Journal of Education and Health Promotion

Factors affecting nonadherence to treatment among type 2 diabetic patients with limited health literacy: Perspectives of patients, their families, and healthcare providers

. Nasrin Pourhabibi; . Roya Sadeghi; . Bahram Mohebbi; . Elham Shakibazadeh; . Mojgan Sanjari; . Azar Tol; . Mehdi Yaseri

Volume 12, Issue 10 , November 2022, , Pages 1-13

Abstract

BACKGROUND: Treatment adherence is one of the behaviors associated with type 2 diabetes thatpredicts whether it will be successfully treated or develop complications and become uncontrolled.This ... Read More BACKGROUND: Treatment adherence is one of the behaviors associated with type 2 diabetes thatpredicts whether it will be successfully treated or develop complications and become uncontrolled.This study aimed to determine factors affecting nonadherence to treatment among diabetic patientswith limited health literacy from the perspectives of patients, their families, and healthcare providers.MATERIALS AND METHODS: This qualitative study with a content analysis approach was conductedon 84 eligible type 2 diabetes patients with limited health literacy and poor adherence to treatment,as well as their families and healthcare providers using a purposive sampling method, in Kerman cityin 2021. Interviews were conducted using a semistructured interview guide with a broad, open‑endedquestion to provide a general history of the disease separately. The interviewer asked participantsto identify the perceived barriers to treatment nonadherence. Each interview lasted 45–60 min.MAXQDA version 20 and inductive content analysis were used to code and analyze extracted data.RESULTS: Four major themes emerged from the patients’ perspectives as “financial problems,”“individual factors,” “problems related to medication availability,” and “healthcare providers’ poorpractices.” Two major themes were classified from the perspective of patients’ families as “financialproblems” and “Individual factors,” and four major themes were identified from the viewpoint ofhealthcare providers including “financial problems,” “individual factors,” “scarcity and medicationavailability,” and “poor practice of the healthcare provider.” These mentioned barriers were confirmedregarding treatment nonadherence among study participants.CONCLUSION: Study findings revealed different factors of treatment nonadherence among diabeticpatients with limited health literacy. Therefore, these factors should be considered in tailoringpromotive educational and supportive interventions. Considering the importance of adherence totreatment patients, planning empowerment family‑based interventions focusing on health literacyimprovement seems necessary.

Application of health education and promotion theory‑based interventions on patients with cardiovascular disease: A systematic review

. Bahram Mohebbi; . Maryam Sabouri; . Azar Tol

Volume 11, Issue 5 , June 2021, , Pages 1-14

Abstract

BACKGROUND: Adopting healthy behaviors can lead to better outcomes which can deeply impactcardiovascular diseases (CVDs) development; consequently, tailoring appropriate theory‑basedinterventions ... Read More

Factors predicting nutritional knowledge, illness perceptions, and dietary adherence among hypertensive middle‑aged women: Application of transtheoretical model

. Bahram Mohebbi; . Banafsheh Tafaghodi; . Roya Sadeghi; . Azar Tol; . Mir Saeed Yekanenejad

Volume 11, Issue 5 , June 2021, , Pages 1-7

Abstract

BACKGROUND: Healthy dietary adherence might be one of the effective and modifiable factorsfor hypertension (HTN) control; therefor, empowering patients for self‑care management includinghealthy ... Read More

Validity and reliability properties of the Persian version of perceived health competence scale among patients with cardiovascular diseases

. Elham Shakibazadeh; . Maryam Sabouri; . Bahram Mohebbi; . Azar Tol; . Mehdi Yaseri

Volume 11, Issue 1 , January 2021, , Pages 1-5

Abstract

BACKGROUND: Cardiovascular diseases are among progressive diseases that begin in childhoodand are manifested mainly in adulthood. This study was assessed the validity and reliability ... Read More

Effectiveness of an educational intervention using theory of planned behavior on health care empowerment among married reproductive‑age women: A randomized controlled trial

. Maryam Sabouri; . Elham Shakibazadeh; . Bahram Mohebbi; . Azar Tol; . Mehdi Yaseri; . Sohrab Babaee

Volume 10, Issue 10 , October 2020, , Pages 1-8

Abstract

BACKGROUND: Empowerment is an essential issue in women’s lives. Powerful women can actsuccessfully in health‑related issues more than others. This study aimed to determine the ... Read More BACKGROUND: Empowerment is an essential issue in women’s lives. Powerful women can actsuccessfully in health‑related issues more than others. This study aimed to determine the effectivenessof an educational intervention designed based on theory of planned behavior (TPB) on health careempowerment among married women in reproductive age.METHODS: This randomized controlled trial was carried out among 488 reproductive‑age womenbetween 2018 and 2019 in Tehran, Iran. Participants were recruited using randomized clustersampling and divided into intervention (n = 243) and control (n = 245) groups by random allocation.Data were collected using a self‑administered researcher‑made questionnaire based on TPB andHealth Care Empowerment Questionnaire. Validity (content validity index = 0.87; content validityratio = 0.89) and reliability of the questionnaires were confirmed ( = 0.96). Intervention wasimplemented within four sessions (lasting 60 min) using eight health related scenarios based onTPB constructs. Baseline and post intervention data (6 months after the intervention) were analyzedby SPSS25 (Inc., Chicago, IL, USA) using independent t‑test, Chi‑squared test, Fisher’s Exact test,Mann–Whitney, path analysis, and regression of generalized estimating equation model. P < 0.05was considered statistically significant.RESULTS: Results showed the mean ± standard deviation age of the participants was 33.6 ± 7.1.Six months after the intervention, a significant difference was highlighted in health care empowermentdomains as well as behavioral intention, attitude toward behavior, subjective norms, and perceivedbehavioral control (P < 0.001) between intervention and control groups.CONCLUSION: TPB‑based educational intervention can significantly improve women’s perceptionabout health care empowerment. Tailoring and implementation of TPB‑based intervention by healthpolicy makers and health care providers is suggested to achieve better perception of empowermenttoward receiving health care among women.

A problem‑based learning health literacy intervention program on improving health‑promoting behaviors among girl students

. Neda Karimi; . Shahrzad Saadat‑Gharin; . Azar Tol; . Roya Sadeghi; . Mehdi Yaseri; . Bahram Mohebbi

Volume 9, Issue 12 , December 2019, , Pages 1-11

Abstract

BACKGROUND: Health‑promoting behaviors are essential beliefs and actions to develop andsustain the adolescent health; however, people with inadequate health literacy have poorer healthstatus. ... Read More

Assessing the effect of an educational intervention program based on Health Belief Model on preventive behaviors of internet addiction

. Aghbabak Maheri; . Azar Tol; . Roya Sadeghi

Volume 7, Issue 4 , July and August 2017, , Pages 1-8

Abstract

INTRODUCTION: Internet addiction refers to the excessive use of the internet that causes mental,social, and physical problems. According to the high prevalence of internet addiction ... Read More

BASNEF Model intervention on blood pressure modification among hypertensive diabetic patients

. Azar Tol; . Hadiseh Farhandi; . Bahram Mohebbi; . Roya Sadeghi

Volume 7, Issue 3 , May and June 2017, , Pages 1-5

Abstract

BACKGROUND: Prevalence of hypertension in patients with type 2 diabetes is two to three timesmore than nondiabetic patients. This study aimed at assessing the impacts of an educational ... Read More

The impacts of a health belief model‑based educational program on adopting self‑care behaviors in pemphigus vulgaris patients

. Roya Sadeghi; . Azar Tol; . Azita Moradi; . Masoud Baikpour; . Mostafa Hossaini

Volume 5, Issue 5 , December 2015, , Pages 1-5

Abstract

Introduction: Since pemphigus vulgaris (PV) is a chronic disease and regarding its autoimmunenature, patients need to adopt self‑care behaviors. This study aimed to assess the impacts ... Read More

Determinants of healthy lifestyle and its related factors among elderly people

. Samaneh Zanjani; . Azar Tol; . Bahram Mohebbi; . Roya Sadeghi; . Keramat Nouri Jalyani; . Azita Moradi

Volume 5, Issue 5 , December 2015, , Pages 1-5

Abstract

Background: Medical and health advances have led to relative increases in human longevityand elderly population. Common diseases in elders can be prevented using healthy lifestyle.Identifying ... Read More

An empowering approach to promote the quality of life and self-management among type 2 diabetic patients

. Azar Tol; . Fatemeh Alhani; . Gholamreza Sharifirad; . Nahid Moazam

Volume 5, Issue 2 , March 2015, , Pages 1-8

Abstract

Type 2 diabetes is one of the most serious health concerns and policy agendas around theworld. Epidemiological evidence suggests that it will likely continue to increase globally.Diabetes ... Read More

Analysis of some predictive factors of quality of life among type 2 diabetic patients

. Azar Tol; . Gholamreza Sharifirad; . Ahmadali Eslami; . Davoud Shojaeizadeh; . Fatemeh Alhani; . Mohamadreza Mohajeri Tehrani

Volume 5, Issue 1 , February 2015, , Pages 1-5

Abstract

Introduction: Considering the chronic nature of diabetes and its significant effect onquality of life of patients, the present study was conducted to evaluate predictors ofquality of ... Read More

Evaluation of dietary habits and related factors among type 2 diabetic patients: An innovative study in Iran

. Azar Tol; . Bahram Mohebbi; . Roya Sadeghi

Volume 4, Issue 1 , February 2014, , Pages 1-5

Abstract

Introduction: The aim of this study was to assess dietary habits and related factorsamong type 2 diabetic mellitus patients for designing an effective nutrition intervention.Materials ... Read More

The effectiveness of nutrition education program based on health belief model compared with traditional training

. Gholam Reza Sharifirad; . Azar Tol; . Siamak Mohebi; . Mohammad Matlabi; . Hossein Shahnazi; . Marzieh Shahsiah

Volume 3, Issue 3 , March 2013, , Pages 1-5

Abstract

Introduction: This study was aimed to compare the effect of nutrition educational programbased on HBM with traditional education recommended weight gain among pregnant womenin Gonabad. ... Read More

Socio-economic factors and diabetes consequences among patients with type 2 diabetes

. Azar Tol; . Gholamreza Sharifirad; . Davoud Shojaezadeh; . Elahe Tavasoli; . Leila Azadbakht

Volume 3, Issue 2 , February 2013, , Pages 1-6

Abstract

Background: Considering the effect of socio-economic factors on the emergence of chronicdiseases and the importance of this aspect of diseases for policy makers and authorities ofhealth ... Read More

Health-promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan University of medical sciences

. Azar Tol; . Elaheh Tavassoli; . Gholam Reza Shariferad; . Davoud Shojaeezadeh

Volume 3, Issue 2 , February 2013, , Pages 1-4

Abstract

Background: Health promoting lifestyle (HPL) focuses on life promotion through lifestylewhich consists of six aspects of “physical activity”, “nutrition”, “health ... Read More Background: Health promoting lifestyle (HPL) focuses on life promotion through lifestylewhich consists of six aspects of “physical activity”, “nutrition”, “health responsibility”, “spiritualgrowth”, “interpersonal relations” and “stress management”. This lifestyle promotes healthand welfare and induces satisfaction, self-persuasion and self-improvement. Consideringthe importance of the way a new behavior affects “life quality” as a motivational factor forstarting and continuing that behavior, this study aimed to determine the relationship betweenhealth-promoting lifestyle and its aspects. Materials and Methods: This cross-sectionalstudy was performed on undergraduate students at School of Health, Isfahan University ofMedical Sciences, using a census method. Health promoting lifestyle was measured by HealthPromotion Lifestyle Profile two and life quality was assessed by the Persian version of QLQ-C30questionnaire. Data analysis was conducted using descriptive and inferential statistical testsin SPSS. Results: Mean age of the participants was 21.12 years old. From among six aspectsof health promoting behaviors, spiritual growth and responsibility with the means of 22.01 ±2.224 and 20 ± 2.31 had the highest and physical activity with the mean of 17.58 ± 2.9 had thelowest scores, respectively. General life quality of 40.7% students was good and only 19.8% ofthem had an average global life quality. The highest and lowest frequencies of health-related lifequality belonged to very good (58.6%) and excellent (9%) health, respectively. Except for stressmanagement (P = 0.05) and gender of the students, there were no significant relationshipsbetween other HPL aspects and gender. There was no statistically significant relationshipbetween global life quality of students and nutrition, physical activity, self-health responsibilityand stress management while there was a significant relationship between global life qualityand spiritual growth of the students. Health-related life quality and stress management weresignificantly related to each other; however, no statistically significant relationship was observedbetween health-related life quality and nutrition, physical activity, interpersonal relations andspiritual growth. Conclusion: There is a significant relationship between adopting healthpromoting lifestyle and aspects of spiritual growth and stress management on the one handand general quality of life on the other, at least among students.

The introduction of self-management in Type 2 Diabetes care: A narrative review

. Abdolvahab Baghbanian; . Azar Tol

Volume 2, Issue 4 , October 2012, , Pages 1-5

Abstract

Type 2 diabetes is one of the most life-threatening public health challenges in the world. Itcauses a high disease burden including increased disability, reduced life expectancy and ... Read More

Evaluation of self‑care practices and relative components among type 2 diabetic patients

. Azar Tol; . Davoud Shojaeezadeh; . Golamreza Sharifirad; . Ahmadali Eslami; . Mohamadreza Mohajeritehrani; . Abdolvahab Baghbanian

Volume 2, Issue 2 , July 2012, , Pages 1-5

Abstract

Background: The purpose of this study was to assess self‑care practices and their relativecomponents among type 2 diabetic patients. We hypothesized that some sociodemographicand ... Read More Background: The purpose of this study was to assess self‑care practices and their relativecomponents among type 2 diabetic patients. We hypothesized that some sociodemographicand health‑related factors, high diabetes distress, and low self‑efficacy would be associatedwith poorer self‑care practices. Materials and Methods: A cross‑sectional study was conductedfor a period of 6 months in 2011. Study population was type 2 diabetic patients referring toOmolbanin center, an outpatient diabetic center in Isfahan. One hundred forty diabetic patientsmet the inclusion criteria and were all included in the study. Patients’ self‑care practices weremeasured by Summary of Diabetes Self‑care Activities (SDSCA) self‑report scale that includesitems on the following aspects of the diabetes regimen: General diet, specific diet, exercise,blood glucose testing, foot care, medications, and smoking. Diabetes distress measuredby Diabetes Distress Scale (DDS) scale and Stanford diabetes self‑efficacy scale was usedfor scoring this issue. Collected data were analyzed by using SPSS software version 11.5.Results: Participants were between the ages of 37 and 75 years, with a mean of 53.23 years(SD=7.82). Fifty‑four percent (n=76) were females; 97.1% were married (n=136), and 53.6%had education lower than diploma (n=75). Mean of duration of diabetes was 7.1 (SD=5.63)years. “Medications” subscale was considered as the most important one in measuringdiabetes self‑care practices (5.24 ± 2.38 days/week). Study findings revealed that general diethad significant relation with comorbidity, type of treatment, body mass index (BMI), fastingblood sugar (FBS), (Blood Sugar) (BS), waist circumference, diabetes distress, and self‑efficacy.Specific diet had significant relation with comorbidity, education, triglyceride (TG), diastolicblood pressure (DBP), and low density lipoprotein (LDL). Exercise showed significant relationwith history of diabetes, education, type of treatment, disease duration, TG, BMI, and BS. Also,blood glucose testing showed significant relation with disease duration, self‑efficacy, TG, DBP,BS, LDL, and high density lipoprotein (HDL). On the other hand, foot care was related to age,diabetes distress, TG, BMI, HDL, and diabetes complications. Medications subscale as themost important subscale of self‑care practices was relevant with age, disease duration, diabetescomplications, type of treatment, FBS, HDL, and self‑efficacy. The last subscale, smoking, hadsignificant relation with sex, diabetes complications, diabetes distress, self‑efficacy, TG, totalcholesterol, BS, and HDL. Conclusion: This information should be used in clinical practicewhen targeting and designing educational and care plan for patients with type 2 diabetes.

Volume 13 (2023)

Volume 12 (2022)

Volume 11 (2021)

Volume 10 (2020)

Volume 9 (2019)

Volume 8 (2018)

Volume 7 (2017)

Volume 6 (2016)

Volume 5 (2015)

Volume 4 (2014)

Volume 3 (2013)

Volume 2 (2012)

Volume 1 (1900)

Author = . Azar Tol

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