مجله سلامت و سالمندی خزر
سال دوم شماره 2 (پاییز و زمستان 1396)

The aim of this study was to investigate the motivational model of life in nursing homes with regard to physical and skeletal factors involved in the design of physical environment. This study introduced the tool and determined the fitness and correlation among the questionnaire items as well as the impact of each 5-design factors effective. This applied research is from the category of environmental studies. The study population consisted of the older people in nursing homes. Following previous studies and applying confirmatory factor analysis (CFA), 150 subjects were selected as sample. A researcher-made questionnaire about motivation for life was used for data collection. Data were analyzed using SPSS 21 at the level of inferential statistics and CFA was performed using Lisrel. The five-factor model of motivation for life in the older people had a good fitness and all items had a significant impact factor on the related factors. The findings also suggested that the five factors were reliable with a mean reliability score of 0.782. Convergent validity between the factors of motivation for life in the elderly in terms of correlation coefficients was from 0.42 to 0.88. The research shows that personal peace, sense of belonging, environmental desirability and comfort, educational and persuasive spaces, and home likeness ordinal from more to less necessity are effective in determining the correlation with elderly motivation for life.

Change of life, from family life to student life, is stressful for students despite facing students with new opportunities. Specially, students living in dorms experience the feeling of severe homesickness and desolation. This experience affects academic achievement, narcotics addiction, suicide and social and academic performance. Therefore, the aim of this study was to determine the relationship between homesickness and depression among students, living in dorms. This descriptive cross-sectional study was conducted on 300 dormitory students of schools of Nursing-Midwifery and Paramedicine in eastern Guilan Beck Depression Inventory (BDI) and Utrecht Homesickness Scale (UHS) in 2016. Data were analyzed using independent such as independent t, ANOVA, Spearman. Totally, 131 students of whom 95(72.5%) were female and 36 cases (27.5%) were male. There was a significant relationship between homesickness and depression (p=0.045) in 24-26-year-old students. Reverse and significant relationship was found between homesickness and depression for students with grade point average (GPA) less than 15.5 (p=0.027). No significant relationship was observed between homesickness and depression with other cases such as marital status and distance of residence and education. Because of high levels of homesickness and depression among students and the importance of mental health of this group as future medical staff, some social support methods can have a significant impact on this issue.

Labor pain catastrophizing (LPC) is one of the important factors in choosing the childbirth type and can disrupt the activities of daily living (ADL) of pregnant women. The aim of this study was to determine the relationship of LPC with the intensity of labor pain and the ADL after the childbirth. This descriptive-correlational study was conducted on 400 pregnant women, referred to Ramsar City's healthcare centers in 2016 and selected using cluster and random method. Data were collected using Pain Catastrophizing Scale (PCS) whose one part includes self-report measure and ADL questionnaire. Participants were studied during their pregnancy to determine their pain catastrophizing and to evaluate their pain intensity and ADL 10 days after the childbirth. Data were analyzed using SPSS18 through independent t-test, Chi-square, Pearson correlation coefficient and multiple linear regression. Results showed that 64% of participants gained the total scores above the cut-off point of PCS while 57% of them had relative independence in their ADL. The mean pain intensity score was 23.92±4.12 and 19.05±2.14 for the groups who had LPC and no LPC, respectively. There was a significant difference between two groups in terms of pain intensity during the childbirth (P=0.003). Among the regression model variables, "childbirth pain intensity", "participating in educational classes", "number of the previous childbirths", "the time interval between the previous and the current childbirth" and "the level of trust to the healthcare providers" had no significant statistically relationship with LPC (p<0.05). Furthermore, there was no significant relationship between LPC and ADL (p=0.14). It is concluded that LPC is a predictor factor for labor pain intensity. Childbirth preparation classes, screening the psychological disorders and receiving healthcare providers' consultation can be effective in LPC prevention and decrease. Moreover, providing interventions like cognitive and behavioral skills education plays an important role in managing LPC and empowerment the pregnant women against the effective factors of this phenomenon.

Poor management of hypertension is a major dilemma in the elderly, which affects the selection of appropriate coping methods. The aim of this study was to determine the effect of 5A self-management program on coping strategies in elderly male patients with hypertension. This clinical trial study was performed on 60 elderly men with hypertension aged 60-75 years, referred to health centers of Ramsar City in 2017. The subjects were randomly divided into two groups of experimental (n= 30) and control (n= 30). Jalowiece Coping Questionnaire (problem-focused and emotion-focused) was used to measure the coping styles of patients before and after intervention. The intervention of self-management program using 5A model consisted of group training and individual guidance. The patients had been followed-up through phone call for 12 weeks. There was no intervention in the control group. Data were analyzed using SPSS 19 through descriptive and analytical statistics. The mean and standard deviation of age in the control and intervention groups were 67.55 ± 5.01 and 68.34 ± 5, respectively. The rate of problem-focused coping strategies before and after the intervention was more desirable in experimental group and a significant difference was found between experimental and control groups (p=0/0001). Considering the growing trend of elderly people with chronic diseases and the impact of problem-focused strategies on self-management behaviors, it is necessary to use well-planned training such as 5A self-management program in order to increase the welfare and ultimately improve the quality of life. Based on the results of this research, in the elderly men with hypertension, appropriate coping strategies can be promoted through regular educational planning and continuous follow-up.

During studentship, marriage can promulgate and internalize simple life and easy marriage culture among young adults, especially university students. In spite of the importance of this subject, university students, especially students of medical sciences universities, face many more barriers and problems on their way of marriage. Therefore, the aim of this study was to determine university students' attitudes toward the marriage problems during studentship. This analytical-descriptive and cross-sectional study was conducted on 400 students of Mashhad University of Medical Sciences, selected using clustering –classifying method. Data were collected using a researcher-made questionnaire including 16 questions which measured students' marriage problems during studentship. The validity of this questionnaire was approved by professors of Mashhad University of Medical Sciences and Faculty of Educational Sciences in Ferdowsi University, and its reliability was approved by test – retest and internal parallelism method. The findings revealed that the most important marriage problems in studentship period, according to students' point of view, included lack of students' independence-of-thought in selecting their future spouse (54.6%), their economic status (48.2%), and the scare of cultural incompatibility (44.5%), respectively. On the other hand, factors like non-educational activities (11.2%), parents' inclination on family marriage (13.8%), also emphasis of parents on traditional marriage (0.16%) had the least effect on unwillingness to marry during studentship, respectively. Since independence-of-thought on marriage, and economical and welfare issues is of great importance for university students, it is suggested that the managers and decision makers for maintaining and improving the students' health should provide a background to make marriage easier by considering cultural, religious and social criteria.

Aging is an inevitable necessity in the path of human growth and can make the person and the environment difficult to adapt. Increasing age is associated with increased hypertension. Regular control of hypertension prevents, suppresses and reduces the complications and mortality from cardiac diseases. The aim of this study was to determine the effect of health promotion model-based education on the self-care of the elderly with hypertension in 2016. In this semi-experimental study, 84 elderly people with high blood pressure were randomly divided into two experimental and control groups (each=42). To collect data, a health promotion model-based questionnaire whose validity and reliability were measured, was used. Educational intervention was conducted based on the self-efficacy structure that was the most predictive in experimental group. The questionnaire was completed immediately and two months after the intervention. Data were analyzed at the significant level of 0.05 using statistical softwares. In assessing the changes of health promotion model constructs, there was a significant difference in perceived behavioral constructs, perceived self-efficacy, feelings related to behavior, perceived benefits and perceived barriers (p<0.001). There was a significant difference between the scores of interpersonal and positional influences in the intervention group (p <0.001).The behavioral outcomes after the intervention had a significant difference in the intervention group (p=0.014). A significant difference was found in the self-care score in the intervention group (p<0.001). Pender's HPM-based training can improve the self-care in the elderly with hypertension.