Journal of Education and Health Promotion

Abstract BACKGROUND: Female sexual dysfunction is a common and often distressing public health problem.
This study aimed to determine the effect of the sexual health program on female sexual function and
attitude in reproductive age in the west of Iran.
MATERIALS AND METHODS: This was a field trial study. A total of 103 women attending health
centers were assigned into two groups; an experiment and a control group. Data collection tool involved
sociodemographic characteristics questionnaire, sexual female attitude questionnaire, and the Female
Sexual Function Index (FSFI), which was completed by participants before and after the implementation
of a sexual health education program. Data were analyzed using SPSS software version 22.
RESULTS: The results revealed that after the intervention, female sexual function in the experiment
group based on the FSFI tool was significantly improved (P < 0.01) in the domains of desire, arousal,
orgasm, satisfaction, pain, and the total score compared with the control group. Besides, there was
no significant difference between posttest mean score of sexual attitude in the experiment group and
control group (P > 0.05). However, a significant difference was found in the mean score of sexual
attitudes in the experimental group before and after the intervention (P = 0.004).
CONCLUSION: The findings showed that sexual health program was effective in improving women’s
sexual function and attitude in the experiment group. It is recommended that the effect of other training
methods remain to be addressed on women’s sexual function and attitude.

Abstract BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress that
is an underlying issue in the nursing profession, which can lead to problems such as reduced quality
and quantity of care and sleep disorder. Besides, given the increased privatization of hospitals, this
study aimed to explore the association between nurses’ moral distress and sleep quality and its
comparison among nurses in private and public hospitals.
MATERIALS AND METHODS: This was a descriptive‑analytical study involving 150 nurses working
in Ilam Province hospitals. Sampling conducted using a multistage random sampling method. Data
were collected through the questionnaire of sociodemographic characteristics, the Corley’s Moral
Distress Scale, and the Pittsburgh Sleep Quality Index. Data were analyzed using SPSS software
version 22. Descriptive statistics such as frequency, mean, ANOVA, independent t‑test, multiple linear
regression, and Pearson correlation coefficient at the significant level of P < 0.05 were calculated.
RESULTS: The analysis revealed that moral distress was positively associated with sleep quality.
Furthermore, the scores of nurses’ moral distress and sleep quality were different in private and
public hospitals, so that the level of moral distress in the public hospital and sleep quality in the
private hospital was higher and lower, respectively, but the difference was not statistically significant.
Moreover, sleep quality, and the type of employment was the most important predicting variables of
moral stress (B = 1.86) and sleep quality (B = 2.39), respectively.
CONCLUSION: According to the study results, a positive and significant association was found
between moral distress and nurses’ sleep quality. It is recommended that appropriate strategies
and training program be formulated by the health‑care system to increase nurses’ ability to combat
moral distress adverse effects.

Abstract INTRODUCTION: Sexual problems in elder people are considered as a public health concern and
can affect their overall health and quality of life. This study aimed to investigate the sexual quality of
life and its relationship with general health in older men in the west of Iran.
METHODS: This was a cross‑sectional study among 362 older men aged 60 years or older attending
Comprehensive Health Care Centers in Ilam, Iran. Samples selected through Quota sampling method
and simple random sampling. Data were collected using the Sexual Quality of Life Questionnaire‑Male
and General Health Questionnaire‑28.
RESULTS: The mean ± standard deviation (SD) of age was 69.9 ± 8.1 years. The mean ± SD
score of sexual quality of life and general health of older men was 46.6 ± 14.6 and 19.2 ± 9.7,
respectively. A positive and significant association was found between sexual quality of life and
general health (P < 0.001, r = −0.41). Moreover, general health, age, sleep problems, and the level
of education were the important predictors for sexual quality of life in elder men (P < 0.05).
CONCLUSION: According to the results, the sexual quality of life of participants was at a moderate
level. Since only some factors influencing the sexual quality of life were ascertained, further studies
are required to investigate all factors influencing older men’s sexual quality of life.

Abstract INTRODUCTION: Majority of critical care nurses do not have desirable skills in performing
endotracheal tube suctioning (ETS) despite related training taught in the curricula. This study aimed
to investigate and compare the effect of education through video and performance feedback (PF)
on nurses’ skills in performing ETS.
METHODS: This was a quasi‑experimental study. The sample size comprised of all nurses (n = 49)
working in the intensive care unit of one of the educational hospital located in one of the western
cities of Iran. Nurses were assigned to either one of educational video (EV) and PF groups. Data
were collected using a 25‑item structured best practices information sheet. Data were analyzed using
SPSS software version 20 (SPSS Inc., Chicago, IL, USA).
RESULTS: After the interventions, no significant difference was found in the total mean score of
nurses’ practice in ETS between those who received education through EV and those who received
through PF (16.3 vs. 15.1) (P > 0.05). Before and after the intervention, a significant improvement
was observed in the total mean score and other dimensions of nurses’ practice in endotracheal
suctioning (P < 0.0001).
CONCLUSIONS: The results showed that both of methods through feedback and EV are useful
in improving nurses’ ETS practice. However, further studies are required to examine the effects of
such interventions in the long term.