Translation and Psychometric Evaluation of the Persian Version of the Nurses' Quality of Life Scale: A Validation Study in Iran

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The current study aimed to translate and validate the Persian version of the Nurses' Quality of Life Scale. Material and method In this methodological research, the Nurses' Quality of Life Scale (NQOLS) was utilized to assess the quality of life among 500 employed nurses in hospitals in the cities of Gonabad and Sabzevar. The translation process of the NQOLS followed the model proposed by Wild et al. The content validity of the Persian version of the scale was evaluated using the Content Validity Index (CVI) and Content Validity Ratio (CVR). Structural validity was assessed using exploratory and confirmatory factor analyses. Internal consistency reliability was assessed using Cronbach's alpha, while test-retest reliability was determined using the Intraclass Correlation Coefficient (ICC). Data analysis was conducted using SPSS version 26 and LISREL version 8.8 software. Results The exploratory factor analysis of the Persian version of NQOLS revealed six factors that accounted for 62.15% of the total variance. The structural validity of the extracted factors was confirmed through confirmatory factor analysis. The Cronbach's alpha coefficient and ICC for the entire questionnaire were 0.91 and 0.95, respectively. Conclusion The findings of the present study suggest that the Persian version of the NQOLS exhibits sufficient validity and reliability. Therefore, it can be used as an effective tool for measuring and examining the quality of life among nurses in Iran. Validation quality of life nurses translation psychometric evaluation Iran Background The human workforce is essential for the success of organizations, including healthcare organizations [ 1 ]. Nurses play a crucial role in the healthcare system by ensuring the continuity of care and promoting health. However, nursing is a high-stress profession that can significantly impact the overall health and well-being of nurses [ 2 , 3 ]. The demanding nature of nursing work and the associated stressors can have a negative impact on the physical and emotional well-being of nurses. This can lead to physical and mental illnesses, as well as negative self-perceptions and attitudes. Ultimately, these factors diminish the overall quality of life for nurses [ 3 ]. Assessing the quality of life within communities is crucial for comprehending the health of societies and ensuring the well-being of individuals and communities [ 4 ]. Occupational factors and work conditions in the nursing profession can significantly impact the quality of life of nurses. Quality of life, as defined by the World Health Organization, encompasses various dimensions such as physical and mental health, social relationships, and environmental well-being [ 5 , 6 ]. Nurses with a lower quality of life tend to have poorer job performance [ 7 ]. Given the influence of living conditions and stressors on nurses' health and quality of life, it is essential to prioritize their well-being, as they play a crucial role in protecting the health of society [ 8 ]. Neglecting the mental health and quality of life of nurses can lead to decreased motivation, despair, and various physical and psychological disorders [ 9 ]. This can contribute to high job turnover rates, resulting in significant costs for the healthcare system [ 10 ]. While researching the quality of life of nurses is important, it is a complex concept with multiple dimensions influenced by factors such as age, culture, gender, education, socioeconomic status, and more [ 11 ]. Studying all these factors in working individuals poses challenges. Research studies on the quality of life of nurses raise awareness among policymakers and inform better planning for improved working conditions [ 12 ]. These studies emphasize the significance of addressing this complex issue, which is influenced by factors such as age, culture, education, and socioeconomic status [ 10 ]. Implementing a comprehensive tool to assess the quality of life of nurses in Iran would enable focused evaluation and identification of areas for improvement. Prioritizing the quality of life for nurses is crucial for enhancing job satisfaction and improving patient care [ 13 ]. The current scales used to assess the quality of life of nurses can be categorized into two groups: general scales designed for the general population and work-related scales specifically tailored for nurses. However, these scales do not comprehensively address all aspects of nurses' quality of life. Therefore, there is a need for a valid and specific tool. The Nurse Quality of Life Scale (NQOLS) is a suitable tool that integrates various dimensions of nurses' quality of life into four domains. It takes into account the unique circumstances of nurses and provides a precise and comprehensive assessment [ 14 ]. Translating and validating the Persian version of the NQOLS in this study aims to facilitate a more precise evaluation of nurses' quality of life in Iran. It can serve as a basis for additional research and interventions aimed at improving the quality of life for nurses and enhancing patient care. Methods Study Design This methodological study carried out in the cities of Gonabad and Sabzevar in northeastern Iran from April to November 2023. Scale The Nurse Quality of Life Scale (NQOLS) was developed by Zaghini et al. to evaluate the quality of life of nurses. The scale comprises 28 items categorized into four domains: physical, emotional, work, and social dimensions. Respondents rate their satisfaction using a 4-point Likert scale. Higher scores indicate a better quality of life. The scale showed good fit and reliability, with omega coefficients ranging from 0.84 to 0.92 for components and 0.93 for the overall scale [ 14 ]. Demographic Questionnaire The demographic questionnaire aimed to gather essential information about the background characteristics of the participants. The survey included various items related to age, gender, level of education, marital status, shift work schedule, work experience, overtime hours, willingness to work overtime, income level, and the specific department where the nurses worked. These demographic variables were considered important factors for capturing a comprehensive understanding of the sample's characteristics and their potential influence on the research outcomes. Scale translation The scale was translated following the guidelines of Wild et al(2005) [ 15 ], and with permission from the original developers. Two translators, proficient in English and Persian, translated the scale into Persian. Their translations were compared and modified to create a final version. Two additional translators, fluent in both languages, then translated the Persian version back into English. The original tool designer then validated the translated version. The translated scale was subsequently validated for face validity, content validity, construct validity, internal consistency, and scale stability. Validity Face validity: The scale translated into Persian was given to 20 nurses to evaluate the face validity using a qualitative method, and the items were assessed in term of difficulty level, appropriateness level and wording ambiguity. Quantitative analysis involved calculating item impact scores to assess their significance [ 16 ]. Content validity: To assess the content validity using a qualitative and quantitative method. 10 experts (professional nurses and expert in the field of psychometrics) were asked to give their opinion on language accuracy, word suitability, and item arrangement. Quantitative assessment utilized the Content Validity Ratio (CVR) and Content Validity Index (CVI), with a focus on relevance [ 17 ]. A minimum CVR value of 0.62 was required. Overall, both the face and content validity were rigorously examined to ensure the accuracy and appropriateness of the research instrument. . Participants The study included all nurses working in different clinical departments at educational hospitals in Gonabad and Sabzevar. A sample of 500 nurses completed the Persian version of the Nurses' Quality of Life Scale for psychometric evaluation. The inclusion criteria included having a bachelor's degree in nursing, being employed in clinical departments, providing consent to participate, and having at least one year of clinical experience. Non-participation and incomplete questionnaires were excluded. Sample For exploratory factor analysis, it is recommended to have a sample size of approximately 100 to 250 individuals, or 2 to 20 individuals per item [ 18 ]. For confirmatory factor analysis, it is recommended to have a sample size of 150 to 500 individuals [ 19 ]. The study involved 500 nurses, who were randomly divided into two sub-samples: 200 for exploratory factor analysis and 300 for confirmatory factor analysis. Data Analysis Descriptive statistics were utilized to report participant characteristics. Mean and standard deviation were used to analyze quantitative variables, while frequency and percentage were used for qualitative variables. Construct Validity Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Exploratory Factor Analysis (EFA) An exploratory factor analysis (EFA) was conducted on a sample of 200 individuals. The suitability of the data for exploratory factor analysis (EFA) was assessed using the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test of sphericity. Confirmatory Factor Analysis (CFA ) CFA was conducted on a sample of 300 individuals using LISREL software version 8.8. Model fit was assessed using several indices, including Incremental Fit Index (IFI), Normed Fit Index (NFI), Non-Normed Fit Index (NNFI or TLI), Comparative Fit Index (CFI), Goodness-of-Fit Index (GFI), chi-square to degrees of freedom ratio, and Root Mean Square Error of Approximation (RMSEA). These indices are commonly used to assess the fit of the CFA model. Scale reliability Two methods were employed to evaluate the reliability of the scale in this study. Internal consistency reliability and test-retest reliability. Internal consistency reliability was assessed using Cronbach's alpha coefficient with a sample of 200 volunteer nurses. A minimum acceptable value of 0.70 was established for item acceptance. Stability and reliability were evaluated using a test-retest method with a two-week interval for 30 nurses. The intraclass correlation coefficient (ICC) was calculated to measure the reliability of stability. Values between 0.50 and 0.75 were considered to indicate good reliability, while values exceeding 0.75 were considered to indicate high reliability. Ethical consideration The research proposal was approved by the Ethics Committee of Gonabad University of Medical Sciences (code: IR.GMU.REC.1402.002), and informed consent was obtained from participants. The questionnaires used in the study were designed to ensure anonymity and did not contain any personal identifying information. Results Demographic characteristics The demographic characteristics of the participants are presented in Table 1 . Table 1 Demographic characteristics of the participants (N = 500) Variable Categories N (%) Gender Men 222 (44.4) Female 278 (55.6) City Gonabad 220 (44) Sabzevar 280 (56) Academic degree bachelor's degree 407 (81.4) Master's degree 92 (18.2) PhD 1 (0.2) Marital status Married 309 (61.8) Single 191 (38.2) Income Low 230 (46) Moderate 261 (52.2) High 9 (1.8) Shift status Temporary 447 (89.4) Stable 53 (10.6) Overtime Yes 404 (80.8) No 96 (19.2) Willingness to work overtime Yes 153 (30.6) No 347 (69.4) Employment status Temporary 183 (36.6) Contractual 80 (16) Official 237 (47.4) Ward of work Internal (20/2) 101 Surgery (14/2) 71 Intensive care unit (27/6) 138 Pediatric (8/2) 41 Emergency department (22) 110 Psychiatric (7/8) 39 Variable Mean ± SD Age 31.03 ± 6.27 Overtime (hours/month) 62.63 ± 29.90 Work experience (year) 7.35 ± 6.09 Face and content validity Face validity was qualitatively assessed with input from nurses, while content validity was evaluated with input from experts, nursing stakeholders, and psychologists. Minor modifications were made to the wording of items without changing their meaning. Content validity was also quantitatively assessed using CVI and CVR values, which were obtained from the opinions of ten experts (Table 2 ). No items were excluded due to these validity measures. Table 2 CVR, CVI and factor loading of the Persian NQOLS Item Item content Content validity Factor loading CVR CVI F1 F2 F3 F4 F5 F6 1 I am satisfied with the amount of my sleep 1 1 0.801 2 I am satisfied with the quality of my sleep 1 1 0.838 3 I am satisfied with the quality of my nutrition 1 1 0.648 4 I am satisfied with my eating habits 1 1 0.588 5 I am satisfied with my physical health 1 1 0.495 6 I am satisfied with my physical appearance and physical image 1 1 0.665 7 I am satisfied with my physical skills 0.8 1 0.711 8 I am satisfied with my level of physical activity 1 1 0.741 9 I am satisfied with the number of my sexual relations 1 1 0.858 10 I am satisfied with the quality of my sexual relations 1 1 0.844 11 I am satisfied with my resistance in stressful situations 1 1 0.621 12 I am satisfied with my mood 1 1 0.665 13 I am satisfied with my mental efficiency 1 1 0.631 14 I am satisfied with my emotional stability 0.8 1 0.583 15 I am satisfied with my self-confidence 1 1 0.761 16 I am satisfied with my ability to solve problems 1 1 0.757 17 I am satisfied with my psychological independence 0.8 1 0.688 18 I am satisfied with my capacity to control myself 0.8 1 0.638 19 I am satisfied with my type of job 1 1 0.767 20 I am satisfied with the way my work is organized 1 1 0.737 21 I am satisfied with my professional role 1 1 0.820 22 I am satisfied with what I do in my job 1 1 0.804 23 I am satisfied with my relationships with others 1 1 0.711 24 I am satisfied with my role in my family 1 1 0.674 25 I am satisfied with the relationships I have with my relatives 1 1 0.851 26 I am satisfied with the relationships I have with my friends 1 1 0.697 27 I am satisfied with the relationships I have with my colleagues 1 1 0.628 28 I am satisfied with my financial situation 1 1 0.328 Construct validity Exploratory Factor Analysis (EFA) In the exploratory factor analysis (EFA) with a sample size of N = 200, the Kaiser-Meyer-Olkin (KMO) measure was 0.866, indicating sufficient sample adequacy [ 20 ]. The Bartlett's test of sphericity was significant (χ 2 = 2629.789, df = 378, p 1 were identified, explaining 62.15% of the total variance of the Nursing Quality of Life Scale (NQOLS). The six-factor structure, labeled as Self-care (F 1 ), Physical (F 2 ), Sexual (F 3 ), Emotional (F 4 ), Career (F 5 ), and Social (F 6 ) dimensions, was confirmed (Table 2 ). Confirmatory Factor Analysis (CFA) To evaluate the appropriateness of the model derived from the EFA with a six-factor structure, a CFA was performed. The model fit indices for the CFA are presented in Table 3 . Based on the CFA results, it was determined that the obtained model demonstrated a good fit according to the fit indices, confirming the six-factor structure for the Persian version of the NQOLS (Table 3 ). Table 3 Model fit indices of CFA for the Persian version of the NQOLS Index IFI GFI CFI NFI RMSEA χ 2 /df (p value) value 0.96 0.84 0.96 0.93 0.068 783.38/335 (< 0.0001) IFI: Incremental Fit Index, GFI: Goodness of Fit Index, CFI: Comparative Fit Index, NFI: Normed Fit Index, RMSEA: Root Mean Square Error of Approximation Reliability The Cronbach's alpha values obtained for the scale factors ranged from 0.764 to 0.911, indicating satisfactory internal consistency for the Persian version of the NQOLS. The minimum threshold of 0.764 was met for each factor, indicating sufficient reliability. The overall scale exhibited a Cronbach's alpha value of 0.911, indicating strong internal consistency for the entire scale. To evaluate the test-retest reliability, we calculated the intraclass correlation coefficient (ICC), which yielded a value of 0.958 for the overall scale. This indicates a high level of stability in repeated measurements. (CI: 95%, 0.912–0.980, p-value < 0.001) (Table 4 ). Table 4 ICC and Cronbach α of the Persian NQOLS Factors Number of items Cronbach α ICC Self-caring 4 0.764 0.918 Physical 4 0.768 0.894 Sexual 2 0.910 0.902 Emotional 8 0.875 0.931 Career 5 0.826 0.942 Social 5 0.837 0.885 Total scale 28 0.911 0.958 ICC: intraclass coefficient correlation Discussion The study aimed to examine the psychometric properties and factor structure of the translated Nurses' Quality of Life Scale among Iranian nurses. The findings indicate that the Persian version of the scale exhibited suitable validity and reliability within the Iranian nursing community. However, no previous research has specifically focused on adapting the scale to the cultural context of Iranian nurses. Furthermore, there is limited research on the psychometric properties of the scale in other countries and languages beyond the original Italian study. Quality of life, now recognized as an important indicator of health, refers to the factors that contribute to a satisfying life [ 21 ]. It is a dynamic concept that evolves over time [ 22 ]. Quality of life is defined as the combination of characteristics that are valuable to an individual and contribute to a sense of comfort, well-being, and satisfaction. These characteristics support the development and maintenance of physical, emotional, and cognitive functioning. It enables individuals to maintain their abilities in meaningful life activities [ 23 ]. Nursing, by its very nature, presents unique challenges and issues for practitioners, which can significantly impact their quality of life [ 24 ]. The present study's findings on the face and content validity determination indicate that all items of the scale have been confirmed to be relevant, clear, and simple after undergoing minor modifications. Furthermore, the obtained CVI values indicate that the Persian version of the NQOLS possesses a highly suitable content validity, demonstrating its ability to measure the quality of life among Iranian nurses effectively. The original NQOLS version, designed and validated by Zaghini et al. in Italy, comprises 28 items and 4 factors [ 14 ]. However, in our study, after conducting exploratory factor analysis and thoroughly examining the results, the questionnaire with 28 items (without excluding any items from the original questionnaire) and 6 factors was deemed more appropriate than other alternatives. The findings from the exploratory factor analysis revealed that the six factors of the nurses' quality of life scale collectively account for 62.15% of the total variance. Regarding the selection of factor names, careful consideration was given to the content of the respective items. The factor names were chosen in line with the original version of the scale and with reference to the nursing foundations of Koozar and Erb [ 25 ], aiming to select the most suitable names. Based on the objective of translating and validating measurement tools, the aim is to ensure their cultural appropriateness within a specific society. Therefore, in the current study, in line with the cultural background of Iranian nurses, a six-factor structure was derived for this instrument. It should be noted that validation studies of quality of life measurement tools in different languages may not necessarily yield the same number of items, factors, or item placement as the original versions [ 26 , 27 ]. In our study, some items were allocated to different factors compared to the original version of the questionnaire. This discrepancy could be attributed to cultural or linguistic variations. The fit indices for the six-factor structure of the Nurses' Quality of Life Scale, including NFI (0.93), CFI (0.96), GFI (0.83), IFI (0.96), RMSEA (0.068), X 2 /df (2.34), and p-value (< 0.0001), demonstrated an acceptable fit [ 28 ] for the extracted six-factor model in the present study. In accordance with the findings of our study, Zaghini et al. (2022) have validated the four-factor structure of the Nurses' Quality of Life Scale among Italian nurses in the community using confirmatory factor analysis (TLI = 0.96, CFI = 0.97, X2/df = 0.73, SRMR = 0.039, P = 0.000) [ 14 ]. In the present study, the reliability of the tool was assessed using two methods: internal consistency (Cronbach's alpha coefficient) and stability (test-retest). The Cronbach's alpha coefficients ranged from 0.74 to 0.91 for the subscales and 0.91 for the overall scale. Furthermore, the ICC for the entire tool was 0.95, which coefficients higher than 0.8 suggest that the scale has a high internal consistency [ 29 ]. Thus, based on the study results, it can be concluded that the Persian version of the Nurses' Quality of Life Scale exhibits high reliability for implementation in the Iranian nursing community. Zaghini et al. (2022) utilized the omega reliability coefficient to examine the internal consistency reliability of the NQOLS. Consistent with our findings, their study yielded omega reliability coefficients ranging from 0.84 to 0.92 for the factors and 0.93 for the overall scale, indicating the scale's reliability in measuring nurses' quality of life [ 14 ]. Additionally, the psychometric analysis conducted in this study suggests that the Persian version of the Nurses' Quality of Life Scale possesses strong validity for utilization within the Iranian nursing community. The scale aims to encompass various dimensions of quality of life, including physical, emotional, work-related, sexual, social, and family aspects. The scale items and factors were developed in consideration of the unique and specific circumstances encountered by nurses. In the design of the NQOLS, efforts were made to employ a minimal number of items with concise wording in order to facilitate ease of administration and save time [ 14 ]. Conclusion The Persian version of the Nurses' Quality of Life Scale has shown excellent levels of validity and reliability among the Iranian nursing community. Considering its favorable psychometric properties, ease of administration, and ability to specifically assess the quality of life in nurses, it is recommended to utilize this scale in various clinical and research settings, including both clinical practice and research projects. Abbreviations NQOLS = Nurses' Quality of Life Scale EFA= Exploratory Factor Analysis CFA= Confirmatory Factor Analysis NFI= Normed Fit Index IFI: Incremental Fit Index CFI = Comparative fit index GFI = goodness of fit index RMSEA= root-mean-square error of approximation CVI= content validity index CVR= content validity ratio ICC = Interclass Correlation Coefficient χ 2 = Chi square df = degree of freedom Declarations Ethics approval and consent to participate The research proposal was approved by the Ethics Committee of Gonabad University of Medical Sciences (code: IR.GMU.REC.1402.002), and informed consent was obtained from participants. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests "The authors declare that they have no competing interests". Funding The authors received no financial support for the research, authorship, and/or publication of this article. Authors' contributions Y M: design of the study, collecting the participants' data (in Gonabad) and entering data to the SPSS software, writing the first draft of the manuscript. SH H: design of the study and prepared the first draft of the manuscript. Kh E: collecting of the data (in Sabzevar), and was major contributor in drafting and writing the manuscript. S M: participated in the conception and design of the study, data analysis and interpretation, final revision of the manuscript. It should be noted that all authors have read and approved the manuscript. Acknowledgements Authors would like to extend our sincere gratitude and appreciation to the esteemed Deputy of Research and Technology at Gonabad and Sabzevar University of Medical Sciences, as well as all the participants who took part in this study. 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Kharazmi A, Brant JM, Sajjadi M, Moshki M, Sadegh Moghadam L. Validation of the Persian version of family health climate scale (FHC-Scale) in Iranian families. BMC Public Health. 2020;20(1):1854. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 18 Mar, 2024 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Revision requested 29 Jan, 2024 Reviews received at journal 28 Jan, 2024 Reviewers agreed at journal 23 Jan, 2024 Reviewers agreed at journal 23 Jan, 2024 Reviewers invited by journal 23 Jan, 2024 Editor invited by journal 23 Jan, 2024 Editor assigned by journal 23 Jan, 2024 Submission checks completed at journal 23 Jan, 2024 First submitted to journal 15 Jan, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3867545","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":268850429,"identity":"1467dbdb-3dcb-477e-901d-e0e415db0924","order_by":0,"name":"Mehrdad Yousefnezhad","email":"","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mehrdad","middleName":"","lastName":"Yousefnezhad","suffix":""},{"id":268850430,"identity":"c8a7c7dc-c3e9-4ec3-9275-057a095125c2","order_by":1,"name":"Habib Shareinia","email":"","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Habib","middleName":"","lastName":"Shareinia","suffix":""},{"id":268850431,"identity":"85b3db6d-b191-4131-888a-a19fe4b8cd98","order_by":2,"name":"Elahe Lal Kheirkhah","email":"","orcid":"","institution":"sabzevar university of medical sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Elahe","middleName":"Lal","lastName":"Kheirkhah","suffix":""},{"id":268850432,"identity":"8f3e481e-f158-440c-8ed8-9318128e8fee","order_by":3,"name":"Moosa Sajjadi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYHCCBAMGNgkefvn3Dx8AeTx8xGqRkWzIYTYAaWEjziI2BhuDAzlsEhA2ASDffuBBwY8yCx6DA2ePVX7NsZNhY2B++OgGHi0GZxISDHvOSfBIHuxLuy27LRnoMDZj4xx8WhgSEgx42yR4+A4zmN2W3MYM1MLDJo1Pi3z/gwTDv0AtDMcYzIolt9UT1sJwIyHBGGSLwBkeM8aP2w4T1mJw40GCsQzILzPYkqUZtx3nYWMm4Bf5/pw0wzdldfb8EswHP/7cVm3Pz9788DFehzHwpBnAmMw8YBKvchBgP/wAxmT8QVD1KBgFo2AUjEQAAPLOQ/jewwY2AAAAAElFTkSuQmCC","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Moosa","middleName":"","lastName":"Sajjadi","suffix":""}],"badges":[],"createdAt":"2024-01-15 19:59:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3867545/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3867545/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-024-01839-7","type":"published","date":"2024-03-18T15:00:54+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":53403544,"identity":"adbb1d11-e2de-47d4-83e3-1730d68a8b7d","added_by":"auto","created_at":"2024-03-25 15:12:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":358426,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3867545/v1/5c049d78-2e77-40b2-aa2c-4c81ab6d5fff.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Translation and Psychometric Evaluation of the Persian Version of the Nurses' Quality of Life Scale: A Validation Study in Iran","fulltext":[{"header":"Background","content":"\u003cp\u003eThe human workforce is essential for the success of organizations, including healthcare organizations [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Nurses play a crucial role in the healthcare system by ensuring the continuity of care and promoting health. However, nursing is a high-stress profession that can significantly impact the overall health and well-being of nurses [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The demanding nature of nursing work and the associated stressors can have a negative impact on the physical and emotional well-being of nurses. This can lead to physical and mental illnesses, as well as negative self-perceptions and attitudes. Ultimately, these factors diminish the overall quality of life for nurses [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Assessing the quality of life within communities is crucial for comprehending the health of societies and ensuring the well-being of individuals and communities [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Occupational factors and work conditions in the nursing profession can significantly impact the quality of life of nurses. Quality of life, as defined by the World Health Organization, encompasses various dimensions such as physical and mental health, social relationships, and environmental well-being [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Nurses with a lower quality of life tend to have poorer job performance [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Given the influence of living conditions and stressors on nurses' health and quality of life, it is essential to prioritize their well-being, as they play a crucial role in protecting the health of society [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Neglecting the mental health and quality of life of nurses can lead to decreased motivation, despair, and various physical and psychological disorders [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This can contribute to high job turnover rates, resulting in significant costs for the healthcare system [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. While researching the quality of life of nurses is important, it is a complex concept with multiple dimensions influenced by factors such as age, culture, gender, education, socioeconomic status, and more [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Studying all these factors in working individuals poses challenges. Research studies on the quality of life of nurses raise awareness among policymakers and inform better planning for improved working conditions [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. These studies emphasize the significance of addressing this complex issue, which is influenced by factors such as age, culture, education, and socioeconomic status [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Implementing a comprehensive tool to assess the quality of life of nurses in Iran would enable focused evaluation and identification of areas for improvement. Prioritizing the quality of life for nurses is crucial for enhancing job satisfaction and improving patient care [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The current scales used to assess the quality of life of nurses can be categorized into two groups: general scales designed for the general population and work-related scales specifically tailored for nurses. However, these scales do not comprehensively address all aspects of nurses' quality of life. Therefore, there is a need for a valid and specific tool. The Nurse Quality of Life Scale (NQOLS) is a suitable tool that integrates various dimensions of nurses' quality of life into four domains. It takes into account the unique circumstances of nurses and provides a precise and comprehensive assessment [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Translating and validating the Persian version of the NQOLS in this study aims to facilitate a more precise evaluation of nurses' quality of life in Iran. It can serve as a basis for additional research and interventions aimed at improving the quality of life for nurses and enhancing patient care.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis methodological study carried out in the cities of Gonabad and Sabzevar in northeastern Iran from April to November 2023.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eScale\u003c/h2\u003e \u003cp\u003eThe Nurse Quality of Life Scale (NQOLS) was developed by Zaghini et al. to evaluate the quality of life of nurses. The scale comprises 28 items categorized into four domains: physical, emotional, work, and social dimensions. Respondents rate their satisfaction using a 4-point Likert scale. Higher scores indicate a better quality of life. The scale showed good fit and reliability, with omega coefficients ranging from 0.84 to 0.92 for components and 0.93 for the overall scale [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eDemographic Questionnaire\u003c/h2\u003e \u003cp\u003eThe demographic questionnaire aimed to gather essential information about the background characteristics of the participants. The survey included various items related to age, gender, level of education, marital status, shift work schedule, work experience, overtime hours, willingness to work overtime, income level, and the specific department where the nurses worked. These demographic variables were considered important factors for capturing a comprehensive understanding of the sample's characteristics and their potential influence on the research outcomes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eScale translation\u003c/h2\u003e \u003cp\u003eThe scale was translated following the guidelines of Wild et al(2005) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], and with permission from the original developers. Two translators, proficient in English and Persian, translated the scale into Persian. Their translations were compared and modified to create a final version. Two additional translators, fluent in both languages, then translated the Persian version back into English. The original tool designer then validated the translated version. The translated scale was subsequently validated for face validity, content validity, construct validity, internal consistency, and scale stability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eValidity\u003c/h2\u003e \u003cp\u003eFace validity: The scale translated into Persian was given to 20 nurses to evaluate the face validity using a qualitative method, and the items were assessed in term of difficulty level, appropriateness level and wording ambiguity. Quantitative analysis involved calculating item impact scores to assess their significance [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eContent validity: To assess the content validity using a qualitative and quantitative method. 10 experts (professional nurses and expert in the field of psychometrics) were asked to give their opinion on language accuracy, word suitability, and item arrangement. Quantitative assessment utilized the Content Validity Ratio (CVR) and Content Validity Index (CVI), with a focus on relevance [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A minimum CVR value of 0.62 was required. Overall, both the face and content validity were rigorously examined to ensure the accuracy and appropriateness of the research instrument.\u003c/p\u003e \u003cp\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe study included all nurses working in different clinical departments at educational hospitals in Gonabad and Sabzevar. A sample of 500 nurses completed the Persian version of the Nurses' Quality of Life Scale for psychometric evaluation. The inclusion criteria included having a bachelor's degree in nursing, being employed in clinical departments, providing consent to participate, and having at least one year of clinical experience. Non-participation and incomplete questionnaires were excluded.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eSample\u003c/h2\u003e \u003cp\u003eFor exploratory factor analysis, it is recommended to have a sample size of approximately 100 to 250 individuals, or 2 to 20 individuals per item [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. For confirmatory factor analysis, it is recommended to have a sample size of 150 to 500 individuals [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The study involved 500 nurses, who were randomly divided into two sub-samples: 200 for exploratory factor analysis and 300 for confirmatory factor analysis.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics were utilized to report participant characteristics. Mean and standard deviation were used to analyze quantitative variables, while frequency and percentage were used for qualitative variables.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eConstruct Validity\u003c/h2\u003e \u003cp\u003eConstruct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eExploratory Factor Analysis (EFA)\u003c/h2\u003e \u003cp\u003eAn exploratory factor analysis (EFA) was conducted on a sample of 200 individuals. The suitability of the data for exploratory factor analysis (EFA) was assessed using the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test of sphericity.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConfirmatory Factor Analysis (CFA\u003c/b\u003e)\u003c/p\u003e \u003cp\u003eCFA was conducted on a sample of 300 individuals using LISREL software version 8.8. Model fit was assessed using several indices, including Incremental Fit Index (IFI), Normed Fit Index (NFI), Non-Normed Fit Index (NNFI or TLI), Comparative Fit Index (CFI), Goodness-of-Fit Index (GFI), chi-square to degrees of freedom ratio, and Root Mean Square Error of Approximation (RMSEA). These indices are commonly used to assess the fit of the CFA model.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eScale reliability\u003c/h2\u003e \u003cp\u003eTwo methods were employed to evaluate the reliability of the scale in this study. Internal consistency reliability and test-retest reliability. Internal consistency reliability was assessed using Cronbach's alpha coefficient with a sample of 200 volunteer nurses. A minimum acceptable value of 0.70 was established for item acceptance. Stability and reliability were evaluated using a test-retest method with a two-week interval for 30 nurses. The intraclass correlation coefficient (ICC) was calculated to measure the reliability of stability. Values between 0.50 and 0.75 were considered to indicate good reliability, while values exceeding 0.75 were considered to indicate high reliability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e The research proposal was approved by the Ethics Committee of Gonabad University of Medical Sciences (code: IR.GMU.REC.1402.002), and informed consent was obtained from participants. The questionnaires used in the study were designed to ensure anonymity and did not contain any personal identifying information.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eDemographic characteristics\u003c/h2\u003e\n \u003cp\u003eThe demographic characteristics of the participants are presented in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographic characteristics of the participants (N\u0026thinsp;=\u0026thinsp;500)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e222 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e278 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eCity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGonabad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e220 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSabzevar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e280 (56)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eAcademic degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e407 (81.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMaster\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e309 (61.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e191 (38.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e230 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e261 (52.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eShift status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTemporary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e447 (89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eOvertime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e404 (80.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eWillingness to work overtime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e153 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e347 (69.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eEmployment status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTemporary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e183 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eContractual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOfficial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e237 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" align=\"left\"\u003e\n \u003cp\u003eWard of work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInternal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(20/2) 101\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSurgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(14/2) 71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIntensive care unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(27/6) 138\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePediatric\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(8/2) 41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmergency department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(22) 110\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePsychiatric\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(7/8) 39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.03\u0026thinsp;\u0026plusmn;\u0026thinsp;6.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOvertime (hours/month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.63\u0026thinsp;\u0026plusmn;\u0026thinsp;29.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWork experience (year)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.35\u0026thinsp;\u0026plusmn;\u0026thinsp;6.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eFace and content validity\u003c/h2\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eFace validity was qualitatively assessed with input from nurses, while content validity was evaluated with input from experts, nursing stakeholders, and psychologists. Minor modifications were made to the wording of items without changing their meaning. Content validity was also quantitatively assessed using CVI and CVR values, which were obtained from the opinions of ten experts (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). No items were excluded due to these validity measures.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCVR, CVI and factor loading of the Persian NQOLS\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/th\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eItem content\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eContent validity\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"6\" align=\"left\"\u003e\n \u003cp\u003eFactor loading\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCVR\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCVI\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eF1\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eF2\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eF3\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eF4\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eF5\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eF6\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the amount of my sleep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.801\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the quality of my sleep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the quality of my nutrition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.648\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my eating habits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my physical health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my physical appearance and physical image\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.665\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my physical skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my level of physical activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the number of my sexual relations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.858\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the quality of my sexual relations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my resistance in stressful situations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.621\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my mood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.665\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my mental efficiency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my emotional stability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my self-confidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my ability to solve problems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my psychological independence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my capacity to control myself\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.638\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my type of job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.767\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the way my work is organized\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.737\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my professional role\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with what I do in my job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.804\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my relationships with others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my role in my family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.674\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the relationships I have with my relatives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.851\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the relationships I have with my friends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.697\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with the relationships I have with my colleagues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.628\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am satisfied with my financial situation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n \u003ch2\u003eConstruct validity\u003c/h2\u003e\n \u003cdiv id=\"Sec19\" class=\"Section3\"\u003e\n \u003ch2\u003eExploratory Factor Analysis (EFA)\u003c/h2\u003e\n \u003cp\u003eIn the exploratory factor analysis (EFA) with a sample size of N\u0026thinsp;=\u0026thinsp;200, the Kaiser-Meyer-Olkin (KMO) measure was 0.866, indicating sufficient sample adequacy [\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e]. The Bartlett\u0026apos;s test of sphericity was significant (\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;2629.789, df\u0026thinsp;=\u0026thinsp;378, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), indicating that the data is suitable for factor analysis. Six factors with eigenvalues\u0026thinsp;\u0026gt;\u0026thinsp;1 were identified, explaining 62.15% of the total variance of the Nursing Quality of Life Scale (NQOLS). The six-factor structure, labeled as Self-care (F\u003csub\u003e1\u003c/sub\u003e), Physical (F\u003csub\u003e2\u003c/sub\u003e), Sexual (F\u003csub\u003e3\u003c/sub\u003e), Emotional (F\u003csub\u003e4\u003c/sub\u003e), Career (F\u003csub\u003e5\u003c/sub\u003e), and Social (F\u003csub\u003e6\u003c/sub\u003e) dimensions, was confirmed (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\n \u003ch2\u003eConfirmatory Factor Analysis (CFA)\u003c/h2\u003e\n \u003cp\u003eTo evaluate the appropriateness of the model derived from the EFA with a six-factor structure, a CFA was performed. The model fit indices for the CFA are presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. Based on the CFA results, it was determined that the obtained model demonstrated a good fit according to the fit indices, confirming the six-factor structure for the Persian version of the NQOLS (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eModel fit indices of CFA for the Persian version of the NQOLS\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eIndex\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eIFI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eGFI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCFI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNFI\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eRMSEA\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e/df (p value)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e783.38/335 (\u0026lt;\u0026thinsp;0.0001)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eIFI: Incremental Fit Index, GFI: Goodness of Fit Index, CFI: Comparative Fit Index,\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eNFI: Normed Fit Index, RMSEA: Root Mean Square Error of Approximation\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\n \u003ch2\u003eReliability\u003c/h2\u003e\n \u003cp\u003eThe Cronbach\u0026apos;s alpha values obtained for the scale factors ranged from 0.764 to 0.911, indicating satisfactory internal consistency for the Persian version of the NQOLS. The minimum threshold of 0.764 was met for each factor, indicating sufficient reliability. The overall scale exhibited a Cronbach\u0026apos;s alpha value of 0.911, indicating strong internal consistency for the entire scale. To evaluate the test-retest reliability, we calculated the intraclass correlation coefficient (ICC), which yielded a value of 0.958 for the overall scale. This indicates a high level of stability in repeated measurements. (CI: 95%, 0.912\u0026ndash;0.980, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eICC and Cronbach \u0026alpha; of the Persian NQOLS\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFactors\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber of items\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCronbach \u0026alpha;\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-caring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.764\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.918\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhysical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.768\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.894\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmotional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.931\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCareer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.826\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.942\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSocial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.885\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.911\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\"\u003e\u003cem\u003eICC: intraclass coefficient correlation\u003c/em\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u0026nbsp;\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study aimed to examine the psychometric properties and factor structure of the translated Nurses' Quality of Life Scale among Iranian nurses. The findings indicate that the Persian version of the scale exhibited suitable validity and reliability within the Iranian nursing community. However, no previous research has specifically focused on adapting the scale to the cultural context of Iranian nurses. Furthermore, there is limited research on the psychometric properties of the scale in other countries and languages beyond the original Italian study. Quality of life, now recognized as an important indicator of health, refers to the factors that contribute to a satisfying life [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. It is a dynamic concept that evolves over time [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Quality of life is defined as the combination of characteristics that are valuable to an individual and contribute to a sense of comfort, well-being, and satisfaction. These characteristics support the development and maintenance of physical, emotional, and cognitive functioning. It enables individuals to maintain their abilities in meaningful life activities [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Nursing, by its very nature, presents unique challenges and issues for practitioners, which can significantly impact their quality of life [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe present study's findings on the face and content validity determination indicate that all items of the scale have been confirmed to be relevant, clear, and simple after undergoing minor modifications. Furthermore, the obtained CVI values indicate that the Persian version of the NQOLS possesses a highly suitable content validity, demonstrating its ability to measure the quality of life among Iranian nurses effectively. The original NQOLS version, designed and validated by Zaghini et al. in Italy, comprises 28 items and 4 factors [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, in our study, after conducting exploratory factor analysis and thoroughly examining the results, the questionnaire with 28 items (without excluding any items from the original questionnaire) and 6 factors was deemed more appropriate than other alternatives. The findings from the exploratory factor analysis revealed that the six factors of the nurses' quality of life scale collectively account for 62.15% of the total variance. Regarding the selection of factor names, careful consideration was given to the content of the respective items. The factor names were chosen in line with the original version of the scale and with reference to the nursing foundations of Koozar and Erb [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], aiming to select the most suitable names. Based on the objective of translating and validating measurement tools, the aim is to ensure their cultural appropriateness within a specific society. Therefore, in the current study, in line with the cultural background of Iranian nurses, a six-factor structure was derived for this instrument. It should be noted that validation studies of quality of life measurement tools in different languages may not necessarily yield the same number of items, factors, or item placement as the original versions [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In our study, some items were allocated to different factors compared to the original version of the questionnaire. This discrepancy could be attributed to cultural or linguistic variations. The fit indices for the six-factor structure of the Nurses' Quality of Life Scale, including NFI (0.93), CFI (0.96), GFI (0.83), IFI (0.96), RMSEA (0.068), X\u003csup\u003e2\u003c/sup\u003e/df (2.34), and p-value (\u0026lt;\u0026thinsp;0.0001), demonstrated an acceptable fit [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] for the extracted six-factor model in the present study. In accordance with the findings of our study, Zaghini et al. (2022) have validated the four-factor structure of the Nurses' Quality of Life Scale among Italian nurses in the community using confirmatory factor analysis (TLI\u0026thinsp;=\u0026thinsp;0.96, CFI\u0026thinsp;=\u0026thinsp;0.97, X2/df\u0026thinsp;=\u0026thinsp;0.73, SRMR\u0026thinsp;=\u0026thinsp;0.039, P\u0026thinsp;=\u0026thinsp;0.000) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In the present study, the reliability of the tool was assessed using two methods: internal consistency (Cronbach's alpha coefficient) and stability (test-retest). The Cronbach's alpha coefficients ranged from 0.74 to 0.91 for the subscales and 0.91 for the overall scale. Furthermore, the ICC for the entire tool was 0.95, which coefficients higher than 0.8 suggest that the scale has a high internal consistency [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Thus, based on the study results, it can be concluded that the Persian version of the Nurses' Quality of Life Scale exhibits high reliability for implementation in the Iranian nursing community. Zaghini et al. (2022) utilized the omega reliability coefficient to examine the internal consistency reliability of the NQOLS. Consistent with our findings, their study yielded omega reliability coefficients ranging from 0.84 to 0.92 for the factors and 0.93 for the overall scale, indicating the scale's reliability in measuring nurses' quality of life [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Additionally, the psychometric analysis conducted in this study suggests that the Persian version of the Nurses' Quality of Life Scale possesses strong validity for utilization within the Iranian nursing community. The scale aims to encompass various dimensions of quality of life, including physical, emotional, work-related, sexual, social, and family aspects. The scale items and factors were developed in consideration of the unique and specific circumstances encountered by nurses. In the design of the NQOLS, efforts were made to employ a minimal number of items with concise wording in order to facilitate ease of administration and save time [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe Persian version of the Nurses' Quality of Life Scale has shown excellent levels of validity and reliability among the Iranian nursing community. Considering its favorable psychometric properties, ease of administration, and ability to specifically assess the quality of life in nurses, it is recommended to utilize this scale in various clinical and research settings, including both clinical practice and research projects.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eNQOLS\u0026nbsp;=\u0026nbsp;Nurses\u0026apos; Quality of Life Scale\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEFA= Exploratory Factor Analysis\u003c/p\u003e\n\u003cp\u003eCFA= Confirmatory Factor Analysis\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNFI= Normed Fit Index\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIFI: Incremental Fit Index\u003c/p\u003e\n\u003cp\u003eCFI = Comparative fit index \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGFI = goodness of fit index\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRMSEA= root-mean-square error of approximation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCVI= content validity index\u003c/p\u003e\n\u003cp\u003eCVR= content validity ratio\u003c/p\u003e\n\u003cp\u003eICC = Interclass Correlation Coefficient\u003c/p\u003e\n\u003cp\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e= Chi square\u003c/p\u003e\n\u003cp\u003edf = degree of freedom\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThe research proposal was approved by the Ethics Committee of Gonabad University of Medical Sciences (code: IR.GMU.REC.1402.002), and informed consent was obtained from participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Competing interests\u003c/p\u003e\n\u003cp\u003e\u0026quot;The authors declare that they have no competing interests\u0026quot;.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThe authors received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eY M:\u0026nbsp;design of the study, collecting the participants\u0026apos; data (in Gonabad) and entering data to the SPSS software, writing the first draft of the manuscript.\u003c/p\u003e\n\u003cp\u003eSH H: design of the study and prepared the first draft of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKh E:\u0026nbsp;collecting of the data (in Sabzevar), and was major contributor in drafting and writing the manuscript.\u003c/p\u003e\n\u003cp\u003eS M:\u0026nbsp;participated in the conception and design of the study, data analysis and interpretation, final revision of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIt should be noted that all authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eAuthors would like to extend our sincere gratitude and appreciation to the esteemed Deputy of Research and Technology at Gonabad and Sabzevar University of Medical Sciences, as well as all the participants who took part in this study. Their valuable contributions and cooperation were essential to the successful completion of this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDean BB, Crawley JA, Schmitt CM, Ofman JJ. The association between worker productivity and quality of life in GERD. Am J Gastroenterol. 2001;9(96):276\u0026ndash;S277.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNajafpour Z, Mahmoodi M, Pourreaza A. Analysis of patient safety indicators in hospitals affiliated with Tehran University of Medical Sciences: recommendations for improving patient safety. J Hosp. 2015;13(4):53\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen M-C, Huang Y-W, Sun C-A, Lee C-H, Hsiao S-M, Chou Y-C, Han T-C, Yang T. 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Avicenna J Nurs Midwifery Care. 2021;29(1):1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoshtaghi M, Asghari Ebrahimabad MJ, Salayani F. Associations between Resilience and Quality of Life in Nurses: The Mediating Role of Emotional Expressivity. J Mazandaran Univ Med Sci. 2020;30(191):53\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLebni JY, Toghroli R, Abbas J, Kianipour N, NeJhaddadgar N, Salahshoor MR, Chaboksavar F, Moradi F, Ziapour A. Nurses\u0026rsquo; work-related quality of life and its influencing demographic factors at a public hospital in Western Iran: a cross-sectional study. Int Q Community Health Educ. 2021;42(1):37\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChegini Z, Asghari Jafarabadi M, Kakemam E. Occupational stress, quality of working life and turnover intention amongst nurses. Nurs Crit Care. 2019;24(5):283\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBall J, Day T, Murrells T, Dall\u0026rsquo;Ora C, Rafferty AM, Griffiths P, Maben J. Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures. BMC Nurs. 2017;16(1):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSili A, Maria MD, Fiorini J, Zaghini F, Barbarnelli C. Nurses\u0026rsquo; Quality of Life Scale: Validation and Psychometric Properties. Eval Health Prof. 2022;45(3):249\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. 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Volume 1. lippincott williams \u0026amp; wilkins; 2005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchmitt TA. Current methodological considerations in exploratory and confirmatory factor analysis. J Psychoeducational Assess. 2011;29(4):304\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBourdel N, Chauvet P, Billone V, Douridas G, Fauconnier A, Gerbaud L, Canis M. Systematic review of quality of life measures in patients with endometriosis. PLoS ONE. 2019;14(1):e0208464.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUysal M, Sirgy MJ, Woo E, Kim HL. Quality of life (QOL) and well-being research in tourism. Tour Manag. 2016;53:244\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMikhail E, Azizoglu S, Gokhale M, Suphioglu C. Questionnaires assessing the quality of life of ocular allergy patients. J Allergy Clin Immunology: Pract. 2020;8(9):2945\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSukut O, Sahin-Bayindir G, Ayhan‐Balik CH, Albal E. Professional quality of life and psychological resilience among psychiatric nurses. Perspect Psychiatr Care 2022, 58(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBerman AT, Snyder S, Frandsen G. Kozier \u0026amp; Erb's Fundamentals of Nursing: Concepts, Process, and Practice (10th. Edition: Macmillan Heinemann; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMazloumi A, Kazemi Z, Mehrdad R, Shahri MHK, Hossein MP. Validity and reliability of WRQoL-2 questionnaire for assessment of nurses' quality of work life. J Health Saf Work 2017, 7(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh S. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. J school public health Inst public health Res. 2006;4(4):1\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBahri N, Sajjadi M, Hunter MS, Mohammadzadeh F. Translation, cross-cultural adaptation, and validation of the Persian version of the Attitude Towards Menopause scale. Menopause. 2023;30(9):933\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKharazmi A, Brant JM, Sajjadi M, Moshki M, Sadegh Moghadam L. Validation of the Persian version of family health climate scale (FHC-Scale) in Iranian families. BMC Public Health. 2020;20(1):1854.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Validation, quality of life, nurses, translation, psychometric evaluation, Iran","lastPublishedDoi":"10.21203/rs.3.rs-3867545/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3867545/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e The quality of life for nurses can be significantly impacted by various occupational factors that Influence their working conditions and professional performance. The current study aimed to translate and validate the Persian version of the Nurses' Quality of Life Scale.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterial and method \u003c/strong\u003e\u0026nbsp;In this methodological research, the Nurses' Quality of Life Scale (NQOLS) was utilized to assess the quality of life among 500 employed nurses in hospitals in the cities of Gonabad and Sabzevar. The translation process of the NQOLS followed the model proposed by Wild et al. The content validity of the Persian version of the scale was evaluated using the Content Validity Index (CVI) and Content Validity Ratio (CVR). Structural validity was assessed using exploratory and confirmatory factor analyses. Internal consistency reliability was assessed using Cronbach's alpha, while test-retest reliability was determined using the Intraclass Correlation Coefficient (ICC). Data analysis was conducted using SPSS version 26 and LISREL version 8.8 software.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e The exploratory factor analysis of the Persian version of NQOLS revealed six factors that accounted for 62.15% of the total variance. The structural validity of the extracted factors was confirmed through confirmatory factor analysis. The Cronbach's alpha coefficient and ICC for the entire questionnaire were 0.91 and 0.95, respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e The findings of the present study suggest that the Persian version of the NQOLS exhibits sufficient validity and reliability. Therefore, it can be used as an effective tool for measuring and examining the quality of life among nurses in Iran.\u003c/p\u003e","manuscriptTitle":"Translation and Psychometric Evaluation of the Persian Version of the Nurses' Quality of Life Scale: A Validation Study in Iran","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-25 08:56:27","doi":"10.21203/rs.3.rs-3867545/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-01-29T06:43:26+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-01-28T05:07:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"a0246875-9190-4045-afba-5cea04a696ce","date":"2024-01-23T11:07:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"6d0518e2-6141-49cf-a331-c2c390a0c6e0","date":"2024-01-23T09:46:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-01-23T09:41:19+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-01-23T08:19:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-01-23T08:17:21+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-01-23T08:17:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2024-01-15T19:49:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f82b4db3-5a02-4e41-9ed7-b64415324f6f","owner":[],"postedDate":"January 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-03-25T15:04:27+00:00","versionOfRecord":{"articleIdentity":"rs-3867545","link":"https://doi.org/10.1186/s12912-024-01839-7","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2024-03-18 15:00:54","publishedOnDateReadable":"March 18th, 2024"},"versionCreatedAt":"2024-01-25 08:56:27","video":"","vorDoi":"10.1186/s12912-024-01839-7","vorDoiUrl":"https://doi.org/10.1186/s12912-024-01839-7","workflowStages":[]},"version":"v1","identity":"rs-3867545","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3867545","identity":"rs-3867545","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}