فهرست مطالب

Journal of Education and Health Promotion
Volume:12 Issue: 2, Feb 2022

  • تاریخ انتشار: 1401/02/21
  • تعداد عناوین: 38
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  • Vahid Delshad, Marcus Stueck, Abbas Ebadi, Mariola Bidzan, Hamidreza Khankeh Page 41
    BACKGROUND

    Health is a complex structure and has physical, psychological, and social approaches. The importance and impact of health assessment have caused considerable attention to be paid to the employees of the health system and the determining factors of this relationship. Hence, the main purpose of this study was to find out the bio‑psycho‑social health situation in prehospital emergency technicians as the research question staff.

    MATERIALS AND METHODS

    The present study is a systematic review and data have retrieved through extensive search in Scopus, Web of Science, PubMed (including Medline), Cochrane Library, Irandoc, Magiran, MedLib, and SID databases with a combination of keywords of “Health, ” “Assessment, ” “Social,” “Psychological,” “Biological,” “Emergency,” and “prehospital,” according to the search strategy, between 2000 and 202111 studies were reviewed; then, they were entered based on the objectives of the study and narrative analysis was performed by the researcher.

    RESULTS

    After analyzing the articles, a total of 4 factors affecting bio‑psycho‑social health in prehospital emergency technicians have been extracted and identified, which included health management, bio‑psycho‑social factors, occupational factors, and behavioral factors.

    CONCLUSION

    This research showed four factors, namely health management, bio‑psycho‑social factors, occupational factors, and behavioral factors which could be effective in Bio‑Psycho‑Social health. Since prehospital emergency services have an important role in maintaining the health of the community, which requires attention to the bio‑psycho‑social health of emergency personnel, more studies have focused on health management among the four mentioned factors, but the need to examine the other three factors for a more accurate assessment of the health of emergency personnel seems necessary. Therefore, prevention and response strategies based on bio‑psycho‑social health assessment models are proposed to promote the health of prehospital emergency technician staff.

    Keywords: Assessment, bio‑psycho‑social, emergency medical services, health
  • Azarmidokht Firoozjahantighi, Fariba jokar, Fariba Haghani, Shirin Ahmadnia Page 42
    BACKGROUND
    Purpose

    The success of any educational system depends on the fitness of the curriculum components with the characteristics of its audience. The students of the present generation are different from the previous ones due to the changes resulting from the changes that have taken place in society, media, technology, and communication as we entered the 21th century. Hence, this study was conducted to identify the characteristics of MD students in universities of medical sciences in Iran.

    MATERIALS AND METHODS

    This qualitative study was conducted on 32 MD students among 7 universities of medical universities of Iran. The participants were selected through purposive sampling method, and the data were collected via semi‑structured interviews after getting informed consent. Then, the data were analyzed using conventional content analysis method.

    RESULTS

    Technology as a Double-Edged Sword, in digital age, Quick access, Reasoning the basis of acceptance. Evaluation ambiguity, Seeking independence,get involved in problems, desirable teaching qualities, my favorite teacher, features of content, Role models traces,my favorite teacher, The rest are unchanged.

    CONCLUSION

    MD students are interested in using various teaching methods and technologies, applying methods that are similar to their future job and learning by doing; they also tend to use visual materials and shortening the time and memorizing content. They prefer professors who love to teach and are good role models for them. What motivates them is to be involved in the classroom, to be active, to be respected, and not to be ignored.

    Keywords: Curriculum components, generation, generational characteristics, MD students
  • Zelalem Jabessa Wayessa, Wako Golicha Wako Page 43
    BACKGROUND

    Coronavirus pandemic puts healthcare workers (HCWs) at high risk and challenges the abilities of healthcare systems to respond to the crisis. This study aimed to assess the level of knowledge of HCWs and associated factors in West Guji zone public health facilities in southern Ethiopia.

    MATERIALS AND METHODS

    A health facility‑based quantitative cross‑sectional study was undertaken from June 10 to July 10, 2020. Two hundred and eighty‑three HCWs were involved in the study using a systematic sampling method. The instrument was pretested on 5% of the sample in Yabello Hospital. Data were analyzed using bivariate and multivariate logistic regression.

    RESULTS

    The HCW who had good knowledge was 84.7%. HCWs who had degree holders, masters and above holders, work experience of 2–4 years, and >4 years of experiences, had training on Coronavirus, and medical diseases were significantly associated with good knowledge of Coronavirus.

    CONCLUSIONS

    This study indicated that HCWs’ knowledge about the Coronavirus was good. Improving the educational status of HCWs and giving updated training on the Coronavirus will improve HCW’s knowledge of the Coronavirus.

    Keywords: COVID‑19, Ethiopia, health personnel, classification, knowledge, protective factors
  • Fatemeh Mokhtari, Fatemeh Torabi, Masoume Pirhadi Page 44
    BACKGROUND

    Infertility and the use of assisted reproductive therapies affect infertile couples quality of life. Infertile couples face many physical, psychological, and financial challenges due to having a higher level of spiritual intelligence and resilience will help the infertile couple to adapt to infertility conditions and achieve their therapeutic goals. This study was aimed to determine the relationship between fertility characteristics and spiritual intelligence and resilience in infertile couples.

    MATERIALS AND METHODS

    This was a cross‑sectional study that was conducted in 2020 on 162 infertile couples referring to infertility centers in Isfahan who met the inclusion criteria. Samples were selected by convenience sampling method. Information was gathered using a questionnaire consists of three parts: demographic and fertility characteristics, spiritual intelligence, and resilience. Data were analyzed using descriptive and inferential statistical methods (t‑test, Pearson’s correlation coefficient, and Chi‑square). P < 0.05 was considered statistically significant.

    RESULTS

    Pearson’s correlation coefficient showed that there was no significant relationship between resilience score and spiritual intelligence score with age, duration of marriage, and duration of treatment (P > 0.05). There was no significant relationship between resilience score and spiritual intelligence score and its dimensions with the level of education and economic status of the family (P > 0.05).

    CONCLUSIONS

    There was no significant relationship between demographic and fertility factors with spiritual intelligence and resilience.

    Keywords: Infertility, Iran, resilience, spiritual
  • Bahram Mohebbi, Parham Sadeghipour, Feridoun Noohi, Majid Maleki, Mohammad Mehdi Peighambari, Saeid Hosseini, Ali Zahedmehr, Jamal Moosavi, Omid Shafe, Mohammad Javad Alemzadeh‑Ansari, Melody Farrashi, Hamidreza Pouraliakbar, Behshid Ghadrdoost Page 45
    BACKGROUND

    In the coronavirus disease 2019 pandemic era, clinical programs and mandatory hands‑on activities have been supplanted by remote teaching to maintain the fundamental capabilities of medical training and to furnish medical students with quality education. Nonetheless, the satisfaction of faculty members with this training method in the current pandemic has yet to be assessed. The aim of this study was to design a Persian questionnaire with appropriate validity and reliability on cardiology professors’ satisfaction level with virtual education.

    MATERIALS AND METHODS

    In this cross‑sectional study, a questionnaire was devised drawing upon scientific sources and Iranian medical educators’ expertise. Seventeen faculty members in various specialties evaluated the questionnaire concerning face and content validity. Content validity was assessed through the calculation of the content validity ratio (CVR) (values >0.62 were considered acceptable) and the content validity index (CVI) (values >0.79 were considered acceptable), construct validity was evaluated through principal component factor analysis by the Kaiser–Meyer–Olkin (KMO) statistic and Bartlett’s sphericity test, internal reliability was measured through the calculation of Cronbach’s alpha coefficient, and consistency was appraised through the use of test‑retest reliability at two different time points.

    RESULTS

    The questionnaire had a reliability rate of 95%, indicating high internal validity. Concerning test‑retest reliability, the intraclass correlation coefficient was 0.96 (P < 0.001), demonstrating relatively good stability. The CVI was 0.81, and the CVR was 0.85. The KMO measure of sampling adequacy was 0.954, indicating the acceptability of the degree of common variance among the all items.

    CONCLUSIONS

    This Persian questionnaire on virtual education aimed at cardiology faculty members in the current pandemic with its low question count and appropriate domains had high reliability and validity. By knowing the level of professors’ satisfaction with the new method of education, it is possible to take steps to better provide specialized medical education to cardiology residents.

    Keywords: Cardiology, coronavirus disease 2019, faculty members, pandemic, questionnaire, reliability, validity
  • Resiana Citra, Rizma Adlia Syakurah Page 46
    BACKGROUND

    Ineffective health communication could cause the increase of COVID‑19 cases in Indonesia. Medical students can involve in efforts in health communication on social media to positively impact prevention behaviors during a pandemic. This study aims to identify and analyze medical students’ and internship doctors’ perceptions toward health communication related to COVID‑19 through social media.

    MATERIALS AND METHODS

    A mixed method with exploratory sequential used. A qualitative study was done using phenomenology approach through deep and semi‑structured interviewing. After data analysis, the draft of the instrument prepared. Items in the draft selected based on the respondents’ answer. Then, a quantitative cross‑sectional study was used. The data obtained from 399 medical students and doctors at a University in Indonesia using Google Form on October 14 to October 20, 2020 through media social. Data were analyzed using Pearson Correlation and Chi‑square (alternative: Fisher’s exact test) and logistic regression analysis with P < 0.05 and 95% confidence interval, respectively.

    RESULTS

    Based on interview, respondents communicate health on social media because the condition of COVID‑19 in Indonesia is dangerous, feel vulnerable to COVID‑19, understand the benefits, obligations, or responsibilities as a candidate and/or medical personnel and believe they can create content/find valid sources. Meanwhile, the perception of limited knowledge is their biggest obstacle in conducting health communication. There were a relationship between gender (P = 0.028, PR = 0.657), perceived severity (P = 0.044, PR (Prevalence Ratio) =4.844 [0.725–32,354]), perceived susceptibility (P = 0.005, PR = 1.803 [1.182–2.750]), perceived barrier (P < 0.001, PR = 2.543 [1.908– 3.388]), and self‑efficacy (P = 0.012, PR = 1.810 [1.120–2.926]) with health communication behavior. The perceived barrier (P < 0.001, RR = 4.278 [2.709–6.754]) and perceived susceptibility (P = 0.004, PR = 2.304 [1.302–4.077]) were the most influenced behavior.

    CONCLUSIONS

    This study showed that perceived severity, perceived susceptibility, perceived barrier, and self‑efficacy are predictor factors of health communication behavior related to COVID‑19 on social media with perceptions of susceptibility and perceived barriers as the most influential variables. It is necessary to provide communication learning on social media as effectively and applied directly to reduce perceived barriers and increase self‑efficacy.

    Keywords: COVID‑19, health behavior, health communication, medical, students
  • Parastoo Baharvand, Farideh Malekshahi, Nafiseh Gheydar Page 47
    BACKGROUND

    Health‑promoting behaviors can affect the psychological and physical consequences of hypertension. For the prevention and control of hypertension, lifestyle modification has been recommended. This study aimed to investigate the health‑promoting behaviors of patients with hypertensive heart disease in Iran and compare them with those of healthy people.

    MATERIALS AND METHODS

    This was a descriptive comparative study with cross‑sectional design. Participants were 141 patients with hypertensive heart disease (mean age = 39 ± 10.2 years) referred to the cardiac clinic of Madani Hospital in Khorramabad, Iran, and 141 healthy people selected from those referred to the hospital. The Persian version of the revised Health‑Promoting Lifestyle Profile‑II (HPLP‑II) was used to evaluate the health‑promoting behaviors of participants. After collecting data, they were analyzed in SPSS v. 22 software using descriptive statistics and statistical tests including independent t‑test and one‑way ANOVA.

    RESULTS

    The overall HPLP‑II score was 142.34 ± 30.48 in patients and 150.52 ± 37.07 in controls. The highest and lowest HPLP‑II dimension scores in both groups were related to health responsibility and stress management dimensions. There was a significant difference between groups only in dimensions of nutrition (P = 0.017) and physical activity (P = 0.016), and in the overall score (P = 0.044), whose scores were lower in patients compared to controls. The difference in HPLP‑II score of patients with different demographic characteristics (marital status, place of residence, gender, age, educational level, and occupation) was not statistically significant.

    CONCLUSION

    Patients with heart disease caused by high blood pressure in Iran have poorer diet and physical activity compared to healthy people. Educational interventions with a focus on the importance of dietary regime and exercise are recommended for them.

    Keywords: Clinical health, comparative study, diet, healthy lifestyle, heart diseases, hypertension, physical activity
  • Forozan Ganji, Farzad Khani, Zahra Karimi, Leili Rabiei Page 48
    BACKGROUND

    Students on campus are exposed to drug abuse and mental health disorders due to various challenges and motivating factors. This issue requires attention to interventions based on coping skills training. The present study was conducted with the aim to investigate the effect of an assertiveness program on the drug use tendency, mental health, and quality of life in clinical students of Shahrekord University of Medical Sciences in 2020.

    MATERIALS AND METHODS

    This is a quasi‑experimental study. Seventy clinical students (nursing, midwifery, and intern students) attending Ayatollah Kashani and Hajar teaching hospitals of Shahrekord were included into the study and randomly assigned into an intervention group and a control group. The assertiveness training program was implemented for eight 1‑h sessions (one session per week for 2 months) for the intervention group, while the control group received no programs. Both study groups completed drug tendency questionnaire, depression, anxiety and stress scale, and quality of life questionnaire in pretest, posttest, and 2‑month follow‑up. The data were analyzed using SPSS software (v22), analysis of variance repeated measures, and t‑test.

    RESULTS

    The mean scores of drug use tendency (P = 0.26), stress (P = 0.31), anxiety (P = 0.29), depression (P = 0.43), and quality of life (P = 0.33) showed no statistically significant difference between the intervention and control groups in the pretest, but the scores of the drug use tendency, stress, anxiety, and depression were statistically lower and the score of quality of life was statistically higher than that of the control group in the posttest and 2‑month follow‑up (P < 0.05).

    CONCLUSION

    The findings of the study showed that assertiveness skill training as a preventive program can reduce the students’ tendency to addiction and improve their mental health and quality of life. Considering the effectiveness of the program, planners and policymakers can use it to plan for reducing the youth tendency to drugs.

    Keywords: Assertiveness program, clinical students, drug use tendency, mental health, quality of life, trainingprogram
  • K Vidhya, Sweety Gupta, R Lekshmi, Kritika Bhardwaj, K Kusum, Vasantha CKalyani, Amit Gupta Page 49
    INTRODUCTION

    Knowledge about cancer, treatment, and likely treatment outcomes is critically important for decision‑making regarding adherence to the treatment. Hence, it seems imperative to find out the attitude and belief of cancer patients to determine the efficacy of cancer diagnostic and treatment available along with assessing the efficacy of prevention. The purpose of this study was to determine the level of knowledge, belief, and attitude of cancer patients who came to our facility.

    MATERIALS AND METHODS

    The present study was a descriptive cross‑sectional study which was conducted at All India Institute of Medical Sciences, Rishikesh, from July 2020 to December 2020. One hundred fifty‑six newly diagnosed cancer patients were recruited. The participants were provided with a validated 44 key questionnaire divided into four different categories including the sociodemographic profile, knowledge, belief, and attitude subheading. Mean, frequency, percentage, and Chi‑square test were calculated to do data analysis using SPSS version 23.0.

    RESULTS

    Out of the total of 156 newly diagnosed cancer patients, only 130 patients provided responses so the overall response rate was 84.3%. Most of cancer patients had moderately adequate knowledge (79 [60.5%]), poor belief (111 [86%]), and neutral attitude (69 [54%]) regarding cancer. The Chi‑square test revealed a link between educational level and cancer knowledge (P = 0.01). Males showed a more positive attitude than females, and this difference was statistically significant (P = 0.02).

    CONCLUSIONS

    Cancer patients need to be made more aware of the red flag signs of cancer and improvise their attitude toward cancer. Cancer care programs should not only involve cancer patients but also involve their caregivers because the understanding of family members is of utmost importance to fight this disease.

    Keywords: Cancer, cancer screening, cancer’s attitude, cancer’s belief, cancer’s knowledge
  • Taufik Edi Rahmat, Saqlain Raza, Hasan Zahid, Jaffar Abbas, Fatimah Azzahraa Mohd Sobri, Shehla Najib Sidiki Page 50
    BACKGROUND

    The advent of the pandemic COVID‑19 has resulted in a global crisis that resulted in the closure of universities and educational institutions worldwide. This study aims to explore the determinants of students’ intention towards e‑library services usage amid the challenging time of the COVID‑19 pandemic. This paper reviews the technology‑oriented individual attitude based on four dimensions of the technology readiness 2.0 index factors, which affect medical students’ perspectives.

    MATERIALS AND METHODS

    The authors provided a self‑administered questionnaire to medical students to investigate their e‑library adoption attitude during the COVID‑19 crisis. The authors distributed 542 questionnaires, received 361 complete responses and analyzed the data through path modeling/partial least squares structural equations modeling technique (PLS‑SEM) with the smart PLS software version 3.3.3. The structural equation‑modelling tool permits the estimation of results.

    RESULTS

    The main finding revealed that medical students have a positive and explicit approach to use the services available at the e‑library. Technology use and online services helped students continue their educational needs in the advent of the current pandemic COVID‑19. Attitude and subjective norms have significant influence and are strong predictors of intention. However, due to inadequate support for the government side, the perceived behavioural control has an insignificant impact on intention. This paper indicated one of the pioneers investigating the determinants of e‑library adoption among medical students based on technology‑oriented personality traits, employing the four dimensions of the technology readiness 2.0 index during the challenges of the COVID‑19 outbreak.

    CONCLUSION

    The study’s findings provide useful insight that offers valuable insights to implement specific strategies from the government officials to address medical students’ uncertainties and increase the technology adoption amid the COVID‑19 pandemic in medical education for developing nations.

    Keywords: E‑library services, Medical education, COVID‑19, Smart partial least squares, Technology adoption
  • Seyed Vahid Ahmadi Tabatabai, Armita Shah Esmailinejad, Reza Sadeghi, Batool Zeidabadi Page 51
    BACKGROUND

    To control blood sugar and prevent complications related to diabetes, eating fruits and vegetables in standard amounts is recommended. The aim of this study was to investigate the factors affecting the consumption of fruits and vegetables in diabetic patients based on the Pender health promotion model.

    MATERIALS AND METHODS

    This cross‑sectional study was conducted on 260 diabetic patients in Sirjan; one of the cities of Kerman in Iran in 2020. To collect data, a researcher‑made questionnaire of Pender’s Health Promotion Model and a standard Behavioral Risk Factor Surveillance System questionnaire were used to measure fruit and vegetable consumption. Data were analyzed using SPSS24 software. Data were analyzed using t‑test, Pearson correlation coefficient, linear regression, and path analysis. Significance level <0.05 was considered.

    RESULTS

    The study showed that 71.5% of patients consumed fruits three or more times and 52.3% consumed vegetables per week. Employment, income, education, and gender were significantly associated with fruit and vegetable consumption (P < 0.05). Perceived barriers (P < 0.0001, β =0.23), self‑efficacy (P < 0.0001, β =0.32), and commitment to action plan (P = 0.002, β =0.20) were the main predictors of fruit and vegetable consumption.

    CONCLUSION

    In this study, self‑efficacy was the strongest predictor of fruit and vegetable consumption in diabetic patients. Therefore, it is necessary to consider health education as well as health promotion interventions based on these variables is considered to increase the consumption of fruits and vegetables for diabetic patients.

    Keywords: Diabetes, fruit, health promotion model, Pender’s, perceived barriers, self‑efficacy, vegetable
  • Shahrbanoo Khazaei, Fatemeh Salmani, Mitra Moodi Page 52
    BACKGROUND

    Colorectal cancer is the most common cancer of the gastrointestinal tract. Health beliefs play an important role in the development of health behaviors. In this study, the effect of educational intervention based on Health Belief Model on colorectal cancer screening behavior was investigated.

    MATERIALS AND METHODS

    This study was performed as a randomized controlled intervention. The study population was 50–70‑years old in Khosf city. Initially, 120 eligible populations were randomly divided into intervention and control groups (60 people in each group). The data collection tool was a standard colorectal cancer screening questionnaire that was completed before, immediately, and 3 months after the intervention. The intervention consisted of eight 60‑min training sessions. The collected data were analyzed using SPSS19 software and statistical tests.

    RESULTS

    The mean age of the intervention and control groups was 63.53 ± 5.67 and 57.73 ± 5.77 years. In terms of mean scores of knowledge, perceived susceptibility, perceived severity, and perceived barriers were homogeneous before intervention. After the intervention, the mean score of the model constructs showed significant changes, which was statistically significant (P < 0.05). The rate of occult blood test in stool 3 months after training reached 90% in the intervention group and 15% in the control group.

    CONCLUSIONS

    The results of this study showed that by taking measures to reduce perceived barriers as well as increase knowledge, perceived susceptibility, severity, benefits and self-efficacy, the rate of participation in occult blood testing in feces can be significantly increased.

    Keywords: Cancer screening, colorectal cancer, fecal occult blood test, health belief model
  • Sweety Suman Jha, Bobby Paul, Rahul Das, Biswadip Chattopadhyay, Arista Lahiri Page 53
    BACKGROUND

    For any effective vaccination strategy, the willingness of the beneficiaries and its contributing factors are important. This study was conducted among the health‑care workers (HCWs) and community members to find the perceptions regarding the COVID‑19 vaccine and understand the influencers and the barriers of vaccine acceptance.

    MATERIALS AND METHODS

    A qualitative study was conducted from October 2020 to December 2020 in two primary care settings in an urban area. Eighteen in‑depth interviews (IDIs) after taking consent were conducted with the help of IDI guide developed and validated beforehand by the experts. IDIs were done among the ten community members and eight HCWs selected conveniently. Data collection were continued till data saturation when no new information yielded from the interviews. Thematic analysis was performed.

    RESULTS

    All the participants were hopeful about availability of the vaccine. The key influencers identified for promoting willingness to accept the vaccine among both the groups were opinion of the health‑care providers, colleagues’ and other people’s acceptance of the vaccine, effectiveness of vaccine on other people, and perceived risk of the disease. Fear of adverse reactions was the most important barrier among all the respondents. The prevalent perception was that other preventive practices and vaccine together can only be the best solution to prevent COVID‑19 illness. The HCWs perceived that acceptance of vaccine among the community members would be good overall but apprehended some initial difficulties. Mass campaign to promote COVID‑19 vaccination and sensitization events are the need of the hour.

    CONCLUSIONS

    Since opinion of health‑care personnel emerged as an important influencer of vaccine acceptance, mass campaign and sensitization programs spearheaded by the health‑care providers can bring about change by increasing the vaccine acceptance among the beneficiaries at large. Re‑enforcement regarding practice of preventive measures should be made among the population irrespective of the vaccination status.

    Keywords: Community, COVID‑19, health‑care workers, qualitative research, social factors, vaccine, vaccinerefusal
  • Fatemeh Aliakbari, Tahereh Pirani, Mohammad Heidari, Soleiman Kheiri Page 54
    BACKGROUND

    It is necessary to assess the level of preparedness to reduce the side effects of disasters, so regarding to the role of nurses in responding to the disasters, this is of particular importance. Holding a maneuver and exercises is one of the ways to increase the level of capability and assess the level of readiness, so the aim of the current study was to investigate the impact of the implementation of the operational exercises program on the competency of nurses in disaster response in 2020.

    MATERIALS AND METHODS

    The present study is a quasi‑experimental study in two groups, in which seventy nurses of hospitals affiliated to Shahrekord University of Medical Sciences were selected by census and randomly divided into two groups. Before the intervention, a native questionnaire to assess the competence of nurses in the disaster response was completed. Then, the empowerment program including educational workshop, tabletop, and operational maneuvers were performed. Immediately and 3 months after the intervention, the questionnaires for both groups were completed, and the data were analyzed using SPSS 21 through descriptive‑analytical statistical tests.

    RESULTS

    The results showed that the mean score of nurses’ competence in all domains of management, ethics, personal, team work, and technical immediately and 3 months after the intervention in the intervention group increased significantly (P = 0.001), while in the control group, these changes were not significant (P > 0.05).

    CONCLUSION

    According to the results of a recent study, the implementation of the empowerment program and the implementation of maneuvers as a part of the process of preparing nurses to deal with disasters have been effective. Therefore, it is suggested to use periodic maneuvers in in‑service training programs to improve the level of competence of nurses.

    Keywords: Disaster, nursing competency, operational maneuver
  • Maryam Hashemian, Mahdi Abdolkarimi, Mostafa Nasirzadeh Page 55
    BACKGROUND

    Fruits and vegetable (F.V) consumption is the most pivotal strategy of preventing cardiovascular diseases, obesity, diabetes, and cancers. The present study aims to evaluate the effect of educational intervention based on social cognitive theory (SCT) on consumption of F.Vs among female high schools’ students in Rafsanjan (South of Iran).

    SUBJECTS AND METHODS:

    This quasi‑experimental study was carried out among 272 students (intervention = 134 and control group = 138) using a multistage sampling method. The instrument used in this study included demographic characteristics, the students’ F.V consumption during the past 7 days and its determinants based on the theory. Educational interventions were made in three sessions for students and two sessions for parents, teachers, and school officials. The data were analyzed by SPSS version 18 using the statistical tests of Chi‑square, independent samples t‑test, paired‑samples t‑test, and univariate model at a significant level of 0.05.

    RESULTS

    Three months after the educational program, mean scores and standard deviation of F.V consumption and constructs in the intervention group increased significantly (P < 0.001). Respectively, 22.2% and 36.1% of the changes in the average unit of F.V consumption were the result of the present educational intervention.

    CONCLUSION

    The intervention based on SCT with an emphasis on the interaction between student, family, and school has had an effect on F.V consumption behavior. Therefore, in forming behavior, attention is paid to the interaction of individual and interpersonal factors.

    Keywords: Education, fruit, social theory, student, vegetables
  • Govindappa Lakshmana, Vasunaik Sangeetha, Vijyendra Pandey Page 56
    BACKGROUND

    The Government of India and State Government authorities are trying their best to provide adequate mental health services through various mental health policies and programs. To reduce the burden in psychiatric hospitals, Government has decentralized mental health services. Although Government has provided mental health services, the utilization has always been low due to many reasons. In the present study, an attempt was made to assess the accessibility and the barriers to utilizing mental health services with various community stakeholders.

    MATERIALS AND METHODS

    This is a qualitative study wherein data was collected from youth, women, geriatric groups, community key leaders, and Anganwadi workers. The primary data were collected through focused group discussions and interview methods. The collected data were analyzed using thematic coding.

    RESULTS

    A total of twenty‑five factors have been identified in the study, which were categorized under eight themes. (a) Lack of awareness and misinformation on mental health, illness, and available services, (b) Perceived causes for mental illness, (c) Reasons for not approaching health professionals, (d) Treatment adherence‑related issues, (e) No multidisciplinary team in private hospitals and lack of involvement in government sector (f) Manpower issues, (g) Quality of service issues and building confidence among community people, and (h) Belief system and stigma.

    CONCLUSIONS

    Inadequate mental health services, lack of awareness of mental health, and illness are still persist. The District Mental Health Program and other service providers need to reach communities, especially in remote areas. Periodical evaluation should be carried out to improve the utilization of mental health services.

    Keywords: Barriers to utilize mental health services, community perception, mental health, mental healthservices, mental illness
  • Surahalli J Naresh*, Mahendra M Reddy*, Ravishankar Suryanarayana, Ananta Bhattacharyya, Prasanna B T Kamath Page 57
    BACKGROUND

    Capturing the baseline information on awareness, practices, and prevailing myths related to the ongoing coronavirus disease‑19 (COVID‑19) pandemic in rural India will help in planning interventions to improve the health literacy on COVID‑19. The aim of the study was to assess the level of awareness, practices, and myths regarding COVID‑19 among rural population of Kolar district in South India.

    MATERIALS AND METHODS

    A concurrent mixed‑methods study with a quantitative community‑based cross‑sectional analytical design and a qualitative phenomenological design was conducted in five randomly selected villages during June 2020. A prevalidated and pretested semi‑structured questionnaire was administered to one adult in the households selected using systematic random sampling to capture the sociodemographic details and their awareness, practices, and myths related to COVID‑19. The supervisors additionally and concurrently used a nonparticipant observation technique to record the real‑time behaviors and preventive practices adopted by the villagers. Quantitative analysis was done using STATA and included multivariable regression analysis, and the association was reported using prevalence rates along with their 95% confidence intervals (CIs). Qualitative analysis was done manually as per discussion and concordance among supervisors and reported as categories along with supporting statements.

    RESULTS

    Among the 298 respondents, “poor awareness” was seen in 128 (43.0%, 95% CI: 37.5%–48.6%). Among the responders, 89 (29.9%) believed in the myth that “Corona disease is due to God’s wrath or curse.” The field observations were categorized under three categories – “avoidance of masks,” “nonexistent social distancing,” and “rampant spitting.”

    CONCLUSION

    About two in five villagers were found to have “poor awareness” to COVID, and practices related to COVID were found to be largely unsatisfactory. Lower level of education and belonging to nuclear family were associated with “poor awareness.” Various myths were identified that has to be debunked on priority basis by the government, especially targeting the people having low level of education in rural India.

    Keywords: Coronavirus disease‑19, health literacy, health promotion, prevention, control
  • Kamal Bandhu Klanidhi, Avinash Chakrawarty, Shailendra S. Bhadouria, Sudeep M. George, Gaurav Sharma, Prasun Chatterjee, Vijay Kumar, Saurabh Vig, Nishkarsh Gupta, Vishwajeet Singh, Aparajit Ballav Dey, AnantMohan, Sushma Bhatnagar Page 58
    BACKGROUND

    The world is worsely hit by the COVID‑19 pandemic resulting in increased morbidity and mortality. Increased mortality has been observed in older adults with multiple comorbidities. Six‑minute walk distance (6MWD) at admission can help us to guide the requirement of oxygen during hospital stay that can be used to determine which patient can be managed at home.

    MATERIALS AND METHODS

    This study was a prospective observational study conducted on COVID‑19 patients admitted at AIIMS, New Delhi, from October to December 2020. Patients aged more than 60 years were included in the study and underwent 6‑min walk tests. Polypharmacy and multimorbidity were also assessed along with dyspnea which was measured on BORG scale. P < 0.05 was considered statistically significant. Statistical software STATA (version 14.2) was used for all the analyses.

    RESULTS

    The mean age of the study population was 68.76 (7.4). Oxygen saturation prior to the 6‑MWT was normal and has significantly higher than the post test (P ≤ 0.001). 6MWD was significantly correlated with pre values of oxygen saturation. 6MWD was observed more in patients who did not require oxygen during hospital stay. Self‑reported dyspnea, pulse rate, oxygen saturation, and systolic blood pressure were significantly associated with the patients who had an oxygen requirement during the hospital stay.

    CONCLUSION

    Self‑reported dyspnea after 6MWT was found to be associated with oxygen requirement during hospital stay. Patients who have covered more distance in 6‑min walk test have less oxygen requirement during hospital stay hence can be managed at home. This will reduce the health‑care burden and will help to tackle the outburst during the ongoing pandemic.

    Keywords: COVID‑19, oxygen requirement, six‑minute walk test
  • Zaid Khan, Syed Quibtiya Khursheed, Shabir Ahmad Dar, Naveed Nazir Shah, Shuja Reagu, Majid Alabdulla, Inaamul Haq, Aaliya Mohi Ud Din Azad, Khurshid Ahmad Dar, Syed Suraiya Farooq, Zaid Ahmad Wani Page 59
    BACKGROUND

    Vaccine hesitancy is seen, globally, as a major factor that will determine future coronavirus disease‑19 (COVID‑19) spread and its effective management. This study aimed to identify COVID‑19 vaccine perception, acceptance, confidence, hesitancy, and barriers among the general population.

    MATERIALS AND METHODS

    This was an online survey which was developed and shared through social media platforms among the general population of Kashmir. The survey captured demographic data and used a validated hesitancy measurement tool. We analyzed the data using descriptive statistics and multivariable logistic regression using Stata 15 (Stata Corp. 2017. Stata Statistical Software: Release 15. College Station, TX, USA: Stata Corp LLC).

    RESULTS

    A total of 835 responses were received. Most participants were males, with females compromising of 19.5% participants. 65.1% of participants were in the age group of 30–50, whereas 19.2% were below 30 years of age. 52.70% of respondents were willing to take the vaccine when available, while 32.5% of respondents were unsure about their decision of inoculation. The most cited reason for willingness to get vaccinated was an understanding of the disease and vaccination. 41.70% felt that the vaccines developed against COVID‑19 have not been fully tested; therefore, concerns around the safety and its longer‑term side effects were the reasons cited. Public health messaging should be tailored to address these concerns.

    CONCLUSIONS

    Vaccine hesitancy is a global threat undermining the control of preventable infections. The government should take proactive steps to address the factors that may potentially impact the benefits expected from the introduction of a COVID‑19 vaccine in the union territory.

    Keywords: Coronavirus disease‑19, coronavirus disease‑19 vaccine, mistrust, participants, side effects, vaccineacceptance, vaccine hesitancy
  • Zahra Dehghan, Nasrollah Alimohammadi, Shahla Mohamadirizi Page 60
    BACKGROUND

    One of the important challenges faced by health‑care system is to raise the level of knowledge of nurses about cerebrovascular accident (CVA) nursing care in the emergency department. Therefore, the aim of this study was comparison of two new educational techniques (noninteractive multimedia learning and workshop) on knowledge of nurses about CVA nursing care in the emergency department.

    MATERIALS AND METHODS

    This experimental study was conducted with a two‑group design. Sixty‑four eligible nurses working in the emergency department in selected hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, were selected as the study participants. Nurses were randomly assigned into two groups of noninteractive multimedia (n = 32) and workshop (n = 32) using random number table. The data‑gathering tools including a demographic questionnaire (6 items) and knowledge questionnaire (24 items) were completed before and 2 weeks after the intervention in both the groups. Data were analyzed using SPSS 18 and descriptive (mean and standard deviation) and analytical statistics (ANOVA, independent t‑test, and paired t‑test). The level of statistical significance was P ≤ 0.05.

    RESULTS

    The result shows that independent t‑test showed that there was not a significant difference between the mean total scores of nurses’ knowledge before intervention in the two groups (P > 0/05). Furthermore, the results of paired t‑test showed a significant difference in the knowledge score 2 weeks after compared to before the education in both the groups (P < 0.005). In addition, the results of independent t‑test showed a significant difference in the knowledge score 2 weeks after the intervention in the two groups (P < 0.005). The average knowledge score in the workshop group was significantly higher than in noninteractive multimedia learning group.

    CONCLUSION

    According to the result, new educational techniques such as noninteractive multimedia learning and workshop could improve knowledge of nurses about CVA nursing care in the emergency department.

    Keywords: Education, Iran, knowledge, multimedia, nursing, workshop
  • Shamim Saniei, Fariba Fahami, Rahele Samouei, Hatav Ghasemi Tehrani Page 61
    BACKGROUND

    Pregnancy causes a set of complex physiological and psychological changes that affect marital relationships. Mindfulness is a form of meditation that can promote person’s performance and perception of sexual relationships. The present study aimed to determine the effect of mindfulness on sexual desire and sexual satisfaction in primigravida pregnant women.

    MATERIALS AND METHODS

    The present study is a quasi‑experimental that has investigated on 72 primigravida pregnant women. The samples were selected randomly and assigned to experimental and control groups. The experimental group received six 90‑min sessions of mindfulness intervention, and the control group received the educational pamphlet. The female sexual function index (FSFI) was filled by the subjects of the two groups in three stages of before the intervention, a week, and a month after the intervention. Data analysis was done by SPSS20 (Statistics 20 software; SPSS Inc., Chicago, IL, USA) at the significance level of 0.05.

    RESULTS

    According to the statistical tests, there was no significant difference between the two groups in terms of demographic characteristics and pregnancy information. The findings suggest no significant difference between the mean pretest and posttest score of sexual desire in the two groups (P > 0.05). However, the two groups were significantly different in terms of the mean score of sexual satisfaction before and after the intervention (P<0.05).

    CONCLUSION

    By increasing the concentration on the present moment and avoiding judgment, mindfulness can increase sexual satisfaction. However, sexual desire can be affected by various factors such as the cultural context, the quality of marital relationships, and the pregnancy hormonal changes that can influence the sexual response.

    Keywords: Mindfulness, pregnant women, primigravida, sexual desire, sexual satisfaction
  • Fernanda de Souza e Silva Ramos, Laryssa de Castro Oliveira, Diego Felipe Mardegan Gonçalves, Rafael Santos Rocha, Eduardo Bresciani, Ticiane Cestari Fagundes Page 62
    BACKGROUND

    The current pandemic associated with SARS‑CoV‑2 has negatively influenced several activities, including teaching in Operative Dentistry. The aim of this study was to evaluate the influence of knowledge in Operative Dentistry on undergraduate students’ perception related to personal life and return to clinical practices classes during pandemic.

    MATERIALS AND METHODS

    The present research was a cross‑sectional, observational, and qualitative survey. The 16‑item based questionnaire was sent to undergraduate students in 2020, which were divided into two groups, according to the Operative Dentistry knowledge: G1‑not started clinical practice; G2‑already started or completed clinical practice. Questions were focused on the impact of the pandemic in relation to their personal lives and return to clinical practice classes. Chi‑square association test was performed using the SigmaPlot 12.0 software (P ≤ 0.05).

    RESULTS

    The response rate was 55.5% for G1 and 44.4% for G2. Regarding the questions related to personal life, G1 demonstrated higher percentages of fear of contracting the virus during theoretical classes. Same observations were found when students answered about their fear of contracting coronavirus during the clinical practice classes. However, G2 presented the highest agreement responses for the preparedness feeling to return to theoretical classroom, clinical practice classes, and the possibility of applying online learning.

    CONCLUSIONS

    In general, students’ knowledge had little influence on perception of personal life. However, students who have more knowledge in operative dentistry presented more security about returning to clinical classes.

    Keywords: Coronavirus, dental education, perception, students, teaching methods
  • Yasaman Pourfarid, Mohsen Hojat Page 63
    BACKGROUND

    The health reform plan (HRP) is a plan to improve Iran’s health systems that began in 2014. The three main approaches of this plan include financial protection of the people, creating justice in access to health services, and improving the quality of services. It predicted that the level of health system responsiveness would increase. Achieving this goal is possible only with the correct implementation. The best people to measure the correct implementation are nurses, midwives, and physicians. Hence, this study was conducted to assess the attitude of nurses, midwives, and physicians about the implementation of the HRP.

    MATERIALS AND METHODS

    This cross‑sectional descriptive study was conducted in educational hospitals of Jahrom University of Medical Sciences in 2020. By convenience sampling method, 325 nurses, midwives, and physicians participated in this study. Sampling was done in all work shifts, and in all wards. A researcher‑making questionnaire was used to collect data. The scoring did by the Likert scale from (completely agree = 4 to completely disagree = 1). Quantitative and qualitative face and content validity was calculated (IS: 0.84, CVI: 0.92, CVR: 0.87), and its reliability was calculated by Cronbach’s alpha method (0.78). The data were analyzed by SPSS software version 16. Descriptive statistics, Mann–Whitney U‑test, and Kruskal–Wallis test were used for the data analysis (P ≤ 0.05).

    RESULTS

    In the study, 90.15% agreed with the implementation of the HRP. There was no significant difference between the male and female (P = 0.063). There was a significant difference between the educational degree (P = 0.006), married and the single participants’ attitude (P = 0.003), the nurses, midwives, and physicians (P = 0.001).

    CONCLUSION

    HRP is more successful in the field of financial protection, so policymakers should pay more attention to justice in access to health services and improving the quality of services fields.

    Keywords: Attitude, health reform plan, hospital, midwife, nurse, physician
  • Reza Heidari‑Soureshjani, Tayeb Mohammadi, Ali Hashemi‑Shahraki, Roya Khorrami Estakhri, Arezoo Rasti Page 64
    BACKGROUND

    Present study attempts to investigate health‑related quality of life (HRQoL) and its relation with knowledge, attitudes, and practices (KAP) of students of Tehran University of Medical Sciences (TUMS) during this pandemic.

    MATERIALS AND METHODS

    In this cross‑sectional study which was conducted between 23 may to 21 June 2020, 470 students in different levels of TUMS were included to the study randomly. participants completed validate, designed online questionnaire which assessed KAP towards coronavirus disease 2019 (COVID‑19) and HRQoL. All statistical tests were applied, including Chi‑square and Fisher’s exact test, Partial correlation, analysis of variance, multiple linear regression, multiple binary and multinomial logistic regression models (P < 0.05) and were performed in SPSS 16, R 4.0.2, and GraphPad Prism 6.0 softwares.

    RESULTS

    A total of 470 students were included in the study. The overall correct answer rate of the COVID‑19 knowledge questionnaire was 74.43% and total score of the HRQoL was 72.50 (14.85). 61.7% of the students were agreed that COVID‑19 will finally be successfully controlled, 44.3% had confidence that Iran can win the battle against the COVID‑19, and 92.6% agreed that Quarantine will reduce the prevalence of COVID‑19. Most of them adhered to health protocols and about a relation between HRQoL and knowledge we have a weak positive and unsignificant correlation between them (r = 0.05, P = 0.27).

    CONCLUSIONS

    TUMS students showed expected levels of knowledge, proper attitudes, and preemptive practices regarding COVID‑19, whereas COVID‑19 outbreak substantially affected the physical and mental health but, the students were in a way better physical health rather than mental. Therefore, motivational planning and other related intervention to improve mental health can be noticeable.

    Keywords: Attitude, COVID‑19, health, knowledge, quality of life
  • Alireza Safaeian, Negah Tavakolifard, Azita Roohi Page 65
    BACKGROUND

    Burnout is a syndrome of emotional exhaustion, depersonalization, and low professional efficacy that health workers, especially nurses, experience the highest rates of this. Burnout causes stress and negative attitude towards work and feeling unable to perform tasks in the person. The purpose of this study was to investigate the effect of a method called compassion, awareness, resilience, and empowerment (CARE) on nurses’ burnout.

    MATERIALS AND METHODS

    This study was a semi‑experimental study with control group, the statistical population in this study was nurses of Kashani Hospital in Isfahan as intervention group and nurses of Al‑Zahra Hospital as control group. The samples were selected by stratified sampling. For both groups before and after and 3 months after the intervention, the burnout questionnaire (Maslach Burnout Inventory) was completed. The intervention was performed in 5 sessions of 90 min 1 day a week. Data were analyzed by SPSS version 25 software (IBM Inc., USA) and independent t‑test, repeated measures analysis of variance and Chi‑square test and Friedman test, significance level was set at P < 0.05.

    RESULTS

    The comparison of mean and intensity of burnout and two dimensions of emotional exhaustion and depersonalization showed a difference between the two groups and this difference was statistically significant (P < 0.05). Mean of Individual performance also had a statistically significant difference between the two groups (P < 0.05), but its intensity did not change.

    CONCLUSION

    CARE method can be effective in burnout of nurses and it can be used as a practical method. This training program can be implemented both preservice and in‑service for health workers.

    Keywords: Awareness, burnout, compassion, empowerment, resilience
  • Sayeh Shiri, Azizeh Farshbaf‑Khalili, Khalil Esmaeilpour, Niloofar Sattarzadeh Page 66
    BACKGROUND

    Adolescence is a stressful time period. Adolescents experience new changes physically, mentally, emotionally, and socially. The purpose of this study was to determine the effects of acceptance and commitment therapy (ACT) on anxiety (primary outcome), depression, and quality of life (secondary outcomes) of adolescents.

    MATERIALS AND METHOD

    This was a quasi‑experimental study with pre and postintervention design. One hundred female students aged 16–18 years with mild to moderate anxiety selected through multistage cluster sampling from five educational districts of Tabriz. During six group counseling sessions, students were consulted with the acceptance and commitment approach according to the protocol. Beck Anxiety and Depression Inventory and the World Health Organization brief Quality of Life Questionnaire consultation were completed before, immediately after, and 8 weeks after the consultation. Data were analyzed using repeated measure ANCOVA.

    RESULTS

    The mean anxiety score decreased significantly immediately after the intervention (mean difference [MD]: −4.0, 95% confidence interval [CI]: −5.9 to − 2.0; P < 0.001) and 8 weeks later (MD: −3.9, 95% CI: −5.8 to − 1.9; P < 0.001). The mean depression score immediately (P < 0.001) and 8 weeks after intervention (MD; −4.2, CI: −1.6 to − 6.8), P < 0.001) declined significantly. The mean overall quality of life score increased significantly after the intervention (P < 0.001) and 8 weeks later (MD: 4.7, 95% CI: 7.1–2.3, P < 0.001) compared to baseline.

    CONCLUSIONS

    Based on the effectiveness of counseling based on ACT on anxiety, depression, and quality of life in the female students with the mild and moderate anxiety over time, it can be used as a helpful method in high schools.

  • Mahshid Bokaie, Marzie Zarei Gashiri, Azam Khoshbin, Hajar Salimi Page 67
    BACKGROUND

    Pregnancy may change sex life, this period may be associated with decreased sex, and this is due to fear of miscarriage, nausea and vomiting, fear of harm to the fetus, fatigue, and fear of ruptured membranes. Midwives could help them to improve their sexual life during this period. One of the important approaches to improving sexual life during pregnancy is cognitive‑behavioral therapy (CBT). This nonmedical approach could improve misconceptions about sex during pregnancy. The aim of this study was the effect of sexual health counseling based on CBT on sexual satisfaction and inefficient sexual beliefs of primigravida women.

    MATERIALS AND METHODS

    This was a randomized clinical trial study, the research population being 52 pregnant women who were randomly divided into groups, the experimental (26) and the control (26). Before the sexual health counseling based on CBT, the Sexual Satisfaction Questionnaire and the Inefficient Sexual Beliefs Questionnaire were filled by both the groups. These standard questionnaires were completed three times (before, immediately, and 4 weeks after intervention). After pretest, eight sexual health counseling sessions (90 min) were performed for the experimental group. The control group received routine care. Data analysis was performed by using descriptive statistics tests, ANOVA, and post hoc tests by Bonferroni method in SPSS version 22. P < 0.05 was considered statistically significant.

    RESULTS

    The mean score of inefficient sexual beliefs in the interventional group before intervention, immediately after the intervention, and 1 month later was obtained 22.85 ± 9.57, 12.92 ± 7.25, and 7.86 ± 13.88, respectively (P < 0.001). The mean score of sexual satisfaction before the study, immediately after the intervention, and 1 month later was 88.77 ± 11.89, 95.62 ± 9.27, and 94.65 ± 8.28, respectively, in the experimental group (P < 0.001).

    CONCLUSION

    Sexual health counseling based on CBT could reduce inefficient sexual beliefs and increase the sexual satisfaction of the primigravida women during pregnancy, but most participants preferred fewer sessions.

    Keywords: Behavioral‑cognitive approach, beliefs, pregnant women, sexual satisfaction
  • Mahdi Moshki, Reza Yaghubi, Fariba Pariafsai Page 68
    BACKGROUND

    Positive psychology introduce mental health as a positive psychological functioning and represent it as well‑being psychology. From this point of view, psychological health is more supposed to be known as having positive characteristics such as self‑esteem, positive social relationships, and satisfaction. This study was conducted to compare the effect of education in two methods of person‑centered and supportive group based on the PRECEDE‑PROCEED model on women’s psychological well‑being during menopause.

    MATERIALS AND METHODS

    The present study was a clinical trial. One hundred and ten menopausal women have been placed in two groups (tests and control). The training program was designed according to the PRECEDE‑PROCEED model. The educational intervention was implemented for two groups (person‑centered and the supportive group) and the control group did not receive any training. Data analysis was used by descriptive statistics and in the case of normal distribution of alternative tests such as Kruskal–Wallis test, Man–Whitney test, Wilcoxon, spearman correlation, Spearman correlation was used.

    RESULTS

    Results of variance analysis showed that awareness, attitude, self‑efficacy, enabling factors, reinforcement, support, behavioral environment, six psychological well‑being factors were significantly different from the individual group and control group. Furthermore, the overall score of the psychological well‑being was significantly higher than the control group.

    CONCLUSIONS

    As a result of the design and deployment of health care monitoring system, building and reform of community beliefs toward women’s status in decision making and their role in menopause, the design and development of support group meetings in women’s health care system and enhancing women’s access to specialist and heterogeneous health services tailored to the needs of the menopause.

    Keywords: Menopause, person‑centered group, PRECEDE‑PROCEED model, psychological well‑being, support group
  • Navid Mirzakhani Araghi, Mehdi Alizadeh Zarei, Shafagh Saei, Hamid Reza Yousefi Nodeh, Ebrahim Mahmoudi Page 70
    BACKGROUND

    COVID‑19 virus is on the rise globally, and people with the disease experience a variety of physical and mental problems. According to studies, depression can be a complication of the virus. So far, limited measures have been taken to prevent and treat emotional–psychological complications of COVID‑19. The aim of this study was to evaluate the effect of online cognitive behavioral therapy (CBT) on depressive symptoms in recovered patients with COVID‑19.

    MATERIALS AND METHODS

    This study was conducted in a quasi‑experimental design. A sample of 150 recovered patients with COVID‑19 who referred to Imam Reza Hospital in Tabriz city, were selected by random sampling method. The patients’ emotional–psychological status was assessed by the Beck Depression Inventory, and they entered the treatment process according to the inclusion criteria. As a therapeutic intervention, a scientific and valid approach called CBT was implemented, which two occupational therapists performed in eight treatment sessions in the context of a social communication application. Paired sample t‑test was used to analyze the time sequence of quantitative data due to its normality.

    RESULTS

    After the last session of the intervention, the effect of this therapeutic approach on reducing the depressive symptoms of patients was evaluated. According to the findings, the Beck score of the participants decreased significantly after the intervention (MD = ‒45/9, P < 0/001).

    CONCLUSION

    Therefore, in order to promote the recovery of patients with COVID‑19 and help health authorities to develop preventive measures and effective treatment of emotional–psychological problems caused by this virus, it is recommended to use the online CBT approach.

    Keywords: Cognitive behavioral therapy, COVID‑19, depression
  • Faranak Safdari-Dehcheshmeh, Mahnaz Noroozi, Fariba Taleghani, Soraya Memar Page 71
    BACKGROUND

    One of the most basic life events is fertility or reproduction, which, although known as a social phenomenon, is a complex and multidimensional concept with economic, cultural, political, and religious significance. The present study aims to explain the pattern of childbearing behaviors in couples.

    MATERIALS AND METHODS

    This study is a focused ethnographic qualitative research. Participants of this study will be 20–35 years old couples who, using purposeful sampling method, will be selected from comprehensive health centers, ultrasound centers, laboratories, premarital counseling centers, offices of obstetricians and midwives, universities, shopping centers, cinemas, parks, restaurants, and entertainment centers in Isfahan, Iran. Sampling will continue considering the strategy of maximum variation in terms of age, occupation, education, and economic status until data saturation is reached. Data will be collected through semi‑structured and in‑depth individual interviews, focus group discussions, observation, field notes, daily notes, and document analysis. Simultaneous with data collection, the data will be analyzed using the thematic analysis method based on Braun and Clarke’s approach.

    CONCLUSION

    This present study is expected to lead to a deep understanding and identification of the attitudes, beliefs, and values of couples with regard to childbearing. Moreover, by understanding the pattern of childbearing behaviors of couples, useful information will be provided to the policymakers and planners for effective planning in the field of healthy childbearing. The findings can also be used in reproductive health counseling for newly married couples and community‑based interventions.

    Keywords: Anthropology, culture, reproduction, reproductive behavior, spouses
  • Rajan Rushender, Yuvaraj Krishnamoorthy, Ameenah Anwar Hussain Siraja Page 72
    BACKGROUND

    Addressing good breastfeeding practices among antenatal and postnatal mothers is important as it helps in bringing about a positive change in the behavior, attitude, and practice with appropriate health education. Hence, this study was done to determine the awareness level of antenatal and postnatal mothers about the breastfeeding practices and benefits and identify the factors associated with it in rural Chengalpattu, Tamil Nadu, India.

    MATERIALS AND METHODS

    We conducted this community‑based cross‑sectional study among 377 antenatal and postnatal mothers in the selected rural villages of Chengalpattu between October 2019 and September 2020. Details regarding the sociodemographic characteristics and awareness/ knowledge about the breastfeeding were collected using pretested semistructured questionnaire. Knowledge adequacy was summarized as proportion with 95% confidence interval (CI), and factors associated with knowledge were interpreted as adjusted prevalence ratio (aPR) with 95% CI using log‑binomial regression.

    RESULTS

    About 19.6% (95% CI: 15.7%–24.0%) mothers had inadequate knowledge about breastfeeding. Women who were unemployed (aPR = 1.60; 95% CI: 1.02–2.51), belonging to the lower socioeconomic status (aPR = 2.62; 95% CI: 1.80–3.82), belonging to Muslim religion (aPR = 1.63; 95% CI: 1.14–2.35), and living in joint family (aPR = 1.58; 95% CI: 1.12–2.21) had significant higher risk of inadequate knowledge about breastfeeding practices compared to those who were employed, belonging to upper socioeconomic status, Hindu religion, and living in nuclear family.

    CONCLUSION

    We found that almost one‑fifth of the antenatal and/or postnatal mothers had inadequate knowledge about the breastfeeding benefits and practices. Health education sessions are required to promote the awareness about breastfeeding during antenatal and postnatal check‑ups.

    Keywords: Awareness, breastfeeding, postnatal care, prenatal care
  • Naveed Nazir Shah, Syed Quibtiya Khursheed, Zaid Khan, Shuja Reagu, Majid Alabdulla, Inaamul Haq, Shabir Ahmad Dar, Adnan Hamza, Khurshid Ahmad Dar, Syed Suraiya Farooq, Bikram Singh Datta Page 73
    BACKGROUND

    The World Health Organization declared vaccine hesitancy as one of the planet’s top 10 global health threats in 2019. With the rollout of the coronavirus disease‑19 (COVID‑19) vaccines, a survey was conducted to find out the hesitancy and the apprehensions that come along with taking COVID‑19 vaccines among health‑care workers (HCWs).

    MATERIALS AND METHODS

    This was an online cross‑sectional survey which was developed and shared through social media platforms among the HCWs of Kashmir. The survey captured demographic data and used a validated hesitancy measurement tool from January 2021 to February 2021. The data were analyzed by descriptive statistics and multivariable logistic regression using Stata 15 (Stata Corp. 2017. Stata Statistical Software: Release 15. College Station, TX: Stata Corp LLC).

    RESULTS

    Willingness to take the COVID‑19 vaccine when available was seen in 67.7% of the HCWs. Overall, 9.59% of respondents reported unwillingness to receive a vaccine for COVID‑19, while 22.7% were unsure. The most commonly cited reason for willingness to get vaccinated was an understanding of the disease and vaccination, as reported by 81.5%. Being single was significantly related to an increased risk of vaccine hesitancy (adjusted odds ratio = 5.27, 95% confidence interval: 2.07–13.40). Among vaccine attitudes, concerns about the safety of the vaccine, unforeseen problems in children, and possible unknown future adverse effects of the vaccine were the most important determinants of unwillingness.

    CONCLUSIONS

    A significant proportion of the HCWs showed vaccine hesitancy to the COVID‐19 vaccine. Hesitancy attitudes were almost always driven by concern around the vaccine safety. States and health‑care authorities need to recognize the massive trust deficit around the Covid‑19 vaccine and use the popular media used by people to share credible and reliable information.

    Keywords: COVID‑19, COVID‑19 vaccine, health‑care workers, safety, survey, vaccine acceptance, vaccinehesitancy
  • Maneesh Sharma, Divita Sharma, Ashok Kumar Sharma, Aroop Mohanty, Meenakshi Khapre, C. Vasantha Kalyani Page 74
    BACKGROUND

    To reduce the likelihood of transmission of infection to health‑care workers (HCWs), personal protective equipment is used. However, wearing personal protective equipment (PPE) increases the risk of heat stress and loss of dexterity, leads to poor compliance to PPE. To address the issues of poor compliance to PPE, it was necessary to gain a deeper understanding about the factors that influence compliance. Thus this qualitative study was planned to explore barriers faced by HCWs while using PPE during a pandemic situation in a tertiary care hospital, Uttarakhand, India.

    MATERIALS AND METHODS

    A exploratory qualitative study was undertaken among health care workers involved in the care of COVID patients. FGDs were done and an unstructured interview guide with open‑ended questions was used which helped to explore the factors which can be potential barriers to the HCWs while working wearing PPE.

    RESULTS

    Organizational and individual factors acting as barriers such as unavailability of essential personal protective equipment, a disharmonious work environment, lack of comfort, inadequate size, and quality of PPE were identified as the major barriers in the present study.

    CONCLUSION

    Future efforts to optimize PPE use should focus on to adequate supplies both in quality and quantity can help in avoidance of such barriers. Resources should be prioritized with the needs of the HCWs in the times of pandemic. Regular training and feedbacks are necessary for the satisfaction of HCWs and improving PPE compliance.

    Keywords: Barriers, COVID‑19, health‑care workers, personal protective equipment, tertiary care hospital
  • Roy Rillera Marzo, Sudip Bhattacharya, Mohamad Zulfadhli Bin Mohamad Yunus, Nurin Irdina Bt Noraidiazhar, Ain Mastura Nnakaliisa Bt Ssuna Salim, Thevanai A, P Subramanian, Nurainun Mardhiah Binti Samril Page 75
    BACKGROUND

    According to the perception of majority of people, especially the elderly, it is believed that elderly people who are sent to old‑age homes are more prone to have depression compared to those who are living with the community. This study was aimed to assess the significance of the place of residence in relation to the presence of depression among the elderly.

    MATERIALS AND METHODS

    A cross‑sectional descriptive study was conducted between March and August 2020 to assess the depression among the elderly population residing in the Muar district, of Malaysia. A random table was generated of 250 house numbers in Muar where there is at least one geriatric person was living and a random sampling method was used for data collection. A questionnaire was distributed to a sample size of 250 old folks of Muar: those residing in old‑age homes (n = 125) and those residing in their own houses (n = 125). A standard sociodemographic and geriatric depression scale interview was employed for data collection. All details were keyed into the SPSS version 22 software Standard Gradpack 23, and simple description and inferential statistics such as mean, median mode, percentages, and Chi‑square tests were performed to compare the effects of different residences toward the mental health of the elderly.

    RESULTS

    The total mean age of the elderly in both the places was 73.06 ± 9.116 years. Female respondents of this research accounted for 52.8%. In terms of religion, Islam had the highest number of respondents of 46.8%, followed by Buddhist (33.6%), Christian (10.8%), and Hindu (8.8%). The percentage of elderly having more than three children was 45.2%. The marital status and employment status of the elderly in Muar area are mostly widowed (40.8%) and retired (50%). They are predominately literate (81.6%) and most have a monthly income less than RM 2000 (90.8%). We found that the prevalence rate of depression was 70.4% in the elderly residing in old‑age homes and 24.8% in the elderly living in the community. Females had a higher prevalence of depression than males (60.2% vs. 39.8%) among the elderly in old‑age homes, whereas males had a higher prevalence in the community than females (51.6% vs. 48.4%). Logistic regression analysis revealed the place of residence (P < 0.01 and employment status (P = 0.011) as the predictors of depression.

    CONCLUSION

    Results of this study revealed that the high prevalence rate of depression among the elderly is in old‑age homes compared to elderly living in the community.

    Keywords: Community health, depression, elderly, geriatric assessment, homes for the aged
  • Sabira Aalia Dkhar, Asif Jeelani, Ruqia Quansar, S. Muhammad Salim Khan Page 76
    BACKGROUND

    COVID‑19 has led to significant morbidity and mortality globally in addition to unprecedented disruption in economic activities. Vaccination against it is considered to be the only sustainable way out of this pandemic. The study was conducted to estimate vaccine acceptance among doctors in India using an online survey.

    MATERIALS AND METHODS

    A cross‑sectional study using a purposive sampling method was conducted two weeks before vaccine rollout. A pretested questionnaire developed using Google forms was shared by social media groups targeting doctors only.The questions collected information regarding socio‑demographic details, knowledge, attitude and practices towards COVID‑19 vaccination. Data was downloaded and analysed using SPSS‑v23. Chi‑square test and fisher exact test was used and P < 0.05 was considered significant.

    RESULTS

    A total of 511 records were included in the final analysis of which 340 (66.53%) reported to be either definitely or probably willing to accept COVID‑19 vaccine. One third of respondents were working in COVID‑19 designated hospitals (37.2%), 30% were posted in non COVID‑19 hospitals, 25.1% had no direct contact with COVID‑19 patients while 7.7% doctors were involved in testing COVID‑19 diagnosis. Subjects who perceived a higher risk of contracting COVID‑19, those who perceived that vaccine would be effective against COVID‑19 and those who felt that vaccine will not have any serious side effects were more likely to accept the vaccine.

    CONCLUSION

    There is an urgent need to address any apprehensions regarding COVID‑19 vaccines. A tailored and intensified advocacy program for doctors is needed before the launch of vaccine.

    Keywords: Anti‑vaccination movement, COVID‑19, COVID‑19 vaccines, vaccination refusal, vaccine safety
  • Lidia Gavic, Ana Maretic, Sanda Putica, Antonija Tadin Page 77
    BACKGROUND

    This cross‑sectional study aimed to evaluate attitudes and knowledge regarding oral health and infant oral health among pregnant women.

    MATERIALS AND METHODS

    The study involved 325 pregnant women in the Republic of Croatia who completed an anonymous online questionnaire (Google forms) from January to June 2019. The questionnaire was divided into three parts. The first part contained questions about the demographic data experience about oral health in pregnancy. The second part was related to the knowledge of the relationship between oral health and pregnancy. The third section consisted of questions related to knowledge about the oral health of children at the earliest age. The results were analyzed with descriptive statistics, Spearman correlation analysis, and Chi‑square test.

    RESULTS

    The women are mostly informed about oral health in pregnancy from their dentists (53.54%) and least from their general doctors (4%). In pregnancy, gingival bleeding was observed by 52.31% of respondents and tooth mobility by 12.31%. The Chi‑square test found that there was a difference in attitude regarding the age at which they should stop breastfeeding between respondents who had their first pregnancy and those who already had children. Only 9.23% of respondents are aware that breastfeeding can cause tooth decay.

    CONCLUSION

    Pregnant women in the Republic of Croatia do not have sufficient knowledge, and they are neither aware of the importance of oral health during pregnancy nor infant oral health.

    Keywords: Oral health, pregnancy, pregnant women
  • Page 78

    In the article titled Exploring the experiences of nurses and physicians infected with COVID‑19 published on pages 35, Issue 1, Volume 11 of Journal of Education and Health Promotion,[1] the affiliation of Maryam Moghimian is written incorrectly as Nursing Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran instead of Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran.