Journal of Education and Health Promotion

Abstract INTRODUCTION: Self‑management leads to blood glucose control and reduced morbidity and
mortality in adolescents with type 1 diabetes. Different factors affect the self‑management whose
role and effect are still unknown. Among the influential factors whose effect is vague are spiritual
intelligence, and this study aims to investigate the predictive role of spiritual intelligence in diabetes
management.
MATERIALS AND METHODS: In this descriptive‑correlation study, 200 adolescents with type 1
diabetes were enrolled. To measure spiritual intelligence, the 24‑question SISRI questionnaire and
to measure self‑management of diabetes, the SMOD‑A questionnaire (48 questions) were used.
Data were analyzed using SPSS software version 18 using linear regression analysis tests. Data
collection was conducted by simple sampling.
RESULTS: Mean score of self‑management of diabetes and spirituality was 86.1 ± 15.1 and
60.42 ± 12.9, respectively. Linear regression test (ANOVA: 0.002, F = 9.839) showed effect on
diabetes self‑management (β: 0.218).
CONCLUSION: This study showed that spiritual intelligence can predict diabetes self‑management,
though poorly predicted, and by strengthening it, has a decisive role in improving the health of
adolescents with diabetes. Considering the findings of this study, a new window of nurses’ performance
in managing diabetes based on the promotion of spiritual intelligence in the educational, care,
counseling, and support roles of nursing science can be opened.

Abstract Infertility requires long‑term care and treatments which would influence different aspects of health
including the mental health of infertile women. The present study was conducted to determine
strategies for psychological empowerment of infertile women. This systematic review was performed
on previously conducted clinical trials. To achieve the intended studies, databases of Magiran,
Scientific Information Database, Google Scholar, Scopus, PubMed, ProQuest, ScienceDirect, and
Web of Science and also Iranian Registry of Clinical Trials website were searched using “infertility
and infertile women” as the keywords. The inclusion criteria were being an interventional study
and assessing the psychological status of infertile women. Performed studies in Iran with no time
limitations were evaluated. Based on the Jadad criteria, studies with a score of 3 or more were
enrolled in the systematic review. After assessing the quality of the studies, 21 studies were enrolled
in the review for final evaluation. Reviewing the conducted studies showed that educational and
counseling interventions could be effective in improving the aspects of psychological well‑being of
infertile women. Existing evidence revealed that applying coping strategies is effective in improving
the quality of life in infertile women, which consequently lead to the improvement of psychological
empowerment of infertile women.

Abstract PURPOSE: It is essential to adjust the responsibilities and function of medical education offices (MEOs)
in regard to the current societal requirements. Therefore, it is a good idea to learn lessons from the
experiences about the establishment and function of these offices around the world. The aim of the
present study was to carry out a comparative study to investigate the function and structure of MEOs
at some of the medical universities from America, Europe, and Asia.
SUBJECTS AND METHODS: This is a comparative, descriptive study that was conducted in 2015.
Eleven offices around the world (in America, Europe, and Asia) were selected for the study. Expert
group discussion and literature review were used in order to select research sample. The data were
gathered using self‑constructed checklists. Content and face validity of the checklist was assessed
by gathering feedback from experts. The Kappa coefficient was used to determine the inter‑rater
reliability.
RESULTS: All the 11 offices in our study (100%) dealt with the issues of faculty development and
research and scholarship activities. Only one out of the 11 offices (27%) dealt with the issues of
society and patient education. Five out of the 11 offices (36%) dealt with the continuing medical
education and continuing professional development. Consultation services are provided at seven
of the 11 offices (64%).
CONCLUSIONS: This study revealed both commonalities and differences in the function and structure
of MEO among the 11 offices we examined. Based on this study, effective goals and strategies for
MEO can be recommended.

Abstract INTRODUCTION: Antibiotics are considered the most commonly sold drugs in developing countries.
In India, these drugs are very much accessible without a prescription. This irrational and misuse
of antibiotics results not only in the emergence of resistance of bacterial strains but also leads to
adverse reactions.
AIM: The aim of this study was to investigate the level of knowledge, attitude, and practice of
antibiotics usage among dental patients.
MATERIALS AND METHODS: Study design: This study was a cross‑sectional design; a prevalidated
structured questionnaire comprising 24 questions was used.
SAMPLE SIZE: Six hundred and ten patients visiting a dental hospital, Chennai, Tamil Nadu, India,
were included in the study.
RESULTS: The dental patients involved in self‑medication were more than 70%. 80.2% of the
study group opted selection of antibiotics from their previous prescription from dental or medical
professional. Adverse effects were faced by 7.8% of patients on taking self‑medication. The study
group was aware of the common dental procedures such as extraction and root canal treatment
in which antibiotics were commonly prescribed. Half of the patients (53.8%) do not know the term
antibiotic misuse, and 43.3% of the group opted antibiotic misuse to be unacceptable.
CONCLUSION: The study revealed the knowledge, attitude, and practice of the patients about
self‑medication in the Indian scenario. There is need for health‑care professionals and government
bodies to enlighten the public about the harmful effects of self‑medication with antibiotics to overcome
the antibiotic resistance.

Abstract INTRODUCTION: Sexual health is one of the key factors to sustain marital life and having a good
sexual function. On the other hand, temperament affects sexual function. Training is also one of
the basic foundations for promoting sexual health. Therefore, the researcher has designed and
implemented a study (2017) aimed “determining the study of educational package on sexual function
in cold temperament women of reproductive age.”
METHODS: This randomized clinical trial study was performed on 80 women in two groups (40 in
each group). This study was done, in available method, on no pregnant women aged 20–40 years old
that referred to health centers in Mashhad. DASS 21 sexual function and determining temperament
questionnaires were completed in two groups before intervention. At first, the sexual function
training package was held by the researcher at 6 sessions (twice a week for 3 weeks) that was
based on nutrition, sport, and lifestyle axes. The control group also received routine care. A week
after intervention finished, all the units completed a sexual function questionnaire. The results were
analyzed by these techniques as SPSS software (version 16) and statistical tests such as Independent
t‑test, T‑pair, Mann–Whitney, Chi‑square, and Fisher’s exact test.
RESULTS: At the beginning of the study, there was no statistically significant difference between
the personal characteristics and the mean score of sexual function and all its dimensions in the two
groups. The mean sexual performance score and all its dimensions after intervention were significantly
different in intervention and control groups P < 0.001. Sexual function and all its dimensions were
improved after intervention in the intervention group.
CONCLUSION: Giving sexual function package has improved the sexual function of cold temperament
women. So, for routine caring of cold temperament women, it is better that health center employees
consider this training package as an effective, easy, available, nonpharmacological, and economic
intervention.

Abstract BACKGROUND: Premenstrual syndrome (PMS) is the emergence of periodic one or more
symptoms of symptoms before menstruation and in the first few days of menstruation. Lifestyle is
one of the series of factors that affect the health of people. Activity, smoking, and food intake are
factors associated with lifestyle, and evidence suggests that women and girls with PMS do not have
an adequate life span. The aim of this study was to determine the factors associated with PMS in
female high school students.
METHODS: This cross‑sectional correlation study was conducted in 200 female high school students
in Sabzevar city using multistage random sampling in the academic year of 2016–2017. Data
gathering tools include the temporary diagnostic questionnaire of the PMS, and Beck Depression
questionnaire; the nonresonant tape was accurate to 0.1 cm and the digital scale was accurate to
0.1 kg. We analyzed the data using SPSS software and Mann–Whitney U‑test.
RESULTS: The results of this study showed that there is a significant relationship between PMS and
fried foods (P = 0.017), sweet drink (P = 0.018), fast food (P = 0.048), fruit (P = 0.012), no habitual
exercise (P = 0.006), family history of PMS (P = 0.002), hip circumference (P = 0.04), and body
mass index (P = 0.04).
CONCLUSION: There is a relationship between PMS and some anthropometric indices and nutritional/
metabolic factors. Therefore, having a proper lifestyle is effective in reducing PMS.

Abstract INTRODUCTION: Providing health promotion and communication learning opportunities for medical
students practising their theoretical information into action, addressing the health problems, and
trying to find suitable and feasible interventions is very much neededto learn and experience directly
about healthrelated behavior in the community. Health promotion practice of PRECEDE‑PROCEED
model, is used as the foundation of this Family Outreach and Empowerment Program (FOEP). This
study aims to implement and evaluate FOEP as an effective health promotion learning model for
undergraduate medical students.
METHODS: Two hundred and forty‑four medical students joined the program for the whole weeks.
The reports were evaluated to assess their activities throughout the process. Evaluation was done
using the assessment checklists based on PRECEDE‑PROCEED framework. Data collected from
the assessment will be processed and analyzed using the IBM SPSS Statistics 22 program.
RESULTS: Two hundred and forty‑four report’s has been evaluated, the report’s scores in the
category very good is 136, good 64, enough 26, bad 12 and very bad 6. The main problem in FOEP
is behavior (37,6%) and the most alternate intervention choosen is education (232).
DISCUSSION: The most intervention used by students for FOEP was education because it has been
proven that can demonstrate feasibility, effectivity, increase knowledge control, and self‑efficacy
among disease.
CONCLUSION: Student’s reports was already satisfied.

Abstract CONTEXT: Timed up‑and‑go (TUG) test is a valid, reliable, and an objective test for quantifying
functional mobility and assessing the fall risk in all age groups. The analysis of patient scores on
TUG test is limited by lack of data, having a wide range of performance scores among people without
disabilities.
AIM: The objective of the study was to provide the reference value for TUG test in healthy individuals
of Gujarat, India.
SUBJECTS AND METHODS: It was a cross‑sectional observational study. Five hundred and twenty
healthy individuals, aged 40–70 years, were recruited from various regions of Gujarat based on
convenient sampling. All the participants were made to perform TUG test in a controlled environment
in community. Three readings of the actual test were obtained and averaged.
RESULTS: Data were analyzed with mean, standard deviation, confidence intervals (CIs 95%) and
Pearson’s correlation coefficient (r) with α = 0.05 by age groups (40–50, 51–60, and 61–70 years)
and gender. The mean (CI 95%) TUG time for healthy adults of Gujarat was 8.46 (8.35–8.57) s and
demonstrated age‑related decline for both male and female participants. TUG time also demonstrated
strong correlation with the height of individuals.
CONCLUSION: This preliminary data can be used as a reference only for specific population with
specific age groups due to variability in test results among the different population due to age, gender,
anthropometric measures such as height, weight, and body mass index, geographical variation,
nutritional support, and cognitive status.

Abstract BACKGROUND: Physically disabled people experience more restrictions in social activities than
healthy people, which are associated with lower level of well‑being and poor quality of life (QoL).
STUDY DESIGN: A cross‑sectional study was conducted
METHODS: This study was investigated on among 302 eligible physically disabled people. The
predictive role of the demographics and clinical characteristics, anxiety and depression, physical
activity, and self‑efficacy on the 36‑Item Short Form Health Survey (SF‑36) was examined.
STATISTICAL ANALYSIS USED: Statistical analysis used univariate and multivariate regression
models.
RESULTS: Gender, self‑reported physical activity levels, use of the disability aid tools, and depression
were significantly predictors of the physical component summary (PCS) (R2 = 0.20, P < 0.001). We
realized that anxiety, depression, and self‑efficacy could significantly predict the mental component
summary (MCS) (R2 = 0.43, P < 0.001).
CONCLUSIONS: Study results revealed that four and three variables could predict 20% and 43%
of PCS and MCS variations, respectively. These findings warranted the detection of QoL risk factors
and establishment of targeted interventions to optimize the health‑related QoL among physically
disabled people.
Keywords:

Abstract INTRODUCTION: Breast milk provides nutritional, immunological, behavioral, and economic benefits
and helps to build mother‑infant bonding. Antenatal mothers need to be sufficiently aware about the
benefits of breastfeeding.
OBJECTIVES: The aim of this study is to assess the awareness and perception of breastfeeding
among antenatal mothers and to find out any association between sociodemographic factors and
breastfeeding awareness.
METHODOLOGY: A cross‑sectional study was conducted among 250 antenatal women residing in the
urban slums of field‑practice area of urban health and training center; using a predesigned, pretested,
semi‑structured interview schedule. Antenatal checkup followed by one to one counseling for the
women regarding breastfeeding was provided. Data were represented by frequencies, proportions,
and associations using Chi‑square, and the P < 0.05 was considered statistically significant.
RESULTS: Most (55.6%) of the women were in the age group of 18–24 years. The mean age at
marriage was 19.2 ± 2.5 years. 81.2% of them were Hindus, 13.2% had adequate, 49.6% had
moderately adequate, whereas 37.2% women had inadequate awareness about breastfeeding.
About 100% intended to breastfeed their children, but only 64% said that they intended to exclusively
breastfeed. 66.4% knew about the importance of colostrum. Age‑group, religion, literacy, occupation,
type of family, gravida, and number of antenatal visits showed highly significant (P < 0.001) association
with awareness of breastfeeding.
CONCLUSION: Nearly one‑third of the antenatal mothers lacked awareness on breastfeeding
practices. Although all intended to breastfeed, still only 64% knew about exclusive breastfeeding.
These gaps need to be addressed by awareness generation activities during antenatal counseling.

Abstract INTRODUCTION: According to the research mission of the librarianship and information sciences field,
it is necessary to have the ability to communicate constructively between the user of the information
and information in these students, and it appears more important in medical librarianship and
information sciences because of the need for quick access to information for clinicians. Considering
the role of spiritual intelligence in capability to establish effective and balanced communication makes
it important to study this variable in librarianship and information students. One of the main factors
that can affect the results of any research is conceptual model of measure variables. Accordingly,
the purpose of this study was codification of spiritual intelligence measurement model.
METHODS: This correlational study was conducted through structural equation model, and 270 students
were opted from library and medical information students of nationwide medical universities by simple
random sampling and responded to the King spiritual intelligence questionnaire (2008). Initially,
based on the data, the model parameters were estimated using maximum likelihood method; then,
spiritual intelligence measurement model was tested by fit indices. Data analysis was performed by
Smart‑Partial Least Squares software.
RESULTS: Preliminary results showed that due to the positive indicators of predictive association and
t‑test results for spiritual intelligence parameters, the King measurement model has the acceptable fit
and internal correlation of the questionnaire items was significant. Composite reliability and Cronbach’s
alpha of parameters indicated high reliability of spiritual intelligence model.
CONCLUSIONS: The spiritual intelligence measurement model was evaluated, and results showed
that the model has a good fit, so it is recommended that domestic researchers use this questionnaire
to assess spiritual intelligence.

Abstract BACKGROUND: Assessing various therapeutic methods with the intention to decrease the problems
relevant to abused children is of high significance. Accordingly, the present study seeks to compare
the effectiveness of trauma‑focused cognitive behavioral therapy (TF.CBT) with an emphasis on
the theory of mind on posttraumatic growth and emotional regulation strategies in abused children.
MATERIALS AND METHODS: This quasi‑randomized clinical trial study was done on 39 abused
children who referred to welfare organization centers in Ahvaz – Iran. After randomized allocation,
the TF. CBT and theory of mind method were implemented for two groups. Before and after the
interventions, posttraumatic growth and emotional regulation strategies were assessed with using
Kilmer’s posttraumatic growth inventory and Garnefski emotional regulation questionnaire.
RESULTS: The study findings indicated that the mean of the posttraumatic growth and adaptive
and maladaptive emotional regulation strategies in the TF.CBT group was significantly higher than
that of other study groups (P < 0.001).
CONCLUSION: TF.CBT can lead to increased levels of posttraumatic growth and improve emotional
regulation strategies in abused children. Theory of mind method can also be effective in improving
emotional regulation strategies.

Abstract BACKGROUND: Obesity and inactivity have led to an increasing number of individuals with sexual
dysfunctions (43% of women; 31% of men). Small bouts of exercise can drastically improve sexual
functioning. Thus, the present study is designed to examine the effects of physical fitness and
self‑concept on sexual functioning.
MATERIALS AND METHODS: Fitness assessments and questionnaires were administered to 133
participants between the ages of 18 and 50 years. Physical fitness was assessed through body
composition, cardiovascular endurance, muscular strength, and muscular endurance. Self‑concept
was presented as a total self‑concept score and as six individual concepts of self. Sexual
function was presented as both an aggregate score and five separate constructs of sexual
functioning – fantasy/cognition, arousal, orgasm, behavior/experience, and drive/desire.
RESULTS: The results indicated that sexual behavior/experience was predicted by body fat
percentage. In men, fantasy was related to total self‑concept; sexual behavior/experience was related
to likeability. In women, arousal was predicted by cardiovascular endurance. Total self‑concept was
related to both orgasm and sex drive/desire. Power and muscular strength were significantly related
to number of sexual partners in women but not men.
CONCLUSIONS: The present study adds to the growing body of evidence indicating a positive
relationship between physical fitness and sexual health. Individuals with sexual dysfunctions,
particularly women, who are not persuaded by the currently publicized benefits of physical activity,
may be inclined to exercise to improve sexual functioning.