Journal of Education and Health Promotion

Effect of spiritual care education on the spiritual health of preeclamptic women with postpartum stress disorder

. Mahboobe Gholami; . Mahin Tafazoli; . Zahra Mohebbi‑Dehnavi; . Zahra Kamali

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Spiritual health in the field of health has a great importance in mental disorders andposttraumatic stress disorders, in treatment process. The present study was done aiming ...  Read More BACKGROUND: Spiritual health in the field of health has a great importance in mental disorders andposttraumatic stress disorders, in treatment process. The present study was done aiming “determinethe effect of spiritual care education on the spiritual health of preeclamptic women with postpartumstress disorder.”MATERIALS AND METHODS: This randomized clinical trial was done in 2017 on 260 women withpreeclampsia in Mashhad. Data collection was done with questionnaires Perinatal PosttraumaticStress Questionnaire (PPQ), the posttraumatic disorder checklist, Duke University Religion Index,and the Spiritual Well‑Being Scale (SWBS). In the intervention group, first, women were educatedon spiritual care each day based on Richards and Bergin’s pattern, in three sessions, which lasted45–60 min. The control group also received routine cares. All units completed the questionnaireSWBS at the 8th postpartum period. P < 0.05 was meaningful.RESULTS: After the intervention, this score of spiritual health in the intervention and control groupshad a significant difference with independent test (P = 0.004). Spiritual health significantly increasedin the interventional group.CONCLUSIONS: Providing spiritual care to pregnant mothers with preeclampsia, increase theirspiritual health.

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Psychological distress Management in Iranian emergency prehospital providers: A Qualitative study

. Maryam Azizi; . Reza Bidaki; . Abbas Ebadi; . Abbas Ostadtaghizadeh; . Abbasali Dehghani Tafti; . Ahmad Hajebi; . Azizeh Alizadeh; . Hamid Reza Khankeh

Volume 11, Issue 10 , November 2021, Pages 1-10

Abstract

  INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medicalcare in threatening conditions are more at risk of displaying psychological distress presentations ...  Read More INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medicalcare in threatening conditions are more at risk of displaying psychological distress presentations indisaster situations. Problem‑solving strategies are essential for effective and efficient managementof event position. Therefore, the present study aimed to explore psychological distress promotionin Iranian EPHP.MATERIALS AND METHODS: A qualitative content analysis study was conducted based on 24semi‑structured interviews. A purposeful sampling method was applied until reaching data saturation.Interviews were transcribed verbatim, and then, data condensing, labeling, coding, and definingcategories were performed by the qualitative content analysis recommended by the Landman andGraneheim approach.RESULTS: Based on the experience of study participants, two main themes with six categoriesdeveloped. The main themes included emotion‑based management and problem‑based managementwhen confronting with incidence scene.CONCLUSION: The main problems of EPHP in confronting with incidence and disasters scenesare psychological distress which some rescuers have emotional reactions while some others whoare more resilience and experience manage this problem in the form of problem‑based approach.It is recommended these practical strategies to be taught to less experienced rescuers for avoidingemotional‑based reactions and better management of disaster scene.

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The feasibility of simulation‑based high‑stakes assessment in emergency medicine settings: A scoping review

. Loui K. Alsulimani

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

Abstract

  Using simulation in high‑stakes assessments has been evolving as a method to improve theassessment process. There is a concurrent need to address challenges and establish best practicesto ...  Read More Using simulation in high‑stakes assessments has been evolving as a method to improve theassessment process. There is a concurrent need to address challenges and establish best practicesto ensure the best quality when implementing high‑stakes evaluations. The aim of this study is toprovide an insight for stakeholders about using multiple modalities of simulation in high‑stakesevaluations by presenting challenges, best practices, and future directions described in the relevantliterature.A scoping review of original studies (from the year 1994–2021) including the use of commonmodalities (standardized patients, high‑fidelity mannequins, part‑task trainers, virtual simulation, andhybrid simulation) was conducted. The search covered the common databases: PubMed, EducationResource Information Center, Cumulative Index to Nursing and Allied Health Literature, and theCochrane library.Initial screening in the databases resulted in 111,253 articles. After the applicationof a refining search strategy, 47 articles were included for comprehensive evaluation. Most articleswere about credentialing/licensure purposes of assessment. Many articles were specialty‑specific,especially focusing on anesthesia. Most challenges described were related to the validity of theassessment that should be considered in the planning phase. Best practices were mostly relatedto planning for measures to assure the validity of the assessment tools and process.The use ofmultimodality simulation for high‑stakes assessment is growing despite challenges; this growth isassociated with the accumulation of experience shared in literature. This growth will help to improveplanning, practices, and goals achievement from such an application.

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A nationwide cross‑sectional study to assess the impact of COVID‑19 on surgical residency programs in India

. Harkirat Singh Talwar; . Tushar Aditya Narain; . Vikas Kumar Panwar; . Ankur Mittal; . Arup Kumar Mandal

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: The COVID‑19 pandemic with its plenitude of hardships has been a challenge forresidents in training. Besides the fear of contracting the disease, the complete reconfiguration ...  Read More BACKGROUND: The COVID‑19 pandemic with its plenitude of hardships has been a challenge forresidents in training. Besides the fear of contracting the disease, the complete reconfiguration ofhospital services has severely affected the surgical residency programs across India. The currentstudy highlights the lacunae that have arisen in the residency programs and design appropriatesolutions to reframe the remaining part of the surgical training.MATERIALS AND METHODS: The present study is an observational study based on a questionnairesurvey done in November 2020 aimed at gauging the mood and perspective of residents acrossIndia pursuing surgical residency programs on how the pandemic has impacted various domains oftheir residency namely surgical training, clinical skills, research, academic curriculum, and mentalhealth. The analysis was performed using an Internet‑based program.RESULTS: Seventy‑eight percent of residents felt that they have lost crucial months of surgical training.Impact on clinical skills was reported by 73.9% of residents. Almost half of the residents (49.1%)believed that there has been a definite increase in research activities and 81.7% believed that theacademic curriculum was affected during the past 6 months. Furthermore, 86% of respondentsadmitted to have had a profound impact on their mental health as a result of the pandemic.CONCLUSION: Formulating reform policies in the current residency programs is paramount to trainthe current and future generation of surgeons. Whereas personal safety and wellness of the residentsis paramount during these times, residency training via digital medical education and various otherinnovative ways needs to continue.

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Survey of happiness in students of Iran University of Medical Sciences and its relationship with students’ attitudes toward the field of education and the future of career

. Zahra Rahimi Khalifeh Kandi; . Arash Ziapour; . Razieh Pirouzeh; . Mitra Faghihi; . Hadi Jalilvand; . Morteza Mansourian

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: Happiness is one of the main components of mental health that plays an importantrole in promoting people’s health. This study aimed to investigate the status of happiness ...  Read More BACKGROUND: Happiness is one of the main components of mental health that plays an importantrole in promoting people’s health. This study aimed to investigate the status of happiness in studentsof Iran University of Medical Sciences and its relationship with students’ attitudes toward the field ofeducation and the future of career in 2017.MATERIALS AND METHODS: This cross‑sectional study was performed on 500 students of IranUniversity of Medical Sciences The data collection tool was a questionnaire consisting of threeparts: demographic information, Oxford Happiness Inventory; A questionnaire was used to measurestudents’ attitudes about their career future, which was completed by students of Iran Universityof Medical Sciences. In order to analyze the data, SPSS software version 24 and descriptive andanalytical statistics were used.RESULTS: Findings showed that 72% of students had a good level of happiness. There is also asignificant relationship between happiness and attitude toward the field of study. According to theresults, there is a significant relationship between the career future and the amount of happiness.There was a significant relationship between gender and happinessCONCLUSION: The study findings show that, by planning correctly in determining the fields ofeducation and ensuring the future of the job, happiness can be improved among students. Therefore,it is recommended that the authorities take the students with the correct needs assessment in thefield of business education in the field of study.

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Antibiotics at the crossroads – Do we have any therapeutic alternatives to control the emergence and spread of antimicrobial resistance?

. Mohan Bilikallahalli Sannathimmappa1; . Vinod Nambiar; . Rajeev Aravindakshan

Volume 11, Issue 10 , November 2021, Pages 1-11

Abstract

  Antibiotics once regarded as magic bullets are no more considered so. Overuse of antibiotics inhumans, agriculture, and animal husbandry has resulted in the emergence of a wide range ...  Read More Antibiotics once regarded as magic bullets are no more considered so. Overuse of antibiotics inhumans, agriculture, and animal husbandry has resulted in the emergence of a wide range ofmultidrug‑resistant  (MDR) pathogens which are difficult to treat. Antimicrobial resistance  (AMR)is a serious global health problem associated with high mortality in the era of modern medicine.Moreover, in the absence of an effective antibiotic, medical and surgical interventions can highlybecome a risk. In recent times, the decreased incline of pharmaceutical industries toward researchand development of newer effective antibiotics to fight this MDR pathogens have further fuelledthe scarcity of antibiotics, thus the number of antibiotics in the pipeline is extremely limited. Henceit is high time for the development of new strategies to fight against dangerous MDR pathogens.Currently, several novel approaches explored by scientists have shown promising results pertainingto their antimicrobial activity against pathogens. In this article, the authors have summarized variousnovel therapeutic options explored to contain AMR with special attention to the mechanism of action,advantages, and disadvantages of different approaches.

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Satisfaction with nursing care and its related factors in patients with COVID‑19: A descriptive correlational study

. Naser Parizad; . Rasoul Goli; . Roshanak Mirzaee; . Rahim Baghaie; . Hossein Habibzadeh

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: Patients’ satisfaction is a fundamental factor in the quality of nursing care. Theemergence of the novel Coronavirus Disease 2019 (COVID‑19) and the highly contagious ...  Read More BACKGROUND: Patients’ satisfaction is a fundamental factor in the quality of nursing care. Theemergence of the novel Coronavirus Disease 2019 (COVID‑19) and the highly contagious viruscan affect nursing care by increasing the number of care‑seekers.This study aimed to determinethe patients’ satisfaction and related factors in patients with COVID‑19 hospitalized in TaleghaniHospital, Urmia‑Iran, in 2020.MATERIALS AND METHODS: This descriptive, correlational study was conducted on 196 patientswith COVID‑19 hospitalized in Taleghani Hospital, Urmia. Purposive convenient sampling was usedto recruit participants. Study participants completed Patient Satisfaction Instrument and demographicsquestionnaires. Data were analyzed with the SPSS software version 25.0.RESULTS: The majority of patients (68.9%) were moderately satisfied with nursing care. Basedon Pearson Correlation Analysis, only residential status had a significant inverse relationship withsatisfaction level in patients with COVID‑19 (r = −0.0238, P = 0.001).CONCLUSIONS: The patients’ satisfaction with nursing care was mostly at a moderate level. Thus,there is a need to educate health personnel and nurses in particular and motivate them to haveactive participation in achieving patients’ satisfaction with COVID‑19. Notably, only the institutes thattake patients’ satisfaction as a top priority can succeed in a competitive market of health services.

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Potential vaccine hesitancy regarding COVID‑19 vaccines in Kashmiri population

. Syed Najmul Ain; . Rabia Ahmad; . Reyana Qulsum; . Mohamad Azhar Gilani

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: India is all set to begin vaccination against COVID‑19. A good number of peopleare falling prey to anti‑vaccination campaigns, and therefore, some amount of vaccine ...  Read More BACKGROUND: India is all set to begin vaccination against COVID‑19. A good number of peopleare falling prey to anti‑vaccination campaigns, and therefore, some amount of vaccine hesitancymust have developed. The primary objective of the study was to find the level of potential COVID‑19vaccine hesitancy in Kashmiri population.MATERIALS AND METHODS: This was a cross‑sectional study conducted in the valley of Kashmir.A predesigned questionnaire was shared online. The participation of respondents was voluntary.Exclusions were made on account of residence outside Kashmir valley, duplicate forms, and wronginformation. The data were entered into Microsoft Excel 2010 and analyzed using SPSS version 23.RESULTS: A total of 487 respondents were included. About 67% of the participants were in the agegroup of ≤30 years, 55% female, 54% rural, and 16% had ever been COVID‑19 positive. About14% of the participants were completely hesitant about receiving the COVID‑19 vaccine, whereas40% were unsure if they will accept the vaccination. The main reason for the total nonacceptance ofthe vaccine was the doubts about the safety of COVID‑19 vaccines (67%). Urban people were morelikely to be hesitant to the vaccine than rural people (odds ratio [OR] 1.845, confidence interval CI1.022 to 3.333). Those who were ever COVID‑19 positive were 3.3 times more likely to say “no” toCOVID‑19 vaccination than those who were never positive.CONCLUSION: Strategic steps must be taken to minimize the vaccine hesitancy associated withCOVID‑19 vaccination. Authorities should direct efforts toward vaccine education, creating awarenessamong people about the importance of COVID‑19 vaccination.

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Investigating preventive health behaviors against COVID‑19 in elementary school students’ parents: A cross‑sectional study from Tehran – Capital of Iran

. Maryam Bagherzadeh; . Leili Salehi; . Zohreh Mahmoodi

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: Parents act as a role model for children in showing health behaviors. This studyinvestigated factors affecting the preventive behavior in elementary school students’ ...  Read More BACKGROUND: Parents act as a role model for children in showing health behaviors. This studyinvestigated factors affecting the preventive behavior in elementary school students’ parents basedon protection motivation theory (PMT).MATERIALS AND METHODS: This cross‑sectional study was conducted in Tehran (Iran) in 2020.Multistage sampling was used to choose 660 elementary school students’ parents. The data collectioninstrument was a multi‑sectional questionnaire, including sections on demographic characteristics,PMT constructs, self‑reported health, and information sources related to COVID‑19. In this study,descriptive statistics (mean and standard deviation) and analytical statistical methods (Pearsoncorrelation and path analysis) were used to analyze the data. The range of Cronbach’s alpha of thestudy instrument varied from 0.71 to 0.97.RESULTS: The results of the current study revealed significant association between all PMTconstructs and preventive behaviors. Knowledge from both direct and indirect paths was relatedto preventive behaviors (B = 0.76). Preventive behaviors had the strongest, direct relationship withage (B = 0.76). Based on the final fitted model, knowledge had the greatest impact on preventivebehaviors through indirect and direct routes.CONCLUSION: Knowledge was the most important variable which influenced preventive behavior,and it should be noticed in prevention programs.

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Comparing the effectiveness of motivational interviewing and self‑development education on type II diabetes mellitus patients’ lifestyle

. Javad Kazemi; . Fatemeh Rahmati

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Lifestyle can play an important role in controlling type II diabetes (T2D), and ahigh‑risk lifestyle can exacerbate its effects. The aim of this study was to compare the ...  Read More BACKGROUND: Lifestyle can play an important role in controlling type II diabetes (T2D), and ahigh‑risk lifestyle can exacerbate its effects. The aim of this study was to compare the effectivenessof motivational interviewing with self‑development education on T2D patients’ lifestyle.MATERIALS AND METHODS: This was a quasi‑experimental study in 2017–2018. The design waspretest–posttest with an active comparison group. The population of this study was T2D patients ofFirouzgar and Imam Reza Hospitals in Tehran. Using targeted sampling, 80 patients were selected andrandomly assigned into experimental and comparison groups. The instrument was a tool for assessinglifestyle determinants in T2D patients (determinants of lifestyle behavior questionnaire) based on thetheory of planned behavior. Intervention program was initially performed, and motivational interviewingwas conducted on Firouzgar Hospital’s patients for 10 sessions while self‑development educationwas conducted on Imam Reza Hospital’s patients for 10 sessions (active comparison group). Toanalyze the data, independent t‑test and Chi‑square test were used.RESULTS: The results showed that the patients who received motivational interviewing had significantimprovement in their lifestyles with a 95% confidence level at P = 0.042, compared to the patientswho had been trained with self‑development education.CONCLUSION: Motivational interviewing improves the lifestyle of T2D patients compared toself‑development education. It is recommended that motivational interviewing be used to help therehabilitation of these patients. This method helps patients control their blood sugar while improvingtheir lifestyle.

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Investigating the relationship between the dimensions of mindfulness and maternal attachment to the fetus during pregnancy

. Nahid Golmakani; . Fatemeh Shaghaghi; . Zohre Ahmadi; . Mahboobe Gholami; . Zahra Kamali; . Zahra Mohebbi‑Dehnavi

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: Maternal attachment to the fetus is a term used to describe the emotional relationshipbetween mother and fetus. This emotional connection increases during pregnancy and ...  Read More BACKGROUND: Maternal attachment to the fetus is a term used to describe the emotional relationshipbetween mother and fetus. This emotional connection increases during pregnancy and is reflectedin her feelings, perceptions, and behaviors. Mindfulness is important as one of the factors affectingthe mental health of people during pregnancy. Therefore, the present study was conducted todetermine the relationship between the dimensions of mindfulness and maternal attachment to thefetus during pregnancy.MATERIALS AND METHODS: The present study was performed on 500 pregnant mothers referredto health centers affiliated to Isfahan University of Medical Sciences. The samples were entered intothe study by available sampling method and if they had inclusion criteria and no exclusion criteria.The research instruments were the Fetal Attachment Questionnaire and the Bauer MindfulnessQuestionnaire. The collected data were analyzed by SPSS software version 22.RESULTS: The results of the data showed that there was no significant relationship between theoverall score of mindfulness and the overall score of maternal attachment to the fetus (P = 0.62).While from the dimensions of mindfulness such as “action with awareness” there was a significantnegative relationship (P = 0.03) with maternal attachment to the fetus and a significant positiverelationship “observation” with maternal attachment to the fetus (P = 0.03).CONCLUSION: According to the results of this study, there is a relationship between maternalattachment to the fetus during pregnancy and a number of dimensions of mindfulness. For thispurpose, since mindfulness can increase the mother’s interactions with the fetus, and this interactionbegins during pregnancy and with the mother’s attachment to the fetus, it is important to pay attentionto this.

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Depression, suicidal ideation, and suicidal behaviors among dental students of Neo‑state capital region in India

. Nijampatnam P. M. Pavani; . G. Anirudh; . Nandita Rani Kothia; . Parveen Sultana Shaik; . K. Krishna Priya; . Suresh Chand Yaddanapalli

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: The challenges of dental education place students at high risk of stress. Becausedental education is a highly demanding and challenging course, placing heavy demands on ...  Read More BACKGROUND: The challenges of dental education place students at high risk of stress. Becausedental education is a highly demanding and challenging course, placing heavy demands on themental resources of the students, making them vulnerable to high levels of stress, this study aimed todetermine the prevalence of depression, suicidal ideation, and suicidal behaviors in dental students.MATERIALS AND METHODS: A descriptive cross‑sectional study was done on a conveniencesample of 388 dental students in a teaching dental institution. Data were collected using standard,prevalidated, self‑administered questionnaires (Patient Health Questionnaire‑9 and SuicidalBehaviours Questionnaire‑Revised [SBQ‑R]). Analysis was done using SPSS version 20. Descriptivestatistics, Chi‑square test, and logistic regression were performed.RESULTS: At least half of the students were in major depression with different levels of severity.When students from different years were analyzed, majority from each year fell under II and IIIcategories (P < 0.001). Most of the students reported that they do not have any suicidal ideationor behavior (SBQ‑R). Nearly 16% of the students either presented the threat of suicidal attemptor likelihood of suicidal behavior in future. Almost 13% of the dental students thought of killingthemselves in the past year for at least two times. Around 16% of them expressed to someone abouttheir thought of committing suicide.CONCLUSION: Even though depression and suicidal tendencies were not prominent in dentalstudents, there is a need to shed light on those who responded positively and take necessary reformsto relieve academic stress.

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The association between body mass index and health literacy in high school Students: A cross‑sectional study

. Mohammad Reza Zare‑Zardiny; . Faroukh Abazari; . Mohammad Ali Zakeri; . Majid Dastras; . Jamileh Farokhzadian

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Obesity and overweight in children and adolescents have become a global problemin recent years. Adolescence increases the likelihood of obesity in adulthood and associated ...  Read More BACKGROUND: Obesity and overweight in children and adolescents have become a global problemin recent years. Adolescence increases the likelihood of obesity in adulthood and associated illnesses.Nowadays, health literacy is one of the greatest determinants of the health. This study was conductedto evaluate the correlation between body mass index (BMI) and health literacy in high school students.MATERIALS AND METHODS: In this descriptive‑analytical study, 430 high school students wereenrolled in a multi‑stage random method in Yazd city in the center of Iran. The data were collectedthrough The Health Literacy Measure for Adolescents and calculate BMI with measurement ofheight and weight of adolescents. The data were then analyzed using SPSS 25 and descriptive andinferential statistics (Chi‑square and multivariate regression).RESULTS: The results showed that the mean score of BMI (21.76 ± 3.76) was in a normal range.The score of health literacy was at the borderline level (58.44 ± 13.79). BMI was not significantlycorrelated with health literacy (P = 0.09). BMI was significantly different in terms of age, high schoolgrade, school type, and health status. School type and health status predict 37% of the variance ofBMI (R2 = 37%) and the best predictor was health status (P < 0.05).CONCLUSIONS: The results of the present study showed that BMI was not correlated with healthliteracy and student health literacy was at the borderline level. It is necessary to carry out furtherstudies on the causes and facilitators and the barriers to increasing health literacy. Furthermore,educational interventions are needed to prevent the increase of BMI in adolescents and identifydetermining factors.

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Organizational impact of faculty development programs on the medical teacher’s competencies

. Mahla Salajegheh

Volume 11, Issue 10 , November 2021, Pages 1-5

Abstract

  BACKGROUND: Faculty development programs as useful approaches for organizational developmentimproved competencies in faculty members which assist them to cope with workload and environmentchanges. ...  Read More BACKGROUND: Faculty development programs as useful approaches for organizational developmentimproved competencies in faculty members which assist them to cope with workload and environmentchanges. Evaluating organizational development for faculty development programs provides insightinto the impact of these programs on system development. The aim of present study was conductedto study the organizational development for faculty development programs at Kerman University ofMedical Sciences.MATERIALS AND METHODS: This analytical and cross‑sectional study was conducted betweenOctober and December 2020. The organizational development for faculty development questionnairewas sent to a simple random sampling of 100 faculty members who had been participated in the“Medical Education Fellowship” program. The data were analyzed using descriptive statistics includingindependent sample t‑test, one‑way ANOVA, and post hoc, using version 24.0 of SPSS.RESULTS: The response rate was 82%. Most of the faculty highly agreed that the “Medical EducationFellowship” program had produced organizational development. The score of the “Development andsustaining faculty development programs” domain (mean = 3.35, standard deviation [SD] =0.96) washigher than “Development and innovation in teaching and learning process” (mean = 3.31, SD = 0.74).CONCLUSIONS: Specific characteristics of the organizational development process for facultydevelopment programs in health profession education were recognized. The findings emphasized onthe importance of these interventions on creating developments in the broader community system.

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Time to reach health‑care facility and hospital exit outcome among road traffic accident victims attending a tertiary care hospital, Puducherry

. Jency Antony; . Venkatachalam Jayaseelan; . Jeby Jose Olickal; . Joseph Alexis; . Manikandanesan Sakthivel

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: In India, most of the deaths due to road traffic accidents (RTAs) occur within24 h of the accident. Hence, this study aimed to assess the proportion of RTA victims reaching ...  Read More BACKGROUND: In India, most of the deaths due to road traffic accidents (RTAs) occur within24 h of the accident. Hence, this study aimed to assess the proportion of RTA victims reaching thehealth‑care facilities within the golden hour.MATERIALS AND METHODS: This cross‑sectional study was conducted in a tertiary care center inSouth India between August and September 2017. All RTA victims who were admitted for treatmentin the emergency department during the study period were included. Data were collected usingstructured, pretested, and validated pro forma. Hospital exit outcomes between those who reachedwithin 1 h and those who did not were expressed as proportion with a 95% confidence interval (CI).The factors associated with hospital exit outcomes were analyzed using a Chi‑square test.RESULTS: Among 626 RTA victims, the mean (standard deviation) age was 37.4 (2.6) years,and about 83% (n = 521) were male. More than one‑third (37%) of the RTAs occurred on urbanroads (n = 235, 37.5%). A total of 424 (67.7%) were referred from other hospitals. The meantime taken for RTA victims to reach any health‑care facility was 3 h. More than half (n = 346,55% [95% CI: 51.3–59.2]) of the RTA victims had reached a health‑care facility within thegolden hour. Among those who reached beyond the golden hour, one‑fourth (n = 77, 27.5%)were delayed due to the unavailability of transporting vehicles. Delay in communication (n = 59,21.1%), prolonged travel (n = 41, 14.6%), lack of knowledge about nearby facilities (n = 39,13.9%), nonavailability of attenders (n = 35, 12.5%) and financial issues (n = 29, 10.4%) werethe other reasons for the delay.CONCLUSION: Almost half of the RTA victims reached the health‑care facilities after the goldenhour. Unavailability of ambulances or vehicles for transport and delay in communication were theimportant factors that played a role in the delay.

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The effect of theory ‑ Based educational intervention on consumption of smokeless tobacco products by merchants’ guilds

. Mohammad Saeed Jadgal; . Somayeh Alizadeh; . Hadi Alizadeh ‑Siuki; . Saeedeh Sadeghi; . Tahmineh Salehian; . Moradali Zareipour

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Smokeless tobacco (SLT) products are highly addictive and contain at least 28carcinogenic chemicals. The purpose of this study was to determine the effect of theory‑based ...  Read More BACKGROUND: Smokeless tobacco (SLT) products are highly addictive and contain at least 28carcinogenic chemicals. The purpose of this study was to determine the effect of theory‑based onthe Transtheoretical Model of Behavior Change on consumption of SLT products by Merchants’Guilds in 2018.MATERIALS AND METHODS: The present quasi‑experimental research was conducted over oneintervention group. The research population consisted of all consumers of the SLT products amongthe merchants’ guilds in Chabahar City, Iran in 2018. Data were gathered from 320 individuals bysimple random sampling using a valid and reliable researcher‑made questionnaire. The interventionprogram was designed based on the Transtheoretical Model of Behavior Change cognitive processesand lasted 6 months. After the intervention, the same questionnaires were administered among theparticipants. The data were analyzed by SPSS version 20 using the descriptive and analytical tests.RESULTS: In the preintervention phase, the participants’ mean scores of the cognitive processesat the precontemplation, contemplation, and preparation stages were 29.16 ± 4.63, 25.07 ± 3.84,and 12.12 ± 1.63, respectively. At the postintervention phase, mean scores of the precontemplation,contemplation, and preparation stages reached to 40.5 ± 5.96, 38.8 ± 5.03, and 35.5 ± 4.23,respectively. Furthermore, the participants’ mean sores at the action and maintenance stages were36.4 ± 4.57 and 43.3 ± 3.29, respectively. According to the ANOVA, a significant relationship wasfound between cognitive processes at the preintervention phase and stages of change (P < 0.001).CONCLUSIONS: Individuals can improve from the precontemplation, contemplation, and preparationphases to the action and maintenance stages by attending based on Transtheoretical Model ofBehavior Change educational interventions. It is suggested that the structure of this model be usedto reduce high‑risk behaviors in other occupations.

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Homemade food, alcohol, and body weight: Change in eating habits in young individuals at the time of COVID‑19 Lockdown

. Elisa Mazza; . Yvelise Ferro; . Roberta Pujia; . Samantha Maurotti; . Tiziana Montalcini; . Arturo Pujia

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: The 2019 coronavirus disease (COVID‑19) lockdown has caused significantchanges in everyday life. This study evaluated the effect of the COVID‑19 quarantine on dietary ...  Read More BACKGROUND: The 2019 coronavirus disease (COVID‑19) lockdown has caused significantchanges in everyday life. This study evaluated the effect of the COVID‑19 quarantine on dietary andalcohol consumption habits and body weight of Italian university students.MATERIALS AND METHODS: An online cross‑sectional survey was carried out among universitystudents than 18 years in July 2020. The online self‑administered questionnaire included demographicand anthropometric data (reported weight and height), weight, and dietary habits changes during ofthe COVID‑19 lockdown.RESULTS: A total of 520 respondents have been included in the study. A total of 393 (~76%) werefemale, 3.8% was obese, and the mean age was 23 ± 4 years. Numerous students reported a changein their eating habits during the lockdown with an increase in consumption of chocolate (40%),ice cream, and desserts (34%), but most of all an increase of homemade bread and pasta (60%),pizza (47%), and homemade sweets (55%). The students also reported an increase of vegetables,fresh fruit, legumes, eggs, and coffee, but also of processed meat, fried foods, cheeses, butter,and sweet beverage, and a reduction in alcohol intake. The weight gain was observed in 43.8%,and males have greater weight gain than females (57% vs. 46%, respectively; P = 0.04). A greaterincrease in body weight was observed in obese as compared to those with normal weight (77% vs.44%, respectively; P < 0.001).CONCLUSIONS: Our data highlighted the need for dietary guidelines to prevent weight gain duringthe period of self‑isolation, especially targeting those with overweight and obesity.

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Epidemiology and factors associated with COVID‑19 outbreak‑related deaths in patients admitted to medical centers of Mazandaran University of Medical Sciences

. Hamidreza Khankeh; . Mehrdad Farrokhi; . Hassan Talebi Ghadicolaei; . Sadegh Ahmadi Mazhin; . Juliet Roudini; . Yazdan Mohsenzadeh; . Zoya Hadinejad

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: The first case of COVID‑19 was reported in Iran on February 19, 2020, in Qom. SinceMazandaran is one of the high‑risk provinces with many patients and deaths, this study ...  Read More BACKGROUND: The first case of COVID‑19 was reported in Iran on February 19, 2020, in Qom. SinceMazandaran is one of the high‑risk provinces with many patients and deaths, this study was conductedto investigate the epidemiological characteristics of COVID‑19‑related deaths in Mazandaran.MATERIALS AND METHODS: In this descriptive study, demographic information and clinicalfindings in patients who died following COVID‑19 in the medical centers of Mazandaran University ofMedical Sciences from February 8, 2020, to October 10, 2020, were extracted. Data were analyzedby using SPSS 21. Logistic regression was used to compare the data. P < 0.05 was considered asthe significance level.RESULTS: Out of a total of 34,039 patients admitted during the 8 months, 2907 patients died. Ofthese, 1529 (52%) were male, and the rest were female. In terms of age, 10 cases in the age groupof fewer than 15 years, 229 cases in the age group of 15–44 years, 864 patients in the age group of45–64 years, and 1793 people in the age group of 65 years and over died. 2206 people (more than75%) by personal visit referred to medical centers. The mortality rate was more than 8 cases per 100hospitalized patients. Men were 16% more likely to die from COVID‑19 than women.DISCUSSION AND CONCLUSION: Older adults over 65 have the highest incidence and death ratedue to this disease. The incidence rate was higher in women, and the death rate was higher in men,which differs from the national pattern.

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Nature of the private hospital services toward universal health coverage: A systematic scoping review of the developing countries evidence

. Razieh Fallah; . Mohammadreza Maleki

Volume 11, Issue 10 , November 2021, Pages 1-15

Abstract

  Private hospital services (PHS) with the undeniable effects on the Universal Health Coverage (UHC)goals have a considerable contribution to the health system of developing countries. ...  Read More Private hospital services (PHS) with the undeniable effects on the Universal Health Coverage (UHC)goals have a considerable contribution to the health system of developing countries. The purpose ofthis systematic scoping review (ScR) was to identify and map the available evidence regarding thedeveloping countries to scrutinize the nature of the PHS toward UHC through providing graphical/tabular information of the records trends and types, sources of the records, frequent settings, driversof the PHS growth, range of the PHS, behaviors of the PHS, and opportunities for policy actions.This study was performed following the 2017 published methodological guidance of the JoannaBriggs Institute for the conduct of ScR. Furthermore, a narrative‑thematic synthesis integrated withthe systematic analysis applying approach to health system strengthening (HSS) through systemsthinking was employed. Thirty‑two included records in English that met the inclusion criteria werefound between 2011 and July 2020. There has been a sharp increase in the generation of the recordswith a 90.6% growth rate between 2015 and 2020. The most frequent records types were reviewarticle, and the lancet was the most specialized journal. India was the most frequent country. Nearhalf of the growth drivers of PHS have been originated from the governance. Besides, the range ofPHS was identified only about Mongolia, and the significant frequency of codes of the PHS behaviors(32.6%) was related to integrated people‑centered health service delivery. 47.8% of the identified HSSinterventions were recommended about governance. Governance plays a decisive role in the natureof the PHS in UHC. Concerning the dynamic architectures of interactions between health systemfunctions, probably the countries themselves have realized the importance of the governance role inthe HSS than other functions. Given the all of the recommended interventions were a combination offoundational and institutional, sustainable participation of PHS in the health system seems far andrequires a solid will of the governments. Future research is needed about the range of PHS and itsbehaviors in terms of consumables, revenue‑raising, and pooling of funds.

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Enhanced learning strategies of undergraduate medical students with a structured case presentation format

. Sarabmeet Singh Lehl; . Monica Gupta; . Sanjay D’Cruz

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Improvement of the learning in undergraduate bedside teaching needs to bepromoted through innovative interventions. Changes in the structured format (SF) for bedside casediscussion ...  Read More BACKGROUND: Improvement of the learning in undergraduate bedside teaching needs to bepromoted through innovative interventions. Changes in the structured format (SF) for bedside casediscussion may help students improve their learning experience and gain insights into collaborativeself‑directed learning. The aim of the present study was to encourage collaborative and self‑directedlearning strategies by MBBS undergraduate students through a new case presentation formatstructured for this purpose.MATERIALS AND METHODS: This was an interventional study carried out in the year 2010–2011.A new SF for bedside cases presentation was developed. A comparison with the traditional formatwas done by holding one session in each format. Uniformity of topic and teaching style was ensuredby having the sessions on pulmonary medicine cases with the same teacher. The student perspectiveof the educational process was analyzed using evaluation pro forma, Likert scale, and narratives.RESULTS: Ninety final year and prefinal year MBBS students participated in this study. There wassignificantly higher participation in history taking (50.7%) and clinical examination (60%) in the SF.A higher statistically significant number of clinical possibilities were considered in the SF (85.3%vs. 66.6%). Similarly, significantly higher number of students indulged in self‑directed learning andreferred to learning resources in the SF. The SF provided students an active role (96.9%), encouragedaccess to resources (93.9%), and control of learning (75.7%). The additional interactive session wasproductive (90.9%), discussions were streamlined (66.6%), and the role of a teacher was consideredimportant (75.7%).CONCLUSION: The SF generated higher participation in the aspects of history taking, clinicalexamination, and consideration of differential diagnoses. It led to a perceived improvement inself‑directed and collaborative learning among students.

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Challenges faced by nurses while caring for COVID‑19 patients: A qualitative study

. Marjan Vejdani; . Samira Foji; . Sara Jamili; . Raha Salehabadi; . Amin Adel; . Zahra Ebnehoseini; . Shapour Badiee Aval; . Ali Asghar Anjidani; . Hossein Ebrahimipour

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  INTRODUCTION: In the COVID‑19 crisis, nurses are directly involved in patient care, so they facemany challenges. This study was performed to determine the challenges faced by nurses ...  Read More INTRODUCTION: In the COVID‑19 crisis, nurses are directly involved in patient care, so they facemany challenges. This study was performed to determine the challenges faced by nurses whilecaring for COVID‑19 patients in Iran in 2020.MATERIALS AND METHODS: This qualitative, content analysis was conducted in Iran on ten nursesdirectly involved in the fight against the corona epidemic, selected through a purposeful samplingstrategy. Data were collected through deep interviews consisting of open questions. All the interviewswere recorded, and immediately after each interview, it was transcribed into written form. The datawere analyzed using MAXQDA software.RESULTS: All the challenges could be classified into three main categories and 17 subcategories.The main categories were miss‑management in controlling corona conditions, mental and physicalcomplications and challenges in corona work conditions, and lack of sufficient workforce.CONCLUSION: Hospital managers and authorities play a significant role in meeting the financialneeds and requirements of nurses, and can minimize the job discrimination prevalent at medicalcenters through providing financial and nonfinancial incentives for nurses. Moreover, the findingsof the present study can help hospital managers and authorities to gain a better understanding ofthe experiences of nurses, and to take the necessary measures to obviate the challenges faced bynurses in public health emergencies.

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The effect of situation, background, assessment, recommendation‑based safety program on patient safety culture in intensive care unit nurses

. Shahram Etemadifar; . Zeynab Sedighi; . Morteza Sedehi; . Reza Masoudi

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

Abstract

  BACKGROUND: Patient safety culture is an integral part of patient care standards and a prerequisitefor safe care. SBAR is an acronym for Situation, Background, Assessment, Recommendation; ...  Read More BACKGROUND: Patient safety culture is an integral part of patient care standards and a prerequisitefor safe care. SBAR is an acronym for Situation, Background, Assessment, Recommendation; thiscommunication model has gained popularity in health‑care settings, especially among professionssuch as nursing. However, there is little evidence that nursing professional education can enhancepatient safety culture. The aim of this study was to investigate the effect of a SBAR‑based trainingprogram on patient safety culture in intensive care unit (ICU) nurses.MATERIALS AND METHODS: The quasi‑experimental study was carried out in 2018–2019 at areascovered by Shahrekord University of Medical Sciences, Iran. This study was performed on 60 nursesworking in ICU. The participants were randomly assigned to two experimental and control groups of30 each. For the experimental group, five workshop sessions of SBAR‑based program were held.For the control group, the patient delivery process was performed according to the ward routine. Datawere collected using patient safety culture questionnaires before and 1 month after the intervention,and were analyzed using descriptive and analytical tests such as paired t‑test, independent t‑test,and Chi‑square test by SPSS 22.RESULTS: The mean score of safety culture was 31 ± 23.5 and 55.2 ± 28.6 in frequency of reportingevents, 32.8 ± 17.8 and 54.3 ± 19 in overall perception of patient safety, 23 ± 20.1 and 52.9 ± 26 incommunication channel openness, and 35.2 ± 19.8 and 52.4 ± 18.8 in information exchange andconveyance before and after training intervention, respectively, so that they improved from poorlevel to neutral‑moderate level. There was no strength in any dimensions of safety culture; however,the implementation of the SBAR‑based program was significantly associated with patient safetyculture (P < 0.001).CONCLUSIONS: Improving patient safety culture requires attention to patient safety models suchas SBAR approach that provides an appropriate and reliable structure for quality improvement.SBAR‑based program training is effective in promoting patient safety culture; therefore, it isrecommended that managers use this technique to promote patient safety culture.

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Distance learning strategies in medical education during COVID‑19: A systematic review

. Soleiman Ahmady; . Per Kallestrup; . Mohammad Mehdi Sadoughi; . Marzieh Katibeh; . Masomeh Kalantarion; . Mitra Amini; . Nasrin Khajeali

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

Abstract

  The current outbreak of coronavirus disease 2019 (COVID‑19) across the world forced universitiesto suspend learning to limit the spread of the virus. Many medical schools have shifted ...  Read More The current outbreak of coronavirus disease 2019 (COVID‑19) across the world forced universitiesto suspend learning to limit the spread of the virus. Many medical schools have shifted to onlineeducation as an information delivery mechanism where the educator and learner are separated inspace and potentially also in time. This systematic review aims to explore and understand the varietyof distance learning strategies in medical students in the contexts of COVID‑19. A systematic reviewwas conducted in Web of Sciences, PubMed, Educational Resources and Information Center, andScopus from December 2019 to July 2020. Eight sets of terminology were used, combining “Distancelearning” AND “Medical education” AND “Pandemic.” Studies were reviewed independently by tworeviewers. Data were extracted and quality appraised using QualSyst tools, and synthesized byperforming thematic analysis. A total of 473 articles were identified after removing duplicates and314 records were screened, of which 125 were included in this study. The primary articles were 52primarily qualitative articles. Five learning strategies consisted of technology‑enhanced learning (TEL),simulation‑based learning, technology‑based clinical education, mobile learning, and blended learning.Tools, methods, and learning resources associated with these five learning strategies were extractedfrom the articles. Our review highlights that TEL and simulation‑based learning were more commonlyused than others in distance learning in medical education during the COVID‑19 pandemic. Thesestrategies have the potential to improve learners’ level of knowledge and performance throughmaking online learning resources such as Massive Open Online Courses, virtual clinical cases, andblended sources accessible.

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A descriptive cross-sectional study on COVID-19 knowledge, attitude, and practices of South Indian population

. Shakeer Kahn Patan; . Sravana Deepthi Chittem; . Pallavi Madithati; . Bayapa Reddy Narapureddy; . Chandra Sekhar Chittooru; . Kalyan Viswanath Reddy Lingala; . Kumar Gular

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: The 2019-novel coronavirus (2019-nCoV) started as an epidemic latertransformed into a pandemic causing a threat to public health globally.  Any community to fightthe ...  Read More BACKGROUND: The 2019-novel coronavirus (2019-nCoV) started as an epidemic latertransformed into a pandemic causing a threat to public health globally.  Any community to fightthe COVID-19 pandemic requires adequate knowledge, attitude of the people, and practice of thegovernment-imposed laws and regulations. Based on these factors, we framed the objectives tofind the sociodemographic profile of the study group and to assess their knowledge, attitude, andpractice (KAP) toward COVID-19. These results will help the health planners and administrators ineach state to find out the gap in health education efforts.MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on SouthIndian population to know KAP toward COVID-19. A convenient sampling technique was used tocollect the data using Google forms, and analysis was done using the SPSS software version 21.The questionnaire includes sociodemographic information, KAP questions toward COVID-19, andperception toward national and community responses.RESULTS: A total of 1644 were participated; the average knowledge score was 17.5 (+1.9).Most of them (92.9%) respondent’s perceived that early detection will have a better outcome fromCOVID-19, whereas the knowledge compared with practice, there is a significant difference Pearsoncorrelation (0.404) P is < 0.001.CONCLUSIONS: Although a high level of knowledge on COVID-19 in the public gradually decreasingthe practice of preventive measures, the government should continue the consistent efforts to changethe behavioral communication and motivate the public social responsibility to adhere to the healthprotocols, masking, hand hygiene, social distancing, and vaccination to prevent expected COVID-19subsequent episodes.

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Force field analysis of driving and restraining factors affecting the evidence‑based decision‑making in health systems; comparing two approaches

. Tahereh Shafaghat; . Mohammad Kazem Rahimi Zarchi; . Mohammad Hasan Imani Nasab; . Zahra Kavosi; . Mahammad Amin Bahrami; . Peivand Bastani

Volume 11, Issue 10 , November 2021, Pages 1-10

Abstract

  BACKGROUND: All policies and decisions need evidence examined by scientific methods. Movingtoward evidence‑based decision‑making (EBDM) as a change in organizations, especially ...  Read More BACKGROUND: All policies and decisions need evidence examined by scientific methods. Movingtoward evidence‑based decision‑making (EBDM) as a change in organizations, especially healthsystems (HSs), is inevitable. This study was conducted to identify the factors affecting EBDM in HSsfrom two approaches and to score them.MATERIALS AND METHODS: A mixed‑method study was carried out using the force field analysisregarding the change toward EBDM in HS in 2020. This study included six steps to identify andscore the key driving forces (DFs) and restraining forces (RFs) to change toward the EBDM inHS: first, finding forces from literature; second, selecting key DFs and RFs through focus groupdiscussion; third, scoring the first group of DFs and RFs by the experts through electronic forms;fourth, determining key DFs and RFs from the managers’ perspective using qualitative interviews;fifth, scoring the second group of DFs and RFs by the experts; and sixth, comparison between forcesresulted from two approaches.RESULTS: According to the literature and experts’ opinions, “relevant, reliable, interpretable, andunderstandable evidence” and “interaction between researchers and decision‑makers” were thestrongest forces to change, and “lack of organizational commitment and support” and “lack of relevant/high‑quality evidence” were the strongest forces against the change toward EBDM in HS. Further,based on managers’ perspective and scores by the experts, “suitable supervision and control” and“reforming the planning and decision‑making system” were the strongest forces to change, and“inadequate knowledge of the managers and staff about the principles and contents of EBDM” and“issues beyond the authorities of managers” were the strongest forces against the change towardEBDM in HS.CONCLUSIONS: Based on the findings, HSs’ managers can focus to reduce RFs and promote DFsfor implementing EBDM strategies, so they can provide better services by making more efficientdecisions.

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The effect of home care on readmission and mortality rate in patients with diabetes who underwent general surgeries

. Lila Faridani; . Parvaneh Abazari; . Maryam Heidarpour; . Hamid Melali; . Mojtaba Akbari

Volume 11, Issue 10 , November 2021, Pages 1-5

Abstract

  BACKGROUND: More than one‑half of people with diabetes need at least one surgery in theirlifespan. Few studies have addressed how to manage the needs of these patients after dischargefrom ...  Read More BACKGROUND: More than one‑half of people with diabetes need at least one surgery in theirlifespan. Few studies have addressed how to manage the needs of these patients after dischargefrom the hospital. The present study is designed to determine the effect of home care on readmissionof Type 2 diabetic patients who underwent surgical procedures.MATERIALS AND METHODS: The present study was a randomized clinical trial. Sixty‑ninepatients with Type 2 diabetes undergoing surgery were assigned to the intervention and controlgroups via blocking order in the selected educational hospitals of Isfahan 2019. Home carewas performed for 3 months with interprofessional team approach. Data collection tools werere‑admission checklist. Data were entered in SPSS software version 23 and were analyzed bynonparametric tests.RESULTS: The background characteristics in the intervention and control groups were not different.The frequency of readmission in the control and intervention groups from the time of discharge until3 months later was 25.7% and 18.9%, respectively. Frequency of readmission in the interventionand control groups was not significant in 3 months from discharge, P > 0.05. The mortality rate was11.4% and 0% in control and intervention groups, respectively, P < 0.05.CONCLUSION: It can be argued that continued home care can decrease the rate of readmissionand mortality rate in patients with Type 2 diabetes who will discharge from surgical wards.

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The effect of nutritional education program on micronutrient intake in children with chronic liver disease: A clinical trial

. Zahra Namjou; . Seyed Ali Jafari; . Aramesh Rezaeian; . Majid Ghayour-Mobarhan; . Samira Nasrfard

Volume 11, Issue 10 , November 2021, Pages 1-11

Abstract

  BACKGROUND: Chronic liver disease (CLD) is one of the most common chronic diseases in theworld that threatens the health of children due to its many complications such as malnutrition ...  Read More BACKGROUND: Chronic liver disease (CLD) is one of the most common chronic diseases in theworld that threatens the health of children due to its many complications such as malnutrition andproblems related to growth and development. Paying attention to nutrition and lifestyle modificationin these children is of special importance. Therefore, the aim of this study was to determine the effectof nutritional education program on micronutrient intake in children with CLD.MATERIALS AND METHODS: The present study is a two‑group randomized clinical trial that wasperformed by available sampling and referred to Ghaem Children’s Hospital in Mashhad in 2016. Inthis study, 77 children with CLD who met the inclusion criteria (45 children in the intervention group and32 children in the control group) were studied. The intervention included six workshops and training onproper diet, post‑workshop phone calls, and regular face‑to‑face counseling sessions (first 4 weeksonce a week and second 4 weeks once every 2 weeks) on adherence to the above diet. Patientsin the control group received routine care. The collection tools in the study included demographicinformation questionnaires, body composition device, and diet plan form in the form of 24‑h recallforms. Data analysis was performed using descriptive statistical tests and Mann–Whitney andWilcoxon statistical tests using SPSS software version 16.RESULTS: Based on the results of the study, the mean age of the research units was 7.8 ± 3.6 years.The mean duration of CLD was 4.6 ± 1.8 years in the intervention group and 5.1 ± 1.9 years in thecontrol group. The mean crude intake of most minerals after the intervention was significantly higherthan before the intervention, except for the crude intake of retinol, thiamine, riboflavin, folate, VitaminC, iodine, and Vitamin B12. Furthermore, in relation to the modified intake of micronutrients, themean modified intake of most micronutrients after the intervention showed a significant increasecompared to before, except for retinol, Vitamin D, niacin, B12, and iodine.CONCLUSION: Considering the effect of providing a nutritional education program to improvemicronutrient intake in children with CLD and emphasizing the importance of adequate micronutrientintake in improving the health of children, special nutrition programs should be provided to thesechildren with special attention. In this regard, nurses can play an important role in improving thequality of nutrition of children by providing nutrition programs with appropriate follow‑up.

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An application of Career Decision Self‑Efficacy Scale – Short Form among Vietnamese medical students

. Luyen Thi Phan; . Arisara Leksansern

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: Choosing the right career can be one of the most crucial decisions in one’s life.Nevertheless, career decisions are filled with uncertainty and daunting challenges. ...  Read More BACKGROUND: Choosing the right career can be one of the most crucial decisions in one’s life.Nevertheless, career decisions are filled with uncertainty and daunting challenges. Therefore, findingways to assist students to better understand and cope with these difficult career decisions is a worthytopic of research. This research was aimed to examine the career decision‑making self‑efficacy ofmedical students’ using a version of the Career Decision Self–Efficacy Scale–Short Form (CDSES‑SF)that was translated and adapted with permission to the Vietnamese context.MATERIALS AND METHODS: A descriptive study was carried out at Can Tho University of Medicineand Pharmacy with a total number of 326 questionnaires distributed to freshmen students and 314questionnaires collected back. Exploratory factor analysis (EFA) was used to finalize the structureof the Vietnamese Career Decision Self‑Efficacy Scale– Short Form (VCDSES‑SF).RESULTS: EFA resulted in the five named factors or subscales of the VCDSES‑SF with 23 items:Occupational Information and Planning (7 items), Self‑Assessment and Career Readiness (6items), Confidence to Change Careers (3 items), Fit My Lifestyle and Interests (4 items), and GoalSelection (3 items).CONCLUSIONS: A number of empirical studies undertaken in various cultural contexts have founddifferent models of career decision‑making self‑efficacy measurement. The present study found thatalthough the VCDSES‑SF is somewhat different than the original CDSES‑SF, the resultant measureis a reliable and effective tool that can be used within the Vietnamese context.

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Essential dimensions of professional competency examination in Iran from academic and clinical nurses’ perspective: A mixed‑method study

. Foroozan Atashzadeh‑Shoorideh; . Sadat Seyed Bagher Maddah; . Leila Azimi; . Tahereh Toulabi; . Leila Valizadeh; . Vahid Zamanzadeh; . Raziyeh Ghafouri

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: Planning for the issuance of professional competency examination has been put onthe agenda of professional policymakers, but the ways of evaluating and conducting examinations ...  Read More BACKGROUND: Planning for the issuance of professional competency examination has been put onthe agenda of professional policymakers, but the ways of evaluating and conducting examinations andits dimensions are the main challenges. The present study aimed to explain the essential dimensionsof professional competency examination in Iran from academic and clinical nurses’ perspective.MATERIALS AND METHODS: The present mixed‑method study was performed at three stages,systematic review, qualitative, and quantitative stages. At the first stage, 56 articles and texts werecollected from PubMed, CINHAL, Ovid, and ProQuest databases, by using the keywords, namelyprofessional competency examination and assessment. Base on the inclusion criteria and eligibilityassessment of article, six articles and one text on regulation were selected. At the second stage,the results of the literature review were approved by 20 nursing experts. Direct content analysis wasused for data analysis. The results were prepared in the form of a questionnaire. At the last stage,the questionnaire was given to 2209 clinical, academic, nurse managers, and nurses.RESULTS: Based on findings of the review literature, essential dimensions of the professionalcompetency examination included a central theme of the client’s needs with four categories. At thesecond stage, the Professional Competency Examination dimensions were approved by experts.At the third stage, a comparison of findings indicated that clinical nurses emphasized more oncardiopulmonary resuscitation, client safety, and implementation of procedures, while academicnurses emphasized on the client’s needs, client education, and clients’ physiological integrity.CONCLUSION: The client’s need is the most important dimension in the professional competencyexamination. The nurses will be successful in providing care if they can identify the clients’ needsand provide care plans based on client needs and priorities.

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The mediating role of compassion in the relationship between COVID‑19 anxiety syndrome and COVID‑19 burnout

. Esmaeil Mousavi Asl; . Hatam Boostani; . Forouzan Behrouzian; . Hamzeh Rostami

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: The coronavirus has caused fundamental changes in our way of life, leading to awave of psychological distress associated with the COVID‑19 epidemic, including stress, ...  Read More BACKGROUND: The coronavirus has caused fundamental changes in our way of life, leading to awave of psychological distress associated with the COVID‑19 epidemic, including stress, anxiety,perceived threats, and fear.Considering the psychological consequences of COVID‑19, the presentstudy was conducted with the aim of mediating the role of compassion in the relationship betweenCOVID‑19 anxiety syndrome and COVID‑19 burnout.MATERIALS AND METHODS: The design of the present study was descriptive correlation. Thepresent study population included all students of Ahvaz Jundishapur University of Medical Sciencesin the academic year 2020. Two hundred and fifty‑one students were selected and completed theCOVID‑19 Anxiety Syndrome Questionnaire, Compassion Scale, and COVID‑19 Burnout Scale.Pearson correlation coefficient test and structural equation model were performed using SPSSversion 18 and LISREL 8.8.RESULTS: The results showed that COVID‑19 burnout had a positive and significant relationshipwith the overall score of anxiety syndrome (r = 0.42, P = 0.01), while it has a negative and significantrelationship with compassion (r = −0.37, P = 0.01). Compassion also has a significant negativerelationship with anxiety syndrome (r = −0.35, P = 0.01). In addition, the results of path analysisshowed that compassion plays a mediating role in the relationship between COVID‑19 anxietysyndrome and COVID‑19 burnout.CONCLUSION: Based on the findings of the present study, it can be said that compassion actsas a protective factor against the negative effects of anxiety syndrome. Therefore, this factor canbe considered in the development of prevention and treatment programs for burnout caused byCOVID‑19.

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Risk analysis and safety assessment of hospitals against disasters: A systematic review

. Seyed Mobin Moradi; . Mahmood Nekoei‑Moghadam; . Ahmad Abbasnejad; . Naser Hasheminejad

Volume 11, Issue 10 , November 2021, Pages 1-16

Abstract

  Both natural and man‑made disasters are increasing in occurrence at the world. Hospitals andhealth‑care centers are very complex and have a high potential for vulnerability depending ...  Read More Both natural and man‑made disasters are increasing in occurrence at the world. Hospitals andhealth‑care centers are very complex and have a high potential for vulnerability depending on externaland internal factors. Unfortunately, past experiences show that health‑care centers and the healthsystem are vulnerable to disasters. Therefore, risk analysis and safety assessment studies of hospitalsand other health‑care centers are absolutely necessary. This systematic review study was conductedon the basis of the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses guidelines.English language international databases (Pub Med, Scopus, Embase, Web of Science, and GoogleScholar) were searched through January 1, 2000 up to June 20, 2019. The quality of the studies wasassessed using the International Narrative Systematic Assessment tool. From 3630 titles identified inthis search, 24 studies were selected. The important findings of this study were grouped into five maincategories: risk analysis method, type of disaster, hospital safety methods, hospital components andkey outcomes of risk analysis, and hospital safety assessments. The nature of disasters is a threatto the lives and property of the people, and therefore hospitals must be available at the incidentsand disasters and they must be able to respond to the needs of the disaster‑affected community.The probability of an incident and its consequences can never be reduced to zero; because theseverity of many natural and even man‑made disasters is unpredictable and the probability of theiroccurrence is different; however, it is possible to identify weaknesses and strengths through riskanalysis studies as well as hospital safety assessments and implement retrofitting programs basedon the type of risks and safety status and reduce the level of risk to an acceptable level.

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Online learning in nursing students: Satisfaction and barriers

. Ashok Kumar; . Nipin Kalal; . Nimarta Rana; . Himanshu Vyas; . Vikas Choudhary; . Raj Rani

Volume 11, Issue 10 , November 2021, Pages 1-6

Abstract

  BACKGROUND: The nationwide coronavirus (COVID‑19) pandemic and ensuing lockdown hasenforced institutions crosswise India to provisionally close to inhibit the spread of the virus ...  Read More BACKGROUND: The nationwide coronavirus (COVID‑19) pandemic and ensuing lockdown hasenforced institutions crosswise India to provisionally close to inhibit the spread of the virus andstarted online learning for students. To measure the level of satisfaction of nursing students withonline learning and to identify the barriers which restrict to online learning.MATERIALS AND METHODS: The current study adopted quantitative research approach with anonline survey research design and carried out during May–June 2020. Participants were selectedthrough a web‑based survey (Google form), in which 219 students enrolled. Self‑structuredquestionnaire with the Likert scale was used to measure the level of satisfaction of nursing studentswith online learning and identify the barriers which restrict online learning. The descriptive andinferential statistics were used for the analysis in which 219 participants were enrolled in the studyof data with IBM SPSS version 20.RESULTS: Majority of student’s participants 148 (67.57%) were extremely satisfied with onlinelearning. The findings suggest that the highest barriers which restrict to online learning amongnursing students is low voice and language clarity (2.16 ± 0.593), physical health barriers such aseye strain (2.43 ± 0.613), reliability and connectivity problem (2.26 ± 0.534). Among all demographicdata, age is significantly associated with the level of satisfaction of online learning.CONCLUSIONS: The study data indicated that maximum students were extremely satisfied the withonline learning and among barriers which effect online learning is low voice and language clarity,reliability and connectivity problem, physical health barriers such as eye strain.

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Reconstruction of individual, social, and professional life: Self‑management experience of patients with inflammatory bowel disease

. Seyed Mostafa Mohsenizadeh; . Zahra Sadat Manzari; . Hassan Vossoughinia; . Hossein Ebrahimipour

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Patients with inflammatory bowel disease (IBD) experience wide range of physicaland psychological problems experience. The use of strategies to improve disease management ...  Read More BACKGROUND: Patients with inflammatory bowel disease (IBD) experience wide range of physicaland psychological problems experience. The use of strategies to improve disease management bypatients is of has special importance in solving these problems. The aim of present study was todiscover the strategies and behaviors of patients to manage their disease.MATERIALS AND METHODS: The present study was conducted with a qualitative research approachand a qualitative content analysis method. The research participants included 20 patients with IBDreferred to gastrointestinal wards in 2020 in Mashhad. Data were collected through unstructuredinterviews and purposeful sampling method and continued until data saturation. Data analysis wasperformed continuously and simultaneously with data collection and comparatively.RESULTS: Data analysis provided five themes of “Improving self‑efficacy and problem‑solving skills,”“Coexistence with disease,” “Reviewing and modifying of interactions,” “Adjusting job and professionalconditions” and “Commitment to self‑care.” The combination of these concepts indicated that is themain theme in disease management for these patients.CONCLUSIONS: Reconstruction of individual, social, and professional life can improve self‑regulationand problem‑solving skills in these patients and make them a sense of control on their lives anddisease.

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Internet addiction, mental health, and sleep quality in students of medical sciences, Iran: A cross‑sectional study

. Arezo Arzani‑Birgani; . Javad Zarei; . Leila Favaregh; . Erfaneh Ghanaatiyan

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: Internet addiction (IA) is a severe problem, especially in academic communities.The association between IA and unfavorable emotional conditions (e.g., anxiety, stress, anddepression) ...  Read More BACKGROUND: Internet addiction (IA) is a severe problem, especially in academic communities.The association between IA and unfavorable emotional conditions (e.g., anxiety, stress, anddepression) can harm students’ relationships and academic and career performance. The presentstudy evaluated (a) the prevalence of IA in a sample of medical sciences university students; (b) theassociation between IA and depression, anxiety, stress, and sleep disorders; and (c) the associationbetween demographic characteristics and IA, depression, anxiety, and stress.MATERIALS AND METHODS: In this descriptive cross‑sectional study, 268 students from AbadanUniversity of Medical Sciences were selected using Morgan Table. The participants responded tothe Young Internet Addiction Test, the Depression Anxiety Stress Scales‑42, and the PittsburghSleep Quality Index. Data were analyzed using descriptive statistics, Pearson correlation coefficient,independent sample t‑test, one‑way ANOVA, and least significant difference.RESULTS: The mean score of IA was 45.65 ± 35.40. IA was found to be significantly related todepression, anxiety, stress, and sleep disorders (except for sleep disturbance) (P < 0.001). Maleswere found to be more likely than females to suffer from IA, depression, anxiety, stress, and sleepdisorders. Furthermore, age was inversely related to IA, depression, and stress. Finally, medicalsciences students suffered from depression, anxiety, and stress more than students majoring inother fields.CONCLUSIONS: The simultaneous occurrence of IA and depression, anxiety, stress, and sleepdisorders in students indicates that IA is associated with other psychological problems. Therefore,researchers and policymakers need to identify preventive measures to help internet‑addicted students.

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Level of anxiety and depression among health‑care professionals amidst of coronavirus disease: A web‑based survey from India

. Haseeb Khan; . Rahul Srivastava; . Neeraj Tripathi; . Dharmendra Uraiya; . Astha Singh; . Ruchi Verma

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: The spread of novel coronavirus diseases‑2019 (COVID‑19) across the world andits associated morbidity and mortality confronted the nations by various means. COVID19 ...  Read More BACKGROUND: The spread of novel coronavirus diseases‑2019 (COVID‑19) across the world andits associated morbidity and mortality confronted the nations by various means. COVID19 pandemichad significant psychological effects not only on the general population but also on health‑careworkers (HCWs). Hence, we aimed to found the level of anxiety and depression among health‑careprofessionals amidst coronavirus.MATERIALS AND METHODS: This is a cross‑sectional study conducted on 829 participants includingdoctors and nurses and other medical staff who were posted in the COVID ward and COVID intensivecare unit using a well‑structured questionnaire through the Google Forms. The two scales used tomeasure anxiety and depression among the HCWs were the Hamilton anxiety scale (HAM‑A) and thePatient Health Questionnaire (PHQ‑9), Cronbach’s alpha of HAM A is 0.921 and Cronbach’s alphaof PHQ 9 is 0.851. Data analysis was done using SPSS 26, Chi‑square test and Fisher’s exact testwere used to establish the association between categorical independent and dependent variables.RESULTS: The results of this study demonstrate that anxiety and depression were significantlyhigher in doctors and staff nurses as compared to other medical staff. According to HAM‑A, 65.1% ofrespondents were in the mild category, 22.0% mild to moderate, and 12.9% moderate to severe. TheHAM‑A (P = 0.022) and PHQ‑9 (P = 0.001) for anxiety and depression respectively were significantlyhigher in females. The means of the scales got increased after postings in the corona wards.CONCLUSION: Concerning the high occurrence of anxiety and fear among health‑care professionals,appropriate psychological/psychiatric intervention necessitates and emphasizes the need to implementurgent measures to prevent further progress to severe mental health disorder.

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Criteria and components of the emergency and disaster database in Iran: A content analysis study

. Sadegh Ahmadi Mazhin; . Mehrdad Farrokhi; . Mehdi Noroozi; . Juliet Roudini; . Seyed Ali Hosseini; . Mohammad Esmaeil Motlagh; . Pirhossein Kolivand; . Hamidreza Khankeh

Volume 11, Issue 10 , November 2021, Pages 1-7

Abstract

  BACKGROUND: Nowadays, emergencies and disasters are considered one of the biggest problemsin human life. To reduce the risk of emergencies and disasters, governments must develop strategiesand ...  Read More BACKGROUND: Nowadays, emergencies and disasters are considered one of the biggest problemsin human life. To reduce the risk of emergencies and disasters, governments must develop strategiesand policies using evidence‑based methods. Disaster databases are the main source and tool forstoring and managing a wide range of data in this field. This study was conducted with the aim ofexploring the necessary criteria and components of the emergency and disasters database in Iran.MARTIALS AND METHODS: This qualitative study was performed using content analysis in which 18managers and experts with experience in registering, documenting, or responding to emergencies anddisasters were selected through purposive sampling. Data collection was done using semi‑structuredinterviews that continued until saturation. Data were analyzed by means of qualitative content analysisrecommended by Landman and Graneheim.RESULTS: In total, three main concepts concerning the necessary criteria and components of thedatabase of natural and artificial emergencies and disasters in Iran were explored. The main conceptsinclude information resources, information evaluation, and information management. Subconceptsinclude data collection, information transfer, access to information, information validation, disasterleveling, information registering, information storage and retrieval, information analysis, andinformation dissemination.CONCLUSION: The experience of the participants showed that there are many challenges in thefield of monitoring and gathering information about injuries and damages caused by emergenciesand disasters in the country. The knowledge obtained from this study can be used to create anddevelop a database of emergencies and disasters in Iran. It will also provide insights for healthcarepolicymakers and managers in future planning areas to more effectively address identified challengesin preventing and responding to disasters at both regional and national levels.

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Effects of dust events and meteorological elements on stroke morbidity in northern Khuzestan, Iran

. Ali Sadeghimoghaddam; . Hamidreza Khankeh; . Mehdi Norozi; . Shahrokh Fateh; . Mehrdad Farrokhi

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: In recent years, the prevalence of dust events has increased in the region andthe world. According to the Meteorological Organization, the most frequent days with dust eventsare ...  Read More BACKGROUND: In recent years, the prevalence of dust events has increased in the region andthe world. According to the Meteorological Organization, the most frequent days with dust eventsare on stations located in Khuzestan province. Objective: Assessment of the effects of dust eventsand meteorological elements on stroke morbidity in health in Iran: a health promotion approach.MATERIALS AND METHODS: The present study was a retrospective cohort study 2020 and 2013provided between based on ecological data‑based on population. Information about patients withstroke was obtained from the hospital. Information on the dust events and meteorological elementswas also from the data center of the Meteorological Organization of Iran. Using STATA the correlationbetween the diseases and the, 14 statistical software version occurrence of dust events and changesin meteorological elements was obtained and the statistical model (Spearman correlation coefficient)individually estigate the equation was used inv modified by Poisson regression simultaneous effectof variables.RESULTS: the results of adjusted statistical models show that increasing the severity of dustevent increases the risk of stroke in males (lag 0–21 confidence interval [CI] 95% = 1.496–1.0067relative risk [RR] = 1.03 P = 0.01). Increasing the average wind speed also increases therisk of stroke in males (lag 0–3 CI 95% = 1.0491–0.9996 RR = 1.02 P = 0.05). Increasedrainfall and average relative humidity increase the risk of stroke in people under 60 years(lag 0–7 CI 95% = 1.0012–0.9058 RR = 1.95 P = 0.05). Increasing the average daily temperaturereduces the risk of stroke in males (lag 0–3 CI 95% = 0.9874–0.9254 RR = 0.51 P < 0.001).CONCLUSION: Increasing the intensity of dust storms along with meteorological elements hasincreased the risk of stroke. However, increasing the average temperature has had a protectiveeffect on the risk of stroke.

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Performance analysis of data mining algorithms for diagnosing COVID‑19

. Raoof Nopour; . Hadi Kazemi‑Arpanahi; . Mostafa Shanbehzadeh; . Akbar Azizifar

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: An outbreak of atypical pneumonia termed COVID‑19 has widely spread all overthe world since the beginning of 2020. In this regard, designing a prediction system for the ...  Read More BACKGROUND: An outbreak of atypical pneumonia termed COVID‑19 has widely spread all overthe world since the beginning of 2020. In this regard, designing a prediction system for the earlydetection of COVID‑19 is a critical issue in mitigating virus spread. In this study, we have appliedselected machine learning techniques to select the best predictive models based on their performance.MATERIALS AND METHODS: The data of 435 suspicious cases with COVID‑19 which were recordedfrom the Imam Khomeini Hospital database between May 9, 2020 and December 20, 2020, havebeen taken into consideration. The Chi‑square method was used to determine the most importantfeatures in diagnosing the COVID‑19; eight selected data mining algorithms including multilayerperceptron (MLP), J‑48, Bayesian Net (Bayes Net), logistic regression, K‑star, random forest,Ada‑boost, and sequential minimal optimization (SMO) were applied in data mining. Finally, the mostappropriate diagnostic model for COVID‑19 was obtained based on comparing the performance ofthe selected algorithms.RESULTS: As the result of using the Chi‑square method, 21 variables were identified as themost important diagnostic criteria in COVID‑19. The results of evaluating the eight selected datamining algorithms showed that the J‑48 with true‑positive rate = 0.85, false‑positive rate = 0.173,precision = 0.85, recall = 0.85, F‑score = 0.85, Matthews Correlation Coefficient = 0.68, and areaunder the receiver operator characteristics = 0.68, respectively, had the higher performance thanthe other algorithms.CONCLUSION: The results of evaluating the performance criteria showed that the J‑48 can beconsidered as a suitable computational prediction model for diagnosing COVID‑19 disease.

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Behavioral drivers and observation of face covering use during the COVID‑19 pandemic among outpatients and visitors at a tertiary hospital in Thailand

. Nanta Kliangkird; . Sommanas Naknual; . Tippawan Liabsuetrakul; . Wit Wichaidit

Volume 11, Issue 10 , November 2021, Pages 1-8

Abstract

  BACKGROUND: Use of face covering may help prevent COVID‑19 transmission. However, thereis a lack of data on behavioral drivers of face covering use and compliance to mandatory facecovering ...  Read More BACKGROUND: Use of face covering may help prevent COVID‑19 transmission. However, thereis a lack of data on behavioral drivers of face covering use and compliance to mandatory facecovering policy at health facilities. This study aimed to describe behavioral drivers and observedface covering use among outpatients and visitors at a tertiary hospital in Southern Thailand duringthe COVID‑19 pandemic.MATERIALS AND METHODS: We conducted a hospital‑based, cross‑sectional study in June 2020.We developed, pilot‑tested and finalized an interview questionnaire in Thai. We also developed astructured observation questionnaire. Two trained enumerators recruited outpatients and visitors atthe hospital’s internal medicine outpatient department (OPD), surgery OPD, and the pharmacy usingthe convenience sampling. Another enumerator conducted structured observation of face coveringuse among outpatients and visitors when interviews were not taking place. We analyzed the datausing the descriptive statistics.RESULTS: A total of 206 persons that our interview enumerators approached agreed toparticipate (n = 206; response rate = 62.4%). Nearly all participants stated that the use of facecovering was beneficial in preventing COVID‑19 infection from others and preventing others from beinginfected (94.0% and 98.0%, respectively). Common barriers included inconvenience in breathing andspeaking (19.7%) and pain at the ears (9.6%). Structured observation of 408 outpatients and visitorsshowed that nearly everyone (>99%) had a face covering on their person, most of whom (94.6%)covered both their nose and mouth.CONCLUSION: We found near‑universal perceived benefits and compliance, but variations inperceived barriers, cues, and social norms for the use of face coverings. The findings of this studycan inform future intervention programs on face covering use promotion.

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Impact of two ergonomics training on prevalence of upper and lower extremity complaints among nurses

. Amir Bahrami‑Ahmadi; . Hamid Reza Hoseini; . Elaheh Kabir‑Mokamelkhah; . Naser Dehghan; . Mashallah Aghilinejad

Volume 11, Issue 10 , November 2021, Pages 1-5

Abstract

  BACKGROUND: Musculoskeletal disorders (MSDs) were known as one of the main occupationalproblems among health‑care workers. However, we had some limitations and difficulties fortransferring ...  Read More BACKGROUND: Musculoskeletal disorders (MSDs) were known as one of the main occupationalproblems among health‑care workers. However, we had some limitations and difficulties fortransferring ergonomic concepts to the health‑care workers, especially nurses due to heavy worktask and insufficient time for that. This study compares the impacts of two ergonomic trainingmethods (lecture and pamphlet) in nurses of an Iranian tertiary hospital on prevalence of their upperand lower extremity complaints.MATERIALS AND METHODS: In the present randomized clinical trial with parallel groups, 1140 nurseswere randomly selected and allocated to the control and two interventional groups. In the interventionalgroups, nurses revived a training program and pamphlet as ergonomic training methods aboutwork‑related MSDs and related ergonomic concept to MSDs prevention and nurses in the control group,did not receive any ergonomic training methods. Upper and lower extremity complaints measure amongstudy nurses with Nordic MSDs before 6 months and 1 year after trial intervention. Statistical analysisincluding the Kolmogorov–Smirnov goodness‑of‑fit, Chi‑square test, and independent sample t‑testwas performed using SPSS version 22. A two‑tailed P ≤ 0.05 was considered statistically significant.RESULTS: At the first and second parts of the study follow‑up, the prevalence of upper and lowerextremities significantly improved in the interventional groups in comparison with the control group.Moreover, between the two trial groups, the frequency of MSDs in upper and lower extremitiessignificantly improved among nurses of the pamphlet group in comparison with the lecture group.CONCLUSION: Findings of the study showed that we can use pamphlet as a suitable tool fordescribing ergonomic concepts in comparison with lecture among nurses.

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