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.

Evaluation of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada's Food Guide 2019 recommendations on healthy food choices

The objective of this study was to evaluate the construct validity and reliability of the Healthy Eating Food Index-2019 (HEFI-2019), which was developed to measure adherence to Canada’s Food Guide 2019 (CFG) recommendations on healthy food choices. Dietary intake data from 24-hour dietary recalls in the 2015 Canadian Community Health Survey - Nutrition were used for that purpose. Multidimensionality was examined using principal component analysis. Mean scores were compared among subgroups of the population. The association between scores and energy intake was assessed using Pearson correlations. Cronbach’s alpha was calculated to assess reliability. The estimated mean HEFI-2019 score (/80) was 43.1 (95%CI, 42.7 to 43.6) among Canadians 2 years and older. The first and 99th percentiles were 22.1 and 62.9 points. The mean HEFI-2019 score for smokers was 7.1 points lower than for non-smokers (95%CI, -8.4 to -5.8). The HEFI-2019 was weakly correlated with energy intake (r=-0.13; 95%CI, -0.20 to -0.06). The principal components analysis revealed at least 4 dimensions. Cronbach’s alpha was 0.66 (95%CI, 0.63 to 0.69). Evidence of construct validity and internal consistency support the use of the HEFI-2019 to assess adherence to CFG-2019’s recommendations on healthy food choices. Novelty: • Examination of the Health Eating Food Index (HEFI)-2019’s psychometric properties is needed prior to implementation • Analyses support the construct validity and internal consistency of the HEFI-2019 • Interpretation of the total HEFI-2019 score must be accompanied by its components’ scores, considering it assesses multiple dimensions of food choices

Coping with pain: Polish versions of the Pain Coping Questionnaire for both children and parents

Aim: This article presents the cultural adaptation and evaluation of the psychometric properties of the Polish versions of the Pain Coping Questionnaire for both children and parents. Materials & methods: The study involved children aged 12–17 years (n = 220), who experienced trauma-related pain, and their parents (n = 220). Results: In the questionnaire for children and parents, the Kaisera-Mayera-Olkina (KMO) measure of sample adequacy was 0.457 and 0.455, whereas Bartlett’s test of sphericity: Chi-square = 1523.93, p < 0.001 and Chi-square = 1325.31, p < 0.001, returned a statistically significant result. Cronbach’s alpha for the factors identified in both groups was between 0.833 and 0.904. Conclusion: The linguistic adaptation has shown that the Polish version of the Pain Coping Questionnaire meets the psychometric criteria for reliability and accuracy of the tool.

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.

A school-based educational on-site vaccination intervention for adolescents in an urban area in Germany: feasibility and psychometric properties of instruments in a pilot study

Background Vaccination rates for measles, mumps, and rubella (MMR) and diphtheria, tetanus, pertussis, and polio (Tdap-IPV) are not optimal among German adolescents. Education in combination with easy access to vaccination may be a promising approach to improve vaccination rates. The present paper describes a pilot study of a planned cluster randomized controlled trial (cRCT) in which we aim to improve MMR and Tdap-IPV vaccination rates together with knowledge and self-efficacy in a school setting. Methods The study covered 863 students from 41 classes of four schools. The optimization and feasibility of access to schools, recruitment strategies, intervention, and assessment procedures were examined. The course and content of the educational unit were evaluated with a mixed-methods approach. A pre-post measurement design was tested for the vaccination rate in all schools. Additionally, at two schools, improvement in vaccination-related knowledge and perceived self-efficacy were measured by questionnaire pre-educational unit (n=287) and post-educational unit (n=293). The remaining two schools provided only postintervention data. Finally, we evaluated the psychometric properties (i.e., reliability, retest reliability, and change rates) of the questionnaire, applying Cronbach’s alpha, factor analyses, generalized estimating equations and linear mixed models. Results The findings of the pilot study indicated good feasibility. Of the total sample, 437 students (50.9%) brought their vaccination cards to school, 68 students received Tdap-IPV vaccinations, and 11 received MMR vaccinations. Out of six knowledge questions, on average, the students had M=2.84 (95% CI [2.69, 3.10]) correct answers before and M=4.45 (95% CI [4.26, 4.64]) after the class. Ranging from 1 to 4, the self-efficacy scale changed by 0.3 points (p <.001); Cronbach’s alpha was 0.67 and 0.76 pre- and post-educational unit, respectively, and a one-factor solution was found. Content analysis of the five semistructured group interviews (n=12, 58.3% female) showed that all students found the length of the intervention to be appropriate. The teaching methods, including interactive and social media components, were perceived as very good. Conclusions A school-based educational and on-site vaccination intervention appears to be feasible in terms of procedures and the adequacy of the instruments for the adolescent target group. Trial registration ISRCTN, ISRCTN18026662. Pilot study for main trial registered 8 December 2017.

Development and Validation of a Knowledge, Attitude and Practice Questionnaire on Antibiotic Use in Arabic and French Languages in Lebanon

Objectives: Validated knowledge–attitude–practice (KAP) questionnaires are essential to design and evaluate intervention programs on antibiotic use. Recently, we validated the first KAP questionnaire on antibiotics in Spain. Cross-cultural adaptation and validation of research tools increase their universal usefulness. Here, we aimed to validate the questionnaire in a developing country with different socioeconomic characteristics from that of Spain. Methods: We translated the previously developed KAP-questionnaire into Arabic and French, tailored it and then validated it in adult population in Lebanon. The item content validity index (I-CVI), scale content validity index (S-CVI/Ave) and modified Kappa (k*) were calculated. The construct validity of the questionnaire was evaluated using confirmatory factorial analysis (CFA, N = 1460) and its reliability was assessed using intraclass correlation coefficients (ICC, N = 100) and Cronbach’s alpha statistic. Results: ICV-I (>0.78), k* (equal to ICV-I for all items) and S-CVI/Ave (≥0.95) confirmed the questionnaire content validity. Pilot testing (N = 40) and face validity showed the understandability of the questionnaire by the population. Test–retest reliability analysis (N = 100) yielded ICC ≥ 0.59 for all knowledge and attitude items, showing the capacity of the questionnaire to generate reproducible results. CFA evidenced adequate fit of the chosen model, thus establishing the construct validity of the questionnaire (root mean squared error approximation = 0.053, standardized root mean square residual = 0.045, comparative fit index = 0.92 and Tucker–Lewis index = 0.90). The questionnaire showed an acceptable internal reliability (Cronbach’s alpha = 0.62) and was highly accepted in Lebanon (response rate = 96% and item response rates ≥ 94%). Conclusions: The validity of the KAP-questionnaire on antibiotics in Arabic and French was demonstrated in Lebanon.

Sự tự tin của bà mẹ trong việc phòng chống bệnh tiêu chảy ở trẻ dưới 5 tuổi tại Bệnh viện Trường Đại học Y-Dược Huế

Mục tiêu: Mô tả mức độ tự tin của bà mẹ trong việc phòng chống bệnh tiêu chảy ở trẻ dưới 5 tuổi và tìm hiểu một số yếu tố ảnh hưởng đến sự tự tin của bà mẹ tại Bệnh viện Trường Đại học Y Dược Huế. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 113 bà mẹ có con dưới 5 tuổi bị tiêu chảy tại Bệnh viện trường Đại học Y Dược Huế. Phương pháp chọn mẫu thuận tiện được sử dụng để thu thập số liệu trong thời gian từ 10/2019 đến 04/2020. Công cụ nghiên cứu bao gồm bộ câu hỏi nhân khẩu học và bộ câu hỏi đánh giá mức độ tự tin của bà mẹ trong việc phòng ngừa bệnh tiêu chảy ở trẻ em của Joventino, chỉ số Cronbach’s alpha trong nghiên cứu hiện tại là 0,827. Số liệu được phân tích trên phần mềm SPSS 20.0. Kết quả: 92,9% bà mẹ có mức độ tự tin thấp, 7,1% bà mẹ có mức độ tự tin trung bình, không có bà mẹ nào ở mức tự tin cao trong việc phòng chống bệnh tiêu chảy của trẻ dưới 5 tuổi. Có mối liên quan có ý nghĩa thống kê giữa địa cư, nghề nghiệp, trình độ học vấn của bà mẹ, nguồn nước sinh hoạt của gia đình, tình trạng học hành của trẻ với mức độ tự tin của bà mẹ trong phòng chống bệnh tiêu chảy (p < 0,05). Kết luận: Điều dưỡng viên trong nhóm chăm sóc đa ngành cần có can thiệp để nâng cao mức độ tự tin của bà mẹ trong việc phòng và chăm sóc trẻ tiêu chảy.

Study of risk factors for healthcare-associated infections in acute cardiac patients using categorical principal component analysis (CATPCA)

Using categorical principal component analysis, we aimed to determine the relationship between health care-associated infections (HAIs) and diagnostic categories (DCs) in patients with acute heart disease using data collected in the Spanish prospective ENVIN-HELICS intensive care registry over a 10-year period (2005–2015). A total of 69,876 admissions were included, of which 5597 developed HAIs. Two 2-component CATPCA models were developed. In the first model, all cases were included; the first component was determined by the duration of the invasive devices, the ICU stay, the APACHE II score and the HAIs; the second component was determined by the type of admission (medical or surgical) and by the DCs. No clear association between DCs and HAIs was found. Cronbach’s alpha was 0.899, and the variance accounted for (VAF) was 52.5%. The second model included only admissions that developed HAIs; the first component was determined by the duration of the invasive devices and the ICU stay; the second component was determined by the inflammatory response, the mortality in the ICU and the HAIs. Cronbach’s alpha value was 0.855, and VAF was 46.9%. These findings highlight the role of exposure to invasive devices in the development of HAIS in patients with acute heart disease.

Reliability analysis and hypothesis testing of critical success factors of total productive maintenance

PurposeThis paper deals with concept of total productive maintenance (TPM) and its implementation approach. It also presents the identification of critical factors for effective implementation of TPM. The reliability analysis identified potential areas where more concentration is required. The application of hypothesis testing in productivity maintenance should be promoted by parametric test and significantly instrumental in explanation of phenomena. It is also indispensable to better understand quality data and provide guidance to production control.Design/methodology/approachThe various critical success factors of TPM implementation has organised into set of eight performance measure and thirty three sub-factors for getting the in-depth details of each indicator. The paper identifies the reliability of these factors and understands the problem with greater clarity and its ramification. Researcher collected responses from forty one manufacturing organisations through structured designed questionnaire. The reliability analysis was carriedout by calculating the value of Cronbach's alpha method. To draw the meaningful conclusions supported by relevant empirical data, provisional formulation is required, and it was carried by hypothesis testing. In this test, samples are taken from a population with known distribution (normal distribution), and a test of population parameters is executed. It determines the relevancy of facts directs the researcher's efforts into productive channels. The statements were hypothetically tested by calculating the arithmetic value of Chi-Square (χ2) and MINITAB-19 software was used for identification of p-value.FindingsThis study identified that main factors and sub-factors of TPM which are critical for implementation of TPM. The study also avoids the complexities involved in implementing TPM by reliability analysis. It is found that all identified CSFs are reliable as Cronbach's alpha is above 0.6. The hypothesis testing shows that all alternative hypothesis statements are acceptable as Chi-Square (χ2) value has satisfied the conditions and null hypothesis are true as calculated p-value is less than the 0.05 for eight identified TPM critical factor.Originality/valueIn this paper researcher provides a comprehensive typology of TPM-CSFs, and its ranking and importance in manufacturing sector. The preparedness of such study related to TPM implementation is becoming a major sourcing base for the world and there is a paucity of such studies. Such studies are equally important in a global context.

Perception, Attitude, and Confidence of Physicians About Antimicrobial Resistance and Antimicrobial Prescribing Among COVID-19 Patients: A Cross-Sectional Study From Punjab, Pakistan

Background: Patients with coronavirus disease 2019 (COVID-19) could experience multiple coinfections, and judicial antimicrobials, including antibiotics, is paramount to treat these coinfections. This study evaluated physicians’ perception, attitude, and confidence about antimicrobial resistance (AMR) and antimicrobial prescribing in patients with COVID-19.Methods: A self-administered and validated online questionnaire comprised of six sections was disseminated among physicians working in public sector hospitals in Punjab, Pakistan, using the convenience sampling method from April to May 2021. The study also assessed the validity and reliability of the study questionnaire using exploratory factor analysis and Cronbach’s alpha. In addition, the descriptive and inferential statistics present survey results.Results: A total of 387 physicians participated in this study. The study showed that the questionnaire demonstrated good internal consistency (Cronbach’s alpha = 0.77). Most physicians (n = 221, 57.1%) believed that AMR is a considerable problem in Pakistan. Less than a quarter of respondents (n = 91, 23.5%) consulted with local antibiotic resistance data to prescribe antibiotics in COVID-19 patients. However, the respondents were confident to select a suitable antibiotic (n = 229, 59.2%). More than three-quarters of the respondents believed that advice from a senior colleague (n = 336, 86.8%), infectious disease (ID) physician (n = 315, 81.4%), and implementing antimicrobial stewardship programs (ASPs) could facilitate appropriate prescribing of antibiotics in COVID-19 patients. Multivariate logistic regression revealed that physicians with more than 10 years of experience had higher odds of consulting local guidelines for antibiotic therapy (OR, 4.71 95% CI: 1.62–13.73, p = 0.004) than physicians with less than 5 years of experience. Similar trends were found for consulting national guidelines and local resistance data to select an empiric antibiotic therapy.Conclusion: AMR-related awareness was optimal among physicians. Only a few physicians looked up local antibiotic resistance data before prescribing antibiotics to COVID-19 patients empirically. The significant approaches advised by physicians to reduce AMR risk among COVID-19 patients were the implementation of ASPs combined with advice from ID physicians.