فهرست مطالب

Journal of Education and Health Promotion
Volume:10 Issue: 11, Nov 2020

  • تاریخ انتشار: 1399/11/20
  • تعداد عناوین: 35
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  • TV Soumya Mohanan, Roopali Manohar Sankeshwari, Anil V Ankola Page 295
    BACKGROUND

    Child abuse (CA) is prevalent in every segment of society and is witnessed in all social, ethnic, religious, and professional strata. In this situation, dentists are in an ideal position to help detect signs of CA and should be able to recognize those signs.

    AIM

    To assess the perspectives toward CA and neglect among dental practitioners of Belagavi city.

    MATERIALS AND METHODS

    A cross-sectional survey was conducted among 102 dental practitioners. The data were collected by self-administered structured questionnaire. Data were analyzed using descriptive analyses for responses to each question, and Chi-square test was applied to test the association.

    RESULTS

    59.8% had learned the topic of CA and neglect as a student. Overall, 16 participants have recognized suspicious case of CA and neglect in their dental office. Only 34.3% had knowledge regarding the findings pointing to CA and neglect, and 96% had reported that there are barriers regarding reporting the same. 93% are of opinion that the topic is of utmost importance and more training is required in this aspect.

    CONCLUSION

    Training and continuing dental education programs should be tailored to the specific needs of all professionals to diagnose, report, and prevent CA.

    Keywords: Attitude, child abuse, neglect, dental practitioners, knowledge
  • Mohammad Hassan Ghasemi Abarghouie, Athar Omid, Ahmad Ghadami Page 296
    BACKGROUND

    There are various instructional methods worldwide and virtual instruction is one of them. This widely used method involves online instruction and e-learning. The present study compares the effects of lecture-based and virtual instruction on student learning, satisfaction, and content retention among surgical technology students at Isfahan University of Medical Sciences.

    MATERIALS AND METHODS

    The population of this two-stage, quasi-experimental study consisted of 40 surgical technology students at the School of Nursing and Midwifery. After fulfilling inclusion criteria, they were randomly assigned to the virtual instruction group (VG, n = 20) and the traditional, lecture-based instruction group (TG, n = 20). Data were collected via a researcher-made student satisfaction questionnaire and two learning examinations. Their validity and reliability had been confirmed. The data were analyzed using SPSS 13 and analytical and descriptive tests (P < 0.05).

    RESULTS

    There was no statistically significant difference between the TG and the VG with respect to the mean score in the first examination (P = 0.89). However, the two groups were significantly different in terms of the mean score in the second examination (P = 0.03). Regarding content retention and recall performance, the VG outperformed the TG. Furthermore, the mean satisfaction score of the VG (132.24 ± 17.92) was higher than that of the TG (115.56 ± 17.57) (P < 0.05).

    CONCLUSION

    Virtual instruction and lecture-based instruction had comparable short-term learning outcomes. Nevertheless, with the passage of time, it was revealed that virtual instruction could result in better learning performance and higher content retention and satisfaction.

    Keywords: Lecture, operating room, surgical technology, virtual instruction
  • Mohsen Poursadeqiyan, Maryam Feiz Arefi Page 297

    Schools are considered as a first community, which plays an essential role in developing the child's life skills; thus, it is important to provide safety and health in these places. Accordingly, health, safety, and environmental (HSE) issues in schools are among the important issues that should be considered. Therefore, the purpose of this study was to review the studies conducted on the HSE status of Iranian schools. A systematic search of databases, including Google Scholar, SID, PubMed, IRANDOC, MEDLIB, and Science Direct, was performed using keywords by March 2020. The reference lists of key studies were also scanned to find additional articles that are suitable to include in this study. Twenty-five studies met the inclusion criteria. The results of the studies showed that the surveyed schools had favorable status in terms of HSE indicators, and only 12% of the studies reported poor status. About 88% of schools had favorable or average condition. Some cases, such as lack of safe emergency exit and inadequate ergonomic seats, have been reported, and some differences have been observed in schools in rural and urban areas. The results showed that the health and safety situation in most of the urban schools in Iran is good and relatively favorable. However, there have also been some problems; hence, the implementation of integrated HSE management is imperative to improve the status of schools. Personal health education and safety education are also recommended.

    Keywords: Environmental, health, Iran, safety, schoo
  • Tina Beyranvand, Aidin Aryankhesal, Asgar Aghaei Hashjin Page 298
    BACKGROUND

    There is a growing global movement toward quality and safety in healthcare and quality improvement (QI) in general surgery. The first step in any QI initiative is identifying the challenges and barriers to achieve such goals and then to define appropriate actions. This study aims to provide an overview of the QI challenges in Iranian hospitals' surgery-related processes and suggest applied solutions accordingly.

    METHODS

    This is a sequential (qual-quant) mixed-method study from November 2019 to January 2020, involving 21 face-to-face interviews with hospital managers, quality officers, and surgery-related clinicians and staff, followed by a Delphi consensus-seeking stage to finalize solutions. MAXQDA software was applied for organizing the concepts, and thematic content analysis was used for analyzing the data as an inductive approach to extract the emerging themes and sub-themes.

    RESULTS

    The managerial problems were classified into four groups of (I) defects and delays in completing patient medical records, (II) irregularity and the lack of transparency in the direction of processes in the hospital, (III) inappropriate and unrealistic operating scheduling, and (IV) poor safety considerations. The proposed solutions included imposing stricter regulations for competing for medical records, such as reduction of payments, development of guiding brochures or protocols for patients on their arrival, assigning a certain number of experienced nurses and surgeons for schedule management, rewarding the report of medical and surgical error cases, and developing a regular monitoring program for the proper implementation of surgical safety guidelines.

    CONCLUSION

    There are various managerial barriers that hamper QI in hospitals' surgery-related processes. Implementing simple but agreed solutions can lead to saving patients' lives, reduction of the unnecessary use of resources, and enhance of patient and staff satisfaction.

    Keywords: Barriers, solutions, general surgery, hospital, operating rooms, operation room, quality improvement, surgical procedures
  • Fatemeh Estebsari, Zahra Rahimi Khalifeh Kandi, Farideh Jalili Bahabadi, Zahra Raiesi Filabadi, Kimia Estebsari, Davoud Mostafaei Page 299

    CONTEXT:

    Quality of life is significant in all stages of life, including within pregnancy. The hormonal, emotional, psychological, and physical factors specific to pregnancy can affect and threaten the quality of life of pregnant mothers.

    AIMS

    This study sought to investigate the health-related quality of life (HRQoL) and related factors among pregnant women
    SETTINGS AND DESIGN: This cross-sectional study was performed on 300 pregnant women who were in the second and third trimesters of pregnancy without any risk of high-risk pregnancy covered by a community health center in Yazd, Iran, between 2018 and 2019.

    SUBJECTS AND METHODS:

    The required data were collected using demographic questionnaire and HRQoL (SF-12v2) questionnaire
    STATISTICAL ANALYSIS USED: Data were analyzed using SPSS 18 software and ANOVA statistical tests (P < 0.05).

    RESULTS

    Physical dimension of quality of life of pregnant women had the mean and standard deviation of 43.7 ± 7.3 and that psychological dimension had the mean and standard deviation of 31.5 ± 11.8. Physical dimension of quality of life was significantly correlated with maternal age, gestational age, body mass index before 12 weeks of pregnancy, mother's education and job as well as spouse's level of education (P < 0.05). Furthermore, the psychological dimension of quality of life was significantly correlated with gestational age, mother's education and occupation as well as spouse's level of education (P < 0.05).

    CONCLUSIONS

    According to the findings, attention to physical and psychological aspects of quality of life of pregnant women and demographic factors affecting it is essential for improving maternal and child health during and after pregnancy.

    Keywords: Demographic factors, health-related quality of life, pregnant women, quality of life
  • Nazila NeJhaddadgar, Arash Ziapour, Jaffar Abbas, Afrouz Mardi, Maryam Zare Page 300
    INTRODUCTION

    The world's population is aging and this trend continues. Older adults are living healthier and longer than in the last decades and their sexual function should also be considered along with their general health. This study aimed to examine the correlation between general health and sexual function in elderly women.

    MATERIALS AND METHODS

    In this cross-sectional correlation study, 1245 women over 60 years old were selected in Ardabil health-care centers by a convenient sampling method. Demographic data of all participants were noted and general health and sexual function were evaluated by the Goldberg General Health Questionnaire and Female Sexual Function Index (FSFI) Questionnaire.

    RESULTS

    The participants' mean ± standard deviation age was 75.1 ± 7.2 years, most of the women (40.08%) were illiterate, and the majority of them were living with their married (44.81%) or single children (27.14%). The general health score for 380 older women (30.52%) was under 22 (healthy). About 60% of the women had engaged in sexual activity during the past 4 weeks, and the total mean score of FSFI was 17.36 ± 1.44. In addition, 84.33% of the women had sexual dysfunction (FSFI < 26.55). The age (P < 0.05), educational level (P < 0.001), living with children (P < 0.01), and general health status (P < 0.01) were found to be significantly related to sexual function. The total scores for FSFI and the scores for all domains except for satisfaction were in positive correlation with the score for the total and all domains of general health (P < 0.001).

    CONCLUSION

    Sexual function in elderly women is affected by several factors, such as general health. Therefore, to promote successful aging in women, sexual function and general health require more attention when implementing women's health initiatives.

    Keywords: General health, older women, sexual function
  • Alka Bansal, Smita Jain, Lokendra Sharma, Neha Sharma, Charu Jain, Moksh Madaan Page 301
    INTRODUCTION

    Medical education is tricky to imbibe and difficult to apply. Various teaching–learning (TL) methods have been tried from time to time to enhance the proficiency of students. The aim was to assess the students' perception toward three different TL methods (pedagogy, andragogy, and heutagogy) in medical education.

    MATERIALS AND METHODS

    A comparative experimentalquestionnaire-based study was done on population of second-year MBBS students of SMS Medical College, Jaipur, in October 2019. They were taught topic of anticancer drugs using pedagogy, andragogy, and heutagogy methods. Then, their opinion regarding these methods was collected and evaluated. The reliability of the questionnaire was ascertained by Cronbach's alpha value which turned out to be 0.89. The data collected were analyzed statistically using one-way Analysis of Variance (ANOVA) and Principal Component Analysis (PCA).

    RESULTS

    The results showed that all these methods differ significantly from each other as the P < 0.05 considering 5% as level of significance. PCA revealed that andragogy and heutagogy were found to be most effective in this study.

    CONCLUSION

    Competency-based andragogy and capability-based heutagogy are more effective TL methods than didactic lecture-based pedagogy for MBBS undergraduate students.

    Keywords: Medical education, pedagogy, self-directed learning
  • Somayyeh Khazaeian, Ali Navidian, Fariba Shahraki Sanavi, Lila Hadipoor Page 302
    INTRODUCTION

    Acquired immune deficiency syndrome (AIDS) is a pervasive disease, and its epidemic is spreading around the world. The only way to effectively fight against human immunodeficiency virus (HIV)/AIDS is good-quality health. The present study aimed to investigate the effect of an educational intervention program on HIV/AIDS preventive behaviors based on the Health Belief Model (HBM) in vulnerable women residing in peripheral neighborhoods.

    MATERIALS AND METHODS

    This study was a quasi-experimental research conducted among 200 vulnerable women, randomly selected from four community health centers in peripheral neighborhoods in 2019 in Zahedan, Iran. The data were collected using a researcher-made questionnaire, containing demographic information, HIV knowledge, and the HBM constructs. Besides, the data were collected before, immediately after, and 1 month after the intervention in both groups. Data analysis was performed in SPSS (version 24) using descriptive statistics, Chi-square test, independent t-test, repeated-measures analysis of variance, and multivariate linear regression.

    RESULTS

    The findings revealed no significant difference in the mean scores of knowledge and the HBM constructs before the educational intervention (P > 0.05). However, after the intervention, this difference was significant in three time intervals (P < 0.05). Despite the effectiveness of the educational intervention in the mean scores of knowledge and the HBM constructs in the intervention group compared with the controls, the largest effect size was observed, respectively, in knowledge (d = 0.762) and perceived barriers (d = 0.612), and the smallest effect size was reported in cues to action (d = 0.421). As well, the F-statistic ratio (0.847) demonstrated that the selected demographic variables had failed to explain variations in knowledge mean scores (P = 0.497).

    CONCLUSION

    HBM-based training interventions were positive for HIV/AIDS prevention behaviors. However, training alone does not seem to have enough effect on behavior persistence. Therefore, further research is recommended to investigate the role of predictive factors, especially social determinants of health and their relationship to different parts of the model, to take more effective measures for behavioral stability at the same time as training.

    Keywords: Health education, human immunodeficiency virus, vulnerable populations, women
  • Yousef Veisani, Zahra Jalilian, Fathola Mohamadian Page 303
    BACKGROUND

    Internet addiction (IA) currently is the major public health concern, especially in adolescents, although the results of previous reports are not generally uniform. This study was conducted to determine IA in adolescents and to examine the correlation of IA with mental health in adolescents.

    METHODS

    This cross-sectional study was conducted in 2019 in Ilam city. In this study, 362 persons were included using stratified cluster sampling; clusters were geographical area and schools. The valid questionnaires including Internet Addiction Test and 28-item General Health Questionnaire (GHQ-28) were used to interview. The correlation statistical technique was used to determine the association between the two variables. The significance level was considered <0.05.

    RESULTS

    The mean ± standard deviation age of the responders was 16.40 ± 2.47 years; the total score of IA and mental health was 43.02 ± 16.50 and 19.27 ± 9.72, respectively. We found that 5.5% of the adolescents had a severe level of IA. The lack of control with anxiety, neglect work and social dysfunction, and neglect social life and severe depression in internet users were found to be statistically significant: r (365) = 0.151, P < 0.033; r (365) = 0.126, P < 0.021; and r (365) = 0.125, P < 0.033, two-tailed, respectively.

    CONCLUSION

    According to the results, the excessive use of internet, lack of control, and neglect social life are significantly correlated with mental health in adolescents; these results could be contribute to improve the theoretical models for IA in adolescents.

    Keywords: Adolescents, internet addiction, Iran, mental health, teenagers
  • Marjan Beigi, Fahimeh Khorasani, Shahnaz Kohan Page 304
    INTRODUCTION

    Reporting medical errors is one of the common methods for identifying and preventing mistakes in-hospital care. This study was conducted to identify the status of reporting and related factors in two groups of midwives and midwifery students.

    METHODOLOGY

    This research was analytic correlational; it was conducted among all the midwives working in the midwifery and labor departments and midwifery students in Isfahan University of Medical Sciences. The data collection tool included a checklist of errors and the researcher-construed questionnaires of awareness and attitude toward reporting errors. The results were examined using descriptive and inferential statistics (ANOVA, Pearson and Spearman correlation coefficient, and independent t-test) by SPSS software version 20.

    RESULTS

    In this research, the error reporting in midwifery staff was 79.1% and the most frequent error was related to the patient's process of testing; the error reporting among the students was 90% and the most frequent error occurred in the labor processes. The present study also showed that there was a direct relationship between awareness and attitude toward reporting medical errors (P < 0.001), while there was not a significant relationship between the midwifery students' awareness and attitude toward reporting the medical errors (P = 0.31).

    CONCLUSION

    According to the study, hospital midwives reporting is less than midwifery students. Accordingly, it is recommended to focus on the error and risk management committee to strengthen the reporting system.

    Keywords: Attitude, awareness, medical error, midwife, midwifery students, reporting
  • Ramin Sarchami, Shakiba Rajaei, Shima Aalaei Page 305
    INTRODUCTION

    Considering the importance of the academic level of university graduates in the advancement of communities, it is necessary to evaluate factors affecting the academic achievements of university students. Therefore, this study investigated the relationship between religious beliefs and academic achievements of students in the Dental School in Qazvin University of Medical Sciences.

    MATERIALS AND METHODS

    In this correlational study, all the dentistry students in the last 4 years of education were selected as the study samples. Of 109 students who had the inclusion criteria, 81 (31 males and 50 females) completed the questionnaires. The data collection tools were three questionnaires, including Gluck–Stark's questionnaire, two researcher-made questionnaires on “sympathy with and responsibility for patients,” and the “self-satisfaction” questionnaire. Data were analyzed with descriptive and deductive statistics (t-test, Friedman test, and Pearson's correlation coefficient).

    RESULTS

    According to the analyses, a significant and positive correlation was found between religiosity and students' overall mean grades (r = 0.27, P = 0.016) or “sympathy with and responsibility for patients” (r = 0.21, P = 0.05). No significant correlation was found between self-satisfaction and religious beliefs.

    CONCLUSION

    Based on the results of the present study, the religious beliefs of the students were at a moderate level. On the other hand, this variable had a direct relationship with academic achievement and responsibility. Therefore, attention has to be paid to the promotion of these beliefs among students in colleges. Reinforcement of religious beliefs will improve the students' academic achievement. Based on the findings of this study, it should be considered by university professors and educational planners that the average score of students with higher religiosity was higher, and with the increase of religious beliefs, academic achievement is increased.

    Keywords: Academic achievement, dental students, religion
  • Akila Prashant, Devananda Devegowda, Prashant Vishwanath, Suma M Nataraj Page 306
    BACKGROUND

    Experiential learning sessions as a teaching aid have been applied early in the medical undergraduate curriculum to improve the knowledge and inculcate research interest. We compared the ability of 1st-year medical undergraduates to answer the molecular biology questions among those who had attended the experiential learning sessions of molecular biology techniques versus those who did not attend.

    SUBJECTS AND METHODS:

    A randomized controlled trial was carried out with 200 1st-year medical undergraduates, among whom 69 students were selected by simple random sampling for the demonstration of the molecular biology techniques, such as isolation of genomic DNA, polymerase chain reaction, cell culture techniques, western blotting, and high-performance liquid chromatography for 1-week duration. Student's feedback was collected on a five-point Likert sc ale at the end of the session to understand how they agree or disagree with a particular statement. The content validity rate (CVR) and content validity index (CVI) of the questionnaire were determined, and its internal consistency was examined by Cronbach's alpha. The internal assessment marks of these students, valued by faculty who were blinded to their training sessions, were compared with the rest of the 131 students by independent t-test to know the outcome of these experiential learning sessions.

    RESULTS

    On CVR and CVI assessment, all the questions scored more than 0.70 and 0.85, respectively. Cronbach's alpha for the whole questionnaire was 0.85. Student's feedback indicated that these sessions did complement the cognitive skills acquired for these techniques. We also found a statistically significant improvement (P = 0.006) in the examination performance between the students who attended versus those who did not attend the experiential learning sessions.

    CONCLUSION

    Experiential learning, through demonstration and hands-on experience, enhance d the learning of molecular biology techniques among 1st-year medical undergraduates.

    Keywords: Cell culture techniques, medical education, molecular biology, polymerase chain reaction, western blotting
  • Esmaeil Mousavi Asl, Sajjad Khanjani, Behzad Mahaki, Youkhabeh Mohammadian Page 307
    BACKGROUND

    Disordered eating attitude may lead to full-blown eating disorders. Recent longitudinal studies show that disordered eating attitudes either remain stable or even increase from childhood to adulthood. The current study was done to determine the psychometric properties of the Eating Attitudes Test-8 (EAT-8) and introduce the suitable measure for researchers and therapist in the field of clinical psychology and psychiatrist.

    MATERIALS AND METHODS

    The Persian version of the EAT-8 was produced through forward translation, reconciliation, and back translation. A sample of 302 students were selected through convenience sampling method and completed a set of questionnaires, including the EAT-8, Eating Attitudes Test-16 (EAT-16), Eating Beliefs Questionnaire-18 (EBQ-18), self-esteem scale, and self-compassion scale short-form. The construct validity of the EAT-8 was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test–retest reliability (2 weeks' interval) were conducted to evaluate the reliability. Data analysis was conducted using SPSS (version 22) software and LISREL (version 8.8).

    RESULTS

    EAT-8 was found to be valid and reliable measures, with good internal consistency and good test–retest reliability among students. In terms of convergent validity, EAT-8 showed a significant positive correlation with self-report measures of EAT-16 and EBQ-18. EAT-8 showed a negative correlation with self-compassion and self-esteem, thus demonstrated a good divergent validity. The results of this study also provide support for the one-factor model of the EAT-8.

    CONCLUSION

    The EAT-8 showed good validity and reliability and could be useful in assessing disordered eating in Iranian population. The EAT-8 shows notable promise as a measure for use in disordered eating research and clinical settings.

    Keywords: Eating, factor analysis, psychological tests, psychometrics, self-report
  • Alireza Nikbakht Nasrabadi, Soodabeh Joolaee, Elham Navab, Maryam Esmaeilie, Mahboobeh Shali, Neda Sheikhzakaryaee Page 308
    INTRODUCTION

    Providing information based on truth is very important in patients' treatment-related decisions and reduces emotional and physical sufferings as well as patient costs. The aim of this study was to design a model that is based on the culture and health-care context of Iran in order to establish a truth-based communication and provide accurate information to patient.

    MATERIALS AND METHODS

    This qualitative study was conducted in 2019. Data were collected through semi-structured interviews with 18 nurses who had been selected by purposeful sampling method. Data analysis was performed in two steps. In the first step, the participants' experiences were determined using the grounded theory approach. In the next step, using Walker and Evant's (2011) method, the concepts and statements were combined and presented in a central concept.

    RESULTS

    The central concept in this study was “an attempt to establish a truth-based communication with patient,” and then, a truth-based communication model was presented. The components of the model were presented in three parts: improving patient communication skills, managing the situation in which the truth is presented, and the patient's participation in decision-making.

    CONCLUSION

    To present the truth of the treatment, which can sometimes be unpleasant and bitter, it is very important to improve communication skills and choose an effective communication strategy. To establish a truth-based communication, it is necessary to create a suitable ground for communication, which should be provided in clinical setting and community.

    Keywords: Care, ethics, grounded theory, model, truth-telling
  • Chaitali Ashish Chindhalore, Ganesh Natthuji Dakhale, Akhil B Giradkar Page 309

    CONTEXT:

    Inappropriate self-medication can increase chances of adverse drug reactions, disease aggravation, or drug interactions. Analgesics are most commonly used as self-medication.

    AIMS

    The aim of this study was to evaluate and compare analgesic self-medication practices among medical and paramedical undergraduate students of a tertiary care teaching institute in Central India.

    MATERIALS AND METHODS

    A cross-sectional, observational study was conducted in 216 undergraduate medical (MBBS and BDS) and paramedical (occupational therapy/physiotherapy and BSc nursing) students. A predesigned, self-developed, semi-structured questionnaire was used.
    STATISTICAL ANALYSIS: The Chi-square test was used for testing statistical significance.

    RESULTS

    The overall prevalence of self-medication with analgesics was 83.33%. Self-medication was significantly high among medical students as compared to paramedical students (P = 0.003). Significantly more medical students were aware about adverse drug reactions of analgesics as compared to paramedical students (P = 0.019). The most common source of information about drugs was previous prescription (58.33%), followed by media including the Internet (53.70%). The most dominant symptom compelling self-medication was found to be muscular pain (42.12%), followed by headache (36.57%). 54.16% of the students revealed that self-medication provides quick relief from pain. The most commonly used analgesic was paracetamol (82.40%), followed by diclofenac (22.68%). A significant number of paramedical students do not know exactly what precautions should be taken while taking analgesics (P = 0.002).

    CONCLUSIONS

    Medical students are more indulged in self-medication practices with analgesics. Paramedical students need to be educated regarding safe use of analgesics.

    Keywords: Analgesics, medical students, nursing students, self-medication
  • Nasrin Azimi, Abbas Ebadi, Hamid Alavi Majd, Assadollah Rajab, Giti Ozgoli Page 310

    A valid tool is of paramount importance in determining women's sexual and reproductive health status, meeting their health needs, and recognizing the effectiveness of some interventions. This review study aimed to assess sexual and reproductive health dimensions tools in women with type 1 diabetes mellitus with regard to Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist. In this review study, in addition to Iranian databases (MagIran, Sid, Irandoc), non-Iranian databases (PubMed, Scopus, Embase, and Web of Science) and Google Scholar search engine were considered. The mentioned databases were searched for articles in English and Persian published within 2000–2019, using the search strategy for each database and Boolean operators along with appropriate keywords according to the MESH term. Articles with nonresearcher-made tools measuring the sexual and reproductive health concepts and dimensions were included in the present study. Afterward, the psychometric properties of the tools were assessed according to the COSMIN checklist. In the selected articles, there were 14 psychometrically valid tools to be assessed from 151 articles containing the sexual and reproductive health dimensions; among which, seven tools were evaluated with regard to COSMIN. None of the tools also had all the features noted in COSMIN. Moreover, all the concerned scales were not interpretable and accountable; however, a majority of them had internal consistency and construct validity. In this study, there was no valid and specific tool for measuring sexual-reproductive health status in this population group. Therefore, it is necessary to develop a valid tool according to the dimensions and needs of specific reproductive health in type 1 diabetes.

    Keywords: Consensus-based Standards for the selection of health status Measurement Instruments, sexual, reproductive health, type 1 diabetes mellitus
  • Mohammadreza Yazdankhahfard, Maryam Ravanipour, Kamran Mirzaei Page 311
    INTRODUCTION

    The clinical environment is an essential and irreplaceable resource in preparing nursing students for their professional role. Despite many changes that occur in the clinical learning environment (CLE), these environments remain important to nurse training. With regard to the importance of students' viewpoints in the evaluation of CLE, this study was performed to the determination of nursing students' viewpoint of the actual and preferred CLE at Bushehr University of Medical Sciences in Iran 2013.

    MATERIALS AND METHODS

    In this cross-sectional analytic study, due to the small size of the research population, all nursing students (86 students) of Bushehr University of Medical Sciences in Iran who had passed at least one clinical course were selected through the census. Participants were invited to complete anonymously the actual and preferred Farsi versions of the CLE Inventory consisting of 42 items originally developed by Professor Chan (2001). Data were analyzed using frequency distribution, mean, standard deviation, and paired t-test.

    RESULTS

    The results indicated that there were significant differences between students' perceptions of the actual and the preferred CLE (P < 0.001). The highest and lowest mean scores of actual CLE belonged to student involvement and individualization, respectively, and the highest and lowest mean scores of preferred CLE belonged to task orientation and individualization, respectively.

    CONCLUSION

    In general, students prefer a more positive CLE than what they actually have experience and would prefer an environment with higher levels of clarification of personalization, student Involvement, satisfaction, task orientation, innovation, and individualization.

    Keywords: Clinical education, clinical learning environment, clinical learning, nursing students
  • Sahebjan Torkian, Firoozeh Mostafavi, Asiyeh Pirzadeh Page 312
    BACKGROUND

    Mobile app education is one of the new educational models. Hence, the purpose of this study was to determine the effectiveness of mobile app intervention on knowledge, attitude, and practice of youth for a healthy marriage.

    MATERIALS AND METHODS

    This quasi-experimental study was conducted in 2019 on 88 young people who were selected by simple random sampling in premarital counseling center of Falavarjan city (Isfahan). Then, participants were randomly allocated to an intervention and a control group. Mobile application intervention was installed on the intervention group's mobiles. Data were collected by questionnaire in two times. Data were analyzed using paired t-test and independent t-test.

    RESULTS:

    The mean (Standard deviation) of couples' age was 21.11 (5.06) years. The results showed that after the installation of educational consulting app in the intervention group, the mean score of knowledge (P = 0.001), attitude (P = 0.001), and practice (P = 0.001) after intervention were significantly higher than before the intervention.

    CONCLUSION

    Mobile-based educational and counseling app increases couples' knowledge, attitude, and practice in premarital education. Therefore, it is recommended that this type of education (mobile app) be used to promote premarriage education classes.

    Keywords: Attitude, knowledge, mobile app, practice, premarriage
  • Nishu Jha, Ajeet Singh Bhadoria, Yogesh Bahurupi, Kanchan Gawande, Bhavna Jain, Jaya Chaturvedi, Surekha Kishore Page 313
    BACKGROUND

    Menstruation is a normal physiological process among reproductive age group females. Although some of them show the abnormal menstrual pattern, which is influenced by several factors, including sociodemographic status, psychosocial stress, improper sleep level, etc. The identification of these risk factors associated with abnormal menstrual patterns may permit risk stratification among adolescent girls. This study was planned to determine various factors which depict menstrual cycle pattern among adolescent girls in urban India.

    MATERIALS AND METHODS

    A school-based case–control study was carried out in urban India from May to December 2019. Urban locality and schools were randomly selected, and data were collected in two phases. Adolescent girls in the age group of 10–19 years studying in government and private (both Hindi medium and English medium) schools of urban India were screened for the abnormal menstrual pattern. Equal numbers of age-matched controls were also enrolled. Data were collected with the help of self-administered predesigned pretested semi-structured questionnaire. Chi-square test, Fisher's exact test, unpaired t-test, and McNemar tests were used to analyze data using SPSS version 23.0.

    RESULTS

    A total of 100 cases and 100 age-matched controls (mean age 14.8 ± 1.5 years) were included in the study, almost half of the cases and controls have normative menarche. Improper sleep patterns increased stress levels, and low education status of mothers show statistically significant (P = 0.047) association with abnormal menstrual patterns.

    CONCLUSION

    More stress, improper sleep levels, and low education status of mothers among school-going adolescent girls were strongly associated with abnormal menstrual patterns with more symptoms during menstruation.

    Keywords: Adolescent, case–control study, menstrual cycle
  • Pari Moradi, Athar Omid, Nikoo Yamani Page 314
    INTRODUCTION

    After graduation, public health students should be able to work as health care givers providing first-level health care services. Therefore, the educational objectives of public health bachelor's programs should ensure that they acquire the capabilities necessary for this purpose. This study identified the educational objectives that are essential for these students and compared them with the current curriculum in Isfahan, Iran.

    METHODS

    This needs assessment study was conducted in two phases. In the first phase, the essential educational objectives were identified using a qualitative approach, which involved eight focus group discussions held by a group consisting of experts of the public health headquarters and public health network administration offices of Isfahan province and the public health graduates working in the province's comprehensive health service centers, who were chosen using the purposive sampling method (n = 59). In the second phase, a comparative study was performed by turning the list of essential educational objectives into a checklist and using it to compare these objectives with the objectives in the current course plan in the examined curriculum. In the end, a list of educational objectives not included in the current curriculum of the public health bachelor's program was created.

    RESULTS

    The focus group discussions produced 433 educational objectives in the cognitive domain, 79 objectives in the affective domain, and 179 objectives in the psychomotor domain, which were arranged in eight competency categories. Comparison of the essential educational objectives with the current curriculum showed that the current curriculum does not cover any of the essential objectives regarding care for the age groups of 18–29 and 30–59 and the first aid and only partially covers essential objectives in other competency categories.

    CONCLUSION

    This study found that considering the requirements of first-level health services and the tasks expected from public health graduates to be providing these services, the current curriculum does not cover all essential learning objectives and should be revised to meet additional essential educational objectives.

    Keywords: Curriculum, educational objectives, health care worker, job description, needs assessment, public health, service package
  • Zahra Hosseinkhani, Hamidreza Hassanabadi, Mahboubeh Parsaeian, Saharnaz Nedjat Page 315
    INTRODUCTION

    In social cognitive theory, self-efficacy and self-concept (SC) have been introduced as important constructs that associate with adolescents' achievements. The aim of this study was to investigate the determinant factors of academic self-efficacy (ASE) and SC in Iranian high school students based on the multilevel analysis.

    MATERIALS AND METHODS

    In this descriptive-analytical cross-sectional study, 1740 students from 53 high schools selected with stratified random sampling method in 2018 in Qazvin, Iran. Data collection tools were the Morgan and Jinks Self-Efficacy Scale and the Piers-Harris Children's SC Scale-Second Edition. The association between some of the students and school variables with ASE and SC was analyzed by hierarchical linear regression models.

    RESULTS

    The score of the students' standardized ASE was lower than SC. ASE and SC had a strong positive significant association with economic status, grade point average, and the educational period of high school. Sex had no association with any of them. Physical activity had a positive significant association with SC but was no found association by ASE.

    CONCLUSION

    These findings revealed that for improving the adolescents' ASE and SC should be attention to the adolescents' family condition and school-related factors. Proper educational, sports, and supportive programs can be effective on the adolescents' self-efficacy and SC.

    Keywords: Academic self-efficacy, adolescents, Iran, school, self-concept, students
  • Sean Karyczak, Ann A Murphy, Michelle Zechner, Ellen Z Anderson, Anthony Zazzarino Page 316
    INTRODUCTION

    Physical therapists provide important services to improve physical health for the general population; however, physical therapy interventions are less utilized with underserved populations such as those with severe mental illness (SMI). The quality of services for these populations is impacted in part by negative provider attitudes and lack of preparation to work with the SMI population. This study examined the impact of structured educational field experience on the physical therapist's attitudes and knowledge about working with the SMI population. This will inform future educational practices to best prepare students to provide quality of healthcare to the population.

    MATERIALS AND METHODS

    Seven graduates of a doctor of physical therapy (DPT) program from a Mid-Atlantic University in the United States who participated in an SMI service-learning (SL) experience completed a semi-structured qualitative interview in 2016. Questions about how the experience impacted their current work were asked. Interviews were digitally recorded, transcribed, and examined using interpretive phenomenological analysis. Coding and investigator triangulation were conducted. All interviews reached thematic saturation.

    RESULTS

    The graduated DPT students reported attitudinal changes toward people with SMI through qualitative interviews. They reported an improvement in their skills, greater competence to work with the SMI population, and an increased focus in the use of person-centered services.

    CONCLUSIONS

    The results of this study suggest that DPT students gain an understanding of both the SMI population and themselves during SL. Using SL as part of the DPT educational curriculum can offer students and the opportunity to build confidence in working with the SMI population. SL can also improve their skills and attitudes toward the population, key areas that are identified as barriers to receiving quality physical healthcare among the SMI population.

    Keywords: Community health services, physical therapy, psychiatric rehabilitation, qualitative research, students
  • Mahboobe Ameri, Ehsan Movahed, Jamileh Farokhzadian Page 317
    BACKGROUND

    Adherence to treatment is one of the major challenges in patients with HIV/ADIS. If the patients do not adhere, they will face recurrent consequences, such as disease progression. The aim of this study was to investigate the effect of information, motivation, and behavioral Skills (IMB) model on medication adherence, diet adherence, and physical activity in HIV/ADIS patients.

    MATERIALS AND METHODS

    This interventional study was conducted on 122 patients with 20 years of age and over with HIV/AIDS in Kerman City, Iran, in 2018. A total of patients were selected by census method and categorized into the intervention and control groups. Later, a researcher-made questionnaire on IMB was used before and 3 months after the intervention to assess medication adherence, diet adherence, and physical activity .The intervention study consisted of at least 8 training sessions (90 min) over a 12-week period.

    RESULTS

    In adherence to medication, information (P = 0.034) and personal motivation (P = 0.003) constructs and in adherence to diet, information (P = 0.025), personal motivation (P = 0.001), self-efficacy (P = 0.010), and skills (P = 0.011) were significantly different between the two groups after the intervention (P = 0.011). However, regarding the adherence to physical activity, no significant difference was found between the two groups after the intervention.

    CONCLUSIONS

    The IMB model can be effective in promoting the diet adherence in HIV/AIDS patients. In this regard, more qualitative and quantitative studies are recommended on the adherence to medication and physical activity.

    Keywords: Adherence, AIDS, HIV, model
  • Shervin-Sadat Hashemian, Soghra Masom-Alipour, Arash Najimi Page 318
    INTRODUCTION

    One of the most critical stages of women's lives is menopause. Meanwhile, group training can have a significant effect on reducing menopausal symptoms. The aim of this study was to investigate the effectiveness of group training on reducing menopausal symptoms in postmenopausal women.

    METHODS

    This study was a randomized controlled trial. The study population was 96 postmenopausal women visiting health centers in the city of Shazand (Markazi Province, Iran). Data collection tools in this study were the Menopausal Rating Scale Questionnaire and the Beck Depression Inventory. Group training intervention consisted of four training sessions. The duration of each session was 2 h. The questionnaires were completed in two stages of pre- and post-test (8 weeks later) for the intervention and control groups. Data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and analytical statistics (independent t-test, paired t-test, and analysis of covariance).

    RESULTS

    The mean age in the intervention group and the control group was 49.93 ± 3.44 and 51.66 ± 2.93 years, respectively. In the intervention group, the mean menstrual time was 2.37 ± 167 years and in the control group, the mean time elapsed from the last menstrual period was 3.91 ± 2.68 years. The mean scores of menopausal physical symptoms (F = 58.69), menopausal symptoms (F = 43.45), menopausal urinary and genital symptoms (F = 33.50), and depression (F = 58.25) had a significant decrease in intervention group, while in the control group, these changes were not significant (P < 0.001).

    CONCLUSION

    Regarding the findings of this study, which indicates the effect of group training program on the improvement of physical, psychological, urinary and genital symptoms, and menopausal depression, it seems that group training in menopause can be an effective method.

    Keywords: Group training, menopausal symptoms, menopause, women
  • Farough Mohammadian, Zahra Sadat Asadi, Mohsen Moradinia, Reza Tajik, Rasoul Abhar, Manijeh Soleimanifar Page 319
    BACKGROUND

    Changing human behavior for the purposes of improving the way people work is an integral part of most educational interventions. This study aimed to evaluate the effect of a model based on the theory of planned behavior (TPB) on correct principles of manual material handling (MMH) among male soldiers.

    SUBJECTS AND METHODS:

    This study was a quasi-experimental, pretest-posttest research with a control group. Furthermore, 140 soldiers, from an area located in the city of Bandar Abbas, Iran, were selected through a simple random sampling and they were divided into two groups: intervention and control (70 subjects in each group). The data were collected using a three-part questionnaire including demographic information, the theory constructs, and MMH behavior. The intervention group was given the relevant education, and after 2 months, the both groups were evaluated.

    RESULTS

    Based on regression analysis, attitude toward behavior and perceived behavioral control were predictors for correct principles of MMH. There were significant differences between the mean scores of the theory constructs before and after the education in intervention group (P < 0.001); however, no significant differences were observed in the theory constructs in the control group after the intervention. Before the education, the mean score of MMH of the intervention group was 38.30 ± 6.45; but after, the education, this changed into 44.20 ± 6.01, and significantly increased (P < 0.001).

    CONCLUSIONS

    Educational intervention based on the TPB was effective in improving behavior for correct MMH in soldiers. Thus, the use of such educational programs according to the constructs of the planned behavior theory is recommended.

    Keywords: Educational intervention, manual material handling, musculoskeletal disorders, planning behavior
  • Mohammad Amiri, Ahmad Khosravi, Reza Chaman, Zakieh Sadeghi, Mehdi Raei Page 320
    INTRODUCTION

    The ultimate goal of education at all levels is the ability to generate and foster students' creativity. This study aimed at determining and comparing creativity and its influencing factors among medical students.

    SUBJECTS AND METHODS:

    In this cross-sectional study conducted in 2019, 720 medical students in Shahroud public and private universities were selected and studied through stratified cluster random sampling. Data were collected using the Guilford Creativity Questionnaire. The data were analyzed using Chi-square, Pearson correlation coefficient, t-test, and multiple logistic regression with a significance level of 0.05.

    RESULTS

    The mean creativity score of the students was 131.4 ± 13.8. The mean creativity scores on the fluency, elaboration, originality, and flexibility dimensions were 49.2 ± 5.3, 22.1 ± 3.4, 34.8 ± 4.7, and 25.4 ± 3.5, respectively. In terms of creativity levels, 75.2% of the students (n = 542) had moderate creativity and 23.8% (n = 171) had high creativity. A significant relationship was observed between creativity and educational level (P = 0.006). Multiple logistic regression results showed that educational level with an odds ratio of 0.59 was associated with a decreased chance of creativity.

    CONCLUSION

    Most of the students had moderate creativity. Moreover, among the factors examined in this study, variables other than the field of the study and educational level had no significant effect on students' creativity. Therefore, using collaborative and cooperative learning and problem-based learning strategies, teachers' critical thinking styles, establishing teamwork groups, concept mapping, and using innovative and creative teaching methods can help to enhance students' creativity.

    Keywords: Creativity, fluency, medical students, pliability
  • Saurav Basu, Yamini Marimuthu, Nandini Sharma, Pragya Sharma, Navya Gangadharan, Sahadev Santra Page 321
    BACKGROUND

    There is growing recognition of the role of mobile learning (M-learning) for undergraduate (UG) academic education and teaching purposes, but teacher attitudes toward it can be variable.

    OBJECTIVE

    To determine the attitudes toward the incorporation of M-learning methods for UG medical education among resident doctors at a government medical college in Delhi, India.

    METHODS

    A cross-sectional study was conducted for 3-months duration (2019) among 60 final year junior and senior resident doctors. The participants were selected from all the preclinical and paraclinical department, and one clinical department selected randomly based on the probability proportion to size method. The data was collected using self-administered instruments including the modified 20-item M-learning Perception Scale (MLPS).

    RESULTS

    Social media (36.7%) and instant messaging platforms (85%) were routinely used by the participants for exchanging academic (medical) and health-related information. The mean score for all the MLPS item responses was >3, indicating positive attitudes toward M-Learning. The participants expressed maximum agreement with the views stating M-Learning can “supplement traditional teaching,” was “reliable for personal use,” and “improves the quality of lessons.” The responses of those participants having preexisting familiarity with health information and education portals, and those aware of massive open online courses correlated significantly with higher MLPS scores.

    CONCLUSION

    M-learning is visualized as an increasingly relevant teaching and learning medium by early-career resident doctors involved in UG medical education in India.

    Keywords: India, medical education, mobile learning
  • Azita Shahraki Mohammadi, Sirous Panahi, Azadeh Sayarifard, Ahmad Ashouri Page 322

    The present study aimed at identifying the prerequisites, facilitators, and barriers to adolescent mental health literacy interventions. To that end, databases PsycINFO, Science Direct, Scopus, Emerald, PubMed, Web of Science, and Google Scholar were systematically searched, out of which 39 articles that had the inclusion criteria were analyzed by the content analysis. Databases searched from September 30, 2018, to October 10, 2018, with the keywords “health literacy,” “mental health literacy,” “mental disorders,” adolescents, students, and more. Seven themes were identified as the prerequisites for interventions to improve adolescents' mental health literacy including education at the school level, parents' education, training of trainers and providers, cooperation and participation among providers, intervention assessment and monitoring, provision of educational content, consideration of the cultural and linguistic issues. Five themes were identified as facilitators: using interactive learning and teaching methods, supplying diverse and stimulating educational content, employing trainers with different backgrounds, having direct contact with people with mental illness, and utilizing technological advancements in education. Finally, short-time intervention, the collaboration between school administrators and researchers, lack of valid information sources were identified as barriers.

    Keywords: Adolescents, facilitators, mental health literacy, prerequisites
  • Ernesto A Moralez, Beti Thompson, Kaitlin Englund, Marilyn Drennan, Nicole Mandall, Helena Loest Page 323

    CONTEXT:

    Immersing students studying health promotion and disease prevention into community settings facing health disparities is an essential supplement to their academic experience. As part of many public health professions, these students will likely need to understand the values and beliefs of different cultures so that decisions of appropriate health promotion and treatment can be made equitably. This paper evaluates an education immersion program that was part of a National Cancer Institute funded collaboration supporting the recruitment and training of university students in cancer research. The primary aim of the Health Disparities Field Experience (HDFE) was to facilitate an experience for students pursuing a health-related degree to understand the conceptual issues in border/rural health and the cultural contexts related to health disparities among medically and financially indigent populations in the region.

    SUBJECTS AND METHODS:

    This study was conducted using qualitative research methods using a variation of the content analysis approach using open codes to categorize the data. Six students were selected to participate in the HDFE (five graduate students and one undergraduate) and all six of the participants completed pre- and post-test surveys.

    RESULTS

    From the analysis of the data, posttest qualitative responses indicated that three participants saw racism as a primary cause of cancer-related disparities, a change from their pretest responses. When asked about the personal impact of the HDFE, respondents mentioned the importance of the experiential component.

    CONCLUSIONS

    Participants learned about health disparities from the HDFE and expressed high satisfaction with this approach to education.

    Keywords: Active learning, experiential education, health disparities, health education
  • Ali Almasi, Alireza Zangeneh, Shahram Saeidi, Razie Toghroli, Raziyeh Teimouri, Akram Sadat Hoseini, Neda Kinipour, Fatemeh Mahmoodi, Kobra Gholami Kiaee Page 324
    INTRODUCTION

    Children are among the most vulnerable groups in society, whose health is of prominent significance. Moreover, as a group of clients with special needs in the health care system, they require special attention. Therefore, the present study aimed to investigate the 0–14-year-old children's access to health centers in rural areas of Kermanshah Province, Iran.

    MATERIALS AND METHODS

    In the present cross-sectional study, both the latest published demographic statistics related to the Population and Housing Census, announced by the Statistical Center of Iran in 2011, and the information about the public and private hospitals in the province, collected by Kermanshah University of Medical Sciences, were used as the basis for the analyses. In addition, given the importance of the spatial nature of the research, geographic information system was used for data analysis, and a buffer model was also applied.

    RESULTS

    The results revealed that out of the total population of 0–14-year-old children residing in rural areas within 15,000 and 30,000-km radii of Kermanshah Province, 87.94% and 75.11% of girls versus 88.15% and 75.38% of boys lacked access to health centers, respectively.

    CONCLUSION

    It was found out that the 0–14-year-old children's access to health centers was in poor condition in rural areas of Kermanshah Province, which would endanger the health of this age group.

    Keywords: Child, geographic information system, health-care disparities, hospitals, rural health services
  • Somayeh Ghafari, Ahmadreza Yazdannik, Shahla Mohamadirizi Page 325
    INTRODUCTION

    Evaluation of students' clinical performance is an essential part of nursing education. Mobile technology is one of the new methods of evaluation that has opened a new horizon for nursing professors. Therefore, this study aimed to design, implement, and evaluate mobile health technology in critical care nursing department in four-phase intervention.

    METHODS

    This study was a four-stage educational intervention in which all postgraduate students of intensive care nursing in Isfahan University of Medical Sciences participated in the study. The four steps were designing and developing a logbook, needs assessment, designing and implementing an Android app, and evaluating users (students) of the Android app. Subjects' satisfaction scores were collected using a researcher-made questionnaire with 14 questions. Data were analyzed using SPSS 14 software.

    RESULTS

    In this study, a clinical practice evaluation app was designed at four levels of access (student, professor, department manager, and faculty dean). The results showed that more than half of app users reported this technology in terms of an overall response to the tool (87.5%), tool specificity (100%), the amount of information displayed (75%), page layout (62.5%), information rate (75%), recall information (87.5%), and ease of doing instructions (100%) were positive.

    CONCLUSION

    Evaluation of clinical practice using technology was associated with increasing students' satisfaction with evaluation method. In addition, this application enabled the simultaneous interaction between the professor with the higher and lower ranks, including the department manager and student and vice versa and the simultaneous recording of this interaction.

    Keywords: Critical care, education, mobile applications, nursing, students
  • Eswara Uma, Chia Hua Lee, Siti Nor Hidayu Binti Mohd Shapiai, Anis Nabila Binti Mat Nor, Htoo Htoo Kyaw Soe, Eby Varghese Page 326
    BACKGROUND

    Undergraduate dental students have to do multiple tasks as part of their extensive curriculum in order to achieve the proficiencies expected of them. During the course of their study, a tendency to procrastinate and question their self-efficacy is detrimental for the students. The aim of this study was to evaluate the level of procrastination and self-efficacy and its related factors among dental undergraduate students.

    SUBJECTS AND METHODS:

    This cross-sectional study was conducted among all (n = 361) consented dental undergraduate students of our dental school. A twenty-item Lay's Procrastination Scale for student population and a ten-item General Self-Efficacy Scale were used for the study after getting institutional ethical approval. The quantitative data were explained using descriptive statistics. Independent sample t-test and ANOVA were used to determine the association between self-efficacy, academic procrastination, and genders and academic years. Pearson correlation coefficient was used to determine the association between self-efficacy and procrastination. Multiple linear regression analysis was performed to determine the related factors to academic procrastination.

    RESULTS

    High procrastination (score ≥62) was seen among 28.5% of students. The mean self-efficacy score was 29.5. There was no significant difference between genders for procrastination scores (P = 0.835) and between academic years (P = 0.226). Males showed significantly more self-efficacy (P < 0.001), and self-efficacy did not show any significant difference (P = 0.204) between academic years though a tendency for year 5 students to have lower self-efficacy scores was observed. Academic procrastination was negatively correlated with self-efficacy (r = −0.238 and P < 0.001).

    CONCLUSIONS

    For dental undergraduates who have cognitive load as well as work associated with patients, procrastination and self-efficacy are negatively correlated.

    Keywords: Dental students, procrastination, self-efficacy, undergraduates
  • Ensiyeh Norozi, Fatemeh Nazari, Mitra Moodi Page 327
    BACKGROUND AND AIM

    Arthritis is the most common type of arthritis in people over 40 years. This study aimed to determine the effect of an educational intervention on the prevention of arthritis among middle-aged women using the health belief model.

    MATERIALS AND METHODS

    This was a randomized controlled field trial. The study population was women aged 29–59 years who referred to health centers in Birjand. Seventy-three women were selected by a systematic random sampling method and were randomly divided into intervention (n = 36) and control (n = 37) groups. The data collection tool was a researcher-made questionnaire. Data were analyzed using the Chi-square test, Fisher's exact test, t-test, repeated-measures ANOVA, and Bonferroni post hoc test. As for the cases where the data were not normally distributed, the Friedman nonparametric test, Mann–Whitney U-test, and Wilcoxon post hoc tests were used.

    RESULTS

    In the intervention group, the mean score of knowledge, perceived susceptibility, severity, benefits, self–efficacy, and behavior significantly increased, and the mean score of perceived barriers significantly decreased after the intervention (≤0.001). In the control group, there were significant differences in the mean scores of perceived susceptibility, perceived severity, perceived self-efficacy, and performance after an intervention (P ≤ 0.001). However, this increase was significantly higher in the intervention group than in the control group.

    CONCLUSION

    Based on the present study and according to the positive impact of the educational intervention based on the health belief model on the prevention of arthritis, it is recommended to use this theory in educational programs to prevent arthritis.

    Keywords: Arthritis, education, middle aged, women health
  • Deena Davis, Lakshmi Ramamoorthy, Biju Pottakkat Page 328
    INTRODUCTION

    A person with colostomy or ileostomy undergoes a comprehensive treatment with a wide range of adjustments which affect the individual's social and psychological functioning. Quality of life (QOL) is a subjective feeling which includes physical, social, psychological, and spiritual domains of an individual that can be affected by a stoma.

    AIM

    This study is aimed at identifying the QOL and impact of stoma on their lifestyle pattern among ostomates attending stoma outpatient department of gastroenterology department of a government tertiary care center in South India during 2018.

    METHODS

    A descriptive study using a cross-sectional survey design was conducted among 55 ostomates, following consecutive sampling technique. The data were collected using a City of Hope QOL Questionnaire for Ostomy patients which had QOL Assessment Questions from four subdomains including physical, psychological, social, and spiritual aspects. This tool also had open-ended questions on lifestyle assessment components.

    RESULTS

    63.6% of the participants had colostomy; 72.7% of the stomas were due to cancer. The mean QOL score of the participants was 4.13 ± 1.07. The ostomates scored relatively well in both physical (5.68 ± 1.76) and spiritual (4.32 ± 1.36) domains, but the sociological (2.85 ± 1.3) domain score was very low. Permanent ostomates scored significantly higher than the temporary ostomates (P = 0.04).

    CONCLUSION

    The QOL score of ostomates was less than the scores reported in the Western population and living with stoma significantly alters their lifestyle. Therefore, follow-up services and counseling services to the ostomates by the health-care professionals are needed.

    Keywords: Cancer, lifestyle, ostomates, ostomy, quality of life, stoma
  • Maryam Jahanbakhsh, Hasan Ashrafi-Rizi, Majid Jangi, Mohammad Sattari Page 329