دکتر ناصر حوایی

 Caring for stroke patients has negative consequences on the health of caregivers. Currently, there is no tool to measure caregiver strain in Iran. This research was conducted for the first time in Iran for the translation and psychometric analysis of the Persian version of the Modified Caregiver Strain Index.

 This methodological and cross-sectional study was conducted on caregivers of elderly people with stroke and included two stages of translation and psychometric properties phases. The translation of the questionnaire was done with the forward-backward method after obtaining permission from the developer. The sample size was 130 items. The psychometric properties phase included content validity, face validity, construct validity, test-retest reliability, and internal consistency.

 The modified caregiver strain index questionnaire was confirmed in terms of content and face validity. For construct validity, exploratory and confirmatory factor analysis were used. The results showed that the translated instrument variables are grouped into one component. Also, the translated tool had good test-retest reliability (0.85-0.98) and excellent internal consistency (0.94).

 The results of this study indicate that the Persian version of the modified caregiver strain index has good validity and reliability and can be implemented in different specialties and settings.

Adherence to treatment is an active and acceptable interaction between patient and therapist to achieve the desired therapeutic and preventive outcomes. The objective of this study is the overview of the aspects and factors affecting non-adherence and offering proper strategies in patients with cystic fibrosis. A database search for relevant articles related to adherence to treatment in cystic fibrosis, published from 2008 to 2015, was conducted using the key words of cystic fibrosis, adherence, treatment, children and parent. Three investigators reviewed 29 relevant articles. Cystic fibrosis is a multisystem fatal disease and its treatment process is costly and time consuming. However, adherence to treatment is lower than 50% even in industrial and developed societies. Many factors such as age, gender, education level of parents and children, attitudes and beliefs of parents and children about the disease, different treatment strategies, cultural differences, frequency of hospitalization, severity of the disease, location of treatment in hospital, home or clinic, stress of parents and children, social support and quality and quantity of health care system are effective in adherence to treatment. Dynamic and respectful communication between the patient and the therapist, introducing benefits of adherence and providing recommendations with the aim of increasing of the survival rate will motivate patient in hopeful manner and enable him/her to comply with costly and time-consuming treatment process. So, it is recommended to all health care professionals to be familiarized with the concept of adherence, identify the barriers and facilitators of adherence and adapt appropriate strategies to achieve better results.

Developmental dysgraphia is a kind of learning disabilities in school students. Evaluation of the sensory and motor skills in hand of these persons by appropriate, functional and real tests demonstrates that their fine and complex hand sensory-motor abilities are prerequisites of intervention planning. Purdue Pegboard and Two-Point Discrimination Tests are used for evaluation of the hand motor and sensory skills respectively. This study was aimed to evaluate the test-retest reliability of these tests in students with developmental dysgraphia. In this descriptive-analytic study hand sensory-motor skills were evaluated in 23 students with developmental dysgraphia (8-11 years) in Tabriz city by Purdue Pegboard and static and moving Two-Point Discrimination tests. Test-retest reliability of mentioned tests was done between and within examiners via intra-class correlation coefficient and independent t-test was done for the comparison of the skills between girls and boys and right and left-handed students and Pearson correlation coefficient was calculated for the relationship between motor and sensory skills. Intra-class correlation coefficients of Purdue Pegboard, static and moving two-point discrimination tests for inter-session and intra-session reliability were ranged from 0.77 to 0.94 and 0.69 to 0.92 respectively. There was no significant relationship between motor and sensory skills (p>0.05). Because of high reliability of these tests, it can be used them for evaluating the sensory-motor skills and intervention planning in students with developmental dysgraphia. Loss of relationship between motor and sensory skills can be related to the pathology of dysgraphia that needs further researches.