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Background & Aim: The presence of pain is a common phenomenon among patients in critical care units. Critically ill patients are often unable to communicate because of illness or sedation so, recognition and assessment of their pain is difficult. In these patients, observational behavioral indices can be used to evaluate pain. The aim of this study was to investigate the effect of application of critical-care pain observation tool in patients with decreased level of consciousness on performance of nurses in documentation and reassessment of pain after palliative intervention.

Methods & Materials: In this before and after quasi-experimental study, 106 nurses working in general intensive care units in selected hospitals affiliated to Tehran University of Medical Sciences were selected. First, we examined the nurses&apos performance three times in relation to documentation and reassessment of pain after palliative intervention, position change and suction procedure in patients with decreased level of consciousness using a researcher-made check list. Then, we taught nurses individually, how to use this tool to investigate the pain of patient in a session lasting an hour. A week after the training, the researcher reevaluated performance of trained nurses in relation to documentation and reassessment of pain after palliative intervention in patients with decreased level of consciousness. Finally, those data collected before and after the training of the CPOT to nurses were compared using the Wilcoxon test.

Results: Findings showed that the CPOT could not lead to improved nurses&apos function in relation to documentation of pain in the patients records (P=0.209) and recording palliative measures related to pain (P=0.117). However, there were significant statistical differences between nurses&apos function in relation to reassessment of pain after palliative intervention, before and after the training and application of the CPOT. Comparing the mean function scores before and after the intervention, demonstrated that the performance of nurses in this area has been improved after the intervention.

Conclusion: The critical-care pain observation tool can increase nurses&apos sensitivity to pain in patients with decreased level of consciousness. It forces the nurses to reassess the pain after palliative intervention. This tool does not motivate in nurses to document pain palliative process. So it is recommended that future studies investigate the impact of this tool on other aspects of pain management, such as diagnosis of pain and using of drugs and non-drug measures.

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  Background & Aim: The aim of present study was to assess psychometric properties of premenstrual symptoms screening tool (PSST) to provide a fast and appropriate screening tool for women who suffer from severe PMS/PMDD and their clinicians .

  Methods & Materials: It was a cross-sectional study. The study included 404 female students studying at Semnan University who were randomly selected using stratified method. In order to assess psychometric properties, we used the exploratory factor analysis, convergent validity (evaluated by symptom checklist-90-Revised), criterion-related validity (calculated by comparing psychiatrist diagnosis and PSST). Sensitivity and specificity coefficients of optimal cutoff points were calculated by the ROC Curve and construct validity was evaluated by the PSST ability to separate PMS and PMDD groups from healthy group. Reliability was evaluated using the cronbach’s alpha and test-retest method . 

  Results: The p rinciple component analysis revealed that the PSST consists of four factors: interest reduction, interference in functions, physical and neurotic symptoms, and eating and sleep patterns. As an evidence of convergent validity, PSST scores showed significant correlations with the SCL-90-R’s dimensions. Agreement coefficient between psychiatrists and the PSST diagnosis was 0.314 for the PMS and 0.80 for the PMDD. This tool separated the PMS and PMDD groups from healthy group well. Optimal Cutoff point for separating females suffering from PMDD was 2.22. The sensitivity and specificity coefficients were 0.9 and 0.77, respectively. The cronbach’s alpha was 0.91 and the test-retest reliability was 0.56 for the total tool .

  Conclusion: The translated version of the premenstrual symptoms screening tool can be used as a valid tool for Iranian females. This instrument can be useful for rapid screening and identifying women who suffer from severe PMS/PMDD, especially in clinical settings .

  

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Background & Aim: Maintaining and improving the health of the elderly through effective interventions requires the recognition of their lifestyle, including exercise using a valid and appropriate culture-specific tool. The aim of this study was to design and evaluate the psychometric properties of a tool for measuring exercise self-efficacy in the elderly.
Methods & Materials: A sequential exploratory mixed method study was performed in the form of a questionnaire with two qualitative and quantitative sections in 2019. The qualitative section consisted of item generation including three stages: theoretical stage (targeted search of existing literature), field work (semi-structured interviews with the elderly) and final analysis (integration of the results from the two previous stages). In the quantitative section, the psychometric properties of the questionnaire was evaluated using face, content and construct validity as well as the reliability through internal consistency and stability.
Results: Out of 37 initial items, four items were removed after calculating the item impact score.  Seven items were removed after assessing the content validity ratio and content validity index. Also, five items were omitted due to having a load factor less than 0.03. The result of exploratory factor analysis consisted of three factors “recognition”, “situational compatibility” and “self-control” which all together could explain 90.180% of the variance. The Cronbach’s alpha and the Intraclass correlation coefficient were found to be 0.957 and 0.949 respectively.
Conclusion: The data analysis approved that the designed tool can be used for measuring exercise self-efficacy among the elderly due to having acceptable reliability and validity, simplicity and a short completion time.