Psychometric evaluation of an Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) in Community-dwelling Older Adults

Psychometric evaluation of an Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) in Community-dwelling Older Adults | 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 Psychometric evaluation of an Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) in Community-dwelling Older Adults Marwa Ibrahim Mahfouz Khalil, Reem Said Shaala, Mayar Elnakeeb, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4697566/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background There is a growing acknowledgment within the scientific community of the importance of preferences for routines (PR) in structuring the daily lives of older adults, as it reliably can serve as either a coping mechanism or contribute to emotional, cognitive, and functional vulnerabilities in its indeclinable form. Therefore, it is crucial to have a reliable, concise, easily administered, and cost-effective tool to assess this concept in clinical practice. The present study aims to evaluate the psychometric properties of the Arabic translation of the Preferences for Routines Scale- Short Form (PRS-S) in older Arabic-speaking adults living in the community. Method This study involved 539 older Arabic-speaking adults residing in the Egyptian community. Participants were provided with the 5-item Arabic-translated versions of the PRS-S, the 13-item Older People Quality of Life-Brief (OPQOL-brief), and the 15-item Resilience Scale of Older Adults (RSOA). Results Confirmatory factor analyses revealed that, after introducing a correlation between the residuals of items 1 and 2 due to a high modification index, the one-factor model of the PRS-S demonstrated excellent fit indices and a reliability of ω = .70; α = .69. Measurement consistency of the Arabic PRS-S was established across males and females at the configural, metric, and scalar levels; no significant difference in PRS-S scores between genders was found. Lastly, PRS-S scores showed significant and appropriate patterns correlations with the Arabic versions of RSOA and OPQOL-Brief scores in our sample, indicating adequate concurrent validity. Conclusion This study presents significant psychometric insights into the PRS-S based on CFA results and other analyses among older adults from a distinct cultural context. Providing the PRS-S in Arabic could be valuable for clinicians working with Arabic-speaking older adults in the community, enhancing the understanding of the prevalence and features of preferences for routines and its relevance to Gero-psychology. Preferences for Routines Psychometric Assessment PRS-S Arabic Older Adults Figures Figure 1 INTRODUCTION The adherence to a consistent routine is of paramount importance for the maintenance of typical and adaptive functioning throughout the entirety of the human lifespan, including the later stages of adulthood. Scholars have emphasized the imperative nature of maintaining, at minimum, a threshold level of consistent behavioural patterns or routines in effectively managing adversity and delineating personal roles, which constitute foundational elements of an individual's identity and character [ 1 , 2 ]. Routines are integral for structuring the day, fostering engagement, and cultivating a sense of purpose amongst older adults, thereby supporting their overall wellbeing. The incorporation of their preferences may serve to heighten their autonomy, social engagement, and life satisfaction [ 3 – 5 ]. The concept of routinization is defined as the organization of daily life around stable routines in the environment, behaviours, or social relationships [ 6 ]. Daily routines may be classified into two distinct categories: (1) Primary routines, which encompass behaviours essential for the maintenance of livelihood and biological needs (such as hygiene, sleep, and eating); and (2) secondary routines, which reflect individual circumstances, motivations, and preferences, including activities such as exercising, leisure pursuits, and practices associated with work or study (such as meticulous time management and the attainment of predetermined objectives) [ 7 ]. The importance of the consistency of daily routines in the evaluation and remediation of psychopathology has been underscored by the Social Zeitgeber Theory. This theory posits that individuals tend to engage in everyday activities regularly to synchronize inherent biological rhythms, such as body temperature, melatonin, and cortisol rhythms, with the 24-hour cycle. Furthermore, irregular daily routines, stemming from stressful life events, are hypothesized to disrupt circadian rhythms, thereby eliciting somatic symptoms that are directly linked to an elevated susceptibility to developing affective episodes [ 8 , 9 ]. Routinization in older adults As individuals age, the preservation of daily routines and structure can assume increasing importance in safeguarding their physical, cognitive, and emotional well-being. Adherence to familiar routines can mitigate cognitive burden during periods of stress in vulnerable older adults, thereby affording them the capacity to allocate mental faculties to other significant tasks or pleasurable pursuits and contributing to the management of chronic conditions [ 10 , 11 ]. Routines may also facilitate social engagement, a crucial component for the physical and mental well-being of older adults, and the perpetuation of healthy behaviors, such as the promotion of health and the management of medication in patients suffering from chronic ailments [ 12 ]. Furthermore, preferences for routines (PR) can significantly impact the quality of life and resilience of older adults. Adherence to familiar routines can provide a sense of stability, predictability, and control, which are essential for maintaining feelings of security and confidence in the management of daily life [ 13 ]. This, in turn, can contribute to enhanced well-being and the ability to adapt to the challenges and uncertainties associated with the aging process (JW Reich and AJ Zautra [ 5 ]. Routines can also serve as a mechanism for coping with stress, as they can shield individuals from the disruption caused by novel circumstances or challenges. This adaptation to stressful situations was believed to foster resilience and improve the overall quality of life for older adults [ 4 , 14 ]. In contrast, while routines can provide benefits for older adults, an excessive or rigid adherence to them can also have negative consequences. Individuals reporting diminished levels of daily routine exhibit inferior physical function, heightened anxiety, and increased depressive symptoms relative to those upholding more consistent daily routines [ 3 ]. There is also evidence that heightened disruptions in daily routines prospectively forecast inferior cognitive adaptation over time [ 15 ]. Rigid behavioral patterns resisting change or staunchly adhering to a specific order may typify maladaptive processes that hinder older individuals from addressing challenges or effecting necessary changes in their daily lives [ 5 ]. This may signify a depletion of resources impeding effective adaptation to loss, rendering them more susceptible in daily functioning [ 14 , 16 ]. In some instances, PR may obscure physical limitations as older adults eschew activities outside of their comfort zone. This lack of adaptability may pose challenges for recovery from setbacks, illnesses, life transitions, or other disruptions to their preferred patterns of living [ 16 , 17 ]. Altogether, PR might be regarded as an intra-individual factor indicative of inadequate adaptation to aging-related losses [ 18 ]. Considering the negative repercussions of an inflexible level of routine preferences on the various facets of older adults’ lives, it is imperative to establish practical methods within clinical practice aimed at assessing routine preferences. This is essential for ascertaining whether an older adult's RP may serve as a constructive coping mechanism or signal underlying vulnerabilities necessitating intervention and support [ 2 ]. Moreover, evaluating routine preferences in older adults holds potential implications across diverse aspects of their well-being and quality of life. A predictable daily routine can inform the formulation of supportive strategies geared towards helping older adults maintain healthy daily habits, contribute to cognitive stimulation, and preserve cognitive abilities in later life. Assessing routine preferences can facilitate the identification of older adults who could benefit from routine-based interventions designed to bolster independence, the aspiration to age in place, and to aid caregivers in developing personalized care plans, designing living environments, caregiving strategies, and community-based services aligned with the older adult's needs and preferences [ 3 ]. Measurement instruments of routinization in the older adults’ population The number of scales rigorously developed and validated to accurately measure the routine preference construct remains limited. Amongst these measures, the Scale of Older Adults’ Routine (SOAR) is a 42-item measure encompassing five routine dimensions, each featuring five scoring systems [ 19 ]. Although these measures have demonstrated satisfactory psychometric characteristics, their length and/or method of administration may pose challenges for data collection in large-scale or multi-time-point studies operated under significant time and cost constraints [ 19 ].The Preferences for Routine Scale (PRS) represents a commonly utilized self-report measure of routine preference in older adults, primarily consisting of ten items rated on a five-point Likert scale. This includes specific items relating to general activities (e.g., ‘In general, I like to do the same things each day’), leisure (e.g., ‘I like to watch new shows or films on television’), and daily rhythms (‘I like to wake up and go to bed at the same time each day’) [ 4 ]. The 10-item PRS has exhibited lower alpha coefficient values in select previous studies, implying the need for further research aimed at assessing and refining the scale's validity [ 20 ]. Recently, V Bergua, A Edjolo, J Bouisson, C Meillon, K Pérès and H Amieva [ 21 ], introduced the Preferences for Routine Scale short form (PRS-S), offering notable advantages over other scales employed within this demographic, providing the same information within a shorter timeframe, at a reduced cost and burden, while preserving sound psychometric properties. This is crucial to account for potential biases inherent in respondent-interviewer interaction, such as the tendency to evaluate individuals with poorer communication skills or lower cognitive abilities as having mild memory impairment [ 21 ]. In the initial validation study, the developer initially conceptualized the PR as a unidimensional instrument assessing the desirability of changes to specific daily life habits or routines. All items loaded into a single higher-order dimension and were deemed a measure of overall general routine preference [ 4 ]. Subsequent efforts aimed at enhancing the scale's reliability [ 21 ] led to the support of a one-factor solution in a sample of community-dwelling older adults. A study by V Bergua, C Meillon, K Pérès, JF Dartigues, J Bouisson and H Amieva [ 22 ], upheld the unidimensional model of the PRS-S as the best fit to the data. In summary, the construct validity of the PRS-S is deemed beneficial in clinical application, with only limited research conducted within this realm. Scant information exists on the psychometric properties of the PRS. Previous validation studies have yielded disparate findings, with some demonstrating favourable psychometric properties [ 4 ], while others indicate lower reliability [ 20 ] of PRS-Long Form. Importantly, two studies revealed that the short form of PRS (PRS-S) exhibited superior psychometric properties compared to the longer version among the general population, as evidenced by a higher Cronbach's alpha coefficient for the short form [ 21 , 22 ]. To the best of our knowledge, no Arabic version of the PRS-S is available to date for use among Arabic-speaking older adults. Rationale of the present study There is currently no validated and reliable measure of PR available in the scientific literature, and there is a dearth of research on this topic in Arabic-speaking countries. The absence of accurate measurement of routine preferences in older adults presents a considerable impediment to understanding its prevalence and to devising effective interventions in Arab contexts. The analysis of the preferences of older adults in their daily routines carries significant implications for informing policy decisions, improving service delivery, and efficiently allocating resources to better accommodate the rising older adults’ population on a global scale, and in the Arab world in particular. To contribute to the extant literature, our study aimed to evaluate the psychometric properties of an Arabic translation of the PRS-S in terms of factor structure, reliability, measurement invariance across sex, and concurrent validity in a sample of Arabic-speaking older adults. The study hypothesizes that the Arabic version of the PRS-S will demonstrate a similar factor structure to the original English version, exhibit adequate internal consistency reliability, and the factor structure of the Arabic PRS-S to be invariant across sex. In addition, it is hypothesized that the Arabic PRS-S will be significantly correlated with measures of older adults' quality of life and resilience, providing evidence of its concurrent validity. METHODS Sample and procedure This cross-sectional study was conducted during September and October 2023, and the participants were outpatients of the one-day clinics affiliated with General Alexandria Main University Hospital in Alexandria, Egypt. They were recruited through face-to-face interviews and an online survey distributed via formal communication platforms such as Facebook, Messenger, and WhatsApp using a Google Form link. The inclusion criteria encompassed individuals aged 65 and over who had successfully passed the Arabic version of the Montreal Cognitive Assessment Test [ 23 ], thereby confirming their cognitive and neurological soundness, and who did not exhibit any sensory perceptual disorders affecting communication. Official permissions were duly obtained from the pertinent authorities and the heads of the one-day clinics prior to participant enrollment, and participants were duly briefed on the study's objectives, as well as the confidentiality and anonymity of their responses. Those who met the inclusion criteria and expressed their consent were duly included in the study. Minimal sample size calculation For the purpose of conducting a confirmatory factor analysis, it has been determined that a sample size ranging from 15 to 100 participants is requisite, based on antecedent research suggesting a sample size that is 3 to 20 times the number of variables within the scale [ 24 ]. Measures Preferences for Routines Scale-Short Form (PRS-S) The PRS-S contains five items, rated from 1 to 5 based on the level of routinization, yields a total score ranging from 5 to 25 [ 22 ]. This scale evaluates participants' tendency to adhere to specific routines or embrace changes in daily life routines among older individuals, deliberately excluding inquiries likely to assess personality dimensions. Sample statements in the scale include "I consistently adhere to the same routine each day" and "I derive enjoyment from transitioning between activities". The researchers employed a rigorous translation-back translation protocol to develop the Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) for use with community-dwelling older adults. This well-established methodology is considered the gold standard for adapting an instrument from its original language to a new target language. First, the original English version of the PRS-S was independently translated into Arabic by two bilingual translators. The two preliminary Arabic translations were then reconciled through discussion to produce a single unified version. Next, this preliminary Arabic translation was back-translated into English by an additional bilingual translator who was blinded to the original English scale. The back-translated version was then compared to the source instrument to identify and resolve any discrepancies or conceptual incongruities. This iterative translation-back translation process was repeated until semantic equivalence and cultural appropriateness were achieved between the original English PRS-S and the adapted Arabic version. This rigorous approach ensured the maintenance of the intended meaning and relevance of the scale items for the target population of community-dwelling older adults in the Arabic-speaking context. The Older People's Quality of Life-brief (OPQOL-brief) Questionnaire The Arabic Version of the OPQOL-brief is designed for the self-assessment of the quality of life among the aging population [ 25 ]. Ann Bowling and her team developed the scale in 2013, as a succinct version of the original OPQOL scale, which comprised thirty-five items [ 26 ]. The questionnaire pertains to various domains such as leisure activities, home and neighborhood environment, social interactions, autonomy, mental and emotional wellbeing, and overall health. Participants traditionally assess their experiences and feelings using a Likert scale with five points, ranging from "strongly agree" to "strongly disagree." The total score on the OPQOL-brief, ranging from 13 to 65, is calculated by summing all the items, with higher scores indicating a superior quality of life [ 27 , 28 ]. The Arabic version of the scale was implemented in our study [ 29 ]. The Resilience Scale of Older Adults (RSOA) The RSOA is a self-report survey designed to assess the protective resilience characteristics of older individuals from their own perspective. It consists of fifteen items, and respondents rate each item on a five-point Likert scale ranging from one (never) to five (always). Higher scores on all RSOA variables as well as the overall score indicate higher resilience levels in older individuals [ 30 ]. The Arabic version of the scale was utilized in our study [ 31 ]. Analytic Strategy There were no missing responses in the dataset. To examine the factor structure of the PRS, we conducted a Confirmatory Factor Analysis using the data from the total sample via SPSS AMOS v.29 software. A minimum sample of 100 elderly was deemed necessary based on a range of 3 to 20 times the number of the scale’s variables [ 24 ]. Parameter estimates were obtained using the maximum likelihood method. Calculated fit indices were the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ .08 for RMSEA, and .90 for CFI and TLI indicate good fit of the model to the data [ 32 ]. Multivariate normality was not verified at first (Critical ratio > 5; Bollen-Stine p = .002); therefore, we performed non-parametric bootstrapping procedure. To examine gender invariance of PRS scores, we conducted multi-group CFA [ 33 ] using the total sample. Measurement invariance was assessed at the configural, metric, and scalar levels [ 34 ]. We accepted ΔCFI ≤ .010 and ΔRMSEA ≤ .015 or ΔSRMR ≤ .010 as evidence of invariance [ 33 ], Comparison between males and females was done using the Student t -test only if scalar or partial scalar invariance. Composite reliability in both subsamples was assessed using McDonald’s ω and Cronbach’s α, with values greater than .70 reflecting adequate composite reliability [ 35 ]. Normality of the PRS score was verified since the skewness and kurtosis values for each item of the scale varied between − 1 and + 1 [ 36 ]. To assess concurrent validity, Pearson test was used to correlate PRS scores with the other scales. Values ≤ .10 were considered weak, ~ .30 were considered moderate, and ~ .50 were considered strong correlations [ 37 ]. RESULTS Description of the sample Five hundred thirty-nine older adults filled the survey, with 50.3% females and 60.7% aged between 65–75 years. The full description of our sample is summarized in Table 1 . Table 1 Description of the sample (n = 539) n (%) Sex Males 268 (49.7%) Females 271 (50.3%) Age (years) 65–75 327 (60.7%) 75–85 169 (31.4%) >85 43 (8.0%) Education level Illiterate / Primary 282 (52.3%) Secondary 61 (11.3%) University 196 (36.4%) Confirmatory Factor Analysis CFA indicated that fit of the one-factor model of PRS scores was poor: RMSEA = .158 (90% CI .127, .191), SRMR = .073, CFI = .855, TLI = .710. After adding a correlation between residuals of items 1 and 2 because of high modification index, the fit indices became excellent: RMSEA = .043 (90% CI .001, .087), SRMR = .023, CFI = .991, TLI = .978. The standardised estimates of factor loadings were all adequate (Fig. 1 ). Reliability was good for the total score (ω = .70; α = .69). Sex Invariance Indices suggested that configural, metric, and scalar invariance was supported across sex (Table 1 ). No significant difference was found between males and females in terms of PRS score (13.42 ± 3.95 vs 13.84 ± 4.04), t (537) = -1.22, p = .223. Table 1 Measurement Invariance across sex in the total sample. Model CFI RMSEA SRMR Model Comparison ΔCFI ΔRMSEA ΔSRMR Configural .988 .037 .034 Metric .987 .031 .045 Configural vs metric .001 .006 .011 Scalar .977 .035 .046 Metric vs scalar .010 .004 .001 Note. CFI = Comparative fit index; RMSEA = Steiger-Lind root mean square error of approximation; SRMR = Standardised root mean square residual. Concurrent validity Higher PRS-S scores were significantly associated with higher resilience (r = .10; p = .020), and quality of life (r = .09; p = .045). DISCUSSION The PRS-S is a brief and easily administered self-report measure that is increasingly being utilized in clinical practice and psychological research. The present study aims to contribute to the psychology literature by examining the construct validity of an Arabic translation of the PRS-S using CFA, its concurrent validity using bivariate Pearson Correlation, internal consistency, and cross-sex measurement invariance. We aimed to determine whether previous findings of the PRS-S’s factor structure can be replicated in a sample of Arabic-speaking older adults from a Middle Eastern country by testing two different solutions. The findings revealed that, after adding a correlation between residuals of two items with high modification index, the one-factor model of the PRS-S demonstrated satisfactory fit indices and a reliability of ω = .70: α = .69. The Arabic 5-item PRS-S was invariant between males and females and showed good concurrent validity through its significant positive correlations with OPQOL, and RSOA scores. CFA showed that the single-factor model of the PRS-S in its Arabic version significantly fit the data after adding a correlation between residuals of two items with high modification index (items 1 and 2). The PR was first considered by the developer as a one-dimensional tool to evaluate how much people desired to change their daily habits. All the items were part of one main category and were seen as a way to measure overall preference for daily routines [ 4 ]. Subsequent research efforts by Bergua et al. in 2021 were focused on improving the reliability of the scale. This work supported a one-factor solution for the scale when tested in a sample of older adults living in the community. A more recent study by Bergua et al. in 2022 reinforced the finding that a one-dimensional (unidimensional) model best fits the data for the PRS-S scale. Both alpha and omega reliability coefficients showed good reliability, indicates the Arabic version of the PRS-S has strong internal consistency reliability, which is an important psychometric property supporting the scale's use for assessing routine preferences in Arabic-speaking older adult populations. Studies have shown that the short form of PRS-S exhibits superior psychometric properties compared to the longer version in the general population, with the 5-item short form demonstrating higher reliability (Cronbach's alpha coefficient of 0.66) in comparison to the 10-item form (0.50). The alpha coefficient was determined to be 0.68 at baseline and at the 2-year follow‐up, and 0.67 at the last follow‐up [ 22 ]. In a separate study, the Cronbach's alpha coefficient for the 5‐item short form was reported as 0.66 versus 0.55 for the 10‐item form [ 21 ]. Moreover, the measurement invariance of the Arabic 5-item one-factor PRS-S was demonstrated across sex groups at the configural, metric, and scalar levels, indicating that the construct validity of the scale is consistent across male and female older adults. Within our sample, no statistically significant difference emerged between sex groups in terms of PRS-S scores. However, previous research has presented conflicting findings regarding sex differences, with males displaying higher levels of PR. The authors posited that this may be linked to the hypothesis of gender differences in social roles, as articulated by AH Eagly [ 38 ]. The preference for routines in domestic and daily living activities may be linked to a man's traditional social role, which aligns more closely with work and social environments [ 21 ]. In order to address these discordant results, evaluating the measurement invariance of the PRS-S is imperative for future research to accurately portray the PR construct in older adults. Guaranteeing that a measure of PR demonstrates invariance across sex will facilitate consistent interpretation and usage by both males and females, potentially leading to a more individualized, sex-tailored approach in managing PR. Finally, the data reveals a statistically significant correlation between PRS-S scores and measures of resilience and quality of life. These findings not only validate prior research but also establish the Arabic PRS-S as a reliable instrument for assessing PR in Arabic-speaking older adults. The study by Bergua et al. [ 16 ] suggests that understanding the progressive routinization of behaviours and activities in older adults can help improve the early identification of difficulties with adaptation in this population. Furthermore, there is compelling evidence that routines can function as a protective mechanism, enabling older individuals to effectively adapt to challenging life experiences, as suggested by [ 5 ]. Contrarily, research conducted by Bouisson and Swendsen [ 6 ] revealed that heightened routinization of everyday life was linked to reduced positive emotions. These results imply that routinization should not be seen as a universally beneficial way of dealing with challenges for the majority of older adults. In a qualitative study examining the impact of established routines on the well-being of elderly women, it was found that adherence to routines correlated with nine favourable adaptive outcomes for the participants. These outcomes encompassed the ability to fulfil obligations, sustain an active lifestyle, preserve health, experience anticipation and positive expectations, maintain a sense of control, strike a balance between work, rest, and recreation, accomplish personal goals, foster self-esteem, and provide a sense of continuity [ 39 ]. The lifestyle of older individuals with predictable activities and schedules may consist of repetitive and unvarying elements, potentially leading to a decline in overall well-being. Notably, a heightened inclination towards routines has been correlated with increased levels of anxiety and depression in older adults residing independently and in residential facilities [ 4 , 16 , 20 ]. Additionally, repetitive activities and environments have been linked to decreased happiness among older adults living at home and in retirement facilities [ 6 ]. Notwithstanding, recent research on the significance of life maintains that the enactment of routine activities fosters a sense of life meaning by anchoring individuals within a broader context, thereby offering a structured framework for interpreting their experiences [ 40 ]. Study limitations It is imperative to interpret these findings in view of certain limitations. The assessment of test-retest reliability was not included in this study, which would have provided additional information on the scale's stability over time. The underrepresentation of participants exhibiting depressive symptoms or cognitive deficits in our study cohort could have impacted our findings. The paucity of psychometric data pertaining to the PRS-S emphasizes the need to re-evaluate the factor structure of the Arabic version. This reassessment should encompass all five items and involve larger samples of older adults in diverse settings, including individuals with acute and chronic. Additionally, longitudinal studies examining the stability of the PRS-S over time would be beneficial. Practice and research Implications The validated PRS-S may serve as a robust instrument for clinicians to appraise routines preferences in Arabic-speaking older adults. This information can be utilized to tailor individualized care plans and interventions. A comprehension of individuals' predilections for routines can facilitate the development of lifestyle interventions geared toward promoting healthy routines and habits, potentially yielding cognitive, emotional, and functional benefits for older adults. The existence of a validated Arabic version permits cross-cultural comparisons of routine preferences and their correlations with health outcomes across varied populations of older adults. Moreover, the PRS-S can be deployed to assess the effectiveness of routine-based therapies, including habit-based behavioural interventions, in ameliorating outcomes in Arabic-speaking older adult populations. Establishing the clinical relevance of the construct would strengthen the utility of the PRS-S in healthcare settings. Finally, examining the use of the PRS-S in guiding the development and implementation of personalized care plans and interventions that align with older adults' PR in Arab healthcare settings could provide valuable insights into the practical applications of the scale and its impact on patient-centered care. CONCLUSION The study findings indicate that the Arabic language version of the PRS-S demonstrated adequate psychometric properties, including factor structure, internal consistency reliability, cross-sex measurement invariance and concurrent validity, when evaluated among community-dwelling older adults in an Arab cultural context. The psychometric evaluation of the PRS-S establishes a reliable and valid tool for investigating routine preferences in Arabic-speaking older adults, with substantial ramifications for clinical practice, intervention design, cross-cultural research, and the dispensation of routine-based therapies to encourage healthy aging in this demographic. Declarations Ethics Approval and Consent to Participate : Ethical approval was obtained under the IRB code 00013620 (AU-20-5-239) from the Research Ethics Committee of the Faculty of Nursing, Alexandria University, Egypt. All subjects provided written informed consent, and the submission of an online soft copy was considered tantamount to providing written informed consent. The study was performed following the standards for medical research involving human subjects recommended by the Declaration of Helsinki for human research. CONFLICT OF INTEREST Authors are obliged to disclose any potential conflicts of interest as stipulated by the journal. DATA AVAILABILITY STATEMENT The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Funding: This study did not receive external funding. Author contributions: Author Contributions: The conception of the study was spearheaded by FFR, MIMK, and SH. MIMK, EFSM, and RSS formulated the initial draft of the manuscript. RSS and EFSM were responsible for data collection. ZB and SH conducted the analysis and provided their interpretation. MIMK, EFSM, RSS, ME, RFMM, FFR, and SH made substantial contributions to the final draft through their writing. All authors granted their final approval of the work following an assessment of its intellectual merit. Acknowledgements: The authors extend their genuine gratitude to each older adult participant who graciously contributed to the study. 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Bowling A, Hankins M, Windle G, Bilotta C, Grant R: A short measure of quality of life in older age: the performance of the brief Older People's Quality of Life questionnaire (OPQOL-brief) . Archives of gerontology and geriatrics 2013, 56 (1):181-187. Bowling A: The Psychometric Properties of the Older People's Quality of Life Questionnaire, Compared with the CASP-19 and the WHOQOL-OLD . Current gerontology and geriatrics research 2009, 2009 :298950. Bilotta C, Bowling A, Nicolini P, Casè A, Pina G, Rossi SV, Vergani C: Older People's Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy . Health and quality of life outcomes 2011, 9 :72. Bowling A, Stenner P: Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD . Journal of epidemiology and community health 2011, 65 (3):273-280. Khalil MIM, Hallit S, Fekih-Romdhane F, Bitar Z, Shaala RS, Mousa EFS, Menessy RFM, Elnakeeb M: Psychometric Properties of an Arabic Translation of the older people’s quality of life-brief (OPQOL-brief) scale . Research Square 2024, 1 :1-19. Li YT, Ow YSY: Development of resilience scale for older adults . Aging & mental health 2022, 26 (1):159-168. Elnakeeb M, Hallit S, Fekih-Romdhane F, Shaala RS, Mousa EFS, Khalil MIM: Psychometric properties of an Arabic translation of the resilience scale for older adults . Aging & mental health 2024, 14 :1-8. Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives . Structural Equation Modeling: A Multidisciplinary Journal 1999, 6 (1):1-55. Chen FF: Sensitivity of Goodness of Fit Indexes to Lack of Measurement Invariance . Structural Equation Modeling: A Multidisciplinary Journal 2007, 14 (3):464-504. Vandenberg RJ, Lance CE: A Review and Synthesis of the Measurement Invariance Literature: Suggestions, Practices, and Recommendations for Organizational Research . Organizational Research Methods 2000, 3 (1):4-70. Dunn TJ, Baguley T, Brunsden V: From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation . British journal of psychology (London, England : 1953) 2014, 105 (3):399-412. Hair JJ, Sarstedt M, Ringle C, Gudergan S: Advanced issues in partial least squares structural equation modeling : saGe publications; 2017. Cohen J: A power primer . Psychological bulletin 1992, 112 (1):155-159. Eagly AH: Sex differences in sexual behavior: A social-role interpretation : Psychology Press; 1987. Ludwig FM: How routine facilitates wellbeing in older women . Occupational Therapy International 1997, 4 (3):215-230. King LA, Hicks JA: The science of meaning in life . Annual review of psychology 2021, 72 (1):561-584. 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Scholars have emphasized the imperative nature of maintaining, at minimum, a threshold level of consistent behavioural patterns or routines in effectively managing adversity and delineating personal roles, which constitute foundational elements of an individual's identity and character [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Routines are integral for structuring the day, fostering engagement, and cultivating a sense of purpose amongst older adults, thereby supporting their overall wellbeing. The incorporation of their preferences may serve to heighten their autonomy, social engagement, and life satisfaction [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The concept of routinization is defined as the organization of daily life around stable routines in the environment, behaviours, or social relationships [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Daily routines may be classified into two distinct categories: (1) Primary routines, which encompass behaviours essential for the maintenance of livelihood and biological needs (such as hygiene, sleep, and eating); and (2) secondary routines, which reflect individual circumstances, motivations, and preferences, including activities such as exercising, leisure pursuits, and practices associated with work or study (such as meticulous time management and the attainment of predetermined objectives) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The importance of the consistency of daily routines in the evaluation and remediation of psychopathology has been underscored by the Social Zeitgeber Theory. This theory posits that individuals tend to engage in everyday activities regularly to synchronize inherent biological rhythms, such as body temperature, melatonin, and cortisol rhythms, with the 24-hour cycle. Furthermore, irregular daily routines, stemming from stressful life events, are hypothesized to disrupt circadian rhythms, thereby eliciting somatic symptoms that are directly linked to an elevated susceptibility to developing affective episodes [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eRoutinization in older adults\u003c/h3\u003e\n\u003cp\u003eAs individuals age, the preservation of daily routines and structure can assume increasing importance in safeguarding their physical, cognitive, and emotional well-being. Adherence to familiar routines can mitigate cognitive burden during periods of stress in vulnerable older adults, thereby affording them the capacity to allocate mental faculties to other significant tasks or pleasurable pursuits and contributing to the management of chronic conditions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Routines may also facilitate social engagement, a crucial component for the physical and mental well-being of older adults, and the perpetuation of healthy behaviors, such as the promotion of health and the management of medication in patients suffering from chronic ailments [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Furthermore, preferences for routines (PR) can significantly impact the quality of life and resilience of older adults. Adherence to familiar routines can provide a sense of stability, predictability, and control, which are essential for maintaining feelings of security and confidence in the management of daily life [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This, in turn, can contribute to enhanced well-being and the ability to adapt to the challenges and uncertainties associated with the aging process (JW Reich and AJ Zautra [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Routines can also serve as a mechanism for coping with stress, as they can shield individuals from the disruption caused by novel circumstances or challenges. This adaptation to stressful situations was believed to foster resilience and improve the overall quality of life for older adults [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn contrast, while routines can provide benefits for older adults, an excessive or rigid adherence to them can also have negative consequences. Individuals reporting diminished levels of daily routine exhibit inferior physical function, heightened anxiety, and increased depressive symptoms relative to those upholding more consistent daily routines [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. There is also evidence that heightened disruptions in daily routines prospectively forecast inferior cognitive adaptation over time [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Rigid behavioral patterns resisting change or staunchly adhering to a specific order may typify maladaptive processes that hinder older individuals from addressing challenges or effecting necessary changes in their daily lives [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This may signify a depletion of resources impeding effective adaptation to loss, rendering them more susceptible in daily functioning [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In some instances, PR may obscure physical limitations as older adults eschew activities outside of their comfort zone. This lack of adaptability may pose challenges for recovery from setbacks, illnesses, life transitions, or other disruptions to their preferred patterns of living [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Altogether, PR might be regarded as an intra-individual factor indicative of inadequate adaptation to aging-related losses [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConsidering the negative repercussions of an inflexible level of routine preferences on the various facets of older adults\u0026rsquo; lives, it is imperative to establish practical methods within clinical practice aimed at assessing routine preferences. This is essential for ascertaining whether an older adult's RP may serve as a constructive coping mechanism or signal underlying vulnerabilities necessitating intervention and support [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Moreover, evaluating routine preferences in older adults holds potential implications across diverse aspects of their well-being and quality of life. A predictable daily routine can inform the formulation of supportive strategies geared towards helping older adults maintain healthy daily habits, contribute to cognitive stimulation, and preserve cognitive abilities in later life. Assessing routine preferences can facilitate the identification of older adults who could benefit from routine-based interventions designed to bolster independence, the aspiration to age in place, and to aid caregivers in developing personalized care plans, designing living environments, caregiving strategies, and community-based services aligned with the older adult's needs and preferences [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMeasurement instruments of routinization in the older adults\u0026rsquo; population\u003c/h2\u003e \u003cp\u003eThe number of scales rigorously developed and validated to accurately measure the routine preference construct remains limited. Amongst these measures, the Scale of Older Adults\u0026rsquo; Routine (SOAR) is a 42-item measure encompassing five routine dimensions, each featuring five scoring systems [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Although these measures have demonstrated satisfactory psychometric characteristics, their length and/or method of administration may pose challenges for data collection in large-scale or multi-time-point studies operated under significant time and cost constraints [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].The Preferences for Routine Scale (PRS) represents a commonly utilized self-report measure of routine preference in older adults, primarily consisting of ten items rated on a five-point Likert scale. This includes specific items relating to general activities (e.g., \u0026lsquo;In general, I like to do the same things each day\u0026rsquo;), leisure (e.g., \u0026lsquo;I like to watch new shows or films on television\u0026rsquo;), and daily rhythms (\u0026lsquo;I like to wake up and go to bed at the same time each day\u0026rsquo;) [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The 10-item PRS has exhibited lower alpha coefficient values in select previous studies, implying the need for further research aimed at assessing and refining the scale's validity [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRecently, V Bergua, A Edjolo, J Bouisson, C Meillon, K P\u0026eacute;r\u0026egrave;s and H Amieva [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], introduced the Preferences for Routine Scale short form (PRS-S), offering notable advantages over other scales employed within this demographic, providing the same information within a shorter timeframe, at a reduced cost and burden, while preserving sound psychometric properties. This is crucial to account for potential biases inherent in respondent-interviewer interaction, such as the tendency to evaluate individuals with poorer communication skills or lower cognitive abilities as having mild memory impairment [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In the initial validation study, the developer initially conceptualized the PR as a unidimensional instrument assessing the desirability of changes to specific daily life habits or routines. All items loaded into a single higher-order dimension and were deemed a measure of overall general routine preference [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Subsequent efforts aimed at enhancing the scale's reliability [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] led to the support of a one-factor solution in a sample of community-dwelling older adults. A study by V Bergua, C Meillon, K P\u0026eacute;r\u0026egrave;s, JF Dartigues, J Bouisson and H Amieva [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], upheld the unidimensional model of the PRS-S as the best fit to the data. In summary, the construct validity of the PRS-S is deemed beneficial in clinical application, with only limited research conducted within this realm. Scant information exists on the psychometric properties of the PRS. Previous validation studies have yielded disparate findings, with some demonstrating favourable psychometric properties [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], while others indicate lower reliability [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] of PRS-Long Form. Importantly, two studies revealed that the short form of PRS (PRS-S) exhibited superior psychometric properties compared to the longer version among the general population, as evidenced by a higher Cronbach's alpha coefficient for the short form [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. To the best of our knowledge, no Arabic version of the PRS-S is available to date for use among Arabic-speaking older adults.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eRationale of the present study\u003c/h2\u003e \u003cp\u003eThere is currently no validated and reliable measure of PR available in the scientific literature, and there is a dearth of research on this topic in Arabic-speaking countries. The absence of accurate measurement of routine preferences in older adults presents a considerable impediment to understanding its prevalence and to devising effective interventions in Arab contexts. The analysis of the preferences of older adults in their daily routines carries significant implications for informing policy decisions, improving service delivery, and efficiently allocating resources to better accommodate the rising older adults\u0026rsquo; population on a global scale, and in the Arab world in particular. To contribute to the extant literature, our study aimed to evaluate the psychometric properties of an Arabic translation of the PRS-S in terms of factor structure, reliability, measurement invariance across sex, and concurrent validity in a sample of Arabic-speaking older adults. The study hypothesizes that the Arabic version of the PRS-S will demonstrate a similar factor structure to the original English version, exhibit adequate internal consistency reliability, and the factor structure of the Arabic PRS-S to be invariant across sex. In addition, it is hypothesized that the Arabic PRS-S will be significantly correlated with measures of older adults' quality of life and resilience, providing evidence of its concurrent validity.\u003c/p\u003e \u003c/div\u003e"},{"header":"METHODS ","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSample and procedure\u003c/h2\u003e \u003cp\u003e This cross-sectional study was conducted during September and October 2023, and the participants were outpatients of the one-day clinics affiliated with General Alexandria Main University Hospital in Alexandria, Egypt. They were recruited through face-to-face interviews and an online survey distributed via formal communication platforms such as Facebook, Messenger, and WhatsApp using a Google Form link. The inclusion criteria encompassed individuals aged 65 and over who had successfully passed the Arabic version of the Montreal Cognitive Assessment Test [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], thereby confirming their cognitive and neurological soundness, and who did not exhibit any sensory perceptual disorders affecting communication. Official permissions were duly obtained from the pertinent authorities and the heads of the one-day clinics prior to participant enrollment, and participants were duly briefed on the study's objectives, as well as the confidentiality and anonymity of their responses. Those who met the inclusion criteria and expressed their consent were duly included in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eMinimal sample size calculation\u003c/h2\u003e \u003cp\u003eFor the purpose of conducting a confirmatory factor analysis, it has been determined that a sample size ranging from 15 to 100 participants is requisite, based on antecedent research suggesting a sample size that is 3 to 20 times the number of variables within the scale [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003ePreferences for Routines Scale-Short Form (PRS-S)\u003c/h2\u003e \u003cp\u003eThe PRS-S contains five items, rated from 1 to 5 based on the level of routinization, yields a total score ranging from 5 to 25 [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This scale evaluates participants' tendency to adhere to specific routines or embrace changes in daily life routines among older individuals, deliberately excluding inquiries likely to assess personality dimensions. Sample statements in the scale include \"I consistently adhere to the same routine each day\" and \"I derive enjoyment from transitioning between activities\". The researchers employed a rigorous translation-back translation protocol to develop the Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) for use with community-dwelling older adults. This well-established methodology is considered the gold standard for adapting an instrument from its original language to a new target language. First, the original English version of the PRS-S was independently translated into Arabic by two bilingual translators. The two preliminary Arabic translations were then reconciled through discussion to produce a single unified version. Next, this preliminary Arabic translation was back-translated into English by an additional bilingual translator who was blinded to the original English scale. The back-translated version was then compared to the source instrument to identify and resolve any discrepancies or conceptual incongruities. This iterative translation-back translation process was repeated until semantic equivalence and cultural appropriateness were achieved between the original English PRS-S and the adapted Arabic version. This rigorous approach ensured the maintenance of the intended meaning and relevance of the scale items for the target population of community-dwelling older adults in the Arabic-speaking context.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eThe Older People's Quality of Life-brief (OPQOL-brief) Questionnaire\u003c/h2\u003e \u003cp\u003eThe Arabic Version of the OPQOL-brief is designed for the self-assessment of the quality of life among the aging population [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Ann Bowling and her team developed the scale in 2013, as a succinct version of the original OPQOL scale, which comprised thirty-five items [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The questionnaire pertains to various domains such as leisure activities, home and neighborhood environment, social interactions, autonomy, mental and emotional wellbeing, and overall health. Participants traditionally assess their experiences and feelings using a Likert scale with five points, ranging from \"strongly agree\" to \"strongly disagree.\" The total score on the OPQOL-brief, ranging from 13 to 65, is calculated by summing all the items, with higher scores indicating a superior quality of life [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The Arabic version of the scale was implemented in our study [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eThe Resilience Scale of Older Adults (RSOA)\u003c/h2\u003e \u003cp\u003eThe RSOA is a self-report survey designed to assess the protective resilience characteristics of older individuals from their own perspective. It consists of fifteen items, and respondents rate each item on a five-point Likert scale ranging from one (never) to five (always). Higher scores on all RSOA variables as well as the overall score indicate higher resilience levels in older individuals [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The Arabic version of the scale was utilized in our study [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eAnalytic Strategy\u003c/h2\u003e \u003cp\u003eThere were no missing responses in the dataset. To examine the factor structure of the PRS, we conducted a Confirmatory Factor Analysis using the data from the total sample via SPSS AMOS v.29 software. A minimum sample of 100 elderly was deemed necessary based on a range of 3 to 20 times the number of the scale\u0026rsquo;s variables [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Parameter estimates were obtained using the maximum likelihood method. Calculated fit indices were the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values\u0026thinsp;\u0026le;\u0026thinsp;.08 for RMSEA, and .90 for CFI and TLI indicate good fit of the model to the data [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Multivariate normality was not verified at first (Critical ratio\u0026thinsp;\u0026gt;\u0026thinsp;5; Bollen-Stine \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002); therefore, we performed non-parametric bootstrapping procedure.\u003c/p\u003e \u003cp\u003eTo examine gender invariance of PRS scores, we conducted multi-group CFA [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] using the total sample. Measurement invariance was assessed at the configural, metric, and scalar levels [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. We accepted ΔCFI\u0026thinsp;\u0026le;\u0026thinsp;.010 and ΔRMSEA\u0026thinsp;\u0026le;\u0026thinsp;.015 or ΔSRMR\u0026thinsp;\u0026le;\u0026thinsp;.010 as evidence of invariance [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], Comparison between males and females was done using the Student \u003cem\u003et\u003c/em\u003e-test only if scalar or partial scalar invariance.\u003c/p\u003e \u003cp\u003eComposite reliability in both subsamples was assessed using McDonald\u0026rsquo;s ω and Cronbach\u0026rsquo;s α, with values greater than .70 reflecting adequate composite reliability [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Normality of the PRS score was verified since the skewness and kurtosis values for each item of the scale varied between \u0026minus;\u0026thinsp;1 and +\u0026thinsp;1 [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. To assess concurrent validity, Pearson test was used to correlate PRS scores with the other scales. Values\u0026thinsp;\u0026le;\u0026thinsp;.10 were considered weak, ~ .30 were considered moderate, and ~\u0026thinsp;.50 were considered strong correlations [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eDescription of the sample\u003c/h2\u003e \u003cp\u003eFive hundred thirty-nine older adults filled the survey, with 50.3% females and 60.7% aged between 65\u0026ndash;75 years. The full description of our sample is summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" 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\u003eDescription of the sample (n\u0026thinsp;=\u0026thinsp;539)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e268 (49.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e271 (50.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e65\u0026ndash;75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e327 (60.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e75\u0026ndash;85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e169 (31.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43 (8.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate / Primary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e282 (52.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e196 (36.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eConfirmatory Factor Analysis\u003c/h2\u003e \u003cp\u003eCFA indicated that fit of the one-factor model of PRS scores was poor: RMSEA\u0026thinsp;=\u0026thinsp;.158 (90% CI .127, .191), SRMR\u0026thinsp;=\u0026thinsp;.073, CFI\u0026thinsp;=\u0026thinsp;.855, TLI\u0026thinsp;=\u0026thinsp;.710. After adding a correlation between residuals of items 1 and 2 because of high modification index, the fit indices became excellent: RMSEA\u0026thinsp;=\u0026thinsp;.043 (90% CI .001, .087), SRMR\u0026thinsp;=\u0026thinsp;.023, CFI\u0026thinsp;=\u0026thinsp;.991, TLI\u0026thinsp;=\u0026thinsp;.978. The standardised estimates of factor loadings were all adequate (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Reliability was good for the total score (ω\u0026thinsp;=\u0026thinsp;.70; α\u0026thinsp;=\u0026thinsp;.69).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eSex Invariance\u003c/h2\u003e \u003cp\u003eIndices suggested that configural, metric, and scalar invariance was supported across sex (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e). No significant difference was found between males and females in terms of PRS score (13.42\u0026thinsp;\u0026plusmn;\u0026thinsp;3.95 vs 13.84\u0026thinsp;\u0026plusmn;\u0026thinsp;4.04), \u003cem\u003et\u003c/em\u003e(537) = -1.22, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.223.\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 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eMeasurement Invariance across sex in the total sample.\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCFI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRMSEA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSRMR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eModel Comparison\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eΔCFI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eΔRMSEA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eΔSRMR\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfigural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.988\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.034\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 \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMetric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.987\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConfigural vs metric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScalar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMetric vs scalar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003eNote.\u003c/em\u003e CFI\u0026thinsp;=\u0026thinsp;Comparative fit index; RMSEA\u0026thinsp;=\u0026thinsp;Steiger-Lind root mean square error of approximation; SRMR\u0026thinsp;=\u0026thinsp;Standardised root mean square residual.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eConcurrent validity\u003c/h2\u003e \u003cp\u003eHigher PRS-S scores were significantly associated with higher resilience (r\u0026thinsp;=\u0026thinsp;.10; p\u0026thinsp;=\u0026thinsp;.020), and quality of life (r\u0026thinsp;=\u0026thinsp;.09; p\u0026thinsp;=\u0026thinsp;.045).\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe PRS-S is a brief and easily administered self-report measure that is increasingly being utilized in clinical practice and psychological research. The present study aims to contribute to the psychology literature by examining the construct validity of an Arabic translation of the PRS-S using CFA, its concurrent validity using bivariate Pearson Correlation, internal consistency, and cross-sex measurement invariance. We aimed to determine whether previous findings of the PRS-S\u0026rsquo;s factor structure can be replicated in a sample of Arabic-speaking older adults from a Middle Eastern country by testing two different solutions. The findings revealed that, after adding a correlation between residuals of two items with high modification index, the one-factor model of the PRS-S demonstrated satisfactory fit indices and a reliability of ω\u0026thinsp;=\u0026thinsp;.70: α\u0026thinsp;=\u0026thinsp;.69. The Arabic 5-item PRS-S was invariant between males and females and showed good concurrent validity through its significant positive correlations with OPQOL, and RSOA scores.\u003c/p\u003e \u003cp\u003eCFA showed that the single-factor model of the PRS-S in its Arabic version significantly fit the data after adding a correlation between residuals of two items with high modification index (items 1 and 2). The PR was first considered by the developer as a one-dimensional tool to evaluate how much people desired to change their daily habits. All the items were part of one main category and were seen as a way to measure overall preference for daily routines [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Subsequent research efforts by Bergua et al. in 2021 were focused on improving the reliability of the scale. This work supported a one-factor solution for the scale when tested in a sample of older adults living in the community. A more recent study by Bergua et al. in 2022 reinforced the finding that a one-dimensional (unidimensional) model best fits the data for the PRS-S scale. Both alpha and omega reliability coefficients showed good reliability, indicates the Arabic version of the PRS-S has strong internal consistency reliability, which is an important psychometric property supporting the scale's use for assessing routine preferences in Arabic-speaking older adult populations.\u003c/p\u003e \u003cp\u003eStudies have shown that the short form of PRS-S exhibits superior psychometric properties compared to the longer version in the general population, with the 5-item short form demonstrating higher reliability (Cronbach's alpha coefficient of 0.66) in comparison to the 10-item form (0.50). The alpha coefficient was determined to be 0.68 at baseline and at the 2-year follow‐up, and 0.67 at the last follow‐up [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. In a separate study, the Cronbach's alpha coefficient for the 5‐item short form was reported as 0.66 versus 0.55 for the 10‐item form [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, the measurement invariance of the Arabic 5-item one-factor PRS-S was demonstrated across sex groups at the configural, metric, and scalar levels, indicating that the construct validity of the scale is consistent across male and female older adults. Within our sample, no statistically significant difference emerged between sex groups in terms of PRS-S scores. However, previous research has presented conflicting findings regarding sex differences, with males displaying higher levels of PR. The authors posited that this may be linked to the hypothesis of gender differences in social roles, as articulated by AH Eagly [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The preference for routines in domestic and daily living activities may be linked to a man's traditional social role, which aligns more closely with work and social environments [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In order to address these discordant results, evaluating the measurement invariance of the PRS-S is imperative for future research to accurately portray the PR construct in older adults. Guaranteeing that a measure of PR demonstrates invariance across sex will facilitate consistent interpretation and usage by both males and females, potentially leading to a more individualized, sex-tailored approach in managing PR.\u003c/p\u003e \u003cp\u003eFinally, the data reveals a statistically significant correlation between PRS-S scores and measures of resilience and quality of life. These findings not only validate prior research but also establish the Arabic PRS-S as a reliable instrument for assessing PR in Arabic-speaking older adults. The study by Bergua et al. [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] suggests that understanding the progressive routinization of behaviours and activities in older adults can help improve the early identification of difficulties with adaptation in this population. Furthermore, there is compelling evidence that routines can function as a protective mechanism, enabling older individuals to effectively adapt to challenging life experiences, as suggested by [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Contrarily, research conducted by Bouisson and Swendsen [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] revealed that heightened routinization of everyday life was linked to reduced positive emotions. These results imply that routinization should not be seen as a universally beneficial way of dealing with challenges for the majority of older adults. In a qualitative study examining the impact of established routines on the well-being of elderly women, it was found that adherence to routines correlated with nine favourable adaptive outcomes for the participants. These outcomes encompassed the ability to fulfil obligations, sustain an active lifestyle, preserve health, experience anticipation and positive expectations, maintain a sense of control, strike a balance between work, rest, and recreation, accomplish personal goals, foster self-esteem, and provide a sense of continuity [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. The lifestyle of older individuals with predictable activities and schedules may consist of repetitive and unvarying elements, potentially leading to a decline in overall well-being. Notably, a heightened inclination towards routines has been correlated with increased levels of anxiety and depression in older adults residing independently and in residential facilities [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Additionally, repetitive activities and environments have been linked to decreased happiness among older adults living at home and in retirement facilities [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Notwithstanding, recent research on the significance of life maintains that the enactment of routine activities fosters a sense of life meaning by anchoring individuals within a broader context, thereby offering a structured framework for interpreting their experiences [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eStudy limitations\u003c/h2\u003e \u003cp\u003eIt is imperative to interpret these findings in view of certain limitations. The assessment of test-retest reliability was not included in this study, which would have provided additional information on the scale's stability over time. The underrepresentation of participants exhibiting depressive symptoms or cognitive deficits in our study cohort could have impacted our findings. The paucity of psychometric data pertaining to the PRS-S emphasizes the need to re-evaluate the factor structure of the Arabic version. This reassessment should encompass all five items and involve larger samples of older adults in diverse settings, including individuals with acute and chronic. Additionally, longitudinal studies examining the stability of the PRS-S over time would be beneficial.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003ePractice and research Implications\u003c/h2\u003e \u003cp\u003eThe validated PRS-S may serve as a robust instrument for clinicians to appraise routines preferences in Arabic-speaking older adults. This information can be utilized to tailor individualized care plans and interventions. A comprehension of individuals' predilections for routines can facilitate the development of lifestyle interventions geared toward promoting healthy routines and habits, potentially yielding cognitive, emotional, and functional benefits for older adults. The existence of a validated Arabic version permits cross-cultural comparisons of routine preferences and their correlations with health outcomes across varied populations of older adults. Moreover, the PRS-S can be deployed to assess the effectiveness of routine-based therapies, including habit-based behavioural interventions, in ameliorating outcomes in Arabic-speaking older adult populations. Establishing the clinical relevance of the construct would strengthen the utility of the PRS-S in healthcare settings. Finally, examining the use of the PRS-S in guiding the development and implementation of personalized care plans and interventions that align with older adults' PR in Arab healthcare settings could provide valuable insights into the practical applications of the scale and its impact on patient-centered care.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe study findings indicate that the Arabic language version of the PRS-S demonstrated adequate psychometric properties, including factor structure, internal consistency reliability, cross-sex measurement invariance and concurrent validity, when evaluated among community-dwelling older adults in an Arab cultural context. The psychometric evaluation of the PRS-S establishes a reliable and valid tool for investigating routine preferences in Arabic-speaking older adults, with substantial ramifications for clinical practice, intervention design, cross-cultural research, and the dispensation of routine-based therapies to encourage healthy aging in this demographic.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e: Ethical approval was obtained under the IRB code 00013620 (AU-20-5-239) from the Research Ethics Committee of the Faculty of Nursing, Alexandria University, Egypt. All subjects provided written informed consent, and the submission of an online soft copy was considered tantamount to providing written informed consent. The study was performed following the standards for medical research involving human subjects recommended by the Declaration of Helsinki for human research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONFLICT OF INTEREST\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors are obliged to disclose any potential conflicts of interest as stipulated by the journal.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDATA AVAILABILITY STATEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.\u003c/p\u003e\n\u003cp\u003eFunding: This study did not receive external funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u0026nbsp;\u003c/strong\u003eAuthor Contributions: The conception of the study was spearheaded by FFR, MIMK, and SH. MIMK, EFSM, and RSS formulated the initial draft of the manuscript. RSS and EFSM were responsible for data collection. ZB and SH conducted the analysis and provided their interpretation. MIMK, EFSM, RSS, ME, RFMM, FFR, and SH made substantial contributions to the final draft through their writing. All authors granted their final approval of the work following an assessment of its intellectual merit.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eThe authors extend their genuine gratitude to each older adult participant who graciously contributed to the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eReich JW: \u003cstrong\u003eRoutinization as a Factor in the Coping and the Mental Health of Women with Fibromyalgia\u003c/strong\u003e. \u003cem\u003eThe Occupational Therapy Journal of Research \u003c/em\u003e2000, \u003cstrong\u003e20\u003c/strong\u003e(1_suppl):41S-51S.\u003c/li\u003e\n\u003cli\u003eChifu VR, Pop CB, Demjen D, Socaci R, Todea D, Antal M, Cioara T, Anghel I, Antal C: \u003cstrong\u003eIdentifying and Monitoring the Daily Routine of Seniors Living at Home\u003c/strong\u003e. \u003cem\u003eSensors (Basel, Switzerland) \u003c/em\u003e2022, \u003cstrong\u003e22\u003c/strong\u003e(3):992.\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Conor R, Benavente JY, Kwasny MJ, Eldeirawi K, Hasnain-Wynia R, Federman AD, Hebert-Beirne J, Wolf MS: \u003cstrong\u003eDaily Routine: Associations With Health Status and Urgent Health Care Utilization Among Older Adults\u003c/strong\u003e. \u003cem\u003eThe Gerontologist \u003c/em\u003e2019, \u003cstrong\u003e59\u003c/strong\u003e(5):947-955.\u003c/li\u003e\n\u003cli\u003eBouisson J: \u003cstrong\u003eRoutinization preferences, anxiety, and depression in an elderly French sample\u003c/strong\u003e. \u003cem\u003eJournal of Aging Studies \u003c/em\u003e2002, \u003cstrong\u003e16\u003c/strong\u003e(3):295-302.\u003c/li\u003e\n\u003cli\u003eReich JW, Zautra AJ: \u003cstrong\u003eAnalyzing the trait of routinization in older adults\u003c/strong\u003e. \u003cem\u003eInternational journal of aging \u0026amp; human development \u003c/em\u003e1991, \u003cstrong\u003e32\u003c/strong\u003e(3):161-180.\u003c/li\u003e\n\u003cli\u003eBouisson J, Swendsen J: \u003cstrong\u003eRoutinization and emotional well-being: an experience sampling investigation in an elderly French sample\u003c/strong\u003e. \u003cem\u003eThe journals of gerontology Series B, Psychological sciences and social sciences \u003c/em\u003e2003, \u003cstrong\u003e58\u003c/strong\u003e(5):P280-282.\u003c/li\u003e\n\u003cli\u003eHou WK, Lai FTT, Hougen C, Hall BJ, Hobfoll SE: \u003cstrong\u003eMeasuring everyday processes and mechanisms of stress resilience: Development and initial validation of the Sustainability of Living Inventory (SOLI)\u003c/strong\u003e. \u003cem\u003ePsychological assessment \u003c/em\u003e2019, \u003cstrong\u003e31\u003c/strong\u003e(6):715-729.\u003c/li\u003e\n\u003cli\u003eEhlers CL, Frank E, Kupfer DJ: \u003cstrong\u003eSocial zeitgebers and biological rhythms. 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2017.\u003c/li\u003e\n\u003cli\u003eCohen J: \u003cstrong\u003eA power primer\u003c/strong\u003e. \u003cem\u003ePsychological bulletin \u003c/em\u003e1992, \u003cstrong\u003e112\u003c/strong\u003e(1):155-159.\u003c/li\u003e\n\u003cli\u003eEagly AH: \u003cstrong\u003eSex differences in sexual behavior: A social-role interpretation\u003c/strong\u003e: Psychology Press; 1987.\u003c/li\u003e\n\u003cli\u003eLudwig FM: \u003cstrong\u003eHow routine facilitates wellbeing in older women\u003c/strong\u003e. \u003cem\u003eOccupational Therapy International \u003c/em\u003e1997, \u003cstrong\u003e4\u003c/strong\u003e(3):215-230.\u003c/li\u003e\n\u003cli\u003eKing LA, Hicks JA: \u003cstrong\u003eThe science of meaning in life\u003c/strong\u003e. \u003cem\u003eAnnual review of psychology \u003c/em\u003e2021, \u003cstrong\u003e72\u003c/strong\u003e(1):561-584.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"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":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Preferences for Routines, Psychometric Assessment, PRS-S, Arabic, Older Adults","lastPublishedDoi":"10.21203/rs.3.rs-4697566/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4697566/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThere is a growing acknowledgment within the scientific community of the importance of preferences for routines (PR) in structuring the daily lives of older adults, as it reliably can serve as either a coping mechanism or contribute to emotional, cognitive, and functional vulnerabilities in its indeclinable form. Therefore, it is crucial to have a reliable, concise, easily administered, and cost-effective tool to assess this concept in clinical practice. The present study aims to evaluate the psychometric properties of the Arabic translation of the Preferences for Routines Scale- Short Form (PRS-S) in older Arabic-speaking adults living in the community.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eThis study involved 539 older Arabic-speaking adults residing in the Egyptian community. Participants were provided with the 5-item Arabic-translated versions of the PRS-S, the 13-item Older People Quality of Life-Brief (OPQOL-brief), and the 15-item Resilience Scale of Older Adults (RSOA).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eConfirmatory factor analyses revealed that, after introducing a correlation between the residuals of items 1 and 2 due to a high modification index, the one-factor model of the PRS-S demonstrated excellent fit indices and a reliability of ω\u0026thinsp;=\u0026thinsp;.70; α\u0026thinsp;=\u0026thinsp;.69. Measurement consistency of the Arabic PRS-S was established across males and females at the configural, metric, and scalar levels; no significant difference in PRS-S scores between genders was found. Lastly, PRS-S scores showed significant and appropriate patterns correlations with the Arabic versions of RSOA and OPQOL-Brief scores in our sample, indicating adequate concurrent validity.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis study presents significant psychometric insights into the PRS-S based on CFA results and other analyses among older adults from a distinct cultural context. Providing the PRS-S in Arabic could be valuable for clinicians working with Arabic-speaking older adults in the community, enhancing the understanding of the prevalence and features of preferences for routines and its relevance to Gero-psychology.\u003c/p\u003e","manuscriptTitle":"Psychometric evaluation of an Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) in Community-dwelling Older Adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-09 21:05:18","doi":"10.21203/rs.3.rs-4697566/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e006af4a-4651-48be-92b3-f1f6e1660d47","owner":[],"postedDate":"August 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-23T09:24:15+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-09 21:05:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4697566","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4697566","identity":"rs-4697566","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}