Journal of Education and Health Promotion

Abstract BACKGROUND: Given the relationship between positivity interventions and psychological problems,
this study aimed to investigate the effect of positive thinking training on stress, anxiety, depression,
and quality of life of hemodialysis patients.
MATERIALS AND METHODS: This is a quasi-experimental and interventional study conducted
on 70 hemodialysis patients referred to Fasa hemodialysis centers, Iran, between April 2019 and
October 2019. Patients were selected using a simple sampling method and randomly divided into
control (n = 35) and intervention (n = 35) groups. The intervention group was trained on positive
thinking skills in eight sessions of a workshop. Before and after the intervention, stress, anxiety,
depression, and quality of life in both the groups were measured using the Depression, Anxiety,
and Stress Scale-21 and Short Form-36 Questionnaire. Data were analyzed using paired t-test,
independent t-test, Kolmogorov–Smirnov, and Chi-square tests.
RESULTS: There was no significant difference in the mean scores of stress, anxiety, depression,
and quality of life in the two groups before the intervention.(P > 0.05), and in the control group, there
was no statistically significant difference before and after the intervention (P = 0.092, P = 0.228,
0.280, respectively). In the intervention group, the mean score of stress and anxiety decreased from
23.65 ± 4.12 to 16.68 ± 4.41 (P < 0.001) and from 17.77 ± 5.15 to 14.57 ± 4.18 (P = 0.002), respectively,
and that of the patients’ quality of life also increased from 35.19 ± 10.07 to 55.98 ± 11.71 (P < 0.001).
However, the mean score of depression did not change significantly after the intervention (P = 0.689).
CONCLUSION: According to the results of this study, the use of positive thinking intervention
programs with other methods for hemodialysis patients’ care and treatment is recommended as a
nonpharmacological, cost-effective, and uncomplicated method.

Abstract INTRODUCTION: Health‑care workers in community service professions are the formerly candidate
for occupation burnout. This study aimed to investigate the relationship between empowerment and
job burnout among auxiliary health workers (behvarzan) at Fasa University of Medical Sciences.
MATERIALS AND METHODS: In this descriptive‑analytical study, 120 auxiliary health workers were
enrolled using the census. Spritzer’s psychological empowerment and Maslach burnout inventory
questionnaires were used to collect the data. Then, they were analyzed through the SPSS software,
using descriptive analytical tests.
RESULTS: The findings of this study revealed that the auxiliary health workers’ empowerment was
in the range of 22–75 with a mean ± standard deviation [SD] of 48.5 ± 9.71, which is in a fairly high
level considering the highest score (75) in this scale. Moreover, with respect to burnout (mean ± SD
of 58.03 ± 18.64), 36 participants (30%) had low level of burnout, 69 subjects (57.5%) were at the
intermediate level, and 15 (12.5%) suffered high levels of job burnout. According to the results of
this study, there were a high correlation and negative relationship (r = 0.406, P > 0.001) between
psychological empowerment and job burnout among the auxiliary health workers. On the other hand,
all empowerment components (competence, autonomy or independence, effectiveness, and trust)
had a reverse and significant association with burnout.
CONCLUSION: Based on the results of this study, the auxiliary health workers (behvarzan) were in a
good range of empowerment; also, the dimensions of empowerment were correlated with job burnout
in Fasa university‑affiliated hospitals’ health workers. On the other hand, demographic features had
no association with these two factors. It is suggested that health authorities should take measures to
empower the workers and identify and remove the effects of the various dimensions of job burnout
among the health workers in these hospitals.

Abstract BACKGROUND: Communication apprehension (CA) is the fear or anxiety about communicating.
This study was designed to investigate the CA and its related factors in the medical students at
Rafsanjan University of Medical Sciences (RUMS).
MATERIALS AND METHODS: In this cross‑sectional study, personal report of CA (PRCA‑24) was
administered to 340 medical and paramedical students to measure anxiety in four domains of large
groups, small groups, public speaking, and dyadic interaction. Pearson’s correlation and linear
regression analysis were used to investigate the relationship between CA and the variables of birth
order, number of siblings, and university entrance score. Data were analyzed using descriptive and
inferential statistics (Chi‑square and Kruskal–Wallis Test).
RESULTS: CA in the dimension of public speaking was higher than the other dimensions. Evaluation
of the economic stability and its relationship to CA indicated a significant difference among all the
domains of the PRCA‑24. There was a significant relationship between the scores of CA and the
number of siblings (P = 0.001). Linear regression and Pearson’s correlation tests indicated a significant
correlation between the variables of birth order, number of siblings, and university entrance score.
The correlation between the CA with dimensions of group discussion, interpersonal, speaking, and
meeting was weak but significant (P < 0.01).
CONCLUSION: Without communication, the materialization and development of the human
community are not possible. This aspect is more evident and crucial in the healthcare industry. Based
on the results of this study, the medical and paramedical students at RUMS have a medium‑to‑high
level of CA. Therefore, it is of utmost importance to detect students with high CA to prevent further
communication problems after graduation.

Abstract INTRODUCTION: Academic burnout is one of the issues involving the educational systems at all
levels, which wastes the human resources and expenditures. Academic burnout refers to the sense
of exhaustion due to educational requirements, the sense of cynicism and indifference, and the
sense of lack of competence. Considering the fact that burnout has already been studied in different
professions and in cultures different from that of ours, there is a need to identify these factors among
the Iranian medical students and accordingly propose some strategies to reduce burnout symptoms
among these students. With this end, this study aimed to identify and quantify the importance of
possible factors causing burnout among medical students in the 2nd and 4th years of their studies in
Mashahd University of Medical Sciences and provide some suggestions.
METHODS: The present research is a cross‑sectional study conducted in 2017. The participants
included medical students who had entered Mashhad University of Medical Sciences in Iran in 2013
and 2015 and were in their 4th and 2nd year of their studies in the university. A questionnaire prepared
and validated by Maslach et al. was used to collect the data and distributed among 195 participants
who were selected randomly as the sample.
RESULTS: The results showed that the mean scores given by 195 selected respondents regarding
emotional exhaustion, indifference, and inefficiency were respectively 3.89, 3.87 and 4.12 out of 7.
CONCLUSION: Based on the results, students had the highest level of academic burnout in
personal inefficiency or incompetence component and the lowest level was observed in indifference.
Therefore, burnout and its components were explicitly seen among medical students; the authorities
are recommended to take measures to reduce academic burnout among the students.

Abstract INTRODUCTION: The aim of this study was to evaluate the cognitive, psychomotor, and attitudinal
readiness of faculty members and students of Shiraz University of Medical Sciences for using
e‑learning in 2019 in order to move toward the desired future of e‑learning in medical education,
promote the benefits of e‑learning in the country, and provide training to each of the research groups
if needed.
METHODS: This is a cross‑sectional study conducted in Shiraz University of Medical Sciences,
Iran, in 2019. The study population consisted of 379 students and 281 professors selected through
the systematic random sampling in Shiraz University of Medical Sciences. The e‑learning readiness
questionnaire developed by Zarif Sanaei et al. was used to evaluate the students’ and teachers’
viewpoints.
RESULTS: The results showed that the average level of skill, knowledge, and attitude among students
and teachers was positive and higher than the mean (P < 0.05). It had only a significant relationship
in the level of education of the teachers and the marital status of the participants. There was also a
significant interaction between skill, knowledge, and attitude.
CONCLUSION: There is a need for successful implementation of e‑learning by creating appropriate
infrastructure, applying the required standards, as well as taking measures to reduce the existing
resistance in this regard, which can be achieved through training workshops. The experience of
successful universities in the country and abroad can also be used to implement e‑learning.