The Validity and Reliability of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) in Primiparous Women in Mashhad, Iran.

BACKGROUND: Although pregnancy and childbirth are physiological processes, fear of childbirth is a common problem that is often associated with requests for cesarean delivery. This study was undertaken to determine the validity and reliability of the Wijma Delivery Expectancy/Experience Questionnaire A (W-DEQ [A]) primiparous women in Mashhad, Iran. METHODS: This study was conducted on 220 primiparous women with a gestational age of 28-30 weeks referred to health centers in Mashhad. Using demographic questionnaire, Beck's Anxiety Inventory, Beck's Depression Inventory, and the W-DEQ (A), for determining the validity and reliability of the W-DEQ (A), first two linguists translated the questionnaire into Persian; then, two other linguists translated the Persian version back into English. The content validity of this version was then assessed by expert faculty members. The final version was sent to the questionnaire's original developers (Klass Wijma and Barbro Wijma) and then used after their approval. Factor analysis was used to analyze the data. RESULTS: The result of actor analysis revealed six factors, forming 58.8% of the total variance. The reliability of this questionnaire was confirmed with a Cronbach's alpha coefficient of 0.84, and the fear of childbirth was found to be correlated with Beck's anxiety (r=0.414) and depression (r=0.287) scores. CONCLUSION: The W-DEQ (A) is a valid and reliable tool for measuring the fear of childbirth and is recommended to be used for measuring the fear of childbirth among Iranian women.

The reliability of the Manchester Triage System (MTS): a meta-analysis.

OBJECTIVE: Although the Manchester Triage System (MTS) was first developed two decades ago, the reliability of the MTS has not been questioned through comparison with a moderating variable; therefore, the aim of this study is to determine the extent of the reliability of MTS using a meta-analytic review. METHOD: Electronic databases were searched up to 1 March 2014. Studies were only included if they had reported sample sizes, reliability coefficients, and adequate description of the reliability assessment. The Guidelines for Reporting Reliability and Agreement Studies was used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models, and meta-regression was performed based on the method-of-moments estimator. RESULTS: Seven studies were included. The pooled coefficient for the MTS was substantial at 0.751 (CI 95%: 0.677 to 0.810); the incidence of mistriage is greater than 50%. Agreement is higher for the latest version of MTS (for adults) among nurse-experts and in countries in closer proximity to the country of MTS origin (the UK, in Manchester) than for the oldest (pediatric) version, nurse-nurse raters, and countries at a greater distance from the UK. CONCLUSION: The MTS showed an acceptable level of overall reliability in the emergency department, but more development is required to attain almost perfect agreement.

The Role Descriptions of Triage Nurse in Emergency Department: A Delphi Study.

Background. Triage nurses play a pivotal role in the emergency department. However some researchers have attempted to expand triage nurse's role; remarkable discrepancies exist among scholarly communities. The aim was to develop a role description of triage nurse relying on the experts. Methods. A modified Delphi study consisting of 3 rounds was performed from March to October 2014. In the first round, an extensive review of the literature was conducted. Expert selection was conducted through a purposeful sample of 38 emergency medicine experts. Results. Response rates for the second and third rounds were 37% and 58%. Average age of panelists was (38.42 ± 5.94) years. Thirty-nine out of 54 items reached to the final round. Prioritizing had the higher agreement rate and least agreement on triage related interventions. Conclusion. Triage nursing as a relatively new role for nurses needs significant development to be practiced. Comprehensive educational programs and developmental research are required to support diagnostic and therapeutic interventions in triage practice by nurses.

Sexual dysfunction in infertile women.

BACKGROUND: Sexual problems have different effects on the life of people by influencing their interpersonal and marital relationships and satisfaction. Relationship between sexual dysfunctions and infertility can be mutual. Sexual dysfunction may cause difficulty conceiving but also attempts to conceive, may cause sexual dysfunction. OBJECTIVE: This paper compares sexual dysfunction in fertile and infertile women. MATERIALS AND METHODS: In this cross-sectional study, 110 infertile couples referring to Montasarieh Infertility Clinic and 110 fertile couples referring to five healthcare centers in Mashhad were selected by class cluster sampling method. Data collection tools included demographic questionnaire and Glombok-Rust Inventory of Sexual Satisfaction. Data were analyzed through descriptive and analytical statistical methods by SPSS. RESULTS: There was no significant difference in total score of sexual problems and other dimensions of sexual problems (except infrequency) in fertile 28.9 (15.5) and infertile 29.0 (15.4) women. Fertile women had more infrequency than infertile women (p=0.002). CONCLUSION: There was no significant difference between fertile and infertile women in terms of sexual problems. Paying attention to sexual aspects of infertility and presence of programs for training of sexual skills seems necessary for couples.

The Reliability of the Canadian Triage and Acuity Scale: Meta-analysis.

BACKGROUND: Although the Canadian Triage and Acuity Scale (CTAS) have been developed since two decades ago, the reliability of the CTAS has not been questioned comparing to moderating variable. AIMS: The study was to provide a meta-analytic review of the reliability of the CTAS in order to reveal to what extent the CTAS is reliable. MATERIALS AND METHODS: Electronic databases were searched to March 2014. Only studies were included that had reported samples size, reliability coefficients, adequate description of the CTAS reliability assessment. The guidelines for reporting reliability and agreement studies (GRRAS) were used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models and meta-regression was done based on method of moments estimator. RESULTS: Fourteen studies were included. Pooled coefficient for the CTAS was substantial 0.672 (CI 95%: 0.599-0.735). Mistriage is less than 50%. Agreement upon the adult version, among nurse-physician and near countries is higher than pediatrics version, other raters and farther countries, respectively. CONCLUSION: The CTAS showed acceptable level of overall reliability in the emergency department but need more development to reach almost perfect agreement.

The reliability of the Australasian Triage Scale: a meta-analysis.

BACKGROUND: Although the Australasian Triage Scale (ATS) has been developed two decades ago, its reliability has not been defined; therefore, we present a meta-analyis of the reliability of the ATS in order to reveal to what extent the ATS is reliable. DATA SOURCES: Electronic databases were searched to March 2014. The included studies were those that reported samples size, reliability coefficients, and adequate description of the ATS reliability assessment. The guidelines for reporting reliability and agreement studies (GRRAS) were used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models, and meta-regression was done based on the method of moment's estimator. RESULTS: Six studies were included in this study at last. Pooled coefficient for the ATS was substantial 0.428 (95%CI 0.340-0.509). The rate of mis-triage was less than fifty percent. The agreement upon the adult version is higher than the pediatric version. CONCLUSION: The ATS has shown an acceptable level of overall reliability in the emergency department, but it needs more development to reach an almost perfect agreement.

Reliability of the Emergency Severity Index: Meta-analysis.

OBJECTIVES: Although triage systems based on the Emergency Severity Index (ESI) have many advantages in terms of simplicity and clarity, previous research has questioned their reliability in practice. Therefore, the aim of this meta-analysis was to determine the reliability of ESI triage scales. METHODS: This meta-analysis was performed in March 2014. Electronic research databases were searched and articles conforming to the Guidelines for Reporting Reliability and Agreement Studies were selected. Two researchers independently examined selected abstracts. Data were extracted in the following categories: version of scale (latest/older), participants (adult/paediatric), raters (nurse, physician or expert), method of reliability (intra/inter-rater), reliability statistics (weighted/unweighted kappa) and the origin and publication year of the study. The effect size was obtained by the Z-transformation of reliability coefficients. Data were pooled with random-effects models and a meta-regression was performed based on the method of moments estimator. RESULTS: A total of 19 studies from six countries were included in the analysis. The pooled coefficient for the ESI triage scales was substantial at 0.791 (95% confidence interval: 0.787-0.795). Agreement was higher with the latest and adult versions of the scale and among expert raters, compared to agreement with older and paediatric versions of the scales and with other groups of raters, respectively. CONCLUSION: ESI triage scales showed an acceptable level of overall reliability. However, ESI scales require more development in order to see full agreement from all rater groups. Further studies concentrating on other aspects of reliability assessment are needed.

Factors influencing job satisfaction among registered nurses: a questionnaire survey in Mashhad, Iran.

BACKGROUND: Job satisfaction is a critical factor in health care. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. OBJECTIVE: To determine the level of nurses' job satisfaction and its associated factors. METHOD: A stratified random sample of 421 registered nurses working at a large hospital in Mashhad, Iran was surveyed. RESULT: The results showed that autonomy, task requirement and work interaction had scores higher than their respective median on the subscales. There were significant differences between demographic characteristics and the autonomy, task requirement, work interaction, salary, work condition, professional development, supportive nursing management, decision making, professional status subscales and mean total job satisfaction. In univariate analysis, young age, being female and being married were significantly associated with a higher level of job satisfaction. The adjusted R(2) for this model was 0.14, indicating that the model explained 14% of the variability. The regression model was highly significant, F (4298) = 13.194, P < 0.001. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: The authors emphasise that the human resources policies and incentives need to be re-visited. Efforts undertaken to improve working conditions, supportive nursing management, improved professional status, professional development and increased salaries are some of the ways for nurse managers to improve job satisfaction.

The reliability of the Australasian Triage Scale:a meta-analysis / 世界急诊医学杂志（英文）

@#BACKGROUND: Although the Australasian Triage Scale (ATS) has been developed two decades ago, its reliability has not been defined; therefore, we present a meta-analyis of the reliability of the ATS in order to reveal to what extent the ATS is reliable. DATA SOURCES: Electronic databases were searched to March 2014. The included studies were those that reported samples size, reliability coefficients, and adequate description of the ATS reliability assessment. The guidelines for reporting reliability and agreement studies (GRRAS) were used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models, and meta-regression was done based on the method of moment's estimator. RESULTS: Six studies were included in this study at last. Pooled coefficient for the ATS was substantial 0.428 (95％CI 0.340–0.509). The rate of mis-triage was less than fifty percent. The agreement upon the adult version is higher than the pediatric version. CONCLUSION: The ATS has shown an acceptable level of overall reliability in the emergency department, but it needs more development to reach an almost perfect agreement.