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Total fertility rate relates to the number of children that a woman bears in the fertility period of her life. Fertility function is one of the most important health and population indicators. This indicator affects social, health, economic and cultural factors. This study is an ecological or correlative one. Factors affecting total fertility rate in Iran in the year 2000 are studied in this paper. The factors include coverage of women with focus on higher education, infant mortality rate (under 1 year), women’s occupation rate, urbanity ratio, mean age in the first marriage of women in the age group 15 to 49 years as per the last census in Iran in 2000 in 26 provinces. The direct and indirect effects of these factors on total fertility rate, with emphasis on path analysis have been determined. Data analysis shows that women's occupation rate is the most important factor in decreasing total fertility rate. Higher education of women is also an important element in this regard. Therefore increase in the number of women with university education not only decreases the total fertility but also increases the occupation of women.

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Introduction: Education of patients and helping them to be independent in process of self-care in both health and disease is one of the basic responsibilities of nurses.

Methods and Materials: This descriptive-analytic research was done to study perceptions of 317 nurses working in hospitals of Tehran University of Medical Sciences of factors affecting the process of patient education. Data was gathered by means of a questionnaire containing 30 questions about facilitating factors and 17 about inhibiting factors. We used Likert score to measure questions. Data analysis performed by SPSS software. Statistical test were Chi square, t test, variance analysis and correlation of variance.

Results: The highest percentage of nurses (52.1%) believed that enough attention is not being paid to facilitating factors such as considering patient education as priority in patient care, nurses being responsible for patient education, considering patient education as a criteria in nurses annual evaluation, importance of patient education for nurse administrators, having in-service education about patient teaching and having proper time, place and personnel for patient education. Majority of nurses (57.4%) believed factors such as shortage of nurses, lack of proper place, time and patient motivation for receiving education, nurses and nurse administrators’ inattention to patient education and negative attitude of doctors toward patient education by nurses are inhibiting factors in process of education. Statistical tests showed a meaningful relation between demographic variables such as sex, clinical background, shift work and position and facilitating factors. There was also a meaningful relation between variables like working in more than one shift, having clinical experience of patient education and being evaluated for patient education during study of nursing and inhibiting factors.      

Conclusion: This study shows low level of facilitating factors for patient education in hospitals of Tehran University of Medical Science. To improve patient education in these hospitals it is necessary to improve facilitating factors.

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Background & Aim: Improving the quality of life is generally one of the main goals in caring of the patients with congestive heart failure, so identifying factors affecting it is significantly important. This study was conducted to determining the quality of life of these patients.

Methods & Materials: 184 of patients congestive heart failure who referred to clinics of Tehran University of Medical Sciences were chosen by goal-based sampling method. Data collection was done by questionnaire, which was consisted of 4 parts: individual factors, factors related to disease, patient knowledge and quality of life. Data analysis was done by SPSS computerized software.

Results: Most of the researching samples in fallowing dimensions had undesirable quality of life: physical activity dimension (44.6%), Psychological dimension (47.3%), Economical/Social dimension (49.5%), total Quality of life (46.7%) and had fairly desirable quality of life in general health dimension (42.4%). There is a significant statistical relationship between quality of life and these variables: job, Education level, care giver, the intensity of illness, duration of illness period, number of refers to physician and hospitalization, duration of combination of hypertension with CHF, presence of edema, high cholesterol, characteristics of disease, the intensity of fatigue at the time of research and in last 1 month ago (p=0.000) and the kinds of using drugs (p=0.039), but there is not a significant statistical relationship between quality of life and these variable: age, gender, Marriage status, Number of people living together, Having therapeutic insurance, Smoking, Body Mass Index: BMI presence of Myocardial Infarction or other diseases and patient knowledge.

Conclusion: Congestive heart failure has a negative affect on quality of life. So assessing the quality of life and promoting it is viewed as one of the duties of nurses and also as one of the major caring goals.

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Background & Aim: Patient education, one of the most important nurses responsibilities, depend on their motivation therefore, this study was performed and the purpose of the study was for determining the nurses motivating factors related to the patients education .

Methods & Materials: A descriptive cross sectional research was carried out among the nurses in the hospitals affiliated to Tehran University of medical science. Sample population was 214 nurses selected by stratified & cluster sampling. Data was collected by questioner through self reporting. The data were analyzed by SPSS computer software. Descriptive statistic and 2 Test, Fisher Exact Test, Exact Test Mont Carlo were used.

Results: Data of motivating factors categorized in 3 levels, high, moderate, low with Lickrate scale showed that in nurses’ opinion salary and payment (48%), facilities (49.5%), supervision (57.5%), have average effect on their motivation related to the patient education. Job security (68%), respect & appreciation (76%), career development (74%), work-interest (81.5%), knowledge (85.5%), professional responsibilities (90%) have much effect on their motivation related to the patient education. Statistical test showed a meaningful relation between demographic variables and motivating factors.

Conclusion: According to the findings, Job security, respect & appreciation, career development, work-interest, knowledge, professional responsibility have much effect on the motivation for patient education.

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Background & Aim: Rheumatoid arthritis is one of the most common chronic diseases with unknown causes and it is the most important cause of disability especially in adulthood that can have a considerable impact on patients&apos quality of life.

Methods & Materials: This is a cross-sectional study. One hundred and ninety patients with rheumatoid arthritis referred to rheumatology clinic and rheumatology wards of Tehran university of Medical sciences&apos hospitals were randomly selected. The data were collected using a two-section questionnaire including demographic and disease characteristics, and quality of life questions. All analyzes were carried out using SPSS statistical software.

Results: The result showed that quality of life of %50 of patients was high and moderate and the other 50% had low quality of life. Approximately 50% of the patients reported that they have no problem in their physical, socio-economic, mental, sleep and rest, and general health regarding rheumatoid arthritis. There were significant relationships between age, marital status, employment, duration of the disease, physiotherapy, and family income with the quality of life.

Conclusion: The results showed that quality of life in half of the patients (%50) was low. Determining the patients&apos quality of life result in designing proper programs and strategies for prevention and control of the disease that result in promoting quality of life.

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Background & Aim: Socio-economical changes have increased the women&aposs opportunity to take job in recent decades. The increased levels of women in work places, has resulted in a high interest in the potential adverse effects of work on pregnancy outcome. This study was conducted in order to surveying the association between occupational factors and preterm childbirth.

Methods & Materials: It is a cross-sectional study. Samples consisted of nurses and midwives (518 person) who working in Tehran&aposs universities of medical sciences hospitals. Also they delivered newborns in gestational age more than twenty weeks (term or preterm) in years 2001-2006. The subjects were selected using a multi stage sampling method. Data gathered using a self-administered questionnaire. Occupational factors labeled as fatigue score and working hours. The relation between Occupational factors and preterm birth was analyzed using descriptive and inferential statistics (Chi-squared, t-test and Mann-Whitney U test) by SPSS software.

Results: Based on the study findings, the prevalence of preterm labor was 17.2% (95%CI=0.14-0.20). Although the proportions of unfavorable working conditions include: working at acute clinical wards, standing up more than 3h per each working shift, physical exercise, working in cold or hot weather, working in busy environment with continuous noise, being checker of visual and aural monitoring signals, working hours equal or more than 40 hours per week, and working fatigue score equal or more than 3 were higher in preterm group but it didn&apost show any significant relation with preterm birth.

Conclusion: According to the research findings, it seems that occupational factors do not have explicit effect on preterm childbirth. Therefore more investigations are recommended.

 

Key words: Preterm Labor, Occupational Factors, Fatigue

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Background & Aim: Labor pain is regarded as one of the most intolerable pains which women experience during their life. Although there are many alternatives which can effect on person&aposs response and perception to pain and suffering, the pain is felt especially more severely and longer by primogeniture. Annually thousands of selective cesarean operations are performed just because of delivery pain frightening as the main reason. The pain can produce diverse and unwanted effects on delivery procedure and mother-fetus condition. So finding a method to relieve the pain and suffering is one the policies intently considered by health care systems. The aim of present study is to determine the effect of Entonox on implication of painless labor and woman&aposs satisfaction in a Hospital in Orumieh in 1385.

Methods & Materials: This research is a single blind clinical trail. Samples were consisted of women (160 persons), in two groups (each group 80 persons), which selected randomly. The intervention group used Entonox and the control group inhaled Oxygen. All subjects were instructed to use Visual Analogue Scale (VAS) and to inhale gases correctly. Due to emergency need for caesarean operation 2 members of the intervention group and 3 ones from the control group leaved the study. Data gathering tool were consisted of data registration form, VAS scale, mother vital sign recorder, and fetus heart rate recorder. The data were analysed using descriptive (relative & absolute frequencies, mean, and standard deviation) and inferential statistics (t-test, Mann-Whitney U, Chi-squared, Kolmogrove-Smirnov test) by SPSS computer software.

Results: According to the findings pain severity rate among the intervention group significantly was lower than the control group in the different hours of delivery procedure (P<0.001). Using Entonox made no effect on mother&aposs vital signs, labor process, fetus heart rate, first and fifth minute Apgar and bleeding rate after delivery. Also it was shown that probable side effects of Entonox inhalation such as drowsiness and mouth stiffness were more common in the intervention group (P<0.001), but no significant difference was seen in other complications. Meanwhile delivery satisfaction rate was higher in the intervention members.

Conclusion: It seems that Entonox inhalation might come in useful as an effective and safe method to alleviate labor pain and suffering along side with fewer likely risks for fetus and mother in clinical centers.

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Background & Aim: Modification of unhealthy life style is a preventive method in cardiovascular diseases. It seems that education which results in enhancing knowledge would improve the life style. For developing effective educational plans, it is required to evaluate the knowledge and performance of the patients. So, this study aimed to determine the relationship between the teachers&apos preventive behaviors and their knowledge on cardiovascular risk factors.  

Methods & Materials: This cross-sectional study was conducted in five zones of Ministry of Education in Tehran. Seven hundred and three teachers participated in the study. Multi-stage sampling was used to gather data using a self-report questionnaire consisted of demographic characteristics, risk factors of CAD, and related modifiable behaviors. Data were analyzed using Pearson coefficient test to determine correlations.

Results: The results showed that the majority of participants (67%) had good knowledge on cardiovascular risk factors with the mean scores of 15.20±2.63 out of 20. Stress was found to be the most recognized risk factor (95.3%). Knowledge about diabetes (61.2%) and gender (17.6%) were in the lowest level. Regarding prevention, just 27.7% of the participants reported healthy nutrition. Some of the patients (35.6%) exercised regularly and majority of them (77.7%) were not active or passive smokers. Pearson coefficient did not find any significant relationship between knowledge level and preventive behaviors among teachers.

Conclusion: According to our findings, teachers&apos knowledge level on cardiovascular risk factors was good but it did not result in healthy practice. Therefore, providing effective educational programs about healthy life style can improve their daily life practices, as well as it can affect the knowledge and practice of their students about prevention of CAD.

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Background & Objective: However, pregnancy is a common event among reproductive-age women, it is often stressful. Physical and emotional changes can alter the ability of women to carry out their usual roles. The aim of this study was to assess quality of life in pregnant women and its related factors.

Methods & Materials: In this cross-sectional study, 600 pregnant women referred to the prenatal clinics of Kashan University of Medical Sciences were selected randomly. Then they were asked to complete the Short Form 36 Health Survey (SF-36) to assess the quality of life. The results were analyzed using t-test, c², and ANOVA in SPSS.

Results: Results showed that the mean of quality of life in pregnant women was 61.18 13.21 (27.96-92.62). A higher score represented a better health status. Statistically significant differences were found in all of the quality of life dimensions in pregnant women except for social functioning (P<0.005). Quality of life was correlated with age (P=0.002), gestational age (P=0.017), gravidity (P<0.001), number of deliveries (P<0.001), income (P<0.001), husband&aposs support (P=0.017) and life satisfaction (P=0.011).

Conclusion: Results of this study showed that the quality of life in pregnant women was low. Thus, it is important for primary care providers to be aware of the changes in health status of pregnant woman to help them to promote their quality of lives.

 

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Background & Aim: Self-care activity is a key factor in managing Rheumatoid Arthritis (RA) in order to reduce disability caused by the disease. Predisposing factors including knowledge, attitude, and self-efficacy are introduced as determinants of self-care behaviors in the forth phase of PRECEDE model, i.e., ecological and educational assessment. This study aimed to assess the relationship between the predisposing factors and self-care behaviors in patients with RA in Yazd, Iran.

Methods & Materials: In this cross-sectional study, a convenience sampling was used to recruit 181 outpatients with RA referred to a rheumatology clinic in Yazd, Iran. Data were collected by conducting interviews with the participants using a survey questionnaire included knowledge, attitude, and self-efficacy, as predisposing factors and self-care behaviors items. Reliability and validity of the instruments were examined and approved. The statistical tests included bivariate correlations, Mann-Whitney U test, and linear regression.

Results: Knowledge, attitude, and self-efficacy scores were 71.7%, 66.9%, and 47.5%, respectively. The total predisposing factors score was 62.3%. There was a significant positive correlation between the self-care behaviors with attitude and self-efficacy. However, there was no significant correlation between the patients&apos knowledge and self-care behaviors. Totally, the measures explained 39.3% of total self-care behaviors variance within which the self-efficacy was the strongest predictor (β=0.41).

Conclusion: Regarding the high power of predisposing factors, especially self-efficacy, in predicting self-care behaviors and the low scores of self-efficacy, health promotion planners should pay more attention to predisposing factors of self-care behaviors especially the self-efficacy in designing health promotion programs.

 

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Background & Aim: Childbearing is a potentially traumatic event in the lives of women and can lead to post traumatic stress disorder in some women. This study aimed to determine the prevalence and predisposing factors of post traumatic stress disorder after childbearing in women in Bushehr.

Methods & Materials: In this cross-sectional study, 400 women who attended the medical centers 6-8 weeks after delivery were recruited to the study. Participants with traumatic delivery were included in the study. They completed the posttraumatic symptoms scale-I (PSS-I), and predisposing factors questionnaire. Data were analyzed in two groups of women with the PTSD and without PTSD using Chi-square and Fisher&aposs exact test with P=0.05.

Results: The results of this study showed that 54.4% of women had experienced a traumatic delivery and one-third of the women were affected to PTSD after childbearing. There were significant differences between obstetrical factors including complications of pregnancy, wanted pregnancy, post-partum complications, interval of the last two pregnancies less than two years neonatal factors including type of feeding, issues of child care, birth weight and psychological factors including stressful life events, and maternity social support with the PTSD (P<0.05). Income had statistically significant association with the PTSD (P<0.05).

Conclusion: Some of obstetrical, neonatal and psychological factors are associated with occurrence of the PTSD after delivery

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Background & Aim: Patients adherence to medical recommendations requires new and effective strategies. Promoting self-efficacy is considered as an important measurement to help patients to participate in their own treatment protocol. This study was conducted to determine the effect of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases in a public hospital in Urmia.

Methods & Materials: In this single group before/after study, 81 patients with at least two cardiovascular adjustable risk factors were recruited. The self-efficacy intervention was presented to the patients and one of their family members. The self-efficacy was scored before, immediately and one month after the intervention. The Cardiovascular risk factors were measured before and one year after the intervention. Descriptive statistics, ANOVA with repeated measures, paired t-tests, and McNemar test were used to analyze data.

Results: Overall self-efficacy scores and its sub-groups were significantly improved after one month. There were significant differences in the mean BMI, HDL, LDL, systolic and diastolic blood pressures, and weight before and one year after the intervention. The number of smokers and patients with hyperlipidemia were significantly decreased one year after the intervention. However, there were not significant differences in the number of overweight patients and patients with hypertension before and after the intervention.

Conclusion: Results showed that our intervention to improve self-efficacy had positive effect on the overall self-efficacy score and the scores of its subgroups. Our intervention was also effective in controlling cardiovascular risk factors and in reducing the frequency of smokers and patients with hyperlipidemia. It seems that combination of medical orders with self-efficacy improving interventions on patients and their families are influential in controlling cardiovascular risk factors.

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Background & Aim: It is crucial to assess communication skills among health workers using valid culture-based instruments. This study aimed to develop and assess psychometric properties of the Interpersonal Communication Skills Scale among Zanjan Health Volunteers.

Methods & Materials: In this study, a total of 191 health volunteers participated in a self-rating assessment of the Communication Skills Scale (CSS). Moreover, 14 experts were asked to rate each item based on the relevance, clarity, and simplicity. Through a literature review, we developed an instrument with 43 items. The validity of the instrument was determined using the impact item method, content validity ratio (CVR), content validity index (CVI), face validity and exploratory factor analysis. Reliability of the instrument was reported by Alpha Cronbach coefficient. The CSS finally contained 35 items, divided into two categories: general and specific communication skills.

Results: Of 43 items, those with impact item index over 1.5, CVR over 0.51, and CVI over 0.79 were considered as valid while the rest were discarded resulting in a 35-item scale. Factor analysis was carried out to determine the relationship among the items of the CSS. Exploratory factor analysis reduced the list of items to 30, which were divided into seven groups with a minimum eigenvalue of 1 for each factor, capable of predicting 68.8% of the variance. Internal reliability of the scale was determined by alpha Cronbach coefficient (0.91).

Conclusion: The results of this study indicated that the CSS is a valid and reliable instrument for assessment of the communication skills among health volunteers in Zanjan. These findings could be used for developing similar instruments in other health worker groups.

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Background & Aim: Delirium is a common problem among patients with open heart surgery admitted to intensive care units. This study aimed to assess effectiveness of a multifactor intervention on delirium prevention and length of stay in patients with open heart surgery.

Methods & Materials: In this semi-experimental study, we first recruited 195 patients. Among them, 15 patients were excluded during the study due to different reasons. The participants were divided into to study groups. The implemented intervention included staff education, environment changes, and installation of guideline reminding on ward. Patients were assessed for delirium twice a day using the CAM-ICU scale. Demographic characteristics as well as disease and sleep items were completed by the researchers a day before surgery. Moreover, length of stay was recorded by the researchers. Data were analyzed using Pearson Chi-Square, Independent Samples, and the Fisher&aposs Exact Test.

Results: A significant decrease was found in the incidence of delirium in the intervention group: 11.1% Vs 35.6% (P<0.05). Average length of stay in the control and intervention groups was 6.23 Vs 6.30 days, respectively. Length of stay among patients with delirium and patients without delirium was 7.5 Vs 5.8 days, respectively. Patients with delirium were aged 55 and more in both groups.

Conclusion: Multifactor intervention was effective in decreasing the prevalence of delirium. Educational interventions are recommended to improve staffs&apos knowledge and environment changes.

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Background & Aim: Multiple structural factors preside over burn units influence nurses&apos quality of care and their activities. The complexity and multy-dimensional nature of nursing care in these units, creates many challenges. Understanding the perspectives of people&aposs involved is recommended. This study, with a theory-to-research approach, was conducted to assess the frequency of confronting intra and extra organizational factors preside over burn units, the intensity of its related pressure, and correlations among these variables from nurses&apos perspectives.

Methods & Materials: In this cross-sectional, correlational study, 98 nurses working in the Shahid Mottahari burn center were recruited by census. Data was collected using the intra and extra organizational factors instrument, provided based on the previous grounded theory study of the researchers. Intra-organizational factors questionnaire consisted of 58 Likert type statements in eight subscales and two dimensions of frequency (α=0.94) and intensity (α=0.96). Extra-organizational factors questionnaire consisted of eight Likert type statements (α=0.74). Data were analyzed using the SPSS version 14.

Results: The results revealed that the frequency of nurses&apos confrontation with factors related to environment and patients as well as its intensity were more than other factors. Moreover, the intensity of the whole factors was more than its frequency. All the extra- organizational factors were significantly correlated with all intra-organizational factors except for the "absence of employment permission" (P<0.05).

Conclusion: This study explained the importance of intra-organizational factors of a burn center in inducing stress on nurses. In addition to verification of some relationships in the previous mid-range theory, the results of this study also modified some of its aspects. Therefore it added to the existing body of knowledge about organizational factors and job stress in burn units. Moreover, it produced some evidences to use in nursing administration and service, and finally it resulted in some directions to control stress in nurses&apos job.

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Background & Aim: Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU.

Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v.18.

Results: Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group (P<0.001). There were no statistically significant changes in the sleep quality before and after hospitalization in the intervention group (P=0.053).

Conclusion: Using environmental factors mitigation strategies can improve sleep quality of patients admitted to CCUs.

 

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  Background & Aim: There is little information regarding relationship between maternal dietary pattern and infant anthropometric parameters at birth. This study was carried out to determine relationship between dietary patterns in pregnancy with infants' anthropometric parameters .

  Methods & Materials: In this cross-sectional study, 94 pregnant women (GA: 37-40 weeks) referred to Ahvaz Razi hospital were selected. Anthropometric parameters were measured. The dietary intakes were assessed using a semi-quantitative food frequency questionnaire. Factor analysis was used to identify dietary patterns. Statistical analysis was done in the SPSS. 

  Results: In this study, three major dietary patterns including "healthy", "traditional" and "western" dietary patterns were identified. After adjusting of confounders (age, physical activity, energy intake, pregnancy weight gain and infant sex), the relationship between dietary patterns with birth weight, height and head circumference were exhibited in three models. The relationship between healthy dietary pattern and infant weight, height and head circumference at birth was significantly positive in all models (P<0.05). Western dietary pattern had significant negative relationship with head circumference in the model 1 and 2. Moreover, it had negative relationship with birth weight in the model 1 (P<0.05). Traditional dietary pattern did not show any significant relationship with anthropometric parameters at birth.

  Conclusion: The present study found significant relationship between maternal dietary patterns with anthropometric parameters at birth. Further prospective studies are suggested to confirm the findings.

  

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Background & Aim: Because of the importance of empathy and positive impact on the relationship between patients and health care providers, as well as the lack of valid instrument to assess student's empathy in health domain, this study aimed to examine the factor structure and reliability of the Persian version of JSE-HPS in the students of the School of Nursing and Midwifery, Mashhad University of Medical Sciences in Iran.

Methods & Materials: In this cross-sectional study, 398 nursing and midwifery students of Mashhad University of Medical Sciences were selected using stratified random sampling. The data collection instrument was JSE-HP. The confirmatory factor analysis was used to investigate the factor structure of the instrument, and the Cronbach's alpha coefficient was applied to examine its reliability. The data analysis was done using LISREL version 8.8 and SPSS version 20.

Results: The results of the confirmatory factor analysis model showed given that fitness model parameters, including CFI, GFI, AGFI and NFI were approximately 1 and RMSEA index was less than 0.1, the fitness of three-factor model is appropriate. The Cronbach's alpha coefficient for the total instrument was 0.63.

Conclusion: The current study confirmed the three-factor structure of the Persian version of JSE-HPS (20 items), included perspective taking, compassionate care and standing in patient’s shoes. Thus, this instrument is appropriate to measure empathy for patient in the health service provider students.

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Background & Aim: Male andropause begins with hormonal, physiological and chemical changes, and usually occurs in men between the ages of 40 to 55 years. These changes affect their quality of life. Hence, the current study investigated the quality of life of men with andropause and its related factors.

Methods & Materials: This preliminary cross-sectional study was conducted through the census method on 80 males aged 40 to 60 years, employed at the schools of Tehran University of Medical Sciences. Data were collected in 2014 using a demographic questionnaire, the Short-Form 36 (QOL) questionnaire, and the Persian version of the Aging Males' Symptoms (AMS) questionnaire. Data were analyzed by SPSS software v.22 through descriptive and inferential statistics (Independent t-test, one-way ANOVA, Pearson’s Correlation Coefficient and Stepwise multivariate Regression). The level of significance was set at 0.05.

Results: The mean age of the andropausal men was 47.6±4.79 years and the majority (38.8%) of the samples were in the 45-49 age group. The mean quality of life score was 61.75±13.52. Stepwise regression showed a significant relationship between age and the scores of overall quality of life, physical and psychological health dimensions. Moreover, significant associations were observed between the overall quality of life score and the andropause severity, and between physical health dimension and sleep hours per day.

Conclusion: This study indicates that andropause lowers the quality of life, and age, andropause severity and sleep hours affect the quality of life in the andropausal men.

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Background & Aim: Increasing understanding of death anxiety among different cultures and patient populations is critical to provide quality patient care. Researchers who investigate death anxiety, are looking for a reliable and valid instrument compatible with culture in order to achieve this goal. The aim of the study was to evaluate the psychometric properties of the Templer’s Death Anxiety Scale-Extended (TDAS-E) among a sample of chemical veterans of Iran–Iraq warfare.

Methods & Materials: In this methodological study, 300 veterans completed the Persian version of the 51-item TDAS-E in 2015. The face, content and construct validity (convergent and discriminant validity) of the TDAS-E were assessed. Also, its reliability was measured using Cronbach’s alpha coefficient, construct reliability and intra correlation coefficient.

Results: Results of exploratory and confirmatory factor analyses extracted four stable distinct factors including fear of the hereafter, fear of facing death, fear of the shortness of life, fear of dying following an incident and mishap. The fitness of the four-factor model of the Templer’s death anxiety construct was approved based on standard indices (c²/df=2.832, GFI=.915, AGFI=.873, PCFI=.657, PNFI=.612, RMSEA=.078). Discriminant and convergent validity of all factors were acceptable. Also, scale reliability was confirmed using Cronbach’s alpha coefficient (0.88), construct reliability (higher than 0.70) and intra correlation coefficient (0.87).

Conclusion: The results of the current study revealed that the four-factor construct of TDAS-E had suitable validity and reliability among Iranian chemical warfare veterans. Given the proper psychometric properties, this scale can be used in future research to evaluate death anxiety in this population.

Background & Aim: Increasing understanding of death anxiety among different cultures and illness populations is critical to provide quality patient care. Researchers who investigate death anxiety, are looking for a reliable and valid instrument compatible with culture in order to achieve this goal. The aim of the study was to evaluate the psychometric properties of the Templer’s Death Anxiety Scale-Extended (TDAS-E) among a sample of chemical veterans of Iran–Iraq warfare.

Methods & Materials: In this methodological study, 300 veterans completed the Persian version of the 51-item TDAS-E in 2015. The face, content and construct validity (convergent and discriminant validity) of the TDAS-E were assessed. Also, its reliability was measured using Cronbach’s alpha coefficient, construct reliability and intra correlation coefficient.

Results: Results of exploratory and confirmatory factor analyses extracted four stable distinct factors including fear of the hereafter, fear of facing death, fear of the shortness of life, fear of dying following an incident and mishap. The fitness of the four-factor model of the Templer’s death anxiety construct was approved based on standard indices (c²/df=2.832, GFI=.915, AGFI=.873, PCFI=.657, PNFI=.612, RMSEA=.078). Discriminant and convergent validity of all factors were acceptable. Also, scale reliability was confirmed using Cronbach’s alpha coefficient (0.88), construct reliability (higher than 0.70) and intra correlation coefficient (0.87).

Conclusion: The results of the current study revealed that the four-factor construct of TDAS-E had suitable validity and reliability among Iranian chemical warfare veterans. Given the proper psychometric properties, this scale can be used in future research to evaluate death anxiety in this population.