Journal of Education and Health Promotion

Abstract BACKGROUND: Increasing in elderly’s population and their individual and social problems especially
mental health problem in this group need special attention. The aim of this study was evaluation
of health promotion behaviors training program efficacy on general health components in elderlies
referring to health centers in Isfahan city.
MATERIALS AND METHODS: This study was a tri phasic field trial in 2014 in which 72 elderlies
allocated randomly in two case and control groups. Case group participated in 9 training sessions on
stress management and interpersonal relationships and the control group participated in 2 sessions
with a neutral discussion content. Data collection tools were demographic information questionnaire
and general health questionnaire 28. Pretest, posttest, and 2‑month follow‑up were performed in
two groups. Data were analyzed by t‑test, analysis of variance with repeated measurement, least
significant difference post hoc test, and SPSS 20 software.
RESULTS: Findings of this study showed that the average of general health score in case and
control groups had not significant difference before the intervention (P > 0.05). However, the mean
difference of general health score after intervention and 2‑month follow‑up was statistically significant
in two groups (P < 0.001).
CONCLUSIONS: This study showed that interpersonal relationship and stress management training
program are effective on promotion of mental health in elderlies. Hence, the findings of this study
can be used in the field of treatment and care of the elderly by other health‑care categories.

Abstract INTRODUCTION: The purpose of this study was to determine the status of observance of structural
standards in rehabilitation centers and nursing homes.
MATERIALS AND METHODS: This cross‑sectional descriptive study was carried out on 12 centers
of the nursing homes of Isfahan city during 2016–2017. The tool was a check. To complete the
checklist, the direct observation of the environment and the review of existing documents were used.
Data were analyzed by descriptive statistics and frequency distribution.
RESULTS:  The findings of this study shows that of 11 standards ofworkforce standards regarding
to health expert presence, nurse presence, therapist and extracurricular instructor presence, have
been observed innone of the centers, and the presence of social worker/psychologist in 50% of the
centers. Of the 21 standards relating to the physical environment, eight standards have not been met
in any of the centers. Of the 25 standards relating to the general conditions of building, 4 standards
have not been met in any of the centers. Of the 10 standard relating to the equipment and supplies
which are needed, 3 were not observed in any of the centers. Of the 10 standards relating to the
required services, except one, standards have been met in all centers. Of the 10 standards relating
to the general provisions, 7 are met in all centers of both types.
CONCLUSION: According to the findings, a significant percentage of standards have not been met
in any of the aging centers or just met in some of these centers. It is hoped that the results of this
study will enable authorities to promote standardization of nursing homes and rehabilitation centers.

Abstract BACKGROUND: Securing a healthy sexual relationship during middle‑agedness would cause new
needs and expectations in women, considering the special changes of this period. Therefore, the
present study was conducted to determine the sexual needs of middle‑aged women.
METHODS: The present study was a qualitative study with content analysis approach. Participants
were 15 middle‑aged women; their expectations and needs about sexual relationship were gathered
using in‑depth semi‑structured interviews. Data were analyzed using Graneheim and Lundman
inductive content analysis.
RESULTS: The main themes that were appeared in the present study included “the need
for information” with subcategories of “the need for information about physiologic changes”
and “information about psychological changes;” “the need for sympathy” with subcategories of “the
need for receiving appropriate feedback” and “appropriate space for expressing the emotions;”
“the need for changing social norms” with subcategories of “accepting middle‑agedness by the society”
and “the need for changing the concept of femininity;” and finally “the need for repairing the sexual
relationship” with subcategories of “solutions for solving sexual problems” and “paying attention to
the new aspects of sexual relationship.”
CONCLUSIONS: Results showed that middle‑aged women have various sexual needs and
expectations and paying attention to these needs and expectations could affect the improvement of
the sexual and mental health of middle‑aged women and their families.

Abstract BACKGROUND: The positive effect of breastfeeding on health is globally accepted. However,
breastfeeding has not yet practiced at a favorite level. Empowerment of mothers is an important
factor for continuing breastfeeding. This study was conducted to explore women’s perception of
empowerment in breastfeeding.
METHODS: The present qualitative study was conducted in conventional content analysis method.
Thirty‑four semi‑structured deep interviews were conducted with 18 mothers, four key family members,
and 12 other personnel involved in breastfeeding counseling services.
RESULTS: Analysis of participants’ descriptions led to the emergence of five main categories: Enough
knowledge and skill for breastfeeding, feeling adequacy in breastfeeding, overcoming breastfeeding
problems, informed belief in the value of breastfeeding, and perceiving comprehensive support for
breastfeeding.
CONCLUSION: in participants’ point of view, empowerment in breastfeeding can be formed
through an acquisition of “Enough knowledge and skill for breastfeeding” as well as assurance
about the proper quality and quantity of mother’s milk. As well as overcoming breastfeeding
problems will lead to stabilization empowerment in breastfeeding. In addition, data analysis
showed that informed belief in the value of breastfeeding strengthens the empowerment in
breastfeeding and presence of perceived comprehensive support for breastfeeding facilitates
empowerment in breastfeeding continuance. Thus, comprehensive plans should be designing
for promoting breastfeeding.

Abstract Background: Primary healthcare (PHC) providers play a major role in provision of public health
in rural areas in Iran. They are considered as the key elements of health development in rural
population. There is limited research on clarification of their experiences from provision of health
services in their working conditions. This study aimed to clarify the experience of PHC providers
from working conditions in giving primary health services in health houses (district branches of
rural health care centers). Materials and Methods: This is a content analysis qualitative study,
conducted through personal and group interviews with 12 health workers working in health
care centers in rural areas in Isfahan province, 2010. Sampling continued until data saturation.
Data were analyzed through conventional content analysis and constant comparative method.
Results: Data analysis led to extraction of 11 categories, and finally, four themes of “ignoring
the rights,” “causing tension in working climate,” “pressure or overload of expectations beyond
the power,” and “occupational worn out” were yielded from the categories. These themes reveal
the concepts and nature of PHC providers’ experiences from giving health care at health houses
as the first level of PHC centers. Conclusion: The results of the present study showed that the
PHC providers work in a tense condition in health houses. Although they devote themselves
to the health of society members, their own health is neglected. Policy makers and authorities
should amend working conditions of PHC providers through modification of resources and
making supportive and collaborative strategies to improve the quality of services and promote
the health level of the service receivers.

Abstract Background: Noncommunicable diseases such as Hypertension are among the
important factors of mortality and morbidity of the elderly people. The family‑centered
empowerment model (FCEM) has not been performed for elderly people with hypertension.
Settings and Design: This clinical trial study was carried out on 62 elderly people with
hypertension under the coverage of the Lenjan Health Network in 2013. After performing the
sampling by using the cluster‑randomized method, the samples were divided randomly into
the experimental and control groups. Methods: For the experimental group, the (FCEM) was
implemented based on the four steps. For the control group, it was only implemented the
usual care and one training session. Research tools included questionnaires of demographic
data, empowerment assessment and a blood pressure‑measuring device. The post‑test was
performed 1 week later. The blood pressure was recorded, and it was followed 1.5 month later
again. Statistical Tests: Statistical tests for data analysis included χ2
‑test, independent t‑test,
Mann–Whitney, analysis of variance, and SPSS 20. Results: 1 week later and 1.5 month after
the intervention, the mean blood pressure was significant in both groups (P < 0.001). also, the
difference in the mean score of empowerment dimensions was significant in the experimental
group 1 week later and 1.5 month after the intervention (P < 0.001). Conclusion: Implementation
of the FCEM for elderly people with hypertension has been possible from a practical point of
view, and it has been associated with controlling and improving the blood pressure.