research can better assess human sufferings such as in the case of DAI trauma. While quantitative research can measure many psychometric parameters to assess some aspects of trauma conditions, qualitative research is able to fully reveal the meaning, ramification and experience of TBI trauma. Both care giving and rehabilitation are overwhelmingly demanding; hence , they may complicate the caregivers' stress. However, some positive outcomes also exist.
RESULTS: Caregivers involved in caring and rehabilitation of TBI victims may become mentally traumatized. Posttraumatic recovery of the TBI survivor can enhance the entire family's closeness and bonding as well as improve the mental status of the caregiver.
CONCLUSIONS: A long-term longitudinal study encompassing integrated research is needed to fully understand the traumatic experiences of caregivers. Unless research on TBI or DAI trauma is given its proper attention, the burden of trauma and injury on societies will continue to exacerbate globally.
METHODS: In this cross sectional study, the Malay version of SAQLI was administered to 82 OSA patients seen at the OSA Clinic, Hospital Universiti Sains Malaysia prior to their treatment. Additionally, the patients were asked to complete the Malay version of Medical Outcomes Study Short Form (SF-36). Twenty-three patients completed the Malay version of SAQLI again after 1-2 weeks to assess its reliability.
RESULTS: Initial factor analysis of the 40-item Malay version of SAQLI resulted in four factors with eigenvalues >1. All items had factor loadings >0.5 but one of the factors was unstable with only two items. However, both items were maintained due to their high communalities and the analysis was repeated with a forced three factor solution. Variance accounted by the three factors was 78.17% with 9-18 items per factor. All items had primary loadings over 0.5 although the loadings were inconsistent with the proposed construct. The Cronbach's alpha values were very high for all domains, >0.90. The instrument was able to discriminate between patients with mild or moderate and severe OSA. The Malay version of SAQLI correlated positively with the SF-36. The intraclass correlation coefficients for all domains were >0.90.
CONCLUSIONS: In light of these preliminary observations, we concluded that the Malay version of SAQLI has a high degree of internal consistency and concurrent validity albeit demonstrating a slightly different construct than the original version. The responsiveness of the questionnaire to changes in health-related quality of life following OSA treatment is yet to be determined.
METHODS: This is a cross-sectional study from 4 primary care clinics where 240 patients aged >60 years and their caregivers were enrolled. Patients were assigned to a nurse or a health care assistant (HCA) for 2 separate PFFS-M assessments administered by HCPs of the same profession, as well as by a doctor during the first visit (inter-rater reliability). Patients were also administered the Self-Assessed Report of Personal Capacity & Healthy Ageing (SEARCH) tool, a 40-item frailty index, by a research officer. The correlation between patients' PFFS-M scores and SEARCH tool scores determined convergent validity. Patients returned 1 week later for PFFS-M reassessment by the same HCPs (test-retest reliability). Caregivers completed the PFFS-M for the patient at both clinic visits. Classification cut-points for the PFFS-M were derived against frailty categories defined through the SEARCH tool.
RESULTS: The inter-rater (intraclass correlation coefficient [ICC] = 0.92 [95% CI, 0.90-0.93)] and test-retest (ICC = 0.94 [95% CI, 0.92-0.95]) reliability between all raters was excellent, including by patients' education levels. The convergent validity was moderate (r = 0.637, p < 0.001), including for varying educational background. PFFS-M categories were identified as: 0-3, no frailty; 4-5, at risk of frailty; 6-8, mild frailty; 9-12, moderate frailty; and >13, severe frailty.
CONCLUSION: PFFS-M is a reliable and valid tool with frailty severity scores now established for use of this tool in primary care clinics.