https://jehp.mui.ac.ir/ Journal of Education and Health Promotion en daily 1 Wed, 01 Feb 2023 00:00:00 +0330 Wed, 01 Feb 2023 00:00:00 +0330 https://jehp.mui.ac.ir/article_29011.html https://jehp.mui.ac.ir/article_29012.html BACKGROUND: Fluoride Ion can cause remineralization of primary caries lesions in the presence ofcalcium and phosphate. New compounds of calcium‑containing casein phosphopeptides‑amorphouscalcium phosphate (CPP‑ACP), make the remineralization more effective. This research has beendone to evaluate the awareness, attitude, and performance of Isfahan general dentists regardingthe prescription of new caries prevention materials containing calcium and fluoride components.MATERIALS AND METHODS: This cross‑sectional‑descriptive‑analytic study has been conducted on152 general dentists in Isfahan ensuring confidentiality of information and obtaining informed consent.Isfahan general dental offices and clinics were selected using a simple random method. Data of thisresearch were collected using a questionnaire from previous studies. The questions were dividedinto four sections, including demographic information, awareness, attitude, and performance towardsproducts containing calcium and fluoride prescription. The significance level of P was considered0.05. Data were analyzed using SPSS version 22, T statistical test, Pearson correlation coefficient,and one‑way analysis of variance.RESULTS: The mean score for dentists awareness was 46.3 (standard deviation [SD] = 15.4),the mean score of attitude was 91.4 (SD = 26.1) and the Mean Score of performance was54.3 (SD = 27.3) (the scores range from 0 to 100). According to the Pearson correlation coefficient,there was no significant relationship between dentists’ awareness, attitude besides performance,and their ages together with dentistry work experiences (P > 0.05).CONCLUSION: According to the study results, dentists’ awareness of compounds containingCPP‑ACP is overall average. However, attending to their positive attitudes toward this context,providing appropriate training programs seem to stimulate them for optimum cooperation as well asusing these products for patients. https://jehp.mui.ac.ir/article_29013.html BACKGROUND: Due to the COVID‑19 pandemic, online learning has become the main method ofinstruction. This study aimed to evaluate Moroccan medical students’ perceptions of medical onlinelearning experience and to list its probable related advantages and barriers.MATERIALS AND METHODS: A cross‑sectional study on 400 medical students randomly selectedfrom the different national medical institutions was conducted. A questionnaire evaluating the onlinelearning experience during the pandemic was distributed via institutional e‑mails. Statistical analyseswere carried out using Statistical Package for the Social Sciences (SPSS).RESULTS: 51.2% of students were satisfied with the online learning experience and reported severalbenefits including no need to travel (35.8%), cost savings (20.7%), and flexibility of home studying(32.3%). Technical issues related to the use of platforms or internet connection, limited interactionbetween students and their instructors, and lack of motivation were the major barriers to online learning.Moreover, results also showed a significant difference when comparing the attendance frequency betweenpresential classes and online learning (i.e., before vs. during the COVID‑19 pandemic) (P < 0.001).CONCLUSIONS: The experience of medical online learning was reported in our study to be associatedto several advantages and disadvantages. Hence, students’ perceptions should be consideredto evaluate and improve the quality of this instructional method for a successful and more activeapproaches implementation. https://jehp.mui.ac.ir/article_29014.html BACKGROUND: The educational environment plays a very important role in determining the overallperformance of students. The aim of this study is to determine the perceptions of undergraduatemedical students about their educational environment in a Nigerian university.MATERIALS AND METHODS: This was an observational, cross‑sectional study conducted amongfinal‑year (600 level) undergraduate medical students. The Dundee Ready Education EnvironmentMeasure (DREEM) questionnaire was used for the study to assess the educational environment ofthe medical students.RESULTS: A total number of 100 final‑year (600 level) undergraduate medical students participated inthe study, out of which 27 (27.0%) were males and 73 (73.0%) were females with a male‑to‑female ratioof 0.37 to 1. The age range of the respondents was 21–30 years with a mean (±SD) of 23.54 (±1.403).The total mean DREEM score was 116.2/200. The total score of SPL domain was 30.2/48 (62.9%).The total score of SPT domain was 27.3/44 (62.0%), while that of SASP was 19.2/32 (60.0%). Thetotal score of SPA domain was 26.6/48 (55.4%) and that of SSP was 13.1/28 (46.8%). For the SPL,SPT, SASP, and SPA domains, the score was above 50%. However, for the SSP domain the scorewas less than 50%.CONCLUSIONS: The total mean DREEM score in this study was 116.2/200, more positives thannegatives, with the students’ social perspective having the least domain score. There is a need toprovide adequate social support system for medical students in general and particularly for thosewho get stressed. https://jehp.mui.ac.ir/article_29015.html BACKGROUND: Recent findings show that a longer breastfeeding duration and proper dietarymanagement could lower the risk of postnatal diabetes. An excellent and interactive educationmodule on breastfeeding and diet may effectively improve breastfeeding practices and dietaryknowledge among women with gestational diabetes mellitus (GDM). Therefore, this study delvesinto developing and validating the content of Breastfeeding and Dietary Education Package (BFDEP)for women with GDM.METHOD: The development of the module involved three phases: need assessment, moduledevelopment, and validation. Six experts deployed a content validity index (CVI) to evaluate threeareas of the module, including objectives, structure or presentation, and relevance. Sixteen womenwith GDM were involved in the face validation process by assessing the “literacy presentation,”“illustrations,” “material is sufficiently specific,” and “quality of information.”RESULTS: Generally, I‑CVI, S‑CVI/Ave, and S‑CVI/UA of the objectives, structure or presentation,and relevance revealed an excellent level of content validity. No alteration was needed for thedomains of objective and relevance (S‑CVI/Ave: 1.0, S‑CVI/UA: 1.0). However, a minor revision wasrequired in the structure or presentation domain (S‑CVI/Ave: 0.98, S‑CVI/UA: 0.90). The expertsalso thought that some module pages were wordy, and a change of font color was needed. Themodule was thus modified accordingly. For face validation, “literacy presentation” and “material issufficiently specific” had a 99% positive response, while “illustrations” and “quality of information”had 100% positive feedback.CONCLUSION: A BFDEP with excellent content validity was developed and can be implemented toimprove breastfeeding practices and dietary knowledge among women with GDM. https://jehp.mui.ac.ir/article_29016.html BACKGROUND: The number of older adults with bipolar disorder is increasing and medicationnon‑adherence is a major problem that negatively impacts the course of bipolar disorder. This studyaimed to determine the effect of a comprehensive individual motivational‑educational program onmedication adherence in elderly patients with bipolar disorder.MATERIALS AND METHOD: An experimental study with pretest‑posttest repeated measures with acontrol group was conducted on two groups of 62 elderly people with bipolar disorders hospitalizedat Ibn Sina Hospital in Mashhad, Northeast Iran, 2019. For the elderly in the intervention group, acomprehensive motivational‑educational program was administered for one month (four 30–45 minutesessions), and for the elderly in the control group, routine clinical care was performed. Medicationadherence in both elderly groups was measured before, immediately after, one and two months afterthe intervention. Data were analyzed by SPSS statistical software (version 16) using descriptivestatistics and independent t‑test, Mann‑Whitney, paired t‑test, repeated measures analysis ofvariance (ANOVA), and Chi‑square tests.RESULTS: The mean age of elderlies in the intervention and control groups were 69.03 ± 5.75 and68.50 ± 6.73 years, respectively. Regardless of the groups to which the patients were assigned, asignificant difference in medication adherence scores was observed during the study period (timeeffect; P < 0.001). Also, the medication adherence score was significantly lower in the interventiongroup, compared to the control group (group effect; P < 0.001). Also, there was a group time interactionbetween the medication adherence score and the time of evaluation (P < 0.001).CONCLUSION: The results of the present study confirm the positive effect of a comprehensiveeducational‑motivational program on improving medication adherence in elderly patients with bipolardisorder. https://jehp.mui.ac.ir/article_29017.html BACKGROUND: Previous studies have shown that psycho‑spiritual state of mothers may havesignificant effects on their breastfeeding. The most common cause of nonexclusive breastfeeding isinadequate breastfeeding; therefore, this study examined the relationship between spiritual healthand perceived stress with breastfeeding adequacy in mothers with infants aged 1–6 months.MATERIALS AND METHODS: This cross‑sectional, descriptive, correlational study was performedon 186 mothers with infants aged 1–6 months, who referred to the health centers in Dorud city ofLorestan province, Iran, in 2021, which were selected based on cluster sampling. Data were collectedthrough four questionnaires including demographic–fertility, spiritual health, perceived stress, andbreastfeeding adequacy. Data was analyzed by Statistical Package for the Social Sciences (SPSS)software version 22 using descriptive and analytical statistics.RESULTS: The mean ± standard deviation (SD) values of spiritual health, perceived stress, andbreastfeeding adequacy were 99.59 ± 12.96, 23.8 ± 72.19, and 55.67 ± 7.67, respectively. There wasa significant positive relationship between spiritual health and breastfeeding adequacy (P < 0.001,r = 0.268). In addition, there was a significant negative relationship between perceived stress andbreastfeeding adequacy (P = 0.002, r = −0.231).CONCLUSION: Breastfeeding adequacy has a significant positive relationship with spiritual health anda significant negative relationship with perceived stress. Since infants are one of the most vulnerablegroups and breastfeeding is the best way to support their health and reduce infant mortality rates,breastfeeding adequacy can be improved by reducing stress and promoting spiritual health. https://jehp.mui.ac.ir/article_29018.html BACKGROUND: Dentists are often overlooked resources in the workforce for disastermanagement (DM). To determine the knowledge, attitudes, willingness, and self‑perceivedeffectiveness to participate in DM among general dental practitioners (GDPs) of Eastern India.MATERIALS AND METHODS: A web‑based online survey was conducted among 256 Dental Councilof India registered GDPs of Cuttack district, Odisha. The 45‑item survey comprised closed‑endedquestions on the demographic data of the participants, years of practice, previous experience in DM,and willingness to participate. Other domains assessed were the participants’ objective knowledgeof DM, attitude, and self‑perceived effectiveness toward participation during disasters. Data wereanalyzed descriptively, and the Chi‑square and Mann–Whitney U tests were used for statisticalanalysis, with a significance threshold of P < 0.05.RESULT: A total of 154 responses were analyzed, giving a response rate of 60.16%. The averageage was ≤35 years, 59.1% were BDS dentists and 78.6% had less than 10 years of practice. Only18% of them had previous experience with DM, and merely 3.2% were formerly trained; however,95.5% of the dentists were willing to participate in DM. The mean DM knowledge and attitude scoreswere 16.12 (CI = 15.4–16.8) and 5.79 (5.45–6.13), respectively. Knowledge and attitude showeda significant correlation. About 56% indicated that they would be able to respond effectively to adisastrous event. Significant associations were observed between age group (P = 0.008), yearsof clinical practice (P = 0.001), qualification (P = 0.012), previous participation (P = 0.029), andself‑perceived effectiveness.CONCLUSION: The knowledge regarding DM among respondents was at an average level. However,the majority of them were found to have a positive attitude toward participation in DM. Thus, includingDM in dental curricula and drills for dental professionals might prove beneficial as almost all GDPswere showing greater self‑perceived effectiveness and willingness to participate in disasters. https://jehp.mui.ac.ir/article_29020.html BACKGROUND: Self‑medication is the use of unprescribed drugs to treat a disease. Elderlyself‑medication can be more dangerous compared to other age groups because of changes in organfunctions that occur due to senescence. This study aimed to estimate the prevalence of self‑medicationin the elderly, its related factors, and common drugs used in this regard.MATERIALS AND METHODS: Electronic databases such as PubMed, Scopus, and Web of Sciencewere searched between January 2016 and June 2021. The search strategy was built on two coreconcepts: “self‑medication” and “aged”. The search was limited to original articles in the Englishlanguage. A random effect model was used to estimate the pooled prevalence of self‑medication.Heterogeneity among studies was assessed using both the I2 statistic and the χ2 test. Also, ameta‑regression model was used to investigate the potential sources of heterogeneity of the studies.RESULTS: Out of 520 non‑duplicate studies, 38 were included in the meta‑analysis. Self‑medicationin the elderly ranged from 0.3% to 82%. The pooled proportion of self‑medication was 36% (95%CI: 27%–45%). The result of the χ2 test and the I2 index (P < 0.001, I2 = 99.90%) revealed notableheterogeneity among the included studies in the meta‑analysis. The meta‑regression showed asignificant association between the sample size (adjusted β = −0.01; P = 0.043) and the pooledproportion of self‑medication.CONCLUSION: The prevalence of self‑medication in the elderly is high. Education through massmedia to raise awareness about the dangers of self‑medication can help solve this problem. https://jehp.mui.ac.ir/article_29021.html BACKGROUND: Online learning is the newest and most popular form of distance education today;within the past decade it has had a major impact on education. The aim of the present study was toknow the effect of online learning basketball using social media on learners’ performance of somefundamental skills in basketball and determine difference between online learning and in‑personlearning, knowing which one is better than the other.MATERIALS AND METHODS: The present experimental study was conducted in Sports Academyfor Basketball in Zagazig‑Egypt during March–April 2022. Thirty two female junior basketball playersvolunteered to participate in the study from Sports Academy for Basketball (age: 16.23 ± 0.66 years;body height: 164.5 ± 3.32 cm; body mass: 65.25 ± 3.22 kg). They were divided into two equally sizedexperimental groups, online learning (ONL) group (n = 16) and in‑person learning (INL) group (n = 16),to perform (15) educational sessions for (5) weeks, (3) sessions per week, and the session timewas 90 minutes. Junior basketball players were assessed before and after five‑week training period.Data were collected by Basketball Passing test, Dribbling Skill test, Lay Up Shoot test, Speed SpotShooting, and Free‑Throw Shooting test. The collected data were analyzed using SPSS version 22software using the descriptive statistical test. The level of significance was set at P ≤0.05.RESULTS: The results showed that the two groups made significant improvements in all variables butINL group had significantly greater improvements than ONL group. The percentage of improvementranged from 13% to 223% for INL group versus 8% to 158% for ONL group.CONCLUSION: We conclude that in‑person basketball learning was better than online learningbasketball. Therefore, teachers and trainers must rely primarily on in‑person learning and not relyon distance learning, especially with regard to learning motor skills, except in emergency cases. https://jehp.mui.ac.ir/article_29022.html BACKGROUND: Assessment of circulating and scrub skills is an important issue in operatingroom (OR) programs. However, there is a lack of well‑designed tools that are specifically developedfor this purpose. Hence, this study aimed to develop and determine the validity and reliability of achecklist to measure the circulating and scrub skills of OR novices.MATERIALS AND METHODS: This cross‑sectional methodological study was conducted among 124OR technology students who were selected during three consecutive academic years (2019–2020 to2021–2022). The developed checklist was evaluated with face validity, content validity (quantitativeand qualitative), construct validity  (known‑groups validity), criterion‑related validity  (concurrentand predictive validities), internal consistency  (Kuder–Richardson 20, KR‑20), and inter‑raterreliability (intra‑class correlation coefficient, ICC). Known‑groups validity was evaluated by comparingthe difference between the checklist scores of first‑semester and third‑semester students usingindependent samples t‑test. Additionally, concurrent and predictive validities were evaluated by ICCthrough measuring the correlation between the total score of checklist and grades of a multiple‑choicetest and two clinical apprenticeship courses, respectively. Data were analyzed in the StatisticalPackage for Social Sciences software.RESULTS: After reconciling the preliminary checklist in terms of face and content validities, achecklist with 17 sub‑scales and 340 items called “Circulating and Scrub Skills of Operating RoomNovices (CSSORN)” was developed. Regarding the known‑groups validity, the third‑semesterstudents had higher scores compared to the first‑semester students (p < 0.001 in most sub‑scales).Besides, the total score of checklist showed a significant correlation with the criteria of concurrentand predictive validities (ICC = 0.64, ICC = 0.72; P < 0.001). The KR‑20 for the entire checklist was0.90 (range: 0.60–0.93). The ICC for inter‑rater reliability was also 0.96 for the entire checklist (range:0.76–0.99, P < 0.001 in all sub‑scales).CONCLUSION: The CSSORN had appropriate validity and reliability to be used for measuring thecirculating and scrub skills of OR novices. To shed light on the findings, further testing of this checkliston larger populations and in different contexts is suggested. https://jehp.mui.ac.ir/article_29023.html BACKGROUND AND AIM: This study aimed to investigate and compare the efficacy of cognitive‑motorrehabilitation (CMR) with methylphenidate on cognitive functions and behavioral symptoms of childrenwith attention deficit/hyperactivity disorder (ADHD) and specified the near‑transfer and far‑transfereffects.MATERIALS AND METHODS: The research was semiexperimental with posttest and follow‑upassessments, in a single‑blind design. Forty‑eight boys with ADHD, aged 9–12, were selectedconveniently regarding the inclusion/exclusion criteria, matched base on severity and Intelligencequotient (IQ) and were randomly assigned to CMR (n = 16), methylphenidate medication (MED,n = 16), and placebo CMR groups (PCMR, n = 16). CMR and PCMR received 20 3‑h trainingsessions, and the MED group received 20 or 30 mg/day methylphenidate. Tower of London (TOL),Swanson, Nolan, and Pelham, Version IV Scale (SNAP‑IV), Wechsler’s digit span and mathematicsubscales, dictation test, and restricted academic situation scale (RASS) were completed atposttest and follow‑up. The data were analyzed by repeated measures multivariate analysis ofvariance.RESULTS: CMR outperformed PCMR on forward digit span, backward digit span, ToL score at bothposttest, and follow‑up (P < 0.05). CMR scored lower than MED on ADHD‑PI and ADHD‑C at bothposttest and follow‑up (P < 0.05). Moreover, CMR outperformed MED on dictation at both assessmentphases (P < 0.01) and RASS at the follow‑up phase (P < 0.05). CMR outperformed PCMR onmathematics at post‑test (P = 0.038) and also, in dictation and RASS, at both post‑test (P < 0.001)and follow‑up (P < 0.05).CONCLUSION: CMR Improves near‑transfer cognitive functions and behavior symptoms of ADHDas much as MED, but only CMR has more generalizable and endurable improvement on complexEfs and academic performance (far‑transfer effects). https://jehp.mui.ac.ir/article_29024.html BACKGROUND: Clinical‑based mobile learning courses have great demand among the nursinggraduates as learners look for possibilities to update skills. The present study explores thefeasibility, familiarity, utility, and attitude of nursing graduates of South India toward mobile learningapplications (m‑apps).MATERIAL AND METHODS: An online‑based cross‑sectional descriptive survey was conducted inMay 2021 among the South Indian nursing graduates of Tamil Nadu and Kerala, using a questionnaireconsisting 49 items categorized under six sections with items related to socio‑demographicinformation; m‑app usage; online learning experience; preference in using m‑apps for learningpurposes before COVID‑19 and during COVID‑19; students’ engagement through e‑learning; andanxiety related to online assessment. Descriptive and inferential (ANOVA, Chi‑square, and t test)statistical data analysis were done using SPSS version 23.RESULTS: A total of 447 student nurses responded. The result shows that most of them, 96% (432)used android phones and 94% (422) owned a mobile. Age was highly influencing mobile learningapplication (m‑learning apps) usage; students of less than 20 years of age used applications morefrequently and possessed more educational applications. Majority of them, 84% (377) of them hadstarted using m‑learning apps only after COVID. 57.7% (249) commonly used m‑learning apps foracquiring nursing knowledge resources, nursing exam preparatory, and drug resources. Studentsrated high for the interactive nature of these m‑learning apps, while abundant learning materialsand usage with ease were rated as other attractive features. Sixty‑six percent (305) had mostlydownloaded these apps from Google Play Store.CONCLUSION: The findings would help the m‑learning application developers to offer customizesolutions to address learning gaps that prevail among the South Indian nursing graduates and helpwith sustainable growth. https://jehp.mui.ac.ir/article_29025.html BACKGROUND: Family caregivers of hemodialysis patients experience various physical,psychological, social, economic, and spiritual problems that reduce their quality of life. The presentstudy aimed to determine the effect of a family‑centered education program on the quality of life offamily caregivers of patients undergoing hemodialysis.MATERIALS AND METHODS: This was a randomized controlled trial that was performed on 70caregivers of patients undergoing hemodialysis in the medical centers of Hazrate Ali Asghar andHazrate Zahraye Marzieh in Isfahan. Caregivers were randomly divided into experimental and controlgroups, and the experimental group received an eight‑session family‑centered education program.Data were collected using the Quality of Life Scale (QOLS)‑short form immediately after and 1 monthafter the intervention. Data analysis was performed using the Statistical Package for the SocialSciences (SPSS) software version 18 and analysis of variance and covariance.RESULTS: The results showed that both experimental and control groups were homogeneous interms of demographic information and there was no significant difference between them in this regard.Analysis of data on quality of life and its four domains showed that the mean scores of quality oflife (P = 0.089) and its four domains including physical health (P = 0.367), mental health (P = 0.429),community relations (P = 0.132), and environmental health (P = 0.232) increased significantlyimmediately after and 1 month after the intervention (P < 0.001 in all cases).CONCLUSION: Educational programs can improve the quality of life of family caregivers ofhemodialysis patients. Therefore, it is recommended that programs be developed and evaluated invarious studies in the future. https://jehp.mui.ac.ir/article_29026.html BACKGROUND: The safety of patients remain at risk due to a higher workload and lowernurse‑to‑patient ratio. However, in India, most hospitals still adhere to long‑known nurse staffingnorms set by their statutory or accreditation bodies. Therefore, the present study was undertakento recommend a standard workload‑based estimation of nursing manpower requirement in the ICUof a tertiary care teaching hospital.MATERIALS AND METHODS: It was a descriptive, observational, time and motion study wasconducted in the medicine ICU of a tertiary care teaching hospital. Data collection was done by usingdemographic and clinical profile sheet of patients, NPDS‑H dependency assessment scale, time andactivities record sheet, and WHO WISN tool. The nurses’ activities were observed by nonparticipatory andnon‑concealment technique. Data analysis was done using descriptive statistics and the WHO WISN tool.RESULTS: The bed occupancy rate and the average length of stay in the medicine ICU were 93.23%and 7.18 days respectively. Distribution of dependency level of the medical ICU patients was veryhigh (41.67%), low‑high (33.33%), and medium‑high (25.0%) dependency level. Considering availableresources and workload in tertiary care hospitals in India, the study recommended a nurse‑to‑patientratio of 1:1.2 in each shift for the medicine ICU of a tertiary care hospital.CONCLUSION: The study suggested minimum nurse-to-patient ratio in medical ICU should be1:1.2 with provision of power to ICU incharge nurse to allocate nurses according to the workload indifferent shifts. Also, nurse staffing norms in hospitals need to be estimated or selected with seriousconsideration of health care demands when employing nurse staffing norms. https://jehp.mui.ac.ir/article_29027.html BACKGROUND: The aim of this study was to investigate the living experience of coronary patientsin Shiraz and the peak prevalence of the second stage in summer. This study could further examinethese experiences in broader groups in subsequent studies. Identifying the psychological causesand effects of this disease with the help of patients involved in some countries has been considered.MATERIALS AND METHODS: The method, which was used in this study, was a qualitative methodand content analysis. Participants in this study were 13 patients with COVID‑19, some of whomwere members of the medical staff. The participants were selected purposefully. The semi‑organizedinterview with the participants continued until the theoretical saturation was reached.RESULTS: After extracting the codes, researchers classify them, and then the results were examinedin more depth and categorized. About 120 extracted codes were classified into seven generalcategories; three of them were directly related to psychological issues. The other four of them wererelated to the subject of psychological effects and consequences.CONCLUSION: In general, during the interview process, it was proved that the more severe thesymptoms of the disease, the psychological experiences of confronting the disease because of itsoutbreak, and the processes of coping with it were deeper. https://jehp.mui.ac.ir/article_29028.html BACKGROUND: The birth of a pre‑mature infant and subsequent hospitalization and separationfrom the family can impair maternal and neonatal attachment and quality of maternal care. Thisstudy aimed to assess the effect of instructing mothers in attachment behaviors on short‑term healthoutcomes of pre‑mature infants admitted to neonatal intensive care units (NICUs).MATERIAL AND METHODS: In this quasi experimental study, 80 mothers of pre‑mature infants whowere admitted to NICUs at two referral health centers in northern Iran were studied in two groups in2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions.Mother–infant attachment behaviors were evaluated at both the beginning and the end of this studyusing a checklist derived from Avant’s Maternal Attachment Assessment Strategy. Moreover, infants’short‑term health consequences were investigated in two groups. SPSS 18 statistical software wasused for data analysis.RESULTS: On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants inthe control and the intervention group to reach full oral feeding and 38/5 (38/4–42/11) and 37 (31/85–42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stayfor the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days,respectively (P > 0/05).CONCLUSION: Instructing mothers in attachment behaviors clinically improved short‑termhealth‑related outcomes. Hence, this intervention is recommended to be incorporated in the careprogram for mothers with pre‑mature infants. https://jehp.mui.ac.ir/article_29029.html BACKGROUND: Chemotherapy is a complex, multi‑disciplinary, and error‑prone process. Informationtechnology is being increasingly used in different health care settings with complex work proceduressuch as cancer care to enhance the quality and safety of care. In this study, we aimed to developa computerized physician order entry (CPOE) for chemotherapy prescribing in patients with gastriccancer and to evaluate the impact of CPOE on medication errors and order problems.MATERIALS AND METHODS: A multi‑disciplinary team consisting of a chemotherapy council groupand system design and implementation team was formed for chemotherapy process evaluation,requirement analysis, developing computer‑based protocols, and implementation of CPOE. A beforeand after study was conducted to evaluate the impact of CPOE on the chemotherapy process andmedication errors and problem orders. To evaluate the level of end‑user satisfaction, an ISO Norm9241/110 usability questionnaire was chosen for the evaluation.RESULTS: Before the implementation of the CPOE system, 37 medication errors (46.25%) and53 problem orders (66.25%) were recorded for 80 paper‑based chemotherapy prescriptions. Afterimplementation of the CPOE system, 7 (8.7%) medication errors and 6 (7.5%) problem orders wererecorded for 80 CPOE prescriptions. The implementation of CPOE reduced the medication error by37.55% and the problematic order by 58.75%. The results for usability evaluation indicate that theCPOE was within the first class of the ISONORM level rating; this shows that a CPOE is with veryhigh satisfaction and a very high functionality rate.CONCLUSION: Developing a CPOE system significantly improved safety and quality of thechemotherapy process in cancer care settings by reducing the medication error, deleting unnecessarysteps, improving communication and coordination between providers, and use of updatedevidence‑based medicine in direct chemotherapy orders. However, the CPOE system does notprevent all medication errors and may cause new errors. These errors can be human‑related factorsor associated with the design and implementation of the systems. https://jehp.mui.ac.ir/article_29030.html BACKGROUND: Preclinical students often fail to appreciate the clinical relevance of basic sciencesduring the first year of undergraduate medical training, leading them to lose interest in the subject,and preventing them from achieving the desired goals. In order to rectify this gap in the curriculum,Medical Council of India (MCI) in 2011 published a document announcing curricular strategiesincluding Early Clinical Exposure (ECE) to effectively modify the Indian system of education. Lackof proper guidance prevented many institutions from implementing ECE. Since our institution hadrun a similar program of “Clinical Observership” as early as 2001, we were able to implement ECEin an efficient way.MATERIALS AND METHODS: Early clinical exposure was implemented as a structured program,with the participation of 10 clinical departments since 2013. Feedback from the students, soon afterECE and also from the batch of CRRIs, who had undergone this program while they were preclinicalstudents amply support the effectiveness of ECE in its contents and methods of implementation.Manual content analysis was performed on open comments. After reading the responses, they werebroken down to meaning units, and these were then condensed. The condensed meaning unitswere labeled with codes. The codes were grouped into categories. Themes were derived from thecategories.RESULTS: Out of the 70 CRRIs, 52 responded to the questionnaire. All the CRRIs except one saidthat ECE was very helpful during their clinical postings and internship period. They suggested thatthe number of hours of posting should be increased and also reiterated the fact that a greater numberof clinical departments could be included in the program. Though the beneficial effects were felt inall the domains of learning, the most remarkable impact was felt in the affective domain, whereinchanges are not easy to come by.DISCUSSION: Recently, National Medical Council has come out with plans of including ECE inthe syllabus with strict time schedule. It is felt that the faculty will find our experience of running theprogram for the past five years helpful in implementing this program, for the fullest benefit of thepreclinical students. https://jehp.mui.ac.ir/article_29031.html BACKGROUND: Gestational diabetes is the most common medical complication and a commonmetabolic disorder during pregnancy. Increasing people’s self‑efficacy is one of the best ways tocontrol this disease. As there is a lag of intervention in this regard, the purpose of this study was todetermine the effect of couple supportive counseling on self‑efficacy in women with insulin‑treatedgestational diabetes.MATERIALS AND METHODS: In this randomized clinical trial, 64 women with gestational diabeteswho referred to diabetes clinic of Mashhad Ommolbanin Hospital were divided into intervention andcontrol groups through block randomization during 2019. Their gestational age was in 26–30 weeks.For the couples in the intervention group, three couple supportive counseling session was held. Eachsession lasted 1 h and was held one time per week. The instruments were diabetes self‑efficacyquestionnaire, fasting and 2‑h postprandial checklist and Cassidy social support, which were assessedbefore and 4 weeks after intervention in both groups. Data was analyzed by SPSS software version 25through Mann–Whitney and Wilcoxon test. P values of < 0.05 were reported to be significant.RESULTS: In the preintervention, the diabetes self‑efficacy score had no significant differencein the intervention (30/6 ± 38/50) and control groups (09/8 ± 56/51) (P = 515/0). However, inthe postintervention, the diabetes self‑efficacy score was significantly higher in the interventiongroup (58/6 ± 41/71) compared to the control group (15/7 ± 31/51) (P < 001/0). Also, before theintervention, there was no significant difference between the intervention (30/2 ± 72/10) and controlgroup (87/1 ± 63/11) (P = 137/0) regarding social support. However, after the intervention, there wasa significant difference between the intervention and control groups (879/0 ± 53/13, 03/2 ± 41/11,P < 0/001 respectively). Also, data analysis showed a significant correlation between self‑efficacyand social support (r = 0.451, P < 0.001), self‑efficacy and fasting blood sugar (P < 0.001, r = ‑0.577),and 2 h post prandial (r = ‑0.778, P < 0.001).CONCLUSION: Couple supportive counseling leads to increased self‑efficacy and social supportin pregnant women with gestational diabetes. Therefore, it is recommended to use this counselingas an effective method in the management of diabetic pregnant women during their prenatal careto have a healthier pregnancy. https://jehp.mui.ac.ir/article_29032.html BACKGROUND: Simulation debriefing influences learning from healthcare simulation activities.Health sciences educators must be competent in conducting simulation debriefing for healthcarestudents. A structured faculty development intervention for health sciences educators must beinformed by educator needs to enhance its utility. This paper describes the needs of health scienceseducators regarding simulation debriefing at a faculty of health sciences.MATERIALS AND METHODS: A parallel convergent mixed methods study design was applied ona selected population of 30 health sciences educators at the University (x) who integrate immersivesimulation for first‑ to final‑year students in their undergraduate programs. The Objective StructuredAssessment of Debriefing tool underpinned observations which informed the quantitative strand of thestudy, while semi‑structured interviews were conducted as part of the qualitative strand. Descriptivestatistics and thematic analysis were used to analyze the data.RESULTS: Health sciences educators struggled to establish the learning environment forsimulation (median 1), facilitate learning (median 3), and evaluate their debriefing activities. However,they were able to apply an appropriate approach toward simulation (median 4). They identified theneed to be educated on the fundamentals of simulation‑based education.CONCLUSION: A continuing professional development program must be developed aimed attransforming approaches toward facilitating learning, explaining the fundamentals of simulation‑basededucation, modeling of best‑practices related to debriefing, and applying appropriate strategies forevaluating debriefing activities. https://jehp.mui.ac.ir/article_29034.html BACKGROUND: Because of the spread of coronavirus disease 2019 (COVID‑19), the preventivemeasures have increased, such as focusing on the use of medicinal plants in most communities,including Iran. The purpose of this study was to identify the knowledge, attitude, and performance ofindividuals toward the use of medicinal plants and to identify the predictors of the use of medicinalplants in the prevention of COVID‑19.MATERIALS AND METHODS: This descriptive‑analytical study (February–April 2021) was performedon 3840 Iranian men and women aged 20–70 years selected as a multi‑stage cluster study. At thefirst stage, all provinces were divided into five regions: North, South, East, West, and Center. In thesecond stage, a provincial center and a city were randomly selected from each region (North: Sari,Babol; South: Bushehr, Bandar Genaveh; East: Mashhad, Sabzevar; West: Hamedan, Toisarkan;Center: Yazd, Ardakan). Data were collected by a researcher‑made scale based on the HealthBelief Model (HBM). Data analysis was performed applying Pearson correlation coefficient, logisticregression, and linear regression.RESULTS: The results showed that people have relatively high knowledge and positive attitude towardthe use of medicinal plants in prevention of COVID‑19. The most important reason for positive attitudewas the perceived benefits with the mean of 75.06%. Also, half of the people had poor performance.Correlation coefficient showed that the use of medicinal plants with perceived sensitivity (p = 0.000,r = 0.3), perceived benefits (p = 0.012, r = 0.126), perceived barriers (p = 0.000, r = 0.179), andperceived self‑efficacy (p = 0.000, r = 0.305) had a significant correlation. The strongest correlationbetween perceived self‑efficacy was observed with the use of herbs in prevention of COVID‑19. TheHBM constructs can predict 26% of the variance for the use of medicinal plants in the preventionof COVID‑19, among which perceived self‑efficacy (β = 0.230) was the most powerful predictor.CONCLUSION: Based on the results, the predictive role of self‑efficacy constructs for the use ofmedicinal plants in prevention of COVID‑19 has been confirmed according to the HBM. Therefore,methods of increasing self‑efficacy such as training programs and providing appropriate interventionmodels can be used not only as promoters of using medicinal plants in prevention of COVID‑19 butalso for improving people’s performance in the proper use of medicinal plants. https://jehp.mui.ac.ir/article_29035.html BACKGROUND: A teacher’s appropriate use of nonverbal communication skills, mainly kinesics, canplay a crucial role in the success of the students. Medical educators are unaware of the effective useof nonverbal communication as an instructional skill that can be used to engage learners, balancelearners’ participation by controlling the classroom environment, and motivate them to have a passionfor learning. The purpose of the study was to explore the students’ perceptions regarding the effectof teachers’ kinesics on students’ learning and their learning environment. This can be helpful forteachers in modifying their teaching styles and delivering quality education.MATERIALS AND METHODS: A qualitative study with an exploratory design was conducted at aprivate medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteeredto participate in the study. Focus group discussions were conducted with the students to explore theexperiences of the medical students regarding the use of nonverbal communication skills by theirteachers and its effect on their learning in the classroom. The data collected was analyzed manually.RESULTS: The results of the study revealed that teachers’ nonverbal behaviors in the classroomsignificantly influence students’ motivation, engagement, and learning in the classroom. Studentspreferred interaction with the teachers who were friendly and confident and used their nonverbalcommunication skills (eye contact, facial expressions, hand gestures) effectively, compared to strictand judgmental teachers.CONCLUSION: Teachers need to motivate their students by improving their teaching styles andincorporating nonverbal behaviors positively in the classroom. By creating an impactful learningenvironment, students’ participation and learning will increase, which will, in turn, improve theiracademic performance. https://jehp.mui.ac.ir/article_29036.html Emotions are universal in academic and clinical settings. A student is likely to hope for success,maybe be worried about failure, or may feel comfortable after an exam. These feelings undoubtedlyaffect his/her motivation, effort, academic performance, and progress. This study aimed to investigatethe role of emotion in the learning and performance of medical students and its mechanism. Thisstudy was a scoping review conducted in 2022 to examine the role of emotions in medical education.The three databases PubMed, ERIC, and Science Direct and the search engine Google Scholarwere searched using the following keywords: “emotion,” “medical student,” “teaching,” “learning,”and “medical education.” English articles published from 2010 to 2022 were reviewed, and finally,34 articles that met the inclusion criteria were reviewed. Review of the selected articles showed thatthere was a significant relationship between the cognitive system and emotions in the brain. Theconceptual framework of the relationship between cognition and emotion can be explained in theform of dimensional and discrete views of emotions and based on cognitive load theory. Emotionsaffect cognition with the four mechanisms of memory, cognitive resources, cognitive strategies,and motivation and can be effective in learning self‑regulation, clinical reasoning, and academicachievement of medical students. Emotions in medical education is a double‑edged sword. In otherwords, it is highly recommended to divide emotions into activating and inactivating, instead of dividingthem into positive and negative ones. In this context, medical educators can use the positive aspectsof nearly all emotions to improve the quality of their teaching. https://jehp.mui.ac.ir/article_29037.html BACKGROUND: E‑learning is the delivery of learning and training through digital resources. Althoughe‑learning is based on formalized learning, it is provided through computers, tablets, and evencellular phones those are connected to the Internet. This makes it easy for users to learn anytime,anywhere, with few, if any restrictions.MATERIAL AND METHODS: A cross‑sectional study was done, and data was obtained throughan online survey method from September 14, 2020 to October 08, 2020. Questions were created in“Google Forms.” The targeted population was all nursing students from all over Nepal. There werea total of 365 respondents. A pilot study was done on 10 students. After the pilot study, the samequestion was distributed to all the respondents.RESULTS: Almost half (40.8%) got disturbed in their online class because of electricity; around half ofthe respondents (41.9%) are disturbed in their online class because of Internet problems. Moreover,around half of the respondents (44.4%) use the data pack daily, and 38.6% use the data sometimes.CONCLUSION: The study concludes that most students suffered from Internet disturbance andelectricity problems during online classes. Because of electricity and Internet problems, most studentsfeel anxious during class, and most of the students are not able to attend classes. Most studentsare compelled to use data packs for online classes. However, the course may not be completed ifthe problems arising during online classes are not solved. https://jehp.mui.ac.ir/article_29038.html BACKGROUND: Sexually transmitted infections (STIs) have always been considered as a healthproblem in the world. Also, vulnerable women (addicts, jail breakers, and prostitutes) are at the highestrisk. According to the World Health Organization’s (WHO) approach, the only effective way to preventand control this disease is public health education, and high‑risk and vulnerable groups should beprioritized in educational programs. The aim of the study was to investigate the effect of health beliefmodel (HBM)‑based education on changing the behaviors related to STIs in vulnerable women.MATERIALS AND METHODS: The present study is an intervention (field trial) study in vulnerablewomen. Convenience sampling method was used in this study and the sample size was determinedto be 84 subjects. Through tossing a coin, the social support center was selected as the interventiongroup and the drop‑in center as the control group. Quantitative data analysis was performed, anddescriptive and inferential statistical methods were used.RESULTS: The mean scores of perceived threat, perceived benefits, perceived barriers, andperceived self‑efficacy and changes in performance between the three measurement stages, aswell as changes in the scores of perceived threat, perceived benefits, perceived barriers, andperceived self‑efficacy over three measurement times were significantly different between the twogroups (interaction) (P < 0.001). The mean score of performance 3 months after the interventionwas significantly higher than before the intervention (P = 0.001).CONCLUSIONS: The present study confirmed the effectiveness of the HBM in promoting behavioralmodifiers that lead to STIs. Therefore, educational interventions with emphasis on understandingthe threats, benefits, barriers, and self‑efficacy and, ultimately, performance improvement in relationto STIs are recommended. https://jehp.mui.ac.ir/article_29039.html BACKGROUND: The usage of smartphones has become common among adolescents, despiteknowing the health‑related problems of the user. Currently, the availability of electronic gadgets hasbecome economical and this has an impact on society, especially on the behavior of adolescents.MATERIALS AND METHODS: A cross‑sectional survey design was used to find the pattern ofsmartphone usage, smartphone addiction, and subjective health problems associated with smartphoneusage. The data were obtained from 270 nursing students using the convenient sampling techniqueusing a sociodemographic proforma, semi‑structured questionnaire on the pattern of smartphoneusage, Smartphone Addiction Scale, self‑reported subjective health problems questionnaire, andstudy habits scale.STATISTICAL ANALYSIS: Descriptive and inferential statistics was used for the analysis usingSPSS 16.0.RESULTS: The study findings revealed that most of the participants 243 (90.0%) were using 4Gphones. The majority 88 (32.60%) of the participants were using a smartphone for less than 2 hoursat a stretch in a day. Most uses of a smartphone were in the night 155 (57.40%). The main usage ofa smartphone was for entertainment purposes 213 (78.90%). Most of the participants 196 (72.6%)were moderately addicted to smartphones. One‑third 109 (40.2%) of the participants complained ofheadache, followed by straining of the eyes 83 (30.6%).CONCLUSION: The awareness of smartphone addiction and health‑related problems associated withsmartphone usage has been shown to decrease its impact. The study concluded that it is very muchnecessary to identify the pattern of smartphone usage, to prevent the consequences of addictionand health problems associated with smartphone usage. https://jehp.mui.ac.ir/article_29040.html The COVID‑19 pandemic has had considerable consequences in many areas of life, including thesocial area and childbearing plans. The present narrative review aimed to examine the childbearingdecisions and its related factors during the COVID‑19 pandemic. This review was conducted bysearching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus,Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institutefor Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June2022. The search resulted in 111 sources, of which 16 were in line with the research objective.Couples have mainly cancelled or delayed their previous plans related to childbearing decisions.There are two groups of direct and indirect factors related to childbearing decisions during theCOVID‑19 pandemic: The former includes (1) well‑being‑related factors such as economic conditions,interpersonal relationships and gender roles in terms of task division; and (2) health‑related factors,including health emergencies and physical and psychological health. The latter includes factors suchas social distancing and social media. Based on the results, governments should facilitate childbearingby adjusting existing policies, addressing economic insecurity and protecting the livelihoods ofthose affected by the crisis. Health policymakers and planners must also prioritize women’s accessto reproductive health services in a safe environment while promoting equity in access. It is alsonecessary to promote the quality and quantity of indirect care and virtual counseling based on theneeds of women in crisis. https://jehp.mui.ac.ir/article_29041.html BACKGROUND: Healthcare professionals have fought hard to restrain the COVID‑19 pandemicby providing high‑quality care for their infected patients, but in doing so they have developedfears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratorytherapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation.The study sought to describe the experiences and coping strategies of Saudi RT managing patientswith COVID‑19.MATERIALS AND METHODS: The study utilized qualitative research methods, specifically employinga phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact withCOVID‑19 patients were selected after they agreed to participate in this study. The study followeda one‑on‑one semi‑structured interview process using the Zoom platform. This qualitative datacollection technique focuses on the participants’ lived experiences and feelings to discover sharedpatterns. The data were analyzed via an inductive approach.RESULTS: Six themes were found in the RT perceptions including stress while treating COVIDpatients, managing the fear of catching of Covid 19, feelings towards COVID‑19 patients, challengesfaced by female RTs, workplace experiences, and excessive workload.CONCLUSIONS: RTs feelings dramatically changed throughout the COVID‑19 pandemic. All theRTs have developed a self‑copying style that has helped them improve their psychosocial behaviorto face the pandemic. During the outbreak, frontline RTs’ positive and negative emotions intertwinedand coexisted. Negative emotions predominated in the beginning, while good feelings emergedgradually. Self‑coping methods and psychosocial development were significant factors in RTs mentalhealth while caring for COVID‑19 patients. https://jehp.mui.ac.ir/article_29042.html BACKGROUND: Caring for a family member with cancer is a challenging issue for families. Familycaregivers often need the help of supportive resources to solve problems in their care role. A deepunderstanding of the requirements of caregivers to seek help is an effective step toward their abilityto use supportive resources. This study aimed to identify and describe the requirements for promotinghelp‑seeking behaviors in Iranian family caregivers of cancer patients.MATERIALS AND METHODS: This qualitative study was conducted through in‑depth semi‑structuredinterviews with 28 participants selected using purposeful sampling method from 2019 to 2021. Aninterview guide with general questions about seeking help was used to maintain coherence in datacollection. The interviews continued until data saturation. All interviews were recorded, transcribedand analyzed through qualitative content analysis.RESULTS: The requirements of promoting help‑seeking behaviors in family caregiverswere grouped into four main categories: (1) improving social paths toward seeking help, (2)spiritual‑psychological‑cognitive empowerment toward seeking help, (3) strengthening the motivationsbehind seeking help, and (4) modifying the perception of cultural barriers to seeking help.CONCLUSION: According to the results of this study, it is expected that by identifying the requirementsof caregivers for seeking help and by health stakeholders designing comprehensive programs toaddress these needs, caregivers will be empowered to use supportive resources and provide abetter care role. https://jehp.mui.ac.ir/article_29043.html BACKGROUND: Mobile phones have become a widely accepted learning mode due to the impactof COVID‑19. This study explores the mobile technology acceptance, among nursing students atselected educational institutions in South India.MATERIALS AND METHODS: Quantitative cross‑sectional descriptive design. First‑year 176 B.Sc.nursing students who underwent blended learning were selected by the purposive sampling method.The tool “Technology Acceptance Model” was used to collect responses. Bivariate analysis was usedto determine the relationship between the demographic and study‑related variables with the mobiletechnology acceptance using SPSS version 25.0.RESULTS: The majority 73.9% of the students belonged to the age group of 18–19 years,females 76.7% and, 98.9% were unmarried. Among the constructs of TAM, a mean (SD) value of22.08 (2.26) was found for material (mobile device audio/video) characteristics the mean (SD) valuewas 22.08 (2.26), attitude about use 17.58 (1.95), behavioral intention 17.46 (1.78) and systemcharacteristics 17.21 (2.27). The mobile technology acceptance revealed that 126 (71.6%) stronglyagreed, 49 (27.8%) agreed, and 1 (0.6%) was neutral with a mean (SD) of 105.19 (8.68), respectively.A positive correlation was found between the system characteristics, material characteristics, perceivedease to use, perceived usefulness, attitude about the use, behavioral intention with a P value <0.001.There was a statistically significant association between Mobile technology acceptance and time spentby the students for independent studies shown the Chi‑square value of 12.7, with P value <0.05.CONCLUSION: Nursing students had a positive acceptance and behavior toward smartphone use. https://jehp.mui.ac.ir/article_29044.html BACKGROUND: Incivility is one of the significant challenges that affect nursing education. Uncivilbehaviors have a significant upward trend compared to the past in nursing education. This studywas conducted to explore academic incivility from the perspective of nursing students and faculty.MATERIALS AND METHODS: This study was conducted in 2021 using a descriptive qualitativemethod. Fifteen baccalaureate nursing students and six faculty were selected using purposefulsampling method. Data was collected through in‑depth semi‑structured interviews, and a qualitativecontent analysis was applied for data analysis.RESULTS: Data analysis revealed four categories, namely, ineffective teaching–learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academicdishonesty, and 14 subcategories.CONCLUSION: To reduce incivility, closer attention needs to be paid to the admission of faculty aswell as training them to use effective communication techniques and interactive teaching methods.In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore,clear and precise rules and regulations concerning incivility incidence should be developed andimplemented in the universities. https://jehp.mui.ac.ir/article_29045.html BACKGROUND: To motivate students toward the path of lifelong learning, it is important to trainthem for a self‑directed learning (SDL) approach, where they identify the need of learning the contentas well as look forward to attaining the learning outcome, independently. The level of readinessfor SDL will allow the learner to be self‑disciplined, self‑organized, an effective team builder andcommunicator, a self‑assessor, and a self‑reflector, thus being a self‑learner with the ability to acceptand give constructive feedback. The aim of the study was to develop, validate, and implement theSDL readiness scale for health professional students.MATERIALS AND METHOD: The readiness scale of 43 items was used in four sub‑titles (awareness,learning strategies, and style, motivation, team building) was developed using the Delphi method with12 experts and was implemented for the medical students at Karamsad, Gujarat as a cross‑sectionalsurvey after a pilot trial scale from May 2021 to September 2021, using mean, the standard deviationfor each item, and arrived sub‑titles. The ANOVA test was used to find differences in readinessscores as per different years of the medical program.RESULT: The result demonstrates that the maximum score was obtained for the first‑year medicalstudent (149.89 ± 24.72), which dropped in year 2 (136.35 ± 32.26) but increased by the finalyear (147.67 ± 56.66), although not as high as the initial joining year. However, a statisticallysignificant difference per gender was identified for a few items of the scale [(items 24 (P < 0.034),26 (P < 0.0005), 37 (P < 0.035), and 40 (P < 0.013)]. The logistic regression analysis showed nostatistical significance for the DSVS‑self‑directed learning readiness scale (SDLRS) score anddemographic variables.CONCLUSION: The outcome of the study strongly suggests training/sensitization sessions forstudents to highlight the importance of a SDL approach in a digital millennium. Moreover, a longitudinalfollow‑up needs to be conducted for the readiness score of the students based on the developedscale and subsequent training sessions need to be organized for students as well as faculty for betteroutcomes for the students toward SDL sessions. https://jehp.mui.ac.ir/article_29046.html Educational policymaking is a kind of public policy that is done in order to achieve the goals of theeducational system in fields areas such as education and students’ health. The purpose of this studywas to determine the components of educational policymaking model in education. The method ofthe present study is systematic review. This is done using the SPIDER framework. The statisticalpopulation of the study included all related Persian and English articles published in the years2010–2021 consisting of 98 articles that are indexed in ScienceDirect, Sage, Springer, Wiley, Eric,and PMC English language databases and SID, Irandoc, and Magiran Persian language databases.The research sample included 52 articles selected in the article screening stage. The number ofPersian language references was 12 and English language references was 40. Sterberg thematicanalysis was used for coding the selected texts of articles. Results of coding the selected texts ofthe articles showed that the components of the educational policymaking model are included in 11themes: quiddity of policy and public policy, educational policy’s necessity, quiddity of educationalpolicy, process of educational policy, consequences, factors, obstacles, stakeholders, evaluationcriteria, and change in educational policies. Paying attention to all the dimensions and factorsinteracting in educational policy can lead to better education and improve the quality of education inall dimensions, especially in the field of health education. https://jehp.mui.ac.ir/article_29047.html The mortality rate of non‑communicable diseases (NCDs) contributes more in low‑income andmiddle‑income countries, also among individuals with lower socioeconomic status in high‑incomecountries, making NCDs a big hurdle to minimizing global and national health disparities. Among 55million fatalities worldwide in 2019, NCDs accounted for about 41 million (71%) deaths. The purposeof this scoping review was to comprehend the available literature on the burden of NCDs in India.This review included the studies that have been published between the period of 2009–2020. Forthis review, 18 full‑text articles have been selected. A preliminary search was done to obtain articlesfrom the search engines such as PubMed, Google Scholar, web of science, and Scopus. Our scopingreview was focused on five major NCDs which are cardiovascular, hypertension, diabetes, cancer,and stroke. In 2019, around 17.9 million individuals died from cardiovascular disease (CVD), whichis accounting for 32% of all deaths. As compared to Chandigarh and Jharkhand (0.12 million and0.96 million, respectively) Tamil Nadu and Maharashtra (4.8 million and 9.2 million, respectively)have a higher percentage of the population affected by diabetes. In India, stroke is the fifth‑significantcause of disability and the fourth‑leading cause of fatality, which is accounting for 3.5 percent of alldisabilities. India should construct a higher‑level coordinating framework and devise an overarchingpolicy or strategy tailored to NCDs. To limit risk factor exposure, it is necessary to emphasize healthpromotion and preventive actions. https://jehp.mui.ac.ir/article_29048.html BACKGROUND: Breast cancer is the most common type of cancer and the second leading causeof death among women. Religion and spiritual behaviors are effective strategies for maintaininghuman health. The aim of this study was to determine the relationship between religious orientationand spiritual intelligence with general health dimensions in women with breast cancer.MATERIALS AND METHODS: The present study is a correlational study that was performed on50 women with breast cancer referred to medical centers affiliated to Isfahan University of MedicalSciences in 2020. Data were collected through questionnaires of religious orientation, spiritualintelligence, and general health. Data were analyzed by Spearman and regression tests.RESULTS: The results showed that religious orientation had a significant positive relationship withthe overall score of general health, but the components of religious orientation had a significantnegative relationship with the number of components of public health (p < 0.05). Spiritual intelligencealso had a significant positive relationship with general health. However, the number of componentsof spiritual intelligence has a significant negative relationship with the number of components ofgeneral health (p < 0.05).CONCLUSION: Considering the relationship between religious orientation and spiritual intelligencewith public health and considering educational programs based on spiritual intelligence and religiousorientation in this group of people can be an important step in promoting their general health.