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November 2017 -
Volume 15, Issue 9

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From the Editor



Original contribution/Clinical Investigation
Diabetes Mellitus - Knowledge, Management and Complications: Survey report from Faisalabad-Pakistan
Ijaz Anwer, Ahmad Shahzad, Kashmira Nanji, Farah Haider, Muhammad Masood Ahmad

Alanine aminotransferase indicates excess weight and dyslipidemia
Mehmet Rami Helvaci, Orhan Ayyildiz* Mustafa Cem Algin, Yusuf Aydin, Abdulrazak Abyad, Lesley Pocock

Comparative Analysis of Antimicrobial Peptides Gene Expression in Susceptible/Resistant Mice Macrophages to Leishmania major Infection

Hamid Daneshvar, Iraj Sharifi, Alireza Kyhani, Amir Tavakoli Kareshk, Arash Asadi

Does socio-economic status of the patients have effect on clinical outcomes after coronary artery bypass grafting surgery?
Forough Razmjooei, Afshin Mansourian, Saeed Kouhpyma

Comparison of the uterine artery Doppler indices during pregnancy between gestational diabetes and diabetes mellitus and healthy pregnant women
Nazanin Farshchian, Farhad Naleini, Amir Masoud Jaafarnejhad,
Parisa Bahrami Kamangar

Survey single dose Gentamicin in treatment of UTI in children with range of 1 month to 13 years old in Jahrom during 2015
Ehsan Rahmanian, Farideh Mogharab,
Vahid Mogharab

Evaluation of control of bleeding by electro cauterization of bleeding points of amplatz sheath tract after percutaneous nephrolithotomy (PCNL) in Jahrom Peymanieh hospital during year 2015-2016
Ali Reza Yousefi , Reza Inaloo

Comparison of the three-finger tracheal palpation technique with triple ID formula to determine endotracheal tube depth in children 2-8 years in 2016-2017
Anahid Maleki, Alireza Ebrahim Soltani, Alireza Takzare, Ebrahim Espahbodi,
Mehrdad Goodarzi , Roya Noori

Effect of Sevoflurane and Propofol on pulmonary arterial pressure during cardiac catheterization in children with congenital heart diseases
Faranak Behnaz, Mahshid Ghasemi , Gholamreza Mohseni, Azim Zaraki
Population and Community Studies

Prevalence and risk factors of obesity in children aged 2-12 years in the Abu Dhabi Islands
Eideh Al-Shehhi, Hessa Al-Dhefairi, Kholoud Abuasi, Noora Al Ali, Mona Al Tunaiji, Ebtihal Darwish

Study and comparison of psychological disorders in normal students and students with multiple sclerosis in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Comparative study of self-concept, physical self-concept, and time perspective between the students with multiple sclerosis and healthy students in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Relationship between Coping Styles and Religious Orientation with Mental Health in the Students of the Nursing-Midwifery Faculty of Zabol
Nasim Dastras, Mohsen Heidari Mokarrar, Majid Dastras, Shirzad Arianmehr

Tuberculosis in Abadan, Iran (2012-2016): An Epidemiological Study
Ali-Asghar ValiPour, Azimeh Karimyan, Mahmood Banarimehr, Marzieh Ghassemi, Maryam Robeyhavi, Rahil Hojjati,
Parvin Gholizadeh

Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study
Zahra Pourmovahed , Seyed Saied Mazloomy Mahmoodabad ; Hassan Zareei Mahmoodabadi ; Hossein Tavangar ; Seyed Mojtaba Yassini Ardekani ; Ali Akbar Vaezi

A comparative study of the self-actualization in psychology and Islam
Simin Afrasibi, Zakieh Fattahi

The effectiveness of cognitive - behavioral therapy in reducing the post-traumatic stress symptoms in male students survivors of earthquake in the central district of Varzeghan
Sakineh Salamat, Dr.Ahad Ahangar, Robab Farajzadeh


Effects and mechanisms of medicinal plants on stress hormone (cortisol): A systematic review
Kamal Solati, Saeid Heidari-Soureshjani, Lesley Pocock

Comparing Traditional and medical treatments for constipation : A Review Article
Mohammad Yaqub Rajput

A review of anti-measles and anti-rubella antibodies in 15- 25 year old women in Jahrom City in 2011
Ehsan Rahmania , Farideh Mogharab, Vahid Mogharab

Review of percutaneous nephrolithotomy in children below 12 years old in Jahrom hospital, during 2010-2014
Ali Reza Yousefi , Reza Inaloo

Physical and mental health in Islam
Bahador Mehraki, Abdollah Gholami

International Health Affairs

The Challenges of Implementation of Professional Ethics Standards in Clinical Care from the viewpoint of Nursing Students and Nurses
Saeedeh Elhami, Kambiz Saberi, Maryam Ban, Sajedeh Mousaviasl, Nasim Hatefi Moadab, Marzieh Ghassemi

Cognitive Determinants of Physical Activity Intention among Iranian Nurses: An Application of Integrative Model of Behavior Prediction
Arsalan Ghaderi, Firoozeh Mostafavi, Behzad Mahaki, Abdorrahim Afkhamzadeh,
Yadolah Zarezadeh , Erfan Sadeghi

Effect of resilience-based intervention on occupational stress among nurses
Hossein Jafarizadeh, Ebrahim Zhiyani, Nader Aghakhani, Vahid Alinejad, Yaser Moradi

Education and Training

Calculation of Salaries and Benefits of Faculty Members in the Ministry of Health and Medical Education of Iran
Abdolreza Gilavand

The effect of education on self-care behaviors of gastrointestinal side effects on patients undergoing chemotherapy
Shokoh Varaei, Ehsan Abadi Pishe, Shadan Pedram Razie, Lila Nezam Abadi Farahani

Creating and Validating the Faith Inventory for Students at Islamic Azad University of Ahvaz
Solmaz Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Creating and Validating the Adjustment Inventory for the Students of Islamic Azad University of Ahvaz
Homa Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Evaluating the Quality of Educational Services from the Viewpoints of Radiology Students of Ahvaz Jundishapur University of Medical Sciences
Abdolreza Gilavand, Jafar Fatahiasl

An Investigation of Psychosocial aspect of Iranian Nursing Students' Clinical Setting
Mahsa Boozaripour , Zanyar Karimi, Sima Zohari Anbohi, Amir Almasi-Hashiani, Fariba Borhani

Clinical Research and Methods

Comparison of the Antibacterial Effects of Chlorhexidine Mouth washes with Jaftex Mouth wash on Some Common Oral Microorganisms (An in Vitro Study)
Ebrahim Babadi, Zahra Bamzadeh, Fatemeh Babadi

Study of the effect of plasma jet on Fusarium isolates with ability to produce DON toxins
Elham Galin Abbasian, Mansour Bayat, Arash chaichi Nosrati, Seyed Jamal Hashemi, Mahmood Ghoranneviss

The comparison of anti-inflammatory effect in two methods of topical dexamethasone injection and topical application of ginger alcoholic extract after removing mandibular wisdom teeth
Sahar Zandi, Seyyed Muhammadreza Alavi, Kamran Mirzaie, Ramin Seyedian, Narges Aria, Saman Jokar

The effect of curcumin on growth and adherence of major microorganisms causing tooth decay
Leila Helalat, Ahmad Zarejavid, Alireza Ekrami, Mohammd Hosein Haghighizadeh, Mehdi Shiri Nasab

Middle East Quality Improvement Program

Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE


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November 2017 - Volume 15, Issue 9

Creating and Validating the Adjustment Inventory for the Students of Islamic Azad University of Ahvaz

Homa Choheili (1)
Reza Pasha
Gholam Hossein Maktabi
Ehsan Moheb

(1) MA in Educational Psychology, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
(2) Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
(3) Department of Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
(4) Phd in Educational Psychology, Department of Educational Psychology, Shahre-kord Branch, Islamic Azad University, Shahre-kord, Iran

Corresponding author:
Reza Pasha
Department of Psychology, Ahvaz Branch, Islamic Azad University,
Ahvaz, Iran


This study was conducted in order to create and validate the adjustment inventory. The sample consisted of 1005 students of Islamic Azad University of Ahvaz who were selected using the multi-stage random sampling method. The adjustment inventory consisting of 100 items was employed to measure their adjustment. Each item was scored on the five-point Likert scale from Not fully used to Fully used. After data collection, the correlation between each item and the total score was determined. The coefficients for 11 items were weak and statistically insignificant. The Cronbach’s Alpha coefficient for the 100-item set was 0.758 and after eliminating 11 items for a set of 89 questions, it was 0.76. Factor analysis was conducted in order to verify the construct validity of the inventory; the KMO value was 0.915 and the significant Bartlett’s sphere test indicated that there were suitable conditions for conducting factor analysis. After eliminating the inappropriate questions with a factor load of less than 0.3, using the Principal Component Analysis (PCA) and varimax rotation, with respect to the factor matrix, gradient diagram and the percentage of explained variance, four factors were extracted from a set of 90 items, explaining 44.87% of the total variance among the variables. The first factor with 29 items and the special value of 16.63 covers about 55.17% of the total variance of the variables and is an indicator of health adjustment; the second factor with 20 items indicates academic adjustment, the third factor with 21 items, shows the family adjustment and the fourth factor with 11 items measures the emotional adjustment and the fifth factor with eight items indicates the social adjustment.

Key words: Adjustment, Validity, Inventory, Narration


Contemporary mankind lives in a world that requires more individual and social flexibility and adjustment (1). Individual adjustment occurs when a person can establish a healthy relationship between themself and the social environment. The social environment also includes the family, the educational setting, the business environment, and so on. If one fails to interact with the environment in a desirable manner, he/she is not considered adjustable (2).

Adjustment originates from biology. For the first time, Darwin suggested it in his theory of evolution, then this concept has been used in other sciences, such as psychology and sociology (3,4). This term refers, in biological terms, to biological structures that facilitate the survival of the species, and includes not only humans but also animals and plants (4). In psychology, adjustment is assumed to be more or less consciously based on if one adjusts to the social, natural or cultural environment. This adjustment requires that a person has to change themself or actively make changes in the environment, and as a result, the necessary coordination is established between the individual and the environment (4). Adjustment is a behavior that increases the individual’s competence and average ability to improve their past and nearby people. Because the content of social learning is not genetic, the proper behavior of the individual is in response to and selected by social consequences. In other words, this behavior is strengthened and one learns that they will get a good result by repeating it (5).

Adjustment is a relative concept and differs in societies under the influence of cultures and beliefs. On the other hand, human behavior is affected by various factors, such as family, school, peer group and other social factors. Human personality will be perfect if a good balance and interaction are established between themself and the surrounding environment.

Social pressures clearly have a great influence on individual behavior. On the other hand, human beings are flexible. They adapt not only to the environment, but also change the environment according to their own needs (6). The human being is a social being, so for success it is necessary to achieve a good adjustment within the society. If the learner fails to achieve adjustment, misadjustment occurs and they distance themself from balanced behavior and show a kind of misadjustment including aggression, anxiety, anti-social personality, attention drawing, escape from school and habitual disorders. Therefore, it is vital to adjust and coordinate yourself with the surrounding environment. Daily struggles focus on this adjustment. Everybody consciously and unconsciously seeks to satisfy their various but conflicting needs in the environment where they live. Underlying factors such as educational methods, school factors, values and beliefs, peer group, family and education are effective in formation of adjustment. Recognition of the factors affecting the students’ adjustment at the critical age and the sustainability effects that this period has on the formation of a teenage personality can predict and plan in helping them to provide good mental health (5).

Adjustment, to Sinha and Singh (1993), is the emotional stability and courage in social relationships, as well as the interest in education and school, which is seen as emotional adaptation, social adjustment and educational adaptation. Also, Sinha and Singh (1993) defined academic or educational adjustment as having positive attitudes toward the academic goals, the effective effort to achieve academic goals and the positive attitude to the educational environment, and considered social adjustment as the mechanisms by which a person finds the ability to belong to a group, and emotional adjustment as the mechanism by which the person finds emotional stability (7).

Social adjustment
Social adjustment involves the individual’s adjustment to his or her social environment and refers to a process in which the relationships between individuals, groups and other elements are satisfactory, so that provides mutual satisfaction (8).

Emotional adjustment
Emotional adjustment is the mechanism by which a person achieves emotional stability. It includes good mental health, satisfaction with personal life, and coordination between feelings, thoughts and deeds (9).

Educational adjustment
Educational adjustment refers to the satisfaction and effective functioning in the educational environment (10).

Family adjustment
Family adjustment is the mechanism by which a person acquires a sense of security and trust towards family members, especially parents, thereby establishing a proper relationship with them (11).

Health adjustment
Health adjustment includes “a sense of responsibility towards oneself and the choice of a healthy lifestyle.” The World Health Organization (1947) defines health as: “Health is the state of complete physical and psychological well-being, and not just the absence of illness or disability” (9).

The development of measurement methods and new psychometric theories have led to the emergence of new scholarly methods for assessing the talents, abilities and other psychometric characteristics of individuals that have been considered by the instructors, consultants, psychologists and other behavioral science experts. Although a number of instruments have been developed for measurement of religious tendencies and similar subjects, limited research has been carried out on the measurement of faith due to its newness. Because this tool (inventory) is designed to measure students’ faith, it is necessary to measure its validity and reliability among the students. Considering that the subject under study has an exploratory aspect, it is also necessary to provide an answer to the following questions:

1. Is there enough internal consistency between the set of questions that are presented to assess the students’ adjustment?
2. Is the set of questions designed to measure the students’ adjustment sufficiently valid?
3. What are the underlying components of adjustment inventory for students and how much are they saturated?


The statistical population in this study consists of all 1,005 high school students of Ahvaz in the academic year of 2016-2017. A multi-stage sampling method was used to determine the sample size. To this end, the population of each school was determined by Ahvaz Education Administration and randomly divided into four districts (Districts 1, 2, 3 and 4) by lot, from all four districts in proportion to the population of each district based on sex. The adjustment inventory is designed to be applicable to all adjustment areas with visible adjustment and implications. Therefore, the questions are designed to show people’s adjustment in social, emotional, educational, family and health adjustments.

The main collection consists of 100 items. Initially, the content validity of the questions was approved by a number of professors, psychologists and counselors to ensure that the items are understandable and applicable to the student groups. After this stage, the items were administered for a group of 1,005 high school students from Islamic Azad University of Ahwaz.

The initial validity coefficient of the inventory for the set of 100 questions was rtt = 0.756. For the second time, the validity of the inventory was calculated after the removal of other questions with factor load less than 0.3. The validity coefficient after the elimination of questions 2, 6, 12, 36, 37, 38, 57, 71, 77, 87, and 96 for the 90-item set was re-calculated and was rtt = 0.76.

In the present study, the KMO value is 0.915 and the Bartlett test was 23510.627 which is significant at 0.0001. Thus, in addition to the sampling adequacy, the implementation of the factor analysis based on the understudy matrix can also be justified.

627.23510, which is significant at 0.0001. In addition, = to the sampling adequacy, the implementation of the factor analysis based on the matrix under study can also be justified.

Table 2 shows the initial statistical characteristics that were obtained by the analysis of the main components, with a special value of 5 factors higher than 1, and the extent of explaining the common variance of variables for these five factors is equal to 29.826% of the total variance of variables.

The slope design, which is a graph of the special values of a 100-item faith inventory, is shown in Figure 1.

The slope design indicates that the contribution of the first factor in the variance of all variables is significant and differs from the contribution of other factors. In the next step, based on the special value, the percentage of variance and the slope design, five factors were considered as the basis for determining the final characteristics. Here, it is worth noting that some researchers in order to investigate the nature of relationships between variables and finding definitions of factors state that coefficients above 0.30 and coefficients higher than 0.40 are significant in the definition of factors and the coefficients below this limit are considered to be zero (random factor). For example, Jones (1954) used the lowest coefficient of 0.3, Houman (1988) used 0.35 and Reynold et al. (1981) used 0.4 values. In the present study, this coefficient is equal to 0.30.

Given that variables in factors 6 and 7 have a factor load, but the number of questions in these factors is less than 3, so according to the relevant theories, sometimes four questions and sometimes 10 questions are at least needed to form a factor. In this study, at least 4 questions were considered for the formation of the factor. Based on the results of factor analysis and the above-mentioned indicators, four factors were extracted from all questions and the special value of four factors/ fourth factor explain the value higher than 29.82. The first factor is a special value of 16.63 and ultimately the fifth factor justifies a special value of 2.11. After ensuring that the sampling is adequate and that the correlation matrix, which is the basis of the factor analysis, is not equal to zero in population, factor analysis was performed.

The special values of these four factors, the percentage of explanation of variance and the condensation percentage of the explained variance are shown in Table 3.

The extracted factors were transferred to new axes using the varimax rotation method. The main matrix after the varimax rotation, which was obtained after 8 repetitions, was shown in Table 4.

Table 1: KMO size and results of Bartlett’s test of adjustment inventory

Click here for Table 2: Primary statistical characteristics of a 100-question inventory

The slope design, which is a graph of the special values of a 100-item faith inventory, is shown Figure 1.

Figure 1: Slope design

Table 3: Special value of the percentage of the explanation of the condensation variance of the five factors

Table 4: Factor matrix after rotation


To investigate the construct validity and answer the question that deals with the number of factors that saturate the faith inventory, the Principal Component Analysis (PC) method was used. Before performing factor analysis, sampling adequacy was proved using Kaisel Mager Olking (KMO) size, and also rejecting the null hypothesis by the Bartlett Spher icity test that the identity matrix is correct in the population; this shows that factor analysis is justifiable.

The factor matrix indicates that the first factor has the highest factor load and its contribution is also more significant than other factors. The results of factor analysis show that this scale has sufficient validity and is saturated with five factors. In order to simplify the extraction factors, the varimax rotation was used. After the interpretation and naming of the factors, the results are as follows:

The largest factor load in the structure matrix is for question 80 (0.579).

Questions 4-15-18-31-33-34-40-44-46-49-58-60-63-68-73-74-76-78-79-85-86-94 focus on two or three factors that are likely to be complicated questions.

The rest of the questions are very pure or their factor load in other factors other than the extracted clusters is negligible.

There is no question without factor load, and in each factor there are at least four variables.

A set of questions with a strong and meaningful correlation make up a piece of test that were extracted and named as follows.

1. There was 29 items in the first factor marked as “health”.
2. There was 20 items in the second factor marked as “educational”.
3. There was 21 items in the third factor marked as “family”.
4. There was 11 items in the fourth factor marked as “emotional”.
5. There was 8 items in the fifth factor marked as “society”.