The association between sleep quality, health status and disability due to breathlessness in chronic obstructive pulmonary disease patients.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) increases susceptibility to sleep disturbances. This study aimed to evaluate the association between COPD severity criteria with sleep quality. METHODS: One hundred fifty-eight patients in Rasul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran, from April 2019 to March 2021 diagnosed with COPD were examined using the Pittsburgh Sleep Quality Index (PSQI), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, spirometry and pulse oximetry. RESULTS: Of 158 subjects, 125 patients were male (79%), and 33 were female (21%). The mean subject's age and FEV1/FVC ratio were 62.6 ± 11.5 and 65.6 ± 14.9%, respectively. The mean CAT scoring and Spo2 saturation reported 16.2 ± 7 and 91.5 ± 10.8%, respectively. The mean PSQI score was 8.2 ± 3.8. The association between PSQI score with FEV1 and FEV1/FVC ratio was not statistically significant (p = 0.64 and 0.58, respectively), whereas the association between PSQI scores with CAT score (p Ë‚ 0.0001, r2  = 0.51) and dyspnoea severity (p Ë‚ 0.0001, r2  = 0.29) were statistically significant. The patients with higher CAT score demonstrated poor sleep quality, particularly in longer sleep latency (p = 0.001, r2  = 0.056), bad subjective sleep quality (p Ë‚ 0.0001, r2  = 0.286), lower sleep efficiency (p = 0.002, r2  = 0.077), higher sleep disturbance (p Ë‚ 0.0001, r2  = 0.225), daytime dysfunction (p Ë‚ 0.0001, r2  = 0.259) and sleep medication intake times a week (p = 0.01, r2  = 0.069). Dyspnoea severity was attributed to bad subjective sleep quality (p Ë‚ 0.0001, r2  = 0.069), higher sleep disturbances (p = 0.005, r2  = 0.08), and daytime dysfunction (p Ë‚ 0.0001, r2  = 0.108). CONCLUSION: The PSQI has a significant association with the CAT and mMRC for COPD patients and is linked to the disease's severity.

Development and Validation of the Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) Among Iranian Population.

Objectives: We aimed to develop a scale and evaluate this scale's validity and reliability to measure factors affecting people's knowledge and attitudes toward the pandemic breaking transmission chain. Methods: This exploratory mixed-method study was carried out in two phases: (1) item generation using literature reviews and interviews and, (2) item reduction by psychometric assessments of the developed scale. The face, content, construct (exploratory and confirmatory factor analysis), convergent, and discriminant validity of the scale were assessed in the Iranian population (n = 500) from March to June 2020. The Composite Reliability (CR) and the internal consistency correlation coefficient were estimated. Results: The Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) among the Iranian population included 18 items. Two factors with a whole variance of 66.05% were identified by exploratory factor analysis. Factors were labeled as "health literacy" and "home health empowerment." The confirmatory factor analysis showed the goodness of fit. The CR of the scale for first and second factors were 0.965 and 0.833 receptively. The scale's internal consistency correlation coefficient was acceptable (Cronbach's alpha = 0.960 and 0.823, average interitem correlation = 0.643 and 0.635, McDonald's omega = 0.963 and 0.829, for the first and second factor, receptively). Conclusion: The KA-C scale can be exerted to screen the people's knowledge and attitude about the COVID-19 pandemic breaking the transmission chain as a valid and reliable scale for further policymaking, health care providers, and for a multi-dimensional psychosocial assessment of the pandemic period.

Evaluation of the psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index in depressed patients.

INTRODUCTION: The Pittsburgh Sleep Quality Questionnaire is capable of covering different stages of sleep, and it is regarded as one of the best ones available, and checking for its validity and reliability among depressed patients is a step in this direction. The aim of this study was to evaluate the reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires in patients with depression. METHODS: In this study, 93 depressed patients were in the study group, and 100 patients were in the control group. The Persian translation of the PSQI and ESS questionnaires and the Beck Depression Inventory (BDI) were at the disposal of both validity and reliability of PSQI and ESS, and its correlation with BDI scores were analyzed. RESULTS: In our study, Cronbach's alpha coefficient of the PSQI questionnaire was 0.821. According to the PSQI and BDI-II scores, the results between the PSQI and ESS scores were significantly correlated. CONCLUSION: Using the Persian PSQI and ESS questionnaires to evaluate sleep quality and daytime sleepiness in patients with depression provides a reliable and valid measure for subjective sleep quality in clinical practice and research.

Development and implementation of Persian test of Elderly for Assessment of Cognition and Executive function (PEACE).

INTRODUCTION: A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants. METHODS: First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale. The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society. In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer's group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate. RESULTS: We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Abstract Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer's disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer's disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer's group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group. CONCLUSION: The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants.