Journal of Education and Health Promotion

Abstract Background and Objectives: Diabetes is one of the major concerns in the third millennium,
affecting more people every day. The prevalence of this disease in Iran is reported to be
high (about 7.7%). The most important method to control this disease and prevent its
complications is self‑care. According to various studies, this method has not found its
proper place among patients with diabetes due to several reasons. The present study was
aimed at determining the relationship between social support, especially family support, and
self‑care behavior of diabetes patients. Materials and Methods: This study was a narrative
review in which the relevant papers of cross‑sectional, cohort, clinical trial, and systematic
review designs were selected using databases and scientific search engines such as
PubMed, ProQuest, SCOPUS, and Elsevier, with the keywords diabetes, social support,
and self‑care. Moreover, Persian papers were selected from MEDLAB and IRANMEDEX
databases and through searching the websites of original research papers published in
Iran. All the papers published from 1990 to 2011 were reviewed. Results: The results of
the study indicated that the status of self‑care and social support in patients with diabetes
was not favorable. All the studied papers showed that there was a positive relationship
between social support and self‑care behavior. Also, some studies pointed to the positive
effect of social support, especially family support and more specifically support from the
spouse, on controlling blood sugar level and HbA1c. Conclusion: As social support can
predict the health promoting behavior, this concept is also capable of predicting self‑care
behavior of patients with diabetes. Therefore, getting the family members, especially the
spouse, involved in self‑care behavior can be of significant importance in providing health
care to patients with diabetes.

Abstract Introduction: Appropriate instructional design plays a crucial role in e‑learning success, and
analyzing learners is the cornerstone for instructional design process. Students’ readiness
for e‑learning was assessed in the present study as an example of learner analysis for a
distance course in medical education master program. Materials and Methods: A census
sample of 23 students applied for distance master program on medical education, completed
the “Students’ E‑Learning Readiness Scale” developed by Watkins, via email. The reliability
and validity of the scale has been confirmed before. Average scores in total and 6 subscales
were calculated. The score range was 1‑5 and scores above 3 indicated good readiness.
Data was interpreted using descriptive and non‑parametric tests (Mann‑Whitney U and
Kruskal‑Wallis). Results: Response rate was 100%. The students’ readiness scores in total and
all subscales (“technology access”, “online skills and relationships”, “motivation”, “online audio/
video”, “readiness for online discussions”, and “importance of e‑learning to your success”) were
above 3. Comparing different subscales, students’ mean scores in “motivation” and “internet
discussion” subscales were less than others, although the difference was not significant. There
were no significant gender differences in the readiness scores. Students who were academic
staff had significantly higher scores than others in total and in “motivation” and “online skills
and relationship” subscales. Conclusion: Good learners’ readiness, observed in the present
study, may imply that the instructional designer can rely on e‑learning strategies and build
the course upon them. However, according to the slightly lower scores in “motivation” and
“online discussion” subscales, it is recommended to stress more on strategies that improve
these two components. To generalize the results, it is needed to test students’ readiness in
more different degree programs.

Abstract Introduction: In this study, by using a problem‑oriented approach in the needs assessment,
identifying the defects and deficiencies in emergency health training centers has been
determined as the basis for the requirements. The main objective of the study was the
implementation of surgical emergencies integration of the five surgical groups (general surgery,
urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy.
Materials and Methods: This interventional study was conducted in three phases: (1) Phase I(design
and planning): Needs assessment, recognition of implementation barriers and providing the objectives
and training program for integrated emergencies. (2) Phase II (implementation): Justification of
the main stakeholders of the project, preparation of students’ duties in the emergency department,
preparation of on‑duty plans, supervising the implementation of the program, and reviewing the
plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing
the evidences based on the amount of efficiency of the plan and justification for its continuation. In
the first and the second phase, the data were collected through holding focus group meetings and
interviews. In the third phase, the opened‑reply and closed‑reply researcher‑made questionnaires were
used. The questionnaire face and content validity were confirmed by experts and the reliability
was assessed by calculating the Cronbach’s alpha. Results: According to the views of the
interns, assistants, teachers, and emergency personnel, the positive features of the plan included
the following: Increasing the patients’ satisfaction, reducing the patients’ stay in the Emergency
Department, increasing the speed of handling the patients, balancing the workloads of the interns,
direct training of interns by young teachers of emergency medicine, giving the direct responsibility
of the patient to the intern, practical and operational training of emergency issues, increasing the
teamwork, facing a variety of patients, practicing the role of general practitioners, role‑playing on a real
patient’s bedside, having a multilateral approach to the patient, reducing the wasting time on minor
wards, balancing the work and rest schedules of the interns, and better learning and satisfaction
of the interns. Over 60% of the participants believed the program has the following benefits: More
attention on the training plan, improving the learning of patient management, being more responsive
for the training of interns, increasing operational approach to emergency patients, being more
aware of the performed actions, and increasing  the quality and speed of services provided to patients. The mean score assigned to the whole questionnaire of investigating the viewpoints was 37.5 out of 50. The mean score of the interns’ questionnaire was significantly more than the mean score of the assistants. Discussion: The results obtained indicated that the greatest existing consensus about this plan was the positive impact on the learning of interns in the emergency setting. Thus, it will not only increase the number of patients who the interns are managing
during the internship course, but also increases the balance of their workload and they can learn and manage the emergency patients with more leisure.

Abstract Introduction: Simultaneous with the rapid changes in the technology and information
systems, hospitals interest in using them. One of the most common systems in hospitals is
electronic medical record (EMR) whose one of uses is providing better health care quality via
health information technology. Prior to its use, attempts should be put to identifying factors
affecting the acceptance, attitude and utilizing of this technology. The current article aimed
to study the effective factors of EMR acceptance by technology acceptance model (TAM) at
central polyclinic of Oil Industry in Isfahan. Materials and Methods: This was a practical,
descriptive and regression study. The population research were all EMR users at polyclinic
of Oil Industry in 2012 and its sampling was simple random with 62 users. The tool of data
collection was a research‑made questionnaire based on TAM. The validity of questionnaire
has been assigned through the strategy of content validity and health information technology
experts’ views and its reliability by test‑retest. Findings: The system users have positive attitude
toward using EMR (56.6%). Also, users are not very satisfied with effective external (38.14%)
and behavioral factors (47.8%) upon using the system. Perceived ease‑of‑use (PEU) and
perceived usefulness (PU) were at a good level. Conclusion: Lack of relative satisfaction with
using of EMR derives from factors such as appearance, screen, data and information quality
and terminology. In this study, it is suggested to improve the system and the efficiency of the
users through software’ external factors development. So that PEU and users’ attitude to be
changed and moved in positive manner.

Abstract Context: Various studies have shown that quality of life in women after menopause undergoes
radical changes. Several factors such as psycho‑social factors are associated with the quality
of life during menopausal period. Aims: The present study surveyed the factors associated
with quality of life of postmenopausal women in Isfahan, based on Behavioral Analysis Phase
of PRECEDE model. Settings and Design: This cross‑sectional study was conducted through
stratified random sampling among 200 healthy postmenopausal women in Isfahan in 2011.
Subjects and Methods: Data were collected by two valid and reliable questionnaires (one
to assess the quality of life and the other to survey the factors associated with the
Behavioral Analysis Phase of PRECEDE model). Data analysis was performed using SPSS
software (version 18) and analytical and descriptive statistics. Results: Pearson correlation
indicated a positive and significant correlation between the quality of life and attitude toward
menopause, perceived self‑efficacy, and enabling and reinforcing factors, but there was no
significant relationship between the quality of life and knowledge about menopause. Also, the
quality of life in postmenopausal women had significant correlation with their age, education
level, marital status, and employment status. Conclusion: Based on the present study, attitude,
perceived self‑efficacy, perceived social support, and enabling factors are associated with the
quality of life in postmenopausal women. So, attention to these issues is essential for better
health planning of women.

Abstract Background: Puberty is one of the most critical periods in a female adolescents’ life. This
intervening study aimed to evaluate the effect of educational program for puberty health
on improving intermediate and high school female students’ knowledge in Birjand, Iran.
Materials and Methods: In this quasi‑experimental study, 325 female intermediate and high
school students were selected through randomized cluster sampling during several stages.
Then, researcher‑made questionnaire including 20 questions, each having one point regarding
puberty health, was distributed. After completion of the questionnaires were gathered. Following
this, under a systemic educational plan all intermediate and high school selected students were
given the same instruction by trained instructors. Instruction time for each meeting was estimated
1.5 hours. One month after the educational program and handing out the pamphlets in schools,
the previous questionnaires were again distributed among the students to fill out. At the end,
302 students who had filled out the questionnaires before and after intervention were studied.
Results: Out of 302 students, 151 were intermediate and 151 high school students. Knowledge
level among intermediate students was 5.03 ± 3.7 before intervention and was 10.8 ± 4.8 after
intervention. Among high school students, the scores were 4.1±2.3 and 8.7±3.8, respectively. There
was a significant difference between pre and post intervention stages in both groups (P < 0.001).
Furthermore, mean knowledge grade in all the students increased from 4.6 ± 3.1 before intervention
to 9.7 ± 4.4 after intervention (P < 0.001). Conclusion: Performing educational programs during
puberty has a crucial role in young girls’ knowledge increase. Since young girls often do not share
their problems with their parents and their peers during the period, instructional classes in schools
provide a good opportunity for them to present their problems and finding solutions.

Abstract Background: The main objective of creating a portal is to make information service available
for users who need them for performance of duties and responsibilities regardless of the
sources. This article is attempted to consider the parameters that can evaluate these sites
since these criteria can be effective in designing and implementing such portals. On the
other hand, portal sites in health systems of every country make it possible for leaders, policy
makers, and directors to system education as a tool for new learning technologies. One of
the main decisions each manager has to make is precise selection of appropriate portal sites.
Materials and Methods: This is a descriptive and qualitative study. The research sample was
53 computer professional working in the area of computer programming and design. In the
first part of the study a questionnaire was send to the participants and in the second part of the
study based on their response to the questionnaire the participant was interviewed and the main
themes of the studies were formulated. The validity and the reliability of the questionnaire were
confirmed. Results: The study results were summarized in 10 themes and 50 sub‑categories.
The main themes included were portal requirements, security, management, and efficiency,
user friendliness, built‑in applications, portal flexibility, interoperability, and support systems.
Conclusion: Portal sites in any education systems make it possible for health system leaders
and policy makers to manage their organization information system efficiently and effectively.
One of the major decisions each manager has to make is precise selection of an appropriate
portal sites design and development. The themes and sub‑categories of this study could help
health system managers and policy makers and information technology professionals to make
appropriate decisions regarding portal design and development.