Psychometric properties of the Persian version of Social Adaptation Self-evaluation Scale in community-dwelling older adults.

INTRODUCTION: The Social Adaptation Self-evaluation Scale (SASS) is used to measure social function and social motivation in depressed patients. There is little attention to social function in the treatment of depression. The aim of this study was to assess the validity and reliability of the Persian version of SASS (P-SASS) for older adults. PARTICIPANTS AND METHODS: This is a cross-sectional and methodological study. The participants were 550 community-dwelling older adults living in Tehran who were selected randomly from the primary health care centers. To assess the psychometric properties of SASS, we first did translation and cross-cultural adjustment on SASS and then used P-SASS and the Geriatric Depression Scale (GDS) for gathering data. A number of analyses, including Pearson's correlation, exploratory factor analysis, and Cronbach's α, and receiver operating characteristic curve were used to manage the data with the IBM SPSS Statistics V.22. RESULTS: The mean age of the participants was 66.09±6.67 years, and 58.9% of them were male. The Cronbach's α was 0.97. The test-retest reliability correlation coefficient was 0.78. Principal component analysis showed that P-SASS consists of two components. P-SASS score showed a significant negative correlation with GDS (r=-0.91, P<0.01), which suggests good convergent validity. The P-SASS cutoff point was 28 (sensitivity: 0.97 and specificity: 0.94). CONCLUSION: P-SASS has good reliability and validity for older adults. So, it can be considered as an appropriate tool to evaluate the social function and social motivation of older persons with and without depression.

Safe Delivery Posts: an intervention to provide equitable childbirth care services to vulnerable groups in Zahedan, Iran.

BACKGROUND: Recently, there has been a shift towards alternative childbirth services to increase access to skilled care during childbirth. OBJECTIVE: This study aims to assess the past 10 years of experience of the first Safe Delivery Posts (SDPs) established in Zahedan, Iran to determine the number of deliveries and the intrapartum transfer rates, and to examine the reasons why women choose to give birth at a Safe Delivery Post and not in one of the four large hospitals in Zahedan. DESIGN: A mixed-methods research strategy was used for this study. In the quantitative phase, an analysis was performed on the existing data that are routinely collected in the health-care sector. In the qualitative phase, a grounded theory approach was used to collect and analyse narrative data from in-depth interviews with women who had given birth to their children at the Safe Delivery Posts. SETTING: Women were selected from two Safe Delivery Posts in Zahedan city in southeast Iran. PARTICIPANTS: Nineteen mothers who had given birth in the Safe Delivery Posts were interviewed. FINDINGS: During the 10-year period, 22,753 low-risk women gave birth in the Safe Delivery Posts, according to the records. Of all the women who were admitted to the Safe Delivery Posts, on average 2.1% were transferred to the hospital during labour or the postpartum period. Three key categories emerged from the analysis: barriers to hospital use, opposition to home birth and finally, reasons for choosing the childbirth care provided by the SDPs. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: Implementing a model of midwifery care that offers the benefits of modern medical care and meets the needs of the local population is feasible and sustainable. This model of care reduces the cost of giving birth and ensures equitable access to care among vulnerable groups in Zahedan.

Is the adapted Radimer/Cornell questionnaire valid to measure food insecurity of urban households in Tehran, Iran?

OBJECTIVE: To assess the validity of the adapted Radimer/Cornell questionnaire to measure food insecurity in low-income urban households in Tehran, the capital of Iran. DESIGN: The Radimer/Cornell questionnaire was modified and used to assess the applicability, validity and reliability of such a measure in a culturally different context of urban households in Tehran. Factor analysis and Cronbach's alpha were used to assess validity and reliability, respectively. Socio-economic characteristics and food consumption frequency of the household were used to assess the criterion validity of the questionnaire. SETTING: District 20 of Tehran. SUBJECTS: A sample of 250 Iranian nuclear households with at least one child aged 1-18 years and a non-pregnant, non-lactating woman of reproductive age, selected through a multistage random sampling method. RESULTS: Three scales, labelled as household, individual and child hunger, were extracted through factor analysis using varimax rotation. Internal consistency of the scales was 0.897, 0.820 and 0.796, respectively. Individual insecurity and child hunger were inversely correlated with monthly per capita income, father's education, mother's education and father's occupational status, and positively correlated with household size, as expected. However, household insecurity did not follow the same pattern. Consumption frequency of fruits, vegetables, dairy, red meat and rice declined as food insecurity status worsened, while bread and potato consumption increased. CONCLUSION: The results show that a modified version of the Radimer/Cornell questionnaire is a valid and reliable instrument to measure household food insecurity in a culturally different context. However, further modifications seem necessary to measure food insecurity at household level. Results lend support to the utility and applicability of experience-based measures in varying cultural communities.