Journal of Education and Health Promotion

Abstract BACKGROUND: Today, considering the importance of bioterrorism, it may be time to assess the
risk of bioterrorism as an important priority. Nurses, as the broadest group of therapy group, are
very influential in this regard.General aim: To determine the impact of bioterrorism education through
two methods of lectures and booklets on the knowledge and attitude of nursing staff. Practical Aim:
Minimizing the damage caused by bioterrorism attacks by empowering nursing staff.
MATERIALS AND METHODS: This two-group semiexperimental intervention study was performed as a
before and after education intervention with the participation of 80 nursing staff of Shams Al-Shomus Nezaja
Hospital affiliated to Health Administration of Islamic Republic of Iran Army Ground Forces. The study
population included all hospital nursing staff in 2021. The inclusion criteria included having a willingness
and informed consent to participate in the study and exclusion criteria included unwillingness to continue
cooperation and failure to complete more than 10% of the questionnaire by the subject. This study was
performed on 77 nurses in 2021. The nurses were divided into two groups: lecture and booklet. First,
the pretest was completed by the nurses. After the educational intervention, both groups completed the
posttest. Both groups then completed the questionnaire again after about 2 weeks. First, all the data were
measured for normal distribution by the Kolmogorov–Smirnoff test. Statistical description was expressed
for the variables with normal distribution as the ratio of geometric mean ± standard error and for abnormal
variables as mean ± standard error. To compare the means of the studied quantitative variables, t-test
and Wilcoxon matched-paired statistical tests were used. The significance level was considered <0.05.
SPSS.16 and Graph Pad Prism 8.0.1 softwares were used to analyze the statistical data.
RESULTS: Using both methods is effective in improving the level of knowledge and betterment attitude,
but according to the paired t-test in comparison of the two groups, at intervals immediately after training
and 2 weeks after training, a significant increase in the average knowledge score of the lecture group
Statistically shows (P < 0.001). However, the analysis of attitude scores was performed between the
two groups of lectures and booklets, which did not show statistically significant changes between them.
CONCLUSIONS: One of the most important issues in the performance of medical staff in bioterrorism
attacks is useful, effective, correct, and sufficient training. According to the results of the present
study,bioterrorism training leads to increasing the level of knowledge and betterment the attitude of
nurses in the field of bioterrorism. Therefore, the inclusion of training courses in medical centers,
especially military medical centers, is necessary and sensitive.

Abstract BACKGROUND: Pain and nausea and vomiting are of serious complications following the use of
opiates after surgery, especially cesarean section. Control of postoperative complications is one of
the necessities of quality promotion of health‑care system. Medications with few side effects such
as corticosteroids including dexamethasone can be an appropriate option. In addition, the route of
administration can have a significant effect on the effectiveness of the drug. The aim of the present
study was to compare the effects of intrathecal with intravenous dexamethasone in reducing the
complications associated with intrathecal morphine after cesarean section.
MATERIALS AND METHODS: The study was a double‑blind randomized controlled clinical trial and
determined the effect of intrathecal and intravenous dexamethasone on the incidence and severity
of complications of intrathecal morphine after cesarean section on 120 patients and its relationship
with serious complications after surgery. Descriptive and analytical statistics were used to examine
the characteristics of the case and control groups, and STATA SPSS software was used to compare
the two groups.
RESULTS: There was no significant association between the two groups in terms of baseline
characteristics. Pain score in the intrathecal injection group was lower than the intravenous injection
group, with a statistically significant difference (P = 0.02). In addition, there was a significant
association regarding to the incidence of nausea, vomiting, and itching between intrathecal and
intravenous injection groups (P = 0.008).
CONCLUSION: Dexamethasone was effective to reduce opiate complications after cesarean section.
Establishing a suitable association between dexamethasone half‑life, efficacy, type of use, and time
of use can result the best outcomes and promote patients’ satisfaction in cesarean section.

Abstract BACKGROUND: Today, hospitals need managers who, in addition to having the necessary skills for
management and leadership, are accountable to stakeholders, especially the community. Accordingly,
the purpose of this study was to evaluate the social accountability of managers of public and private
hospitals in Tehran.
MATERIALS AND METHODS: The present study is descriptive‑analytical and cross‑sectional and
was performed on 155 managers of selected public and private hospitals in Tehran. The research
tools included a demographic characteristic questionnaire and a researcher‑made social accountability
questionnaire for managers. Data analysis was performed using descriptive and inferential statistics
in SPSS 22 software.
RESULTS: The situation of social accountability in the managers of public hospitals was at a
weak level and in the managers of private hospitals in Tehran was at a good level. In comparing
the status of social accountability and its dimensions in the managers of public hospitals with the
managers of private hospitals, the status of social accountability in the dimensions of human resource
management, quality improvement, executive management, and overall social accountability were
significantly different from each other (P ≤ 0.05). However, in terms of governance, the status
of social accountability of public hospital managers was not significantly different from private
hospitals (P ≥ 0.05). Overall, the results of social accountability in private hospitals were better
than in public hospitals.
CONCLUSION: The social response status of managers in private hospitals was better than public
ones. Lack of attention of managers to social accountability affects the quality of other educational,
health, and medical services. This fact raises the need for managers to pay more attention to the
issue of social accountability.

Abstract BACKGROUND: The literacy level of the elderly is predictive of health behaviors, average
hospitalization in health centers, and the type of verbal interaction with health service providers;
as the level of literacy changes, the quality of life may also change. This study aimed to determine
the relationship between health literacy level and quality of life among the elderly living in nursing
homes in 2018–2019.
MATERIALS AND METHODS: This study was of a descriptive‑analytic, correlation type that was
performed on 175 elderly of selected nursing homes in Tehran. The research tools included the
Abbreviated Mental Test; Control, Autonomy, Pleasure and Self‑realization questionnaire‑19;
and Health Literacy of Iranian Adults Questionnaire (HELIA). Data were analyzed using descriptive
and inferential statistics by SPSS 22 software.
RESULTS: The total score of health literacy and the quality of life of the elderly was 51.01 and
47.75, respectively. The literacy of most of the studied samples was “inadequate” and “not much
adequate” (0–66). The relationship between health literacy and quality of life in the elderly was
significant, and there was a direct and statistically significant relationship between them (P = 0.003).
That is, by an increase in literacy rates, the scores of quality of life of elderly people were also
increased. The correlation was equal to r = −0.28. Health literacy has the ability (31.98%) to predict
the quality of life.
CONCLUSION: The results showed a lack of enough education literacy, the average quality of life,
and the existence of a significant relationship between health literacy and quality of life in the elderly.
The wide range of inadequate literacy in the elderly reveals the importance of paying more attention
to the issue of literacy in health planning and health promotion at the national and local levels.

Abstract INTRODUCTION: For many years, numerous researches and risk reduction activists have
emphasized the importance of public awareness and education for disaster risk reduction (DRR).
These needs, due to human natural manipulation, have increased. The present study was aimed to
assess and determine the evidence on the strategies for education of DRR.
MATERIALS AND METHODS: This study was a systematic review of publications and gray literatures
regarding to strategies for education of DRR conducted in December 2016. Fifteen articles and
dissertations published during January 1, 2000 to December 31, 2016 were extracted through PubMed,
Scopus, ProQuest, Web of Science, ScienceDirect, Ovid, Google Scholar, Scientific Information
Database, Magiran, and Irandoc with the inclusion criteria of English and Persian language. Thematic
analysis technique was used to analyze the articles.
RESULTS: The thematic analyses revealed eight major categories of DRR educational strategies
such as raising knowledge, educational needs assessment, educational planning, educational
approaches, educational content, educational tools, involved organizations, and educational learning
barriers and challenges.
CONCLUSIONS: Most countries have launched DRR education activities, but these actions are
not enough, and there are some gaps between what is it and what should be. More effective and
efficient teaching and learning strategies are needed to increase the effectiveness of preparedness
and DRR activities at all levels of community.