Journal of Education and Health Promotion

Abstract BACKGROUND: Assessment of circulating and scrub skills is an important issue in operating
room (OR) programs. However, there is a lack of well‑designed tools that are specifically developed
for this purpose. Hence, this study aimed to develop and determine the validity and reliability of a
checklist to measure the circulating and scrub skills of OR novices.
MATERIALS AND METHODS: This cross‑sectional methodological study was conducted among 124
OR technology students who were selected during three consecutive academic years (2019–2020 to
2021–2022). The developed checklist was evaluated with face validity, content validity (quantitative
and qualitative), construct validity  (known‑groups validity), criterion‑related validity  (concurrent
and predictive validities), internal consistency  (Kuder–Richardson 20, KR‑20), and inter‑rater
reliability (intra‑class correlation coefficient, ICC). Known‑groups validity was evaluated by comparing
the difference between the checklist scores of first‑semester and third‑semester students using
independent samples t‑test. Additionally, concurrent and predictive validities were evaluated by ICC
through measuring the correlation between the total score of checklist and grades of a multiple‑choice
test and two clinical apprenticeship courses, respectively. Data were analyzed in the Statistical
Package for Social Sciences software.
RESULTS: After reconciling the preliminary checklist in terms of face and content validities, a
checklist with 17 sub‑scales and 340 items called “Circulating and Scrub Skills of Operating Room
Novices (CSSORN)” was developed. Regarding the known‑groups validity, the third‑semester
students had higher scores compared to the first‑semester students (p < 0.001 in most sub‑scales).
Besides, the total score of checklist showed a significant correlation with the criteria of concurrent
and predictive validities (ICC = 0.64, ICC = 0.72; P < 0.001). The KR‑20 for the entire checklist was
0.90 (range: 0.60–0.93). The ICC for inter‑rater reliability was also 0.96 for the entire checklist (range:
0.76–0.99, P < 0.001 in all sub‑scales).
CONCLUSION: The CSSORN had appropriate validity and reliability to be used for measuring the
circulating and scrub skills of OR novices. To shed light on the findings, further testing of this checklist
on larger populations and in different contexts is suggested.

Abstract BACKGROUND: COVID‑19 initiated in December 2019 in Wuhan, China, and over a period of
time, the infection outspread across the world in a rapid pace. To protect the people and to further
limit the spread of infection, lockdown was declared in most parts of the world including India.
As all people were forced to stay indoors during this pandemic, internet was the only source of
entertainment whose overuse has side effects on anxiety and sleep quality. This study is aimed to
know the impact of Internet addiction during COVID‑19 on anxiety and sleep quality among college
students of Bhubaneswar city.
MATERIALS AND METHODS: This was a web‑based cross‑sectional, questionnaire study. It
administered 475 students from six colleges. The students were assessed by a proforma containing
demographic details, patterns of internet use, Youngs Internet Addiction Test, Generalised Anxiety
disorder score, and the Pittsburgh Sleep Quality Index. Statistical analysis was done using SPSS
version 21.0 using Chi‑square test and Wilcoxon signed‑rank test.
RESULTS: The mean age of the study group was 18.81 ± 1.189. Out of 475 students, 60.6% were
female and 39.4% were male. 23.6% and 13.4% of recruited students had severe internet addiction
and anxiety disorder, respectively. The mean global PSQI score in the study was 6.356 ± 1.88.
About 84.6% of the students had poor global sleep quality score. All components of sleep quality
were significantly associated (P = 0.000) with different degrees of internet addiction except sleep
duration (P = 0.589) and efficiency (P = 0.767).
CONCLUSION: Females were highly addicted than males. The study findings specified that students’
excessive internet usage leads to anxiety, and affects mental health. Monitoring and controlling
students’ internet addiction through informative sessions on how to use the Internet adequately is
useful.

Abstract BACKGROUND: Due to the COVID‑19 pandemic, many countries have implemented nationwide
lockdowns. While this leads to a decrease in disease transmission, there is a concurrent increase in
the levels of psychological distress. To estimate the levels of psychological distress in school‑ and
college‑going adolescents currently under lockdown and to determine the factors associated with
this psychological distress.
MATERIALS AND METHODS: A cross‑sectional study conducted in Army Public School and
College (APSAC) Sibi, Balochistan province of Pakistan between March and May 2020. Students
of APSAC Sibi were enrolled in this research. Modified Kuppuswamy Socioeconomic Scale, Godin
Leisure‑Time Exercise Questionnaire, and Kessler‑10 were used for data acquisition. Chi‑square
and t‑tests and univariate analysis (nonparametric test) were performed using the Statistical Package
for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, US).
RESULTS: Out of 225 participants, 57.4% were studying at school. Sixty‑four percent of the participants
were likely to be suffering from psychological distress. There is a significant effect of physical activity,
sleep duration, bedtime at night, screen‑time duration, and COVID‑19 positive family member on the
levels of distress. A moderate positive correlation was between psychological distress and bed‑time at
night (rho[223] = 0.328, P < 0.001) and screen time duration (rho[223] = 0.541, P < 0.001). A moderate
negative correlation of physical activity (rho[223] = −0.340, P < 0.001) and a weak negative correlation
of sleep duration hours (rho[225] = −0.158, P = 0.018) was found with psychological distress levels.
CONCLUSIONS: The COVID‑19 lockdown and pandemic have had a considerable psychological
impact on both school‑going and college‑going students, showing increased level of stress. A strong
public health campaign along with mental and physical and social support programs are the need
of the hour.

Abstract BACKGROUND: The phenomenon of Internet addiction has increased due to the delay between
Internet technology and the culture of using it. According to the high prevalence of Internet addiction
among students and its associated complications, the present study was conducted to determine
the effect of education based on the health belief model on Internet addiction status among students
in Tehran, Iran.
MATERIALS AND METHODS: In this interventional study, two dormitories were divided into two
groups of control and intervention in a completely random manner using the random cluster sampling
method from a total of eight dormitories. Then 134 girls in each group answer two questionnaires of
Young (about Internet addiction) and health belief model‑based scale. After the need assessments
of the primary results, intervention was performed in the experimental group in a way that a textbook
based on the health belief model and ten educational text messages were sent to the students’ E‑mail.
Two months later, questionnaires were again given to both groups. The results were analyzed with
the help of independent t‑test, Chi‑square test, Fisher’s exact test, Mann–Whitney test, analysis of
covariance, and logistic regression with repetitive measures with GEE approach.
RESULTS: The average scores of knowledge (P < 0.001), perceived susceptibility (P < 0.001),
perceived severity (P = 0.006), perceived barriers (P  <  0.001), and self‑efficacy  (P = 0.002)
between the two groups, had a significant difference after the intervention. The average scores of
perceived benefits (P = 0.6), Internet addiction behavior (P = 0.11), and the frequency of Internet
addiction (P = 0.63) after intervention did not have a significant difference in the two groups.
CONCLUSIONS: The results of this study show the effectiveness of educational intervention design
based on the structures of health belief model on reducing the frequency of Internet addiction and
adopting preventive behaviors.

Abstract BACKGROUND: Paying attention to students’ opinions and suggestions on existing evaluation
methods and new methods of evaluation is an essential and important part of clinical education, so
this study aimed at determining the effectiveness of two evaluation techniques satisfaction among
undergraduate nursing students.
MATERIALS AND METHODS: This was a quasi‑experimental study conducted on 60 undergraduate
nursing students of Isfahan University of Medical Sciences in 2019. There were 30 samples in each
group (logbook and e‑logbook) that were selected by convenience sampling method. the Android
application (e‑logbook) was used in the intervention group to evaluate the clinical skills of students.
The User Satisfaction Questionnaire was conducted by undergraduate nursing students. Data were
analyzed using SPSS software version 14 and descriptive statistical tests.
RESULTS: The results showed that the mean (standard deviation) overall score of satisfaction
from both evaluation methods including logbook and e‑logbook was 39.7 (9.4) and 47.7 (12.2),
respectively. Also satisfaction score of the evaluation method was significantly different between
the two groups (P = 0.03).
CONCLUSION: According to the results of the present study, the use of new and active methods of
evaluation, including the application of e‑logbook, can be useful in evaluating nursing students and
cause student satisfaction, so using the application is useful.

Abstract INTRODUCTION: Recently, the night shift is included in the curriculum of nursing internship students.
However, this shift is associated with some problems and benefits for students, which have been
assessed in limited studies. This study aimed to discover and describe the problems and benefits
of the night shift for nursing internship students.
METHODOLOGY: This qualitative method was carried out with the conventional content–analysis
method. In total, 15 seventh‑semester and eighth‑semester nursing students at Sabzevar University
of Medical Sciences, Iran, were selected by purposeful sampling. Data were collected using in‑depth
semi‑structured interviews about students’ perceptions of night shift problems and benefits. In addition,
data analysis was performed applying the conventional content–analysis technique.
RESULTS: In this study, seven main categories were extracted, five of which included problems
such as exploitations, being an outsider, moral distress, learning deficits, and annoyance. The other
two categories were benefits including gaining new experiences and independence.
CONCLUSION: The problems related to the students were the nursing personnel and the educational
system of hospitals, which can be dealt with through the interaction of the educational system with
hospitals managers in order to clarifying the role of students, fair division of work, and making
educational resources available. Moreover, gaining new experiences and independence are among
the benefits of the night shift for students, the continuation of which is in favor of nursing education.

Abstract BACKGROUND: Educational justice is one of the fundamental dimensions of social justice, and the
progress of each society depends on its realization. Since students are engaged in the educational
process, recognizing their viewpoints can provide useful guidance to correct existing problems. The
purpose of this study is to investigate the observance of educational justice from the viewpoint of
medical students in southeastern Iran.
METHODOLOGY: This cross‑sectional study was carried out on 200 students of Zahedan University
of Medical Sciences, southeastern Iran, in 2017 by stratified sampling. The tool for measuring
organizational justice was a questionnaire. The validity of the questionnaire was confirmed by
content validity method, and its reliability was confirmed by Cronbach’s alpha (0.8). Descriptive
statistics (frequency and percentage), Chi‑square test, and analysis of variance (ANOVA) test were
used to analyze data.
RESULTS: The mean age of students was 21.7 ± 2.91 years. Fifty percent of students assessed
the educational justice as good to excellent, and based on a general score, educational justice was
observed in 73.2% of cases. The one‑way ANOVA showed a significant difference between the scores
of educational justice from the viewpoints of students in different faculties of Zahedan University of
Medical Sciences (P < 0.001).
CONCLUSION: According to the results, students’ needs for achieving educational justice have
been identified in this study. This study can provide useful guidance to correct existing problems and
help policymakers in Zahedan University of Medical Sciences to achieve a full educational justice.

Abstract BACKGROUND: Simulation is one of the strategies which are suggested and used to reduce stress
and anxiety in clinical student education. This study aimed to determine the effect of simulation‑based
training method on psychological health promotion in operating room students in their educational
internships.
MATERIALS AND METHODS: This study was a clinical trial. Research population was operating
room students at Semnan University of Medical Sciences. A demographic questionnaire and the
Spielberger’s Situational Anxiety Inventory were used as data collection tools. Students were divided
into two intervention and control groups randomly. Situational anxiety was measured before the
intervention and on the 1st and the last days of the internship. The data from the two groups were
compared by using the Mann–Whitney and Friedman statistics at the significant level of 0.05.
RESULTS: There was a significant difference between students’ situational anxiety scores in the
experimental and control groups on the 1st day of internship after education by simulation (P = 0.481).
There was a significant difference between the students’ anxiety scores in the two groups on the last
day of the internship (P = 0.008).
CONCLUSION: Simulation of the operating room environment before the internship cannot reduce
the operating room students’ situational anxiety on the 1st day of internship, but it can reduce their
situational anxiety during the internship and significantly reduce it at the end of internship compared
to those who are not in the simulated environment.

Abstract INTRODUCTION: One of the main criteria for students’ merit in their study process and reaching the
graduation step, is academic success. Therefore, identifying related factors can help the improvement
of academic success rate. The aim of this study was to examine the academic success and related
factors among the students of University of Tehran.
MATERIALS AND METHODS: This cross‑sectional study was done on 384 students of Tehran
University of Medical Sciences. Samples were selected through stratified sampling method. Data
were collected through questionnaires of academic success scale 39 that reliability and validity of
that were confirmed. Data analysis was done through SPSS18 software. Descriptive statistics and
independent t‑test, and correlation coefficient were performed at significance level of 0.05.
RESULTS: The mean academic success was 108.87(standard deviation[SD] =10.63) (69.78% of total score).
The mean academic success in male was 110.04 (SD = 11.75) and in female was 108.20 (SD = 9.91).
Independent t‑test results indicate that there is a significant statistical relationship between marital status and
the academic success (P< 0.05). The Pearson correlation test results showed that there was a statistically
significant relationship between average with academic success (r = 0.17, P = 0.001).
CONCLUSION: Considering the effect of demographic variables on the academic success rate,
academic success rate can be improved by planning to improve these factors.

Abstract Introduction: Cultural intelligence and social compatibility are two acquired processes that their
education and reinforcement between dormitory’s students who have inter cultural interactions
with each other can conclude with results that tension diminution, inter cultural contrast and
conflict, social divisions and consequently healthy and peaceful relationships and governance
and finally mental peace, and health are of its most important. Hence, the research has been
occurring in order to the determination of cultural intelligence relationship with the social
compatibility of Isfahan University of Medical Sciences dormitories resident students in 2012.
Materials and Methods: The research method is descriptive‑correlation, and its population
is composed of all Isfahan University of Medical Sciences dormitories resident students in
2012 that were totally 2500 persons. The two steps sampling method have been used, group
sampling and random sampling has been occurring at first and second steps and totally 447
persons were selected. Research data were collected via Earley and Ang cultural intelligence
questionnaire with 0.76 Cronbach’s alpha Coefficient and California social compatibility standard
questionnaire with higher than 0.70 Cronbach’s alpha factor. Questionnaire data have been
analyzed with the SPSS software and results have been presented in the shape of descriptions
and statistics. Findings: Results showed that there is a direct significant relationship (P < 0.001)
between cultural intelligence and the social adjustment in students living in Isfahan University
of Medical Sciences dormitories and also there is a direct significant relationship in the level
of (P < 0.05) between cognitive and motivational dimensions of cultural intelligence; however,
there is no significant relationship between cognitive and behavioral dimensions of cultural
intelligence and social adjustment (P > 0.05). Conclusion: Cultural intelligence and cognitive
and motivational addition in dimensions of students living in Isfahan University of Medical
Sciences dormitories increase their social integration, therefore, cultural intelligence and social
adjustment of students can be increased through planning and we can try for their mental
health by this way.