Delegating care as a double-edged sword for quality of nursing care: a qualitative study.

BACKGROUND: Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care. METHODS: This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985). RESULTS: In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword". CONCLUSIONS: The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.

Clinical nursing competency during epidemics: a qualitative content analysis.

BACKGROUND: Nurses are on the frontline for managing epidemic diseases. Different aspects of clinical nursing competencies during epidemics are important issues that need investigation. OBJECTIVES: The aim of this study was to determine the required clinical competencies for nurses during epidemics. Understanding these competencies could provide valuable information for health care services and nursing education organizations to prepare nurses for future epidemics. METHODS: The qualitative conventional content analysis study was conducted using semi-structured interviews with 12 nurses that were actively engaged in providing patient care during COVID-19 pandemic in Shahid Beheshti hospital in Kashan/Iran, from October 2022 to March 2023. The data analysis process was conducted according to 5 steps suggested by Graneheim and Lundman. RESULTS: After analysis, the 159 competencies were derived from interviews that were categorized to 11 subcategories, and three categories of clinical nursing skills in epidemics, knowledge of epidemics, and soft skills for nurses in epidemics. CONCLUSION: Nurses need wide range of competencies to address the professional expectations regarding providing acceptable care during epidemics. Knowing these competencies can help nursing managers to prepare nurses for crisis such as what world experienced during COVID-19 pandemic.

Development and Psychometric Evaluation of the Motivation for Healing Scale in Patients with Cancer.

Introduction: This study was conducted to develop and validate a Motivation for Healing Scale (MHS) in Cancer. Methods: in this methodological study, the MHS draft was developed based on the approach of Waltz and colleagues using existing scales and concept analysis. The psychometric features, including face validity (qualitative and quantitative), content validity (qualitative and quantitative), structural validity (exploratory and confirmatory factors), and construct validity (convergent and discriminant validity) were assessed. Finally, the reliability was evaluated using internal consistency, and stability. Results: Based on the results of the qualitative phase, an initial item pool was generated with 55 items, Exploratory and confirmatory factor analyses were performed on the data collected from 404 patients. 25 Items were excluded during the psychometric evaluation phases. Reliability assessment and internal consistency assessment revealed that Cronbach's alpha value of the 25-item MHS was 0.912. The results of intraclass correlation coefficient (0.93, 95% CI: 0.86- 0.96) showed the stability was strong. Conclution: The 25-item MHS is a valid and reliable scale for the assessment of motivation for healing in patients with cancer.

Prevalence and characters of post-acute COVID-19 syndrome in healthcare workers in Kashan/Iran 2023: a cross-sectional study.

BACKGROUND: Post-acute COVID-19 syndrome that is called long COVID-19 consists of the symptoms that last more than 12 weeks with no other explanation. The present study aimed to determine the prevalence, frequency of symptoms, and risk factors of long COVID-19 in the healthcare workers (HCWs) of a selected hospital in Kashan/Iran in 2023. METHODS: A total of 350 HCWs with a history of COVID-19 infection were randomly recruited to the study from February to May 2023. Participants completed a questionnaire including demographic characteristics, information related to COVID-19 infection, underlying diseases, and a checklist of long COVID-19 symptoms. Mann‒Whitney U test, chi-square test, T‒tests, and binary logistic regression were used for data analysis by SPSS 16. RESULTS: The results showed that 75.7% of HCWs experienced symptoms of long COVID-19. The most common symptoms were fatigue (53.1%), cough (43.1%) and muscle weakness (37.1%). In bivariate analysis job title, body mass index (BMI), frequency and number of symptoms of COVID-19 infection, preexisting disease, tobacco use, age, and years of experience showed a significant statistical association with long COVID-19. In binary logistic regression the number of symptoms during COVID-19 infection, nursing occupation, use of corticosteroids, and symptoms of dyspnea and loss of taste could explain the occurrence of long COVID-19. CONCLUSION: The long COVID-19 is a prevalent condition among HCWs especially nurses. Symptoms of long COVID-19 such as fatigue and cough can persists over time. This chronic condition has significant associations with different clinical risk factors.

Translation and Psychometric Evaluation of the Comfort Questionnaire in a Sample of Iranian Nurses: A Methodological Study.

Background and Purpose: This study was conducted to translate the Nurses' Comfort Questionnaire (NCQ) into Persian and examine its psychometric properties. Methods: In this methodological study, after translation, and face and content validity of the instrument, 300 nurses were randomly selected from the various hospitals in Kashan, during 2022. The construct validity and reliability of the instrument were examined. Results: The extracted five factors in exploratory factor analysis were able to explain 35.7% of the total variance of the questionnaire score. Cronbach's alpha, intraclass correlation coefficient, standard error of measurement, and the smallest measurable change of the psychometric of NCQ (P-NCQ) were calculated as .872, .899, ±4.284, and 5.737, respectively. Conclusions: The P-NCQ has 30 items in five subscales and can be used as a valid and reliable instrument to measure the comfort of nurses.

Antibody-modified Gold Nanobiostructures: Advancing Targeted Photodynamic Therapy for Improved Cancer Treatment.

Photodynamic therapy (PDT) is an innovative, non-invasive method of treating cancer that uses light-activated photosensitizers to create reactive oxygen species (ROS). However, challenges associated with the limited penetration depth of light and the need for precise control over photosensitizer activation have hindered its clinical translation. Nanomedicine, particularly gold nanobiostructures, offers promising solutions to overcome these limitations. This paper reviews the advancements in PDT and nanomedicine, focusing on applying antibody-modified gold nanobiostructures as multifunctional platforms for enhanced PDT efficacy and improved cancer treatment outcomes. The size, shape, and composition of gold nanobiostructures can significantly influence their PDT efficacy, making synthetic procedures crucial. Functionalizing the surface of gold nanobiostructures with various molecules, such as antibodies or targeting agents, bonding agents, PDT agents, photothermal therapy (PTT) agents, chemo-agents, immunotherapy agents, and imaging agents, allows composition modification. Integrating gold nanobiostructures with PDT holds immense potential for targeted cancer therapy. Antibody-modified gold nanobiostructures, in particular, have gained significant attention due to their tunable plasmonic characteristics, biocompatibility, and surface functionalization capabilities. These multifunctional nanosystems possess unique properties that enhance the efficacy of PDT, including improved light absorption, targeted delivery, and enhanced ROS generation. Passive and active targeting of gold nanobiostructures can enhance their localization near cancer cells, leading to efficient eradication of tumor tissues upon light irradiation. Future research and clinical studies will continue to explore the potential of gold nanobiostructures in PDT for personalized and effective cancer therapy. The synthesis, functionalization, and characterization of gold nanobiostructures, their interaction with light, and their impact on photosensitizers' photophysical and photochemical properties, are important areas of investigation. Strategies to enhance targeting efficiency and the evaluation of gold nanobiostructures in vitro and in vivo studies will further advance their application in PDT. The integrating antibody-modified gold nanobiostructures in PDT represents a promising strategy for targeted cancer therapy. These multifunctional nanosystems possess unique properties that enhance PDT efficacy, including improved light absorption, targeted delivery, and enhanced ROS generation. Continued research and development in this field will contribute to the advancement of personalized and effective cancer treatment approaches.

Risk factors of bruxism in children and adolescents: A case-control study.

Objectives: This study aimed to investigate the risk factors of bruxism in children and adolescents under 15 years old in Iran. Materials & Methods: This case-control study was conducted in day clinics of Shahid Beheshti Hospital in 2020. Fifty children with bruxism in the case group and 50 without in the control group were compared to five risk factors, including intestinal parasites, sucking the fingers, biting objects, a family history of bruxism, and secondhand smoking (SHS). The statistical tests of smoking, odds ratio, and logistic regression were used for data analysis. Results: The mean age of the subjects was 10.6±3.2 and 10.8±2.9 years in the case and control groups, respectively. The bruxism showed significant relation with sucking the fingers, the family history of bruxism, and intestinal parasites. The SHS and biting objects showed no significant relation with bruxism. The logistic regression indicated that the study variables could explain the 22.6 to 30.1% of risk factors in bruxism. Conclusion: Bruxism is a common disorder in children and adolescents. The intestinal parasites might be associated with bruxism. These infestations should be diagnosed and treated in children with bruxism.

The advance anticancer role of polymeric core-shell ZnO nanoparticles containing oxaliplatin in colorectal cancer.

We evaluated the activity of core-shell ZnO nanoparticles (ZnO-NPs@polymer shell) containing Oxaliplatin via polymerization through in vitro studies and in vivo mouse models of colorectal cancer. ZnO NPs were synthesized in situ when the polymerization step was completed by co-precipitation. Gadolinium coordinated-ZnONPs@polymer shell (ZnO-Gd NPs@polymer shell) was synthesized by exploiting Gd's oxophilicity (III). The biophysical properties of the NPs were studied using powder X-ray diffraction (PXRD), Fourier transforms infrared spectroscopy, Ultraviolet-visible spectroscopy (UV-Vis), field emission electron microscopy (FESEM), transmission electron microscopy (TEM), atomic force microscopy, dynamic light scattering, and z-potential. (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) (MTT) was used to determine the antiproliferative activity of ZnO-Gd-OXA. Moreover, a xenograft mouse model of colon cancer was exerted to survey its antitumor activity and effect on tumor growth. In the following, the model was also evaluated by histological staining (H-E; Hematoxylin & Eosin and trichrome staining) and gene expression analyses through the application of RT-PCR/ELISA, which included biochemical evaluation (MDA, thiols, SOD, CAT). The formation of ZnO NPs, which contained a crystallite size of 16.8 nm, was confirmed by the outcomes of the PXRD analysis. The Plate-like morphology and presence of Pt were obtained in EDX outcomes. TEM analysis displayed the attained ZnO NPs in a spherical shape and a diameter of 33 ± 8.5 nm, while the hydrodynamic sizes indicated that the particles were highly aggregated. The biological results demonstrated that ZnO-Gd-OXA inhibited tumor growth by inducing reactive oxygen species and inhibiting fibrosis, warranting further research on this novel colorectal cancer treatment agent.

The barriers and facilitators of developing clinical competence among master's graduates of gerontological nursing: a qualitative descriptive study.

BACKGROUND: Clinical competence development is a main goal of specialized nursing courses. Nonetheless, some master's graduates of gerontological nursing programs have inadequate Clinical competence. The aim of this study was to explore the barriers and the facilitators to clinical competence development among the master's graduates of gerontological nursing. METHOD: This qualitative descriptive study was conducted in 2020. Participants were twenty nursing master's students, master's graduates, and instructors of gerontological nursing. They were purposively selected from several faculties of nursing and midwifery in Tehran, Isfahan, and Kashan, Iran. Semi-structured interviews were held for data collection and the conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Data were managed using the MAXQDA 10 software. RESULTS: The main barriers to clinical competence development were students' neglectfulness towards learning, inefficiency of educational system, and ineffective management. The main facilitators to clinical competence development were effective educational planning and management improvement. CONCLUSION: There are different personal, educational, and managerial barriers and facilitators to clinical competence development among master's graduates of gerontological nursing. Effective educational planning and management improvement are needed for clinical competence development among master's students and graduates of gerontological nursing.

Identification and analysis of human errors in emergency department nurses using SHERPA method.

BACKGROUND: Human errors are the underlying cause of many occupational accidents. In recent years, human errors have increased in the healthcare sector. AIM: This study aimed to identify human errors committed by emergency department (ED) nurses working at Shahid Beheshti Hospital in Kashan using the SHERPA method. METHOD: This study is a descriptive cross-sectional study performed in the emergency department of Shahid Beheshti Hospital. Human errors were first identified and analyzed using the Hierarchical Task Analysis (HTA) technique and then studied using the SHERPA method. RESULTS: In total, 426 errors were identified including 263 action errors, 108 checking errors, 35 selection errors, 12 retrieval errors, and eight communication errors. Also, based on the levels presented in the risk matrix in terms of severity of consequences, the highest percentage (36.34%) belonged to the borderline category. CONCLUSION: The majority of identified errors were action errors, which can be reduced by providing appropriate instructions and training nurses, compiling reports and building error recording systems, improving management controls, and promoting a safety culture.

Nanocarrier System for Increasing the Therapeutic Efficacy of Oxaliplatin.

The application of Oxaliplatin (OxPt) in different malignancies is reported to be accompanied by several side effects, including neuropathy, nausea, vomiting, diarrhea, mouth sores, low blood counts, loss of appetite, etc. The passive or active targeting of different tumors can improve OxPt delivery. Considering the demand for novel systems meant to improve the OxPt efficacy and define the shortcomings, we provided an overview of different approaches regarding the delivery of OxPt. There is an extending body of data that exhibits the value of liposomes and polymer- based drug delivery systems as the most successful systems among the OxPt drug delivery procedures. Several clinical trials have been carried out to investigate the side effects and dose-limiting toxicity of liposomal oxaliplatin, such as the assessment on Safety Study of MBP-426 (Liposomal Oxaliplatin Suspension for Injection) to Treat Advanced or Metastatic Solid Tumors. In addition, several studies indicated the biocompatibility and biodegradability of this product, as well as its option for being fictionalized to derive specialized smart nanosystems for the treatment of cancer. The better delivery of OxPt with weaker side effects could be generated by the exertion of Oxaliplatin, which involves the aggregation of new particles and multifaceted nanocarriers to compose a nanocomposite with both inorganic and organic nanoparticles.

Motivation for Healing in Cancer Patients: A Qualitative Study.

BACKGROUND: Studies have revealed that motivation plays a vital role in a person's ability to heal. The nature of motivation for healing in cancer patients is unknown. The aim of this study was to explore the meaning of motivation for healing in cancer patients. MATERIALS AND METHODS: A qualitative research approach was used as the study design. Data were collected using individual semi-structured interviews and the themes were derived from the data using the inductive content analysis method. The patients consisted of 34 cancer patients, 4 family members, 1 psychologist, 1 oncologist, and 3 nurses. The participants were interviewed in the cancer clinics or chemotherapy wards. RESULTS: Based on the results of the interviews, three main themes and seven categories were determined. The themes were identified as (i) the desire to survive, (ii) a spirit of optimism, and (iii) belongingness and responsibility. CONCLUSIONS: The results of this study could be used by researchers to develop tools to measure motivation in cancer patients, and to design intervention mechanisms to enhance the patients' motivation in cancer care. Moreover, a better understanding of motivation can improve psychosocial support in oncology nursing.

Self-Care and Its Predictive Factors in Hemodialysis Patients.

Introduction: Chronic kidney disease is a serious problem and patients need active self-care. This study focuses on the relationship between self-care and its predictive factors in hemodialysis (HD) patients. Methods: This multicenter correlational study was conducted on 201 HD patients referring to HD centers in the west of Tehran, Iran. A multi-stage sampling method was used to select the samples. Data were collected using self-care Scale, Paloutzian-Ellison Spiritual Well-Being Scale, and Connor Davidson Resilience Questionnaires. Data were analyzed using SPSS software version 13 and descriptive statistics and linear regression with stepwise method. Results: The mean (SD) scores of self-care, resilience, and spiritual well-being were 35.5 (5.69), 53.4 (12.94), and 97.4 (17.9), respectively. Univariate analysis showed that self-care had a statistically significant relationship with gender, occupation, education, being diabetic, and hyperlipidemia. Self-care positively correlated with the resilience and negatively correlated with age. Multivariate regression indicated that the resilience (ß = 0.78, P = 0.001), being diabetic (ß = -0.09, P = 0.01), and age (ß = -0.11, P = 0.005) could be predictors of self-care. These variables accounted for 78% of variance in self-care in HD patients. Conclusion: Our results showed that resilience was positively correlated with self-care, but being diabetic and age were negatively correlated with self-care in HD patients. Therefore, the health care providers should pay more attention to HD patients who are diabetic and older, as they are at a higher risk of having impaired self-care.

Severity of illness affecting the length of stay and outcomes in patients admitted to intensive care units, Iran, 2019.

BACKGROUND: Length of stay (LOS) and patients' outcome are two important indicators in intensive care units (ICUs). The severity of illness influences these variables and could have a predictive value in clinical settings. The impact of severity of illness on the LOS and outcomes in patients admitted to ICUs was investigated in a selected hospital in Iran in 2019. MATERIALS AND METHODS: This research was a descriptive longitudinal study. Data were prospectively collected on 150 patients. The sequential organ failure assessment (SOFA) score, LOS, and demographic variables of the patients were recorded. Abbreviated mental test and Barthel index measuring activities of daily living questionnaires were completed at the time of the discharge from ICU and 1 month later to show the patient outcomes. Data analysis was performed using Chi-square test, t-test, analysis of variance, Pearson's correlation, and linear and ordinal logistic regression with SPSS software version 16. RESULTS: The mean of LOS was 11.21 ± 10.54 days. 24.7% of the patients were discharged from ICUs with optimal recovery, 49.3% with poor recovery, and 26% died in ICUs. One month after discharge, 67.6% of patients had optimal recovery, 24.3% had poor recovery, and 8.1% died. The SOFA score had a significant relation with LOS and patient outcomes in discharge and 1 month later. All the patients with SOFA score <5 survived, and all the patients with SOFA score more than 12 died. CONCLUSIONS: The severity of illness had a significant relation with LOS and patient outcomes in the time of the discharge from ICU and 1 month later. It seems that the initial SOFA score of 12 and higher can be suggested as a cutoff point for poor prognosis in ICU patients.

Scoping Review on the Concept of Patient Motivation and Practical Tools to Assess it.

BACKGROUND: In this scoping review, the concept of patients' motivation and the tools that have been designed to measure this concept in clinical settings are presented. MATERIALS AND METHODS: Arksey and O'Malley's framework was used in conducting the current scoping review. Google Scholar, PubMed, Scopus, and Web of Science databases were searched for relevant English articles published between January 1995 and January 2020 using the keywords motivation and tool, and their synonyms. Out of 2820 articles, 34 articles were chosen and were entered into the final analysis. Definitions of patients' motivation were determined using Kyngäs et al., content analysis method. RESULTS: The findings showed that new tools had been developed in 38% of the studies and other studies had revised or translated existing questionnaires. Moreover, 62% of the tools were used to measure patient motivation in mental disorders. Most of the studies did not clearly define the concept of patient motivation in the clinical environment. The findings of content analysis outlined the 3 categories of motivation determinant factors, decisions, and behaviors that determine overall levels of motivations and its consequences. CONCLUSIONS: Motivation is a dynamic concept and is a result of internal and external motives that lead to decisions and behaviors. There are limited tools for measuring motivation in clinical settings. This addresses the need to design specific tools in various diseases, especially chronic diseases. By the concept defined in this study, it is possible to design a short tool with general application that can be used in all diseases.

Clinical competence in nursing: A hybrid concept analysis.

BACKGROUND: Clinical competence (CC) is central issue in nursing. There are some controversies about this concept that needs further investigation. The present study was conducted to analyze the concept of clinical competence in nursing. METHODS: This concept analysis was conducted using the three-phase hybrid model. In the theoretical phase, the Science Direct, PubMed, CINAHL, ProQuest, Scopus, Web of Science, SID, Iranmedex, and Magiran databases were searched to retrieve articles published from 2000 to 2020. Forty two eligible articles were included and analyzed. In the fieldwork phase, semi-structured interviews were held with eighteen university lecturers, clinical instructors, students, and hospital nurses and the data were analyzed through conventional content analysis. In the final analytic phase, the findings of the first and the second phases were combined. RESULTS: The majority of literature defined CC in nursing as a combination of knowledge, and skills, and attitudes that is consistent with those of the fieldwork phase. Most participants in fieldwork stated that gaining CC is a process that is achieved over time through practice and repetition and increasing experience. A nurse needs to acquire personal, social and professional competencies during the study and work period. The CC has antecedents of efficient education, and organizational support. It also has consequences for patients and nurses such as satisfaction, and quality care. CONCLUSION: CC is a continuous process of obtaining knowledge, values, and attitudes, and skills such as critical thinking skills that brings creativity and innovation in nursing practice.

A study on improving nursing clinical competencies in a surgical department: A participatory action research.

Aims: The purpose of the present study was to improve clinical competencies in nursing staff in a selected surgical department in Kashan/Iran during 2016-2018. Design: This was a participatory action research. Methods: This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Conditions of Work Effectiveness Questionnaire-II, job satisfaction and patients' satisfaction questionnaires were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis. Results: Three main problems could affect the clinical competencies including professional insufficiency, basic shortages and external influences. Three changes were implemented in the surgical department including improving education, involving nursing students in patients' education and increasing the motivations by peer evaluation and selecting the nurse of the week. The changes significantly increased patients' satisfaction, nurses' job satisfaction and work effectiveness.

Educating the Existential View to Nurses in Cancer Care: A Review.

BACKGROUND: The aim of this study was to review the interventional studies about educating existential concepts to the nurses working in cancer care. MATERIALS AND METHODS: In this systematic narrative review, the papers published in English and Farsi databases of PubMed, Elsevier, web of since, Scopus, ProQuest, ERIC, Google Scholar and Ovid, MagIran and SID, from 1990 to 2018 were reviewed. Methodological quality of the studies was independently assessed by, using checklists developed by Greenhalgh, and Cochrane Center. No statistical pooling of the outcomes was performed, due to heterogeneity of the outcomes. RESULTS: After wide search, the 17 studies entered to this narrative study. The results showed that educating the existential concept to the nurses dealing with cancer patients can improve their self-competency in providing efficient care to these patients and their ability in decision making. It also enhances their quality of life and decreases the death anxiety and emotional exhaustion. CONCLUSIONS: There were limited and low quality interventional studies about the effects of educating existential concepts to the nurses dealing with cancer patients. These studies showed that knowing this philosophy can help nurses to address caring needs of cancer patients more efficiently. The specific method or content of education cannot be recommended because of the large differences in the methodologies between the studies.

Psychometric Testing of the Persian Version of the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II-PV).

BACKGROUND: Structural empowerment (SE) is an effective method of advancing work environments and has previously been widely discussed in Western countries. Due to the lack of culturally and academically accepted scales in Iran for measuring SE, localization of a foreign scale in this field is necessary. OBJECTIVES: This study aimed at investigating the validity and reliability of the Persian Version of the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II-PV) among Iranian nurses. METHODS: The present cross-sectional methodological research was conducted during 2017-2018. Participants were 230 nurses working in four teaching hospitals affiliated to Kashan University of Medical Sciences in Kashan, Iran, who were selected using quota sampling. A standard forward-backward translation procedure according to Wild et al. (2005) was used to translate the English Version of the CWEQ-II to Persian. The psychometric evaluation processes were achieved by face, content, and construct validity (confirmatory factor analysis [CFA]). Reliability was examined using test-retest and Cronbach's alpha for internal consistency reliability. RESULTS: The CWEQ-II-PV showed good content validity (the mean content validity scores for relevancy, clarity, and simplicity were 94%, 96%, and 94%, respectively). In the CFA, the original six-factor version with 19 items was confirmed. The original model was presented and incorporated in the CFA, indicating an acceptable fit for the model (root mean square error of approximation = 0.06, comparative fit index = 0.92, goodness of fit index (GFI) = 0.94, and adjusted GFI = 0.91). Cronbach's alpha coefficient for the total scale was 0.84 and for each component ranged from 0.71 to 0.87, indicating good internal consistency, and the test-retest Spearman and intraclass correlation coefficients were 0.93 and 0.87, respectively, showing good test-retest reliability. CONCLUSIONS: Evidence was found to support the reliability and validity of the CWEQ-II-PV scale that measures the quality of the work environment for nurses from a SE perspective.

Developing a Tool for Evaluating Ageism in Nursing Care of Older People in Kashan/Iran.

Ageism implies negative views and attitudes towards older people. These unconscious behaviors could make the elderly feel as if they were no longer useful for the family and community. Ageism is common in healthcare services. The objective of this study was to develop a tool to assess ageism in nursing care in Kashan/Iran 2015. This psychometric study was carried out in four stages: literature review for item generation; content validity testing; exploratory factor analysis (EFA) for evaluation of construct validity; and reliability assessment. The data analyzed with SPSS version 16. The final questionnaire had 24 items. The total CVI and CVR were 0.88 and 0.57. Explanatory factor analysis identified 3 factors of respecting older adult in nursing care (14 items); age discrimination and negative views towards older adults (5 items); attention to older adult and their basic caring needs (5 items). The three factors could explain 49.54% of variance. The test-re-test correlation stood at 0.9. The internal consistency of the questionnaire was Cronbach's alpha =0.85. A valid and reliable instrument for the evaluation of ageism in nursing care was developed in this study.