title: Psychometric validation of Emotional Reaction Instrument-English to measure American children's emotional responses to hospitalisation.
abstract: OBJECTIVE
  The aim of this study was to test the initial psychometric properties of the Emotional Reactions Instrument-English with hospitalised American children, ages 7-12 years, in the USA.
  
  
  BACKGROUND
  Children's negative emotional responses have been a subject of concern for paediatric clinicians and researchers, especially because negative emotional responses following or during hospitalisation are associated with adverse patient outcomes. Existing self-report paediatric instruments have a number of limitations including lack of clinical feasibility and psychometric evidence.
  
  
  METHODS
  A survey and psychometric approach was used to test initial reliability and validity of the Emotional Reactions Instrument-ENGLISH.
  
  
  METHODS
  Two hundred hospitalised American children, 7-12 years of age, who were admitted to a Children's Hospital in the USA were recruited for this study. The children were administered the Emotional Reactions Instrument-English, the Facial Affective Scale, and a demographic form.
  
  
  RESULTS
  Internal consistency was supported by a Cronbach's alpha of 0·83 for the total scale. Alpha coefficients for subscales ranged from 0·59-0·82. Construct validity was tested with exploratory factor analysis. Through principal component analysis, four factors were identified that explained 64% of the variance. Concurrent validity was supported by most items in the Emotional Reactions Instrument-English being significantly correlated with the Facial Affective Scale (r = 0·18-0·59). The instrument can be administered to hospitalised children in 5-10 minutes.
  
  
  CONCLUSIONS
  The results of this exploratory study provide initial support for the psychometric adequacy of the Emotional Reactions Instrument-English with hospitalised American children ages 7-12 years. Further testing of the Emotional Reactions Instrument-English is required to validate the subscales and evaluate the instrument's use with children of different ages, race and ethnicity.
  
  
  CONCLUSIONS
  This study introduces a new, clinically feasible instrument to measure children's diverse emotional responses to hospitalisation.
authors.affiliation: Authors: Jin-Sun Kim, PhD, RN, Professor, Department of Nursing, Chosun University; Jeong-hwan Park, PhD. RN, Associate Professor, Department of Nursing, Chosun University, Gwangju, South Korea; Roxie L Foster, PhD, RN, FAAN, Professor, College of Nursing, University of Colorado Denver, Aurora, CO; Abbas Tavakoli, DrPH. MPH, ME, Statistician and Director of Statistical Laboratory, College of Nursing, University of South Carolina, Columbia, SC, USA.
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Jeong-Hwan
authors.initials: JH
authors.lastname: Park
authors.forename: Roxie L
authors.initials: RL
authors.lastname: Foster
authors.forename: Abbas
authors.initials: A
authors.lastname: Tavakoli
mesh_terms: D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009730:Nursing Assessment; D011594:Psychometrics; D015203:Reproducibility of Results; D014481:United States