Journal of Education and Health Promotion

Abstract Background: Considering the effect of socio-economic factors on the emergence of chronic
diseases and the importance of this aspect of diseases for policy makers and authorities of
health care organizations, this study tried to investigate the role of these factors in type 2
diabetes and its consequences, which can be used in health policy making for preventing
from this disease. Materials and Methods: This descriptive-analytical study was conducted
on 384 diabetic patients who were admitted to a diabetes center in the city of Isfahan. The
participants were selected using simple random sampling. A questionnaire with 42 questions
was used for gathering the data which were analyzed using chi-square and Fisher’s statistical
tests. Results: The studied population consisted of 52.1% male and 47.9% female participants.
There was a statistically significant relationship between diabetes complications, age group,
educational level, job status, relationship with family members, number of family visits and
the reassurance provided by the family, type of leisure time activities, health status, years with
diabetes, smoking, type of treatment, fried food consumption and income (P < 0.001), sense
of security and communication in living environment (P < 0.002) and daily intake of vegetables
(P < 0.02). Conclusion: It seems that the application of supportive resources and secondary
strategies is an essential issue in the patients with chronic diseases, particularly diabetes.
Empowering strategies can induce basic changes in order to increase positive expectations,
hope, self-esteem and self- confidence in patients; this is the exact strategy which must be
used to efficiently control diabetes and its different types of complications among patients.

Abstract Background: Health promoting lifestyle (HPL) focuses on life promotion through lifestyle
which consists of six aspects of “physical activity”, “nutrition”, “health responsibility”, “spiritual
growth”, “interpersonal relations” and “stress management”. This lifestyle promotes health
and welfare and induces satisfaction, self-persuasion and self-improvement. Considering
the importance of the way a new behavior affects “life quality” as a motivational factor for
starting and continuing that behavior, this study aimed to determine the relationship between
health-promoting lifestyle and its aspects. Materials and Methods: This cross-sectional
study was performed on undergraduate students at School of Health, Isfahan University of
Medical Sciences, using a census method. Health promoting lifestyle was measured by Health
Promotion Lifestyle Profile two and life quality was assessed by the Persian version of QLQ-C30
questionnaire. Data analysis was conducted using descriptive and inferential statistical tests
in SPSS. Results: Mean age of the participants was 21.12 years old. From among six aspects
of health promoting behaviors, spiritual growth and responsibility with the means of 22.01 ±
2.224 and 20 ± 2.31 had the highest and physical activity with the mean of 17.58 ± 2.9 had the
lowest scores, respectively. General life quality of 40.7% students was good and only 19.8% of
them had an average global life quality. The highest and lowest frequencies of health-related life
quality belonged to very good (58.6%) and excellent (9%) health, respectively. Except for stress
management (P = 0.05) and gender of the students, there were no significant relationships
between other HPL aspects and gender. There was no statistically significant relationship
between global life quality of students and nutrition, physical activity, self-health responsibility
and stress management while there was a significant relationship between global life quality
and spiritual growth of the students. Health-related life quality and stress management were
significantly related to each other; however, no statistically significant relationship was observed
between health-related life quality and nutrition, physical activity, interpersonal relations and
spiritual growth. Conclusion: There is a significant relationship between adopting health
promoting lifestyle and aspects of spiritual growth and stress management on the one hand
and general quality of life on the other, at least among students.

Abstract Introduction: Teachers are one of the most influential groups in elevating social health, and their
teaching nutritional points to the students can both affect students’ awareness and the transferring
of such nutritional education to the families. This study was undertaken tosurvey the influence of
nutrition and nutritional health education on the awareness of female elementary school teachers.
Materials and Methods: Fifty‑seven female elementary school teachers were chosen from the
Ferdows City for this quasi‑experimental study. Prior to the outset of the educational workshop,
they were asked to fill out a questionnaire about nutrition and nutritional health, which was followed
by the two‑day workshop. After two months, they were given a second questionnaire. The results
were analyzed by paired t‑test, ANOVA, and McNemar. In all the tests, a significance level a = 0.05
was considered. Results: Findings of the study showed that the mean score of awareness before
interference was 10.98%, which reached up to 18.2% after the interference (P< 0.001). With regard
to theimportance of breakfast intake, the teachers’ awareness increased from 57.9 to 98.2% from
before to after intervention, respectively. Conclusion: Applying interventional methods of education
in teacher training centers in conjunction with medical and educational centers, with regard to
nutrition and nutritional health, can elevate the health of students.

Abstract Background: Breastfeeding depends on social and cultural conditions of societies. Behavior,Attitude,
Subjective Norms, Enabling Factors (BASNEF) model is one of the comprehensive models of
behavior study, especially in developing countries. This study was performed to investigate the
status of breastfeeding during the first two years of infants’ life and its risk factors through BASNEF
model structures. Materials and Methods: In this cross‑sectional descriptive‑analytical study, 406
mothers with 6-24‑month‑old babies were selected by multistage cluster sampling method. The data
were collected using a questionnaire with five sections based on the BASNEF model structures.
Demographic characteristics of the studied population were also recorded and analyzed using
Chi‑square tests and analysis of variance in SPSS18 statistical software. Results: The prevalence of
breastfeeding was 86.4% (351 mothers). Three hundred and thirty three mothers (82%) had good
knowledge and there was a significant relationship between knowledge and breastfeeding behavior
of mothers (P < 0.05). Two hundred and eighty five mothers (70.2%) had good and very good
attitude in this regard. There was no significant relationship between attitude and breastfeeding
behavior of mothers (P > 0.05). There was a significant relationship between breastfeeding behavior
of mothers and subjective norms of husbands, mother and mother‑in‑law (P < 0.05); however, no
significant relationship was found with regard to enabling factors (P > 0.05). Moreover, no significant
relationship was observed between type of children nutrition and variables of delivery mode,
maternal age and number of children (P > 0.05). Conclusion: In addition to knowledge of nursing
mothers, supports and encouragement of husbands, mothers and mother‑in‑laws, as subjective
norms of behavior, have a positive impact on
the breastfeeding behavior of mothers. Thus,
breastfeeding programs should pay more
attention to the role of these mentioned factors.

Abstract The core part of evidence‑based medicine (EBM) is the ability to critically appraise published
articles on a given subject. Medical students, especially within the developing world, usually
do not learn how to critically appraise a published article since this is not part of their designed
curriculum. This paper is reporting an innovative approach on how to teach critical appraisal
skills to medical students, from an Iranian Medical School.

Abstract Context: The Medical Records Department (MRD) is an important source for evaluating and
planning of healthcare services; therefore, hospital managers should improve their performance
not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is
a tool in the management system that enables organizations to correct operational functions
and provides feedback around both the internal processes and the external outcomes,
in order to improve strategic performance and outcomes continuously. Aims: The main
goal of this study was to assess the MRD performance with BSC approach in a hospital.
Materials and Methods: This research was an analytical cross-sectional study in which data
was collected by questionnaires, forms and observation. The population was the staff of the
MRD in a hospital in Najafabad, Isfahan, Iran. Statistical Analysis Used: To analyze data,
first, objectives of the MRD, according to the mission and perspectives of the hospital, were
redefined and, second, indicators were measured. Subsequently, findings from the performance
were compared with the expected score. In order to achieve the final target, the programs,
activities, and plans were reformed. Results: The MRD was successful in absorbing customer
satisfaction. From a customer perspective, score in customer satisfaction of admission and
statistics sections were 82% and 83%, respectively. Conclusions: The comprehensive nature of
the strategy map makes the MRD especially useful as a consensus building and communication
tool in the hospital.