Assessment of the dimensionality of the Wijma delivery expectancy/experience questionnaire using factor analysis and Rasch analysis

Background: Fear of childbirth has negative consequences for a woman's physical and emotional wellbeing. The most commonly used measurement tool for childbirth fear is the Wijma Delivery Expectancy Questionnaire (WDEQ-A). Although originally conceptualized as unidimensional, subsequent investigations have suggested it is multidimensional. This study aimed to undertake a detailed psychometric assessment of the WDEQ-A; exploring the dimensionality and identifying possible subscales that may have clinical and research utility. Methods: WDEQ-A was administered to a sample of 1410 Australian women in mid-pregnancy. The dimensionality of WDEQ-A was explored using exploratory (EFA) and confirmatory factor analysis (CFA), and Rasch analysis. Results: EFA identified a four factor solution. CFA failed to support the unidimensional structure of the original WDEQ-A, but confirmed the four factor solution identified by EFA. Rasch analysis was used to refine the four subscales (Negative emotions: five items; Lack of positive emotions: five items; Social isolation: four items; Moment of birth: three items). Each WDEQ-A Revised subscale showed good fit to the Rasch model and adequate internal consistency reliability. The correlation between Negative emotions and Lack of positive emotions was strong, however Moment of birth and Social isolation showed much lower intercorrelations, suggesting they should not be added to create a total score. Conclusion: This study supports the findings of other investigations that suggest the WDEQ-A is multidimensional and should not be used in its original form. The WDEQ-A Revised may provide researchers with a more refined, psychometrically sound tool to explore the differential impact of aspects of childbirth fear.Full Tex

Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review

Background: Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of “active” technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. Objective: This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. Methods: A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. Results: A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. Conclusions: Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding of gamification features on adherence and engagement in order to inform the design of future Web-based health interventions in which adherence to treatment is of concern. Conclusions were limited by varied reporting of adherence and usage dat

Green supply chain management – food for thought?

This paper investigates the impact of green supply chain management (GSCM) practices on the performance of UK food retail small and medium-sized enterprises (SMEs). A quantitative approach using a non-probability sampling of 84 participants was employed. Based on the literature review, five hypotheses were developed and tested using the partial least square-structural equation modeling (SEM-Smart PLS 2.03) approach. The reviewed literature revealed that key internal drivers (ID) and external pressures (EP) stimulate organizations to initiate GSCM practices in UK food retail SMEs. Though empirical findings strongly supported the statement that ID influence GSCM practices, they did not show a significant relationship between EP and GSCM practices. Literature also suggests that practicing GSCM can help improve the efficiency, brand image (BI) and profitability, and thus improve the overall firm performance which is also empirically proved. This study helps enrich existing theories on SCM and organizational performance. As to practical impact, this study should facilitate SMEs in GSCM practices and thus help green the economy. While the findings of this study have limited generalisability as the data were collected from UK SMEs only and the sample size was comparatively small, this research establishes a foundation for further study in this domain

Effort-reward imbalance and burnout among humanitarian aid workers

Objectives: This study examined stress-related working conditions – defined in terms of effort-reward imbalance (ERI) – and its association with burnout among a large, international sample of humanitarian aid workers. Methods: Descriptive statistics were applied on crosssectional survey data (N=1,980) to profile ERI and burnout and Pearson’s χ 2 tests used to characterize associated socio- and occupational-demographic factors. Associations between ERI and burnout were established using binary logistic regression to generate odds ratios and 95% confidence intervals adjusted for potential confounding variables. Results: For high emotional exhaustion, the prevalence rate was 36% for women and 27% for men; high depersonalisation, 9% and 10%; and low personal achievement, 47% and 31%. Intermediate and high ERI was associated with significantly increased odds of high emotional exhaustion, with mixed findings for depersonalisation and personal achievement. Conclusions: The ERI model was supported as a useful framework for investigating occupational correlates of burnout

Examining the moderating effect of individual-level cultural values on users’ acceptance of E-learning in developing countries: a structural equation modeling of an extended technology acceptance model

In this study, we examine the effects of individual-level culture on the adoption and acceptance of e-learning tools by students in Lebanon using a theoretical framework based on the Technology Acceptance Model (TAM). To overcome possible limitations of using TAM in developing countries, we extend TAM to include subjective norms (SN) and quality of work life constructs as additional constructs and a number of cultural variables as moderators. The four cultural dimensions of masculinity/femininity (MF), individualism/collectivism, power distance and uncertainty avoidance were measured at the individual level to enable them to be integrated into the extended TAM as moderators and a research model was developed based on previous literature. To test the hypothesised model, data were collected from 569 undergraduate and postgraduate students using e-learning tools in Lebanon via questionnaire. The collected data were analysed using the structural equation modelling technique in conjunction with multi-group analysis. As hypothesised, the results of the study revealed perceived usefulness (PU), perceived ease of use (PEOU), SN and quality of work life to be significant determinants of students’ behavioural intention (BI) towards e-learning. The empirical results also demonstrated that the relationship between SN and BI was particularly sensitive to differences in individual-cultural values, with significant moderating effects observed for all four of the cultural dimensions studied. Some moderating effects of culture were also found for both PU and PEOU, however, contrary to expectations the effect of quality of work life was not found to be moderated by MF as some previous authors have predicted. The implications of these results to both theory and practice are explored in the paper

Rasch analysis of the Multiple Sclerosis Impact Scale (MSIS-29)

<p>Abstract</p> <p>Background</p> <p>Multiple Sclerosis (MS) is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29) is a disease-specific health-related quality of life (HRQoL) instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) impact of MS. Although previous studies have found support for the psychometric properties of the MSIS-29 using traditional methods of scale evaluation, the scale has not been subjected to a detailed Rasch analysis. Therefore, the objective of this study was to use Rasch analysis to assess the internal validity of the scale, and its response format, item fit, targeting, internal consistency and dimensionality.</p> <p>Methods</p> <p>Ninety-two persons with definite MS residing in the community were recruited from a tertiary hospital database. Patients completed the MSIS-29 as part of a larger study. Rasch analysis was undertaken to assess the psychometric properties of the MSIS-29.</p> <p>Results</p> <p>Rasch analysis showed overall support for the psychometric properties of the two MSIS-29 subscales, however it was necessary to reduce the response format of the MSIS-29-PHYS to a 3-point response scale. Both subscales were unidimensional, had good internal consistency, and were free from item bias for sex and age. Dimensionality testing indicated it was not appropriate to combine the two subscales to form a total MSIS score.</p> <p>Conclusion</p> <p>In this first study to use Rasch analysis to fully assess the psychometric properties of the MSIS-29 support was found for the two subscales but not for the use of the total scale. Further use of Rasch analysis on the MSIS-29 in larger and broader samples is recommended to confirm these findings.</p

Including personal development in palliative care education to address death anxiety

Background: Death anxiety may interfere with health care workers' (HCW) relationship with patients and their families. Aims: Evaluate an intervention to address death anxiety and improve HCW skills dealing with patients/families in palliative and end-of-life care. Design: Quasi-experimental mixed methods approach with a pre-test/post-test design. Participants: 208 HCWs receiving the intervention and working in end-of-life care, in and out of palliative care units, were invited to answer quantitative and qualitative questionnaires. In the end, 150 returned with quantitative answers and of these, 94 with qualitative answers as well. Additionally, out of the 150 participants, 26 were recruited for interview. Results: Pre-and post-test results revealed a significant reduction in levels of death anxiety, an increase in existential wellbeing, and a significant improvement in HCWs' perception of the quality of their helping relationship skills with patients/families. Content analysis provided an understanding of the difficulties experienced by the HCWs and the positive impact of the intervention. Conclusion: An intervention to address death anxiety and help relationship skills can reduce the use of avoidance mechanisms and improve HCW self-perceived psycho-existential support to patients/families