Background:Estimating pain in patients of intensive care unit (ICU) is essential, but because of their special situation, verbal scales cannot be used. Therefore, to estimate the level of pain, behavioral pain scale was developed by Payen in 2001.Objectives:The aim of this study was to investigate the validity and reliability of behavioral pain scale in patients with low level of consciousness due to head trauma hospitalized in ICU.Patients and Methods:This descriptive prospective study was performed in Yazd in 2013. In this study, fifty patients, including thirteen women and thirty seven men, were involved. To collect the data a questionnaire including demographic and Glasgow coma scale (GCS) information as well as a list of behavioral pain scale (BPS) were used. SPSS software (version 18) was used to analyze the data.Results:There was no significant difference in reliability proving of average score of BPS recorded by two day and night assessors (P > 5). Cronbach’s alpha was 85 for painful procedures and 76 for non-painful procedures. In addition, known groups’ technique (painful and non-painful procedures) was used to assess validity. The average scores were 7.75 during painful procedures and 3.28 during non-painful procedures (P = 0.001). The results stated that BPS scores during these two procedures were significantly different.Conclusions:BPS in patients with low level of consciousness due to head trauma has strong reliability and validity. Therefore, this scale can be used for patients hospitalized in ICU to assess the level of pain.

Background: Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. Methods: A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). Results: One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." Conclusion: Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women’s awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.

BackgroundMarital conflicts and divorce are among the most crucial problems of society. Therefore, it is important to maintain family stability at the optimal level in order to prevent divorce and its consequences in the family and community.ObjectiveThis study was conducted to design and validate the Family Stability Questionnaire (FSQ) in married couples.MethodsThis study was the second stage of a large study. The FSQ was constructed based on a qualitative research in our previous study in 2016. It was developed through interviews by family therapists, psychiatrists, and couples on 10 dimensions (areas) and was based on McMaster’s Family Assessment Device (FAD). Then, in the present study, a confirmatory factor analysis was conducted on 270 males and females (135 couples) of Yazd City (Iran) from January to May 2017. The construct validity and reliability of the scales were examined using exploratory and confirmatory factor analyses (EFA and CFA) and Cronbach’s alpha coefficient, respectively. Test-retest reliability was assessed with intra-class correlation coefficients (ICC) for the agreement between the individual items and domains. SPSS 21 and AMOS 21 were used for statistical analyses (p≤0.05).ResultsAt first, the results of the CFA on 70 items of FSQ could not confirm (RMSEA=0.06, CFI=0.91, GFI=0.72), but FSQ with 56 questions indicated that it had sufficiently high validity and reliability to measure family stability (RMSEA=0.04, CFI=0.95, GFI=0.96) with an acceptable fit index. A positive significant correlation was observed between the FSQ and FAD (r=0.45, p<0.001) indicating that FSQ has convergent validity. The Cronbach’s alpha and ICC of more than 0.7 in 10 domains of this tool indicated a good internal consistency among the items and their high relevance (0.90 and 0.84, respectively).ConclusionFSQ, as a multi-dimensional questionnaire, is a useful and reliable instrument to assess family stability. It consists of ten factors, which were constructed for the first time in Iran. Given the proper features, this instrument can be utilized to carry out more research regarding family stability in Iranian populations.

Background:The presence of pain and anxiety in a patient affects the results and, therefore, the process of healing, as well as the postoperative complications. Therefore, this study was performed to gauge the effect of individual education-supported needs assessment on anxiety among elderly patients who were candidates for open-heart surgery .Method: This quasi-experimental study was carried out in Iran in 2019. Sixty-one patients, who were candidates for open-heart surgery and aged 60 years or older, were divided into two groups: experiment and control. The patients within the control group received routine care, and therefore, the patients with the intervention received educationsupported needs assessment in addition to routine care. The State-Trait Anxiety Inventory was used to assess the patients' anxiety levels. All analysis was performed in SPSS v19 with a significance level of 0.05 . Results:The demographic variables were similar in both groups (p<0.05). The mean scores of both the state and the trait anxiety among the patients in the intervention group decreased significantly after the intervention (p<0.05). The mean scores of both the state and the trait anxiety among the patients in the control group were similar before and after the intervention (p>0.05). Conclusion:Individual education based on needs assessment among elderly patients is an effective strategy for reducing their anxiety before open-heart surgery.