Translation, Reliability and Validity of the Chinese Version of the Confidence in Dementia Scale for Clinical Nursing: A Cross-Sectional Study.

To translate the 9-item Confidence in Dementia (CODE) scale into Chinese (Confidence in Dementia-Chinese, CODE-C) and evaluate its psychometric properties among clinical nurses. With the rapidly ageing population, an increasing number of patients with dementia will be cared for in hospitals. Clinical nurses' confidence in dementia care is crucial to provide quality care. A reliable and valid assessment tool is urgently needed to measure confidence in dementia and identify educational needs in hospitals. The CODE applies to other societies, and this study aims to standardise this scale for China. This was a cross-sectional study. Following the principles of Brislin bidirectional translation, literal translation, back-translation, expert consultation, cognitive debriefing and preliminary testing were performed, and the CODE-C was preliminarily revised. Internal consistency and test-retest reliabilities with a 2-week interval were tested, and an item analysis was conducted using the Pearson correlation coefficient method. Validity was evaluated, including content, construct, convergent, discriminant and criterion validity. A total of 452 Chinese-speaking nurses from three hospitals in Jinan, China, completed the survey. The scores of each item and the total score of the CODE-C were positively correlated (r = 0.626-0.802, p < 0.05). The difference between the high-score group and the low-score group for each item of the CODE-C was significant (p < 0.05). The Cronbach's α coefficient, Spearman-Brown coefficient and Guttman split-half coefficient of the CODE-C were 0.894, 0.842 and 0.838, respectively, and the test-retest reliability was 0.892. The scale- and item-level content validity indices were both 1.00. The confirmatory factor analysis model only marginally supported the three-factor structure. Positive correlations were noted between the CODE-C and the General Self-Efficacy Scale (r = 0.476, p < 0.01), suggesting acceptable concurrent validity. The CODE-C showed acceptable reliability and validity and can be applied to measure the level of confidence in dementia and the outcome of educational interventions aimed at enhancing dementia care among Chinese clinical nurses. The CODE-C can be used as a valid scale to assess the level of confidence in dementia among clinical nurses and help them recognise and improve their level of dementia care.

Jiang Q ，Li N ，Kong D ，Zhai Y ，Chen H ，Liu J ，Xiao P ，Chen Y ，Pei W ，Song J ... -  《-》

The Turkish validity and reliability of Addenbrooke's Cognitive Examination III.

Addenbrooke's Cognitive Examination III (ACE-III) was developed as a screening tool for cognitive disorders. Many countries have proven the cultural adaptation, reliability and validity of ACE-III. To make cultural adaptations of ACE-III for the Turkish population and to examine its validity and reliability. First, ACE-III was translated and adapted into Turkish (ACE-III-TR), then its validity and reliability were examined. The study included 234 people: 93 with dementia (78 Alzheimer's disease (AD) and 15 frontotemporal dementia (FTD)), 46 with mild cognitive impairment (MCI) and 95 healthy. Two blinded speech and language therapists rated the ACE-III-TR simultaneously for interrater validity. The same practitioner retested the same participants 2 weeks later for test-retest reliability. The construct validity of the culturally adapted test was assessed by analysing subsection correlations with the ACE-III-TR total score. The association between the Mini-Mental State Examination (MMSE) total score, relevant subsections and ACE-III-TR total score was examined for criterion validity. Intergroup differences for healthy, MCI and dementia were studied for ACE-III-TR subsections and total score, and cut-off scores were calculated for total score with sensitivity and specificity in differential diagnosis. Attention, memory and ACE-III-TR total scores showed a statistically significant difference between the three groups of dementia, MCI and healthy (p < 0.001). Statistically significant positive correlations ranging from 0.571 to 0.929 were found between ACE-III-TR subsections and total scores (p < 0.05). A highly significant positive correlation was found between MMSE total score and ACE-III-TR total score (r = 0.870). Between the second and first measurements, positive, moderately significant correlations were found for all subsections and ACE-III-TR total (ICC = 0.508-0.784, r = 0.477-0.646). A high level of agreement was found between two raters for all ACE-III-TR subsections and the ACE-III-TR total score (alpha = 0.9296-0.99995). The total ACE-III-TR cut-off score was 79.5 for healthy and MCI and 69.5 for MCI and mild stage dementia. This study found that ACE-III-TR is a sensitive and specific screening test for the diagnosis of MCI and dementia that has high validity and reliability. ACE-III-TR was found to be a valid and reliable tool in dementia, including AD and FTD, and in mild, moderate and advanced dementia. By providing a more comprehensive assessment of a person's cognitive profile, it can help the clinician make a differential diagnosis of MCI and dementia. ACE-III-TR may be useful in monitoring the progression of cognitive deficits in clinical practice, research studies and therapy follow-up processes. What is already known on the subject ACE was used as a screening tool to detect MCI and to differentiate AD from FTD. ACE was revised by Hsieh et al. in 2013 and updated as ACE-III, which has the advantages of assessing five cognitive domains, not requiring the use of additional materials, and providing an effective and sensitive measurement in a short time. However, the validity and reliability study of the ACE-III in Turkish has not been conducted. What this study adds to the existing knowledge This study demonstrates the validity and reliability of the Turkish ACE-III (ACE-III-TR), which is a sensitive and specific screening test for the diagnosis of MCI and dementia. What are the practical and clinical implications of this work? The ACE-III-TR can provide clinicians and patients with a quick and brief general cognitive screening, indicating both the patient's overall cognitive profile and the measures of each of the assessed domains. By providing a more comprehensive assessment of a person's cognitive profile, it can help the clinician make a differential diagnosis of MCI and dementia. ACE-III-TR may be useful in monitoring the progression of cognitive deficits in clinical practice, research studies and therapy follow-up processes.

Parlak MM ，Bizpınar Munis Ö ，Köse A ，Yıldırım C ，Ülker CA ... -  《-》

Validity and reliability of the revised scale of avoidance and struggle behaviours in stuttering (r-SASBS).

Secondary behaviours, which encompass reactions developed due to an individual's fear and stress about stuttering, have the potential to exacerbate the condition. Therefore, self-evaluation of secondary behaviours is significant in the multidimensional approach for people who stutter (PWS). To determine the validity and reliability of the Revised Scale of Avoidance and Struggle Behaviours in Stuttering (r-SASBS). The results of the item analysis and content validity of the Scale of Avoidance and Struggle Behaviours in Stuttering (SASBS), whose pilot study was completed, were reviewed and the number of items was reduced from 30 to 16. The r-SASBS was administered to 440 participants (PWS = 365; people who did not stutter = 75). The content, construct, discriminant validity, internal consistency and test-retest reliability of the r-SASBS were analysed. Content validity was analysed quantitatively based on expert opinions and was found to be high. The r-SASBS had two factors based on exploratory factor analysis. The number of items was reduced to 14 using confirmatory factor analysis. With discriminant validity, it was found that the r-SASBS could distinguish between the groups. The internal consistency and reliability of the test-retest scores were found to be high. These findings indicated that the r-SASBS is a reliable and valid scale for the self-evaluation of secondary behaviours in PWS. Thus, it can be used by speech-language pathologists for the multidimensional assessment of stuttering. The validity and reliability of the r-SASBS should be investigated in school-aged children who stutter. What is already known on this subject Assessment of secondary behaviours in stuttering can be performed using objective and subjective tools. In this regard, a preliminary study was conducted to evaluate these behaviours, using the SASBS, which was developed based on interviews with PWS and a literature review. This study established the content and structural validity of the assessment and found it to have high internal consistency. What this study adds to the existing knowledge Although secondary behaviour assessments need to be comprehensive, it can be time-consuming in busy clinical settings. Owing to the importance of self-reported secondary behaviours in the assessment of stuttering and the reliability of information obtained from the client, there is a need for scales that can be administered quickly to assess the impact of secondary behaviours in PWS. This study examines the validity and reliability of the r-SASBS. What are the practical and clinical implications of this work? The SASBS was reviewed in this study and the number of items was reduced. The r-SASBS was administered to 440 participants. The validity of the r-SASBS was determined based on its content, discriminant, and construct validity. The reliability of the r-SASBS was determined using internal consistency and test-retest reliability. The results indicate that the r-SASBS is a reliable and valid tool for self-evaluating secondary behaviours in PWS. This could be a valuable measure of secondary behaviours in stuttering, which could improve treatment outcomes.

Hancer H ，Tokgoz-Yilmaz S 《-》

Translation, cross-cultural adaptation, and validation of the Spanish Evidence-Based Practice Confidence (EPIC) scale in occupational therapy students and professionals.

Assessing self-efficacy in evidence-based practice (EBP) is crucial for identifying training needs, evaluating the effectiveness of educational programs, and assessing the overall application confidence of EBP in healthcare professions, including occupational therapy (OT). Thus, the objectives of this study were to cross-culturally adapt the Evidence-Based Practice Confidence Scale (EPIC) for Spanish-speaking OT students and professionals and to evaluate its internal consistency, test-retest reliability, and construct validity. A professional translation and cross-cultural adaptation of the EPIC was developed, including a pilot study that resulted in the EPIC Spanish version. A total of 260 OT students and 202 professionals completed the Spanish EPIC at baseline, with 177 (68.1%) students and 129 (63.9%) professionals participating in the test-retest reliability assessment two weeks later. The EPIC's internal consistency was evaluated using Cronbach's alpha. Test-retest reliability was assessed using Spearman's correlations and intra-class correlations (ICC). Known-groups validity hypothesis based on participants' roles (students, diploma/bachelor's, master's, and doctorate) was explored using ANOVA. Finally, an exploratory factor analysis with oblique Promax rotation was conducted to examine the EPIC factor structure. Cronbach's alpha for the total EPIC score was excellent in both OT professionals (α = 0.91) and students (α = 0.90). For OT students, Spearman's correlation was 0.67 (p < 0.001) for the total score, and the ICC was 0.66 (95%CI 0.57-0.73). Conversely, for OT professionals, test-retest reliability showed a Spearman's correlation of 0.87 (p < 0.001) for the total score, and the ICC was 0.87 (95%CI 0.81-0.90). The highest scores were observed in professionals with a doctorate followed by those with a master's degree (p < 0.001). The exploratory factor analysis yielded a 3-factor solution that explained 71% of the observed variance, with item-level loadings ≥ 0.35. The EPIC scale showed excellent internal consistency, strong test-retest reliability, and adequate construct validity for evaluating EBP self-efficacy among Spanish-speaking OT professionals using the total score. However, test-retest reliability was moderate among Spanish-speaking OT students, indicating that changes in EBP confidence assessed with the EPIC scale in this group should be interpreted with caution.

Prieto-Botella D ，Fernández-Álvarez A ，Ferrándiz-Tecles R ，Valiente-Cantero M ，Peral-Gómez P ，Espinosa-Sempere C ，Company-Devesa V ，Pastor-Zaplana JÁ ，Sánchez-Pérez A ，Fernández-Pires P ... -  《BMC Medical Education》

The cultural adaption and validation of the Self-Regulated Learning Perception Scale (SRLPS) and the development of its short version in Chinese medical students.

Self-regulated learning (SRL) is a pivotal skill in the digital era, closely correlating to academic performance and professional development, particularly within medicine, where rapid advancements in knowledge and technology demand continuous learning. The Self-Regulated Learning Perception Scale (SRLPS), validated for reliability and validity, is a critical tool for assessing SRL among medical students. However, its application in Chinese medical education remains largely unexplored. This study aims to adapt the SRLPS for Chinese medical students and to develop a concise version to reduce participant burden and enhance the scale's practicality and generalizability. Two stages of surveys were conducted. In Stage 1, SRLPS was translated into Chinese through forward translation, back translation, and review and then was administered to 339 medical students. To assess the internal reliability and construct validity of the Chinese version of SRLPS, we calculated Cronbach's α values and conducted Confirmatory Factor Analysis (CFA), respectively. According to psychometric performance, some items were removed to create a short version of SRLPS (SRLPS-S). In Stage 2, the SRLPS-S was administered to 736 medical students to verify its reliability and construct validity using Cronbach's α and CFA. Wilcoxon rank-sum tests were used to examine the associations between self-regulated learning perceptions and personal and household characteristics, including gender, maternal education level, and annual household income. The Chinese SRLPS demonstrated acceptable internal consistency reliability and construct validity, although the elevated Cronbach's α indicated possible item redundancy. The SRLPS-S exhibited satisfactory internal consistency reliability and construct validity, confirming the four-domain structure of the original SRLPS. Wilcoxon Rank-sum test showed students' self-regulated learning positively linked to higher maternal education levels, higher annual household income, and male gender. The Chinese SRLPS and its short version are reliable and valid for assessing self-regulated learning. These scales can assist educators in identifying students who might require additional support in their learning strategies and can also be used for personal development. The short version is recommended for its enhanced psychometric properties and greater cost-efficiency.

Xin C ，Cui X ，Song Y ，Zhang R ，Ding N ，Wen D ... -  《BMC Medical Education》