فهرست مطالب

Journal of Education and Health Promotion
Volume:9 Issue: 9, Sep 2019

  • تاریخ انتشار: 1398/09/12
  • تعداد عناوین: 24
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  • Nader Aghakhani, Claire Su Yeon Park Page 165

    A spiritual well‑being‑based nursing intervention may boost older adults’ resilience‑based recovery. Its potential contribution may have positive knock‑on effects: controlling skyrocketing healthcare costs; reducing the productive population’s social burden of supporting the older adults; and alleviating a generational conflict. However, healthcare policy‑makers are still skeptical about investing in those healthcare resources which would develop and implement a spiritual well‑being‑based nursing intervention for older adults. It is time for nurse scientists, as front‑line gatekeepers for patients’ omnidirectional well‑being, to escape from thinking within the box by actively addressing first the feasibility, then the direct and indirect effectiveness on actual patient outcomes, and finally the cost efficiency of a spiritual well‑being‑based nursing intervention for the added benefit of easing the decision‑making of healthcare policy‑makers.

    Keywords: Aged, crisis intervention, decision‑making, healthcare costs, spirituality
  • Mohamed H Ahmed Page 166
    INTRODUCTION

    Social factors such as culture, race, education, belief, and living and working environment can be part of the causes of diseases or influence the natural history of a disease.

    MATERIALS AND METHODS

    We have adopted the Harden’s ten questions of curriculum development framework approach to assess the social impact of medical curriculum of Faculty of Medicine, Gezira University (FMUG), among the Integrated Program of Field Training, Research, and Rural Development course. We have assessed the objectives and aims of the course and critically analyzed how these will meet the need for social sciences to be integrated into the curriculum.

    RESULTS

    The recommendations about social and behavioral sciences are well implemented in the curriculum of FMUG. The curriculum promotes early exposure to the community learning. The ten questions of Harden for curriculum or course assessment are satisfactorily covered in the Integrated Program of Field Training, Research, and Rural Development course at FMUG. In addition, the course is also fitting well with criteria suggested recently for increasing competency in social medicine within the medical school curriculum. Importantly, the course is part of the social sciences that well integrated through the duration of the curriculum.

    CONCLUSION

    The Integrated Program of Field Training, Research, and Rural Development course at FMUG satisfy most of the competency for social medicine. Therefore, taking all these factors into consideration, it is possible to suggest that further research is needed to establish whether the model of FMUG in social sciences can be exemplary for universities in Africa and the Middle East.

    Keywords: Curriculum, Faculty of Medicine, social science, Sudan, University of Gezira
  • Akbar Azizifar, Majid Salamati, Fathola Mohamadian, Yousef Veisani, Fariba Cheraghi, Mostafa Alirahmi, Sehat Aibod Page 167
    BACKGROUND

    Difficulty with reading fluency has been increasingly acknowledged as a significant aspect of reading disabilities which is called dyslexia. To investigate this important issue, this research aims to examine the impact of an intervention program on reading fluency of dyslexic students.

    MATERIALS AND METHODS

    The research is an experimental one. The population of the study included all the second‑ and third‑grade male and female students in the city of Ilam, Iran, among whom 68 students were recognized to be dyslexic using a screening inventory reading test (IRT) developed by Shafiei et al., in 2009, they were selected using purposeful sampling method. The students were equally divided and assigned into a control and an experimental group. The experimental group received the Barton intervention program for 10 weeks. The reading fluency test was administered for the measurement of reading fluency in pre‑ and post‑tests. Data were analyzed using descriptive statistics (mean and standard deviation) and paired t‑test.

    RESULTS

    The analysis of the finding through t‑test found a statistically significant difference between the control and experimental groups after the intervention program at P < 0.01.

    CONCLUSIONS

    The results revealed that the students who received the intervention program of the experimental group were improved in terms of their reading fluency.

    Keywords: Intervention, reading disability, reading fluency
  • Nahid Tavakoli, Ghasem Yadegarfar, Hossein Bagherian, Fatemeh Ghasri Page 168
    INTRODUCTION

    Responsibility in the higher educational system requires the universities to be sensitive on students’ needs and expectations. The purpose of the present study was to examine the educational service quality among health information technology (HIT) students in Isfahan University of Medical Science based on the SERVQUAL model.

    METHODS

    This was a descriptive cross‑sectional study and carried out at the Management and Medical Information Sciences faculty of IUMS in 2018. Sixty‑eight undergraduate and postgraduate students of HIT participated in this study. For collecting data, the standard SERVQUAL questionnaire was used. The collected data were analyzed using SPSS version 20 software in descriptive level.

    RESULTS

    Findings showed that there was a positive gap in overall dimensions of educational services quality (mean discrepancy of expectations and perceives). Most mean of service gap was contributed to responsiveness dimension 1.06 (0.98 standard deviation [SD]), following that empathy 1.04 (0.97 SD), assurance 1.00 (0.83 SD), reliability 0.83 (0.76 SD), and the least gap was seen intangibles 0.61 (1.02 SD).

    CONCLUSION

    According to the current gaps in all quality dimensions, as well as high amount of expectations in comparison with students’ perception, it is required to evaluate higher education quality through implementing students’ knowledge skill and creative abilities. Therefore, to improve the quality of educational services at the Faculty of Management and Medical Information, all dimensions, especially the responsiveness dimension, should be considered.

    Keywords: Assessment, educational services quality, health information technology, students
  • Reza Sadeghi, Seyed Saeed Mazloomy Mahmoodabad, Hossein Fallahzadeh, Mohsen Rezaeian, Reza Bidaki, Narges Khanjani Page 169
    BACKGROUND

    Smoking hookahs is one of the most preventable risk factors for non communicable diseases. It is also considered as the gateway to youth addiction. Planning and training to prevent this health problem is considered an important priority. The aim of this study was to determine the predictive factors for preventing hookah smoking (PHS) in the youth of Sirjan city, based on the protection motivation theory (PMT).

    MATERIALS AND METHODS

    This research was a cross‑sectional study conducted in 2018, and participants were chosen by simple random sampling. Data were collected by a researcher‑made questionnaire which was valid and reliable and was designed based on the PMT constructs. This questionnaire was completed by 280 young people in Sirjan, Iran. Data were analyzed through descriptive statistics, Pearson correlation coefficients, and linear regression.

    RESULTS

    Pearson correlation coefficients showed that there was a significant correlation between protection motivation and the structures of the PMT, except for the response cost structure. The strongest correlation was between protection motivation and self‑efficacy (r = 0.502) and fear (r = 0.470). The structures of the PMT predicted 36.5% of PHS, and fear (β =0.27) was the strongest predictor of PHS.

    CONCLUSION

    The results of this study show that the constructs of the PMT can partially predict PHS. This theory can be used as a tool for designing and implementing educational interventions to prevent hookah smoking among the youth.

    Keywords: Hookah, predicting factor, protection motivation theory, youth
  • Marziyeh Raisi, Narges Eskandari, Mohammad Abbasi, Ahmad Rahbar Page 170
    BACKGROUND AND AIM

    Customer’s satisfaction is one of the main goals of the health system because it is effective on the desire of external customers for using the services of the health system and also the quality and quantity of the provided care for the internal customers and eventually the health of the society. Considering the importance of the subject, the present study was designed to determine the customers’ satisfaction with the health system reform plan in the field of health.

    MATERIALS AND METHODS

    Participants in the present content analysis qualitative study were 22 technical and operational managers and 118 health‑care providers, and 15 recipients of health services referring to the health centers in Qom; who individually answered the questions of the interview guide. The gathered qualitative data were analyzed using conventional qualitative content analysis.

    RESULTS

    Customers’ satisfaction with the health system reform plan was categorized into six themes of decreased trust of the caregivers, wasting caregivers’ time in the health units, increased provision of services to the caregivers, decreased motivation for work, occupational burnout, and a sense of petition in the care providers.

    CONCLUSIONS

    Although external customers were satisfied with some services of the health system reform such as providing various free services, follow‑up the patients, and beautification the environment of the health centers; but there are multiple weaknesses in this plan that would cause dissatisfaction in the external and internal customers. More studies seem necessary to better determine the different aspects of the satisfaction in the caregivers and care.

    Keywords: Customers, health, health services, health system, reform plan, satisfaction
  • Sabita Yograj, Anjali Nadir Bhat, Rajiv Kumar Gupta, Geetika Gupta, Leela Kalsotra Page 171
    BACKGROUND

    Advances in scientific research necessitates updating of the curriculum and the Medical Council of India now Board of Governors have proposed a new competency‑based undergraduate curriculum for the Indian Medical Graduate. The authors wanted the views of medical students about basic sciences teaching in the form of feedback, their perceptions and attitudes toward the basic sciences and their opinions about the relevance of these subjects, and finally any ideas about improvement in teaching of basic sciences.

    MATERIALS AND METHODS

    The present cross‑sectional study was conducted in two medical colleges of Northern India and 250 medical students from each medical school were the study participants. Students of the 1st year were not included, but interns were included. A pretested questionnaire having twenty questions with answers in the form of “yes” and “no” was used. Chi‑square was the test of significance.

    RESULTS

    Almost all the participants considered the basic sciences as an integral part of medical curriculum and a higher number of Government Medical College respondents opined that their knowledge made it easier to understand clinical subjects (P < 0.05). However, higher proportion of ASCOMS (Acharya Shri Chandra College Medical Sciences) of respondents emphasized that the focus should be on clinical subjects and that current student–teacher ratio be increased (P < 0.05). Majority of the respondents labeled Anatomy having the immense syllabus, while Physiology was designated as more relevant and having a better recall during clinical discourse (P > 0.05).

    CONCLUSION

    Basic sciences lay strong foundation for subsequent clinical learning. Medical education is best taught with hybrid use of lectures, tutorial, group discussions, audio‑visual aids, and integrated teaching. The new proposed competency‑based curriculum and the Attitudes, Ethics and Communication Module are likely to improve the overall medical education and health‑care scenario.

    Keywords: Basic sciences, medical curriculum, medical students, perspectives
  • Gholamreza Mohammadi, Maedeh Tourdeh, Abbasali Ebrahimian Page 172
    BACKGROUND

    Simulation is one of the strategies which are suggested and used to reduce stress and anxiety in clinical student education. This study aimed to determine the effect of simulation‑based training method on psychological health promotion in operating room students in their educational internships.

    MATERIALS AND METHODS

    This study was a clinical trial. Research population was operating room students at Semnan University of Medical Sciences. A demographic questionnaire and the Spielberger’s Situational Anxiety Inventory were used as data collection tools. Students were divided into two intervention and control groups randomly. Situational anxiety was measured before the intervention and on the 1st and the last days of the internship. The data from the two groups were compared by using the Mann–Whitney and Friedman statistics at the significant level of 0.05.

    RESULTS

    There was a significant difference between students’ situational anxiety scores in the experimental and control groups on the 1st day of internship after education by simulation (P = 0.481). There was a significant difference between the students’ anxiety scores in the two groups on the last day of the internship (P = 0.008).

    CONCLUSION

    Simulation of the operating room environment before the internship cannot reduce the operating room students’ situational anxiety on the 1st day of internship, but it can reduce their situational anxiety during the internship and significantly reduce it at the end of internship compared to those who are not in the simulated environment.

    Keywords: Anxiety, education, premedical, simulation training, students
  • Ahmadreza Raeisi, Mostafa Amini Rarani, Fatemeh Soltani Page 173
    BACKGROUND

    The patient handover process is in fact a valuable and essential part of the care processes in the hospitals. This can be a factor in increasing the quality and effectiveness of medical care. Incorrect and incomplete handover can increase the percentage of errors and cause serious problems for patients. The aim of this study was to identify the handover challenges concerning safety and quality of health services.

    MATERIALS AND METHODS

    A systematic review was conducted according to the Preferred Reporting Item for Systematic Reviews and Meta‑analyses guideline. The key words “challenges of patient handover” or “challenges of patient handoff” were used in combination with the Boolean operators OR and AND. The ProQuest, Ovid, Doaj, Magiran, SID, Scopus, Science Direct, PubMed, and ISI were searched.

    RESULTS

    A total of 263 articles were extracted, and 20 articles were selected for final review. The results of selected articles indicated that there are various challenges such as communication, noncoordination, nonuse of checklist, poor management, time management, and other things. These studies reported that communication was the main challenge of handover process.

    CONCLUSIONS

    Hospitals try to provide a lot of services to the patients and other customers in a safe and healthy environment. Lack of communication among the incoming and outgoing nurses in handover process is one of the main causes of reduced safety and quality of services and patient dissatisfaction.

    Keywords: Challenges, hand off, hand over, nurses, safety
  • Farah Shahraki Sanavi, Naziasadat Nasseri, Fariba Shahraki Sanavi, Hamid Salehiniya Page 174
    BACKGROUND

    Educational justice is one of the fundamental dimensions of social justice, and the progress of each society depends on its realization. Since students are engaged in the educational process, recognizing their viewpoints can provide useful guidance to correct existing problems. The purpose of this study is to investigate the observance of educational justice from the viewpoint of medical students in southeastern Iran.

    METHODOLOGY

    This cross‑sectional study was carried out on 200 students of Zahedan University of Medical Sciences, southeastern Iran, in 2017 by stratified sampling. The tool for measuring organizational justice was a questionnaire. The validity of the questionnaire was confirmed by content validity method, and its reliability was confirmed by Cronbach’s alpha (0.8). Descriptive statistics (frequency and percentage), Chi‑square test, and analysis of variance (ANOVA) test were used to analyze data.

    RESULTS

    The mean age of students was 21.7 ± 2.91 years. Fifty percent of students assessed the educational justice as good to excellent, and based on a general score, educational justice was observed in 73.2% of cases. The one‑way ANOVA showed a significant difference between the scores of educational justice from the viewpoints of students in different faculties of Zahedan University of Medical Sciences (P < 0.001).

    CONCLUSION

    According to the results, students’ needs for achieving educational justice have been identified in this study. This study can provide useful guidance to correct existing problems and help policymakers in Zahedan University of Medical Sciences to achieve a full educational justice.

    Keywords: Educational justice, Iran, students
  • Fatemeh Ghorbani Marghmaleki, Zahra Mohebbi Dehnavi, Marjan Beigi Page 175
    INTRODUCTION

    Mental health is one of the focuses of the health assessment of different communities and plays an important role in ensuring the dynamism and efficiency of each community. Pregnancy is one of the most sensitive periods, in which mental health is effective. The mental health of individuals is the result of the interaction of cognitive‑emotional ordering strategies and proper evaluation of stressful situations. The aim of this study was to determine the relationship between cognitive emotion regulation and the health of pregnant women.

    MATERIALS AND METHODS

    This is a descriptive and cross‑sectional study that was carried out on 200 pregnant women who were covered by Navab, Amir Hamzeh and Motahari centers in Isfahan in 2017 by available sampling method. The instrument was the Beck Depression Inventory, Goldenberg Health, and Emotional Cognitive Order. Finally, the data were analyzed using the SPSS software.

    RESULTS

    The mean age of pregnant mothers participating in the study was 26.66 ± 6.09 years. The results of data analysis showed a significant positive correlation in relation to blaming others and disaster with physical health, blaming others and rumination and catastrophes with anxiety, disaster with social health, blaming others and rumination and catastrophes with depression, and also blaming others and rumination, catastrophizing, and positive re‑focusing have a significant positive correlation with total health score.

    CONCLUSION

    Regarding the relationship between mental health and cognitive dysmenorrhea during pregnancy, pregnant women carers can help with pregnant women by conducting educational programs on health promotion and strive to maintain mental health and improve their quality of life. Consequently, they will ensure the mental health of their future children.

    Keywords: Cognitive emotion regulation, pregnancy, pregnancy health
  • Malihe Farid, Zahra Amirkhanzadeh Barandouzi, Nasimeh Setayesh Valipour Page 176
    BACKGROUND

    Adolescent girls experience physical, psychological, and social changes during puberty. Lack of sufficient information, skills, and readiness to overcome this stressful situation make them vulnerable. The present study aims to assess the level of knowledge, attitude, and strategy used for coping with puberty crises of female secondary school students in Karaj, Iran.

    MATERIALS AND METHODS

    Five‑hundred and seventy female secondary school students from Karaj, Iran participated in this cross‑sectional study. Knowledge, attitudes, and coping strategies of adolescents about puberty were evaluated using various questionnaires. The obtained data were analyzed using Chi‑square, Fisher’s exact, Kruskal–Wallis, Mann–Whitney, and Spearman tests.

    RESULTS

    The average age of participants was 15.28 ± 1.58 years old. About 85.1% of the participants had high knowledge about puberty and 66.7% had a good attitude toward it. Nearly, 54.2% of the girls used the avoidance‑oriented coping strategy. There was no significant relationship between knowledge and attitude regarding selective strategies to cope with stressful situations in puberty.

    CONCLUSION

    According to the results, continuous training in secondary schools is necessary to improve adolescents’ knowledge and attitudes toward puberty. Moreover, more training is required to change the dominant avoidance‑oriented coping strategy to a task‑oriented approach, especially at the first‑grade level in secondary school.

    Keywords: Adolescent, attitude, coping strategy, girl, knowledge, puberty
  • Meena Kolar Sridara Murthy, Aruna Rose Mary Kapanee, Geetha Desai, Santosh Kumar Chaturvedi Page 177
    CONTEXT

    The knowledge about mental health problems among the general public is comparatively quite low. The pilot study was conducted with an aim to increase the knowledge of the day‑to‑day mental health problems which people can have among the mass.

    AIMS

    The aims of this study are (1) to assess the knowledge and attitude about mental health problems of the selected sample and (2) to build the capacity in providing first aid for mental health to the selected sample through training. SETTINGS AND DESIGN: A cross‑sectional study was used in assessing the knowledge and skills of the participants of the first aid for mental health problems. It was conducted in the institute itself.

    SUBJECTS AND METHODS

    A total of 89 participants were taken to participate in the cross‑sectional study. Using a semi‑structured self‑administered questionnaire, a brief training, and a feedback form, capacity building for first aid for mental health problems was provided. STATISTICAL ANALYSIS USED: The questionnaires were analyzed using descriptive statistics.

    RESULTS

    The capacity building program for first aid for mental health problems appears to be effective in improving the knowledge and attitude with regard to the mental health problems. The findings from the program indicated lack of knowledge in understanding of mental health, knowledge of causation, and treatment of mental health problems. Feedback of the training program indicated that it improved the ability of the participants in recognizing persons undergoing mental health problems and brought about a change in their beliefs about mental health, attitudes, and need for prompt referral.

    CONCLUSIONS

    The program was successful in increasing the confidence of the participants in providing help to someone with a mental health problem and referring to appropriate mental health professional. This shows that there is an immediate need for empowering general public with knowledge and skills to provide support to people with mental health problems.

    Keywords: Attitude, capacity building, first aid, knowledge, mental health
  • Hojatollah Yousefi, Elaheh Sadat Ziaee, Parastoo Golshiri Page 178
    AIMS

    Although chronic diseases are the most common and expensive health problems, they are preventable too. Nurses play a key role in the care of these patients. One of the important roles of nurses is consultation role. Due to the high impact of nurse consultant role on health promotion and also the fact that this role is not fully understood in Iran, this study aims at clarifying the role of nurse consultant.

    MATERIALS AND METHODS

    This is a qualitative study with content analysis approach conducted through semi‑structured interviews in Isfahan University of Medical Sciences from April to December 2017. A total of 35 participants (11 patients, 9 nurses, 6 faculty members, 4 postgraduate students, and 5 nursing managers) were included in the study. Sampling was done based on purposive sampling method, and participants were asked to express their opinions about nurse consultant.

    RESULTS

    In this article, we discussed the following three categories and seven subcategories: (1) nursing consultation as a treatment facilitator (nursing consultation as a way to reduce the treatment course, nursing consultation as a way to reduce complications, and nursing consultation as a way to reduce costs); (2) professional performance in nursing consultation (nursing consultation based on problem‑solving and evidence‑based practice and management and teamwork in nursing consultation); and (3) prerequisites for the nursing consultation role (supporting nurses and introducing the role in decision‑making units and creating demand).

    CONCLUSION

    Nursing consultation has an essential role in patient health promotion. Therefore, it is better that nurses and other health‑care team should be familiar with this vital role.

    Keywords: Chronic diseases, consultant nurse, health promotion
  • Noushin Mobaraki Asl, Zahra Ghavami, Mehdi Khanbabayi Gol Page 179
    INTRODUCTION

    Cultural competence is the main component of cultural care; therefore, it is necessary to be aware of its levels. The lack of a suitable tool that can measure cultural competence levels among midwives led us to carry out the present study aiming to develop and validate a cultural competence questionnaire for health promotion of Iranian midwives.

    METHODOLOGY

    This methodological study was performed on 302 midwives selected through three‑stage cluster sampling method in 2018 in East Azarbaijan Province. The initial tool was designed after qualitative study and searching similar studies. Then, the tool validity was assessed through evaluating the face and content validity in midwives and performing survey and psychometrics. Finally, the data were statistically analyzed by SPSS version 19 through exploratory factor analysis, item analysis, Cronbach’s alpha coefficient, and Pearson correlation, at the significant level of <0.05.

    RESULTS

    The initial tool was constructed with 42 items in the five‑point Likert scale. By eliminating 9 items during face and content validation and 6 items during factor analysis, the final 25‑item questionnaire was developed in five areas of theoretical and practical learning, clinical application, cultural skill, cultural excellence, and cultural competence. According to Cronbach’s alpha, reliability of the tool was at a good level (0.889) with a confidence interval of 0.95 (P < 0.001).

    CONCLUSION

    The cultural competence questionnaire for Iranian midwives, with five‑factor verification and acceptable validity and reliability can be used in studies considering the components of Iranian culture.

    Keywords: Assessment tool, cultural competence, Iran, midwife
  • Zahra Khazir, MohammadAli Morrowati Sharifabad, AliAkbar Vaezi, Behnaz Enjezab, Hossein Fallahzadeh, Fatemeh Yari Page 180
    BACKGROUND

    Health beliefs play an important role in people’s willingness to participate in health‑promoting behaviors. Given the role of beliefs in women’s function and the importance of the benefits of mammogram, and because the predictors of a behavior are a major prerequisite to codification of an effective prevention program, the present study was conducted with the aim of predicting mammography based on Health Belief Model (HBM) in women in Khorramabad.

    Materials and Methods

    In this cross‑sectional study, 262 women referring to health centers in Khorramabad, Lorestan province, in 2018, were selected by randomly sampling. The data collection tool was a four‑part questionnaire including demographic information, knowledge on breast cancer and mammography, Champion’s Health Belief Model, and Champion’s Self‑Efficacy Questionnaire for Mammography. Validity and reliability of the tool were investigated and confirmed. Data were analyzed by version 16 of SPSS software using descriptive statistics, Chi‑squared test, and multiple logistic regression.

    RESULTS

    The mean (standard deviation) age of the participants was 49.26 (±7.79) years. Seventy‑nine (30.85%) of the 262 participants reported mammography. Constructs’ sensitivity, benefits, barriers, and perceived self‑efficacy were significantly different in terms of performing mammography (P < 0.05). Participants with a history of breast cancer (odds ratio [OR] = 11.18, 95% confidence interval [CI] = [3.73–33.46]) had lower perceived barriers (OR = 3.54, 95% CI= [1.77–7.09]), were more likely to undergo mammography than women with no family history of breast cancer, and had moderate‑to‑high perceived barriers (P < 0.001).

    CONCLUSION

    The results of this study indicate that health managers are required to pay more attention to training and promoting screening methods. Understanding the barriers to mammography in women by managers can help design and implement effective programs that enhance mammography in women.

    Keywords: Breast cancer, breast cancer screening, Health Belief Model, mammography
  • Noreen Maqbool Bokhari, Mubashir Zafar Page 181
    PURPOSE

    There are different learning styles adopted by medical education participants. The aim of this study is to investigate which learning styles and approaches are preferred to be learnt by medical students.

    METHODOLOGY

    It is a cross‑sectional study; 320 students were selected through stratified random sampling. Visual, auditory, read/write, and kinesthetic questionnaire was used which measures dimension of learning styles and approaches.

    RESULTS

    Majority of medical students have preferred (32%) for Kinesthetic modality; 26% for Aural; Visual 21% and Reading/Writing 21%. The majority (53%) preference for Bimodal modality; 41% for Unimodal; 5% for Trimodal and 1% for Multimodal.

    CONCLUSION

    Medical education participants commonly used kinesthetic styles, and there is no difference among different year of study; but, in learning approach, multimodal has increased as year of studying increased. It suggests that curriculum of medical education should be revised according to result of research.

    Keywords: Learning, medical education, multimodal, styles, visual
  • Marzeiyeh Feizi, Mahboobe Gholami, Akram Poosti, Fatemeh Azizi Mayvan, Zahra Kamali, Minoo Toghraee Page 182
    BACKGROUND

    Growing interest in issues of attachment, sociocultural, psychological, and above all clinical perspectives is also reflected in the emergence of research on “attachment style and parental parenting style in referrals to addiction treatment centers.”

    METHODS

    This was a cross‑sectional study. Three health centers were selected randomly from among the health centers of Neyshabur city in 2015–2016 year. The sampling was done so that all individuals who had the characteristics of the research unit and had the consent to participate in the study were justified by the researcher and completed questionnaire form. We used Chi‑square, one‑way analysis of variance, Mann–Whitney, and Kruskal–Wallis tests.

    RESULTS

    In the present study, safe attachment scores in children with healthy parents were significantly more than children with addicted parents.

    CONCLUSION

    Addiction has an important role in reducing attachment to children, and because this decrease in attachment has dangerous consequences in child’s life.

    Keywords: Health care, object attachment, substance abuse
  • Atefeh Khajeh, Hossein Molavi Vardanjani, Alireza Salehi, Negin Rahmani, Sajad Delavari Page 183
    INTRODUCTION

    Health systems aimed to increase health utilization. Habits and behavior about using health facilities, which is called health-seeking behavior, are different among different cultures and influenced by different factors. The present study is aimed at investigating Iranian Southern population health‑seeking behavior and its influencing factors.

    MATERIALS AND METHODS

    A sample of 397 people was selected using proportional stratified random sampling for this cross‑sectional study. They were asked to fill a questionnaire about their health‑seeking behaviors (seeking treatment, inattention to treatment, and self-medication) and socioeconomic factors. Data were analyzed using regression models including linear, ordinal, and logistic regressions.

    RESULTS

    Near 80% of participants reported self‑medication and most of them prefer public hospitals as their first point of contact with health system compared to others such as family physician. Using linear regression revealed seeking treatment has significant relationship with age (P = 0.037), living place (P = 0.018), and having complementary insurance (P = 0.013). Self‑medication behavior has relation with age (P = 0.015), gender (P = 0.039), education years (P = 0.031), living place (P = 0.005), having complementary insurance (P = 0.001), and satisfaction with health‑care providers (P = 0.003) in logistic regression. Using ordinal regression, it was found that inattention to treatment has a relation with education years (P = 0.044), living place (P = 0.042), having complementary insurance (P = 0.049), and severity of illness (P = 0.031).

    CONCLUSION

    Southern population does not accept family physician as the first point of interaction with the health system, and they prefer to go to public hospitals directly. Moreover, self‑medication is a prevalent behavior among the population and thus their acceptance of health care is low. Based on the findings, it can be suggested providing more satisfying health care, increasing insurance coverage, and informing population could lead to better utilization of health‑care services.

    Keywords: Acceptability of health care, healthcare‑seeking behavior, health‑care utilization, health facilities, Iran, patient acceptance of health care, self‑medication
  • Suraj Reddy Loka, Dolar Doshi, Suhas Kulkarni, Pavan Baldava, Srilatha Adepu Page 184
    INTRODUCTION

    Self‑directed learning is a vital principle promoted in health profession’s education, particularly with the increasing use of online learning methods. Likewise, reflection has been recognized as an indispensable and formidable concept for learning which plays a positive role in fostering students’ self‑reflection, critical thinking, and development of professional values and skill. Hence, the present study was undertaken to identify the effect of reflective thinking on academic performance among undergraduate dental students.

    MATERIALS AND METHODS

    Reflective thinking was assessed among 2nd‑, 3rd‑, and 4th‑year undergraduate dental students and interns of a dental college and hospital in Hyderabad. Reflection questionnaire assessed habitual action, understanding, reflection, and critical reflection on a 5‑point Likert scale. The percentage of marks obtained in the last university examinations was considered for academic performance. The completed questionnaires were analyzed using the Statistical Package for the Social Sciences software (SPSS version 20). P < 0.05 was considered statistically significant.

    RESULTS

    A total sample of 263 individuals comprising 188 (71.5%) females and 75 (28.5%) males participated in the study. Our findings showed that the four scales of reflective thinking, such as habitual action (P = 0.0001*), understanding (P = 0.02*), reflection (P = 0.02*), and critical reflection (P = 0.01*), showed statistically significant difference based on the year of study. However, no difference based on gender was noted. Reflection (17.2 ± 2.41) and critical reflection (16.3 ± 2.77) mean scores were highest among 4th years. Higher understanding (17.83 ± 1.78) and reflection (17.33 ± 2.01) mean scores were observed among students who attained more than 75% in their academic performance.

    CONCLUSION

    Thus, the present study emphasizes the role of reflective thinking and its significance in academic learning process.

    Keywords: Academic performance, dental students, reflective thinking
  • Foruzandeh Sabaghpoor, Shahnaz Kohan, Pejman Aghdak, Marjan Beigi Page 185
    INTRODUCTION

    The healthcare program has opponents and supporters with its multiple policies and also its difficult implementation, which requires that its barriers and problems be addressed comprehensively and extensively. This study was conducted aimed to determine the service provision challenges by healthcare providers, from their point of view, in selected comprehensive health centers of Isfahan.

    MATERIALS AND METHODS

    The present study is a descriptive‑analytic one. One‑hundred and ninety‑seven healthcare providers were selected by census sampling method from the population of female healthcare providers in Isfahan comprehensive health centers in 2017. The data collection tool was a researcher‑made questionnaire in the field of individual–professional, managerial–organizational, and executive challenges. Data analysis was done by repeated measures ANOVA and post hoc test.

    RESULTS

    The findings indicated that there was a significant difference between the mean score of individual–professional, managerial–organizational, and executive challenges (P < 0.001) from the point of view of healthcare providers. According to least significant difference post hoc test, the mean score of individual challenges was significantly lower than that of managerial and executive challenges (P < 0.001). However, there was no significant difference between the mean score of managerial–organizational and executive challenges (P = 0.46).

    CONCLUSION

    Based on the results, healthcare providers have put forward several challenges during the implementation of the healthcare program. Meanwhile, executive and managerial challenges have been considered more than individual challenges. Considering that this could lead to improper service provision to the clients, the role of policymakers in this program to remove obstacles and to provide satisfaction to healthcare providers is emphasized.

    Keywords: Challenges, healthcare providers, health services, Iran, midwifery, pregnancy, public health
  • Sathish Rajaa, Shanthosh Priyan, Subitha Lakshminarayanan, Ganesh Kumar Page 186
    BACKGROUND

    Health promotion is the process of enabling people to increase control over their own health. Community involvement in social and environmental interventions tends to improve people’s health and quality of life. Self‑help groups (SHGs) primarily focus on microfinancing, thereby acting as a catalyst in bringing backward society to the mainstream. They possess huge potential to influence the health of the community.

    OBJECTIVE

    The objective of the study is to assess the willingness among SHGs for the involvement in health promotion activities and to assess their health information needs.

    MATERIALS AND METHODS

    A community‑based, cross‑sectional study was conducted during September 2017 in rural Puducherry. All 86 SHGs in four selected villages were covered, and their leaders were interviewed using a structured questionnaire on functioning of SHGs and their health information needs. Willingness for health promotion activities was rated on an interest scale (1–100).

    RESULTS

    Among the 86 heads of SHGs interviewed, 81 SHGs (94.1%) were registered. They were mainly involved in microfinancing. Health information needs expressed were cancer detection (45%), diabetes (60%), hypertension (56%) and vector‑borne diseases (63%). When asked to rate their willingness on an interest scale for health promotion activities, nearly 64% showed a great interest (i.e., score > 60). Majority were willing to work for noncommunicable disease‑related activities such as provision of drugs (86%) and for screening of various cancers (84%).

    CONCLUSION

    This study has shown that majority of SHG members have expressed willingness for the involvement in health‑related activities, thereby can be utilized as an important resource for health promotion in rural areas.

    Keywords: Health promotion, self‑help groups, willingness
  • Hasan Ashrafi Rizi, Rahele Samouei Page 187
    INTRODUCTION

    Reviewing articles are one of the most important methods for maintaining and improving the scientific quality of research outputs, especially in the field of health and medicine, and are often accompanied with various challenges.

    AIM

    The current study was carried out to Health Promotion in the Review Process of the Health Scientific Journals according to Explanation of Experts.

    MATERIALS AND METHODS

    This study has a qualitative approach and was carried out using the content analysis method. Data were gathered through semi‑structured interviews with experts with direct and related experiences with health scientific journals including editors in chief, internal managers, editorial boards, authors’ council and members of national journal commission with at least 2 years of continuous related work experience in journals and review of at least 10 articles. Sampling was carried out using purposeful snowball sampling, and data were analyzed using content analysis method. Lincoln and Guba tests were used to determine the validity and reliability of the analysis based on the following four criteria – credibility, transferability, certainty, and verifiability.

    RESULTS

    Experts’ opinions were categorized based on criteria for reviewer selection with three dimensions of technical expertise, ethical behavior, and orientation and order; reviewer selection methods including emphasis on others and emphasis on self; and review problems in the Iranian Health Science and Research Journals including incentive system, reviewer characteristics, and structural problems.

    CONCLUSION

    Findings of the current study are usable for all Iranian Health Scientific Journals, editors, editors in chief, and internal managers as well as lawmakers in the area of scientific research.

    Keywords: Articles, health promotion, health scientific journals, review process
  • Vinay Suresan, Avinash Jnaneswar, SP Swati, Kunal Jha, Bala Subramanya Goutham, Gunjan Kumar Page 188
    INTRODUCTION

    Inequalities persists in distribution, accessibility, and utilization of oral health services between urban and rural population. One approach to lessen this inequality is by incorporating rural outreach programs in the academic curriculum of health‑care professionals.

    OBJECTIVES

    The objective of the study was to evaluate the effectiveness of outreach programs on academic development, personal development, and civic responsibilities of dental students and also to assess the changes in the domain scores within and between genders postintervention.

    METHODOLOGY

    The study population consisted of 100 dental students. The study methodology followed a before and after without control informal experimental study designs. At baseline, the participants were administered pretested structured questionnaire developed by D. Diaz Gallegos. Intervention involved posting participants in various rural outreach activities and academic field visits in various public health installations. A postintervention questionnaire developed by Anu F. Shinnamon et al. was administered to assess the change from the baseline. The change in domain scores was assessed using paired and unpaired t‑test appropriately. P ≤ 0.05 was considered as statistically significant.

    RESULTS

    The baseline scores of academic, personal, and civic domains were 6.05 ± 2.44, 8.04 ± 2.84, and 6.36 ± 2.23 which increased to 6.52 ± 2.10, 13.56 ± 3.44, and 8.55 ± 2.71 postintervention, respectively (P ≤ 0.05). When comparing within genders, there was increase from the baseline, and this change in the scores postintervention was statistically significant (P = 0.001). The mean scores of all three domains between genders were statistically insignificant.

    CONCLUSION

    The outreach programs developed and enhanced the subject’s academic skills, leadership qualities, self‑confidence, communication skills, managerial skills, and responsibilities toward the rural community.

    Keywords: Academic, community dentistry, dental outreach, dental students, program evaluation, social responsibility