Journal of Education and Health Promotion

The challenge of outsourcing of hospital services in Iran: A qualitative study

. Noureddin Niknam; . Hasan Abolghasem Gorji; . Mostafa Langarizadeh

Volume 10, Issue 10 , October 2020, Pages 1-12

Abstract

  INTRODUCTION: Outsourcing, as one of the important managerial strategies to improve performance,has become one of the main areas of research in hospital management studies. The aim ...  Read More INTRODUCTION: Outsourcing, as one of the important managerial strategies to improve performance,has become one of the main areas of research in hospital management studies. The aim of thisstudy was to identify the challenges of outsourcing hospital services in Iran.METHODS: This research was conducted in a qualitative manner with the aim of determining thechallenges of outsourcing hospital services in Iran. The research community consisted of managersand experts in the field of outsourcing. 21 managers and staff experts of the Ministry of Health,universities, and hospitals affiliated to Iran University of Medical Sciences, Tehran, and ShahidBeheshti, were selected as the target for the interview. Finally, the data were analyzed using contentanalysis method.RESULTS: Outsourcing challenges were extracted and reported in the form of 6 theme topics and40 subthemes. The main issues included legal and political challenges, finance, human resources,organizational, managerial, and private sector.CONCLUSION: Outsourcing hospital services in all six areas faced serious challenges. To thisend, partnership between the private and government sectors through outsourcing requires thecontinuous development of effective political, organizational, and managerial capacity in order toguide and manage this process properly and efficiently to ensure that the goals and policies in thefield of health. It is clearly understood and not forgotten or neglected.

---

• View Article
• PDF 507.38 K

Effectiveness of an educational intervention using theory of planned behavior on health care empowerment among married reproductive‑age women: A randomized controlled trial

. Maryam Sabouri; . Elham Shakibazadeh; . Bahram Mohebbi; . Azar Tol; . Mehdi Yaseri; . Sohrab Babaee

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  BACKGROUND: Empowerment is an essential issue in women’s lives. Powerful women can actsuccessfully in health‑related issues more than others. This study aimed to determine the ...  Read More BACKGROUND: Empowerment is an essential issue in women’s lives. Powerful women can actsuccessfully in health‑related issues more than others. This study aimed to determine the effectivenessof an educational intervention designed based on theory of planned behavior (TPB) on health careempowerment among married women in reproductive age.METHODS: This randomized controlled trial was carried out among 488 reproductive‑age womenbetween 2018 and 2019 in Tehran, Iran. Participants were recruited using randomized clustersampling and divided into intervention (n = 243) and control (n = 245) groups by random allocation.Data were collected using a self‑administered researcher‑made questionnaire based on TPB andHealth Care Empowerment Questionnaire. Validity (content validity index = 0.87; content validityratio  =  0.89) and reliability of the questionnaires were confirmed  ( = 0.96). Intervention wasimplemented within four sessions (lasting 60 min) using eight health related scenarios based onTPB constructs. Baseline and post intervention data (6 months after the intervention) were analyzedby SPSS25 (Inc., Chicago, IL, USA) using independent t‑test, Chi‑squared test, Fisher’s Exact test,Mann–Whitney, path analysis, and regression of generalized estimating equation model. P < 0.05was considered statistically significant.RESULTS: Results showed the mean ± standard deviation age of the participants was 33.6 ± 7.1.Six months after the intervention, a significant difference was highlighted in health care empowermentdomains as well as behavioral intention, attitude toward behavior, subjective norms, and perceivedbehavioral control (P < 0.001) between intervention and control groups.CONCLUSION: TPB‑based educational intervention can significantly improve women’s perceptionabout health care empowerment. Tailoring and implementation of TPB‑based intervention by healthpolicy makers and health care providers is suggested to achieve better perception of empowermenttoward receiving health care among women.

---

• View Article
• PDF 679.04 K

Yoga and perceived stress, self‑compassion, and quality of life in undergraduate nursing students

. Elizabeth Kinchen; . Victoria Loerzel; . Theresia Portoghese

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  BACKGROUND: Student nurses’ experience of stress while enrolled in educational programs iswell‑documented; however, complementary and alternative therapies to alleviate or prevent ...  Read More BACKGROUND: Student nurses’ experience of stress while enrolled in educational programs iswell‑documented; however, complementary and alternative therapies to alleviate or prevent nursingprogram‑related stressors are not. The purpose of this study was to explore the effect of a yogaintervention on stress, self‑compassion, and quality of life in undergraduate nursing students.METHODS: Seventy‑three undergraduate nursing students participated in this two‑group,quasi‑experimental, repeated‑measures, study. Students self‑selected participation in a one‑houryoga class, offered each week for 12 weeks, and completed Stress, Self‑Compassion, and QOLscales at baseline, week 6, and week 12. Information on intervention participation and yoga practiceoutside the intervention was also solicited. Descriptive statistics and mixed‑model analysis of variancewere used to analyze the data.RESULTS: There were no statistically significant differences between groups over time on perceivedstress or QOL. There were statistically significant differences between groups on self‑kindness(F3, 69 = 3.86, P = 0.013).CONCLUSIONS: Further research on the effects of yoga for stress reduction in nursing studentsusing randomized controlled trials is recommended.

---

• View Article
• PDF 510.96 K

Evaluating the responsiveness of higher education system in relation to social determinants of health

. Rahele Samouei; . Kamal Heidari; . Sakineh Saghaeiannejad; . Sedigheh Karami; . Pejman Aghdak

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  BACKGROUND AND AIM: To answer the society’s health‑care needs related to social determinantsof health (SDH), higher education system must be responsive in training knowledgeable ...  Read More BACKGROUND AND AIM: To answer the society’s health‑care needs related to social determinantsof health (SDH), higher education system must be responsive in training knowledgeable students andfaculty members. Therefore, this study was carried out to determine the responsiveness of highereducation system in relation to the SDH.METHODS: This is a content analysis study carried out using qualitative approach. Semi‑structuredinterviews were used to gain access to the knowledge of experts in the fields of health care, education,and SDH. Sampling was carried out until data saturation was achieved during which 15 experts wereselected using purposeful sampling method with highest possible variety. Data were categorizedusing qualitative content analysis approach.RESULTS: In total, 11 themes and 43 categories of codes were identified in semi‑structuredinterviews with experts. A total of two approaches were identified for the training of responsivestudents including educational–research approach and cultural–social approach; five approacheswere identified for the development of faculty members including cognitive development, executivedevelopment, evaluation, promotion and incentives, and revisions; two approaches were identified forprovision of theoretical and practical education including education in a real and active environmentand structural education; and finally, two approaches were identified for evaluation of students andfaculty members in regard to their responsiveness to society’s health needs and SDH includingcontent and operational approaches.CONCLUSION: In general, the results of the current study indicate the need for the higher educationsystem to use educational, research, and society‑based approaches in real and social environmentsalong with an incentive system and use of evaluation for responsiveness to society’s health needsand SDH. These results can be useful for the health‑care system and the higher education system.

---

• View Article
• PDF 457.15 K

The problematic use of mobile phone and mental health: A review study in Iran

. Mandana Amiri; . Behnaz Dowran; . Hossein Salimi; . Mohammad Hossein Zarghami

Volume 10, Issue 10 , October 2020, Pages 1-10

Abstract

  There is growing evidence that the problematic use of mobile phone is an evolving problem. Althoughsome studies have noted a greater prevalence in the Middle East, intercultural differences ...  Read More There is growing evidence that the problematic use of mobile phone is an evolving problem. Althoughsome studies have noted a greater prevalence in the Middle East, intercultural differences have notbeen sufficiently studied to date. The present study, therefore, aims at reviewing Iranian publishedstudies on the problematic use of mobile phone in Iran. This study was conducted as a review study.For this purpose, we searched all published studies in this field that were conducted in Iran andreviewed all of the articles by studying the prevalence of the problematic use of cell phone in Iran,the adopted measuring instruments, the employed terms, predictors of the problematic use of cellphone, and the consequences of the problematic use of cell phone. After applying the inclusion andexclusion criteria, 47 articles were selected for evaluation. Among the problematic consequences,sleep disturbance was the most studied factor. Additionally, gender, feeling of loneliness, attachmentstiles and age were mostly referred to as predictors. In addition, the reported prevalence varied from0.9% to 64.5%, depending on the studied population and the measuring instruments. The diversity ofreported prevalence rate of problematic use of mobile phone in Iran can be related to the ambiguityof the concept of “problematic use” and the diversity of the employed measuring tools. Thus, careshould be taken in generalizing and interpreting the results.

---

• View Article
• PDF 732.76 K

Family caregivers’ burden in inflammatory bowel diseases: An integrative review

. Seyed Mostafa Mohsenizadeh; . Zahra Sadat Manzari; . Hasan Vosoghinia; . Hossein Ebrahimipour

Volume 10, Issue 10 , October 2020, Pages 1-9

Abstract

  Inflammatory bowel disease (IBD), including Crohn’s and ulcerative colitis diseases, is characterizedby clinical periods of remission and relapse. Excessive care stress can have ...  Read More Inflammatory bowel disease (IBD), including Crohn’s and ulcerative colitis diseases, is characterizedby clinical periods of remission and relapse. Excessive care stress can have long‑term negativephysical and psychological consequences not only for caregivers but also for the recipients of care.This integrative review aims to identify, describe, and synthesize the results of current availableresearch focused on the burdens of IBDs on family caregiver. An integrative review was performedusing Whittemore and Knafl methodology. A systematic search of electronic databases includingWeb of Science, PubMed, Embase, and Scopus from January 2000 to October 2019 was conducted.Articles were included if published in English and focus on IBD burden on family caregivers. Of 730records, 16 articles with quantitative, qualitative, and Q methodology study designs were eventuallyincluded in the review. The synthesis of these articles led to the identification of four key types ofeffects: biopsychosocial, daily life activities, physical health, and financial. The chronic and relapsingnature of IBD exposes family caregivers to considerable risk. Thus, the care burden of IBD patients’caregivers needs to be evaluated continuously and relieved through family‑centered interventions.

---

• View Article
• PDF 694.3 K

Assessment of stress among parents of neonates admitted in the neonatal intensive care unit of a tertiary care hospital in Eastern India

. Ria Ganguly; . Lipilekha Patnaik; . Jagdish Sahoo; . Sumitra Pattanaik; . Trilochan Sahu

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  BACKGROUND: An infant admitted to the neonatal intensive care unit (NICU) is a potentiallystressful event for parents. Severe stress is experienced by parents, affecting their mental ...  Read More BACKGROUND: An infant admitted to the neonatal intensive care unit (NICU) is a potentiallystressful event for parents. Severe stress is experienced by parents, affecting their mental healthand relationship, and infants’ development. The current study aims to assess the stress levels amongparents of neonates admitted to NICU and to identify the factors influencing their stress levels.MATERIALS AND METHODS: A cross‑sectional study was conducted in a tertiary care hospitalof Eastern India over 2 months. Stress levels were assessed using Parental Stressor Scale: NICUquestionnaire among 100 NICU parents (mother or father) with more than 24 h of admission. Stresswas quantified using the Likert scale. The statistical analysis was performed using the SPSS software.RESULTS: In this study, 60.8% parents experienced severe and extreme stress level for overallstress. The mean for overall stress experienced was 3.71 ± 0.70. There was no significant differencein overall stress between father and mother (P = 0.65). The highest levels of stress experienced werein sight and sound subscale (3.23 ± 0.41) followed by relationship with the baby and parental role,”i.e., 2.46 30. There was no significant association in overall stress score with maternal age, parity,education level, previous baby being admitted to the NICU (P > 0.05). Stress in sight and sounddomain was statistically significantly higher (P = 0.009) among parents of babies with stay of ≤7 days.CONCLUSION: These results support wider use in research and clinical practice to identify parentalstress. Interventions can be developed to ameliorate its negative effects on individual, interpersonal,and societal levels. The stress score was not significantly different between fathers and mothers ofneonates admitted to NICU and the length of stay was significantly associated with sight and sounddomain. Appropriate counseling should be targeted toward both parents. Future intervention studiesshould be planned to decrease the stress level among parents.

---

• View Article
• PDF 823.13 K

Students’ perception of problems and benefits of night shift nursing internship: A qualitative study

. Farhad Bahramirad; . Narjes Heshmatifar; . Mostafa Rad

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  INTRODUCTION: Recently, the night shift is included in the curriculum of nursing internship students.However, this shift is associated with some problems and benefits for students, ...  Read More INTRODUCTION: Recently, the night shift is included in the curriculum of nursing internship students.However, this shift is associated with some problems and benefits for students, which have beenassessed in limited studies. This study aimed to discover and describe the problems and benefitsof the night shift for nursing internship students.METHODOLOGY: This qualitative method was carried out with the conventional content–analysismethod. In total, 15 seventh‑semester and eighth‑semester nursing students at Sabzevar Universityof Medical Sciences, Iran, were selected by purposeful sampling. Data were collected using in‑depthsemi‑structured interviews about students’ perceptions of night shift problems and benefits. In addition,data analysis was performed applying the conventional content–analysis technique.RESULTS: In this study, seven main categories were extracted, five of which included problemssuch as exploitations, being an outsider, moral distress, learning deficits, and annoyance. The othertwo categories were benefits including gaining new experiences and independence.CONCLUSION: The problems related to the students were the nursing personnel and the educationalsystem of hospitals, which can be dealt with through the interaction of the educational system withhospitals managers in order to clarifying the role of students, fair division of work, and makingeducational resources available. Moreover, gaining new experiences and independence are amongthe benefits of the night shift for students, the continuation of which is in favor of nursing education.

---

• View Article
• PDF 539.24 K

Investigating the effect of health literacy level on improving the quality of care during pregnancy in pregnant women covered by health centers

. Leila Asadi; . Fatemeh Amiri; . Hadise Safinejad

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic informationand services necessary for appropriate health decisions. Given the importance of health ...  Read More BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic informationand services necessary for appropriate health decisions. Given the importance of health literacy inwomen, the aim of the present study was to determine the effect of health literacy level on improvingthe quality of care during pregnancy in pregnant women.MATERIALS AND METHODS: The present study was a cross‑sectional analytical study. In thisstudy, 130 women referred to Yazd health centers were examined. Health literacy questionnairesand a researcher‑made checklist of the quality of pregnancy care were used to gather information.The researcher‑made checklist of the quality of pregnancy care was in accordance with the standardprotocol of the Ministry of Health and Medical Education, entitled Integrated Health Care for PregnantMothers, which was validated and reliable. SPSS statistical software version 19 and t‑test and ANOVAstatistical tests were used to analyze the data.RESULTS: According to the findings, the average score of health literacy in pregnant women was74.09, which showed that the level of health literacy was in the marginal or border range. Peoplewith higher health literacy received significantly more prenatal counseling than other women andhad a planned pregnancy (P = 0.04).CONCLUSION: The level of health literacy in pregnant women is unfavorable. Given that the highlevel of health literacy in women in society can lead to an increase in the quality of pregnancy care, soto increase health literacy in women, it is recommended that regular training in society by health‑careproviders be given more attention.

---

• View Article
• PDF 509.93 K

Introduction of structured feedback for MBBS students: Perception of students and faculty

. Himashree Bhattacharyya; . Jayant Vagha; . Gajendra Kumar Medhi; . Star Pala; . Happy Chutia; . Parash Jyoti Bora; . Vizovonuo Visi

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  INTRODUCTION: Feedback is an important part of the assessment process. However, one‑to‑onestructured and constructive feedback to the students is not practiced mostly due to lack ...  Read More INTRODUCTION: Feedback is an important part of the assessment process. However, one‑to‑onestructured and constructive feedback to the students is not practiced mostly due to lack of practiceand feasibility issues. The present study was conducted to understand the perception of studentsand faculty toward one‑to‑one structured feedback.METHODOLOGY: All the 3rd MBBS professional students were included in the study. An orientationwas given to the faculty regarding the importance of feedback and how to give structured feedback.A standardized format was provided to the faculty for providing the feedback to the students. Aftercompletion of the assessments, a one‑to‑one structured verbal feedback was given to all thestudents. Thereafter, faculty and student’s perception on the feedback process was obtained throughquestionnaires. A focused group discussion was also conducted among the students.RESULTS: A total of 42 students participated in the study out of 50. A positive response was receivedfrom all the students regarding the feedback. Nearly84.34% of the students acknowledged thatfeedback is important for understanding their mistakes, 92.84% of the students responded positivelythat feedback helps to build a good rapport with the teacher, and 92.85% of the students reportedthat they were satisfied with the overall experience of receiving feedback. Most of the faculty (80%)perceived that giving feedback after the assessment was a good idea. The faculty felt motivatedto give feedback to the students after the hands‑on experience. However, only 20% of the facultyagreed that the process of feedback was easy to carry out (mean score: 2.2 ± 1.09).CONCLUSION: The positive responses received from both the students and the faculty highlightthat the students are receptive toward feedback provided it is structured, constructive, and helpsthem to achieve their learning goals.

---

• View Article
• PDF 469.09 K

The effect of counseling based on ex‑PLISSIT model on sexual function and marital satisfaction of postpartum women: A randomized controlled clinical trial

. Jamileh Malakouti; . Robab Golizadeh; . Mojgan Mirghafourvand; . Azizeh Farshbaf‑Khalili

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  INTRODUCTION: Since routine counseling does not suffice to resolve the sexual problems atpostpartum period, the present study aimed to investigate the effect of counseling based on ...  Read More INTRODUCTION: Since routine counseling does not suffice to resolve the sexual problems atpostpartum period, the present study aimed to investigate the effect of counseling based on theEx‑PLISSIT model on sexual function and marital satisfaction of postpartum women.METHODS: This was a randomized controlled clinical trial that was conducted on 68 postpartumwomen (within 3–6 months after childbirth) who obtained a score <28 on the Female Sexual FunctionIndex (FSFI). The participants were randomly assigned to the intervention and control groups.Participants in the intervention group received counseling based on the Ex‑PLISSIT model and thosein the control group received the routine postpartum care. The required data were collected using ademographics form, the FSFI, and the ENRICH Marital Satisfaction Scale. The primary outcomes werethe mean function and martial satisfaction score of participants 4 and 8 weeks after the intervention.RESULTS: There was no statistically significant difference between the two groups in terms of sexualfunction at baseline (P = 0.381), but it was significantly higher in the intervention group than controlgroup after intervention (the adjusted MD: 4.24, 95% confidence interval [CI]: 3.18–5.29, P < 0.001).There was no statistically significant difference between the two groups in marital satisfaction beforethe intervention (P = 0.433), but it increased significantly in the intervention group in comparison tocontrol after intervention (adjusted MD: 23.17, 95% CI: 15.10–31.24, P < 0.001).CONCLUSIONS: The study findings suggested that sexual counseling based on the Ex‑PLISSITmodel can improve the sexual function and increase marital satisfaction of postpartum women.

---

• View Article
• PDF 615.82 K

Surgical technologists’ knowledge and performance about radiation protection in Zahedan educational hospitals. A descriptive‑analytical study

. Fatemeh Rezaei Kahkhaei; . Hamed Sarani

Volume 10, Issue 10 , October 2020, Pages 1-5

Abstract

  INTRODUCTION: The use of ionizing radiation in various sciences, especially in medical science, hasplayed an important role in human health. As the use of radiology tests in medical ...  Read More INTRODUCTION: The use of ionizing radiation in various sciences, especially in medical science, hasplayed an important role in human health. As the use of radiology tests in medical centers, includingthe operating room ward, is increasing, increasing the level of awareness of the operating room staffcan improve their performance in this area as well as reduce the risk of exposure to radiation. Theaim of this study was to determine the knowledge and performance of surgical technologists aboutradiation protection in Zahedan educational hospitals.MATERIALS AND METHODS: The present study is a descriptive‑analytical study that was performedon 80 surgical technologists of Zahedan teaching hospitals from January 2019 to December 2019.The Knowledge Questionnaire was used in this study, which was a researcher‑made questionnaire.After filling out questionnaires and checklists, the data were analyzed by SPSS software usingdescriptive statistics and analytical, statistical tests, including independent t‑test and Pearsoncorrelation coefficient.RESULTS: The results showed that the mean age of participants was 31 ± 7.03 years . 27% were men,and 53% were women. The mean of work experience was 7 ± 7.56. The mean score of knowledgewas 6 ± 3.02 and the performance score was 12 ± 7.38. There was a correlation between age,awareness and performance of the participants (P < 0.001), and there was a correlation betweenparticipants’ radiation protection training and awareness and performance (P = 0.000). There is adirect relationship between staff knowledge and performance. No significant relationship was foundbetween the other variables (P = 0.029).CONCLUSION: The results of the study showed that there is a relationship between radiationprotection training courses so that the personnel who passed these courses are more aware andfunctioning. Given that action is needed to raise awareness through workshops.

---

• View Article
• PDF 450.86 K

Knowledge, attitude, practices, and barriers regarding pharmacovigilance and adverse drug reaction reporting among medical and dental faculties of the teaching hospitals in Bhubaneswar City

. Avinash Jnaneswar; . Suranjana Jonak Hazarika; . Kunal Jha; . Vinay s; . Gunjan Kumar

Volume 10, Issue 10 , October 2020, Pages 1-5

Abstract

  AIM: To assess the knowledge, attitude, practices (KAP), and barriers regarding pharmacovigilanceand adverse drug reaction (ADR) reporting among medical and dental faculties of the ...  Read More AIM: To assess the knowledge, attitude, practices (KAP), and barriers regarding pharmacovigilanceand adverse drug reaction (ADR) reporting among medical and dental faculties of the teachinghospitals.METHODOLOGY: This study was conducted for a period of 3 months among medical and dentalfaculties. A self‑structured, 42‑item closed‑ended questionnaire based on pharmacovigilance andADR reporting was used in this study. Data were analyzed using Statistical Package for the SocialSciences Version 21. All the items of the domains along with demographic variables were summarizedas absolute and relative frequencies. Intergroup comparison was done using Kruskal–Wallis test andMann–Whitney U‑test. The correlation between the domains was assessed by Spearman correlationcoefficient.RESULTS: Among the study subjects, 272 (60.4%) were females and 178 (39.6%) were males.The number of medical and dental faculties was 360 (80%) and 90 (20%), respectively. The meanKAP scores for medical and dental faculties were 7.58 and 5.37, 8.78 and 6.01, and 6.91 and 6.32,respectively. The Spearman correlation coefficient (ρ) was found to be significant for knowledge–attitude and knowledge–practice domains. The values obtained between attitude with practice andbarrier also were significantly correlated.CONCLUSION: Our study findings advocate that although medical faculties have better knowledgeabout pharmacovigilance and ADR reporting, dentists have a positive attitude, thereby suggesting ahuge scope of progress if more emphasis is given on the need for continuous educational initiativesand including the topic in their academic curriculum.

---

• View Article
• PDF 517.1 K

Validation of the 30‑item nurses’ observation scale for inpatient evaluation and mental health‑care promotion

. Masoud Sirati Nir; . Robabe Khalili; . Hosein Mahmoudi; . Abbas Ebadi; . Rahim Habibi

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  CONTEXT: The 30‑item nurses’ observation scale for inpatient evaluation (NOSIE‑30) developedfor the behavioral and observational rating of psychiatric inpatients.AIMS: The ...  Read More CONTEXT: The 30‑item nurses’ observation scale for inpatient evaluation (NOSIE‑30) developedfor the behavioral and observational rating of psychiatric inpatients.AIMS: The purpose of this study was to evaluate the validation of the NOSIE‑30 and mentalhealth‑care promotion.MATERIALS AND METHODS: The participants with psychiatric disorders were selected from 310inpatients referred to the military educational hospital in Iran. This study was carried out in two phases:First, translation of the NOSIE‑30 into Persian followed the stepwise, iterative procedures developedby the International Quality of Life Assessment project approach. Second, face validity, criterion‑relatedvalidity and construct validity, and reliability of the Persian version were determined. The concurrentvalidity was assessed by using the global assessment of functioning (GAF) instrument. Data wereanalyzed with the SPSS software of version 22. Exploratory factor analysis, the Cronbach’s alphacoefficient, and interrater agreement with intraclass correlation coefficient and Pearson’s correlationcoefficient were used to data analysis.RESULTS: Pearson’s correlation coefficient between the NOSIE and GAF was 0.75. The interraterreliability for subscale scores and structure of the NOSIE were ranging from 0.70 to 0.94 and Cohen’skappa = 0.74. Furthermore, the internal consistency of the scale’s total scores was estimated byCronbach’s alpha = 0.85.CONCLUSIONS: The finding indicated that NOSIE‑30 Persian version scale has the desirable validityand reliability for evaluating the nursing care of inpatients. Thus, nurses can promote mental healthcare by applying this scale in the psychiatric setting.

---

• View Article
• PDF 614.72 K

Comparison of the effect of two training methods (webinar and group discussion) on improving the attitude and performance of health workers in providing counseling with fertility promotion approach

. Raziyeh Rahmati; . Talat Khadivzadeh; . Habibollah Esmaily

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  INTRODUCTION: Due to the significant decrease in fertility in recent decades and the important roleof health workers and health‑care providers in providing healthy reproductive counseling, ...  Read More INTRODUCTION: Due to the significant decrease in fertility in recent decades and the important roleof health workers and health‑care providers in providing healthy reproductive counseling, their trainingis necessary using effective educational methods. Webinar and group discussion (GD) are effectivein this regard. This study was conducted to determine the most effective method and with the aimof comparing the effect of two training methods (webinar and GD) on the attitude and performanceof health workers in providing counseling with fertility promotion approach in comprehensive healthcenters in Mashhad.METHODS: In this randomized trial study with a control group, 108 health workers working in healthcenters no. 2–3 and 5 of Mashhad entered the study and were randomly divided into three groups oftraining by webinar, GD, and control. Intervention groups received healthy fertility counseling skillsin three training sessions. Research tools were demographic information questionnaires, fertilityattitudes, and performance measurement checklists for fertility counseling. The questionnaires werecompleted in three groups at the beginning and after the completion of the interventions. Data analysiswas performed by Chi‑square test and one‑way analysis of variance using SPSS software version 16.RESULTS: The analysis of variance test showed that before the intervention, there was no statisticallysignificant difference between the three groups in terms of average scores of fertility attitude andperformance scores of fertility counseling. After the interventions, the difference between the fertilityattitude scores (P < 0.001) and the performance scores of fertility counseling (P < 0.001) was significantin the three groups. There was no significant relationship between demographic characteristics andattitude and performance.CONCLUSION: Teaching by webinar and GD promotes the attitude and performance of healthworkers in providing counseling with a fertility promotion approach. Therefore, it is recommended touse new educational methods such as webinar and GD to promote childbearing counseling, whichhas been emphasized in the country’s population policies. Since the mean score difference forthe webinar training method was the highest due to the mean scores, this method could be moreeffective than the GD method.

---

• View Article
• PDF 498.3 K

Assessment on knowledge and practice of postexposure prophylaxis of human immuno‑deficiency virus among staff nurses and paramedical workers at a tertiary care hospital in South India

. Harsha Vardhini; . Nitya Selvaraj; . R. Meenakshi

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  INTRODUCTION: Adequate knowledge about the presence of postexposure prophylaxis (PEP)against human immuno‑deficiency virus (HIV) is imperative for health‑care workers. This studyfocuses ...  Read More INTRODUCTION: Adequate knowledge about the presence of postexposure prophylaxis (PEP)against human immuno‑deficiency virus (HIV) is imperative for health‑care workers. This studyfocuses on the evaluation of the present knowledge and practice of nurses and paramedical workerson the post exposure prophylaxis against HIV.AIM: The aim of this study is to assess and compare the knowledge and practice of PEP againstHIV among Staff Nurses and Paramedical workers.SUBJECTS AND METHODS: A descriptive cross‑sectional questionnaire study about the knowledgeand practice of PEP against HIV among Staff nurses and Paramedical workers done at a tertiary carehospital in South India. The analysis of the data was performed using SPSS software version 24.The statistical tests used to compare the knowledge between nurses and paramedical workers wasChi‑square test. P < 0.05 was considered statistically significant.RESULTS: About 339 nurses and 66 paramedical workers participated in the study. An overallof 65.4% of the study participants had a good level of knowledge, higher (P = 0.000) amongnurses (71.1%) compared to paramedical workers (36.3%). However, only 23% of nurses and 14.3%of paramedical workers received PEP after a needle prick injury.CONCLUSION: This study revealed a low‑level practice of HIV PEP among staff nurses andparamedical workers despite their good knowledge. This can be improved by providing formal trainingsessions to the health care workers.

---

• View Article
• PDF 581.26 K

A questionnaire on factors affecting the precaution adoption process model for cervical cancer – Psychometric properties

. Seyed Saeed Mazloomy Mahmoodabad,; . Ali Asadian; . Hossein Fallahzadeh; . Minoo Rajaei

Volume 10, Issue 10 , October 2020, Pages 1-10

Abstract

  BACKGROUND: Implementing a cervical cancer prevention program requires an exploration ofcertain behaviors concerning this disease. This study is aimed to evaluate the psychometrics ...  Read More BACKGROUND: Implementing a cervical cancer prevention program requires an exploration ofcertain behaviors concerning this disease. This study is aimed to evaluate the psychometrics of aquestionnaire that enquired about the factors involved in Precaution Adoption Process Model (PAPM)for cervical cancer among suburban women in Bandar Abbas, south of Iran.MATERIALS AND METHODS: The primary draft of the questionnaire was developed with a reviewof the related literature on cervical cancer and the constructs affecting PAPM, with 68 items. Theface validity, content validity ratio (CVR), and content validity index (CVI) of the questionnairewere approved by a panel of 10 experts. The internal consistency and test‑retest reliability of thequestionnaire were estimated too. Field testing sample included 300 women recruited from a women’shealthcare center in suburban areas of Bandar Abbas in the south of Iran. Exploratory factor analysiswas used to evaluate validity, and Cronbach’s alpha coefficient was estimated for reliability.RESULTS: After the face validation, 11 items were eliminated. Once CVR was estimated, two itemswere discarded. The remaining items had a CVR >0.79. All had a CVI >0.79. Six items were eliminatedin the factor analysis. The final questionnaire included 49 items organized in 8 factors includingawareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers,social norms, fear, and self‑efficacy. Principal component analysis with varimax rotation indicatedeight main components that explained 56.25% of the variance. Reliability assessment showed agood internal consistency for all subscales and the Cronbach’s alpha score ranged between 0.82and 0.90. The test‑retest reliability showed that the correlation coefficients (between 0.81 and 0.89)were significant at the 0.01 level for all sub‑scales.CONCLUSIONS: The final questionnaire was a new instrument comprised the effective constructsof PAPM and had a high reliability and validity. Thus, this questionnaire is recommended to be usedto explore and enhance preventive behaviors of cervical cancer.

---

• View Article
• PDF 690.51 K

A study on physical activity by a need‑based curriculum for students in a rural area of West Bengal

. Nirmalya Biswas; . Nazrul Mallick; . Aparajita Dasgupta; . Rabindra Nath Sinha; . Indranil Saha; . Bobby Paul

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  BACKGROUND: Students must be made aware about the essentiality of optimum level of physicalactivity and the fact that it is the key to good health and an important technique to prevent ...  Read More BACKGROUND: Students must be made aware about the essentiality of optimum level of physicalactivity and the fact that it is the key to good health and an important technique to prevent and controla lot of noncommunicable diseases including depression and other related mental ill‑health.MATERIALS AND METHODS: It was an institution‑based intervention study among 187 Madrasahstudents of classes VII and VIII, conducted in five‑phase assessment of the training needs ofMadrasah students on different aspects of healthy lifestyle, development of a need‑based moduleto be used by teachers to impart training of students through classroom setting, training of teachersto use the module to train students, training of students by the trained teachers in classroom setting,and evaluation of effectiveness of the training module.RESULTS: The mean pretest knowledge score in study Madrasah was 2.64 ± 1.35 (Mean ± SD)and post test score was 4.13 ± 0.88 (Mean ± SD). In paired t‑test, t‑value was 13.54 and P < 0.05with effect size of 1.370 (Cohen’s d). Practice related to the mean score in pretest was 2.38 ± 1.08and posttest score was 2.73 ± 1.03. In paired test, t‑value was 6.25 and P < 0.05 with effect size of0.458 (Cohen’s d).CONCLUSIONS: The study revealed the effectiveness of training by teachers using the moduledeveloped by the researcher to address significant changes in lifestyle‑related issues.

---

• View Article
• PDF 632.57 K

What must Iran do for Palliative care? A systematized review

. Marziyeh Hadian; . Alireza Jabbari; . Elaheh Mazaheri

Volume 10, Issue 10 , October 2020, Pages 1-5

Abstract

  Palliative care has been proposed as a multidisciplinary method for providing patients with care. Thepresent study proposes to discuss the necessary principles required for any country ...  Read More Palliative care has been proposed as a multidisciplinary method for providing patients with care. Thepresent study proposes to discuss the necessary principles required for any country to successfullyimplement a palliative medicine program. The present study was a systematic review conducted inJanuary 2019, and the articles related to palliative care requirements on the databases of Web ofScience, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, and Google Scholar from January1, 2009, to January 20, 2019, were searched. Strategy for searching and selecting the articles wasPreferred Reporting Items for Systematic Reviews and Meta‑Analyses Guidelines. The findingsshowed that the World Health Organization has introduced for main phases for increasing these typesof services including: defining and developing a national policy, training and educating healthcareemployees and general public, as well as pain relief. In general, two scenarios are described in thedevelopment of palliative medicine: bottom‑up and top‑down approaches. In conclusion, althoughthere seem to be progressing activities regarding the issue of making palliative medicine accessible,there are still many obstacles including lack of adequate knowledge and political support, social andcultural problems, inadequate training and education of physicians and nurses, fixed and biasedattitude in medical professions, and low priority of palliative medicine among policymakers. Therefore,it could be said that implementing palliative medicine programs requires an overall change in culture,public and individual education, political support, and appropriate policies.

---

• View Article
• PDF 672.3 K

A study on the preference of teaching methods among medical undergraduate students in a tertiary care teaching hospital, India

. Pulak Kumar Jana; . Tarun Kumar Sarkar; . Mrinmoy Adhikari; . Vinoth Gnana Chellaiyan; . Fasna Liaquath Ali; . Shubho Chowdhuri

Volume 10, Issue 10 , October 2020, Pages 1-5

Abstract

  BACKGROUND: In medical education, the learning–teaching method is an active process in whichboth students and teachers have to work mutually to enlighten the knowledge. Currently, ...  Read More BACKGROUND: In medical education, the learning–teaching method is an active process in whichboth students and teachers have to work mutually to enlighten the knowledge. Currently, in India,there is an increase in the enrollment of students in medical fields and thus medical educators facethe challenge of teaching larger classes in a short period. Furthermore, it is observed that there isa lack of consensus about the best teaching and learning methods for medical students. This studyaims to assess the preference of teaching methods and identify the reason for absenteeism amongmedical undergraduate students in a tertiary care teaching hospital.MATERIALS AND METHODS: A cross‑sectional study was conducted among 246 medicalundergraduate students in a tertiary care teaching hospital from August 2019 to October 2019.A pretested, validated self‑administered questionnaire was used to assess the preference of teachingmethods. The data were analyzed using SPSS‑IBM software 23.RESULTS: The majority of the students belonged to 20–21 years of age group. Most of the studentspreferred practical demonstration (81.3%) as the preferred method of teaching and computer witha liquid crystal display projector as ideal media for teaching (63.8%). Boring/monotonous teachingclass was found (73.5%) to be an important cause for absenteeism among medical undergraduatestudents.CONCLUSION: The results indicate that the medical student’s preference is changing from passivelearning to active learning. We conclude by linking these emerging perceptions with suggestions tohelp drive excellence in medical education.

---

• View Article
• PDF 466.21 K

Effect of the jigsaw technique as a cooperative learning approach on motivation and job performance of community health workers: A quasi‑experimental study

. Sareh Shakerian; . Leila Hassan Abadi

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  BACKGROUND: In Iran, community health workers (CHWs) are native and are only employed inthe health‑care system. Therefore, the training and empowerment of these staff are essential. ...  Read More BACKGROUND: In Iran, community health workers (CHWs) are native and are only employed inthe health‑care system. Therefore, the training and empowerment of these staff are essential. Thepresent study was aimed to develop cooperative learning techniques in CHWs to improve bothcognitive and noncognitive aspects such as accountability and other social skills in learners.METHODOLOGY: This study employed a quasi‑experimental pre‑ and post‑test design with a controlgroup that was conducted in Kangavar City, Iran, in 2019. Forty‑four CHWs were selected using atwo‑stage cluster sampling, of whom 22 were randomly assigned to the experimental group wherethe jigsaw technique was applied and the rest to the control group where the lecture method wasapplied. The aim was to identify job performance and motivation among the CHWs after instructionand compare the two groups. Pre‑ and posttests were applied to the groups before and after anin‑service training course using valid questionnaires. Data analysis was performed on both descriptiveand inferential statistics such as mean and standard deviation, paired t‑test, and covariance analysiswith the confidence level of 95%.RESULTS: The findings showed that the intervention significantly increased the mean score ofmotivation and performance in the experimental group. Covariance analysis with the removal of thepretest effect was also statistically significant (P = 0.01). Moreover, the MANCOVA test showed thejigsaw technique effect considering motivation and performance with a confidence level of 95%.CONCLUSION: Given the well‑known effect of cooperative learning techniques and since CHWshave multi roles and tasks, it is necessary to use such techniques so that they can be accountablefor developing health indicators in local areas.

---

• View Article
• PDF 703.95 K

The challenges of Iranian health system preparedness before earthquakes based on the World Health Organization framework

. Mohammad Heidari; . Samaneh Heidari; . Hamid Jafari

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  INTRODUCTION: The state of health‑care disaster preparedness in Iran prior to the possibleearthquakes is not well documented. This study identified the challenges of the Iranian health ...  Read More INTRODUCTION: The state of health‑care disaster preparedness in Iran prior to the possibleearthquakes is not well documented. This study identified the challenges of the Iranian health systembefore possible earthquakes in Tehran based on the World Health Organization (WHO) framework.MATERIALS AND METHODS: In this qualitative study, in‑depth and semi‑structured interviews wereconducted for 17 health experts and authorities, who were selected based on purposive samplingmethod. The questions were designed based on the proposed framework of the WHO in six areasincluding policies and planning, communication, collaboration and coordination, training, volunteersand the public, and surge capability. The data were analyzed by using framework analysis.RESULTS: The main themes included weak communication infrastructures, inappropriate assessmentof specialized training courses and lack of a clear scenario, integrated urban commanding,extra‑sectorial coordination, and data banks for public volunteers.CONCLUSION: Iran health‑care disaster preparedness was tested by many earthquakes. Thisresearch showed that disaster preparedness in Iran faces several challenges.

---

• View Article
• PDF 492.58 K

Investigation of medical error‑reporting system and reporting status in Iran in 2019

. Asaad Ranaei; . Hasan Abolghasem Gorji; . Aidin Aryankhesal; . Mostafa Langarizadeh

Volume 10, Issue 10 , October 2020, Pages 1-11

Abstract

  INTRODUCTION: Reporting medical errors is a major challenge in patient safety and improvingservice quality. The purpose of the present study is to investigate the status of error reporting ...  Read More INTRODUCTION: Reporting medical errors is a major challenge in patient safety and improvingservice quality. The purpose of the present study is to investigate the status of error reporting andthe challenges of developing an error‑reporting system in Iran.METHODS: This study was designed with qualitative approach and grounded theory method inteaching hospitals affiliated to Iran University of Medical Sciences. The views of safety authoritiesat various levels of management, including those responsible for safety at the Ministry of Health,Vice Chancellor and Hospitals affiliated to Iran University of Medical Sciences, were investigated in2019 regarding adverse events.RESULTS: Four major themes were identified included iceberg reporting and disclosure, weakreporting, underreporting, and non‑error disclosure. The most common problems in reportingmedical error were non‑involvement of physicians in the error‑reporting process, structural (humanand information) bugs in root cause analysis sessions, and defective error prevention approachesdesigned based on the failure mode and effects analysis.DISCUSSION: Despite a large number of medical errors occurred in health‑care settings, errorreporting is still very low, with only a limited number of errors being reported routinely in hospitalsand the rest are minor and occasional reports.CONCLUSION: Creating a mandatory error‑reporting system and requiring physicians to report andparticipate in error analysis sessions can create a safety culture and increase the error‑reporting rate.

---

• View Article
• PDF 490.37 K

Determinants of well‑being of middle‑school students in Moroccan urban and rural areas: A comparative study

. Salah‑Eddine Khzami; . Abdelaziz Razouki; . Sabah Selmaoui; . Boujemaa Agorram

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  CONTEXT: Well‑being in schools is often considered in relation to the educational and academicsuccess of students. However, it is difficult, at present, not to consider the well‑being ...  Read More CONTEXT: Well‑being in schools is often considered in relation to the educational and academicsuccess of students. However, it is difficult, at present, not to consider the well‑being of a studentwithout an ecological and holistic perspective, in view of the interaction principles implemented inschools. This research aimed to identify the representations hold by Moroccan teenagers aboutwell‑being. It aimed, also, to do a comparison between two groups of teenagers: one belonging tourban and the other to rural areas.METHODS: This quantitative study concerns a sample of 1444 pupils (755 girls and 689 boys)enrolled in middle school. Research instrument for this study was questionnaire that includes 15questions relating to well‑being at school, relationships with the teacher, relationships betweenstudents, violence experienced, and coeducation.RESULTS: From the analysis of data, pupils in the rural areas seem to be most sensitive to the“emotional” aspects of the teacher–pupil relationship. The girls are more satisfied in middle schoolthan boys. This fact seems to be a very important factor in their retention and in reducing their dropoutrate. As expected, academic success is highlighted in the two groups of students as an indicatorof well‑being. However, the fact of not knowing which orientation to choose constitutes a factor ofill‑being for pupils, especially for girls. The results show also that well‑being is not taken care of inthe two environments (urban and rural). This will explain the results of Moroccan students assessedby the Program for the Monitoring of Student Achievement.CONCLUSIONS: Training programs should focus on the development of teachers communicationskills, ability to manage behavioral problems of their students and use teaching approaches to developpositive relationships between students.

---

• View Article
• PDF 454.53 K

Key educational and research factors affecting the future of medical education discipline in Iran: A qualitative study

. Atiye Faghihi; . Mohammad Hoseini Moghadam; . Nikoo Yamani

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  CONTEXT: Along with the evolutions of medical sciences education, the importance of medicaleducation discipline has gained more attention for keeping up with these evolutions. Therefore,paying ...  Read More CONTEXT: Along with the evolutions of medical sciences education, the importance of medicaleducation discipline has gained more attention for keeping up with these evolutions. Therefore,paying attention to policymaking regarding the development of this discipline and its position inuniversities is very necessary.AIMS: This study has been done with the aim of investigating key educational and research factorsaffecting the future of medical education discipline in Iran.SETTINGS AND DESIGN: This is a qualitative study with directed content analysis approach,which has been conducted in eight medical sciences universities having medical educationdepartment (Tehran, Iran, Shahid Beheshti, Isfahan, Mashhad, Shiraz, Tabriz, and Kerman) in2018–2019.SUBJECTS AND METHODS: A total of 25 participants (professors, students, and graduates) ofmedical education discipline were selected by purposeful sampling and with maximum diversity. Datawere collected through semi‑structured interviews. Interviews were analyzed using MAXQDA software.RESULTS: After analyzing the data, a number of 1561 initial codes were obtained, of which 914 codeswere extracted after removing repetitious codes and merging similar codes. Finally, the obtainedresults from content analysis were classified into two main categories including key educational andresearch factors and ten subcategories.CONCLUSIONS: Among the most important key educational and research factors affecting the futureof medical education discipline, it can be mention to the role of the discipline curriculum and needto revise it, the need to monitor the graduates and their status , globalization, the role of medicaleducation centers and departments, and the role of theses. It is recommended that future studiesinvestigate other key factors affecting the future of the discipline.

---

• View Article
• PDF 534.45 K

Nursing education in the path of globalization: Promotion or challenge?

. Safoura Dorri; . Azar Abedi; . Nooredin Mohammadi

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  Globalization has been attracted by great literature and papers of many disciplines in recent years.Although globalization has considerable social, political, and economic effects, ...  Read More Globalization has been attracted by great literature and papers of many disciplines in recent years.Although globalization has considerable social, political, and economic effects, it has turned to animportant challenge in health‑care systems. Nursing, as the largest part of the health system inthe world, has also been affected by globalization. The purpose of the present paper is to critiqueglobalization and its impacts on the nursing profession. This review article was conducted by searchingfor reliable internet resources in the English language on the impact of globalization on nursing.Published articles were searched until 2018, and related articles were extracted in three stages:1‑selection of articles by reading abstract, 2‑selection with an overview of the text, and 3‑selectionwith a full review of the article’s text. According to the literature of globalization, we categorize anddiscuss the nursing areas that are affected by globalization in nine areas: global nursing development,nurses emigration,information interchange and interactions in nursing, higher education in nursing,professional territory, nursing specialization, professional ethics, management and supervision, andprofessional independence. The intensity of globalization effects on the nursing profession has notbeen the same in all societies, and factors such as compliance of society, culture, and technologyare among the most important factors that affect it. Globalization is an inevitable process and bringswith itself many prominent promotions such as global nursing development and important challengessuch as nursing emigration and ethical issues.

---

• View Article
• PDF 506.27 K

The association between nurses’ moral distress and sleep quality and their influencing factor in private and public hospitals in Iran

. Zeynab Rezaei Fard; . Arman Azadi; . Yousef Veisani; . Amirreza Jamshidbeigi

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress thatis an underlying issue in the nursing profession, which can lead to problems such as ...  Read More BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress thatis an underlying issue in the nursing profession, which can lead to problems such as reduced qualityand quantity of care and sleep disorder. Besides, given the increased privatization of hospitals, thisstudy aimed to explore the association between nurses’ moral distress and sleep quality and itscomparison among nurses in private and public hospitals.MATERIALS AND METHODS: This was a descriptive‑analytical study involving 150 nurses workingin Ilam Province hospitals. Sampling conducted using a multistage random sampling method. Datawere collected through the questionnaire of sociodemographic characteristics, the Corley’s MoralDistress Scale, and the Pittsburgh Sleep Quality Index. Data were analyzed using SPSS softwareversion 22. Descriptive statistics such as frequency, mean, ANOVA, independent t‑test, multiple linearregression, and Pearson correlation coefficient at the significant level of P < 0.05 were calculated.RESULTS: The analysis revealed that moral distress was positively associated with sleep quality.Furthermore, the scores of nurses’ moral distress and sleep quality were different in private andpublic hospitals, so that the level of moral distress in the public hospital and sleep quality in theprivate hospital was higher and lower, respectively, but the difference was not statistically significant.Moreover, sleep quality, and the type of employment was the most important predicting variables ofmoral stress (B = 1.86) and sleep quality (B = 2.39), respectively.CONCLUSION: According to the study results, a positive and significant association was foundbetween moral distress and nurses’ sleep quality. It is recommended that appropriate strategiesand training program be formulated by the health‑care system to increase nurses’ ability to combatmoral distress adverse effects.

---

• View Article
• PDF 594.69 K

Factors related to the international research collaboration in the health area: A qualitative study

. Roya Moradi; . Ali Zargham‑Boroujeni; . Mohammad Reza Soleymani

Volume 10, Issue 10 , October 2020, Pages 1-8

Abstract

  BACKGROUND: International research collaboration (IRC) is known as one of the important indicatorsof productivity, efficiency, and validity of universities in the world. In other words, ...  Read More BACKGROUND: International research collaboration (IRC) is known as one of the important indicatorsof productivity, efficiency, and validity of universities in the world. In other words, IRC is necessaryfor the scientific trade‑off between researchers in international scientific societies. The study aimedto address the experiences of an academic researcher about factors related to IRC.MATERIALS AND METHODS: The present study was conducted using a qualitative approachand conventional content analysis method. The participants consisted of 19 experienced facultymembers and researchers from Isfahan University of Medical Sciences, who were selected basedon the purposive and snowball sampling techniques. Data were collected through semi‑structuredinterviews and were analyzed using the content analysis technique. Guba and Lincoln’s evaluativecriteria, including credibility, confirmability, dependability, and transferability, were applied to evaluatethe trustworthiness of the study.RESULTS: According to the research findings, factors of “personal skills,” “personality,” “professionalposition,” and “scientific activities” under the category of personal factors; “rules and regulations”and “equipment and facilities” under the organizational factors; and “domestic policies” and “foreignpolicies” were identified under the government factors category.CONCLUSION: Research collaborations are influenced by individual, intra‑academic, andextra‑academic factors; thus, research policymakers can help further to enhance the quantity andquality of scientific output and promote the university’s placing in international rankings throughproviding conditions that enable international interactions.

---

• View Article
• PDF 533.78 K

Assessment of knowledge, attitude, and practice related to ergonomics among the students of three different dental schools in India: An original research

. Mohan Kumar P; . S. Sahitya; . Gautami S. Penmets; . S. Supraja; . Shivashankar Kengadaran; . A. Chaitanya

Volume 10, Issue 10 , October 2020, Pages 1-5

Abstract

  BACKGROUND AND OBJECTIVE: Dental students and practitioners are frequently prone towork‑related musculoskeletal disorders (WMSDs) due to the unawareness of ergonomic principleswhen ...  Read More BACKGROUND AND OBJECTIVE: Dental students and practitioners are frequently prone towork‑related musculoskeletal disorders (WMSDs) due to the unawareness of ergonomic principleswhen practicing dentistry. The aim of this study was to assess the dental student knowledge, attitude,and practice toward ergonomics in three different dental schools.METHODOLOGY: A cross‑sectional study was conducted among 1166 dental students from threedifferent dental schools of Andhra Pradesh, India, to assess knowledge, attitude, and practiceregarding ergonomics. All the participants were provided with prestructured questionnaire formcomprising 13 questions to know their knowledge, attitude, and practice related to ergonomics beforeand after providing guidelines on ergonomic principles.RESULTS: The majority of the dental students appreciate that the most affected regions due towork‑related disorders were back (475 before and 559 after instructions), neck (354 and 420), handand wrist (205 and 117), and shoulder and elbow (132 and 70), respectively. Knowledge and practicescores of dental students (mean and standard deviation) regarding WMSDs before and after applyingergonomic principles were 3.92 ± 2.44, 1.29 ± 1.67 and 5.81 ± 0.87, 3.03 ± 0.60, respectively.CONCLUSION: The present study provides an insight into ergonomics for dental students duringroutine dental procedures. The knowledge, attitude, and practice related to ergonomics weresatisfactorily increased among the participants. Thus, ergonomic education of the dental health‑carepersonnel must be focused in all the educational institutions and at continuing dental health programs bydelivering ergonomic principles both theoretically and practically and should be a part of the curriculum.

---

• View Article
• PDF 563.05 K

Self‑care behaviors in high‑risk women for breast cancer: A randomized clinical trial using health belief model education

. Maryam Damghanian; . Habibollah Mahmoodzadeh; . Zohreh Khakbazan; . Behjat Khorsand; . Mohadese Motaharinezhad

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  BACKGROUND: Breast cancer is the most common cancer in Iranian women. The number of peoplewith this disease is increasing across the world. Positive family history is one of the risk ...  Read More BACKGROUND: Breast cancer is the most common cancer in Iranian women. The number of peoplewith this disease is increasing across the world. Positive family history is one of the risk factors fordeveloping breast cancer. However, early detection is the main method to fight this disease. Thisstudy was conducted to examine the effect of education based on the health belief model (HBM) onself‑care behaviors among first‑degree relatives of patients with breast cancer.METHODS: This clinical trial was conducted in 2016 on 80 women in Tehran city, Iran. Data werecollected using a three‑part questionnaire regarding demographic data, the HBM, and self‑carebehaviors. The educational program based on the HBM was held in 4 ninety‑minute training sessionsthrough lectures, group discussions, question and answer, image presentations, and PowerPointpresentations. The questionnaires were completed before and 2 months following the interventionby intervention and control groups. Data were analyzed using descriptive and inferential statisticsthrough the SPSS16 software.RESULTS: The mean score of the HBM constructs before the intervention in the groups had nostatistically significant differences (P > 0.05). Eight weeks after the intervention, the mean score of theconstructs of the HBM in the intervention group significantly increased and a statistically significantincrease in the mean score of self‑care in the intervention group compared to the preinterventionwas found, so that the self‑care behavior score in the intervention group was 0.69 ± 0.09 before theintervention and was changed to 0.74 ± 0.09 after the intervention (P < 0.0001).CONCLUSION: Our results suggest that education based on the HBM was effective in promotingself‑care behaviors among first‑degree relatives of breast cancer patients. Therefore, educationbased on HBM may have an important implication for breast cancer prevention in Iran.

---

• View Article
• PDF 618.38 K

The relationship between Life Style and mental health among medical students in Kermanshah

. Omran Davarinejad; . Nima Hosseinpour; . Tahereh Mohammadi Majd; . Farzaneh Golmohammadi; . Farnaz Radmehr

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  INTRODUCTION: Given the close relationship between life style and mental health and the importanceof students as valuable human resources, the present study aimed at determining the ...  Read More INTRODUCTION: Given the close relationship between life style and mental health and the importanceof students as valuable human resources, the present study aimed at determining the relationshipbetween life style and mental health among medical students in Kermanshah.METHODS: This is a descriptive‑correlational study that was conducted in 2018. The study involved200 medical students. The sampling method was convenience sampling. Demographic questionnaire,general health questionnaire, and life style questionnaire were used for data collection. The data wereanalyzed Pearson’s correlation test and regression analysis. The significance level was considered0.05.RESULTS: The mean mental health score of the students was 25.43 ± 13.02 (2 points higher thanthe cutoff point of this test). The life style of 59.5 students was moderate. The results showed thatall life style subscales had a negative significant relationship with the total mental health score andall its subscales (P < 0.05). Among the life style subscales, the highest relationship and predictivepower to mental health were obtained for psychological health, social health, sport and fitness, andenvironmental health (R2 = 0.48, P < 0.001).CONCLUSION: According to the results, the life style of most medical students in the final year ofKermanshah University of Medical Sciences was moderate. Further, the students had a better lifestyle, and they had higher mental health. Therefore, considering the vital role of medical students inproviding and promoting community health, the need for more detailed planning and interventionsto improve their life style and mental health is essential.

---

• View Article
• PDF 504.79 K

Comparing relationship between spiritual well‑being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers

. Nasrin Nezami; . Forouzandeh Dashti; . Leyla Alilu; . Shiva Heidari

Volume 10, Issue 10 , October 2020, Pages 1-7

Abstract

  BACKGROUND: Death anxiety is one of the most common problems among women with cancer,which can affect the useful treatment process. With regard to the superior role of spiritual well‑beingover ...  Read More BACKGROUND: Death anxiety is one of the most common problems among women with cancer,which can affect the useful treatment process. With regard to the superior role of spiritual well‑beingover other aspects of health, the present study is aimed to compare the relationship between spiritualwell‑being and death anxiety among women with breast and cervical cancers and women with gastricand colorectal cancers.METHODOLOGY: This was a descriptive–correlational study. Research statistical population includedIranian women with cancer at major hospitals in Isfahan, Iran. 160 research samples were selectedthrough convenience sampling method based on inclusion criteria using a demographic questionnaire,spiritual well‑being scale (Paloutzian et al.) and death anxiety scale (Templer). Research data wereanalyzed through SPSS 22 using independent t‑test, Pearson’s correlation, and analysis of varianceat significance level 0.05.RESULTS: The study findings indicated a significant inverse relationship between death anxietyand spiritual well‑being (at 0.05) in both groups. As a result, people with higher spiritual well‑beingwould experience less anxiety about death. In addition, the relationship between death anxiety andspiritual well‑being in women with gastric and colorectal cancers was stronger than those with breastand cervical cancers.CONCLUSION: Spiritual well‑being is of effective factors of death anxiety among women sufferingfrom cancer. Spirituality and meeting spiritual needs are considered as nursing care priorities forthese women. Furthermore, paying attention to the spirituality by nurses may shield against individualdifficulties.

---

• View Article
• PDF 515.15 K

Data integration in cardiac electrophysiology ablation toward achieving proper interoperability in health information systems

. Hadi Kazemi-Arpanahi; . Mostafa Shanbehzadeh; . Esmat Mirbagheri; . Abdolvahab Baradaran

Volume 10, Issue 10 , October 2020, Pages 1-9

Abstract

  INTRODUCTION: Providing information exchange and collaboration between isolated informationsystems (ISs) is essential in the health‑care environments. In this context, we aimed to ...  Read More INTRODUCTION: Providing information exchange and collaboration between isolated informationsystems (ISs) is essential in the health‑care environments. In this context, we aimed to develop acommunication protocol to facilitate better interoperability among electrophysiology study (EPS)‑relatedISs in order to allow exchange unified reporting in EPS ablation.MATERIALS AND METHODS: This study was an applied‑descriptive research that was conductedin 2019. To determine the information content of agreed cardiac EPS Minimum Data Set (MDS) inIran, the medical record of patients undergoing EPS ablation procedure in the Tehran Heart Center(THC) hospital was reviewed by a checklist. Then, an information model based on Health LevelSeven, Clinical Document Architecture (HL7 CDA) standard framework for structural interoperabilityhas been developed. In this framework, using NPEX online browser and MindMaple software, a setof terminology mapping rules was used for consistent transfer of data between various ISs.RESULTS: The information content of each data field was introduced into the heading and bodysections of HL7 CDA document using Systematized Nomenclature of Medicine – Clinical Terminologynames and codes. Then, the ontology alignment was designed in the form of thesaurus mappingroutes.CONCLUSION: The sensitive, complex, and multidimensional nature of cardiovascular conditionsrequires special attention to the interoperability of ISs. Designing customized communication protocolsplays an important role in improving the interoperability, and they are compatible with the needs offuture Iranian health information exchange.

---

• View Article
• PDF 582.55 K

Relationship between fear of childbirth and the sense of cohesion with the attachment of pregnant mothers to the fetus

. Nahid Golmakani; . Mahboobeh Gholami; . Fatemeh Shaghaghi; . Hadise Safinejad; . Zahra Kamali; . Zahra Mohebbi-Dehnavi

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  INTRODUCTION: Maternal–fetal attachment is a term used to describe the emotional relationship thata pregnant woman has with her developing fetus. Mental care for pregnant women ...  Read More INTRODUCTION: Maternal–fetal attachment is a term used to describe the emotional relationship thata pregnant woman has with her developing fetus. Mental care for pregnant women (fear of childbirthand a sense of cohesion of pregnant women) is one of the most important aspects of prenatal carethat affects the mother’s attachment to the fetus. If fear and anxiety are relieved, psychological andphysical relaxation will be replaced. Therefore, the present study was conducted with the aim ofdetermining the relationship between fear of childbirth and the sense of cohesion with the attachmentof pregnant mothers to the fetus.METHODS: The present study is a descriptive study that was performed by multi‑stage samplingmethod on 500 pregnant mothers who referred to health centers in Isfahan in 2017. The studyparticipants completed the following questionnaires: fear of childbirth, sense of cohesion, andmother’s attachment to the fetus. The data were analyzed by descriptive and analytical statisticalmethods (Pearson correlation) using SPSS software version 22.RESULTS: The results showed that there was a significant negative relationship between the overallscore of maternal attachment to the fetus and fear of childbirth (r = −0.153, P = 0.001). However,there is a significant positive relationship between the overall score of maternal attachment to thefetus and the sense of cohesion (r = 0.112, P = 0.01). The results also showed a significant negativerelationship between the fear of childbirth and the dimensions of maternal attachment to the fetus,including interaction with the fetus (P = 0.04), self‑sacrifice (P = 0.04), and attributing characteristics tothe fetus (P = 0.05). There was a positive and significant relationship between the sense of coherenceand the subsequent acceptance of the maternal role of maternal attachment to the fetus (P = 0.004).CONCLUSION: More attention of prenatal care provider to the psychological issues of the pregnantmother and their fears and worries can lead to appropriate interventions in this field, and as a result,mothers’ attachment to their fetus has increased so that they can take proper care during andafter pregnancy.

---

• View Article
• PDF 525.36 K

A cross‑sectional study to investigate the impact of focused group discussion on menstrual hygiene among rural school girls of Southern Haryana, India

. Abhishek Singh; . Vikas Gupta; . Deepika Agrawal; . Pooja Goyal; . Mitasha Singh; . Shveta Lukhmana

Volume 10, Issue 10 , October 2020, Pages 1-6

Abstract

  INTRODUCTION: Menstruation is a natural phenomenon among women who experience sheddingof blood for 1–7 days every month which usually starts between age 11 and 14 years and continuesuntil ...  Read More INTRODUCTION: Menstruation is a natural phenomenon among women who experience sheddingof blood for 1–7 days every month which usually starts between age 11 and 14 years and continuesuntil menopause at about 51 years of age. It is important to maintain menstrual hygiene, as poorpractices increase vulnerability to reproductive and urinary tract infections. The present study wasconducted with an aim to investigate the impact of focused group discussion (FGD) compared todidactic lectures (DLs) on the menstrual hygiene knowledge and practices.METHODS: The present cross‑sectional study was conducted among 649 school girls during Januaryto August 2019 using a convenience sampling technique. After collecting baseline information usinga pretested, predesigned, standardized questionnaire, the participants in the control and interventiongroups were exposed for the DLs and FGD, respectively, and 1 month after such intervention, thesame questionnaire was again self‑administered by participants. All tests were performed at a 5%level of significance using SPSS (version 22.0).RESULTS: The baseline characteristics of both the groups such as participants’ mean age, meanage of menarche, mother’s literacy status, religion, type of family, and socioeconomic status werecomparable. There was a difference in the knowledge and practice mean score of participants inthe control group for pre‑ and postintervention, which was highly statistically significant (P < 0.001).CONCLUSIONS: This study reveals that menstrual hygiene is far from satisfactory among most ofthe school girls. The DLs and FGD have improved the menstrual hygiene knowledge and practicesamong school girls.

---

• View Article
• PDF 802.23 K