Journal of Education and Health Promotion

Abstract BACKGROUND: Assessment of circulating and scrub skills is an important issue in operating
room (OR) programs. However, there is a lack of well‑designed tools that are specifically developed
for this purpose. Hence, this study aimed to develop and determine the validity and reliability of a
checklist to measure the circulating and scrub skills of OR novices.
MATERIALS AND METHODS: This cross‑sectional methodological study was conducted among 124
OR technology students who were selected during three consecutive academic years (2019–2020 to
2021–2022). The developed checklist was evaluated with face validity, content validity (quantitative
and qualitative), construct validity  (known‑groups validity), criterion‑related validity  (concurrent
and predictive validities), internal consistency  (Kuder–Richardson 20, KR‑20), and inter‑rater
reliability (intra‑class correlation coefficient, ICC). Known‑groups validity was evaluated by comparing
the difference between the checklist scores of first‑semester and third‑semester students using
independent samples t‑test. Additionally, concurrent and predictive validities were evaluated by ICC
through measuring the correlation between the total score of checklist and grades of a multiple‑choice
test and two clinical apprenticeship courses, respectively. Data were analyzed in the Statistical
Package for Social Sciences software.
RESULTS: After reconciling the preliminary checklist in terms of face and content validities, a
checklist with 17 sub‑scales and 340 items called “Circulating and Scrub Skills of Operating Room
Novices (CSSORN)” was developed. Regarding the known‑groups validity, the third‑semester
students had higher scores compared to the first‑semester students (p < 0.001 in most sub‑scales).
Besides, the total score of checklist showed a significant correlation with the criteria of concurrent
and predictive validities (ICC = 0.64, ICC = 0.72; P < 0.001). The KR‑20 for the entire checklist was
0.90 (range: 0.60–0.93). The ICC for inter‑rater reliability was also 0.96 for the entire checklist (range:
0.76–0.99, P < 0.001 in all sub‑scales).
CONCLUSION: The CSSORN had appropriate validity and reliability to be used for measuring the
circulating and scrub skills of OR novices. To shed light on the findings, further testing of this checklist
on larger populations and in different contexts is suggested.

Abstract BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursing
and safe care profession as well as evaluation of the nurses’ educational needs. The present study
was conducted to determine psychometric properties of the Persian version of the patient safety
competency self‑evaluation (PSCSE) tool in Iranian psychiatric wards.
MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman,
Iran, were included in the present cross‑sectional study using census method. This tool contains 41
items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill
dimension. Psychometric properties of the questionnaire including its content and face validity were
also examined. The factor structure of the questionnaire was evaluated using exploratory factor
analysis. The internal consistency and reliability were assessed by test–retest method with an interval
of 14 days. Cronbach’s alpha and corrected item‑total correlation were used to measure reliability.
RESULTS: The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 was
removed from the skill domain because it was not related to the psychiatric ward. According to the
results of factor analysis, there was a significant relationship between the questions and the relevant
factors. The correlation coefficient for test–retest with 14 days interval was intraclass correlation
coefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge,
attitude, and skill, respectively. The internal consistency coefficient (Cronbach’s alpha) of the whole
tool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively.
Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items),
attitude (14 items), and skills (20 items).
CONCLUSION: Persian version of the nurses’ competency tool in ensuring patient safety in psychiatric
wards has acceptable psychometric characteristics.

Abstract BACKGROUND: Diagnosing cancer, as a life‑threatening event, in children and adolescents stops
the normal course of life for all family members. Spirituality, which plays an essential role in coping
with illness and death, can increase resistance against psychological crises induced by cancer
diagnosis and treatment. This study aims to discover the spiritual needs of mothers having children
with cancer aged 1–12 years old.
MATERIALS AND METHODS: In this qualitative study, the conventional content analysis approach
was used. The research environment was three pediatric oncology wards of Amir Hospital in Shiraz,
Iran. Data were collected from September 2019 to March 2020 through face‑to‑face semi‑structured
in‑depth interviews. Fifteen participants including 12 mothers and 3 nurses were interviewed through
purposive method considering maximal variation. The interviews were recorded, transcribed, and
subjected to a qualitative analysis. Credibility, dependability, confirmability, and transferability of
data were confirmed.
RESULTS: The mean (± standard deviation) age of the mothers was 35.76 (±5.96) years old. The
spiritual needs of the mothers were classified into three categories, including religious well‑being,
existential well‑being, and growth and excellence as well as seven subcategories. Religious well‑being
included subcategories of direct and indirect connection with God, existential well‑being included
subcategories of need for hope, multifaceted support, and rethinking, growth, and excellence consisted
of subcategories of devoting yourself and surrender.
CONCLUSION: Mothers of children with cancer face important spiritual needs. Therefore, it is
necessary for the treatment team to identify these needs and use them to provide appropriate
spiritual care.