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

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

The 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.

Translation and validation of the Comfort Behaviors Checklist in hospitalized children with chronic diseases.

BACKGROUND: Different tools have been developed to measure patients' comfort. This study aims to translate, validate, and apply the Comfort Behaviors Checklist to hospitalized children with chronic diseases. METHODS: Validity and reliability are assessed using face and content validity, construct validity (known-groups technique and Principal Component Analysis), internal consistency, and inter-rater reliability. The study takes place in a children's hospital in Iran, involving 220 children aged 4 to 6. RESULTS: The Comfort Behaviors Checklist demonstrates acceptable face and content validity. Construct validity is supported by the lack of correlation between behavioral comfort scores in known groups. The Principal Component analysis results in five components, explaining 70.39% of the total variation. The checklist exhibits acceptable reliability, with a total Cronbach's alpha coefficient of 0.86 and an intraclass correlation coefficient of 0.835. CONCLUSION: The Comfort Behavior Checklist is a valid and reliable tool for assessing the level of comfort in Iranian children with chronic diseases.

A concept analysis of cultural competence in nursing: A hybrid model approach.

BACKGROUND: Cultural competence is considered one of the criteria for high-quality nursing care. AIM: This study aimed to analyse cultural competence in nursing. METHODS: This study was performed using the hybrid concept analysis approach in three phases. In the theoretical phase, literature was reviewed by searching Persian and English language databases, and 94 articles were included. In the second or fieldwork phase, 11 semi-structured interviews were conducted with purposefully selected nurses. The results of both theoretical and fieldwork phases were analysed using conventional content analysis, and in the final analysis phase, the results of the previous phases were triangulated. RESULTS: The attributes of cultural competence were obtained in the theoretical phase in six and the fieldwork phase in three categories. In the final phase, the categories obtained in both previous phases were triangulated: cultural competence in nursing is a continuous, developmental, flexible, extensive and complex process that is patient- and justice-oriented and emerges through learning and skills acquisition, including cultural knowledge, attitudes and practices. CONCLUSION: Managers and planners of nursing education can use the results of this study to educate nursing students and nurses and evaluate outcomes as one of the criteria for quality care.

Exploring the Impacts of Caring for Hospitalized COVID-19 Patients on Nurses: A Qualitative Descriptive Study.

Background: The impacts of caring for hospitalized COVID-19 patients on nurses are wide and varied and have not been comprehensively explained in the existing literature. The aim of this study was to explore the nurses' perception of the impacts of caring for hospitalized COVID-19 patients. Materials and Methods: In this qualitative descriptive study, data were collected via semi-structured interviews with 20 nurses and head nurses of emergency/internal wards and Intensive Care Units (ICUs) of 2 hospitals in Tehran, Iran. The purposive sampling method was used, and data analysis was performed using a conventional content analysis approach. Results: After data analysis, 12 subcategories, 3 main categories, and 1 theme (professional resilience) were extracted. The three main categories included "complex care," "professional development," and "caring self-efficacy." Caring for hospitalized COVID-19 patients was complex for nurses; however, the care provided to these patients could also lead to the nurses' professional development and caring self-efficacy. Conclusions: Health organizations and nursing managers can better manage the COVID-19 pandemic and other similar future crises through strategies such as providing nurses with adequate and diverse resources and facilities, encouraging and supporting nurses in various dimensions, providing positive media advertisements for the nursing profession and nurses, and providing nurses with necessary and applicable knowledge and skills.

Cross-Cultural Evaluation of the Psychometric Properties of the Spiritual Well-Being Scale: A Systematic Review.

Since spiritual well-being has a significant role in individual and social health, using a valid scale to identify these properties is essential. Comparing factor structure and differences in the number of dimensions and items of subscales could be an indicator of differences in individuals' attitudes toward spirituality among diverse cultures. The present review was performed for psychometric evaluation of the spiritual well-being measures. A systematic review of international databases and Iranian databases was conducted to evaluate studies published between January 1, 1970, and October 1, 2022. QUADAS-2, STARD, and COSMIN scales were used for risk of bias assessment. Following two rounds of screening, 14 articles entered quality assessment. According to the results, studies examining the factor structure of the spiritual well-being scale (SWBS) instrument have been conducted for the years 1998 to 2022. The mean age of the participants in these studies ranged from 20.8 to 79.08 years. During the process of exploratory factor analysis, the researchers reported the presence of two to five latent factors, and the range of explained variance was between 35.6 and 71.4%. However, most of the reports indicated the existence of two or three latent factors. The findings of the present study provide an image of the psychometric status of the SWBS for researchers and clinicians in this field and can help them make optimum decisions in selecting a scale or conducting additional psychometric studies or adopting this scale for studies in new populations.

Cooling spray or lidocaine spray and needle insertion pain in hemodialysis patients: an open-label cross-over randomized clinical trial.

BACKGROUND: The needle insertion pain to perform hemodialysis is the main challenge and a common problem that requires pain management techniques for patients' comfort. AIM: This study aimed to compare the effects of cooling and lidocaine sprays on needle insertion pain in hemodialysis patients. METHODS: In this randomized cross-over clinical trial study, the hemodialysis patients were selected through convenience sampling according to inclusion criteria and randomly assigned to three intervention groups using the block randomization method. Each patient received three interventions in a cross-over design: Cooling spray or 10% lidocaine spray or placebo spray. There was a 2-week wash-out time between each intervention. The pain score was measured four times for each patient by the Numerical Rating Scale. RESULTS: Forty-one hemodialysis patients were included. The results showed a significant interaction between time and group (p < 0.05), so only observations of time 1 with adjustment for baseline values were used to evaluate the effect of the intervention. Patients receiving cooling spray reported 2.29 less pain score on average compared to placebo (B=-2.29, 95% CI: -4.17 to -0.43; p < 0.05); Also, patients receiving cooling spray reported a 1.61 lower pain score than those receiving lidocaine spray, but this difference was not statistically significant (95% CI: -0.26 to 3.48; p > 0.05). CONCLUSION: The cooling spray was effective in reducing the needle insertion pain. Although it was impossible to compare the pain scores at different times and following different interventions, the present study results can help supplement the existing knowledge regarding cooling and lidocaine sprays.

Comparison of the Effect of the Person-Centered and Family-Centered Training via Telenursing on the Quality of Life in COVID-19 Patients.

Background: Education of the patients with Coronavirus Disease 2019 (COVID-19) and their families is necessary to improve the quality of life. This study investigated the effect of person and family-centered training via telenursing on the quality of life in patients with COVID-19. Methods: This interventional study was performed on 88 patients with COVID-19 18--65 years and 44 family members referred to the Bank Melli Hospital, Tehran, Iran. The samples were randomly assigned into two groups person-centered and family centered. A cyberspace group including patients and their families was created. Four educational sessions planned (15--30-min-every day) and three sessions planned for completing the questionnaires via phone. The data were collected using demographic characteristics form and the 12-item Short-Form Health Survey version 2 before and 6 weeks after the intervention and were analyzed in SPSS 22 using Chi-square test, paired t-test, and independent t-test. Results: The mean scores of quality-of-life increased significantly in the person-centered group from 26.81 ± 5.15 to 34.4 ± 4.39 before and six weeks after intervention, respectively (p < 0.001). The means scores of quality-of-life increased significantly in the family-centered group from 28.11 ± 4.79 to 35.86 ± 3.85 before and 6 weeks after the intervention, respectively. (p < 0.001). Conclusions: The person and family centered methods increase the mean scores of quality-of-life of patients with COVID-19. The family centered method can be more effective to improve the quality of life of these patients.

Psychometric evaluation of the Connor-Davidson Resilience Scale among Iranian population.

BACKGROUND: The resilience construct is considered a personal trait composed of multiple aspects. Connor-Davidson Resilience Scale is a standard tool composed of five factors and 25 items. This study aimed to determine the psychometric properties of this scale. METHODS: In this cross-sectional study, after the scale translation, the factorial structural validity was assessed via the confirmatory factor analysis with 70 180 samples. Internal consistency, composite reliability, convergent validity were assessed by calculating Cronbach's alpha, composite reliability, maximum reliability, and Average Variance Extracted. The discriminant validity was assessed using Heterotrait-monotrait ratio of correlations matrix and also, measure invariance was evaluated. RESULTS: The original five-factor model had good model fit indices but due to low factor loading of item 2 and 20, the model was modified. The Cronbach's alpha and composite reliability for four factors were above 0.7 (except for factor 5). The convergent validity for all five factors were achieved. Between factors 1 with 2 and 4, 2 with 3 and 4 discriminant validity was not established (correlations > 0.9) and the results suggested that there might be a second-order latent construct behind these factors. Therefore, a second-order assessment was performed. The results of the second-order latent construct assessment showed a good goodness-of fit and strong measurement invariance for both men and women. CONCLUSION: The 23-item version of Connor-Davidson Resilience Scale is a reliable and valid scale to measure resilience as a complex construct in the Iran context.

The Farsi version of meaning of life in Iranian patients with cancer: A psychometric study.

BACKGROUND: Having meaning in life is a protective factor for psychological well-being. Accurate assessment of this construct needs a valid and reliable tool. PURPOSE: This study aims to evaluate the psychometric properties of the Farsi version of the meaning of life questionnaire in patients with cancer. METHOD: In this cross-sectional study, after translating the questionnaire to Farsi, in a sample of 212 patients with cancer, feasibility, content and convergent validity, exploratory and confirmatory factor analysis, internal consistency, stability, and responsiveness were evaluated. RESULTS: The results show that the content validity ratio of all ten items was greater than 0.49. Also, the modified Kappa coefficient of each item was greater than 0.6. The maximum likelihood exploratory factor analysis extracted one factor, which explains 76.13% of the total variance of the sample. Item nine was removed. The confirmatory factor analysis results show that the one-factor model had good fit indices. The Cronbach's alpha, McDonald's omega, composite reliability, MaxR, and intraclass correlation coefficient were 0.96, 0.96, 0.96, 0.96, and 0.98, respectively. The questionnaires had responsiveness and its response time was 3 s. CONCLUSION AND POLICY SUMMARY: The nine-item Farsi version of the meaning of life questionnaire has good validity and reliability and responsiveness.

Nursing Performance and Smartphone Use in Clinical Settings.

Objectives: The present study was conducted to examine the relationship between smartphone dependency and its effect on clinical tasks of nurses in educational and medical centers of Hamadan, in western Iran. Method: In this cross-sectional study, 248 nurses were selected via the proportional allocation sampling method. The required data were collected using a self-report, reliable and validated questionnaire, covering patterns of smartphone use, smartphone dependency, effects of smartphone dependency, and influence of smartphone on the clinical performance of nurses. The collected data were analyzed through descriptive statistics and logistic regression analysis. Results: The average age of the participants was 30.43 (± 5.68) years. The average smartphone dependency, effects of smartphone dependency, and clinical performance of the examined nurses were, respectively, 38.65 (20.93), 20.78 (13.90), and 29.48 (10.03). Clinical performance of nurses decreased with age (P = 0.02) and increase of smartphone dependency (P = 0.02), effects of smartphone dependency (P ≤ 0.001), and smartphone use while working (P ≤ 0.001). Higher work experience (P = 0.02) and the application of smartphone multiple capabilities (P = 0.02) had positive effects on the clinical performance of the examined nurses. Conclusions: The results of this study indicated that using smartphones affects the clinical performance of nurses, and if not well managed, it can lead to some physical, psychological, and social problems for the individual nurse, patients, and society. Thus, training nurses and developing regulations for the use of smartphones in the workplace must be considered by the relevant authorities.

Development and psychometric properties evaluation of caregiver burden questionnaire in family caregivers of hemodialysis patients.

BACKGORUND: This study aimed to design and psychometrically evaluate the caregiver burden questionnaire for family caregivers of hemodialysis patients. METHODS: This study was conducted using an exploratory sequential mixed method on family caregivers of hemodialysis patients in Iran. In the first phase, the generation of the items was done based on results of directed qualitative content analysis according to the Structural model of the caregiver burden and review of the literature. After developing the item pool, face and content validity, item analysis, structural, convergent and discriminant validity, internal consistency, reliability, interpretability, and feasibility were evaluated. RESULTS: The primary tool entered the psychometric evaluation phase with 64 items. After performing face and content validity and item analysis, the number of items was reduced to 28. Exploratory factor analysis was performed with 28 items and 300 caregivers, and finally, four subscales with 21 items were developed. The results of confirmatory factor analysis indicated a good fit of the model. Cronbach's alpha and the Intraclass Correlation Coefficient of all subscales were higher than 0.7 and 0.9, respectively. The standard error of measurement was 1.39. All subscales had acceptable values in convergent validity criteria and the HTMT index less than the threshold value. The total score of the questionnaire had no ceiling and floor effect; the percentage of unanswered items was within the acceptable range. CONCLUSION: The results show that the caregiver burden questionnaire for caregivers of patients undergoing hemodialysis has good psychometric properties and can measure the caregiver burden in these caregivers.

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.

Caregiver burden in Iranian caregivers of patients undergoing hemodialysis: a qualitative study.

So far, limited studies have investigated the caregivers of hemodialysis patients and the concept of caregiver burden from their own perspective. The present study aimed to explore the issue of caregiver burden among family caregivers of patients undergoing hemodialysis. A total of 21 family caregivers, patients, and formal caregivers were enrolled using the purposive sampling method. In-depth, semi-structured interviews were conducted to collect the data. For data analysis, a directed qualitative content analysis method was applied. Finally, five dimensions of caregiver burden were extracted, including physical, psychological, emotional, spiritual, financial, social, and time-dependent burdens.

Components of quality of life in hemodialysis patients from family caregivers' perspective: a qualitative study.

BACKGROUND: Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients' quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients' disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers' perspective. METHODS: In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas' method. RESULTS: A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). CONCLUSION: Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients' quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients' quality of life and even reduce the caregivers' burden.

Thermodynamic Investigation of the Effect of Electric Field on Solid-Liquid Equilibrium.

In this study, the thermal, mechanical, and chemical equilibrium conditions are derived for binary solid-liquid equilibrium under the effect of an electric field. As an example, the effect of an electric field on the water/glycerol solid-liquid phase diagram is computed over the complete mole fraction range. We show that the application of an electric field can affect the composition dependent freezing and precipitating processes, changing freezing and precipitating temperatures and changing the eutectic point temperature and mole fraction.

Development and Psychometric Evaluation of "Caregiver Burden Questionnaire for Family Caregivers of Patients Undergoing Hemodialysis": A Protocol for A Sequential Exploratory Mixed-Method Study.

Objective: Caregiver burden is defined as the physical, financial, mental, and social problems stemmed from providing care for one of the family members who is involved with a medical problem. The precise measurement of caregiver burden is crucial, and it is essential to have an appropriate and specific tool for measuring caregiver burden. This study will be carried out using sequential exploratory mixed-method design with the aim of development and psychometric evaluation of a questionnaire for caregiver burden in family caregivers of hemodialysis patients. Method : The study will be done in 2 phases: 1. qualitative study and literature review, and 2. designing and psychometric evaluation of the questionnaire. In the qualitative phase, family caregivers of hemodialysis patients, patients, nurses, physicians, and social workers will be selected using the maximum variation purposive sampling method. Data will be gathered through semi-structured interviews using a combination of the questions derived from the model and open-ended questions and will be analyzed using directed content analysis. The literature review will be carried out based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses to improve the reporting of the systematic review. After developing the primary item pool, in the quantitative phase, the psychometric properties of the questionnaire will be evaluated. In this regard, face, content, and construct validity (exploratory factor analysis), internal consistency (Alpha's Cronbach), reliability (test-retest), responsiveness, interpretability, and feasibility of the questionnaire will be assessed. Results: The primary questionnaire will be developed based on the qualitative and systematic literature review; then, its psychometric properties will be assessed in the second phase. The result section will consist of the findings of these two phases. Conclusion: It seems that a specific questionnaire could be a facilitator of identifying and measuring the actual caregiver burden.

Resilience in Iranian adolescents during the COVID-19 pandemic: Psychometric Evaluation of the Connor-Davidson Resilience Scale.

Background: Resilience is a measure of the ability to cope with stress and the accurate measurement of it is critical. This study aimed to translate and evaluate the psychometric properties of the Connor-Davidson Resilience Scale in Iranian adolescents during the Coronavirus Disease (COVID-19) pandemic.Methods: In this cross-sectional study, after the scale translation, the content and construct validity were assessed using exploratory and confirmatory factor analysis. Moreover, internal consistency, composite reliability, and invariance measurement were evaluated.Results: The content validity ratio was greater than 0.49, and the modified kappa coefficient for all items was higher than 0.6. With exploratory factor analysis, two factors were extracted consisting of 16 items and explaining 43% of the total variance. The results of confirmatory factor analysis indicated a good fit for the model. Cronbach's alpha and composite reliability for both factors were greater than 0.7. Although there is no significant difference (p = 0.09) in the average resilience of adolescents in different provinces, boys (42.64 ± 10.90) had a significantly (p < 0.001) higher resilience score than girls (40.10 ± 11.92).Conclusion: The study results showed that the Persian 16-item version of the Connor-Davidson Resilience Scale has acceptable reliability and validity in the Iranian adolescent population.

Resilience and therapeutic regimen compliance in patients undergoing hemodialysis in hospitals of Hamedan, Iran.

BACKGROUND: The relationship between resilience, one of the important issues in mental health, and therapeutic regimen compliance, the key in the successful management of chronic disease such as chronic kidney disease, is unclear. OBJECTIVE: The aim of this study was to determine the relationship between resilience and therapeutic regimen compliance in ESRD patients, undergoing hemodialysis. METHODS: In this cross-sectional study, 107 hemodialysis patients referred to Besat and Shahid Beheshti Hospitals of Hamedan, Iran were selected through systematic sampling method from January to April 2013. The tool was Connor-Davidson Resilience Scale (CD-RISC). The criteria for compliance were: mean of interdialytic weight gain less than 5.7% to the dry weight, serum potassium 5.5 mEq/L or less, serum phosphorus of 6 mg/dL or less and no more than 3 absences in dialysis sessions. For data analysis, statistical tests such as independent t-test and Logistic regression were performed. RESULTS: Fifty-seven (53.3%) patients were males and the mean age of subjects was 49.96±17.39 years. The difference in the mean scores of resilience between compliance or non-compliance patients was statistically significant (p=0.032). Only resilience and age were significant factors related to regimen compliance. In those subjects with greater resilience for 1 score, the chance of compliance with the therapeutic regimen would be 5.4% higher (OR=1.054, CI 95%: 1.01-1.103). In addition, the elderly patients were more likely to comply with the regimen (OR=1.072, CI 95 %: 1.033, 1.113). CONCLUSION: According to the results, the patients with greater scores of resilience were more likely to comply with the therapeutic regimen.