hamid sharifnia
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Background
Gastrointestinal tube feeding is one of the most important and beneficial methods of nutrition in patients admitted to the intensive care unit. There is still no consensus on the best nutritional method that will lead to fewer complications. This study aimed to investigate the disadvantages of different methods of tube feeding in patients admitted to the adult intensive care unit.
MethodsThe present study is a review study conducted in 2022. Articles published in the English language databases including Web of Science, Scopus, Science Direct, and PubMed, between 2000 and 2022 were used.
ResultsIn the initial search phase, 2893 articles were obtained. In the next step, after the review of titles and abstracts, 760 articles remained. Finally, based on inclusion criteria and full text review, 14 related articles were selected. Disadvantages of tube feeding methods were classified into four categories: "respiratory complications", "gastrointestinal complications", "metabolic complications" and "bed occupancy".
ConclusionsBased on the results of this study, in terms of complications, intermittent and continuous methods are safer and more preferable than the bolus method. However, low-speed bolus feeding has fewer side effects.
Keywords: Intensive Care Units, Enteral Nutrition, Nutritional Support -
Background & Objective
The aim of this study was to assess the validity of the Persian version of the Academic Major Satisfaction Scale (P-AMSS) among Iranian Nursing Students.
Material & MethodsA cross-sectional study was carried out from January to March 2023. A total of 231 undergraduate nursing students completed demographic information and the P-AMSS. The data were analyzed using exploratory (EFA) and confirmatory factor analysis (CFA).
ResultsThe mean (± SD) score of academic major satisfaction among nursing students was 25.47 ± 6.4. The EFA results revealed a single factor that accounted for 63% of the total variance. The CFA results indicated a good fit (χ2(6) = 8.53, p = 0.202, CMIN/DF = 1.422, CFI = 0.99, NFI = 0.99, TLI = 0.99, RMSEA (90% CI) = 0.043 [ 0.00;0.1]). The P-AMSS demonstrated good internal consistency and reliability (α=0.907; ω=0.921). Measurement invariance was confirmed across gender.
ConclusionThe P-AMSS, consisting of 6 items, is a brief scale with strong psychometric properties suitable for evaluating academic major satisfaction among Iranian nursing students.
Keywords: Psychometric, Major Satisfaction, Nursing Students, Iran -
Background & Aims
Little is known about managing delirium in neonates admitted to Neonatal Intensive Care Units. The current study investigated whether kangaroo mother care can affect neonates' delirium under non-invasive mechanical ventilation.
Materials & MethodsIn this randomized control trial, a total of 50 term neonates who were under non-invasive mechanical ventilation were allocated to intervention and control groups (n=25 in each group) using block randomization. Utilizing “Cornell Assessment of Pediatric Delirium”, and “ACoRN respiratory sequence protocol”, the data were gathered at baseline, 24, 48, and 72 hours after. The intervention group received 30 minutes of kangaroo mother care daily.
ResultsThere was a statistical delirium mean scores difference between the two groups on day 2 (p < 0.045) but not on other days. Repeated measures modeling (linear mixed models and generalized linear mixed models) indicated significant differences in change curves for both Cornell Assessment of Pediatric Delirium scores and the incidence of delirium.
ConclusionImplementing kangaroo mother care for a 30-minute duration each day for neonates under non-invasive mechanical ventilation may markedly decrease delirium occurrence.
Keywords: Infant, Delirium, Mechanical Ventilation, Neonatal Intensive Care Unit, Kangaroo Mother Care Method -
BackgroundDespite remarkable advancements in the use of embryo donation, concerns havearisen regarding its potential effects on the psychological well-being of children conceivedthrough this assisted reproductive technology and their parent-child relationships.MethodIn a cross-sectional analytical study, the psychological adjustment of 31 children aged3 to 7 born through embryo donation was assessed and compared to 30 age-matched childrenfrom families who conceived naturally using the Strengths and Difficulties Questionnaire.Parenting styles within these families were also evaluated using the Baumrind Parenting StylesInventory through clinical interviews.ResultsAlthough 8 out of 31 children born through embryo donation (25.8%) and 3 out of 30children from natural conception families exhibited psychological maladjustment, this differencewas not statistically significant. Furthermore, parenting styles did not significantly differbetween the two groups.ConclusionThe absence of genetic parent-child relationships does not appear to be a dominantfactor influencing the psychological adjustment of children or parenting styles.Keywords: Embryo, Donation, Child, Pychologic, Adaptation
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زمینه و هدف
اغلب بیماران آسیب دیده مغزی بستری در بخش مراقبت ویژه، قادر به گزارش درد خود نیستند و برای بررسی درد آنان ابزار CPOT-Neuro توسعه یافته است. اما ممکن است این بیماران، با توجه به شرایط بالینی، رفتارهای درد متفاوتی از خود نشان دهند؛ لذا این مطالعه با هدف مقایسه رفتارهای درد در بیماران آسیب دیده مغزی مبتنی بر ویژگی های بالینی آنان انجام شد.
روش هااین پژوهش مقطعی بر روی 132 بیمار آسیب مغزی در شهر آمل که به روش در دسترس از آذر تا اسفند 1402 وارد مطالعه شدند، انجام شد. داده ها با استفاده از چک لیست جمعیت شناختی و ابزار مشاهده درد بحرانی- عصبی جمع آوری شد. رفتار بیماران قبل، حین و بعد از تغییر وضعیت (رویه دردزا) مورد ارزیابی قرار گرفت.
یافته هابا توجه به فراوانی رفتارهای درد مشاهده شده در حین رویه دردزا، در کل 105 بیمار تغییر در حالت چهره، 13 بیمار پاسخ خودمختار، 88 نفر حرکات بدنی، 46 بیمار تغییر در صداسازی و تحمل ونتیلاتور و 31 بیمار تغییر تون عضلانی را نشان دادند. با مقایسه فراوانی این رفتارها در حین رویه دردزا بر اساس ویژگی های بالینی، شانس مشاهده حرکات بدن در حین رویه دردزا در بیماران غیرتروماتیک 60 درصد کمتر از بیماران تروماتیک بود (P<0.05) احتمال مشاهده پاسخ خودمختار، صداسازی/ تحمل ونتیلاتور و تغییر تون عضلانی با بهبودی سطح هوشیاری، کاهش یافت (P<0.05) همچنین شانس مشاهده پاسخ خودمختار، حرکات بدن، صداسازی/ تحمل ونتیلاتور و تغییر تون عضلانی با تغییر سطح آرام سازی بیمار افزایش یافت (P<0.05) و احتمال مشاهده تغییر تون عضلانی در بیماران تحت تهویه مکانیکی 74 درصد کمتر از بیماران بدون تهویه مکانیکی بوده است (P<0.05).
نتیجه گیریاین مطالعه نشان داد که فراوانی رفتارهای درد مشاهده شده در بیماران آسیب دیده مغزی بر اساس نوع آسیب مغزی، سطح هوشیاری، سطح آرام سازی و نحوه تنفس متفاوت بود. این یافته ها، اهمیت در نظرگرفتن ویژگی های بالینی را هنگام ارزیابی و مدیریت درد این بیماران برجسته می کند.
کلید واژگان: آسیب مغزی, درد, رفتار, اندازه گیری درد, بخش مراقبت های ویژهBackground & aimMost of the brain-injured patients hospitalized in the Intensive Care Unit (ICU) are not able to report their pain. In order to assess their pain, the CPOT-Neuro has been developed. Actually they may indicate different pain behaviors according to clinical conditions. Therefore, this study was conducted with the aim of comparing pain behaviors in brain-injured patients based on their clinical characteristics.
MethodsThis cross-sectional study was carried out on 132 brain-injured patients in Amol city, Iran who were enrolled in the study from December 2023 to March 2024. Data were collected using a demographic checklist and a Critical-Care Pain Observation Tool Neuro (CPOT-Neuro). Patients' behaviors were evaluated before, during and after change position (nociceptive procedure).
ResultsAccording to the frequency of pain behaviors observed during nociceptive procedure, a total of 105 patients indicated changes in facial expression, 13 patients in autonomic response, 88 patients in body movements, 46 patients in vocalization/ventilator tolerance and 31 patients indicated changes in muscle rigidity. By comparing the frequency of these behaviors during nociceptive procedure based on clinical characteristics, the chance of observing body movements during nociceptive procedure in non-traumatic patients was 60% lower than in traumatic patients (P<0.05). The probability of observing the autonomic response, vocalization/ ventilator tolerance and muscle rigidity during the nociceptive procedure decreased with the improvement of the level of consciousness (P<0.05). In addition, the chance of observing the autonomic response, body movements, vocalization/ ventilator tolerance and muscle rigidity during nociceptive procedure increased with the change in patients' sedation (P<0.05). The possibility of observing a change in muscle rigidity during nociceptive procedure in patients under mechanical ventilation was 74% lower than in patients without mechanical ventilation (P<0.05).
ConclusionThis study showed that pain behaviors in brain-injured patients were different based on the type of brain-injury, the level of consciousness, the level of sedation and the way of breathing. These findings highlight consideration of clinical characteristics when evaluating and managing pain in these patients.
Keywords: Brain Injury, Pain, Behaviors, Pain Measurement, Intensive Care Units -
زمینه و هدف
مدیریت موثر فشار کاف لوله تراشه، امری حیاتی در پیشگیری از عوارضی مانند پنومونی و ترومای راه هوایی است. علیرغم توصیه به استفاده از مانومتر برای پایش فشار کاف لوله تراشه، پایبندی به آن کمتر از حد مطلوب است. از آنجایی که قصد، مهم ترین پیش بینی کننده رفتار واقعی است، درک عوامل موثر بر آن، با استفاده از ابزاری معتبر، می تواند به شناسایی دقیق تر موانع و تسهیل کننده های استفاده از مانومتر کمک کند. بنابراین، مطالعه حاضر با هدف طراحی و روانسنجی ابزار ارزیابی عوامل موثر بر استفاده از مانومتر پایش فشار کاف لوله تراشه در پرستاران انجام شد.
روش هااین مطالعه روش شناختی در سال 1402 بر روی 186 پرستار شاغل در بخش های مراقبت ویژه بیمارستان های دولتی شهرستان آمل انجام شد. برای طراحی این ابزار بر اساس تئوری رفتار برنامه ریزی شده، از نظریه و نمونه ارائه شده توسط آجزن و برای تکمیل طراحی و طی روند روانسنجی از دستورالعمل اکلس استفاده شد. بر این اساس ابتدا رفتار هدف تعریف شد. سپس، مجموعه اولیه ای از گویه ها از طریق مرور منابع مرتبط و تجارب بالینی پژوهشگران تولید شد. پس از آن، روایی صوری و محتوایی ابزار با استفاده از رویکردهای کیفی و کمی ارزیابی گردید. روایی سازه ابزار از طریق تحلیل عاملی اکتشافی و پایایی درونی آن با ضرایب آلفای کرونباخ و امگای مک دونالد و پایایی ثبات به روش آزمون- باز آزمون بررسی شد.
یافته هادر مرحله تولید گویه ها، 41 گویه بر اساس مرور متون مرتبط طراحی شد. پس از ارزیابی کیفی و کمی روایی صوری و محتوایی، تعداد گویه ها به 25 کاهش یافت. تحلیل عاملی اکتشافی با شاخص کفایت نمونه برداری برابر با 0/853 و آزمون بارتلت معنادار مناسب بودن داده ها برای تحلیل را تایید کرد. چهار عامل با مقادیر ویژه بیشتر از یک شناسایی شدند که به ترتیب 22/50، 10/95، 9/30 و 10/60 درصد از واریانس کل را تبیین می کردند (مجموعا 53/35 درصد). در مرحله نهایی، شش گویه به دلیل بار عاملی کمتر از 0/3 حذف شدند و 19 گویه نهایی در چهار عامل «باور رفتاری و کنترلی مثبت»، «باورهای هنجاری»، «قدرت باورهای کنترلی درک شده» و «انگیزه برای پیروی» دسته بندی شدند. ضرایب آلفای کرونباخ و امگای مک دونالد در محدوده 0/827 تا 0/900 و 0/95 = ICC بود.
نتیجه گیریاین ابزار روایی و پایایی قابل قبولی برای ارزیابی عوامل موثر بر قصد پرستاران بخش مراقبت های ویژه در استفاده از مانومتر را دارد؛ بنابراین استفاده از این ابزار در تحقیقات آینده می تواند به شناسایی موانع و تقویت کننده های بیشتری در رفتار پرستاران منجر شود و به طراحی برنامه های آموزشی موثرتری بینجامد. همچنین توصیه می شود این ابزار در میان گروه های مختلف پرستاران و در محیط های بیمارستانی متنوع مورد آزمون قرار گیرد تا بیشتر اصلاح و بهبود یابد.
کلید واژگان: پرستاری مراقبت های ویژه, تئوری رفتار برنامه ریزی شده, روان سنجی, قصد, لوله گذاری داخل تراشهBackground & aimEffective management of endotracheal tube cuff pressure is crucial in preventing complications such as pneumonia and airway trauma. Despite recommendations for using a manometer to, cuff pressure monitoring, adherence remains suboptimal. Since intention is the most significant predictor of actual behavior, understanding the factors influencing it through a valid tool can help identify barriers and facilitators more accurately. Therefore, this study aimed to develop and psychometrically evaluate of a Scale for Assessing Factors Influencing Nurses' Intention to Use a Manometer for Endotracheal Tube Cuff Pressure Monitoring.
MethodsThis methodological study was conducted in 2024 on 186 nurses working in the Intensive Care Units (ICUs) of public hospitals in Amol, Iran. The tool was developed based on the Theory of Planned Behavior using the framework and examples provided by Ajzen, and the psychometric process followed Eccles' guidelines. First, the target behavior was defined. Then, an initial set of items was generated through a literature review and clinical experience of the researchers. The content and face validity of the tool were evaluated using both qualitative and quantitative approaches. The construct validity of the tool was assessed through exploratory factor analysis, and its internal consistency was examined using Cronbach's alpha and McDonald's omega coefficients. The test-retest method was used to assess stability.
ResultsDuring the item generation phase, 41 items were developed based on a review of relevant literature. After qualitative and quantitative assessments of face and content validity, the number of items was reduced to 25. Exploratory factor analysis indicated an acceptable fit for the data, with a Kaiser-Meyer-Olkin (KMO) sampling adequacy index of 0.853 and a significant Bartlett's test. Four factors with eigenvalues greater than one were identified, accounting for 22.50%, 10.95%, 9.30%, and 10.60% of the total variance, respectively (53.35% cumulatively). In the final stage, six items with factor loadings less than 0.3 were removed, resulting in 19 items categorized under four factors: "Positive Behavioral and Control Beliefs," "Normative Beliefs," "Perceived Control Beliefs Strength," and "Motivation to Comply. Cronbach’s alpha and McDonald’s omega coefficients ranged from 0.827 to 0.900, with ICC = 0.95.
ConclusionThe tool demonstrated acceptable validity and reliability for assessing factors influencing the intention of ICU nurses to use manometers. Therefore, its application in future research could help identify additional barriers and facilitators in nurses' behavior, leading to the development of more effective training programs. It is also recommended that this tool be tested among different groups of nurses and in various hospital settings to further refine and improve it.
Keywords: Critical Care Nursing, Intention, Intratracheal Intubation, Psychometrics, Theory Of Planned Behavior -
زمینه و هدف
ارزیابی دقیق آمادگی قلبی-تنفسی برای آگاهی و ارائه مداخلات تمرینی و پیشگیری از بیماری های بعدی ضروری به نظر می رسد؛ بنابراین هدف تحقیق حاضر، تحلیلی جامع از ارزیابی آمادگی قلبی-تنفسی در افراد مبتلا به ناتوانی هوشی بود.
روش بررسیمطالعه حاضر، مروری نظام مند بود. جست وجو در پایگاه های اطلاعاتیPubMed ، Web of Science،Medline ،Google scholar ، Scopus و همچنین در پایگاه های فارسی، پایگاه مرکز اطلاعات علمی جهاد دانشگاهی، MedLib (بانک جامع مقالات پزشکی)، IranMedex، پژوهشگاه علوم و فناوری اطلاعات ایران (IRANDOC) و بانک اطلاعات نشریات کشور (MAGIRAN) تا سال 2021 صورت گرفت. در هر پایگاه داده، جست وجویی با درنظرگرفتن ترکیبی از کلمات کلیدی ازقبیل ناتوانی هوشی، آمادگی جسمانی، آزمون، آمادگی قلبی-تنفسی، ویژگی روان سنجی و آزمودنی انجام شد. در این مطالعه، مقالاتی بررسی شدند که به ارزیابی آمادگی قلبی-تنفسی اختصاصی افراد مبتلا به ناتوانی هوشی پرداخته بودند و جدول ریسک تورش برای ارزیابی کیفیت مقالات به کار رفت.
یافته هااز بین 1086 مقاله شناسایی شده، در هیجده مقاله معیارهای ورود مدنظر برای مطالعه نهایی به دست آمد. درمجموع، نه مجموعه آزمون آمادگی جسمانی اختصاصی و هشت مطالعه به صورت مقاله که به ارزیابی اختصاصی آمادگی قلبی-تنفسی پرداخته بودند، شناسایی و بررسی شد. درکل، شناسایی هیجده آزمون مختلف آمادگی جسمانی دارای روایی و پایایی و قابلیت امکان سنجی برای ارزیابی آمادگی قلبی-تنفسی افراد با کم توانی ذهنی صورت گرفت. به ترتیب آزمون های پیاده روی/دویدن و پیسر، فراوانی بیشتری در بین آزمون های عملکردی آمادگی قلبی-تنفسی اختصاصی افراد مبتلا به ناتوانی هوشی داشتند.
نتیجه گیریباتوجه به تعداد زیاد آزمون های قلبی-تنفسی اختصاصی افراد مبتلا به ناتوانی هوشی و ارتباط بین این فاکتور و سلامتی، نیاز به استانداردسازی و اجماع ارزیابی های اختصاصی وجود دارد تا آزمونی انتخاب شود که دارای بیشترین تناسب با هدف و ارزیابی خاص این گروه باشد.
کلید واژگان: کم توان ذهنی, آمادگی جسمانی, آمادگی قلبی-تنفسی, مجموعه آزمونBackground & ObjectivesIntellectual disability is associated with many comorbidities, such as epilepsy, cerebral palsy (CP), and anxiety disorders, and can affect the health status of the individual. The physical fitness (PF) of people with intellectual disability is lower than typical developing peers, making them particularly vulnerable to health problems in adulthood. People with intellectual disabilities show lower aerobic capacity in childhood (8–10 years), adolescence (11–14 years), and youth (15–18 years) than healthy counterparts, and this difference gradually increases with age increases. With this in mind, PF assessment is a simple, safe, and low–cost tool that allows several health indicators to be evaluated. Based on the PF level of children, educational and public health strategies and policies can be developed. Accurate evaluation of cardiorespiratory fitness seems necessary to prepare and present training interventions to prevent subsequent diseases. Therefore, this study aims to examine and summarize a set of tests and specific field tests related to cardiorespiratory fitness in people with intellectual disabilities.
MethodsThe present study was a systematic review. The relevant data were selected, collected, and analyzed from studies on physical fitness and the health of people with mental disabilities. Databases of PubMed, Web of Science, Medline, Google Scholar, and Scopus, as well as Persian databases, Jahad Daneshgahi Scientific Information Center database, MedLib (Comprehensive Database of Medical Articles), IranMedex, Iran Research Institute of Information Science and Technology (IRANDOC) and the country's publications database (MAGIRAN), were searched until 2021. The articles searched should include a set of PF tests. The search was performed in each database based on predefined keywords. The data extraction process and literature results were evaluated according to PRISMA (preferential reporting items for systematic and meta–analysis) guidelines. After collecting studies from databases, duplicate items were removed. Two authors screened the remaining articles, considering their 'Titles' and 'Abstracts' to identify studies that met the inclusion criteria. During the study selection process, one researcher blindly analyzed the 'Titles' and 'Abstracts.' As the 'Titles' and 'Abstracts' did not contain enough information to make an informed decision, a researcher reviewed the full text. Related articles were retrieved for the whole study. Then, two authors reviewed the full text of the potential studies, and consensus made decisions to include or exclude the studies. Disputes were resolved by consensus; if necessary, the third arbitrator, as a judge, assisted in the review and selection.
ResultsA total of 1086 articles were identified, and with the removal of duplicates, the number reached 448 articles. The analysis of the articles 'Titles' and 'Abstracts' showed that 332 articles did not meet the required criteria, and led to their deletion. The full text of the remaining 116 articles was studied, and 98 articles were deleted. Finally, 18 articles met the inclusion criteria for the final study. Of these 18 articles, ten studies were related to a set of health–related fitness tests in people with intellectual disability that examined cardiorespiratory fitness with functional tests, and 8 studies were articles that examined cardiorespiratory fitness in people with intellectual disability with functional tests. In addition, the tests of these articles did not exist in the set of physical fitness tests of people with intellectual disability and were not repetitive. About 53 sets of physical fitness tests were found, of which 10 were related to people with disabilities (intellectual disability) according to the study criteria. According to the PF factors evaluated in this set of tests and the large volume of material, the important factor of PF in people with intellectual disability and the cardiorespiratory fitness factor were studied to examine the content more accurately. Through this set of tests and articles, 18 functional tests of cardiorespiratory fitness related to people with intellectual disabilities were identified.
ConclusionGiven the relationship between physical fitness and health and the opportunity provided by the school environment to assess physical fitness in people with intellectual disabilities, we need to standardize and reach a consensus on specific physical fitness assessments for people with intellectual disabilities in this environment
Keywords: Intellectual Disability, Physical Fitness, Cardiorespiratory Fitness, Test Set -
سابقه و هدف
اختلال پیوند پس از زایمان از مهم ترین اختلالات در رابطه مادر و نوزاد در دوره پس از زایمان است. هدف از این مطالعه ترجمه و اعتبارسنجی پرسش نامه پیوند پس از زایمان در مادران ایرانی بوده است.
مواد و روش هادر این مطالعه از روش توصیفی - تحلیلی مقطعی استفاده شد. پس از کسب اجازه از طراح اصلی پرسش نامه، برای ترجمه پرسش نامه اصلی از انگلیسی به فارسی از روش ترجمه بازترجمه استفاده شد. سپس به دنبال روایی صوری کیفی، نمونه ای از مادران نخست زا پرسش نامه را تکمیل کردند و روایی سازه با استفاده از تحلیل عاملی اکتشافی بررسی شد. پایایی با انجام تحلیل همسانی درونی (میانگین همبستگی بین گویه ای، آلفای کرونباخ و امگا مک دونالد) و پایایی سازه ارزیابی شد.
یافته هادر مجموع 263 مادر نخست زا پرسش نامه را تکمیل کردند. تجزیه و تحلیل عاملی اکتشافی نسخه 13 موردی پرسش نامه پیوند پس از زایمان را با ساختار سه عاملی (عامل عمومی، طرد و خشم و اضطراب در مورد مراقبت) 49.19٪ از واریانس کلی مشاهده شده را تبیین کرد و روایی سازه این ابزار را تایید کرد. ضریب آلفای کرونباخ برای خرده مقیاس ها 0.744 بود. پایایی آزمون بازآزمون (0.850 - 0.952) پرسش نامه با فاصله دو هفته نشان دهنده دامنه خوب پایایی است.
نتیجه گیرییافته ها نشان داد پرسش نامه پیوند پس از زایمان (نسخه فارسی 25 موردی)، ابزاری قابل اعتماد و معتبر برای غربالگری و شناسایی اختلال پیوند پس از زایمان در جمعیت مادران ایرانی است.
کلید واژگان: پیوند, ایران, مادر و نوزاد, پس از زایمان, پرسش نامهBackground and ObjectivePostpartum bonding disorder is a significant impairment in the mother-infant relationship during the postpartum period. The present study aimed to translate and validate the Postpartum Bonding Questionnaire (PBQ) in Iranian mothers.
Materials and MethodsA descriptive, cross-sectional survey design was employed in the current investigation. With the developer's permission, a back-translation procedure was used to translate the original questionnaire from English to Persian. Then, following qualitative face validity, a sample of primiparous mothers completed the questionnaire, and construct validity was assessed using exploratory factor analyses. Moreover, reliability was evaluated using internal consistency analysis (average inter-item correlation, Cronbach’s alpha, and McDonald’s omega) and construct reliability.
ResultsA total of 263 primiparous mothers completed the questionnaire. Exploratory factor analysis revealed the 13-item version of the PBQ with a three-factor (‘general factor,’ ‘rejection and anger,’ and ‘anxiety about care’) structure, which explained 49.19% of the overall variance observed, and this confirmed the construct validity of the tool. Cronbach's alpha coefficient for the subscales was equal to 0.744. In addition, the test-retest reliability (0.850-0.952) of the questionnaire with a two-week interval indicated an acceptable range of reliability.
ConclusionThe findings indicate that the Persian version of the 25-item PBQ is a reliable and valid tool for screening and identifying the postpartum bonding disorder among Iranian mothers.
Keywords: Bonding, Iran, Mother-Infant, Postpartum, Questionnaire -
Background
Given the importance of quality of life, especially in women with breast cancer, it is essential to have a valid scale to measure their quality of life.
ObjectivesTherefore, we conducted a study to examine the psychometric properties of the Persian version of the quality of life questionnaire for women with breast cancer within the cultural context of Iranian society.
MethodsThis methodological study was conducted on 404 women with breast cancer, aged 20 to 60 years, from September 2021 to April 2022 in three cities in Iran. After translating the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (version 3) into Farsi and obtaining experts' opinions, the content, construct, convergent, and discriminant validity, as well as the reliability of the scale, were assessed using exploratory and confirmatory factor analysis. The construct validity of the scale was investigated through exploratory factor analysis.
ResultsThrough exploratory factor analysis of this scale, a version with 24 questions was confirmed, identifying five dimensions: Psychological symptoms, daily activities, physical problems, physical activity, and social support. Four items were removed due to factor loadings less than 0.3 and the presence of commonalities. In this study, Cronbach's alpha, McDonald's omega, CR, MaxR, and convergent validity coefficients for each factor were greater than 0.7.
ConclusionsThis study demonstrated that the Persian version of the quality of life questionnaire is a valid and reliable scale within the cultural context of Iranian society, with potential applications in clinical environments.
Keywords: Breast Cancer, Quality Of Life, Questionnaire, Psychometrics -
Background and Objective
Despite the impact of hemodialysis on patients’ lives, religious strategies are effective in reducing dependence and maintaining self-esteem. Additionally, a positive body image can enhance the quality of life (QoL). This study investigates the association between religious coping and body image in hemodialysis patients to predict their QoL.
Materials & MethodsThis descriptive-correlational study was conducted from March to June 2023 on 280 hemodialysis patients. The participants were selected through purposive sampling. The data collection instruments included a demographic form, Littleton’s body image concern inventory (BICI) and the religious coping questionnaire (RCOPE). The associations between variables were analyzed using linear regression in SPSS software version 26.
ResultsThe participants had an Mean±SD age of 56.92±13.42 years. The results indicate that increasing age (B=0.128) and female gender (B=3.356) are associated with reduced body image concerns. In contrast, marital status (B=-4.246) and religious coping (B=-0.578) effectively decrease body image concerns.
ConclusionReligious coping serves as a predictor of positive body image among hemodialysis patients, highlighting the significance of religious beliefs and values in how patients perceive their bodies. Enhanced levels of religious coping assist patients in adapting to physical challenges and fostering a more positive body image. This discovery can be valuable in crafting psychological interventions to enhance body image and boost the mental well-being of patients. Acknowledging spiritual dimensions proves effective in managing chronic illnesses.
Keywords: Body Image, Religious Coping, Hemodialysis -
سابقه و هدف
کیفیت زندگی بیماران مبتلا به نارسایی مزمن کلیه تحت درمان با همودیالیز تحت تاثیر عوامل جسمی، روانی و اجتماعی قرار دارد. ارزیابی دقیق این ابعاد با استفاده از ابزارهای استاندارد، اهمیت بالایی دارد. هدف این مطالعه تعیین ویژگی های روان سنجی پرسشنامه 12 گویه ای کیفیت زندگی در بیماران تحت درمان با همودیالیز در جمعیت ایرانی بود.
مواد و روش هادر این مطالعه مقطعی در سال 1402، 411 بیمار تحت همودیالیز در مازندران به روش نمونه گیری در دسترس انتخاب شدند. پس از ترجمه فرم کوتاه 12 گویه ای پرسشنامه کیفیت زندگی، ویژگی های روان سنجی آن با ارزیابی تحلیل عاملی اکتشافی، تحلیل شبکه ای و تحلیل عامل تاییدی، روایی سازه (روایی همگرا و روایی واگرا)، مورد ارزیابی قرار گرفت. سازگاری درونی به کمک ضریب آلفای کرونباخ و امگا مک دونالد محاسبه شد.
یافته هانتایج تحلیل عامل اکتشافی نشان داد دو عامل وضعیت سلامت روانی و جسمی استخراج شده، 44/55 درصد واریانس کیفیت زندگی را در مددجویان همودیالیز تبیین می کند. هم چنین تحلیل عاملی تاییدی نشان داد مدل مفروض دارای برازش مناسب است (0/930CFI=، 0/931=IFI=، 0/936RFI و 0/954=TFI). عامل سلامت روانی استخراج شده در مردان دارای روایی همگرا (AVE بالای 0/5) و هر دو عامل نیز دارای روایی واگرای مناسبی بودند و در نهایت پایایی درونی پرسشنامه کیفیت زندگی در محدوده قابل قبول (بیش تر از 0/7) گزارش شد.
استنتاجنتایج روان سنجی پرسشنامه کیفیت زندگی نشان داد که بیماران مبتلا به نارسایی مزمن کلیه که تحت درمان با همودیالیز هستند، کیفیت زندگی خود را با دو مفهوم وضعیت سلامت جسمی و روانی، تجربه و درک می کنند. این مطالعه ویژگی های روان سنجی (روایی و پایایی مناسب) و ساختار عاملی مناسب برای نسخه فارسی پرسشنامه کیفیت زندگی در بیماران تحت درمان با همودیالیز را تایید کرد. این ابزار می تواند توسط ارائه دهندگان مراقبت های بهداشتی در مطالعات مختلف و برای ارزیابی و بهبود کیفیت زندگی بیماران همودیالیزی استفاده شود. استفاده از این پرسشنامه می تواند به پژوهشگران و متخصصان مراقبت های بهداشتی کمک کند تا به طور دقیق تر و جامع تری ابعاد مختلف کیفیت زندگی بیماران همودیالیزی را ارزیابی کنند. بهره گیری از این ابزار می تواند به بهبود فرایندهای درمانی و افزایش رضایت بیماران کمک کرده و به عنوان یک ابزار مفید در تحقیقات آینده مورد استفاده قرار گیرد.
این پژوهش با تاکید بر اهمیت استفاده از ابزارهای معتبر و قابل اعتماد در ارزیابی کیفیت زندگی، به پرستاران و دیگر متخصصان بهداشت و درمان توصیه می کند که از نسخه فارسی پرسشنامه کیفیت زندگی 12 گویه ای در برنامه های درمانی و تحقیقاتی خود بهره بگیرند تا بتوانند به بهبود کیفیت زندگی بیماران همودیالیزی کمک کرده و نتایج بهتری در درمان این بیماران حاصل نمایند. پیشنهاد می شود در مطالعات آینده، تاثیر عوامل مختلف مانند تغذیه، حمایت اجتماعی و برنامه های توانبخشی بر کیفیت زندگی بیماران همودیالیزی مورد بررسی قرار گیرد. هم چنین، استفاده از این پرسشنامه در جمعیت های مختلف و در شرایط درمانی متفاوت می تواند به تعمیم پذیری نتایج کمک کرده و ابزار کارآمدتری برای ارزیابی کیفیت زندگی فراهم آورد. به طورکلی، نتایج این مطالعه نشان می دهد که پرسشنامه کیفیت زندگی 12 گویه ای یک ابزار قابل اعتماد و معتبر برای ارزیابی کیفیت زندگی بیماران همودیالیزی است و می تواند به طور موثر در تحقیقات و برنامه های بالینی استفاده شود. استفاده از این ابزار می تواند به بهبود کیفیت زندگی و درمان بیماران کمک کرده و اطلاعات ارزشمندی برای تصمیم گیری های بالینی فراهم آورد.کلید واژگان: پایایی, روان سنجی, روایی, پرسشنامه 12 گویه ای کیفیت زندگی, همودیالیزBackground and purposeThe quality of life of patients with chronic kidney failure undergoing hemodialysis is influenced by physical, psychological, and social factors. Accurate assessment of these dimensions using standardized tools is of great importance. This study aimed to determine the psychometric properties of the 12-item Quality of Life Questionnaire in patients undergoing hemodialysis in the Iranian population.
Materials and methodsIn this cross-sectional study conducted in 2023, 411 hemodialysis patients in Mazandaran were selected through convenience sampling. After translating the Short Form-12 Quality of Life Questionnaire, its psychometric properties were assessed through exploratory factor analysis, network analysis, and confirmatory factor analysis, along with construct validity (convergent and divergent validity). Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients.
ResultsThe results of the exploratory factor analysis indicated that two factors—physical health status and mental health status—accounted for 44.55% of the variance in the quality of life among hemodialysis patients. Furthermore, confirmatory factor analysis showed that the hypothesized model had a good fit (CFI= 0.930, IFI= 0.931, RFI= 0.936, TLI= 0.954). The extracted mental health factor in men demonstrated convergent validity (AVE above 0.5), and both factors exhibited appropriate divergent validity. Ultimately, the internal consistency of the Quality of Life Questionnaire was found to be within an acceptable range (greater than 0.7).
ConclusionThe psychometric analysis of the Quality of Life Questionnaire indicates that patients with chronic kidney failure undergoing hemodialysis perceive their quality of life through two primary dimensions: physical and mental health status. This study confirmed the psychometric properties (validity and reliability) and the appropriate factor structure of the Persian version of the Quality of Life Questionnaire for patients undergoing hemodialysis. Healthcare providers can use this tool in various studies to assess and improve the quality of life of hemodialysis patients The use of this questionnaire allows researchers and healthcare professionals to more accurately and comprehensively evaluate the different aspects of quality of life in hemodialysis patients. Employing this tool can enhance treatment processes and improve patient satisfaction, serving as a valuable instrument for future research. This study emphasizes the importance of using valid and reliable tools to assess quality of life and recommends that nurses and other healthcare professionals integrate the Persian version of the 12-item Quality of Life Questionnaire into their treatment and research programs to help improve the quality of life of hemodialysis patients and achieve better treatment outcomes.Future studies are recommended to investigate the impact of factors such as nutrition, social support, and rehabilitation programs on the quality of life of hemodialysis patients. Additionally, utilizing this questionnaire in different populations and therapeutic contexts can contribute to the generalizability of the findings and offer a more effective tool for quality of life assessments. Overall, the findings of this study indicate that the 12-item Quality of Life Questionnaire is a reliable and valid tool for assessing the quality of life in hemodialysis patients, making it valuable for both research and clinical programs. Using this tool can help improve patients' quality of life and treatment outcomes while providing essential data for clinical decision-making.
Keywords: Reliability, Psychometric, Validity, Short-Form-12 Questionnaire Of Quality Of Life, Hemodialysis -
مقدمه
پریشانی اخلاقی زمانی ایجاد می شود که فرد، در اثر تضادهای اخلاقی و ناتوانی در پایبندی به اصول اخلاقی خود، دچار احساس نارضایتی می شود که می تواند، باعث افسردگی و کاهش رضایت شغلی گردد. سنجش پریشانی اخلاقی بسیار ضروری است؛ از سوی دیگر اطمینان به روایی و پایایی ابزارهای معتبر، برای ارزیابی پریشانی اخلاقی نیاز می باشد؛ بنابراین هدف از پژوهش حاضر، ارزیابی خواص روان سنجی مقیاس پریشانی اخلاقی بود.
روش کاردر این پژوهش، اسکوپینگ پایگاه داده های" PubMed", "Scopus ", "Web of Science", "Google Scholar"," SID" ," Magiran "، به طور نظام مند، بین سال های (2001 تا ،2023) و با استفاده از کلیدواژه های" Psychometric ", "validity"," reliability"," moral", "distress، scale " که مترادف آن ها به زبان فارسی (روان سنجی، روایی، پایایی، اخلاق، پریشانی، مقیاس) بود، مورد جستجو قرار گرفتند. چهار محقق به طور مستقل، کیفیت مطالعات را بر اساس چک لیست استانداردهای گزارش صحت تشخیصی (STARD) و ارزیابی کیفیت مطالعات دقیق تشخیصی (QUADAS-2) ارزیابی کردند.
یافته هااز 2677 مقاله (321 مقاله فارسی و 2356 مقاله انگلیسی) به دست آمده، سرانجام 8 مقاله، مورد ارزیابی قرار گرفت. کیفیت مطالعات، قابل قبول بود. یافته ها نشان داد که تعداد عوامل برآمده در تحقیقات مختلف، متفاوت بود؛ اما در مقابل، مقیاس پریشانی اخلاقی و پریشانی اخلاقی بازنگری شده، دارای روایی و پایایی مناسبی نشان داد. پیوستگی درونی مطالعات، با استفاده از دامنه آلفای کرونباخ، از 385/0 تا 97/0درصد گزارش شد. کم ترین واریانس کل فاکتورهای به دست آمده (38/19 درصد) و بیشترین مقدار (99/68 درصد) گزارش کردند.
نتیجه گیریمحدودیت در کاربرد روش های روان سنجی در مقیاس های مورد بررسی کاملا مشهود بود و مقیاس دیسترس اخلاقی به طور زیاد، در جمعیت های مختلف به کارنرفته است؛ بنابراین عدم کاربرد آن در زمینه های فرهنگی مختلف، اطمینان از عملکرد مقیاس را محدود می کند. استفاده از تکنیک های محکم، در جهت روان سنجی و بررسی روایی و پایایی مقیاس دیسترس اخلاقی، در تحقیقات بعدی پیشنهاد می گردد.
کلید واژگان: پریشانی اخلاقی, روان سنجی, تضاد اخلاقی, سلامت روانیIntroductionMoral distress occurs when an individual feels dissatisfaction due to ethical conflicts and an inability to adhere to their moral principles, which can lead to depression and decreased job satisfaction. Measuring moral distress is crucial. Moreover, ensuring the validity and reliability of credible tools for assessing moral distress is essential. Therefore, the aim of the present study was to evaluate the psychometric properties of the Moral Distress Scale.
Materials and MethodsIn this scoping study, databases including PubMed, Scopus, Web of Science, Google Scholar, SID, and Magiran were systematically searched between 2001 and 2023 using keywords such as "Psychometric," "validity," "reliability," "moral," "distress," "scale," and their Persian equivalents ("روان سنجی," "روایی," "پایایی," "اخلاق," "پریشانی," "مقیاس"). Four researchers independently assessed the quality of the studies based on the Standards for Reporting Diagnostic Accuracy (STARD) checklist and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2).
ResultsOut of 2677 articles (321 Persian articles, 2356 English articles) retrieved, eight articles were ultimately evaluated. The quality of the studies was acceptable. The findings indicated that the number of factors extracted varied across studies, and both the Moral Distress Scale and the Revised Moral Distress Scale demonstrated appropriate validity and reliability. The internal consistency of the studies, as reported by Cronbach's alpha, ranged from 0.385 to 0.97. The lowest total variance of extracted factors was 19.38%, while the highest was 68.99%.
ConclusionThere were evident limitations in the application of validation methods in the scales under review, and the Moral Distress Scale has not been widely used across different populations. Hence, the lack of application in various cultural contexts limits confidence in the scale's performance. The use of robust techniques for validation and further investigation of the validity and reliability of the Moral Distress Scale in future studies is recommended.
Keywords: Moral Distress, Psychometrics, Moral Conflict, Mental Health -
زمینه و هدف
پریشانی تشنگی یکی از عوارض شایع مرحله نهایی بیماری کلیوی است. هدف این مطالعه تحلیل شبکه ای و ویژگی های روان سنجی مقیاس پریشانی تشنگی در بیماران همودیالیزی ایرانی بود.
روش هادر این مطالعه مقطعی در سال 1402، 411 بیمار تحت همودیالیز در مازندران به روش نمونه گیری در دسترس انتخاب شدند. پس از ترجمه مقیاس، ویژگی های روان سنجی آن با ارزیابی تحلیل عاملی اکتشافی، تحلیل شبکه ای و تحلیل عامل تاییدی، روایی سازه (روایی همگرا و روایی واگرا)، مورد ارزیابی قرار گرفت. سازگاری درونی به کمک ضریب آلفای کرونباخ، امگا مک دونالد و پایایی سازه (Composite Reliability) محاسبه شد.
یافته هانتایج تحلیل عامل اکتشافی نشان داد دو عامل پریشانی ناشی از تشنگی و خشکی دهان استخراج شده، 46/80 درصد واریانس پریشانی تنشگی را در مددجویان همودیالیز تبیین می کند. همچنین تحلیل عاملی تاییدی نشان داد مدل مفروض دارای برازش (0/971=CFI)، (0/971=IFI )، (0/923 =RFI) و (0/969=NFI ) مناسب است. عامل های استخراج شده دارای روایی همگرا (AVE برای هر دو عامل بالای 0/5 و پایایی سازه بالای 0/7) و واگرای (0/512 = Heterotrait-Monotrait Ratio (HTMT)) مناسبی بودند و در نهایت ثبات درونی مقیاس پریشانی تشنگی قابل قبول ارزیابی شد (آلفای کرونباخ و پایایی سازه بالاتر از 0/7).
نتیجه گیرینتایج روانسنجی مقیاس پریشانی تنشگی نشان داد مددجویان نارسایی مزمن کلیوی که تحت درمان با هودیالیز هستند، دسترس تنشگی را با دو مفهوم پریشانی ناشی از تشنگی و خشکی دهان تجربه و درک می کنند. این مطالعه ویژگی های روانسنجی (روایی و پایایی مناسب) و ساختار عاملی مناسب برای نسخه فارسی مقیاس پریشانی تشنگی در مددجویان تحت درمان با همودیالیز را تایید کرد. ارائه دهندگان مراقبت های بهداشتی می توانند از آن در مطالعات مختلف استفاده کنند.
کلید واژگان: پایایی, بومی سازی, روانسنجی, روایی, مقیاس پریشانی تشنگی, همودیالیزBackground & aimThirst distress is a common complication in the final stage of kidney disease. The aim of this study was to analyze the network and psychometric properties of the thirst distress scale in the Iranian hemodialysis patients.
MethodsIn this cross-sectional study in 2023, 411 hemodialysis patients in Mazandaran were selected using the convenience sampling method. After translating the scale, its psychometric properties were evaluated through exploratory factor analysis, network analysis, and confirmatory factor analysis, and the structural validity (convergent and divergent validity) was assessed. Internal consistency was calculated using Cronbach's alpha coefficient, McDonald's omega, and composite reliability.
ResultsThe results of exploratory factor analysis showed two factors of distress due to thirst and dry mouth were extracted, explaining 80.46% of the variance in thirst distress among hemodialysis patients. Additionally, confirmatory factor analysis showed that the assumed model had a good fit (CFI = 0.971, IFI = 0.971, RFI = 0.923, NFI = 0.969). The extracted factors demonstrated good convergent validity (AVE above 0.50 for both factors) and high reliability (composite reliability above 0.70), and were appropriately divergent (HTMT ratio of 0.512). Finally, the internal stability of the thirst distress scale was deemed acceptable (Cronbach's alpha and composite reliability above 0.70).
ConclusionThe psychometric results of the thirst distress scale indicated that chronic kidney disease patients undergoing hemodialysis experience and perceive distress with two concepts of thirst and dry mouth. This study confirmed the psychometric properties (appropriate validity and reliability) and suitable factor structure for the Persian version of the thirst distress scale in hemodialysis patients. It can be stated that healthcare providers can utilize it in future studies.
Keywords: Reliability, Localization, Psychometrics, Validity, Thirst Distress Scale, Hemodialysis -
The pretest-posttest control group design is one of the most widely used quantitative experimental design models for evaluating the efficacy of programs, treatments, and interventions. Despite the prevalence and utility of this research design, best practices for data analytical procedures are not clearly defined. Invalid results decrease the chance of generalization. Given that Iranian Journals are interested in publishing pretest-posttest control group design studies, it is important to denote the accuracy of them. The aim of the current study is to explore the correct procedure for using ANCOVA in pretest-posttest control group designs to mitigate the potential limitations of this approach. This study explores the use of ANCOVA in pretest-posttest control group design. It has been done by analyzing data from experimental studies published in five Iranian journals indexed in PubMed or Scopus between 2011 and 2018. The results indicate that among the 280 published experimental studies in these journals, 53 papers (18.9 percent) used ANCOVA as the statistical test in pretest-posttest studies. The power of the test represents the probability of detecting differences between the groups being compared when such differences exist. Our analysis concludes that ANCOVA, which runs a multiple linear regression, is a suitable method for comparing and examining pretest-posttest study designs. Implications of this study have potential utility for researchers employing the use of pretest-posttest control group designs in various fields in and outside of Iran.
Keywords: Pretest-Posttest Study, Analysis Of Covariance, Nursing -
پیش زمینه و هدف
زخم پای دیابتی یکی از علل اصلی ناتوانی در بیماران مبتلا به دیابت است که منجر به قطع عضو و ناتوانی می شود. با مراقبت مناسب از پاها می توان از بروز زخم پای دیابتی پیشگیری کرد. یکی از ابزارهای بررسی خودمراقبتی پای دیابتی، ابزار بررسی عملکرد مراقبت از پای ناتینگهام است. این مطالعه باهدف تعیین ویژگی های روان سنجی نسخه فارسی ابزار بررسی عملکرد مراقبت از پای ناتینگهام انجام شد.
مواد و روش هااین مطالعه مقطعی در زمستان 1401 روی 517 بیمار دارای دیابت نوع یک و دو مراجعه کننده به واحد دیابت شهرهای بم، همدان و اسدآباد انجام شد. بیماران به صورت در دسترس انتخاب شدند. برای ارزیابی ویژگی های روان سنجی، روایی صوری، روایی محتوا، روایی سازه، همسانی درونی و ثبات ابزار بررسی شد.
یافته هامیانگین سن و طول مدت ابتلا به دیابت در بیماران شرکت کننده در مطالعه به ترتیب 14/18±01/50 سال و 9±70/10 سال بود. اغلب نمونه های موردمطالعه زن (54درصد)، متاهل (9/80درصد) بودند. بیش از یک سوم این بیماران (4/36درصد) قرص های کاهنده قند خون مصرف می کردند. در تحلیل عامل اکتشافی پنج عامل خودمراقبتی عمومی از پا، معاینه پا، معاینه کفش، مدیریت زخم و استفاده از کفش مناسب استخراج شد که روی هم رفته 381/52 درصد واریانس کل را تبیین می کردند. همسانی درونی تمام عوامل استخراج شده بر اساس ضریب مک دونالد امگا بالای 70/0 بود. پایایی ثبات پرسشنامه با فاصله دو هفته برای کل ابزار 790/0 بود.
نتیجه گیرینسخه فارسی ابزار بررسی عملکرد مراقبت از پای ناتینگهام، روایی و پایایی مناسبی برای اندازه گیری مراقبت از پای بیماران دیابتی دارد. وجود نسخه فارسی این ابزار این امکان را به پژوهشگران داخلی می دهد که بر اساس امکانات و سلایق خود از این ابزار هم در کنار سایر ابزارهای موجود برای بررسی و اندازه گیری مفهوم خودمراقبتی پای دیابتی استفاده نمایند.
کلید واژگان: دیابت, پای دیابتی, ابزار بررسی عملکرد مراقبت از پای ناتینگهام, ویژگی های روان سنجیBackground & AimDiabetic foot ulcers are among leading causes of disability in diabetic patients, often resulting in amputation and disability. Proper foot care can prevent diabetic foot ulcers. One assessment tool is the Nottingham Assessment of Functional Footcare (NAFF). This study aimed to assess the psychometric properties of the Persian version of the Nottingham Assessment of Functional Footcare.
Materials & MethodsThis cross-sectional study was conducted in the winter of 2023 on 517 patients with type 1 and type 2 diabetes who were referred to the diabetes clinics in Bam, Hamadan, and Asadabad cities, Iran. Patients were selected using convenience sampling. The instruments were examined to assess their psychometric properties, including face validity, content validity, construct validity, internal consistency, and stability.
ResultsThe mean age and duration of diabetes in patients were 50.01±18.14 years and 10.70±9 years, respectively. Most samples were female (54%) and married (80.9%). More than one-third of the patients (36.4%) were taking hypoglycemic tablets. The exploratory factor analysis identified five factors: general foot self-care, foot examination, shoe examination, wound management, and use of appropriate shoes. Together, these factors accounted for 52.381% of the total variance. The internal consistency of all extracted factors was above 0.70, as measured by McDonald's Omega coefficient. The stability reliability of the questionnaire was 0.790 for the whole instrument with a two-week interval.
ConclusionThe Persian version of the Nottingham Assessment of Functional Foot-care tool is a valid and reliable tool for measuring the foot care of diabetic patients. It allows domestic researchers to use this tool along with other available tools to check and measure the concept of diabetic foot self-care based on their facilities and preferences.
Keywords: Diabetes, Diabetic Foot, Nottingham Assessment Of Functional Foot-Care Tool, Psychometric Properties -
مقدمه و اهداف
ارزیابی دقیق عملکرد قلبی-تنفسی، قدرت و استقامت عضلانی جهت آگاهی و ارائه مداخلات تمرینی و پیشگیری از بیماری های بعدی ضروری به نظر می رسد. بنابراین هدف از تحقیق حاضر تدوبن ابزار جامع ارزیابی اختصاصی عملکرد قلبی-تنفسی، قدرت و استقامت عضلانی در افراد با کم توان ذهنی بود.
مواد و روش هاپژوهش حاضر از نظر هدف، بنیادی و کاربردی است. در این مطالعه برای تدوین ابزار اندازه گیری عملکرد قلبی-تنفسی، قدرت و استقامت عضلانی از روان سنجی 51 آزمون اختصاصی افراد کم توان ذهنی استفاده شد. روایی صوری ابزار از طریق پرسشنامه 51 آزمونی توسط 15 نفر متخصص و 15 نفر مربی کم توانان ذهنی، روایی محتوا از طریق پرسشنامه 51 آزمونی توسط 15 نفر متخصص و روایی سازه نیز از طریق پرسشنامه 19 آزمونی توسط 243 نفر مربی کم توانان ذهنی مورد بررسی قرار گرفت. پایایی ابزار از طریق همسانی درونی، درون آزمونگر و بین آزمونگر بررسی شد. همسانی درونی با آلفای کرونباخ محاسبه شد. پایایی درون آزمونگر و بین آزمونگر نیز از طریق اجرای آزمون ها توسط 18 نفر کم توان ذهنی در سه زمان و با سه آزمونگر از طریق شاخص همبستگی درونی (ICC)، فاصله اطمینان (CI) و خطای استاندارد اندازه گیری (SEM) بررسی شد. تجزیه و تحلیل داده ها از طریق تحلیل عامل اکتشافی و تاییدی و با نرم افزار AMOS26 و SPSS22 انجام شد.
یافته هابر اساس نتایج حاصل از محاسبه نسبت روایی محتوا (CVR)، 19 آزمون از 51 آزمون دارای نسبت روایی محتوای بالاتر از 0/49 بودند و بقیه آزمون ها حذف شدند. در روایی سازه نیز 10 آزمون از 19 آزمون حذف شد و 9 آزمون نهایی برای ارزیابی عملکرد قلبی-تنفسی، قدرت و استقامت عضلانی تایید شد. تحلیل عامل اکتشافی سه عامل پنهان استخراج کرد که 46/21 درصد واریانس کل تبیین شد. تحلیل عامل تاییدی مدل نهایی سازه را تایید کرد. از نتایج تحلیل عاملی KMO=0/829 و BT= 4706/93 و P<0/0001 بود.
نتیجه گیریمطالعه حاضر، مجموعه آزمون اختصاصی افراد کم توان ذهنی را در زمینه ارزیابی قلبی-تنفسی (یک آزمون)، قدرت (چهار آزمون) و استقامت عضلانی (چهار آزمون) بعد از روانسنجی 51 آزمون اختصاصی در این زمینه ارائه کرد. با استفاده از این مجموعه آزمون می توان ارزیابی دقیق از آمادگی جسمانی مرتبط با سلامتی افراد کم توان ذهنی انجام داد.
کلید واژگان: کم توان ذهنی, قلبی-تنفسی, قدرت عضلانی, استقامت عضلانیBackground and AimsAccurate assessment of cardiorespiratory function, muscular strength and endurance seems necessary for awareness and for providing exercise interventions and prevention of subsequent diseases. Therefore, the aim of the current research was to develop a comprehensive tool for assessing cardiorespiratory, muscular strength and endurance function in people with intellectual disabilities.
Materials and MethodsThe current research is fundamental and has practical implications in terms of its purpose. In this study, the psychometrics of 51 specific tests of intellectual disability people were used to develop a tool for measuring cardiorespiratory function, muscular strength and endurance. The face validity of the instrument was examined through a 51-test questionnaire by 15 experts and 15 intellectually disabled educators, the content validity by a 51-test questionnaire by 15 experts, and the construct validity through a 19-test questionnaire by 243 intellectually disabled educators. The reliability of the tool was checked through internal, intra-rater and inter-rater consistency. Internal consistency was estimated with Cronbach's alpha. The intra-rater and inter-rater reliability were also checked through the implementation of the tests by 18 people with intellectual disability in three times and with three raters through the internal correlation index (ICC), confidence interval (CI) and standard error of measurement (SEM). Data analysis was done through exploratory and confirmatory factor analysis with AMOS26 and SPSS22 software.
ResultsBased on the results of estimating the content validity ratio (CVR), 19 out of 51 tests had a content validity ratio higher than 0.49 and the rest of the tests were excluded. In terms of construct validity, 10 out of 19 tests were removed and the final 9 tests were approved for evaluating cardiorespiratory function, muscular strength and endurance. Exploratory factor analysis extracted three latent factors that explained 46.21% of the total variance. Confirmatory factor analysis confirmed the final construct model. From the results of factor analysis, KMO=0.829, BT=4706.93 and p<0.0001.
ConclusionThe current study provided a special set of tests for people with intellectual disability in the fields of cardiorespiratory assessment (one test), strength (four tests) and muscular endurance (four tests). after psychometry, 51 specific tests were presented in this field. By using this set of tests, it is possible to make an accurate assessment of the physical fitness related to the health of people with intellectual disability.
Keywords: Intellectual Disability, Cardiorespiratory, Muscular Strength, Muscular Endurance -
سابقه و هدف
در دانشگاه ها موضوع جذب و نگهداشت اعضای هیات علمی از اهمیت بالایی برخوردار است. چنان چه این امر به هر دلیلی میسر نگردد، می تواند منجر به رکود علمی اعضای هیات علمی و افت انگیزه در مسیر شغلی و وقفه در اجرای وظایف هفتگانه آنان گردد. با توجه به اهمیت پیشرفت اعضای هیات علمی به عنوان نخبگان آموزشی و پژوهشی کشور و نقش بسزای آن ها در تربیت نیروی انسانی ماهر به خصوص نقش اعضای هیات علمی وزارت بهداشت درمانی و آموزش پزشکی در تربیت دانش آموختگان رشته های علوم پزشکی که با سلامت عمومی جامعه در ارتباط هستند لذا پرداختن به دلایل رکود علمی و یافتن راه حل برای جلوگیری از آن ضروری است. این مطالعه کیفی با هدف بررسی عوامل موثر بر رکود علمی و راهکارها از دیدگاه اعضای هیئت علمی دانشگاه علوم پزشکی مازندران، انجام پذیرفت.
مواد و روش هااین مطالعه با هدف کاربردی، و به شیوه کیفی از نوع تحلیل محتوای قراردادی از دی ماه 1401 الی آذر 1402 انجام شده است. در این پژوهش با توجه به ماهیت پژوهش کیفی به منظور تبیین ادراک، نگرش ها و رفتارهای مشارکت کنندگان، از روش نمونه گیری هدفمند با حداکثر تنوع و هم چنین نمونه گیری به روش گلوله برفی استفاده شد چرا که هدف، انتخاب مشارکت کنندگانی بود که منبع غنی از اطلاعات بوده و به محقق جهت درک بهتر مفهوم رکود علمی کمک نمود. مشارکت کنندگان، اعضای هیات علمی بودند که حداقل 10 سال عضو هیات علمی بوده اند. علاوه بر انجام مصاحبه عمیق و نیمه ساختار یافته، اسناد بالادستی و نتایج مطالعات مشابه نیز مورد بررسی قرار گرفت.
یافته هادرمجموع 3 مضمون اصلی، 18 مقوله و 118 کد به شرح پیش رو استخراج شد، مضمون رکود علمی شامل47 کد و 6 مقوله با عناوین عوامل فردی، عوامل سازمانی، عوامل روانشناختی، عوامل مهارتی، عوامل شغلی و عوامل پژوهشی مضمون چالش های مسیر ارتقا شامل 33 کد و 6 مقوله با عناوین چالش های آئین نامه ارتقا، چالش های مربوط به فعالیت های فرهنگی، آموزشی، پژوهشی، اجرایی و چالش های بررسی پرونده های ارتقای مرتبه علمی و مضمون راهکارهای پیشگیری از رکود علمی شامل 38 کد و 6 مقوله با عناوین راهکارهای پیشگیری مرتبط با آئین نامه ارتقا، فعالیت های فرهنگی، فعالیت های آموزشی، فعالیت های پژوهشی، فعالیت های اجرایی و بررسی پرونده های ارتقای مرتبه علمی می باشد.
استنتاجبر اساس نتایج مطالعه حاضر، محققان علل رکود علمی را شناسایی نمودند؛ همچنین آنان بر این باورند که بازنگری در آئین نامه ارتقا مهم ترین راهکار پیشگیری از رکود علمی می باشد. آن ها بیان داشتند در بازنگری آئین نامه می توان، علاوه بر شاخص های کمی در هر یک از عوامل امتیازی ارتقا به کیفیت آن ها نیز پرداخته شود. در مبحث آموزش، کیفیت و نوآوری آموزش در نظر گرفته شود. در بخش پژوهش، به کاربردی بودن پژوهش ها توجه شود. آنان معتقد بودند رکود علمی قابل پیشگیری است و می توان از طریق اقدامات گسترده تر بهره وری علمی و سیستم های پاداش که پروژه های نوآورانه و اکتشافی را تشویق می کنند، با آن مقابله کرد. در بخش اجرایی، کیفیت انجام کار و تغییر و تحولات مفید در حین فعالیت اجرایی ملاک قرارگیرد. در فعالیت فرهنگی، به انجام فعالیت های اجتماعی و با کیفیت توجه شود؛ هم چنین آن ها روند سریع تر پرونده های ارتقا و وجود نیروی انسانی زبده در رسیدگی به مشکلات احتمالی را مطرح نمودند. آن ها بیان داشتند با رویکرد تفویض اختیار به دانشگاه های علوم پزشکی کشور و بازنگری آئین نامه های ترفیع و ارتقا می توان با عوامل ایجاد رکود علمی مقابله کرد و به سوی دانشگاه پاسخگو گام برداشت.
کلید واژگان: رکود علمی, اعضای هیات علمی, دانشگاه علوم پزشکی, مطالعه کیفی, تحلیل محتواBackground and purposeIn universities, the issue of attracting and retaining faculty members is of great importance. If this is not possible for any reason, it can lead to the academic stagnation of academic staff members the loss of motivation in their career path, and interruption in the implementation of their seven duties. Considering the importance of the advancement of academic staff members as educational and research elites of the country and their significant role in training skilled human resources, especially the role of academic staff members of the Ministry of Health and Medical Education in training graduates of medical sciences that are related to the general health of the society, are related, this study was carried out to identify, diagnosing the factors and ways to prevent their scientific stagnation.
Materials and methodsThis study was conducted with a qualitative method from January to December 2023. In this research, according to the nature of qualitative research, to explain the perceptions, attitudes, and behaviors of the participants, the purposeful sampling method with maximum diversity was used, as well as the snowball sampling method because the goal was to select participants, Which was a rich source of information and helped the researcher to better understand the concept of scientific stagnation. The participants were faculty members who had been faculty members for at least 10 years. In addition to conducting in-depth and semi-structured interviews, upstream documents and the results of similar studies were also examined.
ResultsIn total, 3 themes, 18 categories, and 118 codes were extracted as follows: The main themes of this study are the causes of scientific stagnation, the challenges of the advancement path, and the strategies to prevent scientific stagnation. The theme of scientific stagnation includes 47 codes and 6 categories (individual, organizational, psychological, skill, job, and research factors). The content of the challenges of the promotion path, including 33 codes and 6 categories (the challenges of the path of the promotion regulations, challenges in cultural, educational, research, executive activities, and challenges of examining cases for promotion of scientific rank). The content of the solutions to prevent scientific stagnation includes 38 codes and 6 categories (the solution to prevent scientific stagnation in connection with the regulation of promotion, cultural, educational, research, executive activities, and the review of files for the promotion of scientific rank.)
ConclusionBased on the results of the present study, the researchers identified the causes of scientific stagnation; also, they believe that revising the promotion regulations is the most important way to prevent scientific stagnation. They stated that in the revision of the bylaws, in addition to the quantitative indicators, in each of the scoring factors, their quality can also be addressed. In terms of education, the quality and innovation of education should be considered. In the research section, pay attention to the applicability of the research. They believed that scientific stagnation is preventable and can be countered through broader scientific productivity measures and reward systems that encourage innovative and exploratory projects. In the executive department, the quality of work and useful changes and developments during the executive activity should be the criteria. In cultural activities, pay attention to social and quality activities; also, they brought up the faster process of promotion cases and the existence of elite human resources to handle possible problems. They stated that with the approach of delegating authority to the country's medical sciences universities and revising the promotion and promotion bylaws, it is possible to deal with the factors causing scientific stagnation and take a step towards a responsive university.
Keywords: academic stagnation, faculty members, university of medical sciences, qualitative study, content analysis -
Objective
Heart diseases, including coronary artery disease, are among the three main causes of death alongside cancer and stroke in most countries. The current study aimed to predict functional disability in functional somatic syndromes in patients with coronary artery disease based on personality traits and illness perception, considering the mediating role of self-care behavior.
Methods and Materials:
This study, with applied objectives and a correlational research design, was conducted using the structural equation modeling approach. The statistical population included all patients with coronary artery disease in the city of Amol in the year 2022, from which 250 individuals were purposefully selected. Data collection tools included the World Health Organization Disability Assessment Schedule (2014), the McCrae and Costa Personality Traits Questionnaire (1985), the Illness Perception Questionnaire (2006), and the Self-Care Questionnaire (2003). The statistical technique used was structural equation modeling with full latent variables. SPSS version 26, AMOS version 24, and R version 4.2.0 software were used for statistical data analysis.
FindingsThe results showed that all five personality dimensions, illness perception, and self-care significantly explain the variance in functional disability (P<0.01). Additionally, the mediating role of self-care behavior was significant in the relationship between functional disability and four personality dimensions: extraversion, openness to experience, agreeableness, conscientiousness, and illness perception (P<0.01).
ConclusionIt can be concluded that functional disability in functional somatic syndromes in patients with coronary artery disease can be predicted based on their personality traits and illness perception, taking into account the mediating role of self-care behavior.
Keywords: Personality traits, Illness perception, Functional somatic syndrome, Coronary artery, Self-care behavior -
The need for accurate measurement of constructs and understanding of diverse phenomena has prompted researchers to investigate the validity and reliability of developed measures in a continuous effort to improve our understanding of their psychometric properties. However, at times, these endeavors are flawed by serious methodological inadequacies. In this article, we discussed one example of a psychometric study that appears to be deeply flawed, providing some recommendations for remediating the issue.
Keywords: construct validity, exploratory factor analysis, confirmatory factor analysis -
Background
As a prevalent phenomenon in the world, it’s required to view substance abuse as one of the most prominent social problems. Substance abuse, especially by the youth, imposes huge costs on society. The relevant misconceptions include immature mindsets held by individuals who conflict with the currently accepted concepts and empirical findings. Unfortunately, the common misconceptions about this phenomenon are so abundant that the majority of individuals, even the educated ones, are unfamiliar with its meaning and concept as a phenomenon. Thus, a valid and reliable tool is required to examine the common types of such misconceptions.
ObjectivesThis study pursued the goal of designing an inventory of the common types of misconceptions among university students about substance abuse.
MethodsUsing a two-stage approach, the present research study was conducted in 2019 in Iran. The first stage involved conducting individual interviews with 10 students who were substance abusers, as well as reviewing the relevant literature to generate the study items. The second stage consisted of a quantitative evaluation of the instrument, which included assessing the face validity (both qualitatively and quantitatively), content validity (both qualitatively and quantitatively, as calculated by content validity index (CVI), and content validity ratio (CVR)). The construct validity was examined by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with two 375 samples for each of them and its reliability.
ResultsFrom the first phase and literature review, 71 items were codified. Five items were removed from surveying the qualitative and quantitative face validity; besides, due to a CVR of less than 0.49, 24 items were excluded, and also because of the CVI, less than 0.78, 12 items were deleted. Overall, a 30-item scale remained. Via the exploratory factor analysis, three factors, including 16 items and 40.86% of the total variance, were extracted. The intra-class correlation coefficient (ICC) and Cronbach’s alpha coefficient were greater than 0.7 for all factors and 0.8, respectively.
ConclusionsThe designed inventory revealed desirable psychometric properties and the necessary validity to investigate and evaluate the common types of misconceptions regarding substance abuse among the students of medical sciences.
Keywords: Attitude, Substance Abuse, Medical Students, Student -
Background
With the spread of infectious diseases, especially coronavirus disease 2019 (COVID-19), healthcare workers are vulnerable to mental health problems. Culture-based interventions in such critical situations are highly effective for the individuals in that cultural context.
ObjectivesThe current study aimed to investigate the effect of Logotherapy Based on Rumi’s Thoughts (LBRT) on depression, anxiety, and distress in frontline nurses during the COVID-19 pandemic.
MethodsThe present study employed a quasi-experimental controlled pre-test-post-test design with a 2-month follow-up. This interventional study was conducted on frontline nurses during the COVID-19 pandemic 2020. Imam Khomeini and Fatemeh Zahra hospitals were selected as the research samples, as they were the main educational and medical centers of Mazandaran University of Medical Sciences, Mazandaran, Iran, and provincial referral centers. A total of 32 eligible individuals were selected for experimental (n = 16) and control (n = 16) groups through the convenience sampling method. The data were collected using the Impact of Event Scale-Revised and the Hospital Anxiety and Depression Scale. Logotherapy Based on Rumi’s Thoughts included eight sessions of 90 minutes. The control group did not receive any intervention during the study. The data were analyzed using repeated-measures one-way analysis of variance (ANOVA).
ResultsThe results revealed a statistically significant difference between the two groups. The intervention group exhibited lower levels of depression and anxiety among the frontline nurses at the post-test and 2-month follow-up than the control group (P < 0.001). However, there was no significant difference between the two groups in terms of distress at the post-test and 2-month follow-up (P > 0.05).
ConclusionsThe findings showed that LBRT improved anxiety and depression among frontline nurses during the COVID-19 pandemic. However, this intervention did not significantly affect frontline nurses’ distress during the COVID-19 crisis. Further studies should examine the effectiveness of culture-based interventions in critical situations.
Keywords: Logotherapy, Nurses, COVID-19, Anxiety, Depression, Psychological Distress -
Background
Nursing care is one of the main tasks of nursing. Currently, organizations are trying to improve the quality of nursing care to satisfy their patients and reduce the cost and length of hospital stays. Psychological ownership (PO) is intended to be a shortcut to achieving this goal through cognitive-emotional changes in nurses.
ObjectivesThis study was conducted to investigate PO in nursing care.
MethodsThe present study was performed with a qualitative content analysis method. The purposive sample was selected based on inclusion and exclusion criteria. The data were collected from Iranian nurses from May 2013 to November 2021 in semi-structured, in-depth, one-on-one interviews and subsequently analyzed using the method of Graneheim and Lundman. A code of ethics and required permissions were obtained. Lincoln and Guba’s criteria were used to ensure the reliability of the study, and MAXQDA software (version 10) was used for data management.
ResultsData analysis was performed using the conventional qualitative analysis on 13 nurses (mean age: 39 years; 69% female), resulting in the extraction of 395 primary codes, 71 subcategories, 16 subcategories, and 4 main categories (e.g., professional competence, practical efficacy, holistic advocacy, and professional identity).
ConclusionsThe nurses understood that a sense of ownership of nursing meant seeking to acquire sufficient professional competence and an appropriate position in practice to see themselves as supportive and influential in the healthcare system and have a sense of professional identity.
Keywords: Ownership, Nursing Care, Caring, Qualitative Research -
Background
Organ donation is one of the main medical advances in treating patients with organ failure. However, the supply of transplant members ismuchbelow such patients’ demands, thereby arousing a serious challenge to governments. Organ donation is a sacrificial and altruistic behavior, and altruism is recognized as an effective factor in making decisions for organ donation.
ObjectivesThis study aimed to investigate the relationship between altruism and attitudes toward organ donation in society.
MethodsThe present research was a cross-sectional descriptive study conducted in Iran during 2020 - 2021. The research sample encompassed328 individuals selected using the simple random sampling method. Data collection tools included a demographic information form, the standard Self-Report Altruism Scale, and the Attitude Toward Organ Donation Questionnaire. Linear regression controlling the intervening variables was used to investigate the relationship between altruism and attitudes toward organ donation.
ResultsThe univariate analysis results showed that gender, occupation, age, and marital status were not significantly correlated with attitudes toward organ donation. In the multivariate model controlling the intervening variables, altruism increased attitudes toward organ donation (beta-standardized = 0.17; P < 0.001).
ConclusionsThe findings highlighted the significance of altruism in attitudes toward organ donation. Accordingly, intervention programs promoting altruism can be helpful in different groups.
Keywords: Organ Transplantation, Altruism, Attitude, Organ Donation -
Context:
Temperament (Mizaj) as an individual factor plays an important role in physical, mental, and sexual features.
AimsThis study aims to investigate the effect of an educational program based on the temperament in Iranian traditional medicine (ITM) on sexual dysfunction in diabetic women.
Settings and Design:
This was a randomized controlled trial (RCT) study conducted on 30 women with diabetes referring diabetes care centers affiliated to Imam Khomeini Hospital in the city of Sari, Iran, 2021.
Materials and MethodsThe participants were assigned into intervention and control groups by simple randomization. The intervention group received a healthy lifestyle educational program based on the type of temperament in four group education sessions. The tools of Sociodemographic Medical Characteristics, Mizaj Identification Questionnaire and Female Sexual Function Index (FSFI) were used in the study.
Statistical Analysis Used:
Data analysis was performed employing descriptive statistics and statistical tests including Chi square, Kolmogorov–Smirnov, repeated measures analysis of variance, independent t-test, and paired t-test.
ResultsSignificant differences were observed in the total score of sexual function and all the FSFI domains except lubrication between the two groups (P=0.085).
ConclusionAn educational program based on mizaj in ITM can be an appropriate approach to improve the sexual function in diabetic women.
Keywords: Diabetes, Iranian traditional medicine, Sexual, Temperament -
Background
Couples’ childless and one-child intention is one of the crucial challenges in all societies. Considering the aging of the world's population and the need to review birth control policies, it is necessary to take evidence-based measures. Therefore, the present study aimed to investigate the influencing factors on the tendency of couples to be childless and have only one child.
MethodsThe present study is the first part of a mixed (qualitative-quantitative) study. The study is qualitative with a conventional content analysis approach. The research population consists of all couples aged 15-49 in 2021 in Babol city, who were single or childless and had no intention of pregnancy in the future. Sampling is based on the purpose, and the number of samples is 40 couples. To collect data, face-to-face and semi-structured interviews were conducted with the participants. Sampling continued until data saturation. The data were analyzed by the conventional content analysis method.
ResultsThe results of the analysis include 140 codes, 30 sub-categories, 9 categories (family economic problems, uncertainty in the future security of the child, threatened priorities, uncertainty about the continuation of life, Fear of becoming a parent, lack or weakness of support, diminishing religious beliefs, social role modeling and negative experiences of childbearing) and two themes (individual limitations and social limitations). These factors indicate the mandatory conditions for childlessness or one-child choice or voluntary child-free.
ConclusionThe results revealed that voluntary childlessness and single-child depend on various individual and social aspects. Some of these factors have made couples choose a childless or one-child lifestyle against their will and under forced circumstances. Financial support and welfare of the government, parenting education and efforts to change the attitude of couples towards having children by the government can help to maintain and improve the health of the family and achieve the goals of encouraging population growth policies.
Keywords: Effective factors, tendency to childlessness, tendency to have only one child, qualitative study
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