مجله آموزش بهداشت و ارتقای سلامت ایران
سال دهم شماره 1 (پیاپی 37، بهار 1401)

Metabolic syndrome is one of the biggest potential public health problems in the world and a risk factor for non-communicable diseases, especially cardiovascular disease and diabetes. The aim of this study was to determine the effect of self-management training based on cognitive-behavioral group therapy on the components of metabolic syndrome in adults.

The present study was a randomized clinical trial. The sample size consisted of 80 adults 30 to 70 years old with metabolic syndrome who were randomly assigned to intervention and control with 40 adult in each group. Measurement of waist circumference, systolic and diastolic blood pressure, fasting blood sugar, blood triglycerides and high-density lipoprotein were performed and recorded in two stages before the intervention and three months after the intervention. Training sessions were conducted in 8 sessions for the intervention group. Data were analyzed with descriptive statistics and Chi-square, independent t-test and analysis of covariance.

The results showed that self-management training based on group cognitive-behavioral therapy in adult with metabolic syndrome had the most significant effect on the components of the metabolic syndrome, including reduction of fasting blood sugar with an effect size of 0.28, reduction of triglyceride with 0.19, increase of HDL with 0.12, decrease of systolic blood pressure 0.15 and decrease of waist circumference with 0.10 (P <0.05), But it did not significantly reduce diastolic blood pressure (P <0.05).

Considering the effectiveness of self-management training based on cognitive behavioral group therapy on improving the components of metabolic syndrome, it is suggested that the identification of adults with metabolic syndrome be considered and effective educational interventions such as self-management training based on cognitive behavioral therapy while controlling the components of this risky syndrome and self-care of metabolic syndrome in adults, reduced the risk of non-communicable diseases morbidity.

A Pap smear test is one of the most effective procedures utilized for cervical cancer (CC) screening purposes. Nevertheless, many women do not like to do such a test. The present study aimed to monitor the impact of an educational intervention developed based on the expanded Protection Motivation Theory (PMT) on CC screening behavior.

A quasi-experiment was conducted on 200 women referred to Karaj health centers, Iran. The participants were randomized into experimental and control groups. The data was collected by a Standardized questionnaire including demographic characteristics, the constructs of the PMT, and a self-administered Emotional Social- Support questionnaire (ESS). They filled the questionnaire before, after, and at 6-months follow-up. Eight educational sessions based on the model were held for the experimental group via lecture, group discussions and role play. The data were analyzed by SPSS (Ver. 24) and repeated measures ANOVA and Chi-square test.

In the pre- intervention and post-intervention stages, the mean score of perceived susceptibility from 8/07±3/28 to 11/83±1/99, perceived severity from 12/64±3/46 to 15/19± 2/85,response efficacy from 12/66±5/37 to 16/06±3/6, self-efficacy from 25/94±5/38 to 29/68±4/68,emotional social support from 27/01±7/16 to 31/46±5/76 and intention from 11/01±2/14 to 13/42±1/65 increased and this difference was statistically significant (p<0/05). The mean score of fear from 10/37±2/29 to 5/54±2/76 and response cost from 6/62±2/13 to 3/97±1/69 decreased and that was statistically significant (p<0/05). No significant difference was observed in the control group. Besides, the Pap smear test was increased after the educational intervention in the post-test and follow-up in the experimental group (p<0/05).

Based on the findings, PMT and ESS can be used as a framework for designing educational programs to promote CC screening behavior.

The aim of this study was to translate and psychometrics the Cervical Cancer Screening Self-Efficacy Scale.

A standard forward-backward translation method was used to develop the Persian version of the cervical cancer screening self-efficacy scale. The validity of the questionnaire was assessed through face validity (qualitative and quantitative), content validity (qualitative and quantitative) and construct validity (exploratory and confirmatory factor analysis) in 400 women. The reliability of the questionnaire was determined by test-retest method (calculation of intra-class correlation coefficient) and also internal correlation (calculation of Cronbach-alpha coefficient). Statistical analyzes were performed by SPSS24 and lisrel 8.8 software.

The range of calculated CVR and CVI of scale items was (0.92-1.00) and (0.92-1.00) impact score of all items was more than 1.5. The range of Cronbach's alpha and ICC were calculated for the reliability of scale items respectively (0.66 – 0.85) and (0.846- 0.977). The three factors of "Confidence in controlling tangible barriers of Pap Smear test ", "Confidence in following Pap Smear test Instructions" and "Confidence in controlling intangible barriers of PAPS". In confirmatory factor analysis the fitted model based on these factors explained 58.29%of the self-efficacy in performing Pap Smear test. These factors confirmed by CFA (X2/df =3.3, CFI=0.91, GFI= 0.96, RMESA=0.081).

  Psychometric of Persian version of the cervical cancer screening self-efficacy scale with 8 items and 3 domains has proper validity and reliability to evaluate the cervical cancer screening self-efficacy in females.

This study was conducted with the aim of comparision study of the effect of educational intervention based on health belief model using two methods of web-based multimedia education and booklet on adherence to mammography in women 40 years and older in Bushehr.

This study is a quasi-experimental study that was performed on 126 women 40 years and older (three groups, each consisting of 42 people). Educational content was designed based on the Health Belief Model. Data gathered by questionnaire before and two months after the educational intervention and, were analyzed using chi-square test and repeated measures analysis of variance in SPSS v.22.

after Intervention, comparison of the three groups showed that the mean score of knowledge in both Web-Based and booklet groups increased compared to the control group. Perceived benefit, susceptibility, perceived severity and health motivation also increased significantly after intervention in the web-based intervention group, but no significant change was observed in control groups. Perceived barriers also decreased in the web-based group after intervention. Adhering to mammography in the web-based intervention after training was significantly higher than the booklet and control group.

The results of this study showed that educational intervention based on psychological structures and web-based can be useful in improving women's beliefs about mammography behavior and promoting their behavior. It seems that the use of web-based teaching methods is more acceptable and effective than previous methods such as booklets. Therefore, designing studies using modern web-based educational methods is suggested.

There is little knowledge about the underlying motivations that cause caregivers to care for the patient or not. This study aimed to identify the motivations of providing care in family caregivers of hemodialysis patients

This qualitative study was conducted using the conventional content analysis method. Fifteen family caregivers of hemodialysis patients were enrolled in the study via purposive with a maximum variation sampling method. The setting was hemodialysis wards of Tehran teaching hospitals. Data were collected via semi-structured interviews. The analysis was performed using conventional content analysis with MAXQDA version 10. To ensure the trustworthiness of the data, the criteria of Credibility, Dependability, Transferability, and Confirmability were taken into account

Fifteen participants (eight women and three men) were interviewed. The majority (eight of them) were spouses. Totally 200 codes, 12 subcategories, four generic categories, and two main categories were extracted. The main categories included Social Motivation (including two generic categories: providing care influenced by norms and culture and providing care inspired by social influence) and Internal motivation (including two generic categories: religious-spiritual motivation to provide care and emotional-moral motivation to provide care).

To benefit from the valuable capabilities of family caregivers, must pay attention to their social and internal motivations in providing care.  The findings of this study can be helpful for future planning to strengthen internal motivations and improve and guide the external motivations of caregivers.

A health-promoting lifestyle is an essential factor in reducing related health problems and increasing the quality of life. The aim of this study was to determine the health-promoting lifestyle and related predictors in the employees of Tobacco Company.

The present study was a cross-sectional (descriptive-analytical) that performed on 283 employees of a tobacco company in Tehran. All employees of the tobacco company had a chance to enter the study and after considering the inclusion and exclusion criteria, eligible participants entered the study and those who signed the written consent were investigated. Data were collected through a socio-demographic characteristics questionnaire and a health-promoting lifestyle questionnaire and were analyzed by SPSS software version 19 (IBM SPSS Statistics 19.0). P<0.05 was considered significant.

The mean, standard deviation of the total health-promoting lifestyle score was 131.53±21.17. The lowest and highest mean scores were related to the subscales of physical activity 18.50±5.46 and spiritual growth 25.61±5.03, respectively. Modified GLM results showed that smoking and work experience variables were predictors of health-promoting behaviors. So that health-promoting behaviors in smokers are 6 times less than non-smokers (OR: 6.79, CI95%: -13.15—0.42), for one year increase in work experience, 7.7% more health-promoting behaviors (OR: 0.77, CI95%: 0.09—1.46) and in illiterate people was very low compared to academics (OR: -59.61, CI95%: -117.70—1.53).

Considering the effects of some individual factors such as work experience and smoking on health-promoting lifestyle, we can conclude that educational programs to increase lifestyle awareness and its effects on physical and mental health as well as program implementation - Health education programs focus on increasing physical activity among employees are essential.

Health promotion standards are designed to meet the physical, mental and social needs of patients, staff and the community. So, this study aim was investigated the preparedness to implementation of health promotion hospital(HPH) standards from nurses’ perspective in the military hospitals.

This descriptive-analytical and cross-sectional study was conducted in 2019. 400 nursing staff of three selected military hospitals in Tehran selected by quota and simple random sampling. The data collection tool was a valid and reliable questionnaire of the WHO regarding HPH standards in 5 dimensions. The data were analyzed by SPSS 22 using ANOVA test at 95% CI. 

The mean and standard deviation score for the management policy, patient evaluation, patient information, and interventions, providing a healthy workplace, continuity, and cooperation, and the total score were (38.71 ± 8.23), (17.37 ± 4.61), (16.3 ± 10.99), (32.8 ± 53.58), (41.55 ± 10.30) and (146.26 ± 29.13), respectively. The mean differences for the total score and two dimensions of patient management, and evaluation policy were not statistically significant (p> 0.05). The mean differences for the three dimensions of information and patient interventions, creating a healthy work environment, continuity and cooperation were statistically significant (p <0.05).

There was necessary preparation to establish the HPH standards in military healthcare centers from nurses’ perspective. These hospitals have proper planning in this field. To improve the preparedness of HPH standard implementation, it is essential to be given priority to the three dimensions of creating a healthy work environment, patient evaluation, and continuity and cooperation.

Inflammatory bowel disease (IBD) is a recursive chronic disease with no definitive cure. This study was conducted to explore the effectiveness of interventions that aimed to empower patients to improve the consequences of IBD. 

In a systematic review, we searched PubMed, Web of Science, Scopus, and Embase databases, from 2000 to May 2021, using "self-care OR empower", "self-efficacy OR self-management", "self-control OR self-confidence OR self-determination", "inflammatory bowel disease OR IBD OR Crohn disease OR ulcerative colitis" as keywords. Two reviewers separately performed the search, screening of the studies. 

In total, 13 papers were finally included in the study. Most of the interventions aimed to increase patients’ awareness of the effects of the disease and how to prevent its recurrence, foster self-management, self-care, and stress management skills. The majority of interventions were made through consultation, lecture, textual educational material, telephone calls, and computer-based communication. The most prevalent positive effects of the interventions were reduced anxiety, fewer problems with the disease, fewer visits to the hospital, and increase the quality of life. 

the educational interventions based on empowerment can be effective in improving the adverse effects of IBD. These interventions can positively affect patients’ clinical and psychological health and can also increase the quality of life. The most prevalent strategies used were self-management skills and anxiety/stress management strategies.