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  1. Sharif Nia H, Pahlevan Sharif S, Lehto RH, Boyle C, Yaghoobzadeh A, Kaveh O, et al.
    Jpn J Clin Oncol, 2017 Aug 01;47(8):713-719.
    PMID: 28505271 DOI: 10.1093/jjco/hyx065
    Objective: The surfacing of thoughts and depressive affect associated with the prospect of death are prevalent among patients with advanced cancer. Because death cognitions and associated negative affect occur along an adaptive-less adaptive continuum, it is essential that valid and reliable instruments are available to measure death depression. The present study aimed to determine the psychometric properties of the Death Depression Scale among Iranian patients with advanced cancer.

    Methods: About 497 cancer patients completed a Persian version of the 21-item Death Depression Scale-Revised. The face, content and construct validity of the scale were ascertained. Reliability was also assessed using internal consistency, construct reliability and intra-class correlation coefficient (ICC).

    Results: Construct validity determined one factor with an eigenvalue greater than 1. The model had a good fit (χ2 (179, N = 248) = 520.345, P < 0.001; χ2/df = 2.907, CFI = 0.916, TLI = 0.902, IFI = 0.917, SRMR = 0.049 and RMSEA = 0.088 (90% confidence interval = 0.079-0.097)) with all factors loadings greater than 0.5 and statistically significant. The internal consistency, construct reliability and ICC were greater than 0.70. Convergent validity of the scale was demonstrated.

    Conclusions: Findings revealed that the Persian version of the Death Depression Scale-Revised is valid and reliable, and may be used to assess and evaluate death depression in Iranian patients with advanced cancer.

  2. Sharif Nia H, Pahlevan Sharif S, Lehto RH, Allen KA, Goudarzian AH, Yaghoobzadeh A, et al.
    Iran J Psychiatry, 2017 Jul;12(3):172-181.
    PMID: 29062368
    Objective: Limited research has examined the psychometric properties of death depression scales in Persian populations with cardiac disease despite the need for valid assessment tools for evaluating depressive symptoms in patients with life-limiting chronic conditions. The present study aimed at evaluating the reliability and validity of the Persian Version of Death Depression Scale - Revised (DDS-R) in Iranian patients who had recent acute myocardial infarction (AMI). Method: This psychometric study was conducted with a convenience sample of 407 patients with AMI diagnosis who completed the Persian version of the DDS-R. The face, content, and construct validity of the scale were ascertained. Internal consistency, test-retest, and construct reliability (CR) were used to assess reliability of the Persian Version of DDS-R. Results: Based on maximum likelihood exploratory factor analysis and consideration of conceptual meaning, a 4-factor solution was identified, explaining 75.89% of the total variance. Goodness-of-fit indices (GFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), Incremental Fit Index (IFI), and Root Mean Square Error of Approximation (RMSEA) in the final DDS-R structure demonstrated the adequacy of the 4-domain structure. The internal consistency, construct reliability, and Intra-class Correlation Coefficients (ICC) were greater than .70. Conclusion: The DDS-R was found to be a valid and reliable assessment tool for evaluating death depression symptoms in Iranian patients with AMI.
  3. Sharif Nia H, Lehto RH, Farhadi B, She L, Goudarzian AH, Khoshnavay Fomani F, et al.
    Asian Pac J Cancer Prev, 2024 Mar 01;25(3):1087-1096.
    PMID: 38546091 DOI: 10.31557/APJCP.2024.25.3.1087
    BACKGROUND: A cancer diagnosis can be psychologically challenging to individuals due to perceptions that the disease is potentially incurable truncating life expectancy. The purpose of the study was to examine the relationships among religious well-being, existential well-being, fear of progression and quality of life in Iranian patients with cancer and to evaluate the potential mediating role of hope on these relationships.

    METHODS: This study with predictive cross-sectional design was done in 2023. Data was gathered from 398 patients with cancer that was selected with accessible sampling method from cancer center of Mazandaran university of medical sciences (Sari, Iran). Study constructs included the religious and existential wellbeing, cancer fear of progression, Snyder Hope, and quality of life. Analysis of a Moment Structures (AMOS) software (v27) was utilized for all study analyses. Covariance based-structural equation modeling (SEM) was used to assess the mediating role of hope.

    RESULTS: The mean age of patients with cancer was 49.14 (SD = 16.16). The results of the direct effect showed a significant positive relationship between religious well-being and hope (B = 0.164, p < .001), and between hope and quality of life (B = 0.212, p < 0.001). Also, significant negative relationship between fear of progression and hope (B = -0.147, p < 0.05) was founded.

    CONCLUSION: A significant positive relationship between hope and quality of life, as well as religious well-being and hope, suggests the influential effects of hope and religious well-being on improving quality of life in patients with cancer. Negative relationships between fear of progression and hope conclude that managing fear of progression may be an important factor in increasing hope and improving quality of life in patients with cancer.

  4. Pahlevan Sharif S, Sharif Nia H, Lehto RH, Moradbeigi M, Naghavi N, Goudarzian AH, et al.
    J Relig Health, 2021 Apr;60(2):999-1014.
    PMID: 31646425 DOI: 10.1007/s10943-019-00931-6
    The purpose of the present study was to examine the relationship among spiritual intelligence, spiritual well-being and death anxiety among Iranian veterans. In this predictive correlational study, 211 veterans completed King and DeCicco's Spiritual Intelligence Scale, Paloutzian and Ellison's Spiritual Well-being Scale and Templer's Death Anxiety Scale-Extended. After confirming the reliability of the constructs using intra-class correlation coefficient, partial least squares structural equation modeling method was utilized to assess the impact of spiritual well-being and spiritual intelligence on death anxiety. This study found a significant positive relationship between spiritual intelligence and death anxiety after controlling for the effects of age, education level and disability. However, there was a significant negative relationship between spiritual well-being and death anxiety among Iranian veterans. Negative relationships were found between spiritual well-being and death anxiety among Iranian veterans. However, spiritual intelligence had a positive impact on death anxiety.
  5. Sharif Nia H, Lehto RH, Pahlevan Sharif S, Mashrouteh M, Goudarzian AH, Rahmatpour P, et al.
    Omega (Westport), 2021 Sep;83(4):760-776.
    PMID: 31366310 DOI: 10.1177/0030222819865407
    Ensuring use of valid and reliable scales for evaluating death anxiety that are relevant to the cultural context where they are applied is essential. The purpose of the study was to conduct a systematic review of the psychometric properties of Templer's Death Anxiety Scale (DAS) across cultures. PubMed, Scopus, Web of Knowledge, SID, and Magiran databases were systematically searched for studies published between 1970 and 2017 using Mesh terms. Two independent researchers used Quality Assessment of Diagnostic Accuracy Studies and Checklist of Standards for Reporting of Diagnostic Accuracy to evaluate study quality. Included studies were conducted in Iran, United States, Italy, China, Egypt, Spain, and Australia. Overall study quality was acceptable in 15 evaluated articles. However, findings demonstrated that two (one study), three (seven studies), four (four studies), and five factors (three studies) were extracted across the respective studies. Confirmatory concurrent validity was assessed in two studies. While Templer's DAS has stood the test of time as a commonly used index of capturing the conscious experience of death anxiety, there are psychometric inconsistencies in identified factor solutions across cultures. Findings emphasize the need for continued evaluation of how the DAS is translated in specific countries with assessment in relation to other death construct tools.
  6. Pahlevan Sharif S, Lehto RH, Amiri M, Ahadzadeh AS, Sharif Nia H, Haghdoost AA, et al.
    Palliat Support Care, 2021 02;19(1):55-61.
    PMID: 32580795 DOI: 10.1017/S1478951520000383
    OBJECTIVE: This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia.

    METHOD: A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well as the moderating effect of education level on the spirituality hope link were examined.

    RESULTS: Participants with higher self-reported spirituality reported more hope (b = 6.345, p < 0.001) and higher levels of quality of life (b = 1.065, p < 0.001). Higher educational attainment weakened relationships between spirituality and hope (b = -1.460, p < 0.001).

    SIGNIFICANCE OF RESULTS: The role of advanced education in contributing to lessened hope in relation to spirituality emphasizes the importance of skilled and personalized spiritual counseling in the respective socio-cultural religious context.

  7. Sharif SP, Lehto RH, Nia HS, Goudarzian AH, Haghdoost AA, Yaghoobzadeh A, et al.
    Support Care Cancer, 2018 Aug;26(8):2571-2579.
    PMID: 29450638 DOI: 10.1007/s00520-018-4088-2
    PURPOSE: The study investigated relationships among the extent of disease, religious coping, and death depression in Iranian patients with cancer.

    METHOD: A descriptive cross-sectional study was conducted with a convenience sample of 482 Iranian cancer patients. Participants completed demographic and health, death depression, and religious coping surveys.

    RESULTS: After controlling for demographic and health characteristics, positive and negative religious coping behaviors were significantly related to the experience of death depression. There was an interaction effect between negative religious coping and extent of disease with significant positive relationships to the experience of death depression.

    CONCLUSIONS: Negative religious coping was found to be more closely associated with death depression in patients with earlier stage disease than those with advanced stages of cancer in this sample of patients with cancer from Iran. Findings support assessing patients for use of religious coping strategies. Muslim patients who are religiously alienated and have existential anguish may be vulnerable and need heightened support following diagnosis and during treatment of early stage cancer.

  8. Sharif Nia H, Heidari M, Naghavi N, Lehto RH, Haghdoost AA, Jafari-Koulaee A, et al.
    Omega (Westport), 2020 Oct 26.
    PMID: 33106088 DOI: 10.1177/0030222820966934
    This review study fills an important gap by aiming to determine the age changes in attempted and completed suicide in Iran during the past decade. A systematic review of related articles in international and Iranian databases from January 2008 to January 2020 was first conducted and relevant studies were extracted based on established criteria. Results showed that the mean age of suicide in Iran is 29.8 (range 27.7 - 31.8) years old for men and 27.4 (range 25.8 - 28.9) for women (P 
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