Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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On Aug 2018

Dr. Arundhathi. S
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MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
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Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : June | Volume : 17 | Issue : 6 | Page : VC08 - VC13 Full Version

The Translation Process, Validity and Reliability Study in Occupational Health Psychology amongst Healthcare Professionals by Multitrait-Multimethod Matrix: A Multimethod Study

Published: June 1, 2023 | DOI:
Deepak B Sharma, Himanshu K Sharma

1. Professor, Department of Community Medicine, Pramukhswami Medical College, Bhaikaka University, Anand, Gujarat, India. 2. Professor, Department of Psychiatry, Pramukhswami Medical College, Bhaikaka University, Anand, Gujarat, India.

Correspondence Address :
Dr. Deepak B Sharma,
A 302, Green Avenue Apartment, Karamsad, Anand-388325, Gujarat, India.


Introduction: Questionnaires are designed to measure specific constructs. Occupational Health Psychology (OHP) includes various domains/areas like work place well-being, work related stress, flourishing, resilient coping, coping mechanisms, compassion satisfaction, burnout and secondary traumatic stress. At times, specific questionnaire may not be available and if available, may not be in the language intended to be used by the respondents. A new questionnaire needs to be developed or translation of an available questionnaire into the respondents’ language is required in such case.

Aim: To detail out the translation process of the study tools (questionnaires/scales) and to assess the validity and reliability of these study tools used in OHP.

Materials and Methods: The present cross-sectional, Quasi-experimental study was conducted in the Department of Community Medicine, Pramukhswami Medical College, Anand District, Gujarat, India, from February 2021 to January 2023 using multimethod study design amongst the healthcare professionals. For translation, standard World Health Organisation (WHO) translation guide was followed. Nine scales/questionnaires along with a socio-demographic and a qualitative proforma were finalised to achieve the objectives. The questionnaires availability in public domain was taken into consideration while selecting the questionnaires. Reliability analysis and validity assessment were done. Reliability measure was checked for internal consistency by calculating Cronbach’s alpha. Construct validity was assessed by Multitrait-Multimethod Matrix. Translation was done in Hindi and Gujarati languages.

Results: Flourishing scale (FS), Brief resilient coping scale, compassion satisfaction and work satisfaction were positively correlated and all these were negatively correlated with all the stress measures, Depression, anxiety measures of Depression, Anxiety and Stress Scale (DASS), burn out and secondary traumatic stress. Cronbach’s alpha for internal consistency measure was calculated for different sub domains of the nine questionnaires. Construct validity was analysed by calculating correlation coefficients between different identified constructs/ sub constructs. Variables measuring similar construct were found to be positively correlated and significant.

Conclusion: Variables/questionnaires measuring a similar construct were found to be positively correlated and significant, while opposite constructs were negatively correlated. The questionnaires need to be translated in the language in which the participants can understand. The better linguistic comprehension will increase the internal validity of the study.


Convergent validity, Divergent validity, Transation guide

Occupational Health Psychology (OHP) is the application of the principles and practices of psychology to occupational health issues (1). OHP centres directly around the health of employees, further to their families with the overall purpose to develop, maintain and promote health (2). There are aspects of work which are difficult to describe. This includes identifying their effects on psychological and physical health. The recognition of such aspects of work started emerging in nineteenth century after the industrial revolution (3). European perspective of OHP centered around contribution of applied psychology to occupational health and was given by Tom Cox CBE and associates. North American representative body viewed OHP as interdisciplinary partnerships of psychological and occupational health science professionals to improve the quality of working life, safety, health and well-being of workers. Interventions to promote health, organisational research methods, design of the psycho-social work environment, stress theory, and stress interventions were among the five core topics in OHP curriculum (2). Various interactions and their complexities at work places, organisational values and practices, policy decisions, managerial aspects, work satisfaction, burnout, coping and resilience all circumscribe the employees’ health and well-being and impedes on a multiple interactions. There may not be a direct causation, but it is more of a two-way interaction between multiple variables or constructs. Questionnaires to measure different constructs like burnout, work place well-being, flourishing, stress, resilient coping, compassion satisfaction and other constructs are available. Based on the objectives of the study, the specific questionnaires can be decided. Multiple questionnaires measuring a similar construct may be used to prove convergent validity. Questionnaires are the important study tool to collect information from the participants. Data collection can range from collection of quantitative information through questionnaires and experiments to qualitative methods of observations, discussion and interviews. A specific questionnaire that measures the construct of interest may not be available and it becomes more important for some specific context (4). If such a questionnaire is available, it may not be in the desired language and with differing socio-demographic contexts. A new questionnaire needs to be developed or translation of an available questionnaire into the respondents’ language is required in such case, so it requires translation. The questionnaire can be used in the original form, if language and other socio-demographic contexts are not an issue. But still, it should undergo the process of validation and reliability analysis. So, this study was done with the objective to detail out the translation process with the assessment of validity and reliability of the study tools (questionnaires) used in the current study in OHP.

Material and Methods

The current cross-sectional, Quasi-experimental study was conducted in the Department of Community Medicine, Pramukhswami Medical College, Anand District, Gujarat, India, from February 2021 to January 2023 using multimethod study design amongst the healthcare professionals.

Two study designs were used in this multimethod study design (multiple approach design) (5): These were:

1. Cross-sectional study design: base pool of participants
2. Quasi-experimental Solomon four non equivalent control group study design for intervention [6,7]

Sample size calculation: Sample size for cross-sectional study was calculated using OpenEpi Version 2.3.1 and by the formula={DEFF*Np(1-p)}/{(d2/Z21-a/2*(N-1)+p*(1-p)} (8).

In the formula, N is the population size. Hypothesised % frequency of outcome factor in the population (p)- 50% to keep the maximum sample size for the given set of particulars in sample size calculation. Absolute precision %-7%, confidence limits as % of 100-/+7%,

Z21-a/2=Standard normal variate (at 5% type I error p=0.05, it is 1.96)

DEFF=Design effect-1, Confidence level- 95%

Based on the “p” and at 95% confidence limit, the calculated sample size was 196. Considering 10% non response rate, the final sample size came to 216. The data collection was done for 231 participants and during data entry three proformas with incomplete information for the nine scales were rejected. So, the final base pool of participants was 228.

Sample size for Solomon four-group design was calculated by using G Power 3.1 for F tests: ANOVA: Repeated measures, within-between interaction

Effect size f=0.25, α err (prob)=0.05, Power=0.90, Number of groups=4

Keeping the intervention group participants in the overall sample size, the sample increased by 32 participants over the base sample from group III and group IV of Solomon four-group design.

Cross-sectional study of 228 participants in Phase I was done followed by Solomon four-group design with a total 64 participants. A total of 32 participants were from original frame as group I and group II participants. So, 260 was the overall sample size with 32 participants additional to 228.

The current validity and reliability study was based on the analysis of 98 participants who were from the base pool of participants. This included those participants who filled the Gujarati translated questionnaires and those who were in the pilot testing of the Gujarati translation process. This study was approved by the Institutional Ethics committee (IEC) and the clearance number was IEC/HMPCMCE/122/Faculty/4/. All the participants have filled the informed consent form.

Inclusion criteria: Those who agreed to participate in the study and had been working for atleast minimum of one year at the same place were included in the study. Different healthcare professionals viz., allopathic doctors, physiotherapists, nursing professionals and Community Health Officers (CHOs) were included as the study participants.

Exclusion criteria: Participants who did not agree to participate in the study were excluded.


The questionnaire was decided to be self-administered, as it was intended to measure many issues which included individual thinking, perceptions and personal habits and some past experiences. Self-administered questionnaire also increased the likelihood of responding truthfully.

Sampling was done as convenient sampling in two stages:

Stage-1: Primary units (Institutions and Government Public health facilities) (Table/Fig 1).
Stage-2: Participants from the institutions: Those who agreed to participate and were in the inclusion criteria.

Selection of questionnaires: To meet the desired objectives of the overall project, nine scales/questionnaires along with a socio-demographic proforma including occupational attributes and a qualitative proforma were finalised. All the nine questionnaires/scales were translated in both Hindi and Gujarati language (Table/Fig 2) (9),(10),(11),(12),(13),(14),(15),(16),(17).

In all the scales, permission to use and in some permission to translate was available on web page. In spite of the availability and written statement for public use and translation, authors got the permissions through mail for both use and translation in all. So, all the authors of the scales were communicated regarding the study and permission was taken from them regarding the use and the translation in two languages. Positive replies were received for use and translation. After translation, both the translated versions were sent to the respective authors. Different constructs were identified based on the objectives of the study (Table/Fig 3) (6),(7),(18),(19),(20),(21).

All the questionnaires used were in Likert scale whereas brief cope and OHS vulnerability measure questionnaire: Workplace health and safety survey were Likert type scale.

Statistical Analysis

In this study, Multitrait- Multimethod Matrix was prepared based on the correlation coefficient. Cronbach’s alpha was calculated as a measure for internal consistency.


Translation process: This was done following the standard World Health Organisation (WHO) guidelines for translation (22),(23). The described translation process is for both Hindi and Gujarati translations. All the nine questionnaires/scales were translated in both Hindi and Gujarati language.

Forward translation: For Gujarati translation, the translation was first done by the author and checked through four other independent translators in a pair of two. To one group, the objectives of the current study were made clear and the other group did the translation without the study background [24,25]. For Hindi translation, the translation was done primarily by the first author and then checked through one other translator for content similarity and correctness. The translated versions were kept simple, clear and concise.

Backward translation: The translated versions were back translated into the original language i.e., English. The translated versions and the original questionnaire were seen for any dubious and altered meaning. Due consideration was given to each word, modals and the tense in which the questions were framed. Accuracy was checked. The translated versions and the original study tools (questionnaires) were reviewed for conceptual equivalence. This was done by the same translators (for both the languages) as the translators are equipped with the sound knowledge of both the languages. It took two revisions before the final print was ready to be given to the participants for a pilot study. The final version of both the translations were read and approved by both the authors.

After completion of the translation process, the respondents were given the translated versions and asked for any difficulty in understanding the questions. So, the testing and the revisions were done in small groups when the questionnaires were given and this was done two times and no more further queries pertaining to questions came later. The respondents were asked the meaning of different statements and it was matched with the original study tools (questionnaires). This was done in person. The respondents query pertaining to any confusion for the questions was resolved with incorporation of all the necessary and important changes and suggestions thereafter in the respective questionnaires. Further new prints were taken with the incorporated changes. So, with all the suggestions in these two sittings, the study tools (questionnaires) were finalised. Faculties from medical colleges and physiotherapists were given the original set of English questionnaires. Issues related to certain difficult to understand phrases/sentences came into light. So, meaning of these phrases/sentences were also provided at the same site in the English questionnaire in italics putting in the asterix form. Examples of such sentences are “I found it difficult to wind down” and “I feel bogged down by the system”. All such difficulties in comprehension were identified and the meanings were added.

Validity and reliability analysis: Validity and reliability analysis in the present paper is of Gujarati translated questionnaires. Construct validity was measured indirectly by studying multiple measures like face validity, content validity and criterion validity. Face validity and content validity of the original English set of study tools (questionnaires) was assessed primarily by the authors (1st author is also the lead translator). After the translation process was over, it was followed by a discussion with all the translators. The print version of the translated copies was seen for face validity and content validity by the authors and the translators. The study tool comprised of consolidated questionnaire (one set consisted of socio-demographic profile, a qualitative questionnaire and nine scales/questionnaires). The linguistic validity was checked in the initial two sittings, following the translation process. The questionnaire contents, as well as, overall appeal of the questionnaire was discussed with the participants. Divergent validity and convergent validity (for concurrent validity) were assessed for different sub constructs/domains and was statistically checked by preparing Multitrait Multimethod Matrix (26). Convergent validity was seen as positive correlated scores of sub constructs/domains measured through different questionnaires. Discriminant validity of constructs/sub-constructs measured by different questionnaires is proved as non significant correlations.

Reliability analysis (for the collected data) was run which showed a very good reliability for different sub constructs of different scales (Table/Fig 4).

All the different scales measuring stress has a positive significant correlation (Table/Fig 5).

Intrusion of work in private life as a component of work place well-being was negatively correlated with work satisfaction, organisational respect for employees and Employer care. Else all were correlated positively and significant (Table/Fig 6). (Table/Fig 7) shows the assessment of construct validity of Occupational Health and Safety Survey.

Different questionnaires measuring the same construct/dimension are identified and put in same colour as red and blue. All blues and reds are positively correlated with the same type and red and blue were negatively correlated (Table/Fig 8).

Compassion satisfaction, burnout and secondary traumatic stress were three components in professional quality of life measure. Flourishing scale (FS), Brief resilient coping scale, compassion satisfaction and work satisfaction were positively correlated and all these were negatively correlated with all the stress measures, Depression, anxiety measures of Depression, Anxiety and Stress Scale (DASS) Burn out and secondary traumatic stress (Table/Fig 9)a,b.


Reliability and validity study of questionnaires is important. A translated questionnaire needs to be validated and should be checked for reliability. A translated questionnaire is a requirement once the researcher feels that the responses may be ambiguous pertaining to improperly understood questions by the intended participants. Accurate information through questionnaires is highly questionable, if participants struggle with linguistic comprehension. In such case, it becomes a felt need to translate the survey instrument. It is an exhaustive exercise. This is also important because it will help in identifying any modification, if required. Use of already validated and a reliable questionnaire requires validity and reliability to be checked every time whenever a new sample is collected. Validity is not of the questionnaire and it is of the scores, scored during each filling of the questionnaires (27).

Once validity and reliability are checked and approved in the research, then the internal validity is strengthened and external validity can be deduced from it. A construct is an abstract quality which cannot be directly observed/measured and is thus measured by face validity, content validity and criterion validity. There can be interperson variability in measurement of face validity and therefore, this type of evidence alone is insufficient to demonstrate the validity of questionnaire in total. It is not the exact measure and is a crude measure of validity. Apart from the experts, asking the participants regarding the questionnaire and its overall appeal will satisfy the face validity (28). Content validity refers to the degree to which a test covers all the characteristics being assessed (29).

Content validity is very important as it is a reflection of the variables of a construct (30). The criterion-related validity of a measure refers to the degree to which it is related to other concepts for a theoretically assumed association (7). Questionnaires of the same dimensionality and construct should have convergent validity and the opposite constructs should have a weak correlation or no correlation suggesting divergent validity. Divergent validity is proved by very little correlation and no correlation at all [31,32]. To assess the construct validity of a set of measures in a study, the Multitrait-Multimethod Matrix is an approach (26). It was developed in 1959 by Campbell and Fiske. Convergent validity is the degree to which concepts that should be related theoretically are interrelated in reality, whereas discriminant validity is the degree to which concepts that should not be related theoretically are not interrelated in reality. In this study also, convergent and discriminant validation was done by the Multitrait-Multimethod Matrix (26). In this study, the same results were found in having positive correlated scores of questionnaires measuring similar construct and negative correlation of opposing constructs. Discriminant validity of constructs/sub constructs measured by the questionnaire is proved as non significant correlations. In criterion related validity, concurrent type was analysed. It showed correct understanding and theoretical aligned responses as the construct of same dimensionality, being directly proportional has positive correlation and construct for opposite domain has negative correlation. Predictive convergent and divergent validity can be assessed for some predicted occupational variables like sickness absenteeism and leaving a job because of dissatisfaction or vice versa. Reliability as it depends on the data, needs to be checked in each study and differs for two different samples in different studies and is not a once and for all entity. Cronbach’s alpha is a property of the responses from a specific group of respondents (33). Cronbach’s alpha only indicates reliability of a questionnaire for a particular population of examinees by measuring internal consistency. In all the questionnaires, Cronbach’s alpha more than 0.70 was found except for Participation in Occupational Health and Safety (POHS) where it was 0.686 (34). If content validity of an instrument is lacking, establishing reliability becomes impossible (35).


The limitation of the present study was small sample size, same type of study can be applied on a larger sample to confirm the validity and reliability of different scales. Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) are not a part of this manuscript owing to the huge length of the manuscript and all the CFAs and SEM are entitled as an individual manuscript.


Divergent and convergent validity was proved for different construct/subconstruct in the translated questionnaires. Variables/questionnaires measuring a similar construct were found to be positively correlated and significant. Same way opposite constructs was negatively correlated. The questionnaires need to be translated in the language in which the participants can understand. This is for a better linguistic comprehension and by these accurate responses can be ensured, which in turn will increase the internal validity of the study.


The authors would like to acknowledge Dr. Darshana, Dr. Charvi, Dr. Dhara and Dr. Dhruv, Resident Doctors of the Department of Community Medicine for helping in Gujarati translation process and Dr. Anjali Sharma in Hindi translation process.


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DOI and Others

DOI: 10.7860/JCDR/2023/62768.18017

Date of Submission: Feb 05, 2023
Date of Peer Review: Mar 02, 2023
Date of Acceptance: Apr 20, 2023
Date of Publishing: Jun 01, 2023

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Feb 08, 2023
• Manual Googling: Mar 16, 2023
• iThenticate Software: Apr 17, 2023 (5%)

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