Journal of Education and Health Promotion

Factors affecting the overcrowding in outpatient healthcare

. Mohammadkarim Bahadori; . Ehsan Teymourzadeh; . Ramin Ravangard; . Mehdi Raadabadi

Volume 7, Issue 1 , March and April 2017, Pages 1-10

Abstract

  Background: The expansion of outpatient services and the desire to provide more outpatientcare than inpatient care create some problems such as the overcrowding in the outpatientclinics. ...  Read More Background: The expansion of outpatient services and the desire to provide more outpatientcare than inpatient care create some problems such as the overcrowding in the outpatientclinics. Given the importance of overcrowding in the outpatient clinics, this qualitative studyaimed to determine the factors influencing the overcrowding in the specialty and subspecialtyclinic of a teaching hospital. Materials and Methods: This was a qualitative study conducted inthe specialty and subspecialty clinic of a hospital using content analysis method in the periodof January to March 2014. The study population was all managers and heads of the outpatientwards. The studied sample consisted of 22 managers of the clinic wards who were selectedusing the purposive sampling method. The required data was collected using semi‑structuredinterviews. The collected data was analyzed using conventional content analysis and theMAXQDA 10.0 software. Results: Three themes were identified as the main factors affectingthe overcrowding including the internal positive factors, internal negative factors, and externalfactors. Conclusions: Despite the efforts made to eliminate overcrowding, and reduce waitingtimes and increase access to the services for patients, the problem of overcrowding still hasremained unresolved. In addition, the use of some strategies such as clarifying the workingprocesses of the clinic for staff and patients and the relationships between the clinic andother wards especially emergency department, as well as using a simple triage system on thepatients’ arrival at the clinic are recommended.

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Pregnant women’s preferences for mode of delivery questionnaire: Psychometric properties

. Fereshteh Zamani‑Alavijeh; . Parvin Shahry; . Maryam Kalhori; . Marzieh Araban

Volume 7, Issue 1 , March and April 2017, Pages 1-7

Abstract

  Introduction: The rate of caesarean delivery is increasing worldwide. Maternal beliefs may beinfluential on the mode of delivery. This study aimed to validate pregnant women’s ...  Read More Introduction: The rate of caesarean delivery is increasing worldwide. Maternal beliefs may beinfluential on the mode of delivery. This study aimed to validate pregnant women’s preferencesfor mode of delivery questionnaire among pregnant women. Materials and Methods: This wasa cross‑sectional study which was done in Ahvaz Public and Private Health Care Centers. A totalof 342 low‑risk pregnant women were included in a study conducted in spring 2011 in Ahvaz,Iran. After careful consideration and performing content and face validity, a 62‑item measurewas developed and subjects completed the questionnaire. Reliability was estimated usinginternal consistency and validity was assessed by performing face, content and structure anddiscriminate validity. Data were analyzed using explanatory factor analysis, t‑test, and correlationsin SPSS 16. Results: The findings of content and face validity showed almost perfect results forboth content validity ratio = 1 and content validity index = 1. The explanatory factor analysisindicated a 7‑subscale measure (Eigenvalue >1, factor loading >0.4), and discriminate validityrevealed satisfying results P < 0.05 for 6 out of 7 subscales. Internal consistency as measuredby the Cronbach’s alpha coefficient was acceptable for subscales. Conclusions: In general,the findings suggest that this newly generated scale is a reliable and valid specific questionnairefor assessing pregnant women’s preferences for mode of delivery. However, further studies areneeded to establish stronger psychometric properties for the questionnaire.

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The comparison of printed resources bacterial contamination in libraries of Al‑Zahra Hospital and Sciences Faculty of Isfahan University and the determination of their antibiotic sensitivity pattern

. Hosein Rafiei; . Mostafa Chadeganipour; . Rezvan Ojaghi; . Mohammad Reza Maracy; . Rasool Nouri

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Introduction: During the library loan process, the printed resources can be a carrier ofpathogenic bacteria. In this study, it was tried to compare the Bacterial Contamination Ratesand ...  Read More Introduction: During the library loan process, the printed resources can be a carrier ofpathogenic bacteria. In this study, it was tried to compare the Bacterial Contamination Ratesand their antibiotic sensitivity pattern in printed resources of a hospital and a non‑hospitallibrary. Methods: This is a cross‑sectional study. Returning books from the Al‑Zahra hospitallibrary and library of Sciences faculty of Isfahan University provides the research community.The sample size, 96 cases, was calculated using quota sampling. For sampling sterile swabdipped in trypticase soy broth medium and transfer trypticase soy broth medium wereused. To identify different type of isolated bacteria from Gram‑staining test and biochemicaltests such as; TSI, IMViC and etc., were used. Results: 76 (79.2%) and 20 (20.8%) ofcultured samples were negative and positive, the respectively. Of 20 positive samples,11 samples (55%) belong to the family Enterobacteriaceae that after detecting by Differentialteste identified all 11 samples of Enterobacter that all of them were sensitive to Gentamicinand Ofloxacin. Also the most resistance to Nitrofurantoin and Amikacin was observed. 9 casesremained (45%) were coagulase‑negative Staphylococcus that all of them were sensitive to theTrimethoprim‑sulfamethoxazole and Cephalexin antibiotics also the most resistance to Cefiximewas observed. Conclusion: Considering that the Enterobacter sp and coagulase‑negativeStaphylococcus were separated from the books, the books as well as other hospital andmedical equipment can transmit the infection to librarians, library users, patients and hospitalstaff, and also it can produce serious infections in patients with immune deficiency.

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Efficacy of purposeful educational workshop of medical and nonmedical interventions based on needs assessments in nurses

. Abbas Attari; . Mahin Aminoroaia; . Mohammd Reza Maracy

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background: The medical and nonmedical care of patients is the necessary skills in nursingprofession. That it needs proper knowledge and attitude. Hence, it is important to promotenurses’ ...  Read More Background: The medical and nonmedical care of patients is the necessary skills in nursingprofession. That it needs proper knowledge and attitude. Hence, it is important to promotenurses’ knowledge and attitude by education based on need assessment. This study aimed todefine the efficacy of a medical and nonmedical intervention educational workshop on nurses’knowledge and attitude until 3 months after holding the workshop in psychiatric wards ofeducational hospitals in Isfahan. Materials and Methods: This is a quasi‑experimental study.The study population comprised all nurses working in psychiatric wards of Nour and FarabiHospitals (64) in Isfahan in 2012. An educational workshop was held through educationalsessions in the form of lectures and group discussion in two above‑mentioned hospitals.Nurses’ level of knowledge and attitude were investigated by a researcher made questionnairebefore, immediately after and 3 months after intervention. Data were analyzed by descriptivestatistical tests of repeated measure ANOVA and Bonferroni. Results: A significant increase wasobserved in mean scores of nurses’ knowledge immediately after and 3 months after educationcompared to before education (P < 0.001). Also, the mean of attitude score in 3 phases havesignificant different (P < 0.009). Nurses have the high satisfaction (86.3%) of need assessmentbased education workshop. Moreover, it is effective in the science information revival of nurses.Conclusion: Educational sessions notably affected the promotion of nurses’ knowledge andattitude. With regard to nurses’ satisfaction with the workshop which was held, designing andorganizing educational workshops based on constant needs assessment is suggested for thepromotion of nursing cares.

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The relationship between media literacy and health literacy among pregnant women in health centers of Isfahan

. Farideh Akbarinejad; . Mohammad Reza Soleymani1; . Leila Shahrzadi

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background: The ability to access, analyze, evaluate, and convey information in various formsof media including print and nonprint requires media literacy, but the capacity to obtain, ...  Read More Background: The ability to access, analyze, evaluate, and convey information in various formsof media including print and nonprint requires media literacy, but the capacity to obtain, process,and understand basic information and services needed for appropriate decisions regardinghealth, considered an important element in a woman’s ability to participate in health promotionand prevention activities for herself and her children, is needed to a level of health literacy. Thepurpose of this study was to determine the relationship between media literacy and healthliteracy among pregnant women in health centers in Isfahan. Materials and Methods: Thisstudy used a descriptive correlation study. Data collection tools include Shahin media literacyand functional health literacy in adults’ questionnaires. The population include pregnantwomen in health centers of Isfahan (4080 people). Ten out of the 351 health centers in Isfahanwere selected as cluster. Data were analyzed using both descriptive and inferential statistics.Results: Media literacy of respondents in the five dimensions was significantly lower thanaverage 61.5% of pregnant women have inadequate health literacy, 18.8% had marginal healthliteracy, and only 19.7% of them have had adequate health literacy. There was a significantpositive relationship between media literacy and health literacy among pregnant women.Conclusion: This study showed that the majority of pregnant women covered by healthcenters had limited health literacy and media literacy. Since one of the basic requirements forthe utilization of health information is needed for adequate media literacy, promotion of medialiteracy is necessary for the respondents.

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Nurses’ commitment to respecting patient dignity

. Zahra Raee; . Heidarali Abedi; . Mohsen Shahriari

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background: Although respecting human dignity is a cornerstone of all nursing practices,industrialization has gradually decreased the attention paid to this subject in nursing care.Therefore, ...  Read More Background: Although respecting human dignity is a cornerstone of all nursing practices,industrialization has gradually decreased the attention paid to this subject in nursing care.Therefore, the present study aimed to investigate nurses’ commitment to respecting patientdignity in hospitals of Isfahan, Iran. Methods: This descriptive‑analytical study was conducted inhospitals of Isfahan. Overall, 401 inpatients were selected by cluster sampling and then selectedsimple random sampling from different wards. Data were collected through a questionnairecontaining the components of patient dignity, that is, patient‑nurse relationships, privacy, andindependence. All items were scored based on a five‑point Likert scale. The collected datawere analyzed using descriptive statistics and Chi‑square tests. P < 0.05 were consideredsignificant in all analyses. Findings: Most patients (91%) scored their relationships with nursesas good. Moreover, 91.8% of the participants described privacy protection as moderate/good.Only 6.5% of the subjects rated it as excellent. The majority of the patients (84.4%) believed theirindependence was maintained. These subjects also approved of taking part in decision‑making.Conclusion: According to our findings, nurses respected patient dignity to an acceptable level.However, the conditions were less favorable in public hospitals and emergency departments.Nursing authorities and policy makers are thus required to introduce appropriate measuresto improve the existing conditions.

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Job demand‑control and job stress at work: A cross‑sectional study among prison staff

. Jafar Akbari; . Rouhollah Akbari; . Mahnaz Shakerian; . Behzad Mahaki

Volume 7, Issue 1 , March and April 2017, Pages 1-7

Abstract

  Introduction: Job stress can impose significant costs to the workplaces and organizationsdue to some issues such as absenteeism, less productivity, and medical costs. Job overloadand ...  Read More Introduction: Job stress can impose significant costs to the workplaces and organizationsdue to some issues such as absenteeism, less productivity, and medical costs. Job overloadand lack of decision latitude can lead to job stress. The current study aimed to investigatethe job demands and control as predictor of job stress and its relationship, with some of thedemographic characteristics of Iranian prison staff. Materials and Methods: This study wasperformed on 171 male employees working in four prisons located in Ilam, Iran. The samplingmethod was census and all four prisons’ staff were selected to respond the Job ContentQuestionnaires. Finally, the data were analyzed using t‑test or independent samples test aswell as SPSS 20. Results: The highest amount of job demand (mean = 21.28) and the lowestamount of job control on average (9.76) were reported by those staff working in Darehshahrprison. There was also a significant relationship between job post and job control among theprison staff (β = −0.375, P = 0.001). Conclusion: The level of job stress reported by prisonstaff was high in this study mainly caused by high job demand and low job control, especiallyin Darehshahr prison staff.

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Information seeking anxiety among M.A. Students of Isfahan University of Medical Sciences

. Fereshteh Aghaei; . Mohammad Reza Soleymani; . Hassan Ashrafi Rizi

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background: Information‑seeking anxiety is a feeling caused by abundance of information orfailure to proper interpret the information that can adversely affect the ability of individuals ...  Read More Background: Information‑seeking anxiety is a feeling caused by abundance of information orfailure to proper interpret the information that can adversely affect the ability of individuals forseeking information and meeting their information needs. Therefore, it is necessary to investigateinformation‑seeking anxiety, factors causing it, and methods for addressing and reducingthis type of anxiety. The purpose of this study was to evaluate information‑seeking anxiety inpostgraduate students of Isfahan University of Medical Sciences. Materials and Methods: Thisstudy has been conducted using survey method. A total of 265 postgraduate students of IsfahanUniversity of Medical Sciences were selected with the help of stratified random sampling. Datacollection tool was a questionnaire designed for this purpose. The gathered data was analyzedusing descriptive and inferential statistics. Results: The results indicated that the topic selectionfactor played a more prominent role in creating information seeking anxiety compared to otherfactors. Apart from students of school of medicine, information seeking anxiety was belowaverage among the students. In addition, there was a significant difference between informationseeking anxiety in students from different departments. Finally, female students had higherinformation seeking anxiety compared to male students. Conclusion: Although informationseeking anxiety among students was lower than average in most cases, further reduction ofanxiety could be achieved by facilitating access to information resources and library informationservices and increasing the quality of students’ information literacy through training coursestailored to each discipline are necessary.

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Effectiveness of concept mapping and traditional linear nursing care plans on critical thinking skills in clinical pediatric nursing course

. Fereshteh Aein; . Fatemeh Aliakbari

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Introduction: Concept map is a useful cognitive tool for enhancing a student’s criticalthinking (CT) by encouraging students to process information deeply for understanding.However, ...  Read More Introduction: Concept map is a useful cognitive tool for enhancing a student’s criticalthinking (CT) by encouraging students to process information deeply for understanding.However, the evidence regarding its effectiveness on nursing students’ CT is contradictory.This paper compares the effectiveness of concept mapping and traditional linear nursing careplanning on students’ CT. Methods: An experimental design was used to examine the CT of 60baccalaureate students who participated in pediatric clinical nursing course in the ShahrekordUniversity of Medical Sciences, Shahrekord, Iran in 2013. Results: Participants were randomlydivided into six equal groups of each 10 student, of which three groups were the control group,and the others were the experimental group. The control group completed nine traditional linearnursing care plans, whereas experimental group completed nine concept maps during thecourse. Both groups showed significant improvement in overall and all subscales of the CaliforniaCT skill test from pretest to posttest (P < 0.001), but t‑test demonstrated that improvement instudents’ CT skills in the experimental group was significantly greater than in the control groupafter the program (P < 0.001). Conclusions: Our findings support that concept mapping canbe used as a clinical teaching‑learning activity to promote CT in nursing students.

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How much elderly people of Isfahan are adherent to their drug therapy regimens?

. Parvaneh Abazari; . Tayebe Arab Jafari; . Ali Mohammad Sabzghabaee

Volume 7, Issue 1 , March and April 2017, Pages 1-4

Abstract

  Background: The need for a correct follow‑up for medical advices of health givers is thecornerstone for avoiding drug‑related complications in especial period of elderly people ...  Read More Background: The need for a correct follow‑up for medical advices of health givers is thecornerstone for avoiding drug‑related complications in especial period of elderly people life.There isn’t any data about drug therapy regimens adherence of elderly people of Isfahan. Inthis study, we aimed to cover this deficit. Materials and Methods: In this cross‑sectional studywhich was carried out in Isfahan (Iran) in 2013 senior citizens (aged 65 or more) who weretaking at least one medication and had no record of residency in nursing homes were included.We used Morisky medication adherence scale (after validation and reliability assessment forusing this questionnaire in Persian language) to evaluate the level of adherence in the studypopulation. Results: A total of 200 elderly participants were fully studied (n = 200, 61% females),and 52% of them had poor medication adherence. 77.5% of participants were suffered from atleast four medical illnesses, and 18.5% of them were taking more than eight medications perday. We have not found any significant statistical relationship between vision or hearing lossdisorders and the medication adherence of the participants). There was a significant positiverelationship between the level of education and medication adherence (P = 0.001), (2 = 0.29).Conclusion: Low Medication adherence is a common and important drug issue in the elderlyin Isfahan. This issue can lead to medical complications and huge cost if it is not addressedappropriately.

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A comparison the effects of reflexology and relaxation on the psychological symptoms in women with multiple sclerosis

. Mozhgan Soheili; . Fatemeh Nazari; . Vahid Shaygannejad; . Mahboobeh Valiani

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background: Multiple sclerosis (MS) occurs with a variety of physical and psychologicalsymptoms, yet there is not a conclusive cure for this disease. Complementary medicine is acurrent ...  Read More Background: Multiple sclerosis (MS) occurs with a variety of physical and psychologicalsymptoms, yet there is not a conclusive cure for this disease. Complementary medicine is acurrent treatment which seems is effective in relieving symptoms of patients with MS. Therefore,this study is aimed to determine and compare the effects of reflexology and relaxation on anxiety,stress, and depression in women with MS. Subjects and Methods: This study is a randomizedclinical trial that is done on 75 women with MS referred to MS Clinic of Kashani Hospital. Aftersimple non random sampling, participants were randomly assigned by minimization method tothree groups: reflexology, relaxation and control (25 patients in each group). In the experimentalgroups were performed reflexology and relaxation interventions within 4 weeks, twice a week for40 min and the control group were received only routine treatment as directed by a doctor. Datawere collected through depression anxiety and stress scale questionnaire, before, immediatelyafter and 2 months after interventions in all three groups. Chi‑square, Kruskal–Wallis, repeatedmeasures analysis of variance and one‑way analysis of variance and least significant differencepost hoc test via SPSS version 18 were used to analyze the data (P < 0.05) was considered assignificant level. Results: The results showed a significant reduction in the severity of anxiety,stress and depression during the different times in the reflexology and relaxation groups ascompared with the control group (P < 0.05). Conclusion: The results showed that reflexologyand relaxation in relieving anxiety, stress and depression are effective in women with MS. Hence,these two methods, as effective techniques, can be recommended.

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The effect of electronic education on knowledge of patients with multiple sclerosis

. Soheila Mohamadirizi; . Vahid Shaygannejad; . Shahla Mohamadirizi; . Zahra Tolou‑Ghamari

Volume 7, Issue 1 , March and April 2017, Pages 1-5

Abstract

  Background: Multiple sclerosis (MS) could be considered as one of the most common chronicdisorders of the central nervous system. However, patient education tasks in this group area ...  Read More Background: Multiple sclerosis (MS) could be considered as one of the most common chronicdisorders of the central nervous system. However, patient education tasks in this group area challenge for health care provider team but due to increase in the incidence of MS, a newcategory of contact, care, and education seems to be useful. Hence, the aim of this studywas to compare the effect of electronic education and illustrated booklet on knowledge ofpatients with MS. Methods: This was a quasi‑experimental research was carried out on120 patients with MS from January 2013 to July 2013. All patients attended MS clinic located atthe Ayatollah Kashani Hospital conducted to Isfahan Neurosciences Research Center (INRC).Patients were divided randomly into two equal groups: (1) Electronic education (n = 60)and (2) illustrated booklet (n = 60). Participants’ knowledge score was collected accordingto the researcher‑made questionnaire with 40 questions. Data were analyzed using Student’st‑test and paired t‑test through SPSS (version 11.5) with a significance level of P < 0.05.Results: Although there was not any significant difference between the knowledge scoreof electronic education and illustrated booklet group before intervention (18 ± 2.2 vs.17.01 ± 3.4(, (P = 0.434, t = −5.64), but there was a significant difference after 2 weeksintervention (35.74 ± 1.4 vs. 33.74 ± 3.4), (P = 0.021, t = −6.64). Paired t‑test showed astatistically significant difference in the knowledge level in both groups after intervention asfollow: (1) Electronic education (18 ± 2.2 vs. 35.74 ± 1.4), (P = 0.024, t = −7.55) and illustratedbooklet (17.01 ± 3.4 vs. 33.74 ± 3.4), (P = 0.003, t = −8.55). Conclusion: The electroniceducational program applied in this study appears increased knowledge of patients with MS.Therefore, the conveyance of this program to earn time for patient and healthcare providerteam is suggested as a valuable and appropriate teaching method.

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Predicting body mass index in women: The value of the psychological components of depression, anxiety, dietary restraint, and nutritional habits

. Behnaz Nikkar Esfahani; . Majid Kolahdouzan; . Abdulaziz Aflakseir; . Mojgan Gharipour

Volume 7, Issue 1 , March and April 2017, Pages 1-5

Abstract

  Background: Understanding the association between psychological affective disturbancesand anthropometric parameters, including body mass index (BMI), is important. These issuesmay have ...  Read More Background: Understanding the association between psychological affective disturbancesand anthropometric parameters, including body mass index (BMI), is important. These issuesmay have potential preventive effects on weight reduction in relation to different aspectsof women’s lifestyles and psychopathological states. The present study aimed to predictBMI based on psychological factors including; depression, anxiety, dietary restraint, andnutritional habits, in a sample of women with sedentary jobs in several Iranian governmentalorganizations. Methods: Two hundred consecutive women aged over 25 years, working onsedentary or low standing works such as banker, teachers, and employee in the social securityorganizations in Isfahan, Iran, were entered the study. To assess the severity of depressionand anxiety symptoms, the Beck Depression Inventory II and the State‑Trait Anxiety Inventorywere used, respectively. To assess nutritional habits, a self‑administered questionnaire wasdesigned, and to evaluate dietary restraint status, the Ruderman questionnaire was used. Tofind the co‑relationship between BMI and each of the psychological components, Pearson’scorrelation coefficient test was applied. Results: To assess the relationship between BMIand each of the psychological components, a multivariate regression model was used. Onlytwo components of nutritional habits (b = −0.19, P < 0.001) and dietary restraint (b = 0.51,P < 0.001) could effectively predict BMI in Iranian women; while depression and anxietycomponents had low predictive values for predicting BMI. In total, these four variables couldpredict 34% of the variance of the dependent indicator (BMI). Conclusion: Nutritional habitsand dietary restraint have high value for predicting BMI status in women aged more than25 years working in sedentary jobs, while BMI status could not be predicted by assessingdepression or anxiety severity.

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Altruism, the values dimension of caring self‑efficacy concept in Iranian pediatric nurses

. Azam Alavi; . Ali Zargham‑Boroujeni; . Alireza Yousefy; . Masoud Bahrami

Volume 7, Issue 1 , March and April 2017, Pages 1-5

Abstract

  Background: Self‑efficacy is the most influential among factors affecting nurses’ performance.Yet, understanding of the constituent elements of the caring self‑efficacy concept ...  Read More Background: Self‑efficacy is the most influential among factors affecting nurses’ performance.Yet, understanding of the constituent elements of the caring self‑efficacy concept was notconsidered. This study was to introduce altruism as one of the main aspects of caringself‑efficacy in pediatric nurses. Materials and Methods: This is part of a larger study on theconcept of caring self‑efficacy conducted with qualitative content analysis approach in Iran.Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data werecollected using semi‑structured interviews and analyzed using conventional content analysismethod. Results: Theme “altruism” as one of the main themes extracted from the analysis ofthe interviews in this study. This theme includes two main categories of “humanistic care” and“caring attitude.” Conclusions: This paper introduces altruism as one of the values aspects ofcaring self‑efficacy in pediatric nurses. Efficient nurse with features Humanistic care, throughthe provision of maternal care and family‑centered care and caring attitudes resulting fromreligious beliefs and loving children to care for the children.

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The survey of mindfulness in multiple sclerosis patients and its association with attachment style

. Soheila Mohamadirizi; . Vahid Shaygannejad; . Shahla Mohamadirizi

Volume 7, Issue 1 , March and April 2017, Pages 1-5

Abstract

  Background: Mindfulness may be conceptualized as a dispositional trait which differsacross individuals, so this study was, therefore, designed to determine the survey ofmindfulness ...  Read More Background: Mindfulness may be conceptualized as a dispositional trait which differsacross individuals, so this study was, therefore, designed to determine the survey ofmindfulness in multiple sclerosis (MS) patients and its association with attachment style.Materials and Methods: This was a cross‑sectional study which was conducted in KashaniHospital affiliated to Isfahan University of Medical Sciences, Iran, in 2013. Samples were 210adult patients who suffered from MS completed demographic and disease characteristicsquestionnaire, Five Factor Mindfulness Questionnaire and adult attachment style. The SPSSversion 16 software was used to conduct statistical tests including t‑test, NOVA, and Pearsoncorrelation. Results: The means of age and duration of illness were (33/96 ± 9/5) yearsand (24/3 ± 6/3) month, respectively. Most patients were married (66/1%), without universityeducation (62/8%) and with incomes suffice (63%). The majority of the patients had receivedbeta‑interferon (55/4%) as their main treatment. The mean ± standard deviation attachmentstyle and mindfulness were 25/6 ± 11/6 and 79/8 ± 25/6, respectively. Furthermore, therewas a significant negative correlation between the attachment style score and mindfulnessscore (P = 0.001, r = −0.32). Conclusion: The result shows that stronger association betweenmindfulness and attachment can reflect the beneficial effects of mindfulness interventionson both mindfulness and attachment and it can provide some evidence that mindfulnessinterventions may enhance secure attachment.

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The impact of the customer relationship management on organizational productivity, customer trust and satisfaction by using the structural equation model: A study in the Iranian hospitals

. Maryam Yaghoubi; . Hamed Asgari; . Marzieh Javadi

Volume 7, Issue 1 , March and April 2017, Pages 1-5

Abstract

  Context: One of the challenges in the fiercely competitive space of health organizations isresponding to customers and building trust and satisfaction in them in the shortest time, ...  Read More Context: One of the challenges in the fiercely competitive space of health organizations isresponding to customers and building trust and satisfaction in them in the shortest time, withbest quality and highest productivity. Hence the aim of this study is to survey the impact ofcustomer relationship management (CRM) on organizational productivity, customer loyalty,satisfaction and trust in selected hospitals of Isfahan (in Iran). Materials and Methods: Thisstudy is a correlation descriptive research. Study population was the nurses in selected hospitalsof Isfahan and the sampling has been conducted using stratified random method. Data collectiontool is a researcher‑made questionnaire of CRM and its effects (organizational productivity,customer loyalty, satisfaction and trust) which its validity and reliability has been confirmedby researchers. Structural equation method was used to determine the impact of variables.Data analysis method was structural equation modeling and the software used was SPSSversion 16 (IBM, SPSS, 2007 Microsoft Corp., Bristol, UK) and AMOS version 18 (IBM, SPSS,2010 Microsoft Corp, Bristol, UK). Results: Among the dimensions of CRM, diversificationhad the highest impact (0.83) and customer acquisition had the lowest (0.57) CRM, had thelowest impact on productivity (0.59) and the highest effect on customer satisfaction (0.83).Conclusions: For the implementation of CRM, it is necessary that the studied hospitalsimprove strategies of acquiring information about new customers, attracting new customersand keeping them and communication with patients outside the hospital and improve thesystem of measuring patient satisfaction and loyalty.

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The impact of mother’s literacy on child dental caries: Individual data or aggregate data analysis?

. Ali‑Akbar Haghdoost; . Hossein Hessari; . Mohammad Reza Baneshi; . Maryam Rad; . Arash Shahravan

Volume 7, Issue 1 , March and April 2017, Pages 1-4

Abstract

  Introduction: To evaluate the impact of mother’s literacy on child dental caries based on anational oral health survey in Iran and to investigate the possibility of ecological ...  Read More Introduction: To evaluate the impact of mother’s literacy on child dental caries based on anational oral health survey in Iran and to investigate the possibility of ecological fallacy inaggregate data analysis. Materials and Methods: Existing data were from second nationaloral health survey that was carried out in 2004, which including 8725 6 years old participants.The association of mother’s literacy with caries occurrence (DMF (Decayed, Missing, Filling)total score >0) of her child was assessed using individual data by logistic regression model.Then the association of the percentages of mother’s literacy and the percentages of decayedteeth in each 30 provinces of Iran was assessed using aggregated data retrieved from thedata of second national oral health survey of Iran and alternatively from census of “StatisticalCenter of Iran” using linear regression model. The significance level was set at 0.05 for allanalysis. Results: Individual data analysis showed a statistically significant associationbetween mother’s literacy and decayed teeth of children (P = 0.02, odds ratio = 0.83). Therewere not statistical significant association between mother’s literacy and child dental caries inaggregate data analysis of oral health survey (P = 0.79, B = 0.03) and census of “StatisticalCenter of Statistics” (P = 0.60, B = 0.14). Conclusion: Literate mothers have a preventiveeffect on occurring dental caries of children. According to the high percentage of illiterateparents in Iran, it’s logical to consider suitable methods of oral health education which do notneed reading or writing. Aggregate data analysis and individual data analysis had completelydifferent results in this study.

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Modification of infant hypothyroidism and phenylketonuria screening program using electronic tools

. Behjat Taheri; . Asefeh Haddadpoor; . Mahmood Mirkhalafzadeh; . Fariba Mazroei; . Pezhman Aghdak; . Mehran Nasri; . Gholamreza Bahrami

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background: Congenital hypothyroidism and phenylketonuria (PKU) are the most commoncause for preventable mental retardation in infants worldwide. Timely diagnosis and treatmentof these ...  Read More Background: Congenital hypothyroidism and phenylketonuria (PKU) are the most commoncause for preventable mental retardation in infants worldwide. Timely diagnosis and treatmentof these disorders can have lasting effects on the mental development of newborns. However,there are several problems at different stages of screening programs that along with imposingheavy costs can reduce the precision of the screening, increasing the chance of undiagnosedcases which in turn can have damaging consequences for the society. Therefore, given theseproblems and the importance of information systems in facilitating the management andimproving the quality of health care the aim of this study was to improve the screening processof hypothyroidism and PKU in infants with the help of electronic resources. Methods: Thecurrent study is a qualitative, action research designed to improve the quality of screening,services, performance, implementation effectiveness, and management of hypothyroidism andPKU screening program in Isfahan province. To this end, web‑based software was designed.Programming was carried out using Delphi.net software and used SQL Server 2008 for databasemanagement. Findings: Given the weaknesses, problems, and limitations of hypothyroidismand PKU screening program, and the importance of these diseases in a national scale, thisstudy resulted in design of hypothyroidism and PKU screening software for infants in Isfahanprovince. The inputs and outputs of the software were designed in three levels includingHealth Care Centers in charge of the screening program, provincial reference lab, and healthand treatment network of Isfahan province. Immediate registration of sample data at the timeand location of sampling, providing the provincial reference Laboratory and Health Centers ofdifferent eparchies with the ability to instantly observe, monitor, and follow‑up on the samplesat any moment, online verification of samples by reference lab, creating a daily schedule forreference lab, and receiving of the results from analysis equipment; and entering the resultsinto the database without the need for user input are among the features of this software.Conclusion: The implementation of hypothyroidism screening software led to an increase inthe quality and efficiency of the screening program; minimized the risk of human error in theprocess and solved many of the previous limitations of the screening program which werethe main goals for implementation of this software. The implementation of this software alsoresulted in improvement in precision and quality of services provided for these two diseasesand better accuracy and precision for datainputs by providing the possibility of enteringthe sample data at the place and time ofsampling which then resulted in the possibilityof management based on precise data and also helped develop a comprehensive databaseand improved the satisfaction of service recipients.

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Assessment of nonscholastic abilities and its associated factors among medical students: An exploratory study

. S. Ganesh Kumar; . Sonali Sarkar

Volume 7, Issue 1 , March and April 2017, Pages 1-5

Abstract

  Background: Nonscholastic abilities among medical students are an important area of concernfor the health professionals. Very few studies had been conducted in the past with regard ...  Read More Background: Nonscholastic abilities among medical students are an important area of concernfor the health professionals. Very few studies had been conducted in the past with regard to it.Objective: This study was an exploratory study aimed to assess the nonscholastic abilities amongmedical students in a medical institution in coastal South India. Materials and Methods: Thisstudy assessed three broad domains of nonscholastic abilities namely personal qualities,interpersonal activities, and communication skills among 106 medical students using astructured questionnaire (27 questions with a total score of 27). The data were analyzed byindependent t‑test and linear regression model. Results: About 41.5% (44) of the subjects weremales and 52.8% (56) of them were belonged to 18–19 years age group. Overall mean score ofnonscholastic abilities was found to be 19.40 (standard deviation = 3.27). Percentile distributionof subjects is at score 17 (25th percentile), 20 (50th percentile), and 22 (75th percentile). Meanpersonal quality domain score was found to be proportionately lesser than other domains ofnonscholastic abilities. Nonscholastic ability score was significantly associated with marksobtained in the previous examination (P = 0.006). However, linear regression analysis revealedthat the presence of family problems (P = 0.005) and alcohol use (P = 0.026) were associatedwith low nonscholastic ability score among medical students. Conclusion: Nonscholasticabilities are still a required need in medical student’s career. Further analytical studies will helpin identifying the in‑depth evaluation of factors associated with it.

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A comparative study of the origin, structure, and indexing language of the Persian and English keywords of articles indexed in the IranMedex database and their compliance with the Persian medical thesaurus and Medical Subject Headings

. Parastoo Parsaei-Mohammadi; . Ali Hossein Ghasemi; . Raziyeh Hassanzadeh-Beheshtabad

Volume 7, Issue 1 , March and April 2017, Pages 1-7

Abstract

  Introduction: In the present era, thesauri as tools in indexing play an effective role in integratingretrieval preventing fragmentation as well as a multiplicity of terminologies and ...  Read More Introduction: In the present era, thesauri as tools in indexing play an effective role in integratingretrieval preventing fragmentation as well as a multiplicity of terminologies and also in providinginformation content of documents. Goals: This study aimed to investigate the keywords ofarticles indexed in IranMedex in terms of origin, structure and indexing situation and theirCompliance with the Persian Medical Thesaurus and Medical Subject Headings (MeSH).Materials and Methods: This study is an applied research, and a survey has been conducted.Statistical population includes 32,850 Persian articles which are indexed in the IranMedex duringthe years 1385–1391. 379 cases were selected as sample of the study. Data collection was doneusing a checklist. In analyzing the findings, the SPSS Software were used. Findings: Althoughthere was no significant difference in terms of indexing origin between the proportion of differenttypes of the Persian and English keywords of articles indexed in the IranMedex, the compliancerates of the Persian and English keywords with the Persian medical thesaurus and MeSH weredifferent in different years. In the meantime, the structure of keywords is leaning more towardsphrase structure, and a single word structure and the majority of keywords are selected fromthe titles and abstracts. Conclusion: The authors’ familiarity with the thesauri and controlledtools causes homogeneity in assigning keywords and also provides more precise, faster, andeasier retrieval of the keywords. It’s suggested that a mixture of natural and control languagesto be used in this database in order to reach more comprehensive results.

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Effects of progressive muscle relaxation, guided imagery and deep diaphragmatic breathing on quality of life in elderly with breast or prostate cancer

. Mohsen Shahriari; . Mojtaba Dehghan; . Saeid Pahlavanzadeh; . Abdolrahim Hazini

Volume 7, Issue 1 , March and April 2017, Pages 1-6

Abstract

  Background and Objectives: Due to the increasing number of elderly and an increase in thenumber of cases of cancer by age, cancer is a common problem in the elderly. For elderlypatients ...  Read More Background and Objectives: Due to the increasing number of elderly and an increase in thenumber of cases of cancer by age, cancer is a common problem in the elderly. For elderlypatients with cancer, the disease and its treatment can have long‑term negative effects ontheir quality of life (QoL). The purpose of this study was to evaluate the effect of progressivemuscle relaxation, body image and deep diaphragmatic breathing on the QoL in the elderlywith cancer. Materials and Methods: This study was a randomized controlled trial in which50 elderly patients with breast or prostate cancer were randomized into study and controlgroups. Progressive muscle relaxation, guided imagery, and deep diaphragmatic breathingwere given to the study group, but not to the control group. The effect of the progressivemuscle relaxation, guided imagery and deep diaphragmatic breathing was measured atthree different time points. European Organization for Research and Treatment of Cancerand QoL Questionnaire‑Core questionnaires was completed before, after and 6 weeks afterthe intervention for the patients in both groups simultaneously. The data were analyzedby SPSS. Results: There was statistically significant improvement in QoL (P < 0.001) andphysical functioning (P < 0.001) after progressive muscle relaxation, guided imagery and deepdiaphragmatic breathing intervention. Conclusions: The findings indicated that concurrentapplication of progressive muscle relaxation, guided imagery, and deep diaphragmaticbreathing would improve QoL in the elderly with breast or prostate cancer.

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