Validity and reliability properties of the Persian version of perceived health competence scale among patients with cardiovascular diseases

Predictive influence of disease knowledge and hope on self-care behavior among adults with heart failure

Background

Self-care, disease knowledge, and hope are critical concepts in health-related studies. Therefore, all three are considered solutions for controlling heart failure (HF) and reducing its complications. This study aimed to identify the predictive influence of disease knowledge and hope on self-care behavior among adults with HF.

Materials and Methods

This descriptive-analytical and cross-sectional study examined the data of 113 HF patients referred to the Imam Reza Clinic in Shiraz, Iran, in 2021. This study used HF patients' self-care instruments based on Orem's self-care theory, the HF Knowledge Scale-Persian version, and the Heart Hope Index-Persian version. The data were analyzed using the general linear model (GLM) and Pearson's correlation coefficients.

Results

Of the 113 HF patients, 54.90% (n = 62) were male, and 45.10% (n = 51) were female. The analysis of the Pearson correlation coefficient indicated the presence of a positive and significant correlation between "self-care and hope" (r = 0.532, P = 0.0001), "HF knowledge and hope" (r = 0.432, P = 0.0001), and "self-care and HF knowledge" (r = 0.410, P = 0.0001). GLM showed that HF knowledge symptoms (P = 0.0001), hope (P = 0.0001), unemployed patients (P = 0.042), and housewife patients (P = 0.0001) predicted self-care behavior of HF patients.

Conclusion

Considering the positive and significant correlation between "self-care and HF knowledge," "self-care and hope," and "HF knowledge and hope," it seems necessary for doctors and nurses should pay attention to providing educational programs to increase HF knowledge to improve self-care and hope in HF patients.

The effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults in cardiac intensive care unit: A quasi-experimental study

BACKGROUND

Patient satisfaction helps healthcare organizations to improve their quality level and nurse-patient relationship is effective in increasing satisfaction. The aim of this study was to determine the effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults' patients in cardiac intensive care unit.

MATERIALS AND METHODS

This quasi-experimental study was conducted by available sampling method on 78 hospitalized older adults (39 interventions, 39 control) in cardiac intensive care unit of Guilan hospitals in north of Iran in 2021. In the intervention group, Peplau's communication theory (four stages of orientation, identification, exploitation, and resolution) was implemented and the control group received routine care. At the time of discharge, patient satisfaction questionnaire of quality of nursing care was completed for both groups. Data were analyzed through descriptive and inferential statistics (independent t test, Chi-square test).

RESULTS

The mean score of nursing satisfaction in the intervention group (5.4 ± 93.0) was significantly higher than the control group (6.8 ± 75.7) (t (64) = 11.54, P < 0.001, d = 2.84). In other words, the mean satisfaction scores of nursing care in the intervention group were 17.4 units (95% confidence interval: 14.4-20.4) more than the control group.

CONCLUSION

Using Peplau's communication theory in the care of hospitalized older adults in cardiac intensive care unit can lead to improvement of satisfaction, so it is suggested to use this communication method in the care of these patients to improve the level of satisfaction, quality of care, and functional independence.

Relationship between hypertension/blood pressure and hearing sensitivity among drivers: A correlation analysis

BACKGROUND

One of the most common chronic diseases is hypertension. The majority of research has linked hearing loss to hypertension. However, the relationship between hypertension and hearing is still unknown. The primary goal of the study is to investigate the effect of hypertension on hearing and to find out the association between blood pressure levels and auditory health in auto-rickshaw drivers.

MATERIALS AND METHODS

The study utilized 121 healthy professional auto-drivers between the age range of 25 and 55 years. Pure-tone audiometry (PTA) and extended high-frequency audiometry (EHFA) were used to determine the participants' hearing thresholds from 0.25 to 16 kHz. The cochlear hair cell functioning was evaluated using distortion-product otoacoustic emission (DPOAE) testing. Blood pressure (mmHg) measurements were categorized under hypertension stage (normal (120; <80); elevated (120-129; <80); hypertension - stage 1 (130-139; 80-89); hypertension - stage 2 (≥140; ≥90)).

RESULTS

The mean age of the study participants was 42.17 ± 9.03 years. The mean systolic and diastolic BP of all the study participants were 138.24 ± 19.73 (105-216) mmHg and 87.69 ± 12.14 (60-134) mmHg, respectively. BP levels were normal for 17.4% (N = 21) of the study participants, 21.5% (N = 26) had elevated blood pressure, 21.5% (N = 26) of the population falls under stage 1 hypertension, and 39.7% (N = 48) had stage 2 hypertension. Our study discovered a significant difference between main group effects and no significant difference between group interaction effects. Hearing thresholds were significantly higher in hypertensive participants compared to non-hypertensive participants. However, there was no statistically significant relationship between the two variables hypertension and hearing loss.

CONCLUSION

Implementing health promotion initiatives and raising awareness about hearing health could improve the quality of life for a high-risk occupational group of drivers.

Design, implementation and evaluation of an intervention based on a social cognitive theory of physical activity and nutritional behaviors in middle-aged people at the risk of coronary artery disease in Bandar Abbas: A study protocol

BACKGROUND

Coronary artery disease (CAD) is the most common cardiovascular disease (CVD) and the main cause of mortality in developed and developing countries. Physical activity and nutritional behaviors are modifiable factors in people at the risk of CAD and its risk factors; thus, the present study aimed to design, implement, and evaluate an intervention based on the social cognitive theory for physical activity and nutritional behaviors in the middle-aged population at the risk of CAD residing in Bandar Abbas city.

MATERIALS AND METHODS

The present study will be conducted in three phases: qualitative, cross-sectional, and community-based intervention. The middle-aged population with less than 150 minutes of physical activity a week with at least one other risk factor of CAD (hyperlipidemia, hypertension, diabetes, overweight and obesity, smoking) will be included in the study. In the qualitative phase of study, the participants will be selected with maximum diversity and with the aim of obtaining comprehensive information to clarify the nature and dimensions of the phenomenon in question. The cross-sectional phase aimed to determine the intensity of physical activity and nutritional behaviors. By analyzing the data obtained from the cross-sectional phase, the most important constructs of the social-cognitive theory in physical activity and nutritional behaviors will be determined, and accordingly, an effective intervention will be designed. The third phase of the pre-test-post-test intervention study will include a randomized control group. The interventions will be a combination of face-to-face meetings and the use of educational technologies. Individuals in the control group will not undergo the educational intervention. Those in the intervention group will be evaluated in two phases (before the implementation of the intervention, and 3 months after the intervention).

CONCLUSION

The findings of the present study can be used as a strategic plan to help policy makers to strengthen CVD prevention and management alternatives to include physical activity and nutritional behavior as part of their preventive measures.

Experiences of what influences physical activity adherence in Iranian patients with heart failure: A qualitative study

BACKGROUND

Heart failure (HF) is becoming one of the important health care problems around the world. Physical activity as the foundation of the cardiac rehabilitation program is poorly adhered by patients with HF. This study aimed to understand the experiences of patients with HF in terms of adherence to physical activity.

MATERIALS AND METHODS

This study was conducted using conventional qualitative content analysis. Data were collected by semistructured telephone interviews with 25 patients with HF through open-ended questions. Data were collected from patients with HF in Birjand and Mashhad hospitals and heart departments from December 2021 to March 2022. Data were analyzed using Max-QDA10 and data analysis was continuous, comparative, and simultaneous with data collection.

RESULTS

After data analysis, three main categories were identified: (1) patient-related barriers and facilitators, (2) support system-related barriers and facilitators, and (3) environmental barriers and facilitators. These categories were subdivided into two main themes: (1) threatening disease and (2) challenging disease.

CONCLUSION

The results showed that beyond patient-related, support system-related, and environmental categories, perceiving the disease as a challenge or a threat is crucial in the activity of patients with HF. Nurses and other health care providers can train problem-solving behaviors to patients with HF to improve their physical and mental well-being. It is suggested that theoretical-behavioral approaches can be used in future clinical trials to improve adherence to physical activity.

Undiagnosed hypertension and its correlates among adults attending urban and rural health training centers in a South Indian district

BACKGROUND

In developing countries, many people with high blood pressure are not aware of their disease. Those who are diagnosed to have elevated hypertension may not have access to treatment. It contributes to the high burden of heart diseases, kidney failure stroke, and premature mortality and disability. The objective of this study is to estimate the burden of undiagnosed hypertension and to describe the factors associated with it among adults attending outpatient department of an urban and rural health centers in a South Indian district.

MATERIALS AND METHODS

A hospital-based cross-sectional study was done among 539 outpatient adults of rural and urban health centers in a South Indian district during May-December 2021 recruited through consecutive sampling. Data were collected using a pretested semistructured questionnaire. Variables significant in univariate analysis were further analyzed using multivariate logistic regression.

RESULTS

One-hundred and ninety-nine (36.9%) out of 539 participants had undiagnosed hypertension. Multivariate analysis showed the following risk factors as significantly associated with undiagnosed hypertension (age more than 50 (AOR = 5.936, 95% CI = 3.787-9.304), adults with a family history of hypertension (AOR = 1.826, 95% CI = 1.139-2.929), participants without physical activity (AOR = 1.648, 95% CI = 1.089-2.496), and participants from urban area (AOR = 1.837, 95% CI = 1.132-2.982)).

CONCLUSION

A high burden of undiagnosed hypertension was identified emphasizing the need for strict implementation and monitoring of health promotion, awareness generation, and promotion of healthy lifestyle strategies proposed by the government.

A descriptive study to assess knowledge related to hypertension and its impact upon exercises and sleep pattern among adults from communities of Uttarakhand

INTRODUCTION

Hypertension nowadays is a major community health problem. It is high prevalence, which becomes an important area of research which is also a major possibility for circulatory diseases and other complications. It is a silent killer, which does not show any warning sign until a severe medicinal crisis occurs. The study aims to assess the knowledge regarding hypertension and its effect on the amount of exercise and sleep among adults at risk of hypertension from both rural and urban communities of Uttarakhand.

METHODS AND MATERIALS

A descriptive cross-sectional research design with the total sample size was calculated as 542 adults at risk of hypertension. A purposive sampling method was used for sample selection in this study. A semi-structured questionnaire regarding knowledge related to hypertension and amount of exercise and sleep patterns was administered as tools for data collection. Analysis was done by using SPSS 23.0 version software, descriptive statistics with the use of frequency %, inferential statistics with Chi-square test, and P value ≤ 0.05 considered as significant.

RESULTS

Majority (58%) of them were male, living with a nuclear family with very poor educational status. It showed that whenever they have free time, only then they were performing simple work without having any experience with regular exercise and yoga. Less than half of them (45%) were having good knowledge about increased blood pressure is a disease, medical management, and how to prevent it. Knowledge regarding hypertension showed significant association with less amount of exercise (use of a motored vehicle to going to job/work) (p value = 0.0001*) and satisfactory pattern of sleep among adults at risk of hypertension (p value = 0.001*).

CONCLUSION

In this study, a lack of education and very poor knowledge regarding the management of hypertension found to be associated with less amount of exercise but satisfactory sleep among adults at risk of hypertension.

The burden of non-communicable diseases: A scoping review focus on the context of India

The mortality rate of non-communicable diseases (NCDs) contributes more in low-income and middle-income countries, also among individuals with lower socioeconomic status in high-income countries, making NCDs a big hurdle to minimizing global and national health disparities. Among 55 million fatalities worldwide in 2019, NCDs accounted for about 41 million (71%) deaths. The purpose of this scoping review was to comprehend the available literature on the burden of NCDs in India. This review included the studies that have been published between the period of 2009-2020. For this review, 18 full-text articles have been selected. A preliminary search was done to obtain articles from the search engines such as PubMed, Google Scholar, web of science, and Scopus. Our scoping review was focused on five major NCDs which are cardiovascular, hypertension, diabetes, cancer, and stroke. In 2019, around 17.9 million individuals died from cardiovascular disease (CVD), which is accounting for 32% of all deaths. As compared to Chandigarh and Jharkhand (0.12 million and 0.96 million, respectively) Tamil Nadu and Maharashtra (4.8 million and 9.2 million, respectively) have a higher percentage of the population affected by diabetes. In India, stroke is the fifth-significant cause of disability and the fourth-leading cause of fatality, which is accounting for 3.5 percent of all disabilities. India should construct a higher-level coordinating framework and devise an overarching policy or strategy tailored to NCDs. To limit risk factor exposure, it is necessary to emphasize health promotion and preventive actions.

Development and validation of a questionnaire based on the protection motivation theory to predict cigarette smoking preventive behavior in the Iranian university students

BACKGROUND

Prevention of smoking is very important at a young age and during the student period. Because of the lack of a questionnaire based on the prevention of smoking behavior, this study was conducted to design and standardize a tool according to the protection motivation theory (PMT).

MATERIALS AND METHODS

This was an analytical cross-sectional study where information and opinions of experts and then designing tools and assessing the face validity in the first phase and content validity, construct validity, test-retest reliability, and internal consistency of questions in the second phase were examined. The initial themes and structures were determined based on the literature Review and the opinion of experts. Three hundred students of Yazd Universities were selected by cluster sampling and included in the study. All analyses were performed in SPSS and AMOS software version 24 with a significance level of less than 5%.

RESULTS

The final version of the scale had 39 questions in eight dimensions. The overall Cronbach's alpha value was 0.89, and for each dimension, it was more than 0.7. The content validity ratio and content validity index for the whole tool were 0.87 and 0.94, respectively. The results of confirmatory factor analysis showed that the latent construct model had good fit (X2/df = 4.31; RMSEA = 0.07; CFI = 0.94; NFI = 0.92; TLI = 0.91, P < 0.001).

CONCLUSION

In this study, a valid and reliable tool based on PMT to predict smoking behavior in students was introduced. This tool can be used in interventional and etiological studies. It also has questions related to the coronavirus disease 2019 (Covid 19) virus and can be used in the coronavirus pandemic.

Development and psychometric properties of teamwork scale in resuscitation: A sequential exploratory mixed-method study

BACKGROUND

Non-technical skills as a complement to technical skills have become increasingly important in cardio-pulmonary resuscitation, and teamwork is one of the most prominent of these skills. Because of the limited number of tools introduced and validated for measuring teamwork in resuscitation, this study was conducted to develop and evaluate the psychometric properties of the Teamwork Scale in Resuscitation (TSR).

MATERIALS AND METHODS

This study was a sequential exploratory mixed-method study and was conducted between March 2020 and April 2021 and in two phases. In the first phase (qualitative), semi-structured interviews were performed with resuscitation team members who were selected using a purposeful sampling method with maximum variation in terms of experience, level of education, age, and gender. Using directed qualitative content analysis, the data were analyzed and the primary item pool was developed. In the second phase (quantitative), assessing face, content, and construct validity as well as reliability via the internal consistency and stability, the psychometric properties of the instrument are evaluated.

RESULTS

The initial tool consisted of 54 items; after assessing the face validity, ten items were removed during content validity, and the final tool consisted of 44 items and three main categories including the essential prerequisites for resuscitation, leadership, and teamwork, which was scored based on a 5-point Likert scale from strongly disagree to strongly agree. The convergent validity and concurrent validity of the tool were confirmed. The reliability of the instrument was also confirmed using Cronbach's alpha test and re-test and the intra-class correlation coefficient (ICC) between raters.

CONCLUSION

The validity and reliability of TSR for measuring teamwork in resuscitation in a simulated environment are approved. Further studies are suggested for different contexts of resuscitation and with trained raters to evaluate its use in real resuscitation situations.

When narratives speak louder than numbers: the effects of narrative persuasion across the stages of behavioural change to reduce air pollution

Is narrative persuasion effective when promoting new behaviours in favour of the environment? Does this effectiveness vary depending on whether individuals are already thinking about changing? This paper has two main objectives: (1) to explore how individuals at different stages of the behavioural change process perceive air pollution, focussing on the perceived psychological distance of its environmental risks (Study 1); and (2) to test whether the effects of presenting the risks of air pollution in a narrative vs. statistical format on pro-environmental intentions vary depending on the individuals' stage of behavioural change (Study 2). Study 1 (N = 263) is based on a survey measuring individuals' perceived psychological distance of the environmental risks of air pollution, and the perceived effectiveness of different pro-environmental behaviours. Results suggest that perceived distance and perceived effectiveness vary across different stages of behavioural change. Study 2 (N = 258) presents a 2(Format: narrative vs. statistical) × 3(Stages of change) protocol, testing the effectiveness of a narrative format depending on individuals' stage of behavioural change. Results suggest that proximising a threat through a narrative format of communication is more effective especially for individuals in the pre-action stage of change. We also present a moderated mediation model explaining the influence of the interaction between the message format and the stage of behavioural change on behavioural intentions and on efficacy appraisal via narrative engagement. Findings are discussed with regards to the stage model and narrative persuasion.

The effectiveness of Meaning-Centered Group Psychotherapy on improving spiritual well-being and reducing anxiety in Iranian male cardiovascular patients

BACKGROUND AND PURPOSE

Cardiovascular diseases (CVDs) are the most important cause of death in Iran and the Kermanshah province. One of the most important problems that cardiovascular patients are dealing with is the psychological consequences of their illness. This study aimed at investigating the effectiveness of Meaning-Centered Group Psychotherapy (MCGP) intervention in improving spiritual well-being and reducing anxiety in cardiovascular patients.

MATERIALS AND METHODS

The study population included all patients referred to specialized cardiovascular centers in Kermanshah province in 2019. The participants consisted of 30 patients who were randomly assigned into experimental and control groups after the primary and secondary screening. The experimental group received routine treatment + MCGP (8 weeks and 90-120 min per session) and the control group only received routine treatment. The dependent variables were assessed by Spiritual Well-Being Scale and Beck Anxiety Inventory before and after receiving the treatment and 2 months after the treatment. ANCOVA and multivariate analysis of covariance were applied to the data through SPSS-22. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

RESULTS

The results of covariance analysis showed that MCGP increased spiritual/existential well-being and decreased anxiety in the experimental group (P < 0.001), while no significant difference was traced in the control group.

CONCLUSION

The findings of this randomized controlled trial provide good evidence for the effectiveness of MCGP as a treatment to improve the psychological and spiritual/existential distress in patients with CVDs.

Predicting preventive behaviors of cardiovascular disease among oil industry workers based on health belief model

BACKGROUND

Working conditions play a significant role in the process that causes cardiovascular disease. In this regard, it is required to monitor the health conditions of workers to design proper interventions to encourage healthy behaviors. This investigation was performed to determine preventive behaviors against cardiovascular disease based on the health belief model (HBM).

MATERIALS AND METHODS

This research was a cross-sectional and descriptive study with 228 subjects of oil industry workers under shift work schedules in the oil regions of Khuzestan, Iran. The HBM questionnaire provided the theoretical framework for this study. Participants completed the questionnaires in person at work. Data were analyzed using SPSS 24.0. Descriptive statistics including frequencies, percentages, and means, and linear regression analysis were calculated for variables.

RESULTS

Findings of the study showed that most workers were of a weak level of knowledge (55.3%), self-efficacy (82.5%), perceived severity (83.8%), perceived susceptibility (75.4%), perceived benefit (57.5%), and behavior (82.5%). Furthermore, results showed that most of the workers considered smoking (3.51 out of 5) and proper diet for good heart function (2.54 out of 5). In this study, the item of exercise was the lowest among all the preventive behaviors (1.39 out of 5). Self-efficacy was the strongest predictor of health belief about cardiovascular disease.

CONCLUSION

To decrease the increasing burden of cardiovascular disease in our population, and fight against this rank-one killer, multiple useful prevention strategies must be adopted. Educational theory-based interventions and applying designed programs to improve the adoption of preventive behaviors are a necessity.

Investigating the effect of teach-back method on improving the lifestyle of health ambassadors in Urmia

BACKGROUND

Adopting a healthy lifestyle is necessary to maintain and promote health. The aim of this study was to determine the effect of teach-back method on improving the lifestyle of health ambassadors in Urmia.

MATERIALS AND METHODS

In this quasi-experimental study, 200 health ambassadors were participated. The research sample was obtained using simple random sampling method. Data collection tool was a questionnaire including demographic characteristics and lifestyle standard. The educational intervention was performed in 4 sessions of 45 min based on the teach-back method. Data were collected through a lifestyle questionnaire before and 3 months after the educational intervention. Then, the data were analyzed by mean and standard deviation, independent t-test, paired t-test, and Chi-square test through SPSS 19.

RESULTS

The results showed that 24% of the control group and 21% of the intervention group had a good lifestyle before the educational intervention. After the educational intervention 27% of the control group and 54% of the intervention group were in good lifestyle. The results also showed that the mean score of total lifestyle and all its dimensions in the intervention group increased compared to the control group after the educational intervention and the difference between the mean score of total lifestyle and all its dimensions in the intervention group after the intervention was significant (P < 0.05).

CONCLUSIONS

Among health ambassadors, teach-back communication is more effective in improving the lifestyle. Therefore, it is suggested that this method must be used in designing training programs for health ambassadors.

Facilitators and barriers to return to work in patients after heart surgery

BACKGROUND

Recognition of the factors influencing returning to work by people after heart surgery is very significant in performing supportive interventions. Factors affecting return to work of Iranian patients after surgery are unknown. Therefore, a qualitative study is in demand in order to close this knowledge gap. This study was aimed to explore the facilitators and barriers of return to work after heart surgery.

MATERIALS AND METHODS

This qualitative study was conducted during 2020-2021. People after heart surgery were studied in this research. Nineteen interviews were performed with 17 participants. The main participants were selected from the cardiac surgery ward of Golestan Province Hospital. The sampling method was purposeful. Data were collected through semi-structured interviews. Questions were asked in an unguided and open-ended manner. Data analysis was performed by qualitative content analysis.

RESULTS

According to the results, "perceived psychosocial support," "individual characteristics," and "occupational factors" were considered as facilitators and "effects of heart surgery" and "limited support of public and private institutions" were introduced as barriers to return to work in patients after heart surgery.

CONCLUSIONS

The effects caused by heart surgery and limited support of public and private institutions were identified as barriers to return to work. Cardiac rehabilitation after surgery can reduce the impact of heart surgery and can help people to return to work. It is recommended that the planners of the Ministry of Labor and Social Welfare and Health, with the support of insurance organizations, help solve the work problems of people after heart surgery.

Perceived factors contributing to the care provided by informal (family) and formal caregivers of older adults with noncommunicable diseases in rural communities: A qualitative focus group study

BACKGROUND

Informal and formal caregivers of older adults with noncommunicable diseases (NCDs) are important in every aspect of current caregiving for older adults by understanding reality specific to direct experiences perceived by each person in caring for older adults in order to develop nursing knowledge and using knowledge to plan care for older adults with NCDs to have a good quality of life. The current study aimed to investigate the points of view on factors concerning the care provided by informal and formal caregivers providing care for older adults with chronic diseases in the community.

MATERIALS AND METHODS

This study was conducted with a qualitative design. The sample was 5 informal and 20 formal caregivers providing care for patients with chronic diseases, namely hypertension and diabetes mellitus. Furthermore, a qualitative approach was used with four focus groups (FGs) with 25 informants. Data were collected during March-August 2021 in rural communities of Nakhon Phanom Province, Thailand. Finally, the qualitative analysis used content analysis; FG data were analyzed using content analysis in which a preliminary set of codes was determined according to other documented experiences of patients.

RESULTS

The findings revealed three main themes emerging in the data obtained on the perceived factors contributing to the care provided by informal and formal caregivers: "caregivers' knowledge," "factors related to caregivers" and "community factors."

CONCLUSION

Points of view on the factors correlated with the care provided by informal and formal caregivers of older adults with chronic diseases that explain and confirm the findings can be used to plan care with effects on quality of life among older adults with chronic diseases.

Quality of life and empowerment among women

BACKGROUND

Few women in history were respected by society because of their contributions to the field of science, arts, politics, and so on, but in general, women are deprived of their rights and being refrained from decision-making in major areas of individual and family life. This research tried to investigate the degree of empowerment and quality of life (QOL) of the women to find out the relationship between empowerment and QOL of women.

MATERIALS AND METHODS

An exploratory survey was carried out among 210 purposively selected married women aged between 20 and 49 years in a selected municipality area of West Bengal. Data were obtained by one-to-one interviews using Women Empowerment Interview Schedule and WHOQOL Scale BREF.

RESULTS

The mean total QOL score of the women was found as 98.59 ± 13.61. The transformed scores in the physical, psychological, social relation, and environmental domains were 74.92 ± 14.97, 66.58 ± 15.78, 81.00 ± 18.07, and 65.28 ± 17.99, respectively. The degree of empowerment was calculated as 64.71 ± 6.79. Among the women, 5% had poor, 62% had medium, and 33% had a high degree of empowerment. A weak positive correlation (r = 0.325, P = 0.001) was found between QOL and empowerment. Significant associations were established between empowerment and education (Fisher's exact = 13.975 [0.007]) and education gap with husband (Fisher's Exact = 8.68, P 0.069). Multiple regression analysis between empowerment dimensions and QOL shows that personal or family dimensions, including health, are a significant predictor for the QOL (P < 0.01).

CONCLUSION

Most of the women had medium degree of empowerment. Increased degree of empowerment improves their QOL of women. Women should be aware of their rights that can enhance the empowerment in different dimensions of life.

Psychometric analysis of Persian version of patient safety competency self-evaluation in psychiatric wards

BACKGROUND

Assessment of the patient safety competency is necessary for the growth of nursing and safe care profession as well as evaluation of the nurses' educational needs. The present study was conducted to determine psychometric properties of the Persian version of the patient safety competency self-evaluation (PSCSE) tool in Iranian psychiatric wards.

MATERIALS AND METHODS

All nurses (n = 209) working in two psychiatric hospitals of Kerman, Iran, were included in the present cross-sectional study using census method. This tool contains 41 items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill dimension. Psychometric properties of the questionnaire including its content and face validity were also examined. The factor structure of the questionnaire was evaluated using exploratory factor analysis. The internal consistency and reliability were assessed by test-retest method with an interval of 14 days. Cronbach's alpha and corrected item-total correlation were used to measure reliability.

RESULTS

The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 was removed from the skill domain because it was not related to the psychiatric ward. According to the results of factor analysis, there was a significant relationship between the questions and the relevant factors. The correlation coefficient for test-retest with 14 days interval was intraclass correlation coefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge, attitude, and skill, respectively. The internal consistency coefficient (Cronbach's alpha) of the whole tool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively. Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items), attitude (14 items), and skills (20 items).

CONCLUSION

Persian version of the nurses' competency tool in ensuring patient safety in psychiatric wards has acceptable psychometric characteristics.

Online learning self-efficacy: A necessity for virtual education

BACKGROUND

Online learning self-efficacy is considered a major contributor to academic success. The present study was conducted to assess the psychometric properties of the Persian version of the Online Learning Self-Efficacy Scale.

MATERIALS AND METHODS

A cross-sectional study was conducted on 211 medical students at Kerman University of Medical Sciences in 2021 who were selected through the convenience method. Data were collected using a two-part self-administered online questionnaire containing demographic information and the Persian version of the Online Learning Self-Efficacy Scale (OLSES). Forward and back-translation methods were used to provide the Persian version of OLSES. Internal consistency of the Persian version was determined by the Cronbach alpha coefficient in a pilot study. Exploratory and confirmatory factor analyses were conducted using SPSS version 20.0 and LISREL version 8.80.

RESULTS

The mean of the participants' age was 21.40 ± 2.52 years, and most of them (56.4%) were female. The Cronbach alpha coefficient was determined as 0.74, 0.90, 0.75, and 0.89 for learning, time management, technology use subscales, and the whole scale, respectively. Exploratory factors analysis revealed the justifiability of factor analysis. In confirmatory factor analysis, most of the goodness of fit indices had an acceptable level.

CONCLUSIONS

Our study found that the Persian version of OLSES had good psychometric properties and can be used as a simple, valid, and reliable tool to assess students' self-efficacy related to the e-learning environment.

Study of outcomes of delay in referral of patients with acute myocardial infarction

BACKGROUND

Delay in seeking medical help in patients with acute myocardial infarction (AMI) challenges the patients in terms of diagnosis and treatment. This study aimed to evaluate the outcomes of delay referral (≥12 h) in patients with AMI.

MATERIALS AND METHODS

In this retrospective cohort study, the medical records of 252 patients with AMI (2017-2019) admitted to Shahid Beheshti Hospital, Qom, Iran, was reviewed. Data collection tool was a researcher-made data sheet that included demographic characteristics, times, hospitalization costs, risk factors, history of heart disease, results of paraclinical tests, clinical information at the time of admission, and outcomes of delayed referral. Data were analyzed using t-test, Chi-square, Kaplan-Meier estimator, log-rank test, Cox regression by STATA, and SPSS (version 25).

RESULTS

The levels of troponin, creatine phosphokinase, lactate dehydrogenase were significantly higher in the delayed referral group (P < 0.05). After treatment, the cardiac ejection fraction was significantly different in the nondelayed referral (41.56 ± 9.16) and the delayed referral group (38.39 ± 11.01) (P < 0.001). There was no significant difference in the percentage of hospital deaths in the groups (P = 0.078).

CONCLUSION

Delayed referral of patients with AMI is associated with decreased physiological cardiac function, which complicates recovery for these patients.

Reliability and validity of a satisfaction questionnaire on virtual education in the coronavirus disease 2019 pandemic era aimed at cardiology faculty members

BACKGROUND

In the coronavirus disease 2019 pandemic era, clinical programs and mandatory hands-on activities have been supplanted by remote teaching to maintain the fundamental capabilities of medical training and to furnish medical students with quality education. Nonetheless, the satisfaction of faculty members with this training method in the current pandemic has yet to be assessed. The aim of this study was to design a Persian questionnaire with appropriate validity and reliability on cardiology professors' satisfaction level with virtual education.

MATERIALS AND METHODS

In this cross-sectional study, a questionnaire was devised drawing upon scientific sources and Iranian medical educators' expertise. Seventeen faculty members in various specialties evaluated the questionnaire concerning face and content validity. Content validity was assessed through the calculation of the content validity ratio (CVR) (values >0.62 were considered acceptable) and the content validity index (CVI) (values >0.79 were considered acceptable), construct validity was evaluated through principal component factor analysis by the Kaiser-Meyer-Olkin (KMO) statistic and Bartlett's sphericity test, internal reliability was measured through the calculation of Cronbach's alpha coefficient, and consistency was appraised through the use of test-retest reliability at two different time points.

RESULTS

The questionnaire had a reliability rate of 95%, indicating high internal validity. Concerning test-retest reliability, the intraclass correlation coefficient was 0.96 (P < 0.001), demonstrating relatively good stability. The CVI was 0.81, and the CVR was 0.85. The KMO measure of sampling adequacy was 0.954, indicating the acceptability of the degree of common variance among the all items.

CONCLUSIONS

This Persian questionnaire on virtual education aimed at cardiology faculty members in the current pandemic with its low question count and appropriate domains had high reliability and validity. By knowing the level of professors' satisfaction with the new method of education, it is possible to take steps to better provide specialized medical education to cardiology residents.

A reproductive and sexual health promotion program for women with heart diseases: A protocol for mixed methods study

BACKGROUND

Nowadays, for various reasons, the prevalence of heart diseases has increased in women during reproductive age. These diseases can lead to serious reproductive and sexual-related complications in the affected women. This study will conduct to develop a reproductive health promotion program for women with heart diseases.

MATERIALS AND METHODS

This is an exploratory sequential mixed methods study that will be conducted in four phases. The first phase is a qualitative research that is done using content analysis method and semi-structured individual interviews. The experiences of women with heart disease and health providers' team in educational hospitals, health centers, and private offices of physicians about reproductive health need will be explored. Purposive sampling will be continued until data saturation is reached and the conventional content analysis method will be used. In the second phase, the studies published from 2000 to 2020 will be reviewed by the matrix method and then will be analyzed by using thematic analysis. Integrating the results of these two stages, the draft of the program will be designed. In the third phase, the validation of the program will be checked by using the two-round modified Delphi method. In the fourth phase, the program will be implemented by the health system and its process will be monitored.

CONCLUSION

A life cycle reproductive health program for women with heart disease can help improve their preconception health, fertility planning, and sexual health and promote the well-being of these women in the long run.

Virtual learning during the COVID-19 pandemic: What are the barriers and how to overcome them?

CONTEXT

Virtual learning is not without challenges. It can cause stress, lack of motivation, and social isolation. Due to COVID-19 pandemic, our college shifted from face-to-face to virtual teaching-learning style. the aim was to find out the barriers in virtual learning among medical students and provide solutions to overcome them.

MATERIALS AND METHODS

This cross-sectional study was conducted among 3^rd- and 4^th-year Bachelor of Medicine and Bachelor of Surgery students in 2020. Prevalidated electronic survey forms on institutional barrier, technical barrier, and individual barrier were sent to students, 160 students responded. SPSS version 12 was used to calculate descriptive statistics and independent t-test.

RESULTS

The students had the highest mean score in individual barrier (mean: 2.82 [standard deviation (SD): 0.72]) followed by institutional barrier (mean: 2.79 [SD: 0.74]) and technological barrier (mean: 2.72 [SD: 0.75]). Regarding technological barriers, 38.6% of the students agreed difficulty in procurement of the laptop and 66.4% faced slow Internet connection. Regarding institutional barriers, 75.9% were stressed to join one lecture to another lecture as the lectures were continuous, 69.6% had limited opportunity to interact with lecturers, and 62.7% had poor communication between lecturers and students. Regarding individual barriers, 74.1% of the students were not motivated for online learning, 71.5% of the students could not learn as well as they were in the classroom, and 58.2% disagreed taking online courses in future.

CONCLUSION

Low motivation, communication, Internet connectivity, and technical problems were the main barriers. Smaller size class, highly motivated and well-trained lecturers, and interactive lectures may help in breaking the barriers of virtual learning.

Validity and reliability of a virtual education satisfaction questionnaire from the perspective of cardiology residents during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has prompted the further virtualization of medical education. The satisfaction level of specific users such as cardiology residents with virtual education can augment its quality; hence, the significance of a valid and reliable questionnaire to obtain feedback is needed. This study aimed to design and measure validity and reliability of a satisfaction questionnaire for virtual education of cardiology residents during COVID-19 pandemic.

MATERIALS AND METHODS

In this cross-sectional study, a self-administered questionnaire was developed by the faculty members of Rajaie Cardiovascular Medical and Research Center. Reliability was tested utilizing Cronbach's alpha and intercorrelation which was tested using Pearson's correlation coefficient test (ICC). Factor analysis was done by the Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's sphericity test. The statistical analyses were performed with the SPSS software version 22.

RESULTS

The face validity index was determined via an assessment of the relevance, clarity, and simplicity of each item, and values >0.79 were accepted. The total Cronbach's alpha coefficient was calculated 0.93. Concerning test-retest reliability, the correlation between two rounds of evaluation was >80 (P > 0.001) and ICC was 0.99 (P = 0.001). The content validity evaluation yielded an index of 0.95 and a ratio of 0.91. The principal component factor analysis, conducted to investigate construct validity, generated four domains.

CONCLUSIONS

The study results confirmed the validity and reliability of the designed questionnaire to evaluate the level of satisfaction of cardiology residents with virtual learning in COVID-19 pandemic.