Development and psychometric properties of an instrument to measure sleep behavior self-regulation in adolescent students.

Background: The prevalence of inadequate sleep among adolescents is a significant worry due to its potential to adversely affect their health and academic performance. Addressing this matter necessitates a comprehensive grasp of the underlying factors influencing sleep regulation and the formulation of evidence-based interventions to counteract its detrimental consequences. Hence, the central objective of this study is to create and assess a dependable questionnaire designed to evaluate adolescents' self-regulation of sleep behavior. Methods: In this cross-sectional study, data from 401 high school students randomly selected from west Iran were incorporated and subjected to psychometric assessments. The average age of the participants was 16.5 ± 0.92. Initially, 136 preliminary items were formulated, drawing from a contextual framework and comprehensive literature review. The subsequent steps involved specialized analyses, including content validity analysis, item analysis, exploratory and confirmatory factor analysis, as well as convergent validity analysis. Results: Both exploratory and confirmatory factor analyses support a strong structural model, including factors like self-control, outcome expectation, goal setting, and self-efficacy, which are linked to regulating sleep behavior. The model fit was satisfactory. The instrument had 22 items which demonstrated good internal consistency, adequate test-retest reliability, and evidence of convergent validity. Conclusion: In future studies exploring sleep behavior, the present questionnaire, which has demonstrated initial validity and reliability, holds the potential to provide valuable assistance in evaluating and enhancing self-regulation in sleep behavior, particularly within school environments.

The effect of educational intervention based on the Progressively Lowered Stress Threshold extended model on the process of caregiving for people with dementia.

BACKGROUND: This study examined the impacts of an educational intervention based on the Progressively Lowered Stress Threshold (PLST) extended model on caregiving for people with dementia (PWD). METHOD: This study was conducted in Isfahan, Iran, from May 2016 to June 2018, with 38 caregivers of PWD as participants assigned to an intervention group. Data were collected using a multi-sectional, researcher-developed questionnaire that recorded the demographic characteristics, and measured the dementia-related knowledge and caregiving practices of the participants. The questionnaire and an educational program were designed in three parts according to the educational needs of caregivers to enhance their practice, skills, and ability to handle challenging behaviours in PWD. The questionnaire's face validity was confirmed by expert review, and its reliability was assessed with Cronbach's alpha coefficient (knowledge section, 0.838; practice section, 0.802). The sampling method used was convenience sampling, and none of the caregivers refused to receive the educational content. Therefore, the evaluation of the program lacks a randomized controlled group. To tailor the intervention program to the participants' needs, the educational content was based on the PLST extended model. RESULTS: The mean scores for knowledge and practice increased following the intervention (P < 0.05). An educational intervention, using the PLST extended care model, thus produced positive impacts in improving the knowledge and practice of caregivers of PWD. CONCLUSION: Educating caregivers with the PLST extended model, with a specific focus on the cultural and religious backgrounds of societies, is recommended.

Family-based interventions in youth to prevent HIV/AIDS: A systematic review.

Parents are primary sex educators of their teenagers and also function as resources for advice and information about sexual decision-making and partner selection. So far, various family-based programs were carried out to prevent HIV infection in young people; however, their findings are contradictory and inconclusive. Therefore, we carried out the current systematic review to critically review the available literature regarding the role of family-based interventions among young people to prevent HIV infection. The available online databases including ISI Web of Science, Scopus, and PubMed were searched systematically up to November 2022. The risk of bias in the eligible studies was examined by two independent authors using the Cochrane Collaboration Risk of Bias tool. A total of 7 studies including 4952 participants were enrolled in the current study. They were conducted between 2006 and 2020. On the basis of the available literature, family-based HIV prevention interventions seem to be effective in terms of improving HIV/AIDS knowledge and also parent-youth communication. It seems that family-based interventions in youth to prevent HIV/AIDS are effective; however, further well-designed studies are needed to help the researchers reach a firm conclusion on this issue. The current systematic review may be used by investigators for future studies in terms of settings and the selection of educational approaches. Moreover, it strongly suggested that further studies investigating the role of family-based education in the prevention of HIV/AIDS utilize more sample size and also a more robust educational framework.

Assessment of the psychometric properties of the Persian version of the diabetes self-management questionnaire (DSMQ) in patients with type 2 diabetes.

Background: Performing self-care behaviors by diabetic patients is essential to achieve optimal glycemic control, reduction of complications, and improvement in the quality of life. The Diabetes Self-care Questionnaire (DSMQ) is designed to assess self-care behaviors that can predict glycemic control. The present study aimed to evaluate the psychometric properties of the Persian version of the DSMQ in patients with type 2 diabetes. Methods: The present methodological cross-sectional study investigated 460 patients with T2DM referred to the Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran through the convenience sampling procedure. The translation process of the DSMQ was carried out based on the guidelines suggested by Beaton et al. We assessed the reliability (internal consistency), content validity, convergent validity and construct validity. Construct validity was evaluated using exploratory factor analysis (calibration sample = 230) and confirmatory factor analysis (validation sample = 230). Furthermore, a linear regression analysis was used to determine the prediction power of self-care behaviors in explaining the variance of the HbA1c level. Results: In the EFA with Varimax rotation, we extracted four factors that could explain 67.46% of the total variance of the DSMQ scale. The CFA exhibited a satisfactory fit level for the four-factor structure extracted from EFA with the following measures. CFI: 0.980, IFI: 0.980, NFI: 0.956, TLI: 0.974, RMSEA: 0.042). Internal consistency was good (Cronbach's alpha coefficient for the whole scale: 0.84; the subscales: 0.75-0.91). The convergent validity showed significant negative correlations (GM: -0.53; DC: -0.22; PA: -0.16; HU: -0.17; SS: -0.45; p < 0.01) between DSMQ subscales and HbA1c. However, only two factors of glucose management and diet control in the statistical model obtained from regression analysis (stepwise) were able to explain 30% of the HbA1c level (P < 0.001). Conclusion: The Persian version of the DSMQ is a valid and reliable instrument to assess self-care behaviors associated with glycemic control in Iranian patients with T2DM. Therefore, this instrument can be used in both future research and clinical practices.

Development and evaluation of a new questionnaire to assess social cognitive factors of self-management in patients with type 2 diabetes: a psychometric study.

Background: Self-care behaviors are essential to control blood sugar and to prevent mortality and complications of diabetes. The evidence suggests that social cognitive factors play a crucial role in adopting self-care behaviors. This study aimed to develop and examine the psychometric properties of the Diabetes Self-Management Questionnaire based on the social cognitive theory (DSMQ-SCT). Methods: The present methodological cross-sectional study investigated 460 patients with T2DM referred to the Isfahan Endocrine and Metabolism Research Centre, Isfahan, Iran using the convenience sampling method. We assessed the reliability (internal consistency), content validity, convergent validity and construct validity. Construct validity was evaluated using exploratory factor analysis (calibration sample = 230) and confirmatory factor analysis (validation sample = 230). Results: In the EFA with the varimax rotation, we extracted four factors that could explain 65.9% of the total variance of the DSMQ-SCT scale. The CFA exhibited a satisfactory fit level for the four-factor structure extracted from the EFA with the following measures. CFI: .971, IFI: .971, NFI: .942, TLI: .966, RMSEA: .046).Internal consistency was good (Cronbach's alpha coefficient for the whole scale: 0.88; the subscales: 0.85 to 0.92). The convergent validity showed significant negative correlations between DSMQ-SCT subscales and HbA1c. Conclusion: DSMQ-SCT is a valid and reliable instrument to assess social cognitive factors associated with self-management behaviors in patients with T2DM. Therefore, this instrument can be used in both future research and clinical practices.

A modified Delphi study to identify strategies to promote health literacy in parents of children with cancer.

BACKGROUND: Parents play a key role in the care, monitoring, management of symptoms experienced in children with cancer, the support, and follow-up of treatment. However, there is a paucity of research as how to improve the health literacy of parents with cancer. The aim of this study was to identify the best and most important strategies to promote health literacy in parents of children with cancer. MATERIALS AND METHODS: A two-step modified Delphi method was used to establish consensus in Iran in 2021. Fourteen experts representing oncology, clinical nursing, and faculty members of nursing were selected by purposive sampling. In round one, 90 strategies to promote health literacy obtained in the qualitative study were distributed to the experts, which were scored from 1 to 5. In order to discuss statements without consensus in the first round, round two was held in a face-to-face meeting. Descriptive statistics such as mean, standard deviation, and percentage of response frequency were used to calculate agreement levels between experts. RESULTS: In round one, 57 statements reached a consensus. In round two, 21 statements reached a consensus. Finally, 78 statements reached consensus representing four domains including functional health literacy, interactive health literacy, critical health literacy, and care health literacy. CONCLUSION: Delphi method helps to identify the best and most important strategies to use in health literacy promotion programs for parents of children with cancer. Identifying these strategies will help health officials, planners, and policymakers.

The Prevalence of Psychotropic Drugs and Relevant Factors in Iranian Youth: A Systematic Review and Meta-Analysis.

BACKGROUND: Psychotropic drugs can cause many complications and side effects including cognitive, behavioral, and psychological disorders. In recent years, the Iranian youth and adolescents have growingly been using psychotropic drugs. Therefore, this study analyzes the overall prevalence of psychotropic drugs and the relevant factors among the Iranian youth through a systematic review and a meta-analysis. METHODS: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, this study includes a systematic review and a meta-analysis. For bias prevention, qualitative evaluation and data extraction were performed independently by two people. Different databases (PubMed, Science Direct, Springer, Wiley, ISI Web of Science, Cochran, Google Scholar, Magiran, IranMedex, SID, ISC) were investigated online, and data analysis was done in Stata software. FINDINGS: In total, 5 articles were selected for the meta-analysis phase. They had been published between 2008 and 2018. According to the meta-analysis results, the overall prevalence of psychotropic drugs was 4.18% [95% confidence interval (CI): 2.52-5.84] in the Iranian youth population. The overall prevalence of psychotropic drugs was 4.74% (95% CI: 1.49-7.99) and 1.06% (95% CI: 0.72-1.41) in young men and women, respectively. Three studies indicated a significant relationship between gender and the use of psychotropic drugs. In other words, the prevalence of psychotropic drugs was significantly higher in boys than in girls (P < 0.05). CONCLUSION: The research results showed that family, parents, close friends, and unemployment were the factors affecting the prevalence of psychotropic drugs in the youth and adolescents.

The social-cognitive determinants of calcium intake for preventing osteoporosis in women in Isfahan: A cross-sectional study using path analysis.

BACKGROUND: Osteoporosis is a common disease in women over age 45 years. Calcium intake is among the factors that help prevent osteoporosis. Identifying the social-cognitive determinants of calcium intake can have a major role in the development of osteoporosis prevention programs. MATERIALS AND METHODS: This cross-sectional study was conducted on 400 women aged <50 years from 10 health centers by cluster sampling in Isfahan in 2016. A hypothetical social-cognitive model was assessed using path analysis, and the fit indices and explanatory power of the model were assessed. The constructs, including self-efficacy, outcome expectations, social support, and self-regulation, were taken as the explanatory variables and calcium intake as the criterion variable. RESULTS: The mean age of the participating women was 34.07 years (standard deviation = 7.99) (range = 19-50), and their mean calcium intake was reported as 909.94 (12. 6) mg/day. The conceptual model was able to explain 73% of the variance in calcium intake and had good fit indices. Self-regulation was identified as the strongest predictor of calcium intake, and outcome expectation was eliminated from the model since it was the weakest explanatory factor of calcium intake. CONCLUSIONS: The theoretical model of this study is recommended as a suitable framework for the development of targeted osteoporosis prevention interventions.

Stress as a challenge in promoting mental health among dementia caregivers.

BACKGROUND: Caregiver stress is harmful to the health of both caregivers and people living with Alzheimer's disease or other dementias. The present study was conducted to assess stress and its predictors of people living with Alzheimer's disease or other dementias' caregivers. METHODS: The present descriptive, analytical, cross-sectional study was conducted in December 2017-June 2018 in Isfahan, Iran. Data were collected by interviewing 99 caregivers had at least 6 months of experience caring for a patient diagnosed with Alzheimer's disease, through questionnaires developed by the researcher. A convenience sample (easy access) of caregivers was recruited from calling the home of formally diagnosed with Alzheimer's patient, that have registered in educational hospitals affiliated to Isfahan University of Medical Sciences and psychiatrists' office both paid caregivers (formal) and unpaid caregivers (family). All caregivers provided informed consent. The type and severity of the relationship between the dependent (stress) and independent variable were assessed using Pearson's and Spearman's correlation coefficients, the independent t-test, and the multivariate regression analysis. RESULTS: The caregivers' mean stress score was 25.4 ± 10.9 (range: 4-54). About 80% of the caregivers were female. Age and stress score was correlated (P = 0.004), the mean stress score was significantly higher in female caregivers (P = 0.04), informal caregivers (P < 0.001), and significantly lower in the caregivers with previous experience of caring for Alzheimer's patients (P = 0.02) or those introduced by service companies (P = 0.005). Variables including the family relationship with the patient (P = 0.01), kind of caregiving (P = 0.03), and previous experience of caring for Alzheimer's patients (P = 0.04) were stronger predictors of the stress score. CONCLUSION: Stress is a challenge in promoting mental health among dementia caregivers. Providing social support with an emphasis on physical, mental, and social health is mandatory, especially for female and family caregivers, to promote stress management, mental health in this group, and enable optimal and purposeful care.

Marital communication skills training to promote marital satisfaction and psychological health during pregnancy: a couple focused approach.

BACKGROUND: Studies showed that decreased marital satisfaction and increased risk of depression and anxiety were mutually related. Therefore, this study was conducted to evaluate the effect of communication skills training with a couple focused approach on marital satisfaction and psychological symptoms among pregnant women. METHODS: This experimental study was performed on 60 pregnant women with low marital satisfaction who were divided into two groups of intervention and control. The women in the intervention group and their husbands participated in a communication training program based on the couple focused approach. The levels of anxiety, depression, and marital satisfaction were evaluated before and then one and three months after the intervention using valid questionnaires. RESULTS: The results indicated that after the intervention, compared to the pre-intervention period, the levels of marital satisfaction increased while the levels of depression and anxiety decreased significantly in the intervention group (p < 0.05). The comparison of the groups revealed significant differences in the scores of marital satisfaction, depression, and anxiety in the intervention and control groups at the intervals of one month and three months after the intervention (p < 0.05). CONCLUSIONS: The research findings indicated that communication skills training program based on the couple focused approach and an emphasis on the needs of pregnant women during the pregnancy can improve the marital satisfaction and psychological health of pregnant women. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT2017012932264N2, Date of registration: 2017-06-28 Retrospectively registered.

Evaluating the Effect of Family-Centered Intervention Program on Care Burden and Self-Efficacy of Hemodialysis Patient Caregivers Based on Social Cognitive Theory: A Randomized Clinical Trial Study.

BACKGROUND: Caregivers of hemodialysis patients spend a large amount of time providing care to these patients while tolerating fatigue and stress. This study evaluated a family-centered empowerment program on the care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory. METHODS: In this randomized clinical trial, 70 family caregivers of hemodialysis patients in Isfahan, Iran, were selected and randomly allocated to intervention and control groups, in 2015-2016. Two questionnaires were used to collect the family caregivers' characteristics, care burden, and self-efficacy, and patients' negative and positive outcomes expectancies. Data were analyzed using SPSS before, immediately after, and 2 months after the intervention. RESULTS: There was no significant difference in the mean scores of care burden, positive outcomes expectancies, negative outcomes expectancies, and self-efficacy between the two groups before the intervention. However, there were significant differences in the post-test and follow-up data analyses (P<0.05). CONCLUSION: Given the degenerative nature of chronic kidney disease, it can be considered as a source of long-term and chronic stress for caregivers. Therefore, by implementing an empowerment program, caregiving behaviors can be improved, positive outcomes expectancies can be increased, and negative outcomes expectancies can be reduced.

The relationship between family social capital, social media use and life satisfaction in adolescents.

Background: Nowadays, two social phenomena are identified as factors that significantly influence life satisfaction among adolescents: family social capital and social media use. This study aimed to investigate the direct and indirect relationships between family social capital and life satisfaction, and the possible mediating role of social media use between the variables among Iranian adolescents. Methods: In 2018, this cross-sectional study was carried out on 835 adolescents aged from 12to 19, in six high schools of Isfahan, Iran. Data were collected using a validated four-section questionnaire including demographic characteristics (3 items), life satisfaction (5 items), family social capital (31 items) and social media use (4 items) scales. IBM SPSS version 21 statistical software and AMOS version 24 were used to analyze the data. Structural equation modeling was used to assess the fit of model. The significance level of 0.05 was considered for all data analyses. Results: The findings indicated that family social capital and social media use explained 50%of the variance in life satisfaction. Social media use was found with a partial mediating role in the association between family social capital and life satisfaction. Family social capital was the strongest predictor of life satisfaction (ß =0.681, P<0.001). The relationship between social media use and life satisfaction was also statistically significant (ß =- 0.12, P<0.001). Conclusion: Social media use and family social capital should be considered while investigating the determinants of life satisfaction among adolescents.

What motivates informal caregivers of people with dementia (PWD): a qualitative study.

BACKGROUND: The burden of caring for People with Dementia (PWD) is heavy; identifying incentives that motivate them in providing care is essential in facilitating and optimizing care. This study aims to explore and describe these motivating factors. METHODS: We conducted this qualitative study between January 2016 and January 2017 in Isfahan, Iran. Data were extracted through in-depth, semi-structured interviews with 19 caregivers of PWD. These data were then examined through thematic content analysis. RESULTS: We identified four categories of psychological motives based on the caregivers' feedback and experience. These include 1) Moral-based motives, 2) Religious, and spiritual motives; 3) Financial motives, and 4) Wicked motives. CONCLUSIONS: Our results revealed several aspects of caregivers' motives. They include moral, religious, and spiritual aspects; sharing housing accommodations, and the likelihood of inheriting a portion of the patient's assets based on unspoken rules and informal arrangements in the family, and wicked and immoral aspects. These findings can inform future efforts in enhancing the experiences of caregivers of PWD, and subsequently, the quality of care these patients receive. It further suggests that family members, members of a religious and spiritual organization, as well as social media, could play important roles in setting the stage.

Relationship Between Marital Quality, Social Support and Mental Health During Pregnancy.

The aim of this study was to investigate the relationship between marital quality and mental health during pregnancy. This cross-sectional study was conducted on 300 Iranian pregnant women. The ENRICH marital satisfaction subscales, levels of domestic violence, perceived social support, as well as depression and anxiety levels were assessed using a questionnaire. AMOS path analysis was used to explore the causal relationship and the mediating effect of social support among the variables of marital quality subscales and mental health. The results showed that, adjusted for age, the history of infertility and level of anxiety were related to marital satisfaction, marital relationships and level of depression which were related to the level of domestic violence. Sexual satisfaction and the level of perceived social support had a mediating role in such relationships. The study confirmed that marital quality is an important predictor of mental health. Improving the marital quality may lead to improvement in mental health.

Development and psychometric evaluation of the diabetic Men's dietary behaviors inventory based on the theory of reasoned action.

BACKGROUND: Unhealthy dietary behaviors have progressively increased the prevalence of diabetes mellitus. Thus, assessing such behaviors and their associated beliefs by valid measurement tools seems essential. This study sought to develop and evaluate the psychometric properties of the Diabetic Men's Dietary Behaviors Inventory based on the Theory of Reasoned Action. METHODS: Initially, a preliminary 78-item inventory on diabetic men's dietary beliefs and behaviors was developed based on the six constructs of the Theory of Reasoned Action. Then, psychometric evaluation methods were employed to select the most appropriate items and also to validate the inventory. The validity of the inventory was assessed through face, content, and construct validity assessment. For construct validity assessment, a sample of 206 diabetic men was selected from two educational, research and healthcare settings located in Isfahan, Iran. The inventory was completed for all men through interviewing them. The reliability of the inventory was evaluated through internal consistency assessment. RESULTS: The preliminary inventory contained 78 items, 33 of which were excluded during the phases of psychometric evaluation. Exploratory factor analysis revealed a five-factor structure for the inventory; the factor loads ranged from 0.41 to 0.80. All items were significantly correlated with the inventory. Cronbach's alpha values of all factors were greater than 0.6, denoting the high internal consistency of the inventory. CONCLUSION: The Diabetic Men's Dietary Behaviors Inventory is a valid and reliable instrument for evaluating diabetic men's dietary perceptions and behaviors.

Dedication in Caring of Hemodialysis Patients: Perspectives and Experiences of Iranian Family Caregivers.

BACKGROUND: Although dialysis treatment is considered as a life-saving treatment for chronic renal failure patients, the caregivers face challenges in caretaking of these patients. OBJECTIVES: This study is aimed to explain the perspectives and experiences among caregivers of the patients undergoing hemodialysis in Iran. METHODS: A qualitative design, based on a thematic analysis approach, was used to reach the study aim. In this study, 25 hemodialysis family caregivers were selected by purposeful sampling. The data were gathered through in-depth and unstructured interview and field observation and analyzed by the inductive thematic approach. RESULTS: The three main themes were generated from the analysis of the data indicating that the caregivers face challenges such as heavy burden of care, tension in care, and emotional exhaustion. CONCLUSION: Caretaking of the hemodialysis patients is constantly accompanied with challenges and concerns regarding the effective care for patients. Health-care providers need to address these concerns based on both patient- and caregiver-focused approaches, rather than only patient focused, to the design and planning for helping the patients and their caregivers.

Hospitals reorientation towards health promotion: A qualitative study of barriers to and strategies for implementation of health promotion in hospitals of Isfahan, Iran.

CONTEXT: The World Health Organization (WHO) has emphasized the need for reorientation of hospitals toward health promotion (HP). AIMS: This study explores health-care professionals' perception of barriers and strategies to implementing HP in educational hospitals of Isfahan Province in Iran. SETTINGS AND DESIGN: The study settings included four selective educational hospitals and the Treatment Administration affiliation to the Isfahan University of Medical Sciences. SUBJECTS AND METHODS: A qualitative content analysis approach was employed in this study, with semi-structured in-depth interviews. Eighteen participants from hospital and accreditation managers, nurses, community medicine specialist, and directors of health-care quality improvement and accreditation participated in the study by purposeful sampling method. The data were analyzed using content analysis method. RESULTS: The barriers can be categorized into the following areas: (1) barriers associated with patient and community, (2) barriers associated with health-care professionals, (3) barriers associated with the organization, and (4) external environment barriers. The results were summarized into four categories as strategies, including: (1) marketing the plan, (2) identifying key people and training, (3) phasing activities and development of feasible goals, and (4) development of strategic goals of health promoting hospitals and supportive policies. CONCLUSIONS: The interactions of individual, organizational, and external environmental factors were identified as barriers to implementation of HP in hospitals. To hospital reorientation toward HP, prioritizing the barriers, and using the proposed strategies may be helpful.

Psychological factors of healthful diet promotion among diabetics: an application of health action process approach.

BACKGROUND AND AIM: Worldwide, type 2 diabetes mellitus (T2DM) prevalence has increased. Non-healthful diet is one of the main reasons to T2DM growth. This study aims to determine the efficacy of the health action process approach (HAPA) in explaining healthful diet (HD) in T2DM patients. METHODS: This cross-sectional study was conducted based on HAPA in Isfahan, Iran between July and December 2015. Participants were recruited by convenience sampling method. HAPA inventory was administered to 203 Isfahan diabetics. Intentions, outcome expectancies, risk perception, action self-efficacy, action and coping planning, maintenance and recovery self-efficacy, and dietary style were the constructs measured. Structural equation modeling (SEM) in AMOS 21 was used to test the hypothesis. RESULTS: The results based on the common fit indices revealed that the HAPA fitted the data acceptably well among the T2DM patients and within dietary behavior (p<0.001), RMSEA=0.082, CFI=0.903, NFI=0.899). Action self-efficacy was the best predictor of intention (ß=2.49, p<0.001). Result revealed action and coping planning (ß=5.36, p=0.027) and recovery self-efficacy (ß=5.67, p=0.021) significantly predicted behavior. CONCLUSIONS: Our findings provide preliminary support for the practical usage of the HAPA model for predicting HD intention and behavior among T2DM patients. Randomized controlled trials should be performed in the future in order to involve causality.

Development and psychometric properties of a Calcium Intake Questionnaire based on the social cognitive theory (CIQ-SCT) for Iranian women.

Background: Osteoporosis is common among women which may be mostly due to the low intake of calcium. This article reports the development, cultural adaptation and psychometric properties of a Calcium Intake Questionnaire based on the social cognitive theory (CIQ-SCT)among Iranian women. Methods: In 2016, this cross-sectional study was carried out among 400 younger than 50 years old women in Isfahan, Iran. After literature review, a preliminary 35-item questionnaire was developed. Then, forward-backward translation and cultural adaptation of the tool was conducted. Content Validity Index confirmed by an expert panel and Face Validity was evaluated in a pilot study. Exploratory and confirmatory factor analyses (EFA &CFA) were conducted on the calibration and validation sample, respectively. Reliability was also assessed using internal consistency test. Results: After determining content and face validity, 20 items with 5 factors (self-efficacy,outcome expectations, social support and self-regulation) were obtained. Cronbach alpha for the instrument was found to be 0.901. In EFA, we identified a 4-factor model with a total variance of 72.3%. The results related to CFA (CMIN/DF=1.850, CFI =0.946, TLI=0.938, RMSEA=0.069[90% CI: 0.057-0.081]) indicated that the model was fit to the social cognitive theory. Self regulation was detected as the best predictor for calcium intake. Conclusion: The CIQ-SCT showed acceptable levels of reliability and validity in explaining the calcium intake based on the constructs of social cognitive theory. Further psychometric testing is recommended in different population to approve the external validity of the instrument.

Psychological profiles of risk for antenatal depression and anxiety in Iranian sociocultural context.

BACKGROUND AND AIM: Mental health issues including depression and anxiety are common in pregnancy worldwide. This study aimed to identify factors associated with mental disorders in a sample of Iranian pregnant women. MATERIALS AND METHODS: A cross-sectional study was conducted among pregnant women referred to a prenatal-care clinic in an urban area, Isfahan, Iran. The questionnaires in this study included the General Health Questionnaire and additional structured questionnaires exploring sociodemographic, obstetric, and economic risk factors and empowerment for decision-making regarding pregnancy, parenting, financial authority, trust, and confidence in health-care staff. Regression analysis was performed to assess the impact of the number of variables on the likelihood of the presence of mental health problems. RESULTS: Overall, 54.2% and 11.7% of the women had anxiety and depression, respectively. No statistically significant associations were reported between anxiety and depression and obstetric characteristics such as gestational age, parity, abortion, previous infertility, unwanted pregnancy, and the screening test results. According to the logistic regression analysis, the predictors of depression and anxiety were acknowledging psychological changes in pregnancy and empowerment for decision-making regarding pregnancy and parenting and financial authority (P < 0.05). CONCLUSIONS: probably, women's empowerment on becoming aware of psychological changes during pregnancy and making decisions on pregnancy, parenting, and financial authority is the factor affecting the mental health of pregnant women.