فهرست مطالب

Journal of Education and Health Promotion
Volume:10 Issue: 6, Jun 2020

  • تاریخ انتشار: 1399/06/18
  • تعداد عناوین: 29
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  • Mostafa Shanbehzadeh, Hadi Kazemi Arpanahi, Arezo Arzani Birgani, Azimeh Karimyan, Fatemeh Mobasheri Page 134
    BACKGROUND

    Hypertension (HTN) has become a major public health problem which can cause serious complications when it is not well-controlled. Prevention and effective care of HTN require a population-based registry. Thus, establishing this registry can be used to collect comprehensive, timely, and reliable data on epidemiology cases. The aim is to create a registry for the collection of highly required prospective data that will present an in-depth analysis of the characteristics of all individuals with HTN and track them over a particular chronological interval.

    MATERIALS AND METHODS

    The study was divided into three phases: At first, a comprehensive literature review was conducted to determine the proposed data classes and data fields. Then, the final minimum data set was designed by a two-round Delphi consensus approach of 20 experts of cardiologists, nephrologists, nutritionist, and health information management. Finally, a web-based registry system was developed by a Structured Query Language environment.

    RESULTS

    A total of two clinical and nonclinical data categories with nine data classes and 68 data fields were selected for their inclusion in the registry following the consensus phase. A web-based registry was designed with a modular and layered architecture.

    CONCLUSIONS

    This study provides an appropriate information infrastructure for active tracing and monitoring of individuals with HTN. It has provided a practical information system allowing quality improvement, aggregate reporting for planning, and research purposes.

    Keywords: Hypertension, minimum data set, registry system
  • Somayeh Panahi, Hasan Ashrafi rizi, Maryam Panahi Page 135
  • Fateme Shahedi, Javad Ahmadi, Tahereh Sharifi, Seyedeh Nahid Seyedhasani, Mahbubeh Abdollahi, Negar Shaabani, Mohammad Sarmadi Page 136
    BACKGROUND

    Improving the learning process in education will empower medical students, and also formative assessment helps improve the teaching–learning process by providing ongoing reflective information about learning gaps.

    OBJECTIVE

    The aim of this study was to explore the effect of student‑centered formative assessment by weekly reflective self‑correction quizzes on medical laboratory students’ performance on the final examination of hematology course in 2018.

    MATERIALS AND METHODS

    A semi‑experimental study was conducted on fifty students divided randomly into intervention (n = 25) and control groups (n = 25) using convenience sampling in 2018 from Torbat Heydariyeh University of Medical Sciences, Iran. Data analysis was performed using SPSS software version 16, two‑sample t‑test, Chi‑square test, and analysis of covariance.

    RESULTS

    The intervention had positive effects on students’ mean test scores in hematology II so that the intervention and control groups managed to obtain 18.45 ± 1.46 and 14.57 ± 2.64, respectively (P < 0.01).

    CONCLUSIONS

    The results suggested that weekly formative assessments along with reflective self‑correction activity and active participation of students in the learning process by designing questions could improve student learning.

    Keywords: Assessment, education, health promotion, student, test
  • Meadeh Hesam, Ahmad Abedi Page 137
    INTRODUCTION

    Gifted students are superior to their peers in terms of cognitive, educational, scientific, creativity, and artistic abilities. There are also gifted students who struggle with cognitive, educational, social, emotional, and behavioral development, especially academic performance. They are called underachieving students. One of the main problems of these students is the low level of academic engagement in educational settings. Thus, this study investigated the effectiveness of Martin’s educational program on academic engagement (behavioral, emotional, cognitive, and agency) of underachieving gifted students.

    MATERIALS AND METHODS

    Thirty underachieving gifted students were selected by purposeful sampling from a high school in Isfahan, Iran, and were divided randomly into the experimental (n = 15) and the control (n = 15) groups. All participants completed the students’ academic engagement questionnaire (behavioral engagement, emotional engagement, cognitive engagement, and agency engagement) at pre/post‑test.

    RESULTS

    The findings showed that Martin’s cognitive‑behavioral program had a significant effect on academic engagement and its subscales, including behavioral engagement, emotional engagement, cognitive engagement, and agency engagement.

    CONCLUSION

    School counselors could benefit Martin’s cognitive‑behavioral program to promote the academic engagement of underachieving gifted students.

    Keywords: Academic engagement, Martin’s cognitive‑behavioral program, underachieving gifted student
  • Carlos Martín Ardila, Ángela María Gómez Restrepo Page 138
    BACKGROUND

      Ethnic  minorities  are  underrepresented  in  health  sciences  programs  in  various   nations. Furthermore, there is no known research studying the occurrence of physical inactivity (PI)  and insufficient sleep (IS), and their effects on academic achievement (AA) in ethnic minority  students (EMS) in higher education.

    OBJECTIVE

    The objective of this study is to explore the occurrence of PI and IS, and their  independent and mixed effects on AA in EMS of a dental school.

    MATERIALS  AND  METHODS

    Thirty EMS and sixty non‑EMSs were matched (1:2) in this  case–control study. It was utilized as an administrative dataset that stores register related to the  students. Moreover, the grade point average was considered an indicator of AA. Logistic regressions  models were run, expressed in odds ratios, complemented by confidence intervals (CIs) of 95%.

    RESULTS

    A total of 73% and 60% EMS were PI and slept insufficiently, respectively. The groups  presented statistically significant differences (P < 0.0001) in physical activity, sleep, and AA, with  inferior values for EMS. All unadjusted models showed that PS, IS, and low AA were strongly  associated with EMS, demonstrating their independent effect. After controlling for PI and IS, the  multivariate model for AA and EMS increased odds by 6.5 times (95%CI: 1.8–23;), indicating  that EMS is strongly associated with low AA. Besides, PI and IS were also statistically significant  higher (<0.0001) in the model, demonstrating their mixed effect.

    CONCLUSIONS

    This study found a higher occurrence of PI and IS in EMS. Besides, independent  and mixed effects of these variables on low AA in EMS were very significant.

    Keywords: Educational achievement, ethnic groups, inequalities, physical activity, sleep
  • Sogand Tourani, Zainab Malmoon, Rouhollah Zaboli, Mehdi Jafari, Ali Nemati Page 139
    BACKGROUND

    University health coverage gives everyone accesses to health services focused on the most important causes of illness and death and ensures that the quality of services is high enough to improve the health of those receiving services. Nurses as the largest group of staff in the health system play an important role in achieving UHC. This study aimed to determine the training needs of nursing managers in universities of medical sciences of Iran in achieving UHC.

    MATERIALS AND METHODS

    This study was a qualitative study conducted in 2019 using the framework method. There were 15 experts in nursing management, health management, and nursing authorities at the national level using the purposive random sampling. Data were collected from the expert panel. We used the Atlas.ti software version 7.2 and using the framework method for the analysis of qualitative data. A set of codes organized into categories that were jointly developed by the researchers involved in the analysis. The UHC framework used to summarize data in a way that could support answering research questions.

    RESULTS

    This study showed that three educational modules leadership and strategic thinking, management, and decision‑making, achieving excellence in nursing management to capacity building of nursing managers in the country.

    CONCLUSION

    Training leadership skills and strategic thinking in the nursing empowerment modules illuminate global and national health roadmaps and policies and change attitudes to the model of nursing service delivery. Since nurses are the largest group of professionals in the health system, it facilitated by changes in the role and functions of the hospital and nurses to reach UHC.

    Keywords: Capacity building, education, needs assessment, nurses
  • Maryam Chegeni, Aliakbar Haghdoost, Mahin Eslami Shahrbabaki, Parvin Mangolian Shahrbabaki, Nouzar Nakhaee Page 140
    BACKGROUND AND AIM

    Measuring child abuse and adverse experiences is a critical task with regard to its long‑term impact on the health of individuals and communities. The purpose of this study was to validate the Persian version of the International Adverse Childhood Experiences Abuse Short Form (ACE‑ASF) in Iranian society.

    MATERIALS AND METHODS

    This cross‑sectional study was conducted in Kerman, southeast of Iran, in 2019, on 494 students from Kerman University of Medical Sciences, selected by convenience sampling method. Psychometric properties of the questionnaire were examined after the forward and backward translation processes. The factor structure of the questionnaire was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The concurrent validity of the questionnaire was assessed using the childhood trauma questionnaire (CTQ). Cronbach’s alpha and corrected item‑total correlation were used to measure reliability.

    RESULTS

    The mean age of participants was 24.3 ± 5.3 years. Based on EFA, two physical–emotional abuse and sexual abuse factors were obtained. The CFA fit indices well supported two extracted factors. The CFA showed acceptable factor loadings. The internal consistency coefficient of Cronbach’s alpha was 0.75 for the physical–emotional abuse factor and 0.77 for the sexual abuse factor. The correlation coefficient of ACE‑ASF and CTQ was r = 0.56. The reliability index of intraclass correlation coefficient was 0.73 (95% confidence interval: 0.60–0.84).

    CONCLUSION

    The Persian version of the ACE‑ASF questionnaire has acceptable psychometric properties.

    Keywords: Adverse childhood experiences, child abuse, child maltreatment, Iran, psychometrics
  • Nayereh Baghcheghi, HamidReza Koohestani, Mahmood Karimy Page 141
    BACKGROUND AND AIM

    Given the absence of a scale specially designed to measure willingness to mobile learning (m‑learning) in medical sciences students, the present study was conducted to design and evaluate the psychometric properties of “willingness to m‑learning” scale for medical sciences students.

    METHODOLOGY

    The study was carried out as a mixed‑method study in two phases at Saveh University of Medical Sciences in 2019. Phase one was a qualitative study to elaborate on the students’ perception of m‑learning. Then, the statements were extracted, and statement pool was completed through reviewing the text. In the second phase, the psychometric properties including face, content, and construct validities (using explorative factor analysis), internal consistency (Cronbach’s alpha), and test–retest reliability (intercluster correlation test) were measured. A total of 482 students who were selected randomly participated in the second phase. Data analysis was done with MAXQDA software (VERBI Software 2019, Berlin, Germany) for qualitative data and SPSS 19 software (SPSS Inc., Chicago, IL, USA) for quantitative data.

    RESULTS

    Based on qualitative content analysis and literature review, 92 statements were extracted. After checking face and content validity, 55 statements remained in the study. Construct validity of the questionnaire based on explorative factor analysis removed 10 more statements and the remaining 45 statements were categorized into nine factors, namely technophilia, perceived attraction, perceived ease, perceived conflict, self‑management, attitude, behavioral intention to use, educational use, and efficacy of m‑learning. Reliability of the scale was obtained as 0.95 based on Cronbach’s alpha and stability was checked using test–retest method (intercluster correlation coefficient; r = 0.92).

    CONCLUSION

    Willingness to m‑learning scale had an acceptable reliability and validity in medical sciences students. Therefore, it can be used for medical sciences students for improve learning and education.

    Keywords: Medical sciences students, mobile learning, psychometric properties, scale, validation, willingness
  • Fariba Shahraki Sanavi, Alireza Ansari Moghaddam, Mahdi Mohammadi, NourMohammad Bakhshani, Hamid Salehiniya Page 142
    AIM

    This study aimed to investigate the effect of school‑based interventions on mental health among adolescents in the southeast of Iran.

    METHODS

    This interventional quasi‑experimental study included a total of 420 adolescent girls studying 10th grade in the public schools of Zahedan, Iran. Data were collected using general health questionnaire‑28 questionnaire. After pretest, multidimensional interventions (individual education, group education, individual consultations, modern education, and parents’ educational packages) were given to the intervention group from October 2015 to June 2016. After a 3‑month interval, the posttest was conducted in October 2016. Data were analyzed by covariance analysis.

    RESULTS

    There was a significant statistical difference between the changes in the mental health scores after the intervention among the two study groups (P < 0.05). Furthermore, after the intervention, moderate‑to‑severe mental health problems decreased considerably among the students in the intervention group compared to controls. The greatest impact was on individual psychological counseling.

    CONCLUSIONS

    The results of the study showed that by applying group training and individual counseling in the schools improves mental health. Therefore, identifying student problems and parent–teacher cooperation as well as consulting with specialist counselors can be effective in providing practical and effective solutions in this regard. Therefore, findings suggest that prioritizing mental health and taking action on the field are of utmost importance.

    Keywords: Adolescent, Iran, mental health
  • Hossein Ghalavand, Sirous Panahi, Shahram Sedghi Page 144
    INTRODUCTION

    Social media is becoming a new tool for developing health knowledge management. However, despite the rapid growth of research in this area, few attempts have been made to review previous research. This study tried to summarize the opportunities and challenges of using social media to managing health knowledge.

    METHODOLOGY

    This article used a narrative approach to collect and review studies. In this review, published documents during 2010–2019 were retrieved by search in the following three electronic scientific databases: Web of Knowledge, PubMed, and Google Scholar search engine using keywords including social media, public health, health knowledge, knowledge management, and health promotion.

    RESULTS

    Social media by overcoming geographical barriers, developing health promotion, facilitating decision‑making, and providing public health education has been able to enhancing health awareness and improving health behavior. Doctors’ unwillingness to interact with the public, lack of compliance with the principles of medical ethics, users’ privacy concerns, and difficulty of managing negative comments are the four challenges to health knowledge management in social media.

    CONCLUSION

    Social media can be a suitable tool for developing health knowledge management processes if medical professional ethics and users’ privacy managed properly.

    Keywords: Health communication, health knowledge, health promotion, knowledge management, public health, social media, technology
  • Sepideh Zhali, Shahnaz Kohan, Azar Danesh Shahraki, Marjan Beigi Page 145
    INTRODUCTION

    Investigating severe maternal morbidity and near‑miss cases are applied internationally as a new indicator to examine the quality of maternal care and as an effective strategy to reduce maternal mortality. This study aimed to determine the root causes of severe maternal morbidity in order to improve maternal health.

    MATERIALS AND METHODS

    The present research is a descriptive case series study. The data was obtained from the hospital and health records of mothers admitted to hospitals affiliated to Isfahan University of Medical Sciences due to severe morbidity in the first 6 months of 2018, which were selected randomly. The data collection was completed by interviews with the mentioned mothers and 14 related health‑care staffs and that led to the development of the morbidity story. The compiled story of each case was evaluated by the root analysis team’s opinion. Causes of morbidity were determined according to a root cause analysis checklist composing of factors such as health‑care services (human and structural factors), family‑social status, and disease status of maternal morbidity.

    RESULTS

    The findings indicated that human factors related to the health system led to severe maternal morbidity more than any cause. Inadequate knowledge and skills of service providers, disregard for guidelines and protocols, lack of teamworking, and lack of considering competency were the most important human factors. Disease condition, family, and social status were the other related factors, respectively.

    CONCLUSION

    Human factors are the most important cause of maternal morbidity based on the results of this study. Therefore, modifying the health structure can be one of the most important reducing factors for maternal mortality in order to improve the services for these individuals.

    Keywords: Iran, maternal near‑miss, root cause analysis, severe maternal morbidity
  • Fatemeh Aliakbari, Forouzan Mohammad Alipour, Elahe Tavassoli, Morteza Sedehi Page 146
    OBJECTIVE AND AIM

    Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The patient’s fear and anxiety of shortness of breath and coughing during exercise may lead to a decrease in patients’ daily activities. Therefore, the present study aimed to determine the effect of empowerment program based on the social cognitive theory (SCT) on the daily activity of patients with COPD.

    METHODS

    This quasi‑experimental study was performed on 70 patients with COPD referred to Kashani and Hajar centers in 2019. Samples were randomly divided into two groups of experimental and control. Data collection tools included demographic information questionnaire and activity of daily living questionnaire, specific for COPD, and a researcher‑made questionnaire for measuring SCT constructs. For the experimental group, the training program consisted of four theoretical and practical sessions of 40 min/week. The data were collected at three time points, before, immediately and 3 months after the training are 3 time. The data were analyzed by SPSS software using descriptive and inferential statistics.

    RESULTS

    The difference between the mean scores of behavioral ability, self‑efficacy, and empowerment in the three stages was significant only in the experimental group (P < 0.001). The mean daily activity score of patients before, immediately, and 3 months after intervention showed a statistically significant difference between the two groups (52.46 ± 21.98, 63.36 ± 21.95, and 71.34 ± 19.02), respectively, in the intervention group, and (51.79 ± 19.29, 53.70 ± 19.28, and 53.82 ± 19.26), respectively, in the control group (P < 0.001).

    CONCLUSION

    The results of this study showed that empowerment of patients through interventions based on SCT can increase the daily activity of patients with COPD. Because nurses play an important role in patient education and improvement, it is hoped that the findings of this study will be used as a strategy to increase the daily activity and ultimately improve the quality of life in these patients.

    Keywords: Activity of daily living, chronic obstructive pulmonary disease, social cognitive theory
  • Nafiseh Ghassab Abdollahi, Seyed Kazem Shakouri, Alireza Taheri Aghdam, Ali Farshbaf Khalili, Somayeh Abdolalipour, Azizeh Farshbaf Khalili Page 147
    BACKGROUND

    Medical students face a variety of challenges during their years of medical education that can affect their quality of life (QOL). This study aimed to investigate the association of QOL with physical activity (PA), depression, and demographic characteristics, as well as to determine its predictors among medical students in different stages of education.

    METHODS

    A cross‑sectional descriptive‑correlational study was conducted on 186 medical students of Tabriz University of Medical Sciences in different educational stages including basic sciences, physiopathology, externship, and internship using stratified random sampling method. Data were collected using demographic questionnaire, International PA Questionnaire, World Health Organization QOL Questionnaire, and Beck depression inventory‑2. Data analysis was performed using SPSS/Ver 23 through descriptive and analytic statistics including one‑way analysis of variance, independent t‑test, Pearson and Spearman correlation coefficient, and multivariate linear regression model.

    RESULTS

    There were significant differences in total score of QOL among students in different stages (P < 0.05). There were indirect significant correlations between total score of QOL (β [confidence interval 95%]:−0.85 [−1.11–−0.59]) and its all subdomains with Beck depression score but direct significant correlations with total PA (P < 0.05) except for social relationship. Educational stage, employment status, family income, inhabitant, moderate PA, and depression were the predictors of QOL and altogether explained 63% of its variance.

    CONCLUSIONS

    To pay attention to the predictors of QOL, life among medical students seems necessary for increasing their QOL to provide high‑quality care for people with disabilities as well as for the whole community.

    Keywords: Demographic characteristics, depression, physical activity, predictors, quality of life
  • Payal Kahar, Lirio K Negroni Page 148
    BACKGROUND

    Latinos in the U.S., one of the fastest growing minority population, have low health‑related knowledge and higher rates of diabetes and obesity.

    AIM

    The study aims (1) to assess health‑related knowledge levels and change in knowledge levels after brief educational intervention and (2) to assess undiagnosed diabetes, hypertension, and hypercholesterolemia in adult Latinos residing in Immokalee, Florida. A total of 164 participants completed pre–posttests while 161 participants took part in health screenings comprising blood pressure (BP), total cholesterol (TC), blood glucose (BG), and body mass index (BMI).

    METHODS

    Health‑related knowledge levels were assessed using 10 questions before and after the educational intervention via face‑to face interviews. BP was measured using automated sphygmomanometer, BG and TC were measured using lipid and glucose analyzer, waist circumference using inch tape and BMI using digital scale. T test and Chi square were used to examine the differences in knowledge levels and distribution of screening results across demographic characteristics and self‑reports respectively.

    RESULTS

    Mean age was 40.1 ± 13.3 years; there were 77 males and 87 females. The knowledge levels based on 10 questions increased by 1.43 (0.42) after educational sessions (P < 0.001). Participants with college degree had statistically significantly higher pre–posttest scores than those with no formal or less than high school education (P = 0.041). More males than females had high BP in the age groups of 18–44 and ≥45 years (P < 0.001). More males in the age group of 18–44 years had high TC (P = 0.024). Differences between screening results and self‑reports for diabetes and BP were statistically significant (P < 0.001 and P = 0.01, respectively). Mean BMI was 28.5 ± 5.1 and waist circumference was 38.6 ± 4.8 inch. Mean random and fasting BG levels and TC were higher in females than in males (P = 0.003, P = 0.022, and P = 0.004, respectively).

    CONCLUSIONS

    The study highlights undiagnosed diabetes and hypertension in Latinos and more Latino males than females to have hypertension and hypercholesterolemia. Latinos’ vulnerability to chronic diseases and associated complications is further confounded by limited health knowledge. However, the results of the brief educational program were encouraging and have implications in setting up structured educational interventions in health clinics and migrant education programs.

    Keywords: Community health education, Latinos, screenings
  • Arezoo Sheikh Milani, Meimanat Hosseini, Mahsa Matbouei, Maliheh Nasiri Page 149
    CONTEXT

    Emotional communications play an important role in having a satisfying relationship and a more successful marriage. If marriage does not provide suitable conditions to satisfy couple’s needs, not only it does not help to mental health but also results in negative and irreversible effects.

    AIMS

    This research was performed with the aim of determining the impact of emotional intelligence training on marital satisfaction, sexual quality of life, and psychological well‑being of women. SETTINGS AND DESIGN: The present research is an experimental study conducted on 70 women referring to community health centers of Shahid Beheshti University of Medical Sciences in 2019.

    SUBJECTS AND METHODS

    The sampling was performed using multistage cluster sampling. Before implementing the training intervention, the research instruments (general questionnaire, Kansas Marital Satisfaction Scale, Iranian version of Sexual Quality of Life‑Female questionnaire, and World Health Organization Five Well‑Being Index) were provided to the participants in order to complete them. All participants recompleted the instruments immediately and 1 month after the training intervention. STATISTICAL ANALYSIS USED: The significance level was considered as P < 0.05.

    RESULTS

    The mean scores of marital satisfaction in the control group had no significant difference before, immediately after, and 1 month after the intervention (P = 0.895). However, in the intervention group, over time, the mean scores of marital satisfaction increased (P = 0.001), and the difference between the two groups was significant (P < 0.001). The mean scores of sexual quality of life and psychological well‑being had no significant differences before, immediately after, and 1 month after the intervention in the control group. However, in the intervention group, over time, the mean scores of sexual quality of life and psychological well‑being firstly increased and then decreased (P < 0.001), and the difference between the two groups was significant (P < 0.001).

    CONCLUSIONS

    Training the components of emotional intelligence can be effective on enhancing marital satisfaction, sexual quality of life, and psychological well‑being of women.

    Keywords: Emotional intelligence, marital satisfaction, psychological well‑being, sexual quality of life
  • Alireza Najimi, Yousef Veisani, Sanaz Azami, Arman Azadi Page 150
    INTRODUCTION

    Sexual problems in elder people are considered as a public health concern and can affect their overall health and quality of life. This study aimed to investigate the sexual quality of life and its relationship with general health in older men in the west of Iran.

    METHODS

    This was a cross‑sectional study among 362 older men aged 60 years or older attending Comprehensive Health Care Centers in Ilam, Iran. Samples selected through Quota sampling method and simple random sampling. Data were collected using the Sexual Quality of Life Questionnaire‑Male and General Health Questionnaire‑28.

    RESULTS

    The mean ± standard deviation (SD) of age was 69.9 ± 8.1 years. The mean ± SD score of sexual quality of life and general health of older men was 46.6 ± 14.6 and 19.2 ± 9.7, respectively. A positive and significant association was found between sexual quality of life and general health (P < 0.001, r = −0.41). Moreover, general health, age, sleep problems, and the level of education were the important predictors for sexual quality of life in elder men (P < 0.05).

    CONCLUSION

    According to the results, the sexual quality of life of participants was at a moderate level. Since only some factors influencing the sexual quality of life were ascertained, further studies are required to investigate all factors influencing older men’s sexual quality of life.

    Keywords: General health, Iran, older men, sexual function, sexual quality of life
  • Maryam Javidi Sarafan, Mahin Tafazoli, Talat Khadivzadeh, Seyed Reza Mazloum Page 151
    INTRODUCTION

    Midwifery screening is one of the duties of midwives according to national guidelines. It is possible to increase midwives’ knowledge and practice through effective education. The aim of this study was to compare the effect of standardized patient‑based education and feedback lecture on midwives’ knowledge and practice in screening counseling for fetal malformations.

    METHODS

    This quasi‑experimental, two‑group study (standardized patient‑based training and feedback lecture) was performed on 67 midwives (licensed by the office) in Mashhad in 2018. Midwives’ knowledge and practice before and 2 weeks after training (a 4‑h training program) were assessed by the Objective Structured Clinical Examination and a questionnaire. The data were analyzed by the SPSS software version 16 using Mann–Whitney, Chi‑square, Wilcoxon and independent t‑test while P < 0.05 considered as a significant level.

    RESULTS

    Before intervention, the total score of knowledge and practice showed no statistically significant difference between the two groups (P > 0.05). After intervention, knowledge score in feedback lecture group was statistically significantly higher than that of standard patient group (P < 0.001). In addition, there was no statistically significant difference in performance scores between the two groups after intervention (P = 0.761).

    CONCLUSION

    Both educational methods can increase midwives’ knowledge and practice in fetal screening counseling. However, in raising midwives’ awareness, feedback lecture group was more effective than standard patient group.

    Keywords: Feedback lecture, fetal malformations screening counseling, knowledge, practice, standardized patient‑based education
  • Akram Sadeghian, Shahram Tofighi, Nikoo Yamani, Tahereh Changiz Page 152
    CONTEXT

     Universities of medical sciences are responsible for educating and training human resources (HRs) that provide services to all members of the community. Clinical educators play a significant role in the promotion of health and education in medical sciences universities.

    AIMS

    The aim of this study was to prioritize and develop a model to illustrate the relationship between faculty recruitment challenges in medical sciences universities. SETTINGS AND DESIGN: Interpretive structural modeling (ISM) is a system design method initially introduced by Warfield (1974). This method helps create order in the complex interconnections between components of a system by interpreting the opinions of a group of experts. It both determines the priority of elements influencing one another and uncovers the association between the elements of a multipart set in a hierarchical structure.

    SUBJECTS AND METHODS

    In this method, the identified challenges were built into a paired comparison questionnaire to be completed by policymakers and experts. By the same token, the obtained results were analyzed with the ISM technique. STATISTICAL ANALYSIS: The four steps include identified variables related to the issue, structural self‑interaction matrix, initial reachability matrix, and final reachability matrix was used for analysis. According to these steps, the ISM model was portrayed.

    RESULTS

    The ISM model was developed in ten levels that divided into three parts including key challenges, strategic challenges, and dependent challenges.

    CONCLUSION

    Health promotion and quality of education in medical sciences universities is dependent on quality of faculty recruitment system. According to the results, it is imperative that HR managers and policymakers improve existing rules and develop policies to solve the challenges in this area.

    Keywords: Educator, human resource, interpretive structural modeling, recruitment
  • Nikzad Shahidi, Farshad Mahdavi, Mehdi Khanbabayi Gol Page 153
    INTRODUCTION

    Psychological factors affect the tendency of individuals toward cosmetic surgeries although their contribution has not been clearly understood. Therefore, the current study aimed at comparing the emotional intelligence, body image, and quality of life between rhinoplasty candidates and the control group.

    METHODS

    The current case–control study was conducted on 160 individuals referring to Rhinoplasty Clinic of Imam Reza Hospital in Tabriz, Iran, from 2018 to 2019. The tools used in this study including demographic information, Schering’s emotional intelligence questionnaire (α = 0.75–0.85), the 36‑item Short Form Health Survey Questionnaire (α = 0.75), and body image (α = 0.77–0.91) were used to collect data. Data were analyzed by the Kolmogorov– Smirnov and t‑tests for the two independent groups. P < 0.05 was considered as the level of significance.

    RESULTS

    There was no significant difference between the groups in terms of the overall mean of emotional intelligence and its subcomponents (P > 0.05), except social skills, such as self‑awareness (P = 0.019). Appearance evaluation and appearance orientation variables were statistically significant between the two groups (P < 0.05), while the quality of life was not statistically significant (P = 0.051).

    CONCLUSION

    In the psychological parameters studied, we found that the appearance evaluation and social skills of the rhinoplasty applicants are low, and it is better to have interventions before the rhinoplasty in people who have difficulty with these variables.

    Keywords: Body image, emotional intelligence, quality of life, rhinoplasty
  • Ahmad Mahdizadeh, Fatemeh Oskouie, Sedigheh Khanjari, Soroor Parvizy Page 154
    BACKGROUND

    Many kidney transplant recipients lack the knowledge, abilities, and support they need for self‑care. On the other hand, most kidney transplant centers do not have a well‑planned and specific training program for them, and educational interventions for kidney transplant recipients have not been adequately effective. This study aimed to describe strategies for improving patient education in kidney transplantation.

    MATERIALS AND METHODS

    Data were collected through semi‑structured individual and group interviews with 24 patients, family members, and health‑care staff in one of the main kidney transplant centers in Tehran. Participants were selected purposefully, and qualitative content analysis was used to analyze the data.

    RESULTS

    The main finding emerged from the data was the shift from current patient education program to patient‑ and family‑centered education (PFCE). The strategies to achieve this goal were categorized into four main categories including “continuous patient and family education” (pre‑ and posttransplant patient education), “facilitating the process” (using new technologies, teamwork education, and patient and family accessibility), “strengthening human resources” (empowerment health‑care team, allocation of human resources, promoting staffs’ motivation, and updating educational content and materials), and “monitoring and evaluation” (correcting patient education recording, supervising the patient education, and appropriate educational evaluation).

    CONCLUSIONS

    Transforming from the current patient education program to PFCE seems to be essential to increase the effectiveness of patient education in kidney transplant process. To this end, providing continuous patient and family education, facilitating the processes, strengthening human resources, and monitoring and evaluation in health‑care organizations conducting the kidney transplantation is necessary.

    Keywords: Kidney transplantation, patient education, qualitative study, strategies
  • Maliheh Abootalebi, Mansoureh Dehghani, Marzieh Akbarzadeh Page 155
    BACKGROUND

    Mental health is one of the major determinants of a person’s health which has a significant impact on the quality of life. Implementing of mental health training programs for promotion of health affected teenage girls to premenstrual syndrome (PMS) in Shiraz, southern Iran: a community‑based study.

    MATERIALS AND METHODS

    This study is randomized controlled trial done on 100 teenage girls affected to PMS in Shiraz‑Iran (selected from400 girls). Multistage cluster sampling method was used f or sampling. In the intervention group, six training sessions were held twice a week for 2 h. For data collection, Standard Goldberg Mental Health Questionnaire‑28 and Premenstrual Symptoms Screening Tool were used. For data analysis, independent t‑test and Chi‑square statistics were used at significant level of 0.05.

    RESULTS

    The average age was (16.56 ± 0.92) and (16.24 ± 1.45) in the intervention and control groups, respectively. The average intensity of physical complaints, level of anxiety and sleep disorder, level of social functions disorders and depression were significantly lower in the group of training classes than control group (P < 0.001).

    CONCLUSION

    Appropriate training‑care programs are effective in reducing stress and improving mental health, prevention and treatment of mental disorders, emotional growth, and development of communication skills among female students with premenstrual syndrome.

    Keywords: Training‑care programs, mental health, premenstrual syndrome
  • Nirav Vaghela, Daxa Mishra, Jayshree Patel, Vyoma Dani Page 156
    BACKGROUND AND OBJECTIVE

    Osteoarthritis (OA) is a chronic degenerative disorder which primarily affects the articular cartilage of synovial joints followed by bony remodeling and overgrowth at the margins of these joints. The consequences of OA are pain, joint stiffness, decreased muscle performance, and decreased aerobic capacity, which eventually affect the quality of life (QOL) and increased risk for disability. The objective of the present study was to investigate the effectiveness of two nonpharmacological treatment regimens, that is, yoga and conventional physiotherapy, on QOL in patients suffering from OA of knee joint.

    MATERIALS AND METHODS

    A total of 83 patients with bilateral OA of knee joint, between the age group of 40 and 80 years, both males and females, were assigned into two groups using computer‑generated scheme: 43 in the experimental group (yoga with conventional physiotherapy program) and 40 in control group (conventional physiotherapy program). Western Ontario and McMaster Universities OA index (WOMAC) and Short‑Form 36 (SF‑36) health survey were measured before, after 15 days, and after 30 days of treatment sessions, and the data were analyzed using paired and unpaired t‑test.

    RESULTS

    The results of the study show significant improvement in both groups with regard to WOMAC and SF‑36 at the end of 15 and 30 days of treatment regimen; however, when compared to the control group, experimental group had more significant improvement (P < 0.05) in WOMAC and SF‑36 at the end of 15 and 30 days of treatment.

    CONCLUSION

    Yoga is more beneficial when added to conventional physiotherapy treatment regimen in promoting health and improving QOL in patients with OA of knee joint.

    Keywords: Health survey, knee, osteoarthritis, quality of life, yoga
  • Mozhgan Falahatdoost, Behrouz Dolatshahi, Abbas Pourshahbaz, Mahmoud Dehghani, Mohsen Nouri Yalguzaghaji, Zahra Mohammadi Page 157
    INTRODUCTION

    In spite of our general knowledge about psychological roots and defects of developmental processes in the formation of somatic symptoms, the effect of the interaction of developmental components with cognitive‑emotional variables is unclear. Previous researches suggest that individuals with insecure attachment may have a higher risk to experience of somatic symptoms. The main aim of this study is “Modeling the Relationship between Attachment Styles and Somatic Symptoms with the Mediating Role of Emotional Processing.”

    MATERIALS AND METHODS

    This study was a descriptive‑correlational study. Two hundred and twenty individuals aged 18–59 years living in Tehran were selected by available sampling from the general population. Collins and Reed’s Adult Attachment Scale, Baker’s Emotional Processing Scale, and Patient Health Questionnaire were used to collecting data. Data analysis was performed by Pearson correlation and independent t‑test. The conceptual model presented in this study was tested with a path analysis approach.

    RESULTS

    Given the Chi‑squared size (² = 1.214; P > 0.05), it can be said that the proposed conceptual model fits well with the observed model. Besides, checking the other absolute and relative indices also shows a very good fit of the model.

    CONCLUSION

    Our results showed that when the reciprocal effects of attachment styles were controlled, secure attachment could be considered as a protective factor against deficits in emotional processing and somatization of negative emotions. On the other hand, we found that when the dominant attachment style in individuals was anxiety based, it could be possible that they experience deficiency in the processing of emotion and more severe somatic symptoms.

    Keywords: Attachment, emotional processing, somatic symptoms
  • Ahmadreza Yazdannik, Shahla Mohamadirizi, Mohammad Nasr Esfahani Page 158
    INTRODUCTION

    Nurse educators need to develop the level of scientific and practical of the students with the goal of becoming expert nurses. However, the use of modern educational methods to raise the motivation and satisfaction of learners can help individuals achieve this goal. Therefore, the aim of this study was to investigate the effect of health education in emergency nurses about triage.

    METHODS

    A two‑group pool‑blind experimental study was performed on seventy emergency nurses. Samples were randomly assigned into two groups: e‑learning group (35 individuals = electronic education) and traditional group (35 = workshop education). The demographic questionnaire and the satisfaction questionnaire before and 2 weeks after the intervention in both groups were completed.

    RESULTS

    Independent t‑test showed that the satisfaction scores before intervention in both e‑learning and traditional groups were not statistically significant, whereas there was a significant difference between two groups after 2 weeks after the intervention (P = 0/015).

    CONCLUSION

    Using nursing professors’ electronic education programs can increase the level of satisfaction and motivation in the nursing mothers. Therefore, the use of this new educational method is recommended by managers and educational planners as an effective teaching.

    Keywords: Education, health, nurses, triage
  • Swati Tukaram Dahake, Uzma A Shaikh Page 159
    BACKGROUND

    Underweight is still prevalent in developing countries like India. Prepregnancy body mass index (BMI) is used as the standard against which the measurements are made in pregnancy.

    AIM

    To study the association between early pregnancy BMI and feto‑maternal outcome among nulliparous women

    METHODOLOGY

    This is a prospective observational study, with a sample size of 294. The antenatal patients were categorized into four categories of BMI according to the WHO classification, and pregnancy outcomes were compared. Data were analyzed using SPSS Software Version 17.0. Statistical tools used were percentages and mean, and categorical variables were analyzed by Chi‑square statistics.

    RESULTS

    48.94% of the patients enrolled in the study had normal early pregnancy BMI, and 44.22% and 6.8% were underweight and overweight, respectively. Obese women who gained more weight were at a higher risk of preterm delivery, cesarean section, and more time required for resumption of normal routine. Underweight women were at higher risk of postterm delivery, low birth weight, and increased hospital stay.

    CONCLUSION

    Adverse maternal and fetal outcomes are seen more commonly with the extremes of BMI.

    Keywords: Body mass index, maternal, nulliparous, pregnancy outcomes
  • Roghayeh Mohammadibakhsh, Aidin Aryankhesal, Mehdi Jafari, Behzad Damari Page 160
    BACKGROUND

    In the 21st century, with the epidemiological and demographic transition and the changing nature of diseases and the increase in the burden of chronic diseases, the need to strengthen primary health care and the development of the family medical program as a strategy is felt significantly.

    AIM

    The purpose of this study is to compare the model of implementation of family physician program (FPP) in the United States, England, Germany, Singapore, Turkey, Egypt, and Iran.

    MATERIALS AND METHODS

    This is a comparative study that examines the model of family physician implementation in selected countries. Data for each country were gathered from the valid databases, were compared according to the comparative table, and analyzed by a framework approach. In order to assure the validity of data, the researchers referred to the websites of the selected nations’ Ministry of Health and also cross‑checked the findings with reports published by the World Health Organization.

    RESULTS

    In this study, we used the Control Knobs framework to compare countries’ FPPs because the framework can demonstrate all necessary features of national health system programs. This framework includes governance and organization, regulation, financing, payment, and behavior in each country. The results of this study show that although the principles of FPP in the selected countries are almost common, they use different methods in FPP implementation.

    CONCLUSIONS

    As the success of any policy depends on the political, economic, social, and cultural context of each country, considering these factors and reinforcing each of the control knobs are critical to the success of the family physician’s policy implementation.

    Keywords: Comparative study, Control Knobs, Family Physician Program
  • Elnaz Ghaffari, Farbod Ebadi Fard Azar, Nammam Ali Azadi, Morteza Mansourian Page 161
    BACKGROUND

    Today, one of the biggest concerns of parents is protecting their children and properly educating them about sex. The aim of this study was to determine the effect of educational intervention on parental skills in sex education on their children in elementary schools in the northwest of Tehran‑Iran in 2019 based on literature.

    MATERIALS AND METHODS

    This quasi‑experimental study was conducted on 125 parents of elementary schoolchildren in the northwestern of Tehran. The data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled up the pretest questionnaire; the data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled the pretest questionnaire, and then the parents participated in the educational program based on dramatic literature. Two months later, the same questionnaire was completed by the control and intervention groups. Finally, the data were analyzed by regression and one‑way ANOVA test.

    RESULTS

    The results showed that there was a statistically significant difference between the mean scores of knowledge in the experimental and control groups in the posttest (P < 0.01). There was also a statistically significant difference between the mean scores of attitude in the experimental and control groups at the posttest stage (P < 0.01). There was also a statistically significant difference between the mean scores of performance based on group membership (experimental group and control group) in the posttest phase (P < 0.01).

    CONCLUSIONS

    The findings of the study showed that educational intervention on parental skills in sex education based on the dramatic literature to their children has significant effect on parental knowledge, attitude, and performance.

    Keywords: Dramatic literature, educational intervention, parents
  • Rachna Parashar, Mukesh Shukla, Abhimanyu Ganguly, Sandip M Hulke Page 162
    INTRODUCTION

     Different types of learners based on sensory modalities are observed. Cognition or physiological alterations in the sensory pathways might play its role in different modalities of visual, auditory, read and write, and kinesthetic learners which are based on different sensory modalities of perception

    OBJECTIVE

    The objective of this study is to ascertain an objective parameter (neurophysiological parameters) for the classification of learners based on their preferred sensory modality

    MATERIALS AND METHODS

    An experimental cross‑sectional study was conducted among 100 medical students. Learners were classified into visual, auditory, read‑write, and kinesthetic learners based on the interpretation drawn on the basis of the VARK questionnaire. Sensory‑evoked potentials (SEPs), including pattern shift visual (PSVEPs), brain stem auditory (BAEPs), short‑latency somatosensory (SSEP), and event‑related potentials (P300) were measured. SEPs measured in microvolts were recorded from the scalp with the help of active and reference electrodes. Multiple responses to sensory stimuli (using NIHON KOHDEN Corporation Neuropack X1, Tokyo, Japan) were recored and averaged using the computerized signal averging technique.

    RESULTS

    No statistically significant difference was observed in conduction velocities (in terms of latency and amplitude) of SEP among different type of learners, except latency N145 wave form in VEP (P < 0.05). A characteristic pattern of minimal comparative latency was observed among the majority of visual learners. Similary, P300 has shown a characteristic pattern of decreased comparative latency among majority of read and write learners.

    CONCLUSION

    Study findings suggested that among existing teaching and learning modalities, visual modalities were observed faster but to retain it in memory and for abstract thinking, students should utilize read and writing skills which are lacking in the era of digitalization and overuse of electronic devices.

    Keywords: Event‑related potentials, Evoked potentials, VARK learners