Depression literacy, mental health literacy, and their relationship with psychological status and quality of life in patients with type 2 diabetes mellitus.

Background: This study was conducted to measure depression literacy (D-Lit) and mental health literacy (MHL) and to investigate their relationship with psychological status and quality of life among Iranian patients with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study was conducted in 2021 among 400 patients with T2DM in Iran. Samples were selected using proportional stratified sampling. Data collection tools comprised a demographic questionnaire, measures of MHL and D-Lit, the diabetes quality of life (DQOL) scale, and the DASS-21. After confirming the normality of the data using the Kolmogorov-Smirnov test, parametric statistical tests (such as one-way ANOVA, independent samples t-test, and Chi-Square) were used to investigate the relationship between the variables using SPSS v22 software. The results of continuous quantitative data are reported in the form of means and standard deviations, and qualitative data are reported in the form of absolute and relative frequencies. Results: In this study, 10.25% of the participants (n = 41) had severe depression, while 36.75% (n = 147) experienced severe anxiety. The mean (standard deviation) of MHL was 80.92 (9.16) from 130 points. Of the participants, only 1.7% (n = 7) did not answer any questions correctly on the D-lit scale, and only 5.8% (n = 23) were able to answer 15 questions or more correctly on the D-lit. MHL had a significant negative correlation with depression (r = -0.236), anxiety (r = -0.243), and stress (r = -0.155) (P < 0.001). There was a positive and significant correlation between MHL and D-Lit (r = 0.186) (P < 0.001). D-Lit had a significant negative correlation with depression (r = -0.192), anxiety (r = -0.238), and stress (r = -0.156) (P < 0.001). There was a positive and significant correlation between the ability to recognize disorders (r = 0.163), knowledge of self-treatment (r = 0.154), and DQOL (P < 0.001). Depression (r = -0.251), anxiety (r = -0.257), and stress (r = -0.203) had a significant negative correlation with DQOL (P < 0.001). Conclusion: MHL and D-Lit levels were found to be inadequate in patients with T2DM. These low levels of MHL and D-Lit among patients with T2DM were associated with higher levels of anxiety, depression, and stress, as well as a lower quality of life. Therefore, designing and implementing preventive programs to improve the mental health of patients with T2DM can help prevent mental disorders and ultimately improve their quality of life.

The evaluation of the role of diabetes health literacy and health locus of control on quality of life among type 2 diabetes using the Path analysis.

Quality of life (QOL) in patients with diabetes is affected by multiple factors, and this study aimed to determine the effect of health locus of control points (HLOC) and diabetes health literacy (DHL) on QOL in Iranian patients with type 2 diabetes. This cross-sectional study was conducted between October 2021 and February 2022 among 564 people with type 2 diabetes. Patients were selected using proportional stratified sampling and simple random sampling methods. Data were collected using three questionnaires: (1) Multidimensional Health Locus of Control scale (form C), (2) World Health Organization Quality of Life Scale, and (3) Diabetes Health Literacy Scale. Data were analyzed by software's of SPSS V22 and AMOS V24. There was a positive and significant correlation between DHL and QOL. There was a positive and significant correlation between the subscales of internal HLOC, and doctors HLOC with QOL. According to the Path analysis results, all variables showed 58.93% of the direct effects and 41.07% of indirect effects of the final model. Numerate health literacy, informational health literacy, communicative health literacy, internal HLOC, other powerful people HLOC, chance HLOC, and doctors HLOC were able to predicted 49% variance of diabetes QOL (R2 = 0.49). The subscales of communicative health literacy, informational health literacy, internal HLOC, doctors HLOC, and chance HLOC had the greatest impact on QOL of people with diabetes. Based on the results of Path analysis, diabetes health literacy and HLOC play an effective role in QOL of diabetic. Therefore, there is a need to design and implement programs to improve the health literacy of patients as well as HLOC to improve QOL of patients.

Midwives' Perception Regarding Conditions Influencing the Implementation of the Natural Childbirth Promotion Program in Iran: A Qualitative Study.

Background: In Iran, the Natural Childbirth Promotion Program (NCPP) has been implemented as a component of the Health Transformation Plan (HTP) since 2014 and as an attempt to encourage natural childbirth practices and reduce cesarean section rates. The purpose of this qualitative study was to explore the perceptions of midwives about conditions influencing the implementation of NCPP. Methods: In this qualitative study, data were collected through 21 in-depth semi-structured individual interviews with expert midwives who were selected using purposive sampling mainly from one medical university in Eastern Iran from October 2019 to February 2020. Based on the framework method as a thematic analysis approach, the data were analyzed manually. To enhance the rigor of the study, we followed Lincoln and Guba's criteria. Results: Data analysis yielded 546 open codes. After the codes were reviewed and similar codes were removed, there remained 195 codes. Further analysis led to extraction of 81 sub-sub themes, 19 sub-themes, and eight main themes. These themes included: Responsive staff; Characteristics of the parturient; Recognition of midwifery role; Teamwork; The birthing environment; Effective management; Institutional and social context; and Social education. Conclusion: Based on the perceptions of the studied midwives, the success of the NCPP is guaranteed by a set of conditions identified in this study. In practice, these conditions are complementary and interrelated, and they cover a wide range of staff and parturient characteristics to the social context. It seems that effective implementation of the NCPP also calls for the accountability of all stakeholders, from policymakers to maternity care providers.

Anxiety Severity Levels and Coping Strategies during the COVID-19 Pandemic among People Aged 15 Years and Above in Gonabad, Iran.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak is a global health problem. It is necessary to provide evidence on its unprecedented psychological effects to develop effective psychological interventions. The current study aims to determine the anxiety severity level, coping strategies, and influencing factors in response to the COVID-19 pandemic among people aged 15 years and above in Gonabad, Iran. METHODS: We conducted a cross-sectional survey via online questionnaires between February and March 2020. We evaluated the anxiety severity levels and coping strategies using the Corona Disease Anxiety Scale (CDAS) and Coping Inventory for Stressful Situations-Short Form (CISS-SF), respectively. Multinomial and ordinal logistic regression models were used to identify the predictors of coping strategies and anxiety. RESULTS: Totally, 500 people completed the questionnaires (response rate: 73%). Of them, 53.4% (95% confidence interval [CI]: 48.9%- 57.8%) suffered moderate to severe levels of anxiety. More than half of the respondents (52.0%; 95% CI: 47.5%-56.4%) utilized emotional-based or avoidant coping strategies. People with no academic education (odds ratio [OR]: 2.16; 95% CI: 1.41- 3.31) and without physical exercise (OR: 2.04; 95% CI: 1.22-3.33) preferred emotional-based coping instead of problem-based coping strategy. Female gender (OR: 1.60, 95%, CI: 1.13-2.28), underlying medical conditions (OR: 2.52, 95% CI: 1.65-3.87), and emotional-based coping (OR: 4.06, 95% CI: 2.76-5.99) were associated with higher severity levels of anxiety. CONCLUSION: The severity of anxiety during the COVID-19 pandemic was significant among participants. Further attention is needed to enhance the mental health of the vulnerable population during the COVID-19 pandemic. Our findings also identified some factors related to the severity level of anxiety related to COVID-19 that could help formulate better psychological interventions.

Suicide rate in relation to the Human Development Index and other health related factors: A global ecological study from 91 countries.

There has been no worldwide ecological study on suicide as a global major public health problem. This study aimed to identify the variations in suicide specific rates using the Human Development Index (HDI) and some health related variables among countries around the world. In this ecological study, we obtained the data from the World Bank Report 2013. The analysis was restricted to 91 countries for which both the epidemiologic data from the suicide rates and HDI were available. Overall, the global prevalence of suicide rate was 10.5 (95% confidence intervals: 8.8, 12.2) per 100,000 individuals, which significantly varied according to gender (16.3 in males vs. 4.6 in females, p<0.001) and different levels of human development (11.64/100,000 individuals in very high development countries, 7.93/100,000 individuals in medium development countries, and 13.94/100,000 individuals in high development countries, p=0.004). In conclusion, the suicide rate varies greatly between countries with different development levels. Our findings also suggest that male gender and HDI components are associated with an increased risk of suicide behaviors. Hence, detecting population subgroups with a high suicide risk and reducing the inequality of socioeconomic determinants are necessary to prevent this disorder around the world.

A predictive model of apartment-living based on socio-economic and demographic factors with health-based approach in Iran.

OBJECTIVE: Due to importance and progressive growth of apartment-living phenomenon in the world today, it is essential to survey the different dimensions of this modern lifestyle. The aim of this study is to predict rate of apartment-living based on the different predicted variables of socio-economic and demographic factors with approach to different health aspects. METHODS: A descriptive- analytic study was carried out between 600 apartment and 800 non-apartment residents in the Shiraz (Southern Region of Iran) through multi-stage cluster sampling during the year 2011. The statistical analysis was performed on the obtained data using multi-variable logistic regression as well as ANOVA analysis. RESULT: the rate for apartment-living in above 30 years old age group was 8.31 times more than 15-30 years old, 9.6 times more in employed vs. unemployed; 6.57 and 9.49 times more in families with average and high monthly incomes, respectively, vs. family with low monthly income; 8.73 times more in owner sub-group vs. renter sub-group; and 1.30 times more in people living lonely than those living with family. People living in an apartment are in poor health status considering physical, mental and social aspects. CONCLUSION: Based on the results, it is very important that policy makers in urban areas consider the determinative role of socio-economic and demographic factors, which are involved in selecting apartment-living lifestyle by urban residents and also are effective on health.