What factors affect the quality of life of employed physically disabled people? A qualitative exploration of their experiences.

BACKGROUND: According to the literature, the majority of People With Physical Disabilities (PWPDs) have a low Quality of Life (QOL). The goal of this study was to look at the experiences of a group of employed PWPDs in Iran in terms of the factors influencing their QOL. MATERIALS AND METHODS: A conventional qualitative content study was carried out in Qazvin City, Iran, from February to August 2020. Twenty-eight semi-structured, in-depth interviews with 20 employed PWPDs (6 men and 14 women), 5 five family members, and 3 of the participants' employers (n = 3) were conducted. Participants were asked about their experiences with factors that impacted the QOL of employed PWPDs. RESULTS: Continuous analysis of data began and continued up to data saturation. The participants' experiences on influencing variables QOL were merged into four major categories: psychological state, socioeconomic problems, structural obstructions, and physical constraints. CONCLUSION: Conducting psychological therapy to reduce stress and using adaptive coping strategies, changing perceptions of the community about PWPDs via the media, and also improving environmental infrastructure may help to increase QOL in PWPDs.

Effectiveness of a mobile app-based educational intervention to treat internet gaming disorder among Iranian adolescents: study protocol for a randomized controlled trial.

BACKGROUND: The use of video games, a hobby for many teenagers in their leisure time, has brought with it a new potential for concerns. Internet gaming disorder (IGD) is a mental condition classified as a disorder due to addictive behaviors. It may include use of video games, both online and offline. Consequences of IGD may include introversion, social anxiety, mood swings, loneliness, sleep problems, behavioral problems, depression, low self-esteem, and increased violence. In order to design an app-based intervention for adolescents, a transtheoretical model (TTM) has been used. This widely used model in the field of behavioral change is also practical for health education programs. In addition, cognitive-behavioral therapy (CBT) has been used to make people more aware of their behaviors, feelings and thoughts and how to achieve behavioral change. The present study seeks to determine the effectiveness of this app-based intervention in in the treatment of IGD among adolescents. METHOD: In this single-blinded, randomized, controlled trial, 206 high-school adolescents aged 13 to 18 years in Qazvin city will be recruited. Eligible adolescents will be randomly assigned into intervention and control groups. Eight consecutive sessions delivered over 2 months and based on the TTM and CBT will be delivered through the `app (named HAPPYTEEN) to the intervention group. The control group will receive a sleep hygiene intervention (8 consecutive sessions for 2 months) via the app. Data collection tools include the Internet Gaming Disorder Scale, Insomnia Severity Index, Depression, Anxiety, and Stress Scales, Stages of Change Questionnaire, Decision Balance, and Self-Efficacy. The study measures will be completed at baseline, post intervention, and 1 month and 3 months after the intervention. DISCUSSION: The results of this intervention could be used as adjunct therapy for adolescents with IGD. TRIAL REGISTRATION: Clinical Trial Registration Center of Iran (IRCT) IRCT20181226042140N1 . Registered on June 9, 2020.

Corrigendum to "Depression, anxiety, and stress mediate the associations between internet gaming disorder, insomnia, and quality of life during the COVID-19 outbreak" [Addict. Behav. Rep. 12 (2020) 100307].

[This corrects the article DOI: 10.1016/j.abrep.2020.100307.].

A theory of planned behavior-enhanced intervention to promote health literacy and self-care behaviors of type 2 diabetic patients.

BACKGROUND: Improved health literacy and awareness could help type 2 diabetic patients to control the disease complications. OBJECTIVE: The current study aimed to evaluate the impact of theory-based educational intervention on health literacy and self-care behaviors of type 2 diabetic patients in Tonekabon city. METHODS: This randomized controlled trial study was conducted at health care centers in Tonekabon city, Iran, from April 5, 2017, to October 22, 2018. Using multistage random sampling, 166 patients with type 2 diabetes divided into two groups: theory-based intervention (n = 83) and custom education (n = 83). The data collection tools consisted of demographic information, Theory of Planned Behavior (TPB) measures, health literacy for Iranian adults (HELIA) and summary of diabetes self-care activities (SDSCA). The five 45-minute group training sessions based on the baseline assessment and model constructs along with the targeted pamphlet and m-health strategy were designed for the experimental group. Data were analyzed using chi-square, independent and paired t-test and Analysis of covariance (ANCOVA). RESULTS: After controlling for pre-test effect, there was a significant difference between the two groups in terms of mean scores of attitudes, subjective norms, perceived behavior control and intention in post-test (P < 0.001). Also, after controlling for the pre-test effect, the results showed a significant difference in the self-care domain in the post-test (P < 0.001). Finally, after controlling for the pre-test variable effect, covariance analysis reflects significant difference in total health literacy score and its dimension at posttest (P < 0.001). CONCLUSIONS: Applying TPB based education is suggested to maintain and improve self-care behaviors and health literacy in type 2 diabetic patients and other chronic diseases.

A Persian Adaptation of Medication Adherence Self-Efficacy Scale (MASES) in Hypertensive Patients: Psychometric Properties and Factor Structure.

INTRODUCTION: Poor adherence to anti-hypertensive treatment significantly contributes to the failure to achieve well-controlled blood pressure in patients with hypertension. AIM: To convert the original English version of Medication Adherence Self-efficacy Scale (MASES) into a Persian version for clinical application in hypertensive patients. METHODS: The backward-forward translation method was used to produce the Persian version of the questionnaire. Then the internal consistency was assessed using Cronbach's alpha. Exploratory Factor Analysis was applied to extract the components of the questionnaire. Correlation between blood pressures and drug adherence was then determined using the Persian MASES in hypertensive patients. RESULTS: Cronbach's alpha coefficient of the Persian version of MASES was >0.92, suggesting that it can yield consistent results. Exploratory Factor Analysis suggested an uni-dimensionality of the scale. Patients with uncontrolled hypertension showed poor adherence to hypertensive medications, therefore had significant lower self-efficacy scores than those with well-controlled blood pressure by medications. CONCLUSION: The Persian version of MASES is valid and reliable to assess self-efficacy of antihypertensive medication adherence in hypertensive patient, which is helpful to improve medication compliance in such patients in order to achieve better blood pressure controls.

Household waste behaviours among a community sample in Iran: an application of the theory of planned behaviour.

Understanding the factors influencing recycling behaviour can lead to better and more effective recycling programs in a community. The goal of this study was to examine factors associated with household waste behaviours in the context of the theory of planned behaviour (TPB) among a community sample of Iranians that included data collection at time 1 and at follow-up one year later at time 2. Study participants were sampled from households under the coverage of eight urban health centers in the city of Qazvin. Of 2000 invited households, 1782 agreed to participate in the study. A self-reported questionnaire was used for assessing socio-demographic factors and the TPB constructs (i.e. attitude, subjective norms, perceived behavioural control, and intention). Furthermore, questions regarding moral obligation, self-identity, action planning, and past recycling behaviour were asked, creating an extended TPB. At time 2, participants were asked to complete a follow-up questionnaire on self-reported recycling behaviours. All TPB constructs had positive and significant correlations with each other. Recycling behaviour at time 1 (past behaviour) significantly related to household waste behaviour at time 2. The extended TPB explained 47% of the variance in household waste behaviour at time 2. Attitude, perceived behavioural control, intention, moral obligation, self-identity, action planning, and past recycling behaviour were significant predictors of household waste behaviour at time 2 in all models. The fact that the expanded TPB constructs significantly predicted household waste behaviours holds great promise for developing effective public campaigns and behaviour-changing interventions in a region where overall rates of household waste reduction behaviours are low. Our results indicate that educational materials which target moral obligation and action planning may be particularly effective.

Cross-cultural adaptation of the Female Genital Self-Image Scale (FGSIS) in Iranian female college students.

The aim of the present study was to investigate the psychometric properties of a translated and culturally adapted Iranian version of the Female Genital Self-Image Scale (FGSIS-I) in a sample of college women. Further, the relationship between women's self-image, body appreciation, sexual functioning, and gynecological exam behavior was explored. A sample of 1,877 female students from five different universities across Qazvin and Tehran completed the Female Sexual Function Index (FSFI), the Body Appreciation Scale (BAS), the Rosenberg Self-Esteem Scale (RSES), the FGSIS-I, and a gynecological exam behavior questionnaire. Good to excellent internal consistency reliability, test-retest reliability, and convergent and construct validity were found. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) both provided a two-factor structure for the FGSIS-I. The validity of the FGSIS-I in predicting gynecological exam behavior of college women was tested using structural equation modeling (SEM). The final model accounted for 33% of the variance in gynecological exam behavior (p < 0.01). In conclusion, the FGSIS-I was found to be a highly valid and reliable instrument to assess female genital self-image in Iranian women.

Validation of a translated and culturally adapted Iranian version of the International Index of Erectile Function.

This study aimed to examine the psychometric values of a Farsi-translated version of the International Index of Erectile Function among a population sample of Iranian men. A community sample of 2,345 healthy men and a clinical sample of 421 men with diagnosed erectile function from 2 cities of Iran participated in the study. Participants were asked to complete the International Index of Erectile Function, the Life Satisfaction questionnaire, and a demographic questionnaire at baseline. Four weeks later, both samples were asked to recomplete the International Index of Erectile Function. The response rates were 84% (n = 1,969) and 98% (n = 412) for healthy men and men with erectile function, respectively. The retest reliability of the International Index of Erectile Function showed excellent intraclass correlation coefficients for both the healthy and patient samples. The International Index of Erectile Function subscales correlated significantly with the scores resulting from the clinical rating of erectile function conducted by urologists. Men with erectile function, as diagnosed by urologists, had significant lower scores in all subscales. The results of the exploratory factor analysis indicated that the International Index of Erectile Function could be summarized into a 5-component solution.The Iranian version of the International Index of Erectile Function was found to be a highly valid and reliable instrument to be used for the assessment of erectile function in clinical and population samples.

Psychometric properties of the national eye institute refractive error correction quality-of-life questionnaire among Iranian patients.

BACKGROUND AND AIM: To evaluate the psychometric properties of the national Eye Institute refractive error correction quality of life questionnaire (NEI-RQL-42) among Iranian patients with refractive errors. MATERIALS AND METHODS: Two samples of patients (n1 = 296, n2 = 95) were consecutively selected from the eye clinic of the Boo-Ali Hospital, Qazvin. A forward-backward procedure was conducted to translate and cross-culturally adapt the Iranian version of the NEI-RQL-42. A homogeneity, stability, and reliability test was conducted for the first sample after a two-week interval. Convergent validity was computed using the correlation between the NEI-RQL-42 subscale scores, National Eye Institute-Visual Functioning Questionnaire (NEI-VFQ-25), and the Short Form-36 (SF-36). Furthermore, Known-group analysis was performed, to determine the discriminant validity between the subgroups of patients with hyperopia, emmetropia, and myopia. Responsiveness to clinical change was tested by administering NEI-RQL-42 on the second sample that was scheduled for surgery. RESULTS: Homogeneity was satisfactory with the Cronbach's alpha coefficients ranging between 0.70 and 0.92. The 13 subscales of the NEI-RQL-42 showed a considerable stability in intra-class-correlation (ICC) ranging between 0.70 and 0.89. Positive correlation coefficients were found among all subscales of the NEI-RQL-42 and the other quality-of-life instruments (NEI-VFQ-25 and SF-36). The NEI-VFQ-25 displayed excellent discriminant validity to differentiate the subgroups of patients, and was found to be responsive to change after the surgical correction at three months. CONCLUSIONS: The Iranian version of the NEI-RQL-42 is a valid and reliable instrument to assess refractive error correction quality-of-life in Iranian patients. Moreover this questionnaire can be used to evaluate the effectiveness of interventions in patients with refractive errors.

Psychometric properties of the Iranian version of the Sexual Quality of Life Scale among women.

INTRODUCTION.: Female sexual dysfunction has a known impact on the quality of life. AIM.: The purpose of this study was the translation and validation of an Iranian version of the Sexual Quality of Life questionnaire-Female (SQOL-F) in Iranian women. METHODS.: A population sample of N = 2,675 women aged 17-67 years from Qazvin City of Iran and two clinical population samples (women with sexual dysfunctions N = 295 and women with type 2 diabetes N = 449) participated in the study. A self-constructed demographic questionnaire, the SQOL-F, the Short Form Health Survey (SF-36), and the Female Sexual Function Index (FSFI) were used for data collection. MAIN OUTCOME MEASURES.: Internal consistency and test-retest reliability were examined. Correlations between the SQOL-F, SF-36, and FSFI were assessed with convergent validity. Furthermore, known-groups comparison analysis was conducted to compare differences in SQOL-F scores between healthy women and those with sexual problems and diabetes. Confirmatory factor analysis assessed the factor structure of the SQOL-F. RESULTS.: Cronbach's alpha ranged from 0.84 to 0.98. Significant correlations between the SQOL-F, SF-36, and FSFI scores were found (ranging from r = 0.4 to r = 0.72). The SQOL-F scores were significantly different between women with and without a clinical condition (P < 0.05). A unifactorial model provided the best fit to the data. CONCLUSION.: The questionnaire represents a suitable measure to assess sexuality-related quality of life to sexual function in healthy women, as well as in women suffering from a chronic medical condition. Application of the scale to other clinical samples needs to be further explored.

Psychometric properties of the Persian version of the Duke University Religion Index (DUREL): a study on Muslims.

The aim of this study was translation and validation of the Duke University Religion Index in Iranian Muslims. The study was performed in two stages. In the first stage, 1,762 college students from Qazvin city with an average age of 21.2 years participated in the study. In the second phase, 796 college students with an average age of 23.7 were recruited from Tehran. A demographic questionnaire, Santa Clara Strength Faith questionnaire (SCSORF), and Duke Religion Index (DUREL) were administered. Cultural adaptation of these measures was performed by a forward-backward translation technique. Test-retest reliability and intraclass correlation coefficients (ICC) were used for assessing reliability. Convergent validity was measured by Spearman correlation between DUREL and SCSORF. Explanatory and confirmatory factor analyses (EFA and CFA) evaluated the factor structure. Results showed that the scale is reliable. Cronbach's alpha ranged from 0.866 to 0.921 and ICC ranged from 0.937 to 0.991. Correlations between DUREL and SCSORF were also strong (ranging from 0.62 to 0.79). Results obtained from CFA and EFA confirmed one-dimension for the DUREL. Thus, the DUREL appears to be a proper measure for assessing religiosity among Iranian Muslims. Further testing of the scale among minorities and those with special health-related conditions is suggested.

Health-related quality of life in young adult patients with rheumatoid arthritis in Iran: reliability and validity of the Persian translation of the PedsQL™ 4.0 Generic Core Scales Young Adult Version.

The objective of the present study was to determine the reliability and validity of the Persian translation of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 Generic Core Scales Young Adult Version in an Iranian sample of young adult patients with rheumatoid arthritis (RA). One hundred ninety-seven young adult patients with RA completed the 23-item PedsQL™ and the 36-item Short-Form Health Survey (SF-36). Disease activity based on Disease Activity Score 28 was also measured. Internal consistency and test-retest reliability, as well as construct, discriminant, and convergent validity, were tested. Confirmatory factor analysis (CFA) was used to verify the original factor structure of the PedsQL™. Also, responsiveness to change in PedsQL™ scores over time was assessed. Cronbach's alpha coefficients ranged from α = 0.82 to α = 0.91. Test-retest reproducibility was satisfactory for all scales and the total scale score. The PedsQL proved good convergent validity with the SF-36. The PedsQL distinguished well between young adult patients and healthy young adults and also RA groups with different comorbidities. The CFA did not confirm the original four-factor model, instead, analyses revealed a best-fitting five-factor model for the PedsQL™ Young Adult Version. Repeated measures analysis of variance indicated that the PedsQL scale scores for young adults increased significantly over time. The Persian translation of the PedsQL™ 4.0 Generic Core Scales Young Adult Version demonstrated good psychometric properties in young adult patients with RA and can be recommended for the use in RA research in Iran.

Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women.

BACKGROUND: Infertility has a major impact on women's quality of life and emotional well-being. The resulting interpersonal problems extend to women's sexual relationships, with a high proportion of infertile women reporting sexual problems. AIM: To determine the prevalence and identify the potential risk factors of female sexual dysfunction (FSD) among infertile Iranian women. METHODS: Using a cross-sectional study design including 12 infertility clinics in five Iranian cities, FSD was assessed in 604 infertile women using the culturally adapted, multidimensional Female Sexual Function Index (IV-FSFI). Depression, anxiety and health-related quality of life (HRQL) were also assessed for all infertile patients. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS) while HRQL was measured using the Short Form 36 (SF-36). MAIN OUTCOME MEASURE: Prevalence of FSD in infertile women and associated factors. RESULTS: Infertile women reported significantly lower scores on the FSFI domains in comparison with healthy women. Risk factors for FSD as determined by multilevel analyses were older age and self-reported depression. Furthermore, secondary infertility, lower educational level and higher partner education put women at increased risk for FSD. CONCLUSIONS: Among infertile women, sexual dysfunctions seem to be prevalent higher than previously published in Iran. This finding may have implications on the clinical assessment of sexual function and the role of demographic and psychological factors in infertile women.

The Female Sexual Function Index: translation and validation of an Iranian version.

INTRODUCTION: Female sexual dysfunction (FSD) is a prevalent problem in the female population in Iran. A subjective assessment instrument that allows cross-cultural comparison of FSD is urgently needed. AIM: The aims of the study were to translate, validate, and enhance cross-cultural comparability of an Iranian version (IV) of the Female Sexual Function Index (FSFI)-the IV-FSFI. METHODS: A total of 448 women (19-54 years, mean 29.7, standard deviation 7.3) from five different Iranian outpatient obstetrics and gynecology clinics were eligible for this study. The IV-FSFI was developed through forward and backward translation, revision by a research team, and a subsequent pilot study. After an interview for clinical diagnosis of FSD based on the Diagnostic and Statistical Manual of Mental Disorders, all participants completed the IV-FSFI for the validation study. Three hundred sixty-two women completed the IV-FSFI again, 4 weeks after the first visit. MAIN OUTCOME MEASURES: Test-retest reliability was determined by Pearson's product-moment correlations. Reliability was tested using Cronbach's alpha coefficient. Construct validity was evaluated by principal component analysis using varimax rotation and by subsequent confirmatory factor analysis (CFA). Discriminant validity was assessed with between-groups analysis of variance. RESULTS: The overall test-retest reliability coefficients were high for each domain of the IV-FSFI (r ranging from 0.73 to 0.86) and the internal consistencies within the acceptable range (α from 0.72 to 0.90). Principal component analysis with varimax rotation revealed a best fitting five-factor structure similar to the original FSFI (χ(2) = 2.1, degree of freedom = 17, P < 0.001). CFA confirmed the underlying domain structure, supporting the factorial validity of the IV-FSFI. CONCLUSIONS: In conclusion, the newly developed IV-FSFI has demonstrated to be a reliable and valid instrument with good psychometric properties that allows a quick and accurate preliminary screening of women with unknown sexual health status in clinics and other medical settings.