Prevalence of Cardiovascular Risk Factors in Rural Kenya-2023: Vihiga II.

BACKGROUND: The aim of this study was to estimate the prevalence of cardiovascular disease (CVD) risk factors among adults in Vihiga County, Western Kenya. METHODS: A cross-sectional population-based study was completed. Participants (n = 575) were selected at the household level using a systematic random sample, and sociodemographic, anthropometrical, clinical, and biochemical data were collected. RESULTS: The sample consisted of 71.8% women and 28.2% men. The prevalence of high blood pressure (BP) was 56.4%. A greater proportion of women (62.8%) had low levels of high-density lipoprotein (HDL) compared with men (44.7%) (odds ratio [OR], 2.99; 95% CI, 1.59-5.64). High triglyceride levels were more prevalent in men (16.4%) compared with women (15.4%) (OR, 0.37; 95% CI, 0.19-0.71). Based on average waist to hip ratio, abdominal obesity was significantly higher in women (55.4%) compared with men (27.6%) (OR, 2.62; 95% CI, 1.52-4.49). Low levels of physical inactivity were prevalent in women (36.3%) at significantly higher proportions compared with men (22.7%) (OR, 1.73; 95% CI, 1.02-2.92). Women used tobacco at significantly lower proportions (0.5%) compared with men (27.2%) (OR, 0.01; 95% CI, 0.00-0.06). A higher proportion of women (47.9%) rated their general health as poor compared with men (37.1%), a statistically significant difference (OR, 2.0; 95% CI, 1.23-3.28). CONCLUSION: The prevalence of CVD risk factors, such as hypertension, obesity, dyslipidemia, low physical activity, and tobacco use indicates the urgent need for comprehensive health promotion programs to improve public health in rural areas of Kenya.

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.

Validity and Reliability of the Persian Version of Positive Body Image Among Adolescents Scale.

Background and Purpose: This study evaluated the validity and reliability of the Persian version of Positive Body Image among Adolescents Scale (PBIAS-P) in Tehran, Iran, in order to better understand adolescents' positive perceptions of their physical selves and the accompanying thoughts and emotions. Methods: This cross-sectional study was carried out involving adolescents from Tehran Province, Iran, in 2022. Both exploratory factor analysis and confirmatory factor analysis were performed in order to evaluate the construct validity of the PBIAS-P. Cronbach's alpha, McDonald's omega, and intraclass correlation coefficients were also used to confirm the internal consistency of the scale. Results: The findings indicate that three factors extracted from the PBIAS-P account for 50.1% of the total variance. The model fit is considered good based on cut points for various fit indices. All factors had values of Cronbach's alpha, McDonald's omega, and average interitem correlation above .73, .74 and .4, respectively. Also, test-retest reliability for three factors was acceptable. Conclusions: The PBIAS-P has acceptable validity and reliability in Iranian adolescents, making it useful for researchers, psychologists, and health care professionals.

The relationship among positive body image, body esteem, and eating attitude in Iranian population.

Background and aim: The correlation between eating attitudes, positive body image, and body esteem is a pivotal area of research that has garnered substantial attention in recent years, given its implications for both mental and physical well-being. The objective of this study was to examine the interplay between positive body image, body esteem, and eating attitudes within an Iranian population. Materials and methods: This study employed a cross-sectional study design and was conducted in the year 2022. A convenience sample of 752 participants residing in Tehran, Iran, was included in the study. The data collection tools were comprised of a demographic registration form, the Adolescence/Adults Scale (PBIAS), the Eating Attitudes Test (EAT), and the Body Esteem Scale (BES) as measurement instruments. Results: Mean age of participants was 26.36 (SD = 8.49). Significant relationships were found among positive body image (B = - 0.095, ß = -0.150, p < 0.001), and body esteem (B = 0.175, ß = 0.149, p < 0.001) with eating attitudes. Conclusion: These findings suggest that individuals with positive body image and high body esteem may have healthier eating attitudes, while those with negative body image and low body esteem may be more likely to have unhealthy eating attitudes.

Effectiveness of Community-based Obesity Intervention for Body Weight, Body Mass Index, and Waist Circumference: Meta-analysis.

Background: Obesity is a significant health problem worldwide and an alarming problem in the developed world including the United States of America and European populations. Subsequently, obesity can lead to different health problems, such as non-communicable diseases. However, it can be prevented through a healthy diet, exercise, and lifestyle modification. The study's purpose was to analyze the published literature on community-based obesity interventions and to present a comprehensive summary of how to reduce the body weight, Body Mass Index (BMI), and Waist Circumference (WC) among overweight and obese individuals in the community through health education and behavior interventions. Material and Methods: The meta-analysis was conducted in February-July 2021, searching CINAHL, Cochrane Library, Google Scholar, PubMed, and Science Direct databases. Studies published during the prior 12 years on community-based obesity intervention for weight, BMI, and WC were included in this review. Cochrane Revman software was used for meta-analysis. Results: Seventeen studies met the selection criteria for the review. A meta-analysis of the studies on health education and behavioral intervention studies resulted in a statistically significant reduction at 95% confidence intervals in the mean differences of BMI -1.19 (-1.77, -0.62) and WC -1.11 (-1.54, -0.68). Conclusions: Community-based obesity interventions through health education and behavior interventions effectively reduce the body weight, BMI, and WC. Implementing community-based health education and behavioral interventions effectively prevents and treats obesity in communities.

The Persian version of the body esteem scale among Iranian adolescents: a translation, psychometrics, and network analysis.

Introduction: The psychometric properties of the body esteem scale have not been assessed in Iran. Therefore, the aim of this study was to translate and determine the validity and reliability of the Persian version of the body esteem scale among Iranian adolescents. Methods: The sample of this methodological study consisted of 504 adolescents [mean age: 16.55 (SD = 1.54) years] living in Tehran City, Iran. After translation of the scale, its content validity (quantitative and qualitative) and structural (exploratory and confirmatory factor analysis), convergent, and discriminant validity were evaluated. Exploratory graph analysis was performed to determine the number of factors. Cronbach's alpha, composite reliability, and maximal reliability were calculated. Results: In the content validity evaluation step, all items had acceptable scores and were retained. The results of exploratory factor analysis with Promax rotation and exploratory graph analysis extracted three factors accounting for 49.49% of the variance, comprising 18 items. Furthermore, after necessary modifications during CFA, the final model was approved. Convergent and discriminant validity were confirmed. Cronbach's alpha, CR, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. Conclusion: According to the results, the Persian version of the body esteem scale has a valid structure and acceptable reliability. Health professionals, in many ways, can use this scale.

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.

Development and validation of the care challenge scale in family caregivers of people with Alzheimer's disease.

Background: Alzheimer's disease (AD) is a progressive and debilitating disorder that strongly affects people with AD and their families. The changes in signs of the disease and its treatment lead to many challenges in people with AD that affect the performance and the ability of caregivers, their social life, and physical, emotional, and psychological aspects of caregivers' health. Therefore, this study was designed to develop and validate the Care Challenge Scale (CCS) for family caregivers of people with AD in the care context of Iran. Method: This is a cross-sectional study, and the primary scale was based on 14 semi-structured interviews with family caregivers of Iranian people with AD. In the next phase, the psychometric features were assessed, including the face validity (qualitative and quantitative), content validity (qualitative and quantitative), item analysis, structural validity (exploratory and confirmatory factors), and construct validity (convergent and discriminant validity). Finally, the reliability was assessed using internal consistency (Cronbach's alpha, McDonald's omega coefficient, and the average inter-item correlation), stability (intraclass correlation coefficient), and absolute reliability. Results: Totally, 435 Iranian family caregivers filled out online questionnaires, with a mean age of 50.26(±13.24) years. Based on the results of the qualitative phase, an item pool was generated with 389 items, and after deleting overlapping and unrelated items, the CCS with 14 items was created. The results of the quantitative phase showed that the CCS consists of two factors with 10 items each, which are named effective role-play challenge and lack of social-financial support, and they explained 42.23% of the total variance. Furthermore, the results of confirmatory factor analysis showed a good fitness of the scale structure model, and it had convergent and discriminant validity. The reliability indexes showed this scale has internal consistency and stability. Conclusion: The most care challenge among Iranian family caregivers of people with AD is effective role-play challenges and lack of social-financial support. The scale as designed has good validity, internal consistency, and stability that can be used by therapists, nurses, and researchers for the assessment of the challenges of this population.

Validity and Reliability of the Persian Version of COVID-19 Anxiety Syndrome Scale Among the Iranian General Population.

The crisis of the COVID-19 prevalence in Iran, as well as the world, caused mental disorders and anxiety syndrome. The COVID-19 anxiety syndrome scale (C-19ASS) assesses conceptually and psychometrically the nature of the COVID-19 threat experience instead of a response to the threat, fear, and COVID-19 anxiety. Therefore, the aim of this study is to evaluate the psychometric properties of the Persian version of the anxiety syndrome scale of COVID-19 in the population of Iran. The Persian version of C-19ASS was sent to Iranian adults via online social networking applications and finally, 932 adults responded to the questionnaire. The results of exploratory factor analysis revealed two-factor structures for C-19ASS, which explained 48.70% of the total variance. Given the confirmatory factor analysis findings, all goodness of fit indices confirmed the model fit. All coefficients of internal consistency were estimated as acceptable reliability. The results showed that the C-19ASS has good psychometric properties, and can be used by researchers, psychologists, and healthcare providers to assess the anxiety syndrome of the Iranian population during the COVID-19 pandemic.

The relationship between abusive supervision, psychological ownership, and quality of nursing care: The mediating role of job satisfaction.

PURPOSE: This study tested a hypothetical model to evaluate the relationship between job satisfaction, abusive supervision, and psychological ownership with the quality of nursing care. DESIGN AND METHODS: In this cross-sectional study, a sample of 300 nurses from two public hospitals in Iran was selected. Exploratory factor analysis was used to assess the measurement model and the proposed structural model. FINDINGS: There was a significant negative relationship between abusive supervision with nurses' job satisfaction and quality of nursing care. A positive relationship between psychological ownership with nurses' job satisfaction and quality of nursing care was observed. PRACTICE IMPLICATIONS: Given the importance of nurses' job satisfaction, nursing managers can enhance the quality of nursing care by providing a favorable work environment for nurses.

Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID-19.

AIM: To investigate the accuracy, reliability and agreement between infrared forehead thermometers versus infrared tympanic thermometers temperature, a cross-sectional study was conducted in April 2020. METHODS: The forehead and tympanic temperatures of 615 subjects were measured simultaneously in three exposed SARS-COV-2 groups at one hospital in Iran, during April 2020. These comparisons were evaluated by Bland-Altman Plot, repeatability, Passing-Bablok regression and Lin's concordance correlation coefficient. The receiver operating characteristic (ROC) analysis was done to describe the discrimination accuracy of a diagnostic test. The study adhered to STROBE checklist for cross-sectional studies. RESULTS: A Bland-Altman plot indicated that the limits of agreement between the forehead and tympanic temperature were -0.259 to +0.19°C. Passing-Bablok regression analysis illustrated that the infrared forehead was not linearly related to tympanic temperatures (reference method), with a slope estimate that was significantly different from 1.00. The infrared forehead thermometer showed poor precision and lower accuracy than the tympanic. The forehead temperature readings had 60.0% sensitivity and 44.4% specificity (p > .05) to predict disease. CONCLUSION: According to the results of study, there is no evidence that the assessment of temperature by infrared forehead thermometer could discriminate between the two groups (positive and negative).

Psychometric Properties of the Persian Version of the Center for Epidemiological Studies Depression Scale Among the Iranian Public People During COVID-19 Pandemic.

Background: Several studies indicate a high prevalence of depression around the world during the period of the COVID-19 pandemic. Using a valid instrument to capture the depression of an individual in this situation is both important and timely. The present study aims to evaluate the psychometric properties of the Persian version of the Center for Epidemiological Studies Depression Scale (CES-D) among the public during the COVID-19 pandemic in Iran. Method: This is a cross-sectional study that was conducted in the Iranian population (n = 600) from April to July 2020. A two-part online form was used: sociodemographic characteristics and depression items (CES-D). The construct validity and internal consistency reliability of the scale were evaluated. Result: The results of the exploratory factor analysis illustrated two factors with 43.35% of the total variance of the depression were explained. Confirmatory factor analysis indicated that this model fits well. Internal consistency reliability was evaluated, and it was acceptable. Conclusion: The findings demonstrated that, in the Iranian sample, this depression scale yielded two factors (somatic and positive affects) solutions with suitable psychometric properties.

A model of nurses' intention to care of patients with COVID-19: Mediating roles of job satisfaction and organisational commitment.

AIM AND OBJECTIVES: This study aims to test the hypothesis that job satisfaction and organisational commitment might play a mediating roles between workload, quality of supervision, extra-role behaviour, pay satisfaction and intention to care of patients with COVID-19. BACKGROUND: Given the high incidence of coronavirus and shortage of nurses in Iranian hospitals, learning about nurses' intention to care for patients with COVID-19 is important. DESIGN: In this cross-sectional study, 648 Iranian nurses were surveyed during March 2020. The online questionnaire consisted of two parts. The mediating role was explored for the following: job satisfaction and commitment in the association of workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care. The study adhered to STROBE checklist for cross-sectional studies. RESULTS: The results of this study show that job satisfaction and organisational commitment mediated the relationship of nurses' workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care for patients with COVID-19. CONCLUSION: The results of the study indicate the importance of job satisfaction and organisational commitment as mechanisms that help to understand the association of nurses' workload, quality of supervisor, extra-role behaviours and pay satisfaction with the intention to care during the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE: Hospital managers need to attend to the role of nurses' job satisfaction and other organisational factors to ensure that they can cope with the challenges of the COVID-19 pandemic.

Psychometric Evaluation of Persian Version of Nurses' Intention to Care Scale (P-NICS) for Patients with COVID-19.

BACKGROUND: Given the high incidence of coronavirus and the shortage of nurses in Iranian hospitals, nurses' intention to care for patients with COVID-19 is important. The aim of this study is to evaluate the reliability and validity of the Persian version of the nurses' intention to care scale (NICS) by Iranian nurses who care for patients with COVID-19 in hospitals. METHODS: A cross-sectional study was conducted on nurses (n= 400) at public and private Mazandaran hospitals. An online questionnaire was used that consisted of two parts: demographic variables and NICS. The scale was translated into Persian first and then validated using both construct and content validity. RESULTS: The findings from an exploratory factor analysis yielded six factors that explained 53.12% of the total variance of the NICS. The confirmatory factor analysis demonstrated that the model had a good fit and the inter-item correlation values of the factors indicated good internal consistency. CONCLUSION: The Persian version of NICS in Iranian nurses had six factors. The results of our study add insight for nurse administrators and educators to further develop strategies to increase nurses' intention by improving positive attitudes and reducing their negative beliefs.

The estimate of average age at the onset of acute myocardial infarction in Iran: A systematic review and meta-analysis study.

BACKGROUND: Research indicates that the age of onset of first acute myocardial infarction (AMI) is an essential element in the life expectancy that has been decreasing in developing countries. There are various studies performed in Iran reporting a range of ages at time of AMI. Thus, this meta-analysis study is designed to determine the mean age at first AMI in the Iranian population. METHODS: All studies that met the inclusion and exclusion criteria were reviewed using standard keywords in the databases from 2000 to 2016. Two raters verified a total of 658 articles. Sixteen studies met the inclusion criteria of this study for meta-analysis. Cochran test and I-squared (I2) were used for samples' homogeneity. Pooled estimates of mean were calculated using the random effects inverse-variance model. RESULTS: The mean age of AMI varied between 55.9 to 62.9 years among the primary studies. The pooled mean age of first AMI with a 95% confidence interval (CI) for the total sample, men, and women were 59 (58.9, 60.4), 58.7 (58.3, 59.2), and 64.2 (63.5, 64.8), respectively. CONCLUSION: Our meta-analysis shows that the mean age of first onset of AMI in Iranian people is slightly lower than that reported elsewhere; and it is lower for men than for women.

Cognitive deficits and self-care behaviors in elderly adults with heart failure.

INTRODUCTION: Elderly adults with heart failure (HF) may have problems with self-care behaviors because of cognitive deficits. Self-care deficits have been found to be significantly associated with negative health care outcomes among HF patients. The aim of this paper was to assess cognitive deficits and the level of self-care ability in elderly patients with HF, and to determine if a relationship exists between cognitive deficits and self-care. MATERIALS AND METHODS: The study included 270 elderly patients (mean age: 72.5 years) with HF. We used the Mini Mental State Examination Scale (MMSE) to evaluate cognitive functioning, and the European Heart Failure Self-care Behavior Scale, revised into a nine-item scale (EHFScBS-9), to evaluate self-care behaviors. Associations between the variables were examined using multiple regression analysis. RESULTS: Lower scores in both MMSE and EHFScBS-9 questionnaires were correlated with older age, living alone, lower education, longer duration of illness, higher number of rehospitalizations, as well as lower left ventricular ejection fraction and higher New York Heart Association (NYHA) class. The multiple regression analysis was used for evaluation of the impact of the following predictors: MMSE score, age, duration of illness, ejection fraction, number of hospitalizations, sex, residence, education, relationship status, and NYHA class on EHFScBS-9 score. CONCLUSIONS: Elderly patients with HF may have worse self-care behaviors because of their cognitive deficits. Age was the strongest predictor of worse MMSE scores. Multidisciplinary health teams should pay attention to the special needs of elderly patients who live with their illness for many years and have no social support because of living alone.

Jordanian nurses' and physicians' learning needs for promoting smoking cessation.

Smoking causes many health problems, including myocardial infarction, stroke, and peripheral vascular disease, and has devastating effects on the cardiovascular system. This study was performed to assess: (1) the prevalence of smoking among Jordanian nurses and physicians, (2) the differences in prevalence of smoking by sex, and 3) nurses' and physicians' learning needs for promoting smoking cessation. A descriptive cross-sectional design was used. Five Jordanian hospitals were randomly selected; 164 nurses (65.3%) and 87 physicians (34.7%) participated in the study. Prevalence of smoking among nurses and physicians was 41.5% (n = 66) and 43.6% (n = 38), respectively, and significantly more men than women smoked (odds ratio, 5.45; confidence interval, 2.52-11.74 [P = .00]). Many Jordanian nurses and physicians do not recognize the addictive aspect of smoking, and health professionals receive no formal training in smoking cessation approaches to use with patients. Most nurses and physicians recognize that University curricula must include information about smoking cessation.

High rates of sustained smoking cessation in women hospitalized with cardiovascular disease: the Women's Initiative for Nonsmoking (WINS).

BACKGROUND: Although men hospitalized with cardiovascular disease (CVD) show high smoking-cessation rates, similar data for women are lacking. We tested the efficacy of smoking-cessation intervention in women hospitalized for CVD. METHODS AND RESULTS: In this randomized controlled trial conducted from 1996 to 2001, 277 women diagnosed with CVD (mean age 61+/-10 years) were randomly assigned within 1 of 12 San Francisco Bay Area hospitals to a usual-care group (UG; n=135) or intervention group (IG; n=142). Baseline histories were obtained, and interviews to ascertain self-reported smoking status occurred at 6, 12, 24, and 30 months after hospitalization. The UG received strong physician's advice, a self-help pamphlet, and a list of community resources. The IG received strong physician's advice and a nurse-managed cognitive behavioral relapse-prevention intervention at bedside, with telephone contact at intervals after discharge. The groups were similar demographically and had smoked cigarettes for a median of 38 (IG) or 40 (UG) years. Time to resumption of continuous smoking was assessed by Kaplan-Meier analysis, and risk differences between groups were determined. Time smoke-free was significantly greater for the IG than the UG (P=0.038). Point prevalence for nonsmoking at the interviews was somewhat greater for the IG than the UG (P>0.15 at all times). CONCLUSIONS: Cognitive behavioral intervention resulted in longer average times to resumption of smoking, but in these 2 groups of older women with limited social and financial resources, long-term success rates were similar. Systematic identification of smokers and even the brief intervention afforded the UG yielded a high smoking-cessation rate over time.