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Summary: Restless legs syndrome (RLS) is a common neurological disorder characterised by an urge to move arms and legs, usually associated with discomfort, pain, motor restlessness, and sleep disturbance. An individually adapted treatment is needed but difficult to optimise, which makes shared decision‐making (SDM) important. However, brief validated instruments on how patients with RLS perceive their involvement in treatment decisions are lacking. Therefore, the aim was to validate two instruments, SURE (Sure of myself, Understand information, Risk–benefit ratio, Encouragement, i.e., to assess decisional conflict) and CollaboRATE (brief patient survey focused on SDM, i.e., to assess SDM), in patients with RLS. A cross‐sectional design, including 788 participants with RLS (65% females, mean [SD] age 70.8 [11.4] years) from a national patient organisation for RLS, was used. A postal survey was sent out to collect data regarding weight, height, comorbidities, demographics, and RLS‐related treatment data. The following instruments were included: the SURE, CollaboRATE, Restless Legs Syndrome‐6 Scale, and eHealth Literacy Scale. Confirmatory factor analysis and Rasch models were used to assess the validity and reliability of the SURE and CollaboRATE. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age, gender, and medication groups were assessed. The SURE and CollaboRATE were both identified as unidimensional instruments with satisfactory internal consistency. No DIF across age and gender was identified, while significant DIF was observed for both the SURE and CollaboRATE regarding medication use categories. However, both the SURE and CollaboRATE are potential instruments to be used in research, but also as reflection tools by healthcare professionals, patients, and students to explore and assess SDM, and support its development in clinical care. [ABSTRACT FROM AUTHOR]

Health literacy is important for health behavior engagement. Therefore, it is important to have a good instrument assessing health literacy with a theoretical framework. The present study aimed to examine the measurement invariance and differential item functioning (DIF) of a newly developed health literacy instrument; that is, the Health Literacy Instrument for Adults (HELIA). Confirmatory factor analysis (CFA) and Rasch models were used to examine the data collected from a large Iranian sample (N = 9678; 67.3% females; mean age = 36.44 years). All the participants completed the HELIA. CFA was used to examine if the HELIA had a five-factor structure (including reading, access to information, understanding, appraisal, and decision making/behavioral intention factors) and multigroup CFA to examine if the five-factor structure of HELIA was invariant across gender, educational level, accommodation, and age subgroups. Rasch models were used to examine whether each factor of HELIA was unidimensional and DIF contrast in Rasch to examine if the HELIA items were interpreted similarly across the aforementioned subgroups. The CFA results supported the five-factor structure of HELIA, and the Rasch models verified that each HELIA factor is unidimensional. Additionally, multigroup CFA supported the measurement invariance of HELIA across the following subgroups: male vs. female; highly educated vs. poorly educated; city residents vs. suburban residents; and younger age vs. older age. The DIF contrasts in the Rasch models additionally showed that there are no substantial DIF items in the HELIA across aforementioned subgroups. Therefore, the HELIA is a feasible and comprehensive instrument assessing health literacy across different populations in Iran. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Osteoarthritis is a serious and prevalent health problem that creates considerable disability when it involves the knee or hip joints. The aim of the study was to adapt and validate the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire for use in a Persian‐speaking population. Methods: A total of 434 patients were recruited. The forward‐backward translation process was used to develop the Persian version. Participants were asked to complete the Short Form 12 Health Survey, EuroQoL, visual analog scale for pain and the OAKHQOL questionnaire. Reliability was assessed using Cronbach's alpha and the test‐retest method. The structure of the questionnaire was evaluated by exploratory factor analysis. The OAKHQOL was correlated with related measures to establish construct validity. Convergent and discriminant validity were examined with demographic and clinical variables. Comparisons were performed between patients with different severity grades of osteoarthritis. Results: The mean age of participants was 61.9 (SD 12.1) and the majority were female (91.2%). Principal component analysis demonstrated a five‐factor solution that explained 58.4% of the variance. Cronbach's alpha coefficients ranged between 0.74 and 0.89 for all domains of the questionnaire with the exception of the social activities domain. The kappa for test‐retest reliability was 0.85. The OAKHQOL demonstrated good discriminative and convergent validity. Construct validity was established by determining significant relationships between related measures. The results of known‐groups validity indicated different scores on most domains (P < 0.001) across different levels of disease severity. Conclusion: The questionnaire may be used as a valid and reliable measure for assessing quality of life among Iranian patients with lower limb osteoarthritis. [ABSTRACT FROM AUTHOR]

Purpose: There are only a few measures to assess quality of life among patients with liver disorders. The aim of this study was to determine the psychometric properties of the Liver Disease Symptom Index Version 2.0 (LDSI 2.0), a disease specific measure of health-related quality of life (HRQOL), in Persian-speaking patients with chronic hepatitis B. Method: Using a cross-sectional design, 312 patients were recruited. Data were collected from the patients using the LDSI 2.0, Chronic Liver Disease Questionnaire, and EuroQol. Convergent and discriminant validity were investigated. Known-groups validity and factor structure of the scale were also determined. Receiver operating characteristics was used to discriminate patients based on their general health status. Results: Significant correlations were found between HRQOL measures. Disease duration, disease stage, and serum aspartate aminotransferase differentiated patients. Factor analysis determined a seven-factor solution that explained 70% of the total variance. Area under the curve in receiver operating characteristics analysis was 0.706; 95% confidence interval = [0.648, 0.764]. Conclusions: The LDSI2.0 is an appropriate HRQOL scale for use among Iranian patients with chronic hepatitis B based on its solid psychometric properties in this population. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to establish the psychometric properties of the Rapid Estimate of adult Literacy in Dentistry-99 ( REALD-99) in the Persian language for use in an Iranian population ( IREALD-99). Methods A total of 421 participants with a mean age of 28 years (59% male) were included in the study. Participants included those who were 18 years or older and those residing in Quazvin (a city close to Tehran), Iran. A forward-backward translation process was used for the IREALD-99. The Test of Functional Health Literacy in Dentistry ( TOFHLiD) was also administrated. The validity of the IREALD-99 was investigated by comparing the IREALD-99 across the categories of education and income levels. To further investigate, the correlation of IREALD-99 with TOFHLiD was computed. A principal component analysis ( PCA) was performed on the data to assess unidimensionality and strong first factor. The Rasch mathematical model was used to evaluate the contribution of each item to the overall measure, and whether the data were invariant to differences in sex. Reliability was estimated with Cronbach's α and test-retest correlation. Results Cronbach's alpha for the IREALD-99 was 0.98, indicating strong internal consistency. The test-retest correlation was 0.97. IREALD-99 scores differed by education levels. IREALD-99 scores were positively related to TOFHLiD scores ( rh = 0.72, P < 0.01). In addition, IREALD-99 showed positive correlation with self-rated oral health status ( rh = 0.31, P < 0.01) as evidence of convergent validity. The PCA indicated a strong first component, five times the strength of the second component and nine times the third. The empirical data were a close fit with the Rasch mathematical model. There was not a significant difference in scores with respect to income level ( P = 0.09), and only the very lowest income level was significantly different ( P < 0.01). Conclusions The IREALD-99 exhibited excellent reliability on repeated administrations, as well as internal consistency. The IREALD-99 can be used for the basic screening of oral health literacy among the Iranian population. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to cross-culturally translate the Qualiveen-30 into Persian and validate it in Iranian patients with spinal cord injury ( SCI) and multiple sclerosis ( MS). Methods This was a cross-sectional prospective validation study. The translation and cross-cultural adaptation of the original questionnaire was performed in accordance with published guidelines. A total of 154 patients with SCI or MS who suffered from lower urinary symptoms for at least 6 months were asked to complete the questionnaire in the first visit to the clinic and after 3 weeks. To assess reliability, the internal consistency was assessed by Cronbach's alpha coefficient, and validity was assessed using convergent and discriminant validities. Results The Cronbach's alpha coefficients for the Qualiveen-30 at two assessments ranged from 0.82 to 0.95, indicating a good internal consistency for the questionnaire. There were high amounts of test-retest reliability for the Qualiveen questionnaire and each of its domains (ICC > 0.90). Also, Qualiveen and its domains had a moderate to high correlation with the International Consultation on Incontinence Questionnaire- Urinary Incontinence Short Form ( ICIQ-UI SF) (0.36 < r < 0.57) and SF-12 MCS (−0.51 < r < −0.11) and SF-12 PCS (−0.29 < r < −0.19), indicating good convergent validity. Comparison of Qualiveen in groups of income, education and manner of voiding revealed the high discriminative power of this instrument. The hypothesized four factor structure was approved using confirmatory factor analysis ( CFA). Conclusions In general, the Persian version of Qualiveen-30 performed is a reliable and valid measure for the evaluation of the quality of life related to lower urinary symptoms in patients with SCI or MS. [ABSTRACT FROM AUTHOR]

Background: Smoking poses varions adverse effects on human health. Unfortunately, there is still a large population of smokers worldwide. Well understanding the potential consequences of smoking by the general public may prevent the initiation of smoking behavior and help the smokers to quit. Aims: The aim of this study was to cross-culturally translate and validate the Persian version of Smoking Consequences Questionnaire (SCQ). Design and methods: The backward-forward translation technique was used to setup the scales among 40 smokers. Using a convenient sampling method, 400 smokers were recruited from a smoking cessation department in Qazvin city. Internal consistency and test-retest method was used to assess reliability. Cronbach's Alpha and Intraclass Correlation Coefficients (ICC) were used to assess Internal Consistency and Test-retest reliability. Predictive validity of Nicotine Dependence was measured by correlation between SCQ and Fagerstrom Test. The scale construction was verified by Factor Analysis (explanatory and confirmatory). Data are expressed as mean ± SD, which were analyzed by SPSS. Results: The average age of participants was 40 ± 0.6 (376 male, 24 female). More than half of the participants smoked between 11 and 20 cigarettes per day. The Cronbach's alpha coefficients test showed an acceptable internal consistency (ranged from 0.70 to 0.93). All items of the SCQ were significantly correlated with each other at two assessments with 2-week interval ( r ranged from 0.76 to 0.93). The ICC ranged from 0.73 to 0.89 for all factors ( p < 0.05). The scale well fitted the data (GFI = 0.97, RMSEA = 0.064). There were 10 factors on the scale which explained ∼78% of the variance. Conclusion: Our results suggest that Persian SCQ is a valid and reliable application among Iranian smokers. The scales can nicely recognize the smokers' views on health consequences across different languages and cultures, which is highly recommended in general public education. [ABSTRACT FROM AUTHOR]

Objective: Good personal hygiene (PH) behavior is recommended to prevent contagious diseases, and members of military forces may be at high risk for contracting contagious diseases. The aim of this study was to develop and test a new questionnaire on PH for soldiers. Methods: Participants were all male and from different military settings throughout Iran. Using a five-stage guideline, a panel of experts in the Persian language (Farsi) developed a 21-item self-administered questionnaire. Face and content validity of the first-draft items were assessed. The questionnaire was then translated and subsequently back-translated into English, and both the Farsi and English versions were tested in pilot studies. The consistency and stability of the questionnaire were tested using Cronbach's alpha and the test-retest strategy. The final scale was administered to a sample of 502 military personnel. Explanatory and confirmatory factor analyses evaluated the structure of the scale. Both the convergent and discriminative validity of the scale were also determined. Results: Cronbach's alpha coefficients were >0.85. Principal component analysis demonstrated a uni-dimensional structure that explained 59 % of the variance in PH behaviors. Confirmatory factor analysis indicated a good fit (goodness-of-fit index = 0.902; comparative fitness index = 0.923; root mean square error of approximation = 0.0085). Conclusions: The results show that this new PH scale has solid psychometric properties for testing PH behaviors among an Iranian sample of military personnel. We conclude that this scale can be a useful tool for assessing PH behaviors in military personnel. Further research is needed to determine the scale's value in other countries and cultures. [ABSTRACT FROM AUTHOR]

Introduction. Female sexual dysfunction has a known impact on the quality of life. Aim. The purpose of this study was the translation and validation of an Iranian version of the Sexual Quality of Life questionnaire- Female ( SQOL- F) in Iranian women. Methods. A population sample of N = 2,675 women aged 17-67 years from Qazvin City of Iran and two clinical population samples (women with sexual dysfunctions N = 295 and women with type 2 diabetes N = 449) participated in the study. A self-constructed demographic questionnaire, the SQOL- F, the Short Form Health Survey ( SF-36), and the Female Sexual Function Index ( FSFI) were used for data collection. Main Outcome Measures. Internal consistency and test-retest reliability were examined. Correlations between the SQOL- F, SF-36, and FSFI were assessed with convergent validity. Furthermore, known-groups comparison analysis was conducted to compare differences in SQOL- F scores between healthy women and those with sexual problems and diabetes. Confirmatory factor analysis assessed the factor structure of the SQOL- F. Results. Cronbach's alpha ranged from 0.84 to 0.98. Significant correlations between the SQOL- F, SF-36, and FSFI scores were found (ranging from r = 0.4 to r = 0.72). The SQOL- F scores were significantly different between women with and without a clinical condition ( P < 0.05). A unifactorial model provided the best fit to the data. Conclusion. The questionnaire represents a suitable measure to assess sexuality-related quality of life to sexual function in healthy women, as well as in women suffering from a chronic medical condition. Application of the scale to other clinical samples needs to be further explored. [ABSTRACT FROM AUTHOR]

Background and Aim: To evaluate the psychometric properties of the national Eye Institute refractive error correction quality of life questionnaire (NEI-RQL-42) among Iranian patients with refractive errors. Materials and Methods: Two samples of patients (n1 = 296, n2 = 95) were consecutively selected from the eye clinic of the Boo-Ali Hospital, Qazvin. A forward-backward procedure was conducted to translate and cross-culturally adapt the Iranian version of the NEI-RQL-42. A homogeneity, stability, and reliability test was conducted for the first sample after a two-week interval. Convergent validity was computed using the correlation between the NEI-RQL-42 subscale scores, National Eye Institute-Visual Functioning Questionnaire (NEI-VFQ-25), and the Short Form-36 (SF-36). Furthermore, Known-group analysis was performed, to determine the discriminant validity between the subgroups of patients with hyperopia, emmetropia, and myopia. Responsiveness to clinical change was tested by administering NEI-RQL-42 on the second sample that was scheduled for surgery. Results: Homogeneity was satisfactory with the Cronbach's alpha coefficients ranging between 0.70 and 0.92. The 13 subscales of the NEI-RQL-42 showed a considerable stability in intra-class-correlation (ICC) ranging between 0.70 and 0.89. Positive correlation coefficients were found among all subscales of the NEI-RQL-42 and the other quality-of-life instruments (NEI-VFQ-25 and SF-36). The NEI-VFQ-25 displayed excellent discriminant validity to differentiate the subgroups of patients, and was found to be responsive to change after the surgical correction at three months. Conclusions: The Iranian version of the NEI-RQL-42 is a valid and reliable instrument to assess refractive error correction quality-of-life in Iranian patients. Moreover this questionnaire can be used to evaluate the effectiveness of interventions in patients with refractive errors. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The objective of this study was to translate and validate an Iranian version of the Diabetes Quality of Life (DQOL) questionnaire in an Iranian population of males and females with a diagnosis of type 2 diabetes. Materials and Methods: A total of 503 patients with type 2 diabetes were recruited from nine diabetes clinics across several Iranian cities. A standard backward and forward translation procedure was used to convert the English version of the DQOL into the Iranian language (Persian). Internal consistency, convergent validity, known group comparison, confirmatory factor analysis (CFA) and factorial invariance were applied for the assessment of psychometric properties of the translated version. Results: The translated version of the DQOL showed adequate internal consistency reliabilities for all subscales (Cronbach's α >0.70). CFA confirmed the underlying domain structure to be the same as for the original English version, therefore supporting the factorial validity of the translated questionnaire. In addition, questionnaire responsiveness showed good sensitivity to interventions. Conclusions: In conclusion, the translated Iranian version of DQOL has shown high internal reliability and good construct validity, and can potentially be applied as an assessment tool for health-related quality of life in patients with diabetes. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2012.00217.x, 2012) [ABSTRACT FROM AUTHOR]

Summary Restless legs syndrome (RLS) is a highly prevalent condition that significantly disrupts sleep and causes reduced quality of life. While previous RLS research has mainly focused on the pharmacological treatment, this study presents the first instrument to measure self‐care, the RLS‐Self‐care Behaviour questionnaire (RLS‐ScBq). Self‐care, defined as an active decision‐making process, can empower patients to effectively participate in their own healthcare through awareness, self‐control, and self‐reliance to cope with their disease. Self‐care can in a RLS context include actions such as physical exercise, meditation, and massage. Hence, the aim of this study is to explore the psychometric properties of the RLS‐ScBq in patients with RLS. A cross‐sectional design, including 788 patients with RLS (65% women, mean age 70.8 years, [standard deviation (SD) =11.4]) was used. Sociodemographics, comorbidities, and RLS‐related treatment data, including insomnia symptoms (i.e., Insomnia Severity Index), daytime sleepiness (i.e., Epworth Sleepiness Scale) and RLS symptoms (i.e., RLS‐6 scale) were collected. The validity and reliability of the RLS‐ScBq were investigated using exploratory factor analysis and Rasch models. The two‐factor solution (i.e., physical, and mental actions) showed an explained variance of 32.33% for The Self‐care Behaviour Frequency part and 36.28% for The Benefit of Self‐care Behaviour part. The internal consistency measured by Cronbach's α was 0.57 and 0.60, and McDonald's ω was 0.60 and 0.67, respectively. No differential item functioning was identified for gender, age, insomnia, daytime sleepiness, or RLS severity. The eight‐item RLS‐ScBq can serve as a tool enabling healthcare personnel to explore use and benefit of self‐care activities in patients with RLS. [ABSTRACT FROM AUTHOR]