Oral Health-Related Quality of Life in Persian-Speaking Elementary Schoolers in Iran: A Psychometric Study of Child Perception Questionnaire.

Background and Purpose: The study aims to examine the validity and reliability of the impact of 16-item Short-Form Child Perception Questionnaire (CPQ11-14-ISF:16) in Persian-speaking elementary schoolers. Methods: From two main cities in Iran, 708 mother-child dyads were enrolled in 2018. Decayed, missing, and filled teeth (DMFT/dmft) indexes were examined for divergent validity. Two built-in indexes of overall oral health and overall impacted well-being were used for concurrent validity. Exploratory factor analysis (EFA) with Geomin rotation, Cronbach's α, and Spearman's correlation were executed. Results: The total Cronbach's α was 0.71. EFA indicated CPQ11-14-ISF:11 (α = 0.66) to compose three eligible factors (α = 0.66), including oral problems (α = 0.54), emotional problems (α = 0.66), and social problems (α = 0.41). The concurrent/divergent validity of CPQ11-14-ISF:11 and the subscales was partially confirmed. Conclusions: The use of CPQ11-14-ISF:11 to multidimensionally address dental care for children requires further investigations.

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.

Treatment self-regulation questionnaire across three self-care behaviours: An instrument validation study in Iranian patients with type 2 diabetes mellitus.

AIM: The study aimed at testing the validity and reliability of the Persian version of the treatment self-regulation questionnaire (TSRQ-15) across healthy diet, exercise and medication-use/glucose-monitoring among Iranian people with type-2 diabetes. DESIGN: Cross-sectional design. METHODS: Content validity was investigated by 16 experts. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed. Construct validity, convergent/discriminant validity and internal consistency were examined. Concurrent validity was assessed using Spearman's rho correlation across different behaviours. RESULTS: Content validity was confirmed for Persian TSRQ-15. A three-factor structure was revealed, in which external regulation and introjected regulations were validated, while amotivation and autonomous failed to show discriminant validity. Internal consistency was sound, and concurrent validity was approved. The Persian version of TSRQ-15 was shown to be a valid and reliable tool for assessing motivation behind the practice of healthy diet, exercise and medication-use/glucose-monitoring in people with type 2 diabetes.

Stigma and Quality of Life in Women With Breast Cancer: Mediation and Moderation Model of Social Support, Sense of Coherence, and Coping Strategies.

OBJECTIVES: The breast cancer stigma affects Health-related quality of life (HRQoL), while general resilience resources (GRRs), namely, sense of coherence (SOC), social support, and coping skills, are thought to alleviate this effect. The study aimed to explore the mediating/moderation role of GRRs in the relationship between stigma and HRQoL and its dimensions in Iranian patients with breast cancer. METHODS: In this cross-sectional study, Stigma Scale for Chronic Illness 8-item version (SSCI-8), SOC-13, Medical Outcome Survey- Social Support Scale (MOS-SSS), Brief COPE, and Functional Assessment of Cancer Therapy-Breast (FACT-B) were investigated in a convenience sample of Iranian women with confirmed non-metastatic breast cancer. Following the establishment of correlations using Pearson's correlation, single and parallel mediation analysis and moderation analysis were conducted to determine the extent to which each GRR might be impacted by stigma or decrease the adverse impact of stigma on HRQoL. RESULTS: An analysis of 221 women (response rate of 87.5%) with the mean age of 47.14 (9.13) showed that stigma was negatively correlated to all HRQoL's dimensions (r = -0.27∼0.51, p < 0.05), SOC (r = -0.26∼0.35, p < 0.01), social support (r = -0.23∼0.30, p < 0.01), and the bulk of coping skills. In the single mediation analysis, stigma affected all facets of SOC, all subscales of social support, and positive reframing, which partially reduced breast cancer HRQoL. Stigma affects general HRQoL through damaging meaningfulness, social support (except for tangible), and positive reframing. Meaningfulness was marked as the most impacted GRR in terms of all domains of HRQoL. In parallel mediation, reduced meaningfulness, total social support, and positive reframing were highlighted as the pathways of diminished breast cancer HRQoL. Moderation analysis indicated the higher levels of humor, behavioral disengagement, and use of instrumental support behaviors to be functional in protecting different dimensions of HRQoL, while the results were mixed for venting, especially in patients with mastectomy surgery. CONCLUSION: While GRRs may be impacted by stigma, they exert a relatively small protective effect against the impact of stigma on HRQoL. This study provides some novel findings, but longitudinal studies are needed to further verify these before any causal conclusion or recommendations for health policy can be drawn.

Short quality of life scale: A cross-cultural validation in Iranian patients with multiple sclerosis.

Health-related quality of life (HRQoL) is the prioritized measure in multiple sclerosis (MS) patients. The short quality of life scale (SQoL) developed by Devy et al. (2013) is an MS-specific and abbreviated scale with ten items suitable for routine medical care settings. The current study reported the cross-cultural validation of the scale in the Persian language. A total of 455 convenient MS patients with a mean age of 38.39 (9.28) ranged from 18 to 64 filled out the primary measure and the validating measures, including hospital anxiety and depression scale, visual analogue scale - quality of life, and a single index of the number of past-year MS relapse. The confirmatory factor analysis on original structure indicated an acceptable model fit. However, a modestly modified structure composing of physical-functional dimension (items #1-3), mental dimension (items #5-8), and pain & energy dimension (items 4 & 9,10) was also exposed with a sound fit and a meaningful structure. The overall internal consistency reliability was sound (0.88), and the concurrent validity was confirmed. The Persian short quality of life scale (P-SQoL) is the first translated and validated version of the scale, surfacing significant implications. Further cross-cultural investigations are recommended to re-examine current findings. The classic and recent suggestions concerning the close interplay between the immunity system and the psychological system and the implications based on Iran's context are discussed.

Body image, internalized stigma and enacted stigma predict psychological distress in women with breast cancer: A serial mediation model.

AIMS: To investigate the roles of total stigma, enacted stigma, and internalized stigma in the prediction of psychological distress among breast cancer patients, and to evaluate the mediating effect of body image in this process. DESIGN: Cross-sectional. METHODS: Between Oct-2014 to May-2015, a cross-sectional study was conducted with participation of 223 patients from three cancer centres located in Tehran, Iran. The study variables were assessed using the stigma scale for chronic illnesses 8-item version (SSCI-8), body image scale (BIS), and depression anxiety stress scale (DASS-21). Structural equation modelling using MLR estimator was employed based on the two-step procedure to validate both the full measurement models and the structural models. Five models were tested to determine predictability of all stigma constructs for psychological distress, including stress, anxiety, and depression, through the mediation of body image. Three equivalent models were further examined to re-evaluate the direction of the relationships. RESULTS: Psychological distress and body image were largely predicted by total stigma, enacted stigma, and internalized stigma. The effect of stigma on psychological distress was mediated through body image. In a serial mediation model, the significance of the pathway of enacted stigma > internalized stigma > body image > psychological distress was confirmed. The serial model in which internalized stigma precedes body image was also supported by the equivalent models. CONCLUSION: Stigma has been identified as a major source of psychological distress among women with breast cancer. Enacted stigma not only psychologically disturbs the patients but also triggers a chain of other identity transformations (i.e. internalization of stigma and distortion of body image), their ultimate result being a full-blown psychological distress. IMPACT: Both enacted and internalized stigma distorts breast cancer patients' perception of their body image, which in turn renders them psychologically distressed. The serial process of enacted stigma, internalized stigma, and body image plays an important role in perpetuating distress in these patients. To break this chain of psychological consequences and for interventions to have a greater impact on overall well-being of patients, the effect of enacted stigma on distress via the sequence of two mediators needs to be specifically targeted at each stage.

Which Domains of Social Support Better Predict Quality of Life of Women with Breast Cancer? A Cross-Sectional Study.

OBJECTIVES: The study aimed at investigating the specific role of social support types (SSTs) on quality of life (QoL) and its domains of women with breast cancer in Iran. METHODS: In this cross-sectional study, a number of 223 women with breast cancer visiting three cancer centers of Tehran, Iran, participated from October 2014 to May 2015. Medical Outcome Study-Social Support Scale and Functional Assessment of Cancer Therapy-Breast Cancer were used for data gathering. Backward multiple regression was utilized, adjusted by age, education, and family size. RESULTS: The study indicated positive correlations between all SSTs and QoL domains, whereas only positive social interaction (PSI) showed a significant association with physical well-being. PSI showed the only predictive performance in terms of all QoL outcomes, beyond the covariates. CONCLUSIONS: The study revealed the PSI as the most influential support type to enhance all domains of QoL of women with breast cancer.

Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model.

PURPOSE: Depression and anxiety are now considered as common adverse reactions to cancer. Prior research has shown that social support and functional coping strategies alleviate depressive and anxious symptoms of cancer patients but the exact relationship between social support and coping strategies in amelioration of the symptoms is yet to be elaborated. METHODS: The current study examined the relationship between social support, coping strategies and depressive-anxious symptomatology and explored the possible role of coping strategies in mediating the relationship between social support, depression and anxiety in Iranian breast cancer patients (N = 221). Anxiety and depressive symptoms were measured using the Depression-Anxiety-Stress (DASS-21) scale, social support was measured using the Medical Outcome Survey, Social Support Scale (MOSS-SSS), and coping strategies were measured using the brief COPE. RESULTS: All of the social support subscales were negatively correlated with depression and anxiety. Most of the coping strategies were negatively correlated with depressive-anxious symptoms. When controlling for covariates, mediation analysis revealed that active coping, positive reframing and acceptance partially mediated the association of social support of different types with depression. Positive reframing also partially mediated the relationship of the total social support and positive social interactions with anxiety. CONCLUSIONS: High levels of social support may relieve depressive and anxious symptoms of breast cancer patients through functional coping. The management of breast cancer patients should also focus on providing patients with social support and educating them on the practice of functional coping strategies.

Sense of coherence and coping strategies: How they influence quality of life in Iranian women with breast cancer.

AIM: To investigate the mediation/moderation effect between Coping Behaviors (CBs) and Sense of Coherence (SOC) in the prediction of health-related quality of life (HRQoL) in breast cancer patients. DESIGN: Cross-sectional. METHODS: A total of 221 patients were included in this study. The 13-item Orientation to Life Questionnaire, Brief COPE and Functional Assessment of Cancer Therapy-Breast were investigated. Pearson's correlation coefficient and mediation/moderation analysis were performed. RESULTS: Significant correlations were observed for SOC, active coping, acceptance, positive reframing (PR), planning, use of emotional support (UES), use of instrumental support, behaviour disengagement and self-blame with HRQoL. Except for planning and acceptance, SOC partially mediated the CBs' effect on HRQoL. The UES and PR's effects on HRQoL were significant at lower SOC levels and diminished at higher SOC levels. CONCLUSION: Practitioners can incorporate SOC and adaptive CBs, including PR and UES, into the rehabilitation programmes to improve HRQoL in patients.

Differences in and Correlates of Sexual Function in Infertile Women with and without Polycystic Ovary Syndrome.

BACKGROUND: The aim of this study was to examine sexual function and its correlates among infertile women with polycystic ovary syndrome (PCOS) in comparison with their non-PCOS counterparts. MATERIALS AND METHODS: In this case-control study, 209 infertile women (116 PCOS and 93 non-PCOS) from Tehran, Iran, were evaluated in February and March 2018. Female sexual function index (FSFI), hormonal status, and documented reports of hyperandrogenic manifestations of the patients were investigated. RESULTS: The mean age of the patients was 32.00 ± 5.00 years old. Eighty-four (40.2%) patients including 42.2% of the PCOS patients and 37.6% of the non-PCOS cases (P>0.05), were suspected of female sexual dysfunction (FSD). The most impaired functions in both groups were desire and arousal. Sexual function was not significantly different between the groups. However, PCOS women had more orgasm problems and acne worsened their sexual function. Total FSFI was positively associated with prolactin level but negatively associated with central obesity in the non-PCOS group; it was negatively correlated with marital duration in the PCOS group. Luteinizing hormone (LH) and pain, prolactin level and lubrication, and central obesity and arousal were correlated in the non-PCOS women. Prolactin level and orgasm, marital duration and arousal, and marital duration and the total FSFI were correlated in the PCOS women. CONCLUSION: Sexual function was similarly low in infertile PCOS and non-PCOS women. However, orgasm problems and the negative effect of acne varied between the two groups. Further investigations may target how hormonal profile may affect sexual function. Practitioners should scrutinize the specific impaired sexual domains and their correlated conditions in PCOS women, notably orgasm, acne, and prolactin level. Interventions should be well tailored based on particular needs of infertile PCOS women.

The Impact of Relational Adverse Childhood Experiences on Suicide Outcomes During Early and Young Adulthood.

This study aimed at investigating the degree to which relational adverse childhood experiences (ACEs) would affect suicide outcomes during early and young adulthood of Iranian female and male students. In all, 487 undergraduate students (59.2% females) with a mean age of 20.66 ± 1.42 were recruited using a multistage clustering sampling method from eight schools from the fields of humanities, engineering, and basic sciences. Suicide Behavior Questionnaire-Revised form (SBQ-R) was employed for assessing past year suicidal ideation (PYSI, once or more), the meaningful likelihood of future suicide (mLoFS, a score of 2 or more), and suicide risk (SR ≥7). Relational ACEs were assessed in the form of a yes/no question, including caregivers' maltreatment, household relational dysfunction, family loss events, school events, and sexual abuse. Analyses were conducted using Fisher's exact test, chi-square test, and univariate binary logistic regression. The rates of PYSI, LoFS, and SR were, respectively, 37.2%, 44.6%, and 30.8%. The most experienced event was witnessing verbal violence (68.8%) and the least was divorce/separation (6.2%). All the events and domains (except family loss events), the interaction of domains, and cumulative events significantly increased the odds of suicide outcomes, in which females were more affected by all types of relational ACEs. Students whose ethnicity was Azari & Turk and who were studying in humanities or basic sciences showed a higher suicide risk than their counterparts. The study showed that the rates of relational ACEs and suicide outcomes were remarkable, in Iran. Because of the detrimental effects of relational ACEs on suicidality, mostly for females, it is necessary to improve the initiatives promoting child protection and legal support for health professionals to address child abuse. There is also an urgent need for providing young students with supports and effective interventions.

Suicide-related interpersonal needs of young Iranian people: A preliminary validation of thwarted belongingness and perceived burdensomeness constructs.

The aim of the current study was to validate the Interpersonal Needs Questionnaire (INQ-15) and to test its reliability in Persian-speaking Iranian undergraduate students. In this cross-sectional study, 485 undergraduate students (age: 20.66 ± 1.42, 60% female) were assessed on the two subscales of perceived burdensomeness (PB) and thwarted belongingness (TB) and the Suicide Behavior Questionnaire-Revised (SBQ-R). Exploratory structural equation modelling (ESEM) confirmed the construct validity of INQ-14, excluding INQ#9. In addition, INQ#8, articulated in an equivalent Persian phrasing, loaded well on TB. The measurement model tested by confirmatory factor analysis (CFA) suggested INQ#11 to be eliminated, resulting in INQ-13-P to consist of PB and TB-7. The internal consistency and convergent/discriminant validity were established. The concurrent validity of PB was solidly established in terms of past year suicidal ideation (PY-SI) above and beyond anxiety, depression, prior suicidality, and TB-7. The effect of PB on PY-SI was stronger, where prior suicidality had already occurred or the perceived likelihood of future suicide (PLFS) was high. Moreover, TB-7 could only indicate PY-SI, where prior suicidality had already occurred or PLFS was high, albeit when PB was omitted. The interaction term was significant; however, beyond anxiety and depression, the effect of TB-7 on PY-SI was significant where PB was very high (n = 40, 8.25%). Therefore, future studies can utilize INQ-13-P as a valid and reliable instrument in Persian-speaking populations. However, further studies should examine the construct validity of TB and its relationship with suicide ideation in different populations.

Social-Ecological measure of resilience: an adapted measure for Persian-speaking university students.

Background: There is no validated instrument for Persian-speaking students to apply the social-ecological resilience theory (SERT), which emphasizes the ecological resources for developing resilience. The study aimed at developing the student social-ecological resilience measure(Student-SERM) in Iran's context. Methods: Three separate samples of undergraduates participated in this mixed-methods research from the University of Tehran, Iran. Phase-1 qualitatively explored the resilience features in the university setting, to devise the university-specific subscale (USS). Phase-2piloted the construct validity and reliability of the Student-SERM in 242 undergraduates, who also completed Depression, Anxiety, and Stress Scale (DASS-21). Phase-3, as a cross-validation study, investigated 487 undergraduates, who completed the refined Student-SERM, HospitalAnxiety and Depression Scale (HADS), and three indices screening academic performance, loneliness, and suicide acceptability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), Pearson's correlation, and Cronbach's alpha were performed. Results: Phase-1 yielded nine items for USS. In phase-2, EFA indicated the construct validity of the main 20-item measure (RMSEA=0.06 and SRMR=0.04) and the nine-item USS (RMSEA=0.07and SRMR =0.04), and the reliability and convergent/divergent validity were confirmed. In phase-3, EFA (RMSEA=0.07 and SRMR=0.04) and CFA (RMSEA=0.07, CFI=0.89, TLI=0.87,and SRMR=0.07) in two separate subsamples and CFA (RMSEA=0.06, CFI=0.92, TLI=0.90,and SRMR=0.06) in the total sample indicated the construct validity of the refined Student-SERM, including family, peer, culture, growth, and USS subscales. The reliability and convergent/divergent validity were also reconfirmed. Conclusion: The Student-SERM incorporates ecological resources, accounting for the students'resilience. Since the resilience process involves a return to healthy functioning after adversity, further research can examine the application of Student-SERM in high-risk student populations.

The impact of personality traits on medication adherence and self-care in patients with type 2 diabetes mellitus: The moderating role of gender and age.

OBJECTIVES: This study aimed to investigate the role of the five-factor model of personality (FFM) and the moderating role of gender and age in predicting medication adherence (MA) and self-care behaviors (SCB) among Iranian patients with type 2 diabetes mellitus (T2DM). METHODS: This study was conducted on 495 patients with T2DM (73.5% female; n = 364) from two major cities of Iran (Tehran and Qom) in 2019. Pearson's correlation coefficient, multiple regression analysis, and conditional process analysis were performed. P < .05 and P < .10 were considered significant for the relationships and moderation analysis, respectively. RESULTS: Neuroticism indicated a negative association with MA and SCB. Positive associations were found between MA and personality traits, including extraversion, agreeableness, and conscientiousness, whereas extraversion showed a weak correlation with SCB. According to the covariate-adjusted regression model, neuroticism had a negative effect on MA and SCB. Agreeableness had a positive effect on MA and a negative effect on SCB. However, extraversion exerted a negative effect on MA and a positive effect on SCB. Also, the negative effect of neuroticism on MA was highlighted in women, indicating marginally significant moderation effect. The positive effects of extraversion and conscientiousness on MA were moderated by age. The effect of conscientiousness on SCB was positive in young patients and negative in old patients. No interaction effect was observed between age and gender. CONCLUSION: This study indicated that neuroticism, extraversion, and agreeableness significantly contributed to MA, but not to SCB. However, the effects were conditioned by age for extraversion and conscientiousness to some extent.

Translation and Factor Analysis of the Stigma Scale for Chronic Illnesses 8-Item Version Among Iranian Women With Breast Cancer.

BACKGROUND: Cancer stigma is rarely addressed among Iranian population and patients. The current study aimed at translating and examining the construct validity of the stigma scale for chronic illnesses 8-item (SSCI-8) among Iranian women with breast cancer. METHODS: In the current study, a total of 223 patients aged 19-75 years were recruited from three cancer centers in Tehran, Iran, from 2014 to 2015. Forward-backward translation method was used. The item-total correlation was evaluated. Exploratory factor analysis employing maximum likelihood method and direct Oblimin rotation was conducted. Reliability was assessed using composite reliability (CR). Average variance explained (AVE) was used for convergent/divergent validity. RESULTS: The items mean was 1.47 (0.19), the scale mean 11.75 (5.57); the inter-item correlations were positive and significant (P <0.0001). A two-factor solution with seven eligible items (five for enacted and two for internalized stigma) showed the model fitness. The CR for the total scale, as well as enacted and internalized facets was 0.78, 0.89, and 0.79, respectively; the AVE was 0.66 for each latent variable. CONCLUSION: The Persian version of SSCI-7 was found as a reliable and valid abbreviated instrument to assess experiences of enacted and internalized stigma among Iranian women with breast cancer.
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Translation, Validation, and Psychometric Properties of Breastfeeding Self-Efficacy Scale-Short Form Among Iranian Women.

BACKGROUND: Iranian researchers have investigated breastfeeding self-efficacy and its related factors. However, there is no valid and reliable tool for assessing the breastfeeding self-efficacy of Iranian Farsi-speaking women. RESEARCH AIM: To examine the validity and reliability of the Breastfeeding Self-Efficacy Scale-Short Form among Iranian Farsi-speaking mothers. METHODS: We conducted this cross-sectional study at Izadi teaching hospital in Qom, Iran. Using convenience sampling, we recruited 174 mothers, who completed the questionnaire on the first postnatal day. A forward-backward translation method was used to translate the scale. Cronbach's alpha and item-total characteristics were examined to test reliability. Construct validity was evaluated via principal component analysis (PCA), as well as known-groups validity. RESULTS: The mean (standard deviation) of sample age was 28.33 (5.38). The mean (standard deviation) of breastfeeding self-efficacy score was 54.32 (10.50), ranging from 24-70. Cronbach's alpha (.92), inter-item correlations (.21-.72), and corrected item-total correlations (.44-.75) indicated the adequate reliability of the scale. PCA yielded one component with an eigenvalue of 6.97, explaining 49.8% of the total variance. There was no significant difference in the self-efficacy scores between primiparous and multiparous women. Breastfeeding self-efficacy was not significantly different between the groups in terms of the demographic characteristics. CONCLUSION: The Farsi version of the Breastfeeding Self-efficacy Scale-Short Form is a valid and reliable instrument for Iranian Farsi-speaking mothers, with sound psychometric properties per the other studies worldwide.

Validation and psychometric properties of Suicide Behaviors Questionnaire-Revised (SBQ-R) in Iran.

BACKGROUND: Suicide is increasing in young Iranian population, which necessitates the employing of valid, yet abridged instruments assessing the constellation of suicide-related behaviors. The study aimed at validating Suicide Behavior Questionnaire-Revised (SBQ-R) among Iranian undergraduates. METHODS: A total of 487 undergraduates were surveyed in 2018. Construct validity of SBQ-R was examined via confirmatory factor analysis (CFA), and Spearman's correlation with two single-item indices of suicide acceptability (SA) and lifetime suicidal ideation (LSI) was determined. Logistic regression and Kruskal-Wallis tests were used to examine the cut-off points (≥ 7 and ≥ 8) and categorizations as per item 1. RESULTS: The mean SBQ-R score was 5.79 ±â€¯3.55. Cut-off points ≥ 7 and ≥ 8 categorized 150 (30.8%) and 123 (25.2%) samples with suicide risk, respectively. Women obtained significantly higher scores on all indices, except items 1 and 4. CFA confirmed the model with sound goodness-of-fit, with factor loadings of 0.70 to 0.83. Composite reliability and average variance extracted were 0.87 and 0.63, respectively. The SBQ-R's correlation with SA and LSI confirmed its concurrent validity. Regression analysis confirmed the ability of both cut-off points to distinguish the participants with high SA and LSI; however, the cut-off point ≥ 8 produced better results regarding high LSI. Based on item 1, normal versus low- and high-risk samples were significantly different in terms of SA, LSI, and adjusted total score of SBQ-R (P < 0.0001). CONCLUSION: SBQ-R is an economic and psychometrically sound tool, which can be utilized to identify suicide-related behaviors and risks in young Iranian population.

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.