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Background and purpose:. The quality of life of patients with chronic kidney failure undergoing hemodialysis is influenced by physical, psychological, and social factors. Accurate assessment of these dimensions using standardized tools is of great importance. This study aimed to determine the psychometric properties of the 12-item Quality of Life Questionnaire in patients undergoing hemodialysis in the Iranian population. Materials and methods: In this cross-sectional study conducted in 2023, 411 hemodialysis patients in Mazandaran were selected through convenience sampling. After translating the Short Form-12 Quality of Life Questionnaire, its psychometric properties were assessed through exploratory factor analysis, network analysis, and confirmatory factor analysis, along with construct validity (convergent and divergent validity). Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients. Results: The results of the exploratory factor analysis indicated that two factors—physical health status and mental health status—accounted for 44.55% of the variance in the quality of life among hemodialysis patients. Furthermore, confirmatory factor analysis showed that the hypothesized model had a good fit (CFI= 0.930, IFI= 0.931, RFI= 0.936, TLI= 0.954). The extracted mental health factor in men demonstrated convergent validity (AVE above 0.5), and both factors exhibited appropriate divergent validity. Ultimately, the internal consistency of the Quality of Life Questionnaire was found to be within an acceptable range (greater than 0.7). Conclusion: The psychometric analysis of the Quality of Life Questionnaire indicates that patients with chronic kidney failure undergoing hemodialysis perceive their quality of life through two primary dimensions: physical and mental health status. This study confirmed the psychometric properties (validity and reliability) and the appropriate factor structure of the Persian version of the Quality of Life Questionnaire for patients undergoing hemodialysis. Healthcare providers can use this tool in various studies to assess and improve the quality of life of hemodialysis patients The use of this questionnaire allows researchers and healthcare professionals to more accurately and comprehensively evaluate the different aspects of quality of life in hemodialysis patients. Employing this tool can enhance treatment processes and improve patient satisfaction, serving as a valuable instrument for future research. This study emphasizes the importance of using valid and reliable tools to assess quality of life and recommends that nurses and other healthcare professionals integrate the Persian version of the 12-item Quality of Life Questionnaire into their treatment and research programs to help improve the quality of life of hemodialysis patients and achieve better treatment outcomes. Future studies are recommended to investigate the impact of factors such as nutrition, social support, and rehabilitation programs on the quality of life of hemodialysis patients. Additionally, utilizing this questionnaire in different populations and therapeutic contexts can contribute to the generalizability of the findings and offer a more effective tool for quality of life assessments. Overall, the findings of this study indicate that the 12-item Quality of Life Questionnaire is a reliable and valid tool for assessing the quality of life in hemodialysis patients, making it valuable for both research and clinical programs. Using this tool can help improve patients' quality of life and treatment outcomes while providing essential data for clinical decision-making.

Abstract Background Caring for a person with Alzheimer’s disease is stressful for caregivers. So that, considering all the emotional and financial costs imposed on the families of Alzheimer’s patients, stress from caring is an issue that cannot be ignored and plans need to be developed to help these caregivers to manage the care properly. The current study was designed to develop a valid and reliable care stress management scale for family caregivers of patients with Alzheimer’s. Methods This study is a methodological study with a sequential-exploratory mixed-method approach that was performed in two-phase: develop the caring stress management scale and evaluate the psychometric properties of the scale. In the first phase, 14 semi-structured face-to-face interviews were performed with family caregivers of patients with Alzheimer’s. The interviews were transcribed immediately and an item pool with 275 items was prepared. After removing the duplicate or overlapping code, the initial format of the caring stress management scale (CSMS) was designed. In the second step, the items of the CSMS were evaluated using face and content validity. After that, the construct validity was evaluated using exploratory factor analysis, confirmatory factor analysis, and convergent and divergent validity respectively. Finally, the reliability was assessed by stability and internal consistency. The sample size was 435 and data was gathered via an online form questionnaire. Results This study designed the CSMS with two factors including emotional-focused coping (4 items) and problem-focused coping (4 items) that explained 51.00% of the total variance. The results of the confirmatory factor analysis showed a good model fit. Furthermore, the internal consistency and stability of this scale were acceptable. Conclusion The results showed that the care stress management scale has two factors in Iranian family caregivers and it is valid and reliable and can be used by therapists and researchers.

Abstract Background Older adults duo to circumstances of aging such as relationship losses, medical morbidities, and functional declines, are prone to social isolation and loneliness more than any other age group. Furthermore, with The recent outbreak of the COVID-19 pandemic and the need to quarantine, the possibility of feelings of loneliness, especially in older adults, became an important nursing priority. Therefore, it is important to quickly identify loneliness and respond appropriately to prevent, reduce, or treat it. The aim of this study was to translate the De Jong Gierveld loneliness scale into Persian for older adults. Methods The sample was 400 adults aged 65 and older with a mean age of 71.32 (SD= ± 6.09) years. Recruitment and data collection was done via online methods. The original scale was translated into Persian using the World Health Organization (WHO) protocol of forward-backward translation technique. Face validity and content validity; was followed by exploratory and confirmatory factor analysis. Lastly, reliability was assessed using the Average Inter-Item Correlation, Cronbach’s alpha, and McDonald’s Omega. Results The results showed that the Persian version of the loneliness scale had two factors namely social loneliness (5 items) and emotional loneliness (3 items) and the combined score explained 45.66% of the total variance of this scale. In addition, all goodness of fit indices confirmed a two factors model fit and all of the reliability indices were excellent. Conclusions The Persian version of the loneliness scale is useful and suitable for detecting social loneliness and emotional loneliness in older Iranian adults.

BackgroundAlzheimer's disease (AD) is a progressive and debilitating disorder that strongly affects people with AD and their families. The changes in signs of the disease and its treatment lead to many challenges in people with AD that affect the performance and the ability of caregivers, their social life, and physical, emotional, and psychological aspects of caregivers' health. Therefore, this study was designed to develop and validate the Care Challenge Scale (CCS) for family caregivers of people with AD in the care context of Iran.MethodThis is a cross-sectional study, and the primary scale was based on 14 semi-structured interviews with family caregivers of Iranian people with AD. In the next phase, the psychometric features were assessed, including the face validity (qualitative and quantitative), content validity (qualitative and quantitative), item analysis, structural validity (exploratory and confirmatory factors), and construct validity (convergent and discriminant validity). Finally, the reliability was assessed using internal consistency (Cronbach's alpha, McDonald's omega coefficient, and the average inter-item correlation), stability (intraclass correlation coefficient), and absolute reliability.ResultsTotally, 435 Iranian family caregivers filled out online questionnaires, with a mean age of 50.26(±13.24) years. Based on the results of the qualitative phase, an item pool was generated with 389 items, and after deleting overlapping and unrelated items, the CCS with 14 items was created. The results of the quantitative phase showed that the CCS consists of two factors with 10 items each, which are named effective role-play challenge and lack of social–financial support, and they explained 42.23% of the total variance. Furthermore, the results of confirmatory factor analysis showed a good fitness of the scale structure model, and it had convergent and discriminant validity. The reliability indexes showed this scale has internal consistency and stability.ConclusionThe most care challenge among Iranian family caregivers of people with AD is effective role-play challenges and lack of social–financial support. The scale as designed has good validity, internal consistency, and stability that can be used by therapists, nurses, and researchers for the assessment of the challenges of this population.

BackgroundHardiness is one of the personality traits that can help individuals in stressful situations. Since human beings are constantly under stressful situations and the stresses inflicted on people in each situation are different, various scales have been developed for assessing this feature among different people in different situations. Hence, it becomes necessary for researchers and health workers to assess this concept with valid and reliable scales. This systematic review aims to rigorously assess the methodological quality and psychometric properties of hardiness scales.MethodIn the first step, the databases including Scopus, PubMed, Web of science, and Persian databases were searched using suitable keywords without limitation time. We select eligible suitable studies after screening titles and abstracts. The quality of studies was evaluated using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the Terwee quality criteria.ResultOf the 747 articles identified, 33 articles were entered in this study. Based on the COSMIN checklist, the most reported properties were as following structural validity (84%), hypothesis testing (56%), content validity (42%), and internal consistency (39%). Furthermore, 12 studies reported cross-cultural validity, three studies criterion validity, and one study reported measurement error.ConclusionThe “family caregivers’ hardiness scale,” “Japanese Athletic Hardiness Scale,” “Occupational Hardiness Questionnaire,” and “Children’s Hardiness Scale” are the best tools for assessing hardiness in family caregivers, athletes, employees, and children respectively. In addition, the “Dispositional Resilience Scale” (DRS-15) and The Personal Views Survey (PVS III-R) are the most frequently used scales with suitable features for measuring hardiness in the general population.

ObjectiveCaring for patients with Alzheimer’s disease (AD) is a stressful situation and an overwhelming task for family caregivers. Therefore, these caregivers need to have their hardiness empowered to provide proper and appropriate care to these older adults. From the introduction of the concept of hardiness, few studies have been conducted to assess the hardiness of caregivers of patients with AD. Presumably, one reason for this knowledge gap is the lack of a proper scale to evaluate hardiness in this group. This study was conducted to develop a reliable and valid Family Caregivers’ Hardiness Scale (FCHS) to measure this concept accurately among Iranian family caregivers sample.MethodsThis study is a cross-sectional study with a sequential-exploratory mixed-method approach. The concept of family caregivers’ hardiness was clarified using deductive content analysis, and item pools were generated. In the psychometric step, the samples were 435 family caregivers with a mean age of 50.26 (SD ± 13.24), and the data were gathered via an online form questionnaire. In this step, the items of the FCHS were evaluated using face and content validity. Then, the factor structure was determined and confirmed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) followed by convergent and divergent validity, respectively. Finally, scale reliability, including stability, and internal consistency were evaluated.ResultsThe finding revealed that FCHS consists of five factors, namely, “Religious Coping” (5 items), “Self-Management” (6 items), “Empathic Communication” (3 items), “Family Affective Commitment” (3 items), and “Purposeful Interaction” (4 items) that explained 58.72% of the total variance. The results of CFA showed a good model fit. Reliability showed acceptable internal consistency and stability.ConclusionBased on the results of the psychometric evaluation of the FCHS, turned out that the concept of hardiness in Iranian family caregivers is a multidimensional concept that is most focused on individual-cultural values, emotional family relationships, and social relationships. The designed scale also has acceptable validity and reliability features that can be used in future studies to measure this concept in family caregivers.

Objective: This study was designed to describe the experiences of family Caregivers' hardiness in caring for Alzheimer's Patients.Methods: The deductive content analysis method was performed between April 2020 and February 2021 in one of the teaching hospitals in Iran. Fourteen family caregivers of Alzheimer's patients were selected using purposive and snowballing sampling and the data were collected by semi-structured interviews. After that, data were analyzed using Elo and Kingas steps.Results: The results of this study showed that based on the experiences of family caregivers, the family caregivers' hardiness in caring for Alzheimer's patients is a feature of cognitive ability to deal with stressful care situations and consists of five dimensions of commitment, control, challenge, communication and culture with 22 generic categories that they were nested into this five dimension.Conclusion: Family caregivers' hardiness is a trait related to the individual and environmental factors, and the prevailing social and cultural conditions affect the individual's perception and experience of hardship and threats, as well as his/her understanding of protective factors and how to use them. Therefore, hardiness should not be interpreted as a simple approach regardless of culture.

Background: Studies have revealed an increase in discrimination, neglect, and abuse among the older adult population during this period. This study assessed the validity and reliability of the Persian version of the ageism survey instrument tested on a sample of the Iranian older adult population during coronavirus disease (COVID-19) pandemic. An important move in counteracting ageism is to classify the ageism scale comprehensively by employing adequate psychometrics.Methods: The Persian version of the ageism scale was developed using a two-step procedure. The first step involved translating and revising the original scale to develop a Persian version of the ageism scale. The second step involved assessing the psychometric features of the newly adapted scale using construct validity through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and thereafter assessing the reliability through the average inter-item correlation (AIC), Cronbach's alpha. The sample consisted of 400 older adults (age 65 and older), who were recruited through online data collection, with samples for EFA and CFA randomly selected from the total samples.Results: The Persian version of the ageism survey has three factors: age-related deprivation with five items, dignity with three items, and employment with three items; all of which explained 57.02% of the total variance. The outcome of the EFA was verified by the CFA, with internal consistency reliability being excellent (Cronbach's alpha was 0.725, 0.698, and 0.708 for the three factors).Conclusion: This study specifically offers a restructured three factors Persian version of the ageism survey for Iranian older adults with acceptable construct validity and reliability.

Objective: The aim of this study was to translate and evaluate the validity and reliability of the Impact of Events Scale-Revised (IES-R) among the Iranian general population during the coronavirus disease 2019 (COVID-19) pandemic.Method: This study was methodological cross-sectional. It was conducted on an Iranian public population from April to July 2020 which was during the COVID-19 pandemic. Construct validity was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a total of 500 adults recruited via online data gathering. Reliability was checked through the average inter-item correlation (AIC), Cronbach's alpha, and McDonald's omega. Convergent and divergent validity was determined using Fornell and Larcker's approach.Results: The results showed that the Persian version of IES-R had three factors, including intrusion (six items), avoidance (seven items), and hyperarousal (five items), that explained 59.22% of the total variance of the IES-R. The CFA findings indicated that all goodness-of-fit indices confirmed the model fit. The Cronbach's alpha, McDonald's omega, composite reliability (CR), and maximal reliability were excellent, and the three factors have good convergent validity.Conclusion: The findings of this study indicated that the Persian version of the IES-R scale is efficient and useful to assess post-traumatic stress disorder among Iran general population in the COVID-19 outbreak.

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