Development and validation of a modified LibQUAL scale in health sciences libraries: application of Structural Equation Modeling.

Objective: The application of structural equation modeling (SEM), a statistical modeling tool for scale construction and development, is becoming increasingly popular in the health sciences librarianship and information science research. This study explores the application of SEM to health science libraries by describing the development and validation of a modified LibQUAL scale within an Iranian health sciences library setting. Methods: A literature search was performed across several information sources to identify candidate items to be included in the primary questionnaire. After translation, linguistic validation, and a pilot study, two cross-sectional studies were performed. SEM modeling framework was used for the assessment of the reliability and validity of the modified LibQUAL scale. The internal consistency of the scale was evaluated by measuring Cronbach's alpha coefficient and composite reliability. Exploratory and confirmatory factor analyses were used for the evaluation of the construct validity of the scale. Smart-PLS software was used for statistical modeling. Results: Composite reliability and Cronbach's alpha coefficient for each scale ranged between 0.90 and 0.95, indicating adequate internal consistency with the LibQUAL scale. Confirmatory factor analysis confirmed the three-factor model of the LibQUAL scale. The convergent validity of the scale was supported, as the average variances extracted for all proposed factors were above 0.50. The discriminant validity was also confirmed using Fornel and Larcker and Heterotrait-Monotrait Ratio (HTMT) methods. Conclusion: Evaluation of psychometric properties of the translated and locally modified LibQUAL in the Persian language indicated adequate reliability, factorial validity, and stability of this instrument for Iranian health sciences libraries.

The role of online social networks in improving health literacy and medication adherence among people living with HIV/AIDS in Iran: Development of a conceptual model.

Online social networks have been used to enhance human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) prevention, diagnosis, and treatment programs worldwide. This study aimed to develop a conceptual model of using online social networks in improving health literacy and medication adherence among people living with HIV/AIDS in Iran. This mixed-method sequential exploratory study was conducted in three phases. Firstly, a series of semi-structured interviews with a purposive sample of 29 HIV-positive patients were conducted to investigate the perceptions and experiences of HIV-positive patients about using online social networks to support health literacy and medication adherence. Thematic analysis was used to analyse qualitative interviews, extract potential components, and design a conceptual model. Then, a Delphi study with 27 HIV-positive patients was subsequently conducted to examine the consensus of patients on the proposed model. Finally, the trustworthiness and credibility of the proposed model were reviewed and evaluated by expert panel members from epidemiology and public health. Seven themes and 24 sub-themes emerged from the qualitative interviews. Five themes encompassed components of online social networks that supported communication and information-seeking behaviour of people living with HIV/AIDS. The two other themes encompassed social support and health-related outcomes including medication adherence. The credibility of the proposed conceptual model was confirmed methodologically using the expert panel and Delphi technique. Our findings highlighted that using online social networks has empowered Iranian people living with HIV/AIDS, making them more connected, safe, and able to access HIV/AIDS-related information and services. The role of online social networks in improving health literacy and medication adherence was also demonstrated in a conceptual model to understand the supportive components of online social networks in the HIV care continuum as well as customized interventions to improve the success of antiretroviral therapies.

The Prevalence of Polypharmacy and Potential Drug-Drug Interactions among Iranian Cancer Patients: Which Patients were at Risk?

INTRODUCTION: Drug-Drug interactions (DDIs) are one of the considerable consequences of polypharmacy. Due to the influence of polypharmacy and drug interactions on cancer treatment and patients` health outcomes, this study aimed to determine the prevalence of polypharmacy and potential DDIs among adult cancer patients in Kerman province, southeast of Iran. METHODS: In this cross-sectional study, 315 cancer patients who referred to Kerman city oncology clinics were assessed in 2018. Data were collected through face-to-face interviews and medical charts were reviewed. Polypharmacy was defined as the use of at least five drugs simultaneously. Potential DDIs were checked using the "Drugs.com" online database. A bivariable and a multivariable logistic regression were used to determine the associated factors of outcome variables, polypharmacy status, and potential DDI in SPSS software version 23. RESULTS: Of 315 cancer patients, 191 patients (60.6%; 95% CI: 54.9, 66) used at least five drugs during chemotherapy courses. The prevalence of potential DDIs was 59.6% (n = 140, 95% confidence interval [CI]: 53.6-66.0. Experience co-morbid diseases (OR: 6.60; 95% CI: 3.82, 11.42; p value ≤ .0001), and positive metastatic status (OR: 2.80; 95% CI: 1.62, 4.82; p value ≤ .0001) could predict the polypharmacy during chemotherapy courses. Patients who suffered gastrointestinal cancers (OR: 5.55; 95% CI: 2.26, 13.62; p value ≤ .0001) and the number of prescribed or Over The Counter (OTC) drugs (OR: 1.29; 95% CI: 1.12, 1.48; p value < .0001) predicted the occurrence of potential DDIs among cancer patients. CONCLUSIONS: Regarding the high prevalence of polypharmacy and potential drug interactions among Iranian cancer patients during chemotherapy courses, it is advisable for physicians, nurses, and pharmacists to be vigilant to improve prescribing patterns. In addition, with intensive monitoring, alternative treatment strategies can be replaced.