Development and validation of the short form domestic elder abuse assessment questionnaire (SF-DEAQ).

BACKGROUND: The present study aimed to design and determine the psychometric properties of a short-form questionnaire to investigate the domestic elder abuse. METHODS: This study consisted of two phases: in phase 1 we employed a modified Delphi approach with 18 participants. Consequently, content and face validity, and item analysis were applied. In Phase 2 we evaluated structural validity and convergent validity. Reliability was assessed by looking at internal consistency, stability, and absolute reliability. RESULTS: The findings led to the development of a 27-items short form of domestic elder abuse in four domains that jointly accounted for 74.14% of the variance observed. The short form showed high internal consistency (Cronbach's alpha = 0.93) and significantly correlated (r = 0.91; p < 0.001 for both scales) with the comprehensive (49-item) domestic elder abuse. CONCLUSION: The short form of domestic elder abuse was found to be reliable and valid as the longer version. The short form of domestic elder abuse could lessen the burden on respondents.

Psychometric properties of the Persian version of the COVID-19 Phobia Scale (C19P-S).

BACKGROUND: During various infectious pandemics, phobia or panic has been suggested as one of the most common mental disorders. The current study reports on the psychometric properties of the Persian version of the COVID-19 Phobia Scale (C19P-S) in Iran. METHODS: The forward-backward translation procedure was applied to translate the English version of the C19P-S into Persian. Then, content and face validity, structural validity (exploratory and confirmatory factor analyses), convergent and discriminant validity, concurrent validity, reliability, and stability were performed to evaluate the Persian version. RESULTS: In all, 660 people participated in the study. The mean age of patients was 35.55 (SD = 12.24) years. Exploratory factor analysis confirmed a four-factor structure for the scale. Confirmatory factor analysis showed that almost all fitness indices for the model were satisfactory (RMSEA = 0.06, CFI = 0.96, TLI = 0.96, IFI = 0.97). The Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) for the questionnaire were 0.95 and 0.96, respectively. CONCLUSION: The Persian version of C19P-S showed good psychometric properties and a good fit for the four-factor structure. It can now be used to assess panic disorder in therapeutic settings and identify candidates needing clinical intervention.

Development and psychometric evaluation of the loneliness inventory for older adults (Lonely): A mixed-methods study.

AIM: To develop and initially validate the Loneliness Inventory for Older Adults. DESIGN: Scale development and evaluation. METHODS: This was a two-phase study. In phase 1, the initial items pool (126 items) was generated based on the concept analysis and literature review. Moreover, content validity was established by geriatric and psychometric experts. Phase 2 evaluated structural validity by performing item analysis, exploratory factor analysis and convergent validity. Reliability was evaluated by examining internal consistency, stability (ICC) and absolute reliability. RESULTS: Following the development process, 94 items were removed and a provisional version of the questionnaire with 32 items was subjected to psychometric evaluation. Three hundred and seventy older adults completed the questionnaire. After performing factor analysis, overall 3 items were removed due to low loading, and the questionnaire was reduced to 29 items tapping into five factors. The Cronbach's alpha for the instrument was 0.94, and the ICC value was 0.97.

Happiness, quality of working life, and job satisfaction among nurses working in emergency departments in Iran.

BACKGROUND: Nurses have a vital role in the healthcare system. One of the basic steps to increase their happiness is to recognize factors such as job satisfaction and quality of working life. Therefore, the goal of the present study was to examine the relationship between happiness and quality of working life and job satisfaction among nursing personnel. METHODS: This descriptive study was carried out on 270 hospital nurses who worked in emergency departments in Iran. Nurses were recruited through the census method. Data collection instruments included the Oxford Happiness Inventory (OHI), the Quality of Work Life Questionnaire (QWL), and the Job Satisfaction Questionnaire (JSQ). Data were explored using descriptive statistics, and stepwise multiple linear regression analysis. RESULTS: The mean age of participants was 30.1 ± 6.26 years. The mean happiness score was 38.5 ± 16.22, the mean Quality of Working Life (QWL) score was 84.3 ± 17.62, and the mean job satisfaction score was found to be 45.5 ± 13.57); corresponding to moderate levels of attributes. The results obtained from the ordinary least-square (OLS) regression indicated that happiness significantly was associated with economic status and satisfaction with closure (R2: 0.38). CONCLUSION: Overall the current study found that nurses who work in emergency departments did not feel happy. Additionally, the findings suggest that their happiness were associated with their economic status, and closure over their duties.

Psychometric properties of the Persian version of Instrument of Professional Attitude for Student Nurses (IPASN).

AIM: To evaluate nursing students' professionalism attitude, it is necessary to use a validated and reliable instrument. DESIGN: This study aimed to develop the Persian version of the eight-dimensional professionalism attitude questionnaire for student nurses (Instrument of Professional Attitude for Student Nurses). METHODS: In this cross-sectional study during March to April 2017, after being translated into Persian and receiving experts' comments face, content, and construct validity of the questionnaire were sought among nursing students. Internal consistency reliability was examined by estimating the Cronbach's alpha coefficient and stability was estimated by calculating intraclass correlation coefficinet. RESULTS: A total of 750 students with an average age of 24.15 (SD = 1.32) years participated in the study. Both exploratory and confirmatory factor analyses confirmed the construct of the questionnaire. Cronbach's alpha coefficient for the entire instrument was 0.89 and more than 0.70 for all dimensions. Also the intraclass correlation coefficient for the questionnaire was found to be 0.92, well above acceptable threshold. The findings approved that the Iranian version of Instrument of Professional Attitude for Student Nurses is a reliable and valid questionnaire. Hence, using this questionnaire to conduct studies is recommended.

Development and psychometric evaluation of the healthy lifestyle questionnaire for elderly (heal).

BACKGROUND: The present study was conducted to design and evaluate the psychometric properties of a questionnaire for assessing the healthy lifestyle among older adults in Iran. METHODS: First, items were generated based on a qualitative study, the literature review, and with help received from experts in gerontology and questionnaire design. Then, content validity was carried out. Accordingly, a cross sectional study was conducted to perform factor analysis and known groups comparison in order to examine the construct validity. Internal consistency was measured by the Cronbach's alpha coefficient and the stability of the questionnaire was evaluated by estimating interclass correlation coefficient (ICC). RESULTS: In total 68 items was generated. Following development process 22 items were removed and a provisional version of the questionnaire with 46 items was subjected to psychometric evaluation. At this stage a sample of 390 elderly people attending the community centers in Tehran, Iran were entered into the study and completed the questionnaire. Most elderly were female (52.8%) and the mean age of participants was 67.97 (SD ± 7.77) years. After performing factor analysis, overall 10 items were removed due to low loading and the questionnaire was reduced to 35 items tapping into eight factors, which explained a total of 57.1% of the variance. In addition, the results obtained from known groups comparison indicated that the questionnaire well differentiated among participants who were differed in self-reported health condition. The Cronbach's alpha coefficient showed excellent internal consistency (alpha = 0.89). The intraclass correlation coefficient also indicated a good stability for the questionnaire (ICC = 0.94). CONCLUSION: The healthy lifestyle questionnaire for elderly (Heal) can be used as a simple and an easy-to-use valid and reliable measure in determining healthy life style and the frequency of health-oriented activities among older adults.

Cultural adoption, and validation of the Persian version of the coronary artery disease education questionnaire (CADE-Q): a second-order confirmatory factor analysis.

BACKGROUND: Evaluating knowledge in patients with coronary artery disease requires a specific measure. The aim of the present study was to translate and evaluate the CADE-Q in patients with coronary artery disease in Iran. METHODS: Forward-backward procedure was applied to translate the questionnaire from English into Persian. Then a cross-sectional study was conducted to evaluate psychometric properties of the questionnaire. A sample of patients with coronary artery disease attending to cardiac departments of teaching hospitals affiliated to medical universities in Tehran, Iran completed the 19-item CADE-Q from April to December 2017. Structural validity of CADE-Q was assessed using both exploratory and confirmatory factor analyses. Reliability was examined using Cronbach's alpha coefficient. Stability was evaluated by estimation intraclass correlation coefficient. RESULTS: In all 500 patients participated in the study. The mean age of patients was 53.63. (SD = 14.36) years, and 57% were male. The results obtained from the exploratory factor analysis showed a four factor solution (lifestyle habits and exercise, risk factors, diagnosis and treatment, signals & symptoms and medicine) that jointly explained 48.9% of the total variance observed. However, the second-order confirmatory factor analysis supported the three-factor solution while convergent and divergent validity were not confirmed. Finally, the Cronbach's alpha coefficient of 0.84 ranging from 0.50 to 0.82 was obtained for the scale and its subscales. In addition, the ICC value of 0.88 showed satisfactory stability for the questionnaire. CONCLUSION: The Coronary Artery Disease Education Questionnaire was found to be a multidimensional instrument. The results confirmed the factor structure of the questionnaire with a second-order analysis. Since the convergent and divergent validity of the scale were not confirmed, further assessment is essential to establish fitness of the questionnaire in Iran.

Psychometric assessment of the Persian version of short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemetic tool.

INTRODUCTION AND OBJECTIVE: Managing chemotherapy-induced nausea and vomiting (CINV) in patients with cancer is still a challenge for the patients and also the clinicians. The Multinational Association of Supportive Care in Cancer (MASCC) has developed a scale for better measurement and management of CINV. Thus, this paper aims at translating the scale into Persian and assessing the psychometric properties of the proposed translated version of MASCC Antiemesis Tool (MAT). METHODS: Having received the necessary permissions and complying with the Forward-Backward translation protocol, we conducted a qualitative assessment of the face validity through cognitive interviewing and content validity assess with 5 experts in Persian Literature. Internal consistency using Cronbach's Alpha Coefficient was applied to determine the scale reliability. In order to determine the construct validity, the three methods of exploratory factor analysis, known group analysis, and convergent validity (assessment of the correlation between Rhodes Index of Nausea, Vomiting and Retching (INVR) scale and the Persian version of MAT scale) were conducted on 300 participants. RESULTS: About 300 patients with a mean age of 50.73 ± 0.81 participated in the study. The results showed a significant difference in the index of nausea and vomiting between the patients who are below 50 years old and those who are above 50 (P = 0.0001). The Cronbach's Alpha Coefficient was reported 0.88 for the whole MAT questionnaire. Due to the low factor load (fewer than 0.5) for question 1, it was removed in the factor analysis. Besides, exploratory factor analysis (EFA) led to the exploration of the two factors of nausea and vomiting. CONCLUSION: According to the results of the study, the Persian version of the MAT questionnaire is considered as a highly reliable and valid tool, in order to efficiently and accurately measure chemotherapy-induced nausea and vomiting and to better manage this side effect.

The Persian short form Aging Perceptions Questionnaire (APQ-P): A validation study.

BACKGROUND: Population aging is an important phenomenon for many countries worldwide. Considering the growing trend of aging population in Iran, it is very important to consider beliefs and perceptions of old people about aging. The Aging Perception Questionnaire (APQ) is one of the most common instruments that used to measure aging comprehension. The present study was a methodological inquiry that aimed to examine validity and reliability of the Persian version of the Aging Perception Questionnaire (APQ). METHODS: Forward-backward procedure was used for translation. Content validity and face validity were evaluated qualitatively. In order to evaluate construct validity a cross section study was conducted and both exploratory and confirmatory factor analyses were performed. In order to determine reliability, internal consistency (the Cronbach's alpha) and stability (Intraclass Correlation Coefficient -ICC) were estimated. RESULTS: A total of 500 elderly people attending the community centers in Tehran, Iran were entered in other study and completed the Persian version of the questionnaire. Most elderly were female (52.8%).The mean age of participants was 68.33 (SD ± 6.10) years. The results obtained from exploratory factor analysis showed a four-factors solution (consequences negative, emotional representation, control positive and consequences positive) that jointly explained 52.8% of the total variance observed. In addition the confirmatory factory analysis showed a good fit for the data. Finally, the Cronbach's alpha coefficient of 0.83 ranging from 0.80 to 0.87 was obtained for the whole scale and the subscales. The ICC value of 0.96 ranging from 0.90 to 0.98 was found for the whole scale and the subscales. CONCLUSION: The results indicated that the Persian version of APQ is valid and can be used to measure aging perception in Iran.

The Iranian version of geriatric anxiety inventory (GAI-P): a validation study.

BACKGROUND: Anxiety is one of the most common mental health problems experienced by the elderly that affects quality of life. This study aimed to assess the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-P) in order to provide a valid instrument for measuring anxiety in this population. METHODS: Forward-backward translation was used to translate the Geriatric Anxiety Inventory from English into Persian and was tested by 10 elderly to assess its face validity. Then a sample of elderly people attending health centers in Dezful, Iran completed the questionnaire. Validity was assessed using both exploratory and confirmatory factors analysis, known-groups comparison (abused and non-abused elderly) also was administered. The internal consistency of the instrument was assessed using Kuder-Richardson 20 coefficients (KR-20). Afterwards, the reliability and validity through assessing the correlation between the Persian version of the GAI-P and the SF-36, were measured. RESULTS: In all 720 elderly completed the questionnaire. Of these data from 420 elderly were used for exploratory factor analysis and the data from the remaining 300 elderly were used for confirmatory factor analysis. The exploratory factor analysis showed a three-factor solution (cognitive, arousal and somatic) for the questionnaire that jointly explained 59.48% of the overall variance observed. The confirmatory factor analysis supported the three-factor solution and the second-order latent factor model. The findings indicated a positive and significant correlation between the two measures lending support to its concurrent validity (r = 0.67, p < .001).Ultimately, the Geriatric Anxiety Inventory was found to have a favorable internal consistency. CONCLUSION: This study confirmed that the GAI-P is a valid measure of anxiety in elderly population and now can be used in geriatric studies in Iran.

Defining loneliness in older adults: protocol for a systematic review.

BACKGROUND: Socialization is an important part of the healthy aging process, but natural changes in the lifestyle and health of older people increased risk of loneliness. However, loneliness is not well defined and might differ in different cultures and settings. The main objective of this systematic review is to summarize literature on the topic and propose a definition that might help aging research and practice in the future. METHODS: Eight databases including PubMed, Scopus, CINAHL, Web of Science, EMBASE, PsycINFO, Proquest, and Age Line bibliographic will be run individually to retrieve relevant literature on loneliness among elderly population using subject headings and appropriate MeSH terms. Inclusion and exclusion criteria will be developed and refined by the research team. Two reviewers will participate in each search stage including abstract/title and full text screening, data extraction, and appraisal. We will restrict our search to articles published in the English language biomedical journal between 2000 and 2017. The protocol adheres to the standards recommended by the PRISMA-P. DISCUSSION: The results of this systematic review can present a more accurate definition of loneliness for researchers who aim at conducting new primary and secondary studies on this subject. SYSTEMATIC REVIEW REGISTRATION: CRD42017058729.

Tracheostomy in Patients Who Need Mechanical Ventilation: Early or Late? Surgical or Percutaneous? A Prospective Study in Iran.

Tracheostomy can be performed surgically or by percutaneous (percutaneous dilatory tracheostomy, PDT) methods, and it may be used early or late. In a 3-month follow-up, all patients who underwent tracheostomy in Semnan in 2013 were evaluated for complications of tracheostomy considering the method used and the timing of operation. A total of 55 patients underwent tracheostomy (26 cases surgery, 29 cases PDT, 30 cases early, and 25 cases late based on 14 days reference). The mean durations of operation were 19.19 ± 5.78 min in the surgery method and 4.7 ± 2.42 min in the PDT method (P < 0.001). The mean durations of the need for ventilator after the tracheostomy were 10.7 ± 9.25 and 18.6 ± 14.39 days in early and late tracheostomy, respectively (P = 0.024). The mean intensive care unit (ICU) stay were 12.70 ± 10.24 and 23.44 ± 18.49 days (P = 0.014) and the mean hospital stay were 16.04 ± 10.88 and 23.48 ± 18.47 days, respectively (P = 0.100). Short-term complications were observed in six cases (10.09 %) in the surgery group, including emphysema (two), bleeding (two), wound infection (one), and clot formation inside the tube (one). Only one complication (bleeding) occurred in one case in the PDT group. After 3 months, 21 patients survived. Compared with surgery, the most important advantage of the PDT method was its shorter duration of surgery. Nearly half of the patients underwent tracheostomy late, while the majority of the patients in the late group were referred from internal ICU. No major and minor complications were noted during the procedure, as well as no tracheostomy-related deaths were observed. Early tracheostomy was shown to be superior to late, reducing the time of mechanical ventilation and ICU or hospital stay.

Effects of Adding Midazolam and Sufentanil to Intrathecal Bupivacaine on Analgesia Quality and Postoperative Complications in Elective Cesarean Section.

BACKGROUND: Intrathecal adjutants can be used for regional anesthesia (RA) in cesarean section to improve its quality in terms of time and complications. Some previous studies focused on the effects of adding sufentanil and/or midazolam to bupivacaine and compared each with using bupivacaine alone. However, there has been no study to assess the effects of using sufentanil and midazolam in combination with bupivacaine. OBJECTIVES: The aim of this study was to evaluate and compare properties (time of achievement/recovery of sensory/motor blocks; and time to request opium), complications (nausea, vomiting, shivering and hypotension), and neonatal first minute Apgar score with and without the addition of midazolam (M) or sufentanil (S) to bupivacaine (B) through intrathecal injection for spinal anesthesia, after the cesarean section. PATIENTS AND METHODS: In this double blind randomized clinical trial participants were randomly allocated to three equal groups: Group B (2.5 cc of bupivacaine 0.5% + 1 cc normal saline 0.9%), Group BM (2.5 cc of bupivacaine + 0.02 mg/kg midazolam) and Group BS (2.5 cc of bupivacaine 0.5% + 0.7 cc normal saline 0.9% + 1.5 µg of sufentanil, 0.3 cc). We used analysis of variance (ANOVA), post hoc test with Bonferroni adjustment, and chi-square test for statistical analysis; the analyses were performed using the SPSS-16 software. Given a significant level of 0.05, overall and pair-wise comparisons were made. RESULTS: Seventy-five females participated in the study with no significant age difference (mean ± standard deviation (SD): 28.60 ± 6.06, 28.12 ± 5.29 and 28.76 ± 3.97 year; P = 0.9). Except for "time to motor block recovery" (P = 0.057), the overall differences among the three groups was significant in terms of "time to sensory/motor block" (P < 0.001), "time to sensory block recovery" (P < 0.001), and "time to request opium" (P < 0.001). In all pair-wise comparisons there was no significant difference between the BM and BS group, except for "time to request opium", which was longer in the BS group (P < 0.001). The occurrence of nausea (P = 0.02), postoperative shivering (P = 0.01) and hypotension (P < 0.001) were significantly different between the groups, unlike vomiting, where the difference was not significant (P = 0.2). All neonates had an Apgar score of nine. CONCLUSIONS: The findings showed that adding sufentanil or midazolam to bupivacaine shortens the onset of spinal anesthesia and increases the time duration of anesthesia; however it does not change the motor block recovery time. Adding sufentanil delays the first request for narcotic analgesics while adding midazolam leads to a decrease in nausea and hypotension. Adding sufentanil or midazolam does not have any deleterious effect on infants' Apgar scores. However, increases shivering in patients.

Psychometric properties of the Persian version of the Critical Care Family Needs Inventory.

BACKGROUND: Life-threatening illnesses and subsequent hospitalization in the intensive care unit (ICU) often occur unexpectedly. In many cases, this event is devastating for families and may lead to emotional stress, anxiety, and fear. To offer comprehensive and high-quality nursing care, critical care nurses not only provide critical care to patients but also attend to the psychological and social needs of patients and their families. PURPOSE: The purpose of this study was to assess the psychometric properties of the Persian version of the Critical Care Family Needs Inventory (CCFNI-P). METHODS: This was a cross-sectional methodological research study. Forward-backward translation was used to develop the instrument. The first version was pretested with 10 families to assess face validity. The main sample consisted of 720 family members of hospitalized patients, composed of 360 admitted to ICUs and 360 admitted to general wards of hospitals in Tehran, Iran. Participants were selected randomly to evaluate the instrument in terms of known-groups, construct, and convergent validities. The internal consistency of the translated instrument was assessed using Cronbach's alpha coefficient. RESULTS: A significant difference was found between the scores of participants with patients in ICUs and participants with patients in the general wards (p < .001). In agreement with the original instrument, five distinct components were extracted from the CCFNI-P, which accounted for more than 52% of the total variance. The correlation between the total score for the instrument and the State-Trait Anxiety Inventory criterion was positive and significant (r = .23, p < .04). The Cronbach's alpha coefficient for the entire instrument was .89 and more than .70 for all dimensions. CONCLUSIONS: This study confirmed the validity of the CCFNI-P in terms of face, construct, convergent, and known groups and showed acceptable internal consistency. The CCFNI-P is valid for investigating the needs of Iranians who have a family member hospitalized in an ICU.

Six-month follow-up study of ultrarapid opiate detoxification with naltrexone.

BACKGROUND: Illicit opiate use has an increasing incidence and prevalence, which increases mortality and morbidity, marginalization, and criminal behaviors, and causes major adverse effects on society. OBJECTIVES: This study aimed to investigate and follow the outcome of patients who underwent ultrarapid opiate detoxification (UROD) prospectively. PATIENTS AND METHODS: In this randomized clinical trial, 64 patients who underwent UROD were evaluated. The opiate antagonist regimen of naloxone was administered intravenously under general anesthesia, and detoxification was confirmed by naloxone challenge test. All patients were cared in intensive care unit (ICU) for 24 hours, and oral naltrexone was prescribed the next day, after recovery and discharge. Patients were followed up for one month after the procedure. Relapse was considered if routine use of opiates (daily use for at least two weeks) was reported by the patient after detoxification. The data was analyzed by SPSS 16.5 and the study was performed using descriptive analysis and Chi square test. RESULTS: All 64 participants were opiate-dependent males (ASA physical status of I or II) who aged over 18 years with a mean age of 31.11 ± 8.93 years at the time of UROD. One month after UROD, 48 patients (75%) reported relapse and 16 (25%) reported abstinence; however, four patients of the non-relapsed group reported one episode of opiate use. There was no significant difference between relapsed and non-relapsed patients regarding their marital status, level of education, and family history of opiate dependency (P > 0.05). CONCLUSIONS: Although UROD by naloxone is a safe and effective method of detoxification, if used alone, it has a very high relapse rate in long term.