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Original Articles
Scale Development and Model Validation for the Process of Exercise Engagement for People with Prediabetes
Chang, Shu-Chuan , Yeh, Hsiu-Chen , Kuo, Yu-Lun
J Korean Acad Nurs 2020;50(2):298-312.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.298
AbstractAbstract PDF
Purpose
This study had two objectives: 1) to develop a scale for the process of exercise engagement (SPEE) for prediabetic individuals (PDIs); 2) to validate a structural model for the process of exercise engagement for PDIs.
Methods
A cross-sectional survey with simple random sampling was conducted from September 2013 to December 2015 (in Taiwan). A total of 310 PDIs were enrolled for scale development and model validation via item analysis, factor analyses, and structural equation modeling. The Kuo model was used as the basis for developing the Chinese version of the SPEE for PDIs.
Results
The SPEE contains five subscales with a total of twenty-one items that account for 54.9% to 65.9% of the total variance explained for assessing participants’ process of engagement during exercise. For Kuo model validation, the model measures indicated goodness of fit between the Kuo model and sample data. Analysis further revealed a direct effect between the creating health blueprints (CHB) stage and the spontaneous regular exercise (SRE) stage (b=.60).
Conclusion
The SPEE includes five subscales for assessing the psychological transition and behavioral expression at each stage of the process of exercise engagement for PDIs. The SPEE for people with prediabetes provides deeper insights into the factors of behavioral change stages that are required to initiate long-term health care outcomes and avoid developing diabetes. These insights are significant as they allow for patient- specific mapping and behavior modification to effect exercise.
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Development of a Korean Geriatric Suicidal Risk Scale (KGSRS)
Sang Ju Lee, Jung Soon Kim
J Korean Acad Nurs 2016;46(1):59-68.   Published online February 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.1.59
AbstractAbstract PDF
Purpose

Increase in suicide rate for senior citizens which has become widespread in our society today. It is not a normal social phenomenon and is beyond the danger level. The contents of this study include Korean senior citizens' suicide related risk factors and warning signs, and the development of a simple Geriatric Suicide Risk Scale.

Methods

This study is Methodological Research to verify reliability and validity of the Geriatric Suicide Risk Scale according to the tool development process suggested by Devellis (2012).

Results

For predictive validity assessment, high suicide screening accuracy was showed with an Area under the ROC curve (AUC) of .93. For the optimal cutoff point of 11, sensitivity was 93.9%, and specificity, 75.7% which are excellence levels. Cross validity for assessment of generalization possibility showed the Area under the ROC curve (AUC) as .82 and in case of a cutoff point of 11, sensitivity was 73.7%, and specificity, 65.9%.

Conclusion

When it comes to practical nursing, it is significant that the Korean Geriatric Suicide Risk Scale has high reliability and validity through adequate tool development and the tool assessment step to select degree of suicide risk of senior citizens. Also, it can be easily applied and does not take a long time to administer. Further, it can be used by health care personnel or the general public.

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Cross-cultural Validation of Instruments Measuring Health Beliefs about Colorectal Cancer Screening among Korean Americans
Shin-Young Lee, Eunice E. Lee
J Korean Acad Nurs 2015;45(1):129-138.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.129
AbstractAbstract PDF
Purpose

The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization.

Methods

Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis.

Results

The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales.

Conclusion

Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.

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Development of a Coping Scale for Families of Patients with Schizophrenia
Ji Min Seo, Eun Kyung Byun, Kyung Yeon Park, So Hee Kim
J Korean Acad Nurs 2012;42(5):738-748.   Published online October 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.5.738
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and evaluate a coping scale for families of patients with schizophrenia(CSFPS).

Methods

Item construction was derived from literature reviews and interviews with family members and psychiatric nurses. Content validity was tested by experts. Each item was scored on a four-point Likert scale. The preliminary questionnaire was administered to 188 family members of patients with schizophrenia. The data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's alpha.

Results

From the factor analysis, 32 items in five factors were derived. The factors were named active coping strategies, avoidance coping strategies, hospital treatment-oriented coping strategies, emotional coping strategies, and suppressive coping strategies for problematic behaviors. The five factors explained 49.7% of the total variance, Cronbach's alpha of the total items was .83 and the factors ranged from .66 to .86.

Conclusion

The results of this study suggest that CSFPS is a reliable and valid instrument to measure coping in families of patients with schizophrenia.

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Development and Psychometric Evaluation of a Scale to Measure Health Behaviors of Adolescents
Yun Hee Shin
J Korean Acad Nurs 2010;40(6):820-830.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.820
AbstractAbstract PDF
Purpose

The purpose was to develop a preliminary scale to measure Korean adolescents' health behaviors through a qualitative approach, to evaluate the scale psychometrically, and to develop a final scale.

Methods

Participants were 61 adolescents for qualitative interviews and 1,687 adolescents for the psychometric evaluation. Procedure included content analysis of interviews to identify health behavior categories for Korean adolescents, pre-test to confirm that preliminary scale items were understandable, content validity by an expert panel, development of the web-based computer-assisted survey (CAS), and psychometric analysis to determine reliability and validity of the final scale.

Results

A final scale was developed for both paper-and-pencil and CAS. It consisted of 14 health behaviors (72 items), including stress and mental health (10), sleep habits (5), dietary habits (12), weight control (4), physical activity (4), hygiene habits (5), tobacco use (5), substance use (2), alcohol consumption (4), safety (4), sexual behavior (9), computer use (3), health screening (4), and posture (1).

Conclusion

The scale's strong points are: 1) Two thirds of the final scale items are Likert scale items, enabling calculation of a health behavior score. 2) The scale is appropriate to Korean culture. 3) The scale focuses on concrete health behaviors, not abstract concepts.

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