structural equation modeling

Considering special needs, paying attention to health-promoting behaviors, and adopting a healthy lifestyle during old age is of considerable importance. Therefore, this research was conducted with the aim of explaining the relationship between self-efficacy and health-related lifestyle in the elderly.

This descriptive-correlational study was conducted on 370 elderly people of Mallard City, Iran, by
multi-stage random sampling method. To collect data, lifestyle questionnaires related to health in the elderly and Sherer General Self-Efficacy Scale (GSES) were used. Data were tested and analyzed using descriptive statistics (central and dispersion indices), Pearson's correlation test, and structural equation modeling (SEM) in EQS and SPSS software.

Examining the goodness-of-fit index (GFI) results indicated that the model had a good fit and GFI was found to be within the acceptable range. Furthermore, the analysis of the research hypotheses revealed that the self-efficacy scores of the elderly had a direct and significant relationship with the overall health-related lifestyle score and all its components (P < 0.001).

Self-efficacy has a direct relationship with the lifestyle related to health and all its components, especially exercise and prevention, and can be one of the most important factors influencing health behaviors. Educational and especially intervention measures are emphasized to increase self-efficacy in the elderly.

 A fearless organization fosters psychological safety, ensuring that every member feels secure to express concerns, ask questions, or share mistakes without fear of humiliation, ridicule, or punishment. This research aims to introduce the Fearless Organization Model in Iran's healthcare sector, with a focus on the Ta’amin Ejtemaie hospitals.

This research employs a mixed-methods approach. In the qualitative phase, methods such as meta-synthesis, expert Delphi, and Shannon’s entropy were used to identify the components of a fearless organization. The quantitative phase involved structural equation modeling (using surveys distributed among the staff of Ta’amin Ejtemaie hospitals in Tehran) to validate the research model.

The Fearless Organization Model consists of two main dimensions: “Behavioral” and “Structural.” The behavioral dimension includes "managers' behavioral components" and "employees' behavioral components." The structural dimension includes "organizational components," "human resource components," and "environmental components." Key characteristics of a fearless organization include: creating psychological security, openness, transparency, accountability, humble listening, quick employee feedback, learning from mistakes, encouraging knowledge sharing, avoiding silence, and promoting open communication. Effective response systems and coherent organizational structures for extracting ideas and concerns, as well as fostering a supportive culture, are essential.

The findings of this study emphasize the importance of addressing both behavioral and structural dimensions in creating a fearless organization. However, the behavioral dimension plays a more significant role than the structural one. Within the behavioral dimensions, "employee behavior" is the most crucial factor. Managers should focus on cultivating behaviors that promote security and openness within the organization. This research can serve as a foundation for further studies on the drivers and barriers to establishing fearless organizations in different contexts.

Today, traffic accidents resulting in fatalities are recognized as one of the significant challenges facing developing countries, with substantial economic and social repercussions. This study aimed to investigate the effect of socio-economic and behavioral factors on the fatalities caused by road accidents involving drivers in the West Azerbaijan Province, Iran.

The present study was a cross-sectional-analytical research conducted from 2018 to 2022. The research population included 428 drivers hospitalized due to road accident. A Generalized Structural Equation Modeling (GSEM) approach was employed to assess the simultaneous relationships among the variables, based on a dichotomous response variable. Data analysis was performed using Stata and Mplus software.

A significant positive linear relationship was found between deaths caused by traffic accidents and several factors: gender [odds ratio (OR) = 1.770, P = 0.030], education (OR = 2.053, P = 0.002), alcohol consumption (OR = 2.193, P = 0.001), drug use (OR = 3.170, P < 0.001), use of mobile phone (OR = 6.695, P < 0.001), safety belt usage (OR = 3.664, P < 0.001), airbag (OR = 4.314, P = 0.038), occupation (OR = 5.809, P = 0.012), income (OR = 8.212, P = 0.013), and the value of the car (OR = 9.634, P = 0.001). In contrast, marital status showed a significant negative linear relationship (OR = 0.43, P = 0.014). Besides, no significant relationship was found between deaths caused by traffic accidents and age.

The results indicated a significant relationship between socio-economic and behavioral factors and accidental deaths. Specifically, low car value, low driver income, and the use of mobile phones while driving were found to have the greatest impact. It is recommended that health and economic policymakers acknowledge these risk factors and implement appropriate interventions to reduce accidents and fatalities associated with them.

Due to the progress of science and technology and the improvement of quality in health care, public health has improved in general and social welfare has been increasingly improved, which leads to an increase in the number of elderly people around the world. Therefore, investigating factors affecting the social health of elderly tourists is one of the necessities of the 21st century. The purpose of this research is to identify the most important factors affecting the social health of the elderly.

The method of collecting information was library and field (keyes standard questionnaire) and descriptive and inferential statistics were used to analyze the data. The statistical population of the research is the elderly tourists present in the Asara section and the sample size is estimated to be 384 people through the infinite Cochran formula, which was used to perform the exploratory factor analysis test using Spss software and for confirmatory factor analysis, structural equation modeling was used using Amos Graphics software.

Based on the findings of the exploratory factor analysis of factors affecting the social health of elderly tourists in the study area; The highest to lowest impact with the variance percentage of the eigenvalue, respectively, includes: social participation 15.974%, social solidarity 12.622%, social flourishing 10.938%, social acceptance 10.677%, social cohesion 10.357% and belonging Social is 8.195%. The findings of the confirmatory factor analysis section based on structural equation statistics; It shows that the chi-square index with the value of 77.629 is significant and the relative indices with the value of 0.030 for the square root index of the residual mean square, the comparative indices with the value of 0.938 indicate the appropriateness of the model and indicate the appropriate situation and confirm the goodness of the model fit.

 In the first part, by performing the exploratory factor analysis method; It can be concluded that six factors (social participation, social solidarity, social prosperity, social acceptance, social cohesion and social belonging) were able to explain more than 68% of the cumulative variance of the social health components of the elderly, and the social participation factor has the highest effect and factor. Social belonging has the lowest effect among the six factors affecting the social health of elderly tourists. In the second part of the research, using confirmatory factor analysis, it can be concluded that the identified factors on the social health of elderly tourists in the study area are significant and positive, and the model has appropriate power in line with the appropriateness and significance of the factors affecting the social health of elderly tourists in Asara district.

Structural equation modeling (SEM) is a class of multivariate statistical methods that combines the dimensions of factor analysis and regression to enable researchers to simultaneously examine the relationships between variables. This method has not been used in dental research until now. In this article, the effect of parents' awareness, attitude and performance on their children's dmft with the mediation of sugary substance consumption has been investigated using the SEM method.

In this research, questionnaires about the knowledge, attitude and performance of parents were completed among 385 people in Tabriz city. These questionnaires are based on previous research and made by researchers. Cronbach's alpha coefficients obtained for them were 0.949, 0.943 and 0.801 respectively, which indicates their good reliability. Also, checking the validity of the questionnaires (content validity with confirmatory factor analysis, convergent validity with average variance criterion and face validity with experts' approval) shows the usefulness of the tool. Structural equation modeling method with partial least squares (PLS) was used to test the research hypotheses.

According to the results of statistical analysis, the effect of "parental awareness", "parental performance" and "children's consumption of sugary substances" on "dmft" and also the effect of "parental awareness", "parental attitude" and "parental performance" on " The consumption of sugary substances by children" is significant at the level of 0.01 (P-value<0.01). Also, the results of the analysis showed that the indirect effect of the variables "awareness", "attitude" and "performance" of the parents on "dmft" through the mediator variable "amount of consumption of sugary substances" is significant at the level of 0.01 (P-value<0.01). But the effect of "parental attitude" on "dmft" was not significant (P-value>0.05).

In this study, it was shown that the knowledge, attitude and performance of parents have a significant effect on "dmft" through the variable of consumption of sugary substances.

Attitudinal factors based on traits are one of the most important issues affecting the self-care of patients with cardiovascular disorders (CVDs). This study aims to design an attitudinal model based on the characteristics of self-care in patients with CVDs.

This is a descriptive-analytical cross-sectional study. The study population consists of 467 patients with CVDs who were selected non-randomly. The data was collected using a research-made questionnaire and analyzed in SPSS software, version 23, using descriptive tests, Pearson correlation test, multiple linear regression analysis. Structural equation modeling was done in Amos software, version 24.

The mean age of the participants was 59.96±14.25 years. The construct of “meaning in life” construct was the significant predictor of the construct of “sense of coherence” (P<0.001, β=0.26), and the construct of “illness perception” was the significant predictor of self-care behaviors (P<0.001, β=0.21). The degree of freedom (χ2/df) and root mean square error of approximation (RMSEA) were <5 and <0.8, respectively, indicating the good fit of the study model.

The most important predictors of self-care behaviors in CVD patients are a positive perception of illness, health locus of control, and meaning in life. These factors should be further investigated for managing the self-care behaviors of CVD patients.

 The purpose of this research is to design and build a comprehensive questionnaire covering all three indicators of environment, safety and health for pedestrians and vulnerable groups based on structural equation modeling (SEM).

 Following the gathering of information to provide the basic foundations for the formulation of the necessary elements for the structures of this questionnaire, the 10th district of Shiraz was chosen as a statistical population given the existence of two neighborhoods with old and new textures. Totally, 383 pedestrians participated in the study with the approach of vulnerable groups living in this area. The formal, content, and structural validity of the questionnaire was assessed Data were analyzed through SPSS and LISREL software.  Ethical considerations were observed in all stages of the study.

 The reliability coefficient of the questionnaire (ICC coefficient) was 0.875 with Cronbach's alpha of more than 0.7, indicating its proper reliability. The power of the relationship between the quality of safety and health was 0.64, demonstrating the optimal correlation between the variables. The t -test was also 13.04 and showed the significant correlation. Therefore, the quality of safety has a positive effect on health.

 The optimization of urban passages and spaces enables pedestrian, especially the vulnerable groups, to use their abilities and experiences in the best way for the development of the society. Also, they will be more active and thus less mental and physical problems and diseases will occur in these groups of people.

Objectives :

The tendency to suicide in conscripts can be due to several factors, including organizational factors, socio-economic factors, and family emotional climate. The current study aims to develop a structural model to show the relationship of organizational and socio-economic factors with tendency to suicide in conscripts in Iran, considering the mediating role of family emotional climate.

Methods :

This is a descriptive-correlational study. The study population consists of all male conscripts of the Islamic Republic of Iran Police Force in 2021-2022. Of these, 1000 were selected by multi-stage cluster random sampling method from three provinces. The sample size was determined using Cochran’s formula. To collect data, the tendency to suicide scale based on the interpersonal-psychological theory of suicidal behavior, two researcher-made questionnaires of organizational and socio-economic factors, and Hilburn’s family emotional climate scale were used. Structural equation modeling (SEM), SPSS version 22, and Amos version 24 were used for data analysis.

Results :

The SEM model had an acceptable fit. The effect of organizational factors on the tendency to commit suicide mediated by the family emotional climate was significant and negative (β=-0.252, P=0.038). The effect of socio-economic factors on the tendency to suicide mediated by the family emotional climate was significant and negative (β=-0.267, P=0.002). The variables of organizational and socio-economic factors and family emotional climate together were able to explain 32.6% of variance in tendency to suicide. The organizational and socio-economic factors were able to explain 23.1% of variance in family emotional climate.

Conclusion:

 The organizational and socio-economic factors, by mediating role of family emotional climate, have a relationship with tendency to suicide in Iranian conscripts.

Socialization is a critical organizational process that significantly contributes to effectively adapting personnel into a new organization and playing a suitable role according to the Ottawa Charter, which is one of its important areas for promoting health, developing people's skills, and also reorienting health care services. This study aims to identify the influential factors that contribute to the organizational socialization process among employees inside the health system of Iran.

The current study is an exploratory sequential mixed-method that was conducted in 2022 among managers and personnel of the health system in Tabriz, Iran. The qualitative phase of the study employed a content analysis methodology, wherein a purposive sample technique was utilized to pick 16 managers and staff from the health system. During the quantitative phase, a study was devised and executed utilizing the Delphi technique to thoroughly assess and finalize the components derived from the initial stage. The third part of the study involved a cross-sectional examination employing a descriptive-analytical methodology to assess the indicated parameters. A total of 333 health system employees and administrators were surveyed using a questionnaire.

Organizational socialization of health system employees can be improved through increased awareness of employees, organizational planning, recruitment and retention of talented personnel, performance evaluation of employees, alignment of individual and organizational values, and increased organizational commitment. The results of structural equation modeling showed that organizational planning, employee awareness, individual-organizational values, recruitment and retention of talented staff, and increased organizational commitment had a significant effect on organizational socialization of the healthcare system employees by 9%, 13%, 15%, 11%, and 14%, respectively.

Socialization, as one of the most important organizational processes, can help managers and policymakers to facilitate and plan the process of empowering the employees and reorienting health-oriented processes based on health promotion approaches.

There is a large body of evidence that suggests a relationship between childhood trauma and psychological distress, but relatively few studies have examined potential mediating factors for this relationship. The present study was conducted with the aim of investigating the mediating role of rumination and mindfulness in the relationship between childhood trauma and psychological distress.

The research method was descriptive-correlation. The statistical population of the research was made up of all people referring to clinics and psychological service centers in Tehran. Among the statistical population, 300 people were selected by convenience sampling method. The research tools were: Bernstein et al.'s childhood trauma questionnaire (2003), Nolen-Hoeksema's rumination response scale (1991), Brown & Ryan’s mindfulness assessment scale (2003) and Kessler's psychological distress questionnaire (2003). Pearson correlation, structural equation modeling and SPSS and AMOS version 23 software were used for data analysis.

The results showed that the research model has a good fit. The coefficients of the direct paths of childhood trauma (T = 8.041, β = 0.262), mindfulness (T = -56.421, β = -0.896) and Rumination (T = 5.519, β = 0.163) were significant on psychological distress. Also, indirect coefficients of traumatic life events through rumination and mindfulness on psychological distress were significant.

The results indicated the mediating role of rumination and mindfulness between childhood trauma experience and psychological distress. The findings of this study provide us with an important clinical concept that rumination and mindfulness should be a goal for the prevention and treatment of psychological distress in victims of childhood trauma.

The aim of this study was to investigate stress, anxiety and depression and design of a structural equation model to express the importance and contribution of each risk factor in students of Alborz University of Medical Sciences.

The present study is a cross-sectional study with structural equation modeling method, which was conducted in the second half of 2018 among 700 students of Alborz University of Medical Sciences. The data were collected using Pittsburgh Sleep Quality and Depression, Anxiety and Stress DASS1. The primary model was developed based on literature review and significant variables. Structural equation modeling was performed to evaluate the fitting index of the model. Data was analyzed using SPSS and AMOS software.

According to the final structural model, 91% of depression variance was expressed by the factors presented in the model. According to this model, stress alone explained 17% of depression changes, so that high levels of stress lead to depression. The fitting index of the final model RMSEA, CFI, TLI and CMIN / DF was 0.95, 0.96, 0.06 and 2.23, respectively.

The overall results showed that there is a significant relationship between mental health problems and academic performance, family relationships and type of residence of students in Alborz University of Medical Sciences. Addiction and worrying about finding a job in the future will increase the risk of mental health problems such as stress, anxiety and depression.

Medication errors reduce quality of life, immune system function, and cause significant mortality in children with HIV/AIDS. The present study was conducted with the aim of identifying and explaining the factors affecting the management of medication errors in children infected with HIV/AIDS virus in Iran's health system.

The current study was a descriptive one conducted in 2020-2021. At first, by reviewing the research literature and interviewing experts in the field of treating children with HIV/AIDS virus, the main factors affecting the occurrence of medication errors in children with HIV/AIDS virus were extracted and using them, the research questionnaire was designed. Data were collected from 400 experts in the field of treating children with HIV/AIDS virus and analyzed using exploratory factor analysis and through SPSS version 16 and Lisrel software.

Four factors included organizational factors (p < 0.001), individual factors (p < 0.001), educational factors (p < 0.001) and communication factors (p < 0.001), were identified as effective factors in the management of medication errors in children with HIV/AIDS virus. Factors including Individual, communication, organizational and educational with respective factor loadings of 0.84, 0.81, 0.79 and 0.77 had an effect on the management of medication errors in HIV positive children.

For successful management of medication errors in children infected with HIV/AIDS, it is advisable to prioritize individual and communication factors (i.e., behavior-based disease counseling specialists) while attending to all four of the relevant factors.

Curriculum plays a central role in effective teaching and educational change in higher education. The present study was conducted to design and validate a tool for assessing the curriculum quality of universities in Iran.

This study was performed using a mixed method of explorative plan-tool development model. First, in qualitative part of this study, questionnaire consisted of 14 scales and 107 sub-scale s were designed by using the method of Grounded Theory and interview with 25 experts. Then, in the quantitative section, designed questionnaires were conducted on 180 experts in different cities of Iran. The validity of the questionnaire was confirmed by experts and its reliability was calculated by Cronbach's alpha which was equal to (0/944). Non-probability purposive sampling method was used in the qualitative part of the study whereas random classified sampling method was applied in the quantitative part. In addition, analysis of Confirmatory Factor Analysis was used for testing mentioned tool.

By doing first-order confirmatory factor analysis, mentioned tool were confirmed with 14 scales and 107 sub-scale s. Results of second-order confirmatory factor analysis, also showed that 14 extracted scales are sufficient factor leading to prediction scale related to curriculum quality of high education systems in Iran. In addition, all goodness of fit indices were confirmed.

The results of statistical tests displayed that the designed tool enjoys very favorable fitness for the curriculum quality assessment of Universities of Iran.