فهرست مطالب

Journal of Education and Health Promotion
Volume:13 Issue: 1, Jan 2023

  • تاریخ انتشار: 1401/11/22
  • تعداد عناوین: 39
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  • Helia Gholizadeh Page 1

    In the article titled “Health-promoting behaviors in staff and students of Ardabil University of Medical Sciences”, published on pages 283, Issue 1, Volume 11 of Journal of Education and Health Promotion,[1] the affiliation of Abdollah Dargahi and Helia Gholizadeh are written incorrectly as "Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran” and “Medical student of Islamic Azad University, Ardabil Branch, Ardabil, Iran respectively." instead of "Department of Environmental Health, Khalkhal University of Medical Sciences, Khalkhal; Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran and Students Research Committee, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran respectively.

  • Page 2

    In the article titled “Iranian nongovernmental organizations' initiatives in COVID-19 pandemic”, published on pages 225, Issue 1, Volume 11 of Journal of Education and Health Promotion,[1] the acknowledgement of the article has been added as “This study was financially supported by a nongovernmental organization named Dr. Mojtaba Moein in collaboration with Social Welfare Management Research Center of the University of Social Welfare and Rehabilitation Sciences. Also, the Authors of this study express their sincere gratitude to all the non-governmental organizations that participated in this study.”

  • Shirin Alsadat Hadian, Mohammad Hossein Yarmohammadian *, Nasrin Shaarbafchizadeh Page 3
    BACKGROUND

    Organizational health (OH) is an organizational aspect in which staff is encouraged to be clearly involved and participate in decision‑making, problem solving, and collaborating to improve organizational climate and culture. Multilevel staff involvement facilitates strengthened relationships, open communication, trust, and organizational commitment. The purpose of this study was to find components of OH for small‑sized health‑care organizations.

    METHODS

    A systematic review across three key databases by using an extensive list of keywords components and interventions was conducted. This survey included studies that explored various OH elements, components and interventions.

    RESULTS

    It comprises 34 full‑text studies from 221 received studies. Afterward, the OH elements were classified into three main categories (OH elements, organizational health literacy, and organizational health interventions). Then, according to the reviewed data, 23 dimensions were defined similarly for all groups of studies and relevant explanations related to them were reported.

    CONCLUSION

    The OH encompasses multiple dimensions. Empirical research is required for designing a questionnaire according to the final extracted components and measuring its validation in small‑sized health organizations.

    Keywords: Component, Health care, Organizational Health
  • Vaibhav Kumar *, Yashashree Patil, Romi Jain, Nikhil Bhanushali, Ketaki Gaonkar, Jobsy Ciby Page 4
    BACKGROUND

    Since the outbreak of the pandemic, the release of the COVID (Corona Virus Disease)‑19 vaccine was highly anticipated. Nevertheless, vaccine availability does not symbolize the end of pandemic due to ongoing vaccine hesitancy and anti‑vaccination movements. The objective of this study is to evaluate COVID‑19 vaccine acceptance among pregnant and lactating individuals in Maharashtra state, India.

    MATERIALS AND METHODS

    A descriptive cross‑sectional study was conducted via a hybrid approach using various digital portals such as Whatsapp, telegram, and physical distribution to those who did not have access to smartphone devices. A probability proportional sampling strategy was deployed. A pre‑validated structured self‑administered questionnaire tool designed by Freeman et al. 2020 (Oxford COVID‑19 vaccine hesitancy scale) was used, which consisted of seven close‑ended targeted and focused questions. Analysis of several survey items and vaccine acceptance was conducted using the Chi‑square test.

    RESULTS

    Analysis revealed that 58% of individuals were willing to take vaccines after government approval and 26% of individuals showed hesitancy toward vaccination. When compared, lactating individuals showed less vaccine hesitancy (22%) than pregnant individuals (27%). The maximum vaccine hesitancy was observed in the third trimester of pregnancy (29.5%).

    CONCLUSIONS

    Trust in vaccines is a crucial factor and is dependent on the ability of the government in promoting vaccines through effective communication; this can be one of the reasons for the high level of acceptance and awareness toward COVID‑19 vaccination in this study.

    Keywords: Breastfeeding women, COVID‑19, pandemics, population, pregnant women, public health, vaccines
  • Amin Zirakbash, Farah Naderi *, Fatemeh Sadat Marashian, Behnam Makvandi Page 5
    BACKGROUND

    The immense comorbidity among disorders could be ascribed to common trans‑diagnostic processes. The term trans‑diagnostic has been of interest in both pathology and psychology. Trans‑diagnostic treatments were created as opposed to treatments based on single‑diagnosis treatments. It addresses the common underlying mechanisms in a range of comorbid disorders. Trans‑diagnostic treatment is one of the new psychological treatments, and its efficacy has been proven on many psychological variables. The main focus of the current study is on designing unified trans‑diagnostic interventions and their efficacy on the shared mechanisms of comorbid obsessive personality disorder with anxiety, depression, and obsessive‑compulsive disorder.

    MATERIALS AND METHODS

    the sequential transformative strategy has two stages; qualitative and quantitative. In The first and qualitative section of the research, explanatory research will be carried out to investigate the trans‑diagnostic intervention using a systematic review. To validate the trans‑diagnostic intervention, and simultaneously with the trans‑diagnostic intervention, a questionnaire has been prepared and given to 10 psychology experts and professionals in the treatment field concerning content validity by evaluators. Quasi‑experimental research will be assessed with a pre‑test, post‑test, and a two‑month follow‑up after confirming the validity and reliability of the intervention in the quantitative section.

    CONCLUSION

    Designing unified trans‑diagnosis interventions and their efficacy on the common mechanisms of comorbid obsessive personality disorder with anxiety, depression, and obsessive‑compulsive disorder is an effective treatment method for helping those suffering from a personality disorder. Clinical psychologists, psychology experts, psychiatrists, and mental health experts are all the immediate beneficiaries of this study. Moreover, clients could benefit from this intervention with less money and time.

    Keywords: Anxiety, comorbid, depression, obsessive‑compulsive, trans‑diagnostic, unified
  • Narayana Goruntla *, Kokkala Akanksha, Katta Lalithaasudhaa, Vikash Pinnu, Dasaratharamaiah Jinka, Pradeepkumar Bhupalam, Jyosna Doniparthi Page 6
    BACKGROUND

    The World Health Organization (WHO) states that vaccine hesitancy is one of the top 10 threats to global public health. Evidence shows that vaccine hesitancy studies in India are limited and targeted toward individual vaccines. The study aimed to fill this gap by exploring the relationship between demographics and SAGE factors toward vaccine hesitancy.

    MATERIALS AND METHODS

    A hospital‑based, cross‑sectional, analytical study was conducted in a non‑governmental organization (NGO) hospital with 330 beds, located in Bathalapalli, Andhra Pradesh, India. Mothers of under‑five children who attended outpatient departments of pediatrics or obstetrics and gynecology were included. A total of 574 mothers were enrolled and vaccine hesitancy was determined by reviewing the mother–child protection card for the presence of delay or refusal of the recommended vaccine. A face‑to‑face interview was conducted to obtain demographics and WHO–SAGE variables from the participants. Binary logistic regression analysis was performed to associate independent variables (demographics and SAGE variables) with the dependent variable (vaccine hesitancy).

    RESULTS

    Out of 574 respondents, 161 mother’s children were noted as vaccine‑hesitant (refusal = 7; delay = 154); and the prevalence of vaccine hesitancy was 28.05%. The delay was observed in all recommended vaccines, but the refusal or reluctance was seen in only four vaccines (hepatitis B birth dose = 1; IPV 1 and 2 = 2; Measles 1 and 2 = 3; and Rota 1, 2, and 3 = 1). The respondents’ demographics like no or lower parent education (OR = 3.17; 95%CI = 1.50–6.72) and fewer antenatal visits (OR = 2.30; 95%CI = 1.45–3.36) showed higher odds, whereas the upper socioeconomic status showed lower odds (OR = 0.09; 95%CI = 0.02–0.36) toward vaccine hesitancy. The WHO– SAGE dimensions like awareness (OR = 0.14; 95%CI = 0.03–0.53), poor access (OR = 7.76; 95%CI = 3.65–16.51), and low acceptability of the individual (OR = 07.15; 95%CI = 1.87–27.29), community (OR = 6.21; 95%CI = 1.58–24.33) were significantly associated with vaccine hesitancy.

    CONCLUSION

    The study concludes that the prevalence of vaccine hesitancy was high. Vaccine safety and children’s health are primary concerns for parents’ refusal/reluctance. To achieve 100% immunization coverage, policymakers need to reduce vaccine hesitancy by developing strategies based on demographic and WHO–SAGE working group predictors.

    Keywords: Childhood vaccination, immunization coverage, vaccine delay, vaccine hesitancy
  • Gaurang Narayan, Anandaraj Rajagopal *, Lopamudra Moharana Page 7
    BACKGROUND

    Biomedical research is not given adequate attention during undergraduation due to the failure of the medical curriculum to motivate the students to take up research, teach the research methodology, and emphasize the scope of research in the future. Our objective was to study the perceptions of medical undergraduate students toward biomedical research and to explore the facilitators and barriers to biomedical research.

    MATERIALS AND METHODS

    This was an explanatory, sequential, mixed‑method study. Consenting medical undergraduate students, irrespective of their previous contribution to research, were interviewed by a pretested questionnaire concerning biomedical research, its barriers, and facilitators. For the qualitative component, two focused group discussions (FGDs) were conducted among students in the nonclinical and clinical phases. Data were analyzed and expressed as percentages. Thematic manual content analysis of the transcribed manuscripts was performed.

    RESULTS

    This study included 553 participants. Only 5.52% had previous experience undertaking research. Self‑interest and acquiring deeper knowledge were identified as drivers. Lack of motivation, proper guidance, and training in research methodology was found to be the barrier among 90% of the subjects. The FGD reflected the perceptions of students and variations in their ideologies toward taking up research.

    CONCLUSION

    It becomes important to analyze the factors that promote or avert a student from taking up research. A thorough investigation in this regard will be helpful for future cohorts of medical students and will impact their decisions on taking up research and in seeking a career in research‑based fields.

    Keywords: Barriers, biomedical research, curriculum, facilitators, perceptions, undergraduate (UG)
  • Alireza Jabbari, Marziye Hadian, Elaheh Mazaheri, Zahra Khakdel Jelodar * Page 8
    BACKGROUND

    With more than 12 million new cases of cancers and nearly 7.6 million deaths worldwide in 2020, cancer is currently the third leading cause of mortality in the world. The costs spent on treating patients with cancer account for a significant amount of healthcare costs. Healthcare expenditures for cancer treatment have also increased significantly and are projected to skyrocket further over the next decade. This study was conducted to determine medical and non‑medical direct costs for the prevention of cancer in patients hospitalized in 10 selected educational hospitals in Iran.

    MATERIALS AND METHODS

    The study employed a cross‑sectional design and was conducted in 10 selected educational hospitals in Tabriz, Tehran, Isfahan, Mashhad, and Shiraz in 2020. Using a researcher‑made questionnaire, we assessed direct medical costs and direct non-medical costs of cancer in patients over 20 years old with kinds of breast, prostate, leukemia, lymphatic, stomach, liver, lung, bladder, uterine, and intestine cancers who undertook oncology treatments (n = 2410). Data were analyzed using descriptive statistics including mean and standard deviation and analytic statistics such as Kolmogorov–Smirnov, analysis of variance, and t‑test, using SPSS 18 and P ≤0.05.

    RESULT

    The mean direct non-medical cost paid out of pocket per month was $99.6 ± $10.81 USD, and the mean direct medical cost per month was $1029.4 ± $68.5 USD. The total cost paid by the patients was $889.4 ± 69.81 USD per month.

    CONCLUSION

    Given the increasing number of patients with cancer, it is necessary to increase the number of special centers for the prevention and treatment of cancers. Dissemination of information about the costs of illnesses and their complications enables decision‑makers to make a proper comparison between different uses of resources. Moreover, to support the patients, the health system must implement plans to decrease out‑of‑pocket payments by patients.

    Keywords: Cancer, direct medical costs, direct non-medical costs, economic cost, Iran
  • Fatemeh Bahrambeygi, Sakineh Rakhshanderou, Ali Ramezankhani, Mohtasham Ghaffari * Page 9
    BACKGROUND AND AIM

    Given the complexities of the health care system and the importance of the subject and effects of health literacy in all aspects of care, defining specific health literacy in this context seems necessary. The purpose of this research was to explain the concept of hospital health literacy (HHL), its definition, and the related dimensions using the qualitative research method.

    MATERIALS AND METHODS

    An exploratory qualitative design was used. Exploratory, open‑ended, and face‑to‑face interviews based on the interview guide were used to elicit participants’ perspectives between July 2021 and January 2022. By using the content analysis method, researchers coded transcripts and collated these codes into sub‑categories and then merged them into the main category and explored the dimensions of the concept.

    RESULTS

    A total of 23 service providers and 25 service recipients were included in the study. Analysis of qualitative data led to the identification of 6 categories and 25 sub‑categories including cognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, media literacy, and emotional literacy.

    CONCLUSION

    The findings of the present study provide a deep understanding of the concept of HHL that could be applied to develop valid and reliable measurement tools for assessing HHL among a variety of populations. Also, it is hoped that the present attempt can be useful to guide future research and interventions as well as to provide a clear base for planning, implementing, and evaluating interventions aimed at promoting individuals’ health literacy in health settings.

    Keywords: Health care, health care providers, health literacy, hospital, qualitative research, recipients
  • Sourya Acharya, Sunil Kumar *, Ruchita Kabra, Mansi Patel, Neha Phate, Dhruv Talwar, Varun Daiya Page 10
    BACKGROUND

    The angiotensin‑converting enzyme 2 (ACE2) receptor, a membrane receptor present in the respiratory system, the gastrointestinal tracts, the heart, and the kidney is the entry point for SARS‑CoV‑2 to enter human cells. Concerns were raised about the influence of using antihypertensive drugs like angiotensin‑converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in individuals with COVID‑19 due to its tight relationship with the ACE2 receptor. The aim of this study was to investigate the impact of being on an Angiotensin Receptor Blockers (ARB) on mortality in patients consecutively diagnosed with COVID‑19.

    MATERIAL AND METHODS

    This is the retrospective observational study done in all patients consecutively diagnosed with COVID‑19 from January 2021 to June 2021. All related patient information and clinical data was retrieved from the hospitals electronic medical record system.

    RESULTS

    In this study, out of 500 patients, 51 died, having mean age of 66.92 ± 10.85 years. 144 (28.8%) patients were on angiotensin receptor blockers as antihypertensive treatment, 142 (28.4%) having other antihypertensive and 214 (42.8%) were not on any treatment. Out of 51 Death 7 (4.9) patients were on ARBs, 15 ± 10.6 were on other medication [OR 2.31 (0.94–6.22, P = 0.077) univariable; OR 2.57 (1.00–7.23, P = 0.058) multivariable] and 29 ± 13.6 had no treatment at all [OR 3.07 (1.38–7.80, P = 0.010) univariable; OR 3.36 (1.41–9.08, P = 0.010) multivariable].

    CONCLUSION

    Use of ARB medications for the hypertensive patients who acquire COVID‑19 infection has shown protective effects of such medications on COVID‑19 disease severity in the term of mortality and the mortality rate among hypertensive patients on COVID‑19 with ARBs/ACE inhibitors showed significant differences as compared to other antihypertensives.

    Keywords: ARB (Angiotensin II receptor blocker), COVID − 19, ICU (intensive care unit), mortality
  • Hani Rahimi, Mohammadreza Pirmoradi *, Fahimeh Fathali Lavasani, Hojjatollah Farahani Page 11
    AIM AND BACKGROUND

    Multiple sclerosis (MS) is a long‑course incurable disease as well as an unknown prognosis causing patients to experience a variety of psychological outcomes. Meanwhile, inability to control the disease‑related uncertainty leads to the use of maladaptive coping strategies, causing more psychological distress. This study investigated the effectiveness of intervention focused on the intolerance of uncertainty on psychological distress and quality of life in MS patients.

    MATERIALS AND METHODS

    This research adopted a true experimental design. All phases of the study were conducted online due to the COVID‑19 pandemic during 2021 in Tehran. The statistical population of the study was purposefully selected from among MS patients and was randomly assigned to three groups of 20: IU intervention and two control groups (cognitive behavioral therapy (CBT) and treatment as usual (TAU) groups). The study included pre‑test, post‑test, and follow‑up stages. The outcome measures of the study included the Depression Anxiety Stress Scale (DASS‑21) as well as Multiple Sclerosis Quality of Life‑54 (MSQoL‑54). Mixed analysis of variance was used to analyze the data.

    RESULTS

    The results showed that IU intervention compared to CBT, is more effective on psychological distress (depression P = 0.006, anxiety P = 0.01, and stress P = 0.01) and quality of life (P = 0.001) in MS patients. Nonetheless, IU‑focused intervention is more effective than TAU on psychological distress (depression P = 0.0001, anxiety P = 0.0001, stress P = 0.0001) as well as quality of life (P = 0.0001) in these patients.

    CONCLUSIONS

    IU‑based intervention can reduce psychological distress and improve quality of life of MS patients. Accepting uncertainty can reduce the anxiety and stress of MS patients which can increase the quality of life of these patients.

    Keywords: Cognitive behavioral therapy, intolerance, multiple sclerosis, psychological distress, quality of life, uncertainty
  • Vanessa Ravel, Venkatachalam Jayaseelan *, Sasirekha Rengaraj, Subitha Lakshminarayanan, Sivaranjini Kannusamy, Balaji Susindhran Page 12
    BACKGROUND

    Globally, one in ten pregnant women have diabetes; out of which, 90% contribute to gestational diabetes mellitus (GDM). Medical Nutrition Therapy (MNT) is the cornerstone for GDM treatment yet adherence to MNT among the masses is not adequately monitored as part of the routine antenatal services. The study aimed to estimate the proportion of adherence to MNT and determine the factors related toadherence among antenatal women with GDM. This study also explores the facilitators, barriers, and possible suggestions for improving adherence.

    MATERIALS AND METHODS

    This facility‑based sequential explanatory mixed‑method study was conducted among 341 antenatal women with GDM at, Puducherry. The study was conducted in 2021. Dietary adherence was evaluated using Perceived Dietary Adherence Questionnaire and based on the scores obtained they were selected for in‑depth interviews to explore the facilitators and barriers. Collected data wereanalysed by Chi‑square test using STATA version 16.

    RESULTS

    Out of 341 participants, the proportion of participants adherent to MNT was 135 (39.6%) with 95% CI of 34%–44%.Thepredictors for poor adherence were unemployment (PR: 0.65; 95%CI: 0.48–0.88) and good adherence was antenatal women in the 2nd trimester (PR: 1.541; 95%CI: 1.18–2.025).Barrierstonon‑adherence were financial crisis, lack of awareness ofthe need for MNT, and joint family pressure.

    CONCLUSIONS

    About two‑thirds of antenatal women with GDM are non-adherent to MNT. Unemployment and period of gestation were found to be theirdeterminants. Appropriate action has to be implemented for improving the adherence rate.

    Keywords: Gestational diabetes mellitus (GDM), medical nutrition therapy (MNT), perceived dietary adherencequestionnaire (PDAQ)
  • Fatemeh Doremami, Hajar Salimi, Zeinab Heidari, Fatemeh Torabi * Page 13
    BACKGROUND

    One of the most important goals of sexual intercourse is to arouse the psychological effects of intercourse and to increase sexual self‑concept, which changes following sexual behaviors such as the use of contraception methods. This study was performed to investigate the relationship between sexual self‑concept and contraception sexual behavior in 15–49‑year‑old women covered by community health centers.

    MATERIALS AND METHODS

    The present descriptive correlational study was performed on 297 married women referring to Isfahan community health centers in 2020 who were selected as cluster that randomly classified. The tools included demographic information and the Snell’s Multidimensional Sexual Self‑Concept Questionnaire, the data of which were analyzed via SPSS version 22 software by Mann–Whitney U test and Pearson correlation.

    RESULTS

    Among a total of 297 women, 5.4% of the samples used hormonal methods and 94.6% used non‑hormonal methods, which was the most common intermittent method. The results also showed that the mean score of negative sexual self‑concept in women using the hormonal level method was significantly higher (P = 0.012). Positive and positive sexual self‑concept score was significantly higher in women using non‑hormonal methods (P = 0.048 and P = 0.002). Therefore, there was a significant relationship between sexual self‑concept and contraception method.

    CONCLUSION

    Due to the relationship between contraception and sexual self‑concept, it is recommended to pay attention to the aspects of sexual self‑concept and contraception during reproductive health counselling sessions so that if there is a disorder, useful advice can be provided or referred, if necessary.

    Keywords: Contraception Method, self‑concept, sexual behavior
  • Kinjari Kancharla *, Sagayaraj Kanagaraj, Ram Gopal C. N. Page 14
    BACKGROUND

    Metamemory can be described as an intentional endeavor to guide or control one’s memory processes. In other words, awareness and knowledge of one’s own memory process and strategies for using the memories effectively. Planning, allocating cognitive resources, selecting strategies, assessing understanding, and evaluating performance all rely heavily on metamemorial information. For efficient learning, good memory abilities are necessary. This study aimed to understand metamemory functioning and to see if there were any gender differences in metamemory functioning among medical students.

    MATERIALS AND METHODS

    This cross‑sectional study was conducted by collecting data from 350 medical students using the Memory Functioning Questionnaire in 2021. The sample group was selected from medical colleges in South India such as Kerala, Karnataka, Tamil Nadu, Telangana, and Andhra Pradesh using a purposive sampling technique. This questionnaire focused on the seriousness of forgetting, the rate at which people recalled things over time, and frequency of use of mnemonics and techniques that assist memory. Descriptive statistics, independent sample t‑test, correlation, and regression were used for analysis.

    RESULTS

    There was a significant difference based on gender among medical students in general memory functioning and frequency of forgetting (P < 0.001). Similarly, it was also found that gender was a major predictor of general memory functioning and frequency of forgetting among medical students (P < 0.001).

    CONCLUSION

    Most medical students believe they have a minor memory issue. Even if the majority of medical students forget information, the vast majority of them believe they have an exceptional memory. Gender acts as a significant predictor of general memory performance and forgetfulness.

    Keywords: Health education, health promotion, medical education, medical students, memory, metamemory
  • Shandiz Moslehi, Fahimeh Barghi Shirazi * Page 15
    BACKGROUND

    Cardiovascular diseases are the most common causes of death in the world. Because of the rate of emergencies and disasters in the country, this study was conducted to investigate the challenges of providing health services to cardiovascular patients in emergencies and disasters in Iran.

    MATERIALS AND METHODS

    This conventional content analysis study was conducted in 2020. Subjects were selected from among 16 Iranian experts) epidemiologists, cardiologists, PhD in Disaster Health, and PhD in Nursing (using purposeful and snowball sampling methods. Data were collected using semi‑structured interviews and were analyzed by the content analysis.

    RESULTS

    The results were obtained after analyzing the data in the pre‑emergency phase (lack of training on medication and nutrition, lack of training vulnerable groups, lack of databases of cardiovascular patients, and lack of identification of patients before disasters), the emergency response phase (lack of sleep and rest patterns, lack of health forces, lack of blood pressure control, lack of proper nutrition, increased medication needs, and lack of mental health interventions), and the post‑emergency phase (lack of planning, lack of management of patients’ mental problems).

    CONCLUSION

    Developing strategies for planning, training, providing resources, and mental health during the three phases of the emergency management cycle for specific groups such as cardiovascular patients together with empowering these patients in the event of disasters is one of the key strategies which can be used after curbed emergencies and disasters to reduce the rate of mortality.

    Keywords: Cardiovascular diseases, challenges, emergencies, disasters, health services
  • Fatemeh Keshmiri, Sara Jambarsang, Amir Houshang Mehrparvar * Page 16
    BACKGROUND

    The teacher must conduct educational responsibilities in the best way by observing the ethical principles to meet students’ educational needs. The aim of the study was to investigate the main factors of professionalism among faculty members from the viewpoints of various stakeholders including learners, peers, and educational officials, as well as the components were assessed from the viewpoints of the stakeholders.

    MATERIALS AND METHODS

    This was a descriptive analytical study conducted in two phases. In the first phase, a questionnaire was developed and validated to assess the professional behavior of faculty members. In the second phase, the evaluation of the teachers’ professional behavior was done from the viewpoint of various stakeholders, including learners, middle and senior education managers and peers. The participants were faculty members from 10 schools enrolled in the study by census (n = 427). To extract the factors that constitute professional behavior in faculty members, exploratory factor analysis was used. Data were summarized using descriptive indices (mean, standard deviation, and percent). Exploratory factor analysis (EFA) was used to extract the factors that constitute professional behavior in faculty members. Data was analyzed by using SPSS software (version 23.0).

    RESULTS

    In the first phase, the questionnaire with 11 items was developed. The validity and reliability of the tool was confirmed. The mean (SD) of the faculty members’ scores was 4.54(±0.34), with a minimum score of 2.33 and a maximum score of 5.00. The highest scores of faculty members were reported in the items of “altruism to colleagues and students” and the lowest scores were related to “feedback seeking and feedback acceptance”. Professional behavior was categorized under two domains: accountability to professional duties and adherence to professional values. Fifty percent of the participants followed the adherence to professional values (P = 0.22), but less than 50% of the individuals followed the adherence to professional duties significantly (P = 0.002).

    CONCLUSION

    The results of the present study showed that adherence to professional duties was low in faculty members. Assessment of individuals’ adherence in these two domains showed that faculty members’ compliance in the domain of accountability to professional duties was significantly lower.

    Keywords: Evaluation, professionalism, teacher, teaching
  • Uma Phalswal, Vani Pujari, Rasmita Sethi, Ranjana Verma * Page 17

    During the COVID‑19 pandemic, people are using social media more than usual routine because they rely on online sources to seek health information for themselves and their loved ones. The spread of inaccurate and misleading information via social media has a number of detrimental psychological effects on members of society. The aim of this systematic review was to describe the impact of social media on the mental health of the general population. An extensive systematic search was done till the last month of 2021 for collecting the evidence using the PRISMA technique. The search was mainly focused on the article leading with keywords and search engines used during the course of the study were Pubmed, Semantic Scholar, Mendeley, and Science direct. Articles for this study were selected based on the predetermined eligibility criteria and performed quality assessment by using the NHLBI quality assessment tool. Most of the studies included in this review are found fair (score between 9 and 12) quality. Out of 866 publications, 533 articles were included in the initial screening, after duplication removal 46 full‑text articles were assessed for eligibility and 14 studies were selected for systematic review. In most of the studies, maximum participants used social media as a primary source of information. Relatively high rates of symptoms of depression (14.14% to 48.3%), anxiety (7.4% to 47.82%), and prevalence of stress increased to 37.67% are reported after exposure to social media for coverage of COVID‑19 news in the general population. Risk factors of psychological distress are associated with female gender, younger age group, marital status, staying alone, and duration of exposure to mass media. Increased exposure to COVID‑19 information through mass/social media is associated with highly significant levels of psychological health issues; mitigating the hazardous effect of social media exposure during the COVID‑19 pandemic on the psychological health of the general population is an international public health priority.

    Keywords: Anxiety, covid‑19, depression, general population, mass media, mental health, pandemic, social media
  • Mehdi Bagheri, Shahram Shayan *, Fariba Jowkar Page 18
    BACKGROUND

    Educational managers at universities of medical sciences are the suppliers of human resources to the healthcare system. Thus, attention to their professional empowerment can play a prominent role in improving the quality of medical science education.

    MATERIALS AND METHODS

    The present study was implemented through the method of modeling and in the three stages of conceptual, modeling, and validation. The research environment was the medical science universities of Iran and the sampling method was purposive. The two qualitative approaches of literature review and semi‑structured interview were used to develop the components of the model. The results were then integrated, the relationships between the components were investigated, and the model was eventually finalized. The resulting scores were analyzed using MicMac software.

    RESULTS

    Twelve categories and 20 subcategories were identified in the first micro‑study (desk research). Qualitative analysis of the interviews in the second stage led to the identification of 21 subcategories and seven categories. Components of the conceptual model were extracted from the results of the two first stages, both of which were aimed at the extraction of concepts relevant to dynamic empowerment of medical science educational managers, and the conceptual model for dynamic empowerment of medical science education managers was designed in the six categories of education, decision‑making, organization, belief, dynamic capabilities, and environment after the interactions between the components were studied.

    CONCLUSIONS

    Results of the present study revealed that dynamic empowerment of the managers is a multifaceted and multidimensional concept, and all of the factors incorporated in the conceptual model for dynamic empowerment of managers must receive special attention.

    Keywords: Dynamic empowerment, educational managers, medical science education
  • Rajeshwari S., S. Meenakshi * Page 19
    BACKGROUND

    Human survival requires the ability to communicate. Today’s students’ use of social media has opened up a slew of new possibilities; nevertheless, it is hard to say how many more may emerge in the future. As the years have gone by, the use of social networking sites has grown in popularity among teenagers. This research investigates both the ways in which social media draws in users and the ways in which it hooks users by revealing the gimmicky worlds that they inhabit. Depending more on social media than on oneself causes a tremendous problem. It is quite challenging to separate human beings from their many electronic devices in today’s world. The use of devices gradually began to take over the world.

    MATERIALS AND METHODS

    Qualitative research approaches were used in this research. The qualitative study’s findings were gathered from a variety of secondary sources, including media articles, academic journal articles, and past theses. Throughout the course of this study, a discourse analysis method was employed, and several case studies were gathered from news articles and journals.

    RESULTS

    According to the results of the research, addiction to the Internet has been defined as a decrease in an individual’s ability to exercise self‑control within the context of the social‑cognitive framework. The research is based on true events that occurred in and around India. This research article focuses on the various positive and negative effects that social media may have on education and students. It is critical to figure out how to tackle this issue.

    CONCLUSION

    One effective strategy is to restrict their access to social media. The bulk of the disadvantages may be mitigated by reducing the amount of time spent on social media sites. Keeping track of their academic progress and dealing with any problems early on can help them avoid the negative effects of social media on their education.

    Keywords: Addiction, education, mental health, narcissism, social media
  • Dorcas Rosaley Prakaschandra *, Rhoda Meyer, Raisuyah Bhagwan Page 20
    BACKGROUND

    This study sought to understand whether the theoretical components of the curriculum prepared students for clinical practice training in the Bachelor of Health Sciences (BHSc) in Clinical Technology program at the Durban University of Technology.

    MATERIALS AND METHODS

    Two samples were recruited, namely, academics and students using non‑probability sampling methods. The first sample comprised 13 students, and the second sample included four academics, involved in teaching and supervising the placement of students at healthcare institutions. At least one student from each of the 13 units where clinical practice training was undertaken was invited to participate. Data was gathered using in‑depth, semi‑structured interviews on an adapted version of Gibbs’ cycle of reflection.

    RESULTS

    Three broad themes emerged, namely, curriculum structure, factors that enabled graduate attribute development in the clinical environment, and the transition to online teaching.

    CONCLUSION

    While it appears that the curriculum had in many ways prepared students for clinical practice, the study highlights key issues that may guide curriculum developers when seeking to improve preparedness of students for clinical practice. Furthermore, it underscores the need for continuous review of current curricula so that these are responsive to student and societal needs.

    Keywords: Clinical practice learning, clinical technology, curriculum preparedness, South Africa
  • Vivek Bhat, Reubel Coates *, Deepthi Shanbhag, Natasha Pillai, Neha Zacharias, Reema D’Souza, Geo Judes Mathew Page 21
    BACKGROUND

    Cardiovascular disease (CVD) is the number one cause of death in India. Atherosclerosis begins in the second decade of life; thus, preventive efforts beginning in adolescence are crucial. Yet, there are no national or regional school‑based educational programs in India for the prevention of CVD. We aimed to assess the impact of a simple educational intervention on the awareness regarding CVD among school‑going adolescents in a rural area of Bengaluru.

    MATERIALS AND METHODS

    This study was conducted using a convenience sample of school‑going adolescents of classes 8, 9, and 10 in three schools in a rural area of Anekal subdistrict, Bengaluru, with a sample size of 170. A standardized, validated questionnaire testing CVD awareness was administered, followed by a simple lecture with audio‑visual aids on key aspects of CVD. Three weeks later, the same questionnaire was administered to the same students. The results were then analyzed using appropriate descriptive (mean, percentage) and inferential analyses (Chi‑square, paired t‑test).

    RESULTS

    The mean (SD) age was 14.5 (1.0) years, and 54% (n = 100) were boys. 75% (139) belonged to privately funded schools. 23% (43) belonged to class 8, 37% (69) to class 9, and 40% (74) to class 10. The mean (SD) total score on baseline assessment was 27.4 (9.3) out of 100, with girls and students of private schools scoring higher. The mean (SD) post‑test total score was 48.5 (15.7), with significant increases in all domains of awareness, and in all categories of students.

    DISCUSSION

    Awareness regarding CVD among adolescents from rural Bengaluru was poor, highlighting the need for educational interventions to aid preventive efforts. A simple educational intervention resulted in significant improvements in CVD awareness, even after 3 weeks.

    Keywords: Adolescent health, atherosclerosis, health education, healthy lifestyle, heart diseases, primaryprevention
  • Najmolmolook Amini, Sakineh Rakhshanderou, Ali Ramezankhani, Alireza Delavari, Mohtasham Ghaffari * Page 22
    BACKGROUND

    Skill Training Intervention Based on the Healthy Lifestyle Counselling Module (5As model) in the Ira PEN Program.

    MATERIALS AND METHODS

    This study was a randomized controlled trial in Iran. Participants were 184 health workers and 184 clients (92 in each study group). The training program entailed an online training course, educational video, and clip. The behavior related to a healthy lifestyle in clients was also followed‑up 2 months later. Data were analyzed using SPSS 22 software.

    RESULTS

    Based on the observations, significant improvement in lifestyle counseling skills among health workers in the intervention group compared to the control group in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), smoking cessation (P = 0.03), and withdrawal of alcohol consumption (P < 0.001) was observed. Also, lifestyle‑related behaviors among clients in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), and withdrawal smoking (P < 0.001) increased significantly. Furthermore, waist circumference (P < 0.024) and BMI (P < 0.001) among clients were significantly reduced.

    CONCLUSION

    The training program for health personnel in healthy lifestyle has a more effective role in changing people’s behavior and prevention of noncommunicable risk factors. Healthy life style counselling in primary health cares may lead to control risk factors for Noncommunicable disease.

    Keywords: Counseling model, healthy lifestyle, noncommunicable diseases, primary health care, randomized‑controlled trial
  • Amir Abushouk *, Mohamed Eldigire Ahmed, Zaher Althagafi, Abdulrhman Almehmadi, Samer Alasmari, Fares Alenezi, Muhannad Fallata, Rayan Alshamrani Page 23
    BACKGROUND

    Annual influenza vaccine is recommended among health professionals especially, health science undergraduates; although, studies suggest that there is a low level of vaccine coverage among health care undergraduates. Thus, the study aimed to investigate students’ knowledge, attitudes, and practices regarding the seasonal influenza vaccine at King Saud bin Abdulaziz University for Health Sciences (KSAU‑HS) in Jeddah, Saudi Arabia.

    METHODS

    A cross‑sectional, unicentral study was carried out during the period of April to November 2021. A total of 341 validated questionnaires that included four sections were distributed in all four different colleges of KSAU‑HS. Data management and analyses were carried out using Statistical Software for Social Sciences (SPSS) version 25.

    RESULTS

    Out of 341 respondents, 336 participants completed the full survey (98.53% completion rate). The majority of participants were males (67.6% and the most participants were from the college of medicine (60.4%). The mean knowledge score of students was found to be (11.3 ± 2.0) out of 14 points. The most common barrier to vaccination among healthcare students was not having enough time to take the vaccine (23.8%), while the second one was the COVID‑19 pandemic (22.32%). The vaccination rate in 2020 was 103 (30.7%), while 235 (80.4%) students stated that they have received the vaccine previously. School/work requirements and the student’s awareness of the vaccine’s importance were the most common reasons for taking the influenza vaccine.

    CONCLUSION

    Even though students showed a high level of knowledge and a positive attitude towards the influenza vaccine, they generally had a low level of vaccine uptake. To enhance immunization rates, we encourage vaccine campaigns in all healthcare colleges. Further studies are needed to identify influences on students’ attitudes and practices regarding influenza vaccination.

    Keywords: Attitude, KAP, knowledge, KSAU‑HS, practice, seasonal influenza, vaccine
  • Raoof Nopour, Mostafa Shanbezadeh, Hadi Kazemi-Arpanahi * Page 24
    BACKGROUND

    Accurately predicting the intubation risk in COVID‑19 patients at the admission time is critical to optimal use of limited hospital resources, providing customized and evidence‑based treatments, and improving the quality of delivered medical care services. This study aimed to design a statistical algorithm to select the best features influencing intubation prediction in coronavirus disease 2019 (COVID‑19) hospitalized patients. Then, using selected features, multiple artificial neural network (ANN) configurations were developed to predict intubation risk.

    MATERIAL AND METHODS

    In this retrospective single‑center study, a dataset containing 482 COVID‑19 patients who were hospitalized between February 9, 2020 and July 20, 2021 was used. First, the Phi correlation coefficient method was performed for selecting the most important features affecting COVID‑19 patients’ intubation. Then, the different configurations of ANN were developed. Finally, the performance of ANN configurations was assessed using several evaluation metrics, and the best structure was determined for predicting intubation requirements among hospitalized COVID‑19 patients.

    RESULTS

    The ANN models were developed based on 18 validated features. The results indicated that the best performance belongs to the 18‑20‑1 ANN configuration with positive predictive value (PPV) = 0.907, negative predictive value (NPV) = 0.941, sensitivity = 0.898, specificity = 0.951, and area under curve (AUC) = 0.906.

    CONCLUSIONS

    The results demonstrate the effectiveness of the ANN models for timely and reliable prediction of intubation risk in COVID‑19 hospitalized patients. Our models can inform clinicians and those involved in policymaking and decision making for prioritizing restricted mechanical ventilation and other related resources for critically COVID‑19 patients.

    Keywords: Artificial intelligence, coronavirus, COVID‑19, data mining, intubation, machine learning, neuralnetworks
  • Rachna Pasi, Thirunavukkarasu Arun Babu *, Vinoth Kumar Kalidoss Page 25
    BACKGROUND

    COVID‑19 (Coronavirus disease‑19) is an ongoing pandemic. COVID vaccine administration in adults has provided some degree of protection from infection but children are still susceptible So, we have to be prepared to handle COVID‑19 infection in children by training our healthcare workers by updating both their knowledge and skills. We developed a training module to train our healthcare workers in all domains of learning and also planned related assessment methods to know the effectiveness of the module.

    MATERIALS AND METHODS

    This was a quasi‑experimental study with pre‑ and post‑intervention conducted at a tertiary‑level teaching medical college in southern India from July to September 2021. The training module was developed as per the “ADDIE” model of the development process module. It was further validated by five experts before implementation. In addition to the quasi‑experimental method of evaluation like pre‑ and post‑test, Observed Skill clinical examination (OSCE) had been also used as an assessment tool at the completion of training. A total of 92 participants have been trained as per this module in our tertiary‑level care hospital. The association between continuous and categorical variables was assessed using an independent t‑test and ANOVA, and paired t‑test was used for comparing the difference between pre‑ and post‑test scores.

    RESULTS

    Pre‑test scores had no association with years of experience (P = 0.803) and previous training status of participants (P = 0.350). The mean difference of pre‑ and post‑test scores was 3.8 and it was statistically significant (P value < 0.001) A weak positive correlation between pre‑ and post‑test was present by the Spearmen correlation test (r = 0.337). The correlation between post‑test score and OSCE score does not have a significant correlation.

    CONCLUSION

    Structured training module was effective in training the participants. Multimode assessment method (Pre‑test, Post‑test, and OSCE) is an important step to evaluate any training program as compared to only the pre‑ and post‑test methods of evaluation.

    Keywords: Children, COVID‑19, health personnel, OSCE, pandemic
  • Elaha Jafari, Mahnaz Zarshenas, Monireh Toosi, Azar Nematollahi *, Mehrab Sayadi Page 26
    BACKGROUND

    Breast cancer is the most prevalent cancer and a major cause of mortality among women. Breast self‑examination (BSE) is a key technique for early diagnosis of breast cancer, which, along with lifestyle changes, can alleviate the risk of mortality. This study aimed to examine the effect of self‑care training programs on lifestyle change and BSE of immigrant Afghan women residing in Iran.

    MATERIALS AND METHODS

    In this quasi‑experimental study, 140 immigrant Afghan women visiting health‑care centers in Shiraz (Iran) were selected via convenience sampling during 2019–2020. The data were collected using a lifestyle questionnaire, a demographic information checklist, and a BSE checklist. Following the pretest, the experimental group received three sessions of self‑care training and took the posttest 2 months after the intervention. The control group did not receive any intervention, but took the same posttest 2 months after the pretest. Data analysis was performed using paired and independent t‑test and Chi‑squared test in Statistical Package for the Social Sciences (SPSS) 22.

    RESULTS

    The post‑intervention level of knowledge and performance of the experimental group significantly increased in terms of a healthy lifestyle (P < 0.001) and performance of BSE (P < 0.001) compared to the control group. The intervention also had a significant positive effect (P < 0.000) on all dimensions of lifestyle.

    CONCLUSION

    Self‑care training for lifestyle and BSE can promote the prevention and early diagnosis of breast cancer in immigrant Afghan women who have limited access to health care.

    Keywords: Breast Self‑examination, immigrants, lifestyle, self‑care, women
  • Vaibhav Kumar *, Sushrut Anarase, Romi Jain, Nikhil Bhanushali, Prachi Salvi, Liza Ansari Page 27
    BACKGROUND

    This exploratory study was done to assess the multidimensional perfectionism trends among various core and allied health care professionals in a major Indian metropolitan city of western India. Unlike other scales, here we considered both individual and intersubjective components of perfectionism by introducing three trait dimensions – self‑oriented perfectionism, other‑oriented perfectionism, and socially prescribed perfectionism.

    MATERIALS AND METHODS

    A cross‑sectional descriptive type of study was conducted with total sample consisting of 500 participants with the main motive of evaluation and comparison of the multidimensional perfectionism among interns of the core and allied health care professionals from fields of medicine, dentistry, ayurveda, and homeopathy residing in the major Indian metropolitan cities of western India.

    RESULTS

    This study showed that under the self‑oriented domain, highest mean score is of medical faculty (73.97). In other‑oriented domain, dental (62.62) and homeopathy (62.38) professionals have almost similar mean. Lowest being of ayurveda (61.65) compared to the highest score of the medical fraternity (67.62). In the socially prescribed domain, medical professionals (65.53) have the highest mean though it is the lowest mean value of the medical faculty compared to other two domains. Chi‑square test is applied to the data for the questions among all the three domains. Correlation has been deduced by applying Pearson’s correlation to the collected data from the study. The degree of correlation between self‑oriented with self‑oriented is 1, self‑oriented with other‑oriented is 0.763, and that of self‑oriented with socially oriented is 0.678.

    CONCLUSION

    Medical professionals scoring maximum in self‑oriented perfectionism compared to other two domains reflect their extreme personal standards. Medical professionals are followed by dental professionals in self oriented perfectionism who are demanded of perfection in their routine practice. Ayurveda and homeopathy professionals scored better in other‑oriented and socially prescribed perfectionism attributing to their sentiments of fulfilling the expectations and demands of others.

    Keywords: Ayurveda, behaviour, comparison, dentistry, domains, health care, homeopathy, medicine
  • Salime Zare Abdollahi, Seyed Saeed Mazloomy Mahmoodabad *, Mohammad Hasan Lotfi, Seyed Mojtaba Yassini Ardakani Page 28
    BACKGROUND

    Prevention of smoking is very important at a young age and during the student period. Because of the lack of a questionnaire based on the prevention of smoking behavior, this study was conducted to design and standardize a tool according to the protection motivation theory (PMT).

    MATERIALS AND METHODS

    This was an analytical cross‑sectional study where information and opinions of experts and then designing tools and assessing the face validity in the first phase and content validity, construct validity, test–retest reliability, and internal consistency of questions in the second phase were examined. The initial themes and structures were determined based on the literature Review and the opinion of experts. Three hundred students of Yazd Universities were selected by cluster sampling and included in the study. All analyses were performed in SPSS and AMOS software version 24 with a significance level of less than 5%.

    RESULTS

    The final version of the scale had 39 questions in eight dimensions. The overall Cronbach’s alpha value was 0.89, and for each dimension, it was more than 0.7. The content validity ratio and content validity index for the whole tool were 0.87 and 0.94, respectively. The results of confirmatory factor analysis showed that the latent construct model had good fit (X2/df = 4.31; RMSEA = 0.07; CFI = 0.94; NFI = 0.92; TLI = 0.91, P < 0.001).

    CONCLUSION

    In this study, a valid and reliable tool based on PMT to predict smoking behavior in students was introduced. This tool can be used in interventional and etiological studies. It also has questions related to the coronavirus disease 2019 (Covid 19) virus and can be used in the coronavirus pandemic.

    Keywords: Protection motivation theory, psychometric, questionnaire, smoking behaviors, student, Yazd
  • Nur A. Nordin, Syasya N. Haris, Syahrul B. A. Hamid * Page 29
    BACKGROUND

    Nutrition is essential for schoolchildren to reach their full potential psychologically and cognitively. Malnutrition, which is prevalent among aboriginal schoolchildren in Malaysia, can interfere their learning and academic performance. Developing a module to be used during a school‑based nutritional intervention program is essential to ensuring that students develop healthy eating habits and lifestyles. Thus, this study aims to develop and validate nutrition education module focusing on aboriginal schoolchildren for the eat right future bright (ERFB) nutrition education program.

    MATERIALS AND METHODS

    This cross‑sectional study was conducted in three steps: Step 1: development of module based on literature reviews, Step 2: content and face validation of the module by the expert panels, and Step 3: face validation of the module by target users. This study has used the validation form proposed by de Castro. This form consists of seven aspects, two aspects related to content validity and another four aspects related to face validity. A content validity index (CVI) was used to analyze the content validity. Two formulas were used to calculate CVI, which were I‑CVI and S‑CVI. Meanwhile, the data for module’s face used the level of agreement.

    RESULTS

    Both I‑CVI and S‑CVI obtained more than 0.78 and 0.80, respectively, which indicate that the module has good content validity. Moreover, for face validity, the total of agreement from expert panels and target users was more than 75%, which is considered face validated.

    CONCLUSIONS

    In conclusion, the module that has been developed has good content validity and can be used by teachers in teaching appropriate nutrition knowledge to aboriginal primary schoolchildren.

    Keywords: Children, health education, health promotion, malnutrition, program development
  • Mohammad Hosseini, Abbas Heydari *, Hamidreza Reihani, Hossein Kareshki Page 30
    BACKGROUND

    Non‑technical skills as a complement to technical skills have become increasingly important in cardio‑pulmonary resuscitation, and teamwork is one of the most prominent of these skills. Because of the limited number of tools introduced and validated for measuring teamwork in resuscitation, this study was conducted to develop and evaluate the psychometric properties of the Teamwork Scale in Resuscitation (TSR).

    MATERIALS AND METHODS

    This study was a sequential exploratory mixed‑method study and was conducted between March 2020 and April 2021 and in two phases. In the first phase (qualitative), semi‑structured interviews were performed with resuscitation team members who were selected using a purposeful sampling method with maximum variation in terms of experience, level of education, age, and gender. Using directed qualitative content analysis, the data were analyzed and the primary item pool was developed. In the second phase (quantitative), assessing face, content, and construct validity as well as reliability via the internal consistency and stability, the psychometric properties of the instrument are evaluated.

    RESULTS

    The initial tool consisted of 54 items; after assessing the face validity, ten items were removed during content validity, and the final tool consisted of 44 items and three main categories including the essential prerequisites for resuscitation, leadership, and teamwork, which was scored based on a 5‑point Likert scale from strongly disagree to strongly agree. The convergent validity and concurrent validity of the tool were confirmed. The reliability of the instrument was also confirmed using Cronbach’s alpha test and re‑test and the intra‑class correlation coefficient (ICC) between raters.

    CONCLUSION

    The validity and reliability of TSR for measuring teamwork in resuscitation in a simulated environment are approved. Further studies are suggested for different contexts of resuscitation and with trained raters to evaluate its use in real resuscitation situations.

    Keywords: Mixed‑method study, psychometric properties, resuscitation, scale, teamwork
  • Apurva P Deshpande, Anil V Ankola, Roopali Sankeshwari, Sagar Jalihal, Deepika V Bhat, Abhra Roy Choudhury, Ram Surath Kumar *, Atrey Pai Khot Page 31

    Appropriate oral health education (OHE) plays a vital role in prevention of oral diseases and would bridge the gap between dentists and visually impaired individuals. Hence, this systematic review was planned with an aim to evaluate effectiveness of various OHE techniques on the oral hygiene status and oral health knowledge of visually impaired young individuals. An electronic search extended to September 30, 2020 was conducted on PubMed, Wiley, ProQuest, ScienceDirect, Cochrane library, EBSCO, and Google Scholar. Two independent reviewers assessed the studies using a two‑stage process; data were extracted according to PRISMA statement. Risk of bias assessment of selected studies was executed according to the study designs. Meta‑analysis using the random‑effects model was conducted for the outcomes for all oral health education techniques using STATASE 16.1 software. Hand and electronic search identified 3829 articles. After screening for titles and duplicates, 37 articles were retrieved, which were screened through abstract and full text. Of the 37 articles, 17 articles were included for qualitative synthesis, and out of that, 13 were for meta‑analysis. Ten variations in oral health education (OHE) techniques were used in the included 17 studies to impart oral health education to visually impaired young individuals. Overall, all OHE techniques demonstrated a positive impact on oral hygiene status. The pooled overall cumulative mean difference of the oral hygiene status after imparting education in ATP, Audio, and Braille was 1.33 [1.06, 1.59], 1.76 [1.11, 2.42], and 1.96 [1.40, 2.55], respectively. An appropriate OHE technique boosts confidence in visually impaired young individuals, making the learning process an enjoyable experience. Use of either Braille or the ATP OHE technique was found to be a reliable and useful method to improve oral hygiene of visually impaired young individuals.

    Keywords: Audio, audio tactile performance, Braille, oral health education, oral hygiene status, visually impaired
  • Alireza Irajpour, Fatemeh Maleki *, Mohsen Shati, Mohamad R. Najafii Page 32
    BACKGROUND

    Advanced stages of dementia interfere with elderly self‑care. Consequently, they need caregivers who take responsibility for their care in the long‑term. Restrictions to the caregiver’s access to information, resources, and organizational support have created problems in their caregiver role, which is why the World Health Organization (WHO) emphasizes caring for caregivers by providing evidence‑based information and training programs. As there is no clinical practice guideline for home care in the Islamic Republic of Iran, this study aims to develop a home health care guideline for the elderly with dementia.

    MATERIALS AND METHODS

    The ADAPTE process provided by the Guidelines International Network was considered as the basis. In order to identify the care needs of Iranian patients with dementia, semi‑structured interviews were added to this guideline.

    DISCUSSION

    The identification and implementation of the perspectives of patients and caregivers during the process of guidelines adaptation increase the applicability of the guidelines. Improved quality of life for the patients in their place of residence is one of the expected consequences of this guideline’s implementation. The developed guidelines will be used at home health care centers, and dementia and Alzheimer’s associations in Iran.

    Keywords: Dementia, Alzheimer, Home Health Care, Caregivers, clinical practice guidelines, Adaptation, IslamicRepublic of Iran
  • Zohreh Sohrabi, Shoaleh Bigdeli, Shabnam Nadjafi * Page 33
    BACKGROUND

    The relationship between personality traits and learning styles is an attractive subject for researchers. “Learning Style” indicates on a method of education for effective studying. The Kolb’s Learning Style is a known theory in the field of learning style. The Kolb’s four learning styles include: Divergent, convergent, assimilating, and accommodating. Furthermore, personality, known as relatively fixed and durable characteristics that distinguish people from each other, and personality contains five broad identified traits of extraversion, agreeableness, openness, conscientiousness, and neuroticism. In this study, we intended to evaluate the relationship between personality traits and learning styles in medical education students.

    MATERIALS AND METHODS

    This research was an observational analytic cross‑sectional study that was conducted on medical education students at Iran University of Medical Sciences, between 2018 and 2019, and 31 students were participated as volunteers. NEO Five‑Factor Inventory and the Kolb’s learning style inventory (version 3.1) were used to evaluate the students’ personality traits and learning styles, respectively. The simple and multiple analysis of multinomial logistic regression were used for statistical analysis.

    RESULTS

    The results indicated that if one unit would be added to the score of the “Extraversion” personality trait, the estimated odds, by which the student’s learning style would become “Accommodating” rather than “Assimilating,” is 1.3 times more than the basic condition, in which “Extraversion” score would be remained unchanged (P = 0.035).

    CONCLUSION

    It seems that “Accommodating” learning style might be related to “Extraversion” personality trait in medical education students. However, researches with a larger population are suggested. 

    Keywords: Learning style, medical education, personality trait
  • Kobra Mirzakhani, Abbas Ebadi, Farhad Faridhosseini, Talat Khadivzadeh * Page 34
    BACKGROUND

    Physical changes in high‑risk pregnancy (HRP) can lead to changes in mood and social relationships and negative effects on women’s well‑being. Individuals in different sociocultural contexts have different perceptions of well‑being. Yet, there is limited information about perceptions of well‑being in HRP. This study aimed to explore the Iranian women’s experiences of well‑being in HRP.

    MATERIALS AND METHODS

    This qualitative study was conducted in 2019–2020 through directed content analysis based on the conceptual framework of well‑being in HRP. Participants were 26 women with HRP purposively recruited from public and private healthcare settings in Mashhad, Iran. Face‑to‑face semistructured interviews were held for data collection until data saturation. Data were analyzed through directed content analysis proposed by Elo and kyngäs (2008) and were managed using the MAXQDA (v. 10) program.

    RESULTS

    Well‑being in HRP had seven attributes in the five main dimensions of physical, mental‑emotional, social, marital, and spiritual well‑being. The seven attributes of well‑being in HRP were controlled physical conditions, controlled mood, emotions, and affections, perceived threat, self‑efficacy, and competence for multiple role performance, maintained social relationships, meaning seeking and relationship with the Creator, and positive marital relationships.

    CONCLUSION

    The present study provide an in‑depth understanding about well‑being in the Iranian women with HRP. It is a complex and multidimensional concept with physical, mental‑emotional, social, marital, and spiritual dimensions. Comprehensive multicomponent interventions are needed to promote well‑being among women with HRP and designed the guidelines to provide woman‑centered care.

    Keywords: Complicated, experiences, high‑risk, mental health, pregnancy, pregnant women, qualitative study, understanding, welfare, well‑being, wellness
  • Iryna Savenkova, Mykola Didukh *, Volodymyr Schevchenko, Oksana Oleksyuk, Vira Yaroshenko Page 35
    BACKGROUND

    It’s already known for certain that SARS‑CoV‑2 can affect any vital human organ, and super‑complex cases are even characterized by multiple organ pathology. In particular, complications of COVID‑19 for the kidneys can be irreversible. Consequently, this virus forces us to review the approaches and standards of diagnosis and treatment in most nosologies to minimize the risks as much as possible. Thus, a low level of prediction of the course of coronavirus infection requires a comprehensive approach considering the psychological characteristics of the individual suffering from this disease.

    MATERIALS AND METHODS

    The method of chronometric testing is used to predict the predisposition to the course of SARS‑CoV‑2 with nephrotic complications (using an electronic chronoscope) and calculate the duration of an individual’s biological life cycle to predict the severity of the course of coronavirus infection. Experimental study of the localization of symptoms of chronic nephrological diseases in typological groups of patients with SARS‑CoV‑2 using the method of psychodiagnostics. The duration of the study is six months 2020–2021. The study was conducted under the guidance of a nephrologist at the Odrex Clinic I.I.

    RESULTS

    The results of an experimental study show that the psychological type determines the predisposition to the course of SARS‑CoV‑2 with nephrotic complications; in most of these patients, severe (834 patients) forms of the course coincided with the end of quarters of the long biological cycle of an individual’s life.

    CONCLUSION

    The chronopsychotype makes it possible to predict the predisposition of individuals to the course of SARS‑CoV‑2 with nephrological complications and the severity of the disease.

    Keywords: Chronopsychotype, duration of an individual’s biological life cycle, SARS‑CoV‑2
  • Nima Pourgholamamiji, Hooman Shahsavari, Arpi Manookian, Tahereh Soori, Maryam Zandkarimkhani, Zahra Zare * Page 36
    BACKGROUND

    Sexually transmitted diseases are a major health problem in all countries. Human papillomavirus (HPV) infection is the most common viral sexually transmitted disease in both genders. High‑risk sexual behaviors (HRSBs) are among the major risk factors for HPV infection. Lack of knowledge can contribute to HRSBs and hence, education can potentially reduce HRSB risk. This is a study using theory of reasoned action to reduce the high‑risk sexual behaviors among patients with HPV.

    MATERIALS AND METHODS

    This study was a two‑grouped, randomized, controlled trial. The educational program was developed based on the results of a survey into the most important components of the theory of reasoned action contributing to HRSBs among 100 patients recruited from Razi hospital, Tehran, Iran. Then, 110 patients from the same hospital were consecutively recruited and randomly allocated to a control (n = 55) and an intervention (n = 55) group. Then, each participant in the intervention group was provided with the developed educational program. Their counterparts in the control group solely received routine care services. Three months after the first educational session, HRSBs were reassessed in both groups. Data were analyzed via the SPSS software (v. 21.0).

    RESULTS

    After the intervention, the mean score of HRSBs significantly decreased in the intervention group (P < 0.001) but did not significantly change in the control group (P = 0.70). The post‑test mean score of HRSBs in the intervention group was significantly less than the control group (P = 0.015).

    CONCLUSION

    Education based on the theory of reasoned action is effective in significantly reducing HRSBs. Nurses can develop and use educational interventions based on this theory to reduce HRSBs and HPV infection.

    Keywords: Education, health promotion, HPV, sexual behavior
  • Vinita Singh *, Gitika Rajpal, Sagarika Majumdar, Sucharita Mandal, Rajshree Sahu Page 37
    BACKGROUND

    The lack of fundamental knowledge and awareness about the biological process of reproduction is low worldwide but has reportedly higher incidence rates in under‑developed countries. Infertility can have a tremendous effect on a woman’s psychological and social well‑being, pushing her toward mental stress, anxiety, depression self‑blame, self‑isolation, feeling of worthlessness, and lack of interest in life. The present study was conducted to determine the level of knowledge and awareness regarding factors affecting fertility and also to ascertain the emotional status of females visiting the Obstetrics and Gynecology out‑patient department for fertility assistance.

    MATERIALS AND METHODS

    A cross‑sectional study was performed by using a questionnaire which had two parts; the first part had questions about awareness and knowledge of the subject of infertility, and the second part had 12 questions that assessed the psychological and emotional status of the participants, and it also explored prevailing myths about infertility based on a validated questionnaire.

    RESULTS

    There was a significant difference in mean knowledge score; those who were more educated had better knowledge of various aspects of infertility. The overall adequacy for knowledge and awareness revealed that only 62 (47.7%) of the participants had adequate knowledge (score >6) regarding female infertility. The mean score for knowledge among all the respondents was 6.61 ± 1.48. The overall emotional and psychological score suggested that 30 (23%) of the respondents were disturbed because of stress because of infertility.

    CONCLUSION

    Infertility can have a serious impact on the psychological well‑being of females, and social pressure and stigma associated with childlessness can further worsen the physical and emotional well‑being of couples, which needs to be addressed before starting treatment of infertility for a better response to treatment. The limited knowledge and prevailing mis‑conceptions regarding infertility need to be sincerely dealt with to complement the medical treatment of infertility.

    Keywords: Depression, infertility, knowledge, myths, psychological stress
  • Mansoureh A. Farahani, Shabnam Shariatpanahi *, Fereshteh J. Tehrani, Mahsa Boozaripour Page 38
    BACKGROUND

    Patients with heart failure experience severe and chronic physical and psychological manifestations while the disease progresses. Assessing the degree of distress caused by manifestations of the disease in patients is the first step in designing and evaluating intervention programs to improve patients’ symptoms. The aim of this study was to investigate the psychometric properties of the Persian version of the Symptom Distress Scale in HF patients.

    MATERIALS AND METHODS

    This study was conducted via methodological research design from March to November 2019. The translation process and cross‑cultural adaptation were performed using a process recommended by the World Health Organization. The face and content validity and internal consistency were used to evaluate the validity and reliability of the instrument. The scale was evaluated by exploratory and confirmatory factor analysis in 300 patients with heart failure, and the obtained data were analyzed using SPSS‑22 and AMOS‑22 software.

    RESULTS

    The content validity of the scale was approved based on the results of the study. One‑factor scale with 13 items was used in the confirmatory factor analysis, and the results showed that the instrument had high goodness‑of‑fit indices. Spearman correlation test for convergent validity showed a correlation between the score obtained by the Scale of Symptoms of Disease and the scores of The European Heart Failure Self‑care Behavior scale (9 items) (P < 0.0001).

    CONCLUSION

    The Persian version of the Symptom Distress Scale can be used as a valid instrument for people with heart failure due to its desirable psychometric properties.

    Keywords: Cross‑cultural adaptation, factor analysis, heart failure, psychometrics
  • Aditi Rathore, Rishabh Sharma, Parveen Bansal, Manik Chhabra, Malika Arora * Page 39
    BACKGROUND

    Potentially inappropriate medication (PIM) prevalence in older adults is increasing day by day due to lack of knowledge among medical students and professionals.

    OBJECTIVE

    To determine the knowledge of medical students toward American Geriatric Society (AGS) Beers criteria for PIM prescribing.

    MATERIALS AND METHODS

    This cross‑sectional study employed a self‑administered questionnaire which was validated and designed to assess the knowledge, attitude, and practice of medical interns and postgraduate residents on Beers criteria for PIMs in older adults. The study was conducted in Faridkot region of Punjab in 2019. This study will utilize a purposive sampling strategy and a convenience sampling of up to 183 participants. Mann–Whitney U or Kruskal–Wallis tests were used to compare different issues as appropriate. P values of <0.05 were considered significant.

    RESULTS

    Out of 183 questionnaires distributed, only 155 participants (response rate 84.6%) had filled the survey and were included in the study. 61.3% (n = 95) of the respondents were males. The mean knowledge score of 155 participants was (5.16 ± 1.56), where the highest score was 9 and the lowest score was 2 out of 10. 15.5% (n = 24) of the participant strongly agreed that Beers criteria use is necessary in clinical setting and would be very helpful. While 22.5% (n = 35) of the participants strongly agreed that PIMs cause adverse drug event (ADE) and drug‑related problems (DRPs) in older adults. Age of the participant had a significant effect on the knowledge score (p = 0.009), and participant aged between 31 and 40 years had significantly higher knowledge scores compared with participants falls under 20–30 years.

    CONCLUSION

    Medical students and postgraduate residents had average knowledge of PIMs and are unaware of the standard guidelines in older adults such as the Beers criteria. Lack of formal education or training about Beers guidelines was the main reason responsible for average knowledge among participants.

    Keywords: Attitude, Beers criteria, knowledge, older adults, practice