A comprehensive measure assessing different types of problematic use of the internet among Chinese adolescents: The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11).

BACKGROUND: Problematic use of the internet (PUI) is prevalent, particularly among adolescents and young adults. Given the limited measures to assess specific types of PUI, which encompasses a broad spectrum of activities such as online gaming, social media use, pornography use, shopping, gambling, and web-streaming, Muller et al. (2022) developed the Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) to comprehensively assess different types of PUI (i.e., gaming, shopping, social media use, gambling, and pornography use). The present study aimed to validate the Chinese ACSID-11 among adolescents incorporating cross-cultural adaptations. METHODS: Using forward-backward translation method, a culturally adapted version of the ACSID-11 was prepared. Then, a cross-sectional online survey was administered between September 8 and September 26, 2023. Adolescents, using a convenience sample (N = 11,492; mean age = 16.42 years [SD ± 0.91]; 59.1% male), were recruited from six schools to complete the translated ACSID-11, Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Application Based Addiction Scale (SABAS) via an online platform. Pearson correlation coefficients assessed convergent/discriminant validity. Factor structure and measurement invariance were examined through confirmatory factor analysis (CFA) and multi-group CFA. Cronbach's alpha and McDonald's omega tested internal consistency. RESULTS: Associations between the ACSID-11 components and other scales supported convergent validity (i.e., ACSID-11 gaming scale with IGDS9-SF [0.37 ≤ r ≤ 0.41]; social networks use scale with BSMAS [0.24 ≤ r ≤ 0.31]) and discriminant validity (i.e., online gambling scale with BSMAS [0.16 ≤ r ≤ 0.19] and with SABAS [0.11 ≤ r ≤ 0.13]). A four-factor solution indicated good fit with comparative fit index (CFI) ranging from 0.982 to 0.958. The ACSID-11 was measurement invariant across sexes (∆CFI = -0.001 to 0.000) and different levels of related addictive behaviors (∆CFI = -0.001 to 0.000). Both Cronbach's alpha and McDonald's omega (0.63 to 0.97) were acceptable for both frequency and intensity of responses. CONCLUSIONS: The ACSID-11 is an appropriate scale to assess different kinds of PUI among Chinese adolescents and students. Psychometric assessment of the measure in other cultures and among clinical samples is recommended.

Burnout during the COVID-19 pandemic among nurses in Taiwan: the parental role effect on burnout.

BACKGROUND: During the COVID-19 pandemic, medical workers were concerned about the care of their children or family members and the impact of being separated from them. This increased stress could harm the relationship between nurses and patients. This study assessed how medical workers' parental role may affect burnout during such a high-stress period. METHODS: This cross-sectional observational study was carried out in 2021 during the COVID-19 pandemic. The client burnout (CB) scale of the Copenhagen Burnout Inventory, the Nordic Musculoskeletal Questionnaire, and a demographic questionnaire were used. Statistical methods such as the t-test, one-way ANOVA, and univariable/multiple linear regression were applied. RESULTS: A total of 612 nurses were included in this study. The likely risk factors of CB were identified and the parenthood effect was found to be associated with reduced CB. The parental role and leisure activity with family and friends on CB were found to have an impact. Engaging in leisure activity with family and playing the role of a parent diligently will help relieve nurses' burnout from frequent contact with patients and their families, thus lowering the risk of clinical burnout. CONCLUSION: The parental role, family/friends relationships, and a complex work environment associated with nurses' burnout during the COVID-19 pandemic. This finding allows us to re-examine the importance of family life and parent-child relationships in high-stress work environments.

Health education using the theory of planned behavior to modify ergonomic posture in hospital computer users: a randomized controlled trial.

OBJECTIVE: Work-related musculoskeletal disorders are prevalent in those who use computers, and education using ergonomic principles may be helpful to prevent such conditions. The present study sought to identify how an educational intervention based on the theory of planned behavior (TPB) may be effective for adopting healthy ergonomic postures. METHODS: A convenience sample of 162 computer users working in a hospital setting in Iran were randomly assigned to intervention or control groups. The intervention group (n = 81) received six weekly educational sessions based on TPB principles, whereas the control group received no intervention during the study period. Both groups were assessed at baseline and 3 months after the intervention using a TPB questionnaire, rapid office strain assessment (ROSA), and Nordic musculoskeletal questionnaire. Data were analyzed using the independent/paired Student's t test, chi-square, and analysis of covariance. RESULTS: All TPB constructs in the intervention group improved from baseline to follow-up, indicating considerable progress compared to the control group (p < 0.001). More than 60% of intervention and control groups were categorized as high risk at baseline in terms of ergonomic posture measured by ROSA. This percentage was reduced to 21% for intervention group and increased to 65% in the control group at follow-up. Symptom relief was obtained for wrist/hands, lower back, neck, shoulders and upper back in the intervention group (all p < 0.05). The number of affected areas also significantly decreased in the intervention group compared to the control group three months after the intervention. CONCLUSION: Educational programs based on TPB principles may be helpful in correcting ergonomic postures among computer users. Such interventions are recommended for worksite health promotion in that they may prevent the development of musculoskeletal disorders in staff.

An Intervention Program Using the Health Belief Model to Modify Lifestyle in Coronary Heart Disease: Randomized Controlled Trial.

BACKGROUND: Most effective interventions to control coronary heart disease (CHD) and prevent negative outcomes involve behavioral modification. This study examined how such modification based on the Health Belief Model (HBM) might improve lifestyle and clinical outcomes. METHODS: A total of 120 people with CHD seeking help at a general hospital in Iran were randomly assigned to either the intervention or control group. Information was collected using an HBM-specific questionnaire and the Health Promoting Lifestyle II (HPLP-II) scale. Clinical outcomes (blood pressure, body mass index, and fasting blood sugar) were also measured. The intervention group received a tailored education based on HBM principles plus routine care, while those in the control group received only routine care. Three months after the intervention, both groups were reassessed using Student's t test and analysis of covariance. RESULTS: All HBM subscale scores indicated significant improvements in the intervention group, in contrast to the control group, where scores worsened or stayed the same. Perceived severity and susceptibility were the dimensions that changed most. Total score on the HPLP-II improved significantly in the intervention group (p < 0.001, F = 747.5); however, subscale scores on spiritual growth and interpersonal relationships did not demonstrate significant between-group differences at follow-up. After adjustment for baseline scores, significant improvements in lifestyle subscales were also accompanied by significant improvements in clinical measures. CONCLUSIONS: This HBM-based behavior modification program improved both lifestyle and clinical measures in patients with CHD. Utilizing this program in patients with other cardiovascular diseases may in the future demonstrate similar results.

Psychometric Properties of the Spiritual Coping Strategies Scale-Chinese Version (SCSS-C) for Adults in Taiwan.

This study examined the psychometric properties of the Spiritual Coping Strategies Scale-Chinese version (SCSS-C) in Taiwanese adults. A convenience sample of 232 participants in Taiwan completed an online survey, and 45 of the 232 participants completed the SCSS-C again over a 2 week interval. The content validity index of the SCSS-C was 0.97. Parallel analysis and exploratory factor analysis results revealed two factors (religious coping and non-religious coping). The internal consistency of the SCSS-C was satisfactory (α = 0.88 to 0.92). Test-retest reliability was satisfactory (r = 0.68 to 0.89). The psychometric properties of the SCSS-C were found to be acceptable for use in Taiwanese adults.

Temporal associations between depressive features and self-stigma in people with substance use disorders related to heroin, amphetamine, and alcohol use: a cross-lagged analysis.

BACKGROUND: Depression is a mental health problem and substance use concerns are socially unacceptable behaviors. While depression and substance use may individually impact self-concept and social relationships, their co-occurrence can increase the risk of self-stigmatization. However, there is no evidence regarding how depression and self-stigma may influence each other over time. The aim of the current study was to evaluate the cross-sectional and longitudinal relationships between features of depression and self-stigma in people with substance use disorders. METHODS: Overall, 319 individuals with substance use disorders (273 males) with a mean (± SD) age of 42.2 (± 8.9) years were recruited from a psychiatric center in Taiwan by convenience sampling. They were assessed for features of depression and self-stigma at four times over a period of nine months using the depression subscale of the Depression Anxiety Stress Scales (DASS-21) and Self-Stigma Scale-Short S (SSS-S), respectively. Repeated-measures analyses of variance, Pearson correlations and cross-lagged models using structural equation modeling examined cross-sectional and temporal associations between depression and self-stigma. RESULTS: Positive cross-sectional associations were found between depressive features and all assessed forms of self-stigma over time (0.13 < r < 0.92). Three models of cross-lagged associations between different forms of self-stigma and depressive features indicated good fit indices (comparative fit index > 0.98). The direction of associations between depressive features towards self-stigma was stronger than the opposite direction. CONCLUSION: Positive associations between depressive features and self-stigma were found in people with substance use disorders. Although these associations may be bidirectional longitudinally, the directions from depressive features to self-stigma may be stronger than the reverse directions, suggesting treatment of depression in earlier stages may prevent self-stigmatization and subsequent poor outcomes in people with substance use disorders.

An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial.

BACKGROUND: Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children. METHODS: A total of 112 children ages 6-12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student's t-test and analysis of covariance. RESULTS: All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = - 0.9 to - 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups. CONCLUSION: An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

Effect of Spiritual Care Based on the Sound Heart Model on Spiritual Experiences of Hemodialysis Patients.

Hemodialysis patients require spiritual care due to their spiritual distress. This study aimed to investigate the effect of spiritual care on spiritual experiences of hemodialysis patients. This randomized controlled trial was conducted in 2017 at hemodialysis departments of Baqiyatallah and Cham ran hospitals in Tehran. The volunteer patients were selected by available sampling according to the inclusion criteria. Participants were randomly assigned to intervention and control groups. Interventions were performed in the educational-supportive nursing system according to the patients' self-care ability. Eight individual counseling sessions, 15-45 min, face-to-face, during dialysis, once a week were implemented for intervention group. Developing the relationship with God, self, people and nature were the main goals of care. Daily spiritual experience questionnaire was completed by patients before and three months after the intervention. There was no significant difference in the spiritual experience score of the intervention (75.20 ± 9.14) and control group (76.63 ± 10.03), before the intervention (P = 0.523). There was a statistically significant difference between the intervention (82.93 ± 5.69) and the control group score (77.24 ± 12.09) three months after the intervention (P < 0.0001). Due to the need for holistic and community-oriented care and the positive effect of this study, the use of the Sound Heart Model is recommended for Muslim patients.

Maximum Relevance Minimum Redundancy Dropout with Informative Kernel Determinantal Point Process.

In recent years, deep neural networks have shown significant progress in computer vision due to their large generalization capacity; however, the overfitting problem ubiquitously threatens the learning process of these highly nonlinear architectures. Dropout is a recent solution to mitigate overfitting that has witnessed significant success in various classification applications. Recently, many efforts have been made to improve the Standard dropout using an unsupervised merit-based semantic selection of neurons in the latent space. However, these studies do not consider the task-relevant information quality and quantity and the diversity of the latent kernels. To solve the challenge of dropping less informative neurons in deep learning, we propose an efficient end-to-end dropout algorithm that selects the most informative neurons with the highest correlation with the target output considering the sparsity in its selection procedure. First, to promote activation diversity, we devise an approach to select the most diverse set of neurons by making use of determinantal point process (DPP) sampling. Furthermore, to incorporate task specificity into deep latent features, a mutual information (MI)-based merit function is developed. Leveraging the proposed MI with DPP sampling, we introduce the novel DPPMI dropout that adaptively adjusts the retention rate of neurons based on their contribution to the neural network task. Empirical studies on real-world classification benchmarks including, MNIST, SVHN, CIFAR10, CIFAR100, demonstrate the superiority of our proposed method over recent state-of-the-art dropout algorithms in the literature.

A spiritual intervention to reduce stress, anxiety and depression in pregnant women: Randomized controlled trial.

We assessed the efficacy of a spiritually-integrated cognitive-behavioral educational group intervention for reducing stress, anxiety, depression, and blood pressure during pregnancy and improving delivery outcomes. A randomized controlled trial was conducted in 84 pregnant women randomly assigned to either the intervention or a control group. Demographic information was collected at baseline, along with measures of religiosity, stress, anxiety, depression, and blood pressure. Our intervention consisted of four 90-minute group sessions over 8 weeks that utilized a spiritually-integrated cognitive-behavioral approach to help participants cope with the stress of pregnancy. Stress, anxiety and depression scores in the intervention group decreased significantly by 41%, 28%, and 41%, respectively, from baseline to 3-month follow-up. There were also significant differences in systolic and diastolic blood pressure between groups at the 3-month follow-up, favoring the intervention group. Between-group differences were also significant for these outcomes. Applying such spiritually-integrated intervention may help to improve the mental and physical health of young, healthy nulliparous pregnant women.

Effect of a health-education program using motivational interviewing on oral health behavior and self-efficacy in pregnant women: a randomized controlled trial.

Oral health problems are common among pregnant women. The objective of this study was to examine the effectiveness of motivational interviewing (MI) as a behavior-change technique to enhance self-efficacy and oral health among pregnant women. A randomized controlled trial was conducted with 112 pregnant Iranian women. Women in the intervention group received an education program on oral health using MI during two face-to-face sessions, along with routine health education (two 1-h lectures on oral health changes and needs during pregnancy presented as a lecture by an oral health technician over a 2-wk period). Those in the control group received two 1-h lectures on oral health changes and needs during pregnancy. Oral health behaviors, oral health self-efficacy, and general self-efficacy, were assessed, along with gingival and dental health from baseline to the 3-month follow-up. Analysis of covariance was used to determine differences between intervention and control groups. Scores for both general and specific self-efficacy and for healthy behaviors increased in the intervention group, whereas there was no significant change within controls from baseline to follow-up. Between-group analyses also indicated a significant difference in the scores for self-efficacy and behavior favoring the intervention group. Scores on the gingival inflammation index decreased, as did the number of decayed teeth in the intervention group relative to the control group. The number of filled teeth increased significantly in the intervention group. Health education interventions using MI techniques may help to improve oral health-related self-efficacy and behaviors among pregnant women.

The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes.

PURPOSE: Type 2 diabetes is a major public health issue particularly in the elderly. Religion may affect the Health Related Quality of Life (HRQoL) in such patients, mediated by factors such as religious coping and social support. This study aimed to investigate the impact of religiosity on medication adherence and HRQoL. METHODS: 793 adults (> 65 years old, 45% females) were recruited from 4 diabetes care centers and followed for 1 year. Duke University Religion Index, Spiritual Coping Strategies, Multidimensional Perceived Social Support, Medication Adherence Report Scale, WHOQOL-BREF and Diabetes-specific Quality of Life Questionnaire Module were used for assessment, as well as HbA1c and fasting blood glucose level. Using structural equation modeling, the potential paths were tested between religiosity, medication adherence and HRQoL; social support, religious coping and medication adherence served as the mediators. RESULTS: Religious coping and social support were recognized as the significant mediators between religiosity and medication adherence (CFI = 0.983, TLI = 0.985, and RMSEA = 0.021). The relationships between religiosity and HRQoL were considerably mediated by social support, religious coping and medication adherence and these variables explained 12% and 33% of variances of generic and specific HRQoL, respectively. There was no significant direct effect of religiosity on HRQoL. HbA1c and fasting blood glucose level were successfully loaded on the latent construct of medication adherence (factor loading = 0.51 and 0.44, respectively). CONCLUSIONS: The impact of religiosity on medication adherence and HRQoL occurs through the mediators such as religious coping and social support. Therefore, to improve the adherence to treatment and quality of life, interventions may be designed based on these mediators.

Effects of religiosity and religious coping on medication adherence and quality of life among people with epilepsy.

The epidemiologic information demonstrates the importance of caring people with epilepsy (PWE). Indeed, the impaired quality of life (QoL) and medication nonadherence rate among PWE have been reported. However, religiosity and religious coping could be potential factors for clinicians to foster appropriate intervention on epileptic care. This study investigated two models to further understand the relationships between religiosity, religious coping (including positive and negative coping), medication adherence, and QoL in an Iranian sample with epilepsy. Eligible PWE (n=760) completed the religiosity scale (Duke University Religion Index; DUREL) at baseline; the religious coping scale (Brief Religious Coping Scale; Brief RCOPE) one month later; the medication adherence scale (Medication Adherence Report Scale; MARS-5) two months later; and the QoL scale (Quality of Life in Epilepsy; QOLIE-31) twelve months later. Their antiepileptic drug serum level was measured during the period they completed the MARS. Through structural equation modeling (SEM), we found that religiosity directly correlated with negative religious coping and medication adherence, and indirectly correlated with medication adherence through negative religious coping. Both positive and negative religious coping directly correlated with medication adherence and QoL. Therefore, religiosity and religious coping may be determinants of medication adherence and QoL in PWE; health professionals may consider asking PWE if religion is important to them and how they use it to cope with their epilepsy.

Polycystic ovary syndrome and its impact on Iranian women's quality of life: a population-based study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a major public health concern worldwide affecting up to one in five women at reproductive age. It is associated with biochemical and hormonal disturbances as well as adverse cosmetic, reproductive, metabolic, and psychological consequences, resulting in worsened quality of life. The aim of the present study is evaluating the quality of life and determining its degrading factors among Iranian women suffering from this syndrome. METHODS: This cross-sectional study was conducted on 200 PCOS women in Hamadan, Iran. In order to measure quality of life we used the Persian version of Health-related Quality of Life Questionnaire for PCOS (PCOSQ). Descriptive statistics was used to explore the data. In addition linear regression analysis was performed to assess factors affecting health-related quality of life in this population. RESULTS: The mean score for quality of life domains (from the greatest to the least serious concern) were: infertility (3.43 ± 1.63), emotions (3.55 ± 1.17), menstrual problems (3.77 ± 1.36), body hair (3.80 ± 2.05) and weight (4.32 ± 1.80), respectively. The higher score represents better function. However, multivariate analysis revealed that hirsutism had the strongest impact on the patients' quality of life (p < 0.001) followed by infertility (p = 0.038) and menstrual irregularity (p = 0.003). CONCLUSION: The findings showed that impairment of quality of life was associated with PCOS related conditions such as hirsutism, infertility and menstrual problems.

The effectiveness of a model-based health education intervention to improve ergonomic posture in office computer workers: a randomized controlled trial.

PURPOSE: Lack of knowledge about computer ergonomics predisposes users to musculoskeletal and visual disorders. The present study examined the effect of a trans-theoretical model (TTM)-based educational program on work-related posture in office computer users. METHODS: This experimental study examined 102 hospital personnel whose primary job involved working at a computer. Participants were randomized to intervention and control groups. An educational intervention based on TTM was conducted over five sessions. A self-report questionnaire was used to collect data including stages of change, processes of change, pros and cons of change, and self-efficacy. A pen-paper-based observational method (i.e., Rapid Office Strain Assessment or ROSA) was used for assessing work posture. A visual analogue scale assessed pain intensity. Data were collected at baseline and 3-month follow-up. RESULTS: Significant differences were found on TTM's constructs and ROSA score between intervention and control groups at follow-up (p < 0.05). The mean ROSA score decreased from 5.65 (SD 1.03) to 3.95 (SD 0.83) in the intervention group, while no significant change was found in the control group. Pain intensity also decreased significantly among those in the intervention vs. control group (p < 0.001). CONCLUSION: An educational intervention based on TTM was effective in improving ergonomic posture in computer workers. Further research is needed to determine if these results can be generalized to computer workers in other settings.

Multidimensional Fatigue Inventory in People With Hepatitis B Infection: Cross-cultural Adaptation and Psychometric Evaluation of the Persian Version.

There is no valid and well-established tool to measure fatigue in people with chronic hepatitis B. The aim of this study was to translate the Multidimensional Fatigue Inventory (MFI) into Persian and examine its reliability and validity in Iranian people with chronic hepatitis B. The demographic questionnaire and MFI, as well as Chronic Liver Disease Questionnaire and EuroQol-5D (to assess criterion validity), were administered in face-to-face interviews with 297 participants. A forward-backward translation method was used to develop a culturally adapted Persian version of the questionnaire. Cronbach's α was used to assess the internal reliability of the scale. Pearson correlation was used to assess criterion validity, and known-group method was used along with factor analysis to establish construct validity. Cronbach's α for the total scale was 0.89. Convergent and discriminant validities were also established. Correlations between the MFI and the health-related quality of life scales were significant (p < .01). The scale differentiated between subgroups of persons with the hepatitis B infection in terms of age, gender, employment, education, disease duration, and stage of disease. Factor analysis indicated a four-factor solution for the scale that explained 60% of the variance. The MFI is a valid and reliable instrument to identify fatigue in Iranians with hepatitis B.

Validation of the Persian version of the Daily Spiritual Experiences Scale (DSES) in Pregnant Women: A Proper Tool to Assess Spirituality Related to Mental Health.

Assessing spirituality in healthy pregnant women may lead to supportive interventions that will improve their care. A psychometrically valid measure such as the Daily Spiritual Experiences Scale (DSES) may be helpful in this regard. The current study sought to adapt a Persian version of DSES for use in pregnancy. A total of 377 pregnant women were recruited from three general hospitals located in Tehran, Iran. Administered scales were the DSES, Duke University Religion Index, Santa Clara Strength of Religious Faith scale, and Depression Anxiety Stress Scale, as well as demographic measures. Reliability of the DSES was tested using Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC) for test-retest stability. Scale validity was assessed by criterion-related tests, known-groups comparison, and exploratory factor analysis. Participant's mean age was 27.7 (4.1), and most were nulliparous (70%). The correlation coefficient between individual items on the scale and the total score was greater than 0.30 in most cases. Cronbach's alpha for the scale was 0.90. The ICC for 2-week test-retest reliability was high (0.86). Relationships between similar and dissimilar scales indicated acceptable convergent and divergent validity. The factor structure of the scale indicated a single factor that explained 59% of the variance. The DSES was found to be a reliable and valid measure of spirituality in pregnant Iranian women. This scale may be used to examine the relationship between spirituality and health outcomes, research that may lead to supportive interventions in this population.

Psychometric characteristics of the Muslim Religiosity Scale in Iranian patients with cancer.

OBJECTIVE: Cancer is a leading cause of death worldwide. Religiosity is a factor that may help cancer patients to cope with their disease. The aim of the current study was to validate a Persian translation of the Muslim Religiosity Scale (MRS) in a population of Iranian patients with cancer. METHOD: Two thousand patients were invited to participate in this multisite study, of whom 1,879 participated. Patients completed a demographic questionnaire, the MRS, and several scales, including the Patient Health Questionnaire-9, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, and the SF-12 quality of life measure. Backward-forward translation was employed to develop a Persian-language version of the MRS. Cronbach's alpha and two-week test-retest reliability were also assessed. Convergent and discriminative validity as well as the factor structure of the scale were also examined. RESULTS: The internal reliability (α) of the religious practices and beliefs subscales was 0.88 and 0.92, respectively. The intraclass correlation coefficient (ICC) was 0.92 (range = 0.75-1.0). The scale demonstrated solid convergent and discriminative validity. Factor analysis indicated two main factors, as predicted, with an appropriate goodness of fit (χ2 = 76.23, RMSEA = 0.065). Such factors as marital status, quality of life, social support, and self-efficacy were positively associated with MRS total score, while anxiety, depression, and suicide ideation had negative associations. SIGNIFICANCE OF RESULTS: The MRS is a useful tool for assessing religiosity in Iranian patients with cancer and is associated with a number of important health outcomes.

Psychometric evaluation of the Persian version of the Type 2 Diabetes and Health Promotion Scale (T2DHPS): a diabetes-specific measure of lifestyle.

BACKGROUND: A healthy lifestyle is important for maintaining health and preventing complications in patients with type 2 diabetes, and yet, few instruments are available to measure this. AIM: The aim of the present study was to examine the psychometrics of a recently developed tool that can be used to screen for a health-promoting lifestyle in patients with type 2 diabetes. METHODS: Data were collected from outpatients attending diabetes clinics. The Type 2 Diabetes and Health Promotion Scale (T2DHPS), EQ-5D, medical records and a demographic questionnaire were administered to 368 participants. Forward-backward translation of the original English version was used to develop a Persian version. Internal consistency of the scale was assessed by Cronbach's alpha and item-to-total correlation. Acceptability was measured by assessing floor and ceiling effects for each item and subscale. The item scaling test was used to examine the convergent and discriminant validity of the measure. Pearson correlation was used to determine the predictive validity of the scale. An explanatory factor analysis and known-group method were used to establish construct validity. RESULTS: Adjusted item-total correlations were higher than 0.20. Cronbach's alpha for the 28-item scale was 0.88 and for subscales ranged from 0.53 to 0.94. Correlations between the total score and subscale scores were significant (<0.01) and adequate (r's ≥ 0.53). There were significant relationships between the T2DHPS and both the EQ-5D and indicators of glycaemic control. Convergent and discriminant validity of the scale was established. Significant differences in lifestyle dimensions were present between different groups of patients, demonstrating known-group validity. A six-factor solution was obtained that explained 54.6% of the total variance. CONCLUSION: The T2DHPS is a valid and reliable tool for investigating lifestyle behaviours in patients with type 2 diabetes. Further studies to establish the psychometric properties of the scale in other languages and cultures are suggested.

Personal hygiene among military personnel: developing and testing a self-administered scale.

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