The Relationship between Daily Spiritual Experiences and the Dimensions of Spiritual Care Competence in Nursing Students: The Dimension of Professionalization and Improvement of the Quality of Spiritual Care.

Background: Daily spiritual experiences and spiritual care competence have positive health effects on patients and form an integral part of the nursing profession. This study was conducted to determine the relationship between daily spiritual experiences and the dimensions of spiritual care competence in nursing students. Materials and Methods: This cross-sectional study was conducted on 401 nursing students in their last year of the program. The participants were selected from nursing schools in Tehran Province, Iran, in the academic year 2019-2020. The required data were extracted using a demographic information questionnaire, the Daily Spiritual Experiences Scale (DSES), and the Spiritual Care Competence Scale (SCCS). The collected data were analyzed in SPSS software at the significance level of 0.05. Results: The mean (SD) of daily spiritual experiences and total spiritual care competence was 67.15 (16.33) and 101.77 (16.26), respectively. The personal support and patient counseling dimensions had the highest mean (SD) [22.10) 4.80)]. Among all these dimensions of spiritual care competence, only professionalization and improvement of the quality of spiritual care were predictors of the students' daily spiritual experiences (p < 0.05). Conclusions: The professionalization dimension of spiritual care competence was identified as a predictor of daily spiritual experience in nursing students. Therefore, the researchers recommend the highlighting of this dimension in nursing programs to promote the students' spiritual care competence.

Application of a Risk Management Program Based on the Health Belief Model for Preventing Home Accidents.

Background: Accidents are the main cause of mortality in children aged less than 5 years throughout the world. The present study was conducted to empower mothers with children aged less than 5 years in preventing home accidents through the implementation of a risk management training program based on the Health Belief Model (HBM). Materials and Methods: The present pretest-posttest, quasi-experimental study was conducted on 70 mothers with children aged less than 5 years who referred to Community Health Centers of Shahid Beheshti University of Medical Sciences, Iran, in 2019. The subjects were selected through multistage random sampling and were randomly assigned to intervention (n = 35) and control (n = 35) groups. The data were collected using a two-part questionnaire for demographic characteristics and HBM constructs before, immediately after, and 45 days after the implementation of the risk management training program at a significance level of <0.05. Results: No significant difference was observed between the two groups before the intervention in terms of HBM constructs (p>0.05). However, they significantly differed between the intervention and control groups after the intervention. Moreover, scores of HBM constructs were significantly different immediately and 45 days after the intervention (p <.05). Conclusions: The study results showed the effectiveness of the HBM-based risk management training program; thus, it is essential to design and implement such programs in community health centers to prevent and reduce injuries caused due to home domestic accidents.

Protection Motivation Theory and Prevention of Breast Cancer: A Systematic Review.

Breast cancer is a global health problem with a high rate of incidence and annual death. The protection motivation model (PMT) is a health psychology theory that has been introduced to motivate health behaviors using coping appraisal and threat appraisal. We aimed to systematically review the applicability of PMT to predict and improve the knowledge and intention (the patient's intent to undergo breast cancer screening with self/clinical breast exam or mammography) for protective behaviors among women. A systematic search was performed in May 2022 in electronic databases to investigate the role of PMT in the prediction of protection behaviors in addition to improving the knowledge about the prevention of breast cancer using specific keywords. The relevant studies were then included for data extraction. Seventeen articles including 7 interventional and 10 prediction studies were selected for data assessment. Findings demonstrated that PMT could be used to predict the rate of knowledge and intention about breast cancer risk among women. It was also shown that PMT could be considered as a framework for the prevention of breast cancer by changing the behaviors of individuals by training the participants. Fear arousal, response efficacy, and response cost were found as the main determinants of knowledge and intention rate. PMT can provide a useful framework to evaluate the factors associated with women's intentions about breast cancer. Periodical educational programs should be implemented to improve protection behaviors by increasing the intention of women to regular self-examination.

Reducing care burden and improving adherence to health-promoting behaviors among family caregivers of patients with multiple sclerosis through a healthy lifestyle empowerment program.

BACKGROUND AND AIM: The chronic, progressive nature of multiple sclerosis (MS) demands long-term family-centered care for patients. In view of that, inadequate education and support provided for the family caregivers (FCGs) of MS patients increase their care burden (CB) and affect their lifestyle. This study aimed to investigate the impact of a healthy lifestyle empowerment program (HLEP) on CB and adherence to health-promoting behaviors (HPBs) in the FCGs of patients suffering from MS. METHODS: In this experimental study with parallel groups, conducted in Iran in 2020, a total of 60 FCGs of MS patients were recruited, and then randomized into intervention (n = 30) or control (n = 30) groups. The intervention program, the HLEP, was thus implemented virtually via WhatsApp in the intervention group upon coordinating with the MS Association in the city of Yasuj, Iran, and selecting the participants. The data were collected at three stages, including baseline, follow-up 1 (immediately after the HLEP), and follow-up 2 (three months after HLEP). The research tools were a 14-item demographic survey questionnaire, the 24-item Caregiver Burden Inventory, and the 52-item Health-Promoting Lifestyle Profile-II. Independent-samples t-test, repeated measures analysis of variance, and a linear mixed model were further used for statistical analyses, considering the significant level of 0.05. RESULTS: The study results revealed a significant decrease in the CB scores from the baseline to the follow-up 2 (77.03 ± 15.76 to 42.33 ± 12.37), and a significant increase in the values of adherence to HPBs from the baseline to the follow-up 2 (123.53 ± 14.01 to 148.06 ± 15.04) were obtained in the intervention group (p < 0.001). The linear mixed model also showed that the significant absolute changes in the scores of CB and adherence to HPBs during the follow-ups in the intervention group, compared to those in the controls, were - 8.92 and 16.47 units, respectively (p < 0.001). CONCLUSION: Health care managers, planners, and providers are highly recommended to start developing and implementing various HLEPs for reducing CB and improving adherence to HPBs among the FCGs of patients with MS.

The correlation between emotional intelligence and clinical competence in nurses working in special care units: A cross-sectional study.

BACKGROUND: Emotional intelligence and clinical competence are essential skills of the nursing profession to elevate the quality of nursing services and patient satisfaction. OBJECTIVES: This study aimed to determine the correlation between emotional intelligence and clinical competence in nurses working in critical care units of hospitals affiliated to Shahid Beheshti University of Medical Sciences. DESIGN: A cross-sectional study with a correlational design. SETTINGS: Special care units (SCUs) of hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. PARTICIPANTS: The research subjects included 200 nurses working in the Special care units SCUs of hospitals affiliated to Shahid Beheshti University of Medical Sciences, selected via convenience sampling. METHODS: Data were collected using three questionnaires, including a demographic information questionnaire, the Bar-On Emotional Quotient Inventory (EQ-i), and Benner's Nurse Competence Scale (NCS). The questionnaires were completed from October to December 2019. Data were analyzed using SPSS-18 software at a significance level of P < 0.05. RESULTS: The emotional intelligence of nurses participating in the study had the highest mean (SD) of 17.31(3.34) in the self-expression dimension and the lowest mean of 12.04(3.40) in the empathy dimension. There was a significant direct correlation between emotional intelligence and clinical competence (P = 0.05). There was also a significant relationship between the total clinical competence and its dimensions (P < 0.05). CONCLUSIONS: Communication skills and accountability significantly impact the provision of optimal care, and the proper training of staff in responsibility, accountability, and communication skills will have many benefits for promoting nursing services and can be considered one of the strategies to improve the quality of nursing services. They are therefore recommended to be considered in designing and implementing continuing education programs for nurses.

Challenges in Access to Support Resources for Diabetic Patients: A Qualitative Study in Deprived Areas of Iran.

OBJECTIVES: This study aimed to identify the perceptions of challenges in access to diabetes-related support resources among patients with type 2 diabetes and their family caregivers. METHODS: This qualitative study was conducted with 18 patients with type 2 diabetes and nine of their family caregivers, using the conventional content analysis method, in 2020 in Lorestan Province, Iran. The participants were selected through purposive sampling and the process continued until the data was saturated. Thirty semi-structured interviews, carried out from February to April 2020, were used to collect the data; they were analyzed using Graneheim and Lundman's content analysis (2004). RESULTS: The study showed two main categories of structural challenges (subcategories: shortage of skilled professionals and defects in executive processes) and destructive inefficiencies (subcategories: service bottlenecks, uncertain support, and irresponsibility of medical team), indicating the dimensions of the participants' perceptions of barriers to support. DISCUSSION: The findings of the study showed that barriers relating to the structure and function of healthcare organizations were among the most important challenges perceived by patients with diabetes when pursuing their care. However, there may be other barriers that have not been addressed due to the lack of support resources in deprived areas and the lack of awareness of patients.

The effect of peer support on quality of life among type 2 diabetic patients in deprived areas in Iran: A randomized clinical trial.

BACKGROUND: Quality of life (QOL) is one of the effective factors in promoting the health of diabetic patients. In recent years, the role of peer support in the optimal management of diabetes has gained increasing attention. However, contradictory results have been reported from the effectiveness of this method. This study aimed to investigate the effect of peer support on the QOL among type 2 diabetic patients in deprived areas. MATERIALS AND METHODS: This study was a randomized clinical trial conducted on 80 patients with T2D referring to the diabetes Clinic in Aligoudarz in Iran. Participants were randomly assigned into two groups of 40 patients. Intervention group received a peer Supportive-educational program for 3 months and the control group received routine clinic care. Diabetes QOL brief clinical inventory was used to collect the data. This questionnaire was completed three times at the beginning of the study, immediately after the 3-day training, and after 3 months of peer supportive intervention. The SPSS software (v. 18.0) was used to analyze the data through the Generalized Estimating Equations. RESULTS: There was no significant difference in mean QOL between the two groups before the intervention (P = 0.891) and immediately after the education (P = 0.076). However, after 3 months of intervention, the intervention group showed a significant improvement in mean QOL compared to those in the control group (P < 0.001). CONCLUSION: Peer support program can improve the QOL in type 2 diabetic patients in deprived areas. Therefore, this method can be recommended to improve care and educational programs in these patients.

Relationship between Health Literacy and Knowledge, Attitude, and Performance Regarding Cancer Warning Signs.

BACKGROUND: Health literacy (HL) is considered a cancer-preventive strategy. In addition, success in early diagnosis of cancer largely depends on individuals' knowledge, attitude, and performance regarding cancer warning signs. The aim of the present study was to investigate the potential relationship between HL and Knowledge, Attitude, and Performance (KAP) regarding cancer warning signs. MATERIALS AND METHODS: This descriptive-correlational study was conducted on 280 adults who were referred to 3 health centers in Tehran, Iran, from January to March 2020. Data were collected using the Health Literacy Instrument for Adults (HELIA) and the researcher-made KAP regarding cancer warning signs questionnaire. Data were analyzed using the Pearson correlation test and linear regression in an adjusted model in the statistical package for social sciences software. RESULTS: Total HL score was positively and significantly correlated with knowledge (r = 0.35; p < 0.001), attitude (r = 0.17, p = 0.003), and performance (r = 0.46, p < 0.001). Moreover, after controlling for potential confounders, a significant and positive relationship was found between HL and knowledge (ß = 0.48; t275= 4.45; p < 0.001), attitude (ß =0.17; t265= 4.64; p < 0.001), and performance (ß = 0.62; t265= 8.23; p < 0.001). CONCLUSIONS: It seems that adults' KAP regarding cancer warning signs can be promoted by increasing their HL. Therefore, greater attention should be paid to individuals' HL at community health centers when designing and performing programs to improve their KAP regarding cancer warning signs.

The predictors of nursing students' clinical competency in pre-internship objective structured clinical examination: The roles of exam anxiety and academic success.

BACKGROUND: Identifying the predictors of nursing students' clinical competency in objective structured clinical examination (OSCE) is of utmost importance. Therefore, the present study was to investigate the predictive roles of exam anxiety and academic success in nursing students' clinical competency in the pre-internship OSCE. METHODS: In this descriptive-analytical study, a total number of 102 nursing students, meeting the inclusion criteria and enrolled in the sixth semester (third year) of the graduate nursing program in Iran, were firstly selected by the census method. The pre-internship OSCE was then implemented at eight stations based on a pre-designed schedule template. The required data were also collected through a demographic-academic characteristics questionnaire and the State-Trait Anxiety Inventory to determine the exam anxiety score, the nursing program grade point average (GPA) to reflect on the levels of academic success, and the OSCE score to control clinical competency. The data analysis was also performed at the significance level of 0.05. RESULTS: The linear regression model, in which the exam anxiety, the nursing program GPA, and the demographic-academic characteristics variables had been imported, could explain 33.52% of the variance of the nursing students' clinical competency in the pre-internship OSCE (R2 = 0.616). Of the variables concerned, only the nursing program GPA could be a significant predictor of the nursing students' clinical competency scores in the OSCE, so that 0.8 points were added to the clinical competency scores in the OSCE as the nursing program GPA increased by one unit (p = 0.000, ß = 0.717), but no significant relationship was observed between exam anxiety and clinical competency in the pre-internship OSCE among the nursing students. CONCLUSIONS: The results of this study endorsed the use of the OSCE in assessing the nursing students' clinical competency and implementing learning strategies to strengthen the levels of academic success in such individuals.

Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model.

OBJECTIVE: There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS: Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS: The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS: The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.

Exploring the relationship between sexual function, sense of coherence, and well-being in a sample of Iranian breast cancer survivors.

PURPOSE: This study was aimed at exploring the type and role of relationships between sexual function, sense of coherence (SOC), and well-being in a sample of Iranian breast cancer survivors. METHODS: In this cross-sectional study with correlational design, data were collected from 181 survivors by consecutive sampling. They answered demographic and clinical information sheet, the SOC scale, the Female Sexual Function Index (FSFI), and the Health Index (HI). The data were analyzed using SPSS version 20. RESULTS: The mean age of survivors was 47.04 ± 9.05 years. Most survivors were menopausal (51.9%) and underwent mastectomy (69.1%), and 12 months or more had passed since their treatment ended (71.2%). Sexual function was positively correlated with the level of SOC (r = 0.20) and the HI (r = 0.33). Also, there was a positive correlation between the level of SOC and the HI (r = 0.51). The results of logistic regression analyses showed the protective role of the SOC (OR: 0.95; 95% CI: 0.92-0.97) and the HI (OR: 0.87; 95% CI: 0.79-0.96) for women's sexual function. According to these results, the mediating role of the SOC was assessed between the variables of the HI and the FSFI. The SOC revealed a complete mediating effect in this relationship. CONCLUSIONS: The mediator role of the SOC between survivors' well-being and their sexual function helps nurses and clinicians to understand how the SOC can be used as a screening test to detect survivors who are at risk of sexual problems and to plan for salutogenic interventions.

Relationship between electronic health literacy, quality of life, and self-efficacy in Tehran, Iran: A community-based study.

BACKGROUND: The concept of electronic health literacy has become a main focus of health-care professionals along with the increasing use of the Internet. In Iran, the Internet not yet has much impact on providing health services, and the physicians' and patients' community are now more willing to use the traditional method for diagnosing disease and prescribing medicines. This study aimed to determine the correlation between electronic health literacy, quality of life (QoL), and self-efficacy among Tehran citizens. MATERIALS AND METHODS: The present study is a descriptive, cross-sectional study with a correlation approach that was conducted on 400 clients of community health centers of Shahid Beheshti University of Medical Sciences in 2019. Samples were selected by stratified random sampling method. Data were collected using E-Health Literacy Questionnaire (α = 0.88), 12-item Short-Form Health Survey (α = 0.73), and General Self-Efficacy Scale (α = 0.87). Analytic statistics were using by descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation coefficient and regression analysis) at the significant level (P < 0.05). RESULTS: Correlation between electronic health literacy and QoL was 0.14 and with self-efficacy was 0.10, which was positive and statistically significant (P < 0.05). In addition, the correlation between QoL and self-efficacy was 0.33, which was positive, statistically significant, and moderate (P < 0.05). CONCLUSION: According to the findings of this study, it is possible to improve the QoL through the promotion of electronic health literacy and self-efficacy. The results of this study can be used as a basis for health service providers and policymakers in designing and implementing health-related interventions.

An Analytical Comparison of Knowledge, Attitudes, and Practices Regarding HIV/AIDS Among Medical and Non-Medical Students in Iran.

BACKGROUND AND OBJECTIVES: Young people are the main group at risk of HIV/AIDS due to factors such as curiosity, peer pressure, lack of knowledge and skills, unsafe sexual behaviors, and drug abuse. The present study was conducted to compare the knowledge, attitudes, and practices regarding HIV/AIDS among medical and non-medical students in Iran. METHODS: This cross-sectional descriptive-analytical study was conducted on a population consisting of the students of Shahid Beheshti University (SBU) and Shahid Beheshti University of Medical Sciences (SBMU). A total of 303 students were randomly selected from the two universities. Data were collected using a researcher-made HIV/AIDS knowledge, attitude, and practice questionnaire. Data were then analyzed using the independent t-test, Mann-Whitney's U-test, the ANOVA, and the Kruskal-Wallis test in SPSS-18. P<0.05 was set as the level of significance for all the tests. FINDINGS: The frequencies of marital status, education, smoking, alcohol and psychotropic substance use, employment status, and source of information differed significantly between the medical and non-medical students. There was a significant difference between the two groups regarding knowledge (P<0.001) and practice (P=0.019) regarding HIV/AIDS. Meanwhile, there was no significant difference between the two groups in terms of their attitude toward HIV/AIDS (P=0.503). The results of the ANOVA revealed a significant correlation between marital status and practice (P=0.022), education and attitude (P=0.004), and smoking and knowledge (P=0.008) among the medical students. Meanwhile, there was no significant difference between the demographic variables and knowledge, attitudes and practices regarding HIV/AIDS among the non-medical students (P>0.005). CONCLUSION: The present findings showed that designing and developing appropriate educational programs, offered through group media, scientific seminars, courses, lectures, and group discussions, can be effective in enhancing the students' knowledge and changing their attitudes and should be incorporated into healthcare programs.

Predictors of Health-Promoting Lifestyle in Pregnant Women Based on Pender's Health Promotion Model.

BACKGROUND AND OBJECTIVES: Pregnancy causes changes in women's lifestyle; therefore, their health-promoting behaviors should be improved in order to avoid problems during this critical period, which requires knowledge of the factors affecting these behaviors. This study was conducted to determine the predictors of health-promoting lifestyles in pregnant women based on Pender's health promotion model constructs. METHODS: This descriptive study was carried out on 300 pregnant women in their second and third trimesters of pregnancy and sought to determine the correlation between lifestyle and the constructs of Pender's health promotion model. Data were collected using a demographic questionnaire, the Health Promoting Lifestyle Profile II (HPLP-II) and a questionnaire based on Pender's model constructs. Data were analyzed using descriptive and analytical statistics. FINDINGS: A health-promoting lifestyle had a significant positive correlation with the constructs of social support and perceived benefits and a significant negative correlation with the construct of perceived barriers (P<0.05). A health-promoting lifestyle also had a significant relationship with the constructs of perceived barriers, social support and perceived benefits in pregnant women (P<0.05) based on the results of the regression analysis. The regression coefficients showed that all the three variables can significantly explain the variance in health promoting lifestyles in pregnant women (P<0.05). CONCLUSION: According to the results of the present study and based on the constructs of Pender's health promotion model, social support, perceived benefits and perceived barriers were the most important predictors of health-promoting lifestyles in pregnant women. These predictor constructs are recommended to be further considered in designing and implementing training packages and interventions for promoting pregnant women's lifestyle.

Health-related quality of life and related factors among pregnant women.

CONTEXT: Quality of life is significant in all stages of life, including within pregnancy. The hormonal, emotional, psychological, and physical factors specific to pregnancy can affect and threaten the quality of life of pregnant mothers. AIMS: This study sought to investigate the health-related quality of life (HRQoL) and related factors among pregnant women. SETTINGS AND DESIGN: This cross-sectional study was performed on 300 pregnant women who were in the second and third trimesters of pregnancy without any risk of high-risk pregnancy covered by a community health center in Yazd, Iran, between 2018 and 2019. SUBJECTS AND METHODS: The required data were collected using demographic questionnaire and HRQoL (SF-12v2) questionnaire. STATISTICAL ANALYSIS USED: Data were analyzed using SPSS 18 software and ANOVA statistical tests (P < 0.05). RESULTS: Physical dimension of quality of life of pregnant women had the mean and standard deviation of 43.7 ± 7.3 and that psychological dimension had the mean and standard deviation of 31.5 ± 11.8. Physical dimension of quality of life was significantly correlated with maternal age, gestational age, body mass index before 12 weeks of pregnancy, mother's education and job as well as spouse's level of education (P < 0.05). Furthermore, the psychological dimension of quality of life was significantly correlated with gestational age, mother's education and occupation as well as spouse's level of education (P < 0.05). CONCLUSIONS: According to the findings, attention to physical and psychological aspects of quality of life of pregnant women and demographic factors affecting it is essential for improving maternal and child health during and after pregnancy.

The Concept of Successful Aging: A Review Article.

BACKGROUND: With the increasing number of elderly people in the world, usage of concepts and terminology related to this phenomenon has substantially increased. One concept in this context is successful aging. The purpose of the present study is to extract and introduce a common concept to be used in studies on measuring successful aging. METHODS: This is a review study. First, by searching the databases of Magiran, Noormags, Medlib, Irandoc, Iranmedex, Barakat Knowledge Network System, Civilica, SID, ISI Web Of Science, PubMed, Scopus, Science Direct and search engines, Google Scholar and Elmnet as well as using standard keywords such as elder, elderly, aging, and successful aging, all related published articles during the period 1995 to 2017 were retrieved. A total of 3417 documents were retrieved. By removing 3390 unrelated, duplicate and unusable documents, 27 articles were included in the study after quality control. RESULTS: The findings of the study were categorized in three areas: "defining successful aging by focusing on dimensions", "successful aging principles" and "factors influencing successful aging". Reviewing various studies, we found that the definition of successful aging deals with cognitive action, perception, control, life satisfaction, and ethics. Successful aging is also defined as having inner feelings of happiness and satisfaction with life for the present and the past. Sometimes successful aging is also considered to be survival with health. CONCLUSION: Health care professionals as community health supporters can use the results from the present study for providing the grounds for successful aging. Then, they can use the designed successful aging program for preserving and promoting active and healthy aging for every elderly person in old age.

Health Belief Model-based Intervention on Women's Knowledge and Perceived Beliefs about Warning Signs of Cancer.

OBJECTIVE: Early detection of cancers essentially depends on knowledge of the warning signs. This study, therefore, aimed at investigating the effect of Health Belief Model (HBM)-based educational intervention on the knowledge and perceived beliefs of women about the warning signs of cancer. METHODS: This experimental study with intervention (n = 80) and control (n = 80) groups was performed at four urban health centers affiliated to the university. Data collection was done in two phases, before and one month after the educational intervention, using three instruments, a demographic-clinical information questionnaire, the awareness questionnaire on cancer warning signs, and the cancer warning signs-HBM questionnaire. RESULTS: The results of the multivariate repeated-measures analyses of variance indicated that the hypothesis of this study was confirmed. It means that "women's knowledge and their perceived beliefs of cancer warning signs" improved after HBM-based educational intervention in the intervention group, compared to the controls over time. Thus, the "level of knowledge" and perceived beliefs of the women in the intervention group compared to the controls increased, in terms of perceived "sensitivity," "severity," "benefits," "barriers," "cue to action," and "self-efficacy" over time (P < 0.001). CONCLUSIONS: It could be hoped that this intervention would be effective for improving the performance of women in health-promoting behaviors of cancer prevention. It is recommended that health-care providers plan for HBM-based educational interventions, based on educational needs of the target groups at different community levels.

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial.

BACKGROUND: Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. METHODS: This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). RESULTS: The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sß) showed that the intervention had the highest impact on increase social support (Sß=0.80, ß=48.64, SE=1.70, P<0.05), self-efficacy (Sß=0.76, ß=13.32, SE=0.52, P<0.05) and health promoting behaviors (Sß=0.48, ß=33.08, SE=2.26, P<0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sß=-0.406, ß=-0.340, SE=0.03, P<0.05), and through social support, self-efficacy, and health promoting behaviors. CONCLUSION: Educational interventions can be effective in preventing elder abuse.

Correlation between social support, self-efficacy and health-promoting behavior in hemodialysis patients hospitalized in Karaj in 2015.

BACKGROUND: In hemodialysis, as a choice of treatment due to long treatment duration, the patient encounters limitations. Perceived social support, perceived self-efficacy and health promoting activities are important strategies to facilitate and maintain their health. AIM: To determine the correlation between social support, self-efficacy and health promoting behaviors in hemodialysis patients hospitalized in Karaj city in 2015. METHODS: This cross-sectional descriptive correlational study was carried out on 200 hemodialysis patients who were selected from four hospitals in Karaj based on cluster sampling. Data were collected using these methods: "General Questionnaire", "Perceived Self-Efficacy Scale", "Multidimensional Perceived Social Support Scale" and "Health-Promoting Lifestyle Profile 2". Data were analyzed by SPSS version 22 and the EQS 6.1. Independent t-test, Mann-Whitney U, Kruskal-Wallis test, spearman correlation coefficient was used to analyze the data. To determine the relation between perceived self-efficacy, perceived social support and health promoting behavior, structural equation modeling was applied. RESULTS: Self-efficacy has a significant positive correlation with social support (r=0.592, p<0.001) and significant negative correlation with health-promoting behaviors (r=-0.709, p<0.001), and social support has a significant negative correlation with health-promoting behaviors (r=-0.709, p<0.001). Also, results showed that perceived self-efficacy had a greater role than perceived social support in explaining health-promoting behaviors. CONCLUSION: The relationship between health promoting behaviors, self-efficacy and social support reveals a necessity for Community Health Nursing planners, matrons and hospital managers and nurses to pay more attention to the needs of patients under hemodialysis. It is recommended that due to some unexpected findings in this study, further studies shall be fulfilled on the factors effective on the discussed variables.