Journal of Education and Health Promotion

Abstract Background: Today, lumbar herniation discs, a prevalent problem with a sign of lumbar and feet
pain in society. Removal of disk by surgery decrease pain but reduce quality‑of‑life (QOL). In some
cases, lake of following and caring of patient after surgery, herniation disc recurrent. Previous
studies show that patient education and followings is important, therefore, this study aimed to
investigate the effect of continuing care on patient QOL after disc surgery in neurosurgery and very
important person (VIP) ward in Al‑Zahra Hospital. Materials and Methods: This study is a clinical
trial conducted on 64 patients hospitalized in the neurosurgery and VIP wards of Al‑Zahra Hospital,
in Isfahan, Iran, in 2013. The patients were selected by simple sampling method and were randomly
assigned to two groups (study and control). Patients’ response to short form‑36 questionnaire
before and 4 weeks and 3 months after continuing care in study group, and simultaneously, in
the control group. Results: Repeated measures ANOVA showed a significant difference in mean
of physical and psychological dimensions before and 4 weeks and 3 months after intervention in
study group (P < 0.05), but in control group, the difference was not significant (P = 0.8). Pairwise
comparison of mean physical and psychological dimensions at different time points by Fisher’s
least significant difference showed that there was a significant difference in the intervention
group (P < 0.022). But in the control group, there was no significant difference between pairs of
time points (P > 0.18). Conclusion: Continuing care improves dimensions of patients’ QOL, and
it is recommended as a nursing and nonmedical intervention in disc surgery patients.

Abstract Introduction: Since pemphigus vulgaris (PV) is a chronic disease and regarding its autoimmune
nature, patients need to adopt self‑care behaviors. This study aimed to assess the impacts of
an educational program based on health belief model (HBM) on adopting self‑care behaviors
among patients with PV referred to Razi Hospital. Materials and Methods: Eighty‑eight patients
with PV were randomized in an educational intervention study in two groups in 2013–2014. The
intervention group attended a 6 months self‑care educational program in a specialized outpatient
clinic, in addition to the regular care presented for both groups. To collect information about
demographic characteristics, PV‑related variables, and HBM constructs items, a self‑designed
questionnaire was used. Data were analyzed by SPSS 20. A P < 0.05 was considered as
statistically significant. Results: Increase in perceived susceptibility, severity, and benefits score
were significantly higher in intervention group compared with controls when adjusting for the
difference in baseline scores of these HBM constructs and house ownership and employment
status distribution in two groups using ANCOVA (P < 0.001). Furthermore, after intervention,
the decrease in perceived barriers’ scores was significantly more than controls (P < 0.001),
However, the decrease in cues to action score was not found significant (P = 0.380).
Discussion: The results of this study show the effects of an HBM‑based educational program
as a tertiary preventive measure on adopting self‑care behaviors in patients that can help
them achieve self‑efficacy in controlling their disease and enhancing their treatment process.

Abstract Purpose: Patient and family involvement in the education and training of medical practitioners
increases the likelihood that the care delivered will meet the needs of service users and
carers. The purpose of this study was to determine the effect of a consumer informed
educational program on knowledge and attitude to patient‑centered care among hospital
clinical trainees. Methods: A total of 66 junior medical staff and 35 orthoptists in training
were invited to participate in a controlled before‑and‑after trial at the Royal Victorian Eye
and Ear Hospital from October to November, 2011. Thirty‑eight participants were allocated
to the intervention program (interactive workshop) and 63 to the control program (assigned
reading). Questionnaires regarding knowledge, attitude, and practice, patient‑practitioner
orientation and communication were administered. Differences between groups and
differences before and after the program were evaluated using the t‑test or Chi‑square test, as
appropriate. Narrative data obtained from the questionnaires were analyzed using Grounded
Theory qualitative analysis techniques. Results: A total of 24 participants (63%) completed
the intervention program and eight (13%) the control program. The intervention group felt
more prepared to introduce themselves and their role (Chi‑square = 11.19, P = 0.01) and
to acknowledge patients’ waiting time prior to consultation (Chi‑square 8.52, P = 0.04)
compared with the control group. For the intervention group, there was an improvement
in mean score on the Communication Assessment Tool (mean change = 0.55, P = 0.01).
Conclusion: There were minor improvements in self‑perceived knowledge and attitude to
patient‑centered care and communication among hospital clinicians‑in‑training following
a consumer informed education program. The majority of participants who received this
program agreed it would influence how they conducted future consultations. Further work
is required to determine if these improvements translate to sustainable changes in clinical
practice and patient satisfaction.

Abstract Background: Medical and health advances have led to relative increases in human longevity
and elderly population. Common diseases in elders can be prevented using healthy lifestyle.
Identifying current status of the elderly is necessary to design educational intervention programs
to improve their health and quality of life. Therefore, this study aimed at assessing the lifestyle of
the elderly in Islamshar (suburban of Tehran). Materials and Methods: A descriptive – analytical
study conducted among 480 elderly people over 60 years old referred to Islamshahr Health
Center of Tehran University of Medical Sciences for a period of 12 months in 2012–2013. Data
were collected through at two‑part questionnaire including sociodemographic and health‑related
characteristics and healthy lifestyle instrument. Healthy lifestyle of the elderly was assessed
using a 46 items self‑report standard instrument with five subscales reflecting domains including
exercise, nutrition, prevention, stress management, and social relationship. Finally, the data
obtained were analyzed using the SPSS 18 software using an independent t‑test, analysis of
variance and ordinal logistic regression test at a significant level of P < 0.05. Results: Mean
score of total healthy lifestyle was 148.56 ± 11.5. Men and women scored 151.95 ± 11.15 and
145 ± 10.32, respectively (P < 0.001). 76.2% of participants had moderately healthy lifestyle,
and 23.8% had desirable healthy lifestyle. Marital status and gender were important factors
in elderly healthy lifestyle. Discussion: The status of a healthy lifestyle among the elderly in
Islamshar was relatively moderate. However, more studies are needed for further information to
confirm study results. Study results were posed the necessity of tailoring specific interventional
programs to achieve desirable healthy lifestyle.

Abstract Background: Due to the wide influence of public media, they become important communication
channels for changing health beliefs and behaviors. One of the areas that have gained increased
attention in public media is nutritional information. Cancer is one among the diseases related
to nutrition. The goal of this study is to do a content analysis of the popular magazines in Iran
for nutritional information related to cancer in year 2012–2013. Materials and Methods: This
is an applied survey performed using content analysis method. The data gathering tool is a
checklist designed by the researcher. The statistical population consisted of all of the messages
printed in 173 volumes of eight most popular magazines which were selected based on their
characteristics by searching the Iranian publication database using certain inclusion and
exclusion criteria. The sample size calculated using non‑probability – purposive sampling was
295 messages from 96 magazine volumes. Results: Findings showed that prevention trends
had the highest (86.8%) and treatment had the lowest (4.7%) frequency in the messages.
Pomegranate was the most commonly mentioned preventive food, while mayonnaises were
the most commonly mentioned carcinogen and tangerine was the most commonly mentioned
food used for cancer treatment. Among the different types of cancer, more than half of the
messages (51.2%) mentioned “cancer” as a general term. After that, breast cancer (13.2%)
and prostate cancer (10.51%) were the most commonly motioned cancers and messages
regarding pancreatic cancer and hormone‑related cancers were the least frequent (0.3%).
Conclusions: The findings of this study show that the main goal of these messages was to
increase the information provided to the readers, although some doubts regarding the scientific
credibility of the claims made in these messages still remain.

Abstract Introduction: Ensuring achievement of research experience by students is one of the most
important goals of the thesis‑conduction process and evaluation of student satisfaction with
this process is one of the most imperative challenges herein. Aims: The aim of this study is to
investigate the satisfaction of dental students passing the thesis educational course from the
Isfahan Dental School. Settings and Design: Sixty‑two dental students who had graduated
in2011, from the Isfahan Dental School, participated in this descriptive cross‑sectional study
Materials and Methods: The postgraduate Research Experience Questionnaire (PREQ) was
used for data collection. The questionnaire evaluated student satisfaction in seven domains:
Thesis supervision, skill development, intellectual climate, infrastructure, thesis examination,
goals and expectations, and overall satisfaction. Statistical Analysis Used: The data were
analyzed on an SPSS software using descriptive and inferential statistics. Results: The mean
score of satisfaction of the participants was 75 ± 12. On the basis of their scores, satisfaction
in 3.2% of them was slow, in 33.9%was medium, in 61.3% was good and in 1.6% was high. The
highest satisfaction was found to be in thesis supervision and the least was in the intellectual
climate domain.There was no significant statistical difference between satisfaction and
gender (P = 0.46). Conclusions: Considering the results, to increase student satisfaction for
passing the thesis courses, it is necessary to improve the intellectual climate in dental schools
and also increase the research budget for more financial support of students to carry out their
projects.

Abstract Background: Physical activity generally declines during pregnancy, but activity barriers during
this period are not well understood. The objective was to determine physical activity and some
relative factors in referred pregnant women. Materials and Methods: This cross‑sectional
study was carried on 384 in referred pregnant women to Isfahan Health Care Centers and
Shahid Beheshti Hospital in second stage sampling method in 2013. Demographic/prenatal
characteristics, physical activity (36Q) and prenatal life quality questionnaire (26Q) were
completed by participants. The statistical analysis was performed with various statistical tests
such as the t‑test, one‑way ANOVA, individual correlation coefficient, and linear regression
using SPSS statistical software (version 16). Results: Based on the findings, 98.7% (n = 378)
of pregnant women had low physical activity. Also, there were a correlation among physical
activity and parity, age, gestational age (P ≤ 0.005). Conclusion: Since physical activity is
recommended for the most of pregnant women, it is imperative to promote physical activity
between pregnant women and some intervention suggestions.

Abstract Introduction: Birth can cause and post‑traumatic stresses in many women even when the
occasion of birth results in alive baby. Fetal death can challenge her understanding of justice
and God’s love toward his creatures. Religious beliefs have a considerable effect on decreasing
individuals’ tendency toward bereavement; thus, it is expected to have a relationship with sorrow
and mental distress ensuing fetal death. The present research has been conducted to review the
existing literature on religion and fetal death and then study Iranian women and their families’
response to such a tragedy. Materials and Methods: This is a unsystematic (narrative) review.
Research was conducted to study the role of mothers’ religious belief in their encounter with
pregnancy loss in cases belonging to a 23‑year period from 1990 to 2013. PubMed and Ovid
databases and Iranian religious resources such as Tebyan were utilized for these studies. Of
course, several articles were also derived by means of manual search. Results: Nine out of
31 papers had the searched keywords in common in the preliminary search. A review of the
existing papers indicated that only 4 out of 22 papers dealt exactly with the role of religion on
reaction of parents to fetal death. The four papers belonged to the years 2008, 2010, 2011, and
2012 indicating the new approach to religion in pregnancy loss cases. Conclusion: Religion
has a significant effect on parents’ acceptance of such mishaps and it may have a considerable
effect on their recovery from such tragic events.

Abstract Context: Fatigue is a factor that can have negative effects on family life, social relationship
and work. Work schedule is one of the affective factors on personnel’s fatigue in different
jobs. In this study, the work schedule and its effect on rescue personnel in Isfahan are
explored. Aims: The purpose of this study was to investigate the relationship between
work schedules and fatigue among rescue personnel. Settings and Design: This study
is periodical and has been conducted on 72 employees of rescue personnel in Isfahan.
Materials and Methods: Random sampling was done and the primary data that was collected
through fatigue assessment questionnaire after being conducted as a pilot study on 10%
of samples were collected to confirm the validity of this study. Finally, the data was given
to SPSS11.5 software and were analyzed by descriptive statistics and linear digression.
Results: The results showed that from the statistical point of view some parts of work schedules
like work hours satisfaction, resting time and work order on total fatigue are effective in linear
and inverse way but the item “predictibility of work conditions” does not have a meaningful
relationship with total fatigue. Furthermore, the results showed that there is a meaningful and
inverse relationship with work hours, resting time and work order with mental fatigue and also
the work schedule has a meaningful, linear and inverse relation with mental fatigue and total
fatigue. Conclusions: By increasing the satisfaction of working hours, increasing resting time
and also with an increase of work order the total fatigue of rescue personnel will decrease.

Abstract Background and Aim: The postpartum period is a critical then effects on the structure of the
family. Most women in the postpartum period may place at risk of undesirable experiences such
as changes in sleep patterns. Therefore, this study aimed to identify the efficacy of the relaxation
program on sleep quality of mothers with premature infants. Materials and Methods: This
study is a clinical trial that 60 mothers with premature infants. The mothers in the intervention
group were trained for muscle progressive relaxation by Jacobson method within 24–72 h
after delivery. Research tool was the Pittsburgh Sleep Quality Index, which was completed by
the mother at the beginning of the study, end of the first and the second 4‑week. Data were
analyzed using parametric statistics tests by SPSS software version 16. Results: No significant
difference was observed between two groups in terms of underlying characteristics (P < 0.05).
The independent t‑test at the beginning of the study showed that the comparison of the mean
scores of mothers’ sleep quality has no significant difference between two groups (P = 0.43).
But, 1‑month after the intervention (P = 0.024) and 2 months after the intervention (P > 0.001),
mean sleep quality score in the intervention group was significantly less than the control group.
Conclusion: Relaxation training can improve mothers’ sleep quality at postpartum period.

Abstract Context: Identification of parenting skills determinants among mothers is an ongoing field
of research. Aims: The aim of this study was to identify the social cognitive predictors of
parenting skills among mothers. Settings and Design: Previous studies have demonstrated
the health action process approach (HAPA) as a credible frame for predicting behavior,
but the number of studies considering the predictive value of parenting skills determinants
among mothers is rare. Subjects and Methods: An 8 months prospective design was
applied. Participants were mothers with preschool and early elementary school‑aged children.
At the 1st time, 120 participants completed self‑report questionnaires regarding their risk
perception, outcome expectancies, task self‑efficacy, and intentions toward parenting skills.
At the 2nd time, they returned a follow‑up questionnaire, which measured planning, coping
self‑efficacy, and recovery self‑efficacy and finally, 8 months later as the 3rd time, parenting
skills were measured. Path analysis was used for analysis. Results: Path analysis indicated
that, in the motivational phase, there was no relationship between parenting skills intention
and risk perception, outcome expectancies, and task self‑efficacy. Furthermore, no relationship
was found between parenting skills intention and planning. In the volitional phase, coping
self‑efficacy, recovery self‑efficacy, and planning were statistically significant predictors of
parenting skills. Conclusion: The results of this study confirm that volitional phase of the HAPA
model is useful in determining parenting skills. However, the role motivational variables seem
to be unimportant in performing these behaviors. It was concluded that everybody intended
to apply parenting skills, in nature, and intervention strategies should be focused on turning
intentions into behavior.

Abstract Background: Appropriate nutritional support is effective on achievement of expected
outcomes in intensive care unit (ICU) patients. Although several studies have suggested
different conclusions about the effectiveness of tube feeding methods, there is no specific
program of nutritional support for patients who have been hospitalized. There is a possibility
for complications due to an inadequate nutrition. The aim of our study is to compare the effects
of enteral feeding through the bolus and continuous methods on blood sugar and prealbumin
level among the ICU inpatients. Materials and Methods: Fifty subjects were selected by
convenient sampling from April to Aug 2013 in the ICU wards of Alzahra Hospital, Isfahan, Iran,
and randomly assigned to study and control groups in this clinical trial. The subjects in the
study group received infusion pump feeding while the control group received bolus feeding for
72 h. Blood sugar was checked for every 4 h for 72 h and the prealbumin level was assessed on
the first and the fourth day in two groups. Results: In the study group, the mean blood sugar
significantly decreased on the fourth day, compared with the first (P = 0.03, F = 3.85) and
third (P = 0.01, F = 3.15) day. In the control group, the mean blood sugar increased from the
first day. It was significantly higher in the control group on the second day (P = 0.02, F = 3.55),
compared with the study group. In the study group, there was a significant difference in the
mean prealbumin before and after intervention (P = 0.048, t = 1.97), but no significant difference
was observed in the control group. There was a significant difference between two groups after
intervention (P = 0.04, t = 2.05). Conclusion: The obtained results showed that supportive
nutrition through a continuous method had an effect on critical patients’ blood sugar control
and made a better nutritional status for these patients through an increase of prealbumin level.
Positive effects of this feeding method can result in appropriate outcomes for patients’ recovery
and reduce the complications.

Abstract Background: Noncommunicable diseases such as Hypertension are among the
important factors of mortality and morbidity of the elderly people. The family‑centered
empowerment model (FCEM) has not been performed for elderly people with hypertension.
Settings and Design: This clinical trial study was carried out on 62 elderly people with
hypertension under the coverage of the Lenjan Health Network in 2013. After performing the
sampling by using the cluster‑randomized method, the samples were divided randomly into
the experimental and control groups. Methods: For the experimental group, the (FCEM) was
implemented based on the four steps. For the control group, it was only implemented the
usual care and one training session. Research tools included questionnaires of demographic
data, empowerment assessment and a blood pressure‑measuring device. The post‑test was
performed 1 week later. The blood pressure was recorded, and it was followed 1.5 month later
again. Statistical Tests: Statistical tests for data analysis included χ2
‑test, independent t‑test,
Mann–Whitney, analysis of variance, and SPSS 20. Results: 1 week later and 1.5 month after
the intervention, the mean blood pressure was significant in both groups (P < 0.001). also, the
difference in the mean score of empowerment dimensions was significant in the experimental
group 1 week later and 1.5 month after the intervention (P < 0.001). Conclusion: Implementation
of the FCEM for elderly people with hypertension has been possible from a practical point of
view, and it has been associated with controlling and improving the blood pressure.

Abstract Introduction: Hepatitis C virus (HCV) infection is a major complex public health problem.
Different resources have proved that healthcare workers more than the general population
are at a risk of infection. Therefore, medical field students, due to the future occupational
hazards, are included in the risk group. Aim: The purpose of the study was to evaluate the
level of knowledge, public and individual risk perception, and behavioral intention about
HCV, among medical sciences students of the Isfahan University of Medical Sciences.
Settings and Design: This is a descriptive–analytical study that was conducted among
457 students of the Medical Sciences in the Isfahan University of Medical Sciences.
Materials and Methods: The data was collected using a questionnaire. Sampling was done
randomly. Statistical Analysis Used: The data was analyzed using the SPSS18 software and
statistical tests of Pearson, Spearman, T‑ test, and the analysis of variance (ANOVA); P < 0.05
was considered significant. Results: Four hundred and fifty‑seven students (41.8% male and
58.2% female) in 29 fields of study (six categories) participated in this research. The mean age
was 21.55 ± 2.6 years. The mean and standard deviations of the students’ knowledge was
3.71 ± 2.9 (out of 8), and the behavioral intention to accruing information and performance
of preventive actions related to HCV was 11.52 ± 3.16 (out of 20). Public risk perception was
20.1 ± 3.5 (out of 30); and personal risk perception was 6.96 ± 1.8 (out of 10). The ANOVA
test showed that public perception of the risk among students of different academic fields was
different (F = 1.52, P < 0.05). Conclusions: According to the low knowledge of students of
Medical Sciences in the Isfahan University of Medical Sciences about HCV, it was recommended
that the University Policymakers design an educational intervention about it, in order to minimize
the chances of being infected.

Abstract Background: Quality of life (QOL) is one of the health indexes for which many efforts have been
made to define and measure during the last four decades of the 20th century in many countries.
This paper is aimed at studying the QOL in relation to socioeconomic status of the general
population of Isfahan in 1390. Materials and Methods: We applied a descriptive‑analytical and
sectional method. In this research, 385 women and men over 15 years of age from 14 regions of
Isfahan’s municipality were studied using multi‑stage quota sampling. We examined QOL using
the SF‑36 standard questionnaire, along with two domains of mental and physical health and
eight subscales within the validity domain of 65–90%. Social (81%) and economical (70%) status
was also measured by the questionnaire instrument in both objective and subjective domains
after confirming the validity and reliability of the instruments. The given data were analyzed by
SPSS 17 software and using descriptive and statistical tests. Results: The indicators of QOL
showed that a score deviation of the SF‑36 questionnaire in physical health (SD = 2.31) and
mental health (SD = 3.22) domains was obtained from the population. Of the eight subscales,
bodily pains and limitations on functioning as physical and mental had an inverse relationship
with socioeconomic status. However, physical health, mental health, social activities, public
health, and vitality had a significant positive relationship, including different strengths and
weaknesses, with socioeconomic status. Also, sexuality and housing status had no relationship
with QOL. Conclusion: There is a direct and significant relationship between quality of life and
socioeconomic status variables in Isfahan.

Abstract The purpose of this survey was to assess the health literacy levels and determine the relationship
between health literacy with demographic variables and the socioeconomic status Three
hundred and eighty adults, 18 years and older, were randomly selected and assessed by the
Test of Functional Health Literacy in Adults (TOFHLA) instrument in two sections of reading
comprehension and numeracy. The second instrument used to detect the relationship between
the demographic variables and socio‑economic status and the level of health literacy of the
subjects of adults in Yazd district. Three hundred and eighty adults, 18 years and older, were
randomly selected and assessed by the Test of Functional Health Literacy in Adults (TOFHLA)
instrument in two sections of reading comprehension and numeracy. The second instrument
used to detect the relationship between the demographic variables and socio‑economic
status and the level of health literacy of the subjects. The mean score of a participant’s health
literacy was 73.33 ± 1.29. Fifty‑four percent of the individuals had adequate health literacy and
the rest of them had limited health literacy. The mean score of functional health literacy was
significantly different by socio‑economic status (p0.05) and the years of schooling (P = 0.00).
On the basis of linear regression, in this research, the years of schooling (B0.28, p0.01) and
marital status (B = 3.08, p0.05) were two predictors of health literacy.

Abstract Background and Objectives: Addicts account for approximately 68.15% of AIDS cases in
Iran and injection drug users are considered as a major factor in the spread of AIDS in Iran.
The purpose of this study was to determine the effect of an educational intervention on the
perceived self‑efficacy, benefits, and barriers concerning AIDS preventive behaviors among drug
addicts in Khorramabad, Iran. Methods: This is a quasi‑experimental study carried out in 2013
on 88 addicts kept in rehabilitations center in Khorramabad. The data collection instruments
included a questionnaire on self‑efficacy, perceived benefits, perceived barriers, knowledge and
preventive behaviors regarding HIV. Data were analyzed by paired t‑test, independent t‑test,
Chi‑square and analysis of covariance. Results: Paired t‑test showed that the mean scores for
perceived benefits and barriers, knowledge and preventive behaviors significantly increased
in the intervention group after the intervention than before the intervention. But the increase
in self‑efficacy score was not statistically significant. Conclusions: The results of this study
showed that training and education based on the health belief model led to an increase in
knowledge, self‑efficacy, perceived benefits, performance and reduction in perceived barriers
in addicts. It is recommended that future studies should include strategies for enhancing
self‑efficacy and perceived benefits as well as strategies for reducing barriers to the adoption
of preventive behaviors.

Abstract Introduction: Training the man power is an inevitable necessity that the organizations need in
order to survive and develop in today changing world. Aims: The aim of the present study is to
identify the relationship between the components of on‑site training and emotional intelligence
in librarians of Isfahan University of Medical Sciences and Isfahan University with moderating
role of personality characteristics. Settings and Design: Descriptive correlation method was
used in the present study. The statistical population of the study was all of the 157 librarians
of Isfahan University of Medical Sciences and Isfahan University from whom the appointed
individuals were selected through random sampling method. Subjects and Methods: The
research tools included the researcher‑made questionnaire of investigating the effectiveness of
on‑site training system and two other standard questionnaires of Shrink emotional intelligence,
and NEO personality questionnaire, which all of them had the needed reliability and validity.
Statistical Analysis: The descriptive indices (distribution and mean) and also the inferential
methods (Pearson correlation, regression analysis and analysis of variance) were used through
applying version 20 of SPSS software to analyze the obtained data. Results: There was a
significant relationship with certainty level of 95% between the components of on‑site training
with emotional intelligence in those who obtained low grades in the features of being extrovert
and between the individual aspects of on‑site training with emotional intelligence in those who
got higher grades in the characteristic of being extrovert. Conclusion: The emotional intelligence
is a promotable skill and considering the existence of a significant relationship between some
components of emotional intelligence and on‑site training, these skills can be institutionalized
through conducting mentioned educational courses.

Abstract Background: Diabetes is the most common metabolic disease and the sixth cause of mortality
in the world. Most of the conducted studies show that the only way to control this disease and
prevent its disabling complications is constant administration of self‑care. Aim: This study
was conducted with the goal of determining the effect of public health nurses’ educational
intervention on the self‑care of the patients with type 2 diabetes who referred to Hazrat Ali clinic
in Isfahan. Materials and Methods: This is a two‑group two‑step clinical trial with a before–after
intervention design in which 50 patients with type 2 diabetes and with a mean age of 40–70 years
were selected and assigned to study (n = 25) and control (n = 25) groups by allotting them
even and add numbers. Educational intervention was conducted in the study group through
seven educational sessions. Mean scores of self‑care before and after interventions were
compared by Toobert and Glasgow brief self‑care activities questionnaire. Results: Results
showed no significant difference in the self‑care scores before intervention in the two
groups (P = 0.67, z = 0.43), but the mean score of self‑care showed a significant increase
after intervention in the study group, compared to the control group (P = 0.002, z = 3.14).
Conclusion: Based on the obtained results, it is suggested to provide constant education
of self‑care for diabetic patients in health care centers, with more emphasis on a change in
self‑care skills and behavior.

Abstract Background: The study tries to understand what are the dimensions of Reproductive Health
care seeking behavior among the urban slum women in Delhi, their level of awareness and
treatment seeking patterns? Materials and Methods: The study was carried out in one of the
slum in south district of Delhi. 253 women of reproductive age group were selected by systematic
random sampling. Interpersonal interview was conducted to seek information on the selected
parameter. Results: Around three/fourth women had undergone for blood pressure check up,
weight recording and stomach/abdomen check up during pregnancy. Only 39.9% received
advice on avoiding intake of medicine during pregnancy. About 14.6% mentioned that at least
40 days rest were required for resuming daily routine activities after delivery. Thus majority of
these slum women are ignorant about the importance of post natal care which was necessary
for post delivery care of the women and her infant. Conclusion: The correct knowledge on the
importance of ANC and PNC and various checkups need to be carried out during pregnancy
and postnatal period needs to be imparted to these women. Thus, health education and health
promotion campaigns are needed for bring changes in the existing health‑seeking behaviors
among urban slum women.

Abstract Background: The incidence of cesarean section is increased. About 3–30% of the women
who undergo cesarean experience surgical site infections (SSIs). Many methods, have been
used to decrease the incidence of SSIs, but despite much effort, no definite efficacious method
has been suggested.Materials and Methods: In this parallel, single‑blinded, randomized
control trial, 56 women with post‑surgical superficial wound dehiscence were divided into two
groups in a 1:1 ratio. One group was irrigated with normal saline for irrigation and Firooz®
baby soapand the other with normal saline for irrigation and povidone‑iodine. Formation of
granulation tissue was monitored in both groups. Also, the reason for surgery, length of wound
dehiscence, and duration of hospitalization and wound union after were compared in both
group’s. Results: The soap group patients were irrigated for 4.18 ± 1.96 days compared
to 5.36 ± 2.83 days for the patients in povidone‑iodine group (P = 0.414). The granulation
tissue was formed after 3.88 ± 1.94 days in the soap group compared to 4.48 ± 2.92 days in
the other group (P = 0.391), and the duration of hospitalization was 5.48 ± 2.04 days in the
soap group compared to 6.3 ± 2.95 days in the other group (P = 0.423). So, no differences
were observed between the two groups. Conclusion: It can be concluded since there is no
difference between the results of two groups, irrigation with normal saline and soap is safe,
easy and causes no harm or allergy compared with povidone iodine and normal saline.

Abstract Background: Parenting style is one of the most important and effective factors in training
and growth of children and adolescents and the method that parents communicate with their
children is an effective factor on family contact models. Objectives: The aim of this study was
to determine the impact of group training about parenting styles on maternal attitudes that were
admitted to Isfahan Imam Ali (AS) health care center in 2013. Materials and Methods: This
was an experimental study, which was conducted on a random sample of 25 mothers referred
to this health care center. They were divided into two groups (experimental and control). The
experimental group received five sessions of group training, and the control group received a
booklet about parenting styles. The used tool in this study was the Bamerind Parenting Style
Questionnaire that was completed by the mothers before and after the intervention and finally,
their obtained scores were compared with each other. Results: The results of the present study
showed that the mean score of attitude toward easy‑going style in test group was less than the
control group after intervention (P = 0.045). The mean score of attitude toward authoritative
style in the experimental group was less than control group after intervention (P = 0.037)
and the mean score of attitude toward authoritative style in the experimental group was more
than the control group after intervention (P = 0.011). Conclusions: Group training can be an
appropriate method in changing maternal attitudes toward parenting styles.

Abstract Background and Objectives: Pregnancy is one of the most important and risky periods in
mothers and the fetus life, which plays a key role in health and social activity of the person,
family and community. This study is trying to see if there is a relation between increasing
weight and urinary tract infection (UTI) in pregnancy by using the open nested case‑control
study in the city of Shahrekord. Materials and Methods: In a nested case‑control study,
one cohort including 832 patients was examined until week 26 to 30 of pregnancy and their
UTIs were studied. The required information was collected by examining the health records
of pregnant women and completion of the data registration forms. Data collection was
controlled by using SPSS and analyzed by using an independent t‑test, Chi‑square test,
Pearson correlation and logistic regression. Results: According to the results of the cohort
study with 832 individuals, average weight gain of the group with a UTI was 11.13 ± 3.9 kg
and it was 10.63 ± 3.9 kg in the group without UTI, showing no statistically significant
difference (P = 0.245). According to the results, genitourinary problems had the highest
predictive value for UTIs and the numbers of infertility and the childbirth variables were in
the second and third positions, respectively. Conclusion: According to the results study
we can conclude that screening and treatment of UTIs have been on time and appropriate
in health systems of the city of Shahrekord which have lead to the reduction of infant and
maternal diseases even with the condition in having no UTI, and continuing this process for
screening and treatment is recommended.

Abstract Background: Multiple sclerosis (MS) is a chronic disease prevalent in young and middle‑aged
people. Patients with MS often have numerous complicated needs and, consequently, require
a broad range of health services. Results of a number of studies indicate that patients’ needs
are only partially met. Aims: This study was conducted to explore the challenges of healthcare
delivery to patients with MS in Iran. Materials and Methods: In this qualitative case study,
43 participants selected through purposeful sampling were interviewed using semi‑structured
method in the cities of Isfahan and Tehran in 2012–2013. Besides the interview, documentations
relevant to healthcare delivery were collected from different sources, including websites of
all Iranian universities of medical sciences, insurance organizations, patients’ weblogs, news
agencies, the MS Center forum for MS patients, and MS Payam bimonthly. The data were
analyzed through the constant comparative analysis. Results: The data were categorized
into four main categories, including functional challenges (diagnosis problems, failure to
pay attention to patient needs, failure to follow‑up, and miscommunication), administrative
challenges (resource allocation and supervision), policy‑making challenges (lack of
comprehensive services, bureaucracy, and problems in provision of medications), and structural
challenges (difficult access to services, lack of comprehensive centers, space limit, and long
wait). Conclusion: Despite all attempts of governmental and nongovernmental organizations
for healthcare delivery to MS patients, these services cannot satisfy all needs of the patients.
In this regard, service providers and administrators should pay more attention to the needs
and expectations of patients and their families.

Abstract Background: The benefits of fermented foods consumption have been demonstrated in
a number of research reports. These qualities have been demonstrated, for example, to
reduce childhood diseases such as diarrhea and malnutrition. Thus, fermented foods may be
recommended for improving the health and nutritional quality of traditional African foods and
regular inclusion of fermented foods as part of the daily diet would be desirable. Aims: Lack of
knowledge and understanding toward fermented food preparation may limit their usage. This
study explores the South African community’s understanding of fermented foods preparation
and usage. Materials and Methods: This was a qualitative study using focus group interviews to
determine the community’s understanding and their perception of fermented foods preparation
in the rural villages of Odi, in Gauteng Province between May and June 2012. The target
population was the caregivers of children under 5 years, attending the hospital’s antenatal
clinic at the time of study. The information was transcribed, coded, and analyzed using NVivo
software. Results: Most caregivers were aware of food fermentation process, and some of
them could not clearly differentiate between fermented and unfermented foods. Although
most participants knew what fermented foods were, there were misconceptions on how they
were made. This was exemplified by the undesirable artifacts, labeled as ingredients, in the
fermentation process. Conclusion: Caregivers demonstrated a fair knowledge of fermented
foods but lack a standard preparation procedure for these foods. There is an urgent need to
educate communities and conduct a health promotion campaign on the fermented foods and
probiotics.

Abstract Introduction: Today, many jobs are associated with the inactivity or sedentary lifestyle.
Employees’ health will be affected by their depriving of the benefits of physical activity (PA).
Therefore, the present study was undertaken to determine the PA among employee
women in Isfahan University of Medical Sciences based on the transtheoretical model.
Materials and Methods: This is a cross‑sectional study has been performed in Isfahan
University of Medical Sciences employee women (2013). A convenience sample of 100
women was selected. Data were collected by validated and reliable questionnaire in three
parts (demographics information, PA scale, and TTM constructs). Data were analyzed by SPSS
SPSS (version 16.0; SPSS, IBM, Inc, Chicago, IL, USA) and descriptive and analytical statistics
such as ANOVA and independent t‑test were used. A two‑tailed P < 0.05 was considered
statistically significant. Results: The mean of PA was 21.17 ± 27.30 min in a day. Weekly
heavy, moderate, and light exercise mean was 0.72 ± 1.81, 0.89 ± 1.87 and 0.57 ± 1.57 days,
respectively. In this study, 26% of women were in contemplation, 22% in contemplation, 20%
in preparation, 13% in action, and 19% in the maintenance stage. Furthermore, there were
significant differences between consciousness raising, dramatic relief, counter‑conditioning,
stimulus control, helping relationships, reinforcement management, and self‑liberation with
stages of change constructs. Conclusion: Because of a significant relationship between
cognitive and behavioral processes and PA in this group, designing and implementing an
educational program based on the transtheoretical model may be useful in promoting PA of
a female employee.

Abstract Background: The aim of this research was to study the pathology of Isfahan University
of Medical Sciences based on Weisbord six box model and to find its relation with mental
health. Materials and Methods: The research method followed was a descriptive survey.
The statistical society consisted of all staffs of the Isfahan University of Medical Sciences
consisting of professors in the year 2012 (personnel of deputy of treatment, deputy of training,
cultural‑student deputy, supporting deputy, deputy of food and drugs, health deputy, and deputy
of research). The number of subjects in the mentioned society was 1647, sample size was 332
Based on Cochrane’s formula. They were selected by random sampling method in proportion
with the statistical society.The measurement instruments included organizational pathology
questionnaire (ODQ) with 35 questions and the questionnaire of mental health standard [General
Health Questionnaire (GHQ)] with 28 questions. The validity of the questionnaires obtained
from reviews by faculties and experts, and the reliability of the questionnaire assessed
through Cronbach’s coefficient were 0.86, 0.85, and 0.76, respectively.To analyze data, the
statistical methods such as single‑variance t‑test, regression analysis, correlation coefficient,
Kolmogorov–Smirnov test, and Multivariate Analysis of Variance (MANOVA) were used.
Findings: The findings of research demonstrated that the organizational damage based on
six box model was seen only in the reward component at the Isfahan University of Medical
Sciences. Mental health of persons in the sample group of Isfahan University of Medical Sciences
was in the suitable status. There was a meaningful and positive interrelation between mental
health and attitude toward the organizational damages in the dimensions of communications,
useful merchandises, and attitude to change. However, no meaningful interrelation was seen
between aims, structure, leadership, and reward and mental health. There was no meaningful
difference between the averages of staffs’ attitude about their mental health per the demographic
properties. Conclusions: The results show that there was a meaningful and positive interrelation
between mental health and attitude toward the organizational damages in the dimensions of
communications, useful merchandises, and attitude to change. Therefore, managers should
focus on all parts of the organization and the pathology strengths and weaknesses in these areas.

Abstract Background: Today, social capital is a need in the society. Also, leisure time and physical
activities are among the most important productive sources of social capital, which have
been realized recently. This study aims to find the relationship between social capital and
physical leisure time of the faculty members of Isfahan University of Medical Sciences.
Materials and Methods: A descriptive correlation method was used in this study. Two
questionnaires were used for data collection. Social capital questionnaire is based on SCAT
Model. Also, leisure time questionnaire was made by the researcher for which face and content
validity was verified by experts. Reliability coefficients by using Cronbach’s alpha coefficients
were calculated as 0.92 and 0.82, respectively. Sample population was calculated by Cochran’s
formula, and 150 people were selected as the sample using multiple cluster sampling by taking
the sex and college into consideration as the variables. Findings: According to the findings,
there was a direct relationship between a combination of social capital parameters (including
commitment, attitude, trust, participation, mutual relationship, social norm, and unity) and
the way of spending physical leisure time (R = 0.659, P = 0.000). Among the parameters,
“commitment” was significant with a beta coefficient B = 0.293 and P = 0.044 and social norms
was significant with a beta coefficient B = 0.196 and P = 0.047, but the rest of the factors
were not significant. Conclusion: Playing sport and doing physical activities in the leisure time
and also taking part in group activities and their membership provide a situation for people
to respect the group interests through communication. Such activities can cause the level of
social capital and its factors to be increased.

Abstract Background: Adolescence is associated with so many changes, and to provide sexual health it
is necessary for teenagers to learn enough knowledge about the changes and appropriate health
behaviors. The attraction of sexual issues in teenagers is associated with more conversations
related to sexual matters. Therefore, this study has evaluated the effect of organizing these
interactions using peer education in schools on the knowledge and attitude toward sexual health.
Materials and Methods: This was an interventional study conducted on 282 girl teenagers
from high schools of Isfahan that were divided into two groups of intervention and control.
Peer education in the intervention group was done through 35 trained teenagers during normal
communications in school. Before the training knowledge and attitude of students in both
groups were evaluated; then peer education was conducted during 6 weeks through normal
communications on the intervention group and then afterward the knowledge and attitude of
the students were evaluated again. To analysis of data independent t‑test and paired t‑test were
used. Results: The results showed that the mean score of knowledge and attitudetoward all
sexual health dimensions during puberty in the intervention group was significantly higher after
the intervention (P < 0.05). In addition, there was a significant difference between the mean
score of knowledge and approach toward all the aspects of sexual health of both the studied
groups. Conclusions: The results showed that using peer education in schools informally could
enhance the knowledge and approach toward aspects of physical health, sexual behaviors,
and social and mental changes among female adolescences and could be applied in schools.

Abstract Introduction: Mass‑media campaigns such as, “Change4Life’ in the UK and “get
active America” in the US, promote physical activity (PA) recommendations of at least
150 min/week of moderate‑to‑vigorous PA (MVPA). We investigated whether different
messages used in MVPA campaigns were associated with intention to engage in more
MVPA. Materials and Methods: Theory of planned behavior (TPB) constructs; subjective
norms, affective attitudes, instrumental attitudes and perceived behavioral control (PBC)
were applied to explain the associations between campaign messages and intentions to
engage in more MVPA. Results: A total of 1412 UK adults completed an online survey on
MVPA and TPB. The sample was 70% female and 93% white with 23% reporting meeting PA
guidelines. Participants received one of three messages: A walking message either with or
without the 150 min/week threshold (WalkT; WalkNT); a physiological description of MVPA
with the 150 min/week threshold (PhysT). ANCOVA examined group differences in intention.
Path analysis evaluated mediation by TPB variables. ANCOVA identified lower intentions to
increase MVPA in group PhysT relative to WalkT and WalkNT (P < 0.001). PBC mediated
this relationship in WalkT (β = 0.014, 95% confidence interval [CI] = 0.004–0.028) whereas
affective attitudes mediated this relationship in WalkNT (β = 0.059, 95% CI = 0.006–0.113).
Conclusions: Campaigns promoting MVPA guidelines need to choose their messages carefully.
Messages which exemplified MVPA through walking were associated with higher intentions to
increase MVPA than messages using a physiological description. Further, PBC was enhanced
when the 150 min/week threshold was promoted alongside the walking exemplar. Future
exemplars should be investigated to inform adults how to meet MVPA guidelines.

Abstract Background: Information literacy is the basis for lifelong learning. Information literacy skills,
especially for student in an environment that is full of information from multiple technologies
are being developed is equally important. Information literacy is a set of cognitive and
practical skills and like any other science, proper training is needed, and standard‑based
education is definitely better and evaluation would be easier. This study aimed to determine
the impact of information literacy training course on information literacy skills of Isfahan
University of Medical Sciences students based on ACRL standard in 2012. Materials and
Methods: The study method is semi‑experience with two group design (with pre‑test and
post‑test) and applied. The data collection toll was a questionnaire assessing student’s
information literacy that developed by Davarpanah and Siamak and validity was confirmed
by professional librarians and reliability as measured by Cronbach’s alpha, was 0.83. The
sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences
that by random sampling method was perch in both case and control groups. Before and
after the training (once a week), a questionnaire was distributed between the two groups.
This training was held in a classroom equipped with computers with internet access and in
addition to training using brochures and librarian presentation, interactive methods such as
discussion and exercises were used. The data were analyzed using SPSS version 20 software
and two level of descriptive (mean and SD) and inferential statistics (t‑test and t‑paired).
Results: The results showed that the students’ information literacy scores before the training
was lower than average, so that in the control group was 32.96 and in the case group was
33.24; while information literacy scores in the case group significantly increased after the
training (46.68). Also, the effect of education, respectively had a greater impact on the ability
to access information (the second standard), ethics and legal use of information (the third
standard), effective use of information (the fourth standard), critically evaluate information and
its sources (the fifth standard). Conclusion: This study showed that the training was effective
on enhancing students’ information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of
object recognition, there is a need for more training in this area.

Abstract Introduction: Assessment of students’ perspective is an essential element in effective educational
quality evaluation. By identifying strengths and weaknesses, it leads to improvement in future
performance. Methods: This cross‑sectional study was performed through a questionnaire
comprising 23 questions. Reliability was assessed using α‑Chronbach (α =0.87), and validity
was confirmed by a group of five experts. Tukey test, Pearson correlation coefficient, and two
sample t‑tests were used for data analysis. Results: A total of 168 answered questionnaires
were entered in our study. Maximum satisfaction in most items was shown in removable
prosthodontics and orthodontics departments whereas oral surgery and comprehensive
treatment departments acquired the least scores. In all departments, personnels’ respectful
attitude had the highest score whereas minimum grade was given to stressful workload
and overall satisfaction in each department. In comparison with a similar study, conducted
3 years ago, level of satisfaction was raised for orthodontics and removable prosthodontics
departments though it was declined for the pediatrics department. Conclusion: The special
cadre of clinical instructors comprising both experienced and young members is considered
as an important factor leading to high student satisfaction in the orthodontics department.
Promotion of a removable prosthodontics department is related to the high relevance between
the implemented educational program and the curriculum. The moderate performance of oral
surgery and restorative departments is indicative of the need for more attention from ministry
authorities to major dental departments such as oral surgery, endodontic, restorative and
periodontics, in order to increase the students’ scientific capability in these fields.

Abstract Introduction: Noncommunicable diseases are recognized as the major cause of old
people’s death. One of the models concerning the family health level is the family‑centered
empowerment model (FCEM) which has been designed with the aim of promoting the health
level and self‑esteem of the patients and their family members. Purpose: This study was
carried out to investigate about the effect of implementation of FCEM on the self‑esteem of old
people with high blood pressure. Settings and Design: This was a clinical trial study which
focused on 62 old adults with high blood pressure in 1392. After cluster sampling, samples
were divided randomly into test group and control group. Methods: FCEM was used for
the test group; whereas, for the control group, common health cares and one educational
session were performed. Study materials were checklist of demographic information, and
a researcher‑made questioner to evaluate the level of self‑esteem. Posttest was given
1‑weak after the intervention and was followed‑up 1½ months later. Statistical Tests: T‑test,
analysis of variance, and SPSS 20 were used to analyze the date. Finding: Before the
intervention, the mean scores of self‑esteem in both the test group and the control group
were the same (t = 0.55) (P > 0.05). However, 1‑week after the intervention (t = 6.38) and
1½ months later, meaningful differences were observed in the test group (P < 0.001).
Conclusion: Implementation of FCEM has a positive effect on the high self‑esteem of the
old people with high blood pressure.

Abstract Introduction: Health and healthy human being as a core concept of nursing have attracted
considerable attention in the Western literature but have received less attention in the context
of Eastern philosophy contexts. Methods: This study was done based on philosophical inquiry;
this method could be accomplished by means of different approaches like philosophical analysis
through concept analysis. There are different methods for concept analysis. Mors’s method
was employed to analyze the concept of health and healthy human being, we sought to clarify
them according to ideas deriving from the Islamic thought. To achieve the research objective,
Islamic texts were studied and analyzed based on the criteria of concept analysis (definition,
attributes/characteristics, and beaneries). Results: Our analysis revealed in the Islamic
thought human being is an integrated entity. Therefore, his health not only consists of each
single dimension, but also the full health together with the health of society gets meaning in
a balanced and coordinated set. Conclusion: Based on the results, in this study, there are
a series of similarities and differences with the perspectives of health in Islamic thought and
holism paradigm available in nursing.

Abstract Aims: The aims of this study were to determine fluoride concentration in drinking water and staple
foods consumed by residents of Dayyer port (Bushehr province, south of Iran) and to assess its
health risk via human intake in 2013. Materials and Methods: Health risk assessment due to
fluoride exposure via consumption of drinking water, date, vegetables and fish was conducted
in spring and summer of 2013 using the US‑EPA (United States—Environmental Protection
Agency) method, which considers hazard quotient (HQ) as a ratio of the estimated dose of a
contaminant to the reference dose. A fluoride ion‑selective electrode (ISE) measured the fluoride
contents of food samples. The sodium‑2‑(parasulfophenyl largo)‑1,8‑dihydroxy‑3,6‑naphtnalene
disulfonate colorimetric method (SPADNS) was used to determine fluoride concentration in
water samples. Results: The total estimated oral intake of fluoride for children in summer and
spring were 120.6 and 145.6 µg/kg/day, respectively. These values for adults were 99.2 and 112
µg/kg/day. This survey demonstrated that drinking water was the most important contributor of
dietary fluoride intake in the study area. Conclusion: HQ values for adults and children were >1
which approves that a potential health risk of fluorosis can exist. The recommendations for the
study area are supplying drinking water from alternative sources and defluoridation of drinking
water by an adsorption technique and membrane filtration, respectively. Furthermore, people are
suggested to have a good nutrition (especially rich of vitamin C) to reduce the risk of fluorosis.

Abstract Background: To have high‑quality primary health care services, an adequate doctor–patient
communication is necessary. Because of time restrictions and limited budget in health system,
an effective, feasible, and continuous training approach is important. The aim of this study is
to assess the appropriateness of a communication skills training program simultaneously with
routine programs of health care system. Materials and Methods: It was a randomized field
trial in two health network settings during 2013. Twenty‑eight family physicians through simple
random sampling and 140 patients through convenience sampling participated as intervention
and control group. The physicians in the intervention group (n = 14) attended six educational
sessions, simultaneous organization meeting, with case discussion and peer education method.
In both the groups, physicians completed communication skills knowledge and attitude
questionnaires, and patients completed patient satisfaction of medical interview questionnaire
at baseline, immediately after intervention, and four months postintervention. Physicians and
health network administrators (stakeholders), completed a set of program evaluation forms.
Descriptive statistics and Chi‑square test, t‑test, and repeated measure analysis of variance
were used to analyze the data. Results: Use of routine program as a strategy of training was
rated by stakeholders highly on “feasibility” (80.5%), “acceptability” (93.5%), “educational
content and method appropriateness” (80.75%), and “ability to integrating in the health
system programs” (approximate 60%). Significant improvements were found in physicians’
knowledge (P < 0.001), attitude (P < 0.001), and patients› satisfaction (P = 0.002) in intervention
group. Conclusions: Communication skills training program, simultaneous organization meeting
was successfully implemented and well received by stakeholders, without considering extra time
and manpower. Therefore it can be a valuable opportunity toward communication skills training.

Abstract Context: Breast cancer is the most common cancer among Iranian women. Although survival
rate of breast cancer patients has been increased some distresses affect the patients’ quality
of life negatively. the effectiveness of self‑care education, particularly in the sociocultural
context of Iran, has not been adequately investigated. Aims: This study aims at evaluating
the effectiveness of nurse‑led self‑care education program on quality of life in this patients.
Settings and Design: A controlled trial as pretest and posttest design was conducted in
Sayyed‑Al‑Shohada Hospital in Isfahan in 2012. Materials and Methods: Sixty patients with
breast cancer were assigned to either the nurse‑led self‑care education program (n = 30),
or to routine care (n = 30). Quality of life was measured at the time of recruitment and also
3 months after the intervention by the instrument of the National Medical Center and Beckman
Research Institute. Statistical Analysis Used: Data were analyzed by SPSS (version 16)
software using T‑independent, T‑paired and 2
, and Fisher’s exact tests. Results: The
intervention group had significantly greater improvements in quality of life status (P < 0.05).
Furthermore, self‑care education caused a significant increase in the quality of life score related
to physical (P = 0.00), psychological (P = 0.00), social (P = 0.00), and emotional (P = 0.00)
dimensions. Conclusions: Quality of life in patients with breast cancer can be improved by
participating in a nurse‑led self‑care education program. It is suggested that self‑care education
to be added to the routine nursing care delivered to these patients.