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The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern
Mohammad Asif
2014, 3:1 (21 February 2014)
DOI:10.4103/2277-9531.127541  PMID:24741641
Type-2 diabetes is a major, non-communicable disease with increasing prevalence at a global level. Type-2 diabetes results when the body does not make enough insulin or the body cannot use the insulin it produces. Type-2 diabetes is the leading cause of premature deaths. Improperly managed, it can lead to a number of health issues, including heart diseases, stroke, kidney disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or adult-onset diabetes is most common type of diabetes, usually begins when a person is in his or her mid-50s, but diabetes is not inevitable. Minor changes in your lifestyle can greatly reduce your chances of getting this disease. Therefore, in order to prevent this condition, action should be taken regarding the modifiable factors that influence its development-lifestyle and dietary habits. However, with proper testing, treatment and lifestyle changes, healthy eating as a strategy, promote walking, exercise, and other physical activities have beneficial effects on human health and prevention or treatment of diabetes, promoting adherence to this pattern is of considerable public health importance.
  9,711 1,905 35
Learning theories application in nursing education
Fatemeh Aliakbari, Neda Parvin, Mohammad Heidari, Fariba Haghani
2015, 4:2 (23 February 2015)
DOI:10.4103/2277-9531.151867  PMID:25767813
Learning theories are the main guide for educational systems planning in the classroom and clinical training included in nursing. The teachers by knowing the general principles of these theories can use their knowledge more effectively according to various learning situations. In this study, Eric, Medline, and Cochrane databases were used for articles in English and for the Persian literature, Magiran, Iran doc, Iran medex, and Sid databases were used with the help of keywords including social cognitive learning, learning theory, behavioral theory, cognitive theory, constructive theory, and nursing education. The search period was considered from 1990 to 2012. Some related books were also studied about each method, its original vision, the founders, practical application of the training theory, especially training of nursing and its strengths and weaknesses. Behaviorists believe that learning is a change in an observable behavior and it happens when the communication occurs between the two events, a stimulus and a response. Among the applications of this approach is the influence on the learner's emotional reactions. Among the theories of this approach, Thorndike and Skinner works are subject to review and critique. Cognitive psychologists unlike the behaviorists believe that learning is an internal process objective and they focus on thinking, understanding, organizing, and consciousness. Fundamentalists believe that learners should be equipped with the skills of inquiry and problem solving in order to learn by the discovery and process of information. Among this group, we will pay attention to analyze Wertheimer, Brunner, Ausubel theories, Ganyeh information processing model, in addition to its applications in nursing education. Humanists in learning pay attention to the feelings and experiences. Carl Rogers support the retention of learning-centered approach and he is believed to a semantic continuum. At the other end of the continuum, experiential learning is located with the meaning and meaningful. It applies the minds and feelings of the person. From this group, the main focus will be on the works of Rogers and Novels. Finally, it could be concluded that the usage of any of these theoriesin its place would be desired and useful.
  6,590 1,302 -
Exercise and academic performance among nursing and kinesiology students at US colleges
David Bellar, Lawrence W Judge, Jeffrey Petersen, Ann Bellar, Charity L Bryan
2014, 3:9 (21 February 2014)
DOI:10.4103/2277-9531.127560  PMID:24741649
Context: Lack of physical activity is a contributor to the obesity epidemic and is speculated to relate to reduced academic performance; however, this link has yet to be examined within the college population. Aims: The purpose of this study in a group of undergraduate students, was to determine if aerobic exercise activity was related to academic performance. Materials and Methods: The participants for this study included 740 students at multiple universities enrolled in nursing and kinesiology studies. The participants completed the Leisure and Physical Activity Questionnaire. Results: Pearson's χ2 analysis revealed differences in grade point average with aerobic activity (χ2 = 44.29 , P ≤ 0.001) as well as a trend toward differences in grade point average with weightlifting activity (χ2 = 22.69, P = 0.61). Conclusions: Based on these findings it can be suggested that college students engage in greater aerobic exercise.
  6,984 642 6
Quality evaluation of portal sites in health system, as a tool for education and learning
Sayed Mehdi Hejazi, Sima Sarmadi
2013, 2:56 (30 October 2013)
DOI:10.4103/2277-9531.120845  PMID:24520554
Background: The main objective of creating a portal is to make information service available for users who need them for performance of duties and responsibilities regardless of the sources. This article is attempted to consider the parameters that can evaluate these sites since these criteria can be effective in designing and implementing such portals. On the other hand, portal sites in health systems of every country make it possible for leaders, policy makers, and directors to system education as a tool for new learning technologies. One of the main decisions each manager has to make is precise selection of appropriate portal sites. Materials and Methods: This is a descriptive and qualitative study. The research sample was 53 computer professional working in the area of computer programming and design. In the first part of the study a questionnaire was send to the participants and in the second part of the study based on their response to the questionnaire the participant was interviewed and the main themes of the studies were formulated. The validity and the reliability of the questionnaire were confirmed. Results: The study results were summarized in 10 themes and 50 sub-categories. The main themes included were portal requirements, security, management, and efficiency, user friendliness, built-in applications, portal flexibility, interoperability, and support systems. Conclusion: Portal sites in any education systems make it possible for health system leaders and policy makers to manage their organization information system efficiently and effectively. One of the major decisions each manager has to make is precise selection of an appropriate portal sites design and development. The themes and sub-categories of this study could help health system managers and policy makers and information technology professionals to make appropriate decisions regarding portal design and development.
  6,365 259 -
Effect of Health Belief Model based intervention on promoting nutritional behaviors about osteoporosis prevention among students of female middle schools in Isfahan, Iran
Mohtasham Ghaffari, Elaheh Tavassoli, Ahmad Esmaillzadeh, Akbar Hassanzadeh
2012, 1:14 (30 July 2012)
DOI:10.4103/2277-9531.98572  PMID:23555117
Background: Osteoporosis is a systemic skeletal disorder characterized by reduction of one mass, deterioration of bone structure, increasing bone fragility, and increasing fracture risk. Prevention of osteoporosis during childhood and adolescence is one of the most important issues in World Health Organization. The purpose of this study was to determine the effect of Health Belief Model based intervention on promoting nutritional behaviors about preventive osteoporosis among the second grade middle school girl students. Materials and Methods: This was an experimental intervention study, the research population being 130 students who were randomly divided into groups, experimental (66) and control (64). Before the educational program, Health Belief Model based standard questionnaire and Food Frequency Questionnaire (FFQ) questionnaire were filled up by both the groups. The standard questionnaire was completed three times (before, immediately, and 2 months after education) and FFQ questionnaire was completed two times (before and 2 months after education) by the students. After pre-test, four educational session classes in the experimental group were performed. Finally, data collected were analyzed by SPSS 18 computer software. Results: The result of this study showed a significant increase in the mean score of knowledge, perceived susceptibility, seriousness, benefits, barriers, as well as taking health action among girl students in the experimental group. Conclusion: The findings of the present study confirmed the practicability and effectiveness of the Health Belief Model based educational program in promoting nutritional behaviors about prevention of osteoporosis.
  5,573 880 5
The effect of three ergonomics interventions on body posture and musculoskeletal disorders among stuff of Isfahan Province Gas Company
Ehsanollah Habibi, Shiva Soury
2015, 4:65 (6 August 2015)
DOI:10.4103/2277-9531.162386  PMID:26430692
Background: Prevalence of work-related musculoskeletal disorders (WMSDs) is high among computer users. The study investigates the effect of three ergonomic interventions on the incidence of musculoskeletal disorders among the staff of Isfahan Province Gas Company, including training, sport, and installation of software. Materials and Methods: The study was performed in the summer of 2013 on 75 (52 men, 23 women) Isfahan Province Gas Company employees in three phases (phase 1 : e0 valuation of present situation, phase 2 : p0 erforming interventions, and phase 3 : r0 e-evaluation). Participants were divided into three groups (training, exercise, and software). The Nordic Musculoskeletal Questionnaire (NMQ) and rapid upper limb assessment (RULA) were used. Data collected were analyzed using SPSS software and McNemar test, t-test, and Chi-square test. Results: Based on the evaluations, there was a decrease in musculoskeletal symptoms among the trained group participants after they received the training. McNemar test showed that the lower rate of pain in low back, neck, knee, and wrist was significant (P < 0.05). The results obtained from the RULA method for evaluation of posture showed an average 25 points decrease in the right side of the body and 20 points decrease in the left side of the body in the group subjected to training. Based on t-test, the decrease was significant. Conclusion: The study demonstrated that majority of the participants accepted interventions, which indicates that most of the people were unsatisfied with the work settings and seeking improvement at the workplace. Overall, the findings show that training, chair adjustment, and arrangement in workplace could decrease musculoskeletal disorders.
  4,791 400 5
Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran
Mahnoosh Reisi, Seyed Homamodin Javadzade, Firoozeh Mostafavi, Gholamreza Sharifirad, Fatemeh Radjati, Akbar Hasanzade
2012, 1:31 (27 August 2012)
DOI:10.4103/2277-9531.100160  PMID:23555134
Background: Health literacy is a measure of an individual's ability to read, comprehend, and act on medical instructions. Limited health literacy can reduce the adults' ability to comprehend and use basic health-related materials, such as prescription, food labels, health education pamphlets, articles, appointment slips, and health insurance plans, which can affect their ability to take appropriate and timely health care action. Nowadays, low health literacy is considered a worldwide health threat. So, the purpose of this study was to assess health literacy level in older adults and to investigate the relationships between health literacy and health status, health care utilization, and health preventive behaviors. Materials and Methods: A cross-sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected using home interviewing. Health status was measured based on self-rated general health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations, and health preventive behaviors were measured based on self-reported preventive health services use. Results: Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, had fewer years of schooling, lower household income, and were females. Inadequate health literacy was associated with poorer general health (P < 0.001). Health literacy level was negatively associated with outpatient visits (P = 0.003) and hospitalization (P = 0.01). No significant association was found between health literacy level and emergency room utilization. Self-reported lack of PSA (Prostate-Specific Antigen) test (P < 0.001) and fecal occult blood test (FOBT; P = 0.003) was higher among individuals with inadequate health literacy than those with adequate health literacy. No significant association was found between health literacy level and mammogram in the last 2 years. Conclusion: Low health literacy is more prevalent in older adults. It indicates the importance of health literacy issue in health promotion. So, with simple educational materials and effective interventions for low health literacy group, we can improve health promotion in the society and mitigate the adverse health effects of low health literacy.
  4,277 906 21
Development and psychometric testing of the Adolescent Healthy Lifestyle Questionnaire
Parvaneh Taymoori, Babak Moeini, David Lubans, Mitra Bharami
2012, 1:20 (31 July 2012)
DOI:10.4103/2277-9531.99221  PMID:23555123
Background: Lifestyle choices and individuals' behaviors have the potential to influence health and improve the quality of life. Objectives: The purpose of this study was to develop and psychometrically test an instrument for measuring healthy lifestyle in Iranian adolescents. Materials and Methods: A comprehensive literature review related to health-promoting lifestyles was used to identify potential scale items. Data were collected from 797 school students. Construct validity was analyzed using exploratory factor analysis. Confirmatory factor analysis (CFA) was used to cross-validate. Results: Nine factors emerged that explained 59.8% of the variance in the 43 items. Cronbach's α coefficient Healthy Lifestyle Questionnaire was r=0.82. After the model was modified, the fit indices indicated that the data were an adequate-to-good fit to the proposed models. Conclusions: The current study provides some support to the internal and external validity of the healthy lifestyles questionnaire for Iranian adolescents.
  4,452 722 6
Personal hygiene among college students in Kuwait: A Health promotion perspective
Jenan M Al-Rifaai, Aneesa M Al Haddad, Jafar A Qasem
2018, 7:92 (6 July 2018)
DOI:10.4103/jehp.jehp_158_17  PMID:30079363
Background: Most infectious diseases result from a lack of knowledge and poor personal hygiene. Hand hygiene, in particular, is one of the most common means by which pathogens are transmitted. The aim of this study was to determine college student's knowledge and awareness of personal hygiene in Kuwait. Materials and Methods: A multi-dimensional health assessment approach was followed using a self-administered questionnaire that was distributed among students of two colleges (the College of Nursing and the College of Health Sciences). Item analysis was conducted on 33 items of the questionnaire and measure five types of hygiene practices: hand hygiene, body hygiene, special hair application, oral care, and clothes hygiene. The data collected in the questionnaires and results were analyzed using statistical software SPSS version 23. Statistical analysis was performed using ANOVA and Student's t-test. Internal consistency, reliability was good, with an overall Cronbach's Alpha value of 0.749. Results: Most respondents were female with 64%, while 80% of the college students were in the age of <20-year-old. Twelve items were underhand hygiene practices, and four items under body hygiene. Nine items were under oral care; three, items were under hair application. Three were under clothes hygiene. Conclusions: This study showed that female students had a better knowledge and were more hygienic in hand hygiene, hair application, and body hygiene whereas, male students showed a better oral hygiene practice. Nevertheless, this study shows that the hygiene questionnaire is an acceptable and reliable measure of awareness and practice among college students.
  4,673 234 1
Phenomenological explanation of an experiential curriculum in medical education: A feministic approach
Narges Keshtiaray, Kourosh Fathi Vajargah, Craig Zimitat, Ahmad Ali Foroughi
2012, 1:8 (28 March 2012)
DOI:10.4103/2277-9531.94417  PMID:23555111
Introduction: This study addresses the design and validation of the experiential curriculum model for medical education using a Feministic approach. Method: The present study was conducted on two non separable planes. On the first plan, the model was designed based on the Feministic approach using the theoretical study method and emphasizing the perspectives ascribed to Nell Noddings, Madeline Grumet and Janette Miller. Results: The levels of this model include Expected Curriculum, Imaginal Curriculum, Concealed curriculum, Interactive curriculum (Manifest Curriculum, Latent Curriculum, Look the parenting), Transferential Curriculum and Self Determination. On the second plane, to validate the combined model, a phenomenologically qualitative study was conducted. In this study, using goal-oriented sampling, undergraduate and graduate (Master's degree) students majoring in Dentistry, Nursing at Islamic Azad University Khorasgan Branch, Esfahan as well as those at at Esfahan University of Medical Sciences were selected. Deep interview was used to collect data. The findings were analyzed using Van Manen's six-stage model. To determine the reliability of the findings, reliability of reality reconstruction were used. Conclusion: The results obtained suggested that: Education is in need of some conceptual reconstruction. On this way, women's perceptions and experience of education and of the interior epistemological and curricular system which shape the discourse and performance of education must be addressed. Serving as a research model offering the various planes of the experiential curriculum and focusing more sharply on the dimensions of curriculum than the formal plane, the present study is recommended to the decision-makers of higher education curricular system.
  4,422 443 -
Factors associated with the fecal occult blood testing for colorectal cancer screening based on health belief model structures in moderate risk individuals, Isfahan, 2011
Seyed Homamodin Javadzade, Firoozeh Mostafavi, Akbar Hasanzade, Mahnoosh Reisi, Hossein Shahnazi, Gholamreza Sharifirad
2012, 1:18 (31 July 2012)
DOI:10.4103/2277-9531.99218  PMID:23555121
Background: Colorectal cancer is one of the most important and most common cancers and the second leading cause of cancer deaths worldwide. Every year, nearly 1 million new cases of colorectal cancer are recognized around the world and nearly half of them lose their lives due to the disease. The statistics reveal shocking incidence and mortality from colorectal cancer, therefore secondary prevention of this cancer is important and research has shown that by early diagnosis 90% of patients can be treated. Among the colorectal cancer screening tests, fecal occult blood test (FOBT) takes the priority because of its convenience and also low cost. But due to various reasons, the participation of people in this screening test is low. The goal of this study is to assess the factors that affect participation of population at average risk in colorectal cancer screening programs, based on health belief model structures. Materials and Methods: A cross-sectional survey of 196 individuals, more than 50 years old, was conducted in Isfahan. Ninety-eight people of the target group were selected from laboratories while they came there for doing FOBT test; the method of sampling in this group was random sampling. The method of data collection in the other 98 ­individuals was by home interview and they were selected by cluster sampling. The questionnaire used was based on health belief model to assess the factors associated with performing FOBT. The data collected were analyzed using descriptive and inferential statistical methods. Results: The mean score of knowledge in the first group was 48/5 ± 11/7 and in the second group was 36/5 ± 19/3. Individuals in the first group were more likely to be married, had more years of schooling, and better financial status. There were significant relationships between knowledge (P<0.001), perceived susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P<0.001), and self-efficacy (P<0.001) in the two groups. There was no significant association between the perceived benefits in the two groups. Those people who have had FOBT test in last year in each group reported better score of Health Belief Model model structures. Conclusion: According to this study, it seems that there is an urgent need to pay more attention to this disease and its prevention through screening. With a better ­understanding of factors affecting the test, it can be a useful step to reduce the rate of death and costs, and ­improve the community health outcomes.
  4,113 719 6
Study of knowledge and attitude regarding prenatal diagnostic techniques act among the pregnant women at a tertiary care teaching hospital in Mumbai
Pallavi R Shidhaye, Purushottam A Giri, Shashikant N Nagaonkar, Rahul R Shidhaye
2012, 1:36 (6 October 2012)
DOI:10.4103/2277-9531.102049  PMID:23555139
Background: Sex ratio, an important social indicator measuring extent of prevailing equity between males and females in society, is defined as number of females per 1000 males. Changes in sex ratio reflect underlying socioeconomic, cultural patterns of a society. As per 2011 census sex ratio in India is 914/1000 males, which continues to be significantly adverse towards women. Objectives: This study was conducted to assess the knowledge and attitude regarding Prenatal Diagnostic Techniques (PNDT) Act among the pregnant women at a tertiary care teaching hospital in Mumbai. Materials and Methods: A cross-sectional study was carried out in the antenatal ward of Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai during the period of January to April 2008. A total of 143 women were included and a pre-designed and pre-tested questionnaire was used to get information regarding socio-demographic details of the pregnant women. They were asked regarding the knowledge and attitude towards the PNDT Act. Data was analyzed by using Statistical Package of Social Sciences (SPSS) 16.0. Results: In the present study, out of 143 women, 105 (73.5%) knew about sex determination. Even out of those who had heard, the correct knowledge regarding PNDT act was very less. Sonography as a technique for sex determination done at private hospital was known to the majority of women. Conclusion: Education of women about gender equality and recommendations under PNDT act in order to improve declining sex ratio in our country must be done. Wide publicization in the media of the Act must be scaled up.
  3,909 871 -
The survey of nurse's knowledge and attitude toward cancer pain management: Application of Health Belief Model
Hossein Shahnazi, Hamid Saryazdi, Gholamreza Sharifirad, Akbar Hasanzadeh, Abdurrahman Charkazi, Mitra Moodi
2012, 1:15 (30 July 2012)
DOI:10.4103/2277-9531.98573  PMID:23555118
Background: Effective cancer pain management requires accurate knowledge, attitudes, and assessment skills. The purpose of this study was to obtain information about the knowledge and attitudes of nurses concerning cancer pain management with the use Health Belief Model (HBM) as conceptual framework. Materials and Methods: The study was a descriptive survey and included 98 randomly selected nurses from Alzahra hospital, Isfahan, Iran. A self-administered questionnaire which was designed on the basis of HBM was used to collect the data. Knowledge, attitudes, and HBM constructs regarding cancer pain were the main research variables. The obtained data were analyzed by SPSS (version11.5) using descriptive statistics, independent t-test, and Pearson correlation at the significant level of α=0.05. Results: Ninety-eight nurses aged 38.7 ± 7.04 years were studied in this survey. From the 10 pain knowledge questions assessed, the mean number of correctly answered question was 61.2 (SD=16.5), with a range of 30-100. There was a direct correlation between knowledge and attitude of nurses with HBM constructs except for perceived barriers and perceived threat. Among the HBM constructs, the highest score was related to self-efficacy with mean score of 87.2 (SD=16.4). Conclusions: The findings support the concern of inadequate knowledge and attitudes in relation to cancer pain management. We believe that basic and continuing education programs may improve the knowledge level of nursing about pain management.
  3,793 722 7
Effectiveness of breastfeeding education on the weight of child and self-efficacy of mothers - 2011
Gholamreza Shrifirad, Aziz Kamran, Seyed Kamal Mirkarimi, Abbas Farahani
2012, 1:11 (30 July 2012)
DOI:10.4103/2277-9531.98569  PMID:23555114
Background: Breastfeeding is the most natural and essential way for feeding newborn babies. This is an ideal approach for physical and emotional development of babies, as well as for the recovery of mothers. This study was aimed to determine the effect of breastfeeding education based on the health belief model (HBM) toward primiparous women. Materials and Methods: In a case-control group, quasi-experimental study, 88 subjects were allocated in control and experimental groups. Subjects who were assigned to the experimental group were provided a program consisting of group education based on HBM during their prenatal period. Instrument for data gathering was made by the researchers and standard questionnaire from Dennis and Faux for Breastfeeding Self-efficacy Scale (BSES). Baseline interviews were conducted before delivery and follow-up visits were conducted after 30 days and at the fourth month after delivery. Data were analyzed using SPSS (version 16) with c 2 , independent sample t-tests, and paired t-test. Results: Mean age of pregnant women who participated in the study was 22 ± 3.29 years. After the program, the experimental group had significantly better scores in terms of self-efficacy, knowledge, and attitude scores statistically. In the fourth month, the mean of child weight in the experimental group was significantly higher than that of the control group (P=0.001) and exclusive breastfeeding was significantly higher than in the control group (P=0.007). Conclusion: Prenatal education in this study based on HBM was successful, and knowledge, attitude, self-efficacy, and related indicators improved. The necessity of producing standard education package and education of pregnant mothers, especially in their first pregnancy, by health professionals is perceived.
  3,732 702 5
Learning challenges of nursing students in clinical environments: A qualitative study in Iran
Shahram Baraz, Robabeh Memarian, Zohreh Vanaki
2015, 4:52 (6 August 2015)
DOI:10.4103/2277-9531.162345  PMID:26430679
Background: Clinical learning environment is a complex social entity. This environment is effective on the learning process of nursing students in the clinical area. However, learning in clinical environment has several benefits, but it can be challenging, unpredictable, stressful, and constantly changing. In attention to clinical experiences and factors contributing to the learning of these experiences can waste a great deal of time and energy, impose heavy financial burden on educational systems, cause mental, familial and educational problems for students, and compromise the quality of patient care. Therefore, this study was carried out with the goal of determining the learning challenges of nursing students in clinical environments in Iran. Materials and Methods: In this qualitative study carried out in 2012-2013, 18 undergraduate nursing students were selected by using purposive sampling method from the Faculty of Nursing and Midwifery of Tehran and Shahid Beheshti Universities. Semi-structured interviews were used to collect data. The content analysis method was used to determine relevant themes. Results: Two themes were derived from the data analysis, which represented the students' clinical learning challenges. These two themes included insufficient qualification of nursing instructors and unsupportive learning environment. Conclusions: Identification of the students' clinical learning challenges and actions to remove or modify them will create more learning opportunities for the students, improve the achievement of educational goals, provide training to nursing students with the needed competencies to meet the complex demands of caring and for application of theories in practice, and improve the quality of healthcare services.
  3,706 673 6
Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model
Ahmad Reza Raeisi, Mohammad Hossein Yarmohammadian, Roghayeh Mohammadi Bakhsh, Hamid Gangi
2012, 1:1 (28 March 2012)
DOI:10.4103/2277-9531.94408  PMID:23555104
Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective.
  3,608 732 6
Related factors to choose normal vaginal delivery by mothers based on Health Belief Model
Mohammad Hossein Baghianimoghadam, Razieh Zolghadar, Behnam Baghiani Moghadam, Maryam Darayi, Fatemeh Jozy
2012, 1:17 (30 July 2012)
DOI:10.4103/2277-9531.99216  PMID:23555120
Background: Normal vaginal delivery (NVD) is the best method of delivery, but its rate is decreasing. Results of many studies have shown that the risk of cesarean section (CS) for both mother and child is more than that of NVD. The World Health Organization's (WHO) goal was to achieve a CS rate of 15% in 2010, but this rate in most of the developing countries is over than 50%. In this study, we try to determine the related factors influencing the method of delivery selection by mothers in Yazd city, Iran, based on Health Belief Model (HBM). Materials and Methods: This was a cross-sectional study done on 130 pregnant women who presented in four clinics of Yazd. The mothers were in 32-37 weeks of gestational age. Samples were selected by simple randomized method. Data were collected by questionnaire by interviewing and then analyzed by analysis of variance (ANOVA) and t-test. Results: Mean age of samples was 42.23 ± 4.52 years. Eighty-four (64%) women were primigravids and 49 (37.7%) mothers were multigravids. Of them, the method of delivery in previous pregnancy was NVD in 29 (22.3%) and CS in 20 (14.3%). In their present pregnancy, the method of delivery was NVD in 88 (67.7%) and CS in 42 (32.3%). The Pearson test showed a significant correlation between perceived barriers and behavior (P=0.012). Also, there was significant relationship between perceived susceptibility and behavior (P=0.03). There was no significant relation between other variables (perceived benefits and perceived severity). Conclusion: Based on the results of this study, perceived susceptibility and perceived barriers were related to behavior significantly, so we must educate mothers using HBM to influence their behavior toward selecting NVD as their delivery method.
  3,698 559 1
The effectiveness of nutrition education program based on health belief model compared with traditional training
Gholam Reza Sharifirad, Azar Tol, Siamak Mohebi, Mohammad Matlabi, Hossein Shahnazi, Marzieh Shahsiah
2013, 2:15 (31 March 2013)
DOI:10.4103/2277-9531.112684  PMID:24083265
Introduction: This study was aimed to compare the effect of nutrition educational program based on HBM with traditional education recommended weight gain among pregnant women in Gonabad. Target population was pregnant women who were resided in Gonabad and went to urban health care centers for prenatal cares. Materials and Methods: 110 pregnant women (case group: 54, control group: 56) were selected who had come to this centers in the first stage of prenatal care (6th -10th week of pregnancy) in 1388 and were consequently classified in case and control group. There is no significant difference for age, education, number of parity, history of abortion and job between case and control groups. Results: There was no significant differences in nutritional behavior mean score before intervention in case (74.42 ± 12.78) and control (77.14 ± 15.35) groups (P value = 0.82, independent t- test); but after education, intervention was significant in nutritional behavior between two groups (P value = 0.01, independent t - test); Discussion: after intervention, there also was significant difference in HBM structures mean score in case group compare with control group and the highest rise in score was related to perceived benefits (15.13 increment).
  3,361 762 7
Assessing the service quality of Iran military hospitals: Joint Commission International standards and Analytic Hierarchy Process (AHP) technique
Mohammadkarim Bahadori, Ramin Ravangard, Maryam Yaghoubi, Khalil Alimohammadzadeh
2014, 3:98 (28 August 2014)
DOI:10.4103/2277-9531.139680  PMID:25250364
Background: Military hospitals are responsible for preserving, restoring and improving the health of not only armed forces, but also other people. According to the military organizations strategy, which is being a leader and pioneer in all areas, providing quality health services is one of the main goals of the military health care organizations. This study was aimed to evaluate the service quality of selected military hospitals in Iran based on the Joint Commission International (JCI) standards and comparing these hospitals with each other and ranking them using the analytic hierarchy process (AHP) technique in 2013. Materials and Methods: This was a cross-sectional and descriptive study conducted on five military hospitals, selected using the purposive sampling method, in 2013. Required data collected using checklists of accreditation standards and nominal group technique. AHP technique was used for prioritizing. Furthermore, Expert Choice 11.0 was used to analyze the collected data. Results: Among JCI standards, the standards of access to care and continuity of care (weight = 0.122), quality improvement and patient safety (weight = 0.121) and leadership and management (weight = 0.117) had the greatest importance, respectively. Furthermore, in the overall ranking, BGT (weight = 0.369), IHM (0.238), SAU (0.202), IHK (weight = 0.125) and SAB (weight = 0.066) ranked first to fifth, respectively. Conclusion: AHP is an appropriate technique for measuring the overall performance of hospitals and their quality of services. It is a holistic approach that takes all hospital processes into consideration. The results of the present study can be used to improve hospitals performance through identifying areas, which are in need of focus for quality improvement and selecting strategies to improve service quality.
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A comprehensive test of clinical reasoning for medical students: An olympiad experience in Iran
Alireza Monajemi, Kamran Soltani Arabshahi, Akbar Soltani, Farshid Arbabi, Roghieh Akbari, Eugene Custers, Arash Hadadgar, Fatemeh Hadizadeh, Tahereh Changiz, Peyman Adibi
2012, 1:10 (28 March 2012)
DOI:10.4103/2277-9531.94420  PMID:23555113
Although some tests for clinical reasoning assessment are now available, the theories of medical expertise have not played a major role in this filed. In this paper, illness script theory was chose as a theoretical framework and contemporary clinical reasoning tests were put together based on this theoretical model. Based on this model, we concluded that no single test could thoroughly assess clinical reasoning competency, and therefore a battery of clinical reasoning tests is needed. This battery should cover all three parts of clinical reasoning process: Script activation, selection and verification. In addition, not only both analytical and non-analytical reasoning, but also both diagnostic and management reasoning should evenly take into consideration in this battery. This paper explains the process of designing and implementing the battery of clinical reasoning in the Olympiad for medical sciences students through an action research.
  3,570 412 1
Breastfeeding status during the first two years of infants' life and its risk factors based on BASNEF model structures in Isfahan
Abdurrahman Charkazi, Sayyede Zeynab Miraeiz, Atena Razzaghnejad, Hossein Shahnazi, Akbar Hasanzadeh, Mohammad T Badleh
2013, 2:9 (28 February 2013)
DOI:10.4103/2277-9531.107938  PMID:24083259
Background: Breastfeeding depends on social and cultural conditions of societies. Behavior,Attitude, Subjective Norms, Enabling Factors (BASNEF) model is one of the comprehensive models of behavior study, especially in developing countries. This study was performed to investigate the status of breastfeeding during the first two years of infants' life and its risk factors through BASNEF model structures. Materials and Methods: In this cross-sectional descriptive-analytical study, 406 mothers with 6-24-month-old babies were selected by multistage cluster sampling method. The data were collected using a questionnaire with five sections based on the BASNEF model structures. Demographic characteristics of the studied population were also recorded and analyzed using Chi-square tests and analysis of variance in SPSS 18 statistical software. Results: The prevalence of breastfeeding was 86.4% (351 mothers). Three hundred and thirty three mothers (82%) had good knowledge and there was a significant relationship between knowledge and breastfeeding behavior of mothers ( P < 0.05). Two hundred and eighty five mothers (70.2%) had good and very good attitude in this regard. There was no significant relationship between attitude and breastfeeding behavior of mothers ( P > 0.05). There was a significant relationship between breastfeeding behavior of mothers and subjective norms of husbands, mother and mother-in-law ( P < 0.05); however, no significant relationship was found with regard to enabling factors ( P > 0.05). Moreover, no significant relationship was observed between type of children nutrition and variables of delivery mode, maternal age and number of children ( P > 0.05). Conclusion: In addition to knowledge of nursing mothers, supports and encouragement of husbands, mothers and mother-in-laws, as subjective norms of behavior, have a positive impact on the breastfeeding behavior of mothers. Thus, breastfeeding programs should pay more attention to the role of these mentioned factors.
  3,550 387 5
Nutritional status of adolescents in Bangladesh: Comparison of severe thinness status of a low-income family's adolescents between urban and rural Bangladesh
Neyamul Akhter, Farida Yasmin Sondhya
2013, 2:27 (29 June 2013)
DOI:10.4103/2277-9531.114209  PMID:24083277
Introduction: This study estimated the nutritional as well as the severe thinness status (according to the World Health Organization [WHO]) of a low-income family's adolescent girl and also their early age of life in both urban and rural adolescent girls in Bangladesh. Materials and Methods: This cross-sectional study measured the height, weight and muac by standard procedure for calculating the body mass index according to the WHO reference. A 2-days, 24-h food recall and food frequency questionnaire was used to estimate the food frequency, energy intake, protein and carbohydrate. A multistage, multiphase stratified cluster sampling was used to select the study population from two locations in Bangladesh: Dhaka city and the east region of Trishal (district of Mymensingh). The study subjects were low-income families' adolescent girls (n = 214) aged 14-17 years. The two groups contained an equal number of respondents (n=107/group). Results: Results revealed that economic status had a significant effect on nutritional status. Nutritional status of low-income families' adolescent were low both in urban and rural adolescents, but severe thinness rate according to the WHO of urban (22.4%) adolescents was much higher than rural (10.3%) adolescents (chi-square = 4.9 and P-value = 0.01), and was also higher at an earlier age of their life. In food intake distribution and food consumption status, the same results were seen. The percentage of never eat meat and fish of low-income families adolescent girls were (29.7%, 11.4%) in urban group and (24.4%, 6.8%) in rural group. The main food rice consumption of urban adolescents was also about half that of rural adolescents per day. The study also shows that intake of energy, protein, carbohydrate and fat were significantly different between urban and rural girls. Only 53% energy was covered of the recommended daily energy intake in urban adolescents. Conclusion: Based on the food recall and anthropometric results, we conclude that malnutrition is common in low-income family's adolescents, and the severe thinness rate is much higher in urban than in rural adolescents, as also their early age of life in both low-income family's adolescents girls in Bangladesh.
  3,458 451 -
Motivation and academic achievement in medical students
Alireza Yousefy, Gholamreza Ghassemi, Samaneh Firouznia
2012, 1:4 (28 March 2012)
DOI:10.4103/2277-9531.94412  PMID:23555107
Background: Despite their ascribed intellectual ability and achieved academic pursuits, medical students' academic achievement is influenced by motivation. This study is an endeavor to examine the role of motivation in the academic achievement of medical students. Materials and Methods: In this cross-sectional correlational study, out of the total 422 medical students, from 4th to final year during the academic year 2007-2008, at School of Medicine, Isfahan University of Medical Sciences, 344 participated in completion of the Inventory of School Motivation (ISM), comprising 43 items and measuring eight aspects of motivation. The gold standard for academic achievement was their average academic marks at pre-clinical and clinical levels. Data were computer analyzed by running a couple of descriptive and analytical tests including Pearson Correlation and Student's t-student. Results: Higher motivation scores in areas of competition, effort, social concern, and task were accompanied by higher average marks at pre-clinical as well as clinical levels. However, the latter ones showed greater motivation for social power as compared to the former group. Task and competition motivation for boys was higher than for girls. Conclusion: In view of our observations, students' academic achievement requires coordination and interaction between different aspects of motivation.
  3,259 639 5
Knowledge and attitude toward menopause phenomenon among women aged 40-45 years
Ensieh Noroozi, Nayereh Kasiri Dolatabadi, Ahmad Ali Eslami, Akbar Hassanzadeh, Soheila Davari
2013, 2:25 (30 May 2013)
DOI:10.4103/2277-9531.112701  PMID:24083275
Background: Appropriate understanding of women that certain physical, mental, social and psychological changes occur during menopause helps them with greater readiness to cope with these changes. In all training programs to identify and analyze perceptions of the subjects is a key component. The purpose of this study was to investigate the knowledge and attitude of women toward the menopause phenomenon. Materials and Methods: This cross-sectional study was conducted on 400 healthy and non-menopaused women aged 40-45 years. The stratified sampling method was used and participation in this study was based on obtaining informed consent. The data collection instrument was a questionnaire consisting of three parts: demographic information, questions to assess knowledge and attitude investigation questions. Findings: The results showed that the average knowledge score of subjects was 63.57 ± 10.79, and their average attitude score was 61.21 ± 12.73. In this study, 8% of the subjects had poor knowledge, 68% had moderate knowledge and 38.5% had good knowledge. Meanwhile, 81.5% of the women had a positive attitude toward menopause. The correlation test showed that knowledge and attitude are meaningfully related to economic status and education level. But, the relationship between knowledge and attitudes of women under study was not significant. Conclusion: Identifying the quality of women's subjective perception of menopause has an essential role in the development of accurate and appropriate programs to promote women's health during menopausal years.
  3,332 556 7
Health-promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan university of medical sciences
Azar Tol, Elaheh Tavassoli, Gholam Reza Shariferad, Davoud Shojaeezadeh
2013, 2:11 (28 February 2013)
DOI:10.4103/2277-9531.108006  PMID:24083261
Background: Health promoting lifestyle (HPL) focuses on life promotion through lifestyle which consists of six aspects of "physical activity", "nutrition", "health responsibility", "spiritual growth", "interpersonal relations" and "stress management". This lifestyle promotes health and welfare and induces satisfaction, self-persuasion and self-improvement. Considering the importance of the way a new behavior affects "life quality" as a motivational factor for starting and continuing that behavior, this study aimed to determine the relationship between health-promoting lifestyle and its aspects. Materials and Methods: This cross-sectional study was performed on undergraduate students at School of Health, Isfahan University of Medical Sciences, using a census method. Health promoting lifestyle was measured by Health Promotion Lifestyle Profile two and life quality was assessed by the Persian version of QLQ-C30 questionnaire. Data analysis was conducted using descriptive and inferential statistical tests in SPSS. Results: Mean age of the participants was 21.12 years old. From among six aspects of health promoting behaviors, spiritual growth and responsibility with the means of 22.01 ± 2.224 and 20 ± 2.31 had the highest and physical activity with the mean of 17.58 ± 2.9 had the lowest scores, respectively. General life quality of 40.7% students was good and only 19.8% of them had an average global life quality. The highest and lowest frequencies of health-related life quality belonged to very good (58.6%) and excellent (9%) health, respectively. Except for stress management (P = 0.05) and gender of the students, there were no significant relationships between other HPL aspects and gender. There was no statistically significant relationship between global life quality of students and nutrition, physical activity, self-health responsibility and stress management while there was a significant relationship between global life quality and spiritual growth of the students. Health-related life quality and stress management were significantly related to each other; however, no statistically significant relationship was observed between health-related life quality and nutrition, physical activity, interpersonal relations and spiritual growth. Conclusion: There is a significant relationship between adopting health promoting lifestyle and aspects of spiritual growth and stress management on the one hand and general quality of life on the other, at least among students.
  3,027 807 17