Journal of Education and Health Promotion

Abstract Background and Purpose of Study: Statistical indices show a growing increase in the elderly
population around the world and our country. On the one hand, senior citizens are more exposed to
tragic events than other age groups due to natural physiological changes. Falling down, accidents
and scalds are among the most prevalent deadly events in this age group. Environmental security
is vital in maintaining the elderly’s health. Therefore, the present research was conducted seeking
to determine the prevalence and causes of falls among the elderly hospitalized in Bandar Abbas
hospitals. Methods and Materials: The present research is of a descriptive, cross‑sectional
type. Research population is comprised of all the elderly patients in Bandar Abbas hospitals.
The sample included 300 individuals who were selected according to convenience sampling
method till the sample was saturated. The instrument used was a questionnaire and the data were
also gathered through interviews. The collected data were later analyzed by SPSS version 16.
To analyze the data, descriptive statistics (frequency and percentage) were used along with
the Chi‑squared test. The significance level was set at P < 0.05. Results: From among the 300
subjects, 47.3% had experienced falls since the age of 60. In 22 of cases, it had led to injury and
they were obliged to visit a doctor. The results of this research revealed that the causes of falls
among the elderly were respectively: 43.33% of unbalance, 12.3% of poor eyesight, 11.66% of
non‑existing handles or fences, 12% of slippery ground, 2.66% of insufficient lightning, 8.66% of
unbalance and poor eyesight and 9.33% of other reasons. As the results revealed, a correlation
existed between falls and educational level (P < 0.025). Moreover, a significant correlation was
found between sex and falls (P < 0.011). A similar significant correlation was also observed
between the place of residence and falling down (P < 0.045). Conclusion: According to the
research results, planning to prevent events and traumas among the elderly and securing their
residential environment is of an essential significance.

Abstract Background and Aim: Students in junior high school, particularly in the third level, are
prone to a variety of stressors. This in turn might lead to stress, anxiety, depression, and
other health‑related problems. There are a very limited number of action research studies to
identify the effect of stress management techniques among students. Therefore, a study was
conducted to assess the effect of a program used in the math class to decrease the student’s
level of stress, anxiety, and depression. Material and Methods: This was an action research
study, which was conducted in region three of the Education and Training Office of Isfahan,
in the year 2012. Fifty‑one students in a junior high school were selected and underwent a
comprehensive stress management program. This program was prepared in collaboration
with the students, their parents, teachers, and managers of the school, and was implemented
approximately during a four‑month period. The student’s stress, anxiety, and depression were
measured before and after the program using the DASS‑21 questionnaire. Findings: The
t‑test identified that the mean scores of stress, anxiety, and depression after the intervention
were significantly lower than the corresponding scores before the program. One‑way analysis
of variance (ANOVA) also showed that the students from the veterans (Janbaz) families
had higher levels of stress compared to their classmates, who belonged to the non‑veteran
families (P < 0.05). Results: Education and implementation of stress management techniques
including cognitive and behavioral interventions along with active and collaborative methods
of learning in the math class might be useful both inside and outside the class, for better
management of stress and other health‑related problems of students.

Abstract Introduction: Considering the chronic nature of diabetes and its significant effect on
quality of life of patients, the present study was conducted to evaluate predictors of
quality of life in these patients in order to facilitate planning health promotion intervention
programs. Materials and Methods: The present study was designed as a cross-sectional
study on 140 type 2 diabetic patients of Om-ol-Banin Diabetes Center of Isfahan. Data
collection tool was a multidimensional questionnaire including demographic and disease
related data (12 items), the standard scale for diabetes distress (17 items), the standard
scale for self-efficacy in diabetic patients (8 items), and standard scale for specific
quality of life of diabetic patients (15 items). Collected data were evaluated by SPSS
version 11.5 using the Chi-square test, Independent T-test, ANOVA, Pearson correlation
and multivariate regression analysis. Results: Results showed that the quality of life of
diabetic patients had a statistically significant correlation with diabetes distress variable
(P < 0.001) and self-efficacy variable (P < 0.001). In this study R2
 (predictive power) was
0.66. Multivariate regression model indicated diabetes distress (b = -0.277, P = 0.01) and
self-efficacy (b = -0.161, P < 0.001) as variables influencing adjusted self-management for
other variables. Conclusion: The result of the present study urges that in planning health
promotion interventions in the field of diabetes, more attention be paid to self-efficacy
and diabetes distress variables in order to improve the efficiency and effectiveness of the
interventions carried out.

Abstract Introduction: Diabetes is increasingly becoming prevalent worldwide. Pregnancy with diabetes
is prone to maternal and fetal complications. Preconception care (PCC) is an important
factor in alleviating gestational complications in those women who suffer from diabetes. This
study seeks to gain insight into experiences of diabetic women and providers about PCC.
Subjects and Methods: The present research was a qualitative research conducted on eight
women with diabetes during the reproductive age and 15 health care providers of the public and
private medical centers, which provide health care for women with diabetes in Isfahan (Iran), with
a qualitative approach. Based on the aims of research, purposive sampling was done through
semi‑structuralized individual interview. Data were analyzed using conventional qualitative
content analysis method. Results: Data analysis revealed three major categories: (1) Health
centers weakness in providing PCC for diabetic women, (2) lack of a comprehensive PCC plan
for diabetic women and (3) diabetic women’s negligence about having planned pregnancy.
Conclusion: In order to improve diabetic women’s health, precise training of students, health
care providers and patients themselves with respect to PCCs should be taken into account.
Designing diabetic PCC system is an essential factor to succeed in this trend.

Abstract Background: Reviewing the human resources management literature shows an absence
of attention given to the employee’s benefits. Taking a look at functions of the Tehran
University of Medical Sciences’ wellbeing services system, it uncovers a gap between
employees’ real needs and what is delivered to meet their needs. So it requires an improved
comprehensive system for delivering wellbeing services (financial, insurance, health care
services, educational and training services, etc). Wellbeing need assessment can helps
planners to identify vital needs of employee and response to them effectively. Moreover it
can be used to evaluate the effectiveness of the current services which are delivered. Thus,
the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate
the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs
which were not fulfilled by the organization. Material and Methods: Being a cross‑sectional
and analytic‑descriptive survey including 98 responding participants, it is conducted by
a questionnaire collecting employees’ demographic information, their satisfactory rate
of the implemented services, and determines unfulfilled wellbeing needs which were not
already covered. Result: Results indicated that services related to financial, educational,
non‑financial, insurance, occupational health and tourism/recreational services were the
most satisfactory services successively. ‘Staff’s unwillingness to receive services’ and
‘poor announcement’ (unawareness on the wellbeing services),’ were found to be the most
frequent reasons for not receiving the existing wellbeing services. Conclusion: To increase
the satisfaction rate and responsiveness to the real needs of the staff, the current delivery
system of wellbeing services in the TUMS should be redesigned by defining new wellbeing
packages.

Abstract Background: Pregnancy and birth are unique processes for women. Women and families
hold different expectation during childbearing based on their knowledge, experiences, belief
systems, culture, and social and family backgrounds. These differences should be understood
and respected, and care is adapted and organized to meet the individualized needs of women
and families. The purpose of this study was to explore Iranian parturient needs, values and
preferences during normal labor and delivery. Materials and Methods: An exploratory
qualitative study was used. Twenty‑four parturient women from three governmental medical
training centers in Isfahan, Iran were recruited using purposive sampling. Participants were
recruited to low‑risk women after they had given birth, but before they were discharged from
hospital. Data were collected through semi‑structured in‑depth interviews, informal observations
and field notes. Interviews were transcribed verbatim and analyzed by the conventional content
analysis according to Graneheim and Lundman approach. Results: Women’s needs and
expectations fell into seven main categories: Physiological, psychological, informational, social
and relational, esteem, security and medical needs. All of the key needs in these data relates to
a fundamental need, named “sense of control and empowerment in childbirth.” Conclusion:
Knowing a woman’s needs, values, preferences and expectations during normal labor and
delivery assists healthcare professionals especially midwives in providing high‑quality care to
parturient women.

Abstract Background: Quality is one of the most important criteria for the success of an information
system, which refers to its desirable features of the processing system itself. The aim of this
study was the analysis of system quality of hospital information systems (HIS) in teaching
hospitals of Isfahan based on the DeLone and McLean model. Materials and Methods: This
research was an applied and analytical‑descriptive study. It was performed in teaching hospitals
of Isfahan in 2010. The research population consisted of the HIS’s users, system designers and
hospital information technology (IT) authorities who were selected by random sampling method
from users’ group (n = 228), and system designers and IT authorities (n = 52) using census
method. The data collection tool was two researcher‑designed questionnaires. Questionnaires’
reliability was estimated by using Cronbach’s alpha was calculated. It was 97.1% for the
system designers and IT authorities’ questionnaire and 92.3% for system users’ questionnaire.
Results: Findings showed that the mean of system quality score in a variety of HIS and among
different hospitals was significantly different and not the same (P value ≥ 0.05). In general,
Kosar (new version) system and Rahavard Rayaneh system have dedicated the highest and
the lowest mean scores to themselves. The system quality criterion overall mean was 59.6%
for different HIS and 57.5% among different hospitals respectively. Conclusion: According to
the results of the research, it can be stated that based on the applied model, the investigated
systems were relatively desirable in terms of quality. Thus, in order to achieve a good optimal
condition, it is necessary to pay particular attention to the improving factors of system quality,
type of activity, type of specialty and hospital ownership type.

Abstract The most important preventive measure is technique to resist against peer pressure. Any
educational program should design with an emphasis upon theories of behavioral change and
based on effective educational program. To investigate the interventions through educational
program in prevention of cigarette smoking, this paper has used the Extended Parallel
Process Model (EPPM). Materials and Methods: This study is a quasi‑experimental study.
Two middle schools were randomly selected from male students in Shiraz. Therefore, we
randomly selected 120 students for the experimental group and 120 students for the control
group. After diagnostic evaluation, educational interventions on the consequences of smoking
and preventive skills were applied. Results: Our results indicated that there was a significant
difference between students in the control and experimental groups in the means of perceived
susceptibility (P < 0.000, t = 6.84), perceived severity (P < 0.000, t = −11.46), perceived
response efficacy (P < 0.000, t = −7.07), perceived self‑efficacy (P < 0.000, t = −11.64),
and preventive behavior (P < 0.000, t = −24.36). Conclusions: EPPM along with educating
skills necessary to resist against peer pressure had significant level of efficiency in improving
preventive behavior of cigarette smoking among adolescents. However, this study recommends
further studies on ways of increasing perceived susceptibility in cigarette smoking among
adolescents.

Abstract Introduction: Suicide is committed by a person himself or herself and whether conscious
or semiconscious it is aimed to end one`s life. This action is not committed inadvertently or
incongruously. However, it could be related to one`s unmet needs and feelings of despair. Studies
on the prevalence of suicide are related to environmental and seasonal circumstances. As there
are diverse populations in Bandar Abbas of different races due to its geographical position, and as
its weather condition is different from the other parts of country there is no study with this regard.
Hence, the aim of this research is to investigate the correlations between and among demographical
variables and suicide in different seasons of the year. Materials and Methods: This study is a
cross‑sectional one. Participants included 80 persons who had attempted suicide and were
hospitalized within 2011 in the Ebnesina Hospital of Bandar Abases, Iran. The variables under
investigation are the suicidal patients` demographic characteristics, where, when, and how the
person had committed suicide. All of these data were available in their profiles. These data were
analyzed by using the SSPS software. Results: The results showed that 45% of the suicidal
people were the young and adolescent. Also, 75.5% of these people were single and 22.5% of
them were married. Most suicides occurred in summer, which makes up 41.3% of all the suicidal
people. On the other hand 11.3% of the suicides were committed successfully and 88.7% of them
had been unsuccessful; 42.5% of suicidal people had used drugs and 38.8% of them had used
pesticides to commit suicide — 78.8% of these patients had psychotic disorders and 12.5% of
them suffered from mental disorders such as schizophrenia. Furthermore, a significant relationship
was found between seasons in which suicide was committed, marital status, age, mental illness,
and educational and occupational characteristics of suicidal patients. Conclusion: This study
showed that the most vulnerable people
committing suicide were from among the
young and adolescent. Singles had attempted
suicide more than the married. Most of suicide
attempters had used drugs to commit suicide.
Generally, in the current study, some variables
including season, marital status, age, history
of mental illnesses, and educational and
occupational variables were all associated
with committing suicide.

Abstract Learning theories are the main guide for educational systems planning in the classroom and
clinical training included in nursing. The teachers by knowing the general principles of these
theories can use their knowledge more effectively according to various learning situations. In
this study, Eric, Medline, and Cochrane databases were used for articles in English and for the
Persian literature, Magiran, Iran doc, Iran medex, and Sid databases were used with the help
of keywords including social cognitive learning, learning theory, behavioral theory, cognitive
theory, constructive theory, and nursing education. The search period was considered from
1990 to 2012. Some related books were also studied about each method, its original vision,
the founders, practical application of the training theory, especially training of nursing and its
strengths and weaknesses. Behaviorists believe that learning is a change in an observable
behavior and it happens when the communication occurs between the two events, a stimulus
and a response. Among the applications of this approach is the influence on the learner’s
emotional reactions. Among the theories of this approach, Thorndike and Skinner works are
subject to review and critique. Cognitive psychologists unlike the behaviorists believe that
learning is an internal process objective and they focus on thinking, understanding, organizing,
and consciousness. Fundamentalists believe that learners should be equipped with the skills
of inquiry and problem solving in order to learn by the discovery and process of information.
Among this group, we will pay attention to analyze Wertheimer, Brunner, Ausubel theories,
Ganyeh information processing model, in addition to its applications in nursing education.
Humanists in learning pay attention to the feelings and experiences. Carl Rogers support the
retention of learning‑centered approach and he is believed to a semantic continuum. At the
other end of the continuum, experiential learning is located with the meaning and meaningful.
It applies the minds and feelings of the person. From this group, the main focus will be on
the works of Rogers and Novels. Finally, it could be concluded that the usage of any of these
theoriesin its place would be desired and useful.

Abstract