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Background and purpose: This study was aimed to assess the reliability and reproducibility of a designed food frequency questionnaire (FFQ) and to determine the major dietary pattern of overweight and obese adults in Tabriz, Iran. Materials and methods: The study included two studies: (1) a pilot study (n = 30) assessment of reliability and reproducibility of FFQ, (2) a cross-sectional study (n = 422) aiming to determine the major dietary pattern of overweight and obese adults. A 189-food item FFQ was completed twice with one-month interval for each subjects. Food consumption over one year for 422 adults aged 20-60 years in Tabriz was collected after assessment of reliability and reproducibility of FFQ. Weight and height were measured and body mass index (BMI) was estimated. Factor analysis was used to determine major dietary pattern. Results: Correlation coefficient of the two completed FFQ was varied from 0.60 (for garlic) to 0.97 (for potatoes). Three major dietary patterns were found using factor analysis: "healthy", "western" and "traditional" dietary pattern. Correlation coefficient for the three "Healthy", "Western" and "Traditional" dietary patterns, were 0.90, 0.83 and 0.92, respectively. These dietary patterns included 23% of the total variances. Conclusion: The reliability and reproducibility of the FFQ used in this study was good. There were three major dietary pattern using FFQ among overweight and obese adults in Tabriz.

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Background and purpose: Psychiatric disorders as a chronic illness lead to the exacerbation of physical symptoms and controlling them is very difficult. Respiratory chemical damaged veterans have many different psychiatric problems and low health-related quality of life. In this study, we evaluated the relations of spirometry parameters and health- related quality of life with mental health. Material and methods: This was a descriptive- co relational study done on 41 respiratory chemical veterans (Iran-Iraq war) selected with randomized available sampling in Tehran City. We used Spirometry test, St. George's Respiratory Questionnaire (SGRQ) & General Health Questionnaire (GHQ) for assessing the patients and Pearson's correlation matrix for analyzing the data. Results: There were significant negative correlations between the total score of GHQ and depression subscale with FVC & FEV1. There were significant positive correlations between the total score of GHQ and depression & anxiety subscales with total score of SGRQ. There were significant positive correlations between the total score of GHQ and depression & anxiety subscales with "symptoms" score of SGRQ. There were significant positive correlations between the total score of GHQ and depression & anxiety subscales with "impacts" score of SGRQ. Conclusion: Poor mental health condition with increased level of depression & anxiety leads to the decrease in FVC & FEV1 in spirometry and health-related quality of life, and increase in respiratory symptoms such as cough, breathless and sneezing. Totally, there were significant correlations between spirometry and health-related quality of life with mental health. It seems that in rehabilitation programs for mustard gas exposed veterans with chronic respiratory diseases, the psychological and psychiatric interventions should be considered.

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Background and purpose: A clear agreement is doubted in identifying vaginismus based on the clinical diagnostic criteria including pain, cramps and spasms. This study was performed to design a diagnostic questionnaire for vaginismus and investigating its psychometric characteristics. Materials and methods: This study was performed with a combinatorial approach. The final questionnaire was approved after performing 33 interviews and applying professional expertise in the qualitative part. In first stage of the quantitative part in face validity, the questionnaire was completed by 30 participants and its content validity was studied by 11 people from expert panel. Finally the validity was calculated by asking 100 patients. The internal and external validity were determined using Cronbach's alpha and test-retest in 30 patients with pain during examination. Results: At first, the changes in the qualitative stage of face validity was applied and the item effect index for 6 items were lower than 1.5 in the quantitative stage of face validity. Five questions did not receive desired points in CVR and CVI calculation in the quantitative part of content validity. KMO rate was 0.810 in the qualitative factor analysis. Also, the Bartlett's test of significance level was less than 5 percent. Cronbach alpha rate was calculated as 0.907. The external reliability was lower than 0.05. Conclusion: This instrument contains low number of questions, simple items to answer and is both reliable and valid, so it could be used for proper diagnosis of vaginismus in women with pain during sexual intercourse.

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Background and purpose: Fibromyalgia (FM) is a chronic pain condition with non-articular origin that is defined by generalized pain, fatigue and sleep disturbance. The aim of this study was to evaluate the reliability and validity of Persian version of Revised Fibromyalgia Impact Question­naire (FIQR) in Iranian patients with FM.

Materials and methods: The FIQR was translated into Persian and adminis­tered to 44 female patients with primary FM. All patients filled out the questionnaire along with the Persian version of the Hospital Anxiety and Depression Scale (HADS) and short form-36 (SF-36). One week later, FM patients filled out the FIQR at their second visit. Reliability was analyzed by internal consistency Cronbach’s α coefficient and intra-class correlation coefficient. Construct validity was evalu­ated by Spearman’s and Pearson’s correlation coefficient. Statistical analysis was performed in SPSS ver. 19.

Results: From 69 female patients with primary FM who had HADS score less than 15, 44 were selected. The total scores of the FIQR in first and second visits were 52.85±20.2 and 53.62±18.3, respectively. Evaluation of construct validity with SF-36 and HADS showed a significant correlation at the 0.01 level. The intraclass correlation coefficient (ICC) was CI95%=0.929 (0.896-0.956) and Cronbach’s α was 0.93 for FIQR in the first visit. The correlation between first and second total scores was 0.82 (P=0.001).

Conclusion: The Persian version of FIQR showed adequate reliability and validity.

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Background and purpose: Sense of security in patients is a prerequisite for developments in delivering appropriate health services. It can play a major role in finding solutions to improve the quality of care being delivered. The aim of this study was to design and validate a questionnaire to evaluate the sense of security in hospitalized patients.

Materials and methods: This methodology was conducted in 900 patients in selected hospitals in Mazandaran province, Iran. A questionnaire consisting of 78 items and 11 factors based on a Likert scale of 1 to 5 was designed. The content validity of the scale was examined by content validity ratio and content validity index and construct validity was examined by exploratory factor analysis. The reliability of the questionnaire was evaluated by Cronbach's alpha. 

Results: Only six items were found with no appropriate content validity. Exploratory factor analysis showed that the first factor (11 items) had the maximum of factor loadings (27.66) and factor 11 (4items) exhibited the minimum factor loadings (1.54). The internal consistency in all items was found to be more than 0.80.

Conclusion: The questionnaire designed is a valid and reliable scale for evaluating the sense of security in patients. 

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Background and purpose: Occupational fatigue is one of the main problems in work environments. Investigation of different aspects of occupational fatigue in drivers is of great benefit in reducing the level of road accidents.

Materials and methods: We conducted a cross-sectional study in 420 drivers of heavy vehicles. Data was collected using a demographic and job information questionnaire and Swedish Occupational Fatigue Inventory (SOFI). T-Test and multivariate linear regression were applied for data analysis.

Results: The average daily driving hours was found to be significantly associated with all dimensions of fatigue except for lack of energy (P<0.05). Also, significant relations were found between parameters such as average hours of rest, smoking and sport activity and all dimensions of fatigue (P<0.05). Adjusting for confounding variables by linear regression model, sport activity displayed the greatest effect on reducing the level of fatigue.

Conclusion: Occupational fatigue in drivers has close relations with their habits and occupational activities. Modifying some negative behaviors such as smoking, inactivity, lack of attention to rest and continues driving can play major roles in incidence of occupational fatigue.

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 Background and purpose: Avoidance and cognitive fusion are two components of psychological inflexibility and are the main concepts of Acceptance and Commitment Therapy (ACT). The purpose of this study was to evaluate the psychometric properties of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8).
Materials and methods: A descriptive cross-sectional study was conducted in 300 students in Kashan, Iran who were selected by cluster sampling. The Avoidance and Fusion Questionnaire for Youth (AFQ-Y8) and the Revised Children's Manifest Anxiety Scale (RCMAS) were administered to collect the data. The factor structure of the questionnaire was evaluated using exploratory and confirmatory factor analysis. Also, the convergent validity with RCMAS, test-retest reliability, and internal consistency of this questionnaire were examined.
Results: Exploratory factor analysis indicated one factor called psychological inflexibility. Confirmatory factor analysis confirmed the one factor model of the questionnaire (RMSEA 90%
CI =0.00-0.07). Also, the convergent validity with RCMAS was found to be good (r = 0.60, p<0.001) and the internal consistency and test-retest reliability (4 weeks interval) were 0.71 and 0.65, respectively.
Conclusion: AFQ-Y8 is an appropriate tool with acceptable psychometric properties to measure the psychological inflexibility of adolescents in Iran.

 

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Background and purpose: This preliminary study was conducted for the adaptation and standardization of Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) in a sample of Iranian students.
Materials and methods: The current psychometric study was carried out in male and female students in public elementary and secondary schools in Tehran, Iran during 2017-2018 academic year. The samples consisted of 412 participants, including 56.8% females, who were selected using multi-stage clustering sampling. Data were collected using the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), Positive and Negative Affect Schedule for Children (PANAS-C), Children's Depression Inventory (CDI), and Spence Children's Anxiety Scale (SCAS). Data analysis was performed in SPSS V20 applying descriptive and inferential statistics (factor analysis, principal component analysis, Cronbach's alpha, and Pearson correlation).
Results: Factor analysis revealed that the ERQ-CA has two factors (reappraisal and suppression). Cronbach's alpha was 0.81 for total items and 0.79 and 0.68 for reappraisal and suppression, respectively. Also, significant correlation coefficients were found for the relationship between reappraisal and suppression with positive and negative affect, anxiety (excluding obsessive-compulsive disorder), and depression subscales (P=0.01, and P=0.05, respectively).
Conclusion: The Persian version of ERQ-CA showed reasonably good psychometric properties, therefore, it could be used in clinical and research evaluations of emotion regulation strategies in Iranian children and adolescents.

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Background and purpose: Musculoskeletal disorders (MSDs) are among the major causes of occupational injuries and disability in industrialized and developing countries. The aim of this study was to compare MSDs in female staff working in radiology department of Imam Khomeini and Bouali Sina hospitals in Sari, Iran, 2018.
Materials and methods: The research population, in this cross-sectional study, included 45 female staff working in radiology departments who were selected via census sampling. Then, 20 subjects who met the study inclusion criteria were studied. The Nordic Musculoskeletal Questionnaire (NMQ) was administered to collect the data. Statistical analysis was performed in SPSS V16.
Results: The mean age of participants was 37.7 years. Findings showed that during the past 12 months, musculoskeletal disorders were more prevalent in shoulder area (65%), wrists and hands (64.7%), and elbows (55%). There was no significant correlation between acute skeletal disorders and age, height, weight, and BMI.
Conclusion: The prevalence of musculoskeletal disorders has an increasing rate in radiography staff. Lack of appropriate trainings result in more occupational disabilities, therefore, improving working conditions and use of electronic systems rather than mechanical systems for radiation chamber door are suggested.
 

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 Background and purpose: Musculoskeletal disorders are among the most common causes of injury and disability. Farm workers are at higher risk for these disorders due to hard physical work. In this study, the prevalence and factors related to musculoskeletal disorders were investigated in paddy workers in Golestan province, 2020.
Materials and methods: The samples of this cross-sectional study were 220 people who were selected by cluster sampling. Data, including demographic and occupational information, and the prevalence of work-related musculoskeletal disorders were collected using the Persian version of Dutch Musculoskeletal Disorders (DMQ) and analyzed in SPSS V25.
Results: The mean age of participants was 46.28 years and 163 (74.1%) were men. The highest frequent musculoskeletal pain was reported to be low back pain in the past year and past week (58.6% and 40.5%, respectively). Significant direct relationships were observed between age and total health (r= 0.141), musculoskeletal health (r= 0.381), and low back pain (r= 0.261). Findings showed significant differences between the scores of men and women in performing duties, work load, work schedule, breaks, and working condition (P < 0.05).
Conclusion: Providing educations to paddy workers and mechanizing their activities could decrease the severity of exposure to risk factors for musculoskeletal disorders.

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 Background and purpose: Population aging is increasing and aged people need supports and care from individuals who are resilient enough in providing all types of care. Measuring the resilience of caregivers requires a valid and reliable tool. This study aimed at designing, analyzing the psychometric properties, and using a questionnaire to investigate resilience among in-home caregivers of aged people.
Materials and methods: In first phase, a descriptive study was performed in 400 people aged 20 years and older in Isfahan, Tehran, Shiraz, and Hamedan provinces, Iran and the second phase was carried out in 216 individuals in 2021. Professors and experts in different fields, including psychology, psychiatry, gerontology, health of aged people, and geriatrics cooperated at different stages of designing the questionnaire. Face validity, content validity index, content validity ratio, convergent validity and divergent validity, exploratory factor analysis, and reliability (Cronbach's alpha) of the questionnaire were assessed. Descriptive statistics and Pearson correlation coefficient were used to report the data.
Results: At content validation stage, 31 items out of 70 were removed from the questionnaire. One other item was removed at internal consistency phase. In exploratory factor analysis, based on the acceptability of the factor load, 38 items were defined in 4 factors. These factors were named self-efficacy and acceptance, tolerance and controllability, responsibility and commitment, and behavioral emotion regulation, which explained 48.70% of the dispersion. Convergent validity and divergent validity were confirmed due to strong correlation between the scores of each item and its corresponding scale score (P<0.0001). The Cronbach alpha reliability coefficient for the whole questionnaire was 0.92 and for the scales ranged between 0.668 and 0.912.
Conclusion: Considering the validity and reliability of the questionnaire designed for investigating the resilience of in-home care givers of aged people, current findings could be used in education, research, and prevention. Families, aged people, researchers and the health researchers are among its beneficiaries.

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 Background and purpose: In today's world, declining fertility rates have led most high- and middle-income countries to pursue pronatalist policies. To plan for fertility desire and intention, it is necessary to examine their determinants in different societies. The purpose of this study was to design and evaluate the validity and reliability of a questionnaire that could measure the components affecting the intention to have children.
Materials and methods: First, based on an extensive review of the literature, the most appropriate conceptual framework for explaining the immediate components related to the intention to have children was identified. After that, using the literature and expert opinions, the desired domains were selected and experts approved the content of the domains and items via deductive method. The designed questionnaire was completed through interviewing 500 married women (15- 49 years) selected from visitors of inpatients in public and private hospitals in Kerman, Iran 2021. Then, the construct validity of the items indicating three main constructs affecting fertility intention were evaluated using exploratory factor analysis and known-groups validity. The item reliability of these three constructs were examined by calculating Cronbach's alpha.
Results: The theory of planned behavior was selected as the theoretical framework for compiling the constructs of the questionnaire. The three immediate components affecting fertility intention were attitude (8 items), subjective norm (3 items), and perceived control (3 items). All three factors were factorable and the factor loadings of the items in each of the three constructs were above the acceptable minimum level of 0.4. The three factors explained 58% of the variance. Cronbach's alpha values for the three constructs were 0.83, 0.79, and 0.66, respectively.
Conclusion: The determinants of childbearing intention questionnaire designed based on the theory of planned behavior had acceptable validity and reliability and can be used in Iranian married women.
 

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Background and purpose: The knowledge, attitude, and practice (KAP) of healthcare workers are important to reduce the transmission and burden of dengue. There is no standard tool to assess KAP of healthcare workers about dengue in Mazandaran Province, Iran, so this study was conducted to design and assess the validity and reliability of a questionnaire in Persian assessing KAP of healthcare workers about these mosquito-borne viral disease.
Materials and methods: In this descriptive analytical study, a preliminary questionnaire containing 81 questions was designed after reviewing articles and interviews with experts. To determine the validity of the scale, quantitative-qualitative face and content validity were measured, and Cronbach's alpha coefficient was used to assess the reliability.
Results: In the study of face validity and qualitative content, experts' opinions were applied to the items as minor changes. The Impact Score (IS) of all items were higher than 1.5 (1.5-5) which provided supports for items importance. Content validity, based on the Lawshe table, optimal value of content validity ratio (CVR), and content validity index (CVI) were 0.6 and higher than 0.8, respectively. All items except one that was removed, obtained the desired score and were retained in the scale. Cronbach's alpha coefficient was 0.79 which showed that all items had an acceptable correlation.
Conclusion: This study provided a reliable and valid tool in Persian to assess KAP of healthcare workers about dengue in Mazandaran Province, north of Iran and can be used for measuring dengue KAP by Iranian researchers.
 

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 Background and purpose: Counseling services in Iran are required to understand the motivations for childbearing to provide better services. This study was conducted to investigate the confirmatory factor analysis of the Childbearing Questionnaire (CBQ) in Iranian men and women.
Materials and methods: In this cross-sectional study, 398 married women of reproductive age (15-49 years of age) and 390 men, whose wives were at similar age were recruited. They were selected from Mashhad healthcare settings using multi-stage cluster sampling. The participants completed the CBQ. The reliability of the CBQ was assessed by test-retest and Cronbach's alpha. The validity of the scale was evaluated applying confirmatory factor analysis. SPSS V19 and Amos-21 were used for data analyses.
Results: Cronbach's alpha coefficient and the test-retest reliability indicated satisfactory reliability of the CBQ in terms of positive childbearing motivation and negative childbearing motivation. The original model did not show acceptable fit. After removing eight factors with low loading and two correlated error terms, the modified model was found to have adequate fitness.
Conclusion: This study showed that some of the positive and negative motivations have changed due to cultural values of the Iranian society and are different compared with those of the western societies. This study supported the use of CBQ as a valid instrument in assessing childbearing motivations in Iran.
 

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Background and purpose: Thalassemia is a common disorder in Iran and the world. The progress in the field of diagnosis and treatment of thalassemia made these people able to live for a longer period. In these patients, frequent blood transfusions are associated with numerous complications such as depression, anxiety, stress, etc. These problems are associated with a decrease in the quality of life. Therefore, this study was carried out to investigate and compare the quality of life in beta-thalassemia major patients with and without blood transfusion.
Materials and methods: In this study, which was cross-sectional and descriptive-analytical in nature, a total of 170 patients with thalassemia major, aged 18-60, who were referred to the Thalassemia Center of Bo Ali Sina Hospital in Sari during the summer of 2014, were examined. The study was conducted with the ethical code IR.MAZUMS.REC.1402.18665 of Mazandaran University of Medical Sciences. According to the inclusion criteria, education level, and age range of the studied population, 116 patients out of 170 thalassemia major patients were studied. Considering that the number of thalassemia major patients with and without blood transfusions referring to the thalassemia center of Bo Ali Sina Hospital in Sari is almost equal, out of 116 patients with inclusion criteria, 58 patients are treated with periodic blood transfusions and 58 patients are under control without the need for transfusions. Blood was studied. Thalassemia patients are treated with blood transfusion every 15-30 days for injection and patients who do not need blood transfusion every 1-3 months to the thalassemia center for control. SF 36 standard questionnaire was used to check the quality of life. The reliability and validity of the Persian questionnaire were reported with Cronbach's alpha coefficient of 0.77 to 0.90 and vitality scale of 0.65. To analyze the variables, frequency indices, percentages, independent t-test, and chi-square test were used.
Results: Among the thalassemia major patients studied, 52 (44.8%) were male and 64 (55.1%) were female. The average age in the group with and without blood transfusion was 34.75±8.35 and 39.33±8.18 years, respectively. There was no statistically significant difference in the average age between the two groups (P=0.128). There was no significant difference in the marital status, occupation, and level of education between the patients with and without thalassemia major injection. Among the investigated clinical complications, diabetes was significantly higher in the blood transfusion group (P=0.001). From the average coefficients of the eight indices of the SF 36 test, the subscale of general health (GH) was significantly better in patients with blood transfusion with a mean and standard deviation of 55.79±19.20 than in the non-injection group, 44.05±21.59 (P=0.002).
Conclusion: It is suggested that in patients with thalassemia, especially thalassemia major, with or without blood transfusion, like other periodical control measures and medical treatment, evaluation of general health and quality of life should be carried out at regular intervals, to improve the quality of life of these patients, timely psychological or psychiatric interventions to be done at the required time.
 

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Background and purpose: Musculoskeletal disorders (MSDs) are becoming increasingly prevalent as a source of occupational disability injuries. Musculoskeletal disorders in midwives are a major concern, as midwifery is one of the professions with a high risk of occupational diseases, in addition to risk factors such as awkward posture, repetition of movements, heavy workload, fatigue, and stress, are also dependent on individual-organizational factors, which can be caused by occupational tensions and may lower the quality of care provided to mothers and newborns. Because there is little research in this field, the current study aimed to determine the prevalence of musculoskeletal disorders among midwives working in public and private hospitals in Sari City, as well as the influence of related risk factors on it.
Materials and methods: This descriptive-analytical cross-sectional study was conducted in 2023 (summer) among midwives working in public and private hospitals in Sari City as a census. 193 workers in maternity wards were chosen, with having more than one year of experiencea nd the exclusion being a history of musculoskeletal disorders. The data collection tool included a demographic and organizational information collection form, the Cornell musculoskeletal disorders questionnaire. This questionnaire looks at 12 body areas and the frequency, severity, and impact of discomfort on work abilities throughout the previous working week. Data analysis was done by SPSS statistical software, descriptive statistics, chi-square, and independent t-tests at a significance level of 0.05.
Results: The mean and standard deviation of the age and work history of the studied subjects were 35.60±7.74 and 10.42±6.84, respectively. Analysis of the frequency of musculoskeletal problems revealed that the most commonly affected areas were the wrists, shoulders, lower back, and neck. Meanwhile, 79.4% of people have experienced discomfort in at least one of the various organs. In terms of the amount of pain, the highest average pain sensation among participants was reported the highest average pain intensity at night (40.7%). Based on the results, the highest prevalence of MSDs was found in the neck region (58.4%), followed by the lower back (57.6%), shoulder (53.9%), and then one or both wrists (51%). Also, the average age and history of midwives with MSDs had a significant relationship (P<0.05).
Conclusion: The current study found that the majority of midwives felt pain and discomfort in at least one part of the musculoskeletal system. Also, the highest rate of musculoskeletal disorders was in the neck, waist, and shoulder, respectively, which indicates the high prevalence of disorders in the upper limbs. The study's analytical investigations revealed an effective relationship between the prevalence of musculoskeletal disorders and demographic and work-related variables. As a result, to improve working conditions and reduce musculoskeletal disorders in midwives, specialized ergonomics

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Background and purpose: Health tourism is one of the dimensions of sustainable development to help Mazandarn’s economic dynamic. A strong agreement is doubted in identifying factors influencing the attraction of health tourists. This study was implemented to design a questionnaire to measure the factors influencing the attraction of healthy tourists and investigate its psychometric properties.
Materials and methods: This study was done with a combinatorial approach in three steps, including relevant literature and the opinions of experts as long as health tourists' opinions of Mazandaran province were applied to the development of the item pool. Then, content validity, face validity, construct validity, and reliability of the questionnaire were assessed for the psychometric properties of the questionnaire. The final questionnaire was approved after performing 17 interviews and applying professional expertise in the qualitative part. In the first stage of the quantitative part content validity was studied by 10 people from an expert panel, and its face validity, the questionnaire was completed by 10 participants. Finally, the construct validity of the designed instrument was calculated using exploratory factor analysis using SPSS 24 software and confirmatory factor analysis using AMOS 24 software by asking 300 people familiar with health tourism in Mazandaran province. The internal and external validity were determined using Cronbach's alpha and test-retest in 25 people.
Results: The results of the literature review and interviews with experts in the first and second stages of the study led to the design of 76 items. In the next step, the changes in the qualitative stage 15 questions did not receive favorite points in Content validity ratio (CVR) and content validity index (CVI) calculation in the quantitative part of content validity. Then face validity was applied and the item effect index for 8 items was lower than 1.5 in the quantitative stage of face validity. Then the questionnaire with 53 items was entered into construct validity. In the exploratory factor analysis, the value of KMO was equal to 0.778. Furthermore, the value of Bartlett's test of significance was less than 5%. Based on the rotated matrix of components, eight factors with positive values were obtained. The results of exploratory factor analysis showed that 7 items had a factor loading of less than 0.4, which were removed from the questionnaire, and finally, 46 items remained. In the confirmatory factor analysis stage, the factor load of all dimensions was in good condition and the P-value was in the acceptable range. Cronbach alpha rate was calculated as 0.831. The external reliability was lower than 0.05 (ICC= 0.90, P<0.001).
Conclusion: The designed questionnaire, due to the low number of questions, the simplicity of the sentences, as well as the acceptable validity and reliability, can be used to identify and investigate the factors affecting the attraction of health tourists. Normalization of the questionnaire in other cultures is suggested. It is hoped that the findings of this study will be utilized by researchers, healthcare and tourism system managers, and other stakeholders to inform the planning of interventions aimed at increasing medical tourism. Additionally, it is hoped that the results of this study will serve as a springboard for future research in this area.

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Background and purpose:. The quality of life of patients with chronic kidney failure undergoing hemodialysis is influenced by physical, psychological, and social factors. Accurate assessment of these dimensions using standardized tools is of great importance. This study aimed to determine the psychometric properties of the 12-item Quality of Life Questionnaire in patients undergoing hemodialysis in the Iranian population.
Materials and methods: In this cross-sectional study conducted in 2023, 411 hemodialysis patients in Mazandaran were selected through convenience sampling. After translating the Short Form-12 Quality of Life Questionnaire, its psychometric properties were assessed through exploratory factor analysis, network analysis, and confirmatory factor analysis, along with construct validity (convergent and divergent validity). Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients.
Results: The results of the exploratory factor analysis indicated that two factors—physical health status and mental health status—accounted for 44.55% of the variance in the quality of life among hemodialysis patients. Furthermore, confirmatory factor analysis showed that the hypothesized model had a good fit (CFI= 0.930, IFI= 0.931, RFI= 0.936, TLI= 0.954). The extracted mental health factor in men demonstrated convergent validity (AVE above 0.5), and both factors exhibited appropriate divergent validity. Ultimately, the internal consistency of the Quality of Life Questionnaire was found to be within an acceptable range (greater than 0.7).
Conclusion: The psychometric analysis of the Quality of Life Questionnaire indicates that patients with chronic kidney failure undergoing hemodialysis perceive their quality of life through two primary dimensions: physical and mental health status. This study confirmed the psychometric properties (validity and reliability) and the appropriate factor structure of the Persian version of the Quality of Life Questionnaire for patients undergoing hemodialysis. Healthcare providers can use this tool in various studies to assess and improve the quality of life of hemodialysis patients
The use of this questionnaire allows researchers and healthcare professionals to more accurately and comprehensively evaluate the different aspects of quality of life in hemodialysis patients. Employing this tool can enhance treatment processes and improve patient satisfaction, serving as a valuable instrument for future research. This study emphasizes the importance of using valid and reliable tools to assess quality of life and recommends that nurses and other healthcare professionals integrate the Persian version of the 12-item Quality of Life Questionnaire into their treatment and research programs to help improve the quality of life of hemodialysis patients and achieve better treatment outcomes.
Future studies are recommended to investigate the impact of factors such as nutrition, social support, and rehabilitation programs on the quality of life of hemodialysis patients. Additionally, utilizing this questionnaire in different populations and therapeutic contexts can contribute to the generalizability of the findings and offer a more effective tool for quality of life assessments. Overall, the findings of this study indicate that the 12-item Quality of Life Questionnaire is a reliable and valid tool for assessing the quality of life in hemodialysis patients, making it valuable for both research and clinical programs. Using this tool can help improve patients' quality of life and treatment outcomes while providing essential data for clinical decision-making.
 

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Background and purpose: Pharmacists perform a diverse range of activities and services in the field of pharmaceutical care. Therefore, the quantitative and qualitative monitoring of these pharmaceutical services in hospital wards is essential. Since monitoring such services in hospitals requires a valid instrument, the aim of this research is to develop and conduct a scientometric evaluation of a questionnaire to quantify the quality of pharmaceutical care services in general hospital wards.
Materials and methods: This methodological research was conducted between December 2023 and July 2024. To compile the questionnaire, the relevant areas were first identified. Subsequently, questions related to these areas were developed through a focused group discussion. Next, the appropriate scoring method was determined, and the initial questionnaire was constructed in two parts (technical and professional), formatted as a checklist. The content validity of the instrument was assessed in terms of clarity, simplicity, relevance, and necessity of each question. Internal consistency of the questionnaire was assessed using Cronbach's alpha.
Results: The mean content validity ratio of the technical part was 0.84 and 0.88 for the professional part. Also, the content validity index was 0.85 for the technical and 0.84 for the professional part. The alpha values were 0.771 for the first part and 0.773 for the second part, indicating an acceptable internal consistency.
Conclusion: While introducing a practical instrument, our results revealed acceptable validity and reliability indices for it. This tool can be used to evaluate and quantify pharmaceutical care services in hospital wards, and also as an indicator to identify high-risk areas where medication errors could occur.

 

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Background and purpose: Clinical education, as the cornerstone of medical education, plays a fundamental role in shaping the professional competencies of students and necessitates ongoing evaluation and quality improvement in accordance with relevant standards.
Materials and methods: This descriptive-analytical study examines the educational environment of residents at Mazandaran University of Medical Sciences in 2024-2025. The statistical population consisted of 200 residents selected through stratified random sampling. The inclusion criterion was completion of at least six months since beginning the residency program. Data collection tools comprised two parts: demographic information and a validated 23-item D-RECT questionnaire.
Results: Scores across different educational domains averaged between 7.94 and 16.33. Also, there was a significant positive correlation between all domains. The highest correlation was observed between the roles of instructors and formal education. The mean total questionnaire score was 13.07 ± 4.43, corresponding to approximately 70% of the maximum achievable score, indicating a high level of participant satisfaction with the educational environment. The highest correlation coefficient was observed between the domains of instructors’ roles and formal education, with a correlation coefficient of 0.670, indicating a strong relationship between these two domains.
Conclusion: Residents at Mazandaran University of Medical Sciences reported a high level of satisfaction with their educational environment. The positive correlations among the different questionnaire domains indicate a strong connection between formal education, instructors’ roles, and other aspects of the educational setting. Continual evaluation is essential for strengthening educational programs and enhancing the quality of the learning environment.