مجله علوم پزشکی صدرا
سال پنجم شماره 1 (زمستان 1395)

Providing adequate health services is regarded as an important key in maintaining and satisfying veterans, as a main human source. This study aimed to identify the problems of veterans’ health insurance in Iran.
This qualitative study was performed using Delphi technique in 2015. The study population included 30 elite individuals and managers of Martyr Foundation and Veterans Affairs (members of medical committee (n=6), provincial general managers (n=5), and vice-chancellors of health and treatment system in provinces (n=14)). After collecting the data, coding, and classification of information, the priorities and problems of veterans’ insurance were determined. Then, the identified problems and themes were ranked according to the participants’ opinions.
According to the results of Delphi technique, the main problems related to health insurance were policy of insurance, financial contributions, coverage, decision makers, services system, monitoring and evaluation, and modeling in providing health services.
According to the findings, it is necessary to design and implement a system of internal and independent health insurance for veterans that provides prevention and treatment services.

Competency results in provision of patient-centered care and safety, eventually promoting the quality of care. This study aimed to determine nurses’ competency in clinical settings and its related factors.
This cross-sectional, descriptive-analytical study was performed on 500 nurses of Shiraz University of Medical Sciences selected through stratified random sampling. The data were collected using the Competency Inventory for Registered Nurses. Then, the data were analyzed by the SPSS statistical software, version 16.
The nurses’ mean score of competency was 164.42.03. Moreover, 268 nurses (65%) had high levels of competency. The results also showed a significant relationship between nurses’ competency and age, work setting, years of nursing experience, employment status, membership in the organization of nursing, universities in which the nurses were educated, and interest in the nursing field.
The results indicated the nurses’ high competency levels in clinical settings. Additionally, formally employed nurses and those who were members of professional organizations showed higher competency levels. The nurses who were educated in state and highlevel universities also reported higher levels of competency. Therefore, considering these related factors can improve nurses’ competency. Yet, further studies are required to determine nurses’ competency process.

Coping skill is defined as the ability to understand and control one’s emotions and characteristics and is the foundation of emotional management. Various studies have indicated the effect of painting on increasing coping skills. Therefore, this study aimed to investigate the effect of training coping skills together with painting on multidimensional health locus of control among orphan adolescents.
This semi-experimental randomized controlled trial was conducted on 80 orphan adolescents within the age range of 12 to 18 years. The subjects were randomly assigned to either the intervention or the control group. The intervention group received training about coping skills and painting. The data were collected using coping skills questionnaire, Multidimensional Health Locus of Control (MHLC), Internal Health Locus of Control (IHLC), Powerful others Health Locus of Control (PHLC), and Chance Health Locus of Control (CHLC) scales with Cronbach’s alpha of 0.85. Data collection was performed one and six weeks after the intervention. Then, the data were analyzed using the SPSS statistical software, version 19.
After the intervention, the scores of coping skills (34.55.04) and IHLC scale significantly increased in the intervention group compared to the control group (p

Considering the high prevalence and negative consequences of infant feeding problems, there is an urgent need to identify the causative factors. The present study aimed to compare temperament of infants with and without feeding problems according to their mothers’ reports.
This casual-comparative study was conducted on 50 mother-infant dyads selected using convenient sampling. The infants’ ages ranged from 6 to 12 months. After matching with respect to age, sex, birth order, and maternal age and education level, the infants were classified into two groups of with and without feeding problems according to their mothers’ reports. The data were collected using Infant Behavior Questionnaire (IBQ-R), which was completed by the mothers. Then, the data were entered into the SPSS statistical software and were analyzed using MANOVA.
The results showed that the infants with feeding problems had higher fear (F=5.7, P=0.02) and sadness (F=5.8, P=0.02) compared to those without feeding problems. The infants with feeding problems also demonstrated more distress to limitations (F=5.5, P=0.02) and negative affectivity (F=8.01, P=0.007). On the other hand, the infants without feeding problems gained higher scores in high intensity pleasure subscale (F=4. 1, P=0.04).
The results of this study indicated a significant difference between the infants with and without feeding problems regarding their temperament. This could be considered by specialists in preventive and therapeutic programs for eating problems in infants.

Diabetes is considered to be one of the health problems in all societies. Exercise training and supplements are approaches for improving diabetes. This study aimed to investigate the effect of 8 weeks of aerobic training with and without 25-hydroxy vitamin D supplementation on fasting blood sugar, serum insulin, and insulin resistance.
This semi-experimental research with pretest-posttest design was conducted on 48 men aging 40 to 60 years with type 2 diabetes admitted to Jesus, son of Mary Hospital in Isfahan. Volunteers were selected through convenience sampling and were divided into four groups as follows: aerobic exercise group (n=12), aerobic exercise with 25-hydroxy vitamin D supplementation group (n=12), 25-hydroxy vitamin D supplementation group (n=12), and control group (n=12). The aerobic exercise program was performed for 8 weeks (3 sessions a week, each session lasting for 60-75 minutes, with the intensity of 60-80% of maximum heart rate). The supplement groups also received 50000 units of oral vitamin D weekly for 8 weeks. Fasting blood sugar, serum insulin, and insulin resistance were measured in the 4 groups before and after the intervention. The data were analyzed by ANCOVA and LSD post-hoc test.
The findings showed a significant difference among the four groups regarding the mean of fasting blood sugar, serum insulin, and insulin resistance (P The results indicated that vitamin D supplementation combined with aerobic exercises improved fasting blood sugar, plasma insulin level, and insulin resistance. Thus, aerobic training together with the use of vitamin D supplements can be considered as a complementary therapy in improvement of diabetes.