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  • 1.
    Alimoradi, Z.
    et al.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Golboni, F.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, United Kingdom.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Lin, C. -Y
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Weight-related stigma and psychological distress: A systematic review and meta-analysis2019Ingår i: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background & aims:

    Individuals who are overweight or who have obesity are likely to perceive or experience unfriendly treatment (i.e., weight-related perceived stigma) from different sources such as work colleagues because of the stigma towards excess weight. People who are overweight may accept such stigma and devalue themselves (i.e., weight-related self-stigma).

    Methods:

    A systematic review and meta-analysis was conducted to examine the relationship between weight stigma (including weight-related self-stigma and weight-related perceived stigma) and psychological distress (including depression and anxiety) using random-effects meta-analyses. Utilizing five academic databases (PubMed, Scopus, WOS, Embase and ProQuest) and keywords related to weight stigma and psychological distress, empirical studies focusing on the association between weight stigma and psychological distress were selected. The timeline for the searched papers was from the inception of each database to the end of August 2019.

    Results:

    Eligible studies (N = 30; 25 on weight-related self-stigma and eight on weight-related perceived stigma) were analyzed with a total of 9345 participants experiencing weight-related self-stigma, and 15,496 experiencing weight-related perceived stigma. The pooled associations were moderate between weight-related self-stigma and psychological distress (corrected Fisher's Z = 0.40 for depression; 0.36 for anxiety) and between perceived stigma and depression (Fisher's Z = 0.44).

    Conclusions:

    Results of the meta-analysis demonstrated that weight stigma is associated with psychological distress. The comprehensive search of the literature and rigorous methodology employed are the two major strengths in the present study. Because self-stigma and perceived stigma are different concepts, their associations with psychological distress should not be merged together. 

  • 2.
    Alimoradi, Zainab
    et al.
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Bülow, Pia H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Bajalan, Zahra
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Ohayon, Maurice M.
    Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, United States.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Internet addiction and sleep problems: A systematic review and meta-analysis2019Ingår i: Sleep Medicine Reviews, ISSN 1087-0792, E-ISSN 1532-2955, Vol. 47, s. 51-61Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The pathological use of the internet – conceptualized as ‘internet addiction’ – might be crucial in initiating and increasing sleep disturbances in the community. While inconsistent evidence is reported regarding the association of internet addiction and sleep disturbances, the severity of this association remains unclear. This systematic review and meta-analysis were conducted to increase our understanding of the relationship between internet addiction and sleep disturbances. A systematic review was conducted through Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and EMBASE using keywords related to internet addiction and sleep problems. Observational studies (cohort, case-control or cross-sectional studies) focusing on association between internet addiction and sleep disturbances including sleep problems and sleep duration were selected. A meta-analysis using random-effect model was conducted to calculate the odds ratio (OR) for experiencing sleep problems and standardized mean differences (SMDs) for sleep duration. Eligible studies (N = 23) included 35,684 participants. The overall pooled OR of having sleep problems if addicted to the internet was 2.20 (95% CI: 1.77–2.74). Additionally, the overall pooled SMDs for sleep duration for the IA group compared to normal internet users was −0.24 (95% CI: −0.38, −0.10). Results of the meta-analysis revealed a significant OR for sleep problems and a significant reduced sleep duration among individuals addicted to the internet.

    Publikationen är tillgänglig i fulltext från 2020-07-04 00:00
  • 3.
    Alimoradi, Zainab
    et al.
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Griffiths, Mark D
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Social media addiction and sexual dysfunction among Iranian women: The mediating role of intimacy and social support.2019Ingår i: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 8, nr 2, s. 318-325Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND AIMS: Social media use has become increasingly popular among Internet users. Given the widespread use of social media on smartphones, there is an increasing need for research examining the impact of the use of such technologies on sexual relationships and their constructs such as intimacy, satisfaction, and sexual function. However, little is known about the underlying mechanism why social media addiction impacts on sexual distress. This study investigated whether two constructs (intimacy and perceived social support) were mediators in the association of social media addiction and sexual distress among married women.

    METHODS: A prospective study was conducted where all participants (N = 938; mean age = 36.5 years) completed the Bergen Social Media Addiction Scale to assess social media addiction, the Female Sexual Distress Scale - Revised to assess sexual distress, the Unidimensional Relationship Closeness Scale to assess intimacy, and the Multidimensional Scale of Perceived Social Support to assess perceived social support.

    RESULTS: The results showed that social media addiction had direct and indirect (via intimacy and perceived social support) effects on sexual function and sexual distress.

    DISCUSSION AND CONCLUSIONS: The findings of this study facilitate a better understanding of how problematic engaging to social media can affect couples' intimacy, perceived social support, and constructs of sexual function. Consequently, sexual counseling should be considered an essential element for assessing individual behaviors in the context of social media use.

  • 4.
    Ameryoun, Ahmad
    et al.
    Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Qazvin University of Medical Sciences, Qazvin, Iran.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Iran.
    Saffari, Mohsen
    Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
    Yaseri, Mahdi
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    O'Garo, Keisha-Gaye N.
    Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
    Koenig, Harold G.
    Duke University Medical Center, Durham, North Carolina.
    Effectiveness of an In-Service Education Program to Improve Patient Safety Directed at Surgical Residents: A Randomized Controlled Trial2019Ingår i: Journal of Surgical Education, ISSN 1931-7204, E-ISSN 1878-7452, Vol. 76, nr 5, s. 1309-1318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patient safety is a critical issue in healthcare services particularly in surgical units and operation rooms because of the high prevalence and risk of medical errors in such settings. This study was conducted to determine whether a 1-day educational intervention can change the attitude and behavior of surgical residents regarding patient safety.

    Methods: A total of 90 surgical residents were recruited from 6 university hospitals located in Tehran and Qazvin, Iran, and were randomized to either the intervention or a control group. Those in the intervention group participated in a 1-day workshop on patient safety, whereas the control group received no intervention. Both groups were followed for 3 months after the intervention was completed. The Safety Attitude Questionnaire and Oxford Non-Technical Skills scale were administered at 3 points in time (baseline, 1 month after the intervention, and 3 month later). The data were analyzed using repeated measures analysis of variance.

    Results: Total score on the Safety Attitude Questionnaire improved from 54.5 (SD = 14.4) at baseline to 58.3 (SD = 13.8) 3 months after the intervention in the intervention group; all dimensions, with the exception of working condition, showed significant changes. In addition, the Oxford Non-Technical Skills scale – as assessed by attending surgeons – improved significantly in all domains (p < 0.05). More than 60% of participants in the intervention group scored in the positive range for items assessing safety and teamwork climate.

    Conclusions: A 1-day interactive educational workshop may be effective in changing the attitude and practice of surgical residents regarding patient safety. Further assessment of this intervention in other healthcare settings involving health professionals from various specialties and use of an objective measure such as number of reported medical errors are needed to corroborate these findings. 

  • 5.
    Broström, Anders
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Nilsen, P.
    Department of Health and Society, Division of Social Medicine and Public Health Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Fridlund, Bengt
    CICE, Linneus University, Växjö, Sweden.
    Ulander, M.
    Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated2019Ingår i: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 23, nr 3, s. 761-768Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Continuous positive airway treatment (CPAP) is the recommended treatment for patients with obstructive sleep apnea (OSA). Outcome measures often focus on clinical and/or self-rated variables related to the medical condition. However, a brief validated instrument focusing on the whole life situation (i.e., ethos) suitable for clinical practice is missing. The aim of this study was to investigate factorial structure, categorical functioning of the response scale, and differential item functioning across sub-populations of the Ethos Brief Index (EBI) among patients with obstructive sleep apnea (OSA) before and after initiation of continuous positive airway pressure (CPAP).

    Methods: A prospective design, including 193 patients with OSA (68% men, 59.66 years, SD 11.51) from two CPAP clinics, was used. Clinical assessment and overnight respiratory polygraphy were used to diagnose patients. Questionnaires administered before and after 6 months of CPAP treatment included EBI, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and global perceived health (initial item in SF-36). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis models. Measurement invariance, unidimensionality, and differential item functioning across gender groups, Apnea-Hypopnea Index, and ESS groups were assessed.

    Results: The reliability of the EBI was confirmed using composite reliability and Cronbach’s alpha. The results supported unidimensionality of the EBI in confirmatory factor analysis and the Rasch model. No differential item functioning was found. A latent profile analysis yielded two profiles of patients with low (n = 42) and high (n = 151) ethos. Patients in the low ethos group were younger and had higher depression scores, lower perceived health, and higher body mass index.

    Conclusions: The EBI is a valid tool with robust psychometric properties suitable for use among patients with OSA before and after treatment with CPAP is initiated. Future studies should focus on its predictive validity. 

  • 6.
    Broström, Anders
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Nilsen, Per
    Division of Health Care Analysis, Faculty of Health Sciences, Department of Health and Society, Linköping University, Linköping, Sweden.
    Gardner, Benjamin
    Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
    Ulander, Martin
    Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners' beliefs and practices2018Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, nr 6, artikel-id UNSP e12675Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The benefits of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea are well established, but adherence tends to be low. Research exploring CPAP practitioners' beliefs around determinants of CPAP adherence, and the actions they use in clinical practice to promote CPAP adherence is lacking. This study aimed to: (i) develop and validate a questionnaire to assess beliefs and current practices among CPAP practitioners; (ii) explore practitioners' beliefs regarding the main determinants of patient adherence, and the actions practitioners most commonly use to promote CPAP adherence; and (iii) explore the associations between perceived determinants and adherence-promotion actions. One-hundred and forty-two CPAP practitioners in Sweden and Norway, representing 93% of all Swedish and 62% of all Norwegian CPAP centres, were surveyed via a questionnaire exploring potential determinants (18 items) and adherence-promotion actions (20 items). Confirmatory factor analysis and second-order structural equational modelling were used to identify patterns of beliefs, and potential associations with adherence-promotion actions. Patients' knowledge, motivation and attitudes were perceived by practitioners to be the main determinants of CPAP adherence, and educating patients about effects, management and treatment adjustments were the most common practices. Knowledge was shown to predict educational and informational actions (e.g. education about obstructive sleep apnea and CPAP). Educational and informational actions were associated with medical actions (e.g. treatment adjustment), but knowledge, attitude and support had no association with medical actions. These findings indicate that a wide variety of determinants and actions are considered important, though the only relationship observed between beliefs and actions was found for knowledge and educational and informational actions. 

  • 7.
    Broström, Anders
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Nilsen, Per
    Department of Health and Society, Division of Social Medicine and Public Health Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Hedberg, Berith
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Ulander, Martin
    Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Validation of CollaboRATE and SURE - two short questionnaires to measure shared decision making during CPAP initiation2018Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 28, nr 5, artikel-id e12808Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Adherence to continuous positive airway pressure (CPAP) treatment tends to be low. Brief validated instruments focusing on shared decision making have not been used in a CPAP context. The aim was to investigate factorial structure, categorical functioning of the response scale and differential item functioning across sub-populations of the CollaboRATE and Sure questionnaires among patients with obstructive sleep apnea (OSA) before CPAP treatment is initiated. A prospective design, including 193 objectively diagnosed (polygraphy) OSA patients (68% men, 59.7 years, SD 11.5) from two CPAP clinics was used. Data were collected with the following questionnaires; Sure, CollaboRATE, Attitudes to CPAP Inventory, Epworth sleepiness scale, minimal insomnia symptoms scale, and hospital anxiety and depression scale. Objective CPAP use was collected after 6 months; 49% demonstrated decisional conflict on SURE and 51% scored low levels of shared decision making on CollaboRATE. Unidimensionality was found for both CollaboRATE (one factor explaining 57.4%) and SURE (one factor explaining 53.7%), as well as local independence. Differential item functioning showed both to be invariant across both male and female patients. Internal consistency (Cronbach's alpha 0.83) and composite reliability (0.89) were good. Latent class analyses showed that patients with low decisional conflict and high shared decision making were more adherent to CPAP treatment. CollaboRATE and SURE provided good validity and reliability scores to measure shared decision making and decisional conflict in relation to CPAP treatment. The questionnaires can be used by healthcare personnel as a tool to simplify the assessment of shared decision making.

  • 8.
    Broström, Anders
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Ulander, Martin
    Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Nilsen, Per
    Division of Social Medicine and Public Health Science Department of Health and Society Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Development and psychometric evaluation of the Swedish propensity to achieve healthy lifestyle scale in patients with hypertension2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 21-22, s. 4040-4049Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To develop and validate a Swedish questionnaire to measure propensity for behaviour change regarding food habits, physical activity and weight reduction in patients with hypertension.

    Design: Cross-sectional design.

    Methods: A total of 270 consecutive patients with hypertension diagnosed at four primary care centres in Sweden were included. The 6-item Swedish version of the Propensity to Achieve Healthy Lifestyle Scale (PAHLS) was developed to measure propensity for behaviour change regarding food habits, physical activity and weight reduction. The PAHLS (i.e., including three items for preparedness and three items for capacity) was developed by three multiprofessional researchers inspired by the transtheoretical model of behaviour change in collaboration with clinically active nurses. Data were collected by questionnaires on food habits (i.e., the Food Frequency Questionnaire), physical activity (the International Physical Activity Questionnaire), propensity for a healthy lifestyle (the PHLQ), as well as during a clinical examination. Exploratory (EFA) and confirmatory factor analyses (CFA), as well as Rasch analysis, were used.

    Results: Of the 270 patients (50% women), 27% scored low levels of physical activity on the International Physical Activity Questionnaire, and 34% of the patients were obese (body mass index ≥30 kg/m2). The EFA (explaining 54% of the variance) showed unidimensionality for the PAHLS that was supported by both CFA and Rasch analyses. No floor and 1.9% ceiling effects were found. Multiple group CFA (an extension of structural equation modelling) showed that the PAHLS operated equivalently across both male and female patients. Internal consistency (Cronbach's alpha 0.83) and composite reliability (0.89) were good.

    Conclusion: The initial testing of PAHLS provided good validity and reliability scores to measure propensity for behaviour change in patients with hypertension.

    Relevance to Clinical Practice: The PAHLS can be used by nurses as a tool to simplify shared decision-making in relation to behavioural changes. 

  • 9.
    Chen, I-Hua
    et al.
    Chinese Academy of Education Big Data, Qufu Normal University, Shandong, China.
    Strong, Carol
    Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Lin, Yi-Ching
    Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan.
    Tsai, Meng-Che
    Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Leung, Hildie
    Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Time invariance of three ultra-brief internet-related instruments: Smartphone Application-Based Addiction Scale (SABAS), Bergen Social Media Addiction Scale (BSMAS), and the nine-item Internet Gaming Disorder Scale- Short Form (IGDS-SF9) (Study Part B).2019Ingår i: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, artikel-id S0306-4603(18)31357-1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Given the many technological advances over the past two decades, a small minority of young people are at risk of problematic use or becoming addicted to these technologies (including activities on the internet and smartphones). Many brief psychometric scales have been developed to assess those at risk of problematic use or addiction including the six-item Smartphone Application-Based Addiction Scale [SABAS], the six-item Bergen Social Media Addiction Scale [BSMAS], and the nine-item Internet Gaming Disorder Scale-Short Form [IGDS-SF9]). However, to date, the reproducibility of these three scales has only been examined over a short period of time (e.g., two weeks), and it is unclear whether they are time invariant across a longer period (e.g., three months). Given the emergence of internet and smartphone addiction in Chinese population, the present study translated the three instruments into Chinese and recruited 640 university students (304 from Hong Kong [99 males] and 336 from Taiwan [167 males]) to complete the three scales twice (baseline and three months after baseline). Multigroup confirmatory factor analysis (MGCFA) was applied to examine the time invariance. The intraclass correlation coefficient (ICC) was used to assess the relative reliability, and the percentage of smallest real difference (SRD%) was utilized to explore the absolute reliability for the three scales. MGCFA showed that all three scales were time invariant across three months. ICC demonstrated that all the scales were satisfactory in reproducibility (0.82 to 0.94), and SRD% indicated that all the scales had acceptable measurement noise (23.8 to 29.4). In conclusion, the short, valid, reliable, and easy-to-use Chinese SABAS, BSMAS, and IGDS-SF9 show good properties across periods of three months.

  • 10.
    Ericsson, Carin
    et al.
    Cardiology and Speciality Medicine Centre, Region Ostergotland, Linkoping, Sweden .
    Skagerström, Janna
    Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden.
    Schildmeijer, Kristina
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Region Ostergotland, Linkoping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Nilsen, Per
    Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden.
    Can patients contribute to safer care in meetings with healthcare professionals? A cross-sectional survey of patient perceptions and beliefs.2019Ingår i: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 28, nr 8, s. 657-666, artikel-id bmjqs-2018-008524Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To investigate patients' perceptions of their meetings with healthcare professionals and the extent to which they believe they can influence patient safety in these meetings.

    DESIGN: Cross-sectional survey of patients using a study-specific questionnaire. Data were analysed using both parametric and non-parametric statistics.

    SETTING: The study was conducted in primary and secondary care in three county councils in southeast Sweden by means of a survey questionnaire despatched in January 2017.

    PARTICIPANTS: Survey data were collected from 1445 patients, 333 of whom were complainants (patients who had filed a complaint about being harmed in healthcare) and 1112 regular patients (patients recruited from healthcare units).

    MAIN OUTCOME MEASURES: Patients' perceptions of meetings with physicians and nurses, beliefs concerning patients' contributions to safer care and whether the patients had suffered harm in healthcare during the past 10 years.

    RESULTS: Most respondents reported that it was easy to ask physicians and nurses questions (84.9% and 86.6%) and to point out if something felt odd in their care (77.7% and 80.7%). In general, complainants agreed to a higher extent compared with regular patients that patients can contribute to safer care (mean 1.92 and 2.13, p<0.001). Almost one-third (31.2%) of the respondents (both complainants and regular patients) reported that they had suffered harm in healthcare during the past 10 years.

    CONCLUSIONS: Most respondents believed that healthcare professionals can facilitate patient interaction and increase patient safety by encouraging patients to ask questions and take an active part in their care. Further research will need to identify strategies to support such questioning in routine practice and ensure that it achieves its intended goals.

  • 11.
    Eriksson, Kerstin
    et al.
    Högskolan i Jönköping, Hälsohögskolan. Department of Anesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Wikström, Lotta
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Department of Anesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Predictors for Early Physical Recovery for General and Orthopedic Patients after Major Surgery: Structural Equational Model Analyses2019Ingår i: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Attention to factors that may affect patients’ ability to experience enhanced recovery after surgery is essential in planning for postoperative care.

    Aims:

    To create models of predefined pre,- peri-, and postoperative variables in order to analyze their impact on patients’ physical recovery on postoperative days 1 and 2 after major orthopedic and general surgery.

    Design:

    An exploratory design with repeated measures was used, including 479 patients who had undergone orthopedic (289) or general surgery (190) at three hospitals.

    Methods:

    Pain, nausea, and level of physical ability were measured preoperatively and on postoperative days 1 and 2 by using the Numerical Rating Scale and items from the Postoperative Recovery Profile. Structural equation modeling was used to explore the impact of the predefined variables on patients’ physical recovery.

    Results:

    The orthopedic group contained significantly more women and significantly more patients with pain and opioid use. Although the models showed good fit, “traditional” preoperative (pain, nausea, physical abilities, chronic pain, opioid use) and perioperative variables (anesthesia, length of surgery) constituted few (orthopedic) or no (general surgery) predictive properties for physical recovery. Postoperative average pain intensity, average nausea intensity, and physical ability explained physical recovery on day 1, and physical recovery on day 1 predicted physical recovery on day 2.

    Conclusions:

    “Traditional” predictors had little effect on patients’ postoperative physical recovery, while associations with common postoperative symptoms were shown. Further research is needed to explore additional variables affecting early physical recovery and to understand how soon patients are physically ready to return home. 

  • 12. Fitzmauric, C.
    et al.
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    Murray, C. J. L.
    Global Burden of Disease Cancer Collaboration, ,
    Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study2019Ingår i: JAMA Oncology, ISSN 2374-2437, E-ISSN 2374-2445Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.

    Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.

    Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.

    Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs).

    Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. 

  • 13.
    Hamedi-Shahraki, Soudabeh
    et al.
    Zabol Univ Med Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Zabol, Iran and Univ Tehran Med Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Tehran, Iran.
    Eshraghian, Mohammad Reza
    Univ Tehran Med Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Tehran, Iran.
    Yekaninejad, Mir Saeed
    Univ Tehran Med Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Tehran, Iran.
    Amirkhizi, Farshad
    Zabol Univ Med Sci, Sch Publ Hlth, Dept Nutr, Zabol, Iran.
    Rasekhi, Aliakbar
    Tarbiat Modares Univ, Fac Med Sci, Dept Biostat, Tehran, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Qazvin Univ Med Sci, Social Determinants Hlth Res Ctr, Shahid Bahounar, Qazvin, Iran.
    Kumaraswamy Distribution in Analyzing the Health-related Quality of Life and Effective Factors in Elderly Patients with Epilepsy2019Ingår i: Archives of Neuroscience, ISSN 2322-3944, Vol. 6, nr 4, artikel-id UNSP e95476Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Epilepsy, which develops in the elderly, is recognized as a major health burden. Although health-related quality of life (HRQoL) is an essential element in the medical treatment of elderly patients with epilepsy, it is a question whether epilepsy and its treatment effectively influence the quality of life (QoL) in the elderly. Objectives: The current study aimed at evaluating the relationship between demographic and clinical aspects of epilepsy in HRQoL of elderly patients. Since HRQoL scores are bounded, the Kumaraswamy (Kum) regression model was used to analyze the data. Methods: The current study was conducted on 766 elderly patients diagnosed with epilepsy taking at least one antiepileptic drug (AED) selected from six neurologic clinics in Iran. In addition to demographic information, the Liverpool seizure severity scale (LSSS), medication adherence report scale (MARS-5), and quality of life in epilepsy (QoLIE-31) questionnaire were completed for patients. Data were analyzed using multiple linear regression (MLR) and the Kum regression models. Results: Most of the patients included in the study had focal (70.2%) epilepsy. Mean duration of disease was 17.71 +/- 4.56 years and the average number of seizures was 3.4 +/- 3.2 episodes per month. The Kum regression model indicated that seizure frequency (beta = 0.157, P < 0.0001) and LSSS score (beta = -0.003, P = 0.009) were significant and negative predictors of overall QoLEI-31 score; MARS-5 score was a positive predictor of overall QoLEI-31 score (beta = 0.014, P= 0.002). However, disease duration and serum AED level had no significant effects on overall QoLEI-31 score. Conclusions: The findings suggested that increased seizure frequencyand severity were associated with lower QoL and medication adherence was directly associated with HRQoL. The Kum regression could be a suitable alternative to the methods currently used in the analysis of HRQoL data.

  • 14.
    Hamedi-Shahraki, Soudabeh
    et al.
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran.
    Eshraghian, Mohammad-Reza
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran.
    Yekaninejad, Mir-Saeed
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran.
    Rasekhi, Aliakbar
    Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
    Chen, Hui
    School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, Australia.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Health-related quality of life and medication adherence in elderly patients with epilepsy.2019Ingår i: Neurologia i Neurochirurgia Polska, ISSN 0028-3843, E-ISSN 1897-4260, Vol. 53, nr 2, s. 123-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics.

    METHODS: In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up.

    RESULTS: Medication adherence was significantly correlated with both seizure severity (β = -0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test.

    CONCLUSION: This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.

  • 15.
    Huang, Wen-Yi
    et al.
    Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.
    Chen, Shu-Ping
    Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    The Mediation Role of Self-Esteem for Self-Stigma on Quality of Life for People With Schizophrenia: A Retrospectively Longitudinal Study2018Ingår i: Journal of Pacific Rim Psychology, ISSN 1834-4909, Vol. 12, artikel-id e10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia.

    Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale - Short; SQoL, using the WHO questionnaire on the Quality of Life - Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects.

    Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean (SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical (p = .039), psychological (p = .003), and social SQoL (p = .004), but not in environment SQoL (p = .051).

    Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and self-esteem. Also, we should consider individuals' health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.

  • 16.
    Imani, Vida
    et al.
    Department of Pediatrics, Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Jalilolghadr, Shabnam
    Department of Pediatrics, Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Factor structure and psychometric properties of a Persian translation of the Epworth Sleepiness Scale for Children and Adolescents2018Ingår i: Health promotion perspectives, ISSN 2228-6497, Vol. 8, nr 3, s. 200-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Given the high prevalence of excessive daytime disorder (EDS) among children and adolescents, daytime sleepiness should be effectively measured for them to design appropriate intervention program. However, the commonly used instrument Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) has little information in its psychometric properties. This study aimed to apply 2 different test theories to examine the psychometric properties of the Persian ESS-CHAD among a large sample of Iranian adolescents and children.

    Methods: In this methodological study, participants from 8 high schools (n=1371; 700 males), in Qazvin, Iran, completed the ESS-CHAD, a background information sheet, and Insomnia Severity Index (ISI). The ESS-CHAD was translated by using a forward-backward translation method. Two weeks later, the participants completed the ESS-CHAD again. Internal consistency using Cronbach’s alpha, test-retest reliability using intraclass correlation coefficient (ICC), regression analysis testing the correlation between ESS-CHAD and ISI, Confirmatory factor analysis (CFA) with measurement invariance, Rasch analysis with differential item functioning (DIF), and latent class analysis (LCA) were used to examine the psychometric properties of the ESS-CHAD.

    Results: The internal consistency (a=0.79), test-retest reliability (ICC=0.84), regression findings (beta=0.39, P < 0.001), CFA (comparative fit index [ CFI])=0.974, root-mean square error of approximation [ RMSEA]=0.040), supported measurement invariance (.CFI=-0.009 to 0.007,.RMSEA=-0.009 to 0.001), Rasch analysis (infit mean square=0.88 to 1.31, outfit mean square=0.68 to 1.19), and no substantial DIF (DIF contrast=-0.43 to 0.38) all indicated that ESS-CHAD is a reliable and valid instrument. The LCA further classified the sample into 2 distinct classes.

    Conclusion: Persian ESS-CHAD could be used to assess daytime sleepiness for adolescents who are speaking Persian.

  • 17.
    Leung, Hildie
    et al.
    Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Department of Nursing, Qazvin University of Medical Sciences, Qazvin, Iran.
    Strong, Carol
    Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
    Lin, Yi-Ching
    Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan.
    Tsai, Meng-Che
    Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Chen, I-Hua
    Chinese Academy of Education Big Data, Qufu Normal University, Shandong, China.
    Measurement invariance across young adults from Hong Kong and Taiwan among three internet-related addiction scales: Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), and Internet Gaming Disorder Scale-Short Form (IGDS-SF9) (Study Part A).2019Ingår i: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, artikel-id S0306-4603(18)31156-0Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Internet addiction has been found to be prevalent worldwide, including Asian countries, and related to several negative outcomes and other behavioral addictions. The Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), and nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9) have been extensively used to assess internet-related addictions. However, the three aforementioned instruments have rarely been used in Asian countries. The aim of the present study was to investigate whether the BSMAS, SABAS, and IGDS-SF9 were appropriate for use in heterogeneous subsamples from Hong Kong and Taiwan. University students from Hong Kong (n = 306) and Taiwan (n = 336) were recruited via an online survey. Multigroup confirmatory factor analysis (MGCFA) was used to assess measurement invariance of the BSMAS, SABAS, and IGDS-SF9 across the two subcultures. The original unidimensional structures of BSMAS, SABAS and IGDS-SF9 were confirmed through confirmatory factorial analysis in both subcultures. The MGCFA results showed that the unidimensional structures of the BSMAS and IGDS-SF9 were invariant across the two Chinese cultural areas (Hong Kong and Taiwan). However, the measurement invariance of the SABAS was established after some model modifications. In conclusion, the present study found that the Chinese BSMAS, SABAS, and IGDS-SF9 were all adequate instruments to validly assess internet-related addictions among university students. The three brief instruments used for assessing addictions to social media, smartphone applications, and online gaming are valid and psychometrically robust across two Chinese subcultures and can be used by healthcare professionals in these regions.

  • 18.
    Lin, C. -Y
    et al.
    Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Potenza, M. N.
    Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, United States & Connecticut Council on Problem Gambling, Wethersfield, CT, United States & Connecticut Mental Health Center, New Haven, CT, United States.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, S-58185, Sweden.
    Blycker, G. R.
    College of Nursing, University of Rhode Island, Kingston, RI, United States & Hälsosam Therapy, Jamestown, RI, United States.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Mindfulness-based cognitive therapy for sexuality (MBCT-S) improves sexual functioning and intimacy among older women with epilepsy: A multicenter randomized controlled trial2019Ingår i: Seizure, ISSN 1059-1311, E-ISSN 1532-2688, Vol. 73, s. 64-74Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Women with epilepsy (WWE) frequently experience sexual problems, including sexual dysfunction and sexual distress. Therefore, this study aimed to examine the efficacy of a mindfulness-based cognitive therapy for sexuality (MBCT-S) on sexual function and intimacy among older adult WWE in Iran. Methods: A multicenter randomized controlled trial was conducted at 15 neurology clinics in three Iranian cities. WWE together with their partners and healthcare providers were randomly assigned in patient and partner (PP; n = 220), patient, partner, and healthcare provider (PPHP; n = 220), or treatment as usual (TAU; n = 220) group. WWE and their partners in both the PP and PPHP groups received eight weeks of MBCT-S sessions. In the PPHP group, three individual sessions on sexual counseling were added for healthcare providers. Self-assessment scales were used at baseline, one month and six months after completing the intervention. Mixed linear regression models were developed to determine differences among the three groups. Multilevel mediation analyses were conducted to understand the mediating effects of mindfulness, intimacy, patient-physicians relationship and sexual counseling barriers. Results: Improvements in sexual function, sexual distress, and intimacy were found in both the PP and PPHP groups at one-month and six-month follow-ups. The PPHP group compared with the PP group had greater improvement in intimacy at both follow-ups. Regarding sexual function, the PPHP group performed better than the PP group at the six-month follow-up. Conclusions: The MBCT-S appears efficacious in enhancing sexual function and reducing sex-related distress in Iranian older adult WWE. Future studies should examine its efficacy in other populations. 

  • 19.
    Lin, Chung-Yin
    et al.
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Strong, Carol
    Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Scott, Alexander J.
    School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Webb, Thomas L.
    Department of Psychology, University of Sheffield, Sheffield, United Kingdom.
    A cluster randomized controlled trial of a theory-based sleep hygiene intervention for adolescents2018Ingår i: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 41, nr 11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Objectives: To use theory to design and evaluate an intervention to promote sleep hygiene and health among adolescents.

    Methods: The Theory of Planned Behavior (TPB) and the Health Action Process Approach (HAPA) were used to develop an intervention, which was then evaluated in a cluster randomized trial. Participants were high school students (N = 2,841, M age = 15.12, SD = 1.50). Adolescents in the intervention group received four face-to-face sessions providing behavior change techniques targeting the theoretical determinants of sleep hygiene. Adolescents in the control group only received educational material at the end of the study. The primary outcome was sleep hygiene measured at 1 and 6 months postintervention. A number of secondary outcomes were also measured, including beliefs about sleep, self-regulatory processes, and outcomes related to health and wellbeing.

    Results: Sleep hygiene was improved in the intervention group when compared with the control group at both follow-up points (coefficients = 0.16 and 0.19, 95% CIs = 0.12-0.20 and 0.15-0.23 at 1 and 6 months, respectively, for scores on the Adolescent Sleep Hygiene Scale), as were psychosocial and general aspects of health. Mediation analyses suggested that beliefs about sleep hygiene as specified by the TPB, along with self-regulatory processes from HAPA, both mediated the effect of the intervention on outcomes. In turn, the effects of the intervention on sleep hygiene mediated its impact on general health.

    Conclusions: Healthcare practitioners might consider intervention programs based on the TPB and the HAPA to improve sleep among adolescents.

    Clinical Trial Registration: Clinicaltrials.gov (NCT02551913) https://clinicaltrials.gov/ct2/show/NCT02551913.

  • 20.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center (SDH), Qazvin University of Medical Sciences, Qazvin, Iran.
    Psychometric Evaluation of the Persian eHealth Literacy Scale (eHEALS) Among Elder Iranians With Heart Failure2019Ingår i: Evaluation & the Health Professions, ISSN 0163-2787, E-ISSN 1552-3918, artikel-id 163278719827997Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the present study was to examine the psychometric properties of the eHealth Literacy Scale (eHEALS) using classical test theory and modern test theory among elderly Iranian individuals with heart failure (HF). Individuals with objectively verified HF ( n = 388, 234 males, mean age = 68.9 ± 3.4) completed the (i) eHEALS, (ii) Hospital Anxiety and Depression Scale, (iii) Short Form 12, (iv) 9-item European Heart Failure Self-Care Behavior Scale, and (v) 5-item Medication Adherence Report Scale. Two types of analyses were carried out to evaluate the factorial structure of the eHEALS: (i) confirmatory factor analysis (CFA) in classical test theory and (ii) Rasch analysis in modern test theory. A regression model was constructed to examine the associations between eHEALS and other instruments. CFA supported the one-factor structure of the eHEALS with significant factor loadings for all items. Rasch analysis also supported the unidimensionality of the eHEALS with item fit statistics ranging between 0.5 and 1.5. The eHEALS was significantly associated with all the external criteria. The eHEALS is suitable for health-care providers to assess eHealth literacy for individuals with HF.

  • 21.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Nilsen, Per
    Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Linköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Using extended theory of planned behavior to understand aspirin adherence in pregnant women.2018Ingår i: Pregnancy Hypertension, ISSN 2210-7789, E-ISSN 2210-7797, Vol. 12, s. 84-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To use the Theory of Planned Behavior (TPB) combined with action and coping planning plus global relationship with husband to explain the aspirin adherence in a sample of women with high-risk pregnancy.

    METHODS: A total of 535 Iranian women (mean age = 32.29 ± 4.98; year of marriage = 6.89 ± 3.61) completed the study. Each participant filled out several questionnaires on TPB (i.e., a widely applied theory describing how behaviors are influenced by beliefs, attitudes, perceived behavioral control and behavioral intentions), action planning, coping planning and relationship with husband at baseline. Eight weeks later, each participant completed the Five-item Medication Adherence Rating Scale (MARS-5) and underwent the blood test on aspirin serum level to provide the subjective and objective aspirin adherence information, respectively. Structural equation modeling (SEM) was applied to test three proposed models on aspirin adherence.

    RESULTS: The TPB with planning plus relationship with husband was supported (comparative fit index = 0.969; Tucker-Lewis index = 0.950). Behavioral intention was the mediator in the associations of aspirin adherence and the following variables: attitude, perceived behavioral control, and relationship with husband. Action and coping planning mediated the associations of aspirin adherence and the two variables of behavioral intention and perceived behavioral control. Relationship with husband mediated the association of subjective norm and aspirin adherence.

    CONCLUSIONS: The TPB model with (action and coping) planning plus relationship with husband serves a potential mechanism to explain the aspirin adherence for women with high risk of pregnancy. Possible implications are discussed based on our results.

  • 22.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Steinke, Elaine E.
    School of Nursing, Wichita State University, Wichita, KS, USA.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Using extended theory of planned behavior to determine factors associated with help-seeking behavior of sexual problems in women with heart failure: a longitudinal study2019Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, s. 1-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: This study used extended theory of planned behavior (extended TPB) to understand the underlying factors related to help-seeking behavior for sexual problems among Iranian women with heart failure (HF).

    METHODS: We recruited 758 women (mean age = 61.21 ± 8.92) with HF at three university-affiliated heart centers in Iran. Attitude, subjective norms, perceived behavioral control, behavioral intention, self-stigma of seeking help, perceived barriers, frequency of planning, help-seeking behavior, and sexual function were assessed at baseline. Sexual function was assessed again after 18 months. Structural equation modeling was used to explain change in sexual functioning after 18 months.

    RESULTS: Attitude and perceived behavioral control were positively correlated to behavioral intention. Behavioral intention was negatively and self-stigma in seeking help was positively correlated to perceived barriers. Behavioral intention was positively and self-stigma in seeking help was negatively correlated to frequency of planning. Perceived behavioral control, behavior intention, and frequency of planning were positively and self-stigma in seeking help and perceived barriers were negatively correlated to help-seeking behavior. Help-seeking behavior was positive correlated to the change of FSFI latent score.

    CONCLUSIONS: The extended TPB could be used by healthcare professionals to design an appropriate program to treat sexual dysfunction in women with HF.

  • 23.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Burri, Andrea
    School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, Qazvin, Iran.
    Female sexual function mediates the effects of medication adherence on quality of life in people with epilepsy2017Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 67, s. 60-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose The purpose of this study was to understand the mediating effects of female sexual functioning in the association between medication adherence and quality of life (QoL) in Iranian women with epilepsy (WWE).

    Methods Women's sexual functioning was measured using Female Sexual Function Index; QoL using Quality of Life in Epilepsy; epilepsy severity using Liverpool Seizure Severity Scale; subjective medication adherence using Medication Adherence Report Scale; and objective medication adherence using serum level for antiepileptic drugs in 567 WWE. Medication adherence was measured at baseline, while women's sexual functioning, QoL, and epilepsy severity were measured at the 6-month follow-up. Structural equation modeling and regression models were conducted to examine the mediating role of women's sexual functioning.

    Results The mediating effects of sexual functioning in the relationship between medication adherence (including subjective and objective measures) and QoL were supported in the total score of Female Sexual Function Index (coefficient = 0.415, SE = 0.117, p < 0.001 for subjective medication adherence; coefficient = 1.980, SE = 0.446, p < 0.001 for objective medication adherence). Seizure severity was significantly associated with QoL but only when objective medication adherence was measured (coefficient = − 0.094, SE = 0.036, p = 0.009).

    Conclusion Our results extended the importance of medication adherence from symptom reduction to the beneficial effects of women's sexual functioning and QoL. Health care providers should be aware of these additional benefits of medication adherence and use these arguments to encourage female patients to take their medication, which can eventually increase their sexual satisfaction and overall QoL.

  • 24.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Cheng, Andy S. K.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Nejati, Babak
    Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Ulander, Martin
    Department of Clinical and Experimental Medicine, Division of Clinical Neurophysiology, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Browall, Maria
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, United Kingdom.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer2019Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, artikel-id e12891Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia – Athens Insomnia Scale and Insomnia Severity Index – among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n = 573; 326 males; mean age = 61.3 years; SD = 10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the Athens Insomnia Scale, Insomnia Severity Index, Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for Athens Insomnia Scale (factor loadings from confirmatory factor analysis = 0.61–0.87; test–retest reliability = 0.72–0.82; infit mean square = 0.81–1.17; outfit MnSq = 0.79–1.14) and for Insomnia Severity Index (factor loadings from confirmatory factor analysis = 0.61–0.81; test–retest reliability = 0.72–0.82; infit mean square = 0.72–1.14; outfit mean square = 0.76–1.11). Both Athens Insomnia Scale and Insomnia Severity Index had significant associations with Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on Athens Insomnia Scale or Insomnia Severity Index score. With promising results, healthcare providers can use either Athens Insomnia Scale or Insomnia Severity Index to understand the insomnia of patients with advanced cancer. 

  • 25.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Fung, Xavier C. C.
    Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
    Burri, Andrea
    Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran.
    Using the Theory of Planned Behavior incorporated with perceived barriers to explore sexual counseling services delivered by healthcare professionals in individuals suffering from epilepsy2017Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 74, s. 124-129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    People with epilepsy (PWE) are highly likely to suffer from sexual dysfunction, and dealing with this issue is a challenge for healthcare providers. Unfortunately, there is no theory-driven study that has investigated the counseling practice of healthcare providers for sexual problems in PWE. Therefore, we decided to apply the well-established Theory of Planned Behavior (TPB) to examine factors associated with healthcare providers' sexual counseling in PWE. Apart from TPB, perceived barriers toward providing counseling could be a possible factor that needs to be investigated as well. Therefore, two models explaining sexual counseling practice were proposed. Model 1 included only TPB and Model 2 included TPB incorporated with perceived barriers. Five hundred fifty-nine Iranian healthcare professionals responsible for PWE were recruited across several neurology clinics and asked to complete TPB-specific questionnaires. The same healthcare professionals were asked to complete an additional questionnaire on their attitudes toward sexual counseling 18 months later. Structural equation modeling suggested Model 2 to be more useful in explaining sexual counseling practice compared with Model 1. Moreover, attitude and perceived behavioral control showed stronger associations with behavioral intention, whereas subjective norm showed weaker associations. The associations were similar across different healthcare professionals (i.e., medical doctors vs. nurses). In conclusion, TPB incorporated with perceived barriers might be a useful theory for different types of healthcare providers to improve and enhance sexual counseling practice.

  • 26.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong.
    Ganji, Maryam
    Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Iran.
    Griffiths, Mark D.
    International Gaming Research Unit, Nottingham Trent University, UK.
    Ernsth-Bravell, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysioloy, Linköping University Hospital, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Iran.
    Mediated effects of insomnia, psychological distress and medication adherence in the association of eHealth literacy and cardiac events among Iranian older patients with heart failure: a longitudinal study2019Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Given the importance of improving health for patients with heart failure, the present study examined the temporal associations between eHealth literacy, insomnia, psychological distress, medication adherence, quality of life and cardiac events among older patients with heart failure.

    Methods:

    With a longitudinal design older patients with echocardiography verified heart failure (N=468; 50.4% New York Heart Association class II, mean age 69.3±7.3 years; 238 men) in need of cardiac care at seven Iranian university outpatient clinics went through clinical examinations and completed the following questionnaires at baseline: eHealth literacy scale (eHEALS, assessing eHealth literacy); 5-item medication adherence report scale (MARS-5, assessing medication adherence); Minnesota living with heart failure questionnaire (MLHFQ, assessing quality of life); insomnia severity index (ISI, assessing insomnia); and hospital anxiety and depression scale (HADS, assessing psychological distress). All the patients completed the ISI and HADS again 3 months later; and the MARS-5 6 months later. Also, their cardiac events were collected 18 months later. Three mediation models were then conducted.

    Results:

    eHealth literacy had direct and indirect effects (through insomnia and psychological distress) on medication adherence and quality of life. Moreover, eHealth literacy had protecting effects on cardiac events (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.37, 0.65) through the mediators of insomnia (HR 0.19; 95% CI 0.15, 0.26), psychological distress (HR 0.08; 95% CI 0.05, 0.12) and medication adherence (HR 0.05; 95% CI 0.04, 0.08).

    Conclusion:

    As eHealth literacy was a protector for patients with heart failure, healthcare providers may plan effective programmes to improve eHealth literacy for the population. Additional benefits of improving eHealth literacy in heart failure may be decreased insomnia and psychological distress, improved quality of life, as well as decreased cardiovascular events.

  • 27.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ganji, Maryam
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    Pontes, Halley M
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
    Imani, Vida
    Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Psychometric evaluation of the Persian Internet Disorder Scale among adolescents.2018Ingår i: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, nr 3, s. 665-675Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND AIMS: Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.

    METHODS: After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.

    RESULTS: Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR2 = .12 and .36, respectively) is stronger than the DASS (ΔR2 = .03-.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.

    CONCLUSION: The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.

  • 28.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University , Hung Hom, Hong Kong.
    Griffiths, Mark D
    International Gaming Research Unit, Psychology Department, Nottingham Trent University , Nottingham, UK.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences , Qazvin, Iran..
    Psychometric evaluation of Persian Nomophobia Questionnaire: Differential item functioning and measurement invariance across gender.2018Ingår i: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, nr 1, s. 100-108Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims

    Research examining problematic mobile phone use has increased markedly over the past 5 years and has been related to "no mobile phone phobia" (so-called nomophobia). The 20-item Nomophobia Questionnaire (NMP-Q) is the only instrument that assesses nomophobia with an underlying theoretical structure and robust psychometric testing. This study aimed to confirm the construct validity of the Persian NMP-Q using Rasch and confirmatory factor analysis (CFA) models.

    Methods

    After ensuring the linguistic validity, Rasch models were used to examine the unidimensionality of each Persian NMP-Q factor among 3,216 Iranian adolescents and CFAs were used to confirm its four-factor structure. Differential item functioning (DIF) and multigroup CFA were used to examine whether males and females interpreted the NMP-Q similarly, including item content and NMP-Q structure.

    Results

    Each factor was unidimensional according to the Rach findings, and the four-factor structure was supported by CFA. Two items did not quite fit the Rasch models (Item 14: "I would be nervous because I could not know if someone had tried to get a hold of me;" Item 9: "If I could not check my smartphone for a while, I would feel a desire to check it"). No DIF items were found across gender and measurement invariance was supported in multigroup CFA across gender.

    Conclusions

    Due to the satisfactory psychometric properties, it is concluded that the Persian NMP-Q can be used to assess nomophobia among adolescents. Moreover, NMP-Q users may compare its scores between genders in the knowledge that there are no score differences contributed by different understandings of NMP-Q items.

  • 29.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Huus, Karina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Maria
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Hodges, Eric A.
    School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia2019Ingår i: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To examine whether weight-related self-stigma (aka weight bias internalization) and insomnia are potential predictors of psychological distress and quality of life (QoL) among Iranian adolescents with overweight (OW)/obesity (OB). To examine whether weight-related self-stigma and insomnia are potential mediators in the relationship between excess weight and health outcomes of distress and QoL.

    METHODS: All participants (n = 934; 444 males; mean age = 15.7 ± 1.2 years; zBMI = 2.8 ± 1.0) completed questionnaires on weight-related self-stigma and insomnia at baseline. Six months later, they completed questionnaires on psychological distress and QoL to assess health outcomes. Relationships among variables were tested using mediation analyses with bootstrapping method.

    RESULTS: Weight-related self-stigma significantly mediated the effects of zBMI on psychological distress (effect = 0.22; bootstrapping SE = 0.09; 95% CI = 0.08, 0.45), psychosocial QoL (effect = - 0.64; bootstrapping SE = 0.19; 95% CI = - 1.10, - 0.32), and physical QoL (effect = - 1.35; bootstrapping SE = 0.54; 95% CI = - 2.43, - 0.26). Insomnia also significantly mediated the effects of zBMI on psychological distress (effect = 2.18; bootstrapping SE = 0.31; 95% CI = 1.61, 2.81), psychosocial QoL (effect = - 0.89; bootstrapping SE = 0.33; 95% CI = - 1.60, - 0.28), and physical QoL (effect = - 0.83; bootstrapping SE = 0.42; 95% CI = - 1.69, - 0.02). Full mediations were found in psychosocial QoL; partial mediations were found in psychological distress and physical QoL.

    CONCLUSIONS: Weight-related self-stigma and insomnia were significant mediators in the effects of excess weight on health outcomes. Therefore, it is important to identify and treat weight-related self-stigma and insomnia for adolescents with OW/OB.

    LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

  • 30.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Nilsen, Per
    Fung, Xavier C. C.
    Griffiths, Mark D.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center (SDH), Qazvin University of Medical Sciences, Qazvin, Iran.
    Smartphone application-based addiction among Iranian adolescents: A psychometric study2019Ingår i: International Journal of Mental Health and Addiction, ISSN 1557-1874, E-ISSN 1557-1882, Vol. 17, nr 4, s. 765-780Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Smartphone Application-Based Addiction Scale (SABAS) can be used in screening for the risk of smartphone addiction. This study aimed to validate a Persian version of the SABAS using confirmatory factor analysis (CFA), Rasch analysis, and latent class analysis (LCA). In a sample of 3807 Iranian adolescents, CFAs were used to confirm the factor structure of SABAS, Rasch models were used to examine the unidimensionality of SABAS, and LCAs were used to classify the adolescents in terms of application preferences and smartphone application-based addiction. The unidimensional structure of SABAS was supported by CFA and Rasch model. LCA classified the sample into three subgroups (i.e., low, medium, high) in terms of risk of smartphone addiction. This study showed the unidimensionality of the Persian SABAS with robust psychometric properties. It can be used by healthcare providers in screening for risk of addiction to smartphone applications and provide early intervention if necessary. 

  • 31.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents.2019Ingår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 10, artikel-id 149Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The 7-item Gaming Addiction Scale (GAS) is a brief instrument based on DSM criteria to assess gaming addiction. Although the psychometric properties of the GAS have been tested using classical test theory, its psychometric properties have never been tested using modern test theory (e.g., Rasch analysis). The present study used a large adolescent sample in Iran to test the psychometric properties of the Persian GAS through both classical test and modern test theories. Adolescents (n = 4442; mean age = 15.3 years; 50.3% males) were recruited from Qazvin, Iran. In addition to the GAS, all of them completed the following instruments: the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), and a generic quality of life instrument. Two weeks later, all participants completed the GAS again. Confirmatory factor analysis (CFA) and Rasch analysis were used to test the unidimensionality of the GAS. Pearson correlation coefficients were used to test the test-retest reliability, and a regression model was used to test the criterion-related validity of the GAS. Both CFA and Rasch analysis supported the unidimensionality of the GAS. Pearson correlations coefficients showed satisfactory test-retest reliability of the GAS (r = 0.78 to 0.86), and the regression model demonstrated the criterion-related validity of the GAS (β = 0.31 with IGDS-SF9; 0.41 with PSQI). Based on the results, the Persian GAS is a reliable and valid instrument for healthcare providers to assess the level of gaming addiction among Persian-speaking adolescents.

  • 32.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Cheung, Pauline
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Psychometric testing on two weight stigma instruments in Iran: Weight Self-Stigma Questionnaire and Weight Bias Internalized Scale2019Ingår i: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study aimed to comprehensively and thoroughly examine the psychometric properties of two commonly used weight-related self-stigma instruments on Iranian adolescents with overweight or obesity: Weight Self-Stigma Questionnaire [WSSQ] and Weight Bias Internalization Scale [WBIS].

    METHODS: After ensuring the linguistic validity of both the WSSQ and WBIS in their Persian versions, 737 Iranian adolescents with overweight or obesity (male = 354; mean age = 15.8 ± 1.3 years; body mass index = 30.0 ± 4.8 kg/m2) completed both questionnaires and other relevant measures regarding their depression, anxiety, stress, dietary self-efficacy, weight efficacy lifestyle, quality of life, body fat, self-esteem, body shape preoccupation, and sleepiness.

    RESULTS: In the scale level, the confirmatory factory analysis verified the two-factor structure for the WSSQ and the single-factor structure for the WBIS. The factorial structures were further found to be invariant across gender (male vs. female) and across weight status (overweight vs. obesity). Additionally, both the WSSQ and WBIS had promising properties in internal consistency, test-retest reliability, separation reliability, and separation index. In the item level, all items but WBIS item 1 (infit mean square = 1.68; outfit mean square = 1.60) had satisfactory properties in factor loadings, corrected item-total correlation, test-retest reliability, and infit and outfit mean square. Moreover, all the items did not display substantial differential item functioning (DIF) across gender and across weight status.

    CONCLUSION: Both the WSSQ and WBIS were valid instruments to assess the internalization of weight bias for Iranian adolescents with overweight or obesity.

    LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

  • 33.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ku, Li-Jung Elizabeth
    Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Measurement invariance across educational levels and gender in 12-item Zarit Burden Interview (ZBI) on caregivers of people with dementia2017Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 29, nr 11, s. 1841-1848Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:: The Zarit Burden Interview (ZBI) is a commonly used self-report to assess caregiver burden. A 12-item short form of the ZBI has been developed; however, its measurement invariance has not been examined across some different demographics. It is unclear whether different genders and educational levels of a population interpret the ZBI items similarly. Therefore, this study aimed to examine the measurement invariance of the 12-item ZBI across gender and educational levels in a Taiwanese sample.

    Methods:: Caregivers who had a family member with dementia (n = 270) completed the ZBI through telephone interviews. Three confirmatory factor analysis (CFA) models were conducted: Model 1 was the configural model, Model 2 constrained all factor loadings, Model 3 constrained all factor loadings and item intercepts. Multiple group CFAs and the differential item functioning (DIF) contrast under Rasch analyses were used to detect measurement invariance across males (n = 100) and females (n = 170) and across educational levels of junior high schools and below (n = 86) and senior high schools and above (n = 183).

    Results:: The fit index differences between models supported the measurement invariance across gender and across educational levels (∆ comparative fit index (CFI) = −0.010 and 0.003; ∆ root mean square error of approximation (RMSEA) = −0.006 to 0.004). No substantial DIF contrast was found across gender and educational levels (value = −0.36 to 0.29).

    Conclusions:: The ZBI is appropriate for combined use and for comparisons in caregivers across gender and different educational levels in Taiwan. 

  • 34.
    Lin, Chung-Ying
    et al.
    Faculty of Health and Social Sciences, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ou, Huang-Tz
    Department of Pharmacy, National Cheng Kung University, Tainan, Taiwan.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Validation of the 5-Item Medication Adherence Report Scale in Older Stroke Patients in Iran.2018Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, nr 6, s. 536-543Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is a lack of feasible and validated measures to self-assess medication adherence for older patients with stroke. In addition, the potential determinants of medication adherence for older patients with stroke remain unclear.

    OBJECTIVES: The aims of this study were to (1) examine the psychometric properties of a 5-item questionnaire on medication adherence, specifically the 5-item Medication Adherence Report Scale (MARS-5), and (2) explore the determinants of medication adherence.

    METHODS: Stroke patients older than 65 years (N = 523) filled out the MARS-5 and the Hospital Anxiety and Depression Scale. The medication possession rate (MPR) was calculated to measure the objective medication adherence. Several clinical characteristics (stroke types, blood pressure, comorbidity, HbA1c, quantity of prescribed drugs, fasting blood glucose, and total cholesterol) and background information were collected. We used Rasch analysis with a differential item functioning test to examine psychometric properties.

    RESULTS: All 5 items in the MARS-5 fit in the same construct (ie, medication adherence), no differential item functioning items were displayed in the MARS-5 across gender, and the MARS-5 total score was strongly correlated with the MPR (r = 0.7). Multiple regression models showed that the MARS-5 and the MPR shared several similar determinants. In addition, the variance of the MARS-5 (R = 0.567) was more than that of the MPR (R = 0.300).

    CONCLUSIONS: The MARS-5 is a feasible and valid self-assessed medication adherence for older patients with stroke. In addition, several determinants were found to be related to medication adherence for older patients with stroke. Healthcare providers may want to take heed of these determinants to improve medication adherence for this population.

  • 35.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Oveisi, Sonia
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Burri, Andrea
    Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Theory of Planned Behavior including self-stigma and perceived barriers explain help-seeking behavior for sexual problems in Iranian women suffering from epilepsy2017Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 68, s. 123-128Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose To apply the Theory of Planned Behavior (TPB) and the two additional concepts self-stigma and perceived barriers to the help-seeking behavior for sexual problems in women with epilepsy.

    Methods In this 18-month follow-up study, TPB elements, including attitude, subjective norm, perceived behavioral control, and behavioral intention along with self-stigma and perceived barriers in seeking help for sexual problems were assessed in n = 818 women with epilepsy (94.0% aged ≤ 40 years). The basic TPB model (model 1) and the TPB model additionally including self-stigma and perceived barriers (Model 2) were analyzed using structural equation modeling (SEM).

    Results Both SEM models showed satisfactory model fits. According to model, attitude, subjective norms, perceived behavioral control, and intention explained 63.1% of the variance in help-seeking behavior. Variance was slightly higher (64.5%) when including self-stigma and perceived barriers (model 2). In addition, the fit indices of the models were better highlighting the importance of self-stigma and perceived barriers in help-seeking behavior for sexual problems.

    Conclusion Theory of Planned Behavior is useful in explaining help-seeking behavior for sexual problems in women with epilepsy. Self-stigma and perceived barriers are additional factors that should be considered in future interventions aiming to adopt TPB to improve help-seeking behavior for sexual problems. 

  • 36.
    Lin, Chung-Ying
    et al.
    Faculty of Health and Social Sciences, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, Qazvin, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Strömberg, Anna
    Department of Medical and Health Sciences, Linköping University, Sweden.
    Jaarsma, Tiny
    Mary MacKillop Institute of Health Research, ACU, Melbourne, Australia.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Psychometric Properties of the 9-item European Heart Failure Self-care Behavior Scale Using Confirmatory Factor Analysis and Rasch Analysis Among Iranian Patients.2018Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, nr 3, s. 281-288Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The 9-item European Heart Failure Self-Care Behavior scale (EHFScB-9) is a self-reported questionnaire commonly used to capture the self-care behavior of people with heart failure (HF).

    OBJECTIVE: The aim of this study was to investigate the EHFScB-9's factorial structure and categorical functioning of the response scale and differential item functioning (DIF) across subpopulations in Iran.

    METHODS: Patients with HF (n = 380; 60.5% male; mean [SD] age, 61.7 [9.1] years) participated in this study. The median (interquartile range) of the duration of their HF was 6.0 (2.4-8.8) months. Most of the participants were in New York Heart Association classification II (NYHA II, 61.8%); few of them had left ventricular ejection fraction assessment (11.3%). All participants completed the EHFScB-9. Confirmatory factor analysis was used to test the factorial structure of the EHFScB-9; Rasch analysis was used to analyze categorical functioning and DIF items across 2 characteristics (gender and NYHA).

    RESULTS: The 2-factor structure ("adherence to regimen" and "consulting behavior") of the EHFScB-9 was confirmed, and the unidimensionality of each factor was found. Categorical functioning was supported for all items. No items displayed substantial DIF across gender (DIF contrast, -0.25-0.31). Except for item 3 ("Contact doctor or nurse if legs/feet are swollen"; DIF contrast, -0.69), no items displayed substantial DIF across NYHA classes (DIF contrast, -0.40 to 0.47).

    CONCLUSIONS: Despite the DIF displayed in 1 item across the NYHA classes, the EHFScB-9 demonstrated sound psychometric properties in patients with HF.

  • 37.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Saffari, Mohsen
    Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
    Koenig, Harold G.
    Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Effects of religiosity and religious coping on medication adherence and quality of life among people with epilepsy2018Ingår i: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 78, s. 45-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The epidemiologic information demonstrates the importance of caring people with epilepsy (PWE). Indeed, the impaired quality of life (QoL) and medication nonadherence rate among PWE have been reported. However, religiosity and religious coping could be potential factors for clinicians to foster appropriate intervention on epileptic care. This study investigated two models to further understand the relationships between religiosity, religious coping (including positive and negative coping), medication adherence, and QoL in an Iranian sample with epilepsy. Eligible PWE (n = 760) completed the religiosity scale (Duke University Religion Index; DUREL) at baseline; the religious coping scale (Brief Religious Coping Scale; Brief RCOPE) one month later; the medication adherence scale (Medication Adherence Report Scale; MARS-5) two months later; and the QoL scale (Quality of Life in Epilepsy; QOLIE-31) twelve months later. Their antiepileptic drug serum level was measured during the period they completed the MARS. Through structural equation modeling (SEM), we found that religiosity directly correlated with negative religious coping and medication adherence, and indirectly correlated with medication adherence through negative religious coping. Both positive and negative religious coping directly correlated with medication adherence and QoL. Therefore, religiosity and religious coping may be determinants of medication adherence and QoL in PWE; health professionals may consider asking PWE if religion is important to them and how they use it to cope with their epilepsy.

  • 38.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Scheerman, Janneke F.M.
    Department of Health, Sports & Welfare/Cluster Oral Hygiene, Inholland University of Applied Sciences, Amsterdam, The Netherlands.
    Yaseri, Mehdi
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Webb, Thomas L.
    Department of Psychology, The University of Sheffield, Sheffield, UK.
    A cluster randomised controlled trial of an intervention based on the Health Action Process Approach for increasing fruit and vegetable consumption in Iranian adolescents2017Ingår i: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321, Vol. 32, nr 12, s. 1449-1468Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate an intervention programme based on the Health Action Process Approach and designed to increase the intake of fruit and vegetables (F&V) among Iranian adolescents aged 13 to 18.

    DESIGN: A randomised controlled trial with three arms examined the short- (1 month) and long-term (6 months) effects of the intervention. There were two intervention groups (one included adolescents only [A group; n = 510]; the second included mothers and adolescents [M + A group; n = 462]) and a control group (n = 483). All participants were recruited from schools.

    MAIN OUTCOME MEASURES: Social cognitions, self-regulatory processes and F&V intake.

    RESULTS: The intervention led to an increase in F&V intake for adolescents in the short and long terms. Adolescents in the M + A group increased their F& V intake more than adolescents in the A group. Outcome expectancies, self-monitoring, intentions, action and coping planning, perceived social support and behavioural automaticity mediated the effect of the intervention on F&V intake.

    CONCLUSION: The theory-based intervention led to an increase in F&V intake and promoted more positive social cognitions and self-regulatory processes among Iranian adolescents. The findings also provide evidence that involving mothers in an intervention can confer additional benefit.

  • 39.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Strong, Carol
    Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Siu, Andrew M. H.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Jalilolghadr, Shabnam
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Nilsen, Per
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Validating the Persian Adolescent Sleep Hygiene Scale-Revised (ASHSr) using comprehensive psychometric testing methods2018Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 50, s. 63-71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: This study translated the Adolescent Sleep Hygiene Scale-revised (ASHSr) into Persian and aimed to validate its psychometric properties using classical test theory and Rasch analyses.

    Methods: Adolescents aged 14–18 (n = 389; 199 males) and their parents in Iran participated in the study. Each adolescent wore a wrist actigraphy device during sleep time and completed the ASHSr, the Depression Anxiety Stress Scale (DASS), the General Health Questionnaire (GHQ), the Pediatric Daytime Sleepiness Scale (PDSS), and the Pittsburgh Sleep Quality Index (PSQI). A parent of each adolescent completed the Sleep Disturbance Scale for Children (SDSC).

    Results: The construct validity of the ASHSr was supported by both classical test theory (factor loadings from confirmatory factor analysis [CFA] = 0.64 to 0.88; corrected item-total correlations = 0.70 to 0.92; test-retest reliability = 0.72 to 0.90) and Rasch analyses (infit mean square = 0.73 to 1.30; outfit mean square = 0.74 to 1.32). ASHSr had significantly negative associations with DASS subscales (β = −0.15 to −0.42, ps < 0.001) and GHQ (β = −0.663, p < 0.001). Known-group validity was demonstrated by the significant differences between poor and good sleep hygiene based on ASHSr in the actigraphy measure and scores of PDSS, PSQI, and SDSC. The multigroup CFA and differential item functioning in Rasch analyses suggested that all the participants interpreted the ASHSr similarly, regardless of their gender or living in a private room.

    Conclusions: The Persian ASHSr demonstrated good reliability and validity in assessing sleep hygiene among Iranian adolescents. Healthcare providers may use it to assess the effectiveness of sleep hygiene programs.

  • 40.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Yaseri, Mehdi
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Malm, Dan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Burri, Andrea
    Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
    Webb, Thomas L.
    Department of Psychology, The University of Sheffield, Sheffield, United Kingdom.
    Can a multifaceted intervention including motivational interviewing improve medication adherence, quality of life, and mortality rates in older patients undergoing coronary artery bypass surgery? A multicenter, randomized controlled trial with 18-month follow-up2017Ingår i: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 34, nr 2, s. 143-156Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients undergoing coronary artery bypass graft (CABG) surgery are required to take a complex regimen of medications for extended periods, and they may have negative outcomes because they struggle to adhere to this regimen. Designing effective interventions to promote medication adherence in this patient group is therefore important.

    Objective: The present study aimed to evaluate the long-term effects of a multifaceted intervention (psycho-education, motivational interviewing, and short message services) on medication adherence, quality of life (QoL), and mortality rates in older patients undergoing CABG surgery.

    Methods: Patients aged over 65 years from 12 centers were assigned to the intervention (EXP; n = 144) or treatment-as-usual (TAU; n = 144) groups using cluster randomization at center level. Medication adherence was evaluated using the Medication Adherence Rating Scale (MARS), pharmacy refill rate, and lipid profile; QoL was evaluated using Short Form-36. Data were collected at baseline; 3, 6, and 18 months after intervention. Survival status was followed up at 18 months. Multi-level regressions and survival analyses for hazard ratio (HR) were used for analyses.

    Results: Compared with patients who received TAU, the MARS, pharmacy refill rate, and lipid profile of patients in the EXP group improved 6 months after surgery (p < 0.01) and remained so 18 months after surgery (p < 0.01). QoL also increased among patients in the EXP group as compared with those who received TAU at 18 months post-surgery (physical component summary score p = 0.02; mental component summary score p = 0.04). HR in the EXP group compared with the TAU group was 0.38 (p = 0.04).

    Conclusion: The findings suggest that a multifaceted intervention can improve medication adherence in older patients undergoing CABG surgery, with these improvements being maintained after 18 months. QoL and survival rates increased as a function of better medication adherence. ClinicalTrials.gov NCT02109523.

  • 41.
    Malm, Dan
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Ekblad, Helena
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Karlström, Patric
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Hag, Emma
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients2018Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, nr 7, s. 589-597Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients, up to 12 months post atrial fibrillation.

    Methods: A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 104 persons were randomly assigned to either a CBT (n=56) or a treatment as usual (TAU) group (n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire; EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale; HADS) and sense of coherence (sense of coherence scale; SOC-13).

    Results: At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence (z=2.07, P=0.04).

    Conclusions: A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients. 

  • 42.
    Malm, Dan
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ekblad, Helena
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Impact of a cognitive behavioral intervention on quality of life and psychological distress in patients with atrial fibrillation: the importance of relatives2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S49-S50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although there is an evidence to support the efficacy of cognitive behavioral therapy (CBT) in improving quality of life and decreasing psychological distress in patients with cardiovascular diseases but involving patient’s and relatives in the CBT and its effect on patient’s general health, has not been evaluated.

    Aim: The aim was to determine whether involving the relatives in CBT for patients with Atrial Fibrillation (AF) enhances treatment outcomes relative to treatment as usual group (TAU).

    Method: In a randomized controlled trial, 78 patients diagnosed with AF were randomly assigned to experimental (EXP) or TAU groups. In the EXP group, patients and relative participated in a 6-week program while the patient in the TAU group received standard care. Short Form 36(SF-36), Hospital Anxiety and Depression Scale (HADS),Euro-QoL 5-Dimension Self-Report Questionnaire (EQ-5D) and Sense of Coherence (SOC-13) were completed at  baseline and at 12-month follow-up. 

    Results: In all 78 patients completed the assessment at 12 months. The two groups were similar for sociodemographic and clinical variables at baseline. The EXP group reported significantly higher scores in EQ-5D (F= 6.18, p = 0.01) and SOC (F= 4.15, p = 0.04) than TAU group. Compared with TAU group, patients in EXP group reported significantly lower depression (F= 4.58, p = 0.04). Thirteen percent of Indirect effect of the intervention on improving patient’s quality of life in the EXP group was related to the SOC improvement (z = 11.83, p < .01).

    Conclusions: This study provides evidence that patients and their relatives’ involvement is more effective in improving quality of life and decreasing psychological distress than those who receiving standard care. Our results also indicate that interventions should initially focus on increasing patient’s sense of coherence.

  • 43.
    Miri, Seyedeh Fatemeh
    et al.
    Qazvin University of Medical Sciences, Qazvin, Iran.
    Javadi, Maryam
    Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Griffiths, Mark D.
    Nottingham Trent University, Nottingham, United Kingdom.
    Björk, Maria
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial2019Ingår i: Diabetes & Metabolic syndrome: clinical Research & Reviews, ISSN 1871-4021, E-ISSN 1878-0334, Vol. 13, nr 3, s. 2190-2197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To assess the effectiveness of a cognitive-behavioral treatment (CBT) program on weight reduction among Iranian adolescents who are overweight. Methods: Using a randomized controlled trial design, 55 adolescents who were overweight (mean [SD] age = 14.64 [1.69] years; zBMI = 2.18 [0.65]) were recruited in the CBT program and 55 in the treatment as usual (TAU; mean age = 14.88 [1.50]; zBMI = 2.09 [0.57]) group. All the participants completed several questionnaires (Child Dietary Self-Efficacy Scale; Weight Efficacy Lifestyle questionnaire; Physical Exercise Self-Efficacy Scale; Pediatric Quality of Life Inventory; and self-reported physical activity and diet) and had their anthropometrics measured (height, weight, waist and hip circumferences, and body fat). Results: The CBT group consumed significantly more fruits and juice, vegetables, and dairy in the 6-month follow-up as compared with the TAU group (p-values <0.001). The CBT group consumed significantly less sweet snacks, salty snacks, sweet drinks, sausages/processed meat, and oils in the six-month follow-up compared with the TAU group (p-values<0.001). Additionally, the waist circumference, BMI, waist-hip ratio, and fat mass were significantly decreased in the CBT group in the six-month follow-up compared with the TAU group (p-values<0.005). The CBT group significantly improved their psychosocial health, physical activity, and health-related quality of life (p-values<0.001). Conclusion: The CBT program showed its effectiveness in reducing weight among Iranian adolescents who were overweight. Healthcare providers may want to adopt this program to treat excess weight problems among adolescents. 

    Publikationen är tillgänglig i fulltext från 2020-05-22 00:00
  • 44.
    Namjoo, Shamsedin
    et al.
    University of Social Welfare and Rehabilitation Sciences, Iran.
    Allahverdipour, Hamid
    Research Center of Psychiatry and Behavioral Sciences & Department of Health Education and Promotion, Tabriz University of Medical Sciences, Iran.
    Shaghaghi, Abdolreza
    Department of Health Education and Promotion, Tabriz University of Medical Sciences, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Psychometric properties of Jacelon's Attributed Dignity Scale with Iranian older people2019Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, artikel-id 969733019845125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The main purpose of this study was the psychometric assessment of Jacelon's Attributed Dignity Scale among Iranian older population.

    METHODS: Using a standard "forward-backward" translation procedure, the original English version of Jacelon's Attributed Dignity Scale was translated into Persian. Internal consistency of the scale was checked by the Cronbach's α coefficient. Convergent validity of the instrument was appraised by the Social Skills Scale and General Health Questionnaire. Factor structure of the Iranian version of Jacelon's Attributed Dignity Scale and possible interplay between its subscales were checked through recruiting a convenient sample of 300 Iranian older people and performing the confirmatory factor analysis.

    FINDINGS: The estimated Cronbach's α and intraclass correlation coefficients for the Iranian version of Jacelon's Attributed Dignity Scale were in the vicinity of acceptable range, that is, 0.87 and 0.93, respectively. The output of confirmatory factor analysis revealed that a four-factor model best fitted the study data (χ2 = 323.49; df = 129; p < 0.001; comparative fit index = 0.913; Tucker-Lewis index = 0.901; root mean square error approximation = 0.074; standardized root mean square residual = 0.078). Rasch estimates of item difficulty ranged from -1.28 (less difficult) to 1.33 (more difficult). No significant cross-gender differences were observed regarding the Iranian version of Jacelon's Attributed Dignity Scale's items indicating its invariant psychometric properties for use in the Iranian men and women subgroups.

    ETHICAL CONSIDERTAION: This study was approved by the Ethics Committee at the Tabriz university of medical science. Informed consent, information confidentiality, and voluntary participation were guaranteed.

    CONCLUSION: The study findings were indicative of applicability of the Iranian version of Jacelon's Attributed Dignity Scale as a reliable tool in measurement of the perceived social dignity among Iranian and probably other Persian-speaking older populations.

  • 45.
    Nejati, Babak
    et al.
    Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Lin, Chien-Chin
    Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
    Aaronson, Neil K.
    Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
    Cheng, Andy S. K.
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Browall, Maria
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma2019Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, nr 7, s. 1490-1497Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To identify determinants of shared decision making in patients with multiple myeloma (MM) to facilitate the design of a program to maximize the effects of shared decision making.

    METHODS: This prospective longitudinal study recruited 276 adult patients (52% male, mean age 62.86 y, SD 15.45). Each patient completed the eHealth Literacy Scale (eHEALS), Multidimensional Trust in Health Care Systems Scale (MTHCSS), Patient Communication Pattern Scale (PCPS), and 9-Item Shared Decision-Making Questionnaire (SDM-Q-9) at baseline and the SDM-Q-9 again 6 months later. One family member of the patient completed the Family Decision-Making Self-Efficacy (FDMSE) at baseline. Structural equation modeling (SEM) was used to investigate the associations between eHealth literacy (eHEALS), trust in the health care system (MTHCSS), self-efficacy in family decision making (FDMSE), patient communication pattern (PCPS), and shared decision making (SDM-Q-9).

    RESULTS: SEM showed satisfactory fit (comparative fit index = 0.988) and significant correlations between the following: eHealth literacy and trust in the health care system (β = 0.723, P < 0.001); eHealth literacy and patient communication pattern (β = 0.242, P < 0.001); trust in the health care system and patient communication pattern (β = 0.397, P < 0.001); self-efficacy in family decision making and patient communication pattern (β = 0.264, P < 0.001); eHealth literacy and shared decision making (β = 0.267, P < 0.001); and patient communication pattern and shared decision making (β = 0.349, P < 0.001).

    CONCLUSIONS: Patient communication and eHealth literacy were found to be important determinants of shared decision making. These factors should be taken into consideration when developing strategies to enhance the level of shared decision making.

  • 46.
    Nejati, Babak
    et al.
    Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Lin, Chien-Chin
    Department of Laboratory Medicine and Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences Tabriz, Iran.
    Browall, Maria
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Validating patient and physician versions of the shared decision making questionnaire in oncology setting2019Ingår i: Health Promotion Perspectives, ISSN 2228-6497, Vol. 9, nr 2, s. 105-114Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: This study investigated the psychometric properties of the 9-Item Shared Decision Making Questionnaire (SDM-Q-9) and the 9-Item Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) using comprehensive and thorough psychometric methods in an oncology setting.

    Methods: Cancer survivors (n=1783; 928 [52.05%] males) and physicians (n=154; 121[78.58%] males) participated in this study. Each cancer survivor completed the SDM-Q-9. Physicians completed the SDM-Q-Doc for each of their cancer patient. Confirmatory factor analysis (CFA) and Rasch model were used to test the psychometric properties of SDM-Q-9 and SDM-Q-Doc.

    Results: SDM-Q-9 and SDM-Q-Doc demonstrated unidimensional structure in CFA and Rasch model. In addition, the measurement invariance was supported for both SDM-Q-9 and SDM-Q-Doc across sex using the multigroup CFA. Rash analysis indicates no differential item functioning (DIF) across sex for all the SDM-Q-9 and SDM-Q-Doc items. SDM-Q-9 and SDM-Q-Doc were moderately correlated (r=0.41; P<0.001).

    Conclusion: SDM-Q-9 and SDM-Q-Doc are valid instruments to assess shared decision making in the oncology setting.

  • 47.
    Pakpour, Amir H.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Qazvin University of Medical Sciences, Qazvin, Iran.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Malm, Dan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Saffari, M.
    Baqiyatallah Medical Sciences University, Tehran, Iran.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Prospective case-control study of sexual dysfunction in female patients with Takotsubo cardiomyopathy2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S85-S86Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Regarding the lack of earlier studies on sexual function in female patients with Takotsubo cardiomyopathy (TSCM), the current study aimed at an investigation of psychological and quality of life measures associated with sexual function in female patients with TSCM.

    Methods: In this Prospective case-control study, female patients with TSCM from university hospitals in Tehran and Qazvin were enrolled and matched (1:1.1) with acute myocardial infarction (AMI) along with healthy controls (94 patients per group). Data on hospital anxiety and depression scale, SF-12, female sexual function index and female sexual distress scale were assessed at baseline, 6 months and 18 months. Multilevel logistic regressions ought associations between variables.

    Results: Sexual function, anxiety and depression at baseline were different among the groups with worse situations in female patients with TSCM (p < 0.01). Quality of life at baseline was similar among patient groups but at lower state than healthy controls. Overall, quality of life subscales especially among female patients with TSCM showed a downward trend, indicating deterioration overtime. Higher prevalence of sexual dysfunction in TSCM group was seen compared to female patients with AMI and control group over time (OR, 3.10 and 2.28 respectively). Sexual functioning was found to be a mediator between anxiety and quality of life which positively impacts on patient’s quality of life.

    Conclusions: Since the psychological and quality of life measures as well as sexual function indicated a descending trend across time, there is a necessity to intervene for these women by focus on problems like anxiety to control health deterioration.

  • 48.
    Pakpour, Amir H.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Iran.
    Chen, Chao-Ying
    Department of Rehabilitations Sciences, The Hong Kong Polytechnic University, Hong Kong.
    Lin, Chung-Ying
    Department of Rehabilitations Sciences, The Hong Kong Polytechnic University, Hong Kong.
    Strong, Carol
    Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan.
    Tsai, Meng-Che
    Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan.
    Lin, Yi-Ching
    Department of Early Childhood and Family Education, National Taipei University of Education, Taiwan.
    The relationship between children's overweight and quality of life: A comparison of Sizing Me Up, PedsQL and Kid-KINDL2019Ingår i: International Journal of Clinical and Health Psychology, ISSN 1697-2600, E-ISSN 2174-0852, Vol. 19, nr 1, s. 49-56Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Objective: Overweight and obese children are likely to encounter negative impact on psychological well-being and quality of life (QoL). Hence, for overweight and obese children, measuring QoL could go beyond simply assessing objective medical parameters and cover their physical health, psychological well-being, and social interaction. Generic (Kid-KINDL and Pediatric Quality of Life Inventory [PedsQL]) and weight-related (Sizing Me Up) measures are two major types of QoL measurement instruments; however, little is known about the differences between them.

    Method: We recruited 569 3rd to 6th graders from eleven schools in Southern Taiwan. In addition to the three QoL questionnaires, the Child Depression Inventory and Rosenberg Self-Esteem Scale were applied.

    Results: Depression had significantly negative associations with all three QoL questionnaires. Self-esteem was only associated with Kid-KINDL. Body mass index had a significantly stronger relationship with Sizing Me Up than its relationships with PedsQL and Kid-KINDL. In other words, the items related to body size concerns in Size Me Up significantly contributed to impaired overweight/obese children's QoL.

    Conclusions: The study further identified the characters and strength of these QoL measures for better suggestions on evaluating physical and psychological issues for overweight/obese children. 

  • 49.
    Pakpour, Amir H.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Kumar, Santhosh
    Griffith Health Institute, School of Dentistry and Oral Health, Gold Coast, QLD, Australia.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Jansson, Henrik
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.2018Ingår i: Journal of Investigative and Clinical Dentistry, ISSN 2041-1618, E-ISSN 2041-1626, Vol. 9, nr 1, artikel-id e12264Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: In the present study, we evaluated the direct and mediating (indirect) effects of clinical oral conditions, dental anxiety, sense of coherence (SOC), and socioeconomic variables on oral health-related quality of life (OHRQoL) and general health-related quality of life (GHRQoL) in Iranian adolescents.

    METHODS: A longitudinal design was used with a sample of 1052 (694 males, mean age=15.05 years) schoolchildren from Qazvin, Iran. Each participant completed a background information sheet and the following scales at baseline: Modified Dental Anxiety Scale, SOC, PedsQL 4.0 Generic Core Scale, and PedsQL Oral Health Scale. The PedsQL 4.0 Generic Core and Oral Health scales were recompleted at the 18-mo follow up.

    RESULTS: Father's education, monthly family income, dental anxiety, Community Periodontal Index (CPI), decayed, missing, and filled teeth (DMFT), and SOC significantly and directly predicted OHRQoL at 18 mo. Father's education had indirect effects on OHRQoL through CPI and DMFT, family income had indirect effects through DMFT, and dental anxiety had indirect effects through CPI. OHRQoL at 18 mo (β=0.499) and SOC (β=0.084) had significant and direct and mediating effects through OHRQoL on GHRQoL, while father's education, monthly family income, dental anxiety, CPI, and DMFT only showed mediating effects.

    CONCLUSIONS: Clinical oral indicators had direct effects on OHRQoL, but mediated the effects of dental anxiety and socioeconomic status on both OHRQoL and GHRQoL.

  • 50.
    Pakpour, Amir H.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Tsai, Mengche
    National Cheng Kung University Hospital, Tainan, Taiwan.
    Lin, Yi Ching
    National Taipei University of Education, Taipei, Taiwan.
    Strong, Carol
    National Cheng Kung University, Tainan, Taiwan.
    Latner, Janet D.
    University of Hawaii at Manoa, Honolulu, United States.
    Fung, Xavier C.C.
    Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Lin, Chung-Ying
    Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Tsang, Hector W.H.
    Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Psychometric properties and measurement invariance of the Weight Self-Stigma Questionnaire and Weight Bias Internalization Scale in children and adolescents2019Ingår i: International Journal of Clinical and Health Psychology, ISSN 1697-2600, E-ISSN 2174-0852, Vol. 19, nr 2, s. 150-159Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Objective: Given the negative consequences of weight bias, including internalized weight stigma, on health outcomes, two instruments—the Weight Self-Stigma Questionnaire (WSSQ) and Weight Bias Internalization Scale (WBIS)—have been developed. However, their psychometric properties are yet to be tested for Asian pediatric populations.

    Method: Participants aged 8 to 12 years (N = 287; 153 boys) completed the WSSQ and the WBIS, and they were classified into either a group with overweight or a group without overweight based on self-reported weight and height.

    Results: Both WSSQ and WBIS had their factor structures supported by confirmatory factor analyses (CFAs). The measurement invariance of two-factor structure was further supported for WSSQ across gender and weight status. The measurement invariance of single-factor structure was supported for WBIS across gender but not across weight status.

    Conclusions: WSSQ and WBIS were both valid to assess the internalization of weight bias. However, the two instruments demonstrated different properties and should be applied in different situations. 

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