Measurement properties of the Iranian version of the breast cancer perception scale (BCPS) according to the COSMIN checklist.

BACKGROUND: Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. METHODS: The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. RESULTS: The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. CONCLUSIONS: The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors.

The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis.

BACKGROUND: Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS: To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS: From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS: The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

Emotional intelligence and stress and their relationship with breastfeeding self-efficacy in mothers of premature infants.

BACKGROUND: Premature infants need to be hospitalized in the neonatal intensive care unit (NICU) for long periods of time, which can increase anxiety and stress in their mothers. Additionally, the breastfeeding rate is lower among preterm infants. This study aimed to determine stress levels and emotional intelligence in mothers of preterm infants and their relationship with breastfeeding self-efficacy. METHODS: This descriptive-correlational study was performed with a convenience sampling of 210 mothers of premature infants admitted to the neonatal intensive care unit in Tabriz, Iran in 2021. Data collection tools included socio-demographic checklist, perceived stress scale (PSS14), Dennis' breastfeeding self-efficacy scale, and the Schering emotional intelligence questionnaire. Data were analyzed using SPSS software version 16 via descriptive and inferential statistics (Pearson correlation and one-way ANOVA and modified general linear model). RESULTS: Study findings demonstrated that most of the mothers had low stress (75.2%) and high breastfeeding self-efficacy (61.9%). The mean (SD) of emotional intelligence of the participants was 88.18 (16.60), ranging from 33 to 165. The results of the general linear model by modifying the demographic characteristics showed that the variables of emotional intelligence (B = 0.23, P = 0.03), stress (B=-0.56, P = 0.01), gestational age (B = 2.81, P < 0.001) and number of deliveries (B = 9.41, P < 0.001) were predictors of breastfeeding self-efficacy. CONCLUSION: The findings showed that mothers of preterm infants had low emotional intelligence, and the majority of them had low perceived stress and high breastfeeding self-efficacy. Findings highlight the importance of addressing maternal stress and enhancing emotional intelligence to promote successful breastfeeding in mothers of preterm infants. Healthcare providers and managers are encouraged to offer support and educational programs to mothers of preterm infants, aiming to enhance their emotional intelligence. Further research and interventions focusing on these factors are warranted to improve the overall well-being of both mothers and infants in the neonatal intensive care unit.

Preferences of Iranian smokers regarding smart smoking cessation technologies: a parallel convergent mixed methods study.

BACKGROUND: Considering the values and preferences of individuals who attempt to quit smoking is a crucial step in the development of smoking cessation technologies. This study aimed to explore preferences regarding smart smoking cessation technologies. METHODS: This parallel convergent mixed-methods study was conducted in two phases: quantitative and qualitative. In the quantitative phase, a cross-sectional study was conducted with 360 participants selected through stratified random sampling from technology-based smoking cessation clinics in Tabriz, Tehran, and Karaj cities in Iran. Data on demographic characteristics and preferences for smart smoking cessation technologies were collected using questionnaires and analyzed using descriptive statistics. In the qualitative phase, 25 users of these technologies were selected through purposeful and snowball sampling. The data were gathered through in-depth semistructured interviews and analyzed using qualitative content analysis with a conventional approach. Quantitative and qualitative data were integrated using the merging strategy and convergence model. RESULTS: The quantitative phase results indicated that the highest preference was related to wearing and using a smartwatch for smoking cessation and using mobile apps. In the qualitative phase, 17 subcategories were extracted and classified into 8 main categories: high effectiveness, better management of the smoking cessation process, personalized technology, safe and uncomplicated technologies, attractiveness and innovative design, scientific basis, mobile applications, and smart monitoring devices. CONCLUSION: By combining and integrating quantitative and qualitative results, it can be concluded that users are more interested in wearable technologies and interactive mobile applications. The findings of this study can assist smoking cessation technology developers in designing and improving their tools based on user needs and preferences to enhance their effectiveness and acceptability.

Breastfeeding challenges and the impact of social support in Iranian Muslim mothers: A cross-sectional study.

Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = -0.199؛ p = .001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = -0.165; 95 percent CI: -0.07-0.25, p < .001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems.

Developing the questionnaire of general population knowledge, attitudes and practices towards the COVID-19 outbreak.

AIM: To develop the general population knowledge, attitudes and practices (KAP) questionnaire towards the COVID-19 outbreak. DESIGN: A methodological study. METHODS: The general population KAP questionnaire items were designed using a literature review. A panel of experts was used to calculate content validity ratio (CVR) and content validity index (CVI). Construct validity was examined using exploratory factor analysis (EFA) and hypothesis testing. Internal consistency of the questionnaire was measured using Cronbach's α coefficient. Eight hundred forty-seven patients referred to health centres in Tabriz, Iran completed the questionnaire in 2021. RESULTS: The developed questionnaire consisted of three parts, including knowledge, attitudes and practices. EFA identified three dimensions for the knowledge (ways of transmission and prevention, high-risk groups, and symptoms and treatment), three dimensions for the attitudes (hope, fear and view of the vaccine) and three for the practices (adherence to personal and public hygiene, limiting their presence in society and protecting yourself in the community). The Kaiser-Meyer-Olkin index for knowledge, attitudes and practices was 0.733, 0.725 and 0.886, respectively, with a significant Bartlett's test of sphericity (p < 0.01). The hypotheses of knowledge and attitudes that are the related factors of practices were confirmed. Cronbach's α was 0.63, 0.74, 0.77, 0.1 and 0.85 for knowledge; fear, hope and view of the vaccine subscales of attitudes; and practices, respectively. PATIENT OR PUBLIC CONTRIBUTION: The developed 47-item questionnaire had acceptable validity and reliability. Thus, nurses can use it to assess the clients' KAP during the COVID-19 outbreak. Also, nursing researchers can use this questionnaire in their descriptive and interventional studies.

Breast cancer screening patterns and associated factors in Iranian women over 40 years.

Screening is a key component of breast cancer early detection programs that can considerably reduce relevant mortality rates. The purpose of this study was to determine the breast cancer screening behavioral patterns and associated factors in women over 40 years of age. In this descriptive­analytical cross­sectional study, 372 over 40 years of age women visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling. The data were collected using the sociodemographic characteristics questionnaire, breast cancer perception scale, health literacy for Iranian adults scale, and the Breast Cancer Screening Behavior Checklist. The obtained data were analyzed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (univariate and multivariate logistic regression analyses). In total, 68.3% of all participants performed breast self­examination (BSE) (9.9% regularly, once per month), 60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year), 51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwent sonography (3.8% regularly, twice per year). The findings also showed that women with benign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21; P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography (OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderate breast cancer perception scores were more likely to perform BSE than women with high breast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women who had a history of benign breast disease were more likely to perform screening behaviors than others (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 were more likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE (OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participation of women in regular breast cancer screening, it is suggested that health care providers highlight the need for screening at the specified intervals in their training programs. In addition, health authorities are recommended to use reminder systems to remind women, especially those over 40 years of age, of the best time for breast screening. Moreover, health care providers must seek to improve breast cancer knowledge, attitudes, and perceptions of women who visit health centers, which are the first level of contact with the healthcare system for the general population.