مجله آموزش بهداشت و ارتقای سلامت ایران
سال چهارم شماره 1 (پیاپی 13، بهار 1395)

Physical activity (PA) is a multi-factorial behavior that is affected by intrapersonal, interpersonal, environmental and social factors. The aim of this study was to investigate determinants of PA among patients with cardiovascular (CV) metabolic risk factors based on the educational factors of PRECEDE Model.
This mix method study (qualitative and quantitative) was conducted in two consecutive phases. In the qualitative phase, the experiences of 50 patients with CV metabolic risk factors and 12 healthcare providers who worked in the Diabetes Units of Health Centers of Alborz University of Medical Sciences (ABZUMS) were explained based on the educational factors of PRECEDE Model. In the quantitative phase, the questionnaire of determinants of PA was developed and its validity and reliability were evaluated and confirmed and it was completed by 450 patients and the strongest determinants of PA using the Structural equation modeling (SEM) through AMOS 18 were identified.
Using path analysis the findings showed, self-efficacy (β= 0.90) and perceived barriers (β= -0.63) determinants of predisposing category, skill (β= 0.38) determinant of enabling category, motivation comply (β= 0.47), social support (β= 0.23) and behavioral outcomes (β= 0.17) determinants of reinforcing category were higher predictive power and they were significant.
The determinants mentioned should be targeted in designing an intervention program for promoting PA. Identifying the determinants of PA helps health planners to select the most appropriate methods and applications to address these determinants in order to increase the PA behavior.
Paper Type: Research Article.

Exclusive breastfeeding (EBF) is an important issue in the field of children's health promotion. The aim of this study was to identify the predictive factors of breastfeeding behaviors in order to improve the quality of breastfeeding among Iranian mothers.
A longitudinal study was conducted to collect the data from a large sample of 1445 six-months postpartum mothers referred to health centers in the city of Qazvin, Qazvin province, Iran in 2014. Demographic variables and the constructs of Theory of Planned Behavior (TBP) were measured by a questionnaire. Use of Pearson and Spearman correlation tests along with analysis of variance were conducted to investigate potential associations. Then both hierarchal multiple regression and logistic regression were applied to identify potential determinative factors through SPSS version 21.00.
The average age of the participants was 28.6 ± 5.5 and the majority of maternal were housewives (75.2%). Variables such as age, income, employment and primiparity were associated with EBF (p Interventions to promote knowledge, attitude and behavioral control towards EBF among the young mothers with low socioeconomic status should be considered.

Diabetes is one of the chronic disease that has the most negative effects on the quality of life. This study was aimed to investigate the impact of acceptance and commitment therapy (ACT) on quality of life among patients with type 2 diabetes.
In this quasi-experimental study a pre-test, posttest and a three month follow-up test was used. Among patients from the Diabetes Association in Alborz Province in Iran, 40 diabetic patients were randomly assigned to an experimental and a control group. The instruments for gathering data were demographic characteristics and a shortened form of quality of life questionnaire (DQOL). Besides using their diabetes drugs, during 8 weeks, and each week 2 hours, the experimental group participated in ACT sessions; but the control group only received diabetes drugs. The data were analyzed using covariance analysis, Tukey post hoc test and to compare post-test and medium follow up of two groups the dependent t-test was used through SPSS 20.
ACT in post-test and follow up increased as a psychological intervention of quality of life was used among patients with type 2 diabetes.
ACT can be used as an effective psychological intervention on the quality of life in patients with type 2 diabetes.

Inappropriate function of organizations is directly associated with the physical and psychological health of the society. One such organizations are medical universities which are responsible for educating students of nursing. This study focuses on the association of educational planning with the mental health of nursing students of Tehran Medical Science University with emphasis on the educational stressor factors and stress management methods.
In this descriptive-cross sectional two questionnaires were used: researcher-made questionnaire (a = 0.71) and Jalowiec Coping Styles Questionnaire. The correlation coefficient of test and retest after 3 weeks was used for Jalowiec questionnaire (r=0. 89). The random sampling method among nursing students of Tehran University Medical science was used and the size of the sample was 376. Data were analyzed using descriptive statistics and analytical ones (t-test and ANOVA) through SPSS 21.
Out of 354 students, 32.1% were suspected to have psychological disorders. These disorders were 29.7% among females and 34.6% among males, respectively. There was a statistical correlation between mental health and previous physical illnesses (p A number of nursing students were suspicious to have mental disorders. Therefore, in order to prevent physical and psychological destructive effects of stress on students, it is recommended to think about the educational stressful factors to diminish mental problems.

Hypertension is a psycho-physiological problem. There are several biological and psychological factors that affect the incidence and severity of hypertension. The present study was aimed to investigate the mediating role of subjective-wellbeing in terms of perceived stress and hypertension.
In this descriptive-correlated study, the study population included over-45-adult patients with hypertension who referred to health centers in Tehran. Through convenience sampling 298 persons (121 male and 177 female) were selected as samples of the study. Perceived stress scale questionnaire and subjective well-being questionnaire were used to gather the data. To analyze the data Structural equation modeling (SEM) was used.
There was a significant and negative correlation between subjective well-being and hypertension (p People with high blood pressure have high perceived stress and subjective well-being contributes to the control of hypertension.

Breast cancer is the most common cancer in women worldwide. Its incidence has increased in developing countries due to factors such as increase in life expectancy, urbanization and popularity of western culture. The aim of this study was to identify the social and cultural factors affecting breast cancer screening based on the PEN-3 model (perceptional, enabling and nurturers) among school teachers in Kermanshah, Iran.
This study was a descriptive cross-sectional one. Through random sampling 258 high school teachers were selected as samples. A questionnaire that consisted with 50 questions based on the PEN-3 model was used to gather the data. The validity of the questionnaire was measured with content validity and the reliability with Cronbach alpha coefficient. The data were analyzed through SPSS 21 using one-sample t-test, two-sample t-test and Chi-square test.
48.1% of school teachers had a history of breast self-examination, 24.8% history of breast clinical examination by the physician and medical staff and 9.3% had at least one mammography. The most important affecting factors on screening were: belief to early detection of tumors (87.2%), ability to pay the screening cost (83.7%), negligence and forgetfulness (65.1%), being busy and lack of time (56.2%), fear (24.5%), and anxiety (21.3%).
Due to fact that the affecting factors on breast cancer screening behavior are in the scope of the social and cultural range, a comprehensive plan for intervention and using a health education model, including the PEN-3 model, can be useful.

With the advancement of networks and the Internet industry, computer games have considerably progressed in the recent years and have been released in various types. Hence, the objective of this study was to compare social support in adolescents interested in different types of computer games.
This descriptive study followed a casual-comparative design. The statistical population of this study included all male adolescents and young adults referred to Internet gaming centers in Zahedan, Iran. In this study, multi-stage cluster sampling method was applied through which 8 gaming centers were randomly chosen and then among all people who referred to the considered gaming centers, 156 individuals were selected randomly as the regarded sample. To gather the data, the Mary Procidano and Kenneth Heller’s Social Support Questionnaire (1983) was applied. To analyze the data, frequency, percentage, medium, mode and SD and one- way ANOVA and post hoc Scheffe’s test was used through SPSS 23.
There was a difference among social support of people interested in different types of computer games. In this regard, those who were interested in online multiplayer games perceived higher levels of social support compared to those who were interested in single player games (p ≤ 0.05). Moreover, the findings demonstrated that subjects who chose Internet gaming centers and their houses as places to play compared to those who only selected their houses to play had higher levels of perceived social support.
With the increasing development of computer games and diversification and expansion of its different styles, each type of computer games should be studied and investigated distinctly.

Standard precautions are a proper strategy for prevention of occupational diseases among nurses. The study was aimed to investigate the application of Standard precautions for prevention of transmission of hepatitis B and C and HIV in educational hospitals.
In this cross-sectional study 218 nurses, 174 female and 44 male, of two educational hospitals in Zahedan, Iran uses multi-stages sampling method were studied. A polychotomy standard questionnaire including demographic questions and health belief model constructs were used to gather the data. The participants responded to questions via self-report method. Through SPSS 16 and using descriptive (percentage, Mean) and analytical (paired T test, independent T test, Pearson correlation coefficient, and linear regression coefficient) statistics the data were analyzed.
The mean age of the precipitants was 31.73±6.28.Only 27.7% of nurses had a good level of knowledge and 23.9, 63.3 and 13.8% of them had good, average and weak level of practice, respectively. Also results of Liner regression showed that perceived barrier and self-efficacy predicted the 23.5% of predictive behaviors variances.
Health Belief Model is a proper framework for designing and implementing the educational interventions in promoting the predictive behaviors of Hepatitis and AIDS in hospitals.