Translation, validity and reliability of the persian version of the rapid assessment of physical activity questionnaire.

PURPOSE: The purpose of this study was to produce a valid and reliable Persian version of the Rapid Assessment of Physical Activity (RAPA) questionnaire, which previously has been shown to be valid and reliable for assessing physical activity among older adults. METHODS: Permission was obtained from the scale developer, who provided a copy of the the Linguistic Validation of the RAPA Qestionnaire, which utilizes a forward-backward translation methodology. Content validity, face validity, and construct validity of the questionnaire were then determined. Comparison of known groups (older adults with more or less than 50% balance confidence) was used to assess construct validity and the Leiden-Padua (LEIPAD) quality of life questionnaire were used to assess convergent validity. Three hundred older adults, who were members of the Qom retirement centers, participated in the study. Thirty participants completed the RAPA twice with a one-week interval to determine test-retest reliability. RESULTS: Results of comparisons of known groups showed that the mean RAPA score of the older people with greater balance confidence was significantly higher. Significant correlations between most of the scores obtained from both RAPA and the LEIPAD questionnaires confirmed the convergent validity of the questionnaire. Intraclass Correlation Coefficient (ICC) was as high as 0.94 showing that the test-retest reliability was good. CONCLUSION: This study showed the Persian RAPA is a reliable and valid instrument for measuring physical activity among older individuals in both research and clinical contexts.

The effect of educational intervention on efficacy of 1% permethrin shampoo and 4% dimeticone lotion to treat head lice infestation using propensity score matching (PSM).

BACKGROUND: Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. METHODS: This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. RESULTS: The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. CONCLUSION: Participants who received the training intervention (OR = 3.29; CI 95%: 2.21-4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

Translation and evaluation of psychometric properties of the Persian version of the Hypertension Self-Care Activity Level Effects (H-SCALE).

BACKGROUND & OBJECTIVES: Hypertension is a major cause of cardiovascular disease and premature death worldwide. Managing hypertension through self-care practices is considered one of the most effective strategies. However, to accurately assess the self-care status of individuals with hypertension, a valid and reliable tool is necessary. This study aimed to evaluate the psychometric properties of the Persian version of the Hypertension Self-Care Activity Level Effects Questionnaire. METHODS: Present methodological study was conducted on 218 patients with hypertension visiting the Clinic of Qom educational and medical centers. Subjects were selected with convenience sampling. Data were collected using the H-SCALE, and a demographic questionnaire. The translation was done from the recommended backward-forward method according to the WHO protocol. After that, face and content validity were applied, along with construct validity involving a comparison of known groups and confirmatory factor analysis. To test reliability, Cronbach's alpha was used. Data analysis was performed by SPSS and smart-PLS software. RESULTS: The factor loadings of the self-care behaviors questionnaire were significant in all constructs, and were higher than 0.5 except for three items. The known-groups method showed that the self-care score of patients with controlled blood pressure was significantly higher than those with uncontrolled blood pressure. The extent of average variance extracted (AVE) of the majority of the constructs in the questionnaire was greater than 0.5 and, the composite reliability was greater than the AVE, indicating a good convergent validity. The divergent validity of the questionnaire was confirmed using the Fornell-Larcker criterion and the heterotrait-monotrait ratio (HTMT). Cronbach's alpha coefficient, combined reliability, and communalities index were optimal. CONCLUSION: According to research findings, the Persian version of the questionnaire has good validity and reliability that can be used as a tool to measure the level of self-care of hypertension by health care providers.

Resilience and spirituality mediate anxiety and life satisfaction in chronically Ill older adults.

BACKGROUND: Spirituality and psychological resilience can be considered as a protective factor for coping with anxiety in geriatric populations. The aim of the study was to investigate the structural model related to the mediating role of spirituality and psychological resilience in predicting the relationship between anxiety and life satisfaction in older adults with chronic illness. METHODS: In a cross-sectional study, one hundred patients over sixty years of age from one university hospital were selected by convenience sampling. Data were collected using the Spiritual Health Scale, the Anxiety Module of the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Life Satisfaction Scale, and a sociodemographic questionnaire. Data analysis was performed using Partial Least Squares (PLS) structure modeling. RESULTS: There was a positive and significant relationship between resilience, spirituality and life satisfaction of the samples. The structural model showed that spirituality, and psychological resilience mediated in the relationship between anxiety and life satisfaction directly and in indirectly in the older people with chronic disease, explaining approximately 34% of the variance in life satisfaction. CONCLUSIONS: The findings suggest that spirituality and psychological resilience can help older adults with chronic illness to negate the impact of anxiety on satisfaction, with the effect of spirituality being stronger than resilience in this relationship.

Factors Influencing Brucellosis Preventive Behaviors among Marginalized Iranian Women: An Application of the Health Belief Model.

Background: Brucellosis is still a serious public health threat in developing countries, especially in Iran. Brucellosis is an endemic disease in Iran and risk factors increasing its broadcast are prevalent. This study investigated factors influencing brucellosis preventive behaviors amongst marginalized women in Hamadan city, Iran, using the health belief model (HBM). Methods: In this cross-sectional study, 289 women living in marginal areas were considered from April until May 2018. Via cluster random sampling methods, comprehensive health services where women get health care were selected. Each woman in the selected comprehensive health services was then enrolled by the simple random sampling method. Data were gathered from a face-to-face interview via a questionnaire. Results: Most women had a history of using nonpasteurized dairy products (86.2%). Most women (64.7%) boiled the milk for 3-5 minutes. 61.2% of women put the cheese in a salt-water solution. The results showed that one unit rise in the scores of knowledge, self-efficacy, and cues to action resulted in an increase in the mean score of the protective behavior by 0.189, 209, and 0.150, respectively. Conclusion: The HBM was a helpful model in predicting the influential elements in brucellosis preventive behaviors. Also, recognized effective factors should be taken into account when designing interventions.

Cultural Adaption and Psychometric Analysis of Family APGAR Scale in Iranian Older People.

BACKGROUND: Family function is a necessary factor that influences older people's health. The Family APGAR has been widely used to study family functions. However, there has been no Persian version of this instrument to assess family function in older people. The aim of this study was to determine the psychometric properties of the Persian version of the Family APGAR Scale to evaluate the perception of family functions. METHODS: The "forward-backward" procedure was applied to translate the scale from English into Persian. The translated version was checked in terms of validity and reliability, with a sample of 281 older people selected from retirement centers. The factor structure of the scale was also tested using a confirmatory factor analysis. To test reliability, internal consistency and test-retest analyses were performed. RESULTS: The results of the confirmatory factor analysis indicated a good structural model. Criterion-related validity was strongly supported by the pattern of association between the APGAR Scale and the social support survey. Cronbach's α of the scale was 0.88 and test-retest reliability ranged from 0.96 to 0.98, indicating a good range of reliability. CONCLUSION: The findings of this study suggest that the Iranian version of the Family APGAR is a valid and reliable scale to evaluate family functions in health intervention programs.

Health beliefs and behaviors of livestock industry workers regarding Crimean-Congo hemorrhagic fever in Northwest of Iran.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is an acute, feverous disease that is caused by tick bites or humans' direct contact with the blood and tissues of infected livestock and humans. The transmission of the disease is also possible via human-to-human contacts and nosocomial transmission is well described. The majority of patients suffering from this disease are slaughterhouse workers (including butchers), farmers, veterinarians and hospital staff. Thus, this study aimed to investigate the health behaviors of butchers regarding CCHF and study factors affecting such behaviors based on the health belief model. METHODS: This is a descriptive cross-sectional study conducted on 500 butchers in Ardabil Province in 2020 by a multistage sampling method. The participants of the study completed the researcher-made questionnaire of health belief model and health behaviors model relevant to CCHF. The collected data were then analyzed by descriptive statistical tests and linear regression analysis. RESULTS: The mean (SD) age of the participants was 44.4 (10.5) years, and 96% were males. Only 11.1% of the participants displayed acceptable disease-preventive behaviors. The validity and reliability of the developed questionnaire were confirmed. The results of the exploratory factor analysis showed that the constructs of the model explained 84% of the total variance. The results of the study revealed that among the variables of the health belief model, perceived susceptibility (p-value = 0.006, ß = 0.152) and perceived barriers (p-value = 0.023, ß = 0.14) were the strongest factors predicting disease-preventive behaviors regarding CCHF. CONCLUSION: The results of the study showed that the health belief model can predict preventive behaviors for CCHF. Therefore, designing and executing interventions based on the results of this study may encourage such preventive behaviors in butchers.

Development of a mobile application to screen and manage fall risks in older people.

OBJECTIVE: Falls and related injuries are known to be the major health problem leading to disability and mortality among older adults. Identification and management of fall risks aimed to prevent falling is considered to be essential. The aim of this study was to develop a mobile application for screening and management of fall risks based for older adults. METHOD AND MATERIALS: First, we determined product features based on literature reviews. Then we asked 10 experts to assess the importance of capabilities. The application was designed in Android environment based on the STEADI toolkit. Finally, the usability and satisfaction of the application were assessed among 30 older adults by means of a usability questionnaire, and the final version was modified. RESULTS: The experts rated the majority of feasibility features to be important. The application consisted of falls risk self-assessment, and the Timed Up and Go (TUG) test to measure individual fall risks, fall prevention education, and suggestions for training based on the individuals' level of fall risk among older adults. The results of the usability assessment showed that the users were satisfied with the application, 8.83 out of 10. CONCLUSION: The mobile application can be used to screen and manage fall risks in older adults. It may help health providers to identify older adults at low, moderate, and high risks of falls provide education and training to minimise falls and fall-related injuries.Implications for rehabilitationFalls are a major health problem in older people. A great proportion of falls and falls related injuries are preventable.Given the availability and accessibility of various mobile health application and the increasing mobile device usage among older adults, mobile application can be used as a platform for delivering fall prevention programmes such as education and exercise training.The mobile application may be a valuable tool in the fall prevention and their consequences either in old adult.

Predictors of Fall Protective Behaviors Among Iranian Community-Dwelling Older Adults: An Application of the Protection Motivation Theory.

PURPOSE: The protection motivation theory (PMT) is a common framework understanding the use of protective behaviors. The aim of this study was to assess the predictors of fall protective behaviors among community-dwelling older adults, Iran. METHODS: The cross-sectional study was conducted in Qom, Iran, from May to October 2018. Three hundred older people were selected from retirement centers via stratified sampling method. Data were collected by a questionnaire containing items on socio-demographic information, Falls Behavioral (FaB) Scale, and PMT constructs scale. Data analysis was performed using descriptive statistics and structural equation modeling. RESULTS: The mean (SD) age of the participants was 64.6 (5.5) and the majority were male (77.7%). Level of perceived fall threat was lower than perceived efficacy of fall protective behaviors. There was a significant relationship between protection motivation and fall protective behaviors (ß= 0.515, t-value= 13.650). Coping appraisals (ß= 0.409, t-value= 7.352) and fear (ß= 0.194, t-value= 2.462) were associated with motivation. The model explained approximately 27% of the variance in fall protective behaviors. The goodness of fit index of 0.48 indicating the model good fit. CONCLUSION: The results indicated that protection motivation, coping appraisals and reasonable fear are considered as the strongest predictors of fall protective behaviors among older people. The results can help health care providers to develop appropriate interventions to fall prevention among older people.

Validity and Reliability Evaluation of the Persian Version of the Heart Failure-Specific Health Literacy Scale.

BACKGROUND: Health literacy (HL) has important implications for health outcomes in heart failure (HF) patients. Studying health literacy requires culturally appropriate and valid instruments. The aim of the study was validation of the Persian version of the heart failure-specific health literacy scale (HF-Specific HL Scale). METHODS: One hundred patients with heart failure were selected in Qom, Iran in 2017. The 'forward-backward' procedure was applied to translate the questionnaire from English into Persian. Content validity, face validity, construct validity have been employed to validate the prepared scale. Cronbach's alpha coefficients and the test-retest were used to assess the scale reliability. Data were analyzed using SPSS, version 16, and Smart PLS 3.0 software. RESULTS: Confirmatory factor analysis completely supported the three-factor model of the HL scales. Convergent validity was satisfied in that all factor loadings and the average variance extracted exceeded 0.5. The divergent validity was verified using Fornel and Larcker method. R-square and path coefficient were higher than 0.43 and 0.65 respectively, indicating the good structural model. Composite reliability and Cronbach's α coefficient for all of the constructs were over the recommended threshold of 0.70, ensuring adequate internal consistency of the scale. The test-retest reliability ranged from 0.78-0.90, which indicated a good level of stability. CONCLUSION: The findings indicated that the Persian HF-specific HL scale is reliable and valid for measuring health literacy among heart failure patients. Further research is required to measure the sensitivity and specificity of the scale.

Risk factors for falls in Iranian older adults: a case-control study.

Falls are an important cause of morbidity and mortality in older adults. Identifying potential risk factors would provide a considerable public health benefit. The objective of this retrospective study was to determine the risk factors for falling among Iranian older adults. Two hundred eighty community-dwelling elders, with and without a history of falls, participated in the study. Elders aged 60 or over referred to retirement centres completed a multi-section questionnaire on demographic information, behavioural, environmental, and medical factors of fall from May to September 2018. Data analysis was performed with descriptive statistics and logistic regression using the Stata version 14 software. Sedentary activity level (OR: 2.14; 95% CI: 1.85, 3.23), hearing loss (OR: 2.17; 95% CI: 1.23, 3.83), vertigo or dizziness (OR: 2.24; 95% CI: 1.02, 4.91) and visual impairment (OR: 1.63; 95% CI: 1.01, 2.67) were important predictors of falls. No significant associations were observed between falls with demographic factors and medication. This study indicates several modifiable risk factors may be associated with falls that affect the health of older adults. Appropriate interventions are necessary to reduce modifiable risk factors of falls of high-risk elders.

Increasing Medical Adherence in Elderly With Type 2 Diabetes Mellitus: A Systematic Review.

BACKGROUND: One of the most common problems that the elderly with chronic diseases, especially diabetes, faces is lack or poor medical adherence. The aim of this study was to determine the effect of interventions in increasing medical adherence in the elderly with type 2 diabetes. METHODS: The databases of Cochrane, Embase, PubMed, Scopus, Science Direct, and web of science were searched until April 2017 free from time and language limitation. In review, only randomized controlled trial (RCT) design studies were investigated. The studies of interest were evaluated from three perspectives: educational intervention with or without theories/models of health education and promotion, educational intervention (individual or group education), and noneducational intervention to increase medical adherence. The qualification of RCTs was evaluated through Cochrane Collaboration Risk of Bias Tool. RESULTS: Finally, five studies were considered in this systematic review. Educational interventions were used in all of the studies, and in three of these studies, noneducational interventions such as support group, psychiatric consultation, and phone consultation were implemented along with educational intervention. In all studies, medical adherence in the intervention group increased when compared with the control group or basic conditions ( p < .05). All RCTs had high risk of bias. CONCLUSION: This review provides evidence which must be considered in the elderly with diabetes a combination of the educational and noneducational methods to increase medical adherence. It is necessary to conduct studies with higher quality to assess the efficacy of interventions.

Relationship between stress coping strategies, psychological distress, and quality of life among hemodialysis patients.

PURPOSE: The purpose of this study is to determine the relationship between coping strategies and psychological distress on quality of life (QoL) in hemodialysis patients. DESIGN AND METHODS: The study was conducted with 100 patients undergoing hemodialysis. Data collection instruments were SF-36, HADS, and JCS. Data were analyzed using multiple linear regression and descriptive statistical analysis. FINDINGS: Emotive coping style to be a significant independent determinant of lower QoL in the MCS domain (ß = -0.41; p = 0.024), while anxiety was found to be a determinant of lower scores in both the MCS (ß = -0.47; p = 0.006) and the PCS (ß = -0.55; p = 0.001) domains. PRACTICE IMPLICATIONS: Anxiety and emotive coping style negatively affect QoL in dialysis patients. More attention could be paid to its role to deal with the inevitable sources of stress in the care plan.

Translation and Psychometric Testing of the Persian Version of the Spiritual Needs Questionnaire Among Elders With Chronic Diseases.

CONTEXT: Spirituality plays an important role in coping with chronic diseases for patients and they often report unmet spiritual and existential needs, which should be considered for a holistic view of their health. Studying spiritual needs in this generation requires culturally appropriate and valid instruments. The aim of this study was to determine the psychometric properties, such as validity, reliability, and factor structure of the Persian version of Spiritual Needs Questionnaire (SpNQ). OBJECTIVES: The aim of this study was to determine the psychometric properties, such as validity, reliability, and factor structure of the Persian version of Spiritual Needs Questionnaire (SpNQ). METHODS: The "forward-backward" procedure was applied to translate the SpNQ from English into Persian. The SpNQ-Persian Version (SpNQ-PV) was checked in terms of validity and reliability with a convenience sample of 100 elders with chronic diseases who were recruited from the inpatient wards at two university hospitals in Qom, Iran. The validity was assessed using content, face, and construct validity. The Cronbach alpha and test-retest were used to assess the reliability of the questionnaire. RESULTS: The results of the exploratory factor analysis indicated a five-factor solution for the questionnaire, which included religious needs, existential needs, forgiveness/generativity needs, need for inner peace, and emotional needs. These accounted for 60.1% of the total observed variance. One item was removed (factor loading <0.4). Convergent validity was supported mostly by the pattern of association between SpNQ-PV and the Spiritual Well-being Scale. Cronbach alpha of the subscales ranged from 0.56 to 0.78 and the test-retest reliability ranged from 0.72 to 0.91, which indicated an acceptable range of reliability. CONCLUSION: The SpNQ-PV showed a minor difference in structuring and indicated good psychometric properties, which can be used to assess the spiritual needs of Iranian elders suffering from chronic diseases.

Translation and psychometric testing of the Farsi version of the Seattle angina questionnaire.

BACKGROUND: Angina pectoris causes substantial psychological and functional disabilities and adversely effects quality of life in patients. The aim of this study was to investigate the psychometric properties including validity and reliability of the Farsi version of the Seattle angina questionnaire. METHODS: The 'forward-backward' procedure was applied to translate this questionnaire from English to Farsi. The translated version of the Seattle angina questionnaire was assessed in terms of validity and reliability with a convenience sample of 200 patients suffering from angina pectoris who were recruited from the inpatient ward (post CCU) and outpatient department at two teaching hospitals in an urban area of Iran. Validity was assessed using content, face and construct validity. The calculation of the Cronbach's alpha coefficient and the test-retest method helped with the assessment of reliability of the questionnaire's five subscales. Construct validity of the questionnaire was evaluated using exploratory factor analysis. RESULTS: The results of exploratory factor analysis indicated a five-factor solution for the questionnaire including 'physical limitation in middle to strenuous activities', 'physical limitation in slight activities', 'angina pattern and discomfort of treatment', 'treatment satisfaction' and 'disease perception' that jointly accounted for 64.42% of variance observed. Convergent validity was mostly supported by the pattern of association between the Seattle angina questionnaire-Farsi version and the SF-36. Cronbach's alpha of the subscales ranged from 0.60 to 0.86 and test-retest scores ranged from 0.79 to 0.97 indicating a good range of reliability. CONCLUSIONS: The Seattle angina questionnaire-Farsi version had acceptable psychometric properties. Therefore, it can be used to assess health-related quality of life and assess the effects of different medical and nursing interventions on patients' quality of life.

Development and psychometric evaluation of a questionnaire on nurses' clinical competence eye care in intensive care unit patients.

BACKGROUND: Given the high prevalence of eye disorders in intensive care units, evaluating critical care nurses' competence in providing standard eye care is a matter of utmost importance. However, to the best of our knowledge, there is no valid questionnaire for measuring nurses' competence to undertake eye care. AIMS: The aim of this study was to develop and evaluate the psychometric properties of a questionnaire on nurses' clinical competence in providing eye care to patients hospitalized in intensive care units. DESIGN: This was a psychometric study. METHODS: We initially performed a literature review and developed a 38-item questionnaire consisting of knowledge, attitude and practice domains. We invited a panel of experts and a group of critical care nurses to assess the content and face validity of the questionnaire. Thereafter, we evaluated its construct validity by using the exploratory factor analysis and the known-groups comparison technique. Moreover, the test-retest and the internal consistency evaluation techniques were used for assessing the reliability of the questionnaire. RESULTS: Totally, 35 items remained in the final version of the questionnaire. Based on the results of the exploratory factor analysis, we categorized the items of the questionnaire into three factors. The Cronbach's alpha for the attitude and the practice domains as well as the Kuder-Richardson 20 for the knowledge domain showed satisfactory internal consistency. The Cronbach's alpha for the whole questionnaire also was 0·83. CONCLUSION: The results of this study suggest that the nurses' clinical competence in eye care questionnaire has a good factor structure and an acceptable reliability. RELEVANCE TO CLINICAL PRACTICE: A complication of sedation and coma is that some patients are unable to maintain effective eyelid closure. These patients present a higher risk of eye complications. Development of tools for evaluating nurses' competence in providing standard eye care is a fundamental prerequisite for improving the quality of eye care.

Negative Religious Coping, Positive Religious Coping, and Quality of Life Among Hemodialysis Patients.

BACKGROUND: Religious coping is known as a main resource influencing how individuals cope with the complications and stressors of chronic disease. OBJECTIVES: The aim of this study was to assess the relationship between religious coping and quality of life among hemodialysis patients. METHODS: This cross-sectional study was conducted in Qom, Iran, from June 2012 to July 2013. Ninety-five end-stage renal disease (ESRD) patients undergoing hemodialysis were selected via the convenience sampling method. Data were collected via a questionnaire comprising items on sociodemographic information, quality of life, the anxiety and depression scale, and religious coping. Following this, the data were analyzed using descriptive statistics and logistic regression analysis. RESULTS: The mean age of patients was 50.4 (standard deviation [SD] = 15.7) years, and most were male (61%). The mean score for positive religious coping was 23.38 (SD = 4.17), while that for negative religious coping was 11.46 (SD = 4.34). It was found that 53.6% of patients had higher than the mean score of positive religious coping, while those with negative religious coping made up 37.9%. Negative religious coping was associated with worse quality of life, including physical functioning (odds ratio [OR] = 0.72; P = 0.009), role physical (OR = 0.79; P = 0.04), vitality (OR = 0.62; P = 0.005), social functioning (OR = 0.69; P = 0.007), and mental health (OR = 0.58; P = 0.01) after controlling for sociodemographic, clinical, and anxiety and depression variables. CONCLUSIONS: The results indicated that patients with negative religious coping abilities were at risk of a suboptimal quality of life. Incorporating religious support in the care of hemodialysis patients may be helpful in improving quality of life in this patient population. Further longitudinal studies are needed to determine whether these associations are causal and the direction of effect.

Religious Coping and Quality of Life in Women with Breast Cancer.

BACKGROUND: The aim of this study was to assess the predictive role of religious coping in quality of life of breast cancer patients. MATERIALS AND METHODS: This multi-center cross-sectional study was conducted in Tehran, Iran, from October 2014 to May 2015. A total of 224 women with breast cancer completed measures of socio-demographic information, religious coping (brief RCOPE), and quality of life (FACT-B). Data were analyzed using descriptive statistics and the t-test, ANOVA, and linear regression analysis. RESULTS: The mean age was 47.1 (SD=9.07) years and the majority were married (81.3%). The mean score for positive religious coping was 22.98 (SD=4.09) while it was 10.13 (SD=3.90) for negative religious coping. Multiple linear regression showed positive and negative religious coping as predictor variables explained a significant amount of variance in overall QOL score (R(2)=.22, P=.001) after controlling for socio-demographic, and clinical variables. Positive religious coping was associated with improved QOL (ß=0.29; p=0.001). In contrast, negative religious coping was significantly associated with worse QOL (ß=-0.26; p=0.005). CONCLUSIONS: The results indicated the used types of religious coping strategies are related to better or poorer QOL and highlight the importance of religious support in breast cancer care.

High Intake of Manganese During Second Trimester, Increases the Risk of Preterm Delivery: A Large Scale Cohort Study.

Evidence indicates that nutrients and minerals might play an important role in preterm delivery (PTD). The aim of this study was to determine maternal nutritional status during second trimester of pregnancy and its association with preterm delivery (<34 weeks gestation) in Iranian women. In a large scale longitudinal study, 1033 pregnant women were recruited from prenatal clinics since December 2012 to June 2013. Dietary intake was assessed by Food Frequency Questionnaire (FFQ) in pregnant women of 14 to 20 weeks gestational age. The participants were followed up until delivery. Dietary intake of women with preterm delivery was compared with women who had term delivery. The results show that 61.2% of women were primiparous and that the incidence of preterm delivery was 7%. Manganese dietary intake was significantly higher in mothers with preterm delivery than those with term delivery (P=.03). Manganese was the only micronutrient correlated with preterm delivery after adjustment for maternal characteristics during second trimesters of pregnancy (OR=1.12; P=.01). These results suggest that high maternal manganese dietary intake during the second trimester of pregnancy may be associated with the risk of preterm delivery in Iranian pregnant women.

Translation and psychometric properties of the persian version of the dialysis symptom index in hemodialysis patients.

BACKGROUND: Hemodialysis patients have a high physical and psychosocial symptom burden. There is no valid and reliable tool for assessing symptoms of hemodialysis patients in Iran. OBJECTIVES: The aim of this study was to determine psychometric properties of the Persian version of the dialysis symptom index (DSI). PATIENTS AND METHODS: The forward-backward procedure was applied to translate the DSI from English into Persian (Iranian language). The scale (Persian Version) was tested with a convenience sample of 95 patients with end-stage renal disease referred to main hemodialysis centers from December 2012 to June 2013. Validity was assessed using content, face and convergent validity. To test reliability, the kappa values were calculated for test-retest stability and the Cronbach alpha coefficients were also calculated for internal consistency. RESULTS: The mean age of patients was 50.4 (SD = 15.72) years and % 61.1 of patients were male. The most commonly reported symptoms were fatigue, being irritable and nervous. Divergent validity was mostly supported by the pattern of association between DSI and SF-36 (r = -0.18- -0.48, P< 0.05). Cronbach's alpha of the DSI was 0.90 and the weighted kappa ranged from 0.21 to 0.93, and it was greater than 0.4 for 25 of the 30 items. CONCLUSIONS: The Iranian version of the DSI had good psychometric properties and can be used to assess symptoms of hemodialysis patients.