A model to explain smokeless tobacco consumption in adults: A grounded theory study

Introduction

Smokeless tobacco use remains a significant public health concern, necessitating the acquisition of comprehensive and extensive data to effectively address and control its consumption. Understanding the underlying patterns of consumption is crucial for this purpose.

Objective

This study aimed to develop a model that explains smokeless tobacco consumption among adults in the southeastern province of Iran, specifically in the city of Chabahar.

Methods

A qualitative study was conducted using a grounded theory approach with inductive processes. The participants consisted of 30 adults aged 18-64 years from Chabahar City in southeastern Iran. Purposive sampling was used to select participants, and data collection continued until theoretical saturation was achieved. Data analysis followed Strauss and Corbin's perspective, involving four stages: Analyzing Data for Concepts, Analyzing Data for Context, Bringing Process into the Analysis, and Integrating Categories.

Results

The analysis of data yielded three main categories: "starting to use," "continued use," and "cessation attempts," each with their respective subcategories. Additionally, two main categories related to the consequences of smokeless tobacco consumption were identified: "addiction and efforts to overcome addiction," also with their respective subcategories.

Conclusion

The Dependency Cycle Model in Consumption provides a comprehensive understanding of the contextual factors, processes, and consequences associated with smokeless tobacco consumption. This model serves as a valuable tool for researchers aiming to develop effective interventions in the field of smokeless tobacco consumption.

The relationship between social support and happiness in older adults referred to health centers in Zarrin Shahr, Iran

BACKGROUND

Creasing the older adult population has become a major public health challenge. Social support plays an important role in people's health. Social support helps improve the living conditions of the elderly and brings happiness into the lives of the elderly. This study aimed to investigate the relationship between social support and happiness status in 60-75-year-olds referred to health centers of Zarrin Shahr, Iran in 2019.

METHODS

In this cross-sectional study, 584 samples (female: 62.2%, men: 37.8%) participated in this study. To collect data for this study, Oxford Happiness, and Social Support questionnaires were used. The older adults of the target group were selected through simple multistage random sampling from the health centers of Zarrin Shahr. The collected data were entered into SPSS software version 22. They were described and analyzed by inferential statistics and regressions at a 95% confidence level.

RESULTS

Sex, marital status, and level of education influenced total social support (P < 0.05). Moreover, age, marital status, and level of education affected happiness (P < 0.05). There was a significant positive correlation between total social support and components of social support with happiness (P < 0.05). Also, the multi-stage regression test showed emotional social support and education level were highly correlated with happiness (R2 = 0.265).

CONCLUSION

The results highlight the need to increase social support for older adults because it can increase the level of happiness in this age group. In interventions to improve the social support and happiness of older adults, low-educated, unmarried, divorced, or deceased spouses should be prioritized.

Adolescents' Perspectives on Facilitators and Barriers to Social Health in the Family: A Qualitative Study

BACKGROUND

Family plays the most fundamental role in the adolescent's health. A deep understanding of family characteristics, beliefs, and function about the adolescent social health provides a framework, relying on which one can perceive how this dimension of health is developed and promoted in this setting. In this study, we aimed to understand the family context that facilitates or limits adolescent social health.

METHODS

Fifty-four adolescents and fifteen parents participated using a purposive sampling method. The findings were collected through semi-structured interviews and group discussions. The data was analyzed through conventional content analysis by the MAXQDA10 software.

RESULTS

Healthy and unhealthy family reactions are the two main categories that facilitate and limit the adolescents' social health. Sub-categories of healthy reactions included effective guidance, cultural safeguard, and accountable interactions. The unhealthy family reactions included sub-categories of poor intergenerational perception and passive parenting.

CONCLUSION

Our findings revealed that the family context of the adolescent's social health ranged from healthy to unhealthy responses. These results can contribute to improving and designing interventions for promoting the adolescent's social health. It is essential for policymakers and health experts to pay attention to the family empowerment approaches.

Comparison of Perceived Self-efficacy, Benefits, and Barriers of Hypertension Control between Male and Female Patients Referred to Rajaie Cardiovascular Medical and Research Center in Tehran

Background

Hypertension is a health problem. The purpose of the present study was to compare perceived self-efficacy, benefits, and barriers of hypertension control between male and female patients.

Methods

This cross-sectional study was carried out on 400 patients referred to Rajaie Cardiovascular Medical and Research Center in Tehran from August 2020 through March 2021. The convenience sampling method was used. The data collection tools consisted of a digital sphygmomanometer, a demographic form, and a researcher-made questionnaire of perceived benefits, barriers, and self-efficacy of hypertension control, whose validity and reliability were obtained.

Results

The mean age of the male and female patients was 54.02±12.93 years and 56.48±12.10 years, respectively. The mean score of perceived barriers in women was lower than that in men, and the mean perceived self-efficacy in women was higher than that in men (P<0.001). According to the regression test, history of smoking in men and family history of hypertension and age in women were predictors of perceived benefits. Further, occupation and history of smoking in men and education level, family history of hypertension, and history of smoking in women were predictors of perceived barriers. Additionally, marital status, education level, and disease duration in men and education level, family history of hypertension, history of smoking, and age in women were predictors of perceived self-efficacy (P<0.050).

Conclusion

In men, the mean score of perceived barriers was higher and the mean score of perceived self-efficacy was lower. Additionally, the predictors of each of these perceptions were determined.

Exploring the Consequences of Early Marriage: A Conventional Content Analysis

Early marriage is one of the most important social issues for young women and can have many consequences. The present study aimed to explore the consequences of early marriage among Kurdish women in western Iran who were married under the age of 18. This qualitative study was conducted with the approach of conventional content analysis. The data were collected through semi-structured interviews with 30 women selected by purposeful sampling. Data analysis was performed using Graneheim and Lundman's method. A total of 389 codes, 12 subcategories, 4 sub-categories, and 2 main categories were extracted from the data analysis. Negative consequences of early marriage include: 1-physical and psychological problems (high-risk pregnancy and childbirth, physical illnesses, depression, and emotional distress); 2-family problems (dissatisfaction with married life, experience of having lots of responsibility, lack of independence in family life); 3-social problems (risky social behaviors, lack of access to social and health services, social isolation, lack of access to a job, and educational opportunities); and 4-positive consequences, including receiving intra-family support, improving living conditions, and opportunities for progress and empowerment. It is possible to reduce problems and challenges after early marriage by increasing the awareness and knowledge of young women about contraceptives and providing appropriate social and health facilities, and services during pregnancy. Providing the necessary training and psychological counseling for them and their husbands on how to deal with personal problems and marital life will be effective to a great extent.

Exploration of the primary needs of health care services for earthquake victims in the west of Iran

BACKGROUND

Natural disasters always have significant effects on social infrastructures, living conditions, and health care systems. This study aims to explain the needs of victims in the west of Iran for primary health care services.

MATERIALS AND METHODS

This thematic content analysis and qualitative study was done from September 2020 to June 2021 in the west of Iran. Participants were selected using purposive sampling method. The data were extracted through semi-structured interviews with 17 earthquake victims and then examined through thematic content analysis.

RESULTS

By analyzing and coding the data, the primary needs of victims post an earthquake in the west of Iran were classified into four main categories) health services, mental health, social health, and health management (and 14 subcategories.

CONCLUSION

Regarding the primary needs (health services, mental health, social health, and health management), establishing a headquarters to meet the immediate and special health care needs seems to be required. It was recommended to create institutions for monitoring and supporting the health care needs at the level of the community and even policymaking, as well as guiding earthquake-stricken areas such as the eco-village.

Relationship Between Individual Factors of Empowerment and General Health in Older Adults Attending Neighborhood Houses in Tehran, Iran

Objectives By the rapid growth of the elderly population, the need to pay attention to this group becomes more obvious. General self-efficacy, self-control and self-esteem are the effective individual factors for the empowerment of the elderly. This study aims to examine the relationship between these individual aspects of empowerment and general health in older adults attending neighborhood houses in Tehran, Iran. Methods & Materials In this descriptive-analytical study with cross-sectional study design, 320 older men and women over 60 years of age participated who were selected by a cluster sampling method. Data were collected using a demographic form, the 28-item general health questionaire, 10-item general self-efficacy scale, Rosenberg self-esteem scale, and Tangney’s brief self-control scale. Data was described using mean and standard deviation, and analyzed using chi-square test, Spearman correlation test, one-way-ANOVA, and linear regression in SPSS sofwtare, version 22. Results The mean age of the elderly was 68.42±8.3 years. Their mean score of general health was 21.95±13.4. A significant negative correlation was found between general health, general self-efficacy, self-esteem and self-control (P<0.001). Their general health had a significant relationship with their educational level (P<0.001), years of employment (P=0.002) and housing status (P<0.001). The multivariate regression results showed that housing status (P=0.156), self-esteem (P<0.001), self-control (P<0.001), and general self-efficacy (P<0.001) were the significant predictors of general health in the elderly. Conclusion There is a relationship between general health, general self-efficacy, self-esteem, and self-control of the elderly in Tehran. Their general health is related to their educational level, years of employment, and housing status. Housing status, self-esteem, self-control and general self-efficacy are predictors of their general health. Attention should be paid to these factors in developing health promotion programs for the elderly.

Determining the relationship between burnout and general health among health workers working in Arak health center

Introduction:Work environments have harmful physical, social, and workplace psychological factors that can affect people's health and disrupt other areas of people's lives. Workplace human resources spend at least a third of their lives at work, and the pressures and stresses of work can jeopardize their health and, consequently, threaten organizational interests and goals. Decreasing the performance of the individual, the amount of productivity of the organization also decreases. In recent years, one of the most critical issues and problems in administrative systems, including occupational hazards that have attracted the attention of researchers, is the issue of public health and burnout of individuals in an organization. Due to the recorded adverse effects of burnout, this syndrome can affect job performance, such as quality of work, general health, and job satisfaction. One of the main inevitable consequences of job stress is burnout, affecting the quality of care provided by health workers. This study aimed to determine the relationship between burnout and general health in health workers in Arak health centers. Materials and Methods: In this descriptive-analytical study, 110 health workers working in the Arak health center were studied. The number of samples was done using census, and all health workers working in Arak Health Center were selected. Data collection tools in this study were a 22-item Maslach burnout questionnaire and a 28-item general health questionnaire. The data of this study were analyzed using descriptive data and one-way ANOVA, and Pearson correlation coefficient by SPSS22 software. Results: According to the findings of this study, there was a significant relationship between general health and burnout, meaning that people with higher general health experienced lower rates of burnout. The status of burnout was moderate among the health workers studied. The burnout scores of male and female health workers were almost the same, and there was no significant difference between them. There was a statistically significant direct relationship between general health and emotional fatigue and depersonalization using Kendall, Pearson, and Spearman test. A statistically significant inverse relationship was observed between general health and personal inadequacy. Conclusion: Considering the relationship between burnout and public health, the Arak city health center managers must implement programs to promote and improve job motivation, human relations, and a sense of self-efficacy. Promoting general health and reducing the burnout rate of health workers should be a priority for the University of Medical Sciences managers.

Dimensions of Preparation for Aging: A Systematic Review

Background: A deeper understanding of the dimensions of preparation for aging at the personal level may provide new perspectives for healthy aging promotion policies. Therefore, the present study was conducted to investigate the dimensions of preparation for old age and retirement. Methods: This was a systematic review. The search was performed in the following databases: PubMed, Embase, Scopus, Web of Science, PsycINFO, and Google Scholar up to June 2020. This search was done based on the following keywords: "prepare*", "preparation", "plan* ", "Aged", "Ageing", "Aging", "older people", "senior", "retirement", "older adults", and "elderly" through the AND/OR operators. In the preliminary search, 2032 papers were identified. After removing the duplicated articles and screening the title and abstract, the full text of 141 papers were investigated. Finally, 42 papers were eligible for inclusion in the systematic review. Results: The results indicated that preparation for aging is propounded in the 6 dimensions: (1) health preparation; (2) psychological preparation; (3) financial preparation; (4) housing; (5) social preparation; and (6) active leisure. Conclusion: The findings of the present study indicated that planning for aging requires coverage of all dimensions of old age preparations to achieve healthy aging. The preparation planning should be performed before later life and during the young or middle-age years.

Development of an Instrument to Measure Dietary Supplement Health Literacy

Background:

Health literacy is one of the important social determinants of health.

Objective:

The aim of this study was to develop an instrument to measure Dietary Supplement Health Literacy (DSHL) of Iranian women.

Methods:

In this psychometrics study, an initial nine-factor instrument was developed. Face validity and content validity of the instrument were evaluated. The factor structure of the instrument was explored by the Exploratory Factor Analysis (EFA) among 400 women taking Dietary supplement. Confirmatory Factor Analysis (CFA) was done to determine the underlying factor structure of the instrument in this population. The internal and external reliability of the instrument was evaluated.

Key Results:

According to expert panel opinions, 16 items were deleted. The results of the EFA showed that the Kaiser-Meyer-Olkin and Bartlett's test of sphericity were significant. EFA showed that 30 items could be grouped into nine factors that accounted for 60.84% of the variance. Since two items in the ability to actively engage with health care providers factor were loaded in factor 1, this factor was labeled Engaging in receiving informational supports from health care providers. In addition, one item of the dimension was loaded in factor 3. Given that the one item of factor 5 and 1 item of factor 6 were loaded in a new factor 9, this factor was labeled Applying information to decision-making. The CFA indicated that the nine-factor structure of the DSHL instrument had a poor fit. To modify indices, factor 9 with 2 items and 1 item of factor 6 were deleted. The Cronbach's alpha and intraclass correlation coefficient of the instrument were acceptable. Finally, a 27-item instrument with 8 dimensions was confirmed.

Conclusions:

The results of the study showed that the instrument developed was a valid tool for identifying the DSHL of Iranian women. [HLRP: Health Literacy Research and Practice. 2022;6(2):e159–e166.]

Plain Language Summary:

This study sought to develop and validate a multidimensional instrument to measure the health literacy of Iranian women about dietary supplements that was performed from July 2019 to May 2020 in Iran. Findings showed that the 30-item instrument developed in this study is a valid instrument to be used for identifying the health literacy of Iranian women about dietary supplements.

Determinants of Weight Loss and Obesity Control Behaviors Among Women Based on the Pender’s Health Promotion Model

Background: Lifestyle changes, advertising, and access to high-calorie, low-value foods have led to an increase in the prevalence of obesity and overweight, and women are at greater risk in this regard. The aim of the present study was to identify the determinants of weight loss and obesity control behaviors based on Pender’s health promotion model (HPM) among women referring to the healthcare centers of Shahrekord, Iran. Methods: This descriptive-analytical study was performed on 500 women aged 18-49 years with a body mass index (BMI)≥25 in 2019. The cluster sampling method was performed on the healthcare centers, and women were selected using simple random sampling. The data collection instrument included a researcher-made questionnaire, the reliability and validity of which were approved, and finally, data were analyzed using analytical tests in SPSS 22 and Stata14. Results: The mean (±standard deviation) of the women’s age was 34.33±8.2 years. A total of 57.8% of women had no history of weight loss and obesity control behaviors. Variables such as age, education level, and marital status were statistically significantly related to weight loss and obesity control behaviors (P≤0.05). Moreover, the constructs of prior related behaviors, interpersonal influences, and commitment to a plan of action were among the predictors of weight loss and obesity control behaviors and predicted 6.6% of behavioral changes (R2 : 6.6, P<0.05). Conclusion: Overall, prior related behaviors, interpersonal influences, and commitment to a plan of action are predictors of weight loss and obesity control behaviors, and thus it is suggested to place more on these constructs while designing relevant health-promotion interventions.

Middle-aged preparation for healthy aging: a qualitative study

BACKGROUND

Preparing for aging is investing resources in preparing to cope with the challenges that are expected to happen in older age. This will lead to an increase in the quality and well-being in aging. The present study was conducted to elucidate the preparation of the middle-aged people for healthy older age in Tehran, Iran.

METHODS

The present study was performed with a qualitative approach and using semi-structured interviews with 23 Iranian middle-aged people (45 to 59 years old), selected by purposive sampling, and the interviews continued until theoretical saturation. Data were analyzed using the content analysis technique with MAXQDA ₁₀ software.

RESULTS

The preparation of the middle-aged people was examined in four main categories including staying healthy, financial perspective for the future, outlook on aging, and planning for use time productively. The middle-aged people paid more attention to Staying healthy than other dimensions and the saw their future financially as very dark. Outlook on aging and planning for use time productively dimensions were less considered by the subjects.

DISCUSSION

Preparing for healthy aging is a multidimensional concept. The results of the study showed that the middle-aged studied in Iranian society rarely had the necessary preparation and planning to have healthy aging, also preparation is outside the individual behavioral factors and is more affected by the economic situation of the society. So, interventions and the country's macro-policy are needed to plan for healthy aging these people.

Perspectives on healthy aging in middle age: Evidence for health promotion interventions

CONTEXT

Understanding how middle-aged people perceive healthy aging and what they need to do to stay healthy as they age can help public policy planning to enhance the lifestyles of middle-aged and elderly people.

AIMS

The purpose of this study was to clarify the concept of healthy aging and strategies to achieve it from the perspective of middle-aged people in Tehran, Iran.

SETTING AND DESIGN

This qualitative study was performed on 21 middle-aged people aged 45-59 years of Tehran in 2019.

SUBJECTS AND METHODS

The data collection was carried out through semi-structured and in-depth interviews; the interviews were audiotaped, transcribed. Sampling was carried out gradually until data saturation through purposive sampling was achieved.

STATISTICAL ANALYSIS USED

Data collection and analysis were performed simultaneously. Data were analyzed using conventional content analysis. To establish the reliability and validity of findings, Graneheim and Landman criteria were considered.

RESULTS

The middle-aged perspective on healthy aging was included in four main themes: having good physical and mental health, having financial well-being, having social support. Strategies for achieving healthy aging were included in five themes: future financial planning, promoting physical health, promoting psychological health, maintaining and improving communication.

CONCLUSION

From the middle-aged perspective, healthy aging and strategies to achieve it are multidimensional. Planning for promotional interventions to have a healthy old age should be including all dimensions and done from the years before old age.

Students' beliefs about smokeless tobacco use in Chabahar city: A qualitative study using focus groups

BACKGROUND

Smokeless tobacco use is a public health problem. This study explored students' beliefs about smokeless tobacco use in Chabahar, Iran.

MATERIALS AND METHODS

The qualitative study was conducted using three Focused Group Discussions among 24 students aged 12-14 years in Chabahar City. Focus Group Guide Morgan was used. Qualitative Content Analysis was used to explore and extract codes and themes. The data analysis process was carried out in accordance with the stages of proposed by Graneheim and Lundman. Guba and Lincoln criteria were used for evaluating research transferability.

RESULTS

Two main themes emerged from the analysis including; beliefs of being useful and harmful. Each of these themes is divided into subthemes with useful or harmful physical and psychological beliefs. Four subthemes included: beliefs of being useful physically, beliefs of being useful psychologically, harmful beliefs physically, and harmful beliefs psychologically.

CONCLUSIONS

One of the more significant findings to emerge from this study is that many students mentioned the benefits of using smokeless tobacco to reduce toothache, relieve headaches, and bad breath. This information can be used to develop targeted interventions aimed at reducing smokeless tobacco consumption. However, more research on this topic needs to be undertaken before the association between kinds of beliefs and smokeless tobacco consumption is more clearly understood.

Qualitative exploration of the factors influencing the use of dietary supplements in Iranian women: introduction to areas of focus for developing interventions

BACKGROUND

Literature shows that the consumption of Dietary Supplements (DS) is more common in Iran. This study aimed to explore the experiences of a sample of Iranian women regarding the factors influencing the use of DS.

METHODS

This qualitative content analysis study was conducted in Qods city, Tehran province, Iran from January to March 2020. Forty-two semi-structured in-depth interviews were performed with women. The participants were asked about their experiences about the determinants of the consumption of DS. After the first round of the interviews was done, we performed content analysis of the data and continued up to data saturation.

RESULTS

Two main themes including personal factors (with 5 subthemes including sociodemographic characteristics, perceived benefits of DS, history of illness, physiological conditions, and lifestyle factors) and socio-economic factors (with 3 subthemes including subjective norms, the price of food and commercial considerations of the sectors involved in the production and sale of DS) emerged as the experiences of the participants as to the intake of DS.

CONCLUSIONS

These variables may suggest areas which need to be focused on for performing more effective interventions to affect appropriate consumption of DS in Iran.

Determinants of mammography screening in Tehranian women in 2018 based on the health belief model: A cross-sectional study

BACKGROUND

Breast cancer is the most common type of cancer among women. Mammography is the most sensitive and important method for screening and early diagnosis of breast cancer. Considering the importance of using mammography in breast cancer screening, this study was performed to evaluate mammographic determinants.

MATERIALS AND METHODS

In the cross-sectional study, we surveyed 985 women over 40 years in Tehran concerning demographic characteristics: age, socioeconomic status, a problem in the breast, alcohol use, drug use, and health belief model. Logistic regression was used to identify determinant factors associated with mammography performance.

RESULTS

The results of this study showed that 42.1% (95% confidence interval [CI]: 38, 45) participant performed mammography at least once during their lifetime. Age (odds ratio [OR] = 4.252; 95% CI = 2.041-8.857); housing situation (OR = 1.706; 95% CI = 1.178-2.469); having breast problems (OR = 5.224; 95% CI = 3.501-7.795); socioeconomic status (OR = 1.855; 95% CI = 1.035-3.325); family income level (OR = 1.998; 95% CI = 1.028-3.884); alcohol consumption (OR = 2.676; 95% CI = 1.344-5.328); smoking (OR = 2.824; 95% CI = 1.418-5.623); self-efficacy (OR = 1.935; 95% CI = 1.242-3.015); perceived barriers (OR = 2.017; 95% CI = 1.348-3.019); self-care (OR = 4.901; 95% CI = 3.152-7.620); perceived susceptibility (OR = 1.971; 95% CI = 1.271-3.057) and perceived severity (OR = 1.830; 95% CI = 1.170-2.860) were mammography behaviors determinants.

CONCLUSION

The findings indicated that the rate of mammography screening among Tehranian women is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the priority for health-care providers. Furthermore, the identification of these factors can help to design an appropriate educational intervention that focuses on the benefits of mammography screening.

The Reasons for Using Smokeless Tobacco: A Review

Background:

Smokeless tobacco use is a public health problem in some parts of the world. The major objective of this study was to investigate the reasons and factors of consumption.

Methods:

A content analysis was conducted on articles for the past thirty years (1989–2019). We reviewed and selected 400 abstracts of original articles from PubMed databases by the search strategy, and reviewed one by one. Among these, 45 abstracts were selected, in which the patterns of use, the reasons for using, and the determinants and predictors were described. Eleven papers were selected based on the results and related to the research objectives. The results of these articles were evaluated precisely word by word and phrase by phrase with content analysis method and inductive approach.

Results:

The reasons for the use of smokeless tobacco fell in two main themes: socio-cultural structure; and, beliefs, each contained Sub-themes such as “culture and living conditions”, “laws”, “family and peer relationships”, “beliefs related to psychological” and “beliefs related to physical influences”, “beliefs”, “The role of harm perceptions “.

Conclusion:

There was a difference between beliefs, cultures and social conditions among the people about using of smokeless tobacco and the association of these factors is investigated in future studies. We also suggest for the prevention and control of smokeless tobacco use, cultural norms and beliefs will need to address adequately.

The prevalence of burnout and its relationship with capital types among university staff in Tehran, Iran: A cross-sectional study

Background

Burnout is a job-related syndrome that is common among university staff, and it is caused by various factors. The purpose of this study was to investigate the prevalence of burnout and its relationship with capital types among university staff in Tehran, Iran.

Methods

A cross-sectional descriptive-analytical design was used in which 420 staff were randomly sampled from the Iran University of Medical Sciences. For data collection, the researchers used the Burnout Inventory of Maslach and Jackson and Capital Types Questionnaire. The data were entered into SPSS software (Version 22) and analyzed by descriptive and inferential statistics and regressions.

Results

The mean burnout of staff was 84.42, and 45.9% of them had high burnout. A significant relationship was found among capital types, work experience, gender, education, and burnout. Multiple linear regressions also showed that independent variables estimated about 32% of the variance of the dependent variable, social capital, gender, and work experience, contributed more to explaining and predicting burnout index.

Conclusion

Regarding the relationship between burnout and capital types (economic, cultural, and social), it is necessary to increase capital by increasing cultural activities, staff's knowledge level, income levels, informal groups, and finally, strengthening interpersonal relationships among staff.

Can adopting skin cancer preventive behaviors among seafarers be increased via a theory-based mobile phone-based text message intervention? A randomized clinical trial

BACKGROUND

One of the main occupational hazards for seafarers is the long exposure to sunlight. This study aimed to determine the efficacy of a mobile phone-based text message intervention in adopting skin cancer preventive behaviors among a sample of seafarers in Genaveh port located in Bushehr province, Iran.

METHODS

In this randomized controlled trial, 136 seafarers were randomly selected and assigned to the intervention (n = 68) or a control groups (n = 68). As a theoretical basis, we followed the Protection Motivation Theory (PMT) variables to develop the text messages. The data related to PMT variables and skin cancer preventive behaviors were collected through a questionnaire. Forty-five text messages were designed, pre-tested and sent to the seafarers' phones in the intervention group in 45 days. Both groups were followed up 1 month after the intervention. Data collected in the two stages were analyzed using paired-samples t-test, ANCOVA, and Chi-square tests.

RESULTS

Following the intervention, the mean scores of adopting skin cancer preventive behaviors (p = 0.001), perceived self-efficacy (p = 0.01), protection motivation (p = 0.02), and fear (p = 0.001) were significantly higher in the intervention group than the control group. There was significant reduction in the response costs (p = 0.05) and perceived rewards (p = 0.01) scores in the intervention group compared with the control group after the intervention. However, there were no significant differences in the perceived vulnerability (p = 0.14), perceived severity (p = 0.09), and response efficacy (p = 0.64) between the two groups after the intervention.

CONCLUSIONS

The results of the study indicated the effectiveness of mobile phone-based text message intervention for increasing skin cancer preventive behaviors in Iranian seafarers.

TRIAL REGISTRATION

Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/7572 ). Registered 16 July, 2016. Prospectively registered.

Causes and Grounds of Childbirth Fear and Coping Strategies Used by Kurdish Adolescent Pregnant Women in Iran: A Qualitative Study

BACKGROUND

Fear of childbirth is one of the most common problems among pregnant women that can threaten their and their baby's health. Therefore, the purpose of this study was to explore the causes and grounds of childbirth fear and the strategies used by pregnant adolescent women in Iran to overcome such fears.

METHODS

In this study, which was conducted among primiparous Kurdish women in Iran, conventional qualitative content analysis was used. Data were selected through purposive sampling and semi-structured interviews. Data saturation was reached with 15 participants. The Lincoln and Guba criteria were used to strengthen the research.

RESULTS

After analyzing the data, two main categories were resulted. The first category was fear of childbirth with subcategories of fear of child health, fear of childbirth process, fears about inappropriate medical staff performance, fears about hospital environment, and postpartum fears. The second category was strategies to reduce childbirth fear with subcategories of choosing appropriate medical centers, increasing information on childbirth, avoiding stressful sources, improving self-care, getting prepared for delivery day in advance, and resorting to spirituality.

CONCLUSION

Pregnancy in adult age is better than adolescent age. The women's fear can be reduced by increasing their assurance about child health, providing appropriate training during pregnancy, explaining the whole process of childbirth and making it easier, improving the hospital environment and medical staff specialization, as well as providing appropriate conditions for further care and support after birth.

Experiences and challenges of Prostitute Women in Iran: A phenomenological qualitative study

Background

Prostitutes in Iran are faced with many challenges and problems that pose risks to their health.

Objective

The present study is an attempt to identify and narrate the challenges and experiences of Iranian prostitutes based on a qualitative approach.

Methods

This qualitative study was conducted with a phenomenological approach in (2018) in Tehran, Iran. The data were collected through semi-structured interviews with 22 prostitutes who were selected using a snowball sampling method and analyzed with Colaizzi's method. In order to examine the quality of findings, Guba and Lincoln's measures were used.

Results

Data analysis results were classified into five main categories and 14 subcategories. The main issues are: The experience of violence, Heath risk, social ostracism, objectifying, and lack of social and legal supporting structures.

Conclusion

Prostitutes in Iran experience numerous problems at personal and social levels. By providing social, economic, and legal supports for them such as social services (e.g. educations on how to use contraceptives, how to have safe sexual intercourse, and free counseling services for mental support), we can improve their health and welfare.

Smokeless Tobacco Use in Iran: A Systematic Review

Background

Smokeless tobacco (ST) use is one of the most important public health problems in Southeast Asia. The use of these substances increases the incidence of some cancers and other diseases. The purpose of this review study was to investigate on ST use in Iran.

Methods

A literature search was conducted on PubMed, Google Scholar, and three national databases [Scientific Information Database (SID), IranMedex, and IranDoc] based on the standard search strategy.

Findings

Most consumer people lived in Sistan and Baluchestan Province (Zahedan and Chabahar Cities) and Golestan Province, Iran. ST use rates ranged from 11.0% to 45.7% among college students in Sistan and Baluchestan (Zahedan and Chabahar) and Golestan. There are various types of ST consumed in Iran that have been mentioned in various articles, including Pan, Gutka, Nass, Naswar, Biti, and Supari.

Conclusion

Most studies on ST have been conducted in Sistan and Baluchestan and Golestan Provinces and we need more research for other provinces. Consumption by women is a warning and a threat to women's health in the future. Further studies will be needed to find out more precisely the prevalence of consumption in Iran.

Qualitative study of social determinants of child marriage in Kurdish regions of Iran: Evidence for health promotion interventions

INTRODUCTION

One of the most thought-provoking problems in the world is child marriage that is affected by various factors. Therefore, the purpose of this study is to identify the social determinants of child marriage in Kurdish regions of Iran.

MATERIALS AND METHODS

This qualitative study was conducted using conventional content analysis approach. The participants of the study were 30 Iranian-Kurdish women married under the age of 18 who were selected through purposeful and snowballing sampling. Data collection was conducted through semi-structured interviews and face-to-face interviews and continued until the saturation of concepts was achieved. Graneheim and Lundman method was used to analyze the data, and Guba and Lincoln criteria were used to strengthen the research.

RESULTS

In general, findings include 5 categories and 17 subcategories: 1 - economic factors (financial problems and economic benefits); 2 - sociocultural factors (social customs, cultural beliefs, community encouragement, social learning, gaining prestige, and social support); 3 - individual factors (physical characteristics, personality traits, lack of awareness of the damaging consequences of early marriage, and fear of the future); 4 - family factors (dysfunctional family, weak awareness of parents, and harm prevention); and 5 - structural factors (high demand, limited access to educational services, and the lack of supportive social and legal structures).

CONCLUSION

By raising the level of awareness and attitude of girls and their families about the consequences of early marriage, creating the culture of correcting cultural beliefs and social misconceptions, passing appropriate laws, and the use of local and national media to prevent child marriage, this social harm can be reduced.

Investigation of the quality of life of patients with hypertension in health centers

INTRODUCTION

Hypertension is one of the most critical factors for chronic diseases such as cardiovascular disease, stroke, arrhythmias, heart failure, and renal disease. The aim of this study was to evaluate the quality of life and its related factors in hypertensive patients.

MATERIALS AND METHODS

This study was descriptive research. The sampling method was simple random, i.e., 137 were selected among the ten health centers of the list of the existing patients by simple random sampling. Data were collected using a questionnaire World Health Organization Quality of Life-BREF (Short Form-26). After collecting the questionnaires, the data analysis was carried out using SPSS software and using statistical methods (e.g., number, percentage, mean, standard deviation, and MANOVA tests).

RESULTS

The results showed that the mean score for the physical domain (52.82), the psychological domain (50.26), the social domain (48.33), the environmental domain (46.1), and the total quality of life (49.60). Among the demographic variables, the education level variable (P =0.000), job (P = 0.013), and the duration of hypertension (P = 0.039) were significantly correlated with the quality of life of patients. The "levels of education" variables are significantly correlated with the physical domain (P = 0.000), psychological domain (P = 0.000), social domain (P = 0.000), and environmental domain (P = 0.000) of the quality of life. The "job status" variable is only significantly correlated with the social domain of the quality of life (P = 0.005). The "duration of hypertension" variable is only significantly associated with the physical domain of the quality of life (P = 0.011).

CONCLUSION

The findings of the present study show that demographic variables such as educational level, occupation, and duration of hypertension have a significant relationship with the quality of life domains of hypertensive patients. It is recommended that the principled education of patients is a step toward the improvement of the quality of life of patients.

Prioritization of needs among students of University of Medical Sciences: A needs assessment

INTRODUCTION

The need assessment is a fundamental part of any planning, and almost by neglecting it, the effectiveness of the programs is impossible. The purpose of this study was the prioritization of needs among students of the Iran University of Medical Sciences.

MATERIALS AND METHODS

The design study was conducted in two parts; in the first part, the design of the questionnaire was done by qualitative methods. The questionnaires were extracted by interviewing and obtained acceptable validity and reliability. Moreover, the second part created a questionnaire consisting of four categories: education, welfare, economic, and psychological and social. A simple random sampling method was used to select 363 people using the Cochran formula. Finally, 336 people (including 28 people excluded) completed the questionnaire. A questionnaire designed to collect sample data was used and analyzed using version 23 of SPSS.

RESULTS

A total of 336 students (26.77 ± 5.45 years) participated in the study. 123 (36.6%) were male and 213 (63.4%) were female. Psychological and social needs of students were prioritized, and educational priorities were ranked second. The findings showed that there was no significant statistical difference between the scores of welfares and psychosocial and educational needs and the gender of the research units (P > 0.05). However, in the mean of economic needs scores, there is a significant statistical difference between the marital status of the research units (P < 0.05).

CONCLUSION

The results of our study in the research units showed that the priority of psychosocial needs was more than other needs and the educational priority was the next. According to the results of this study, we suggest that, in future educational and educational planning, policymakers and planners should pay attention to psychological and social issues.

The effect of educational intervention on health-promoting lifestyle: Intervention mapping approach

BACKGROUND

The health-promoting lifestyle by empowering individuals will increase control over their health, improve quality of life, and prevent diseases. The purpose of the present study was to determine the effect of the educational intervention based on the intervention mapping approach on health-promoting lifestyle in Iranian college students.

METHODS

This study is a quasi-experimental control study that was conducted in two groups of 65 students of Iran University of Medical Sciences in 2018-2019. The data were collected using the Health-Promoting Lifestyle Standard Profile II questionnaire and a researcher-made questionnaire based on the mapping approach, whose validity and reliability were confirmed. The educational intervention was designed according to the pretest results, including five training sessions and performed for the intervention group. The two groups were evaluated with the same questionnaires 1 month and 3 months later, and the data were analyzed using independent t-test, Spearman, ANCOVA, ANOVA test, and covariance.

RESULTS

Before the intervention, no significant difference was observed between the mean scores of health-promoting behaviors in the two groups, but after the intervention, the mean scores of attitude, subjective norms, enabling factors, and perceived self-efficacy and mean scores of health-promoting lifestyle and its dimensions increased significantly in the intervention group (P < 0.001) compared to the control group.

CONCLUSION

The educational intervention is effective in improving behaviors related to health-promoting lifestyle and its dimensions. Therefore, performing educational interventions are suggested to adopt and adhere to behaviors related to health-promoting lifestyle by utilizing and reinforcing perceived self-efficacy, subjective norms, enabling factors, and attitudinal change.

Prioritizing health promotion lifestyle domains in students of Qazvin University of Medical Sciences from the students and professors' perspective

INTRODUCTION

An individual's lifestyle is closely related to the health so that a healthy lifestyle improves the purpose of this study was prioritizing health promotion lifestyle domains in students of Qazvin University of Medical Sciences from the students and professors' perspective.

MATERIALS AND METHODS

This study was done in cross-sectional method. The statistical population of this study consisted of students in Qazvin University of Medical Sciences in the academic year 2018. In addition, 10 faculty members in this university and five students were questioned in Delphi method from different educational groups. The questionnaire was used consisted of two parts. The first part included demographic characteristics, and the second part included the standard questions for Pender's health promotion model. The Delphi needs assessment method was also used to collect the information.

RESULTS

The mean score of students' health-promoting behaviors was average (135.22 ± 19.35). The greatest score of health promotion behaviors was related to the spiritual growth scale (25.3 ± 5.4), and the lowest score was for physical activity (19.7 ± 05.1). The results of the Delphi method also suggested that both groups of faculty members and students believe that the dimensions of health accountability, physical activity, and prevention of high-risk behaviors in the students' lifestyle, need to be intervened.

CONCLUSION

The results of the present study indicated that the students' lifestyle at Qazvin University of Medical Sciences was in average condition and low scores in the dimension of physical activity. Planned interventions should be made to promote health-promoting lifestyle among these students.

Effect of Health Literacy Education on Self-Care in Pregnant Women: A Randomized Controlled Clinical Trial

BACKGROUND

Prenatal care reduces the risk of adverse pregnancy outcomes. The present study aimed to determine the effect of health literacy education on self-care in pregnant women.

METHODS

The present randomized controlled clinical trial was conducted at two comprehensive health service centers in Pakdasht (Tehran province, Iran) during January-June 2016. Out of the ten comprehensive health service centers in the city, two centers were selected using a simple randomized sampling and randomly assigned to a control group and an intervention group. From each center, 40 pregnant women were recruited into the study. Dedicated questionnaires on self-care and health literacy during pregnancy were developed by the author as data collection tool. The validity and reliability of the questionnaires were confirmed using the test-retest reliability method and by the opinion of ten experts, respectively. The questionnaires were completed before the intervention, and at 1 and 2 months after the intervention. The intervention consisted of four 45-minute educational sessions and group counseling. The data were analyzed using the SPSS software (version 16.0) with the independent t test, Chi-square test, Mann-Whitney test, and repeated measures ANOVA. P<0.05 was considered statistically significant.

RESULTS

There was no significant difference between the groups before the intervention. However, 1 month after the intervention, there was a significant difference (P<0.001) in the mean scores of the total self-care and total health literacy between the control and intervention groups (65±6.23 versus 76.77±4.28 and 30.95±4.63 versus 40±3.54). Similarly, there was a significant difference (P<0.001) between the mean scores 2 months after the intervention.

CONCLUSION

Intervention for the promotion of physical and mental self-care during pregnancy should emphasize on increasing health literacy in computational comprehension, reading comprehension, and behavior. Trial Registration Number: IRCT2017030415650N8.

The effectiveness of self-management program for people with type 2 diabetes mellitus based on PRECEDE-PROCEDE model

AIMS

Diabetes mellitus (DM) is one of the most common chronic diseases worldwide that requires a person with diabetes to make a multitude of daily self-management decisions. This study sought to evaluate the effectiveness of a self-management program based on PRECEDE-PROCEDE model on self-management behaviors in patients with type 2 diabetes.

METHODS

This experimental study was conducted on 86 diabetic patients referred to the diabetes clinics in Ardabil, Iran, in 2017. From a total of 326 patients with diabetes medical records in those clinics, 86 (26.3%) patients agreed to participate in this study. They were then randomly divided into two groups; intervention (n = 43) and control (n = 43). The intervention group received eight sessions of PRECEDE model-based self-management education program while the control group did not receive any education program. Both groups were assessed at baseline and six months after the intervention.

RESULTS

The mean age of the participants was 55.69 ± 12.04 years (range 32-86 years). 41 patients were men, and 45 were women. The mean time since the first diagnosis of diabetes was 8.6 years (SD = 5.2), and the mean BMI of the patients was 31.63 (SD = 4.20). At baseline, 35.01% of patients had poor self-management behaviors. All PRECEDE variables, including predisposing factors (knowledge, attitude, and self-efficacy), enabling factors, and reinforcing factors, as well as self-management behaviors, were significantly improved in those of intervention group after the education program.

CONCLUSION

Self-management education program substantially enhances the self-management behaviors in patients with type two diabetes.

Effect of Health Literacy Education on Self-Care in Pregnant Women: A Randomized Controlled Clinical Trial

BACKGROUND

Prenatal care reduces the risk of adverse pregnancy outcomes. The present study aimed to determine the effect of health literacy education on self-care in pregnant women.

METHODS

The present randomized controlled clinical trial was conducted at two comprehensive health service centers in Pakdasht (Tehran province, Iran) during January-June 2016. Out of the ten comprehensive health service centers in the city, two centers were selected using a simple randomized sampling and randomly assigned to a control group and an intervention group. From each center, 40 pregnant women were recruited into the study. Dedicated questionnaires on self-care and health literacy during pregnancy were developed by the author as data collection tool. The validity and reliability of the questionnaires were confirmed using the test-retest reliability method and by the opinion of ten experts, respectively. The questionnaires were completed before the intervention, and at 1 and 2 months after the intervention. The intervention consisted of four 45-minute educational sessions and group counseling. The data were analyzed using the SPSS software (version 16.0) with the independent t test, Chi-square test, Mann-Whitney test, and repeated measures ANOVA. P<0.05 was considered statistically significant.

RESULTS

There was no significant difference between the groups before the intervention. However, 1 month after the intervention, there was a significant difference (P<0.001) in the mean scores of the total self-care and total health literacy between the control and intervention groups (65±6.23 versus 76.77±4.28 and 30.95±4.63 versus 40±3.54). Similarly, there was a significant difference (P<0.001) between the mean scores 2 months after the intervention.

CONCLUSION

Intervention for the promotion of physical and mental self-care during pregnancy should emphasize on increasing health literacy in computational comprehension, reading comprehension, and behavior. Trial Registration Number: IRCT2017030415650N8.

Empowerment of type 2 diabetic patients visiting Fuladshahr diabetes clinics for prevention of diabetic foot

AIMS

Diabetic foot is one of the most serious and costly complications of diabetes. Empowerment is an important indicator in promoting foot care behaviors that helps patients to use their maximum abilities. This study was carried out with the aim of empowering patients with type 2 diabetes to prevent diabetic foot in the city of Fuladshahr, Isfahan, Iran.

METHODS

This is a quasi-experimental study. 104 eligible patients were randomly assigned to two groups: intervention group and control group. The data were collected through a form of profile, empowerment questionnaire, and foot care behavior checklist. The questionnaires were completed by the two groups in the pre-intervention, 1 and 3 months after the end of the intervention. Data were analyzed in SPSS22 using independent t-test, paired t-test, Chi-square, ANOVA, LSD post hoc test and repeated data analysis.

RESULTS

The results showed that there was no significant difference between two groups in terms of demographic variables. Independent t-test showed that there was no significant difference between the two groups in terms of mean score of empowerment and foot care behavior before intervention. However, the mean score of empowerment and foot care behavior of the experiment group was significantly higher than that of the control group in 1 and 3 months after the intervention (P < 0.001).

CONCLUSION

The empowerment of diabetic patients is effective in promoting foot care behavior, and implementation of empowerment programs in diabetes clinics in this city is recommended.

Effect of educational intervention based on PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients

AIMS

Diabetes mellitus is a chronic and progressive disease which requires ongoing medical care as well as patient's self-care skills to prevent acute complications. The purpose of this study is to determine the effect of the PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients.

METHODS

In this semi-experimental study, 86 type 2 diabetic patients referred to the diabetes clinic of Ardabil were randomly selected and divided into two groups (n = 43). Patients in group 1 received educations based on PRECEDE-PROCEED model combined with self-management theory while patients in group 2 received only educations based on PRECEDE-PROCEED model. The self-made questionnaire was used to measure demographic information and PRECEDE-PROCEED model variables at baseline and one month after the intervention.

RESULTS

The mean scores of knowledge, attitude, self-efficacy (p = 0.001), self-care (p = 0.001), enabling factors, and reinforcing factors had significant differences in both groups before and after the intervention (p < 0.05). In addition, one month after the intervention, the mean scores of attitude, self-efficacy, self-care, and reinforcing factors were significantly higher in group 1 compared to group 2.

CONCLUSION

The results indicate the effectiveness of an educational intervention based on PRECEDE-PROCEED model combined with self-management theory to improve self-care behaviors in patients with type 2 diabetes.

Association of self-care status with some relevant factors in middle-aged women in their early menopausal stage

BACKGROUND

Through self-care, people can solve their health-related problems through increasing their awareness and correcting their lifestyles.

OBJECTIVES

To determine the association of self-care status with some relevant factors in Kashanian middle-aged women in their early menopausal stage.

METHODS

This is a cross-sectional study on 351 women in the age range of 45-60 years. Women were selected based on cluster sampling method from the individuals at health-care centers in Kashan, Iran. Researcher-constructed questionnaire on self-care was used. The validity and the reliability of the questionnaire were calculated. The information gathering method was questionnaire completion by the study participants or interview with them. Collected data were analyzed with SPSS 16 software. T-test, ANOVA, Spearman correlation, and linear regression analysis were applied.

RESULTS

The mean (±standard deviation) of the self-care score was 108.14 ± 20.43. Self-care scores were weak in 13.92%, intermediate in 71.02%, and good in 15.06%. Regression analysis showed that the mean of self-care was significantly higher in those with higher educational level of women's (P = 0.045) and their spouses (P = 0.001). Women who were covered by insurance also showed higher self-care; in addition, there was no significant relationship between self-care and participants' job, spouses' jobs, marital status, marital satisfaction, economic satisfaction, number of children, number of households, and type of accommodation (P > 0.05).

CONCLUSION

The results indicate that self-care is inadequate and that the level of education of couples and insurance coverage has a positive effect on the level of self-care in postmenopausal women. To promote self-care in old age, education and empowerment can be considered.

Relationship between self-care behaviors and health literacy among elderly women in Iran, 2015

Background and aim

Self-care is a basic concept in health promotion, regarding the importance of health literacy as a key factor in self-care. This study aimed to identify the relationship between self-care behaviors and health literacy among elderly women in Iran.

Methods

This descriptive and analytic study was performed between October and December 2015. A total of 360 participants were selected from elderly women referred to health centers. Data was collected by test of functional health literacy in adults (S-TOFHLA) and a checklist for assessment of self-care behaviors, and health information seeking. Data were analyzed by SPSS software (version 22) with One-Way Analysis of Variance, and the Pearson correlation coefficient, t-test and regression test.

Results

The mean score of functional health literacy was 41.30±6.29. Of the participants, 73.6% had inadequate health literacy, 20.8% borderline health literacy, and 5.6% enough health literacy. The mean score of health information seeking was 1.791. Also, 31.9% of elderly women had poor self-care behaviors, 56.9% moderate, and 11.1% high. A significant difference was observed in mean score of health literacy between different levels of self-care (F=30.087, p<0.001). Based on regression analysis, health literacy and health information seeking predicted 19.9% of the variance of self-care behaviors.

Conclusion

This study highlights the necessity of promoting health literacy and attention to its influencing factors to improve self-care ability of elderly women. In conclusion, Planning interventions to improve health literacy is essential for health promotion among elderly women.

Assessment of health literacy of municipal employees in Shemiranat, Iran

Background

Health literacy is one of the major determinants of health promotion among individuals and within society.

Objective

The present study is aimed to determine the health literacy status of office employees in Shemiranat using the native instruments of health literacy for Iranian adults (HELIA).

Methods

The present descriptive-analytical cross-sectional study was done in 2016–17. It was conducted on 360 office employees in Shemiranat. The samples were selected using a multi-stage simple random sampling method. Data collection tools in this study included HELIA questionnaire. The data were imported into SPSS v.18 software and then analyzed using descriptive statistical indices (mean, SD, number, and percentage) and inferential statistics (Chi-square, Pearson’s correlation coefficient, Spearman’s correlation coefficient, and Kruskal-Wallis test). Written informed consent was obtained from the employees participating in the study and they were assured about confidentiality. Also, they were informed that participation was voluntary.

Results

The mean and standard deviation of the total health literacy score among the studied individuals was 125.99±16.01. The mean score of health literacy in the areas of reading (15.36±2.89) and evaluation (5.01±2.8) among the studied individuals was lower than other dimensions of health literacy. Based on the Chi-square test, there was a statistically significant relationship between health literacy and education level, occupational rank, work place, and work experience (p=0.0001 in all the cases). The individuals with medium and good levels of health literacy acquired most of their health-related information through the Internet, friends, relatives, physicians, and health staff.

Conclusion

Health literacy status was not sufficient among the studied staff. Thus, it is recommended to perform promotional interventions in order to improve the health literacy status and its dimensions among these staff.

Effect of educational intervention based on locus of control structure of attribution theory on self-care behavior of patients with type II diabetes

Background: Different factors, such as personality and psychological characteristics, are effective in the self-care and control of diabetes. This study aimed at determining the effect of educational intervention based on locus of control structure of attribution theory on the self-care behavior of patients with type II diabetes. Methods: This was a quasi-experimental controlled study performed on 180 patients in Babol Diabetes Association. The sampling method was simple random sampling. Data collection tool was form C of standard questionnaire in multidimensional health locus of control (MHLC) and summary of diabetes self-care activities (SDSCA). Based on the results obtained from the initial completion of the questionnaires, educational intervention was designed as three 60-minute educational sessions using short lectures, question and answer, group discussions, and consultation methods, as well as educational materials, such as films, posters, and pamphlets. Intervention was only performed for the test group. The questionnaires were filled out again 2 and 3 months after the intervention. Results: Before the intervention, there was no significant difference in the mean scores of self-care, internal, chance, and external locus of control between the 2 groups. However, 2 to 3 months after the intervention, the mean scores of self-care (p<0.001) and locus of control (p<0.001) increased in the test group. Moreover, the mean score of chance (p<0.001) and external (p<0.001) locus of control decreased significantly. Conclusion: Educational intervention decreases the mean scores of chance and external locus of control and increases the mean score of internal locus of control; as a result, it improves self-care in patients with diabetes.

The effect of intervention using the PRECEDE-PROCEED model based on quality of life in diabetic patients

BACKGROUND

Poor quality of life is common among diabetic patients, and educational intervention is one of the most effective strategies to improve the quality of life for chronic patients.

OBJECTIVES

To determine the effect of an educational intervention based on PRECEDE-PROCEED in quality of life of diabetic patients, in 2016.

METHODS

In this quasi-experimental study, 86 patients referred to diabetic centers of Ardabil participated. We used the components PRECEDE-PROCEED model for planning, implementation and evaluation of the program. Data collection tools were Diabetes Quality of Life questionnaire (DQOL) and a researcher-made questionnaire. Eight training sessions were conducted for the intervention group for self-efficiency, self- management, attitude, knowledge, and enabling reinforcing factors. Quality of life was followed one and three months after intervention. Data were analyzed through SPSS 16 software using descriptive and analytical tests.

RESULTS

The mean age of patients was 55.88 (±12.1) years. The result showed that before intervention, no significant difference was observed among the mean scores of quality of life, self-management, knowledge, attitude, enabling and reinforcing factors, and self-efficiency in two groups. But one and three months after intervention a significant difference was observed (p<0.001).

CONCLUSION

Educational intervention with PRECEDE-PROCEED model improved the diabetic patient's quality of life.

Study of Relationship Between Illness Perception and Delay in Seeking Help for Breast Cancer Patients Based on Leventhal's Self-Regulation Model

One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was 47.3±10.2. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ≥3 months. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

Relationship between Quality of Life of Women-Headed Households and Some Related Factors in Iran

BACKGROUND & AIM

Women heading their households are the ones who lead their life alone. Burden of life probably decreases the quality of life of women-headed households. The aim of this study is to determine the relationship between quality of life of women-headed households and some related factors in Iran.

METHODS

The study was a cross-sectional study and 180 women-head households were selected from Welfare Organization, Tehran Province, using stratified random sampling method in 2015(January up to April). Social World Health Organization's quality of life questionnaire was used to gather information. The data were analyzed using SPSS statistical software (15) and suitable descriptive and analytical methods were applied.

RESULTS

Quality of life was moderate in the studied women. The highest mean score (50.35) was related to the physical aspect and the lowest mean (37.82) was about the environmental aspect.

CONCLUSION

Quality of life of the studied women is not desirable; so, it is necessary to design appropriate interventions to improve their quality of life.

A PRECEDE-PROCEED based educational intervention in quality of life of women-headed households in Iran

Background: Women-headed households are more exposed to social damages than other women. Such condition remarkably influences the women's health-related life quality. The present study is aimed to investigate the effect of an educational intervention in quality of life of women-headed households under protection of Tehran Welfare Organization, in 2015. Methods: In this quasi-experimental study with control group, 180 women-headed households participated. Sampling method was random allocation. Data collection tools were Life Quality standard questionnaire (WHOQOL-BREF) and a researcher-made questionnaire about structures of ecological and educational diagnosis phase of PRECEDE-PROCEED model. Validity and reliability of the questionnaire approved in a primary study. Based on the results obtained from the primary study, the intervention was performed in the case group only. Participants were followed one and three months after intervention. Data were analyzed through SPSS v. 15 software using descriptive and analytical tests. Results: Before intervention no significant difference was observed among the mean scores of life quality, behavioral factors, and knowledge, enabling, and reinforcing factors in the two groups. But, one month and three months after intervention a significant difference was observed between the mean scores of these variables (in five instances p<0.001). Conclusion: Intervention through the PRECEDE-PROCEED model improved the women-headed households' quality of life. The innovation of this study is using such intervention on quality of life in women-headed households for the first time.

The effect of acupressure at third liver point on the anxiety level in patients with primary dysmenorrhea

Background:

Primary dysmenorrhea may lead to severe anxiety and pain relief during menstruation may reduce the anxiety levels. This study was aimed to determine the effect of acupressure at third liver and placebo points on the anxiety level in patients with primary dysmenorrhea.

Materials and Methods:

This clinical trial was conducted in parallel in the control and treatment groups for three menstrual periods at the dormitory of Kashan University of Medical Sciences between March and June 2012. Students with pain score equal to or greater than 4 were selected and divided into groups based on severity of pain using a randomized block design with the allocation ratio of 1:1. Acupressure was applied in two acupoints including third Liver point (Liv3) and placebo points. Spielberg (STAI) anxiety questionnaire was completed before and after intervention. Randomization, subjects, and data analyzer were blinded to the analysis. Chi-square tests, t-test, Mann-Whitney, paired sample t-test, and univariate analysis of variance were used for statistical analysis. P values <0.05 were considered statistically significant.

Results:

Mean [standard deviation (SD)] values of apparent anxiety levels before and after intervention for liv3 were 45.100 (9.769) and 38.100 (10.608), respectively. For the control group, they were 41.200 (9.795) and 38.900(10.140), respectively. Difference was significant only in the intervention group (P < 0.001). Hidden anxiety did not show a significant change before and after intervention. There was no difference between groups in apparent or hidden anxiety after intervention.

Conclusions:

Pressure on liv3 point reduces anxiety. As there are no previous studies on this topic, further studies with more samples are recommended.

Health Promoting Lifestyle and its Determinants Among University Students in Sabzevar, Iran

Background:

Healthy lifestyle is a major strategy to promote current and subsequent health status. The aim of this study was to assess the status of health-promoting the lifestyle and its determinants among students.

Methods:

A stratified random sample of 500 students in a university in the city of Sabzevar, Iran participated in this cross-sectional study. Health-promoting lifestyle was measured using Walker's health-promoting lifestyle profile II.

Results:

There was a significant correlation between all domains of health-promoting the lifestyle. The highest score among the domains was for an interpersonal relationship (70.8%), and the lowest score was for nutrition (53.6%), and physical activity (53.4%). Significant differences were found in physical activity by gender (P ≤ 0.05). There were significant differences in health responsibility, spiritual growth and body mass index by marital status (P < 0.01).

Conclusions:

Since one out of five students in this study were overweight/obese, health program planning to promote lifestyle, especially physical activity and nutrition among students is recommended. Our findings may be helpful for faculty administrators, curriculum planners, and health educators in designing guidelines to structuralize a healthier campus and to develop health promotion programs supporting healthy choices among students.

Factors Influencing Fast-Food Consumption Among Adolescents in Tehran: A Qualitative Study

Background:

The consumption of different types of fast food is increasingly growing in all parts of the world, both in developed and developing countries. Because of the changes and transitions in the lifestyle and dietary habits of people, an increasing number of people from different age groups, particularly adolescents and young adults, are inclined toward consuming fast food.

Objectives:

The objective of this study was to investigate the factors influencing fast-food consumption among adolescents in Tehran, Iran.

Patients and Methods:

The present qualitative study was conducted in 2012 - 2013 in Tehran, the capital of Iran. To achieve the objective of this study, 42 adolescents were enrolled in this study through a purposive sampling method, and the required data was collected via individual semi-structured in-depth interviews. Data collection and analysis were carried out simultaneously, and the collected data was analyzed via a thematic content analysis and using MAXQDA 10 software.

Results:

In this study after coding the transcribed interviews, the findings were categorized into three main themes as follows: personal views, social factors, and family factors. Each theme included several categories and subcategories, and the coded sentences and phrases were placed under each category and subcategory.

Conclusions:

The results of this study showed that the number of factors promoting fast-food consumption appeared to be more than the inhibiting factors and that the diverse factors at the individual and social level influenced fast-food consumption among adolescents.

Educational intervention for reducing work-related musculoskeletal disorders and promoting productivity

BACKGROUND AND OBJECTIVES

Work-related musculoskeletal disorders (WMSDs) are the main causes of pain, suffering, absenteeism, disability and reduction in productivity. This research aims to determine the role of training intervention based on protection motivation theory in reducing WMSDs and promoting productivity.

METHODOLOGY

The conducted study was based on a quasi-experimental design (control) that was carried out on 158 employees of the Kabl Khodro factory which were divided into two groups of 79 people. After splitting the 158 workers, an experimental and control group was formed. The data collection instruments were made up of two questionnaires and were analysed using a quick exposure check (QEC) method.

RESULT

Before intervention in both the experimental and control groups, there were no significant differences among the average protection motivation theory constructs, productivity and QEC scores (p < 0.05). However, following training intervention there was a significant increase in these factors within the investigated group apart from the perceived response costs and efficacy.

CONCLUSION

The conducted study shows that ergonomic training based on the protection motivation theory is effective in reducing musculoskeletal risk factors and that increased knowledge of the subject can lead to an increase in productivity.

Determinants of responsibility for health, spiritual health and interpersonal relationship based on theory of planned behavior in high school girl students

BACKGROUND

Adolescence is a sensitive period of acquiring normal and abnormal habits for all oflife. The study investigates determinants of responsibility for health, spiritual health and interpersonal relations and predictive factors based on the theory of planned behavior in high school girl students in Tabriz.

METHODS

In this Cross-sectional study, 340 students were selected thorough multi-stage sampling. An author-made questionnaire based on standard questionnaires of Health Promotion and Lifestyle II (HPLPII), spiritual health standards (Palutzian & Ellison) and components of the theory of planned behavior (attitudes, subjective norms, perceived behavioral control, and behavioral intention) was used for data collection. The questionnaire was validated in a pilot study. Data were analyzed using SPSS v.15 and descriptive and analytical tests (Chi-square test, Pearson correlation co-efficient and liner regression test in backward method).

RESULTS

Students' responsibility for health, spiritual health, interpersonal relationships, and concepts of theory of planned behavior was moderate. We found a significant positive correlation (p<0/001) among all concepts of theory of planned behavior. Attitude and perceived behavioral control predicted 35% of intention of behavioral change (p<0.001). Attitude, subjective norms, and perceived behavioral control predicted 74% of behavioral change in accountability for health (p<0.0001), 56% for behavioral change in spiritual health (p<0.0001) and 63% for behavioral change in interpersonal relationship (p<0.0001).

CONCLUSION

Status of responsibility for health, spiritual health and interpersonal relationships of students was moderate. Hence, behavioral intention and its determinants such as perceived behavioral control should be noted in promoting intervention programs.

Effects of educational intervention based on PRECEDE model on self care behaviors and control in patients with type 2 diabetes in 2012

BACKGROUND

Diabetes is a chronic disease and its control requires essential change in patients' life style. The aim of this study was survey of effects of educational intervention based on PRECEDE Model on self care behaviors and control in patients with type 2 diabetes.

METHODS

This was a quasi-experimental study carried out in 78 patients with type 2 diabetes who have referred to Minoodasht clinic of diabetes. The educational program has been designed according to the PRECEDE Model. Prior to perform the educational intervention, the patients filled a questionnaire which was designed according to the structure of PRECEDE Model for type 2 diabetes patients. The diabetes education program was performed on three target groups (patients, their families and Health care personnel). After four weeks, the effects of the educational program have been evaluated through the same questionnaire. The findings were analyzed by SPSS version 16 and p-value less than 0.05 was taken as statistically significant.

RESULTS

The mean age of participants was 49 years, 87.2% were married and 19.2% was illiterate. The rate of income of 44.9% was low. 66% had a family history of diabetes and 64% had been afflicted with diabetes more than 5 years. The Chi-square test showed a significant relationship between formation of a file in diabetes clinic and on-time presence to receive services and participation in the educational classes with the marital status variable. The results also showed that there is a significant relationship between observing food diet and job. The mean scores of knowledge, attitude, practice, reinforcing factors and enabling factors has increased after educational intervention. The Chi-square test shows a significant difference before and after of education intervention in stages of the model.

CONCLUSION

The obtained results based on PRECEDE Model would support the positive effect of the educational intervention and its major elements (predisposing, enabling and reinforcing factors) on diabetes self-care behaviors.