Evaluation of the Predictors of the Quality of Life in the Postpartum Period: A Cross-Sectional Study.

Background: It is necessary to study the predictors of life quality in the early postpartum period. Early diagnosis, timely care and intervention can improve the health of mother and baby. We aimed to evaluate the predictors of the quality of life in the postpartum period. Methods: This cross-sectional study was conducted on 407 eligible women aged 18 to 47 yr, in the postpartum period, selected from clinics affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran in 2018. Data were collected using a demographic and obstetric questionnaire and Maternal Postpartum Quality of Life (MAPP-QOL) with Cronbach's alpha coefficients of 0.96 to assess personal details and postpartum quality of life. Data analyzed using SPSS. Linear regression analysis was performed to examine the relationship between maternal predictors and quality of life in the postpartum period. Results: The postpartum quality of life had a significant relationship with income status (P<0.001), Number of Children (P=0.031), mother's education(P=0.009) and maternal complications (P<0.001). Conclusion: This study confirmed the relationship between maternal predictors and the postpartum quality of life. It could facilitate clinicians and educators to improve the quality of life for postpartum women.

The Maternal Postpartum Quality of Life Instrument (MPQOL-I): development and psychometric evaluation in an exploratory sequential mixed-method study.

BACKGROUND: " Postpartum quality of life" refers to women's satisfaction of their position in life, based on cultural status, expectations, values, attitudes, goals, and living standards. Hence the need to pay attention to more specific dimensions of quality of life in the postpartum period is being sensed. This study was conducted to develop the Maternal Postpartum Quality of Life Instrument (MPQOL-I) and assess its psychometric properties. METHODS: This methodological study was conducted in 2019-2020. This exploratory, sequential mixed-method study was conducted in two phases. The first phase is MPQOL-I development and the second phase is psychometric evaluation of the developed scale. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. RESULTS: In this study, 5 factors were extracted from items through exploratory factor analysis: (1) received support, (2) sexual relations, (3) bonding with newborn, (4) breastfeeding and newborn care, and (5) the transition period. These factors accounted for 53.26% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of factors were greater than 0.7. CONCLUSION: The sixteen-item Persian language MPQOL-I is a valid and reliable instrument for postpartum quality of life assessment. It includes items from different aspects of postpartum quality of life and can be used for the early diagnosis of impaired postpartum quality of life. Further studies are needed to assess the psychometric properties of MPQOL-I in different cultures and communities.

Diagnostic Values of the Critical Care Pain Observation Tool and the Behavioral Pain Scale for Pain Assessment among Unconscious Patients: A Comparative Study.

Background: Pain assessment in unconscious patients is a major challenge for healthcare providers. This study aims to compare the diagnostic value of the critical-care pain observation tool (CPOT) and the behavioral pain scale (BPS) for pain assessment among unconscious patients. Materials and methods: This cross-sectional study was conducted in 2019. Forty-five unconscious patients were selected randomly from four general intensive care units (ICUs) in the north of Iran. The discriminant validity of CPOT and BPS were evaluated for pain during a nociceptive and a nonnociceptive procedure. For reliability assessment, interrater agreement was obtained using Lin's concordance correlation coefficient and weighted kappa coefficient. Results: Patients who had been hospitalized in ICU due to surgery or trauma (57.70%) or medical problems (42.30%) were studied. During the nociceptive procedure, the mean scores of CPOT and BPS and all their dimensions, except for the compliance with ventilator dimension, were significantly greater than the nonnociceptive procedure (p <0.05) although the effect size of both instruments was small (0.32 vs 0.18). The Lin's concordance correlation coefficient in nonnociceptive and nociceptive procedures was respectively 0.67 and 0.62 for CPOT and 0.74 and 0.88 for BPS. Conclusion: CPOT and BPS have acceptable discriminant validity in differentiating nonnociceptive and nociceptive procedural pain although the effect size of CPOT is larger than that of BPS. Although both instruments have low reliability, the reliability of BPS is better. How to cite this article: Nazari R, Froelicher ES, Nia HS, Hajihosseini F, Mousazadeh N. Diagnostic Values of the Critical Care Pain Observation Tool and the Behavioral Pain Scale for Pain Assessment among Unconscious Patients: A Comparative Study. Indian J Crit Care Med 2022;26(4):472-476.

Evaluation of Psychometric Properties of NutriCHEQ in Iranian Toddlers.

Background: Although poor dietary habits have a great effect on the health status of children, especially in toddlers, a few questionnaires exist for the assessment of dietary imbalances. This study aims to assess the validity and reliability of the NutriCHEQ in Iranian healthy toddlers. Methods: In this cross-sectional study, first, the NutriCHEQ was translated to Persian and culturally adapted by the forward-backward translation technique. In order to assess the face validity, we used a cognitive interviewing technique of 25 parents/caretakers of healthy toddlers. In the next step, experts assessed content validity, respectively. One item was removed during the content validity process. Then, a blueprint of NutriCHEQ was distributed among 156 parents/caretakers of healthy toddlers in different focal points in Tehran for assessing construct validity by nonlinear principal components analysis. In addition, the anthropometric indices checklist and Food Frequency Questionnaire (FFQ) were filled out for toddlers. Then, construct validity was assessed. The Varimax rotation ran for two sections separately. The four-factor structure was confirmed. Results: The model showed a good fit, and all the extracted variance of four factors were satisfactory (F1 = 20.77; F2 = 22.30; F3 = 14.75; and F4 = 13.71). All of the extracted items of the NutriCHEQ in two parts showed 71.53% cumulative variance. For criterion-related validity, there was a statistically significant positive correlation between the NutriCHEQ and Z-score (rho = 0.632, P < 0.001). The Bland-Altman result indicates 95% limits of agreement between the NutriCHEQ questionnaire and Z-score. Conclusions: Therefore, we concluded that NutriCHEQ is a valid, reliable, and convenient instrument to identify the Iranian toddlers' nutritional status. Therefore, it can be used for research and clinical settings.

Validation of the Persian Version of Health Professionals Communication Skills Scale.

Background: The need for assessing health-care workers' communication skills is increasingly emphasized by researchers. Achieving such a goal requires the use of a reliable tool. The purpose of this study was to validate the Persian version of Health Professionals Communication Skills Scale (HP-CSS). Materials and Methods: For the present methodological study carried out from September 2016 to February 2017, 400 health workers were selected by convenience sampling from educational hospitals in Mazandaran province in Iran and they were asked to fill out the 18-item HP-CSS. All steps of the scale validity were performed. Exploratory and confirmatory factor analysis were used. The reliability of the tool was measured by internal consistency. Results: Two factors of care and verbal clarity with patients and respect for patients' rights, extracted by exploratory factor analysis, explained 47.38% of the variance. Content Validity Index (CVI) and Content Validity Ratio (CVR) of all items were higher than 0.79 and 0.49, respectively. Reliability coefficients of factors were found to be more than 0.70. Model's fitness indicators confirmed the construct of HP-CSS. Both factors had a convergent and divergent validity. Conclusions: This study showed that the Persian version of the communication skills scale has a two-dimensional construct and good psychometric properties; also, this scale was found to be useful for the purpose and context in which it will be used, that is, communication skills.

Psychometric Evaluation of Persian Version of Hope Scale in Iranian Patients With Cancer.

BACKGROUND AND PURPOSE: Adult Hope Scale is one of the most popular tools for hope measuring. The study aimed to evaluate the psychometric properties of the Persian Version of Hope Scale among Iranian patients with cancer. METHODS: In this methodological study, patients with cancer (n = 400) were recruited by convenience sampling from June to December 2019. The construct and content validity and reliability of the scale were evaluated. RESULTS: A two-factor structure for the scale was indicated with the factors being optimism life, and despair that explained 60.483% of the total variance of the scale. The model has the goodness of fit and acceptable internal consistency (Cronbach's alpha: .701-.897). CONCLUSIONS: The Persian Version of Hope Scale demonstrated acceptable validity and reliability among patients with cancer.

Factor Analysis of Iranian Version of Nursing Students' Incivility Questionnaire.

BACKGROUND: Uncivil student behavior is one of the challenging issues in the nursing schools that disrupts the learning process and teacher-student interactions. Planning to control student's incivility requires knowing the condition using valid tools. The purpose of this study was to investigate the validity and reliability of the incivility occurrence's questionnaire among Iranian students. MATERIALS AND METHODS: This methodological study was conducted on 358 nursing students and 122 nursing faculty members. The samples were selected from the nursing students of second to fourth year from September to October 2019. McDonald's omega, Cronbach's alpha coefficients and composite reliability were calculated. Exploratory and confirmatory factor analysis were used to investigate the construct validity of tool. RESULTS: Content validity index was 0.94 for the whole instrument. In factor analysis, three factors of irresponsible, violent, and unsound behaviors were identified. These factors explained more than 50.52% of the variance. Model fit indices Parsimonious Normed Fit Index) = 0.74, Root Mean Square Error of Approximation = 0.05, Parsimonious Comparative Fit Index = 0.78, Goodness-of-Fit Index = 0.92, Comparative Fit Index ( CFI) = 0.92, Adjusted Goodness-of-Fit Index) = 0.89, CIMN=2.58) indicated the proportion of factors. Internal consistency was 0.77 to 0.89. CONCLUSIONS: This questionnaire is a three-dimensional tool with appropriate validity and reliability that can be used to evaluate occurrence rate of nursing student incivility in Iran.

The synergistic effect of topical insulin and clindamycin on acute dermal wound healing in rat model: a histological study.

Reducing the duration of wound healing is important to decrease the chance of infection. Insulin as a peptide hormone has a role in wound healing. Also, the use of clindamycin in the treatment of skin wounds has been studied very little. The aim of this study was to evaluate the synergistic effect of insulin and clindamycin on full-thickness wound healing. In this study, 24 Wistar rats (weight 180-200 g) were randomly divided into four equal groups: control (Eucerin), clindamycin, insulin, and insulin + clindamycin. Drugs were administered in the form of an ointment daily for twelve days. Wound healing rate and wound criteria such as epithelialization, neovascularization, collagen deposition, inflammation, and tissue granulation were investigated histologically on days 3, 7, and 14. The wound healing rate in the insulin + clindamycin group was significantly higher than the other groups on day 7 but there was no significant difference between groups on day 14. In addition, the combination of insulin and clindamycin had a beneficial effect on reducing inflammation and increasing collagen deposition, fibroblast maturation, neovascularization, and keratinization. The data showed that the topical application of insulin with clindamycin has an effective role in full-thickness wound healing by reducing inflammation and accelerating wound closure.

Construct validity of the Herth Hope Index: A systematic review.

OBJECTIVE: The psychological construct of hope is an important determinant for mental health and well-being. The availability of valid and reliable instruments to measure hope is, therefore, critical. Despite a large number of psychometric studies on the Herth Hope Index (HHI), its construct validity has not yet been determined. Therefore, this paper aimed to conduct a systematic review of the psychometric properties of the HHI. METHODS: Databases such as PubMed, Science Direct, Google Scholar, Magiran, SID, IranDoc, and IranMedex were evaluated systematically using the terms "HHI," "psychometric," "validity," "reliability," and related terms (with the use of OR and AND operators) and no restrictions on the year of publication. A total of 13 eligible studies were found published between 1992 and 2018 in the USA, Portugal, Switzerland, Iran, Germany, Petersburg, Japan, the Netherlands, Lima, Peru, and Norway. The methodology used in the available studies included principal component analysis (n = 6), maximum likelihood estimation (n = 5), and principal axis factoring (n = 1). One study did not point the methodology. RESULTS: Four studies reported the total extracted variances to be less than 50%, six studies reported variance between 50% and 60%, and three papers reported variance that exceeded 60%. Of the papers that examined the factor structure of the HHI, two studies reported a one-factor solution, seven reported two factors, and four reported a three-factor solution. Although the HHI is the most widely translated and psychometrically tested tool in languages other than English, psychometric variations in factor solutions remain inconsistent. CONCLUSION: Findings highlight the need for future research that appraises the validity of the HHI in different countries, and how the measure relates to other scales that evaluate hope.

Correction to: The translation and psychometric assessment of the perception of empowerment in midwifery scale: the Persian version.

An amendment to this paper has been published and can be accessed via the original article.

Can financial rewards complement altruism to raise deceased organ donation rates?

BACKGROUND: Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n » 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates. METHODS: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs. ETHICAL CONSIDERATIONS: The study was approved by the University of Malaya ethics committee. RESULTS: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate. CONCLUSION: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

The Changes of Endotracheal Tube Cuff Pressure during Manual and Intermittent Controlling in Intensive Care Units.

BACKGROUND: Usually, the endotracheal tube cuff pressure is controlled by cuff pressure monitoring. However, the intermittent pilot-manometer connection and disconnection may cause a change in the adjusted pressure. This study aimed to investigate changes in the endotracheal tube cuff pressure using both manual and intermittent controls. MATERIALS AND METHODS: A semi-experimental within-subject design was conducted. Fifty-nine intubated patients in the Mazandaran Intensive Care Units (ICUs) participated through convenience sampling in 2018. In the control condition, first, the cuff pressure was adjusted in 25 cm H2O then it was measured without manometer-pilot disconnection at 1 and 5 min intervals. In the intervention condition, cuff pressure was immediately adjusted in 25 cm H2O then it was measured with manometer-pilot disconnection in the 1st and 5th minutes. Data analysis was performed using Independent t-test, Chi-square test, and Phi coefficient. RESULTS: The mean and Standard Deviation (SD) change of cuff pressure after 1 minute, from 25 cm H2O, in the intervention condition was 20.22 (3.53) cm H2O. The mean (SD) of this change in the control condition was 25.22 (3.39) cm H2O. This difference was significant (t 116 = 7.83, p < 0.001, d = 1.44). The mean (SD) change of cuff pressure after 5 minutes, from 25 cm H2O, in the intervention condition was 19.11 (2.98) cm H2O. The mean (SD) of this change in the control condition was 25.47 (4.53) cm H2O. This difference was significant (t 116 = 9.24, p < 0.001, d = 1.70). CONCLUSIONS: The tracheal tube cuff pressure has been significantly reduced during manual intermittent measuring. Therefore, it is suggested that continuous cuff pressure monitoring and regulation should be used.

Evaluating co-occurrence of depression and sexual dysfunction and related factors among Iranian rural women: A population-based study.

BACKGROUND AND OBJECTIVES: Sexual dysfunction and mood disorders have a high prevalence rate and their co-occurrence has been reported in previous studies. This study aimed to determine the prevalence of co-occurrence of sexual dysfunction and depression and related factors in women. MATERIALS AND METHODS: This descriptive-analytical study was carried out on 826 married rural women aged 15-49 years in Sari, Iran in 2018, selected by random sampling. The participants filled the demographic and fertility questionnaires, as well as Beck's Depression Inventory and Female Sexual Function Index (FSFI). RESULTS: In this study, 18% of the participants experienced the co-occurrence of depression and sexual dysfunction. In addition, results of the multiple logistic regression showed that forced marriage (OR = 0.31, CI 95%: 0.15 to 0.64, P < 0.001), a one-level increase in the education of the spouse (OR = 0.76, CI 95%: 0.59 to 0.98, P < 0.041), lack of history of depression (OR = 0.36, CI 95%: 0.20 to 0.66, P < 0.001) and lack of vaginal infection (OR = 0.41, CI 95%: 0.27 to 0.62, P < 0.001) were considered as factors contributing to a decline in the co-occurrence of depression and sexual dysfunction. On the other hand, not having a private bedroom (OR = 1.63, CI 95%: 1.09 to 2.43, P < 0.017), no vehicle (OR = 1.52, CI 95%: 1.02 to 2.27, P < 0.038), a history of sychiatric diseases (OR = 2.09, CI 95%: 1.2.0 to 3.65, P < 0.009), lack of chronic diseases (OR = 2.11, CI 95%: 1.03 to 4.31, P = 0.039) and lack of use of antidepressants (OR = 2.03, CI 95%: 2.03 to 1.03, P < 0.039) increased the co-occurrence of depression and sexual dysfunction. CONCLUSION: According to the results of the study, about one-fifth of the married rural women experienced the co-occurrence of depression and sexual dysfunction. If healthcare providers detect one of the disorders of depression or sexual dysfunction in a patient, it is suggested that the person be assessed in terms of the other disorder and the proper treatment be applied. Furthermore, the healthcare personnel must pay attention to factors related to the co-occurrence of these disorders in addition to providing a treatment program.

Self-blame Attributions of Patients: a Systematic Review Study.

Introduction: Psychological aspects are important issues in patients that will have significant effects on disease progression. A new and important psychological concern is self-blame. This review was performed with the aim of systematic review on studies around patient's self-blame. Methods: This is a systematic review using international databases including PubMed (since 1950), Scopus (since 2004), Web ofSciences (since 1900), and ProQuest (since 1938) and Irani an databases including SID (since 2004) and Magiran (since 2001). Mesh terms including "patient," "regret," and "guilt" and non-Mesh terms including "self-blame attribution," "characterological self-blame," "behavioral self-blame," and "blame" were used in Iranian and international databases with OR and AND operators. Results: The review yielded 59 articles; 15 articles were included in the present study. The ages of patients ranged from 29-68.4 years. Most of studies (86.6%) had cross-sectional design and use characterological self-blame and behavioral self-blame variablesfor assessing self-blame attributions. The results showed that in most studies, a significant relationship among self-blame and psychological distress, anxiety, and depression were reported. Conclusions: A significant relation was reported between self-blaming and the degree of distress, anxiety, and depression in patients in most of the studies.

Psychometric Evaluation of a Persian Version of the Cardiac Depression Scale in Iranian Patients With Acute Myocardial Infarction.

PURPOSE: The aim of this study was to validate a Persian version of the Cardiac Depression Scale (CDS) in Iranian patients with acute myocardial infarction (AMI). METHODS: The CDS was forward translated from English into Persian and back-translated to English. Validity was assessed using face, content, and construct validity. Also Cronbach's alpha (α), theta (), and McDonald's omega coefficient were used to evaluate the reliability. RESULTS: Construct validity of the scale showed two factors with eigenvalues greater than one. The Cronbach's α, , McDonald's omega, and construct reliability were greater than .70. CONCLUSION: The Persian version of the CDS has a two-factor structure (i.e., death anxiety and life satisfaction) and has acceptable reliability and validity. Therefore, the validated instrument can be used in future studies to assess depression in patients with AMI in Iranians.

Religious coping and death depression in Iranian patients with cancer: relationships to disease stage.

PURPOSE: The study investigated relationships among the extent of disease, religious coping, and death depression in Iranian patients with cancer. METHOD: A descriptive cross-sectional study was conducted with a convenience sample of 482 Iranian cancer patients. Participants completed demographic and health, death depression, and religious coping surveys. RESULTS: After controlling for demographic and health characteristics, positive and negative religious coping behaviors were significantly related to the experience of death depression. There was an interaction effect between negative religious coping and extent of disease with significant positive relationships to the experience of death depression. CONCLUSIONS: Negative religious coping was found to be more closely associated with death depression in patients with earlier stage disease than those with advanced stages of cancer in this sample of patients with cancer from Iran. Findings support assessing patients for use of religious coping strategies. Muslim patients who are religiously alienated and have existential anguish may be vulnerable and need heightened support following diagnosis and during treatment of early stage cancer.

Relationships between Death Anxiety and Quality of Life in Iranian Patients with Cancer.

OBJECTIVE: The purpose of the study was to examine relationships between death anxiety and quality of life (QOL) parameters of patients with cancer in the Iranian sociocultural context. METHODS: A descriptive, correlational methodology was used. The sample included 330 patients. Demographics, health information, religious behaviors, death anxiety, and QOL data were collected. RESULTS: Overall death anxiety levels were moderate with satisfactory overall QOL. Death anxiety was predictive of lowered QOL. Female patients had lower QOL and higher death anxiety compared to men. CONCLUSIONS: Findings support that higher death anxiety negatively impacts QOL in an Iranian sample with cancer. Alleviation of existential concerns in vulnerable patients may palliate mental health distress associated with facing cancer and its challenging treatments.