Investigating the structural validity and reliability of the sexual health literacy for adults (SHELA) questionnaire among a sample of women in Qazvin, Iran.

BACKGROUND: The correct measurement of sexual health literacy requires an instrument with desirable psychometric properties and fitness to the sociocultural context. Despite acceptable psychometric properties of the sexual health literacy for adults questionnaire in the mixed population of men and women, the validity and reliability of this questionnaire in the female population were not determined. Therefore, considering differences in the study population, this study aimed to determine the structural validity and reliability of the questionnaire among women. METHODS: The present study was a methodological and psychometric study of instruments conducted among 310 women referring to healthcare centers in Qazvin, Iran in 2020. Sampling was done using a one-step cluster method. We used Cronbach's alpha coefficient, Pearson correlation coefficient, and confirmatory and exploratory factor analyses to determine the reliability, convergence validity, and construct validity of the questionnaire respectively. Also, the Sexual Quality of Life-Female questionnaire (SQOL-F) and the Female Sexual Function Index (FSFI) were used to evaluate the convergence validity. Data were analyzed using SPSS 20, and STATA 13. RESULTS: Exploratory factor analysis identified three factors including, "reading and understanding", "evaluation and application of information", and "skills of access" which together accounted for 70.85% of the whole variance. Based on the results of confirmatory factor analysis, this questionnaire had overall goodness of fit too. (RMSEA = 0.071, CFI = 0.928, TLI = 0.919, SRMR = 0.041, X2/df = 2.501). Convergent validity of the questionnaire showed a correlation of 0.121-0.243 between the questionnaire's dimensions with the FSFI and the SQOL-F questionnaires respectively. Also, the results showed that the questionnaire had proper internal consistency (Cronbach's alpha was 0.981) for measuring sexual health literacy in women. CONCLUSIONS: The 39-item sexual health literacy assessment questionnaire consisting of 3 factors in the present study was endowed with sufficient validity and reliability, and it can be used for precisely assessing women's sexual health literacy.

A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery.

BACKGROUND: This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients. METHODS: Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8  weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups' depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software. RESULTS: The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group. CONCLUSION: The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.

The determinants of methadone maintenance treatment in opioids dependence users: A survival analysis study.

Background: Staying in treatment is one of the basic principles in maintenance treatment with methadone and it is considered as a success criterion in the treatment procedure. This study aimed at analyzing effective determinants on staying in treatment in methadone treatment procedure. Methods: This was a retrospective cohort study, in which 6 MMT centers were randomly selected to be studied. The data were collected using the patients' medical records. Therefore, 1008 medical record files belonging to the patients who received methadone treatment from April 2013 to August 2017 were investigated. Proportional hazard Cox regression (extended) was used to specify the determinants of the methadone maintenance treatment and STATA 11 was used for data analysis. Results: The patients' mean age was 38.8 years (±1.08), and 75.8% were married and only 39.1% had full-time jobs. The mean age for the first substance abuse was at 24.31years (±7.93). The average time of staying in the treatment was 28.8 months. The results of the adjusted Cox proportional hazards regression showed among the 14 variables entered into the model, in the 1-12-month interval age of first drug use (HR=0.945, 95 % CI=0.908-0.983, p=0.005), specific drug use (HR=1.14, 95 % CI=1.026-1.268, p=0.014), and the frequency of treatment (HR=0.974, 95 % CI=0.959-0.990, p=0.002) were significantly correlated with survival status. The 13-36- month interval drug use (HR=0.931, 95 % CI=0.886-0.978, p=0.005) was significantly correlated with survival status. Also, the range of 37-53 month drug use (HR=1.058, 95 % CI=1.001-1.119, p= .044) had a significant relationship with survival status. Conclusion: This study showed age of first drug use, specific drug use, the frequency of treatment and drug use were correlated with a decrease in staying duration in treatment. Therefore, taking these factors into consideration in designing and administering various interventions in addiction treatment and consulting centers is of paramount importance.

The relationship between health literacy and the adoption of COVID-19 preventive behaviors: A cross-sectional study in Iran.

BACKGROUND AND AIM: Health literacy (HL) is one of the effective factors in controlling the COVID-19 epidemic. Considering the high prevalence of COVID-19 disease, the present study aimed to determine the relationship between HL and the adoption of COVID-19 preventive behaviors. MATERIALS AND METHODS: This was a descriptive-cross sectional study conducted on 214 students selected by simple random sampling method in Esfarayen Faculty of Medical Sciences, Iran, in 2022. The data included demographic and background characteristics, health literacy for Iranian Adults (HELIA), and a valid and reliable questionnaire to measure COVID-19 preventive behaviors. The data were analyzed using SPSS 23, descriptive statistics, and ordinal logistic regression tests. RESULTS: The mean and standard deviation of the scores of adoption of COVID-19 preventive behaviors and HL among students were 18.18) 4.02(out of 25 and 72.14) and 12.75 (out of 100, respectively. The results of the logistic regression test showed that the HL (P = 0.003), gender (P<0.001), mother's education (P = 0.039), educational level (P = 0.031), smoking (P = 0.032), and physical activity (P = 0.007) were effective factors in adopting preventive behaviors. CONCLUSION: Adopting preventive behaviors against COVID-19 was lower among students with lower levels of health literacy, male students, students with less physical activity, students with illiterate mothers, undergraduate students, and finally smokers. Therefore, it is necessary to pay more attention to these students in designing educational programs. It is suggested to carry out more extensive studies to clarify the effect of HL on the adoption of COVID-19 preventive behaviors.

The anxiety associated with COVID-19, general health, spiritual health, and job satisfaction in healthcare providers: a cross-sectional study.

BACKGROUND: Previous research has shown the impact of pandemic communicable diseases on the mental health of healthcare providers. This study examined the relationship between general health, spiritual health, anxiety associated with COVID-19, job satisfaction, and the mediating role of sex in healthcare providers in Iran in 2021. METHODS: This was a descriptive-analytical and cross-sectional study performed on 163 healthcare providers of which 71.8% were female and 28.2% were male with an age range between 21 and 58 years, an average work experience of 9.5 years, and working as nurses, doctors, laboratory technicians, etc. in some hospitals in Sanandaj. Data were collected using COVID-19 Anxiety, General Health, job satisfaction, and Spiritual Health questionnaires. Then, the data were analyzed using SPSS-22 software, regression test, and path analysis. RESULTS: Although women averaged lower levels of general health, job satisfaction, and anxiety associated with COVID-19, and higher scores in spiritual health than men, none of these differences were statistically significant, and sex didn't play a significant role here. Also, general health and spiritual health could significantly predict 17.1% of the variance in job satisfaction in the path analysis. However, sex and Covid-19 anxiety could not significantly predict this variable. CONCLUSION: The results showed that there was not a significant difference between the male and female workers' general health when facing such pandemics. However, we may prepare interventions to promote their general and spiritual health and to promote healthcare providers' job satisfaction during such pandemics.

Relationship between health literacy skills and walking behavior to prevent osteoporosis among health volunteers.

Background: Considering the effect of exercise and health literacy in preventing osteoporosis, the effect of health literacy in adopting preventive behaviors, and the role of health volunteers in transferring health messages to the community, this study aimed to determine the relationship between health literacy skills and adopting walking behavior to prevent osteoporosis in women health volunteers. Methods: In a cross-sectional study, 290 health volunteers referring to Qazvin health centers in 2020 were selected through Multi-stage random sampling. Data were collected using a health literacy questionnaire (HELIA) and a questionnaire for the adoption of walking behaviors for the prevention of osteoporosis, and they were analyzed using descriptive statistics and logistic regression in SPSS software version 23. Results: The adoption of walking behaviors to prevent osteoporosis was at an average level. Age (P = 0.034, OR = 1.098), decision-making and application of health information (P < 0.001, OR = 1.135), understanding (P = 0.031, OR = 1.054), and evaluation skills (P = 0.018, OR = 1.049) were factors affecting the adoption of this behavior so that by increasing one score to these variables, the chance of adopting the behavior increased 1.098, 1.135, 1.054 and 1.049 respectively. Also, the level of education was another effective variable in adopting this behavior, so having a favorable level of adoption of this behavior in health volunteers with a diploma degree (P = 0.017, OR = 0.736) and below diploma (P = 0.011, OR = 0.960), were 0.736 and 0.960 times of those with university degrees respectively. Conclusion: The adoption of walking behaviors to prevent osteoporosis among health volunteers - who have lower age, education, and decision-making skills and the use of health information, understanding, and evaluation - was less. Therefore, it is necessary to pay more attention to them when designing educational health programs.

The effect of education based on health belief model on hand hygiene behavior in the staff of Tehran dentistry centers: A quasi-experimental intervention study.

Background and Aims: Considering the increasing prevalence of dental services in the community and the impossibility of identifying each infected patient, hand sanitation is the most critical factor in controlling infection in these centers. Therefore, this study aimed to determine the effect of educational intervention on the hand health behavior of the staff of Tehran dentistry clinics based on the health belief model (HBM). Methods: In this quasi-experimental study in 2017, 128 employees of the health centers were selected through a multistage sampling method and they were placed in two groups of intervention and control (each 64 people). The data was collected using a questionnaire devised by the researcher. The validity and reliability of the questionnaire were determined. The questionnaire consisted of demographics, knowledge, structures of the HBM, and behavior variables. Then, the intervention was administered based on HBM-based education. Data were analyzed by SPSS16 and independent t test, χ 2, and repeated measurement analysis of variance. Results: Before the intervention, the two intervention and control groups did not differ significantly in terms of demographic variables, mean scores of knowledge, constructs of HBM, and hand hygiene behavior (p > 0.05), while the intervention group was scored higher significantly compared to the control one after the intervention (p < 0.001). Conclusion: According to the findings, the HBM can be used as a framework for designing educational interventions to improve hand hygiene behavior to control infection in health centers.

Measuring the Structures of the Health Belief Model Integrated with Health Literacy in Predicting University Students' Adoption of Smoking Preventive Behaviors.

Objectives: One of the priorities of public health in reducing smoking is to prevent young people from becoming smokers. Health literacy (HL), smoking, and preventive behaviors are related. Moreover, HL has a potential impact on strengthening the Health Belief Model (HBM). Considering the high prevalence of smoking among university students, the current study was conducted to measure the structures of the HBM integrated with HL in predicting university students' adoption of smoking preventive behaviors. Methods: This was a cross-sectional descriptive study. Three hundred and forty dormitory students of Shahid Beheshti University of Medical Sciences (Teheran, Iran) in 2016, were selected through single-stage cluster sampling for the study. The data gathering tool was a researcher-made questionnaire based on the HBM and the HL inventory for adults (HELIA). The data were analyzed using the SPSS software version.16. Results: The multiple regression analysis showed that the application of health information from five dimensions of HL, perceived susceptibility, self-efficacy, and decision-making dimensions were the predictors of smoking prevention. Also, the structures of this integrated model were able to anticipate 36.5% of the behavioral changes. Conclusion: The HBM integrated with HL can be used as an appropriate framework for designing educational programs to encourage university students to adopt smoking preventive behaviors.

Studying the factors associated with Premenstrual syndrome prevention among pre-university students in Tehran.

Introduction: Premenstrual syndrome is one of the common menstrual disorders in adolescents. Considering the destructive effects of this syndrome on adolescents' activity and performance and the importance of epidemiological studies in designing preventive interventions. Aim: This study aimed to determine some of the factors associated with the prevention of premenstrual syndrome among adolescents. Settings and Design: In a cross-sectional study, 255 female high school students in Tehran were selected using multistage random sampling method. Methods and Material: The data were collected using a demographic and background questionnaire and a valid and reliable questionnaire to assess preventive behaviors of premenstrual syndrome. Statistical analysis used: The collected data were analyzed using SPSS software version 16 and descriptive statistics and logistic regression. Results: The mean (SD) score of adoption of preventive behaviors of premenstrual syndrome was 19.25 (0.63) out of 50, and it was low. Also, weekly physical activity, mother education level, and family income were the factors affecting the adoption of preventive behaviors of premenstrual syndrome (P < 0.05). Conclusion: Due to the low adoption of preventive behaviors among students with lower income families, students with less physical activity and students with mothers with lower levels of education, it is suggested that more attention be paid to the above students in designing educational programs to promote the prevention of premenstrual syndrome.

The Relationship between Different Levels of Health Literacy and Smoking Prevention Among Medical Sciences Student.

BACKGROUND: Higher rates of Smoking among university students have been reported in various studies. On the other hand, health literacy (HL) can improve health behaviors. In fact, identifying factors affecting the adoption of smoking preventive behaviors such as HL can help prevent and reduce the prevalence of smoking among people. The aim of this study was to identify the relationship between different levels of HL and adoption of smoking preventive behaviors among university student in 2016. METHODS: This was a cross-sectional descriptive study. Three hundred and forty-seven dormitory students of Shahid Beheshti University of Medical Sciences in Iran were selected through single-stage cluster sampling for the study. Data were collected using a measure of HL (the HL inventory for adults-HELIA) and a designed questionnaire to assess the adoption of smoking preventive behaviors. The data were analyzed using SPSS software version. 16 and descriptive statistical and Logistic regression test. RESULTS: The mean (SD) of the score for adoption of smoking preventive behaviors and HL were 45.91 (12.99) and 70.52 (14.12) out of 100, respectively. The results showed that the adoption of smoking preventive behaviors had significant relationship with variables such as HL, gender, father's education and not smoking (P < 0.05). CONCLUSIONS: Less adoption of smoking preventive behaviors was seen in students with lower levels of HL, female students, students with illiterate fathers and smokers. Therefore, it seems essential to take these factors into consideration in designing preventive programs for smoking in target groups.

Seizure Prevalence and Its Related Factors in Tramadol Intoxication; a Brief Report.

INTRODUCTION: Seizure is known to be a serious complication of tramadol consumption even in its therapeutic doses. The aim of this study was to determine the prevalence of seizure and its related factors in tramadol intoxicated patients referred to emergency department (ED). METHODS: In this cross-sectional study, all individuals, admitted to ED following tramadol intoxication were divided into two groups based on the presence or absence of seizures. Demographic data as well as clinical, electroencephalogram and imaging findings were compared between the two groups using SPSS software version 22. RESULTS: 167 patients with the median age of 23 (13-45) years were studied (85% male). Seizure was seen in 97 (58.0%) cases. Risk of seizure had increased 3.7 times in patients with a history of seizure (OR: 3.71 Cl 95%: 1.17 - 11.76). Tramadol dose was significantly higher in patients who had seizure more than once (Median: 2800 IQR: 1800-4000), compared to those who had one seizure episode (Median: 850 IQR: 1800-400) (p <0.0001). CONCLUSION: Based on the findings of this study, history of seizure increased the risk of seizure in patients taking tramadol, and the increase in dose correlated with a significant increase in seizure frequency.