Journal of Education and Health Promotion

Abstract Background: Spiritual well‑being is well‑recognized as a factor that affects cancer patients’
quality of life, quality of care, and satisfaction. There is evidence that supports the fact that
patients’ spiritual needs are associated with better quality of care, higher hospice utilization,
and less aggressive care at the end of life. However, few studies have examined the Spiritual
well‑being (SWB) in cancer patients. Less is known about spirituality; furthermore, no published
research about SWB and its relationship with demographic parameters in breast cancer
patients exists; this made us carry out this project. Materials and Methods: This cross‑sectional
study was a descriptive – analytical one, conducted on 297 breast cancer patients, with
a simple sampling methodology. The data collection instrument included a questionnaire
containing two parts (demographic information and standard SWB Scale questionnaire). The
data were analyzed with 95% confidence by SPSS18, using descriptive and analytic statistics.
Results: According to the results of the present study, SWB of most of the study subjects (52.52%)
was at a moderate level. Results showed that the average score for religious aspect of spiritual
well‑being (RWB) was 51.38 ± 8.17 for 60, average score for the existential aspect of spiritual
well‑being (EWB) was 42.47 ± 10.21 for 60, and the total score of SWB was 93.69 ± 10.04 for 120.
Based on the study findings, there was a statistically significant correlation between the SWB and
age (P = 0.03, r = 0.59), educational level (P = 0.04, r = −0.58), and marital status (P = 0.001), of
breast cancer patients. Conclusion: According to the results of the present study, the SWB of
most study subjects was at a moderate level. Furthermore, according to the results there was a
correlation between some important demographic parameters in women with breast cancer and
SWB. Hence, it is necessary for the treatment team to assess and improve the SWB of patients;
meanwhile the role of nurses is highlighted. In fact, the nurse is the first person who can recognize
the spiritual needs of a patient and even his/her family, and can be effective in meeting the spiritual
needs and improving their SWB. Therefore, it is strongly recommended that in patients with cancer,
a holistic care plan, based on spiritual care, development, and education of patients be applied, as
it is considered to improve their SWB.

Abstract Background: The World Health Organization (WHO) produced the Ottawa Charter for Health
Promotion (HPH) back in 1986. Then expressed the Budapest Declaration of Health Promoting
Hospitals and after determined standards for reorienting hospitals towards health promotion So,
this study evaluated Iranian hospitals based on WHO‑HPH standard. Materials and Methods: This
study was a descriptive ‑ analytical survey in selected hospitals of Iran (38 hospitals from 5
provinces). Method of data collecting was through review of documentation related to each of
the standards. WHOs self‑assessment tool for health promotion was used. Result: Overall the
mean score of health promotion standard in the state hospital was 54.1 ± 15.1 that means the
private hospitals have higher score. In general, patient information and intervention standard
had the highest score (70. 8 ± 8. 1) both in private and government hospitals and the patient
assessment standard had the lowest score (44. 2 ± 20.1). Conclution: Hospitals must design
a specific system for improving and evaluating health promotion in order to encourage
policy‑makers and health service administrators to invest resources.

Abstract Background and Aim: Emotional intelligence (EI) theory provides a view about predicting
effective factors in people’s lives whether in education or profession. According to earlier
studies, people who have higher emotional skills are more successful in many of life aspects
:e.g., reaction to stress and controlling stress situations. Since students are the future of society,
this study was carried out to evaluate the relationship between EI and education stress in the
students of Birjand University of Medical Sciences (BUMS). Materials and Methods: In this
cross‑sectional study, 260 students were selected by proportional sampling in four faculties:
Medicine, Nursing and Midwifery, Paramedical Sciences, and Health. Data were collected
using two questionnaires: The standardized EI Shering’s (33 questions, five domains) and the
Student‑Life Stress Inventory (57 questions, nine domains). The obtained data were analyzed
by independent t‑test, Pearson’s correlation coefficient, and linear regression at the significant
level of α = 0.05. Results: Totally, 65.8% of participants were females and 31.1% were males.
The educational level of the participants included Associate’s degree (44.6%) Bachelor’s
degree in science (31.2%), and medical science (23.1%). There was no significant correlation
between EI scores and educational stress in students. But there was a significant relationship
between EI with sex (P = 0.02) and mean of EI scores with three domains of academic stress:
Personal favorites (P = 0.004), reaction to stressors (P = 0.002), and performance in stressful
situations (P = 0.001). Conclusion: Although EI growth in different individuals can promote
their success, it cannot decrease academic stress by itself which was particularly significant
in females. Therefore, other causes of stress such as individual differences must be taken into
consideration.

Abstract Background and Aim: Adolescents’ overweight problems have been paid much attention due
to their significant increase in recent decades in developed countries. Poor eating patterns
subsequently affect their self‑efficacy and self‑concept. Therefore, paying attention to the
nutritional knowledge of overweight students in this period is essential. This study examines the
relationship between self‑efficacy, self‑concept, and nutritional knowledge of overweight students
in the city of Isfahan. Materials and Methods: The 140 overweight students who participated in
this descriptive, analytical study with were randomly selected from one of five areas of Isfahan
city in the year 2011‑2012. Questionnaires for data collection in this study included demographic
form, nutrition knowledge, Cooper Smith self‑esteem, and general self‑efficacy questionnaire.
Data were analyzed by ANOVA, regression, and Pearson’s correlation coefficient with statistical
package in social sciences version 18. Results: There was a significant correlation between
whole nutritional knowledge and self‑efficacy (r = 0.29, P > 0.001) and self‑concept (r = 0.26,
P = 0.002). There was a significant correlation between self‑efficacy and self‑concept (r = 0.3,
P = 0.001). Furthermore, in the selection of food section there was no significant correlation with the
self‑concept (r = 0.147, P = 0.083). Regression analysis between self‑concept, self‑efficacy, family
dimension, father’s education, mother’s education, father’s occupation, mother’s occupationa
and income with nutrition knowledge showed that these eight variables explain 17.7% of the
variance in health behaviors totally. Conclusion: By conducting this study, and revealing the direct
relationship between nutritional knowledge, self‑concept, and self‑efficacy, we could conclude
that if nutritional knowledge of overweight students is promoted, this factor would lead to an
increase their self‑concept and self‑efficacy in order to adopt healthy behaviors and have the
expected healthy eating and healthy life‑style.

Abstract

Abstract Introduction and Goal: In diseases and disorders such as diabetes, treatment and disease
management depends mostly on patient’s performance. So, self‑care is very important in these
patients and they can affect their own welfare, functional capabilities, and disease processes by
achieving self‑care skills. Nowadays, we know that self care follows individual, psychological
and social factors which its recognition can assist health care providing systems to carry out
educational programs. This study aimed to investigate the role of perceived benefits and barriers
in doing self‑care behaviors among diabetic patients. Materials and Methods: This study is a
narrative review and articles with sectional, cohort, and interventional, clinical trial, qualitative
and narrative designs were chosen using databases and academic search engines such as
PubMed, SCOPUS, ProQuest, Elsevier and key words like self‑care diabetes, perceived benefits
and barriers. Persian articles were also selected using databases like IRANMEDEX, MEDLIB,
as well as searching the articles in sites of domestic scientific magazines. Results: Reviewed
articles’ findings show the average situation of perceived benefits and barriers in diabetic
patients regarding self‑care. Qualified blood sugar (glucose) control, weight control, happiness
feeling and expenses reduction are the most important perceived benefits. The most significant
perceived barriers in self‑care consist of lack of family support, shame feeling, forgetfulness
and not being able to ignore foods’ flavor. Conclusion: Perceived benefits and barriers, as
central constructs in some patterns and theories of behavior change, were related to self‑care,
so that it was directly related to perceived benefits and reversely related to perceived barriers.
Therefore, these two constructs can be considered as strategies for promoting self‑care
behaviors in diabetic patients.

Abstract Introduction and Aims: Diabetes is one of the chronic and prevalent diseases in the world.
Diabetic patients’ number has increased 7 times during last 20 years. If this current situation
continues, diabetic patients’ population will be 350 millions ones in 2030. It means that 7
millions people will be added annually. Up to now, different uncontrollable factors have been
monitored in self‑caring of this disease for managing and preventing from its early and late side
effects. This research is conducted to study the role of self‑efficacy as a determinant agent in
self‑caring of diabetic patients. Study Method: This is a narrative review study in which various
information banks and search motors such as PubMed, ProQuest, SCOPUS, Elsevier were
reviewed. Diabetes, self‑care and self efficacy keywords from cross sectional, cohort, clinical
experimental studies and systematic review were also used in the study construction. Iranian
Banks such as IRANMEDEX, MEDLINE and also different articles from domestic research and
scientific magazines were selected. Time spectrum of reviewed studies was supposed to be
published from 1990 up to 2011. Results: Self‑care situation among diabetic patients not only is
unsatisfactory but also the studies` results show that self‑efficacy rate is low among them. The
findings of the studies prove that there is a direct relation between self‑efficacy and self‑care
in the patients in a way that this construct owns the predictability power of self‑care behavior.
Conclusion: Self‑caring has a significant role in controlling of diabetes disease. Self‑efficacy
can induce motivation directly take health promoting behavior through efficacy expectations.
It also affects motivation, indirectly, through perceived barriers and determining commitment
or stability for following function map. So, self‑efficacy is very important in changing self‑care
behavior process.

Abstract Introduction: Holding bedside round teaching and involving patients in the teaching of the
students might lead to patients’ dissatisfaction. This study was carried out in order to find the
viewpoints of the patients and the medical team about the effect of clinical round on patients
hospitalized in Isfahan University of Medical Sciences. Materials and Methods: This study
is of cross‑sectional descriptive type which is carried out in Isfahan University of Medical
Sciences using researcher‑made tools. The statistical population included the hospitalized
patients, interns, residents, and nurses of the internal wards of educational hospitals. In this
study, 110 patients and 150 health team staff are participated. The analysis of the data was
done through software Statistical Package for Social Science (SPSS) 11.5 and descriptive
and inferential statistics were applied. Statistical analysis of the variance did not show any
significant difference among the interns’, nurses’, and residents’ perception of patient’s
satisfaction. Results: Generally, the patients had a positive viewpoint toward things happening
during a round, whereas the medical team’s viewpoint was negative. In both groups, the
highest satisfaction average pertained to the number of times and the duration of visits, but
both groups believed that lack of a definite responsible medical doctor, feeling of insecurity
during the incongruous and unclear discussions, and the level of respect for the patient were
the causes of dissatisfaction with the clinical round process. Conclusion: The current method
of clinical rounds can result in patients’ dissatisfaction. On the other hand, proper relationship
with them leads to the development of a more positive attitude in them. Therefore, revision and
correction of the current clinical round procedures and teaching the communication skills to
the medical team could help improve this process.

Abstract Introduction: Drug abuse, as a social phenomenon, is one of the health problems of
the present era. Inclination to drug abuse like other social phenomena is complex and
multi‑causal. Emphasizing on the psychological factors, the present study attempts to compare
the amount of depression, anxiety and stress between drug abusers and the comparison
group. Material and Methods: The research method is descriptive‑analytic and its design
is comparative. The population includes the youths of ages of 18‑29 (with and without drug
abuse behavior). The sampling is random and the sample size in drug abuser group is 183
and in the comparison group, it is 207 persons. The data collection instrument is questionnaire
of personal information containing 6 questions and the standard questionnaire is DASS‑21.
The data were analyzed through SPSS‑18 and statistic tests independent T, chi square,
Mann‑Whitney, and logistic regression analysis. Findings: The average age of the drug
abusers is 25.9 ± 2.96 years and the comparison group is 24.2 ± 3.36. The most amount of
methamphetamine is 75.9%. A significant correlation was observed between the education
level and drug abuse behavior (P < 0.001). The score of the stress, anxiety and stress in drug
abusers is more than the comparison group and this relationship was significant (P < 0.001).
Based on the logistic regression analysis results, anxiety has the highest correlation with drug
abuse behavior. Conclusion: The low level of education is an effective factor in drug abuse.
According to the strong correlation between psychological factors and drug abuse behavior,
it is necessary to suggest social plans of prevention and treatment of mental disorders.

Abstract Background: Health education for the school age child is a specialized field within the
broad discipline of education. Oral health education program are educational aspects of any
curative, preventive and promotional health activity. Aim: The study has been undertaken
to evaluate the impact of oral health education on the status of plaque, gingival health and
dental caries among 12 and 15 years old children attending government school in Shimla
city. Materials and Methods: Two hundred and seventy six school children participated in
the study. The study was conducted over a period of 4 months from May 2010 to August 2010
in Government Senior Secondary School, Sanjauli. Plaque, gingival and caries status was
assessed by using Silness and Loe plaque index, Loe and Silness gingival index and WHO
modified DMFT index, respectively. Data was analyzed using the software SPSS version 15.
Paired t‑test and Wilcoxon signed rank sum test were used appropriately for statistical
comparisons. P value ≤0.05 was considered statistically significant. Results: Overall mean
plaque score and gingival score decreased significantly after oral health education irrespective
of gender. However, decrease in plaque score among 15 years old female children and gingival
scores among 12 and 15 years old female subjects was not significant. Difference in mean caries
status was statistically insignificant among all the subjects. Conclusion: Short term oral health
education program may be useful in improving oral hygiene and gingival health. Coordinating
efforts should be enhanced between school personnel, parents and health professionals to
ensure long‑term benefits of such program.

Abstract Introduction: Plagiarism is defined as intentional deceiving or lack of honesty, which deprives
others from both material and spiritual possessions. Ethics is considered as one of the most
important aspects of evaluating the quality of higher education. Moreover, scientific ethics should
be reflected from university values, as a specialized institution, rather than being a reflection of
the others cares. Therefore, the main aim of the present study is explore of expert experiences
about plagiarism in Isfahan University of Medical Sciences. Materials and Methods: This study
employed qualitative method with using in‑deep interview. The research participants consisted
of 21, who tend to this work. Semi structure interview were conducted and recorded. The
method of analyzing data was ‘thematic analysis’. The data were transcribed and saved on
computer after each interview. Themes and sub‑themes were extracted. Finally, relevant
sub‑themes were arranged in a category and suggested were presented. Result: Analyzing
data showed 600 primary codes, 40 sub‑themes and 6 themes. The main themes included
repeated works, non‑normative adoption, non‑normative adaptation, shares distribution, forging,
and profit‑seeking, each of which consisted of one or several subgroups. Conclusion: The
findings of this study show that since, there are numerous ways of cheating, the universities’
research committees must create institutions in order to educate the individuals how to avoid
plagiarism. In addition, providing information about different types of scientific violations, as
well as their following punishments might lead to the decrease of such misbehaviors.

Abstract Background: Many changes have been made in different sciences by developing and advancing
information and communication technology in last two decades. E‑health is a very broad term that
includes many different activities related to the use of electronic devices, software as well as hardware
in health organizations. Aims: The aim of this study is comparing electronic health indicators in the
selected countries and discussion on the best indicators. Settings and Design: This study has
chosen 12 countries randomly based on the regional division of the WHO. The relevant numbers
of health indicators and general indicators and information technology indicators are extracted
of these countries. We use data from the Bitarf’s comparative study, which is conducted by the
Iranian Supreme Council of Information Technology in 2007. Materials and Methods: By using
Pearson correlation test, the relations between health general indicators and IT indicators are
studied. Statistical Analysis Used: Data was analyzed based on the research objectives using
SPSS software and in accordance with research questions Pearson correlation test were used.
Results: The findings show that there is a positive relation between indicators related to IT and
“Total per capita health, healthy life expectancy, percent literacy”. Furthermore, there is a mutual
relation between IT indicators and “mortality indicator”. Conclusion: This study showed differences
between selective indicators among different countries. The modern world, with its technological
advances, is not powerless in the face of these geographic and health disparity challenges.
Researchers must not rely on the available indicators. They must consider indicators like e‑business
companies, electronic data internet, medical supplies, health electronic record, health information
system, etc., In future, continuous studies in this field, to provide the exact and regular reports of
amount of using of these indicators through different countries must be necessary.

Abstract Background: Evaluation of fund of knowledge about SLD among kindergarten and primary school
teachers is essential to avoid misdiagnosis of SLD and to plan for specific teacher education to
enable early identification of SLD among children. Aim: To assess the knowledge of learning
disability among primary school teachers in India and to investigate its psychometric properties.
Materials and Methods: An observational study was carried out 34 primary school teachers from
2 different schools in Puducherry town agreed to participate in this study with informed consent.
We used a multiple choice questionnaire format with a total of 50 questions, 5 choices for each
question and a total score of 50. The study was held at the schools where these teachers were
employed using pen and paper testing method and data were entered into the computer for
statistical analysis. Statistical Analysis: Total scores on the questionnaire of all teachers were
calculated. Content validity, reliability coefficient, discrimination factor, and facility factor were
analyzed using SPSS software. Results: 29% of the questions were correctly answered by all
34 teachers. The mean total score for this sample was 14.50 ± 9 and total item score for the 50
items was 9.90 ± 4. Cronbach’s (α) reliability was 0.89. Overall discrimination index was + 0.2 and
facility factor analysis score was 0.26. Conclusions: Validation of this new screening questionnaire
was successful in Indian setting. It has to be used in other settings to extrapolate our findings.

Abstract Introduction: A favorable or unfavorable attitude about self was named self esteem. According
to Maslow theory to achieve quality of life and happiness, one must reach the gradual
fulfillment of human needs, including a high degree of own self‑esteem. Body dissatisfaction
is a negative distortion of one’s body which is especially mentioned by the women. Many
studies have shown links between self esteem, body dissatisfaction, health and behaviors. this
study intends to determine relationship between body satisfaction, self esteem and unhealthy
weight control behaviors between women. Methods: This cross‑sectional study was done
on 408 women employees in Isfahan University and Isfahan University of Medical Sciences
during 1390. They were chosen according to the stratified random sampling method. Inclusion
criteria were 1) willing to participate in the study and 2) lack of serious physical defect 3) not
being in pregnancy or breastfeeding course. Exclusion criteria was filling out questionnaires
incompletely. Data collection tool was a multidimensional questionnaire which comprised of
4 sections as following: demographic (5items), A self‑administrative questionnaire for body
Satisfaction (7 items), Rosenberg Self‑Esteem Scale (10 items) and a standard Weight Control
Behavior Scale (18 items). Cranach’s alpha was 0.9 or higher for the different sections. Finally,
collected data was analyzed with SPSS18 using the independent T‑test, one‑way ANOVA,
Pearson correlation coefficient, regression, Spearman correlation. Results: Frequencies of
participants by weight category were 14.1% for obese, 35.3% for overweight, 47.6% for normal
weight. The mean body satisfaction score in the studied women was 63.26 ± 16.27 (from
100). Mean score of self esteem was 76.70  ± 10.45. 51.5% of women had medium self
esteem, 47.5% had high self esteem. Pearson correlation showed that the variables of body
Satisfaction (r = 0.3, P = 0.02), BMI (r = ‑ 0.14, P < 0.003), education level (r = 0.22, P < 0.001),
income (r = 0.14, P < 0.004), consumption of fruit (r = 0.13, P < 0.008) all correlated with
self‑esteem significantly. Women with higher self esteem used higher fruits had a good
nutrition overall (r = 0.11, P = 0.02). 92.15%, 10.8% of women respectively participated in one
of healthy and unhealthy weight control behavior. There was not any Relationship between
self esteem and healthy weight control behavior while finding showed reverse relationship
between self esteem and Unhealthy Dieting Behaviors.
Conclusion: It seemed women identity in our society tied
to social appreciations that formed and supported by body
satisfaction. When they feel their current appearance is
differ from ideal appearance, they feel down and have lower
self esteem and used unhealthy dieting behavior and low
fruits daily. Due to importance of precise self evaluation,
self esteem can be used to design and conduct public
health programs, especially for women.