Journal of Education and Health Promotion

Abstract Discourse analysis (DA) is an interdisciplinary field of inquiry and becoming an increasingly popular
research strategy for researchers in various disciplines which has been little employed by health‑care
researchers. The methodology involves a focus on the sociocultural and political context in which
text and talk occur. DA adds a linguistic approach to an understanding of the relationship between
language and ideology, exploring the way in which theories of reality and relations of power are
encoded in such aspects as the syntax, style, and rhetorical devices used in texts. DA is a useful and
productive qualitative methodology but has been underutilized within health‑care system research.
Without a clear understanding of discourse theory and DA it is difficult to comprehend important
research findings and impossible to use DA as a research strategy. To redress this deficiency, in
this article, represents an introduction to concepts of discourse and DA, DA history, Philosophical
background, DA types and analysis strategy. Finally, we discuss how affect to the ideological
dimension of such phenomena discourse in health‑care system, health beliefs and intra‑disciplinary
relationship in health‑care system.

Abstract Background: Self‑efficacy is the most influential among factors affecting nurses’ performance.
Yet, understanding of the constituent elements of the caring self‑efficacy concept was not
considered. This study was to introduce altruism as one of the main aspects of caring
self‑efficacy in pediatric nurses. Materials and Methods: This is part of a larger study on the
concept of caring self‑efficacy conducted with qualitative content analysis approach in Iran.
Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data were
collected using semi‑structured interviews and analyzed using conventional content analysis
method. Results: Theme “altruism” as one of the main themes extracted from the analysis of
the interviews in this study. This theme includes two main categories of “humanistic care” and
“caring attitude.” Conclusions: This paper introduces altruism as one of the values aspects of
caring self‑efficacy in pediatric nurses. Efficient nurse with features Humanistic care, through
the provision of maternal care and family‑centered care and caring attitudes resulting from
religious beliefs and loving children to care for the children.

Abstract Introduction: Traumatic events such as breast cancer along with negative effects on patients
also have positive effects. These cases have been studied less in Iran. Therefore, this study
was conducted with the aim of explanation of positive changes after breast cancer by using a
qualitative approach. Materials and Methods: This qualitative study was conducted in 2012 in
one of the specialized centers for cancer affiliated to Isfahan University of Medical Sciences.
In this study, it was interviewed with 19 women with breast cancer about positive changes
after cancer by using individual, open and deep methods. The interviews were analyzed
with conventional content analysis method. Results: The titles of the three major categories
were included as behavioral changes to maintain and promote health (acquisition of health
information and adopting promoting health behaviors), spiritual development (attention to the
God and sense of meaning in life, revising the values and priorities, strengthening moral and
behavioral traits) and personal growth and flourish (feeling empowerment, confidence and
efforts to achieve the goals and desires). These three categories have led to emerge themes
in this study as the “Awakening after cancer.” Conclusions: The results of this study indicated
positive changes after breast cancer. Considering such changes while providing care and
consulting to patients with breast cancer in addition to facilitate and accelerate positive changes
will be prompted to provide care and proper and influential consulting to promote patient health.

Abstract The cultural compatibility of sexually related instruments is problematic because the contexts
from which the concepts and meanings were extracted may be significantly different from
related contexts in a different society. This paper describes the instruments that have been used
to assess sexual behaviors, primarily in Western contexts. Then, based on the instruments’
working definition of ‘sexual behavior’ and their theoretical frameworks, we will (1) discuss
the applicability or cultural compatibility of existing instruments targeting women’s sexual
behaviors within an Iranian context, and (2) suggest criteria for sexually related tools applicable
in Iranian settings. Iranian women’s sexual scripts may compromise the existing instruments’
compatibility. Suggested criteria are as follows: understanding, language of sexuality, ethics
and morality. Therefore, developing a culturally comprehensive measure that can adequately
examine Iranian women’s sexual behaviors is needed.

Abstract Background: Although psychological factors are now recognized as playing a significant
and independent role in the development of coronary heart disease (CHD) and its
complications, many of these factors are correlated with each other. The present study is
aimed at examining the association between alexithymia and anxiety depression, stress,
quality of life, and social support in CHD patients. Materials and Methods: In this research
398 patients with coronary heart disease (166 females and 232 males) from the city of
Isfahan were selected using random sampling. The tools used included depression, anxiety,
and stress scale (DASS-21), Health-related to Quality Of Life (HRQOL-26), Multiple Scale
Perceived Social Support (MSPSS-12), and the Toronto Alexithymia Scale (TAS-20). The data
were analyzed using structural equation modeling by using the Statistical Package for Social
Science (SPSS21) (IBM Corp: Armonk, New York.U.S.) and Asset Management Operating
System (AMOS21) SPSS, an IBM Company: Chicago, U.S. Software. Results: Results of
the structural equation model showed an acceptable goodness of fit, for the explanation
alexithymia that was significantly associated with lower HRQOL and social support and
increasing anxiety, depression, and stress. Conclusions: Alexithymia may increase anxiety,
depression, and stress and can be a predisposing factor to poorer HRQOL and social
support.

Abstract Background: Research is essential for development. In other words, scientific development
of each country can be evaluated by researchers’ scientific production. Understanding
and assessing the activities of researchers for planning and policy making is essential. The
significance of collaboration in the production of scientific publications in today’s complex world
where technology is everything is very apparent. Scientists realized that in order to get their work
wildly used and cited to by experts, they must collaborate. The collaboration among researchers
results in the development of scientific knowledge and hence, attainment of wider information.
The main objective of this research is to survey scientific production and collaboration rate in
philosophy and theoretical bases of medical library and information sciences in ISI, SCOPUS,
and Pubmed databases during 2001‑2010. Materials and Methods: This is a descriptive survey
and scientometrics methods were used for this research. Then data gathered via check list and
analyzed by the SPSS software. Collaboration rate was calculated according to the formula.
Results: Among the 294 related abstracts about philosophy, and theoretical bases of medical
library and information science in ISI, SCOPUS, and Pubmed databases during 2001‑2010, the
year 2007 with 45 articles has the most and the year 2003 with 16 articles has the least number
of related collaborative articles in this scope. “B. Hjorland” with eight collaborative articles had
the most one among Library and Information Sciences (LIS) professionals in ISI, SCOPUS,
and Pubmed. Journal of Documentation with 29 articles and 12 collaborative articles had the
most related articles. Medical library and information science challenges with 150 articles had
first place in number of articles. Results also show that the most elaborative country in terms
of collaboration point of view and number of articles was US. “University of Washington” and
“University Western Ontario” are the most elaborative affiliation from a collaboration point.
Conclusion: The average collaboration rate between researchers in this field during the years
studied is 0.25. The most completive reviewed articles are single authors that included 60.54%
of the whole articles. Only 30.46% of articles were provided with two or more than two authors.

Abstract Background: Assessment is one of the teachers’ most important activities in teaching process
which bears many purposes. With the rapid change of different sciences,old methods and tools
are not meeting the present needs. Since in medical sciences, half of the educational course,
including nursing courses,occurs at patients’ bedside, the assessment of clinical competency
is of great importance. In this study the goals , skills and expected level of competency for
each skill and procedural skills needed for training nursing studentsreceivingcardiac care field
training compiled. Materials and Methods: This research was a descriptive measurement
study conducted in Esfahan in 2010-2011. Research community was nursing trainers who
are responsible for training students takingcardiac care field training coursesin state medical
science universities all over the country. Sampling was performed first in the form of the multistage cluster and then after selecting the colleges , their trainers entered the study in the form
of census. To gather the information, after literature review and performing a focusing group,
an initial questionnaire was compiled and survey was conducted using Delphi three-stage
method. Results: After literature review and focus group, 23 modules and 142 skills in the
first section and 14 general procedural skills and 15 special procedural skills in the second
stage were compiled. Finally after passing the Delphi stages, 150 skills in the form of 23 modules in the first section and 14 general procedural skill and 13 special procedural skills were
obtainedin the second section. The expectancy levels of all the skills were also determined.
Conclusion: This study has introduced an assessment pattern in the form of clinical performance logbook which can be a valuable tool for assessing the clinical competency of nursing
students receiving field training in cardiac care units(CCU).

Abstract Background: Family health is one of the World Health Organization’s (WHO) programs
concerning individuals’ and families’ health and development. If properly implemented, family health may ensure the health of human beings and support their self-fulfillment; and may
pave the way for bringing up a healthier and better generation by achieving two important
and specific quantitative and qualitative results. This study aims at establishing the existing
problems in the medical education system with respect to family health, which may be managed by the family health professional if a Masters’ course educational program is developed.
Materials and Methods: In this cross-sectional, descriptive study, five Type-1 and four Type-2 and
Type-3 universities were randomly selected. Then, the faculty members of health services/public
health departments, health managers, health and treatment networks managers, personnel of
provincial health centers in family health units, and also public health B. S. students were surveyed
on the existing problems in the national health system which can be solved by family health professional. A questionnaire containing one open-ended and several demographic questions was sent
by mail for some and personally handed over to some others. Since the data were of a qualitative
nature, first the categories were specified through content analysis and then the opinions of each
category of individuals were differentiated based on the relevant categories. Results: Results obtained from the comments of the study population led to specification of problems in health system,
which could be solved by the family health senior expert. Such problems were categorized into six
groups as: Planning and implementation, research, education, management, service-providing, and
cultural problems. Conclusion: Given the problems in our nation concerning various family health
issues, the field of family health in the levels of associate and bachelor degrees cannot respond to
all public requirements, and health personnel in these levels do not possess various professional,
planning, research, and educational skills required to analyze family health problems. Therefore,
it is suggested that a Masters’ course educational program be developed.

Abstract Background: Despite their ascribed intellectual ability and achieved academic pursuits,
medical students’ academic achievement is influenced by motivation. This study is an endeavor to examine the role of motivation in the academic achievement of medical students.
Materials and Methods: In this cross-sectional correlational study, out of the total 422 medical
students, from 4th to final year during the academic year 2007–2008, at School of Medicine,
Isfahan University of Medical Sciences, 344 participated in completion of the Inventory of
School Motivation (ISM), comprising 43 items and measuring eight aspects of motivation. The
gold standard for academic achievement was their average academic marks at pre-clinical and
clinical levels. Data were computer analyzed by running a couple of descriptive and analytical tests including Pearson Correlation and Student’s t-student. Results: Higher motivation
scores in areas of competition, effort, social concern, and task were accompanied by higher
average marks at pre-clinical as well as clinical levels. However, the latter ones showed greater
motivation for social power as compared to the former group. Task and competition motivation
for boys was higher than for girls. Conclusion: In view of our observations, students’ academic
achievement requires coordination and interaction between different aspects of motivation.

Abstract Background: Considering the significance of quality of life in chronic diseases and the role of
education in its improvement, this study was performed to investigate the effect of cognitivebehavioral therapy on improving the quality of life of cardiovascular patients in Isfahan city.
Materials and Methods: In this experimental study, 56 patients, who referred to Chamran
Hospital and Isfahan Cardiovascular Research Center, were randomly selected and assigned
to two groups, i.e. experiment and control. The experiment group was trained in eight sessions, each session taking 2 hours. Both groups received MacNew quality of life questionnaire
before and 2 weeks after treatment. Some demographic data were also gathered along with
the questionnaire. Data were analyzed by SPSS software using statistical tests such as independent t-test, Chi-square, and analysis of covariance. Results: Observing the possible effect
of pre-test, cognitive-behavioral therapy had a significant effect on the total score of quality
of life and its three subscales. Conclusion: It seems that along with other medical therapies,
making use of cognitive-behavioral intervention is an appropriate method for improving the
quality of life of cardiovascular patients.