Journal of Education and Health Promotion

The relationship between lifestyle and metabolic evaluation in women with a history of gestational diabetes

. Esmat Bahador; . Maryam Saber; . Mohammad Mehdi FadakarDavarani1; . Narges Khanjani; . Batol Hosseini Gohari; . Hadise Safinejad

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Gestational diabetes is one of the most common metabolic diseases duringpregnancy. The risk of a lifestyle role in the prevention of metabolic syndrome in women with a historyof ...  Read More BACKGROUND: Gestational diabetes is one of the most common metabolic diseases duringpregnancy. The risk of a lifestyle role in the prevention of metabolic syndrome in women with a historyof gestational diabetes has now been identified. The present study was performed to investigate therelationship between lifestyle and metabolic syndrome in women with a history of gestational diabetes.MATERIALS AND METHODS: The present study was a retrospective case–control study that wasperformed on 90 women (45 women with a history of gestational diabetes and 45 women without ahistory of gestational diabetes) in Kerman health centers 5 years after delivery in 2020. Data werecollected using a demographic questionnaire and a standardized Walker lifestyle Health promotingLifestyle profile II questionnaire. The reference laboratory was also used to perform the experiments.SPSS21 software and Spearman’s and Chi‑square tests were used to analyze the data.RESULTS: The mean age was 35.67 in the case group and 34.27 in the control group (P = 0.230).Lifestyle did not show any difference between the two groups (P = 0.058). However, metabolicevaluation was different in the two groups (P = 0.030). Furthermore, the results of Spearman’s testto examine the relationship between lifestyle and other variables studied showed that in the casegroup (P = 0.075) and in the control group (P = 0.819) there was no relationship between lifestyleand metabolic assessments 5 years after delivery.CONCLUSIONS: In case group women, it is possible to prevent the progression to type 2 diabetesand disturb the metabolic assessment by teaching a healthy lifestyle and timely follow‑up afterdelivery. A history of gestational diabetes can be one of the causes of type 2 diabetes and metabolicsyndrome. Getting training to change your lifestyle during pregnancy and postpartum can reduce theincidence of gestational diabetes and type 2 diabetes. Screening pregnant women during childbirthis a good opportunity to diagnose diabetes early and predict it in the coming years.

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Exploring faculty perspectives on competency‑based medical education: A report from India

. Rashmi Ramanathan; . Jeevithan Shanmugam; . Magadi Gopalakrishna Sridhar; . Kalaniti Palanisamy; . Seetharaman Narayanan

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  INTRODUCTION: Medical education in India is experiencing a paradigm shift from traditionalcurriculum to competency‑based medical education (CBME). It de‑emphasizes time‑based ...  Read More INTRODUCTION: Medical education in India is experiencing a paradigm shift from traditionalcurriculum to competency‑based medical education (CBME). It de‑emphasizes time‑based trainingand promises greater accountability, flexibility, and learner centeredness. Faculty development isintegral in the context of CBME. Considering faculty perceptions toward the new CBME and addressingthe difficulties will play a vital role in successful implementation.MATERIALS AND METHODS: A cross‑sectional study was carried out among 297 teaching facultyin 91 medical colleges across 20 states all over India between February and July 2020. A structuredvalidated questionnaire on CBME was used to collect the responses through Google forms and wasexported and analyzed in Microsoft Excel.RESULTS: More than 80% opined that Faculty members in departments are not adequate forsuccessful CBME implementation. Reflective learning, early clinical exposure, and elective postingwere accepted by 60.2%, 70.4%, and 45.5% of the faculty, respectively. Around 81.8% welcomedhorizontal integration, whereas only 54.2% favored vertical integration during the Phase I MBBS.CONCLUSION: Few reforms such as curtailing the duration of foundation course, sensitization ofall medical teachers through faculty development programs, better synchronized vertical integration,increasing the strength of faculty in each department, and adequate infrastructure for skills laboratorycan be undertaken as per faculty suggestions.

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Mental health of the people of northern Iran during the quarantine time of 2020 following the coronavirus epidemic

. Fereshteh Araghian Mojarad; . Mohammad Ali Heidari Gorji; . Hamid Salehiniya; . Tahereh Yaghoubi

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: Coronavirus (COVID‑19) is an infectious respiratory disease. Quarantine is oftenaccompanied by unpleasant experiences for those who go through it. The aim of this study ...  Read More BACKGROUND: Coronavirus (COVID‑19) is an infectious respiratory disease. Quarantine is oftenaccompanied by unpleasant experiences for those who go through it. The aim of this study was todetermine the mental health status of people during quarantine in northern Iran.MATERIALS AND METHODS: This cross‑sectional study was conducted during the quarantineperiod of coronavirus. Conventional sampling was done from March 6 to April 6. Six hundred andforty‑two individuals were included. Inclusion criteria were living in Sari and being home quarantinedduring the corona outbreak. Exclusion criteria included hospitalization history due to corona andunwillingness to participate in the study. In this study, the General Health Questionnaire‑28 was usedonline to collect the required data. To analyze the data, descriptive and inferential statistics (t‑test,analysis of variance, and correlation coefficient) were used.RESULTS: In this study, individuals were included in the investigation with a mean age of38.74 ± 11.89 (ranged from 15 to 73). Most of the participants were female (72.85%) andmarried (71.34%). According to the results, 21.5% of the participants had poor mental health.Mean mental health scores have a statistically significant relationship with gender, marital status,education, occupation, quarantine period, patients with corona, and exposure to a patient withcorona (P ≤ 0.05). Furthermore, a negative correlation coefficient was observed between age andmental health score (correlation coefficient = −0.31, significance >0.001).CONCLUSION: The average score of mental health has a significant relationship with gender, maritalstatus, education, occupation, quarantine period, corona, and exposure to a patient with corona.Given the high prevalence of mental disorders in people during the COVID‑19 epidemic, educatingpeople and planning to reduce the psychological effects of the epidemic can be helpful.

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Exploring physical therapy students’ experience of peer learning in a student‑run clinic

. Susan Paparella‑Pitzel; . Ellen Zambo Anderson; . Pamela Rothpletz-Puglia; . James Scott Parrott

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Participation in a student‑run pro bono clinic (SRPBC) provides opportunities forstudents to develop professional skills, engage with the community, and provide an often‑underservedpopulation ...  Read More BACKGROUND: Participation in a student‑run pro bono clinic (SRPBC) provides opportunities forstudents to develop professional skills, engage with the community, and provide an often‑underservedpopulation with needed care.MATERIALS AND METHODS: This paper describes the results of a mixed‑method analysis of studentexperiences in an SRPBC. A survey with both Likert‑type and write‑in elements was administeredto three cohorts of students enrolled in a doctoral program of physical therapy. Students wereprompted to provide their perspective on the value of the clinic experience with respect to professionaldevelopment, academic relevancy, and personal growth.RESULTS: The analysis discovered that perspective value of the clinic in the areas of personalgrowth and academic relevancy differed by cohort. Specifically, 1st‑year students reported that theybenefitted immensely by learning from their peers, especially in the use of outcome measures.Second‑year students did not report the same benefits.CONCLUSION: The findings suggest that even though students from different cohorts work togetherin the same clinic, they may experience the clinic very differently. This observation provided the basisfor changes to the SRPBC to enhance leadership and conflict management skills of the 2nd‑yearstudents.

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Mental health status of students pursuing professional training: A questionnaire‑based study

. Swikruti Behera; . Srinikhila Satya Santhoshi Lakshmi Paluri1; . Alpana Mishra

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: Globally, depression is one of the leading causes of illness and disability amongadolescents, and suicide is the third leading cause of death among the young and adolescents.Since ...  Read More BACKGROUND: Globally, depression is one of the leading causes of illness and disability amongadolescents, and suicide is the third leading cause of death among the young and adolescents.Since we have limited data on the prevalence of psychological distress among the youth of India,our aim was to estimate the prevalence of psychological distress, anxiety, and depression amongstudents of professional colleges.MATERIALS AND METHODS: This study was conducted in Visakhapatnam, Andhra Pradesh (India).A total of 502 apparently healthy students have participated in this study. Data were collected from243 medical students, 119 engineering students, 103 dental students, and 36 nursing students.A pretested, prevalidated, and structured Kessler’s Psychological Distress Scale (K10) was used forthe assessment of mental health among students. This is a self‑administered questionnaire‑basedcross‑sectional study. Microsoft Office Excel was used for data storage and tabulation. Mean,standard deviation, Chi‑square test, Mann–Whitney U‑test, and Kruskal–Wallis test were used tofind the association difference between various parameters using SPSS 22 software.RESULTS: Out of 502 students, 34.7% of students were found to have normal mental health, 135students were having mild mental problems, and 116 and 77 had moderate and severe mental illness,respectively. Out of 197 males, 66 were normal, 61, 46, and 24 had mild, moderate, and severemental problems, respectively. Out of 305 females, only 108 were found to be normal.CONCLUSION: Male students were found to have higher prevalence of mental abnormalities.A significant higher prevalence of depression is seen in day‑scholars compared to hostellers. Nursingstudents are having significantly higher prevalence of depression and nonpsychotic mental illnessas compared to dental, engineering, and medical students. Medical students are having the lowestrate of depression than other nonmedical professional subjects.

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Identifying drivers and factors affecting behavioral risk factors of noncommunicable diseases: A scoping review

. Saeide Alidoost; . Mohammadreza Maleki; . Hamid Pourasghari

Volume 11, Issue 9 , October 2021, Pages 1-9

Abstract

  BACKGROUND: A large proportion of noncommunicable diseases (NCDs) can be prevented byreducing unhealthy nutrition, inadequate physical activity, smoking, and alcohol consumption. The ...  Read More BACKGROUND: A large proportion of noncommunicable diseases (NCDs) can be prevented byreducing unhealthy nutrition, inadequate physical activity, smoking, and alcohol consumption. The highburden of NCDs underlines the need for a greater understanding of the causes of these risk factors.This paper aims to identify factors affecting smoking, alcohol consumption, unhealthy nutrition, andinadequate physical activity in current and future times.MATERIALS AND METHODS: A scoping review was conducted in Iran University of MedicalSciences, Tehran, Iran, in 2020 to identify factors affecting smoking, alcohol consumption, unhealthynutrition, and inadequate physical activity. The review was guided by the five‑step Arksey and O’Malleymodel. A deductive qualitative content analysis was employed to identify the factors synthesizedthrough descriptive and narrative synthesis. The search was conducted in English without daterestrictions up to January 2020.RESULTS: We identified 1437 studies through database search and other sources and finally included72 studies in the review. The content analysis of the data led to the identification of 27 factors affectingsmoking, alcohol consumption, nutrition, and physical activity. The factors categorized into social,technological, environmental, economic, political, and values factors.CONCLUSION: Political and economic factors have a significant effect on all risk factors, and it isnecessary to take comprehensive measures to improve these factors. Technological factors have agreater impact on healthy nutrition. Physical activity is more affected by environmental factors thanother risk factors. However, smoking and alcohol consumption are more influenced by social factorsand individual attitudes.

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Comparison of self‑, peer, and teachers’ evaluation about the clinical skills of nursing students at the department of psychiatry

. Mahnaz Ghaljeh; . Nasrin Rezaee; . Azizollah Arbabisarjou

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: Evaluating clinical performance is a challenge in nursing education. On the otherhand, a single evaluation method cannot be used to judge different areas of interpersonal ...  Read More BACKGROUND: Evaluating clinical performance is a challenge in nursing education. On the otherhand, a single evaluation method cannot be used to judge different areas of interpersonal skills.Therefore, this study was conducted to compare the evaluation of teachers’, peer, and self‑evaluationof nursing students in the psychiatric ward of Baharan Hospital affiliated to Zahedan University ofMedical Sciences.MATERIALS AND METHODS: In this analytical cross‑sectional study, forty trainee students wereselected by a census method in a time period and they were evaluated by three methods includingself‑, peer, and teachers’ evaluation. Their clinical skills were assessed using a school‑basedclinical evaluation questionnaire containing 15 questions in the areas of taking history, examinationof psychiatric health, and the ability to communicate with the patient. The analyses were performedby SPSS‑22 software.RESULTS: The mean and standard deviation of the evaluation scores of clinical teachers as wellas peer and self‑evaluation in the areas of taking patient’s history were 13.82 ± 2.74, 14.46 ± 2.68,and 15.75 ± 2.56, respectively. In addition, the outcomes in the areas of psychiatric examinationwere 8.11 ± 1.54, 9.25 ± 2.70, and 10.43 ± 2.65 and in the areas of clinical communication were8.93 ± 2.03, 9.04 ± 2.25, and 10.21 ± 1.98, respectively. There was a significant correlation betweenthe mean of teachers’ evaluation and self‑evaluation scores (P = 0.003) as well as comparing peerand self‑evaluation (P = 0.048). However, no significant correlation was observed between teachers’and peer evaluation (P = 0.062).CONCLUSION: Due to the difference in scores of different methods of evaluation, self‑ and peerevaluation can be used as a complementary method with teachers’ evaluation in measuring theclinical performance of clinical students.

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Assessment of determinants predicting success on the Saudi Nursing Licensure Examination by employing artificial neural network

. Vincent Edward Butcon; . Eddieson Pasay‑An; . Maria Charito Laarni Indonto; . Liza Villacorte; . Jupiter Cajigal

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: This study aims to use the artificial neural network as a novel approach to explorefactors that determine and predict successful performance of nursing interns in Saudi ...  Read More BACKGROUND: This study aims to use the artificial neural network as a novel approach to explorefactors that determine and predict successful performance of nursing interns in Saudi Arabia on theSaudi Nursing Licensure Examination (SNLE).MATERIALS AND METHODS: The study employed a cross‑sectional, analytic approach. A total of62 nursing interns were recruited by convenience sampling from the University of Hail to participate.Data collection was conducted from September to December 2019. Descriptive statistics were usedto describe the demographic characteristics of the nursing interns and their responses regardingexamination determinants. Neural network analysis was used to identify factors that are highlypredictive of the success of the nursing interns on the SNLE.RESULTS: Overall, the nursing interns were undecided (3.94 ± 0.14) about the influential factorsdetermining their success. Their study hours (100%) and grade point average (GPA) (96.9%) wereidentified as strong determinants reflective of the tenacity and vigor of the nursing interns, based onthe predictive power of the model. Meanwhile, age (45.7%), marital status (21.3%), gender (15.2%),and the type of academic program (5.9%) were considered the least important of the sociodemographicvariables.CONCLUSION: Exam preparation activities such as preparation programs, review classes, andexam simulations must be promoted and enhanced to increase the passing tendencies of the nursinginterns in the SNLE. The GPA and increased study hours make the most significant contributions tosuccess on the SNLE as compared to other variables such as age, gender, marital status, and theacademic program. This study serves as a springboard for nursing educators and administrators inlaying tailored strategies to strengthen the nurse interns’ GPA and time management.

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Directives of general surgical practice during the COVID‑19 pandemic: A systematic review

. Ahmad AbdulAzeem Abdullah Omer

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  The coronavirus disease 2019 (COVID‑19) is a serious global pandemic that has extremely affectedhealth‑care systems. This article aimed to review the perspectives of general surgical ...  Read More The coronavirus disease 2019 (COVID‑19) is a serious global pandemic that has extremely affectedhealth‑care systems. This article aimed to review the perspectives of general surgical practice duringthe COVID‑19 pandemic. A systematic review of the literature addressing modification to generalsurgical practice during the COVID‑19 pandemic indexed in PubMed, Scopus, Google, and Googlescholar was carried out on June 19–20, 2020. The literature review yielded 577 articles. The exclusionof duplication, articles not in English, and specialized ones in various surgical disciplines precluded398 articles. Finally, following checking for relevance and publication status, 114 papers were included.Recommendations for surgical practice during the COVID‑19 pandemic revolved around mitigationof the risk of virus transmission to patients and health‑care workers. The emerging themes of safetyprecautions were related to patient prioritization and testing, mindful consideration of the operativestrategy, optimum use of personal protective equipment, operative room setup, and departmentalorganization. However, those recommendations were often diverging and bore on a dearth ofevidence and personal opinions. Multidisciplinary work and cooperation among surgical specialtiesare required to establish and validate the protocols for safe surgical practice during the pandemicand perhaps similar crises in future. The COVID‑19 pandemic has brought several challenges tothe field of medicine, including the surgical specialty. The centrality of safety precautions emergingin this crisis requires surgeons to adopt the new roles and work standards and translate them intopractice during the pandemic and perhaps longer.

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Effective factors on establishment of knowledge translation in the health system policy‑making: A protocol for systematic review

. Shahin Mojiri; . Mandana Sahebzadeh; . Khadijeh Ahmadzadeh; . Azra Daei; . Hasan Ashrafi‑Rizi; . Mohsen Taheri Demneh; . Haniye Sadat Sajadi; . Mohammad Reza Soleymani

Volume 11, Issue 9 , October 2021, Pages 1-5

Abstract

  Despite the importance and position of evidence‑based policymaking in the proper management ofthe health system, studies show that the lack or improper and untimely use of evidence ...  Read More Despite the importance and position of evidence‑based policymaking in the proper management ofthe health system, studies show that the lack or improper and untimely use of evidence are still oneof the main challenges of health systems. Knowledge translation as a solution to this challenge is aprocess that includes a period of time that starts of decision to choose the research topic and continueto publish of research results, in which the interaction of the researchers and stakeholders is the keyfactor and the main axis of the process. Since the recognition and promotion of knowledge translationprocesses resulting from research in health system policy‑making will lead to the improvement of thehealth system, this review protocol was designed to identify factors affecting knowledge translationimplementation, including barriers and facilitators of this process. Identifying these factors can beused as a guide for health system decision‑makers and research managers in planning to selectappropriate policies for deployment of the knowledge translation process to increase the use ofresearch results in the health system.

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A comparative study of the effect of two educational methods of motivational interviewing and peers on self‑efficacy of female high school students in relation to puberty health

. Sarah Mohamadi; . Narges Alizadeh; . Zahra Motaghi; . Sahar Paryab; . Omid Garkaz

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Adolescents experience many physical and psychological changes duringadolescence. Not paying attention to the issue of girls’ puberty may have a negative impact on ...  Read More BACKGROUND: Adolescents experience many physical and psychological changes duringadolescence. Not paying attention to the issue of girls’ puberty may have a negative impact on theirmental health and self‑efficacy in future. The aim of this study was to compare the two methods ofmotivational interviews and peers on puberty health of female high school students.MATERIALS AND METHODS: This study was performed semi‑experimental intervention on 334high school students in 2019 through multi‑stage randomization. Data using two demographicquestionnaires and Scherrer self‑efficacy questionnaire in three stages (pre‑test, immediately afterthe test and one month after the test). It was collected that in the motivational interview group, 5training sessions were presented, and in the peer group, only one training session was taught to thepeers and the control group was not trained in any intervention.RESULTS: Immediately after, and 1 month after the intervention, the two intervention groups hadsignificantly better scores in self‑efficacy compared to the control group (P = 0.001). The mean scoreof self‑efficacy in the control group in the three time periods before, immediately, and one monthafter the intervention, respectively (50.75 ± 5.322, 50.45 ± 5.34, 50.45 ± 5.37), in the motivationalinterview group (50.56 ± 5.95, 53.63 ± 5.83, 56.03 ± 6.49) and in the peer group (50.10 ± 5.62,54.40 ± 4.28, 59.19 ± 4.43) was. Moreover, there were significant differences in self‑efficacy scoreswithin and between the groups by time (P < 0.001) in intervention groups.CONCLUSION: This study showed that puberty health education increases students’ self‑efficacy,that correct information should be conveyed by peers and motivational interview, and motivationalinterview is more effective.

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COVID‑19 vaccine acceptability, determinants of potential vaccination, and hesitancy in public: A call for effective health communication

. Rajesh Kumar; . Mukesh Bairwa; . Kalpana Beniwal; . Ravi Kant

Volume 11, Issue 9 , October 2021, Pages 1-10

Abstract

  BACKGROUND: Coronavirus disease rapidly spreads across the entire world in < 2 months andgravely jeopardizes the regular human routine. The medical fraternity recommends a vaccine ...  Read More BACKGROUND: Coronavirus disease rapidly spreads across the entire world in < 2 months andgravely jeopardizes the regular human routine. The medical fraternity recommends a vaccine as oneof the best solutions to save the universe. However, to be effective, the population should reflect anencouraging attitude to accept it. The study aimed to measure vaccine acceptability and reason forhesitancy among the public.MATERIALS AND METHODS: Eight hundred and forty one adults visiting a tertiary care hospitalresponded to a pretested validated questionnaire on vaccine acceptability and hesitancy. The Chi‑squaretest and independent t‑test, followed by multinomial logistic regression, were used to analyze the findings.RESULTS: Overall, 53.4% (n = 445) of participants interested to take vaccine, 27.2% (n = 229)were not sure, and the remaining 19.4% (n = 163) did not intent to vaccinate. Gender (P = 0.013),information on the vaccine (P = 0.022), chances to get coronavirus disease in the next 6months (P < 0.001), awareness on India COVID‑19 vaccine (P < 0.001), Indian manufacturingcompany of vaccine (P < 0.001), family history of the laboratory‑confirmed case (P < 0.001), andhealth status (P = 0.011) found a significant association with intention to vaccination (a response“yes” vs. “no” and “not sure”). Reasons for vaccine hesitancy included specific antivaccine attitudesand beliefs, a concern of fear and phobia, lack of information, and safety issues on the vaccine.CONCLUSIONS: This institute‑specific survey revealed that approximately every 4 in 8 people werenot sure to take the vaccine, and one in five people refused to be vaccinated. The study recommendsusing target‑based health education to understand and address vaccine‑specific concerns to enhancevaccine coverage, and boost confidence among the population.

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The effect of sexual health literacy on the sexual life quality of women referring to healthcare centers in Qazvin, Iran

. Rahman Panahi; . Mansoure Kheiri; . Zeynab Abolhasani Daronkolaei; . Zahra Arjeini; . Maryam Taherpour; . Leila Dehghankar; . Saman Valinezhad

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Considering the role of sexual quality of life in public satisfaction, improvinginterpersonal relationships, promoting the general quality of life, especially in women, ...  Read More BACKGROUND: Considering the role of sexual quality of life in public satisfaction, improvinginterpersonal relationships, promoting the general quality of life, especially in women, and ultimatelymaintaining, consolidating, and promoting family and community health, the need to explain the factorsaffecting it, such as sexual health literacy, is felt from the perspective of women. This study aimedto determine the relationship of sexual health literacy on the sexual life quality of women referringto health‑care centers in Qazvin.MATERIALS AND METHODS: This research was a descriptive cross‑sectional study. The populationof this study was 420 women of Qazvin in 2020 who were selected by multistage sampling. Thedata collection tool was a demographic questionnaire and the standard questionnaire sexual healthliteracy for adults and Sexual Quality of Life‑Female questionnaire. Data were analyzed using SPSSsoftware version 22 and descriptive statistics and logistic regression.RESULTS: The mean (standard deviation) of the sexual health literacy score was 78.47 (17.85) andsexual quality of life was 59.71 (19.21). The results of logistic regression test showed that the variablesof sexual health literacy, education level, age of marriage, and number of sexual intercourses perweek were effective factors on the sexual quality of life (P < 0.05).CONCLUSION: Women with lower sexual health literacy, lower education level, higher marriage age,and women who had sex less per week had a lower sexual quality of life. Therefore, it is necessary to paymore attention to these women in designing educational programs to improve the quality of sexual life.

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The effect of integration of basic and clinical aspects of a specific topic in a parasitology course on medical students learning: A randomized controlled trial

. Mitra Amini; . Fattaneh Mikaeili; . Farhad Handjani; . Gholamreza Hatam; . Qasem Asgari

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND AND AIM: Parasitology course is one of the basic science courses in the educationalcurriculum for medical students. Since the integration of basic and clinical sciences has ...  Read More BACKGROUND AND AIM: Parasitology course is one of the basic science courses in the educationalcurriculum for medical students. Since the integration of basic and clinical sciences has helpedstudents better understand the basic science course content, the aim of the present study was todetermine the effect of integration of basic and clinical aspects of a specific topic in a parasitologycourse on medical students learning.MATERIALS AND METHODS: A randomized controlled trial was conducted on 110 undergraduatefifth‑semester medical students from April to July 2018. The students were randomly divided into twogroups, based on student identification number: Intervention and control groups. The topic selectedfor this study from the parasitology course was “cutaneous leishmaniasis.” At the beginning of theprogram, a dermatologist presented the clinical aspects of the topic to the intervention group. Then,a parasitologist delivered a traditional lecture about the basic aspects of the topic to both groups.The students’ scores on questions related to cutaneous leishmaniasis in the final exam were usedas a measure of learning and teaching outcomes. A questionnaire that consisted of seven items andthree open‑ended questions was used based on the objectives of the randomized controlled trial.Statistical analysis was performed by SPSS software.RESULTS: Based on the result of the final examination, there was no significant difference inthe learning rate of students between the intervention and control groups (P ≥ 0.05). Accordingto students’ comments, the teaching of clinical science alongside basic science increased theimportance of the topic and the students’ interest in basic science. Most students agreed that thismethod prepares them for their clinical years.CONCLUSION: Many medical students believe that the content of many basic science courses areforgotten in the future. Therefore, basic science education alongside clinical science presentationsare suggested.

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Healthy ageing: Assessment of health‑promoting lifestyle among the elderly population in Karachi Pakistan

. Saima Zainab; . Aneeta Khoso; . Maryam Siddiqui; . Kiran Ashraf; . Muhammad Anees Mumtaz; . Manahil Awan

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: The growth in the elderly population is predicted to expand exponentially anddeveloping countries like Pakistan have about two‑third of the global elderly population. ...  Read More BACKGROUND: The growth in the elderly population is predicted to expand exponentially anddeveloping countries like Pakistan have about two‑third of the global elderly population. It is vital tomaintain the health of the elderly aged population to reduce disabilities and health‑care cost.AIM: This study aimed to determine the health promotion practices among the older aged populationin Pakistan and to explore the factors associate with adopting healthy lifestyle practices.MATERIALS AND METHODS: This was a cross‑sectional study spanning from 2019 to 2020conducted on 317 participants of age more than 60 years in Pakistan. The participants includedhealthy attendants of patients visiting the outpatient clinics of different disciplines in the LiaquatNational Hospital Karachi through purposive sampling technique. The health‑promoting practiceswere assessed using Health‑Promoting Lifestyle Profile II Questionnaire. The factors that determinedthe healthy practices among the elderly population were identified using independent t‑test andanalysis of variance and Tukey test, with a significance level of P < 0.05. IBM SPSS Statistics 22was used for data entry and analysis.RESULTS: The highest subscale was detected from interpersonal relationships and spiritual growth.The lowest score was detected from physical activity. The scores differed significantly by occupation,education, and the marital status of the participants. Females, unmarried people, those who wereless educated, and participants relying on others for financial support had lower health‑promotinglifestyle scores.CONCLUSION: The overall health‑promoting practices were good among the old‑aged population ofPakistan. These practices differed particularly for physical activity, spiritual growth, and interpersonalrelationships.

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Competence in providing spiritual care and its relationship with spiritual well‑being among Iranian nurses

. Mojtaba Jafari; . Masoud Fallahi-Khoshknab

Volume 11, Issue 9 , October 2021, Pages 1-5

Abstract

  BACKGROUND: Competence in providing spiritual care to patients has become an increasinglyimportant aspect of nursing care delivery. However, studies on nurses’ competence in spiritual ...  Read More BACKGROUND: Competence in providing spiritual care to patients has become an increasinglyimportant aspect of nursing care delivery. However, studies on nurses’ competence in spiritual caredelivery and the factors affecting it are very limited. The present study was conducted to evaluateIranian nurses’ competence in providing spiritual care and its relationship with their SpiritualWell‑Being.MATERIALS AND METHODS: The present study is descriptive‑analytical research conducted in Bamin the south of Iran between 2016 and 2017. All nurses working in the teaching hospitals affiliatedwith Bam University of Medical Sciences were invited to participate in the study. For data collection,the Spiritual Care Competence Scale (SCCS) and the Spiritual Well‑Being Scale (SWBS) were used.Collected data were then analyzed using descriptive statistics (mean and standard deviation), Pearsoncorrelation coefficient, independent t‑test, and one‑way ANOVA with SPSS software.RESULTS: In this study, 158 nurses were participated. The result showed that the mean scoreSCCS and SWBS were 101 ± 12.6, 76.92 ± 13.4, respectively. Pearson correlation test showed asignificant and direct relationship between the mean score of SCCS and SWBS (P = 0.001, r = 0.264).The results of this test also showed a significant relationship between all the dimensions of SCCSand SWBS (P < 0.05).CONCLUSIONS: In this study, the nurses had a relatively appropriate competence in providingspiritual care to patients. There was also a significant relationship between the nurses’ spiritualcare competency and their spiritual well‑being. Given the lack of adequate studies in spiritual caredelivery competencies, it is recommended that similar studies are conducted among nurses in otherparts of the country and worldwide.

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Simulation‑based structured training for developing laparoscopy skills in general surgery and obstetrics & gynecology postgraduates

. Kailash Charokar; . Jyoti Nath Modi

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Simulation‑based training is an important strategy for skill development in acompetency‑based curriculum, especially so for laparoscopic surgery given its unique learning ...  Read More BACKGROUND: Simulation‑based training is an important strategy for skill development in acompetency‑based curriculum, especially so for laparoscopic surgery given its unique learning curve,need for practice, and patient safety concerns. The study was conducted for postgraduates in twosurgical disciplines in a medical college tertiary care center. The study evaluates the acceptability andutility of structured simulation‑based training for laparoscopic skills. Simulations provide deliberatepractice in the leaner supportive environment.MATERIALS AND METHODS: The educational intervention was carried out among the 16postgraduates from year 2 and year 3 of general surgery and obstetrics and gynecology. A structuredtraining and assessment module was designed and validated, and a 12‑week structured trainingon laparoscopic box trainers was given to postgraduates under faculty guidance. Feedbackfrom postgraduates and faculty was obtained using separate validated questionnaires. Thepre‑ and post‑training assessment scores were compared applying the Wilcoxon matched‑pairssigned‑rank (2‑tailed) test using the SPSS Windows Version 20.0 (IBM Corporation).RESULTS: Sixteen postgraduates participated in the study. The median satisfaction score of thepostgraduates was 4 (range 3–5), a scale of a maximum of 5. The group identified faculty feedback,stepwise skills learning, supportive learning environment, and trainers’ motivation as enabling factorsin the training. The faculty observed that the trainees were effectively engaged. The group meanimprovement scores in percentage were 40.08 for task 1, 42.08 for task 2, 43.13 for task 3, and45.63 for task 4.CONCLUSIONS: It is feasible to incorporate faculty‑guided sessions of simulation training in basiclaparoscopy skills for postgraduates in our setup. It is well accepted by the key stakeholders, andwe recommend it to be incorporated in the formal training program.

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Providing a model for validation of the assessment system of internal medicine residents based on Kane’s framework

. Mostafa Dehghani Poudeh; . Aeen Mohammadi; . Rita Mojtahedzadeh; . Nikoo Yamani; . Ali Delavar

Volume 11, Issue 9 , October 2021, Pages 1-13

Abstract

  BACKGROUND: Kane’s validity framework examines the validity of the interpretation of a test at thefour levels of scoring, generalization, extrapolation, and implications. No model ...  Read More BACKGROUND: Kane’s validity framework examines the validity of the interpretation of a test at thefour levels of scoring, generalization, extrapolation, and implications. No model has been yet proposedto use this framework particularly for a system of assessment. This study provided a model for thevalidation of the internal medicine residents’ assessment system, based on the Kane’s framework.MATERIALS AND METHODS: Through a five stages study, first, by reviewing the literature, themethods used, and the study challenges, in using Kane’s framework, were extracted. Then, possibleassumptions about the design and implementation of residents’ tests and the proposed methods fortheir validation at each of their four inferences of Kane’s validity were made in the form of two tables.Subsequently, in a focus group session, the assumptions and proposed validation methods werereviewed. In the fourth stage, the opinions of seven internal medicine professors were asked aboutthe results of the focus group. Finally, the assumptions and the final validation model were prepared.RESULTS: The proposed tables were modified in the focus group. The validation table was developedconsisting of tests, used at each Miller’s pyramid level. The results were approved by five professorsof the internal medicine. The final table has five rows, respectively, as the levels of Knows and KnowsHow, Shows How, Shows, Does, and the fifth one for the final scores of residents. The columnsof the table demonstrate the necessary measures for validation at the four levels of inferences ofKane’s framework.CONCLUSION: The proposed model ensures the validity of the internal medicine specialty residencyassessment system based on Kane’s framework, especially at the implication level.

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Promotion of posttraumatic stress disorder following traumatic birth experiences and the influence of maternity religious Attitude: A correlational study

. Sedighe Alipanahpour; . Mahnaz Zarshenas; . Marzieh Akbarzadeh

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Women who experience stillbirth and preterm delivery are likely to be associatedwith an increased risk of posttraumatic stress disorder (PTSD) compared to women with live ...  Read More BACKGROUND: Women who experience stillbirth and preterm delivery are likely to be associatedwith an increased risk of posttraumatic stress disorder (PTSD) compared to women with live birthsand dose religious attitude related to posttraumatic stress? The aim of the study was promotion PTSDfollowing traumatic birth experiences and the influence of maternity religious Attitude.MATERIALS AND METHODS: A cross‑sectional analytical study was conducted at selected hospitalsof Shiraz University of Medical Sciences on 82 subjects in 2018. The instruments were demographicquestionnaire, Religious Attitude questionnaire, and Mississippi PTSD Scale which were completedafter delivery. Data were analyzed using SPSS software, version 22, using the Pearson correlation test.RESULTS: About 75% stillbirth group and 65% of the preterm delivery group had a high level ofreligious attitude. In the stillbirth group, 90% had high levels of PTSD and in the preterm deliverygroup, 90% had moderate stress, and 10% had high PTSD levels. The correlation between religiousattitude and PTSD after stillbirth was 0.373 with a significance level of 0.018. Therefore, there wasa significant positive relationship between religious attitude and PTSD. However, the relationshipbetween religious attitude and PTSD after preterm delivery was not statistically significant (P = 0.158).CONCLUSION: PTSD was significantly higher in mothers with stillbirth and had a significantrelationship with religious attitude. However, in mothers of preterm infants, the level of stress wasmoderate and did not have a significant relationship with religious attitude. The findings indicate theneed of mothers for interventions to cope better with the physical and psychological problems ofstillbirth and preterm delivery.

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The effectiveness of sexual health group counseling based on cognitive behavioral therapy on sexual satisfaction of newly married women

. Mahshid Bokaie; . Fariba Behzadpour; . Tahmineh Farajkhoda

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: The beginning of a marital relationship is very important as a part of a familyrelationship, and it satisfies many mental and physical necessities in a safe environment ...  Read More BACKGROUND: The beginning of a marital relationship is very important as a part of a familyrelationship, and it satisfies many mental and physical necessities in a safe environment and hasa great impact on people’s health. The aims of this study were to investigate the effectiveness ofsexual health counseling based on cognitive behavioral approach on satisfaction and excitability ofnewly married women.MATERIALS AND METHODS: A randomized clinical trial study was conducted in 50 newly marriedwomen who referred to the health center of Jiroft City. They randomly divided into the interventionand the control groups. All of the participants completed Linda Berg’s Sexual Satisfaction Scalebefore intervention, 8 weeks after intervention and 4 weeks later (follow‑up). The interventionalgroup participated in CBT (8 sessions, 90 min), but the control group received routine counseling.In all tests, a significance level of 0.05 was considered. Data were analyzed by SPSS version 20.Descriptive test, t‑test, and repeated measure test used to analyze data.RESULTS: In intervention group, sexual satisfaction was obtained 51.88 ± 12.27, 57.2 ± 12.88and 62.76 ± 11.35 (P < 0.05) and in the control group was gotten 47.12 ± 9.6, 45.8 ± 8.07 and43.48 ± 7.39 (P > 0.05) before intervention, 8 weeks after intervention and 4 weeks later (follow‑up),respectively. In intervention group, sexual excitability was obtained 82.80 ± 17.24, 91.72 ± 13.07,and 99.28 ± 11.2 (P < 0.05) and in the control group was gotten 87.04 ± 12.99, 87.48 ± 11.64, and81.96 ± 12.83 (P > 0.05).CONCLUSION: It can be concluded that cognitive‑behavioral counseling can help to improve thesexual satisfaction and excitability of the newly married and can be used to improve and promotewomen’s sexual health.

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Assessing readiness to change in regular breakfast consumption among elementary students

. Mahsa Mohajeri; . Sajjad Narimani; . Fardin Shahbazzadeh; . Saniyeh Bahrampanah; . Vida Qaderi

Volume 11, Issue 9 , October 2021, Pages 1-5

Abstract

  BACKGROUND: Motivation and desire are the main psychological factors associated with regularbreakfast consumption among elementary students. The purpose of this study was to assess ...  Read More BACKGROUND: Motivation and desire are the main psychological factors associated with regularbreakfast consumption among elementary students. The purpose of this study was to assess thereadiness of students to regular breakfast consumption.MATERIALS AND METHODS: This research was cross‑sectional study; 300 students participatedwho were selected based on cluster sampling from elementary schools in different parts of Ardabiland were interviewed using a motivational questionnaire according to SOC model. The acquireddata was then analyzed by ANOVA and linear regression.RESULTS: Cognitive processes of change such as social liberation (β = 0.31, α = 0.001) andself‑reevaluation (β = 0.13, α = 0.04) and self‑efficacy (β = 0.44, α = 0.001) played a significant rolein motivating students to move from the inactive stage to preparation stage.CONCLUSION: By understanding the motivational factors of regular breakfast consumption, a regularprogram can be implemented to increase breakfast consumption and ensure the health of studentsand help them to grow in learning ability and abstract thinking.

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A questionnaire‑based study to develop an instrument measuring poor interest in biostatistics among postgraduate medical students and faculties

. Uttam Kumar Roy; . Pabitra Biswas; . Purnendu Mandal

Volume 11, Issue 9 , October 2021, Pages 1-5

Abstract

  BACKGROUND: It has been realized by senior researchers that interest in biostatistics is very pooramong medical professionals. Knowledge of biostatistics plays an important role in ...  Read More BACKGROUND: It has been realized by senior researchers that interest in biostatistics is very pooramong medical professionals. Knowledge of biostatistics plays an important role in medical research.Studies conducted about knowledge, attitude toward biostatistics by many researchers, but there wereno works about factors in relation to it. Considering this gap, we tried to develop a new instrument.MATERIALS AND METHODS: Item generation and questionnaire formation were done using focusgroup discussion involving seven experts from different departments of medical colleges. Face validityand content validity and pilot testing were carried out step by step. In estimating reliability, internalconsistency measured after collecting data from 66 study participants. Data were collected throughself‑administered paper‑based questionnaire where response in each item was in five‑point Likertscale. Cronbach’s alpha for reliability analysis was used.RESULTS: In first stage, item generation through FGD, then face validity was assessed by seniorfaculties. Content validity was checked by Aiken’s V index. In initial stages, with six items, Cronbach’salpha was 0.805. Scale mean and variance were 24.24 and 27.26. After final reliability testing, itbecame 0.866 with four items where scale mean and variance came to 15.85 and 16.38.CONCLUSION: All the six items were important factors. Reliability improved when knowledge instatistics in higher secondary level and biostatistics classes in PG course were eliminated as factors.More qualitative research is needed for better understanding of this concept.

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Designing an educational campaign intervention on smoking preventive behaviors in students: A protocol

. Seyed Saeed Mazloomy Mahmoodabad,; . Salime Zare Abdollahi; . Mohammad Hasan Lotfi

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Todays, human lifestyle has faced significant changes, and this lifestyle hascaused health problems. The increase of smoking, among young people, is one of the risk factorsand ...  Read More BACKGROUND: Todays, human lifestyle has faced significant changes, and this lifestyle hascaused health problems. The increase of smoking, among young people, is one of the risk factorsand incorrect lifestyle factors. The present study will design an educational campaign interventionbased on the protection motivation theory (PMT) on smoking preventive behaviors in students.MATERIALS AND METHODS: In designing this study, five phases are considered. (1) needsassessment and determination of the current situation are considered. In this phase, the requiredcommunication is established to form a planning team with key and influential people and experts, (2)tool design, (3) educational intervention (educational campaign) is designed. Some individuals willbe selected and trained as facilitators to start entering the target population, have a better accessto the target group, and implement the interventions in the target group. (4) the implementation ofthe educational plan, in which the designed educational intervention (educational campaign) willbe implemented on the students of the studied universities. (5) the educational evaluation, whichwill be conducted 2 months after the intervention of the educational campaign. The posttest will bebased on before and after the implementation of the educational campaign. In the prevention of thesecond type in smoking students, the salivary cotinine levels of smoking students will be measuredand comparisons will be made before and after educational using appropriate statistical tests.RESULTS: The present study addresses the needs and strategies for smoking prevention using atraining campaign based on the PMT and web .CONCLUSION: Designing a campaign which will lead to smoking preventive behaviors causeslifestyle changes, prevent health problems such as cancer, cardiovascular diseases, and otherchronic diseases, reduce treatment costs, and increase life expectancy.

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Effective strategies for implementing patient‑centered care in cardiac care unit: An opportunity for change

. Firouzeh Charosaei; . Shahnaz Rostami; . Maryam Esmaeili; . Shahram Molavynejad; . Zohreh Vanaki

Volume 11, Issue 9 , October 2021, Pages 1-9

Abstract

  BACKGROUND: Patient‑centered care (PCC) is a cornerstone for health‑care professionals toimprove the quality of care they provide to patients with cardiac disease. However, implementationof ...  Read More BACKGROUND: Patient‑centered care (PCC) is a cornerstone for health‑care professionals toimprove the quality of care they provide to patients with cardiac disease. However, implementationof PCC programs has always accompanied with unpredictable challenges and obstacles. Therefore,the present study was conducted to determine effective strategies for the implementation of PCCfrom the perspective of patients and healthcare providers.MATERIALS AND METHODS: The present research was a qualitative study using conventional contentanalysis method in one of the university hospitals of Abadan University of Medical Sciences during2019–2020. Purposive sampling was performed until data saturation was achieved. Data were collectedthrough four focused group discussions and 24 in‑depth semi‑structured interviews with 22 health‑careproviders and seven cardiac patients. Depending on the interview process and the responses of eachindividual, the sequencing of questions was different from one participant to another. Data analysis wasperformed continuously and concurrently with data collection, using a comparative method.RESULTS: After data analysis, seven subcategories and three main categories were extracted. Themain categories included structural, process, and outcome strategies. The category of structuralstrategies included subcategories of nursing care organization, application of appropriate motivationalmechanisms, and expansion of team coordination. Process strategies included three subcategories,namely, promoting communication, respectful and compassionate care, and the development ofholistic care. Finally, the outcome strategy consisted of the subcategory of patient empowerment.CONCLUSION: The practical strategies for the implementation of PCC in coronary care unit revealedin this study were at structural, process, and outcome levels. Health‑care managers and administratorscan avail themselves of the findings of the present study to promote the quality care for cardiac careunit patients and improve patient satisfaction.

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Training pain management to nursing students: Designing, implementing, and evaluating a mobile‑based application

. Leila Shahmoradi; . Mahtab Mehrabanfar; . Seid Ali Emami Meibodi; . Elham Navab; . Hossein Majedi Ardakani; . Azita Yazdani; . Jebraeil Farzi

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Pain is a common health issue and acute pain is the main problem for patientsafter surgery and injury. Inadequate and inappropriate management of pain is dangerous and costlyfor ...  Read More BACKGROUND: Pain is a common health issue and acute pain is the main problem for patientsafter surgery and injury. Inadequate and inappropriate management of pain is dangerous and costlyfor patients and leads to undesirable health effects. To overcome this problem, empowerment ofthe health‑care team, especially nurses, is essential. Today, to improve the quality of health‑careprovision, various methods are used that e‑learning is one of them.MATERIALS AND METHODS: Based on the studies on pain management, existing parameterswere extracted, and according to them, the educational content of the software was approved bynursing professors and anesthesiologists. The Unified Modeling Language diagrams were designedto provide a better understanding of the entities and the order in which the software operates. Thesoftware was implemented in the google android studio environment using Photoshop and JQuerymobile. Finally, the software was evaluated by using Questionnaire for User Interface Satisfaction.The software was evaluated by experts and students in two stages. The first stage was evaluatedby eight anesthesiologists and nursing professors, and the second stage was evaluated with theparticipation of 55 undergraduate students and 28 M.Sc. nursing students.RESULTS: The software was developed with two main modules of training and testing, and sectionsof the report, about us and exit, and four scenarios for the test section. In the initial evaluation ofsoftware by experts with an average of 91.85%, and in the second assessment of students, with amean of 78.15%, application software was evaluated at a good level.CONCLUSIONS: In order to teach academic and practical (clinical) materials to students, the use ofdigital teaching aids and e‑learning, along with traditional methods such as lectures, increases thestudents’ eagerness, and motivation to learn more and thereby enhance the level of learning andimproving the quality of education.

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The relationship between the willingness to mobile learning and educational achievements in health‑care professional students

. Nayereh Baghcheghi; . Hamid Reza Koohestani

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: The relationship between willingness to mobile learning (m‑learning) and educationalachievement was examined in health‑care professional students.MATERIALS AND METHODS: ...  Read More BACKGROUND: The relationship between willingness to mobile learning (m‑learning) and educationalachievement was examined in health‑care professional students.MATERIALS AND METHODS: This is a descriptive correlative study that was conducted fromJanuary 2020 to February 2020. A total of 295 students in Saveh University of Medical Sciences inIran were selected through census method. The data were collected using the standard willingness tom‑learning questionnaire. The data collected were analyzed statistically using Pearson’s correlationcoefficient and concurrent regression analysis.RESULTS: The mean score of willingness to m‑learning was 165.55 ± 13.4, which is an indicativeof a higher willingness level in the health‑care professional students for m‑learning. There was apositive and significant relationship between willingness for m‑learning and educational achievement(r = 0.77, P < 0.01). The predictive variable, i.e., willingness to m‑learning, predicted 53.8% of thevariance of educational achievement (F = 58.801, P = 0.00). Among the variables of willingness tom‑learning, the regression coefficients of perceived ease, attitude, self‑management in learning,educational use, and efficiency of m‑learning were significant (P < 0.05). This means that thesevariables are direct predictors of educational achievement.CONCLUSIONS: Willingness to m‑learning had a positive and significant relationship with educationalachievement. Although this study was performed just before the corona outbreak, paying attentionto the results of this study can be helpful for students, faculty members, and policymakers in fillingthe educational gap during the coronavirus disease 2019 outbreak.

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Higher coronavirus disease‑19 mortality linked to comorbidities: A comparison between low‑middle income and high‑income countries

. Har Ashish Jindal; . Soumya Swaroop Sahoo; . Limalemla Jamir; . Ashwini Kedar; . Sugandhi Sharma; . Bhumika Bhatt

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Global burden of disease (GBD) provides the estimates of mortality and morbidity,while case fatality rate (CFR) helps in understanding the severity of the disease. People ...  Read More BACKGROUND: Global burden of disease (GBD) provides the estimates of mortality and morbidity,while case fatality rate (CFR) helps in understanding the severity of the disease. People infectedwith severe acute respiratory syndrome coronavirus 2 (SARS CoV‑2) with underlying medicalconditions have shown higher levels of unfavorable outcomes including mortality. We assessed theassociation of SARS‑CoV‑2 CFR with disability‑adjusted life years (DALY) of various comorbiditiesin the low‑middle income countries (LMIC) and high‑income countries (HIC) to study the relationshipof coronavirus disease‑19 (COVID‑19) mortality with GBDs and to understand the linkage betweenCOVID‑19 mortality and comorbidities.MATERIALS AND METHODS: This was an ecological study with secondary data analysis comparingthe DALY of various morbidities from GBD with CFR of COVID‑19. Gross domestic product was thebasis of stratifying 177 countries into low‑middle income (LMIC) and high‑income groups (HIC). Themortality was analyzed using Pearson correlation and linear regression.RESULTS: The median global CFR of SARS‑CoV‑2 was 2.15. The median CFR among LMIC (n = 60)and HIC (n = 117) was 2.01 (0.00–28.20) and 2.29 (0.00–17.26), respectively. The regression analysisfound that, in both LMIC and HIC, maternal disorders were associated with higher SARS‑CoV‑2CFR, while tuberculosis, mental health disorders, and were associated with lower CFR. Further, inLMIC, musculoskeletal disorders and nutritional deficiencies were associated with higher CFR, whilerespiratory disorders were associated with lower CFR.CONCLUSIONS: SARS‑CoV‑2 infection appears to be a systemic disease. Individuals withcomorbidities, such as maternal disorders, neurological diseases, musculoskeletal disorders, andnutritional deficiencies, have poorer outcomes with COVID‑19, leading to higher mortality.

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Evaluation of cytotoxicity and anticancer activity of kombucha and doxorubicin combination therapy on colorectal cancer cell line HCT‑116

. Latifeh Rasouli; . Naheed Aryaeian; . Mehran Gorjian; . Mitra Nourbakhsh; . Fatemehsadat Amiri

Volume 11, Issue 9 , October 2021, Pages 1-8

Abstract

  BACKGROUND: Colorectal cancer is the third leading to death type of cancer in the world.The therapeutic guideline varied between different methods. As the main therapeutic guidelineis ...  Read More BACKGROUND: Colorectal cancer is the third leading to death type of cancer in the world.The therapeutic guideline varied between different methods. As the main therapeutic guidelineis chemotherapy, recent studies had shown utilization of natural products in combination withconventional medication, elevate the efficiency of chemotherapeutic methods. Kombucha is atraditional beverage obtained from the fermentation of green tea as a rich source of flavonoidmedicinal plant. This study aimed to evaluate the natural potential of combination therapy of thisnatural product with doxorubicin as a chemotherapeutic agent.MATERIALS AND METHODS: The study was performed as in vitro evaluation of biological activityof kombucha on HCT‑116 cell line (human colon cancer cell line). The cytotoxic effect of differentkombucha beverages (fermented green tea) in comparison with green tea extract was evaluated bydimethylthiazolyl tetrazolium bromide (MTT) assay. In the next step, anticancer activity of doxorubicinas a general guideline chemotherapeutic agent in combination with kombucha was evaluated bycell cycle analysis and apoptosis assay flow cytometry. Apoptotic genes expression pattern wasdetermined using real‑time polymerase chain reaction. The experiments were designed in threeindependent replications and statistically analyzed using SPSS software.RESULTS: The results show that kombucha compared with the green tea extract causedmore (1.2 fold) early apoptosis induction and G0/G1 phase arrest. Moreover, kombucha increasedthe expression levels of p21, p53, and B‑cell leukemia/lymphoma 2 (Bcl‑2)‑associated X proteingenes (2, 2.5, and 1.5 fold, respectively) while it decreased Bcl‑2 gene expression level (5–8 fold)compared with doxorubicin alone. Combination of kombucha with doxorubicin shows 2‑fold increasedG0/G1 phase compared with the doxorubicin treatment.CONCLUSION: This result indicated that kombucha caused boosted anticancer activity of doxorubicinagent. These findings suggest that kombucha may be has an assistor and useful role in colorectalcancer treatment align with chemotherapy.

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Effectiveness of self‑care program on the quality of life in patients with coronary artery disease undergoing cardiac rehabilitation: A Randomized clinical trial

. Mohammad Goudarzi Rad; . Leila Ghanbari‑Afra; . Mahsa Haji Mohammad Hoseini; . Monireh Ghanbari Afra; . Hamid Asayesh

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Coronary artery disease (CAD) is a life‑threatening condition that causes physicaland psychological disorders and decreases patients’ quality of life (QoL). Performing ...  Read More BACKGROUND: Coronary artery disease (CAD) is a life‑threatening condition that causes physicaland psychological disorders and decreases patients’ quality of life (QoL). Performing propereducational self‑care program may lead to higher QoL in these patients. This study was performedto investigate the effectiveness of a self‑care educational program on QoL in patients with CAD.MATERIALS AND METHODS: This semi‑experimental study was performed on 60 patients withCAD referred to the cardiac rehabilitation (CR) center of Vali Asr hospital in Qom, Iran, in 2018–2019.Patients were divided into control and intervention groups by randomized sampling. The self‑careeducational program was provided through lectures and booklet. Data collection was done using the“demographic and clinical data questionnaire,” and “Seattle Angina questionnaire.” Questionnaireswere completed in both groups, before and at least 1 month after education. Analysis of the obtaineddata was performed using SPSS software (version 25), central indexes, Mann–Whitney test, andWilcoxon test.RESULTS: No significant differences were observed between the two groups for demographicscharacteristics and quality of life before the intervention. Before the self‑care program, the mean scoreof the QoL in the intervention and control group were 56.14 ± 9.75 and 58.46 ± 11.71, respectively.After that, the mean score of the QoL in the intervention and control group were 59.25 ± 10.56 and59.7 ± 13.33, respectively. The statistical analysis showed significant differences in the mean scoresof QoL in the intervention group before and after the intervention (P < 0.05). However, no statisticallysignificant differences were seen in the control group before and after the study (P > 0.05).CONCLUSIONS: The self‑care educational program improved the QoL in patients with CAD.Therefore, lectures and educational booklets should be considered by CR nurses.

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Comparing the effect of electronic and lecture education of pain management on the knowledge, attitude, and practice of nurses: A randomized‑controlled trial

. Azizeh Farshbaf‑Khalili; . Madine Jasemi; . Atefe Seyyedzavvar

Volume 11, Issue 9 , October 2021, Pages 1-10

Abstract

  INTRODUCTION: Efficient pain management by nursing staff initially needs accurate knowledgeand proper attitude in this field. The aim of present study was to compare the effects of ...  Read More INTRODUCTION: Efficient pain management by nursing staff initially needs accurate knowledgeand proper attitude in this field. The aim of present study was to compare the effects of lectureand electronic education on the knowledge, attitude, and practice of nursing staff regarding painmanagement.MATERIALS AND METHODS: The present superiority randomized controlled trial with two parallelarms was conducted on 78 occupied nurses of surgery wards of X. The participants were recruitedrandomly and divided into two groups of lecture and electronic education through random blocking (4and 6 blocks). For allocation concealment, coded nontransparent pockets numbered 1–78 containingthe type of intervention were used. Educational material was presented using teacher‑centeredmethod in lecture group, as well as through multimedia program using FLASH software in e‑learninggroup through 1‑h sessions for 4 weeks. Data on nurses were collected before and 4 weeks after thetraining using demographic questionnaire, Pain Management Principles Assessment Tool, Nurses’Attitude Survey, and nursing practice checklist. Data were analyzed using SPSS software (version 24)utilizing descriptive and analytic statistical test such as Chi‑square, Fisher, independent t‑test, andANCOVA. P < 0.05 was considered statistically significant.RESULTS: Mean ± standard deviation of nurses’ knowledge, attitude, and practice regardingpain management had significant increase in both groups post‑training (P < 0.001). According toANCOVA the mean postintervention knowledge score in e‑learning group by controlling baselinescore had significant increase compared to the lecture group (adjusted mean difference [aMD] =1.8: 95% confidence interval [CI] = 1.5–2.1, P < 0.001). Furthermore, the mean of total scores ofpost‑intervention attitude and practice in e‑learning group adjusted for baseline score significantlyincreased compared to lecture group (aMD = 1.8: 95% CI = 1.5–2.1, P < 0.001) and (aMD = 3.2:95% CI = 2.7–3.6, P < 0.001).CONCLUSION: Electronic education was more efficient than lecture education in increasing ofknowledge, attitude, and practice on pain management among nursing staff.

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Evaluating the implementation of helping babies survive program to improve newborn care conditiona

. Atefeh Jourabian; . Soheila Jafari‑Mianaei; . Najmeh Ajoodanian

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: The main reason of newborn mortalities in low‑ and middle‑income countries is dueto the lack of skilled caregivers in providing essential care for babies. The aim of ...  Read More BACKGROUND: The main reason of newborn mortalities in low‑ and middle‑income countries is dueto the lack of skilled caregivers in providing essential care for babies. The aim of the present studywas to evaluate the implementation of helping babies survive (HBS) program to improve newborncare condition in Isfahan, Iran.MATERIALS AND METHODS: This quasi‑experimental study was conducted in the labor andmidwifery wards of Shahid Beheshti Hospital in Isfahan. Convenience sampling method was usedfor all healthy newborns who weighed >1500 g. First, the samples were selected for the controlgroup. Then, the Helping Babies Breathe and Essential Care for Every Baby training courses wereheld over for ward nurses and midwives. Then, the samples of the intervention group were selected.The research tools consisted of demographic characteristic questionnaire, caregiver performanceevaluation checklist, and breastfeeding registration checklist. SPSS software version 16 was usedfor data analysis.RESULTS: A total of 130 newborns were divided into control (n = 65) and intervention groups (n = 65).The average time of umbilical cord clamping increased from 13.85 to 61.48 s, and the averageduration of skin‑to‑skin contact between mother and baby increased from 11.75 to 60.47 min. Themean of early initiation of breastfeeding improved during the 1st h and the 1st day of the birth. Therate of neonatal hypothermia in the intervention group decreased sharply.CONCLUSION: The implementation of the HBS program can positively impact newborn carecondition.

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Case‑based learning: Modern teaching tool meant for present curriculum: A behavioral analysis from faculties’ perspective

. Sibadatta Das; . Ashima Das; . Pinki Rai; . Naresh Kumar

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Case‑based learning (CBL) is an established bidirectional active learning approachwhere students learn concepts by solving cases or problems under the guidance of a facilitator. ...  Read More BACKGROUND: Case‑based learning (CBL) is an established bidirectional active learning approachwhere students learn concepts by solving cases or problems under the guidance of a facilitator. Inthe present study, the awareness and acceptance level of faculties to implement this method ofteaching were assessed by behavioral analysis.MATERIALS AND METHODS: This cross‑sectional study was done through two workshopsorganized at NDRI Karnal on December 16 and 17, 2019, and BHU Varanasi on March 1, 2020.Fifty‑four faculties from different applied sciences participated. The participants were given an insightinto this teaching tool through didactic lecture and hands‑on training session about implementationof this method. Pre and post‑ session responses were compared through a set of questionnairesand the behavioral change was analyzed by using SPSS version 22. P ≤ 0.05 was considered asstatistically significant.RESULTS: Only 31.5% faculties were aware of the active learning methods though 83% agreed thatactive learning is better than conventional teaching. 96% agreed that CBL is a better way to developconcepts and nearly 81% agreed that more learning could be done with lesser efforts. The clinicaldecision‑making improve significantly. Pre and post‑session mean scores of effectiveness of CBLas a teaching tool were 2.44 ± 0.63 and 2.72 ± 0.53, respectively.CONCLUSION: CBL originally is a mode of imparting knowledge in a student‑centric bimodal learning.Acceptance to the mode is increasing among faculties despite of many deterrents.

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Investigating the relationship of computerized examination anxiety with other variables at the university level: A case of health college students in Saudi Arabia

. Abeer Rasheed

Volume 11, Issue 9 , October 2021, Pages 1-5

Abstract

  BACKGROUND: In the daily lives of people, the level of anxiety plays a significant role. This appliesto students, who experience anxiety when taking examinations referred to as examination ...  Read More BACKGROUND: In the daily lives of people, the level of anxiety plays a significant role. This appliesto students, who experience anxiety when taking examinations referred to as examination anxiety.Majority of the current educational institutions have shifted from a traditional evaluation system to onethat is computerized. The present study aim is to identify the computerized examination anxiety (CEA)among college students in the Faculty of Health and to compare the differences among them basedon study system and gender.MATERIALS AND METHODS: The research is a descriptive quantitative design. The researchpopulation consists of 138 health college students. CEA scale was used to identify the level ofexamination anxiety among students. Data were then exposed to analysis, namely the descriptivestatistics, independent sample t‑test, and Chi‑square tests, to obtain the answers to the researchquestions at the level of <0.05.RESULTS: Based on the findings, the CEA experienced by the health students was of moderatelevel. The findings also showed insignificant differences between students’ levels of anxiety basedon gender and study system at <0.05 value.CONCLUSION: The study contributed to literature by adding a study related to CEA during COVID‑19.The study enumerated implications and recommendations based on the findings.

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A comparative study of the status of supportive‑palliative care provision in Iran and selected countries: Strengths and weaknesses

. Mohammad Salimi Amroud; . Pouran Raeissi; . Seyed-Masoud Hashemi; . Nahid Reisi; . Seyed-Ahmad Ahmadi

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Terminally, illnesses such as cancer, AIDS, dementia, and advanced heart diseasewill require special supportive and palliative care, although a few numbers of these patients ...  Read More BACKGROUND: Terminally, illnesses such as cancer, AIDS, dementia, and advanced heart diseasewill require special supportive and palliative care, although a few numbers of these patients areprovided with these services.The aim of the present study was to perform a comparative study ofsupportive‑palliative care provision in selected countries.MATERIALS AND METHODS: This research was a descriptive comparative study that its researchpopulation was the frameworks of palliative and supportive care provision in Egypt, Turkey, America,Australia, Canada, the Netherlands, and China. These frameworks were compared across sixdimensions of service receivers, financing, providers, service provider centers, type of servicesprovided, and training. Data collection tool has included the checklist and information sources,documents, evidence, articles, books, and journals collected through the Internet and organizationsrelated to the health information of selected countries and by the library search. Data were investigatedand analyzed using the data collection tool and checklists.FINDINGS: The findings showed that the developed countries having decentralized trusteeshipstructure had a more favorable status in palliative and supportive care provision. The type of servicesprovided was a combination of mental, psychological, social, spiritual, financial, and physical andcommunication services. Provider centers included hospital, the elderly, and cancer and charitycenters.CONCLUSION: Regarding the investigation and recognition of the status of supportive‑palliativecare provision, it was observed that the provision of these services was a concern of the selectedcountries, but they did not have a defined model or pattern to provide these services. Therefore, itis suggested that each country takes a step to redesign and define frameworks and structures inthe evolution of supportive‑palliative cares in accordance with the particular conditions, indigenousculture, religion, and other effective cases of that country and pays special attention to the role andposition of supportive‑palliative cares.

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Effect of educational intervention on preventive behaviors of brucellosis among health volunteers in Rafsanjan city: Application of health belief model

. Mostafa Nasirzadeh; . Fatemeh Kaveh; . Ahmad Reza Sayadi; . Mohammad Asadpour

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  BACKGROUND: Human brucellosis can be a source of problems that affect public health, social, andeconomic well‑being of the world’s population. This study was conducted with ...  Read More BACKGROUND: Human brucellosis can be a source of problems that affect public health, social, andeconomic well‑being of the world’s population. This study was conducted with the aim of determiningthe effect of Educational Intervention (EI) based on Health Belief Model (HBM) on preventive behaviorsagainst brucellosis in Health Volunteers (HVs) in Rafsanjan.MATERIALS AND METHODS: Randomly, 104 HVs, in the intervention and control group,participated in a quasi‑randomized, controlled experimental study. Variables were evaluated beforeand 1 month after intervention. In the intervention group, the educational program was conductedwith lecture, group discussion, showing movies and related photos, booklets, and pamphlets. Theprogram included five 45‑min sessions that developed regarding the beliefs and constructs ofHBM about brucellosis and its prevention methods. Data regarding HBM constructs and preventivebehavior were collected using the questionnaire with 100 items by the self‑report method. Finally,the data were entered into the SPSS software version 16.0, and statistical tests such as Chi‑square,independent and paired t‑test, Mann–Whitney, and Wilcoxon test were used for the data analysisat the significant level of 0.05.RESULTS: Prior to the intervention, the mean score of the HBM constructs and preventive behaviorsbetween the two groups did not differ significantly, but 1 month later, in the intervention groupincreased significantly compared to the control group (P < 0.05).CONCLUSION: We recommend to health authorities and health‑care providers to use HBM in EIsto create susceptibility, increase perceived severity and benefits, promote self‑efficacy, uses cueto action, as well as reduce behavioral barriers, and ultimately adopt health‑promoting behaviors.

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The effect of COVID‑19 epidemic on the mental health of nurses’ family members

. Soheila Banitalebi; . Kobra Mohammadi; . Zhila Marjanian; . Leili Rabiei; . Reza Masoudi

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: The COVID‑19 epidemic is a global health crisis that, in addition to physical health,has affected the mental health of all individuals, especially health‑care workers, ...  Read More BACKGROUND: The COVID‑19 epidemic is a global health crisis that, in addition to physical health,has affected the mental health of all individuals, especially health‑care workers, including nursesand family members. In this regard, the present study aimed to investigate the effect of COVID‑19epidemic on mental health of nurses’ family members.MATERIALS AND METHODS: The present descriptive‑analytic and cross‑sectional study wasconducted in 2020 year on family members of nurses working in Hajar Hospital for admission andhospitalization of patients with COVID‑19, after obtaining the necessary permits and coordination. Toprevent the spread of COVID‑19 through respiratory or contact droplets, a blog was designed to collectdata using software. Participation in this study was voluntary. Data collection tools included consent,demographic questionnaire, and mental health questionnaire (Patient Health Questionnaire‑9). Datawere analyzed by SPSS version 22.RESULTS: Findings of this study showed that out of 208 family members of nurses participatingin this study, 96 were male and 112 were female and their mean age was 35.78 years, and 55.3%of the participants had university education. Their mean mental health score was 12.91 ± 3.75, sothat 22.6% of people had mild depression, 71.4% of people had moderate depression, and 1.8%of people had severe depression. Independent t‑test showed that there is a statistically significantrelationship between mental health and gender and marital status (P < 0.001). Furthermore, one‑wayanalysis of variance test showed that there is a significant relationship between mental health andage (P < 0.001); this test also showed that there is no relationship between education and mentalhealth (P = 0.75).CONCLUSION: The results indicate that the mental health of nurses’ family members is affectedby the challenges of COVID‑19 epidemic time, so that many of them suffer from some degree ofdepression. Therefore, supporting this population requires urgent action.

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The effect of peer mentoring on motivation and self‑regulated learning in medical students during transition

. Soroush Najafinejad; . Soroor Tabatabaei; . Nastaran Maghbouli; . Negar Sadat Ahmadi

Volume 11, Issue 9 , October 2021, Pages 1-6

Abstract

  BACKGROUND: Self‑regulated learning (SRL) is a critical skill for medical students to reach theirlearning goals in the bedside clinical rotations. This study was performed with the ...  Read More BACKGROUND: Self‑regulated learning (SRL) is a critical skill for medical students to reach theirlearning goals in the bedside clinical rotations. This study was performed with the aim of comparingSRL and motivation of 4th year medical students who are in their educational transition betweenstudents with mentors and those without mentors.MATERIALS AND METHODS: This study was cross‑sectional. A total of 196 medical studentswere invited to complete a form consisting the motivation and SRL questionnaire through Googleform during their 1st year of clinical clerkship, while some of them had participated in the mentoringprogram beforehand. data correlation and regression analysis were employed.RESULTS: Comparing SRL and motivational beliefs scores between students with mentors andwithout mentors indicated that motivational beliefs mean score in students with mentors (87.5 ± 8.44)was significantly higher compared to the others (83.49 ± 7.36) (P = 0.005). Among SRL subscales,planning and examination stress were significantly different between two groups with higherscores for mentees (P = 0.033 and 0.021). Having a mentor predicted motivational beliefs withOR = 7.974 (1.391–45.719) and P = 0.020.CONCLUSION: Considering a significant correlation between mentor possession and the scale ofmotivation beliefs, future longitudinal and interventional research besides the customized mentoringprogram is required to understand the role of mentoring programs on SRL as a cause‑and‑effectrelationship to recommend the peer mentoring program to enhance SRL skills in the medical studentsespecially during their transition to the new clinical environment.

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A content analysis of social media on outbreak of infodemic amidst COVID‑19 pandemic

. Anusha Divvi; . Shivashankar Kengadaran; . Lakshmi Subhashini Katuri; . M. Kavitha; . Arunkumar Sundaragopal; . Vani Anusha; . Sivabalakumaran Kengadaran; . Hemachandran Sekar

Volume 11, Issue 9 , October 2021, Pages 1-5

Abstract

  BACKGROUND: With so much content on social media platforms about COVID‑19, determiningwhich information is reliable can be a daunting task. Hence, this study is aimed to analyze variousposts ...  Read More BACKGROUND: With so much content on social media platforms about COVID‑19, determiningwhich information is reliable can be a daunting task. Hence, this study is aimed to analyze variousposts with regard to COVID‑19 on various social media platforms for their reliability and also examinedvarious factors that influence information reliability.MATERIALS AND METHODS: A cross‑sectional study was conducted, with 934 samples relatedto coronavirus pandemic published on Twitter, Instagram, and Facebook using systematic randomsampling. We adopted the criteria given by Paul Bradshaw and modified to assess the characteristicsof the samples. Training and calibration of the investigators were carried out for 3 consecutive daysbefore beginning the study. The data were analyzed using the Chi‑square test and multinomial logisticregression to estimate the odds ratios.RESULTS: Out of 934 samples studied, only 570 (61%) were found to be reliable of which243 (42.6%) were from Twitter, 117 (20.6%) from Instagram, and 210 (36.8%) from Facebook.We found that the reliability of the information on social media platforms is significantly influencedby network (odds: 1.32; 95% confidence interval [CI]: 1.16–1.52; P = 0.036), content (odds: 1.83;95% CI: 1.69–1.92; P = 0.009), contextual update (odds: 1.41; 95% CI: 1.24–1.53) and age of theaccount (odds: 1.92; 95% CI: 1.64–2.09; P = 0.002).CONCLUSION: Our study shows that the reliability of the social media posts significantly dependson the network, contextual update, and age of the account. Hence, cross verifying the informationfrom a reliable source is the need of the hour to prevent panic and mental distress.

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Health in disasters in Iranian schools: A systematic review

. Seyednouredin Hosseinighousheh; . Maryam Feiz Arefi; . Amin Babai Pouya; . Mohsen Poursadeqiyan

Volume 11, Issue 9 , October 2021, Pages 1-7

Abstract

  Iran is disaster‑prone country in the world. Lack of awareness and failure to have a properresponse to natural disasters cause heavy damages to nations and national assets. Riskmanagement ...  Read More Iran is disaster‑prone country in the world. Lack of awareness and failure to have a properresponse to natural disasters cause heavy damages to nations and national assets. Riskmanagement is essential to prevent, intervene, and fight disasters as it can attenuate thedestructive effects. The present study reviews studies on health in disasters in Iranian schoolswith an emphasis on readiness to deal with crises. The study was carried out through asystematic search using keywords in Persian and English in Iranian and international databasessuch as Google Scholar, SID, Magiran, Web of Sciences, PubMed, and Scopus. The timerange of the search included all articles published before September 2020. The referencelists were also checked to find more articles. Totally, 575 articles were found and full‑text of32 articles were examined. After omitting repetitious items, the articles were checked by twoindependent researchers in terms of inclusion and exclusion criteria so that 15 articles enteredthe final analysis phases. The target population consisted of students, teachers, managers,and experts of disaster resilience. The articles were mostly focused on earthquake, fire, andstructural safety. Implementation of health school models through improving awareness andcrisis management knowledge in school officials plays a key role in improving and preservinghealth in school environment and safety of students. Measures like paying more attention tosafety of building and physical space of schools, adding crisis management skills to curriculumas practical educations, informing parents about such risk, and educating students about safetyand prevention of risks are recommended.

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Validation of academic motivation scale among medical students using factor analysis and structural equation modeling: Middle Eastern perspective

. Ahmed Mohammed Al Ansari; . Archana Prabu Kumar; . Aseel Fuad Fahad AlSaleh; . Mona Rushdi Khalil Arekat; . Abdelhalim Deifalla

Volume 11, Issue 9 , October 2021, Pages 1-10

Abstract

  BACKGROUND: Demanding careers like medicine requires a lot of motivation and the AcademicMotivation Scale (AMS) developed by Vallerand et al. (1992) is an instrument to measure motivation.This ...  Read More BACKGROUND: Demanding careers like medicine requires a lot of motivation and the AcademicMotivation Scale (AMS) developed by Vallerand et al. (1992) is an instrument to measure motivation.This study evaluated the validity and reliability of AMS among medical students in the Middle East.MATERIALS AND METHODS: This was a methodological research utilizing a convenient samplingtechnique. AMS scale comprising 28 items subdivided into seven subscales was administered to 900students (281 students returned the filled AMS). Data were analyzed using the descriptive statistics,one‑way ANOVA, and t‑tests. Exploratory factor analysis and Cronbach’s alpha were used to evaluatethe validity and reliability of the scale, respectively.RESULTS: There was a statistically significant difference between both genders in overallscores (P = 0.015*), two subscales, namely “Identified Regulation” (P =0.017*) and “StimulatingExperience” (P = 0.015*), with females showing higher value. Second‑year students (n = 91) hadsignificantly higher score (10.9 ± 4.1) for “Amotivation” (P =.001*) and first‑year students (n = 48)had significantly higher score (16.2 ± 3.0) for “Achievement” subscale (P =.014*). P < 0.05was considered statistically significant with 95% confidence interval. No statistically significantdifference was observed between the groups based on nationality or age. Bartlett’s test ofsphericity was significant (Chi‑square: 2988.010; df = 278; P < 0.001). Kaiser–Meyer–Olkinwas 0.890. Principal component analysis with varimax rotation extracted seven factorscorresponding to the original items of AMS questionnaire. All subscales correlated positivelyexcept “amotivation.” Structural equation modeling revealed the relation between observedand unobserved variables.DISCUSSION: This study demonstrated that AMS is valid and reliable for application among MiddleEast medical students, without needing any modification. AMS has widespread application in medicaleducation as it impacts learning outcomes.CONCLUSION: This study demonstrated that AMS is valid and reliable for application among theMiddle East students without needing any modification.

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