BACKGROUND: Fear-avoidance beliefs (FAB) play a crucial role in the treatment outcomes of post-surgery patients. These beliefs can lead to activity avoidance, increased pain, and decreased quality of life. Therefore, accurately measuring these beliefs in Iranian patients is of significant importance. The Fear-Avoidance Belief Questionnaire (FABQ) is a patient-reported questionnaire that evaluates individuals\' FAB. Since the validity and reliability of the Persian version of FABQ (FABQ-P) have not been assessed based on the Iranian population and sociocultural contexts, the current study has been implemented to determine the reliability and validity of the FABQ-P among Iranian post-operative patients by translation and psychometric properties.
METHODS: This methodological study conducted in 2023, a sample of 400 patients who had undergone surgery were selected using a convenience sampling method. The scale used in the study was translated and its psychometric properties were evaluated through network analysis and assessments of construct validity (including exploratory and confirmatory factor analysis), convergent validity, and discriminant validity. Additionally, the study assessed the internal consistency of the scale.
RESULTS: The MLEFA results with Promax and Kaiser Normalization rotation yielded two factors explaining 57.91% of the variance, encompassing 13 items. Also, the model was approved by CFA. Convergent and discriminant validity have been confirmed through the following criteria: Average Variance Extracted (AVE) exceeding 0.5, Composite Reliability (CR) surpassing 0.7, and Heterotrait-Monotrait Ratio of Correlations (HTMT) equating to 0.597. As for reliability, Cronbach\'s alpha, composite reliability (CR), and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency.
CONCLUSIONS: As demonstrated by the results, the FABQ-P has a satisfactory level of reliability along with authentic validity according to the sociocultural contexts of Iranian post-operative patients.

UNASSIGNED: The purpose of this study is to analyze the short anterior cruciate ligament return to sport after injury (ACL-RSI) (Persian) version\'s cultural adaption and validity.
UNASSIGNED: To assess test-retest reliability, 102 participants were filled out the short ACL-RSI(Per) scale 6 months or more after ACLR surgery. Internal consistency (Cronbach\'s alpha), test-retest reliability (intraclass correlation coefficients), construct validity (Pearson\'s r) and sensitivity (floor/ceiling effect) were determined. In addition, patient completed other relevant measures such as Lysholm scores, the hospital for special surgery ACL satisfaction survey (HSS ACL-SS), the visual analogue scale (VAS) of pain and patient\'s satisfaction, the Tegner activity score (TAS), the single assessment numeric evaluation (SANE) and the Cincinnati Knee Rating System (CKRS).
UNASSIGNED: The short ACL-RSI(Per) scale showed high internal consistency (Cronbach\'s alpha = 0.91) and test-retest reliability (ICC = 0.923). Significant correlations between short ACL-RSI(Per) and other scales supported validity. There was a statistically significant connection between the short ACL-RSI(Per) and the following outcomes: HSS ACL-SS (r = 0.698, p < 0.001), VAS pain (r = 0.356, p < 0.001), CKRS (r = 0.644, p < 0.001), TAS (r = 0414, p < 0.001), Lysholm score (r = 0.467, p < 0.001) and SANE score (r = 0.536; p < 0.001). In addition to a satisfactory ceiling impact (15%), a sizeable floor effect (16.7%) was also seen.
UNASSIGNED: The short ACL-RSI(Per) scale is a reliable and valid tool for assessing psychological readiness for return to sport after ACL reconstruction in Persian.
UNASSIGNED: III.

UNASSIGNED: Overactive bladder (OAB) is characterized by urinary frequency and is recognized as a disorder. Various tools are available for diagnosing this condition. This study aimed to evaluate the reliability and validity of the Persian version of the 8-item Overactive Bladder Scale (OAB-V8).
UNASSIGNED: This analytical cross-sectional study was conducted on a sample of 150 OAB patients. The OAB-V8 scale was translated and culturally adapted following established guidelines. Face and content validity were assessed using the Impact Score (IS), Content Validity Index (CVI), and Content Validity Ratio (CVR) indices. Reliability was evaluated by calculating Cronbach\'s alpha (α) and utilizing the test-retest method (Intra-class correlation coefficients (ICC)). Construct validity was explored through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). All statistical analyses were carried out using SPSS version 24 and AMOS version 24, with a significance level set at 5 %.
UNASSIGNED: The face validity was confirmed, with all items having an IS value greater than 1.5. Content validity was also confirmed, as most items had a Content Validity Index (CVI) higher than 0.79, and the average Content Validity Ratio (CVR) value was 0.96. In the initial phase of Exploratory Factor Analysis (EFA), the sample adequacy and suitability of the exploratory analysis were confirmed (Kaiser-Meyer-Olkin (KMO) test value = 0.784, Bartlett\'s Test p-value <0.05). Two dimensions explaining 61.87 % of the variance were then extracted. In the Confirmatory Factor Analysis (CFA), the fit indices were deemed acceptable (χ^2/df = 2.006, CFI = 0.96, GFI = 0.95, AGFI = 0.89, TLI = 0.93, RMSEA = 0.08). The reliability was confirmed with an alpha coefficient of 0.81 and an Intraclass Correlation Coefficient (ICC) of 0.98.
UNASSIGNED: The Persian version of the OAB-V8 questionnaire demonstrated good validity and reliability, indicating its suitability for use in Persian-speaking countries.

OBJECTIVE: Voice disorders can profoundly impact health, quality of life, job performance, and social interactions. Traditional evaluations have expanded to include quality-of-life assessments, emphasizing self-reported outcomes. The Voice Handicap Index (VHI) stands out among relevant questionnaires, with the VHI-10 being a concise derivative. This study was conducted to translate and validate the Voice Handicap Index-10 (VHI-10) questionnaire for Persian speakers, enhancing clinical assessments of voice disorders and quality of life.
METHODS: This cross-sectional study, conducted in Iran, involved (1) translating the VHI-10 into Persian, (2) confirming face and content validity using Content Validity Ratio (CVR), and Content Validity Index (CVI), and (3) evaluating its reliability through a survey. A panel of experts confirmed the validity, and reliability of the study, which was assessed using Cronbach\'s alpha, Spearman-Brown, and Guttman coefficients. The survey involved 225 participants, including 150 healthy people and 75 patients with voice disorders, who were selected using a convenience sampling method.
RESULTS: All question items demonstrated a CVI greater than 0.79 and a CVR between 0.62 and 1. Reliability analysis yielded high Cronbach\'s alpha values for functional, physical, and emotional domains (0.909) and total (0.961). The mean overall scores of VHI-10 for healthy and disordered groups were 18.78 and 0.74, respectively. The VHI-10 effectively discriminated between healthy and disordered groups in all domains, with an accuracy of 97.33%. The determined cut-off point was 4.5, with a strong area under the Receiver Operating Characteristic (ROC) curve (0.989).
CONCLUSIONS: This study successfully adapted and validated the Persian version of the VHI-10. The questionnaire demonstrated high reliability and validity, distinguishing between individuals with and without voice disorders. This Persian version is now a valuable tool for speech and language pathologists conducting clinical voice evaluations in Iran and also it could be applied in studies to determine the effects of voice problems on participant\'s quality of life.

BACKGROUND: The aim of this study was to examine the association between different metabolic obesity phenotypes and the non-alcoholic fatty liver disease (NAFLD).
METHODS: This cross-sectional analysis utilized data from the baseline phase of the Ravansar non-communicable diseases (RaNCD) cohort study, which involved 8,360 adults. Participants with a Fatty Liver Index (FLI) score of ≥ 60 was classified as having NAFLD. The FLI score was calculated using liver non-invasive markers and anthropometric measurements. Participants were categorized into four phenotypes based on the presence or absence of metabolic syndrome and obesity. Logistic regression analysis was used to evaluate the association of NAFLD and obesity phenotypes.
RESULTS: According to the FLI index, the prevalence of NAFLD was 39.56%. Participants with FLI scores of ≥ 60 had higher energy intake compared to those in the FLI < 60 group (P = 0.033). In subjects with metabolically unhealthy phenotypes, the level of physical activity was lower compared to those with metabolically healthy phenotypes. The risk of NAFLD in males with the metabolically healthy-obese phenotype increased by 8.92 times (95% CI: 2.20, 15.30), those with the metabolically unhealthy-non-obese phenotype increased by 7.23 times (95% CI: 5.82, 8.99), and those with the metabolically unhealthy-obese phenotype increased by 32.97 times (95% CI: 15.70, 69.22) compared to the metabolically healthy-non-obese phenotype. Similarly, these results were observed in females.
CONCLUSIONS: This study demonstrated that the risk of NAFLD is higher in individuals with metabolically healthy/obese, metabolically unhealthy/non-obese, and metabolically unhealthy/obese phenotypes compared to those with non-obese/metabolically healthy phenotypes.

OBJECTIVE: The purpose of this study was to translate and validate the ethical awareness scale for nurses working in Iranian intensive care units.
METHODS: A cross-sectional psychometric study.
METHODS: The study was conducted in Oct 2020 to Sep 2021, involving the participation of 200 ICU nurses. The process included translation of the original version of the ethical awareness scale into Persian, following the World Health Organization guideline, for use in Iran. The translated version was then evaluated for reliability, face validity, content validity ratio, content validity index, convergent validity and construct validity.
RESULTS: The initial reliability of the scale was established. In qualitative face validity, a few items changed slightly and all items were retained in the quantitative face validity assessment. Based on Lawshe\'s values, three items were removed from the scale during CVR assessment. All items exhibited acceptable CVI scores. Convergent validity was established with an average variance extracted greater than 0.5. The fit indices, such as CFI = 0.94, GFI = 0.94, RMSEA = 0.01, AGFI = 0.97 and CMIN/DF = 2.99, supported the structural model of the scale. The fit indices for the structural model of the scale were all within acceptable ranges, suggesting that the model fit the data well. Its reliability was confirmed through the test-retest method, with Cronbach\'s alpha = 0.84 and McDonald\'s omega coefficient >0.8.
CONCLUSIONS: The findings of this study indicate the Persian version of the ethical awareness scale for Iran (EAS-IR) is comparable in content to the original version, demonstrating its validity and reliability for assessing ethical awareness among Iranian nurses in ICUs. The scale can be a valuable resource for measuring ethical awareness in the Iranian healthcare context and may contribute to improving ethical practices and decision-making in ICU settings.
UNASSIGNED: In this project, no patient or public contribution was necessary, because it was not applied to our work.

OBJECTIVE: With over 140 million speakers spread across Iran, Afghanistan, and Tajikistan, Persian, also known as Farsi, is a pluri-centric language. The purpose of this study is to perform cross-cultural adaptation and examine the validity and reliability of the Persian translation of the Hospital for Special Surgery Anterior Cruciate Ligament Post-Operative Satisfaction Survey (HSS ACL-SS).
METHODS: In this retrospective study, 102 anterior cruciate ligament reconstruction (ACLR) patients were asked to complete the Persian version of the HSS ACL-SS, Tegner scale, Lysholm score, the Single Assessment Numeric Evaluation (SANE) score, the Cincinnati Knee Rating System (CKRS), and the Visual Analogue Scale (VAS) for pain. Internal consistency was calculated via Cronbach\'s alpha coefficient. Validity was assessed with the correlations of Spearman\'s rho. 18 patients were included in the test-retest reliability assessment. The floor and ceiling effects of the examined content validity of HSS ACL-SS.
RESULTS: The Cronbach\'s alpha coefficient was computed at 0.959, showing outstanding internal consistency. The intra-class correlation coefficient (ICC) demonstrated excellent results (0.986, P-value < 0.001). Insignificant ceiling effects (2.9%) and floor effects (3.9%) were detected. The Persian version of the HSS ACL-SS score significantly correlated with the SANE (r = 0.730, p < 0.001), Lysholm score (r = 0.622, p < 0.001), and CKRS (r = 0.741, p < 0.001).
CONCLUSIONS: The overall performance of the Persian HSS ACL-SS was more than excellent in terms of reliability and validity. To conclude, Persian HSS ACL-SS may be used to assist patients in having a better perception of post-operative satisfaction.

BACKGROUND: Attitudes toward individuals with intellectual disability (ID) are the most important factor affecting their social integration and can cause them to experience a sense of achievement or discrimination. The present study aimed to evaluate the latent factor structure and validity of the Persian version of the Attitudes toward Intellectual Disability (ATTID) Short-Form questionnaire.
METHODS: The latent factor structure of the Persian version of the ATTID Short-Form was established in a convenient sample of the general population (N = 280) in Iran. The structural validity and temporal reliability, internal consistency and confirmatory factor analysis were evaluated. Data analysis was done with SPSS v23 Windows edition and R v4.2.1.
RESULTS: The Persian version of the ATTID Short-Form was shown to have a five-factor structure: discomfort, knowledge of capacity, interaction, sensitivity and knowledge of cause. The structure was appropriately fit according to the fit indices (χ2(485) = 530.12), (P-value = 0.077). All the subscales had good temporal reliability.
CONCLUSIONS: Findings suggest that the Persian version of the Short-Form of ATTID is a brief, valid and reliable measure that can be used in research and clinical practice.

BACKGROUND: Proactively seeking feedback from clinical supervisors, peers or other healthcare professionals is a valuable mechanism for residents to obtain useful information about and improve their performance in clinical settings. Given the scant studies investigating the limited aspects of psychometrics properties of the feedback-seeking instruments in medical education, this study aimed to translate the feedback-seeking behavior scales (frequency of feedback-seeking, motives of feedback-seeking, and promotion of feedback-seeking by supervisors) into Persian and evaluate the psychometric properties of the composite questionnaire among medical residents at Tehran University of Medical Sciences in Iran.
METHODS: In this cross-sectional study, feedback-seeking behavior scales were translated through the forward-backward method, and its face validity and content validity were assessed by 10 medical residents and 18 experts. The test-retest reliability was evaluated by administering the questionnaire to 20 medical residents on two testing occasions. A convenience sample of 548 residents completed the questionnaire. Construct validity was examined by exploratory factor analysis and confirmatory factor analysis and concurrent validity was determined by Pearson\'s correlation coefficient.
RESULTS: Content validity assessment showed that the CVR (0.66 to 0.99) and CVI (0.82 to 0.99) values for items and S-CVI values (0.88 to 0.99) for scales were satisfactory. The exploratory and confirmatory factor analysis demonstrated that the models were confirmed with eight items and two factors (explaining 70.98% of the total variance) for the frequency of feedback-seeking scale, with 16 items and four factors (explaining 73.22% of the total variance) for the motives of feedback seeking scale and with four items and one factor (explaining 69.46% of the total variance) for promotion of feedback-seeking by supervisors. AVE values greater than 0.5 and discriminant validity correlations significantly less than 1.0 demonstrated that the total scores of the composite feedback-seeking behavior questionnaire had a favorable fit and the questions could fit their respective factors, and the latent variables were distinct. We found positive and significant correlations between the three scales and their subscales.
CONCLUSIONS: The results of the present study supported the validity and reliability of the Persian composite feedback-seeking behavior questionnaire for assessing feedback-seeking behaviors in medical residents. Applying the questionnaire in residency programs may enhance the quality of clinical education.

UNASSIGNED: Whether ileal conduit diversion (ICD) or orthotopic neobladder (ONB) urinary diversion provides better quality of life (QoL) is still under debate. The Bladder Cancer Index (BCI) is a specific tool for bladder cancer (BCa) patients, providing reliable results in previous studies. A validated Farsi version of the BCI concerning cultural aspects could help Farsi-speaking clinicians gain more reliable feedback on QoL following urinary diversion.
UNASSIGNED: Based on WHO suggestions, we translated the BCI questionnaire into the Persian language. Then, we performed a cross-sectional study on BCa patients who underwent ICD or ONB urinary diversion. We compared their QoL via BCI and WHO questionnaires. Chi-square and independent t-tests were used where appropriate.
UNASSIGNED: The content validity ratio and the content validity indexes were 1 and 0.8-1.0, respectively. Of 57 participants, six patients (10.5%) were women. The ICD was performed for 38 (66.7%) and ONB diversion for 19 (33.3) participants. The mean age of ICD and ONB was 68.71 ± 7.40 and 64.28 ± 8.34 years, respectively (p-value: 0.055). In all sub-domains of BCI, except bowel habits, the mean scores were higher in the ICD group. A significant difference between ICD and ONB groups was found regarding urinary function (p-value<0.001). There was no significant difference between ICD and ONB groups in none of the domains of the WHO questionnaire.
UNASSIGNED: The QoL of ICD and ONB patients did not differ significantly. Even ICD may be superior in ritual purification, while the psychological status of ONB patients was better.