Case report of spontaneous coronary artery dissection in a 50­year­old man.

BACKGROUND: Spontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality. CASE PRESENTATION: We describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA. CONCLUSIONS: To stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications.

Uric acid to HDL ratio: A marker for predicting incidence of metabolic syndrome in patients with type II diabetes.

BACKGROUND AND AIM: Metabolic syndrome (MetS) refers to existence of a set of risk factors for developing cardiovascular disease and diabetes. Recently, uric acid to HDL ratio has attracted attention in predicting development of diabetes and incidence of metabolic syndrome in diabetic individuals. This study was performed to investigate UHR in patients with type II diabetes as a predicting factor for metabolic syndrome. METHODS AND RESULTS: This descriptive-analytical study examined 300 patients with type II diabetes referring to diabetes clinic of Ali-Ibn Abi-Talib hospital, Rafsanjan city in 2021, selected through convenient sampling. Data were collected by a research-made checklist (including demographic, clinical and laboratory parameters) and analyzed by SPSS 24 and chi-square, Fisher exact test, independent paired t-test, one-way analysis of variance (ANOVA), Mann-Whitney U, and receiver operating characteristic (ROC). The findings revealed that 74.33 % (95 % CI: 69 to 79.18 %) of the patients had metabolic syndrome. Further, patients with metabolic syndrome demonstrated a significantly higher mean UHR ratio and triglyceride levels compared to their counterparts without the syndrome (p = 0.002 and p < 0.001, respectively). The ROC analysis identified a UHR threshold of 8.118 % with a sensitivity of 70.32 % and specificity of 55.08 % for diagnosing metabolic syndrome development in type II diabetes (AUC: 0.621, P = 0.001, 95%CI: 0.549-0.694). CONCLUSION: The results of the present study revealed that the prevalence of metabolic syndrome was high in diabetic patients. UHR showed good sensitivity in the diagnosis of metabolic syndrome in type II diabetes. Thus, regular monitoring of laboratory tests is recommended in patients with diabetes.

Anxiety, self-efficacy, and their determinants in school students during the COVID-19 pandemic: a survey in Southeastern Iran.

BACKGROUND: The COVID-19 pandemic has been linked to various psychological disorders, including anxiety, particularly among the general public. It is crucial to monitor the mental health of school students, who are considered a vulnerable group in society, and assess their self-efficacy, as it can significantly affect their mental health. This study aimed to investigate the levels of anxiety and self-efficacy among school students during the COVID-19 pandemic. METHODS: This cross-sectional study utilized convenience sampling to examine a sample of 335 school students from Sistan and Baluchestan province in southeastern Iran. An online questionnaire, distributed through social media platforms, was used to collect data. The questionnaire included demographic information, COVID-19 related items, the Multidimensional Anxiety Scale for Children-MASC, and the Self-Efficacy Questionnaire for Children-SEQ-C. Data analysis was conducted using IBM SPSS version 24, with a significance level set at < 0.05. RESULTS: The study revealed a significant negative correlation between children's anxiety and self-efficacy (r = -0.23, P < 0.001). Several factors were identified as predictors of anxiety, including low self-efficacy (ß = -0.29, P < 0.001), female gender (ß = 0.27, P < 0.001), concern about family members contracting COVID-19 (ß = 0.18, P < 0.001), persistent advice of others to adopt preventive measures (ß = 0.14, P < 0.005), level of education (ß = -0.12, P < 0.017), and perceived risk of COVID-19 infection (ß = -0.11, P < 0.030). These variables collectively accounted for 17% of the variance in anxiety. CONCLUSION: The findings of the study highlight the importance of addressing the mental health of school students, specifically their anxiety levels, during epidemics. The results also indicate that enhancing self-efficacy among students during a pandemic could be a beneficial strategy for promoting their mental health.

Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak.

BACKGROUND: Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic. METHODS: We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered. RESULTS: The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic. CONCLUSION: The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Is nurses' clinical competence associated with their moral identity and injury?

BACKGROUND: The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. OBJECTIVE: The present study investigated the relationship between nurses' clinical competence, moral identity, and moral injury during the COVID-19 outbreak. RESEARCH DESIGN: This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools. PARTICIPANTS: and research context: The research population for this study consisted of all frontline nurses (n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. ETHICAL CONSIDERATIONS: The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. RESULTS: According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. CONCLUSION: According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses' clinical competence and the overall quality of care they provide.

Muscle strength/intensive care unit acquired weakness in COVID-19 and non-COVID-19 patients.

BACKGROUND: Intensive care unit acquired weakness (ICU-AW) affects both coronavirus disease 19 (COVID-19) and non-COVID-19 patients. ICU-AW can result in a variety of consequences, including increased patient mortality. AIMS: The current study aimed to compare muscle strength and ICU-AW in COVID-19 and non-COVID-19 patients. STUDY DESIGN: This was a cross-sectional, descriptive-analytical pilot study. METHODS: Fifteen conscious COVID-19 patients and 15 conscious non-COVID-19 patients admitted to the ICUs of a public hospital were selected by convenience sampling. Muscle strength in arms and legs was assessed by a hand-held dynamometer (HHD), and ICU-AW was measured with the medical research council sum score (MRC-SS) scale on the first, fourth, and seventh days of admission to ICUs. RESULTS: The results showed that muscle strength in the arms and legs of the COVID-19 patients assessed by a HHD and MRC was significantly lower than that of non-COVID-19 patients. On the fourth day of ICU admission, 80% of the COVID-19 patients and 40% of the non-COVID-19 patients had ICU-AW. All COVID-19 patients and 86.8% of the non-COVID-19 patients had ICU-AW on the seventh day of ICU admission. CONCLUSIONS: Decreased muscle strength and ICU-AW are more likely in COVID-19 patients who must stay in the ICU compared with non-COVID-19 patients. RELEVANCE TO CLINICAL PRACTICE: Health systems should plan to provide rehabilitation facilities for COVID-19 patients and prevent prolonged complications of COVID-19.

Fear of Cancer Recurrence and COVID-19 Anxiety Among Cancer Survivors: A Cross-Sectional Study in Southeast Iran.

Cancer survivors face numerous therapeutic and health challenges during the COVID-19 epidemic. These patients experience high levels of anxiety and stress due to illness, external stresses, and crises, such as the COVID-19 epidemic. The present study showed a positive relationship between FCR and COVID-19 anxiety as well as moderate levels of FCR (according to the midpoint score of the questionnaire) and COVID-19 anxiety among cancer survivors. Factors affecting the mental condition of cancer survivors can play an important role in completing treatment and preventing disease exacerbation.

Quality of life in terminally ill cancer patients: what is the role of using complementary and alternative medicines?

BACKGROUND AND PURPOSE: Cancer is the world's second greatest cause of mortality and a leading cause of death in both developed and developing countries. Patients employ a number of complementary and alternative medicine (CAM) methods to deal with the problems and difficulties of cancer, which can have an impact on their quality of life (QOL). The aim of the present study was to assess the correlation between QOL and the use of different CAM methods in terminally ill cancer patients. METHODS: This was a cross-sectional study. In southern Iran, 238 individuals with advanced cancer were studied in oncology centers and doctors' offices. During the months of January to August 2021, patients were selected using convenience sampling. A demographic information questionnaire, the EORTC core quality of life questionnaire, and the CAM questionnaire were used to collect data. RESULTS: The results showed that terminally ill cancer patients had a good quality of life. Last year, 85.7% of participants used at least one kind of CAM. Furthermore, 45.4% of participants used only one form of CAM, 30.3% used two types of CAM, 6.7% used three types of CAM, and 3.4% used four to five types of CAM. When all CAM users were compared to non-CAM users, CAM users had significantly higher social QOL and overall quality of life. Two subscales of QOL symptoms and function were correlated with cancer history, income, and use of CAMs, and the scores of QOL symptoms and function were greater in CAM users compared to non-CAM users. Among all the study variables, only the usage of CAM was correlated to overall QOL among terminally ill cancer patients. CONCLUSION: The current study found that using CAM could affect different aspects of QOL in terminally ill cancer patients. As a result, it is feasible that using CAM could help these people enhance their health and QOL.

Postpartum depression and its correlates: a cross-sectional study in southeast Iran.

BACKGROUND: Postpartum depression has a negative impact on both infants and women. This study aimed to determine the correlates of postpartum depression in women in southern Iran. METHODS: This cross-sectional study was performed on 186 mothers who had recently given birth to a baby. Data were collected using the demographic form, Quality of Prenatal Care Questionnaire, Edinburgh Postnatal Depression Scale (EPDS), Depression, Anxiety and Stress Scale-21 items (DASS-21) 3 days after delivery and EPDS and DASS-21 6 months after childbirth. RESULTS: Postpartum depression (PPD) was 24.2% and 3.2% 3 days and 6 months after delivery, respectively. Anxiety, Prenatal Care Quality and educational level predicted 34.0% of the variance of PPD 3 days after delivery (R2 = 34.0%). Anxiety, type of delivery, and stress predicted 24% of the variance of PPD 6 months after delivery (R2 = 24.0%). CONCLUSIONS: With an increase in stress and anxiety and a reduction in the quality of prenatal care, the risk of postpartum depression increases. Therefore, attention to the quality of prenatal care and postpartum stress and anxiety should be carefully evaluated to prevent PPD. Psychological support and interventions are recommended to promote the mental health of women before and after childbirth.

Iranian psychosocial status and its determinant factors during the prevalence of COVID-19 disease.

COVID-19 disease has quickly become a major threat and epidemic in the world. Many people are experiencing psychological disorders due to the rapid spread of the COVID-19 disease. The present study aimed to investigate the psychosocial status of the Iranian citizens during the prevalence of COVID-19. One thousand one hundred and sixteen citizens of Rafsanjan city participated in the cross-sectional study from March 15 to 30, 2020. The data were collected using demographic and COVID-19 related-items, and Health General Questionnaire (GHQ -28). The results showed that 35% of the participant had mental health problems. All participants had social functioning disorder, while 22.8% had physical symptoms, 26.8 had anxiety symptoms and sleep disorders. In addition, the risk of psychosocial disorder was higher in females, those who were living in the city, earning less than 1 million, thinking of being at risk for infection with the coronavirus, and those whose most important concern about COVID-19 was death (P < 0.05). The results of the present study showed that all participants had social dysfunction. Therefore, health-care providers are suggested to evaluate the psychosocial consequences routinely, design and implement appropriate interventions to deal with these complications.

Anxiety, anger, and mindfulness as predictors of general health in the general population during COVID-19 outbreak: A survey in southeast Iran.

Communities have been exposed to the complications and problems caused by COVID-19 disease, which has had various and complex effects on general health. The aim of this study was to investigate the relationship between anxiety, anger, mindfulness, and general health in the general population during the COVID-19 outbreak in Iran. This cross-sectional study was performed on 456 participants from September 2020 to April 2021. For data collection, Demographic Characteristics Form, General Health Questionnaire, Freiburg Mindfulness Inventory-Short Form, The trait anxiety section of the State-Trait Anxiety Inventory, The State-Trait Anger Expression Inventory-2 were used. General health was positively correlated with anxiety and anger and negatively correlated with mindfulness. Anxiety was positively correlated with anger and negatively correlated with mindfulness. No significant correlation was found between anger and mindfulness. Based on the multiple regression model, anxiety, anger and a family member infected with COVID-19 were the predictors of general health (p < 0.001). Given that anxiety, anger, and family members infected with COVID-19 are all predictors of public health, it is suggested that psychological programs and interventions be designed to reduce anxiety and anger, as well as to support family members infected with COVID-19, to promote general health.

Generalized Anxiety Disorder During the COVID-19 Outbreak in Iran: The Role of Social Dysfunction.

ABSTRACT: The COVID-19 epidemic has both physical and psychosocial consequences for the general population. The present study aimed to investigate the relationship between the prevalence of generalized anxiety disorder (GAD) and social dysfunction during the COVID-19 epidemic in Iran. This cross-sectional web-based study was conducted on 1000 Rafsanjani citizens in southeastern Iran. Data were collected by using the Generalized Anxiety Disorder-7 and the General Health Questionnaire from March 15 to March 30, 2020. The prevalence of GAD was 27.8%. The mean score of social functioning was 9.71 ± 2.66, and all participants had social dysfunction. Multivariate logistic regression test showed a significant correlation between anxiety and social functioning (confidence interval [CI], 1.16-1.30; p < 0.001), sex (CI, 1.49-3.04; p < 0.001), and concern about COVID-19 (CI, 1.38-2.73; p < 0.001). The COVID-19 epidemic had negative psychosocial consequences in the general population in Iran.

Iranian psychosocial status during and after COVID-19 outbreak mandatory quarantine: A cross-sectional study.

Quarantine, one of the most effective protection measures, plays an essential role in preventing the spread of infectious diseases. The coronavirus 2019 (COVID-19) pandemic, along with quarantine, can have devastating consequences for individuals' mental and social health. This study examined the psychosocial status of individuals during and after quarantine in the COVID-19 pandemic. This cross-sectional study was conducted on 714 individuals in the general population during (365) and 3 months after quarantine (349) in southeastern Iran. Data were collected using General Health Questionnaire (GHQ-28) and Generalized Anxiety Disorder 7-item (GAD-7) based on an online questionnaire. Data were collected from April 13 to April 20, 2020 (in quarantine) and 3 months later from August 20 to September 20, 2020. Psychological disorders in the quarantined population were significantly higher than that after quarantine. The risk of a mental disorder in the quarantined population was 1.54 times higher than that after quarantine. The results showed that quarantine is associated with a significant level of psychosocial disorders; therefore, interventions should be considered to reduce the effects of quarantine on the mental health of general population as a public health priority at the community level.

Psychosocial status during the prevalence of COVID-19 disease: the comparison between healthcare workers and general population.

The prevalence of COVID-19 disease continues to be a significant psychosocial status among health care workers (HCWs) and the general population worldwide. This cross sectional study aimed to compare the psychosocial status between healthcare workers and general population during the prevalence of COVID-19 disease in southeast Iran. Totally 415 health care workers of a medical service center for COVID-19 patients and 1023 people of general population participated in the study. An online socio-demographic characteristics questionnaire, General Health Questionnaire (GHQ -28), and Generalized Anxiety Disorder 7-item (GAD-7) were utilized to evaluate psychosocial status. According to GHQ, the psychological disorders of the HCWs were significantly higher than that of the general population (P < 0.001). According to GAD-7, no significant difference was found between general population and HCWs. Multivariate logistic analysis showed no difference between general population and HCWs in the psychological disorder. Although HCWs suffered from psychological disorders more than general population, nearly one third to half of the participants in both groups had psychosocial disorders.

Pro-neurocognitive and anti-sarcopenic benefits of one-year metformin therapy in ovariectomized aged mice.

Health promotion and healthy nutrition significantly increased life expectancy around the world. Aging is associated with an increase in age-related diseases. The use of metformin (Met) as an anti-aging drug has recently been proposed based on its widespread use in clinical practice. Reports have shown that Met acts as an anti-aging agent. In this study, the effects of long-term, 1 year, Met administration on aging-related behaviors and longevity in ovariectomized mice was studied. Met (1 and 10 mg/kg, daily) was administered orally in ovariectomized mice. The anxiety-like behavior, working memory, and physical strength were measured through elevated plus maze, Y-maze, vertical grid holding, and the obligatory swimming capacity tests. Brains were harvested to measure brain-derived neurotrophic factor (BDNF) level. Also, the Kaplan-Meier survival curves were used to show differences and similarities in survival patterns. Met (10 mg/kg) decreased anxiety-like behaviors as well as increased muscle strength and working memory in the ovariectomized mice. Moreover, Met increased the physical strength and longevity as well as the level of BDNF in the ovariectomized mice. Our results indicate that Met administration can be an effective strategy for having a healthy aging in the absence of female gonadal hormones and reverses deleterious effects of ovariectomy-induced aging possibly through BDNF.

Changes in serum biochemical parameters and digestive enzyme activity of juvenile sobaity sea bream (Sparidentex hasta) in response to partial replacement of dietary fish meal with poultry by-product meal.

A 60-day experiment was conducted to evaluate the effect of dietary fish meal (FM) replacement with poultry by-product meal (PBM) on digestive enzymes, non-specific serum enzyme activity, and serum biochemical parameters of juvenile sobaity sea bream, Sparidentex hasta, weighing 29.27 ± 0.06 g. PBM replaced 0, 15, 25, 35, 45, and 55% of dietary FM in the isoproteic (50%) and isocaloric (21 kJ g-1) experimental diets. The final body weight, percentage weight gain, specific growth rate, and protein efficiency ratio were higher in PBM15, 25, and 35 than in control, PBM45, and 55. Digestive lipase and amylase activity did not differ significantly between the dietary treatments. Significantly lower trypsin and higher chymotrypsin activity were observed at PBM55 and 45, respectively. Digestive alkaline phosphatase (ALP) increased, whereas protein apparent digestibility coefficients (ADC) decreased significantly with increasing levels of PBM above 35%. Hematocrit, hemoglobin, mean corpuscular hemoglobin concentration, serum albumin, globulin, total protein, glucose, urea, uric acid, and aspartate aminotransferase did not show any significant differences between the treatments. Serum ALP, cholesterol, and calcium were higher in PBM diets than in the control diet, whereas an inverse trend was observed in triglyceride. Protein digestibility and trypsin activity and serum biochemical indices suggest that fish meal protein could be reduced up to 45% by the inclusion PBM in the formulated diets for S. hasta juveniles without any adverse effect on its overall performance.

Effects of dietary organic, inorganic, and nanoparticulate selenium sources on growth, hemato-immunological, and serum biochemical parameters of common carp (Cyprinus carpio).

An 8-week feeding trial was conducted to compare the effects of supplementing (0.7 mg kg-1) different dietary selenium (Se) sources including organic [selenomethionine (SeMet)], inorganic [sodium selenite (Na2SeO3)], and nanoparticulate Se (nano-Se) on physiological responses of common carp, Cyprinus carpio juveniles (9.7 ± 0.1 g). Basal diet without Se supplementation used as control. Fish fed nano-Se supplemented diet had the highest weight gain (97.2 ± 10.8%) and feed efficiency ratio (42.4 ± 0.8%). Intestinal villi height was significantly taller in fish fed nano-Se diet than in the control group in both foregut and midgut sections. Serum glutathione peroxidase and superoxide dismutase activities were significantly higher in nano-Se and SeMet groups than in control and sodium selenite groups. Fish fed Se-supplemented diets had greater red blood cell counts and hematocrit and hemoglobin values than the control group (P < 0.05). Nano-Se and SeMet groups showed a significant increase in white blood cell counts, neutrophil percentage, and serum lysozyme activity than the other groups. Fish fed nano-Se diet had the highest serum hemolytic activity, total immunoglobulin, and total protein and albumin contents, as well as the lowest serum total cholesterol and low density lipoprotein levels (P < 0.05). Overall, significant improvements in growth performance, feed utilization, intestinal morphology, and hemato-immunological and serum biochemical parameters of common carp juveniles suggest nano-Se as an efficient source for providing dietary Se in this species.

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial.

BACKGROUND: Muscle weakness is prevalent in intensive care patients. This study focused on comparing the effects of massage and range of motion (ROM) exercises on muscle strength and intensive care unit-acquired weakness (ICU-AW) among patients with coronavirus disease 2019 (COVID-19). METHODS: This study was a randomized clinical trial that recruited patients (n=45) with COVID-19 admitted to the ICU and divided them into three groups (ROM exercises, massage, and control). We evaluated muscle strength and ICU-AW in the arms and legs using a hand dynamometer. The Medical Research Council sum score was determined before and after the intervention. RESULTS: The study findings were that 0%, 20%, and 100% of the participants in the ROM exercises, massage, and control groups had ICU-AW on the 7th day of ICU admission. The ROM exercise group had greater muscle strength in the hands and legs than the massage and control groups, and the massage group had greater muscle strength than the control group. CONCLUSIONS: Massage and ROM exercises could improve muscle strength and reduce ICU-AW in COVID-19 patients admitted to the ICU.

A preliminary validation of the impact on participation and autonomy questionnaire in an Iranian sample of patients with type 2 diabetes.

BACKGROUND: This study aimed to determine the face, convergent validity, internal consistency, and stability reliability of the impact on participation and autonomy-Persian version (IPA-p) scale for using among Iranian patients with type 2 diabetes. MATERIALS AND METHODS: Trained experts interviewed 227 type 2 diabetes patients who were registered in out-patient Diabetes Clinic of Ali-Ibn Abi-Talib Hospital, (Rafsanjan, Southeast Iran from May 2018 to February 2019) and their relatives to assess the face and convergent validity, internal consistency, and stability reliability of the IPA-p scale. A checklist was used to collect demographic information and also to record expert's̛̛̛̛̛̛ points of view about the scale to assess face validity. Internal consistency was measured using Cronbach's alpha, and stability was assessed using interclass correlation coefficients (ICCs). Test-retest method was used to detect the reliability of the questionnaire. Respondents completed the IPA-p scale on the two occasions with an interval of 30-45 days. RESULTS: In relation to convergent validity, the confirmatory model showed an acceptable fit and the scale had a highly convergent validity. Exploratory factor analysis showed that the IPA-p scale has a ten-factor structure that explained 77.42% of the variance. Cronbach's alpha between the mean IPA-p scores achieved on the two occasions ranged from 0.65 to 0.92. Test-retest ICCs for the ten domains were between 0.64 and 0.81. CONCLUSIONS: The IPA-p questionnaire can be a relatively valid and reliable instrument for assessing self-reported participation among Iranian type 2 diabetes patients. However, some improvement is needed to make it fully suitable for using among Persian-language diabetic patients.