Journal of Education and Health Promotion

Abstract

Abstract INTRODUCTION: The postpartum period is a transition to a critical stage. Moreover, the rapid
changes experienced after delivery, expose the mother to unpleasant experiences such as changes
in sleep patterns. Trying to an appropriate training method is necessary. This study aims to conduct
a comparative study between the impact of face‑to‑face training and e‑training on maternal sleep
during the postpartum period.
MATERIALS AND METHODS: The present study was empirically conducted on 110 postpartum
mothers who visited the selected healthcare centers of Isfahan in 2015. Mothers randomly divided into
three groups (face to face, electronic and control). Data collection tools included demographic and
fertility questionnaire and Pittsburgh Sleep Quality Index. Intervention groups were received training
such as mothers with necessary instructions regarding the health approaches, relaxation techniques,
sleeping place, and energy‑saving techniques. Mothers’ quality of sleep was measured and compared
before training (until the 10th day after childbirth) then in the second and third cares (from the 10th to
30th day after childbirth) in all three groups. Data were analyzed using descriptive statistics and ANOVA
and analyze variance with repeated measures in SPSS (SPSS Inc., Chicago, IL, USA,) version 17.
RESULTS: The results showed there was a significant difference among the sleep quality scores in
the three times in the e‑training (P < 0.001) and face‑to‑face groups (P < 0.001) and in the control
group (P = 0.01), but the improvement in the sleep quality score has been higher in the two groups;
e‑training and face‑to‑face, than in the control group. In addition, the mothers’ mean sleep quality
score was different between the control group and face‑to‑face group as well as between the control
group and e‑training group. While, no statistically significant difference was found between the
e‑training group and face‑to‑face group.
CONCLUSION: Training through both methods; face‑to‑face and electronic, had the same impact
on maternal sleep quality during the postpartum period. Therefore, despite the belief that in‑person
trainings are more effective, the findings of this research showed the effectiveness of electronic methods
too, and determined that this method, has the same effectiveness as the face‑to‑face method has.

Abstract AIM AND BACKGROUND: Given the fact that immune system is greatly affected by people’s
emotional characteristics and since these characteristics are mainly formed through interactions
with one’s parents, this study aims to determine the relation between personality characteristics and
disorders of multiple sclerosis (MS) patients and their parents.
METHODS: This is an applied, descriptive study on 88 MS patients and 63 parents who had visited
two physiotherapy clinics in Tehran between January and August 2016. Participants who met the
inclusion criteria were selected using convenient sampling method. After acquiring their consent,
participants were asked to fill the millon personality questionnaire. Gathered data were analyzed using
Pearson and Spearman tests. R statistical software was also used to draw histogram of the data.
RESULTS: The most common personality disorder in MS patients includes histrionic personality
disorder while the most common problems among their parents included histrionic personality
disorder and obsessive character traits. There was also a direct, significant relation between histrionic
personality disorder and narcissistic traits in parents and patients.
CONCLUSIONS: Due to unknown nature and progress of MS, studying personality characteristics
of patients and their parents can help determine better treatment methods along with advances in
neurological treatments.

Abstract INTRODUCTION: Academic self‑efficacy is the learners’ belief in their abilities in academic process.
Perception of the educational‑research environment is one of the effective factors on academic
self‑efficacy. The aim of this study was to examine the perception of educational‑research environment
and academic self‑efficacy in students of the University of Tehran in 2016.
METHODS: This cross‑sectional study was done on 385 students of Tehran University of Medical
Sciences. Samples were selected through stratified sampling method. Data were collected through
questionnaires of perception of educational‑research environment scale 24 and of academic
self‑efficacy scale 32 that reliability and validity of that were confirmed. Data analysis was performed
using Pearson’s correlation coefficient.
RESULTS: The mean age of participants was 25.31 (standard deviation [SD] = 3.94), and 56.1% of
them were female and the rest were male. The mean perception of educational‑research environment
was 65.79 (SD = 13.13), and the mean academic self‑efficacy was 107.44 (15.92). The Pearson’s
correlation test results showed that there was a statistically significant relationship between perception
of educational‑research environment with academic self‑efficacy (P = 0.001, r = 0.180).
CONCLUSION: There was a significant statistical relationship between perception of
educational‑research environment and academic self‑efficacy. Students who have high perception
of educational‑research environment are high academic self‑efficacy. Academic self‑efficacy can be
improved by improving perception of the educational‑research environment.

Abstract BACKGROUND: Through self‑care, people can solve their health‑related problems through increasing
their awareness and correcting their lifestyles.
OBJECTIVES: To determine the association of self‑care status with some relevant factors in
Kashanian middle‑aged women in their early menopausal stage.
METHODS: This is a cross‑sectional study on 351 women in the age range of 45–60 years. Women
were selected based on cluster sampling method from the individuals at health‑care centers in
Kashan, Iran. Researcher‑constructed questionnaire on self‑care was used. The validity and the
reliability of the questionnaire were calculated. The information gathering method was questionnaire
completion by the study participants or interview with them. Collected data were analyzed with SPSS
16 software. T‑test, ANOVA, Spearman correlation, and linear regression analysis were applied.
RESULTS: The mean (±standard deviation) of the self‑care score was 108.14 ± 20.43. Self‑care
scores were weak in 13.92%, intermediate in 71.02%, and good in 15.06%. Regression analysis
showed that the mean of self‑care was significantly higher in those with higher educational level of
women’s (P = 0.045) and their spouses (P = 0.001). Women who were covered by insurance also
showed higher self‑care; in addition, there was no significant relationship between self‑care and
participants’ job, spouses’ jobs, marital status, marital satisfaction, economic satisfaction, number
of children, number of households, and type of accommodation (P > 0.05).
CONCLUSION: The results indicate that self‑care is inadequate and that the level of education of
couples and insurance coverage has a positive effect on the level of self‑care in postmenopausal
women. To promote self‑care in old age, education and empowerment can be considered.

Abstract CONTEXT: The advent of picture archiving and communication system (PACS) as medical image
information system represent a major change of work pattern for radiologists and physicians and
has proved to be a substantial challenge to the organization.
AIMS: The study aimed to investigate the factors affecting the use of PACS through the unified
theory of acceptance and use of technology model.
SETTINGS AND DESIGN: It was an applied and analytical study.
SUBJECTS AND METHODS: Ninety questionnaires were distributed in Kashani hospital of Esfahan
which implemented web‑based PACS, and 45 usable questionnaires were returned. The questionnaire
consists of scales for performance expectancy (PE), effort expectancy, facility condition, social
influences, and behavioral intention (BI) and was developed by the author comparing the similar
studies in which validity was confirmed by a committee of experts and the reliability was calculated
using a Cronbach’s α (α = 0.946).
STATISTICAL ANALYSIS USED: Data were analyzed using SPSS version 20. The statistical tests
for data analysis were Pearson’s correlation and multiple regression analysis.
RESULTS: The findings suggested a direct correlation between BI and factors of PE (P < 0.001,
r = 0.788), effort expectancy (P < 0.001, r = 0.564), social influences (P = 0.001, r = 0.472), and
facility condition (P < 0.001, r = 0.477).
CONCLUSIONS: According to the findings, only the PE is sufficient for predict and evaluation of
user behavior toward PACS. The results could be useful in terms of designing new systems and
understanding users’ need.

Abstract BACKGROUND: Cardiovascular disease (CVD) risk factors are adopted during childhood and
adolescence. Health literacy at these ages remains the cornerstone of a healthy adult life. The aim
of the study was to examine the role of gender regarding CVD risk factors’ awareness and to develop
an evaluation tool for the assessment of CVD risk factors’ knowledge and perception among children.
METHODS: During the school years 2014–2015 and 2015–2016, 1728 students aged
10–12 years (5th and 6th grade), from 5 Greek cities (including Athens metropolitan area), were enrolled;
nearly 45% were boys (participation rate varied from 95% to 100% from school to school). Students
and their parents completed an anonymous questionnaire; students’ somatometric characteristics were
also recorded. Schools were randomly selected. Linear regression models were applied to evaluate
the impact of children’s gender on knowledge and perceptions about CVD risk factors.
RESULTS: Significant higher percentage of correct answers, among girls compared to boys, was
revealed regarding the weekly consumption of legumes, the breakfast weekly consumption, and
the effects of soft drinks on health (all P < 0.05). As far as CVD risk factors’ knowledge, significantly
higher percentage of girls than boys also answered that high blood pressure and television viewing
are bad for health and particularly for heart‑related problems (all P < 0.05). Girls had a significantly
higher mean score of 0.304 than boys, after adjusting for several confounders (P = 0.029).
CONCLUSION: Health education programs should take into account gender differences in children’s
perception and attitudes toward CVD risk factors, in order to increase awareness of children and
eventually reduce CVD risk during adulthood.

Abstract INTRODUCTION: Pain is a common phenomenon and an inevitable part of the labor process. Labor
pain is one of the most severe pains. Auriculotherapy is one of the nonpharmacological aspects of
relieving pain, reduces the intensity of pain, and improves its compatibility. The purpose of this study
was to determine the effect of auriculotherapy on labor pain in primiparous women.
MATERIALS AND METHODS: This clinical trial was performed on 84 pregnant women aged between
18 and 35 years, who referred to Isfahan Shahid Beheshti Hospital in 2017. This study was carried
out between two groups: control group (receiving routine hospital care) and interventional group
(20 min for auriculotherapy). We used the McGill Short‑Form Standard questionnaire with Visual
Analog Scale. Data were analyzed by SPSS software using paired t‑test and ANOVA.
RESULTS: The results showed that there was no significant difference between demographic
variables in the two groups. Statistical analysis also showed that the severity of labor pain in the
interventional group (auriculotherapy) was lower than that of the control group (P = 0.001).
CONCLUSION: Auriculotherapy reduces the severity of labor pain in primiparous women. Due to
the easy, inexpensive, and noninvasive nature of this method, its use has been recommended in
these cases.

Abstract INTRODUCTION: An important construct to consider within diabetes management and the changing
landscape of diabetes therapies is self‑efficacy. Self‑efficacy research holds the potential to inform
and assist the diabetes team as well as patients with type 1 diabetes.
METHODS: In this descriptive‑correlation study, 200 adolescents with type 1 diabetes were enrolled.
To measure spiritual intelligence, the 24‑question Spiritual Intelligence Self‑Report Inventory
questionnaire and to measure self‑efficacy of diabetes, the Self‑efficacy Questionnaire (8 questions)
were used. Data collection was conducted by simple sampling. Data were analyzed using Pearson
analysis, mean, and standard deviation analysis tests.
RESULTS: Nearly 66% of the participants were female, the mean age of the samples was
17.10 ± 1.85 years, the mean duration of diabetes was 5.98 ± 3.79 years, and 62.5% had a history of
diabetes in first‑degree relatives. Almost 42% of the participants were the first children of the family and
29.5% were studying at the university.The mean score of spiritual intelligence was 60.42 ± 12.9. The
mean self-efficacy score was 5.41 ± 1.87.The mean scores in the critical thinking, personal meaning
production, transcendental awareness, conscious state expansion were 18.31 ± 4.33, 13.17 ± 3.36,
11.26 ± 3.36, 46.14 ± 1.04, 11.33 ± 1.04, and 11.89 ± 3.9, respectively. Cronbach’s alpha level on the
level of spiritual intelligence and self‑efficacy was 0.903 and 0.082, respectively, at 95% confidence
level. There was a significant relationship between spiritual intelligence and self‑efficacy (P = 0.026).
There was no significant relationship between self‑efficacy with spiritual intelligence subscales.
CONCLUSION: This study showed that spiritual intelligence correlates with self‑efficacy and has a
decisive role in improving the health of adolescents with diabetes.

Abstract AIMS AND OBJECTIVES: The aim and objective of this study was to sort out the reasons for use
and nonuse of dental services among people visiting a private dental hospital in urban India.
MATERIALS AND METHODS: A descriptive cross‑sectional study was carried out on 1800 people,
aged 18–65 years, visiting a multispecialty dental hospital in urban India. A self‑administered
questionnaire was used to collect data about the history of dental visits and reasons for use and
nonuse of dental services.
RESULTS: For a majority of the people (45%), time since the last dental visit was more than 2 years,
and the main reason for visiting a dentist was dental pain (38%). Majority of the people had received
restoration of teeth in their previous dental visit (46%). The major reason cited for not visiting a dentist
was lack of knowledge toward dental problems and their consequences (30%). Only few people
visited dentists for preventive reasons. More patients with better educational levels visited dentists
than patients with poor educational status.
CONCLUSION: Majority of the people visited dentists when their problem was severe enough to
have a dental appointment. Dental practitioners across locations should also educate the patients
regarding the importance of regular dental care, discuss barriers for dental care, and promote
attitudinal changes toward a positive health‑seeking behavior.

Abstract INTRODUCTION: For many years, numerous researches and risk reduction activists have
emphasized the importance of public awareness and education for disaster risk reduction (DRR).
These needs, due to human natural manipulation, have increased. The present study was aimed to
assess and determine the evidence on the strategies for education of DRR.
MATERIALS AND METHODS: This study was a systematic review of publications and gray literatures
regarding to strategies for education of DRR conducted in December 2016. Fifteen articles and
dissertations published during January 1, 2000 to December 31, 2016 were extracted through PubMed,
Scopus, ProQuest, Web of Science, ScienceDirect, Ovid, Google Scholar, Scientific Information
Database, Magiran, and Irandoc with the inclusion criteria of English and Persian language. Thematic
analysis technique was used to analyze the articles.
RESULTS: The thematic analyses revealed eight major categories of DRR educational strategies
such as raising knowledge, educational needs assessment, educational planning, educational
approaches, educational content, educational tools, involved organizations, and educational learning
barriers and challenges.
CONCLUSIONS: Most countries have launched DRR education activities, but these actions are
not enough, and there are some gaps between what is it and what should be. More effective and
efficient teaching and learning strategies are needed to increase the effectiveness of preparedness
and DRR activities at all levels of community.

Abstract BACKGROUND: Some evidence suggests that childhood croup could be associated with increased
incidence of adulthood bronchial reactivity, but its significance is uncertain. The aim of the present
study was to evaluate the long‑term outcome of early life croup.
PATIENTS AND METHODS: This case–control study was conducted in 2010–2012 in Isfahan,
Iran. The case group consisted of 164 adolescents with a history of severe croup in early life and an
equal number of healthy controls without any history of croup or other chronic or recurrent respiratory
diseases. The two groups were compared according to pulmonary function tests and bronchial
reactivity (exercise challenge test). Statistical analyses were performed using the SPSS software
package, version 20 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered significant.
RESULTS: Baseline spirometric values (forced expiratory volume in 1st s (FEV1), forced volume
capacity (FVC), FEV1/FVC, and forced expiratory flow at 25%–75% (FEF25–75) were similar in case
and control groups. A reduction in FEV1 and FEF25–75 after exercise challenge test was seen in
9% and 12.8% of patients, respectively, whereas this was reduced in only 4.2% and 6.1% of the
controls (P = 0.034 and P = 0.021, respectively).
CONCLUSION: Our findings suggest that childhood croup might be a predisposing factor for bronchial
hyperreactivity in adulthood. Longitudinal studies are necessary to confirm the clinical significance
of these findings.

Abstract INTRODUCTION: Responsible self‑medication plays a vital role in appropriate use of nonprescription
drugs which will improve safety and reduces unwanted effects of drugs.
AIM: This study is designed to assess knowledge, attitude, and practice (KAP) toward responsible
self‑medication among pharmacy students.
SETTINGS AND DESIGN: A cross‑sectional survey was conducted in pharmacy students of various
colleges located in Anantapur district, Andhra Pradesh, India.
MATERIALS AND METHODS: A total of 403 pharmacy students were enrolled and subjected for
interview using prevalidated KAP questionnaire on responsible self‑medication.
STATISTICAL ANALYSIS: Descriptive statistics were used to represent the sociodemographic
characteristics and KAP levels. Association of socio‑demographic variables with KAP levels are
determined using the Chi‑square test.
RESULTS AND DISCUSSION: A total of 403 pharmacy students are recruited in the study, in these
19 (4.7%) diploma in pharmacy, 260 (64.5%) bachelor in pharmacy, 27 (6.7%) master in pharmacy, and
97 (24.1%) are doctor of pharmacy. Among 403 respondents, 150 (37.2%) good knowledge, 397 (98.5%)
positive attitude, and 170 (42.2%) practice toward responsible self‑medication. Respondent’s age,
pharmacy division, residence, and their parents’ profession were significantly associated with good
knowledge and rational practice toward responsible self‑medication with a P < 0.05.
CONCLUSION: The study concludes that pharmacy students are shown more positive attitude toward
responsible self‑medication. However, students are lack of knowledge and practice of responsible
self‑medication.