Parental hesitancy toward children vaccination: a multi-country psychometric and predictive study.

AIM: Understanding vaccine hesitancy, as a critical concern for public health, cannot occur without the use of validated measures applicable and relevant to the samples they are assessing. The current study aimed to validate the Vaccine Hesitancy Scale (VHS) and to investigate the predictors of children's vaccine hesitancy among parents from Australia, China, Iran, and Turkey. To ensure the high quality of the present observational study the STROBE checklist was utilized. DESIGN: A cross-sectional study. METHOD: In total, 6,073 parent participants completed the web-based survey between 8 August 2021 and 1 October 2021. The content and construct validity of the Vaccine Hesitancy Scale was assessed. Cronbach's alpha and McDonald's omega were used to assess the scale's internal consistency, composite reliability (C.R.) and maximal reliability (MaxR) were used to assess the construct reliability. Multiple linear regression was used to predict parental vaccine hesitancy from gender, social media activity, and perceived financial well-being. RESULTS: The results found that the VHS had a two-factor structure (i.e., lack of confidence and risk) and a total of 9 items. The measure showed metric invariance across four very different countries/cultures, showed evidence of good reliability, and showed evidence of validity. As expected, analyses indicated that parental vaccine hesitancy was higher in people who identify as female, more affluent, and more active on social media. CONCLUSIONS: The present research marks one of the first studies to evaluate vaccine hesitancy in multiple countries that demonstrated VHS validity and reliability. Findings from this study have implications for future research examining vaccine hesitancy and vaccine-preventable diseases and community health nurses.

Validity and Reliability of Persian Version of the 12-Item Expectations Regarding Aging Survey.

Objective:The present study was designed to assess the construct validity and reliability of the Persian version of the 12-item Expectations Regarding Aging (ERA) survey among the older adult Iranian population. Methods: The Persian version of this scale was developed using translation and revision in the current study. The construct validity was assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The reliability was assessed through internal consistency (Cronbach's alpha and McDonald's omega), composite reliability (CR), and maximal reliability (MaXR). The data compiled online was based on a sample of 400 older adults aged 65 years and older. Results: The Persian version includes 12 items loading onto three factors with 12 items explaining 46.633% of the total variance with excellent internal consistency and reliability. Conclusion: The Persian version of ERA is reliable and valid that can be used to assess the ERA concept among older adults.

The Persian version of Herth Hope Index in Iranian patients with cancer: A psychometric study.

OBJECTIVES: Hope is a contextual concept that has significant effects on human well-being. This study aimed to evaluate the psychometric properties of the Persian version of the Herth Hope Index (P-HHI) among Iranian patients with cancer. METHOD: This cross-sectional study was conducted on 320 patients with cancer from September to December 2020. After translating the HHI into Persian, content, convergent and discriminant, construct validity (exploratory and confirmatory factor analysis), and reliability of the P-HHI were assessed. RESULTS: The results of exploratory factor analysis showed that the P-HHI was composed of two factors: Life Expectancy and Thinking Positive, which explained 55.20% of the total variance. SIGNIFICANCE OF RESULTS: The research revealed that the P-HHI has acceptable validity and reliability, which can be used to measure the hope concept among Iranian patients with cancer.

Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults.

BACKGROUND: Attachment and support from family and friends are core to the experiences of ageing for older adults. The purpose of this study is to examine the relationships between attachment styles and hope, religiosity, and life satisfaction and provide new knowledge that may assist future planning for a rapidly ageing global population. METHODS: In this cross-sectional study, 504 Iranian older adult participants from Qazvin province were recruited between December 2015 and April 2016. They completed a questionnaire that included the Revised Adult Attachment Scale, the Life Satisfaction Index-Z, and the Herth Hope Index. RESULTS: Participants in the study had a mean age of 66.20 years (SD: 5.76) and most of them were women (57.5%). A mediation model testing the direct relationships between attachment, hope, religiosity, and life satisfaction showed a positive relationship between close attachment and religiosity (ß = .226, p < .001) and a negative relationship between anxiety attachment and religiosity (ß = - .229, p < .001). Religiosity was positively related to hope (ß = .384, p < .01) and hope was related to life satisfaction (ß = .448, p < .001). Religiosity and hope mediated the relationship between close attachment (ß = .119, p < .001) and anxiety attachment (ß = - .056, p < .01) with life satisfaction. More specifically, while religiosity and hope fully mediated the relationship between close attachment and life satisfaction, they partially mediated the attachment anxiety-life satisfaction link. CONCLUSIONS: Findings of the study provide insight into only a narrow perspective of life satisfaction and attachment given the many and varied variables that influence these constructs. Future research is needed whereby other related variables are introduced into the model to be examined further.

A qualitative study of Ghanaian pediatric oncology nurses' care practice challenges.

BACKGROUND: Pediatric cancer is a global problem, and some studies have emphasized that nurses caring for these children experience work-related challenges. This has caused many children diagnosed with cancer to have a prolonged hospital stay and suffer unnecessary pain. However, there is insufficient documentary evidence on this issue. This study aims to explore and understand the challenges faced by pediatric oncology nurses in caring for children in Ghana. METHODS: An exploratory qualitative research design study was conducted from August 2019 to April 2020. The study was conducted at the pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. A semi-structured interview guide was used to collect data. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study. RESULTS: From the analysis of participants transcripts, eight subcategories emerged from two major categories. The subcategories were; time-consuming care, low job motivations, inadequate logistics, work stress, reduced labour force, low knowledge level, lack of teamwork and the perception of contracting cancer. CONCLUSIONS: The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services.

Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment.

OBJECTIVE: This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia. METHOD: A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well as the moderating effect of education level on the spirituality hope link were examined. RESULTS: Participants with higher self-reported spirituality reported more hope (b = 6.345, p < 0.001) and higher levels of quality of life (b = 1.065, p < 0.001). Higher educational attainment weakened relationships between spirituality and hope (b = -1.460, p < 0.001). SIGNIFICANCE OF RESULTS: The role of advanced education in contributing to lessened hope in relation to spirituality emphasizes the importance of skilled and personalized spiritual counseling in the respective socio-cultural religious context.

The Relationship between Religious Well-Being, Existential Well-Being, Fear of Progression and Quality of Life in Patients with Cancer: The Mediating Role of Hope.

BACKGROUND: A cancer diagnosis can be psychologically challenging to individuals due to perceptions that the disease is potentially incurable truncating life expectancy. The purpose of the study was to examine the relationships among religious well-being, existential well-being, fear of progression and quality of life in Iranian patients with cancer and to evaluate the potential mediating role of hope on these relationships. METHODS: This study with predictive cross-sectional design was done in 2023. Data was gathered from 398 patients with cancer that was selected with accessible sampling method from cancer center of Mazandaran university of medical sciences (Sari, Iran). Study constructs included the religious and existential wellbeing, cancer fear of progression, Snyder Hope, and quality of life. Analysis of a Moment Structures (AMOS) software (v27) was utilized for all study analyses. Covariance based-structural equation modeling (SEM) was used to assess the mediating role of hope. RESULTS: The mean age of patients with cancer was 49.14 (SD = 16.16). The results of the direct effect showed a significant positive relationship between religious well-being and hope (B = 0.164, p < .001), and between hope and quality of life (B = 0.212, p < 0.001). Also, significant negative relationship between fear of progression and hope (B = -0.147, p < 0.05) was founded. CONCLUSION: A significant positive relationship between hope and quality of life, as well as religious well-being and hope, suggests the influential effects of hope and religious well-being on improving quality of life in patients with cancer. Negative relationships between fear of progression and hope conclude that managing fear of progression may be an important factor in increasing hope and improving quality of life in patients with cancer.

Connor-Davidson Resilience Scale: a systematic review psychometrics properties using the COSMIN.

Background: Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical. Objective: This review study aimed to evaluate the psychometrics quality of resilience scales. Methods: International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality. Results: Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent. Conclusion: The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

The predictive role of parental attitudes toward COVID-19 vaccines and child vulnerability: A multi-country study on the relationship between parental vaccine hesitancy and financial well-being.

Background and purpose: Recent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents. Method: A predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire. Results: The current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy. Conclusion: The current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children.

Living with Mental Distress, Social Anger, and In-Group Commitment among Working Children: A Qualitative Study.

Background: Working as a child can have various effects on all aspects of children's health. Investigating and identifying issues related to the health of working children can be useful in promoting their health. Therefore, in this qualitative study, we examined issues related to the mental health and behavior of working children. Materials and Methods: This qualitative study was conducted in Tehran, Iran, in 2021 with the contractual content analysis approach. The main participants (N = 32) in this study were working children aged 10 to 18 years. To collect data, in-depth and semi-structured interviews were conducted with working children, their parents, and the center officials. In addition to the interview, some field notes were also taken from interactions between working children. After each interview, they were transcribed and coded. After 27 interviews, the data were saturated, no new code was extracted, and further interviews were conducted to ensure data saturation. Data analysis was performed based on the proposed method of Lundman and Graneheim. Results: The results revealed the three main categories of mental distress (fear and anxiety, depression, loneliness and isolation, decreased self-confidence, and decentralized mind), social anger (negative social role modeling, harassment and harm of others, reprehensible and antisocial behavior, disregard for the property of others, disrupted relationships, and violence), and in-group commitment (self-censorship outside the group, individual independence and group cohesion, and caring for the group). Conclusions: Most working children suffer from various forms of mental and behavioral issues, which, if not taken care of, can have irreparable consequences.

Student satisfaction and academic efficacy during online learning with the mediating effect of student engagement: A multi-country study.

The COVID-19 pandemic caused unprecedented changes to educational institutions, forcing their closure and a subsequent shift to online education to cater to student learning requirements. However, successful online learning depends on several factors and may also vary between countries. As such, this cross-sectional study sought to investigate how engagement of university students, a major driver of online learning, was influenced by course content, online interaction, student acceptance, and satisfaction with online learning, as well as self-efficacy across nine countries (China, India, Iran, Italy, Malaysia, Portugal, Serbia, Turkey, and the United Arab Emirates) during the COVID-19 pandemic. Using a questionnaire-based approach, data collected from 6,489 university students showed that student engagement was strongly linked to perception of the quality of the course content and online interactions (p < .001). The current study also indicated that online interactions are a major determinant of academic efficacy but only if mediated by engagement within the online learning context. A negative correlation between student engagement and satisfaction with online learning was found, demonstrating the importance of students being engaged behaviorally, emotionally, and cognitively to feel satisfied with learning. Academic efficacy and student satisfaction were explained by course content, online interaction, and online learning acceptance, being mediated by student engagement. Student satisfaction and, to a lesser degree academic efficacy, were also associated with online learning acceptance. Overall, the structural equation model was a good fit for the data collected from all nine countries (CFI = .947, TLI = .943; RMSEA = .068; SRMR = .048), despite differences in the percentage variations explained by each factor (no invariance), likely due to differences in levels of technology use, learning management systems, and the preparedness of teachers to migrate to full online instruction. Despite limitations, the results of this study highlight the most important factors affecting online learning, providing insight into potential approaches for improving student experiences in online learning environments.

A Predictive Study Between Anxiety and Fear of COVID-19 With Psychological Behavior Response: The Mediation Role of Perceived Stress.

Objective: Despite the abundance of studies linking fear and anxiety to COVID-19, there are limited studies that examine how these elements impact psychological behavioral responses, especially in Iran. The aim of this study was to investigate the relationship between anxiety and fear of COVID-19 with psychological behavior response, whether this relationship is mediated by role of perceived stress among Iranian population during the COVID-19 pandemic. Methods: A predictive cross-sectional study was used to investigate the relationships between COVID-19 anxiety syndrome, fear of COVID-19 with psychological behavioral responses due to the pandemic, and the mediating role of the COVID-19 perceived stress in these relationships. Results: The current study revealed that during the COVID-19 pandemic, fear and anxiety of COVID-19 can influence the psychological behavioral responses of individuals; however, this can be explained through perceived stress. Conclusion: As such, the current study points out that the individuals who perceived high stress due to COVID-19 were more likely to comply with guidelines, which has given new insight into this field. The current study findings are applicable for health policymakers in order to help them in understanding human behavior for developing health promotion programs and also for fostering resilience among the general population.

The Consideration of Future Consequences Scale Among Malaysian Young Adults: A Psychometric Evaluation.

Background: The consideration of future consequences (CFC) determines the extent to which individuals consider the potential future outcomes of their current behavior. The significance of assessing the CFC scale's validation in different contexts has been acknowledged by the previous studies. While the majority of the studies have been conducted in western countries, no study has been conducted in Malaysia. The aim of the current study was to validate a Malaysian version of the CFC scale among Malaysian young adults. Methods: The methodological cross-sectional approach was adopted in this study. The study recruited 529 young adults (age range from 25 to 40) who fulfilled the inclusion criteria of the paper survey. Construct validity was assessed using content validity, convergent validity, and discriminant validity. Cronbach's alpha, McDonald's omega, and average inter-item correlation (AIC) were used to assess the scale's internal consistency. Also, composite reliability (CR) and maximal reliability (MaxR) were used to assess the construct reliability. Measurement invariance was tested across gender. Results: The findings of the exploratory factor analysis indicated that the Malaysian version of the CFC scale has a two-factor structure (i.e., CFC-Future and CFC-Immediate) with 10-item explaining 61.682% of the total variance. The confirmatory factor analysis (CFA) supported the two-factor structure of the CFC scale with good construct validity. The internal consistency and CR were acceptable. [The Cronbach's alpha, McDonald's omega, and CR for CFC-I were 0.901 (CI 95%: 0.881-918), 0.901, and 0.887, respectively. Also, these parameters for CFC-F were 0.867 (CI 95%: 0.838-891), 0.868, and 0.867, respectively]. Conclusion: We found acceptable psychometric evidence for the 10-item two-factors CFC scale used in the context of young adults in Malaysia. The validated instrument can be used in future studies to assess young adults' CFC tendency and CFC-related behavior in Malaysia.

Resilience and Associated Factors in Mothers of Children with Congenital Heart Disease: A Cross-Sectional Study.

BACKGROUND: Congenital heart disease (CHD) in children affects the parents' mental and physical health and their caring and supportive functions. Resilience is an important factor in health. This study aimed to determine resilience and its associated factors in mothers of children with congenital heart disease. METHODS: This descriptive cross-sectional study enrolled 136 mothers of children with CHD. Samples were selected in two hospitals of Shahid Modarres and Children's Medical Center in Tehran, Iran, via convenience sampling from May to early October 2019. Data were collected using demographics questionnaire, Multidimensional Scale of Perceived Social Support (MSPSS), Life Orientation Test (LOT), and Wagnild and Young Resilience Scale (RS). Data were analyzed in statistical software SPSS-16 using independent t-test, ANOVA, Pearson and Spearman correlation, and multiple linear regression. The significance level was set at P<0.05. RESULTS: Mothers' total mean score of resilience was 94.08±12.81, while 14.7%, 66.2%, and 19.1% had low, moderate, and high resilience, respectively. Regression analysis showed that two variables of social support (B=2.20, P<0.001) and optimism (B=0.76, P=0.003) were associated with resilience in mothers. The duration of the child's disease was positively correlated with the mothers' resilience but did not predict it (B=-0.72, P=0.22). CONCLUSION: The level of resilience in most mothers was moderate. Social support in the dimension of significant others and optimism were associated with mothers' resilience. Therefore, holistic care and providing educational training programs that enhance these variables could be effective in promoting resilience in mothers of children with CHD.

Psychometrics of Persian Version of the Ageism Survey Among an Iranian Older Adult Population During COVID-19 Pandemic.

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.

Psychometric evaluation of Persian version of the balanced measure of psychological needs scale among university students.

AIM: The purpose of the present study was to evaluate the reliability, validity and factor structure of the Persian version of the BMPN in Iranian university students. DESIGN: Cross-sectional. METHODS: Study was conducted among Iranian medical sciences students from April to May 2020. A total of 660 students participated in the online self-administrated questionnaire. Construct validity, convergent and divergent validity, and reliability of P-BMPN were evaluated. RESULTS: The Exploratory factor analysis showed that the Persian version of the BMPN has 17 items with four factors: dissatisfaction, autonomy Satisfaction, relatedness satisfaction and competence satisfaction that explained 40.17% of the total variance. Based on confirmatory factor analysis, all goodness-of-fit indices confirmed the model fit. CONCLUSION: These results suggest that the Persian version of the BMPN is a reliable and valid measure to assess satisfaction and dissatisfaction of the psychological needs in Iranian university students.

Spiritual Well-Being, Social Support, and Financial Distress in Determining Depression: The Mediating Role of Impact of Event During COVID-19 Pandemic in Iran.

This study investigates the relationship between spiritual well-being, social support, and financial distress with depressive symptoms due to the COVID-19 pandemic. A path analysis was used to analyze data collected from 1,156 Iranian participants via an online survey. The results showed that spiritual well-being and social support were negatively related to depressive symptoms and financial distress. The impact of COVID-19 events showed negative associations with depressive symptoms. In addition, the link between spiritual well-being and financial distress with depressive symptoms was partially mediated by the impact of events.

Child Abuse Reporting Barriers: Iranian Nurses' Experiences.

BACKGROUND: Although in many countries child abuse reporting is mandated, Iranian nurses report abused cases voluntary. Some of the cases are reported to the police and others are referred to welfare organizations or other non-governmental organizations. Absence of a uniform reporting system along with a lack of legal support in the specific cultural context of Iran has resulted challenges for the reporters of child abuse. OBJECTIVES: The aim of this study was to explore the Iranian nurses' experiences of reporting child abuse as well as to explore the existing barriers. PATIENTS AND METHODS: A qualitative study with conventional content analysis was conducted to explore the barriers of reporting child abuse. Individual interviews between 30 and 45 minutes in duration were conducted with a purposive sample of 16 nurses with direct experience of dealing with children who had been abused. Graneheim and Lundman's method was used for data analysis. RESULTS: The data were classified to five themes including "knowledge deficit", "previous unpleasant experiences about child abuse reporting", "ethical challenges"," legal challenges" and "cultural beliefs". CONCLUSIONS: According to the findings, enhancement of nurses and public knowledge about child abuse, legal issues and jurisprudence along with legislation of clear and simple laws, are mandatory to protect abused children in Iran.