The effects of a hospital-to-home care transition program on perceived stress and readiness for hospital discharge in mothers of children with congenital heart disease undergoing corrective surgery.

BACKGROUND: The aim of this study was to investigate the effects of a hospital-to-home care transition (H2H-CT) program on perceived stress and readiness for hospital discharge (RHD) in mothers of children with congenital heart disease (CHD) undergoing corrective surgery. METHODS: This study used a quasi-experimental design and involved 78 mother-child dyads, 40 dyads in the intervention group and 38 dyads in the control group, who were affected by CHD undergoing corrective surgery. The participants received the H2H-CT program, which consisted of six face-to-face training sessions during hospitalization and six telephone counselling sessions. For perceived stress, data were collected at four intervals, including baseline, immediately, one month and three months after completion of the intervention. For RHD, data were collected at two times: baseline and immediately after the intervention. RESULTS: The results demonstrated a statistically significant reduction in the mean perceived stress score in mothers of children with CHD in intervention group before, immediately, four weeks and eight weeks after H2H-CT (P < 0.001). The results also indicated a significant increase in the mean RHD score in the intervention group following H2H-CT (P < 0.001). CONCLUSION: The H2H-CT program was found to be an effective intervention in reducing perceived stress and increasing RHD in mothers of children with CHD who undergoing corrective surgery. IMPLICATIONS TO PRACTICE: The results can be used by the nursing planners, nursing instructors, and pediatric nurses to use the results to enhance the mental health of mothers and enable them to provide quality care at home.

A Protection Motivation Theory-Based Empowerment Intervention for Promoting Health Behaviors in Women With Human Papillomavirus: An Experimental Study.

ABSTRACT: This experimental study on 70 women with human papillomavirus, referred to the specialized obstetrics and gynecology clinics of public hospitals in Iran in 2021, revealed that implementing the protection motivation theory-based empowerment intervention could promote their health behaviors.

Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study.

BACKGROUND: This study aimed to investigate the effect of a family-centered empowerment program on hyperphosphatemia management. METHOD: This experimental study was performed on 80 randomly selected eligible patients with hyperphosphatemia undergoing hemodialysis. Patients were assigned randomly to two groups of family-centered empowerment program (FCEPG) and control group (CG) by coin toss (40 people per group). Data collection tools were the researcher-made Phosphate Control Knowledge Scale, the researcher-made Adherence to Dietary Restriction of Phosphorus Intake Scale, the eight-item Morisky Medication Adherence Scale, and serum phosphorus measurements. Data were collected before the intervention, one month, and three months after the intervention. Patients in FCEPG participated in a family-centered empowerment program. The statistical significance level was considered to be 0.05. RESULTS: Inter-group comparisons showed no significant difference between FCEPG and CG in terms of the mean score of knowledge of phosphate control, adherence to dietary restriction of phosphorus intake, adherence to medication, and the mean serum phosphorus level before the empowerment program, but showed significant differences between them in these respects at one month after the program and three months after the program (p < 0.05). Intra-group comparisons showed a significant difference in FCEPG between the mean and standard deviation of all four variables before the empowerment program and the corresponding values one month and three months after the program (P < 0.05). CONCLUSION: The findings of this study can be used in various fields of healthcare in the hospital and community.

Explaining of existing challenges of community-based undergraduate nursing education in Iran: a qualitative study.

BACKGROUND: The education of nursing students should be such that the health needs of the community are met, but in Iran, due to some problems, students do not receive such education. Therefore, the present study was conducted to explain the existing challenges of community-based undergraduate nursing education in Iran. METHODS: Ten individual semi-structured interviews were conducted with the faculty members and nursing specialists in this qualitative study. Eight focus group interviews were conducted to the nurses and nursing students using a purpose-based sampling method in 2022. The interviews were recorded and transcribed and then content analysis was done by the Lundman and Granheim method. RESULTS: Five themes were obtained from the analysis of participants' responses, which include "weakness in community-based nursing education and curriculum", "treatment-oriented health system and education", "defect in the infrastructure and basic structures of community-based nursing education", "weakness in the implementation of community-based nursing education" and "weakness in the stakeholder engagement and cooperation of interested organizations". CONCLUSION: Interviews with the participants provided a vision of the challenges of community-based nursing education so that the reviewers of the undergraduate nursing curriculum in the ministry and nursing schools, educators, policymakers and nursing managers can use the results of the present study to improve the quality of education and the effective use of nursing students in responding to the community's needs and provide a proper context for improving students' learning.

Community-based nursing: a concept analysis with Walker and Avant's approach.

BACKGROUND: Community-based nursing in recent years has received much attention from nursing schools in different countries as a suitable solution in response to existing and future problems and challenges, but there is yet no comprehensive and correct understanding of this concept and considering its importance, the present study was conducted to the aim of analyzing the concept of community-based nursing. METHODS: Concept analysis was done using Walker and Avant's 8-step approach. Nursing dictionary, Persian dictionary, research articles, journals and conferences articles, dissertations, thesis, books, and other sources related to the concept of research were investigated through search engines and available databases using the keywords of nursing, community-based, concept analysis and Walker and Avant from 1990 to 2023. Finally, 54 articles related to the concept were reviewed and analyzed. RESULTS: The results showed that community-based nursing has attributes such as individual-oriented/ family-oriented/ community-oriented, social partnership with the communities and stakeholders, social justice, and group and interprofessional cooperation, the community as the main activity setting, providing services based on cultural diversity, providing services according to the context, conditions and community needs, caring for individuals and families with health problems throughout life, responding to the community needs, community-based experiences and facing real-life issues in the context of community, using a problem-based and service-based approach, providing context-based care and considering factors affecting health. In this regard, borderline and related cases (community health nursing, community-oriented nursing, population-based nursing, and public health nursing) were also presented to clarify the concept. Antecedents of community-based nursing included: determining the position of community-based nursing, making infrastructure and structure, the partnership between university, hospital and community, identifying all settings, the presence of educators proficient in education, survey of community needs, having knowledge, communication and community-based skills, expanding the role of the nurse, stakeholders' attitude towards community-oriented nursing and management and financial support. Consequences of community-based nursing included: competence development in nurses, solving community-based nursing challenges, meeting the health needs of individuals, families and communities, social justice, and increasing access to health care services. CONCLUSION: The results of this study can provide an objective and understandable image of the use of community-based nurses and their education in practice. Conducting more quantitative and qualitative studies about community-based nursing is also recommended.

Developing and validating the nursing presence scale for hospitalized patients.

AIM: We developed and psychometrically tested the Nursing Presence Scale. BACKGROUND: Nursing presence is a foundation for professional nursing practice; therefore, it is critical to measure this concept. INTRODUCTION: This instrument development study was designed to generate an itemized scale and psychometric testing using a sample of Iranian patients. METHODS: Based on both a concept development and literature review, and finally face and content validity 44-item draft scale was generated. During November 2018-2019, 774 patients were surveyed. Exploratory and confirmatory factor analyses were used to evaluate the scale's construct validity; concurrent and predictive reliability of the nursing presence scale were also evaluated. We also examine the weighting to scale items. RESULTS: The analyses yielded a 36-item, 4-factor scale that adequately fit the data. Cronbach's alpha coefficient for the whole instrument was 0.94. The intra class correlation coefficient was 0.91. Nursing Presence Scale scores were positively correlated with Revised Humane Caring Scale and predicted 25% of missed nursing care. CONCLUSION: This 36-item has good reliability and validity, making it useful for measuring the current condition of nursing presence. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Measuring the frequency of nursing presence allows for data-driven planning and upgrading the inpatient care services.

Development and psychometric properties evaluation of caregiver burden questionnaire in family caregivers of hemodialysis patients.

BACKGORUND: This study aimed to design and psychometrically evaluate the caregiver burden questionnaire for family caregivers of hemodialysis patients. METHODS: This study was conducted using an exploratory sequential mixed method on family caregivers of hemodialysis patients in Iran. In the first phase, the generation of the items was done based on results of directed qualitative content analysis according to the Structural model of the caregiver burden and review of the literature. After developing the item pool, face and content validity, item analysis, structural, convergent and discriminant validity, internal consistency, reliability, interpretability, and feasibility were evaluated. RESULTS: The primary tool entered the psychometric evaluation phase with 64 items. After performing face and content validity and item analysis, the number of items was reduced to 28. Exploratory factor analysis was performed with 28 items and 300 caregivers, and finally, four subscales with 21 items were developed. The results of confirmatory factor analysis indicated a good fit of the model. Cronbach's alpha and the Intraclass Correlation Coefficient of all subscales were higher than 0.7 and 0.9, respectively. The standard error of measurement was 1.39. All subscales had acceptable values in convergent validity criteria and the HTMT index less than the threshold value. The total score of the questionnaire had no ceiling and floor effect; the percentage of unanswered items was within the acceptable range. CONCLUSION: The results show that the caregiver burden questionnaire for caregivers of patients undergoing hemodialysis has good psychometric properties and can measure the caregiver burden in these caregivers.

Caregiver burden in Iranian caregivers of patients undergoing hemodialysis: a qualitative study.

So far, limited studies have investigated the caregivers of hemodialysis patients and the concept of caregiver burden from their own perspective. The present study aimed to explore the issue of caregiver burden among family caregivers of patients undergoing hemodialysis. A total of 21 family caregivers, patients, and formal caregivers were enrolled using the purposive sampling method. In-depth, semi-structured interviews were conducted to collect the data. For data analysis, a directed qualitative content analysis method was applied. Finally, five dimensions of caregiver burden were extracted, including physical, psychological, emotional, spiritual, financial, social, and time-dependent burdens.

Improving health-related quality of life and adherence to health-promoting behaviors among coronary artery bypass graft patients: a non-randomized controlled trial study.

PURPOSE: This study aimed to determine the impact of a healthy lifestyle empowerment program on health-related quality of life and adherence to health-promoting behaviors in coronary artery bypass graft patients. METHODS: This non-randomized controlled trial was conducted in 2019 on 97 coronary artery bypass graft patients in Iran. Participants were selected by culturally pragmatic and non-randomized method and assigned to healthy lifestyle empowerment program group (HLEPG) (n = 49) and conventional education group (CEG) (n = 48). Data were collected by the 12-item short-form health survey (SF-12) and health-promoting lifestyle profile II (HPLP2), which were administered at baseline and three-month follow-up. The healthy lifestyle empowerment program and conventional education as two interventions were performed for HLEPG and CEG, respectively. Data analysis was performed using the paired t-test, independent t-test, analysis of covariance and linear mixed method at the 0.05 significance level. RESULTS: In the follow-up, both groups showed a significant increase in the mean score of health-related quality of life (p ≤ 0.001) but this increase was visibly greater in the HLEPG (from 23.47 ± 7.48 to 35.60 ± 5.95) than in the CEG (from 22.93 ± 5.93 to 27.6 ± 4.90). The healthy lifestyle empowerment program also significantly increased the mean score of adherence to health-promoting behaviors in the HLEPG (p ≤ 0.001), whereas no such change was observed in the CEG. The results of the linear mixed model showed that the follow-up scores health-related quality of life and adherence to health-promoting behaviors of the HLEPG were 27.26 and 7.56 units significantly greater than the CEG after HLEP, respectively (p < 0.001). CONCLUSION: Considering the results of this study, health care providers are recommended to devise and implement healthy lifestyle empowerment programs to improve the health-related quality of life of coronary artery bypass surgery patients. CLINICAL TRIAL REGISTRATION: Registered at Iranian Registry of Clinical Trials (IRCT20171213037860N1).

Components of quality of life in hemodialysis patients from family caregivers' perspective: a qualitative study.

BACKGROUND: Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients' quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients' disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers' perspective. METHODS: In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas' method. RESULTS: A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). CONCLUSION: Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients' quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients' quality of life and even reduce the caregivers' burden.

Effect of community-based education on undergraduate nursing students' skills: a systematic review.

BACKGROUND: Community-based education, as an effective approach to strengthen nurses' skills in response to society's problems and needs has increased in nursing education programs. The aim of this study was to review the effect of community-based education on nursing students' skills. METHODS: For this systematic review, ProQuest, EMBASE, Scopus, PubMed/ MEDLINE, Cochran Library, Web of Science, CINAHL and Google Scholar were searched up to February 2021. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Seventeen studies were included in this systematic review. Inclusion criteria included articles published in English and were original articles. RESULTS: In all studies, undergraduate nursing students' skills were improved by participation in a community-based education program. Community-based education enhances professional skills, communication skills, self-confidence, knowledge and awareness, and critical thinking skills and teamwork skills in undergraduate nursing students. CONCLUSIONS: Community-based education should be used as an effective and practical method of training capable nurses to meet the changing needs of society, to improve nurses 'skills and empower them to address problems in society.

The effect of family-centered empowerment program on the family caregiver burden and the activities of daily living of Iranian patients with stroke: a randomized controlled trial study.

Dependence of stroke survivors regarding the ability to perform activities of daily living imposes a burden on family caregivers. The study evaluated the effect of the family-centered empowerment program on the ability of Iranian patients with stroke to perform activities of daily living, as well as on family caregiver burden. In this randomized controlled trial study, a total of 90 pairs of patients with stroke and their family caregivers was selected and randomly assigned to the intervention or control groups. Patients and their family caregivers participated in four family-centered empowerment program sessions over four consecutive days while the patient was hospitalized. The difference in the ability of patients with stroke in the intervention and control groups to perform activities of daily living was not significant 2 weeks after the intervention. However, the ability of patients with stroke in the intervention group to perform activities of daily living increased significantly 2 months after the intervention compared with the control group: 66 ± 35.95 and 51.31 ± 36.28, respectively (p = 0.047). Two weeks after the intervention, the family caregiver burden significantly decreased in the intervention group (29.55 ± 15.38) compared with the control group (38.77 ± 18.53 and p = 0.012). The burden in the intervention group also decreased 2 months after the intervention compared with the control group: 22.95 ± 15.68 and 36.11 ± 18.88, respectively (p < 0.001). Nurses can use the family-centered empowerment program to improve the quality of life of patients with stroke, and to reduce the burden of family caregivers.

An explanatory study on the concept of nursing presence from the perspective of patients admitted to hospitals.

AIMS AND OBJECTIVES: To clarify the concept of nursing presence through patients' perception. BACKGROUND: The holistic caring process at the bedside must incorporate the concept of nursing presence. Most of the research about nursing presence is based on nurses' experiences, and research into patients' experiences is minimal. According to goals of patient centredness, the association between the patient satisfaction and nursing presence, and patients' ability to understand this concept, it is important to explore this concept from the patients' perspective. DESIGN: A qualitative approach. METHODS: Based on purposive sampling technique, 12 patients were recruited. After participant observation, 15 interviews were carried out with participants. Data were transcribed verbatim and analysed using conventional qualitative content analysis. RESULTS: Five main categories were drawn from the data including informed concentration, task-centred/patient-centred relationship, clarification of meanings, comprehensive participation and accountable encounter. Data analysis alongside the authors' reflections resulted in the emergence of one overarching theme, 'coconstructed interaction', which shows the notion that effective nurse-patient interaction enhances cooperation, coordination and collaboration in caring and improves nursing outcomes. CONCLUSIONS: Accordingly, the nursing presence would be ideal for patient-centred caring. RELEVANCE TO CLINICAL PRACTICE: Knowing the perspectives of patients is important as the evaluation of nursing care quality should rely on outcome indicators that are sensitive to patients. For instance, client satisfaction and health status acceptance, especially as it relates to coping, comfort level, hope, and participation in decision-making, are included in the nursing outcomes' classification system. Thus, the findings of this study may facilitate improvement in the quality of care by continuous improvement in knowledge, attitudes and abilities of nurses. It is therefore recommended that managers and clinical nurses, by relying on these findings, design the caring activities so that nurses' presence can act as a facilitating factor for improving quality assurance.

Exploring the Impacts of Caring for Hospitalized COVID-19 Patients on Nurses: A Qualitative Descriptive Study.

Background: The impacts of caring for hospitalized COVID-19 patients on nurses are wide and varied and have not been comprehensively explained in the existing literature. The aim of this study was to explore the nurses' perception of the impacts of caring for hospitalized COVID-19 patients. Materials and Methods: In this qualitative descriptive study, data were collected via semi-structured interviews with 20 nurses and head nurses of emergency/internal wards and Intensive Care Units (ICUs) of 2 hospitals in Tehran, Iran. The purposive sampling method was used, and data analysis was performed using a conventional content analysis approach. Results: After data analysis, 12 subcategories, 3 main categories, and 1 theme (professional resilience) were extracted. The three main categories included "complex care," "professional development," and "caring self-efficacy." Caring for hospitalized COVID-19 patients was complex for nurses; however, the care provided to these patients could also lead to the nurses' professional development and caring self-efficacy. Conclusions: Health organizations and nursing managers can better manage the COVID-19 pandemic and other similar future crises through strategies such as providing nurses with adequate and diverse resources and facilities, encouraging and supporting nurses in various dimensions, providing positive media advertisements for the nursing profession and nurses, and providing nurses with necessary and applicable knowledge and skills.

Theoretical definition of nurse-conscious mechanically ventilated patient communication: a scoping review with qualitative content analysis.

Providing critical nursing care for conscious mechanically ventilated patients is mediated via effective communication. This study aimed to identify and map the antecedents, attributes, consequences, and definition of nurse-conscious mechanically ventilated patient communication (N-CMVPC). This scoping review was conducted by searching the Cochrane Library and the CINAHL, EMBASE, PubMed, Web of Science, and Scopus databases, between 2001 and 2021. The keywords queried included "nurses," "mechanically ventilated patients," "mechanical ventilation," "intubated patients," "communication," "interaction," "relationships," "nurse-patient communication," "nurse-patient relations," "intensive care units," and "critical care." Studies related to communication with healthcare personnel or family members were excluded. The results indicated that N-CMVPC manifests as a set of attributes in communication experiences, emotions, methods, and behaviors of the nurse and the patient and is classified into three main themes, nurse communication, patient communication, and quantitative-qualitative aspects. N-CMVPC is a complex, multidimensional, and multi-factor concept. It is often nurse-controlled and can express itself as questions, sentences, or commands in the context of experiences, feelings, and positive or negative behaviors involving the nurse and the patient.

Nursing Assessment of Vascular Complications after Cardiac Catheterization through the Distal Radial Artery.

Background: Distal Radial Artery (DRA) is a new arterial access for coronary catheterization. Assessment of the vascular complications of this new procedure is important in the provision of nursing care to cardiac patients. The aim of this study was the nursing assessment of vascular complications of DRA in angiography and angioplasty. Materials and Methods: This qualitative longitudinal study was conducted on 315 consecutive patients who were candidates for coronary catheterization via DRA from 2017 to 2020 in three hospitals in Tehran, Iran. Patients who had palpable DRA and were capable and willing to consent to inclusion in the study were evaluated. Moreover, patients whose DRA access failed, and those who had previously undergone coronary artery bypass graft were excluded from the study. Vascular complications were assessed on the day of the procedure and about 1 month later. Results: After the procedure, 29 cases of ecchymosis, 8 cases of hematoma, and 1 case of arteriovenous fistula in the DRA were observed. We did not observe any major vascular complications. Conclusions: Nursing assessment of the snuffbox area indicated that this approach is a safe and convenient technique for cardiac catheterization with few minor complications.

The effect of educational program based on the clinical practice protocol on treatment adherence, self-efficacy and quality of life of patients undergoing coronary artery bypass graft surgery.

BACKGROUND AND AIM: Educating the patients undergoing coronary artery bypass graft (CABG) before and after surgery is one of the most important factors for success in this surgery, as it improves their treatment adherence, self-efficacy, and quality of life. The aim of this study was to determine the impact of the educational program based on clinical practice protocol upon treatment adherence, self-efficacy, and quality of life of patients undergoing CABG surgery in Tehran, Iran, during the period 2021-2022. MATERIALS AND METHODS: This experimental study was conducted on 100 patients who were undergoing CABG and were hospitalized in a public hospital (Shahid Modarres Educational Hospital) in Tehran, Iran, in 2021-2022. Patients were randomly assigned to intervention (n = 50) and control (n = 50) groups. Four questionnaires (demographic-clinical questionnaire, Modanloo's adherence to treatment questionnaire, Sullivan's self-efficacy questionnaire, and McNew's quality of life questionnaire) were completed by both intervention and control groups before and 1 month after the educational intervention. The intervention group received an education program based on the clinical practice protocol. Data were analyzed using descriptive and inferential methods in Statistical Package for the Social Sciences (SPSS) 22 software. RESULTS: The results of the study showed that the intervention and control groups were similar in terms of demographic and clinical characteristics. The average scores of treatment adherence, self-efficacy, and quality of life 1 month after the intervention were significantly higher in the intervention group compared to the control group. Also, the average scores of treatment adherence, self-efficacy, and quality of life were significantly higher 1 month after the intervention than before in the intervention group (P < 0.001). CONCLUSIONS: The results of this study showed that education program based on the clinical practice protocol can be effective and useful for increasing the level of treatment adherence, self-efficacy, and quality of life of patients undergoing CABG.

Comparison of the Effect of the Person-Centered and Family-Centered Training via Telenursing on the Quality of Life in COVID-19 Patients.

Background: Education of the patients with Coronavirus Disease 2019 (COVID-19) and their families is necessary to improve the quality of life. This study investigated the effect of person and family-centered training via telenursing on the quality of life in patients with COVID-19. Methods: This interventional study was performed on 88 patients with COVID-19 18--65 years and 44 family members referred to the Bank Melli Hospital, Tehran, Iran. The samples were randomly assigned into two groups person-centered and family centered. A cyberspace group including patients and their families was created. Four educational sessions planned (15--30-min-every day) and three sessions planned for completing the questionnaires via phone. The data were collected using demographic characteristics form and the 12-item Short-Form Health Survey version 2 before and 6 weeks after the intervention and were analyzed in SPSS 22 using Chi-square test, paired t-test, and independent t-test. Results: The mean scores of quality-of-life increased significantly in the person-centered group from 26.81 ± 5.15 to 34.4 ± 4.39 before and six weeks after intervention, respectively (p < 0.001). The means scores of quality-of-life increased significantly in the family-centered group from 28.11 ± 4.79 to 35.86 ± 3.85 before and 6 weeks after the intervention, respectively. (p < 0.001). Conclusions: The person and family centered methods increase the mean scores of quality-of-life of patients with COVID-19. The family centered method can be more effective to improve the quality of life of these patients.

Protection Behaviors and Related Factors Against COVID-19 in the Healthcare Workers of the Hospitals in Iran: A Cross-Sectional Study.

Background: Protective behaviors play a key role in reducing the incidence of COVID-19 in HealthCare Workers (HCWs), and these behaviors are related to other factors. These related factors have not been comprehensively evaluated and determined in the literature. This study aimed to determine protection behaviors against COVID-19 and their related factors using the Protection Motivation Theory (PMT) among HCWs of hospitals in Tehran, Iran, in 2021. Materials and Methods: For this cross-sectional study, 270 HCWs of different wards in 3 hospitals in Tehran, Iran, were selected through multistage sampling (April to July 2021). The participants completed a self-reporting questionnaire which consisted of a demographic characteristics form and questions about protective behaviors against COVID-19 and other constructs of the PMT (60 items). Data analysis was performed using descriptive and inferential methods. Results: The mean score of the protective behaviors of the HCWs was 4.20 (SD = 0.56) and was significantly higher in the nurses, women, married individuals, and those with a BSc degree compared with others (p < 0.05). Furthermore, the results of multiple regression analysis showed that protection behavior among HCWs could be strongly predicted by the type of profession, protection motivation/intention, and self-efficacy constructs (F14, 255 = 16.34, p < 0.001). Conclusions: The protection behaviors of HCWs against COVID-19 were relatively desirable and these behaviors were related to and predicted by various factors. These results could apply to developing plans for protective behaviors against COVID-19 and possibly other infectious diseases among HCWs. Further research in this regard is recommended.

The predictors of COVID-19 preventive health behaviors among adolescents: the role of health belief model and health literacy.

Aim: The present study aimed to evaluate the predictive role of the Health Belief Model (HBM) constructs and health literacy (HL) in shaping the coronavirus disease 2019 (COVID-19) preventive health behaviors (PHBs) among adolescents. Methods: This cross-sectional study was conducted with 503 adolescent girls and boys, randomly selected via cluster sampling. For this purpose, the data were collected online through four research tools, including the demographic-clinical characteristics information questionnaire, the COVID-19 PHB Scale based on HBM, and the Health Literacy Scale for COVID-19. The data analysis was then performed by regression analysis along with the structural equation modeling (SEM), considering the significance level of 0.05. Results: The regression analysis results demonstrated that following the one-unit increase in the values of self-efficacy and cues to action, the COVID-19 PHBs elevated by 0.063 and 0.078 units, respectively. In addition, the COVID-19 PHBs subsided by 0.018 with the rise in the value of perceived barriers (P < 0.001). According to the path analysis, the direct path from the COVID-19-related HL to the COVID-19 PHBs (B = 0.097, ß = 0.087, 95% confidence interval [CI] = 0.005 to 0.189) was significant. Furthermore, the indirect path from the COVID-19-related HL to the COVID-19 PHBs through perceived susceptibility (B = 0.017, ß = 0.015, 95% CI = 0.001 to 0.032), perceived barriers (B = 0.029, ß = 0.026, 95% CI = 0.004 to 0.055), self-efficacy (B = 0.094, ß = 0.084, 95% CI = 0.031 to 0.156), and cues to action (B = 0.153, ß = 0.137, 95% CI = 0.092 to 0.215) was significant. Conclusion: In keeping with the study results, it is essential to take some effective measures to boost the HBM constructs and HL among adolescents to improve their PHBs during pandemics such as COVID-19.