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Background: Management of type 2 diabetes (T2D) as a chronic disease requires treatment adherence such as controlling the blood glucose level and adopting a healthy lifestyle. The present study aimed to develop and psychometrically evaluate a questionnaire based on the Pender's Health Promotion Model (HPM) to measure treatment adherence and the associated factors among T2D patients. Methods: The present study was conducted in qualitative and the quantitative phases between March 2022 and March 2023. The participants were T2D patients visiting Shahid Mohammadi hospital Diabetes Clinic in Bandar Abbas in the south of Iran. The first draft of items was extracted from the qualitative phase. The present study used interviews with T2D patients, item construction, validity and reliability evaluation of the instrument, and the relevant statistical analyses. It emphasized the significance of content, face, and construct validity, along with reliability testing using Cronbach's alpha and test-retest method. Data were analyzed using SPSS software, V16 and AMOS, V23. Results: A 97-item questionnaire was developed through the qualitative phase and, after content validity, it was reduced to 86 items. Five items were removed in face validation, and after the test-retest method, 79 items were retained. The confirmatory factors analysis confirmed a 65-item model with appropriate fitness of data. Cronbach's alpha coefficient showed an acceptable reliability of the diabetes treatment adherence questionnaire (α = 0.92). Conclusion: The questionnaire developed based on the HPM model provides a standard and comprehensive measurement of the degree of adherence to treatment and the associated factors among Iranian T2D patients. This is especially valuable in the Iranian healthcare context, where effective management of chronic diseases such as diabetes is of a top priority. Questionnaires can help identify barriers and facilitators of treatment adherence to inform systematic and goal-oriented interventions. The proposed questionnaire had good psychometric properties, and can be used as a valid and practical instrument to measure the factors related to treatment adherence behaviors. [ABSTRACT FROM AUTHOR]

Background. More than 1 million colorectal cancers (CRC) are diagnosed annually. This cancer is the cause of 600,000 deaths, and many of these deaths can be reduced by screening. Colonoscopy is the best screening method and tool to diagnose CRC, but it causes anxiety and worry in patients. In addition, no appropriate tool has so far been introduced for assessing anxiety in these patients. Accordingly, the present study aimed to design and psychometrically evaluate a tool for assessing anxiety in patients undergoing colonoscopy. Methods. This methodological study used a descriptive-cross-sectional approach to design a psychometric questionnaire. To this end, 106 patients participated in this research, and the questionnaire was completed online. The validity of the list and the analysis of its main components were determined through exploratory factor analysis with varimax rotation and confirmatory factor analysis. The reliability of the tool was also checked with Cronbach’s alpha. Results. Overall, 20 terms of the questionnaire were examined by exploratory analysis, and 5 factors explained 57.76% of the total variance. The internal consistency of the tool with Cronbach’s alpha was 0.91. Conclusion. The findings of the research revealed that the tool for assessing anxiety in patients undergoing colonoscopy with 20 items and 5 factors has adequate validity and reliability and can be used to assess the anxiety of colonoscopy patients. Practical Implications. The results of this research can change policies in the field of treatment to reduce the anxiety of colonoscopy patients. [ABSTRACT FROM AUTHOR]

We aimed to develop and test the psychometric properties of the Perceived Barriers of Mammography Scale (PBMS-23). Based on a mixed method design researchers generated item pool through qualitative data and literature review and next, 500 women ages 40 to 69 years completed the questionnaire. Based on exploratory and confirmatory Factor Analysis, 23 items, researchers revealed eight domains of fate and destiny, breast conflict, defense avoidance, inconveniences/difficulties of mammography screening, contrasting/competing priorities, fear, distrust of mammography, and lack of knowledge with appropriate fitness for the data. PBMS-23 is valid and reliable instrument for assessing perceived barriers of mammography. [ABSTRACT FROM AUTHOR]

Background: The patient's fear of social reactions, the disease stigma, and being a transmission agent is a psychological and social consequence of contracting some diseases, especially infectious ones, in any society. The present study aimed to design and psychometrically evaluate a COVID-19 social stigma questionnaire in nurses. Methods: This mixed-method study was conducted using a sequential exploratory approach according to the Creswell method in Mazandaran Province (Iran) during 2021-22. The study was performed in three phases: (1) a qualitative phase to explain the key concept, (2) designing the scale items, and (3) an experimental phase with the scale psychometric evaluation. In the first phase, nurses' experiences regarding the concept of COVID-19 social stigma were evaluated using a qualitative method with an inductive qualitative content analysis approach. In this phase, the lived experiences of 12 nurses working at hospitals of Babol University of Medical Sciences were extracted through in-depth interviews with semi-structured questions and analyzed by conventional content analysis. The main classes are contradictory feelings, rejection, and adaptation strategies. In the second phase, the designed items were validated by determining face validity, content validity, and construct validity using exploratory factor analysis (EFA). In addition, the scale's reliability was determined through internal consistency and stability. Results: Following the study's first phase, a pool of questions with 64 initial items was formed. After evaluating face and content validity, the number of items was reduced to 24 cases. An excellent total content validity (S-CVI/Ave) of 0.93 was calculated for the scale. According to EFA outputs, three factors accounted for the most variance (52.82%), and four items were excluded in this phase. The Kaiser-Meyer-Olkin (KMO) statistic and Bartlett's test of sphericity were calculated at 0.776 and P < 0.001, respectively. The results of Cronbach's alpha (0.796) and intraclass correlation (0.793) indicated the correlation and internal consistency of the scale. Conclusion: This scale can help healthcare managers and policymakers apply necessary protective measures by evaluating the social stigma of COVID-19 in nurses and emerging infectious diseases that may occur in the future. [ABSTRACT FROM AUTHOR]

Purpose Knowledge advancement exposes the pharmacists to new ethical and professional challenges in providing pharmaceutical care. The pharmacist's attitude towards the ethical challenges of pharmacy practice could be of great help in assessing pharmacist's ethical sensitivity. This study aimed to design a valid and reliable questionnaire for measuring pharmacists' attitudes. Methods The present study is the second phase of a sequential exploratory mixed-method study for designing and psychometric evaluation of the questionnaire. In the first phase the questionnaire was developed using semi-structured interviews followed by content analysis. The psychometric evaluation of the questionnaire was performed examining the validity (face, content, and construct), and reliability (internal consistency and Intraclass Correlation Coefficient and Standard Error of Measurement) in a sample of pharmacists practicing in community pharmacies in Tehran and Tabriz, Iran (n = 504). The construct validity of the questionnaire was determined using exploratory and confirmatory factor analysis. Results The Scale-Content Validity Index/Average (S-CVI/AVE) was calculated at 0.84. The results of exploratory factor analysis supported 22 items in four factors including regulations and rules, professional communications, providing and supplying medicine, and consultation and providing pharmaceutical care that are explained by a total of 49.50% of the variance. Also, confirmatory factor analysis confirmed goodness of fit indices and model fit. Cronbach's alpha Coefficient was 0.919 and ICC was 0.914. Conclusions The psychometric evaluation of the present questionnaire shows a native, valid and reliable instrument to assess pharmacists' attitudes toward ethical challenges which could be a mirror of pharmacists ethical sensitivity. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cultural competence in clinical nurses can lead to comprehensive care for patients from different cultures. Currently, an appropriate instrument to assess cultural competence in clinical nurses is limited. This study aimed to design and determine the psychometric properties of the clinical nursing cultural competence scale (CNCCS). Methods: This methodological study was conducted in 2018–2019 in two phases. In the first phase, a literature review and semistructured interviews with 18 clinical nurses from Isfahan and Ahvaz were conducted, and the results were used for item generation. In the second phase, the face, content, construct validity, and reliability of the questionnaire were assessed. For construct validity assessment through exploratory factor analysis (EFA), 200 clinical nurses were purposefully recruited to fill out CNCCS. Results: In the first phase, 140 items were produced. In the second phase, the item number was reduced to 40 after the face and content validity assessment. In EFA for construct validity assessment, 13 more items were deleted, and the remaining 27 items were loaded on six factors. The Cronbach's alpha and the test–retest intraclass correlation coefficient were CNCCS 0.86 and 0.93, respectively. Conclusions: The CNCCS had acceptable psychometric characteristics in Iranian nurses and can be used for assessing cultural competence among clinical nurses. The use of this scale can help nursing policymakers and managers develop their understanding of nursing cultural competence and develop strategies for its improvement. [ABSTRACT FROM AUTHOR]

Background and Aim: Evidence-based practice improves the quality of clinical performance. Attitude affects the implementation of research findings into practice. The Evidence-Based Practice Attitude Scale (EBPAS-36) evaluates the attitude of therapists toward evidence-based practice. The present study aimed to provide a validated Persian translation of the EBPAS-36 for audiologists. Methods: The original EBPAS-36 was translated by using the international quality of life assessment protocol. The validity of translated version was surveyed by an expert panel and the Persian version with 35 questions was yielded. A demographic questionnaire and EBPAS P-35 were given to 182 audiologists to evaluate the psychometric properties. The reliability was evaluated by completing the EBPAS P-35 after 2 weeks by 30 of the participants and Cronbach's alpha and Intra-Class Correlation (ICC) were calculated. Confirmatory Factor Analyses (CFA) were also conducted. Results: The content validity ratio was above 0.33 for all except item 10 which was removed from the Persian version. The mean(SD) total score was 2.38(0.46). A significant relationship was observed between the total score and all subscales (p<0.05). The original factor structure showed an acceptable model fit (CMIN/DF=1.39, GFI=0.84, CFI=0.94, IFI=0.94, RMSEA=0.04) confirming the 12-factor structure of the EBPAS-36. The internal consistency was very good for the total score (α=0.88) and adequate to very good for the subscales (0.65--0.84), indicating high reliability. The ICC showed good agreement in the score of test-retest (total ICC=0.65). Conclusion: This study confirms good psychometric properties and validity of the EBPAS P-35 in a sample of audiologists. [ABSTRACT FROM AUTHOR]

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Background: Road traffic injuries are among the main causes of mortality in adolescents. The aim of this study was to determine the psychometric properties of an adjusted adolescent pedestrian behavior questionnaire (APBQ). Materials and Methods: Using the 29-item self-report pedestrian behavior questionnaire designed by Sadeghi-Bazargani et al. for all age groups as the framework, some of the items were removed depending on the type of behaviors among adolescents and some new questions were added. Eventually, the primary questionnaire was developed with 26 items, including 19 questions from Sadeghi-Bazargani et al.'s questionnaire and seven new questions. The tool was adjusted for adolescents and the psychometric properties were determined among a randomly selected group of 300 Junior high school students in Rasht City, Iran. After determining face validity, content validity and construct validity of the tool by experts, the reliability of the tool was examined based on explorative factor analysis (EFA) with Promax rotation and confirmatory factor analysis in AMOS. Eventually, a self-report questionnaire with 14 items was developed to assess the self-report behavior of adolescent pedestrians. Results: The mean age of the participants was 13.59 (±0.92) years. The Kasier-Meyer-Olkin value was 0.828, which confirmed the EFA. The analysis by the maximum likelihood method with Promax rotation identified four factors with eigenvalues >1 and factor loading =0.5. Therefore, pedestrian behaviors were categorized into four groups (unsafe road crossing behavior, distraction, positive behavior, and playing on the road). Conclusion: The APBQ can be a proper tool for self-reporting adolescent pedestrians' behaviors. It can also be used for studies on safe behaviors in adolescent pedestrians. [ABSTRACT FROM AUTHOR]

Aim: Use of mobile phones in health care centres can distract care providers and consequently disrupt the care procedure and risk patient safety. This study aims to develop and evaluate the psychometric properties of a questionnaire for measuring distraction caused by mobile phone use in operating rooms. Sample and setting: 208 operating room nurses and doctors from five hospitals affiliated to Shiraz University of Medical Sciences participated in the study. Method: This methodological study was conducted in two stages. In stage one, through a review of relevant texts, articles and books, the different dimensions of distraction as caused by mobile phone use were determined, and the items of the questionnaire were developed after several meetings with experts. In stage two the researchers used the two tests of content and face validity to determine the validity and internal consistency (Cronbach's alpha) and stability (test-retest) to evaluate the reliability. Also, the construct validity of the instrument was determined using exploratory factor analysis. Results: In the first stage of the study, distraction due to mobile phone use was defined and 29 items on a five-point Likert scale were developed. In the second stage, after face and content validity assessments, 17 items remained. Evaluations of the reliability of the questionnaire using internal consistency and test-retest reliability yielded a Cronbach's alpha of 0.743. The Spearman-- Brown correlation coefficient of the instrument was found to be 0.994. The construct validity of the instrument was examined through factor analysis. Conclusion: The findings show that the developed instrument has enough validity and reliability to measure distraction due to mobile phone use in operating rooms. [ABSTRACT FROM AUTHOR]

To develop and assess the psychometric properties of the Postpartum Sexual Quality of Life Scale (PSQLS) in Iran. We employed a mixed-method approach. In the qualitative phase (17 interviews and two focus groups), we generated items for the scale. In the quantitative phase (N = 282), we assessed the psychometric properties of the pre-final version. The final version contained 22 items. Exploratory factor analysis indicated a 5-factor solution that jointly accounted for 59.6% of the variance. Cronbach's alpha coefficient was 0.87. The PSQLS showed good validity and reliability and could be used to evaluate women's postpartum sexual life. [ABSTRACT FROM AUTHOR]

Objective Stuttering is not just a speech disorder. It can cause negative feelings and emotions in a person especially in children. Therefore, we need a standard tool to identify, study and measure these negative effects and then try to eliminate or reduce them. Considering the increased clinical and research needs for a valid and reliable tool to assess the negative effect of stuttering in Iran, this study aims to design and validate a questionnaire (parents form) for assessment of social/emotional/behavioral disorders in preschool children with stuttering. Materials & Methods This is a methodological study that was conducted in three steps in spring and summer of 2018 in Isfahan, Iran. Participants included 60 parents of preschool children with stuttering aged 3 to 5 years and 11 months (36 boys and 24 girls), who had referred to speech therapy clinics in Isfahan. In the first stage, 10 parents received in-depth and open-ended interviews to collect information about social, emotional and behavioral disorders in children with stuttering. Afterwards, based on these information and the opinions of experts in psychology and speech therapy, the main constructs of the questionnaire were identified: "uncompromising/hyperactive behavior", "social skills", "communication skills", "aggression", "fear", and "separation anxiety". In the second stage, in order to determine the face validity, 10 experts were interviewed face to face. In order to determine the content validity, 15 other experts were asked to examine each item according. Content validity was determined by calculating the content validity ratio (CVR), content validity index (CVI), and total content validity (Lawshe method). Confirmatory factor analysis was used to examine the construct validity. In the last step, the internal consistency was determined by calculating Cronbach's alpha coefficient, and the relaibility was determined by test-retest method and intraclass correlation coefficient (ICC). Results The initial version consisted of 61 items and 6 subscales. According to the experts, by merging items with overlapping concepts, the number of items were reduced to 40. In the face validity assessment stage, items were examined based on difficulty, relevance, and ambiguity. The phrases were read several times, and the opinions of experts were applied. Then, it was reviewed by two experts in Persian literature and finally was approved. The CVR and CVI vaues were obtained 0.76 and 0.90, respectively. For its internal consistency, the Cronbach's alpha coefficient was obtained 0.89 and ICC was more than 0.7 and significant (P<0.001). For the construct validity assessed in AMOS software, the calculated X2 was 631.25. The low number of X2 indicated a good fit of the model (P<0.000). Conclusion The designed questionnaire has acceptable validity and reliability and can be used as a reliable and valid tool for assessing social/emotional/behavioral disorders in Iranian preschool children with stuttering. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the Gerontological Nursing Competence Questionnaire-Farsi version (GNCQ-F) in Iranian hospitals. Method: This exploratory sequential study used a mixed-methods design. The questionnaire items were developed based on a qualitative descriptive exploratory study and a review of the literature. The psychometric properties of the initial questionnaire including face validity, content validity, construct validity, internal consistency, and stability were evaluated. Results: Exploratory factor analysis resulted in the extraction of 42 items in five factors including care competence and patient/older adult and family empowerment, ethical and compassionate care competence, patient safety competence, continuous professional development and self-care competence, and collaborative and team care competence. Cronbach's alpha coefficient confirmed the internal consistency of each subscale and the entire tool (0.942). The stability reliability was 0.973 and was determined by calculating the intra-cluster correlation coefficient. Conclusion: Nurses can use this self-evaluation instrument to assess their gerontological nursing competence. [J Contin Educ Nurs. 2021;52(7):335–343.] [ABSTRACT FROM AUTHOR]

Background: Care and treatment adherence are important factors for given good liver transplantation outcomes. Objectives: Design and validate an instrument to appraise adherence to care and treatment in liver transplantation recipients. Methods: Amixed-methods sequential exploratory study was conducted in two phases from2017 to 2019, in the Liver Transplantation Clinic Tehran, Iran. In the qualitative phase, the concept of care and treatment adherence in liver transplantation recipients extracted by a conventional content analysis was performed on semi-structural interviews that were conducted on 18 liver transplantation recipients that were recruited through purposive sampling technique. Also, two physicians, one nurse coordinator of the liver transplantation team, and two family members were interviewed. The scale was developed based on operational definitions extracted from the qualitative phase. The validity was assessed by face, content, construct validity, and confirmatory factor analysis. The reliability was also evaluated by calculating test-retest intraclass correlation coefficient and Cronbach's alpha. The exploratory factor analysis was carried out with 286 filled the questionnaire. Results: Four factorswere extracted in factor analysis. These factors explained 45.622% of the variance. The final version of the scale consisted of 20 items. The Cronbach's alpha coefficient reported as 0.889 for the total scale and the intraclass correlation coefficient was reported as 0.912. The confirmatory factor analysis led to a fittingmodel. Chi-square indices were reported as CMIN/DF = 2.34, NFI = 0.94, CFI = 0.96, and RAMSEA = 0.067. Conclusions: With a four factors structure, validity and reliability of adherence to care and treatment scale are acceptable; therefore, it can be used for appraisal care and treatment adherence in liver transplant recipients. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop and psychometrics a questionnaire for assessing childbirth experience in Iranian women. Design: Cross‐sectional study. Methods: This cross‐sectional study was done in women who experienced childbirth within the last 12 hr to 2 months from May to December 2018. Questionnaire items were extracted from a comprehensive review of the available studies and questionnaires on childbirth experiences and definitions implied by qualitative interviews. The designed questionnaire was validated in three stages: face, content and construct. Cronbach's alpha was used to determine the reliability of the instrument. Result: Iranian women childbirth experience questionnaire contained seven factors with 52 items which were called professional support, husband's and other important support, baby, preparation, fear, positive perception and control were extracted. The Cronbach's alpha coefficient after factor analysis was 0.62–0.92 and for the whole instrument was 0.91. The findings showed that Iranian women childbirth experience questionnaire was valid and reliable. [ABSTRACT FROM AUTHOR]

Aim: To develop and evaluate the psychometric properties of postgraduate nursing student academic satisfaction scale (PNSASS). Design: The mixed‐method study was carried out in two phases; (a) item generation by hybrid concept analysis and (b) item reduction by psychometric evaluation of the developed scale. Methods: The initial item pool (N = 209) was prepared based on concept analysis results and similar instruments. A total of 402 postgraduate nursing students willingly participated in online data gathering from August 2019 to May 2020. The validity (face, content and construct) and reliability (stability and internal consistency) of the scale were assessed. Results: Exploratory factor analysis identified that the scale had four factors which explained 64.80% of the total extracted variance. The results of confirmatory factor analysis showed a good model fit. The reliability of scale was strong to excellent. The results showed that the PNSASS has suitable validity and reliability properties, which can be used to measure the academic satisfaction of postgraduate nursing students. [ABSTRACT FROM AUTHOR]

Sexual performance refers to activities served by sexual capacity and motivation. As a culturally sensitive issue, to date the scalar invariance of sexual performance has not been examined for Iranians with spinal cord injuries (SCIs). Aim: To develop and assess properties of an instrument evaluating sexual performance of an Iranian population with SCIs., in Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Using multi-modal methods, we developed and assessed the Sexual Performance Questionnaire (SPQ). This included collecting expert opinions; engaging with patients with SCI referred to BASIR; pilot testing to assess the scale; and a formal investigation. Participants (men = 156, women = 58) completed the SPQ. Internal consistency and reliability were measured using Cronbach's α coefficient. Content and face validity were examined by academic experts. Construct validity was assessed by examining convergent and discriminant validity. Finally, exploratory factor analysis was used to extract the factor structure of the questionnaire. The Cronbach's α coefficient was 0.77. There was a significant (p = 0.04) correlation (r = − 0.23) between the SPQ score and age. Those with a partner scored higher (p = 0.001). We found three components: Spouse as initiator, self-initiation, and genital-oriented sex which accounted for 59% of the observed variance. The face and content validity was approved by an expert committee. The development and application of the 13-item SPQ provides a thorough understanding of sexual performance amongst persons with SCI. It facilitates the development of efficient sexual rehabilitation interventions and SCI-specific sexuality education programs. [ABSTRACT FROM AUTHOR]

Background: Aging is associated with changes in some capabilities. Using technology can help older adults to continue living independently at home. This study aimed to develop the Older Adults' Technology Use at Home Scale (OATUHS) and evaluate its psychometric properties in the Iranian context. Methods: It was a sequential-exploratory mixed-method study for the development and psychometric testing of OATUHS. A draft scale with 15 items was generated based on a literature review and interviews with 20 older adults. The psychometric properties were assessed by testing the scale on 200 older adults referring to the Urban Comprehensive Health Service Centers of Kashan province, Iran. The multistage cluster sampling method was used to recruit the participants. Then, the face, content, and construct validities as well as internal consistency and stability reliability were assessed. The obtained data were analyzed using the SPSS, version 16. Also, the exploratory factor analysis was conducted using the principal component analysis and the varimax rotation method to determine the factors of the scale. Results: The OATUHS consisted of 12 items. Exploratory factor analysis resulted in two factors explaining 69.6% of the variance. The internal consistency of the scale was acceptable (r=0.88); it was 0.93 for the "in-kitchen technologies" and 0.87 for "out-of-kitchen technologies" dimensions. Besides, an intraclass correlation coefficient of 0.95 was estimated between the test and retest scores. Conclusion: The OATUHS is a valid and reliable tool for the measurement of the use of technology by older adults at home, in daily life. [ABSTRACT FROM AUTHOR]

Background: Agriculture is one of the most dangerous industries throughout the world, and its risk level is dictated by several determinants whose real weights are often unknown. Objective: The present work aims to develop psychometric properties of farmers' occupational health behavior questionnaire for Iranian farmers. Methods: In this qualitative-quantitative study, the items of the instrument were derived from the qualitative phase. Face validity, content validity, reliability, and consistency methods were applied. Construct validity was estimated by the exploratory factor analysis. Results: Eleven factors with factor loads of >0.501 were extracted as the main factors. They altogether captured about 58.97% of the variance of factors affecting farmers' occupational health behavior. The reliability of the instrument was confirmed as its Cronbach's alpha was in the range of 0.72–0.93. Conclusion: Given the complicated nature of occupational health behaviors among farmers, it is imperative to measure the factors influencing these behaviors precisely. Therefore, the development of a proper instrument can be very crucial in identifying influential factors. The findings showed that the developed instrument was optimally reliable and valid. [ABSTRACT FROM AUTHOR]

To develop and validate a shared governance feasibility instrument in schools of nursing in Iran with respect to the nature of the profession and the sociocultural context of the Iranian community. Background: Nursing schools are liable to the application of shared governance due to the presence of various expert educational groups within the school that necessitates reciprocal cooperation. Since the concept of shared governance is culture-based and given that no full-fledged study has been conducted on shared governance in Iran, the development of a suitable shared governance feasibility instrument is rendered as mandatory. Methods: This sequential exploratory mixed-method study consisted of two qualitative and quantitative parts was accomplished 2016–2019. First, the primary items were extracted through an extensive review of the literature, qualitative interviews and underwent psychometric validation using a methodological approach. Face, content, construct validity and reliability of the instrument was established and completed. Results: One hundred fifty items were distilled from the first stage of the study, was reduced to 70 after establishing face, content validity and primary reliability. Exploratory factor analysis resulted in 52 items covering the two factors "shared atmosphere and culture" and "infrastructural prerequisites". These two factors accounted for 78.6% of the total variance of the questionnaire. In calculating the final reliability coefficient of the instrument, Cronbach's alpha and Omega were 0.981 and 0.805, respectively. The results showed an ICC of 0.91 indicating high reliability of the developed instrument with a standard error of measurement (SEM) of 10.43. Finally, the items underwent weighting via scoring by considering item weights due to differences between the two methods. Conclusion: "Shared governance feasibility instrument" can provide a new insight into organisational performance for all policy-makers and beneficiaries of higher education. This not only leads to the use of intelligence and capabilities of the beneficiaries, but also aids in faster movement toward achieving organisational goals. Implications for nursing management: This study and the developed instrument may serve as a guide for the feasibility of implementing shared governance to assess management styles and performance in higher education centers. [ABSTRACT FROM AUTHOR]

Objectives: Many scales have been developed to assess health literacy. These scales have been developed extensively in clinical populations in developed countries. Our study describes the process of development and validation of the Health Literacy Questionnaire to measure health literacy in the general Iranian population. Methods: We followed the scale development process outlined by Schwab in 1980. After a comprehensive review of the research published on Nutbeam's definition of health literacy and its measurement, two focus groups were considered to generate a pool of items. We then assessed the face validity and content validity of the items. The final version of the questionnaire was subject to independent exploratory and confirmatory factor analysis. The internal consistency of the questionnaire was evaluated using Cronbach's alpha. Finally, construct validity was assessed using bivariate analysis between the total scores on the scale and theoretically relevant variables. Results: The results of exploratory factor analysis revealed a threefactor 14-item structure for the scale. Confirmatory factor analysis provided a good statistical and conceptual fit for the data. The analysis of the internal consistency of the scale was satisfactory (α = 0.798). Further, health literacy was significantly associated with participants' age, educational level, self-rated household income, smoking history, self-rated health, and self-rated health literacy. Conclusions: The results we obtained indicate that this newly constructed health literacy tool is highly valid and reliable. Prospective studies are required to evaluate the predictive validity of the scale with regard to health outcomes. [ABSTRACT FROM AUTHOR]

Background: Therapeutic communication (TC) between nursing students and patients is essential for providing high-quality care. Purpose: This study aimed to introduce a questionnaire for the assessment of TC among Iranian nursing students and to examine its psychometric properties. Methods: This mixed-method research was conducted in two phases of developing tool content and validation of the scale. Results: Five factors were specified, explaining 42.89% of the total variance. The confirmatory factor analysis confirmed the structure of the scale. Cronbach's alpha coefficient of the scale was 0.83. Conclusions: The final questionnaire was a valid and reliable scale for the self-assessment of TC among nursing students. Furthermore, scholars can use this instrument to compare students' TC before and after educational interventions. Impact statement: Nursing students' TC questionnaire is a suitable instrument for assessing nursing trainees' TC and enhancing their engagement in learning. [ABSTRACT FROM AUTHOR]

Background: The existing literature supports the application of the principles of andragogy on patient education. But there is a lack of a suitable tool for assessing patient education's conformity with these principles. Purpose: This study was conducted to develop and evaluate the psychometric properties of a questionnaire that measures the degree to which the patient education adheres to the principles of andragogy. Methods: The primary instrument, consisting of 70 items, was developed after the literature review. The psychometric properties of the instrument were determined. The content validity of the items was assessed by an expert panel review. Exploratory and confirmatory factor analysis was performed to test the construct validity. Cronbach's alpha coefficient was used to assess the internal consistency of the scale. A sample of 300 hospitalized adult CVD patients with a mean age of 54.93 ± 13.59 in 2 heart hospitals, were selected through convenience sampling method. The data were analyzed using SPSS 16 statistical software. Results: After determining face and content validity, the questionnaire items decreased to 59. The exploratory factor analysis indicated the existence of 6 factors that accounted for 53.37% variance of the questionnaire. The confirmatory factor analysis revealed a good fit to a predetermined send of constructs. Analyses also indicated acceptable results for the internal consistency with Cronbach's alpha value (0.72 to 0.93). The final questionnaire was approved; this comprised of six factors with 40 items. Discussion: The psychometric evaluation of the APEQ resulted to a reliable and valid instrument. Translation to Health Education Practice: This instrument is helpful in assessing the adherence of patient education to the principles of andragogy, eliminating deficiencies and promoting the performance of health education providers in patient education. [ABSTRACT FROM AUTHOR]

Background: Despite the fact that many infertile couples have to decide about whether or not to choose donor conception, there is no predictive scale for evaluating the process of decision-making on donor conception and its determinants in such couples. The present study was conducted to develop a decision-making questionnaire for selecting donor conception and assess its psychometric properties in Iranian infertile couples. Materials and Methods: This cross-sectional validation study was conducted based on the method developed by DeVellis (2012) in four steps at Milad Infertility Clinic, Mashhad, Iran. The dimensions of the concept of decisionmaking were determined in the first step based on the qualitative results obtained from 38 semi-structured in-depth interviews. Items that were appropriate for the questionnaire were developed in the second step using the qualitative data and a review of the literature. In the third step, the research team reviewed and eliminated some of the items. The fourth step evaluated the face, content and construct validity of the questionnaire through exploratory factor analysis on a sample of 220 infertile couples using convenience sampling and investigated its initial and final reliability. Results: Based on the results of the qualitative study, a pool of 170 items was developed, 101 of which were eliminated after revision due to ambiguity, repetition or their poor face and content validity and initial reliability. The questionnaire was evaluated for its construct validity with 69 items. After the exploratory factor analysis, the decisionmaking donor conception questionnaire (DMDCQ) having 51 items and seven factors, was finalized. All the factors had Cronbach's alpha values of 0.75-0.87 and intra-class correlation coefficients (ICC) greater than 0.7. Conclusion: This study led to development of a valid and reliable scale for examining infertile couples' decisionmaking about whether or not to use donor conception as well as the determinants of this decision. [ABSTRACT FROM AUTHOR]

Our aim was to develop a framework-based weight control behavior questionnaire (Weight-CuRB) and test its psychometric properties among a non-probability sample of 240 postmenopausal women with osteoporosis. Appropriate validity, simplicity, functionality and reliability were observed for the Weight-CuRB. The explanatory model fits the data well (χ2 [139] = 245.835, p <.001, CFI = 0.950, NFI = 0.901, IFI = 0.950, RMSEA = 0.057[(0.045–0.068]). To our knowledge, this was the first study to develop and validate a framework-based instrument aiming at cognitive needs assessment of postmenopausal women with osteoporosis. The weight-CuRB may be useful in addressing the core cognitive determinants of weight control among the patients. [ABSTRACT FROM AUTHOR]

Background: Health literacy has received growing attention in recent years to reduce health disparities. Health literate individuals can gain access, understand and use health information to maintain, improve and promote good health. Objective: To develop and assess the psychometric properties of a tool for the measurement of health literacy among workers, the Health Literacy Scale for Workers (HELSW). Methods: 15 companies were selected from the factories of the industrial city of Saveh. 450 (400 male and 50 female) workers from Saveh, Iran, were selected through a multistage random sampling. The study had two stages--a qualitative and a quantitative stage. In the qualitative phase, the workers' beliefs were extracted based on 61 in-depth interviews. Content validity was assessed with the help of 12 experts in the field of health education, public health and occupational health. Also, face validity was evaluated through interviewing with 20 workers. In the quantitative phase, the reliability of the questionnaire was evaluated by measuring the internal consistency and test-retest reliability. The construct validity was assessed by the principal component analysis using varimax rotation. Results: In the exploratory factor analysis, six domains (ie, access, reading, understanding, assessment, decision making and applying health information, and self-efficacy) with 34 items were loaded; the model explained 64.3% of the total variance. Intraclass correlation coefficient and test-retest reliability ranged from 0.72 to 0.84 and 0.69 to 0.86, respectively. Conclusion: It seems that the developed Persian questionnaire, HELSW, is a reliable and valid measure of the health literacy in workers. [ABSTRACT FROM AUTHOR]

Background: Lack of accurate menstrual knowledge, attitude, and practices leave female adolescents ignorant of the necessary health behaviors during menstruation. This study aimed to develop a menstrual health-seeking behavior questionnaire based on the theory of planned behavior to evaluate its psychometric properties in female adolescents in Tehran. Methods: This study was conducted on 578 female adolescents aged 12-15 years in Tehran. The first draft of the menstrual health-seeking behavior questionnaire containing 52 items was developed based on the theory of planned behavior (TPB). The content and face validity of the questionnaire was assessed by a panel of experts. Construct validity was also assessed using exploratory factor analysis (KMO=0.73) with varimax rotation. Cranach's alpha and test-retest were used to examine the reliability of the questionnaire. All statistical analysis was performed using SPSS 23.0 and AMOS 23.0. Results: The content and face validity of the 42 items were finally confirmed. Content validity index was greater than 0.73 for all six TPB constructs. Explanatory factor analysis yielded an acceptable fit for the six-factor model (RMSE=0.053, 95% CI 0.042-0.064). These factors jointly explained 65% of the variance in the outcome variables. Cranach's alpha coefficients ranged from 0.79 to 0.91, demonstrating an excellent internal consistency and high reliability of the questionnaire. Test-retest reliability was also satisfactory for all items (ICC=0.86-0.94). Conclusion: The results illustrate that the menstrual health-seeking behavior questionnaire is psychometrically adequate and highly reliable. This theoretically grounded questionnaire can be well applied in future interventions for female adolescents to assess their menstrual health-related knowledge, attitude, and practices. [ABSTRACT FROM AUTHOR]

Background and Purpose: There is no Persian scale for assessing the quality of life of patients with thalassemia major. Thus, this study was conducted to translate and validate the 36-item thalassemia-specific Transfusion-Dependent Quality of Life (TranQoL) questionnaire. Methods: The questionnaire was first translated into Persian and then was backward-translated into English. Afterward, panels of experts commented on the Persian translation, and then its face validity was confirmed and content validity index (CVI) and content validity ratio (CVR) were calculated. The factorial structure and the reliability of the translated questionnaire were assessed using exploratory factor analysis (EFA) and internal consistency method, respectively. Results: The CVI and CVR of the questionnaire were .95 and .84, respectively. Five items were deleted during EFA, and 9 factors were extracted from the 31 remaining items. The reliability of the questionnaire was confirmed through a Cronbach's alpha coefficient of .9. Conclusion: The Persian translation of the TranQoL questionnaire is highly reliable and valid, and thus, it can be used as a specific measure for assessing the quality of life among patients with thalassemia. [ABSTRACT FROM AUTHOR]

Aim: To develop a nutritional screening tool and examine its reliability and validity in elementary school children with malnutrition based on PRECEDE--PROCEED model, in Shiraz, Iran. Methods: A questionnaire was designed and its reproducibility was analysed via test--retest design among students with malnutrition. The students were in the fourth to sixth grades. Validity was assessed using face validity, content validity, construct validity, item difficulty and item discrimination. Reliability was measured by Cronbach's alpha (internal consistency), the intra-class correlation coefficient (ICC) and κ statistics (test--retest reliability). Results: A total of 165 primary school students (mean age of 11.21 ± 1.08 years, 65.5% females) participated in the study. The PRECEDE--PROCEED theoretical model for health education was adapted for this questionnaire. The questionnaire was divided into four main sections: predisposing, reinforcing, enabling factors and behaviour. Coefficient κ reliability estimate was above 0.9 for most scales. The ICCs for different scales of the questionnaire were within the range of 0.402-0.800. Values for κ ranged from 0.412 to 0.785 for most scales. Conclusions: The results showed reasonable validity, excellent reliability and moderate to substantial reproducibility for all scales of the questionnaire except two questions for κ statistics. The present study is of great importance, as there are no psychometrically evaluated tools (based on health behaviour models) with accepted validity and reliability for the evaluation of such factors in children with malnutrition. The questionnaire developed in the present study can be used to assess the effect of intervention among primary school students with malnutrition. [ABSTRACT FROM AUTHOR]

Aim To develop an instrument for the assessment of safe nursing care ( ASNC) within the Iranian context and psychometrically evaluate its reliability and validity. Background There is a need for a valid and reliable instrument to assess how nurses employ the components of safe nursing care in clinical practice in non-Western countries. Method This methodological study was conducted in two phases: (1) a qualitative phase of instrument development, and (2) a quantitative phase of psychometric evaluation of the assessment of safe nursing care ( ASNC). The instrument's content validity was assessed by experts in the field of safe nursing care. The reliability of this instrument was examined using internal consistency reliability and intra-rater reliability analysis. Exploratory factor analysis was then conducted to establish the instrument's initial construct validity. Results The instrument developed was a questionnaire with 32 items. The Cronbach's alpha of the scale was 0.92, and Intra-class Correlation Coefficient for intra-rater reliability was 0.78. Exploratory factor analysis resulted in a four-factor solution: (1) evaluation of nursing skills, (2) assessing the patient's psychological needs, (3) assessing the patient's physical need, and (4) Assessing nurses' teamwork. The four factors accounted for 63.54% of the observed variance. Conclusion The ASNC can be applied to a wide variety of settings because of the broad range of methods utilised to generate items and domains, its comprehensive consideration of the principles of safe care, and its initial reliability and validity. Implications for nursing management The ASNC can help nurse managers assess whether clinical nurses are prepared to apply their safe care skills in clinical practice. It can also be used by clinical nurses to assess their own and peers' practice to detect potential areas for improvement in nursing care and help nurse managers with planning appropriate quality improvement programmes. [ABSTRACT FROM AUTHOR]

Background: Designing cancer prevention programs needs information on knowledge, attitude, and practice of the community. Unfortunately, this information is not available in Iran. Materials and Methods: We developed a questionnaire (NUTCANKAPQ) to assess the knowledge, attitude, and practice of Iranian women regarding cancer prevention dietary habits. We recruited women who had referred to public health-care centers in Tehran, Iran. To assess validity, we applied face, content, and construct validity methods. We performed test–retest approaches to assess reliability, and internal consistency of the questionnaire was assessed through Cronbach's alpha and intraclass correlation coefficients (ICCs). Results: Qualitative content validity was carried out by an expert panel, and internal consistency was deemed satisfactory (Cronbach's alpha, >0.6). We also observed high reliability in the questionnaire (ICC = 0.85). The mean (± standard deviation) scores for knowledge, attitude, and practice of study participants were 28.3 (±14.1), 67.1 (±18.9), and 53.7 (±8.3), respectively. The result of exploratory factor analysis, Kaiser–Meyer–Olkin (KMO), implied that the model was reasonably fit (KMO > 0.6). The final questionnaire included seventy items. Conclusion: NUTCANKAPQ is a valid and reliable tool for the assessment of cancer-related nutrition knowledge, attitude, and practice among the Iranian population. Application of NUTCANKAPQ may provide important clues for policy-making and improvement of cancer prevention programs among the Iranian population. [ABSTRACT FROM AUTHOR]