Gender difference about death anxiety among older adults: Structural Equation Model.

BACKGROUND: Older adults may be more prone to death anxiety than their younger counterparts. This study explores factors affecting death anxiety based on gender differences. METHODS: In this correlational study, 450 older adults referred to the health centres in the city of Bukan, Iran were recruited by using a randomised sampling method. Next, data were collected about the demographic questionnaire, anxiety about ageing, death anxiety, mental well-being, perceived social support, and quality of life questionnaire. The Spearman correlation coefficient was used to determine the correlation between variables, and the predictors of death anxiety were evaluated using quintile regression. Relationship between death anxiety and other variables was evaluated by the Structural Equation Model (SEM). The study was approved by the Tabriz University of Medical Sciences Ethics Committee (Ethics Code: IR.TBZMED.REC.1397.304). RESULTS: The results showed that death anxiety in men had a significant relationship with the level of literacy (P = 0.047), body self-imaging (P = 0.031), and perceived social activity (P = 0.033). Among women, death anxiety had a significant relationship with physical activity (P = 0.007) and perceived social activity (P = 0.002). Additionally, quintile regression analysis was calculated: among men, anxiety about ageing was related to death anxiety (ß = 0.182, P = 0.05), while in women, only perceived social support was associated to death anxiety (ß = -0.376, P = 0.05). Finally, according to SEM, a significantly different level of predictability of mental well-being was found for death anxiety among older men and women. CONCLUSION: Understanding the gender differences about death anxiety by the healthcare system might be useful in controlling and reducing a variety of concerns among elders who experience high levels of anxiety of death.

Psychometric Properties of Jacelon's Attributed Dignity Scale with Iranian Older People.

OBJECTIVE: The main purpose of this study was the psychometric assessment of Jacelon's Attributed Dignity Scale among Iranian older population. METHODS: Using a standard "forward-backward" translation procedure, the original English version of Jacelon's Attributed Dignity Scale was translated into Persian. Internal consistency of the scale was checked by the Cronbach's α coefficient. Convergent validity of the instrument was appraised by the Social Skills Scale and General Health Questionnaire. Factor structure of the Iranian version of Jacelon's Attributed Dignity Scale and possible interplay between its subscales were checked through recruiting a convenient sample of 300 Iranian older people and performing the confirmatory factor analysis. FINDINGS: The estimated Cronbach's α and intraclass correlation coefficients for the Iranian version of Jacelon's Attributed Dignity Scale were in the vicinity of acceptable range, that is, 0.87 and 0.93, respectively. The output of confirmatory factor analysis revealed that a four-factor model best fitted the study data (χ2 = 323.49; df = 129; p < 0.001; comparative fit index = 0.913; Tucker-Lewis index = 0.901; root mean square error approximation = 0.074; standardized root mean square residual = 0.078). Rasch estimates of item difficulty ranged from -1.28 (less difficult) to 1.33 (more difficult). No significant cross-gender differences were observed regarding the Iranian version of Jacelon's Attributed Dignity Scale's items indicating its invariant psychometric properties for use in the Iranian men and women subgroups. ETHICAL CONSIDERTAION: This study was approved by the Ethics Committee at the Tabriz university of medical science. Informed consent, information confidentiality, and voluntary participation were guaranteed. CONCLUSION: The study findings were indicative of applicability of the Iranian version of Jacelon's Attributed Dignity Scale as a reliable tool in measurement of the perceived social dignity among Iranian and probably other Persian-speaking older populations.

Psychometric properties of the General Health Questionnaire (GHQ-12) to be applied for the Iranian elder population.

INTRODUCTION: The General Health Questionnaire (GHQ-12) is a self-administered questionnaire to screen and detect individuals with a diagnosable psychiatric disorder. This study was designed to validate the Persian translated version of the short 12-item General Health Questionnaire (GHQ-12) for use with the Iranian elder population. METHOD: A forward-backward translation method was performed to ensure the quality of the English to Persian translation. A sample of 300 Iranian elder (60 years and over) people was selected from locations known to be frequented by older adults residing in three cities in Iran. Factor of the GHQ-12 was assessed using confirmatory factor analysis (CFA). Internal consistency and test-retest reliability were measured by estimating the Cronbach's alpha and Spearman correlation coefficients, respectively. RESULTS: The study participants included 157 (52.3%) men and 143(47.7%) women with an average age of 66.5 years (SD = 5.5). Cronbach's alpha for Social dysfunction, psychological distress and overall score were 0.80, 0.78 and 0.82, respectively. The test-retest correlation coefficients among two sub-scales of the GHQ-12 as well as the overall scores ranged from 0.84 to 0.93. CFA revealed a good fit for a modified 12-item two-factor structure. CONCLUSION: The Persian version of the 12-item General Health Questionnaire was found to be valid and reliable for measuring general health of Persian speaking elderly populations.

Psychometric properties of the Short Form-8 Health Survey (SF-8) among diabetes and non-diabetes Iranian older people.

Background: The current study aimed to evaluate the psychometric properties of the Persian version of the 8-item Short-Form Health Survey (SF-8). For this purpose, we examined a large sample of the older adult in two different groups with and without diabetes using the YazdHealth Study (YaHS) data. Methods: Using a two-stage cluster random sampling method, 1901 older adults were recruited, according to the World Health Organization (WHO) STEPwise approach to surveillance(STEPS) guidelines. To test the scale's reliability, the internal consistency and test-retest methods were applied. The convergent validity of the entire questionnaire was evaluated by the average variance extracted (AVE) and composite reliability (CR) for each subscale. An independent samples t-test was used to assess the demographic differences between the study groups. Results: The Cronbach's alpha coefficient for the subscales of SF-8 were measured to range between 0.85 and 0.79 (physical & mental health). The test-retest reliability coefficient of the physical component summary (PCS) and (0.97) and mental component summary (MCS) (0.98)indicated the appropriate reliability of the SF-8. The CFA-concerned results indicated that the the2-factor model presented a good fit to the data for the explored diabetes and non-diabetes groups, as well as the total research participants [goodness of fit index (GFI)=0.99, comparative fit index (CFI)=0.992, normed fit index (NFI)=0.99, incremental fit index (IFI)=0.992, root mean square error of approximation (RMSEA)=0.056]. Values >0.5 and >0.7 for AVE and CR indicated the evidence of the convergent validity of the SF-8. Conclusion: The present study was the first attempt to confirm the traditional 2-factor structure of SF-8 among a large sample of Iranian older individuals. The obtained results suggested that the Persian version of the SF-8 is a reliable and valid tool for measuring health-related quality of life (HRQoL) among Iranian older adults (including the older adult with & without diabetes).

Psychometric Properties of the Lasher and Faulkender Anxiety about Aging Scale (AAS) among Iranian Older Adults.

(1) Background: The older adult population of society is exposed to multiple stressors daily, such as the loss of loved ones, dysfunctional mobility, financial dependence, and suffering from numerous chronic illnesses. The present study aimed to assess the psychometric properties of the Anxiety about Aging Scale among older adults in Iran. (2) Methods: A sample of 703 community-dwelling older adults was recruited and screened using a standardized tool. The mean age of participants was 69.4 ± 8.1 years. The majority of participants were male (59.2%), married (66.6%), and illiterate (79.7%). A 'forward-backward' translation method was used in developing the Iranian version of the AAS for assessing the psychometric properties among older adults. Confirmatory factor analysis (CFA) and the Rasch model were used for construct validity. (3) Results: Applying CFA indicated that the model's four original factors are the best solution, representing 55% of the total variance. The result of the CFA showed that this four-factor model had a good fit for the data. The findings were also confirmed by Rasch analysis. (4) Conclusions: The Persian version of the AAS is valid and reliable for measuring aging anxiety among Iranian older adults.