Development of the Self-Efficacy Scale for First Aid Practices in Early Adolescence

Development of the Self-Efficacy Scale for First Aid Practices in Early Adolescence | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development of the Self-Efficacy Scale for First Aid Practices in Early Adolescence İbrahim Bilir, Zerrin ÇİĞDEM, Melike YAVAŞ ÇELİK, Aynur EKREN ÇAKICI, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9137691/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Accidents and injuries remain among the leading causes of morbidity and mortality in childhood. Evidence indicates that these adverse outcomes can be substantially reduced through the timely and appropriate provision of first aid at the scene. The effectiveness of first aid practices depends not only on the individual’s level of knowledge but also on their self-efficacy belief regarding their ability to perform first aid interventions. However, the absence of a valid and reliable instrument specifically designed to measure first aid self-efficacy in children limits the evaluation of educational interventions. Therefore, this study aimed to develop a measurement tool to assess self-efficacy related to first aid practices among children in early adolescence. Methods This methodological scale development study was conducted among 1,496 students attending middle school. Following the necessary administrative approvals, data were collected through face-to-face interviews using a “Personal Information Form” and the “Self-Efficacy Scale for First Aid Practices in Early Adolescence.” Statistical analyses were performed using SPSS version 22 and AMOS version 21. Content validity was evaluated using the Content Validity Index, while construct validity was assessed through Exploratory Factor Analysis and Confirmatory Factor Analysis. Results The draft scale, consisting of 17 items and three sub-dimensions determined based on item factor loadings, demonstrated acceptable to excellent model fit according to confirmatory factor analysis. The path diagram fit indices were as follows: CMIN/DF = 3.929, GFI = 0.964, CFI = 0.938, NFI = 0.919, and RMSEA = 0.044. Reliability analyses were conducted using Cronbach’s α coefficient, item–total score correlations, and response bias assessments. The overall Cronbach’s α reliability coefficient of the scale was 0.848. Examination of the relationships among the sub-dimensions revealed positive correlations, indicating internal consistency across the factors. Conclusion Based on the findings of the present study, the “Self-Efficacy Scale for First Aid Practices in Early Adolescence” was determined to be a valid and reliable instrument for assessing first aid self-efficacy in children during early adolescence. First aid self-efficacy scale development Figures Figure 1 Figure 2 Introduction In daily life as well as in occupational settings, individuals may encounter accidents that can unintentionally disrupt the functioning or integrity of the body due to factors such as inattention, negligence, panic, excitement, or lack of training. The impact of accidents varies depending on when they occur, how they develop, whom they affect, and the extent of the resulting harm. Evidence reported in the literature indicates that mortality and morbidity rates associated with accidents remain considerably high [ 1 – 3 ]. According to the “Statistics on Children-2024” report published by the Turkish Statistical Institute (TÜİK) on April 18, 2025, mortality data indicate that external injuries and poisonings are the leading causes of death among children aged 1–17 years in Türkiye. When examined by age group, death rates due to external injury and poisoning were 12.4% in children aged 1–4 years, 19.1% in those aged 5–14 years, and 35.3% in adolescents aged 15–17 years [ 4 ]. In a study by Davis et al., it has been suggested that approximately 29% of cases had the potential for survival. Additionally, Tannvik et al. (2012), in a published systematic review, reported that effective first aid interventions could reduce mortality rates by between 1.8% and 4.5% [ 5 , 6 ]. First aid refers to the immediate interventions provided at the scene of an accident or acute illness, within the available resources, by individuals who have received appropriate training, with the aim of preserving life and preventing further deterioration of the condition. Delayed initiation of first aid or the implementation of incorrect practices may result in permanent disability or even death of the injured or ill individual. Therefore, it is essential for children—who may require first aid at various stages of their lives and may also be expected to provide first aid—to receive structured first aid education [ 7 , 8 ]. It is critically important that first responders possess adequate levels of knowledge and practical skills in first aid. However, as demonstrated in the literature, knowledge and technical competence alone may not be sufficient to ensure the initiation of first aid interventions. In addition to these competencies, a high level of first aid self-efficacy is considered essential. Individuals with high first aid self-efficacy are more likely to believe that they can effectively manage emergency situations and cope with the challenges encountered during such events. Consequently, when confronted with a situation requiring first aid, they are more likely to make appropriate decisions, organize necessary actions, and promptly initiate first aid interventions [ 9 – 11 ]. The concept of self-efficacy was first introduced by Bandura, the founder of Social Cognitive Theory, and has been described as a construct with a substantial influence on behavior. Bandura defined self-efficacy as an individual’s judgment regarding their capacity to regulate their own actions, exercise control over their behavior, and successfully initiate and sustain performance in a given domain. It also refers to the individual’s belief in their ability to cope with difficulties that may arise while performing a specific behavior. Self-efficacy develops over the course of life through accumulated experiences and may vary across individuals. In addition to personal and familial experiences, peer interactions and school-related experiences also play a significant role in shaping self-efficacy beliefs regarding events encountered throughout life [ 12 – 14 ]. Numerous studies have highlighted the significance of self-efficacy and its influence on individual behavior. Across different contexts and areas of application, the construct of self-efficacy has been operationalized in various domains, including social self-efficacy, technological self-efficacy, and first aid self-efficacy. Evidence indicates that higher levels of self-efficacy, shaped by educational exposure and experiential learning, are associated with improved coping capacity and more favorable behavioral outcomes, whereas lower levels may be related to reduced performance and less effective responses. In the field of first aid, self-efficacy has been examined among diverse professional groups and age populations, underscoring the relevance of this construct in emergency preparedness and response contexts [ 12 , 15 – 18 ]. Through first aid self-efficacy instruments developed for adults, mothers, healthcare professionals, teachers, and similar groups, numerous studies have assessed the perceived self-efficacy levels of these populations regarding first aid. However, when studies focusing on children—who represent a population at increased risk in terms of morbidity and mortality—are examined, it is observed that the majority primarily evaluate first aid knowledge levels, and to a lesser extent, first aid skills. For first aid interventions to be successfully implemented, children must not only possess adequate knowledge and skills but also demonstrate a high level of self-efficacy regarding their ability to perform first aid. A strong sense of first aid self-efficacy is considered essential for initiating and effectively carrying out first aid interventions when required [ 9 , 10 , 19 – 21 ]. A review of the literature revealed the absence of a specific instrument designed to assess self-efficacy related to first aid practices among children. Therefore, this study aimed to develop the “Self-Efficacy Scale for First Aid Practices in Early Adolescence” [ 21 – 23 ]. Data obtained through the use of this scale are expected to contribute to the planning of educational interventions aimed at enhancing first aid self-efficacy and to facilitate the translation of acquired first aid knowledge and skills into actual behavioral practice. Materials and methods The population of this methodological study consisted of students enrolled in the 5th, 6th, 7th, and 8th grades in the city center of Gaziantep, Türkiye. To ensure representativeness, it was planned to include 1,588 students attending 12 middle schools with diverse socio-demographic characteristics, for which official permissions were obtained from the Provincial Directorate of National Education and respective school administrations. Data collection was conducted between 11 September 2023 and 19 January 2024. Recommendations regarding adequate sample size for scale development studies vary in the literature. In line with sources indicating that samples comprising 1,000 or more participants are considered excellent, the sample size for the present study was determined accordingly [24]. Data were collected using the Personal Information Form and the Self-Efficacy Scale for First Aid Practices in Early Adolescence. Face-to-face interviews were conducted with 1,496 students for whom written parental consent and child assent were obtained. The KMO coefficient (0.91) demonstrated strong sampling adequacy for factor analysis. A statistically significant Bartlett’s Test of Sphericity (χ² = 5510.216, p < 0.001) further indicated that the dataset met the assumptions required for EFA [25–28]. Data Collection Instruments 1. Personal Information Form: This form included items related to the child’s age, grade level, parental educational status, and family socioeconomic status. 2. Self-Efficacy Scale for First Aid Practices in Early Adolescence: The scale developed within the scope of this study consists of 17 items and is structured as a 3-point Likert-type instrument (1 = Not confident at all, 2 = Confident, 3 = Very confident). The scale comprises three sub-dimensions: Practical Skills (items 8, 10, 12, 13, 14, 15, and 16), Decision-Making Skills (items 3, 4, 5, 6, 7, 9, and 17), and Environmental Management Skills (items 1, 2, and 11). No negatively worded (reverse-scored) items were included. The scale does not have a predefined cut-off point. The minimum possible total score is 17 and the maximum possible score is 51. Higher total scores indicate higher levels of self-efficacy related to first aid practices. Cronbach’s α coefficients were 0.775 for the Practical Skills sub-dimension, 0.709 for the Decision-Making Skills sub-dimension, 0.564 for the Environmental Management Skills sub-dimension, and 0.848 for the total scale. Scale Development Procedures Within the scope of the study, an initial item pool consisting of 57 items was generated based on a comprehensive review of the literature and expert consultations, ensuring alignment with the developmental characteristics of the target age group and the construct of first aid self-efficacy. Content validity was assessed by seven experts using an expert evaluation form. Expert ratings were obtained using the Davis technique with a four-point relevance scale. Based on expert evaluations, the Content Validity Index (CVI) was calculated for each item. Items with a CVI value below 0.80, those containing overlapping content, those considered unsuitable for the target population, or those deemed insufficient to measure the intended construct were removed. As a result, the number of items was reduced to 19. Following content validity assessment, a draft version of the scale was constructed in a 3-point Likert-type format (1 = Not confident at all, 2 = Confident, 3 = Very confident). Following the expert evaluations, the draft version of the scale was reviewed for face validity by two teachers employed by the Ministry of National Education, specializing in Turkish language and Science education. A pilot application was conducted with 25 students who met the inclusion criteria but were not included in the main study sample. Based on feedback obtained from the students during the pilot application, words and expressions that were considered difficult for children to understand were revised to improve clarity. The draft scale was finalized accordingly prior to the main data collection phase. After administration of the draft scale to the study sample, data analysis was undertaken. Based on their contribution to the total explained variance and in line with expert recommendations, items 5 and 7 were removed from the draft form. Subsequent EFA indicated that the final structure consisted of 17 items distributed across three sub-dimensions. The factor structure identified through EFA was further examined and confirmed using Confirmatory Factor Analysis (CFA). Reliability of the Self-Efficacy Scale for First Aid Practices in Early Adolescence was evaluated using Cronbach’s α coefficients, item–total score correlations, sub-dimension total score correlations, and response bias analysis. Statistical analysis Descriptive data were analyzed using frequencies, percentages, means, and standard deviations. Within the scale development process, the CVI was used to evaluate expert opinions. Item score analyses were conducted for both the total scale and its sub-dimensions, and relationships among variables were examined using Spearman’s correlation analysis. Internal consistency of the scale and its sub-dimensions was assessed using Cronbach’s α coefficients and item–total score correlations. EFA was applied to explore the factor structure and estimate item loadings, and the resulting structure was subsequently examined using CFA to verify model fit and dimensional composition. Statistical analyses were performed using SPSS version 22 and AMOS version 21. A 95% confidence level was adopted, and p < 0.05 was considered statistically significant. Results Upon examination of the socio-demographic characteristics of the students, it was determined that 29.7% (n = 444) were 13 years old and 28.6% (n = 428) were 11 years old, with a mean age of 11.68 ± 1.07 years. Regarding grade level, 28.9% (n = 432) were enrolled in the 6th grade and 25.6% (n = 383) in the 5th grade. It was observed that 49.8% (n = 745) of mothers and 39.2% (n = 587) of fathers had completed primary school education. Additionally, 60.0% (n = 897) of families reported that their income was equal to their expenses (Table 1 ). Table 1 Distribution of Students’ Socio-Demographic Characteristics (n = 1496) Socio-Demographic Characteristics n % Age (year) 10 249 16,6 11 428 28,6 12 375 25,1 13 444 29,7 Grade Level 5th grade 383 25,6 6th grade 432 28,9 7th grade 341 22,8 8th grade 340 22,7 Maternal Education Status Illiterate 77 5,1 Primary school 745 49,8 Middle school 393 26,3 High school 239 16,0 University 42 2,8 Paternal Education Status Illiterate 55 3,7 Primary school 587 39,2 Middle school 454 30,4 High school 313 20,9 University 87 5,8 Family Socioeconomic Status Income lower than expenses 384 25,7 Income equal to expenses 897 60,0 Income higher than expenses 215 14,4 Content validity of the initial item pool consisting of 57 items, developed through literature review and expert consultation, was evaluated by seven experts. Expert assessments were analyzed using the Davis technique, and item elimination was performed based on the calculated CVI values. A total of 38 items with CVI values below 0.80, those considered to contain overlapping content, or those deemed insufficient to measure the intended construct were removed from the scale. The remaining 19 items in the draft scale demonstrated CVI values ranging between 0.85 and 1.00. In the EFA procedure, items with factor loadings below the threshold of 0.40 were eliminated from the model. Guided by principal component analysis results and expert recommendations, items 5 and 7 were subsequently removed from the draft instrument. After item reduction, the final structure consisted of 17 items clustered under three factors with eigenvalues exceeding 1. These three factors accounted for 44.12% of the total variance, supporting the adequacy of the construct structure. Detailed information regarding factor composition, item loadings, and variance explained is provided in Table 2 . Table 2 Scale Items and Exploratory Factor Analysis Findings (n = 1496) Item Number Scale Items Factors Factor Loadings Total Explained Variance (%) A08 I can continue administering first aid to an individual in need until the emergency medical team arrives. Practical Skills ,598 29,49 A10 I can differentiate between types of minor bleeding. ,560 A12 I can perform the necessary first aid interventions to control minor bleeding. ,525 A13 I can distinguish between complete and partial airway obstruction. ,724 A14 I can perform the appropriate first aid interventions in cases of complete or partial airway obstruction. ,724 A15 I can encourage an individual who is able to cough during an airway obstruction to continue coughing. ,495 A16 I can identify situations in which the Heimlich maneuver should be performed. ,563 A03 I can remove individuals who may interfere with first aid interventions at the scene. Decision-Making Skills ,436 8,71 A04 I can calm an individual who requires first aid. ,476 A05 I can assess whether an individual in need of first aid is breathing. ,500 A06 I can inquire about how the incident occurred. ,563 A07 I can ensure that someone at the scene calls the emergency medical services. ,705 A09 I can provide information to the emergency medical team about the interventions performed at the scene. ,405 A17 I can ensure that emergency medical services are contacted in cases of prolonged airway obstruction. ,678 A01 I can ensure a safe environment for both the individual in need of first aid and myself. Environmental Management Skills ,645 5,90 A02 I can take precautions against potential hazards at the scene. ,677 A11 I can identify and obtain the necessary materials to control minor bleeding. ,501 Total Explained Variance 44,12 To test and confirm the factor structure identified through EFA, CFA was performed. The path diagram illustrating the factor structure of the scale, obtained using AMOS version 21, is presented in Fig. 1 . Examination of the path diagram indicated that, in line with covariance modification suggestions between items 1 and 2, and items 15 and 16, the model demonstrated consistency with the structure identified in the EFA. The results of the CFA confirmed that the scale retained its three-factor structure, with factor loadings ranging between 0.43 and 0.65 (Fig. 2 ). Evaluation of the goodness-of-fit indices obtained from the CFA of the Self-Efficacy Scale for First Aid Practices in Early Adolescence indicated that the model demonstrated acceptable to excellent fit. The CMIN/DF value was 3.929, the GFI was 0.964, the CFI was 0.938, the NFI was 0.919, and the RMSEA was 0.044. Overall, these indices suggest that the model fit the data well (Table 3 ). Table 3 Reference Values of Fit Indices and Obtained Results Fit Indices Excellent Fit Values Acceptable Fit Values Obtained Values Result CMIN/DF 0 ≤ χ2/df ≤ 3 3 < χ2/df ≤ 5 3,929 Acceptable GFI 0,90 ≤ GFI 0,80 ≤ GFI 0,964 Excellent AGFI 0,90 ≤ AGFI 0,80 ≤ AGFI 0,952 Excellent CFI 0,95 ≤ CFI 0,85 ≤ CFI 0,938 Acceptable NFI 0,95 ≤ NFI 0,80 ≤ NFI 0,919 Acceptable RMSEA 0,1 ≤ RMSEA ≤ 0,05 0,06 ≤ RMSEA ≤ 1,0 0,044 Excellent Cronbach’s α coefficients were calculated as 0.775 for the Practical Skills sub-dimension, 0.709 for the Decision-Making Skills sub-dimension, 0.564 for the Environmental Management Skills sub-dimension, and 0.848 for the total scale. Item–total score correlation coefficients ranged between 0.414 and 0.616 and were statistically significant. Analysis of item–subdimension total score correlations showed that coefficients ranged from 0.591 to 0.688 for the Practical Skills sub-dimension, from 0.546 to 0.659 for the Decision-Making Skills sub-dimension, and from 0.702 to 0.732 for the Environmental Management Skills sub-dimension. All correlations were statistically highly significant (p < 0.001) (Table 4 ). Table 4 Item–Subdimension Total Score Correlation and Cronbach’s α Reliability Coefficient Findings (n = 1496) Sub-Dimensions Number of Items Possible Score Range Cronbah’s α Coefficient Item Numbers Item–Subdimension Total Score Correlation Findings r p Practical Skills 7 7–21 0,775 A08 0,688 < 0,001 A10 0,593 < 0,001 A12 0,677 < 0,001 A13 0,627 < 0,001 A14 0,647 < 0,001 A15 0,591 < 0,001 A16 0,620 < 0,001 Decision-Making Skills 7 7–21 0,709 A03 0,567 < 0,001 A04 0,585 < 0,001 A05 0,578 < 0,001 A06 0,546 < 0,001 A07 0,654 < 0,001 A09 0,616 < 0,001 A17 0,659 < 0,001 Environmental Management Skills 3 3–9 0,564 A01 0,702 < 0,001 A02 0,729 < 0,001 A11 0,732 < 0,001 Total 17 17–51 0,848 *Spearman’s rho, p < 0,001 When the relationships between the Self-Efficacy Scale for First Aid Practices in Early Adolescence and its sub-dimensions were examined, strong and positive correlations were observed between the total scale score and the Practical Skills sub-dimension (r = 0.860), the Decision-Making Skills sub-dimension (r = 0.837), and the Environmental Management Skills sub-dimension (r = 0.718) (p < 0.001). Within the scope of reliability analyses, response bias was assessed to determine whether children tended to provide uniform responses to the items. Based on the analysis conducted on the dataset, Hotelling’s T² was 221.292 (p = 0.000), indicating that there was no response bias in the scale. Discussion Validity and reliability are among the fundamental properties required of measurement instruments, as they ensure that the developed scale is sensitive, consistent, and stable across independently obtained measurements of the same construct. In scale development studies, it is emphasized that the instrument must measure the intended construct(s) consistently and at the same standard for all participants. Within the framework of validity, it is necessary to evaluate whether the scale accurately measures what it is intended to measure, whether it does so appropriately, and whether the measurement is free from systematic bias. Accordingly, appropriate statistical analyses must be conducted to establish these properties. In terms of reliability, it is explained as the degree to which the instrument consistently measures the construct(s) of interest and the extent to which measurement error is minimized. As the proportion of error decreases, the reliability of the instrument increases [ 29 , 30 ]. For the validity assessment of the scale developed in this study, content validity procedures were undertaken to determine the extent to which the initial pool of 57 candidate items adequately represented the intended construct. Expert evaluations were obtained using structured expert review forms. Based on expert ratings and CVI values calculated using the Davis technique, and in line with recommendations in the literature, 38 items with CVI values below 0.80 were removed from the scale. The remaining 19 items in the draft version demonstrated CVI values ranging between 0.85 and 1.00, indicating that content validity was established [ 29 , 31 , 32 ]. For the assessment of construct validity, it is recommended that EFA be conducted prior to CFA on draft scales composed of items with established content validity. Before initiating factor analysis, the suitability of the sample for EFA should be evaluated using the KMO measure and Bartlett’s Test of Sphericity. Although acceptable threshold values for KMO may vary across sources, values ≥ 0.60 are generally considered adequate, while values ≥ 0.80 indicate strong sampling adequacy. In the present analysis, the KMO coefficient was 0.91, indicating strong sampling adequacy. Bartlett’s Test of Sphericity was statistically significant (p < 0.001), confirming that the correlation matrix was factorable and appropriate for EFA [ 25 – 28 ]. Consistent with commonly accepted criteria in factor analysis, factors with eigenvalues greater than 1 were retained, and a total explained variance of at least 40% was considered indicative of an acceptable factor structure. In this study, EFA identified a three-factor solution with eigenvalues exceeding 1, accounting for 44.12% of the total variance. Based on the conceptual content of the items loading on each factor, the sub-dimensions were defined as Practical Skills, Decision-Making Skills, and Environmental Management Skills [ 25 , 26 , 28 ]. In scale development studies, following EFA and CFA should be conducted to test and verify the factor structure of the construct being measured. Multiple goodness-of-fit indices are used in the evaluation of CFA results, and model fit is interpreted as acceptable or excellent based on established threshold values. In the present study, model fit was evaluated using CMIN/DF, GFI, CFI, NFI, and RMSEA indices. To improve the goodness-of-fit statistics, two modification indices were applied to the model, in accordance with recommendations in the literature suggesting that modifications should not exceed five or 20% of the total number of items [ 29 , 30 , 33 ]. According to the literature, a CMIN/DF value of ≤ 3 indicates excellent, while values ≤ 5 are considered indicative of acceptable. A GFI value of ≥ 0.90 and CFI and NFI values of ≥ 0.95 are generally interpreted as reflecting excellent model fit. The RMSEA value is considered acceptable when below 0.08 and indicative of excellent fit when below 0.05. In light of these criteria, evaluation of the study data demonstrated that the CMIN/DF value was 3.929, the GFI was 0.964, the CFI was 0.938, the NFI was 0.919, and the RMSEA was 0.044. These findings indicate that the model demonstrated acceptable to excellent fit and overall, the CFA results reflected good model fit [ 29 , 30 , 34 ]. Cronbach’s α coefficient, one of the most commonly used indicators of internal consistency in scale development studies, reflects the degree of interrelatedness among items within the context of the construct being measured. In evaluating item consistency and overall reliability, α values below 0.40 are generally interpreted as indicating insufficient reliability; values between 0.40 and 0.59 suggest low reliability; values between 0.60 and 0.79 are considered acceptable to good; and values ≥ 0.80 indicate high reliability. Several sources also recommend that Cronbach’s α values should typically fall between 0.70 and 0.95 for a scale to be considered reliable. Excessively high α values may indicate item redundancy, suggesting that similar items are measuring the same aspect of the construct. Conversely, low α values may result from weak inter-item correlations or a limited number of items. In cases of low α coefficients, it is recommended to examine item–total score correlations and consider removing items with correlation values approaching zero [ 30 , 35 , 36 ]. Based on the analysis of the data obtained in the present study, Cronbach’s α coefficients indicated that the Practical Skills and Decision-Making Skills sub-dimensions demonstrated good reliability, whereas the Environmental Management Skills sub-dimension exhibited relatively low reliability. The overall Cronbach’s α coefficient of the total scale was found to indicate high reliability. Upon further examination of the relatively low Cronbach’s α value of the Environmental Management Skills sub-dimension, it was observed that the item–total score correlations were not low. Consistent with the literature, this finding suggests that the lower reliability coefficient may be attributed to the limited number of items within this sub-dimension rather than weak inter-item relationships [ 36 ]. To further assess the reliability of the Self-Efficacy Scale for First Aid Practices in Early Adolescence developed within the scope of this study, item–total score correlation coefficients were also examined. Item–total correlation analysis is conducted to determine which items appropriately measure the intended construct and which items may require revision or removal. For this evaluation, an r value is calculated for each item. According to the literature, items with an r value greater than 0.30 are considered acceptable and may be retained in the scale, whereas items with r values below 0.30 are regarded as potentially measuring a different construct and are therefore recommended for removal. In the present study, evaluation of the item–total correlation coefficients demonstrated that all values were within acceptable limits. Accordingly, it was concluded that the items included in the scale contributed to internal consistency and that reliability was established [ 29 , 37 ]. When the relationships between the total score of the Self-Efficacy Scale for First Aid Practices in Early Adolescence and the sub-dimension total scores were examined, strong and positive correlations were identified between the overall scale and its sub-dimensions. These findings indicate that the scale, together with its sub-dimensions, constitutes an appropriate instrument for assessing self-efficacy levels related to first aid practices among children in early adolescence. Limitations of the Study The findings of this study can be generalized only to the sample included in the study and to the age groups represented within that sample. Conclusion Based on the validity and reliability analyses performed in this study, the Self-Efficacy Scale for First Aid Practices in Early Adolescence demonstrated satisfactory psychometric properties and can be considered a valid and reliable instrument for use among children aged 10–13 years. Considering that enhancing not only first aid knowledge but also first aid self-efficacy is essential, assessing self-efficacy levels should be taken into account when planning first aid training programs for children in early adolescence. It is therefore recommended that first aid educational content be designed and structured to specifically target and improve baseline self-efficacy levels identified through the use of the developed scale. Abbreviations CFA Confirmatory Factor Analysis CVI Content Validity Index EFA Exploratory Factor Analysis KMO Kaiser-Meier-Olkin TÜİK Turkish Statistical Institute Declarations Ethics approval The study was conducted in accordance with the Declaration of Helsinki and received ethical approval from the Ethics Committee of a foundation university (Decision No: 2023/44; 27 April 2023). 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Gülmez Dağ G. Are tomorrow’s teachers ready to save lives in cases of emergency? İlköğretim Online. 2019;17(3). DeVellis RF. Scale Development: Theory and applications. CA: Sage Publications;2017. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, & Young SL. Best practices for developing and validating scales for health, social, and behavioral research: A primer. Front Public Health. 2018;6, 149. Carpenter S. Ten steps in scale development and reporting: A guide for researchers. Communication Methods and Measures. 2018;12(1), 25-44. Yaşlıoğlu MM. Sosyal bilimlerde faktör analizi ve geçerlilik: Keşfedici ve doğrulayıcı faktör analizlerinin kullanılması. İstanbul Üniversitesi İşletme Fakültesi Dergisi. 2017;46, 74-85. Osborne JW. Best practices in exploratory factor analysis. CA: Createspace Independetn Publishing;2014. Erdoğan S, Nahcivan N, & Esin MN. (Ed.). Hemşirelikte Araştırma: Süreç, Uygulama ve Kritik (Cilt 3). Ankara: Nobel Tıp Kitabevleri;2018. Seçer İ. SPSS ve LISREL ile Pratik Veri Analizi: Analiz ve Raporlaştırma. Ankara: Anı Yayıncılık;2017. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, & Nikanfar A-R. Design and implementation content validity study: Development of an instrument for measuring patient-centered communication. J Caring Sci. 2015;4(2), 165-178. Davis LL. Instrument review: Getting the most from a panel of experts. Applied Nursing Research. 1992;5(4), 194-197. Joseph FH, Barry JB, William CB, & Rolph EA. Multivariate Data Analysis (Cilt 8). Hampshire: Cengage;2019. Koyuncu İ, & Kılıç AF. Açımlayıcı ve doğrulayıcı faktör analizlerinin kullanımı: Bir doküman incelemesi. Eğitim ve Bilim. 2019;44(198), 361-388. Alpar R. Spor, sağlık ve eğitim bilimlerinden örneklerle uygulamalı istatistik ve geçerlik-güvenirlik. Ankara: Detay Yayıncılık;2018. Tavakol M, & Dennick R. Making sense of Cronbach’s alpha. International Journal of Medical Education. 2011;2, 53-55. Çokluk Ö, Şekercioğlu G, & Büyüköztürk Ş. Çok değişkenli istatistik SPSS ve LISREL uygulamaları. Ankara: Pegem Akademi Yayınları;2018. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 03 May, 2026 Reviewers agreed at journal 25 Apr, 2026 Reviewers invited by journal 16 Apr, 2026 Editor invited by journal 24 Mar, 2026 Editor assigned by journal 21 Mar, 2026 Submission checks completed at journal 21 Mar, 2026 First submitted to journal 16 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9137691","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":628514543,"identity":"8871f4bb-53da-42a4-8e3e-d1aa4018f7c9","order_by":0,"name":"İbrahim Bilir","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIie3RMWsCMRTA8RcCcQm6Wk70K7wSUA77bQTXOlpwyCG41VlQ/Bg3Rx7oUnfhXG7p1KUILnUwp0Vdch64OOQ/hZAfeSEAPt8TJqoAHBAAOdcG+gaz3WpBwiz5uhB0mxOB7AjTwEYFSDn4THe9XgytEovoY75VaPgikXB4dw5WW6lgggmEQ6YX6/i7iUZ02hIw1M63dCGQliBZEsX0hkY2A0uck1nC/65klpHK/h4RN7dosoNJkU9qS9G2RJ7eopekXkiocIbKSRrTEU/kIam3KkS/ekCv49Uw3fz06zkfc05el//f5PP5fL4HOgKVpE9waAY1cgAAAABJRU5ErkJggg==","orcid":"","institution":"Hasan Kalyoncu University","correspondingAuthor":true,"prefix":"","firstName":"İbrahim","middleName":"","lastName":"Bilir","suffix":""},{"id":628514544,"identity":"6e693155-2d5e-4c86-bd44-eeaf6a9afaf3","order_by":1,"name":"Zerrin ÇİĞDEM","email":"","orcid":"","institution":"Istanbul Ayvansaray University","correspondingAuthor":false,"prefix":"","firstName":"Zerrin","middleName":"","lastName":"ÇİĞDEM","suffix":""},{"id":628514548,"identity":"930f8507-95f5-4f04-a6b1-1397d871b284","order_by":2,"name":"Melike YAVAŞ ÇELİK","email":"","orcid":"","institution":"Gaziantep University","correspondingAuthor":false,"prefix":"","firstName":"Melike","middleName":"YAVAŞ","lastName":"ÇELİK","suffix":""},{"id":628514550,"identity":"860ce546-3198-449f-a240-e853df297b93","order_by":3,"name":"Aynur EKREN ÇAKICI","email":"","orcid":"","institution":"Hasan Kalyoncu University","correspondingAuthor":false,"prefix":"","firstName":"Aynur","middleName":"EKREN","lastName":"ÇAKICI","suffix":""},{"id":628514552,"identity":"4fd97bbf-8bcf-4d5c-b4ef-25a6994db984","order_by":4,"name":"Nuran TOSUN","email":"","orcid":"","institution":"Hasan Kalyoncu University","correspondingAuthor":false,"prefix":"","firstName":"Nuran","middleName":"","lastName":"TOSUN","suffix":""}],"badges":[],"createdAt":"2026-03-16 12:09:59","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9137691/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9137691/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107833862,"identity":"3edbfcdc-1fc7-496e-91b8-f564d566f90c","added_by":"auto","created_at":"2026-04-26 15:41:30","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":60051,"visible":true,"origin":"","legend":"\u003cp\u003eScale Development Algorithm\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9137691/v1/9921a2d0fc25610a5838c537.png"},{"id":107833863,"identity":"8cb268ba-065e-4aca-829b-7aea91f6a36e","added_by":"auto","created_at":"2026-04-26 15:41:30","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":188966,"visible":true,"origin":"","legend":"\u003cp\u003ePath Diagram of the Self-Efficacy Scale for First Aid Practices in Early Adolescence\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9137691/v1/04770287646df6669228eced.png"},{"id":108181013,"identity":"25272f98-b809-4f29-b45a-fcad6afaecf2","added_by":"auto","created_at":"2026-04-30 08:56:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":553486,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9137691/v1/9091be25-a9f9-4fa0-8208-87a26c5fa6c7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Development of the Self-Efficacy Scale for First Aid Practices in Early Adolescence","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn daily life as well as in occupational settings, individuals may encounter accidents that can unintentionally disrupt the functioning or integrity of the body due to factors such as inattention, negligence, panic, excitement, or lack of training. The impact of accidents varies depending on when they occur, how they develop, whom they affect, and the extent of the resulting harm. Evidence reported in the literature indicates that mortality and morbidity rates associated with accidents remain considerably high [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to the \u0026ldquo;Statistics on Children-2024\u0026rdquo; report published by the Turkish Statistical Institute (T\u0026Uuml;İK) on April 18, 2025, mortality data indicate that external injuries and poisonings are the leading causes of death among children aged 1\u0026ndash;17 years in T\u0026uuml;rkiye. When examined by age group, death rates due to external injury and poisoning were 12.4% in children aged 1\u0026ndash;4 years, 19.1% in those aged 5\u0026ndash;14 years, and 35.3% in adolescents aged 15\u0026ndash;17 years [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In a study by Davis et al., it has been suggested that approximately 29% of cases had the potential for survival. Additionally, Tannvik et al. (2012), in a published systematic review, reported that effective first aid interventions could reduce mortality rates by between 1.8% and 4.5% [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFirst aid refers to the immediate interventions provided at the scene of an accident or acute illness, within the available resources, by individuals who have received appropriate training, with the aim of preserving life and preventing further deterioration of the condition. Delayed initiation of first aid or the implementation of incorrect practices may result in permanent disability or even death of the injured or ill individual. Therefore, it is essential for children\u0026mdash;who may require first aid at various stages of their lives and may also be expected to provide first aid\u0026mdash;to receive structured first aid education [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt is critically important that first responders possess adequate levels of knowledge and practical skills in first aid. However, as demonstrated in the literature, knowledge and technical competence alone may not be sufficient to ensure the initiation of first aid interventions. In addition to these competencies, a high level of first aid self-efficacy is considered essential. Individuals with high first aid self-efficacy are more likely to believe that they can effectively manage emergency situations and cope with the challenges encountered during such events. Consequently, when confronted with a situation requiring first aid, they are more likely to make appropriate decisions, organize necessary actions, and promptly initiate first aid interventions [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe concept of self-efficacy was first introduced by Bandura, the founder of Social Cognitive Theory, and has been described as a construct with a substantial influence on behavior. Bandura defined self-efficacy as an individual\u0026rsquo;s judgment regarding their capacity to regulate their own actions, exercise control over their behavior, and successfully initiate and sustain performance in a given domain. It also refers to the individual\u0026rsquo;s belief in their ability to cope with difficulties that may arise while performing a specific behavior. Self-efficacy develops over the course of life through accumulated experiences and may vary across individuals. In addition to personal and familial experiences, peer interactions and school-related experiences also play a significant role in shaping self-efficacy beliefs regarding events encountered throughout life [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNumerous studies have highlighted the significance of self-efficacy and its influence on individual behavior. Across different contexts and areas of application, the construct of self-efficacy has been operationalized in various domains, including social self-efficacy, technological self-efficacy, and first aid self-efficacy. Evidence indicates that higher levels of self-efficacy, shaped by educational exposure and experiential learning, are associated with improved coping capacity and more favorable behavioral outcomes, whereas lower levels may be related to reduced performance and less effective responses. In the field of first aid, self-efficacy has been examined among diverse professional groups and age populations, underscoring the relevance of this construct in emergency preparedness and response contexts [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16 CR17\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThrough first aid self-efficacy instruments developed for adults, mothers, healthcare professionals, teachers, and similar groups, numerous studies have assessed the perceived self-efficacy levels of these populations regarding first aid. However, when studies focusing on children\u0026mdash;who represent a population at increased risk in terms of morbidity and mortality\u0026mdash;are examined, it is observed that the majority primarily evaluate first aid knowledge levels, and to a lesser extent, first aid skills. For first aid interventions to be successfully implemented, children must not only possess adequate knowledge and skills but also demonstrate a high level of self-efficacy regarding their ability to perform first aid. A strong sense of first aid self-efficacy is considered essential for initiating and effectively carrying out first aid interventions when required [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA review of the literature revealed the absence of a specific instrument designed to assess self-efficacy related to first aid practices among children. Therefore, this study aimed to develop the \u0026ldquo;Self-Efficacy Scale for First Aid Practices in Early Adolescence\u0026rdquo; [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Data obtained through the use of this scale are expected to contribute to the planning of educational interventions aimed at enhancing first aid self-efficacy and to facilitate the translation of acquired first aid knowledge and skills into actual behavioral practice.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThe population of this methodological study consisted of students enrolled in the 5th, 6th, 7th, and 8th grades in the city center of Gaziantep, Türkiye. To ensure representativeness, it was planned to include 1,588 students attending 12 middle schools with diverse socio-demographic characteristics, for which official permissions were obtained from the Provincial Directorate of National Education and respective school administrations. Data collection was conducted between 11 September 2023 and 19 January 2024.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Recommendations regarding adequate sample size for scale development studies vary in the literature. In line with sources indicating that samples comprising 1,000 or more participants are considered excellent, the sample size for the present study was determined accordingly [24]. Data were collected using the Personal Information Form and the Self-Efficacy Scale for First Aid Practices in Early Adolescence. Face-to-face interviews were conducted with 1,496 students for whom written parental consent and child assent were obtained. The KMO coefficient (0.91) demonstrated strong sampling adequacy for factor analysis. A statistically significant Bartlett’s Test of Sphericity (χ² = 5510.216, p \u0026lt; 0.001) further indicated that the dataset met the assumptions required for EFA [25–28].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Instruments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;1. Personal Information Form:\u0026nbsp;\u003c/strong\u003eThis form included items related to the child’s age, grade level, parental educational status, and family socioeconomic status.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;2. Self-Efficacy Scale for First Aid Practices in Early Adolescence:\u0026nbsp;\u003c/strong\u003eThe scale developed within the scope of this study consists of 17 items and is structured as a 3-point Likert-type instrument (1 = Not confident at all, 2 = Confident, 3 = Very confident). The scale comprises three sub-dimensions: Practical Skills (items 8, 10, 12, 13, 14, 15, and 16), Decision-Making Skills (items 3, 4, 5, 6, 7, 9, and 17), and Environmental Management Skills (items 1, 2, and 11). No negatively worded (reverse-scored) items were included. The scale does not have a predefined cut-off point. The minimum possible total score is 17 and the maximum possible score is 51. Higher total scores indicate higher levels of self-efficacy related to first aid practices. Cronbach’s α coefficients were 0.775 for the Practical Skills sub-dimension, 0.709 for the Decision-Making Skills sub-dimension, 0.564 for the Environmental Management Skills sub-dimension, and 0.848 for the total scale.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eScale Development Procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Within the scope of the study, an initial item pool consisting of 57 items was generated based on a comprehensive review of the literature and expert consultations, ensuring alignment with the developmental characteristics of the target age group and the construct of first aid self-efficacy. Content validity was assessed by seven experts using an expert evaluation form. Expert ratings were obtained using the Davis technique with a four-point relevance scale. Based on expert evaluations, the Content Validity Index (CVI) was calculated for each item. Items with a CVI value below 0.80, those containing overlapping content, those considered unsuitable for the target population, or those deemed insufficient to measure the intended construct were removed. As a result, the number of items was reduced to 19. Following content validity assessment, a draft version of the scale was constructed in a 3-point Likert-type format (1 = Not confident at all, 2 = Confident, 3 = Very confident).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Following the expert evaluations, the draft version of the scale was reviewed for face validity by two teachers employed by the Ministry of National Education, specializing in Turkish language and Science education. A pilot application was conducted with 25 students who met the inclusion criteria but were not included in the main study sample. Based on feedback obtained from the students during the pilot application, words and expressions that were considered difficult for children to understand were revised to improve clarity. The draft scale was finalized accordingly prior to the main data collection phase.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;After administration of the draft scale to the study sample, data analysis was undertaken. Based on their contribution to the total explained variance and in line with expert recommendations, items 5 and 7 were removed from the draft form. Subsequent EFA indicated that the final structure consisted of 17 items distributed across three sub-dimensions. The factor structure identified through EFA was further examined and confirmed using Confirmatory Factor Analysis (CFA). Reliability of the Self-Efficacy Scale for First Aid Practices in Early Adolescence was evaluated using Cronbach’s α coefficients, item–total score correlations, sub-dimension total score correlations, and response bias analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive data were analyzed using frequencies, percentages, means, and standard deviations. Within the scale development process, the CVI was used to evaluate expert opinions. Item score analyses were conducted for both the total scale and its sub-dimensions, and relationships among variables were examined using Spearman’s correlation analysis. Internal consistency of the scale and its sub-dimensions was assessed using Cronbach’s α coefficients and item–total score correlations. EFA was applied to explore the factor structure and estimate item loadings, and the resulting structure was subsequently examined using CFA to verify model fit and dimensional composition. Statistical analyses were performed using SPSS version 22 and AMOS version 21. A 95% confidence level was adopted, and p \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eUpon examination of the socio-demographic characteristics of the students, it was determined that 29.7% (n\u0026thinsp;=\u0026thinsp;444) were 13 years old and 28.6% (n\u0026thinsp;=\u0026thinsp;428) were 11 years old, with a mean age of 11.68\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07 years. Regarding grade level, 28.9% (n\u0026thinsp;=\u0026thinsp;432) were enrolled in the 6th grade and 25.6% (n\u0026thinsp;=\u0026thinsp;383) in the 5th grade. It was observed that 49.8% (n\u0026thinsp;=\u0026thinsp;745) of mothers and 39.2% (n\u0026thinsp;=\u0026thinsp;587) of fathers had completed primary school education. Additionally, 60.0% (n\u0026thinsp;=\u0026thinsp;897) of families reported that their income was equal to their expenses (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Students\u0026rsquo; Socio-Demographic Characteristics (n\u0026thinsp;=\u0026thinsp;1496)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSocio-Demographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAge (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28,6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25,1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29,7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eGrade Level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5th grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25,6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6th grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e432\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28,9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7th grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22,8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8th grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22,7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMaternal Education Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e745\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49,8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2,8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003ePaternal Education Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3,7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39,2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e454\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30,4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20,9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFamily Socioeconomic Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncome lower than expenses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25,7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncome equal to expenses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e897\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60,0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncome higher than expenses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14,4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eContent validity of the initial item pool consisting of 57 items, developed through literature review and expert consultation, was evaluated by seven experts. Expert assessments were analyzed using the Davis technique, and item elimination was performed based on the calculated CVI values. A total of 38 items with CVI values below 0.80, those considered to contain overlapping content, or those deemed insufficient to measure the intended construct were removed from the scale. The remaining 19 items in the draft scale demonstrated CVI values ranging between 0.85 and 1.00.\u003c/p\u003e \u003cp\u003eIn the EFA procedure, items with factor loadings below the threshold of 0.40 were eliminated from the model. Guided by principal component analysis results and expert recommendations, items 5 and 7 were subsequently removed from the draft instrument. After item reduction, the final structure consisted of 17 items clustered under three factors with eigenvalues exceeding 1. These three factors accounted for 44.12% of the total variance, supporting the adequacy of the construct structure. Detailed information regarding factor composition, item loadings, and variance explained is provided in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eScale Items and Exploratory Factor Analysis Findings (n\u0026thinsp;=\u0026thinsp;1496)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem Number\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScale Items\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFactors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFactor Loadings\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal Explained Variance (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can continue administering first aid to an individual in need until the emergency medical team arrives.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003ePractical Skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e29,49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can differentiate between types of minor bleeding.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,560\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can perform the necessary first aid interventions to control minor bleeding.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,525\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can distinguish between complete and partial airway obstruction.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,724\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can perform the appropriate first aid interventions in cases of complete or partial airway obstruction.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,724\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can encourage an individual who is able to cough during an airway obstruction to continue coughing.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,495\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can identify situations in which the Heimlich maneuver should be performed.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,563\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can remove individuals who may interfere with first aid interventions at the scene.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eDecision-Making Skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e8,71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can calm an individual who requires first aid.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,476\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can assess whether an individual in need of first aid is breathing.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,500\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can inquire about how the incident occurred.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,563\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can ensure that someone at the scene calls the emergency medical services.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,705\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can provide information to the emergency medical team about the interventions performed at the scene.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,405\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can ensure that emergency medical services are contacted in cases of prolonged airway obstruction.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,678\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can ensure a safe environment for both the individual in need of first aid and myself.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEnvironmental Management Skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,645\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e5,90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can take precautions against potential hazards at the scene.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,677\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can identify and obtain the necessary materials to control minor bleeding.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,501\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eTotal Explained Variance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44,12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTo test and confirm the factor structure identified through EFA, CFA was performed. The path diagram illustrating the factor structure of the scale, obtained using AMOS version 21, is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Examination of the path diagram indicated that, in line with covariance modification suggestions between items 1 and 2, and items 15 and 16, the model demonstrated consistency with the structure identified in the EFA. The results of the CFA confirmed that the scale retained its three-factor structure, with factor loadings ranging between 0.43 and 0.65 (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eEvaluation of the goodness-of-fit indices obtained from the CFA of the Self-Efficacy Scale for First Aid Practices in Early Adolescence indicated that the model demonstrated acceptable to excellent fit. The CMIN/DF value was 3.929, the GFI was 0.964, the CFI was 0.938, the NFI was 0.919, and the RMSEA was 0.044. Overall, these indices suggest that the model fit the data well (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReference Values of Fit Indices and Obtained Results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFit Indices\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExcellent Fit Values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAcceptable Fit Values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eObtained Values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCMIN/DF\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026thinsp;\u0026le;\u0026thinsp;χ2/df\u0026thinsp;\u0026le;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u0026thinsp;\u0026lt;\u0026thinsp;χ2/df\u0026thinsp;\u0026le;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3,929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAcceptable\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGFI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,90\u0026thinsp;\u0026le;\u0026thinsp;GFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,80\u0026thinsp;\u0026le;\u0026thinsp;GFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,964\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExcellent\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAGFI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,90\u0026thinsp;\u0026le;\u0026thinsp;AGFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,80\u0026thinsp;\u0026le;\u0026thinsp;AGFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExcellent\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCFI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,95\u0026thinsp;\u0026le;\u0026thinsp;CFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,85\u0026thinsp;\u0026le;\u0026thinsp;CFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAcceptable\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNFI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,95\u0026thinsp;\u0026le;\u0026thinsp;NFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,80\u0026thinsp;\u0026le;\u0026thinsp;NFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,919\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAcceptable\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRMSEA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,1\u0026thinsp;\u0026le;\u0026thinsp;RMSEA\u0026thinsp;\u0026le;\u0026thinsp;0,05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,06\u0026thinsp;\u0026le;\u0026thinsp;RMSEA\u0026thinsp;\u0026le;\u0026thinsp;1,0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExcellent\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eCronbach\u0026rsquo;s α coefficients were calculated as 0.775 for the Practical Skills sub-dimension, 0.709 for the Decision-Making Skills sub-dimension, 0.564 for the Environmental Management Skills sub-dimension, and 0.848 for the total scale. Item\u0026ndash;total score correlation coefficients ranged between 0.414 and 0.616 and were statistically significant. Analysis of item\u0026ndash;subdimension total score correlations showed that coefficients ranged from 0.591 to 0.688 for the Practical Skills sub-dimension, from 0.546 to 0.659 for the Decision-Making Skills sub-dimension, and from 0.702 to 0.732 for the Environmental Management Skills sub-dimension. All correlations were statistically highly significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eItem\u0026ndash;Subdimension Total Score Correlation and Cronbach\u0026rsquo;s α Reliability Coefficient Findings (n\u0026thinsp;=\u0026thinsp;1496)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSub-Dimensions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of Items\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePossible Score Range\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCronbah\u0026rsquo;s α Coefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItem Numbers\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eItem\u0026ndash;Subdimension Total Score Correlation Findings\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003ePractical Skills\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e7\u0026ndash;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e0,775\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,688\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,677\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,627\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,647\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,620\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003eDecision-Making Skills\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e7\u0026ndash;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e0,709\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,567\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,585\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,654\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,659\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eEnvironmental Management Skills\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0,564\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,702\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,729\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,732\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u0026ndash;51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,848\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*Spearman\u0026rsquo;s rho, p\u0026thinsp;\u0026lt;\u0026thinsp;0,001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen the relationships between the Self-Efficacy Scale for First Aid Practices in Early Adolescence and its sub-dimensions were examined, strong and positive correlations were observed between the total scale score and the Practical Skills sub-dimension (r\u0026thinsp;=\u0026thinsp;0.860), the Decision-Making Skills sub-dimension (r\u0026thinsp;=\u0026thinsp;0.837), and the Environmental Management Skills sub-dimension (r\u0026thinsp;=\u0026thinsp;0.718) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Within the scope of reliability analyses, response bias was assessed to determine whether children tended to provide uniform responses to the items. Based on the analysis conducted on the dataset, Hotelling\u0026rsquo;s T\u0026sup2; was 221.292 (p\u0026thinsp;=\u0026thinsp;0.000), indicating that there was no response bias in the scale.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eValidity and reliability are among the fundamental properties required of measurement instruments, as they ensure that the developed scale is sensitive, consistent, and stable across independently obtained measurements of the same construct. In scale development studies, it is emphasized that the instrument must measure the intended construct(s) consistently and at the same standard for all participants. Within the framework of validity, it is necessary to evaluate whether the scale accurately measures what it is intended to measure, whether it does so appropriately, and whether the measurement is free from systematic bias. Accordingly, appropriate statistical analyses must be conducted to establish these properties. In terms of reliability, it is explained as the degree to which the instrument consistently measures the construct(s) of interest and the extent to which measurement error is minimized. As the proportion of error decreases, the reliability of the instrument increases [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFor the validity assessment of the scale developed in this study, content validity procedures were undertaken to determine the extent to which the initial pool of 57 candidate items adequately represented the intended construct. Expert evaluations were obtained using structured expert review forms. Based on expert ratings and CVI values calculated using the Davis technique, and in line with recommendations in the literature, 38 items with CVI values below 0.80 were removed from the scale. The remaining 19 items in the draft version demonstrated CVI values ranging between 0.85 and 1.00, indicating that content validity was established [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFor the assessment of construct validity, it is recommended that EFA be conducted prior to CFA on draft scales composed of items with established content validity. Before initiating factor analysis, the suitability of the sample for EFA should be evaluated using the KMO measure and Bartlett\u0026rsquo;s Test of Sphericity. Although acceptable threshold values for KMO may vary across sources, values\u0026thinsp;\u0026ge;\u0026thinsp;0.60 are generally considered adequate, while values\u0026thinsp;\u0026ge;\u0026thinsp;0.80 indicate strong sampling adequacy. In the present analysis, the KMO coefficient was 0.91, indicating strong sampling adequacy. Bartlett\u0026rsquo;s Test of Sphericity was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), confirming that the correlation matrix was factorable and appropriate for EFA [\u003cspan additionalcitationids=\"CR26 CR27\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConsistent with commonly accepted criteria in factor analysis, factors with eigenvalues greater than 1 were retained, and a total explained variance of at least 40% was considered indicative of an acceptable factor structure. In this study, EFA identified a three-factor solution with eigenvalues exceeding 1, accounting for 44.12% of the total variance. Based on the conceptual content of the items loading on each factor, the sub-dimensions were defined as Practical Skills, Decision-Making Skills, and Environmental Management Skills [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn scale development studies, following EFA and CFA should be conducted to test and verify the factor structure of the construct being measured. Multiple goodness-of-fit indices are used in the evaluation of CFA results, and model fit is interpreted as acceptable or excellent based on established threshold values. In the present study, model fit was evaluated using CMIN/DF, GFI, CFI, NFI, and RMSEA indices. To improve the goodness-of-fit statistics, two modification indices were applied to the model, in accordance with recommendations in the literature suggesting that modifications should not exceed five or 20% of the total number of items [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to the literature, a CMIN/DF value of \u0026le;\u0026thinsp;3 indicates excellent, while values\u0026thinsp;\u0026le;\u0026thinsp;5 are considered indicative of acceptable. A GFI value of \u0026ge;\u0026thinsp;0.90 and CFI and NFI values of \u0026ge;\u0026thinsp;0.95 are generally interpreted as reflecting excellent model fit. The RMSEA value is considered acceptable when below 0.08 and indicative of excellent fit when below 0.05. In light of these criteria, evaluation of the study data demonstrated that the CMIN/DF value was 3.929, the GFI was 0.964, the CFI was 0.938, the NFI was 0.919, and the RMSEA was 0.044. These findings indicate that the model demonstrated acceptable to excellent fit and overall, the CFA results reflected good model fit [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCronbach\u0026rsquo;s α coefficient, one of the most commonly used indicators of internal consistency in scale development studies, reflects the degree of interrelatedness among items within the context of the construct being measured. In evaluating item consistency and overall reliability, α values below 0.40 are generally interpreted as indicating insufficient reliability; values between 0.40 and 0.59 suggest low reliability; values between 0.60 and 0.79 are considered acceptable to good; and values\u0026thinsp;\u0026ge;\u0026thinsp;0.80 indicate high reliability. Several sources also recommend that Cronbach\u0026rsquo;s α values should typically fall between 0.70 and 0.95 for a scale to be considered reliable. Excessively high α values may indicate item redundancy, suggesting that similar items are measuring the same aspect of the construct. Conversely, low α values may result from weak inter-item correlations or a limited number of items. In cases of low α coefficients, it is recommended to examine item\u0026ndash;total score correlations and consider removing items with correlation values approaching zero [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBased on the analysis of the data obtained in the present study, Cronbach\u0026rsquo;s α coefficients indicated that the Practical Skills and Decision-Making Skills sub-dimensions demonstrated good reliability, whereas the Environmental Management Skills sub-dimension exhibited relatively low reliability. The overall Cronbach\u0026rsquo;s α coefficient of the total scale was found to indicate high reliability. Upon further examination of the relatively low Cronbach\u0026rsquo;s α value of the Environmental Management Skills sub-dimension, it was observed that the item\u0026ndash;total score correlations were not low. Consistent with the literature, this finding suggests that the lower reliability coefficient may be attributed to the limited number of items within this sub-dimension rather than weak inter-item relationships [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo further assess the reliability of the Self-Efficacy Scale for First Aid Practices in Early Adolescence developed within the scope of this study, item\u0026ndash;total score correlation coefficients were also examined. Item\u0026ndash;total correlation analysis is conducted to determine which items appropriately measure the intended construct and which items may require revision or removal. For this evaluation, an r value is calculated for each item. According to the literature, items with an r value greater than 0.30 are considered acceptable and may be retained in the scale, whereas items with r values below 0.30 are regarded as potentially measuring a different construct and are therefore recommended for removal. In the present study, evaluation of the item\u0026ndash;total correlation coefficients demonstrated that all values were within acceptable limits. Accordingly, it was concluded that the items included in the scale contributed to internal consistency and that reliability was established [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhen the relationships between the total score of the Self-Efficacy Scale for First Aid Practices in Early Adolescence and the sub-dimension total scores were examined, strong and positive correlations were identified between the overall scale and its sub-dimensions. These findings indicate that the scale, together with its sub-dimensions, constitutes an appropriate instrument for assessing self-efficacy levels related to first aid practices among children in early adolescence.\u003c/p\u003e\n\u003ch3\u003eLimitations of the Study\u003c/h3\u003e\n\u003cp\u003eThe findings of this study can be generalized only to the sample included in the study and to the age groups represented within that sample.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eBased on the validity and reliability analyses performed in this study, the Self-Efficacy Scale for First Aid Practices in Early Adolescence demonstrated satisfactory psychometric properties and can be considered a valid and reliable instrument for use among children aged 10\u0026ndash;13 years. Considering that enhancing not only first aid knowledge but also first aid self-efficacy is essential, assessing self-efficacy levels should be taken into account when planning first aid training programs for children in early adolescence. It is therefore recommended that first aid educational content be designed and structured to specifically target and improve baseline self-efficacy levels identified through the use of the developed scale.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCFA\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Confirmatory Factor Analysis\u003c/p\u003e\n\u003cp\u003eCVI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Content Validity Index\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEFA\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Exploratory Factor Analysis\u003c/p\u003e\n\u003cp\u003eKMO\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Kaiser-Meier-Olkin\u003c/p\u003e\n\u003cp\u003eTÜİK \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Turkish Statistical Institute\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and received ethical approval from the Ethics Committee of a foundation university (Decision No: 2023/44; 27 April 2023). Following ethical approval, institutional permission was obtained from the Provincial Directorate of National Education to administer the data collection instruments in the participating middle schools. Written informed consent was obtained from parents or legal guardians, and written assent was obtained from the participating children prior to data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no financial support from any funding agency, institution, or organization.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eKaratepe TU, Ekerbi\u0026ccedil;er H\u0026Ccedil;. \u0026Ccedil;ocuklarda ev kazaları. Sakarya Tıp Dergisi. 2017;7(1):69-73.\u003c/li\u003e\n \u003cli\u003eS\u0026uuml;zen LB. Temel ilk yardım. Ankara: Nobel Tıp Kitabevleri;2015.\u003c/li\u003e\n \u003cli\u003eEge R. Kaza, hastalık ve yaralanmalarda ilk ve acil yardım. 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İzmir Katip \u0026Ccedil;elebi \u0026Uuml;niversitesi Sağlık Bilimleri Fak\u0026uuml;ltesi Dergisi. 2023;8(2), 327-335.\u003c/li\u003e\n \u003cli\u003eOrakcı Ş, G\u0026ouml;ksu DY, \u0026amp; Karag\u0026ouml;z S. A mixed methods study of the teachers\u0026rsquo; self-efficacy views and their ability to improve self-efficacy beliefs during teaching. Frontiers in Psychology. 2022;1035829.\u003c/li\u003e\n \u003cli\u003eDemircioğlu H, \u0026amp; Işık E. Analyzing Self-Efficacy Perception of University Students. \u0026Ccedil;ukurova \u0026Uuml;niversitesi Eğitim Fakültesi Dergisi. 2020;49(1), 163-184.\u003c/li\u003e\n \u003cli\u003eYiğit D, Şayık D, A\u0026ccedil;ıkg\u0026ouml;z A, \u0026amp; Mumcu \u0026Ouml;. Pandemide annelerin ev kazalarına y\u0026ouml;nelik g\u0026uuml;venlik \u0026ouml;nlemlerini tanılama ve ilk yardım \u0026ouml;z-yeterlik durumlarının belirlenmesi. sted. 2022;31(6), 451-460.\u003c/li\u003e\n \u003cli\u003eYu YC, \u0026amp; Liang JC. Relationships among affect, hardiness and self-efficacy in first aidr provision by airline cabin crew. Int. J. Environ. Res. Public Health. 2021;18(4), 2108.\u003c/li\u003e\n \u003cli\u003eAltundağ S, Turan T, \u0026amp; Şafak M. Ev kazalarında ilk Yardım \u0026ouml;z-yeterlik \u0026ouml;l\u0026ccedil;eği\u0026rsquo;nin Türk\u0026ccedil;e ge\u0026ccedil;erlik ve güvenirlik \u0026ccedil;alışması. Cukurova Medical Journal. 2020;45(1), 71-78.\u003c/li\u003e\n \u003cli\u003eSihvo M, Heilala V, K\u0026auml;rkk\u0026auml;inen T. First aid self‑efficacy: a scale adaptation and psychometric properties. BMC Public Health. 2025;25, 1234.\u003c/li\u003e\n \u003cli\u003eG\u0026uuml;lmez Dağ G. Are tomorrow\u0026rsquo;s teachers ready to save lives in cases of emergency? İlk\u0026ouml;ğretim Online. 2019;17(3).\u003c/li\u003e\n \u003cli\u003eDeVellis RF. Scale Development: Theory and applications. 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A\u0026ccedil;ımlayıcı ve doğrulayıcı fakt\u0026ouml;r analizlerinin kullanımı: Bir dok\u0026uuml;man incelemesi. Eğitim ve Bilim. 2019;44(198), 361-388.\u003c/li\u003e\n \u003cli\u003eAlpar R. Spor, sağlık ve eğitim bilimlerinden \u0026ouml;rneklerle uygulamalı istatistik ve ge\u0026ccedil;erlik-g\u0026uuml;venirlik. Ankara: Detay Yayıncılık;2018.\u003c/li\u003e\n \u003cli\u003eTavakol M, \u0026amp; Dennick R. Making sense of Cronbach\u0026rsquo;s alpha. International Journal of Medical Education. 2011;2, 53-55.\u003c/li\u003e\n \u003cli\u003e\u0026Ccedil;okluk \u0026Ouml;, Şekercioğlu G, \u0026amp; B\u0026uuml;y\u0026uuml;k\u0026ouml;zt\u0026uuml;rk Ş. \u0026Ccedil;ok değişkenli istatistik SPSS ve LISREL uygulamaları. Ankara: Pegem Akademi Yayınları;2018.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"First aid, self-efficacy, scale development","lastPublishedDoi":"10.21203/rs.3.rs-9137691/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9137691/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAccidents and injuries remain among the leading causes of morbidity and mortality in childhood. Evidence indicates that these adverse outcomes can be substantially reduced through the timely and appropriate provision of first aid at the scene. The effectiveness of first aid practices depends not only on the individual\u0026rsquo;s level of knowledge but also on their self-efficacy belief regarding their ability to perform first aid interventions. However, the absence of a valid and reliable instrument specifically designed to measure first aid self-efficacy in children limits the evaluation of educational interventions. Therefore, this study aimed to develop a measurement tool to assess self-efficacy related to first aid practices among children in early adolescence.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis methodological scale development study was conducted among 1,496 students attending middle school. Following the necessary administrative approvals, data were collected through face-to-face interviews using a \u0026ldquo;Personal Information Form\u0026rdquo; and the \u0026ldquo;Self-Efficacy Scale for First Aid Practices in Early Adolescence.\u0026rdquo; Statistical analyses were performed using SPSS version 22 and AMOS version 21. Content validity was evaluated using the Content Validity Index, while construct validity was assessed through Exploratory Factor Analysis and Confirmatory Factor Analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe draft scale, consisting of 17 items and three sub-dimensions determined based on item factor loadings, demonstrated acceptable to excellent model fit according to confirmatory factor analysis. The path diagram fit indices were as follows: CMIN/DF\u0026thinsp;=\u0026thinsp;3.929, GFI\u0026thinsp;=\u0026thinsp;0.964, CFI\u0026thinsp;=\u0026thinsp;0.938, NFI\u0026thinsp;=\u0026thinsp;0.919, and RMSEA\u0026thinsp;=\u0026thinsp;0.044. Reliability analyses were conducted using Cronbach\u0026rsquo;s α coefficient, item\u0026ndash;total score correlations, and response bias assessments. The overall Cronbach\u0026rsquo;s α reliability coefficient of the scale was 0.848. Examination of the relationships among the sub-dimensions revealed positive correlations, indicating internal consistency across the factors.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eBased on the findings of the present study, the \u0026ldquo;Self-Efficacy Scale for First Aid Practices in Early Adolescence\u0026rdquo; was determined to be a valid and reliable instrument for assessing first aid self-efficacy in children during early adolescence.\u003c/p\u003e","manuscriptTitle":"Development of the Self-Efficacy Scale for First Aid Practices in Early Adolescence","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-26 15:41:27","doi":"10.21203/rs.3.rs-9137691/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-03T05:06:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"111826635920804044828042992063715763375","date":"2026-04-26T01:10:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-16T14:06:29+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-24T06:58:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-21T14:58:25+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-21T14:57:34+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2026-03-16T12:01:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"27f95bb2-9524-46fc-b3fa-1a4c80131ce2","owner":[],"postedDate":"April 26th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-03T05:06:42+00:00","index":65,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-26T15:41:27+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-26 15:41:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9137691","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9137691","identity":"rs-9137691","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}