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Pershang Sharifpour,1 Fazel Dehvan,2 Sahar Dalvand,3 Reza Ghanei Gheshlagh2 1Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran; 2Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranCorrespondence: Reza Ghanei GheshlaghClinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, IranTel +98 9144050284Email rezaghanei30@gmail.comIntroduction: Obstructive sleep apnea (OSA) is a common risk factor for metabolic syndrome (MS) that increases the chance of cardiovascular disease, stroke, and mortality. Many studies have been conducted on this matter, but the results are still conflicting. The aim of the present study was to examine the relationship between metabolic syndrome (MS) and obstructive sleep apnea (OSA) in Iranian patients with type 2 diabetes (T2D).Patients and Methods: This matched case–control study was conducted with 190 patients with T2D in Sanandaj, Iran. The data were selected using the demographic questionnaire, clinical and anthropometric measures, the Berlin Questionnaire (BQ), and the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III). Participants were divided into two groups of high risk of OSA (experimental) and low risk of OSA (control). The data were analyzed using Stata, version 14.Results: The frequency of MS was higher in the OSA group than the control group (81.1% vs 70.5%), but the group difference was not statistically significant (p=0.127). The results of crude and age-sex adjusted logistic regression analysis revealed no significant association between OSA and the other variables under study (P> 0.05). Sensitivity analysis and external adjustment for BMI showed no significant relationship between OSA and the other variables under study (P=0.319).Conclusion: In the present study, no significant association was found between metabolic syndrome (MS) and obstructive sleep apnea (OSA) in patients with T2D; therefore, more studies should be conducted on this subject.Keywords: diabetes, sleep apnea, metabolic syndrome

Hayedeh Rezaei,1 Ali Faiek M Saeed,2 Kamel Abdi,3 Abbas Ebadi,4 Reza Ghanei Gheshlagh,5 Amanj Kurdi6 1Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 2Department of Management, College of Business Administration and Economic, Bayan University, Erbil, Kurdistan, Iraq; 3Nursing Department, Faculty of Medicine, Komar University of Science and Technology, Sulimaniya City, Kurdistan Region, Iraq; 4Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; 5Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran; 6Pharmacoepidemiology and Pharmacy Practice, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK, Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, IraqCorrespondence: Reza Ghanei GheshlaghSocial Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, IranTel +98 9144050284Email rezaghanei30@gmail.comIntroduction: Pain management is a complex process that is managed through a multi-disciplinary team in which nurses have a significant role. The present study aimed at translating and examining the psychometric properties of the Pain Management Self-Efficacy Questionnaire (PMSEQ) among Iranian nurses.Methods: This was a cross-sectional, methodological study conducted in 2019 among nurses working in two teaching hospitals in Sanandaj (Tohid and Kosar). The participants were selected using a convenience sampling method. Responsiveness; interpretability; and face, content, and construct validities were examined using exploratory and confirmatory factor analyses. In addition, internal consistency and stability were examined using the Cronbach’s alpha and test-retest, respectively.Results: Overall, 410 nurses (210 for the EFA and 200 for the CFA) were included in the sample. In the exploratory factor analysis, two factors of comprehensive pain assessment and pain management with eigenvalues of 6.36 and 1.91, respectively, were extracted. The two factors together explained 56.64% of the variance of nurses’ pain management self-efficacy. The confirmatory factor analysis indicated that the model had a moderate fit to the data (RMSEA: 0.12; NFI: 0.84; NNFI: 0.86; CFI: 0.88; IFI: 0.88; RFI: 0.81; GFI: 0.76; AGFI: 0.69; PGFI: 0.59; RMR: 0.09; standardized RMR: 0.09). Total questionnaire and the two factors (i.e. comprehensive pain assessment and pain management) had internal consistency coefficients of 0.891, 0.876, and 0.803, respectively.Conclusion: The Farsi version of PMSEQ had good internal consistency and reliability, as well as content and construct validity, and can be used in future studies.Keywords: validation, pain, self-efficacy, pain management

Abbas Ebadi,1 Fariba Ebtekar,2 Naser Parizad,3 Abdorrahim Afkhamzadeh,4 Sahar Dalvand,5 Reza Ghanei Gheshlagh4 1Behavioral Sciences Research Center, Life-Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Teheran, Iran; 2Department of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran; 4Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran; 5Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranCorrespondence: Reza Ghanei GheshlaghSocial Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj 575611-5111, IranTel +98 9144050284Fax +98 36235450Email rezaghanei30@yahoo.comBackground and aim: Memory impairment in the elderly has a high prevalence and can affect their performance, interactions and quality of life. A valid and reliable questionnaire is required to investigate the changes in the memory of the elderly. The aim of this study was to investigate the psychometric properties of the Persian version of the Memory Impact Questionnaire (MIQ) in the elderly.Methods: In this methodological study, 361 elderly people (181 people for exploratory factor analysis and 180 people for confirmatory factor analysis) were selected via convenience sampling. This questionnaire was translated based on the World Health Organization’s (WHO) guidelines. Construct validities were assessed through exploratory and confirmatory factor analyses. Its reliability was also assessed using Cronbach’s alpha coefficient.Results: In the exploratory factor analysis, three factors of lifestyle restrictions, positive coping, and negative emotion were extracted that were able to explain 54.04% of the total variance of the impact of memory change in the elderly. Confirmatory factor analysis confirmed the goodness of fit of the three-factor model of MIQ (RMSEA: 0.083; GFI: 0.97; NFI: 0.94; IFI: 0.97; PNFI: 0.86; AGFI: 0.75). The reliability of the “lifestyle restrictions”, “negative emotion” and “positive coping” factors was found to be 0.89, 0.74, and 0.67, respectively, using Cronbach’s alpha coefficient.Conclusion: The Persian version of the MIQ is simple and practical and has acceptable reliability and validity that can be used to measure memory changes in the Iranian elderly.Keywords: psychometrics, elderly, memory

Tayebeh Hasan Tehrani,1 Abbas Ebadi,2,3 Zahra Mokhtari,4 Reza Ghanei Gheshlagh5 1Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Teheran, Iran; 3Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran; 4School of Nursing Midwifery, Tehran University of Medical Sciences, Tehran, Iran; 5Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, IranCorrespondence: Reza Ghanei GheshlaghGheshlagh Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, IranTel +98 91 4405 0284Email rezaghanei30@yahoo.comBackground: Some clinical staff nurses show unprofessional behavior toward nursing students in clinical nursing education that can negatively affect their self-esteem and professionally. Examination of uncivil behavior toward nursing students requires a valid and reliable instrument. Therefore, the goal of the present study was to examine the psychometric properties of the Persian version of the Uncivil Behavior in Clinical Nursing Education (UBCNE) among nursing students.Methods: In this methodological study, a total of 558 nursing students participated who were selected using a convenience sampling method, and were asked to complete the Persian version of the UBCNE. The UBCNE was translated based on the WHO guidelines. The face, content, and construct (using explanatory and confirmatory factor analysis) validities were assessed. In addition, internal consistency was assessed using the McDonald’s omega and the Cronbach’s alpha coefficient, and stability was assessed using the test-retest method.Results: Explanatory factor analysis led to two factors, including Dismissive Behavior and Exclusionary Behavior that together explained 62.1% of the total variance of uncivil behavior. In the confirmatory factor analysis, the comparative and parsimonious fit indices were very good, but the absolute fit indices were poor (RMSEA=0.116, GFI=0.98, NFI=0.97, AFGI=0.83, PNFI=0.78). Reliability of the UBCNE was found to be 0.93 and 0.97, using the Cronbach’s alpha coefficient and the test-retest method, respectively.Conclusion: The two-factor structure of the UBCNE has good validity and reliability among nursing students. Therefore, it can be used to assess civil behavior in clinical nursing education.Keywords: psychometric property, uncivil behavior, factor analysis, nursing student, Iran

Mehdi Rezaei,1 Sina Valiee,2 Mohammad Tahan,3 Fariba Ebtekar,4 Reza Ghanei Gheshlagh21Department of Social Sciences, Payame Noor University (PNU), Tehran, Iran; 2Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Young Researchers and Elite Club, Birjand Branch, Islamic Azad University, Birjand, Iran; 4Department of Midwifery, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, IranBackground: Patients with type-2 diabetes have poor adherence to the therapeutic regime. It can result in various complications in body systems associated with undesirable metabolic control.Purpose: The present study aimed to explore the inhibitors of medication adherence in patients with type-2 diabetes.Patients and methods: This was a qualitative study using a conventional content analysis method. Participants were 12 patients with type-2 diabetes referred to the diabetes unit in Saghez, Kurdistan Province in 2015. The purposive sampling method was used with a maximum variation in sampling, and data collection was continued until data saturation was achieved. Semi-structured interviews were used for data collection. Interviews were recorded and immediately transcribed verbatim.Results: Data analysis led to the development of four main categories including disbelief in medical explanatory/prescriptive knowledge, lived experiences of the disease, challenges of everyday life, and interactive/economic challenges. The main inhibitors were the patient’s understanding of his/her own physical status and strategies used for maintaining the internal balance. Healthcare providers need to take patients’ perceptions into account when they are prescribing medicinal diets. Another inhibitor was the incidents of everyday life, including economic and social challenges, and interactions to receive education and skills for living with the disease.Conclusion: Beliefs of the medical team and patients should be brought closer to each other, and patients’ trust in the medical team should be increased. Nurses should consider the unique experience of every patient when giving healthcare recommendations, and try to limit the existing challenges as much as possible.Keywords: medication adherence, diabetes mellitus, content analysis

Mahboubeh Nazari,1 Esmaeil Mohammadnejad,2 Sahar Dalvand,3 Reza Ghanei Gheshlagh4,51Department of Nursing, Garmsar Branch, Islamic Azad University, Garmsar, Iran; 2Department of Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; 3Biostatistics Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 4Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 5Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, IranBackground: Iron deficiency anemia is a prevalent condition among children in developing and developed countries that leads to impaired development, activity intolerance, behavioral changes, irritability, and reduced learning ability. The studies conducted in Iran have reported different prevalence rates for this condition. This systematic review and meta-analysis were aimed at estimating the prevalence of iron deficiency anemia in Iranian children under 6 years of age.Methodology: Persian and English articles published from 2001 to 2018 were collected. The search process was conducted in national and international databases, including SID, MagIran, PubMed, Scopus, and Web of Science, using the following keywords and their combinations: Iron, Iron deficiency, Iron deficiency anemia, Ferritin, Child, Children, and Iran. The data were analyzed using the meta-analysis and random effects model. Heterogeneity was assessed using the I2, statistic. All analyses were performed using the STATA software, version 12.Results: Analysis of six selected articles with a total sample size of 1,700 showed that the prevalence rates of iron deficiency and iron deficiency anemia in the Iranian children under 6 years of age were 27.7% (95% CI: 11.9–43.5) and 18.2% (95% CI: 14.3–22), respectively. In addition, the prevalence of iron deficiency anemia was higher in boys (17.7% with 95% CI: 5.9–29.5) than in girls (14.4% with 95% CI: 4.5–24.2).Conclusion: About one-fifth of Iranian children under the age of 6 years suffer from iron deficiency anemia. Identification of those at risk of developing this condition with the goal of prevention, diagnosis, and treatment seems to be an important and necessary task.Keywords: anemia, iron deficiency anemia, iron, meta-analysis, Iran, prevalence

Tayebeh Jamshidi,1 Reza Ghanei Gheshlagh,2,3 Fariba Ebtekar,4 Sahar Dalvand,5 Amir Vahedian Azimi,6 Amanj Kurdi7 1Psychiatric Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 4Department of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 5Department of epidemiology and Biostatistics, school of Public health, Tehran University of Medical sciences, Tehran, Iran; 6Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran; 7Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK Abstract: Patients with rheumatoid arthritis (RA) are prone to depression due to several factors related to their RA, including chronic and persistent pain, functional disability, economic constraints, and the side effects of RA medication. Previous Iranian studies showed conflicting and inconclusive findings regarding the prevalence of depression among RA patients. Therefore, this systematic review and meta-analysis was conducted to estimate the true prevalence of depression in Iranian patients with RA. Search for eligible articles was performed using the keywords of depression, depressive disorder, dysthymic disorder, major depressive disorder, RA, and Iran, and their possible combinations in the following databases: Scientific Information Database, MagIran, Web of Science/ISI, PubMed, and Scopus. The search was restricted to articles published in Persian and English languages. The meta-analysis was performed using the random effects model, and the data were analyzed using the STATA software version 12. Overall, six articles were selected; the overall prevalence of depression among the Iranian patients with RA was 65.58% (95% CI: 56.53%–74.62%). There were no significant relationships between the prevalence of depression and articles’ methodological quality and year of publication, participants’ age, sample size, and duration of disease. More than half of RA patients suffer from depression. The overlap between the physical symptoms of RA and depression in this group of patients makes it difficult to correctly diagnose depression; therefore, initiative and efforts are required to improve the identification of early depression symptoms in RA patients in order to effectively manage their depression. Keywords: depression, Iran, meta-analysis, prevalence, rheumatoid arthritis

Sahar Dalvand,1 Reza Ghanei Gheshlagh,2,3 Amanj Kurdi4 1Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 3Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; 4Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK Background: Poststroke depression (PSD) is the most common and important neuropsychiatric consequences of stroke, which can result in longer hospital stay, compromise the effectiveness of rehabilitation, and reduce the patients' quality of life. However, Iranian studies have reported different and conflicting prevalence rates for PSD.Objective: The present systematic review and meta-analysis aimed to evaluate the overall prevalence of PSD in Iranian patients.Patients and methods: A systematic search was conducted in 2018 for Persian or English articles on PSD, published in the Scientific Information Database (SID), MagIran, PubMed, Scopus, and Web of Science, using the following keywords: depression, depressive disorder, stroke, cerebrovascular disorder, and Iran and all of their possible combinations. Heterogeneity across the studies was evaluated using the Cochran's Q test. According to the heterogeneity results, a random effects model was used to estimate the overall prevalence of PSD. The data were analyzed using the Stata 12 software. Results: Overall, six articles with a total sample size of 641 patients were included in the analysis. The overall prevalence of PSD in Iran was 46.9% (95% CI: 30.1-63.7). In addition, the prevalence of PSD was higher in women (50.4%, 95% CI: 17.9-82.9) than in men (29.5%, 95% CI: 17.2-41.8). According to the results of univariate meta-regression, there was a significant relationship between PSD prevalence and sample size (P=0.010).Conclusion: Around half of the stroke patients in Iran suffer from PSD. Given the overlap between neurological symptoms of stroke and depression, efforts should be made to quickly and accurately diagnose depression so that it can be effectively managed with minimum complications. Keywords: depression, stroke, outbreak, systematic review, meta-analysis, Iran

Sahar Dalvand,1 Abbas Ebadi,2 Reza Ghanei Gheshlagh3,4 1Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 2Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran; 3Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 4Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Introduction: Inadequate knowledge on pressure injury (PI) can have a detrimental effect on preventive care strategies. The aim of this study was to assess the overall knowledge of nurses on PI prevention based on their scores on the Pressure Ulcer Knowledge Assessment Tool (PUKAT) and its subscales in different settings.Methods: In this systematic review and meta-analysis, databases including Web of Science, Science Direct, Google Scholar, PubMed, and Scopus were searched, using the following keywords: Pressure Ulcer, Pressure injury, Bedsore, Pressure Sore, Decubitus Ulcer, knowledge, and their possible combinations. Based on heterogeneity between the studies, the data were analyzed using a random effects model. All of the analyses were performed using STATA v.12 software.Results: In all three groups (nurses, assistant nurses, and nursing students), the lowest knowledge scores were for prevention measures to reduce the amount of pressure/shear. Nurses’ knowledge (55.4%, 95% CI: 42.4–68.4) was higher than that of nursing students (52.7%, 95% CI: 3–49.56) and assistant nurses (42.2%, 95% CI: 16.4–68).Conclusion: The overall knowledge of nurses on PI prevention was lower than the recommended level (60%). Regular training courses and review of PI prevention guidelines can be useful in updating the knowledge of nurses, especially assistant nurses and nursing students on PI prevention. Keywords: pressure injury, knowledge on pressure injury prevention, nurse

Background: Considering the vital role of nurses in responding to disasters, it is essential to measure their readiness with a valid and reliable tool. The present study aimed to assess the psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI)., Methods: This cross-sectional study was conducted between 2023 and 2024 among 200 nurses working at educational hospitals affiliated with one of the medical universities in Tehran, Iran. The Disaster Nursing Readiness Evaluation Index was translated into Persian. The face, content, and construct validity, as well as internal consistency, were analyzed., Results: In the exploratory factor analysis, five factors were extracted: practical skills for disaster response, adaptability to stressful situations at the disaster site, communication and cooperation skills for teamwork, emergency nursing skills, and effective coping with daily stress. Together, these factors accounted for 39.7% of the total variance. The results of the confirmatory factor analysis indicated that the extracted model fit well: CMIN/DF = 1.519, CFI = 0.889, RMSEA = 0.051. The Cronbach's alpha and McDonald's omega coefficients for the entire questionnaire were 0.890 and 0.891, respectively., Conclusions: Given that Iran is frequently exposed to disasters, it becomes essential to assess the preparedness of Iranian nurses using a valid and reliable scale. The availability of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI), which has undergone validation and reliability testing, facilitates accurate measurement of this concept., (© 2024. The Author(s).)

Death anxiety in cancer patients can cause and exacerbate mental disorders and affect the healing process and survival. In this study, percentage score of death anxiety among Iranian cancer patients was reported. The databases of Scopus, PubMed, ISI, MagIran, and Scientific Information Database were searched and 396 articles were retrieved. Twenty-three eligible studies were included in the analysis considering the inclusion criteria. Heterogeneity among selected studies was assessed through the Cochrane Q test and I 2 test. The percentage of death anxiety scores in Iranian patients with cancer was 59.91% (95% confidence interval: 51.57-62.24). The results of subgroup analysis showed that the percentage of death anxiety scores in patients with breast cancer was 67.55% (95% CI: 56.50-78.60) and in patients with other malignancies was 53.78% (95% CI: 50.20-57.36). Death anxiety is high among Iranian patients with cancer and counseling sessions to control and manage this challenge seems necessary., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: The aim of this study was to evaluate the psychometric properties of the Farsi version of the Surgical Anxiety Questionnaire., Design: Cross-sectional study., Methods: This study was performed on 402 patients who were candidates for elective surgery in Mashhad [East Iran) hospitals in winter 2021. After forward-backward translation, face and content validity checks were performed qualitatively. The construct validity was assessed by exploratory and confirmatory factor analysis. Data analysis was performed with SPSS 16 and AMOS 26., Findings: In exploratory factor analysis, two factors were extracted: concerns about surgery and anesthesia; and postdischarge concerns, which explained 52% of the total variance. The Cronbach's alpha for the entire questionnaire was 0.91 and for the subscales ranged from 0.80 to 0.87. The final model had a good fit as determined by confirmatory factor analysis., Conclusions: The Farsi version of the surgical anxiety questionnaire has acceptable validity and reliability. The existence of this scale measuring domain-specific anxiety allows for further research in this area., (Copyright © 2023 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

This study aimed to determine the correlation between spirituality, religious attitude, and resilience with death anxiety in cardiovascular patients in Sanandaj, Iran. This study was conducted on 414 cardiovascular patients, who were selected by convenience sampling method. Demographic information forms, Spiritual Well Being Scale, Golriz and Burhani's Religious Attitude, Connor-Davidson Resilience Questionnaire, and Templer's Death Anxiety Scale were used to collect data. Results indicated that compared to urban areas, living in rural areas significantly increased the average score of death anxiety by 0.55 points ( p = 0.026). Additionally, a one-unit increase in religious attitude and resilience significantly reduced the mean score of death anxiety by 0.05 ( p = 0.003) and 0.13 ( p <0.001) on average, respectively. Spearman rank correlation indicated that religious attitudes and resilience were inversely and significantly correlated with death anxiety. Therefore, providing counseling sessions with psychologists and clergy seems necessary for a favorable change in the state of death anxiety in these patients., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Background and Objectives: Antibacterial resistance (AMR) is a serious threat and major concern, especially in developing countries. Therefore, we aimed to determine phenotypical patterns of resistance to antibiotics in COVID-19 patients with associated bacterial infection in intensive care units., Materials and Methods: In this cross-sectional study, 6524 COVID-19 patients admitted for more than 48 h in the ICUs of Imam Khomeini Complex Hospital (IKCH) in Tehran from March 2020 to January 2022 were included in the study with initial diagnosis of COVID-19 (PCR test and chest imaging). Data were collected regarding severity of the illness, primary reason for ICU admission, presence of risk factors, presence of infection, length of ICU and hospital stay, microbial type, and antibiotic resistance. In this study, the pattern of antibiotic resistance was determined using the Kirby-Bauer disk diffusion method., Results: In this study, 439 (37.5%) were ventilator-related events (VAEs), and 46% of all hospitalized patients had an underlying disease. The most common microorganisms in COVID-19 patients were carbapenem resistant Klebsiella pneumoniae (KPCs) (31.6%), Escherichia coli ( E. coli ) (15.8%), and Acinetobacter baumannii ( A. baumannii ) (15.7%), respectively. Prevalence of vancomycin-resistant enterococci (VRE) and KPCs were 88% and 82%, respectively., Conclusion: A study on AMR surveillance is the need of the hour as it will help centers to generate local antibiograms that will further help formulate national data. It will guide doctors to choose the appropriate empiric treatment, and these studies will be the basis for establishing antimicrobial surveillance and monitoring and regulating of the use of antimicrobials., (Copyright © 2023 The Authors. Published by Tehran University of Medical Sciences.)

Background: Smoking is one of the modifiable risk factors for cardiovascular disease (CVD) that is related to different types of chronic disorders. Many patients with CVD consider smoking cessation a difficult task due to various reasons. The goal of the present study was to translate the Challenges to Stopping Smoking Scale (CSS) into Persian and examine its psychometric properties., Materials and Methods: In this cross-sectional methodological study, a total of 341 patients with CVD [141 for exploratory factor analysis (EFA) and 200 for confirmatory factor analysis (CFA)] participated, and were selected using a convenience sampling method. Participants completed the Persian version of the CSS. Face, content, and construct validities were examined. Internal consistency was assessed using the McDonald's Omega and Cronbach's alpha coefficients, and stability was examined using the test-retest method., Results: In the EFA, two factors of Internal Challenges and External Challenges were extracted that together explained 42.619% of the total variance. Cronbach's alpha coefficients of 0.740 and 0.799 and Intraclass correlation coefficients of 0.862 and 0.869 were found for Internal and External Challenges, respectively. According to the results of CFA, the three-factor model had a good fit to the data. (RMSEA: 0.059; CFI: 0.94; GFI: 0.97; NFI: 0.90; PNFI: 0.77) ., Conclusion: The Persian version of the CSS has good validity and reliability, and can be used as a valid and reliable instrument in future studies., (Copyright© 2023 National Research Institute of Tuberculosis and Lung Disease.)

Background: Mastectomy as a surgical treatment in women with breast cancer causes a change in their body image due to the loss of femininity and body integrity, decreased sense of sexual attractiveness, and dissatisfaction with the presence of surgical scars. The present study was conducted to evaluate the psychometric properties of the Farsi version of the body image scale for breast cancer survivors., Methods: This cross-sectional study was conducted on 204 women with a mastectomy referred to Kermanshah's surgery and oncology office in 2021. Face and content validity were evaluated qualitatively. Construct validity was evaluated by exploratory factor analysis (with maximum likelihood and Promax rotation) and confirmatory factor analysis. Cronbach's alpha and McDonald's omega coefficients were used to verify internal consistency., Results: The mean age of the participants was 46.57 (SD = 9.47). One factor was extracted that explained 46.56% of the total variance of body image. The factor load of the items varied between 0.561 and 0.801. The results of CFA also showed that the final model has a perfect fit: CMIN = 20.931; DF = 13; CMIN/FD = 1.610; p  = 0.074; GFI = 0.972; AGFI = 0.939; IFI = 0.985; CFI = 0.985; TLI = 0.975; PNFI = 0.595; PCFI = 0.610; RMSEA = 0.055. internal consistency based on Cronbach's alpha and McDonald's omega coefficients was 0.856 and 0.861, respectively., Conclusion: The Farsi version of the body image scale for breast cancer survivors has good construct validity and may be used in various studies in clinical and research settings., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) under exclusive licence to Association of Gynecologic Oncologists of India 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Besides physical complications, COVID-19 is associated with psychological issues such as fear and anxiety. High resilience in nurses enables them to adopt positive coping mechanisms and successfully operate in the stressful environment of COVID-19 wards. The present study aimed to evaluate the correlation between COVID-19 fear and anxiety with resilience in the emergency nurses of the hospital affiliated with Kurdistan University of Medical Sciences (west of Iran) in 2021., Materials and Methods: This cross-sectional study was conducted on 295 emergency nurses of selected hospitals in Kurdistan province, Iran, in 2021. Data were collected using a demographic questionnaire, Fear of COVID-19 Scale (FCV-19S), Corona Disease Anxiety Scale (CDAS), and Connor-Davidson Resilience Scale (CD-RISC). Data analysis was performed in R software version 3.6.3., Results: The mean scores of resilience, COVID-19 fear, and COVID-19 anxiety were 55.07 ± 19.82 (ranging from 0 to 100), 20 ± 7.37 (ranging from 7 to 35) and 36.48 ± 13.21 (ranging from 18 to 54) respectively. There was a negative and significant correlation between resilience with COVID-19 fear ( r = -0.449, p = 0.001), COVID-19 anxiety ( r = 0.458, p = 0.001). A significant correlation was observed between COVID-19 fear and anxiety, which indicated that if the other demographic variables remained unchanged, a one-unit increase in COVID-19 fear and anxiety decreased the mean resilience score by -0.66 ( P = 0.008) and -0.34 ( P = 0.015), respectively., Conclusion: COVID-19 fear and anxiety were significantly correlated. Therefore, providing training courses for promoting resilience could reduce the fear and anxiety of nurses during the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Karimi Khordeh, Dehvan, Dalvand, Repišti and Ghanei Gheshlagh.)

Objective: The Covid-19 epidemic, which has become the most challenging issue for health organizations and governments, has led to panic among people, especially pregnant women. The aim of this study was to investigate the psychometric properties of the Persian version of the Fear of COVID-19 Scale (FCV-19S) on a sample of Iranian pregnant women., Methods: This cross-sectional study was performed on 500 pregnant women referred to gynecology offices in Tehran. Construct validity was performed using exploratory (with maximum likelihood method and Promax rotation) and confirmatory factor analysis. Cronbach's alpha and McDonald omega coefficients were used to examine internal consistency., Results: The mean age of the women was 28.98 (SD = 5.86) years. In exploratory factor analysis, two factors were extracted-emotional response and physiological response, which together explained 65.21% of the total variance of fear of Covid-19. In the confirmatory factor analysis, the final model had a good fit: CMIN/df = 1.515, goodness of fit index (GFI) = 0.981, adjusted goodness of fit index (AGFI) = 0.956, normed fit index (NFI) = 0.979, Incremental Fit Index (IFI) = 0.993, comparative fit index (CFI) = 0.993, and root mean square error of approximation (RMSEA) = 0.045 (95% CI: 0.001-0.085). Cronbach alpha and McDonald omega coefficients for the first factor were 0.874 and 0.878, and for the second factor were 0.853 and 0.854, respectively., Conclusion: The FCV-19S in pregnant women has a good construct validity and can be used in various studies., (© 2022 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Background: Vaccination can be an essential protective measure against Coronavirus disease 2019 (COVID-19) if well received by the public. Various factors affect the acceptance or refusal of vaccines. Several waves of COVID-19 caused much death in Iran. This study aimed to evaluate the acceptance of the COVID-19 vaccine in the general population of Asadabad in 2021., Methods: In this cross-sectional study, 650 people from the general population of Asadabad with a mean age of 34.6 (SD = 15.1) years were selected and included. In addition to socio-economic and demographic data, data were collected using the COVID-19 fear scale. Univariate and multiple logistic regression models were used to investigate the relationship between the tendency to get the COVID-19 vaccine (the dependent variable) and other variables., Results: About 42.3% of participants were reluctant to receive the available COVID-19 vaccines. After adjusting for several covariates, there was a significant relationship between willingness to get vaccinated and family history of COVID-19 infection (AOR = 1.86, 95% CI 1.06-3.27, p = 0.032), trust in healthcare workers (AOR = 2.07, 95% CI 1.13-3.79, p = 0.019), trust in existing vaccines (AOR = 3.94, 95% CI 2.15-7.23, p < 0.001), encouraging family members to get vaccinated (AOR = 7.6, 95% CI 4.12-14.01, p < 0.0001). Also, people infected with COVID-19 are less likely to accept vaccination (AOR = 0.55, 95% CI 0.33-0.93, p = 0.025). Also, a unit increase in the score of fear of getting the COVID-19 virus increased the odds of getting the COVID-19 vaccine by 6% (AOR = 1.06, 95% CI 1.02-1.10, p = 0.002)., Conclusion: The culture and context of different societies can affect the acceptance or refusal of the COVID-19 vaccine. Based on these characteristics and providing extensive education to the people, the health authorities in each community should build trust and better communicate all health information to clear any fear and remove all obstacles to increase willingness to get COVID-19 vaccination., (© 2022. The Author(s).)

Objective: Diabetes burnout refers to the feeling of exhaustion and frustration in the management of diabetes, which can lead to treatment non-adherence, poor glycemic control, and a high prevalence of diabetes complications. Measuring diabetes burnout requires accurate and standard instruments. The aim of this study was to evaluate the psychometric properties of the Farsi version Diabetes Burnout Scale (F-DBS)., Methods: This cross-sectional study was performed on 550 patients with type 1 diabetes (262 men and 288 women) referred to diabetes centers in different cities of Hamedan province (Asadabad, Hamedan, Malayer, and Nahavand) in 2021. The mean age and duration of the disease in these patients were 35.58 (SD=14.32) and 15.02 (SD=10.60) years, respectively. Data were collected using the Diabetes Burnout Scale (DBS), Patient Health Questionnaire-9 and Kessler psychological distress scale. After forward-backward translation, face, content and convergent validity were performed. To evaluate the construct validity, convergent validity, exploratory and confirmatory factor analysis were performed. Internal consistency was examined with Cronbach's alpha coefficients., Results: In the exploratory factor analysis, two factors of exhaustion (five items) and detachment (seven items) were extracted, which together explained 46.58% of the total variance. In confirmatory factor analysis, the fit indices were appropriate. There was a significant positive correlation between diabetes burnout and depression (r = 0.30, p < 0.001) and psychological distress (r = 0.36, p < 0.001). Cronbach's alpha coefficient of diabetes burnout, exhaustion and detachment were 0.813, 0.846 and 0.812, respectively., Conclusion: The Farsi version of the Diabetes Burnout scale has acceptable validity and reliability and can be used in various studies., (Copyright © 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Background: Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology., Aim: To review the published literature on sexual function and mood disorders among peri- and postmenopausal women., Methods: The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method., Outcomes: The main outcome measures used for the review were sexual dysfunction and mood disorders., Results: We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies 16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women., Clinical Implications: In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well., Strengths & Limitations: The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted., Conclusions: While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115., (Copyright © 2022 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

The present study aimed to estimate the standard score of death anxiety in the Iranian elderly. In this systematic review and meta-analysis, national and international databases were searched from inception to January 2022. All the observational studies published in Persian and English, which reported a death anxiety score based on the Templer death anxiety scale, were selected. The standard score of death anxiety in the elderly was 50% (95% CI: 45-56). No correlation was observed between the year of publication ( p = .092) and sample size ( p = .94) with the standard score of death anxiety in the elderly. With increased age, death anxiety scores declined. Publication bias was not significant ( p = .340). Iranian seniors achieved half of the total score of death anxiety, which indicated the average level of death anxiety. Providing training to effectively manage death anxiety is essential to preventing the adverse consequences of extreme death anxiety.

Objective: Today, smoking is considered a pressing global health issue. The present study aimed to estimate the total prevalence of hookah smoking among pupils and university students in Iran., Materials and Methods: This systematic review and meta-analysis were conducted via searching in databases such as Scientific Information Database (SID), MagIran, Scopus, PubMed and Web of Sciences from inception to October 2021. We targeted observational studies evaluating the prevalence or frequency of hookah smoking among Iranian pupils and university students. Data analysis was performed using a random-effects model, and the heterogeneity of the articles was assessed using Cochran's Q test and the I 2 statistic., Results: In total, 124 studies conducted on 155 115 subjects were reviewed. The lifetime prevalence of hookah smoking among high school students and university students was estimated at 34.4% and 32.3%, respectively. In addition, the frequency of hookah smoking within the past month/week (point prevalence) was estimated at 21.5% and 16.6% in university students and pupils, respectively. The frequency of hookah smoking within the past year (period prevalence) was also reported to be 22.5% and 20.8% in these groups, respectively. No significant correlation was observed between the prevalence of hookah smoking, sample size, year of publication and the mean age of the participants. Region 5 had the highest lifetime prevalence (41.7%) and period prevalence (27.1%). However, Region 1 had the highest point prevalence of hookah smoking (27.2%)., Conclusions: According to the results, hookah smoking is highly prevalent among Iranian pupils and university students. Therefore, proper educational interventions are required in the form of workshops and curricula to raise awareness regarding the hazardous effects of this unhealthy habit on the young generation., (© 2022 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.)

To control COVID-19, several strategies were proposed in Iran since the start of the outbreak. The number of reported infected people and its consequent death toll herald relative inadequacies in the quality and extent of the measures in curbing the COVID-19 transmission cycle. This study was conducted to investigate knowledge, attitude, precautionary practices and degree of fear related to COVID-19 in a sample of Iranian population. This study was conducted among 457 residents of Kurdistan Province, Iran, through social networks and social media (WhatsApp and Telegram). Knowledge, attitude and practice and fear of COVID-19 were collected using valid tools. Multiple logistic regression and multivariate linear regression analyses were used to identify factors associated with binary outcome attitudes, practices and continuous variables knowledge and fear of COVID-19, respectively. The mean (SD) age of participants was 37.86 (10.42); of them, 252 (55.1%) were men, and more than two-thirds were married (74.8%). About 10% of the respondents were in believed that COVID-19 could create a type of social stigma. Level of knowledge about COVID-19 in 77.8% of the study attendees was acceptable, and 352 of them (70%) were confident that the virus would eventually be successfully controlled in the world, but only 252 of the attendants (50%) had confidence about successful control of COVID-19 in Iran. Applying multiple logistic regression, knowledge (OR: 1.18, p = 0.028) and fear (OR: 1.04, p = 0.028) of COVID-19 were associated with positive attitude towards controllability of COVID-19. Gender (OR: 1.96, p = 0.012), sources of information (OR: 5.00, p = 0.005) and knowledge (OR: 1.27, p = 0.006) were also indicated association with taking precautionary practices to control COVID-19. Further studies are recommended to boost level of knowledge, strengthen positive attitude and ameliorate behavioural pattern for successful control of COVID-19 in Iran., (© 2021 John Wiley & Sons Ltd.)

This systematic review and meta-analysis aims to estimate the overall prevalence of Internet addiction among Iranian university students. A total of 49 articles written in Persian or English, without time limitation, were gathered. Databases of Scientific Information Database, MagIran, PubMed, Scopus, and Web of Science were searched during the period from February 13 to March 13, 2018. The following keywords and their possible combinations were used: Iran, student, Internet dependency, Internet addiction, and problematic Internet use. The Cochran's Q test was used to test the heterogeneity among the studies, and because heterogeneity was not significant, the random effects model was used to estimate the overall prevalence of Internet addiction. Data analysis was performed using STATA, version 12. Meta-analysis of 49 selected articles with a total sample size of 16,585 indicated that the overall prevalence of Internet addiction among Iranian students was 31.51 percent (95% confidence interval: 26.47-36.55). In addition, meta-regression analysis showed no significant relationship between Internet addiction and year of publication ( p  = 0.972) and sample size ( p  = 0.915). About one-third of Iranian students have Internet addiction. It is necessary to provide training workshops on learning about the consequences of Internet addiction and its management.

Background: Smoking is a preventable cause of morbidity and mortality with an increasing prevalence in developing countries. The present systematic review and meta-analysis aimed to estimate the prevalence of smoking among college and high school students in Iran., Materials and Methods: Databases of Scopus, PubMed, Web of Science, Google Scholar, SID, and MagIran were searched with no time limitation. Observational studies published in Persian or English were included in the analysis. Time frame of the searches was from inception until 1 January 2021. The data was analyzed using random effects model, subgroup analysis, and meta-regression analysis. Heterogeneity among studies was examined using Cochran's Q test and I 2 statistic., Results: A total of 63 articles with a sample size of 58742 were analyzed. The pooled smoking prevalence was found to be 13.56% (95% CI: 11.65-15.47). There was a significant increase in the prevalence of smoking among female students between 1998 and 2020. Regions 1 of Iran had the highest prevalence rates of smoking (Provinces of Alborz, Tehran, Qazvin, Mazandaran, Semnan, Golestan, and Qom). Smoking was more prevalent among college students (15.62%, 95% CI: 13.14-18.10) than in high school students (9.77%, 95% CI: 7.19-12.35)., Conclusion: Given the relatively high prevalence of smoking among Iranian college and high school students, it is necessary to inform them about the harmful effects of smoking through training programs., (Copyright© 2022 National Research Institute of Tuberculosis and Lung Disease.)

Background: Cancer is one of the most common diseases and it has many physical and psychological consequences. Women with cancer are more likely to suffer from sexual dysfunction (SD) than healthy women., Objective: To estimate the overall prevalence of SD in women with cancer., Materials and Methods: The international databases Google Scholar, Embase, PubMed, Web of Science, and Scopus were searched for related articles without any time limitation. The keywords "Neoplasia", "Tumor", "Cancer", "Malignancy", "Female Sexual Function Index", "FSFI", and "female sexual dysfunction" along with their combinations were used in the search. Inconsistencies in the data were examined using the I 2 test. The data were analyzed using the meta-analysis method and the random-effects model in the Stata software., Results: The analysis of 24 articles with a sample size of 5483 women showed that the prevalence of SD in women with cancer was 66% (95% CI: 59-74%). The highest and lowest prevalence were in Africa and Europe, respectively (75%; 95% CI: 66-83% vs. 43%; 95% CI: 26-60%, respectively). There was no relationship between the prevalence of SD and the mean age of the women, sample size, yr of publication, or quality of articles., Conclusion: SD is highly prevalent in women with cancer. African and American women with cancer have a higher average SD prevalence than Asian and European ones., Competing Interests: The authors declare that there is no conflict of interest., (Copyright © 2022 Hosseini et al.)

Introduction: Depression is a debilitating disease that is highly prevalent among cancer patients. Various studies in Iran have reported different prevalence. This systematic review and meta-analysis was conducted to estimate the overall prevalence of depression in Iranian women with breast cancer., Material and Methods: In this study, published articles in Persian and English were collected without time limit. Keyword searches for depression, depressive disorder, dysthymic disorder, major depressive disorder, breast cancer, breast neoplasm, and Iran and all of their potential combinations were performed in Scientific Information Database (SID), MagIran, PubMed, Scopus, Web of Science databases. The heterogeneity between studies was assessed using the Q-Cochrane test and, given the significant heterogeneity, a random-effects model was used to estimate the overall prevalence of depression. Data were analyzed using STATA version 11 software., Results: The analysis of 22 selected articles with a total sample size of 3,082 showed that the overall prevalence of depression in women with breast cancer was 49.98% (95% confidence interval: 48.43-52.52). The prevalence of depression in Region 1 in the country was (28%; 95% confidence interval: 25.53-52.55) and in other regions, it was (63.79% with 95% confidence interval of 61.82-76.76). The highest and the lowest prevalence of depression were related to BDI (69.33%; 95% confidence interval: 67.19-71.48) and HADS (26.43%; 95% confidence interval: 23.14-29.72), respectively., Conclusions: Half of the Iranian women with breast cancer had depression. Given the overlap of physical symptoms of cancer with depression, identifying at-risk patients for controlling and providing therapeutic interventions seems necessary., Competing Interests: The authors declare that they have no competing interests, (© National Institute of Public Health NIH – National Research Institute.)

Introduction: Adopting preventive behaviors and following the guidelines for controlling the COVID-19 epidemic depend on people's self-efficacy in carrying out these behaviors and instructions. The aim of this study was to investigate the psychometric properties of the Persian version of the COVID-19 Self-Efficacy Scale (COVID-19 SES, Hernández-Padilla et al., 2020)., Material and Methods: This cross-sectional study was performed in a group of 400 people who were residents of the city of Asadabad in western Iran from December 2020 to January 2021. The participants were selected using a convenience sampling method. Face and content validity was assessed qualitatively based on feedback from the participants and experts, and the necessary changes were applied to the final version of the questionnaire. For construct validity, exploratory factor analysis (n=200) and confirmatory factor analysis (n=200) were performed. Internal consistency was expressed as Cronbach's alpha coefficient. Relative stability was assessed using the intraclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement (SEM)., Results: In exploratory factor analysis, three factors of prevention, symptom recognition, and homemanagement of COVID-19 were extracted that together explained 71.35% of the total variance. The internal consistency of the whole instrument was 0.955 and its three dimensions were 0.894, 0.916 and 0.955, respectively. In addition, an ICC of 0.986 (95% CI: 0.975-0.993, p=0.001) was found. In the confirmatory factor analysis, comparative and parsimonious fit indices were excellent, and absolute fit indices were moderate., Conclusions: The Persian version of the COVID-19 SES has good validity and reliability and can be used to measure self-efficacy in prevention, symptoms recognition, and home-management of COVID-19., (© National Institute of Public Health NIH – National Research Institute.)

Introduction: The prevalence of hypertension (HTN) is increasing in the middle-aged population, but few studies have examined the prevalence and risk factors associated with hypertension in this age group., Aim: To estimate the prevalence of HTN and its associated demographic risk factors in the middle-aged population (30-59 years) of Iran., Methods: In this cross-sectional study, 4112 middle-aged people from five provinces of the country were selected by multi-stage sampling and entered into the study. HTN or high blood pressure (HBP) was defined as systolic blood pressure ≥ 140 mmHg and diastolic blood pressure ≥ 90 mmHg. The relationship between demographic risk factors and the prevalence of HTN was assessed by multivariate logistic regression in Stata software version 14., Results: The prevalence of HTN was 17.8% (95% CI 16.5-19.0) and was higher in women than men (19.1% vs. 16.5%). The prevalence of HTN in three studied age groups including 30-39, 40-49 and 50-59 years were 7.2, 18.7 and 38.0%, respectively. The frequency of HTN in urban residents was higher than rural residents (18.4% vs. 15.6%). The chance of developing hypertension in urban residents (OR 1.25), overweight (OR 3.94) and obese persons (OR 7.54) was higher., Conclusions: Hypertension has a relatively high prevalence in the middle-aged Iranian population. According to our results, age, living in urban regions, being illiterate, overweight and obesity are independent risk factors for HBP. It seems that the administration of prevention programs in general population especially in younger ages based on existing risk factors is a necessity., (© 2021. Italian Society of Hypertension.)

Background: Breast cancer is the most common type of cancer of women across the world, which can affect the quality of life in patients due to complications caused by the disease and related treatments. Various treatments have been designed for these patients to improve their life quality. This study aimed to estimate the mean score of health-related quality of life patients with breast cancer in Iran., Methods: In this study, we searched the national and international databases of SID, MagIran, Google Scholar, ISI/Web of Science, PubMed and Scopus with no time limits using the keywords of "health-related quality of life", "health related quality of life", "quality of life", "breast neoplasm", "breast cancer", and "breast tumors". Data analysis was performed in STATA version 14 based on the heterogeneity state using random effects model., Results: In this study, 15 articles with a sample size of 1883 were evaluated, and the mean global quality of life in patients was reported at 72.48 (95% CI: 64.94-79.82). In addition, the worst performance and symptoms were related to emotional functioning (56.70) (95% CI: 49.84-63.55) and financial difficulties (43.57) (95% CI: 31.47-55.67)., Conclusion: According to the results of the present study, the Iranian patients with breast cancer had a moderate quality of life in most dimensions.

Objective: This study was conducted to address the importance of identifying nursing errors in critical care units and the lack of appropriate tools for measuring them. This study aimed to develop and psychometrically evaluate a nursing error tool in critical care units., Design: This was a psychometric validity study., Setting: The study involved eight critical care units affiliated with Kurdistan University of Medical Sciences., Methods: The research was conducted in two phases. In the first phase, data were gathered via interviews with nurses, and analyzed with conventional content analysis. The primary codes and subcategories were identified as tool items. In the second phase, the psychometric properties of the instrument, including face validity, content validity, construct validity, internal consistency, and reliability were investigated., Results: In the first phase, 142 items were extracted; this number was reduced to 40 items after assessing qualitative content validity. Exploratory factor analysis identified five factors: medication error, task description error, executive error, procedural error, and safety error, which made up 88% of the total variance. The Cronbach's alpha was 0.97., Conclusions: The development of a validated nursing error tool is helpful in identifying the extent and typologies of nursing errors, and could aid in designing better prevention strategies in critical care units., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Truck, bus, transit drivers, and men with mobile jobs are at high risk for HIV/AIDS. The purpose of this study was to investigate the prevalence of HIV and risky behaviors among truck and bus drivers in Kurdistan province., Methods: This cross-sectional study was conducted on 601 bus and truck drivers in Kurdistan province during 2018-2019. Data on high-risk behaviors were collected using a standard questionnaire. ELISA test was used to detect HIV in the study participants. Data were analyzed using Chi-square, Mann-Whitney U tests, and logistic regression modeling in Stata-14 software., Results: The mean and standard deviation of the age of study participants was 44.04 ± 11.44 years. HIV rapid test was positive in two subjects; in other words, the prevalence of HIV in the study population was 0.33%. Ninety-two (15.3%) individuals reported a history of drug use, with one (1.1%) having a history of injecting drugs. One hundred and thirty-one (21.8%) of them had a history of high-risk sexual behavior outside of marriage., Conclusion: According to the results of the present study, the prevalence of high-risk behaviors in bus and truck drivers is high. It seems necessary to direct the drivers' attention to self-care while considering disciplinary intervention programs to prevent the use of drugs, cigarettes, alcohol along with high-risk sexual behaviors to maintain the health of drivers and passengers., (© 2021. The Author(s).)

Aims: This study aims to test a hypothetical model linking various dimensions of organizational justice to the job satisfaction and nurses' intention to leave the profession based on the theoretical assumptions of the Alexander model of voluntary turnover., Design: A cross-sectional survey., Methods: This study was conducted on 317 inpatient ward nurses of six teaching hospitals in Tehran, Iran during 1 September 2017-14 November 2018. Clinical nurses were recruited by a multistage random sampling. Data were collected using structured questionnaires of organizational justice, job satisfaction, and nurses' intention to leave. Data were analysed by structural equation modelling using Amos 22 statistical program., Results: The structural equation model demonstrated adequate fit and the hypothesized correlations were partially supported. The findings suggested that the distributive justice (p < .001; β = 0.24) and interactional justice (p < .001; β = 0.44) could indirectly affect the nurses' intention to leave the nursing profession via the direct impact on job satisfaction, while job satisfaction had a significant, negative effect on the nurses' intention to leave (p < .001; β = -0.71)., Conclusions: According to the results, the model fit was acceptable, suggesting the validity of the final model. Furthermore, distributive and interactional justice could reduce the intention to leave the nursing profession by influencing the job satisfaction of the clinical nurses., Impact: This was one of the first studies to determine the aspects of justice that must be further emphasized by healthcare managers to increase the job satisfaction of nurses and their retention in healthcare systems. The findings indicated that fair interactions have a greater impact on job satisfaction and retention of nurses than procedural and distributive justice. The results of this study provide valuable references for nursing managers to increase the job satisfaction of nurses and their retention in healthcare settings., (© 2020 John Wiley & Sons Ltd.)

In recent years, published systematic reviews in the world and in Iran have been increasing. These studies are an important resource to answer evidence-based clinical questions and assist health policy-makers and students who want to identify evidence gaps in published research. Systematic review studies, with or without meta-analysis, synthesize all available evidence from studies focused on the same research question. In this study, the steps for a systematic review such as research question design and identification, the search for qualified published studies, the extraction and synthesis of information that pertain to the research question, and interpretation of the results are presented in details. This will be helpful to all interested researchers., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 International Journal of Preventive Medicine.)

Objectives: Self-care is a major factor in managing diabetes. This study aimed to determine the self-care status of Iranian patients with diabetes and to estimate the percentage of self-care in these individuals through a systematic review and meta-analysis., Methods: In this systematic review and meta-analysis 53 domestic articles published in Farsi and English were evaluated. We conducted database searches in domestic and foreign databases of Scientific Information Database (SID), MagIran, Google Scholar, Web of Science, Pub Med, and Scopus with no time limit. Data analysis was performed in Stata version 12 using meta-analysis method and the random effects model., Results: A total of 50 articles (53 groups) with a sample size of 9565 were systematically reviewed. The percentage of self-care in patients with diabetes was reported to be 48.86 (95% confidence interval [CI]: 43.79-53.94). According to the results, the percentage of self-care score was higher in patients with type I diabetes (55.53) when compared with patients with type II diabetes (49.26)., Conclusions: Since patients with diabetes obtained only half of the self-care score and given the importance of self-care in controlling and treating diabetes, it is necessary to perform actions to improve self-care such as benefiting from health facilities, and social and family support., (Copyright © 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Introduction: Pressure ulcer development is a known indicator of the quality of care. Negative attitudes towards the prevention of pressure ulcers can lead to preventive care with suboptimal quality. There is no valid and reliable instrument in Iran to assess clinicians' attitudes towards pressure ulcer prevention; therefore, this study aimed to examine the psychometric properties of the Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) in Nurses., Methods: In this cross-sectional study, 250 nurses were selected using a convenience sampling method. Face, content, and construct validity were examined using exploratory factor analysis (EFA). Internal consistency was assessed using the McDonald's omega (ω), and reliability was assessed using the test-retest method., Results: In the EFA, five factors of Competence, Responsibility, Perceived Consequences of Pressure Ulcers on Patients, Priority, and Confidence in the Effectiveness of Prevention were extracted that together explained 50.26% of the total variance. A McDonald's ω of 0.891 demonstrated the internal consistency of the total scale, and internal consistencies ranging from 0.70 to 0.86 were found for different dimensions of the instrument. In addition, an intraclass correlation coefficient (ICC) of 0.876 was found that indicated the reliability (stability) of the total scale (95% Confidence Interval [CI]: 0.736-0.963)., Conclusion: The Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) has good validity and reliability in Iranian nurses and can be used in future clinical studies., (Copyright © 2020. Published by Elsevier Ltd.)

Background: Obstructive sleep apnea (OSA) is a chronic breathing disorder during sleep. It is prevalent among patients with cardiovascular disease (CVD) and can increase its severity and mortality. Various studies have reported different results in Iran. This systematic review and meta-analysis aimed to determine the prevalence of OSA in Iranian patients with CVD., Materials and Methods: In this study, eight papers published in Persian and English languages were reviewed. The articles were searched using the following keywords and all their possible combinations: "obstructive sleep apnea", "sleep-disordered breathing", "sleep apnea", "OSA", "cardiovascular disease", "hypertension", and "Iran". Scientific databases, including the Scientific Information Database (SID), Magiran, Web of Science, PubMed, and Scopus, were searched with no time limitations. Data were analyzed using a meta-analysis and a random effects model. Besides, heterogeneity was assessed using the I 2 statistic. Data analysis was performed in Stata version 11., Results: The review of eight studies, with a total sample size of 1646 patients, showed that the prevalence of OSA was 59.21% (95% CI: 53.11-65.32) among CVD patients. Also, the prevalence of OSA was higher in men (60.12%; 95% CI: 60.12-82.54) than in women (41.01%; 95% CI: 16.08-65.94). Besides, it was estimated to be higher based on the STOP and STOP-BANG questionnaires (63%; 95% CI: 52.89-73.10) as compared to the Berlin questionnaire (56.63%; 95% CI: 49.20-64.06)., Conclusion: More than half of Iranian CVD patients have OSA. Therefore, identifying high-risk patients to reduce the adverse effects of sleep apnea seems necessary., (Copyright© 2021 National Research Institute of Tuberculosis and Lung Disease.)