Psychometric properties of the Persian Health Care Climate Questionnaire (HCCQ-P): assessment of type 2 diabetes care supportiveness in Iran.

Background: Health-care systems play a key role in responding to the growing problems of patients with type 2 diabetes by supporting their autonomy in providing routine care. The Health Care Climate Questionnaire (HCCQ) was designed to assess patients' perceived degree of autonomy support within the care practice settings. The main purpose of this study was to translate and evaluate psychometric properties of the Persian version of the HCCQ (HCCQ-P) to be applied among Iranian and other Persian-speaking patients with type 2 diabetes. Method: Translation/back-translation procedures were carried out to prepare a preliminary draft of the HCCQ-P that was subsequently sent for face and content validity appraisal by a group of 15 health education/promotion and nursing specialists. Minor revisions were performed based on the feedback, and the content validity ratio (=0.91) and content validity index (=0.95) were within the acceptable range. The structural validity of the scale was assessed by exploratory and confirmatory factor analysis. Results: The exploratory and confirmatory factor analysis outputs (root mean square error of approximation=0.079, comparative fit index=0.976, Tucker Lewis index=0.967, standardized root mean square residual=0.022) demonstrated the proper performance and fitness statistics of the translated HCCQ in a one-dimensional model similar to the original scale. The internal consistency and reliability scores endorsed the validity of the translated measure (α=0.945, intraclass correlation coefficient=0.999, P=0.000). Conclusion: In this study, the translated HCCQ-P scale showed robust internal validity for its application in the assessment of health-care settings' supportiveness in care provision to Persian-speaking patients with type 2 diabetes. Future cross-cultural and multidisciplinary studies are recommended to investigate the applicability of the scale in different patients/cultural groups and health-care settings.

Psychometric responsiveness of the health-related quality of life questionnaire (HeartQoL-P) in the Iranian post-myocardial infarction patients.

BACKGROUND: Cardiovascular diseases (CVD) as a most frequent and costly NCDs account for about 17.3 million annual deaths worldwide. About 80% of these deaths are taking place in low and middle income countries (LMIC). The survivors may experience severe disabling consequences with extensive impacts on their quality of life. The HeartQoL is a relatively new scale to measure health-related quality of life in CVD patients and was validated for use in other languages. Main aim of the present study was to validate the HeartQoL for Persian speaking populations. DESIGN AND METHODS: In this cross-sectional study the participants were 557 admitted patients with acute myocardial infarction (AMI) across three specialized hospitals in Tabriz, North West of Iran from Sep 2014 to Feb 2015. Translation back-translation procedures were applied to prepare the Persian version of the HeartQol (HeartQoL-P) and the content validity of the scale was evaluated by an expert panel of 10 academic staff. Construct validity was assessed by exploratory and confirmatory factor analyses. The internal consistency was assessed based on the numeric value of Cronbach's alpha and sensitivity of the measure according to the ceiling and floor effect's values. RESULTS: The two-factor structure of the HeartQoL-P was supported by the confirmatory factor analysis' outputs and good internal consistency measures (total score α = 0.94) (physical subscale (10 items) α = 0.95) and emotional subscale (4items) α = 0.80)). No ceiling and floor effects were observed for the overall HeartQol-P's score. CONCLUSION: The findings supported the HeartQoL-P usability as a valid instrument in studies on the Iranian or other Persian speaking patients.

A cross-sectional study on adaptability and pertinence of the "Health Promoting Hospitals" (HPH) initiative in Iran: health professionals' perspectives.

BACKGROUND: Despite the expansion of the HPH approach and its application in several countries of the world, the conception is still not ascertained in Iran. The main purpose of this study was to investigate the Iranian health professionals' ideas on applicability of the HPH standards in day-to-day practices of the Iranian hospitals. STUDY DESIGN: A cross-sectional study. METHODS: The study respondents were 354 physicians, nurses and general managers working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences in Tabriz the capital city of the East Azarbaijan province, North West of Iran. A validated self-assessment tool was used for data collection about adaptability of the HPH standards i.e. management policy, patient assessment, patient information, healthy workplace promotion and inter-sectional cooperation from September to November 2016. RESULTS: The mean adaptability score of the HPH standards (60.0, SD: 13.0, range: 0- 136) represents ambivalent sentiment of the Iranian health professionals. The inter-sectoral cooperation and patient information standards were suggested to be the most and lest adaptable elements respectively. Only 32% of the study respondents endorsed the HPH standards' overall appositeness in the studied hospitals. Mean adaptability score of the HPH standards was significantly different between male and female health professionals, specialized and general hospitals, small oppose to the medium and large hospitals and those without prior knowledge and the knowledgeable respondents about the HPH standards (P< 0.05). CONCLUSIONS: This study gave an overall snapshot regarding the applicability of the HPH strategy in typical Iranian education hospitals through a wide range of health professionals' point of views. Understanding the limitations that constrain generalizability of the findings, the study results reflected a part of the gaps existing for application of the HPH strategy in the Iranian hospitals and challenges that might impede its successful conduct.

Measuring unintended pregnancies in postpartum Iranian women: validation of the London Measure of Unplanned Pregnancy.

Research suggests a relatively sizable rate of unintended pregnancies in some subgroups of Iranian women, but there is no concise, standard scale to measure the pregnancy intention of Iranian women. Therefore, the psychometric properties of the Persian version of the London Measure of Unplanned Pregnancy (LMUP) were investigated. The Persian version of the LMUP was tested on randomly selected married women aged 15-49 years in the city of Ajabshir, East Azerbaijan province, north-west of Islamic Republic of Iran. The scale's face validity and internal consistency was examined and its construct validity was tested by exploratory factor analysis. The internal consistency of the scale was acceptable (Cronbach alpha coefficient 0.87). Structural indicators of the Kaiser-Meyer- Olkin measure (0.85) and Bartlett test of sphericity (P < 0.001) verified interpretability of the exploratory factor analysis output. Applicability of the Persian version of the LMUP is accepted. Further investigation is needed to understand cultural norms that might influence Iranian women's responses to queries about pregnancy intentions.

Measuring unintended pregnancies in postpartum Iranian women:validation of the London measure of unplanned pregnancy

Research suggests a relatively sizable rate of unintended pregnancies in some subgroups of Iranian women,but there is no concise, standard scale to measure the pregnancy intention of Iranian women. Therefore,the psychometric properties of the Persian version of the London Measure of Unplanned Pregnancy [LMUP] were investigated. The Persian version of the LMUP was tested on randomly selected married women aged 15-49 years in the city of Ajabshir, East Azerbaijan province, north-west of Islamic Republic of Iran. The scale's face validity and internal consistency was examined and its construct validity was tested by exploratory factor analysis. The internal consistency of the scale was acceptable [Cronbach alpha coefficient 0.87]. Structural indicators of the Kaiser-Meyer-Olkin measure [0.85] and Bartlett test of sphericity [P < 0.001] verified interpretability of the exploratory factor analysis output. Applicability of the Persian version of the LMUP is accepted. Further investigation is needed to understand cultural norms that might influence Iranian women's responses to queries about pregnancy intentions

Les travaux de recherche suggèrent que le taux de grossesses non désirées dans certains sous-groupes de femmes iraniennes est relativement important.Toutefois, il n'existe pas d'échelle concise et normalisée de mesure de l'intention de grossesse chez les femmes iraniennes. Par conséquent, les propriétés psychométriques de la version en langue perse de l'échelle London Measure of Unplanned Pregnancy ont été étudiées. La version en langue perse de l'échelle a été testée auprès de femmes mariées âgées de 15 à 49 ans et sélectionnées aléatoirement dans la ville d'Ajabshir, dans la province de l'Azerbaïdjan oriental, au nord-ouest de la République islamique d'Iran. La validité apparente de l'échelle et sa cohérence interne ont été examinées. Sa validité conceptuelle a été testée par une analyse des facteurs exploratoires. La cohérence interne de l'échelle était acceptable [coefficient alpha de Cronbach : 0,87]. Des indicateurs structuraux de la mesure de Kaiser-Meyer-Olkin [0,85] et le test de sphéricité de Bartlett [P < 0,001] ont permis de vérifier l'interprétabilité du résultat de l'analyse factorielle exploratoire. L'applicabilité de la version en langue perse de l'échelle a été acceptée. Des recherches supplémentaires sont requises pour comprendre les normes culturelles qui pourraient influer sur les réponses des femmes iraniennes aux questions sur l'intention de grossesse