The exploratory sequential mixed-method study proceeded in three phases. In the qualitative phase, researchers conducted semi-structured interviews with 17 mothers, five husbands, and six midwives. Findings from those interviews informed an initial pool of 98 questionnaire items. Researchers subsequently assessed content validity, face validity, construct validity, and reliability, with the psychometric phase reducing the initial item pool to a final questionnaire containing 26 items.

Exploratory factor analysis extracted four factors from the 26-item PSRHQ: spouse abuse, postpartum care, marital problems, and psychological-emotional problems. The instrument had a total Cronbach’s alpha coefficient of 0.899, which the abstract reports as evidence of satisfactory internal consistency, and an intraclass correlation coefficient of 0.846, which provided evidence of test–retest reliability. These results support the preliminary measurement properties of the questionnaire in the study setting, but the abstract does not provide the size or detailed characteristics of the psychometric evaluation sample.

The findings remain preliminary and require further validation before broader use. The abstract identifies confirmatory factor analysis and evaluation of criterion-related, longitudinal, and cross-cultural measurement properties as necessary next steps. Because the supplied evidence consists of the article abstract rather than the complete study report, it does not establish how the instrument performed in populations or settings beyond the population and scope evaluated in the study.

Subject of Research: Preliminary psychometric evaluation of a postpartum sexual and reproductive health questionnaire in Iranian women

Article Title: Development and preliminary psychometric evaluation of the postpartum sexual and reproductive health questionnaire (PSRHQ) in Iranian women

Article References: Rezaei, N., Namazi, M., Sharifi, N., Moghadam, Z. B., Tahmasebi, A., & Taheri, S. (2026). Development and preliminary psychometric evaluation of the postpartum sexual and reproductive health questionnaire (PSRHQ) in Iranian women. Scientific Reports. https://doi.org/10.1038/s41598-026-73330-z

Image Credits: AI Generated

DOI: 10.1038/s41598-026-73330-z

Keywords: postpartum health, questionnaire development, psychometric evaluation, Iranian women, mixed-methods study, reliability, construct validity, exploratory factor analysis, Development, preliminary, psychometric, evaluation

Researchers conducted interviews in 2025 with 217 women who reported experiencing IPV and 183 women who reported no experience of IPV, described in the abstract as non-reporters. The known-groups design was used to develop and test the new scale. Psychometric analyses assessed its structure and internal consistency, while Spearman’s rank correlations examined hypothesized relationships with established IPV stigma scales, IPV severity, psychological maltreatment, community gender norms and beliefs, survivor-blaming attitudes, mental-health symptoms and perceived social support. The abstract reports correlations as associations when they were statistically significant at p < 0.05; it does not establish causal effects.

Among women who reported experiencing IPV, higher BCSI-IPVSS endorsement was statistically significantly associated with greater abuse severity (ρ = 0.16), psychological maltreatment (ρ = 0.26), harmful community gender norms and beliefs (ρ = 0.52), and survivor-blaming attitudes (ρ = 0.41). Greater perceived stigma was also associated with more generalized anxiety (ρ = 0.23), social anxiety (ρ = 0.26), depression (ρ = 0.36), and post-traumatic stress symptoms (ρ = 0.23).

Among non-reporters, scale endorsement was associated with harmful community gender norms and beliefs (ρ = 0.45), survivor-blaming attitudes (ρ = 0.30), generalized anxiety (ρ = 0.22), and lower perceived social support (ρ = −0.25). No statistically significant associations were reported for social anxiety, depression or post-traumatic stress in that group. Across the full analysis, scale scores correlated positively with other IPV stigma scales, with ρ values from 0.24 to 0.40 and p ≤ 0.001. The internal consistency coefficient was ω = 0.859, while the fit indices were RMSEA = 0.055 and TLI = 0.984. The abstract concludes that the scale has acceptable overall psychometric properties for assessing IPV stigma among both groups in Botswana. It also states that further investigation is needed to examine relationships among experienced IPV stigma, stigmatizing beliefs and poor mental health. Because the available evidence is limited to the abstract, the article does not independently assess the full study or establish how the findings apply beyond the sampled urban and peri-urban women.

Subject of Research: Psychometric evaluation of an intersectional intimate partner violence stigma scale among women in Botswana

Article Title: Psychometric analysis of an intersectional stigma scale for women who have experienced intimate partner violence in Botswana

Article References: Ho-Foster, A., Machisa, M. T., Moalusi, L. R., Yang, L. H., & Christofides, N. (2026). Psychometric analysis of an intersectional stigma scale for women who have experienced intimate partner violence in Botswana. BMC Public Health. https://doi.org/10.1186/s12889-026-29809-5

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29809-5

Keywords: intimate partner violence, intersectional stigma, Botswana, psychometric analysis, women’s health, mental health, scale validation, gender norms, survivor blaming, Psychometric, analysis, intersectional

Its population included 3,360 participants divided into three age groups: youth aged 18–30 years, adults aged 31–64 years and older adults aged 65 years or above. The researchers assessed construct validity with confirmatory factor analysis and Item Response Theory using Samejima’s Graded Response Model. They also used correlations and hierarchical regression analyses to examine discriminant, concurrent, concurrent-predictive and criterion-related predictive validity, alongside internal reliability.

This was a psychometric validation study, not an intervention or trial of a health-literacy program. A single-factor structure fit the data well among older adults, but the fit was weaker for youth, adults and the full sample. Item-response modelling indicated satisfactory item discrimination and measurement precision, although four of the six items showed age-related differential item functioning.

That pattern indicated partial measurement invariance: some questionnaire items may not function identically at different levels of underlying health literacy across the three age groups. Despite this qualification, internal consistency was satisfactory in every group, with Cronbach’s alpha ranging from 0.76 to 0.84. The results support the HLS-EU-Q6 as a reliable brief instrument, while also showing that measurement properties should not be assumed to be identical for younger and older respondents.

The questionnaire’s associations with other measures were also favourable. HLS-EU-Q6 scores were distinct from measures of communicative and navigational health literacy, supporting discriminant validity. Concurrent validity with the longer, 47-item HLS-EU-Q47 was supported across all three age groups, with a reported correlation of 0.892.

Predictive validity differed more clearly by age. Among adults and older adults, higher health literacy scores were associated with more favourable self-rated health and attitudes toward vaccination. Among youth, health literacy scores predicted only self-rated health and did not show the vaccination-attitude association reported in the two older groups.

These are modelled predictive associations rather than evidence that health literacy causes better health or vaccination attitudes. Overall, the findings identify the Slovenian HLS-EU-Q6 as a practical screening tool with especially consistent performance among adults and older adults, but they also point to a need for further age-sensitive refinement before its results are treated as fully interchangeable across the lifespan.

Subject of Research: Psychometric validation of the HLS-EU-Q6 among Slovenian youth, adults and older adults

Article Title: Psychometric properties of the European health literacy survey questionnaire short-short form (HLS-EU-Q6) among Slovenian youth, adults, and older adults

Article References: Kirbiš, A., Branilović, S., & Lamot, M. (2026). Psychometric properties of the European health literacy survey questionnaire short-short form (HLS-EU-Q6) among Slovenian youth, adults, and older adults. BMC Public Health. https://doi.org/10.1186/s12889-026-28926-5

Image Credits: AI Generated

DOI: 10.1186/s12889-026-28926-5

Keywords: health literacy, HLS-EU-Q6, Slovenia, questionnaire validation, psychometrics, measurement invariance, youth health, older adults, self-rated health, vaccination attitudes, Psychometric, properties

The research team, led by Álvaro García-Prieto, Carmen Galán-Arroyo and Jorge Rojo-Ramos of the University of Extremadura, set out to resolve a persistent problem in bullying research. Although the TRBQ has been validated in several countries, previous studies have reported conflicting factorial solutions, leaving researchers uncertain about how many distinct dimensions of teacher response the instrument actually captures. This ambiguity matters because the questionnaire is intended to distinguish between very different adult behaviours, from active intervention to deliberate non-intervention, and from mediation to various forms of active response.

To address this, the team employed a cross-validation design that split the sample into two subsamples. In the first subsample of 639 students, they used exploratory factor analysis to uncover the underlying structure of the items. In the second subsample, initially 640 students and analytically 624 after data screening, they used confirmatory factor analysis to test competing models against the data. This two-step approach is considered a gold standard in psychometrics because it prevents researchers from fitting a model and testing it on the same data, which would inflate apparent fit.

The exploratory phase revealed a significant finding: the Non-intervention and Mediation dimensions showed substantial overlap, suggesting that students may not perceive a teacher who stays out of a bullying situation as clearly different from one who tries to mediate. One item, Item 3, was excluded because of inadequate psychometric performance, reducing the instrument to 14 items. Among the models tested, a correlated five-factor solution showed the best statistical fit, although the four-factor and second-order models also demonstrated acceptable fit, indicating that the factorial structure of the TRBQ remains a matter of interpretation rather than settled fact.

The preferred 14-item correlated five-factor model demonstrated excellent fit indices in the confirmatory subsample. The robust chi-square was 139.447 with 67 degrees of freedom, the robust comparative fit index reached 0.979, the robust Tucker-Lewis index was 0.972, the robust root mean square error of approximation was 0.052 with a 90 percent confidence interval of 0.040 to 0.065, and the standardized root mean square residual was just 0.032. These values fall well within accepted thresholds for good model fit, providing strong quantitative support for the five-factor interpretation among Spanish adolescents.

However, the validation also uncovered important limitations. Internal consistency was adequate for the four active-response dimensions, but the two-item Non-intervention factor showed only borderline reliability and narrower content coverage, meaning that this dimension may not reliably capture the full range of teacher inaction that students experience. Convergent validity was supported, but discriminant validity was limited for some factor pairs, indicating that certain dimensions of teacher response are statistically difficult to separate from one another. The substantial overlap among active-response dimensions warrants cautious interpretation of subscale scores.

The team also examined measurement invariance, testing whether the questionnaire functions equivalently across different groups. Strict invariance was supported across sex, meaning boys and girls interpret the items in the same way. Scalar invariance was supported across school grade, while strict grade invariance was borderline. Test-retest reliability over two weeks was moderate, with intraclass correlation coefficients ranging from 0.557 to 0.668, and greater uncertainty for the Non-intervention dimension. Longitudinal analyses provided preliminary evidence of approximate metric invariance, although exact scalar invariance over time was not fully supported.

These findings carry significant implications for bullying research and school psychology. The TRBQ emerges as a promising research measure of adolescents’ perceptions of teachers’ responses to bullying, but the authors are clear that the factorial solution should not be considered definitive. Before the instrument can be recommended for broader applications, further evidence of external and predictive validity, sensitivity to change, longitudinal invariance, and independent replication is needed. The study was approved by the Bioethics and Biosafety Committee of the University of Extremadura and conducted in accordance with the Declaration of Helsinki, with written informed consent from parents or legal guardians.

For schools and policymakers, the research underscores a fundamental point: how students perceive adult responses to bullying is a measurable construct, but measuring it well requires instruments that are statistically robust and culturally validated. The Spanish validation adds an important piece of evidence to the international psychometric literature on the TRBQ, while honestly documenting its limitations. As bullying prevention programmes increasingly rely on data about teacher behaviour, studies like this one ensure that the tools used to generate that data can be trusted, or at least understood, in all their complexity.

Subject of Research: Psychometric validation of the teachers’ responses to bullying questionnaire (TRBQ) among Spanish adolescents

Article Title: Psychometric validation of the teachers’ responses to bullying questionnaire (TRBQ) among Spanish adolescents

Article References: García-Prieto, Á., Galán-Arroyo, C., & Rojo-Ramos, J. (2026). Psychometric validation of the teachers’ responses to bullying questionnaire (TRBQ) among Spanish adolescents. BMC Psychology. https://doi.org/10.1186/s40359-026-05630-y

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05630-y

Keywords: Psychometric, validation, teachers, responses, bullying, questionnaire, TRBQ, Spanish, adolescents, scientific research

Violence against women remains a pervasive problem across rural Peru, where geographic isolation, limited healthcare infrastructure, and language barriers often leave victims without any formal route to help. In communities where Spanish is a second language at best, screening instruments written in Spanish or English simply cannot capture the experiences of Quechua-speaking women. The Woman Abuse Screening Tool, known as the WAST, is an eight-item questionnaire grouped into a single factor, designed to be administered quickly in clinical and community settings. But a translated questionnaire is only as good as its psychometric properties, the statistical evidence that it measures what it claims to measure, reliably and accurately, in the new linguistic context.

The researchers, led by Oscar Mamani-Benito of Señor de Sipán University, administered the Collao Quechua version of the WAST to 300 Quechua-speaking women from the Puno region. Rather than relying on a single statistical technique, they deployed an integrative multi-method approach that combined three complementary analytical frameworks: Exploratory Graph Analysis, Confirmatory Factor Analysis, and Item Response Theory modeled through a graded response model. This triangulation matters because each method interrogates a different aspect of the instrument. Network analysis examines structure, factor analysis examines fit, and IRT examines how each individual question performs at different levels of the underlying trait being measured.

Exploratory Graph Analysis, the newest of the three techniques, treats the questionnaire as a network in which each item is a node and the statistical relationships between items are the edges connecting them. Algorithms then detect how many distinct communities, or dimensions, exist within the network. For the Collao Quechua WAST, the analysis identified a highly stable one-dimensional structure, with a structural consistency value of exactly 1. In plain terms, all eight questions form a single cohesive cluster that measures one unified construct, and this structure is not a statistical fluke but a robust feature that persists under repeated estimation.

Confirmatory Factor Analysis then put the one-factor hypothesis to a formal test. The model showed an excellent fit to the data, with a Comparative Fit Index of 0.985 and a Tucker-Lewis Index of 0.979, both far above the conventional 0.95 threshold that psychometricians consider evidence of good fit. The Standardized Root Mean Square Residual came in at 0.062, comfortably within acceptable limits. Factor loadings, which indicate how strongly each question relates to the underlying construct, ranged from 0.741 to 0.944, values that sit at the high end of what screening instruments typically achieve. Reliability, estimated with the Omega coefficient, reached 0.935, meaning that roughly 93.5 percent of the variance in total scores reflects the true underlying level of the measured construct rather than measurement noise.

Item Response Theory added a third layer of scrutiny. Under a graded response model, each question is characterized by its discrimination parameter, which reflects how sharply the response probability changes as the latent trait increases, and by its thresholds, which mark the trait levels at which respondents shift between response categories. The IRT model presented good global fit, with fit indices of 0.971 and 0.935, adequate item discrimination, ordered thresholds, and an absence of relevant local dependence, the statistical redundancy that occurs when two questions effectively ask the same thing twice. The test’s information function, which quantifies how precisely the instrument measures at each point along the trait continuum, was highest at medium to moderately high levels of the latent trait, around zero to two standard deviations above the mean, precisely the range where clinicians most need accurate detection.

Empirical reliability at those critical trait levels reached 0.899, a value that confirms the instrument’s precision where it counts most. This is a crucial detail for a screening tool. Instruments can be globally reliable yet imprecise in the specific score range where clinical decisions are made. The WAST in Collao Quechua avoids that trap, delivering its sharpest measurement in the score range associated with meaningful levels of the latent construct, which in this context corresponds to the experiences the tool is designed to flag.

The implications reach far beyond statistical elegance. For Quechua-speaking women in the Peruvian highlands, a validated screening instrument in their own language could transform how violence is detected in health posts, community centers, and outreach programs. Healthcare workers who currently lack any culturally and linguistically appropriate assessment tool now have evidence that this eight-question instrument functions with high reliability and adequate item performance in the Collao variant. The findings support the WAST’s validity as a screening instrument for detecting violence in Quechua-speaking women, potentially opening a door for victims who have historically been invisible to formal support systems.

The study also carries broader lessons for global health measurement. Most psychological instruments are developed in English and translated into a handful of major languages, leaving thousands of linguistic communities without validated tools. The multi-method framework used here, combining network psychometrics, confirmatory factor analysis, and IRT, offers a template that can be replicated for other Indigenous languages, from Aymara in the Andes to languages across the Amazon and beyond. As Indigenous-language validation efforts gain momentum worldwide, this study from Puno demonstrates that rigorous modern statistics can travel across languages just as effectively as the instruments they evaluate, provided researchers are willing to apply the full analytical toolkit rather than settling for a single test of fit.

Ethical safeguards framed the research throughout. The study was approved by the ethics committee of Señor de Sipán University under code 1578-CIEI, and all participants provided informed consent before completing the questionnaire. Participation was voluntary and anonymous, with confidentiality ensured in accordance with the Declaration of Helsinki. The research was fully funded by Señor de Sipán University, and the authors declare no competing interests. Behind the fit indices and information functions stand the Quechua-speaking women of Puno who participated in the study, and it is their experiences that the validated instrument is now equipped to capture, in their own words, with statistical precision that could finally make their invisible struggles measurable and actionable.

Subject of Research: Psychometric evaluation of the WAST in the Collao Quechua: an integrative multi-method approach based on CFA, IRT, and network analysis

Article Title: Psychometric evaluation of the WAST in the Collao Quechua: an integrative multi-method approach based on CFA, IRT, and network analysis

Article References: Mamani-Benito, O., Sánchez-Villena, A., Bejarano-Benites, Z., Pacheco-Vizcarra, M. Y., Farfán-Solís, R., & Cruz-Campos, C. (2026). Psychometric evaluation of the WAST in the Collao Quechua: an integrative multi-method approach based on CFA, IRT, and network analysis. BMC Psychology. https://doi.org/10.1186/s40359-026-05574-3

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05574-3

Keywords: Psychometric, evaluation, WAST, Collao, Quechua, integrative, multi-method, approach, based, network, analysis, scientific research

The Physical Effort Scale occupies a deliberately different niche from the instruments most exercise scientists know best. The familiar Rating of Perceived Exertion, or RPE, captures a momentary, state-like judgment: how hard does this particular bout of exercise feel right now? The PES, by contrast, was developed by Cheval and colleagues to capture a trait-like behavioral tendency, asking whether a person generally seeks out or steers away from situations that demand physical effort. The distinction matters because effort perception research has shown that the subjective experience of effort is not a simple readout of physiological demand. It is shaped by motivation, attentional allocation, and self-regulation, and it feeds directly into decisions about whether to initiate, sustain, or abandon physically demanding actions. A scale that measures who tends to embrace effort, rather than how effortful one task feels, could therefore be a useful predictor of exercise participation and adherence.

Crucially, the PES treats approach and avoidance as two related but distinguishable dimensions rather than opposite poles of a single bipolar construct. A person’s score on one dimension does not conceptually fix their score on the other, so the scale can in principle detect people who are high on both, low on both, or high on one and low on the other. Before the Chinese team could exploit that flexibility, however, they had to establish that the instrument behaves the same way in Chinese as it does in the original linguistic context, where it was first developed, and in Japanese, where it has already been adapted. Cross-cultural scale adaptation is a technical gauntlet: two bilingual translators independently produced forward translations, which were synthesized into a preliminary version, back-translated into English by two different bilinguals, and then reviewed by an expert panel of three sport psychologists, one psychometrician, and one linguist for semantic, conceptual, and cultural equivalence. A pilot test in 173 university students, of whom 157 provided valid responses, led to minor wording refinements before the final version was locked in.

The main validation rested on 1,273 students drawn from six universities spanning eastern, central, and western China, including Southwest University, Ningbo University, Henan University, Nanchang University, Jiangxi Normal University, and Nanchang Hangkong University. The sample was almost perfectly balanced by gender, with 630 males and 643 females, and evenly spread across all four academic years. Data were collected online between April and May 2026 through an anonymous survey, with careful screening that excluded incomplete responses, patterned or careless answering, and completions under 180 seconds. The researchers then randomly split the sample into two independent subsamples, 653 participants for exploratory factor analysis and 620 for confirmatory factor analysis, a design that guards against the circularity of validating a factor structure on the same data used to discover it.

The psychometric results were strikingly strong. In the exploratory analysis, the Kaiser–Meyer–Olkin measure of sampling adequacy reached 0.919, and two factors extracted by principal axis factoring accounted for 80.10 percent of the total variance, with standardized loadings between 0.807 and 0.890 and no substantial cross-loadings. Internal consistency was high, with Cronbach’s alpha of 0.935 for the approach dimension and 0.913 for avoidance, and corrected item–total correlations ranging from 0.769 to 0.856. Test–retest reliability, assessed in 106 participants who completed the scale twice, yielded an intraclass correlation coefficient of 0.794, within the range commonly classified as good. Confirmatory factor analysis in the second subscale produced a nuanced picture: the comparative fit index of 0.996, Tucker–Lewis index of 0.994, and standardized root mean square residual of 0.016 all indicated excellent fit, but the root mean square error of approximation came in at 0.119, well above the conventional 0.06 benchmark. The authors handled this honestly, noting that RMSEA can be unstable in models with few degrees of freedom but that the elevated value means overall fit should be interpreted cautiously. They also permitted correlated residuals between two pairs of avoidance items whose content overlaps, which flags possible local dependence worth re-examining in future samples.

Convergent and discriminant validity checks passed their standard thresholds. Composite reliability exceeded 0.92 for both dimensions and average variance extracted exceeded 0.75, well above the usual criteria of 0.70 and 0.50. The latent correlation between approach and avoidance was −0.469 and the heterotrait–monotrait ratio was 0.441, consistent with two empirically distinguishable dimensions. Multigroup confirmatory factor analysis then established metric and scalar measurement invariance across gender and across academic year, meaning the scale measures the same construct the same way in men and women and in freshmen through seniors. The authors again cautioned that elevated RMSEA values in the configural models warrant care, and that the study tested invariance only within the Chinese sample, not across cultures.

With the scale validated, the team turned to the more novel question: how do approach and avoidance tendencies jointly vary across individuals? Using latent profile analysis, a person-centered statistical method that identifies empirical subgroups based on patterns of scores, they compared one- through six-profile solutions. Information criteria kept improving with more profiles, but the four- to six-profile solutions contained vanishingly small classes of 0.31 to 1.41 percent, so the researchers retained a three-profile solution with entropy of 0.770 and a smallest class representing 14.93 percent of the sample. The result was three configurations: a Balanced profile containing 59.07 percent of students with moderate approach and moderate avoidance, an Avoidance-Oriented profile with 14.93 percent showing low approach and high avoidance, and an Approach-Oriented profile with 26.00 percent showing high approach and low avoidance. The authors are careful to note that the profiles were largely ordered along a continuum from low approach–high avoidance to high approach–low avoidance, so they are best read as descriptive configurations of the joint distribution rather than evidence of qualitatively distinct natural subgroups.

The profiles told a coherent story when compared on external variables using the Bolck–Croon–Hagenaars method, which accounts for classification uncertainty. The Approach-Oriented profile showed the highest cognitive reappraisal, at an estimated mean of 6.107 on a 7-point scale, followed by the Balanced profile at 5.172 and the Avoidance-Oriented profile at 4.242, with the same ordering for expressive suppression. On exercise motivation, the Approach-Oriented profile scored highest on autonomous regulation, external regulation, and introjected regulation, and lowest on amotivation, with the Avoidance-Oriented profile at the opposite extreme. The authors resist calling the Approach-Oriented profile globally more adaptive, because elevated external and introjected regulation are controlled rather than autonomous forms of motivation, and simultaneous elevation of both emotion-regulation strategies does not map neatly onto a uniformly beneficial pattern. Still, the motivational gradient is clear: students who embrace effort report far more reasons to exercise and far less motivational absence than those who avoid it.

The behavioral differences were equally telling. The Approach-Oriented profile reported an estimated 2,567.50 MET-minutes per week of total physical activity, compared with 2,011.18 for the Balanced profile and 1,966.57 for the Avoidance-Oriented profile, and the Approach-Oriented group exceeded both others at p < 0.001 while the latter two did not differ. Moderate-to-vigorous physical activity followed the same pattern, at 1,503.91 versus 1,032.09 and 970.89 MET-minutes per week. Weekly exercise frequency was higher in the Approach-Oriented profile than in the Balanced profile, though not significantly different from the Avoidance-Oriented group. Notably, the Balanced and Avoidance-Oriented profiles, despite very different effort configurations, showed no detectable difference in overall activity, suggesting that high approach combined with low avoidance is the configuration consistently tied to higher movement. Profile membership also differed by academic major, with 43.6 percent of physical education students classified as Approach-Oriented versus 22.2 percent of other majors, but the main activity pattern held when physical education students were excluded from the analysis.

The study has limits the authors acknowledge plainly. The cross-sectional design cannot establish whether effort tendencies cause motivational regulation or activity, or the reverse; the latent profiles’ longitudinal stability is unknown; self-report measures carry recall bias, social desirability, and common method bias, with Harman’s single-factor test suggesting the first unrotated factor accounted for 59.606 percent of variance; and the university sample limits generalizability. Future work, they suggest, should test profile reproducibility in independent samples, use longitudinal designs and ecological momentary assessment to track change over time, complement self-reports with accelerometer data, and examine cross-cultural measurement invariance directly. Even so, the findings give exercise scientists in Chinese-speaking contexts a validated tool for a construct that has been gaining theoretical weight, including within the Theory of Effort Minimization in Physical Activity, which proposes that effort-related aversion drives people to minimize exertion. If the way students relate to effort is measurable, stable, and tied to how much they move, then understanding who avoids effort, and why, may become a practical target for interventions aimed at getting young adults off the sidelines and into motion.

Subject of Research: Psychometric validation of the Chinese Physical Effort Scale and latent profiles of physical-effort approach and avoidance among Chinese university students

Article Title: Psychometric validation of the Chinese Physical Effort Scale and profiles of physical-effort approach and avoidance among Chinese university students

Article References: Liu, Y., & Zhou, Q. (2026). Psychometric validation of the Chinese Physical Effort Scale and profiles of physical-effort approach and avoidance among Chinese university students. Frontiers in Psychology, 17, Article 1959219. https://doi.org/10.3389/fpsyg.2026.1959219

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1959219

Keywords: Psychometric, validation, Chinese, Physical, Effort, Scale, profiles, physical-effort, approach, avoidance, university, students

The stakes of this work could hardly be higher. Online misinformation has emerged as a significant threat to public health, healthcare services, and patient treatment outcomes, and nurses occupy a unique position in the battle against it. They are among the most trusted voices in medicine, frequently consulted by family members and patients about claims circulating online, yet no standardized tool existed to evaluate how susceptible Chinese nurses are to those claims. The new study fills that gap by adapting the Online Misinformation Susceptibility Scale, known as OMISS, for use in China and confirming that it performs reliably in this population.

To carry out the translation, the team followed Brislin’s classic guidelines for cross-cultural adaptation, a widely respected framework in nursing research. The process involved forward translation by bilingual experts, synthesis of the translated versions, backward translation to check for conceptual drift, and review by a committee to ensure that every item preserved its original meaning while reading naturally in Chinese. Content validity was then evaluated by an expert panel, and a pilot test with a small group of clinical nurses confirmed the feasibility of the translated version before the full-scale investigation began.

Sample size was estimated using a formula designed for confirmatory factor analysis, and the researchers ultimately recruited 585 clinical nurses through convenience sampling. Confirmatory factor analysis was selected as the primary statistical approach because the original scale’s factor structure had already been established, allowing the team to test whether the same structure held in the Chinese context. The analysis produced striking results: the one-factor model fit the data exceptionally well, with a comparative fit index of 0.989, a Tucker-Lewis index of 0.982, and a standardized root mean square residual of just 0.043. All fit indices met or exceeded conventional thresholds, providing strong evidence that the Chinese OMISS retains the same underlying structure as the original instrument.

Reliability testing delivered equally impressive numbers. Cronbach’s alpha coefficient for the Chinese version reached 0.963, far above the 0.70 benchmark commonly used in psychometric research, indicating outstanding internal consistency across all items. The scale also demonstrated excellent test-retest reliability, with an intraclass correlation coefficient of 0.912 over a two-week interval, confirming that the instrument produces stable results over time. Together, these findings establish that the Chinese OMISS is both a faithful and a dependable measure of misinformation susceptibility in the nursing population.

The implications extend well beyond the borders of China. The validated scale now offers researchers a standardized tool to assess how vulnerable nurses are to online misinformation, opening the door to studies examining the personal, professional, and organizational factors that shape that vulnerability. It also provides a foundation for designing targeted interventions, from media literacy training to critical appraisal workshops, that could strengthen nurses’ resistance to false claims. Because nurses are consistently rated among the most trusted professionals in surveys of public confidence, equipping them with validated instruments to understand and counter misinformation carries enormous potential for protecting patient care.

The study does come with limitations that the authors themselves acknowledge. The sample was drawn through convenience sampling from a limited number of hospitals, which may restrict the generalizability of the findings to other regions and practice settings. The cross-sectional design also prevents any conclusions about how misinformation susceptibility changes over time or how it might respond to interventions. Future research, the team suggests, should employ more diverse sampling strategies and longitudinal designs to build on this foundation and explore the broader organizational and cultural factors that influence nurses’ engagement with online health information.

Nevertheless, the arrival of a validated Chinese OMISS marks a significant milestone in the effort to understand and combat health misinformation within the nursing workforce. As false claims continue to circulate across digital platforms and shape public attitudes toward medicine, tools like this scale give researchers and educators a way to measure the problem precisely rather than anecdotally. The work by Shi, Pan, and their colleagues provides a rigorous, evidence-based starting point for protecting the integrity of health information in China and offers a template that other countries can adapt for their own nursing populations.

Subject of Research: Psychometric validation of a Chinese-language misinformation susceptibility scale for nurses

Article Title: Psychometric evaluation of the online misinformation susceptibility scale: a translation and validation study among Chinese nurses

Article References: Shi, J., Lin, Y., Li, C., Gong, Y., Qin, X., Li, H., & Pan, Y. (2026). Psychometric evaluation of the online misinformation susceptibility scale: a translation and validation study among Chinese nurses. BMC Nursing. https://doi.org/10.1186/s12912-026-05539-2

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05539-2

Keywords: misinformation, nurses, psychometrics, scale validation, China, BMC Nursing, Psychometric, evaluation, online, susceptibility, scale, translation

A new cross-sectional validation study published in Frontiers in Global Women’s Health set out to translate and validate a Norwegian version of the Lipedema Quality of Life questionnaire, known as LIPQOL. The research team, led by Julianne Lundanes of Nord-Trøndelag Hospital Trust and including collaborators from Western Norway University of Applied Sciences, Førde Hospital Trust, the University of Bergen, a German medical practice for vascular diseases, and the Norwegian University of Science and Technology, recruited 432 females with lipedema in Norway through the Norwegian Lymphedema and Lipedema Association’s email registry, which included approximately 2,400 individuals with either lipedema or lymphedema.

The LIPQOL questionnaire was originally developed in German, inspired by the Lymphedema Quality of Life (LYMQOL) questionnaire but adapted specifically for lipedema. The Norwegian research team initially intended to develop a new disease-specific quality-of-life questionnaire for people with lipedema in Norway. During preparatory discussions with clinicians and patient representatives about which aspects of living with lipedema should be represented in such an instrument, the team became aware of the recently developed German LIPQOL and critically examined its content against the aspects identified as important. Finding that the LIPQOL corresponded well with the content considered relevant, the researchers decided to translate it rather than develop a new and potentially overlapping instrument.

The translation from German into Norwegian was carried out by three Norwegian researchers with basic German skills, assisted by artificial intelligence-based translation tools including ChatGPT-5 and Microsoft Copilot. This pragmatic AI-assisted approach was informed by recent recommendations concerning the use of AI-assisted methods in questionnaire translation. The researchers worked collaboratively to ensure correspondence in wording, meaning, and conceptual content between the German and Norwegian versions. The translation was subsequently reviewed by a nutrition researcher who is a native German speaker with strong Norwegian language skills, and finally by two patient representatives who considered the wording, meaning, relevance, and comprehensibility of the items from a patient perspective.

One modification was made to the response structure of the original questionnaire. The German version includes a “Not applicable” option, allowing respondents to skip an item when it is not relevant to their situation. For the Norwegian validation study, this explicit response option was removed to encourage respondents to provide answers whenever an item was applicable and thereby maximize the amount of available data. The team identified two items for which a genuinely non-applicable situation could reasonably arise: the item concerning compression garments, for respondents who did not use them, and the item concerning the impact of lipedema on a romantic relationship, for respondents without a partner. Respondents were not required to answer all items, and unanswered items were treated as missing and excluded from the calculation of the domain score, corresponding to the scoring consequence of selecting “Not applicable” in the original German version.

The LIPQOL consists of three single items and four subscales: Function, Body image, Symptoms, and Feelings. Each subscale score is calculated as the mean of its completed items, with more than 50 percent of the items within a domain required for a domain score to be calculated. The Norwegian versions of the LIPQOL and the RAND-12 questionnaires were distributed via the online platform Questback. The RAND-12, a widely used and freely available measure of generic health-related quality of life that is strongly correlated with the longer RAND-36, was applied for convergent validity testing through its physical component score (PCS) and mental component score (MCS).

A total of 494 participants responded to the survey, a response rate of 21 percent, of whom 62 were excluded because they did not have lipedema, leaving 432 participants with lipedema. Most participants were aged 46 to 64 years (60 percent), and 92 percent reported receiving an official lipedema diagnosis from a health care professional. Notably, 71 percent reported that more than 10 years had elapsed from symptom debut to diagnosis, and 25 percent also had concomitant lymphedema. The mean body weight was 88.7 kilograms, mean height was 166.8 centimeters, and mean body mass index was 31.9 kilograms per square meter.

The psychometric properties of the questionnaire were assessed using confirmatory factor analysis (CFA) for ordinal data with weighted least squares mean and variance estimation. The overall goodness of fit was evaluated using the root mean square error of approximation (RMSEA), the standardized root mean square residual (SRMR), the comparative fit index (CFI), and the Tucker-Lewis index (TLI). Model fit was indicated by RMSEA close to or below 0.06, SRMR close to or below 0.08, and by CFI as well as TLI close to or above 0.95. Internal consistency was assessed using composite reliability from the CFA, with scores of 0.70 or above considered acceptable.

The unmodified CFA showed CFI = 0.929, TLI = 0.922, SRMR = 0.073, and RMSEA = 0.079 (90 percent CI: 0.073 to 0.084). All composite reliability values were considered reasonable, ranging from 0.890 to 0.916. No subscales were affected by floor or ceiling effects, although some individual items showed such effects. Modification indices were evaluated, and two modifications were performed between items 5 and 8, and between items 17 and 18. With modification indices, the overall structure validity showed reasonable but not unequivocal support for the four-factor structure, with CFI = 0.944, TLI = 0.938, SRMR = 0.068, and RMSEA = 0.070 (90 percent CI: 0.064 to 0.075). The modified model yielded a chi-square statistic of χ²(342) = 929.1, compared with χ²(344) = 1091.4 for the unmodified model.

Item 5, which assesses whether participants perceive wearing compression garments as burdensome, exhibited a low factor loading of 0.325 within the Function subscale. The researchers explain that this item is not directly related to functional ability, so a participant may demonstrate excellent functional capacity while still finding compression garments burdensome, likely accounting for the low loading. Modification indices indicated covariance between item 5 and item 8, both of which address the use of compression garments but belong in different subscales. Item 17 and item 18 were also highly correlated, as both assess similar symptoms: item 17 assesses the presence of a feeling of pressure in the legs, while item 18 assesses whether the legs feel heavier as the day progresses. The researchers limited the model modifications to two, aiming to make the minimum number of theoretically justifiable changes necessary to achieve acceptable model fit while minimizing the risk of overfitting.

Because missing responses were mainly in items that could conditionally not apply, the team conducted a sensitivity analysis to assess whether excluding participants with incomplete data affected the results. They re-estimated the same four-factor model using maximum likelihood estimation with and without full information maximum likelihood (FIML), which allows participants with partially missing item data to be included. The sensitivity analysis yielded results very much like those obtained from the complete-case analysis, with the overall model fit remaining essentially the same. This indicates that the missing data and the consequent selection of complete cases had only a minor effect on the substantive results of the CFA, although statistical missing-data methods such as FIML cannot completely resolve the underlying issue of item non-applicability.

Convergent validity was investigated by assessing correlations between the LIPQOL subscales and the PCS and MCS from RAND-12. All LIPQOL variables were significantly associated with both PCS and MCS (P < 0.001). Large correlations were observed between PCS and Function (Spearman’s rho = −0.682), Symptoms (Spearman’s rho = −0.550), and overall quality of life (Spearman’s rho = 0.554). Large correlations were also seen between MCS and Feelings (Spearman’s rho = −0.685) and overall quality of life (Spearman’s rho = 0.608). These findings suggest that the disease-specific impairments captured by the LIPQOL are reflected in broader aspects of generic health-related quality of life, while the measures remain sufficiently distinct to capture different aspects of quality of life.

The relatively strong association between the Function and Symptoms subscales, with a latent factor correlation of 0.819, should be considered when interpreting the instrument. However, the researchers note that strong associations between domains do not necessarily indicate that they measure the same construct. Symptoms and functional limitations are conceptually distinct aspects of quality of life but are also likely to be closely related in females with lipedema. The subscale scores should therefore be interpreted as related rather than independent dimensions of quality of life. The strong correlation between function and symptoms suggests that symptom severity has a substantial impact on physical functioning, highlighting the importance of symptom management for maintaining functional ability, quality of life, and work capacity.

The study has both strengths and limitations. Strengths include the robust overall sample size of 432 participants and the fact that this is the first validation study using this questionnaire. Other validated and non-validated lipedema-specific questionnaires assess symptom burden; however, this is the only multi-domain lipedema-specific health-related quality-of-life instrument. Moreover, most previous studies have used the LYMQOL questionnaire, which was originally developed for patients with lymphedema and includes items irrelevant for lipedema, or other generic PROMs not adapted to lipedema. Lymphedema and lipedema are often confused, although their pathophysiology differs substantially.

Nevertheless, several limitations should be acknowledged. The cross-sectional design precluded assessment of test-retest reliability and responsiveness. Information on previous lipedema surgery, stage, and type was not collected, limiting assessment of measurement properties across clinically relevant subgroups. As data collection was anonymous, reported diagnoses could not be independently verified. Recruitment through the patient organization may also have introduced selection bias towards more engaged patients, potentially limiting representativeness. Furthermore, the 25 percent of participants who also had concomitant lymphedema may affect the results, as patients with lymphedema seem to have more functional disability and lower life satisfaction compared to females with lipedema. Cross-cultural validity and formal content validity according to COSMIN recommendations were not evaluated, and formal cognitive interviewing was not undertaken.

The researchers conclude that the findings provide encouraging, although not unequivocal, initial support for the measurement properties of the Norwegian LIPQOL for assessing quality of life among females with lipedema. The tool may be useful in both clinical settings and research, as it is a short questionnaire with easy scoring that shows preliminary support for its validity and reliability. However, this is the first validation study of the LIPQOL questionnaire, and the German version has not yet been published or validated either. Future research should seek to further establish the measurement properties of the LIPQOL through continued German-Norwegian collaboration and resolve the remaining methodological issues identified in the present study, providing a stronger foundation for subsequent cross-cultural validation and evaluation of the instrument in other languages and populations. The questionnaire has the potential to become a standard disease-specific instrument for assessing quality of life in females with lipedema.

Subject of Research: Initial psychometric evaluation of the Lipedema Quality of Life questionnaire in females with lipedema in Norway

Article Title: Initial psychometric evaluation of the Lipedema Quality of Life questionnaire in females with lipedema in Norway

Article References: Lundanes, J., Andersen, J. R., Dierkes, J., Schrader, K., & Nymo, S. (2026). Initial psychometric evaluation of the Lipedema Quality of Life questionnaire in females with lipedema in Norway. Frontiers in Global Women's Health, 7, Article 1917274. https://doi.org/10.3389/fgwh.2026.1917274

Image Credits: AI Generated

DOI: 10.3389/fgwh.2026.1917274

Keywords: lipedema, LIPQOL, quality of life, psychometric validation, patient-reported outcome measures, womens health, Norway, Initial, psychometric, evaluation, Quality, Life

The research, led by Senne Letouche, Sofie Dupré, Maarten De Schryver, and Bart Wille of Ghent University, responds to a problem that has long frustrated culture scholars. Seminal definitions of organizational culture, including Edgar Schein’s influential account, describe culture as a pattern or system of basic assumptions, values, and beliefs that interconnect and shape one another. Yet the dominant measurement tradition—the Competing Values Framework, or CVF—lumps concrete culture elements into higher-order dimension scores, discarding the very interactions that make a culture what it is. Scholars have described the resulting tangle of mutually reinforcing values, behaviors, and norms as a can of worms: pull on one element and the whole messy pack comes with it.

Psychometric network analysis, which gained popularity in clinical psychology as a way to study symptoms and their interactions rather than higher-order disorders, offers a way out. Instead of assuming that an invisible latent construct causes the observed items—a reflective measurement model—network models abandon latent constructs altogether. Each culture element becomes a node in a graph, and the statistical relationships between them, estimated as regularized partial correlations, become edges. Blue edges indicate positive associations, red ones negative, and the thickness of each line corresponds to the strength of the connection. Because organizational culture is inherently collective, the edges are computed from between-person covariation in employees’ responses within a focal organization and interpreted as a shared culture structure at the organizational level.

To demonstrate the approach, the researchers analyzed culture survey data from two Belgian organizations. The first dataset comprised 4,270 responses from a large public service organization, with a response rate of 98 percent because the survey was part of a mandatory strategic exercise. The second came from a health care organization, where 338 of 800 invited employees completed the survey voluntarily, a response rate of 42 percent. In both samples, culture was measured with a Dutch translation of the 16-item CVF scale, capturing the four classic dimensions—clan, adhocracy, market, and hierarchy—each through four concrete elements covering leadership behaviors, orientations, values, and emphases. Participants rated their agreement on a 7-point Likert scale, and the networks were estimated in R using the bootnet, networktools, and qgraph packages, with a graphical lasso regularization procedure to improve interpretability.

The resulting culture maps revealed connections that would go unnoticed at the dimension level. In both organizations, the element describing rule-enforcing leaders was positively related to the perception of a stable, permanence-emphasizing environment, with partial correlations of 0.59 in the public service organization and 0.16 in the health care organization. More striking were the cross-dimension and cross-organization differences. Risk-taking leader behaviors were positively associated with perceptions of a dynamic, entrepreneurial environment in the health care organization, at 0.34, but the relationship turned slightly negative in the public service organization, at −0.04. Warm and caring leader behaviors went hand in hand with perceptions of an achievement-oriented environment in the public service organization but with reduced competition in the health care organization. Traditional dimension scores would average these patterns away entirely.

The second demonstration tackled a question at the heart of every culture change effort: where are the roots of a culture, and where can interventions do the most good? In network terms, this means identifying the most central nodes—elements with more and stronger connections to the rest of the system. The researchers used the expected influence index, which accounts for the sign of edge values and is therefore appropriate for networks containing both positive and negative relationships. Two leadership elements ranked among the three most influential nodes in the public service network, with market leader—the degree to which managers formulate challenging objectives—emerging as the single most central element, at a standardized expected influence of 1.12. Hierarchy emphasis and hierarchy leader followed closely. The finding aligns with decades of theory holding that leaders establish norms for social conduct, clarify which behaviors are valued, and set priorities by allocating resources, making leadership behaviors plausible drivers of the wider culture.

The third demonstration addressed cultural inertia, the notorious resistance of organizational cultures to change. According to the network view, a culture is an interlocked set of values, practices, and assumptions that fit together as a mutually reinforcing system. Connectivity, or density, quantifies how tightly the elements are interlocked. When two strongly connected elements are both highly present—say, rule enforcement and environmental stability—an external force that reduces one creates an unstable equilibrium: the system must either undo the change or shift all the other connected elements to align with it. As connectivity increases, the latter becomes less likely, so dense networks tend to change in an all-or-none fashion. Drawing on attitude strength theory, the researchers hypothesized that employees with longer organizational tenure would report more strongly connected networks, because culture knowledge, memory accessibility, and person-culture fit all increase with time.

The results were more nuanced than expected. Using a network comparison test with 1,000 permutations, the researchers compared the culture networks of 1,002 low-tenure employees, who had worked in the organization for less than five years, with those of 1,349 high-tenure employees, who had worked there for more than twenty. Contrary to the hypothesis, overall connectivity did not differ significantly between the two groups. But the network structures were not identical: the maximum edge-weight difference was significant, indicating that at least one connection differed between the groups. The edge between hierarchy leader and hierarchy emphasis, for instance, was significantly stronger among high-tenure employees, while the connection between hierarchy leader and clan emphasis was stronger among low-tenure employees. Because age and tenure are naturally correlated, the researchers regressed age out of each culture item and replicated the same pattern.

The authors argue that centrality and connectivity are not opposing predictions but different properties of the same system. Centrality is a local, node-level property: it identifies which element would propagate furthest through the existing pattern of connections if an intervention takes hold. Connectivity is a global, system-level property that reflects how strongly the network pulls back toward its prior configuration once intervention pressure is removed. Dense connections are double-edged—the same conditional dependencies that allow a well-targeted change at a central node to reach many other elements are also what makes the system prone to reverting once the intervention is withdrawn. Centrality tells us where a change would spread; connectivity tells us how much sustained force is needed to make it take hold in the first place.

The implications reach beyond theory. For organizational development practitioners, culture networks generate visual maps that can be presented intuitively as culture maps, guiding change interventions by showing which elements are drivers and how tightly the system is interlocked. The approach also challenges the CVF’s own theoretical mapping: the substantial positive interconnections across elements suggest that the four supposedly competing value orientations co-occur in practice and are better interpreted as ideal-typical tensions rather than mutually exclusive opposites. The researchers acknowledge limitations—cross-sectional data support only putative causal conclusions, and both organizations were public service and health care firms rather than the commercial contexts in which the CVF was originally developed. Still, they argue the time is ripe for a conceptualization that returns to the roots of culture theory, treating cultures as emergent systems of nodes interconnected in specific, organization-dependent ways. Future work could extend the networks to include antecedents and outcomes such as innovation, turnover, or job satisfaction as nodes, and could tailor culture maps to each organization’s own set of elements rather than a universal item set.

Subject of Research: A psychometric network study reconceptualizes organizational culture as a system of interconnected elements and demonstrates the approach with survey data from two Belgian organizations.

Article Title: A psychometric network approach to organizational culture: opening the can of worms

Article References: Letouche, S., Dupré, S., De Schryver, M., & Wille, B. (2026). A psychometric network approach to organizational culture: opening the can of worms. Frontiers in Organizational Psychology, 4, Article 1819497. https://doi.org/10.3389/forgp.2026.1819497

Image Credits: AI Generated

DOI: 10.3389/forgp.2026.1819497

Keywords: organizational culture, psychometric network analysis, culture networks, Competing Values Framework, cultural inertia, centrality, connectivity, leadership, Ghent University, organizational psychology, psychometric, network

The study, published in BMC Nursing, was led by Bahar Kuleyin and Serap Altuntas from the Nursing Management Department at Bandirma Onyedi Eylul University. Their work addresses a persistent gap in healthcare research. Voice behavior, the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the goal of improving situations, has been extensively studied in business contexts. But nursing is different. A nurse who raises a concern may be challenging a physician’s decision, questioning a safety protocol, or flagging a staffing shortage, and the consequences of speaking up or staying silent ripple directly to patient outcomes.

The researchers designed their study in three carefully sequenced phases. First came item generation, where they drew on existing literature and qualitative input to draft candidate questions covering the full landscape of nursing voice. Second, they conducted preliminary evaluation of these items, refining wording and eliminating redundancy. Third, they assessed the psychometric properties of the resulting scales using construct validity and reliability analyses, following evaluation of content and face validity. Data were collected from 890 nurses between December 2024 and June 2025, with institutional permissions obtained from five hospitals where the exploratory phase took place.

From this process emerged three distinct instruments. The Nurses’ Voice Behaviors Topics Scale, or NVBTS, contains 30 items organized into five factors, capturing the range of subjects nurses speak up about. The Nurses’ Voice Behaviors Methods Scale, or NVBMS, includes 12 items across three factors, measuring the different channels and approaches nurses use when voicing concerns. The Nurses’ Voice Behaviors Negative Outcomes Scale, or NVBOS, comprises 10 items with a single factor, assessing the adverse consequences nurses experience as a result of speaking up.

The psychometric validation was thorough. For each scale, the researchers examined explained variance, confirmatory factor analysis fit indices, factor loadings, convergent and discriminant validity, internal consistency, and test-retest reliability. All demonstrated satisfactory properties, meaning the scales measure what they claim to measure, consistently, across time. Convergent validity confirms that items theorized to cluster together actually do so, while discriminant validity ensures the three scales capture genuinely different dimensions rather than overlapping constructs.

Why does this technical achievement matter so much? Because without valid measurement, research on nursing voice is built on sand. Studies using generic voice scales may miss the topics that matter most in clinical settings, such as medication errors, patient handoffs, or equipment failures. They may fail to distinguish between speaking up to a supervisor versus raising concerns in a team huddle. And they rarely capture the negative outcomes, from social exclusion to career damage, that can silence nurses precisely when their input is most needed.

The negative outcomes dimension is particularly significant. Research in healthcare has long documented a culture in some clinical environments where speaking up is perceived as risky, especially across hierarchical lines. Nurses who challenge physicians or question established practices may face dismissiveness, retaliation, or professional isolation. By providing a validated instrument to measure these consequences systematically, the new scales open the door to research that quantifies the cost of voice and identifies organizational conditions that protect nurses who speak up.

The implications extend to patient safety and healthcare quality. Voice behavior among nurses has been linked to error reporting, safety climate, and quality improvement. When nurses feel safe and empowered to voice concerns, organizations catch problems earlier, learn faster, and prevent harm. When they stay silent, near-misses go unreported and systemic weaknesses persist. Having reliable tools to measure voice, its topics, methods, and negative outcomes, allows hospital administrators and researchers to baseline current levels, evaluate interventions, and track change over time.

The study was conducted as a methodological investigation, meaning its primary contribution is the instruments themselves rather than new findings about nurses’ behavior. Ethical approval was obtained from the Bandirma Onyedi Eylul University Health Sciences Non-Interventional Research Ethics Committee in October 2024, and all procedures followed the Declaration of Helsinki. The research received no specific grant from funding agencies, and the authors declare no competing interests. An abstract was presented orally at the 9th International Nursing Management Conference in Ankara in June 2026.

For the global nursing research community, the availability of these validated scales represents a practical advance. Researchers can now assess nurses’ voice behaviors with instruments grounded in the realities of clinical practice rather than adapted from corporate settings. Future studies can explore how voice topics differ across specialties, which methods of voicing are most effective in different team structures, and how negative outcomes vary across organizational cultures. As healthcare systems worldwide grapple with workforce shortages and safety challenges, understanding and encouraging nurses’ voice has never been more urgent, and now researchers have the measurement tools to do it properly.

Subject of Research: “Development and psychometric validation of nurses’ voice behaviors scales: topics, methods and negative outcomes”

Article Title: “Development and psychometric validation of nurses’ voice behaviors scales: topics, methods and negative outcomes”

Article References: Kuleyi̇n, B., & Altuntaş, S. (2026). “Development and psychometric validation of nurses’ voice behaviors scales: topics, methods and negative outcomes”. BMC Nursing. https://doi.org/10.1186/s12912-026-05530-x

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05530-x

Keywords: nursing, voice behavior, psychometrics, scale development, patient safety, BMC Nursing, healthcare quality, nurse voice, Development, psychometric, validation, nurses