Journal of Education and Health Promotion

Relationships between spiritual health and perceived stress with breastfeeding adequacy in mothers with infants aged 1–6 months

. Leila Rasaei; . Tahmine Dadkhah Tehrani; . Zeinab Heidari

Volume 13, Issue 2 , February 2023, , Pages 1-8

Abstract

  BACKGROUND: Previous studies have shown that psycho‑spiritual state of mothers may havesignificant effects on their breastfeeding. The most common cause of nonexclusive breastfeeding ...  Read More BACKGROUND: Previous studies have shown that psycho‑spiritual state of mothers may havesignificant effects on their breastfeeding. The most common cause of nonexclusive breastfeeding isinadequate breastfeeding; therefore, this study examined the relationship between spiritual healthand perceived stress with breastfeeding adequacy in mothers with infants aged 1–6 months.MATERIALS AND METHODS: This cross‑sectional, descriptive, correlational study was performedon 186 mothers with infants aged 1–6 months, who referred to the health centers in Dorud city ofLorestan province, Iran, in 2021, which were selected based on cluster sampling. Data were collectedthrough four questionnaires including demographic–fertility, spiritual health, perceived stress, andbreastfeeding adequacy. Data was analyzed by Statistical Package for the Social Sciences (SPSS)software version 22 using descriptive and analytical statistics.RESULTS: The mean ± standard deviation (SD) values of spiritual health, perceived stress, andbreastfeeding adequacy were 99.59 ± 12.96, 23.8 ± 72.19, and 55.67 ± 7.67, respectively. There wasa significant positive relationship between spiritual health and breastfeeding adequacy (P < 0.001,r = 0.268). In addition, there was a significant negative relationship between perceived stress andbreastfeeding adequacy (P = 0.002, r = −0.231).CONCLUSION: Breastfeeding adequacy has a significant positive relationship with spiritual health anda significant negative relationship with perceived stress. Since infants are one of the most vulnerablegroups and breastfeeding is the best way to support their health and reduce infant mortality rates,breastfeeding adequacy can be improved by reducing stress and promoting spiritual health.

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The economic cost of cancer treatment in Iran

. Alireza Jabbari; . Marziye Hadian; . Elaheh Mazaheri; . Zahra Khakdel Jelodar

Volume 13, Issue 1 , January 2023, , Pages 1-6

Abstract

  BACKGROUND: With more than 12 million new cases of cancers and nearly 7.6 million deathsworldwide in 2020, cancer is currently the third leading cause of mortality in the world. The ...  Read More BACKGROUND: With more than 12 million new cases of cancers and nearly 7.6 million deathsworldwide in 2020, cancer is currently the third leading cause of mortality in the world. The costsspent on treating patients with cancer account for a significant amount of healthcare costs. Healthcareexpenditures for cancer treatment have also increased significantly and are projected to skyrocketfurther over the next decade. This study was conducted to determine medical and non‑medical directcosts for the prevention of cancer in patients hospitalized in 10 selected educational hospitals in Iran.MATERIALS AND METHODS: The study employed a cross‑sectional design and was conducted in10 selected educational hospitals in Tabriz, Tehran, Isfahan, Mashhad, and Shiraz in 2020. Usinga researcher‑made questionnaire, we assessed direct medical costs and direct non-medical costsof cancer in patients over 20 years old with kinds of breast, prostate, leukemia, lymphatic, stomach,liver, lung, bladder, uterine, and intestine cancers who undertook oncology treatments (n = 2410).Data were analyzed using descriptive statistics including mean and standard deviation and analyticstatistics such as Kolmogorov–Smirnov, analysis of variance, and t‑test, using SPSS 18 and P ≤0.05.RESULT: The mean direct non-medical cost paid out of pocket per month was $99.6 ± $10.81 USD,and the mean direct medical cost per month was $1029.4 ± $68.5 USD. The total cost paid by thepatients was $889.4 ± 69.81 USD per month.CONCLUSION: Given the increasing number of patients with cancer, it is necessary to increase thenumber of special centers for the prevention and treatment of cancers. Dissemination of informationabout the costs of illnesses and their complications enables decision‑makers to make a propercomparison between different uses of resources. Moreover, to support the patients, the health systemmust implement plans to decrease out‑of‑pocket payments by patients.

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Developing patient safety standards for health‑care quality promotion in neonatal intensive care units: A mixed‑methods Protocol

. Zahra Shahkolahi; . Alireza Irajpour; . Soheila Jafari‑Mianaei; . Mohammad Heidarzadeh

Volume 12, Issue 8 , September 2022, , Pages 1-6

Abstract

  BACKGROUND: Neonatal intensive care unit (NICU) is one of the accident‑prone settings inthe health‑care system. There is a series of structural and process threats to the safety ...  Read More BACKGROUND: Neonatal intensive care unit (NICU) is one of the accident‑prone settings inthe health‑care system. There is a series of structural and process threats to the safety of infantshospitalized in this unit, which can be prevented by taking the right actions. For this purpose,developing standards based on current knowledge, available resources, and the context that providescare can determine patient injury prevention requirements. Likewise, it can be a source for nationaldevelopment and application of related guidelines and protocols. This study aims to develop patientsafety standards in the NICUs of Iran.MATERIALS AND METHODS: This mixed‑methods study will apply the exploration, preparation,implementation, and sustainment framework to develop patient safety standards. In each phase ofthis framework, a set of activities take place. Exploration is based on the world health organizationmodel to develop standards. Determining the validity and applicability of standards will be done inPhase 2 (Preparation) and Phase 3 (Implementation), respectively. Since the long‑term effects arenot desired, the fourth phase (Sustainment) will not be considered.DISCUSSION: Patient safety standards from this study will contribute to efficient and effective,equitable, and high‑quality health‑care delivery. The application of them will further promote patientsafety and the quality of medical care in Iranian NICUs.

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Challenges of prehospital aerial operations in response to earthquake hazards: A qualitative study

. Seyed Hossein Mousavi; . Hamidreza Khankeh; . Golrokh Atighechian; . Mohammad H. Yarmohammadian; . Mehrdad Memarzadeh

Volume 12, Issue 7 , August 2022, , Pages 1-10

Abstract

  BACKGROUNDS: Due to the severity of the earthquake, it may need immediate treatment andtransfer of the injured people to advanced medical centers, as well as dispatch of the expert ...  Read More BACKGROUNDS: Due to the severity of the earthquake, it may need immediate treatment andtransfer of the injured people to advanced medical centers, as well as dispatch of the expert teamand specialized health equipment to the accident‑affected area. Aerial emergency is an importantresponsibility of the health care system in this situation. The study aimed to extract the prehospitalemergency challenges of Iran aerial operations emergency in response to the earthquake.MATERIALS AND METHODS: The study was qualitative content analysis with conventionalapproach. Sampling was done in a purposive method and data were collected through semi‑structuredinterview. The panel involved consists of 26 health professionals in medical emergencies. Recordedinterviews were transcribed into written and then conventional content analysis was used to derivecoding categories directly from the text data.RESULTS: Content analysis is provided 97 initial codes, 20 subcategories and 4 main categoriesincluding challenges of “response assessment,” “support,” ”pre‑hospital staff‑management,” and“response operation,” respectively.CONCLUSIONS: The results showed that the necessity to assess the affected area, staffing, andmanagement actions, including integrated operations command and the development of a dedicatedresponse plan, as well as the use of strategies inter‑organizational coordination in the responsephase to earthquake. This study also emphasized that providing standard equipment, support actions,and strengthening communication infrastructure, and updating the aerial emergency system shouldbe considered as one of the priorities of the emergency organization of Iran to provide a desiredresponse to the earthquake.

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Iranian nongovernmental organizations’ initiatives in COVID‑19 pandemic

. Meroe Vameghi; . Monir Baradaran Eftekhari; . Katayoun Falahat; . Ameneh Setareh Forouzan

Volume 12, Issue 6 , July 2022, , Pages 1-9

Abstract

  BACKGROUND: With the outbreak of the COVID‑19 virus crisis worldwide, including Iran, the need for corona prevention and treatment has become a national priority. With many businesses closed ...  Read More BACKGROUND: With the outbreak of the COVID‑19 virus crisis worldwide, including Iran, the need for corona prevention and treatment has become a national priority. With many businesses closed in the wake of COVID‑19 and job losses and declining incomes, vulnerable individuals’ and families’ access to the minimum wage and healthcare facilities is falling, and their health is exposed to a great risk. In Iran, a significant number of vulnerable groups are supported by nongovernmental organizations (NGOs). This study is designed to understand the performance of NGOs after the onset of the COVID‑19 crisis.MATERIALS AND METHODS: This study was carried out based on qualitative research between June and September 2020 in Tehran. This study was conducted using individual interviews with 33 managers and experts of 24 active NGOs providing services to vulnerable groups and a member of an NGO network. Data were analyzed using content analysis.RESULTS: Two main themes of service initiatives were extracted: (a) service initiatives to protect the target population against COVID‑19 infection and its aftermath and (b) management initiatives to retain staff, finance, and adapt the organization to crisis situations. Service initiatives included five categories of health service initiatives, livelihood, employment, education, and leisure initiatives, while organizational management initiatives include human resource management, financial management, and communication with organizations.CONCLUSION: The COVID‑19 breadth and its special features have set it apart from other crises and have led NGOs to work hard on several fronts to care for the most vulnerable people against the epidemic and its consequences and maintain the performance of their organizations. The unique role of cyberspace has made it one of the definitive pillars of the activities of NGOs, not only during the epidemic but also after its end.

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Identifying strategies for dealing with the aging population from the perspective of health system experts: A qualitative study

. Rahele Samouei; . Mahmoud Keyvanara

Volume 12, Issue 5 , June 2022, , Pages 1-7

Abstract

  BACKGROUND AND AIM: Given the growing trend of aging and the limited resources of the healthsystem, the lack of long‑term prior government planning, and reduced growth of the productive ...  Read More BACKGROUND AND AIM: Given the growing trend of aging and the limited resources of the healthsystem, the lack of long‑term prior government planning, and reduced growth of the productive forceof society, identifying strategies for planning and action to deal with future aging is very important.In this regard, the study was conducted to identify strategies for dealing with the aging populationfrom the perspective of health system experts.METHODS: The qualitative content analysis study was performed on 29 Iranian male and femaleexperts in the aging and health scope from Isfahan, Tehran, Tabriz, and Babol who purposefullyparticipated in the semi‑structured interview. Data were classified by qualitative content analysis.RESULTS: Two concepts emerged according to the participated experts’ opinions, regarding thestrategies of the Iranian health system in dealing with future aging: “executive policy” strategies,including “design, planning and implementation,” “evaluation and standardization,” “strengtheningdemand‑driven” and “modeling national and international experiences,” “preventive policies”strategy, which includes “Focus on prevention,” “Focus on values and competencies,” “Educationalempowerment,” “Knowledge‑based empowerment,” “Empowerment of age‑related groups,”“Economic empowerment,” and “Social support.”CONCLUSION: The diversity and breadth of the mentioned strategies indicate the necessityof comprehensive readiness and adaptation of health services to the elderly conditions andcharacteristics. Purposeful planning and timely implementation of programs and policies to betteraddress the health system with future aging will be possible by using practical strategies.

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Health protection challenges of slums residents during the COVID‑19 pandemic, according to the social determinants of health framework: A case study of Kerman city in Iran

. Mohammad Hossein Mehrolhassani; . Vahid Yazdi‑Feyzabadi; . Noora Rafiee; . Sara Ghasemi

Volume 12, Issue 5 , June 2022, , Pages 1-10

Abstract

  BACKGROUND: Coronavirus disease‑2019 (COVID‑19) pandemic can aggravate the healthproblems in slum areas. The present study intends to examine the challenges of health protection ...  Read More BACKGROUND: Coronavirus disease‑2019 (COVID‑19) pandemic can aggravate the healthproblems in slum areas. The present study intends to examine the challenges of health protection ofslum’s residences during the COVID‑19 pandemic with the Social Determinants of Health perspective,in Kerman city in Iran.MATERIALS AND METHODS: The present study was a qualitative content analysis. Data werecollected by purposeful sampling in‑depth and semi‑structured interviews with 16 people. Theinterviews were conducted (from October to December 2020) with the local representatives of theslum’s residents, health‑care workers, managers of facilitation offices, and welfare social servicecenters that are located in slum areas (Interview’s guide is attached). The textual material fromthe interviews was entered into the MAXQDA software and directed content analysis was used toanalyze the data.RESULTS: Data analysis led to the identification of 4 categories (Sociocultural, Situational,Economical, and Physical environment) and 12 subcategories: Sociocultural: lack of awareness,begging culture, low trust in disease control programs, low bottom‑up planning, and increasingviolence; Situational: decreasing donors’ activities and canceling important meetings; Economical:unemployment, decreasing in income, and increasing limitations of many institutions in providingresources; and Physical environment: inadequate space and inappropriate conditions in some housesand alleys for people protection against Corona viruses.CONCLUSIONS: Slum residents have faced many challenges during the COVID‑19 pandemic.These challenges can affect the health of slum and other urban dwellers. Multidisciplinary thinkingand actions are needed. Increase awareness and engagement slum residents in control diseaseprograms should be considered.

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Predictors of the intention to receive the COVID 19 vaccine by Iranians 18– 70 year old: Application of health belief model

. Roya Jahanshahi‑Amjazi; . Mohsen Rezaeian; . Mehdi Abdolkarimi; . Mostafa Nasirzadeh

Volume 12, Issue 5 , June 2022, , Pages 1-7

Abstract

  BACKGROUND: In terms of public health, vaccination is considered as the most effective approachagainst the infectious diseases. Accepting and receiving the first vaccine produced as ...  Read More BACKGROUND: In terms of public health, vaccination is considered as the most effective approachagainst the infectious diseases. Accepting and receiving the first vaccine produced as an innovationmay not be easy. Therefore, the present study was conducted to investigate the predictors of intentionto receive COVID‑19 vaccine by Iranians aged 18–70 years based on the health belief model in 2021.MATERIALS AND METHODS: This descriptive study was performed on 2365 people aged18–70‑year old in Iran by random cluster sampling. Receipt of data was done electronicallyquestionnaire through the Porcelain system. Data were analyzed using SPSS software version 20using Chi‑square, one‑way analysis of variance, independent t‑test, and multiple regression analysisat a significance level of 0.05.RESULTS: The mean score of receiving the Iranian corona vaccine was 3.06 ± 1.30 out of 5 points.About 16.7% reported that they will definitely choose the Iranian vaccine. The highest correlationwas between the intention to receive the vaccine with self‑efficacy (r = 0.239, P < 0.001) and barriersto receiving the vaccine (r = −0.237, P < 0.001). Self‑efficacy (β = 0.114, P < 0.001), perceivedbarriers (β = −0.126, P < 0.001), and benefits of vaccine (β = 0.061, P = 0.022) were most importantpredictors the intention to receive the vaccine.CONCLUSION: Approximately 38% reported that they would definitely and probably not choose theIranian corona vaccine. Therefore, it is suggested that more information should be provided aboutthe features and benefits of domestically produced vaccines compared to foreign products.

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Psychometric analysis of Persian version of patient safety competency self‑evaluation in psychiatric wards

. Mahya Torkaman; . Marzieh Momennasab; . Shahrzad Yektatalab; . Mahin Eslami Shahrbabaki

Volume 12, Issue 5 , June 2022, , Pages 1-7

Abstract

  BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursingand safe care profession as well as evaluation of the nurses’ educational needs. ...  Read More BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursingand safe care profession as well as evaluation of the nurses’ educational needs. The present studywas conducted to determine psychometric properties of the Persian version of the patient safetycompetency self‑evaluation (PSCSE) tool in Iranian psychiatric wards.MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman,Iran, were included in the present cross‑sectional study using census method. This tool contains 41items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skilldimension. Psychometric properties of the questionnaire including its content and face validity werealso examined. The factor structure of the questionnaire was evaluated using exploratory factoranalysis. The internal consistency and reliability were assessed by test–retest method with an intervalof 14 days. Cronbach’s alpha and corrected item‑total correlation were used to measure reliability.RESULTS: The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 wasremoved from the skill domain because it was not related to the psychiatric ward. According to theresults of factor analysis, there was a significant relationship between the questions and the relevantfactors. The correlation coefficient for test–retest with 14 days interval was intraclass correlationcoefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge,attitude, and skill, respectively. The internal consistency coefficient (Cronbach’s alpha) of the wholetool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively.Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items),attitude (14 items), and skills (20 items).CONCLUSION: Persian version of the nurses’ competency tool in ensuring patient safety in psychiatricwards has acceptable psychometric characteristics.

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Designing the competency‑based training model of Iranian medical tourism

. Abbas Abbaspour; . Hamid Rahimian; . Nasrin Shaarbafchizadeh; . Amirhossein Maghari; . Zahra Danial

Volume 12, Issue 5 , June 2022, , Pages 1-10

Abstract

  BACKGROUND: Despite the great comparative advantage of Iran in terms of infrastructure,technology, and human resources as well as the significance of medical tourism in the tourist ...  Read More BACKGROUND: Despite the great comparative advantage of Iran in terms of infrastructure,technology, and human resources as well as the significance of medical tourism in the tourist industry,in practice, the quality of human resources has received less attention. Consequently, this study wasconducted to design a model of competency‑based training for Iranian medical tourism.MATERIALS AND METHODS: This study was an exploratory mix, and the Delphi method andsemi‑structured interviews were used for the qualitative part of this study. In the second part, theanalytical method was utilized for the quantitative part of this study.RESULTS: The results indicated the main components of medical tourism to be public interactionsand private interactions and seven subcomponents. Medical Tourism’s Competency includes threemain components and seven subcomponents.CONCLUSION: Although some training separated and scattered is present in Iran’s medical tourism.However, Iran requires a comprehensive training model of which its design was explained in this paper.

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Identifying the themes of medical tourism business in Iran: A systematic review

. Nafiseh Karimi Badrabadi; . Sogand Tourani; . Asef Karimi

Volume 12, Issue 4 , April 2022, , Pages 1-12

Abstract

  BACKGROUND: Nowadays, medical tourism reports impressive growth in terms of number of persons, income, and number of countries involved in cross‑border flows. It refers to people ...  Read More BACKGROUND: Nowadays, medical tourism reports impressive growth in terms of number of persons, income, and number of countries involved in cross‑border flows. It refers to people traveling abroad (from home to a target country) to obtain medical treatment. The present study aimed to identify the themes and codes of the medical tourism business in Iran.MATERIALS AND METHODS: We searched international databases (such as PubMed, Scopus, Embase, and Web of Science) and Iranian bibliography thesaurus and repositories (namely, Scientific Information Database and Magiran) using keywords such as medical tourism, international medical travel, and medical tourism business in the English and Persian literature, published between January 2000 and December 2019, identified with no restriction on the type of the studies. The data were analyzed based on the content analysis method.RESULTS: Out of 1054 articles, 14 were finally selected. In the end, eight themes of the medical tourism business including competitive pricing, safety and security, information and communication technology, labor market and human resources, structure management, leading the way in medical tourism, infrastructure, and exchange with the international world were identified which on the whole contain 45 codes. Most of the articles were quantitative. Four of the themes (competitive price, labor market and human resources, structure management, and infrastructure) were most frequent and of the highest importance.CONCLUSION: The themes and codes identified in this study helps companies and individuals who want to work in the field of medical tourism. According to this study, all 8 themes and 45 codes are of high value, but still, some themes are of higher value than others and special attention should be paid to them.

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Online learning self‑efficacy: A necessity for virtual education

. Habibeh Ahmadipour

Volume 12, Issue 4 , April 2022, , Pages 1-4

Abstract

  BACKGROUND: Online learning self‑efficacy is considered a major contributor to academic success. The present study was conducted to assess the psychometric properties of the ...  Read More BACKGROUND: Online learning self‑efficacy is considered a major contributor to academic success. The present study was conducted to assess the psychometric properties of the Persian version of the Online Learning Self‑Efficacy Scale.MATERIALS AND METHODS: A cross‑sectional study was conducted on 211 medical students at Kerman University of Medical Sciences in 2021 who were selected through the convenience method. Data were collected using a two‑part self‑administered online questionnaire containing demographic information and the Persian version of the Online Learning Self‑Efficacy Scale (OLSES). Forward and back‑translation methods were used to provide the Persian version of OLSES. Internal consistency of the Persian version was determined by the Cronbach alpha coefficient in a pilot study. Exploratory and confirmatory factor analyses were conducted using SPSS version 20.0 and LISREL version 8.80.RESULTS: The mean of the participants’ age was 21.40 ± 2.52 years, and most of them (56.4%) were female. The Cronbach alpha coefficient was determined as 0.74, 0.90, 0.75, and 0.89 for learning, time management, technology use subscales, and the whole scale, respectively. Exploratory factors analysis revealed the justifiability of factor analysis. In confirmatory factor analysis, most of the goodness of fit indices had an acceptable level.CONCLUSIONS: Our study found that the Persian version of OLSES had good psychometric properties and can be used as a simple, valid, and reliable tool to assess students’ self‑efficacy related to the e‑learning environment.

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Evaluation of medical equipment management in educational hospitals in Isfahan

. Mohammad Ghasemi; . Elaheh Mazaheri; . Marziye Hadian; . Saeed Karimi

Volume 12, Issue 3 , March 2022, , Pages 1-6

Abstract

  BACKGROUND: Medical equipment plays an important role in the diagnosis, treatment, and medical education, and each year the major share of hospital costs (about 5%–15% annually) ...  Read More BACKGROUND: Medical equipment plays an important role in the diagnosis, treatment, and medical education, and each year the major share of hospital costs (about 5%–15% annually) is allocated to the purchase of medical equipment. The selection and allocation of medical equipment should be appropriate and in line with the actual needs of the medical centers, clinical goals, human resources, and the conditions required to ensure safety. The purpose of this study was to study and evaluate current systems of medical equipment management and identify their strengths and weaknesses in Isfahan educational hospitals in 2018.MATERIALS AND METHODS: This is a descriptive‑applied research that was done in a cross‑sectional way in 2018. The statistical population of the research is the authorities of medical equipment and other persons related to the management of medical equipment of selected educational hospitals in Isfahan. The data collection tool is a questionnaire.RESULTS: The result of this study was gathered in four areas: medical equipment management, safety, preventive maintenance, and training.CONCLUSION: According to this study, there is no comprehensive program in hospitals for how to manage medical equipment, which itself causes the loss of material and equipment capital of the organization. In most cases, the lack of a system for planning and controlling the amount of inventory and purchasing and maintaining medical equipment creates many problems, such as the accumulation and depreciation of equipment or the lack of these facilities in critical situations. In this study, it is suggested initially a scientific control system. Medical equipment is designed so that the hospital’s need for equipment at any time of year and the amount of its equipment are clear so that it can be easily decided in this field.

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Clinical competence of Iranian nurses: A systematic review and meta‑analysis

. Amir Emami Zeydi; . Mohammad Javad Ghazanfari; . Ehsan Azizi; . Hadi Darvishi‑Khezri; . Hamed Mortazavi; . Joseph Osuji; . Samad Karkhah

Volume 12, Issue 3 , March 2022, , Pages 1-12

Abstract

  BACKGROUND: One of the most important steps in increasing the nurses’ professional competence and consequently improving the quality of nursing care is to evaluate nurses’ ...  Read More BACKGROUND: One of the most important steps in increasing the nurses’ professional competence and consequently improving the quality of nursing care is to evaluate nurses’ clinical competency and then take effective actions to enhance it. This study aimed at exploring the clinical competence of Iranian nurses and factors related to it.MATERIALS AND METHODS: In this systematic review and meta‑analysis, PubMed, Scopus, Web of Science, Scientific Information Database, and Iranmedex databases and Google Scholar search engine were searched to February 14, 2020.RESULTS: After screening, a total of 25 articles were included. In general, the level of clinical competence of Iranian nurses was at a desirable level. After meta‑analysis of the mean score of nurses’ clinical competence, the combined mean was 161.13 (95% confidence interval [CI]: 137.78–184.48;P < 0.001; I2 = 99.8%; P value for heterogeneity = P < 0.001) by the Competency Inventory for Registered Nurses (CIRN) questionnaire. The summarized mean of clinical competency measured by the Nurse Competence Scale (NCS) questionnaire was 70.75 (95% CI: 60.80–80.70; P < 0.001; I2 = 99.9%; P value for heterogeneity = P < 0.001). Factors affecting nurses’ clinical competence were age ≥33 years, nursing work experience ≥9 years, and a master’s degree in nursing. However, the clinical competence of nurses had a significant negative relationship with job stress.CONCLUSION: The level of clinical competence of Iranian nurses was desirable. Studies that used the CIRN, reported the highest and lowest clinical competence in clinical care and professional development dimensions, respectively. Studies that used the NCS, reported the highest and lowest clinical competence in dimensions of work role and ensuring quality, respectively.

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Comparison of two new educational techniques on knowledge of nurses about cerebrovascular accident nursing care in emergency department

. Zahra Dehghan; . Nasrollah Alimohammadi

Volume 12, Issue 2 , February 2022, , Pages 1-5

Abstract

  BACKGROUND: One of the important challenges faced by health‑care system is to raise the level of knowledge of nurses about cerebrovascular accident(CVA) nursing care in the emergency ...  Read More BACKGROUND: One of the important challenges faced by health‑care system is to raise the level of knowledge of nurses about cerebrovascular accident(CVA) nursing care in the emergency department. Therefore, the aim of this study was comparison of two new educational techniques (noninteractive multimedia learning and workshop) on knowledge of nurses about CVA nursing care in the emergency department.MATERIALS AND METHODS: This experimental study was conducted with a two‑group design. Sixty‑four eligible nurses working in the emergency department in selected hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, were selected as the study participants. Nurses were randomly assigned into two groups of noninteractive multimedia (n = 32) and workshop (n = 32) using random number table. The data‑gathering tools including a demographic questionnaire (6 items) and knowledge questionnaire (24 items) were completed before and 2 weeks after the intervention in both the groups. Data were analyzed using SPSS 18 and descriptive (mean and standard deviation) and analytical statistics (ANOVA, independent t‑test, and paired t‑test). The level of statistical significance was P ≤ 0.05.RESULTS: The result shows that independent t‑test showed that there was not a significant difference between the mean total scores of nurses’ knowledge before intervention in the two groups (P > 0/05). Furthermore, the results of paired t‑test showed a significant difference in the knowledge score 2 weeks after compared to before the education in both the groups (P < 0.005). In addition, the results of independent t‑test showed a significant difference in the knowledge score 2 weeks after the intervention in the two groups (P < 0.005). The average knowledge score in the workshop group was significantly higher than in noninteractive multimedia learning group.CONCLUSION: According to the result, new educational techniques such as noninteractive multimedia learning and workshop could improve knowledge of nurses about CVA nursing care in the emergency department.

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Relationship between fertility characteristics with spiritual intelligence and resilience in infertile couples

. Fatemeh Mokhtari; . Fatemeh Torabi; . Masoume Pirhadi

Volume 12, Issue 2 , February 2022, , Pages 1-7

Abstract

  BACKGROUND: Infertility and the use of assisted reproductive therapies affect infertile couples quality of life. Infertile couples face many physical, psychological, and financial ...  Read More BACKGROUND: Infertility and the use of assisted reproductive therapies affect infertile couples quality of life. Infertile couples face many physical, psychological, and financial challenges due to having a higher level of spiritual intelligence and resilience will help the infertile couple to adapt to infertility conditions and achieve their therapeutic goals. This study was aimed to determine the relationship between fertility characteristics and spiritual intelligence and resilience in infertile couples.MATERIALS AND METHODS: This was a cross‑sectional study that was conducted in 2020 on 162 infertile couples referring to infertility centers in Isfahan who met the inclusion criteria. Samples were selected by convenience sampling method. Information was gathered using a questionnaire consists of three parts: demographic and fertility characteristics, spiritual intelligence, and resilience. Data were analyzed using descriptive and inferential statistical methods (t‑test, Pearson’s correlation coefficient, and Chi‑square). P < 0.05 was considered statistically significant.RESULTS: Pearson’s correlation coefficient showed that there was no significant relationship between resilience score and spiritual intelligence score with age, duration of marriage, and duration of treatment (P > 0.05). There was no significant relationship between resilience score and spiritual intelligence score and its dimensions with the level of education and economic status of the family (P > 0.05).CONCLUSIONS: There was no significant relationship between demographic and fertility factors with spiritual intelligence and resilience.

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Health‑care workers’ experience of stressors and adaptation strategies for COVID‑19: A qualitative research

. Vajihe Atashi; . Shahla Abolhasani; . Atefeh Afshari

Volume 12, Issue 1 , January 2022, , Pages 1-7

Abstract

  BACKGROUND: The mental health of health‑care workers with their unique role in respondingto the COVID‑19 pandemic is strictly essential. Hence, to react effectively to the pandemic, ...  Read More BACKGROUND: The mental health of health‑care workers with their unique role in respondingto the COVID‑19 pandemic is strictly essential. Hence, to react effectively to the pandemic, it isessential to collect further data on the stressors and adaptation strategies. The aim of this study isto explain the health‑care workers’ experiences of stressors and adaptation strategies used duringthe COVID‑19 pandemic outbreak.MATERIALS AND METHODS: A qualitative content analysis approach was employed in thisstudy, with semi‑structured in‑depth interviews. Nineteen health‑care workers participated in thestudy by purposeful sampling method. The study setting included selective educational hospitalsthat admitting patients infected with COVID‑19. The data were analyzed using content analysismethod.RESULTS: Stressors were classified under four major categories: idiopathic, i.e., arising fromunknown causes, individual and familial, stressful work environment, and socially imposed stressors.The adaptation strategies were classified under inactive and active adaptation strategies.CONCLUSIONS: The stressors include the stresses arising from the unknown nature of the disease,stressful work environment, individual and familial stresses, and the socially imposed stresses. Theadaptation strategies include inactive and active adaptation strategies. Identification of these factorscan help workers and management to effectively react to the pandemic.

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Comparison of reproductive health and its related factors in vulnerable and nonvulnerable women

. Elham Zolfaghari; . Zahra Boroumandfar; . Nafisehsadat Nekuei

Volume 12, Issue 1 , January 2022, , Pages 1-8

Abstract

  BACKGROUND: Women’s health is supposed to be one of the indicators of development.Reproductive health is an important part of women’s health. Vulnerable women are a group ...  Read More BACKGROUND: Women’s health is supposed to be one of the indicators of development.Reproductive health is an important part of women’s health. Vulnerable women are a group of womenwhose reproductive health needs to be given special attention. The purpose of this study was tocompare the reproductive health of vulnerable and nonvulnerable women.MATERIALS AND METHODS: This cross‑sectional study was conducted on vulnerablewomen (n = 250) and nonvulnerable women (n = 250). The samples were selected from vulnerablewomen’s centers and comprehensive health centers in Isfahan by quota and using simple randomsampling method in 2017. The research tool was a researcher‑made questionnaire completed by theresearcher using interview method. Internal reliability of the questionnaire was confirmed to be 0.89using Cronbach’s alpha. A P < 0.05 was considered to be statistically significant. Data analysis wasperformed using SPSS 18 software and independent t‑test, Mann–Whitney, Pearson, Spearman,and Chi‑square tests.RESULTS: The results showed that the mean total score of reproductive health in the nonvulnerablegroup (81.41) was significantly higher than that of the vulnerable group (68.6). The mean total scoreand the score of reproductive health components, except some of them, were significantly differentbetween the two groups (P < 0.05). Having an addicted spouse and unsafe sex were the mostprevalent features associated with high‑risk behaviors.CONCLUSIONS: According to the results, reproductive health status of vulnerable womenis inappropriate in all dimensions. Given the importance of this issue, the development andimplementation of special health programs for this group seem to be necessary.

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Knowledge and attitude toward professional ethics: A study among Iranian medical and nursing students’

. Poria Hoseinialiabadi; . Ali Omidi; . Mansour Arab; . Zohreh Makarem; . Mojtaba Jafari

Volume 12, Issue 1 , January 2022, , Pages 1-5

Abstract

  BACKGROUND: Professional ethics is a set of principles and standards of human behavior thataffect individual behavior and leads to improve care that provided by medical staff. The presentstudy ...  Read More BACKGROUND: Professional ethics is a set of principles and standards of human behavior thataffect individual behavior and leads to improve care that provided by medical staff. The presentstudy examined the knowledge and attitude of medical and nursing students toward professionalethics in Iran.MATERIALS AND METHODS: This descriptive‑analytic study was carried out on 176 medical andnursing students in Bam University of Medical Science, Iran in 2019. In this study, students wereselected by census sampling. Data collected using two researcher‑made questionnaires related toknowledge and attitude toward professional ethics. Data were analyzed in SPSS software.RESULTS: The mean scores of knowledge among nursing and medical students were 86.56 (8.76)and 85.10 (12.19), respectively. The mean score of attitude among nursing and medical studentswas 127.06 (12.45) and 129.9 (11.88), respectively. Results of the Pearson correlation test showed apositive and significant associated between the score of knowledge and attitude nursing and medicalstudents’ (P < 0.001), (r = 0.76) (r = 0.66). Among the demographics characteristics, student agewas associated to their attitude and knowledge significantly (P = 0.03).CONCLUSION: Iranian nursing and medical students have a positive attitude and a high level ofknowledge about professional ethics. A high level of knowledge was related to the most positiveattitude.

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Testing adaptation and psychometric properties of survey instrument for students’ perspectives on e‑professionalism and social media in Iranian students: Corona crisis and medical education

. Leili Mosalanejad; . Saeed Abdollahifard

Volume 12, Issue 1 , January 2022, , Pages 1-9

Abstract

  BACKGROUND: The use of social networks in the field of education has also accelerated andhas become a powerful source of learning for transformation and empowerment in various fields.This ...  Read More BACKGROUND: The use of social networks in the field of education has also accelerated andhas become a powerful source of learning for transformation and empowerment in various fields.This study aimed to test the adaptation and psychometric properties of an instrument for students’prospective on e‑professionalism in the use of social media in Iranian medical science students.MATERIALS AND METHODS: In this questionnaire, with the aim of psychometric properties of theperception toward social media in Iranian students, this survey instrument developed by (Ness et al.)in five fields in 2nd‑year pharmacology students in Purdue University The fields include accountability,hiring decisions, profile editing, professionalism, and privacy settings. In this study, first, a culturaladaptation was done by an expert panel. Then, psychometric properties of an instrument by contentvalidity and construct validity using explanatory factor analysis were performed. Reliability wasassessed by test–retest and internal consistency of items. The reliability of the survey instrumentwith three factors was 0.82 using the test–retest, and the internal consistency was good (r = 0.94).RESULTS: The result of psychometric properties using the principal component method extractedthree factors (accountability, hiring decision, and professionalism) to assessment of students’ attitudeto professionalism using social media in Iranian students.CONCLUSION: The adapted and psychometric properties of the instrument developed by Nesset al., 2013, with three dimensions and ten items proved to be a valid, reliable instrument for usefor assessing perspectives on e‑professionalism and social media in Iranian medical students. Thisquestioner may be suitable for Iranian researches in medical education.

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Determining the effective factors on developing entrepreneurial managers in the Iranian health system: A qualitative study

. Fatemeh Farajzadeh; . Sogand Tourani; . Hossein Shabaninejad

Volume 11, Issue 11 , December 2021, , Pages 1-11

Abstract

  BACKGROUND: Entrepreneurship is the engine of economic growth and a main symbol of innovationin any country. The health system of the country needs entrepreneur managers to eradicate ...  Read More BACKGROUND: Entrepreneurship is the engine of economic growth and a main symbol of innovationin any country. The health system of the country needs entrepreneur managers to eradicate theproblems and provide better services. The purpose of this study was to identify factors affecting thenurturing of entrepreneurial managers in the Iran’s health system.MATERIALS AND METHODS: This study was carried out qualitatively with the groundedtheory method and through semi‑structured interviews with six questions. The data sourceswere 22 key informants who were purposefully selected from healthcare organizations and otherentrepreneurship‑related institutions. Data were analyzed and interpreted using the frameworkanalysis. Data were managed and analyzed using MAXQDA software.RESULTS: Findings of this study indicated 6 main themes and 46 subthemes. The six factorsaffecting the development of entrepreneurial managers in the Iran’s health system were determinedas individual, family, social, economic, organizational, and educational.CONCLUSION: Iranian health organizations need to nurture entrepreneurial managers to tackle thechallenges of the health system, compete internationally, and have successful performance. Hence,delivering the health industry to entrepreneurial managers in the long run will bring back positiveresults of growth and development to the body of the health system. Therefore, paying attentionto the identified themes and subthemes and the solutions presented in this study can help nurtureentrepreneurial managers’ and successful performance of the Iran’s health sector.

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Impact of comorbidities on mortality in hospitalized patients with COVID‑19: An experience from Iran

. Firooz Toofan; . Seyed Mojtaba Hosseini; . Khalil Alimohammadzadeh; . Mehrnoosh Jafari; . Mohammadkarim Bahadori

Volume 11, Issue 11 , December 2021, , Pages 1-6

Abstract

  BACKGROUND: COVID‑19 pandemic has spread all over the world. However, information regardingclinical characteristics and prognostic factors is scarce. The aim of this study was to ...  Read More BACKGROUND: COVID‑19 pandemic has spread all over the world. However, information regardingclinical characteristics and prognostic factors is scarce. The aim of this study was to explore theimpact of preexistent chronic comorbid conditions and multimorbidity on risk of mortality in patientswith COVID‑19.MATERIALS AND METHODS: We designed a retrospective, cross‑sectional, observational,single‑center study. Data were analyzed from all consecutive patients diagnosed with COVID‑19 whoadmitted in a pandemic hospital affiliated with Tabriz University of Medical Sciences, Tabriz, Iran,from February 20, 2020, to September 25, 2020. The independent effects of preexistent conditionswere evaluated using multivariate logistic regression model.RESULTS: A total of 2597 hospitalized patients with COVID‑19 were included. At least one preexistentcondition was observed in 36.5% of study population. Multivariate logistic regression analysis showedthat older age, male sex, diabetes, cardiovascular disease, hypertension, cancer, chronic kidneydiseases, liver diseases, and chronic obstructive pulmonary disease were associated with increasedrisk of mortality. In addition, the number of comorbidities was significantly associated with increasedodds of mortality compared to no‑comorbidity.CONCLUSION: The results of this study suggest that patients with comorbidities have an increasedrisk of in‑hospital mortality following COVID‑19 infection.

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Quality of life in health Iranian elderly population approach in health promotion: A systematic review

. Mohsen Poursadeqiyan; . Maryam Feiz Arefi; . Amin Babaei Pouya; . Mojtaba Jafari

Volume 11, Issue 11 , December 2021, , Pages 1-9

Abstract

  BACKGROUND: The quality of life (QOL) is essential in all different stages of life; however, It ismore important for older people as it can be effective in promoting their health. Therefore, ...  Read More BACKGROUND: The quality of life (QOL) is essential in all different stages of life; however, It ismore important for older people as it can be effective in promoting their health. Therefore, the presentstudy aimed to review the literature on the QOL in the Iranian elderly population.MATERIALS AND METHODS: The study was carried out as a systematic review. For this purpose,all databases were searched in March 2021. The keywords used for the search were “quality of life,elderly, older adults, aging, seniors, and Iran” along with the Persian equivalents. PRISMA protocolwas used to screen articles. After removing duplicate and irrelevant items, two evaluators appraisedthe articles separately based on a researcher‑made checklist derived from the SBEM and STROBEStatement standard checklists.RESULTS: The initial search yielded 3734 studies on the QOL in the Iranian elderly population. Afterscreening and assessing the studies based on inclusion and exclusion criteria, 22 articles remained inthe study. Most of the studies (cross‑sectional) were conducted in Tehran using a 36‑item Short‑FormHealth Survey to assess the QOL. The studies investigated sociodemographic determinants, physicaland health‑related behaviors, and spirituality and psychological determinants of the QOL. Thesociodemographic determinants were the most common factors under study. The results showedthat the role of gender and socioeconomic status was the strongest among the sociodemographiccharacteristics. A significant association was found between the QOL in the Iranian elderly populationand factors such as depression and religious confrontation.CONCLUSION: In addition to chronic diseases, diseases of the oral and dental, as well as anunhealthy diet, should be considered in the elderly. Therefore, attention should be paid to all social,physical, and psychological variables that affect the QOL of older people.

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Development and psychometric evaluation of the perceived care tension questionnaire for caregivers of hemodialysis patients: A mixed method study

. Leili Rabiei; . Soleiman Kheiri; . Reza Masoudi

Volume 11, Issue 11 , December 2021, , Pages 1-12

Abstract

  BACKGROUND : The complex, multifaceted care environment and the threatening situation of caringfor hemodialysis patients cause tension in their family caregivers. Due to the severe ...  Read More BACKGROUND : The complex, multifaceted care environment and the threatening situation of caringfor hemodialysis patients cause tension in their family caregivers. Due to the severe tension, familycaregivers are likely to ignore their basic needs and only pay attention to the patient’s needs andrelated issues. This study was conducted with the aim of designing and evaluating the PerceivedCare tension Questionnaire for Caregivers of Hemodialysis Patients (PCTQHFC).MATERIALS AND METHODS: The present study was a sequential exploratory mixed methodsstudy of scale development variant conducted in two phases: qualitative and quantitative. This studywas conducted in 2019 in Shahrekord. The qualitative phase included item development and scaledevelopment. In the quantitative phase (Item Analysis), the validation characteristics of the tool wereexamined using face, content and construct validity, and its reliability by internal consistency andstability. Findings were performed using software SPSS 18.RESULTS: Principal components analysis with orthogonal rotation to generate factors, showed thatfive factors, namely emotional exhaustion, inadequate social support, care burden, confusion andambiguity and lack of adaptability skills had an eigenvalue of higher than 1, so that they explained,respectively, 75.98%, 61.36%, 72.49%, 76.33%, and 70.31% of the total variance. The internalconsistency was obtained 0.811 and the inter‑class correlation coefficient for the whole instrument0.832.CONCLUSION: PCTQHFC is a culturally appropriate measure with strong psychometric properties.The instrument designed in this study measures the care tension of hemodialysis patients. Therefore,researchers, health‑care providers, and community health policymakers can plan and implementinterventions to reduce the tension of caregivers of hemodialysis patients by analyzing and identifyingthe tensions of caregivers.

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Mental health of the people of northern Iran during the quarantine time of 2020 following the coronavirus epidemic

. Fereshteh Araghian Mojarad; . Mohammad Ali Heidari Gorji; . Hamid Salehiniya; . Tahereh Yaghoubi

Volume 11, Issue 9 , October 2021, , Pages 1-6

Abstract

  BACKGROUND: Coronavirus (COVID‑19) is an infectious respiratory disease. Quarantine is oftenaccompanied by unpleasant experiences for those who go through it. The aim of this study ...  Read More BACKGROUND: Coronavirus (COVID‑19) is an infectious respiratory disease. Quarantine is oftenaccompanied by unpleasant experiences for those who go through it. The aim of this study was todetermine the mental health status of people during quarantine in northern Iran.MATERIALS AND METHODS: This cross‑sectional study was conducted during the quarantineperiod of coronavirus. Conventional sampling was done from March 6 to April 6. Six hundred andforty‑two individuals were included. Inclusion criteria were living in Sari and being home quarantinedduring the corona outbreak. Exclusion criteria included hospitalization history due to corona andunwillingness to participate in the study. In this study, the General Health Questionnaire‑28 was usedonline to collect the required data. To analyze the data, descriptive and inferential statistics (t‑test,analysis of variance, and correlation coefficient) were used.RESULTS: In this study, individuals were included in the investigation with a mean age of38.74 ± 11.89 (ranged from 15 to 73). Most of the participants were female (72.85%) andmarried (71.34%). According to the results, 21.5% of the participants had poor mental health.Mean mental health scores have a statistically significant relationship with gender, marital status,education, occupation, quarantine period, patients with corona, and exposure to a patient withcorona (P ≤ 0.05). Furthermore, a negative correlation coefficient was observed between age andmental health score (correlation coefficient = −0.31, significance >0.001).CONCLUSION: The average score of mental health has a significant relationship with gender, maritalstatus, education, occupation, quarantine period, corona, and exposure to a patient with corona.Given the high prevalence of mental disorders in people during the COVID‑19 epidemic, educatingpeople and planning to reduce the psychological effects of the epidemic can be helpful.

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