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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]

Investing in the preparation of middle-aged individuals for healthy old age can empower them to surmount the challenges aging. This study was conducted to create and assess the reliability and validity of a scale designed to measure the readiness of middle-aged individuals for healthy aging, referred to as the Middle-Age Preparation Scale for Healthy Aging (MPHA). The research employed a mixed sequential exploratory design. During the qualitative phase, items for the questionnaire were generated by reviewing existing literature and conducting interviews with participants. Subsequently, in the quantitative phase, the psychometric properties of the questionnaire were evaluated by analyzing its face validity, content validity, construct validity, internal consistency, and stability. The reliability and validity of the MPHA were tested with a sample of 440 middle-aged individuals in Tehran, Iran, in 2020. The statistical analyses performed included exploratory factor analysis, measures of internal consistency, and test-retest reliability. Initially, the item pool contained 80 items, which was narrowed down to 44 items during the face and content validation phase. The structural validity assessment resulted in a final 33-item scale, encompassing five factors associated with preparation for healthy aging: financial preparation, maintenance and promotion of physical and mental health, psychological preparation, sustaining communication, and planning productive leisure time. These factors explained 60.37% of the total variance. The Cronbach's alpha coefficient for the overall MPHA was 0.90, and ranged from 0.79 to 0.91 for the five subscales. The MPHA exhibited satisfactory validity and reliability for assessing preparation for healthy aging in the Iranian context. [ABSTRACT FROM AUTHOR]

Background: The high prevalence and associated costs of chronic diseases have challenged global community health. The use of information and communication technology offers patients and healthcare providers the ability to respond to healthcare needs. This study develops an information and communication technology use scale for patients with chronic diseases and evaluates its psychometric properties. Methods: This exploratory sequential mixed-method study was conducted in Kashan City, Iran from September 2020 to July 2021. In the qualitative phase, 18 patients with chronic conditions were recruited via the purposeful sampling method. The initial pool of 33 items was extracted in this phase. Psychometric evaluation of the scale was examined through face, content, and construct validity. The internal consistency of the scale was assessed with the Cronbach a and its stability was examined by the test re-test. To evaluate the scale's construct validity, a crosssectional study was performed with 300 patients referring to hospital wards and private centers that provide services to patients with chronic diseases. A sequential sampling method was used to select the subjects. The exploratory factor analysis was performed using principal component analysis and the varimax rotation method in the SPSS software, version 16. Results: The initial version of the scale consisted of 33 items. A total of 6 items were removed in the face and content validity evaluation phase. Factor analysis with the removal of 4 items resulted in the extraction of 4 factors that explained 67.45% of the variance in the total scale score. The Cronbach a coefficient and intra-class correlation coefficient were estimated at 0.93 and 0.88, respectively. Conclusion: The scale developed in this study is a valid and reliable tool for measuring formation and communication technology use (including its dimensions) in patients with chronic diseases. [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]

This study reports the development process and psychometric testing of the safe environment in psychiatric wards instrument. In this mixed-methods study, the concept of a safe environment was explained with a qualitative study by performing semi-structured interviews with patients and staff and ward observation. Then, the items of the instrument were designed using qualitative data and a literature review. Content and construct validity, internal consistency, stability, and inter-rater agreement were evaluated. This study produced an instrument consisting of two sections. The first section was a scale (α =.920). Exploratory factor analysis of the scale identified two dimensions of "engagement" (α =.931) and "perception" of the physical environment (α =.760). The second section was a checklist with two dimensions, "accident-free living environment" and "staff empowerment." The intra-class correlation coefficients for the scale and checklist were.912 and.809, respectively. This study suggests that this instrument is a valid and reliable tool to assess safety in psychiatric wards. [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: Compassionate care is emphasized within professional ethics codes for nursing and is a key indicator of care quality. The purpose of the present study is to develop and assess the psychometric properties of a compassionate care instrument for nurses. Methods: This methodological study was carried out in two phases -qualitative and quantitative-from February 2016 to October 2018. In the qualitative stage of the study, a content analysis approach was used to establish the concept of compassionate care through interviews with nurses, patients, and family caregivers. The initial draft of the questionnaire was developed based on the qualitative findings and a subsequent review of the literature. In the second phase, the psychometric properties of the questionnaire were assessed for validity and reliability. Data analysis was performed using descriptive and inferential statistics in SPSS v.16. Results: From the results of the qualitative phase and review of literature, 80 items were extracted. In the quantitative phase, after evaluation of the face and content validity, 40 items were kept. After measurement of the construct validity, 28 items whose factor loading was above 0.4 were retained. Measurement of convergent validity showed a moderate correlation between the questionnaire and the nurses' caring behaviors scale (r = 0.67, P = 0.01). The reliability of the 28-item questionnaire was tested by measuring its Cronbach's alpha coefficient and intra-class correlation coefficient which were found to be 0.91 and 0.94 for the whole questionnaire, respectively. Conclusion: The questionnaire has enough validity and reliability to be used for measuring the nurses' compassionate care. Therefore, the instrument can be used to measure and record the quality of nursing care. [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: 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]

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: 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]

Purpose: This study was done to develop and evaluate the psychometric properties of the Elderly Hypertension Self-Care Index. Methods: This was an exploratory mixed method study. Items were developed through conducting a qualitative study with conventional content analysis approach and comprehensively reviewing the existing literature. Then, the developed index was assessed for face, content, and construct validity as well as reliability. Results: Analyses identified four themes of self-care: intelligent acceptance, self-actualization in the pass of the disease, effective supporters, and destructive constraints. Exploratory factor analysis revealed that only 28 items were appropriate which were loaded on six factors, accounting for 45.035% of the total variance of hypertension self-care. Cronbach's alpha and test–retest intraclass correlation coefficients of the index were 0.80 and 0.96, respectively. Conclusion: The Elderly Hypertension Self-Care Index showed that it is a valid and reliable index in the elderly health context; and can be used for self-care assessment among elderly people with hypertension. [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]

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: Food insecurity has a considerable impact on the social, physical, and psychological well-being of people and there is no food security assessment tool specific for Iranians. This study aimed to develop and assess the validity and reliability of an Iranian-specific food security questionnaire. Methods: The food security questionnaire was developed by five food security specialists by evaluating all available questionnaires (not specific to Iranians) in terms of applicability to Iranians. Furthermore, questions were developed from interviews conducted with ten families who were below the poverty threshold to understand how they described their food status. This questionnaire was administered to 200 households from different parts of Isfahan, Iran. Households were selected by multi-stage cluster randomized sampling. Households were categorized into 4 groups based on their score on the questionnaire; food secure (total score 0), mildly (total score 1-2), moderately (total score 3-7) and severely food insecure (total score 8-18). In the second stage of the study, 25 households were selected from each food security status group to evaluate the reliability and validity of the questionnaire by assessing sociodemographic, anthropometric, nutritional and biochemical parameters. Results: The prevalence of food security and mildly, moderately and severely food insecure were 24%, 33%, 27% and 16%, respectively. Content and face validity of the questionnaire was evaluated by experts, and latent class analysis confirmed construct validity. The developed questionnaire had good internal consistency (Cronbach's α = 0.91) and showed significant differences in hypothesized directions in food security status for sociodemographic factors. The prevalence of mothers, but not fathers or children, who had hemoglobin, mean corpuscular volume (MCV) and hematocrit less than the normal ranges increased (P = 0.04, P = 0.02, P = 0.02; respectively) with food insecurity. Conclusion: Our findings indicated that the developed questionnaire was a valid and reliable instrument to measure household food insecurity of Iranian families. [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]