زهرا شاهواری

The aim of this study was to describe the experiences of patients who had recovered from COVID 19 on the psychological factors affecting their recovery during the disease.

This qualitative study was conducted in 1399. The data collection method was semi-structured in-depth interviews. Participants were patients who had recovered from COVID 19 and were willing to talk about their experience. Sampling was done from 3 cities of Gachsaran، Basht and Noorabad with purposeful sampling approach. Data were analyzed by content analysis method. The extracted codes were managed through MAXQDA software version 10.

A total of 15 interviews were conducted with 8 women and 7 men aged 23 to 58 years. Analysis of participants' conversations about psychological factors contributing to the recovery of patients with COVID 19 led to the identification of 305 codes، which were divided into 2 main categories، including " factors related to patient" and “Factors related to patient’s relations" and 9 subcategories.

According to the results of this study، the thoughts and behaviors of the patient، staff and acquaintances are effective in the mental health of the patient and accelerate the healing process، which need pay attention. One of the responsibilities of the medical staff is to provide consultation sessions for patients’ acquaintances and their nurses regarding the thoughts and behavior of the patient and his/her relations.

Medical professionalism is one of the key competencies of physicians and the basis of a trust-based relationship between physician and patient. It has become more important with recent advances and challenges in medicine. The present study investigated the attitudes of geriatric medicine residents toward medical professionalism and determined areas of difference.

In this qualitative study, the six principles of medical professionalism were presented in the form of a clinical scenario and the residents were asked to read them and discuss one or two question(s). Data were evaluated by content analysis method.

There was no significant difference between the variables of age, sex and stages of the residents and their general attitude toward the principles of medical professionalism. In general, the level of familiarity and attention of participants to the concepts of justice and excellence were lower than other principles.

Despite the positive attitude of the residents to the general concepts of medical professionalism, there is still a serious vacuum in the field of education, assessment and adherence. Medical educators should be more concerned with training in this field. Future studies are needed to help identify the teaching mission.

Patients with severe mental illnesses are more prone to experience sexual health problems. Herein, we developed a "Safe Sex Knowledge and Behavior Questionnaire for Patients with Severe Mental Illnesses"(SSKBQ-SMI).

The present study was conducted in the form of methodological research in 4 stages. In the first stage, items of the questionnaire were selected and the item pool was formed by using similar studies and experts' opinions. During the next steps, the psychometric properties of the questionnaire were assessed using content validity, face validity, reliability and construct validity. The content validity was tested using the Content Validity Index and Content Validity Ratio. The charts of content validity were given to 13 specialists expert in sexual health including psychiatrists, clinical psychologists, gynecologists, urologists, and infectious disease specialists. The reliability was tested by using the test-retest method in 70 patients with two-week intervals. The construct validity was tested using exploratory factor analysis in 265 patients. The internal consistency was calculated by using Cronbach's alpha index.

After determining the content and face validity, a tool was obtained with 16 True/False items in the knowledge section (with one score for each correct answer and the total score range from 0 to 16) and 16 five-point Likert scale items in the behavior section (with each question score range from 0 to 3 and the total behavior score range from 0 to 48, the lower score defined safer behavior). The correlation coefficient of the scale scores in the test-retest method was calculated to be 0.880 (P<0.001) and 0.951 (P<0.001) in the sections of knowledge and behavior, respectively. The Cronbach's alpha coefficient was 0.809 for the section of knowledge, 0.756 for the section of behavior, and 0.782 for the whole questionnaire. Exploratory factor analysis confirmed the existence of 4 factors in the knowledge section and 3 factors in the behavior section.

The present 32-item questionnaire was designed based on experts' opinions and important statements of patients about sexual health, simple scoring, good reliability and validity, is a suitable tool for assessing the safe sex knowledge and behavior in patients with severe mental illnesses.

Sexual addiction is a growing disorder which is accompanied with many personal and social consequences. The current fundamental study aims to investigate and discover the factors affecting the development of sexual addiction, with a qualitative view at the experience, thoughts and feelings of patients with sex addiction. Using a qualitative method, 13 patients with sex addiction (10 male and 3 female) aged 21–50 were selected by purposeful sampling and interviewed in 2019 in Tehran with a semi-structured interview. Then, the data was analyzed by using a seven-step Colaizzi method. The results were categorized into three main categories including personal issues, family inefficiency and inattentiveness of the society about sex education, and further categorized into 11 subcategories. Our findings provide invaluable insights into sex addiction for physicians and other mental health providers. Given the lack of community planning and policy regarding the sex education for teachers, parents and youth, we emphasize the responsibility of parents in teaching healthy sexual behaviors to their children and adolescents.

Numerous studies have addressed the impact of cognitive-behavioral therapy and treatment based on acceptance and commitment to depression. However, there is a research gap between comparing the effectiveness of cognitive-behavioral therapy and treatment based on acceptance and commitment to depression and increased sexual activity behavior of patients with sexual addiction.

The aim of the present study is to compare the effectiveness of cognitive-behavioral therapy and acceptance-based therapy. Depression and hyperactive sexual behavior of patients with sexual addiction.

The present study was a quasi-experimental study with a pretest-posttest-follow-up design with a control group The statistical population of this study was men over 18 years of age with sexual addiction living in Tehran in 2019. Thirty patients were selected as a sample by snowball method and were randomly assigned to two experimental groups and one control group (10 patients). The tools of the present study are: Behavioral Cognitive Therapy Sessions (Location, 2014), Acceptance and Commitment Therapy Sessions (Crossbow, 2011), Beck Depression Questionnaire (Beck et al., 1961) and Sexual Increase Sexual Questionnaire (Reid et al., 2011). ). Data analysis was performed by mixed variance analysis methods with repeated measurement, multivariate analysis of variance, Bonfroni test and Toki test.

Cognitive-behavioral therapy and treatment based on acceptance and commitment were effective in reducing depression and increased sexual activity in these patients (P< 0/05). there was no significant difference between the two treatment methods.

Patients who participated in cognitive-behavioral and acceptance therapy sessions based on acceptance and commitment had fewer depressive symptoms and increased sexual activity

The success of hospitals in providing patient satisfaction depends on many factors. The role of employee's commitment to organizational behavior in patient’s satisfaction in hospitals is important.

The present study is a methodological research in Tehran University of Medical Sciences, which aims to design a questionnaire for assessment of the employee's commitment to organizational behavior which was carried out in two phases. In the first phase we developed items pool based on a review of literature and expert’s views. In the second phase we evaluated content validity and face validity of items, and finally the reliability assessment of the instrument.

A questionnaire was developed based on a review of literature; an 80-items pool was formed. By interviewing experts, and omitting the overlap items, the number of items was reduced to 40 items. In the next stage, content validity, face validity and reliability of the items (α = 0.859) were proved, and the number of items were reduced to 17 items. Finally, we allocated 12 items (from 17 items) to be assessed by heads and colleagues. We also found that patients were able to evaluate the employee's commitment to organizational behavior through 5 items (from 17 items).

An assessment tool contain 17 items was developed for assessment of the employee's commitment to organizational behavior, taking into account the views of service providers and patients.

Management-level challenges are among the factors that undermine the individuals' adherence to professional behavior in clinical settings. This study investigated glitches of the management system in clinical settings from the perspective of staff, faculty members, and medical students/residents in hospitals affiliated to Tehran University of Medical Sciences.

This qualitative study was conducted in 2 parts by exploring the viewpoints of personnel and physicians. In this regard, 8 focus group discussions were performed with 85 faculty members, clinical residents, and interns. Furthermore, 15 focus group discussions were held with 165 staffs. Available sampling method was applied to collect the participants and the data were analyzed using the content analysis method.

A total of 22 focus-group discussions were conducted with 250 participants; Participants' age ranged from 24 to 65 years. Participants' education levels varied from diploma to postgraduate for the staff and from medical student to sub-specialist for the physicians. Finally, management-level barriers, which undermine the staffs' ability to adhere to professional behavior in clinical settings were explained with 315 codes, 12 subcategories, and 2 main categories of "macro management issues " and "hospital management issues".

Managers are required to consider providing a proper context for enforcing the professional behavior law, selecting middle managers based on their empowerment in performing the professional behaviors, prioritizing the professional behavior in policy making, and promoting the professional behavior in an administrative system consistent with the health system. In selecting the hospital managers, authorities are recommended to consider the managers' professional behavior and power in implementing the professionalism leadership. Moreover, the possibility of conducting professional behavior should be considered in making the policies.

Despite the consensus on the role of teachers in identity formation of learners, the assessment of the professional behavior of faculty members has not been paid enough attention. Professionalism is best taught in clinical settings through role modeling of teachers. Students can observe the behavior of the physicians, this way, professionalism evaluation in practicing physicians is important. This study endeavored to develop a 360-degree tool for assessing the professional behavior of clinical attending.

This study was conducted in four phases. In the first phase we designed item pool based on a review of literature and experts’ views, in the second phase, content validity and face validity of items were authnticated. In the next phase a pilot study was conducted on 40 people (20 faculty members & 20 assistants). In the versy last phase the reliability of the instrument was calculated on 18 faculty members, 10 head of departments, 16 residents and 17 nurses.

Based on validity and reliability assessment, item pool reduced to 18. Seven items were assigned to department heads, 6 items to colleagues, 8 items to assistants, and 5 items to nurses. It was also found that patients were able to evaluate the professional behavior of clinical members in four aspects.

A 360 degree instrument containing five sections and 18 items was developed that can examine the professional behavior of faculty of members of school of medicine, taking into account the views of stakeholders including service providers and patients.

Data collection is one of the important stages of research process and requires valid and reliable instruments. The aim of this article was to introduce important steps of translation and construction process of a questionnaire. Adopting an appropriate instrument for research and developing an optimal instrument needs knowledge on psychometric criteria. The present paper explains the construct validity reliability and responsiveness as the important components of psychometric properties of health related instruments.
The present paper was written based on exisiting documentaries.
There are different methods for evaluating construct validity, which include structural validity (factor analysis), hypothesis testing, convergent and discriminant validity, and cross-cultural validity. Criterion validity is also a type of validity, which can improve the quality of an instrument if being applicable. Reliability is an essential part of psychometric evaluation, which includes internal consistency, stability, equivalency and standard error of measurement. Instrument developers have often been concerned with internal consistency and stability. Examining standard error of measurement as an important component of reliability has been ignored in the development of most instruments. Responsiveness is approved if the smallest detectable change is less than the clinical minimal important change. Furthermore, the area under the ROC curve can also be used for examining responsiveness. Floor and ceiling effects exist if more than 15% of respondents get the highest or lowest possible scores.
Psychometric knowledge should be considered as basic requirement of translation and development of health-relate measures. This could help investigators to collect valid and reliable information when collecting the data.

Data collection is one of the important stages of research process and requires valid and reliable instruments. The aim of this article was to introduce important steps of translation and construction process of a questionnaire. Furthermore, the present study considers two psychometric properties evaluation including face and content validity.
This is a documentary that accounts for instructions and methods in tanslating and validating a health-related questionnaire.
The most known procedure to translate a standard questionnaire from original language into a different language is forward-backward procedure. This includes several steps including forward translation, review and reconciliation of forward translation, back translation, back translation review, pre-testing and cognitive interviewing and providing the provisional version. Main steps for instrument development include definition of concept and its domain, explication of objectives for the measure, development of a blueprint; and construction of the measure, including administration procedures, item set, and scoring rules and procedures. Then content and face validity could be performed to provide the final version.
Translation or development of a health-related measure and its psychometric properties should methodologically be robust and follow standard procedures.

Sexual satisfaction is a significant factor in prevention of sexual disorders among women. There are many factors associated with sexual satisfaction. The aim of this study was to determine some factors related to women sexual satisfaction in Gachsaran, in South-West of Iran.

This descriptive analytic study was done on 1014 women which refered to health centers in Gachsaran city during Jan-Jun 2008. Data was collected by self–reported questionnaires and analyzed by Chi-Squre and Pearson tests.

The scale of sexual satisfaction were 0.4%, 10.9%, 47.5% and 41.7% unsatisfied, low, moderate and fully satisfied, respectively. There was a correlation between sexual satisfaction and women age, couple age difference, length of marriage, family economical condition and contraceptive method (P<0.05).

This study showed that, woman age, couples age differences, length of marriage, couple economic condition, and contraceptive method were related to sexual satisfaction. These factors should be taken into consideration in all marriages and sexual consultation.

Breast cancer is one of the most important causes of women's mortality, in the world wide. Breast self examination (BSE) is a method that often leads to detect breast cancer in early stage. Therefore, health care team, such as health care volunteers have an important role for traning BSC to women. The aim of the study was to determine the effect of education of breast self- examination on knowledge, attitude and practice of health care volunteers, in Gachsaran, in 2005. A quasi-experimental study was conducted, in which the data were collected by a case-record form and a check-list. The study sample consisted of 53 health mediators by census method from five health care centers (one in rual area) in Gachsaran. The sign test showed a statistically significant increase in the mean of knowledge scores at post-intervention compared to pre-intervention (P=0.000). The result of wilcoxone test showed a significant increase in the mean scores of attitude at posttest compared to pre-test (P=0.021) too. Also the results of kruskalwallis test showed a significant increase in the mean of BSE practice at post-test compared to pre-test (P=0.000). The literacy level of the study subjects had a significant influence on BSE knowledge level at post-test (P=0.015). In addition, the kruskall wallis test showed the mean seores of BSE practice in women with the history of breast pain was significantly high (P=0.019). To sum up, educating health eare volunteers could lead to increase the in levels of knowledge, attitude and practice of BSE. Therefore, it is recommended that to establishe practical BSE classes for all women in the community educating health care voluntcers would be neccessary.

IUDs are the most commonly used reversible contraceptive in the world today, and are known worldwide as contraceptives, but they also provide users with a variety of noncontraceptive health benefits. Most women and clinicians are unaware that IUDs confer important noncontraceptive health benefits, which are as follow, not having systematic effects and protection against endometrial and cervical cancers. Besides, hormonal IUDs treat idiopathic menorrhagia and reduce menstural blood loss and heavy bleeding in patients with uterine fibroma and adenomyosis, they also decrease dysmenorrhea and prevent endometrial hyperplasia. In an overall view considering that the health benefits of IUDs are many, an expert consuler would make the client ready and eager to use them. Trained physicians and health providers are those who can offer proper services to right patients, and increase the usage of IUDs widely.

Nowadays IUDs are the most commonly used reversible contraceptives in the world While more than 130 million women are thaught to use IUDs worldwide, a-large number of the users put it away for some medical reason, anyhow, side effects of this device will diminish with precise patient’s screening programs. Determining the efficacy of use in unitentional pregnancies and also the side effects after 21 months indian T IUDs placement, we conducted a historical cohort retrospectiove study, in which 1008 medical record, belonged to all women whom had reffered to an urban health center were reviewed. The results showed that the probability of continuation with this type of IUDs at the end of 21 months of use was 0.6% and after this time 300 women had discontinued the use of it their main reasons were expulsion 8.3% bleeding and pain 9.5% and cessation due to increased lentgh 2.5%. Besides 6% of porticipants had requested requosted to put it away because of some personal reasons. To conclude, the results were the some as other similar researches, most side effects had occurred during the first year of placement, and as the time passed the side effects started to deminish. We recommend a similar study to investigate the side effects after 21th months of placement.

Nowadays IUD(s) are the most commonly used reversible contraceptive in the world. More than 130 million women are thought to use it, while a large number of them put this method away because of some medical reasons. While a comprehensive patient’s screening may highly decrease it’s side effects, a historical cohort retrospective study was performed to determine the side effects of pregna after 21st month of insertion. In order to gather the data all 1008 files of patients which refferd to one of the health centers in karaj were studied. Findings revealed that after 21st month of insertion patients suffered from expulsion (8.3%), unintended pregnancy (0.6%) dysmenorrhea (2%), heavy bleeding (7.1%)., long lasting bleeding (3.1%), spotting and intermenstural bleeding (11.1%), infection (39.6%), missed period, (1.9%), lost IUD thread (1%) and low back pain (0.4%), meanwhile during the first year of insertion, side effects were as follow, unreasonable bleeding (7.7%), infection 32%, heavy bleeding 6.5%, long lasting bleeding (2.7%), spotting and intermenstural bleeding (9.5%) and dysmenorrhean (1.9%). To sum up, there were not any differences between the results of this study and other similar ones. It can be said that the side effects will decrease as the years pass. We also recommend a prospective study for determination of the side effects in long term period (more than 21 months).