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Background and purpose: The need for continuous measures of preventive behaviors, health researchers is highlighted. Means of achieving that goal requires the use of adequate reliability and validity in the scientific literature. Material and methods: This cross-sectional study was done in 2013 on a two-stage random sampling method, 135 persons were Tehran Health Center East. Through the qualitative and quantitative study of face validity, content validity index calculation and judging the quality via a 14-member panel of experts and validity by performing exploratory factor analysis-with the agreement reliability (coefficient alpha) and test-retest method of estimating was approved. Results: A total of 50 males, first three items need to be corrected with the number 45 on the calculation of the index scores of items (with quantity greater than 1.5) with CVI greater than 0.07 and CVR higher than 0.08 down found. As demonstrated, good homogeneity of subdirectories than the average correlation between questions 0.35 (P<0.001). By calculating Cranach's alpha reliability of the tool, 0.83 was verified and the results show test-retest stability of the questionnaire and its subdivisions. Conclusion: The evidence of the strength of the factor structure and the reliability of an instrument can be developed to provide a tool for research, teaching and practice of health workers are of interest. The psychometric quality of the instrument was satisfactory. The course restrictions of the methodology should be considered in the development of more questionnaires.

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Background and purpose: The Narcissistic Personality Inventory-40 (NPI-40) is a self-report questionnaire for assessing narcissistic characteristics in non-clinical samples. The aim of this research was to assess the validity of the 40- items version of the Narcissistic Personality Inventory (NPI). Materials and methods: In a survey study, 500 people from Shahin Shahr, Isfahan, were randomly selected using stratified sampling. They were assessed by Narcissistic Personality Inventory-40 (NPI-40), NEO personality scale and Millon Clinical Multiaxial Inventory-II. Concurrent validity of the NPI was studied through correlational analysis with the Millon Clinical Multiaxial Inventory-II (MCMI-II). To study discriminate validity, the persons who obtained high low scores in NEO's extraversion and agreeableness factors were compared with their scores in narcissism scores. Results: In exploratory factor analysis (Promax rotation) three components were extracted including ................. .Significant correlation was found between the MCMI-II and NPI-40. Also, Test- Retest reliability coefficient and internal consistence of the scales were estimated to be 0.81 and 0.82, respectively. Conclusion: The results revealed that NPI-40, as a multidimensional scale has agreeable degree of reliability and Psychometric properties which could be considered as an appropriate instrument to screen narcissistic personality traits in non- clinical population.

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BBackground and purpose: Professional quality of life is a concept felt by an individual in relation to their jobs. Positive and negative aspects of a job influence professional quality of life. Evaluation of professional quality of life requires reliable scales. The current study aimed at translating (into Persian) and examining the psychometric properties of professional quality of life scale for health care service providers.
Materials and methods: This methodological research was conducted in 464 physicians, midwives and nurses working in hospitals of Qazvin province, using convenience sampling. Based on permission from the developer of the scale, it was back translated. Face validity, content validity, and exploratory and confirmatory factor analyses were tested. Test-retest and internal consistency were used to evaluate the reliability of the questionnaire.
Results: Confirmatory factor analysis showed that items 1, 4, 15, 17, and 29 did not present significant factor loadings (<0.3), therefore, they were discarded. Factor loadings for other items varied from 0.32 to 0.69. Goodness of fit measures was as follows: Normed Fit Index (NFI(: 0.93; Non Normed Fit Index )NNFI(: 0.95; Goodness of Fit Index )GFI(: 0.84; Comparative Fit Index (CFI:(0.95; X2/ Degrees of freedom )X2/df(:2.9, and Root Mean Square Error (RMSE(: 0.07 (P<0.001). Intra-class reliability of the scale was 0.96. Also, reliability of the scale was 0.73 based on internal consistency (Cronbach's alpha).
Conclusion: Present study showed that the modified Persian version of Professional Quality of Life Scale (ProQOL) consisting of 25 items could be used as a valid and reliable instrument in assessing professional quality of life in physicians, midwives, and nurses.

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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: The midwife's self-efficacy in supporting mothers during labor affects the onset of midwifery support in labor and childbirth. To date, there is no appropriate national instrument for measuring midwives self-efficacy of labor support in Iran. The present study aimed to investigate the factorial structure, validity and reliability of the Persian version of the self-efficacy for labor support scale.
Materials and methods: A methodological study was carried out in which 213 midwives from selected hospitals affiliated to Tehran University of Medical Sciences enrolled between January 2017 and September 2017. The participants completed a demographic questionnaire and the self-efficacy for labor support scale. In order to assess the validity of the instrument, qualitative face and content validity was performed. Construct validity was also evaluated using confirmatory factor analysis. Finally, the reliability of the scale was studied by Spearman's correlation coefficient and internal consistency.
Results: The qualitative face and content validity of the Persian version of labor support self-efficacy scale was confirmed, and a confirmatory factor analysis showed that it was well structured. The reliability of the scale using Cronbach's alpha coefficient was 0.93 and the Spearman's coefficient correlation was 0.72 indicating a good reliability of the Persian version of the scale.
Conclusion: The findings showed that the Persian version of the self-efficacy for labor support scale has good validity and reliability and could be used as an appropriate instrument for assessing self-efficacy for labor support by midwives 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: One of the new areas of research in emotion regulation is interpersonal emotion regulation. This concept refers to individual’s willingness to share emotional states with others to reduce own negative emotions. This study was conducted to investigate the psychometric properties of Interpersonal Emotion Regulation Questionnaire (IERQ) in students.
Materials and methods: A methodological study was carried out and the research population included all student studying in Tehran state universities. A total of 602 students were selected using multistage cluster sampling. Interpersonal Emotion Regulation Questionnaire (IERQ), Emotion Regulation Questionnaire (ERQ), Emotion Regulation Skills (ERSQ), Emotion Regulation of Others and Self (EROS), SCL-25 scale, and Difficulties in Emotion Regulation Scale Short Form (DER-SF) were administered. Eighty-five cases were excluded from the study and statistical analysis was performed for 517 individuals.
Results: The findings showed satisfactory results for the psychometric properties of the IERQ. Exploratory and confirmatory factor analysis confirmed the 3-factor model for this questionnaire. Cronbach's alpha coefficient was 0.90 for the whole questionnaire and 0.84, 0.82, 0.80 and 0.81 for items of enhancing positive affect, soothing, social modeling, and perspective, respectively.
Conclusion: Interpersonal Emotion Regulation Questionnaire has good psychometric properties and adaptation in Persian. Therefore, it can be used in future researches on emotion regulation.

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 Background and purpose: Hospital infections are one of the major challenges that health systems are faced with, leading to economic, social, and psychological damages. Clinical staff play an important role in controlling nosocomial infections, so, this study was conducted to design a standard questionnaire to assess the knowledge, attitude, and practice of clinical staff about nosocomial infections.
Materials and methods: A mixed method confirmatory study was performed to develop an instrument in Tehran, Iran 2019. The items of the questionnaire were extracted for clinical staff by searching electronic databases, including SID, Magiran, PubMed, Scopus, Science Direct, and Google Scholar. The initial questionnaire was designed and its validity was assessed by 10 experts in hospital infection control. To assess construct validity, the questionnaire was completed by 180 clinical staff working in hospitals in Tehran. Cronbach's alpha and retest were used to assess the reliability of the scale.
Results: The Content Validity Index and Content Validity Ratio for the questionnaires in three domains of awareness, attitude, and performance ranged 0.8-1. The face validity of the questions ranged 2.1-4.5. In Knowledge about nosocomial infection, Richardson's coefficient was 0.75 and Cronbach's alpha of attitude and practice were 0.71 and 0.82, respectively. Pearson correlation coefficient obtained in retest for knowledge, attitude, and performance were 0.91, 0.85, and 0.92, respectively. Three-factor confirmatory analysis showed that the questionnaire has a good fit.
Conclusion: The questionnaire designed for clinical staff has good validity and reliability which is suggested as a valid questionnaire in future researches.

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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: Valid and reliable tools are needed to assess the health literacy of heart failure. This study was performed to validate the Persian version of Heart Failure-Specific Health Literacy Scale (HF-Specific HL Scale).
Materials and methods: In this methodological study, 360 patients with heart failure completed the Persian version of HF-Specific HL Scale in two medical centers affiliated with Mazandaran University of Medical Sciences. Factor structure was evaluated using structural validity, convergent and divergent validity. The scale reliability was evaluated by internal consistency (Cronbach’s alpha) and construct reliability.
Results: The results of exploratory factor analysis showed that the scale has two factors: difficulties in understanding prescriptions and hospital pamphlets and understanding the disease and trying to improve knowledge about it, which account for 42.20% of the variance. Cronbach's alpha of the scale was higher than 0.7 and factor loading of the items was more than 0.5 indicating significant correlation coefficient of the items. The fit indices of the model showed that the extracted factor structure was suitable.
Conclusion: Factor structure of the HF-Specific HL Scale in patients with heart failure showed a two-factor structure. In addition, considering the acceptable validation results of the scale, the Persian version can be used as a reliable tool for measuring health literacy in patients with heart failure.
 

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Background and purpose: Electronic learning (e-learning) is highly important nowadays, so, it is necessary to have a suitable tool to check its level of acceptance and outcomes. The present study aimed to evaluate e-learning acceptance and learning outcomes in university students.
Materials and methods: A methodological cross-sectional study was performed in 410 undergraduate students at Mazandaran University of Medical Sciences and Tehran Azad University, Electronics Branch in April-June 2022. The participants completed the 46-item questionnaire about the acceptance of e-learning and the outcomes of learning. The face validity, content validity, and construct validity (convergent and divergent validity) of the questionnaire were evaluated. The reliability was measured using Cronbach's alpha, theta, and McDonald omega coefficients. The construct structure of the questionnaire was analyzed using factor analysis.
Results: Based on the results of exploratory factor analysis, seven factors were extracted: learning outcomes, course content and design, infrastructures, the instructor, student computer competency, supports provided by the university, and easy access to electronic facilities. The fit indices of the model confirmed the two-level structure of e-learning acceptance and learning outcomes in the students (PCFI=0.825, PNFI=0.747, CMIN/DF=1.714, RMSEA=0.050, AGFI=0.831, IFI=0.925). The questionnaire’s convergent validity and divergent validity, and also the internal consistency and reliability (<0.7) were confirmed.
Conclusion: The present study revealed that the acceptance of e-learning and learning outcomes questionnaire had good validity and reliability in a selected population of undergraduate students. Due to the suitable psychometric properties of the tool, it can be used in future studies that evaluate the acceptance of the e-learning and learning outcomes in this population.

 

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Background and purpose: The latest 2022 edition of the International Classification of Diseases (ICD-11) includes updated descriptions and diagnostic rules for "depressive episodes" and " generalised anxiety disorder". The only self- assessment that is consistent with these disorders is the International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ). The aim of the present study was therefore to investigate the psychometric properties of the IDQ and the IAQ in Iran, focusing on the student population.

Materials and methods: In the form of a descriptive study, 550 students of medical sciences universities in Tehran who were studying in 2023 were selected by convenience sampling and answered the research questions. To evaluate the reliability of these two questionnaires, two methods of internal consistency and test-retest were applied with an interval of two weeks. Their construct validity was assessed in the student sample using exploratory and confirmatory factor analysis.

Results: According to the results, the Cronbach's alpha coefficient for the depression and anxiety questionnaires was 0.92 and 0.93 respectively and the intraclass correlation coefficient was 0.86 and 0.84respectively, which indicates a high internal consistency and retest reliability of the two questionnaires. The confirmatory factor analysis showed that all questions in both questionnaires are related to one factor.

Conclusion: In general, it can be concluded that both questionnaires can be used as a brief measure in clinical and research settings for screening, diagnosingand monitoring the treatment of depression and anxiety in the student population.

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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.