Journal of Education and Health Promotion

Abstract Introduction: Although hemodialysis is therapeutic, it causes numerous physical and
psychological tensions, which affect the quality of life of patients. Assessing the quality of
life helps to consider clients’ problems; basically, the relationship between depression and
quality of life of patients has been observed in this study. Materials and Methods: This was
an analytic–descriptive study in which the patients received hemodialysis in Chaharmahal
and Bakhtiari province. They were monitored through census method. The data collection
instrument was questionnaires consisting of demography, Beck Depression Inventory, and
WHO Quality-of-Life Questionnaire. The obtained data was analyzed by SPSS (Version 15) and
Mann–Whitney test, Chi-square test, and t-independent test. Results: Ninety-five men and 76
women (171 totally) receiving hemodialysis treatment participated in the study. Chi-square test
showed a significant relationship between depression and quality of life of these patients (P <
0.05). Discussion: Considering the present study results, it is essential to take into account
depression level and quality of life in planning their care programs.

Abstract Objectives: Critical thinking is an important outcome criterion of higher education in any
discipline. Medical and paramedical students always encounter with many new problems in
clinical settings and medicinal laboratory, and critical thinking is an essential skill in obtaining a
better approach for problem solving. We performed a pre-and post-test to evaluate the change of
critical thinking skills in medical sciences students who enrolled in Isfahan University of Medical
Sciences in Iran during the academic years 2008-2010.Methods: In a longitudinal design
study, the critical thinking skills were compared in medical sciences students in two sequential
semesters using the California Critical Thinking Skills Test. The test is divided into two parts
(parts 1 and 2), including 17 items in each part. Based on proportional stratified sampling, a
groups of students (group 1, n=159) were selected from the university population, who enrolled
in medicine, pharmacy, nursing, and rehabilitation colleges. The students in group 1 were
asked to complete the part 1 of the test (phase I). After one semester, another group (group 2,
n=138) from the same population was randomly selected, and they were asked to complete
the part two (phase II). The students’ demographic data also were recorded. The California
critical thinking skills test was translated and it validity and reliability were approved before.
Results: No significant difference was observed between the two groups in the demographic
data. The students critical thinking scores in phase II significantly reduced in comparison
with phase 1 (p<0.05). The phase II scores in subdivisions of analysis, inference, inductive
reasoning, and deductive reasoning also failed to demonstrate improvement. Conclusion: It
seems curriculum reform is necessary to improve the students’ critical thinking.

Abstract Introduction: Regular physical activity has positive effects on physical, mental and social
aspects of individual and community health. Considering the prevalence of noncommunicable
diseases such as primary hypertension, osteoporosis and cardiovascular diseases for which
sedentary lifestyle is a responsible factor, health policy makers have planned to encourage
people to do more physical activities. Development of beneficial health habits during childhood
and early adolescence are very important because the behaviors, which start at adolescence
tend to continue into adulthood, too. This study aimed to determine the effect of educational
intervention on physical activity-related knowledge, attitude and behavior of the first grade
students in male high schools of Bavanat in 2010. Materials and Methods: In this prospective
experimental study, after selecting two qualified schools from five high schools, all students of
one school (two classes including 42 individuals) were randomly assigned to the experimental
group and all the students of another high school (two classes including 43 individuals) were
randomly assigned to the control group. The data gathering tool was a 4-section questionnaire
which included demographic questions, knowledge- and attitude-related questions and the
questionnaire of physical activity performance. The first three sections of the questionnaire
were the researcher-designed and validated by face and content validity. Test-retest and internal
consistency (Cronbach’s Alpha) methods were used to determine the reliability of knowledge
questionnaire and attitude questionnaire, respectively. For the measurement of physical activity
behavior, a self-reporting questionnaire (valid and reliable Garcia scale) was used in this study.
After conducting the pretest, the educational intervention was done for the experimental group.
Post-tests were conducted immediately and 1 month after intervention. The collected data were
analyzed using SPSS18 statistical software (independent t-test, paired t-test, chi-square, MannWhitney test and repeated measures ANOVA). The participants voluntarily and consciously
participated in this study. Results: The findings indicated no significant differences between the
groups in terms of mean scores of knowledge
(P = 0.934), attitude (P = 0.155) and behavior
(P = 0.387) before the intervention. There
was a significant difference between mean
scores of knowledge in the immediate
follow-up (P< 0.001) and 1 month after
intervention follow-up (P < 0.001), and also
between mean scores of attitude immediately
(P < 0.001) and 1 month after intervention
(P = 0.01) follow-ups in the experimental
group compared with the control one. Mean
scores of physical activity 1 month after the
intervention in both experimental and control groups significantly increased (P < 0.001, P = 0.01, respectively), but the mean scores of
physical activity between two groups were not significantly different (P = 0.390). Discussion and
Conclusion: The results indicated the effectiveness of educational intervention, consequently
increased knowledge and improved attitude of students, in the experimental group compared
with the control one in terms of physical activities; thus, physical activity behavior of intervention
group increased. Although the mean scores of physical activity in the control group significantly
increased, other studies should be done which can control and consider confounding variables.

Abstract Introduction: The elderly are vulnerable to negative effects of stress factors; so, the present
study was conducted to determine the effect of educational intervention based on the PRECEDE
model on stress level of the elderly and to control stress factors. Materials and Methods: In
this quasi-experimental study, 94 elderly people from the clubs for the elderly in Tehran were
randomly divided into case and control groups in 2008–2009. Planning for the educational
program was done according to the PRECEDE model. Before implementing the program,
valid and reliable depression, anxiety, and stress questionnaires (DASS 21) were completed
for both groups. The experimental group received the educational intervention based on the
PRECEDE model (eight sessions, one session per week), and both groups were followed up
two months after the intervention (the previous questionnaires were filled again). DASS 21
Scoring and Interpretation Generator was used for calculating scores of the questionnaires.
Finally, the data obtained were analyzed by the SPSS 15 software using t-test, paired t-test, and
Mann-Whitney test at a significant level of P≤0.05. Results: The findings showed significant
differences between the experimental group and control group in terms of predisposing
factors of knowledge (P≤0.001) and attitude (P≤0.001), enabling factors (P≤0.001), reinforcing
factors (P≤0.001), and functioning especially in deep breathing and relaxation techniques
(P≤0.001). Mean scores and severity of stress were significant after the intervention (P≤0.001).
Conclusion: The findings of the present study confirmed the effectiveness of the PRECEDE
model-based educational program on preventing or reducing stress level in the elderly.

Abstract Background: Healthy nutrition is very important considering the weight status especially in
children. The aim of this study was to assess the relationship between junk foods intake and
weight in 6-7-years old children. Materials and Methods: This cross-sectional study was
carried out in Shahin Shahr and Meymeh, Iran, in 2009. Anthropometrics measures were
done and 24-hour food recall used for dietary information and analyzed with food processor
2 and then compared with dietary reference intakes 2008 (DRI). Findings: 61.1 percent of the
subjects were residing in dormitories and 12.7 percent were marred. Prevalence of overweight
or obesity and abdominal obesity was 6.9 percent and 46.1 percent respectively. Mean (±SD)
systolic blood pressure was 105.2 ± 15.6 mm/Hg and diastolic was 62.2 ± 10.4 mm/Hg.
Totally, 3.9 percent of the subjects had hypertension. The analysis of food intake indicate that
(B12, folate, magnesium, potassium, calcium) with level below the recommended ones, and
(vitamin C, E, pantothenic acid, B1
, B3
, phosphate, zinc) with up levels the recommended
ones, and energy intake, macronutrient, vitamin A, pyridoxine, iron, selenium were in general
appropriate. Conclusion: These results indicated appropriate level of macronutrients intake
and unbalance mainly existed in micronutrients. It is recommended to increase intake important
food groups such as dairy, vegetable, fruit that include good source of micronutrients, and
also it is suggested that need for strategies can improve competence in the area of nutrition.

Abstract Background: Healthy nutrition particularly the energy intake and the essential nutrients in
female students is very important. This study aims to assess micro- and macronutrient intakes
in female students of Isfahan University of Medical Sciences, Iran. Materials and Methods:
This cross-sectional study involved 100 female students aged between 18 and 25 years in
2008–2009. Anthropometrics measures were performed and two 24-hours food recalls were
used to collect the dietary information and were analyzed using food processor 2 and compared
with the dietary reference intakes (DRIs) 2008. Findings: As many as 61.1% of subjects resided
in dormitories; 12.7% were married. Prevalence of overweight or obesity and abdominal obesity
in the subjects studied were 6.9% and 46.1%, respectively. The mean (±SD) systolic blood
pressure was 105.2 ± 15.6 mmHg and the diastolic was 62.2 ± 10.4 mmHg. Totally, 3.9% of
the subjects had hypertension. Food intake analysis indicated that B12, folate, magnesium,
potassium, and calcium were below the recommended level, and vitamin C, E, pantothenic
acid, B1
, B3
, phosphate, and zinc were above, and energy intake, macronutrient, vitamin A,
pyridoxine, iron, and selenium were, in general, adequate. Conclusion: The findings of the
study indicated that macronutrients intake was appropriate, but the problem mainly existed
in the consumption of micronutrients. It is recommended to increase the intakes of important
food groups such as dairy, vegetable, and fruit that are proper sources of micronutrients, and
it is also suggested to improve strategies and the competence in this area of nutrition.