The effect of health literacy intervention on adherence to medication of uncontrolled hypertensive patients using the M-health.

BACKGROUND: Given that patients' medication adherence is regarded as the major part of disease control and improving health literacy can be effective in promoting adherence to healthy behaviors, the present study aimed to investigate the effect of health literacy intervention based on the medication adherence among uncontrolled hypertensive patients using mobile health (M-health). METHODS: An interventional study with a quasi-experimental design, was conducted on 118 uncontrolled hypertensive patients. Participants were randomly divided into the intervention (n = 59) and control (n = 59) groups using blocked randomization. In the intervention group, a mobile health (M-health) program was designed using programmed instruction to improve patients' health literacy over a period of 3 months. Data was collected by administering health literacy and medication adherence questionnaires to participants before and after the intervention. The analysis involved using the independent sample t-test to compare the variables before and after the study. RESULTS: Before the intervention, the total score of health literacy was 33.34 and 33.14 in the intervention and control groups, respectively. After the intervention, it increased to 40.36 and 34.20 in the intervention and control groups, respectively, which was statistically significant in the intervention group (p = 0.01). Moreover, the medication adherence score of the intervention group significantly increased after the intervention. Both systolic and diastolic blood pressure decreased in the intervention group. However, it should be noted that the decrease in systolic blood pressure by 148.98 was statistically significant, while the decrease observed in diastolic blood pressure in the intervention group was not statistically significant (p = 0.08). CONCLUSION: The application of programmed instruction through M-Health has shown a positive effect on the health literacy of uncontrolled hypertensive patients. In addition to detecting and treating patients, it is important to prioritize the improvement of health literacy in terms of medication adherence and the adoption of healthy behaviors.

Identification of the opportunities and threats of using social media among Iranian adolescent girls.

Background: The use of the Social Media (SM) has increased dramatically among adolescents. Social media are full of opportunities and threats. The present study aims at identification of opportunities and threats of using social media among Iranian adolescent girls. Methods: This study was conducted using a qualitative approach and content analysis in 2019 in the city of Kermanshah, western Iran. Data were collected through individual semi-structured interviews and focus group discussions with 36 adolescent girls aged 12-18 years who were selected by theoretical and purposive sampling. ATLAS.ti-2019 software and Graneheim and Lundman analysis method were used to analyze the data and Guba and Lincoln criteria were used to evaluate the transferability of the results. Results: The results showed that social media is both a threat and a flourishing platform for adolescents. Findings were classified into 2 main categories and 8 subcategories: threats of using social media including 5 subcategories such as unhealthy lifestyle, increased risky sexual behaviors, academic challenges, tensions, psychological effects, and unconditional freedom, and opportunities to using social media including 3 subcategories such as psychosocial development, knowledge gain, and increased interactions. Conclusion: To strengthen social media opportunities in the face of its challenges, measures such as strengthening media literacy and teaching the correct use of the Internet and social media, educating adolescents and parents about the dangers of social media, educating and empowering parents to effectively communicate with children, producing content tailored to the cultural context and interests of adolescents, using affirmative approaches and removing access restrictions can be helpful.

Evaluation of quality of life in diabetic pregnant women.

AIMS: Gestational diabetes is the most common clinical complication during pregnancy. Women with gestational diabetes face many problems in their personal, family and social lives that affect their quality of life. The aim of this study was to evaluate the quality of life of diabetic pregnant women. METHODS: This study was a descriptive study and the study population was all diabetic pregnant women referred to health centers in Kermanshah, Iran in 2019-2020. The studied variables were collected using a short form of quality of life questionnaire (WHOQOL-BREF-26 items). Then, with the help of SPSS software version 25, data analysis was performed based on frequency table and independent t-test. RESULTS: 101 pregnant women with gestational diabetes were studied. Their mean age was 33.06 ± 05.05 years. The quality of life of all mothers participating in the study was above average. The average quality of life and psychological domains, social and environmental relationships of mothers were higher in people with higher incomes and employment, and also the average quality of life and psychological domains, social and environmental relationships were higher in mothers who had less than 6 months. CONCLUSIONS: The majority of mothers were overweight (BMI = 25-29.9) and obese (BMI ≥ 30), which is one of the most important risk factors for gestational diabetes. Given the importance of quality of life of pregnant mothers, health policy makers are asked to provide more training for pregnant mothers on nutrition and increased physical activity to prevent gestational diabetes and improve their quality of life.

Health-Promoting Lifestyle and Associated Factors among Medical Sciences Students in Kermanshah, Iran: A Cross-Sectional Study.

Background: Lifestyle includes routine and daily living activities affecting an individual's health. The present study aimed at evaluating the health-promoting lifestyle profile (HPLP) of medical sciences students of Kermanshah, Iran. Methods: In this cross-sectional study, 343 medical sciences students were enrolled by the stratified random sampling method. The data collection tools were demographic information form and the HPLP-II questionnaire. Data were analyzed using descriptive and analytical statistics. Results: The mean overall HPLP-II score of the subjects was 2.25 ± 0.44 out of 4. Of the six HPLP-II dimensions, the highest and lowest scores belonged to interpersonal relations and physical activity, respectively. The mean overall HPLP-II score was statistically different in terms of gender, marital status, smoking habits, and economic status (P ≤ 0.05). Conclusion: HPLP-II level was moderate in most of the students, and health-promoting behaviors, in the physical activity dimension, were in a low state. The results emphasized the need for interventions to improve students' lifestyles.

Essential Oil from Citrus aurantium Alleviates Anxiety of Patients Undergoing Coronary Angiography: A Single-Blind, Randomized Controlled Trial.

OBJECTIVE: To determine the effectiveness and safety of essential oil from Citrus aurantium on anxiety in patients undergoing coronary angiography. METHODS: A single-blind, randomized controlled trial was conducted in 80 patients experiencing coronary angiography in Imam Ali Hospital in Kermanshah, Iran from April to November in 2016. All patients were randomly divided into intervention and control groups by a random number table, 40 cases in each group. The patients in the intervention group inhaled Citrus aurantium essential oil for 15-20 min about 60 min before angiography. Following the same procedure, distilled water was used instead of Citrus aurantium in the control group. Spielbergers State-Trait Anxiety Inventory (STAI) was filled in and vital signs including systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory and pulse rate were recorded before and 20 min after the intervention. Adverse reactions after intervention were observed. RESULTS: In the intervention group, the mean scores of STAI, SBP, DBP, respiratory and pulse rate were 53.30 ± 10.13, 134.82 ± 11.75 mm Hg, 84.49 ± 6.99 mm Hg, 17.87 ± 1.73 times/min, and 76.48 ± 12.55 beats/min at baseline and significantly decreased to 42.37 ± 10.15, 124.49 ± 10.48 mm Hg, 79.23 ± 6.62 mm Hg, 14.54 ± 1.43 times/min, and 70.03 ± 13.66 beats/min respectively 20 min after intervention (all P<0.05); however, in the control group, neither anxiety scores nor vital signs changed significantly (P>0.05). All subjects reported no adverse reactions. CONCLUSION: Inhalation of the essential oil from Citrus aurantium was effective in reducing anxiety and stress levels in patients undergoing coronary angiography. TRIAL REGISTRATION: IRCT2016040816797N2 (retrospectively registered on 21 April 2016, https://en.irct.ir/trial/15600 ).

The role of integrative model of behavioral prediction in voluntary counseling of individuals with sexual high-risk behavior.

BACKGROUND: Voluntary counseling and testing (VCT) is one of the main efforts for the prevention of high-risk sexual behavior, including HIV/acquired immunodeficiency syndrome (AIDS). The aim of this study was to determine cognitive determinants related to voluntary counseling and HIV testing among Iranian adults based on the integrative model of behavioral prediction (IMBP). MATERIALS AND METHODS: This cross-sectional study was conducted in 2018 among Iranian adults with high-risk sexual behaviors, including drug abuse and unprotected sex, in western Iran. A total of 300 adults were randomly selected to participate voluntarily in this study. Participants filled out a self-administered questionnaire, including the background data and IMBP constructs. Data were analyzed by SPSS version 21, using statistical treatments, such as bivariate correlations, Chi-square test, t-test, and logistic regression at a 95% significant level. RESULTS: Almost 73.3% of the participants had a history of VCT. The highest probability of VCT use was in participants who were in high level of VCT skills (odds ratio: 9.635; 95% confidence interval [CI]: 3.255, 28.514]), following environmental constraints (odds ratio: 6.274; 95% CI: 2.166, 18.171). Furthermore, the IMBP constructs accounted for 85% of the variations in the outcome measure of the VCT use intention. CONCLUSIONS: Based on the result, it appears that the design and implementation of educational programs to improve upon skills and environmental constraints toward VCT use among adults with high-risk behaviors could be useful to the promotion of VCT.

Individualism-Collectivism, Social Support, Resilience and Suicidal Ideation among Women with the Experience of the Death of a Young Person.

BACKGROUND: Grief involves a set of emotions, thoughts and behaviors that people experience when faced with a lack or threat of loss. This study was conducted to evaluate the suicidal ideation among women with experience of the death of a young person and assessed the predictive role of individualism-collectivism, social support, and resilience in suicidal ideation. METHODS: This cross-sectional study was conducted from March to August 2016 through recruitment of 146 breaved women from Gilan-e gharb (the west part of Iran). Data gathering instruments included Individualism-Collectivism Questionnaire, Multidimensional Scale of Perceived Social Support (MSPSS), Connor-Davidson Resilience scale (CD-RISC), and Beck Scale for Suicidal Ideation. Collected data were analyzed using SPSS-22. RESULTS: The findings showed that among women, 48 percent had suicidal ideation (scores above 6). The results of Pearson correlation showed that there were significant negative relationships between suicidal ideation (P<0.05) and factors such as collectivism (r=-0.286), family support (r=-0.558), support from friends (r=-0.307), support from significant others (r=-0.617), social support (r=-0.561), and resilience (r=-0.457). The results showed that individualism - collectivism, social support, and resilience correctly predicted 73.5% of women with suicidal ideation and 83.3% of women without suicidal ideation. CONCLUSION: We concluded that higher collectivism, social support, and resilience in the bereaved women can lead to a reduction in suicidal ideation. Therefore, psychologists and counselors can provide the necessary background to strengthen supportive issues and the use of resilience-based interventions among bereaved women.

Knowledge about Cervical Cancer and Pap Smear and the Factors Influencing the Pap test Screening among Women.

BACKGROUND: Although the Pap smear is known as one of the effective methods to detect the cervical cancer, a large group of women are reluctant to do the test because of various reasons. Therefore, we carried out this study to determine the level of knowledge about cervical cancer and Pap smear and the factors influencing the Pap test screening among women. METHODS: In this cross-sectional study, 355 women referred to the health centers of Gilan-e gharb city were randomly recruited in 2015. The participants asked to complete a self-administered questionnaire including five parts (questions about: demographic factors, knowledge about cervical cancer and Pap smear, Pap smear performance, barriers and facilitators related to Pap smear and the sources of information). Data were analyzed through SPSS version 19, using descriptive statistics, Independent T-test, and logistic regression. RESULTS: The mean age of the participants was 34.08±7.81 years. Almost 50.4% of the subjects had a history of Pap smear test. Pap test performance was significantly higher in those who had higher knowledge (P<0.001). Knowledge about cervical cancer, Pap smear and age was the most important predictors of the Pap test performance (P<0.001). The most important barrier and facilitator to Pap smear test were inadequate knowledge and the recommendations received from family, friends and healthcare professionals (44.3% and 40.2%, respectively). CONCLUSION: Knowledge about Pap smear and cervical cancer was important in predicting Pap test doing. In addition, inadequate knowledge was introduced as the most important barrier to screening test from the perspective of women. Therefore, we suggest that health education and health promotion studies as interdisciplinary and targeted interventions should be implemented to improve the women's knowledge.

Persian version of the Moorong Self-Efficacy Scale: psychometric study among subjects with physical disability.

PURPOSE: Self-efficacy plays a key role in varying areas of human conditions which can be measured by different scales. The present study was aimed to evaluate the psychometric properties of Moorong Self-Efficacy Scale (MSES) in Iranian Subjects with Physical Disability (SWPD). METHOD: Data were collected by face-to-face interviews and self-report surveys from 214 subjects. The face and content validity, and reliability were evaluated. Discriminates were evaluated between the sub-groups of disability levels, physical activity, and health condition levels. The concurrent, convergent, divergent, and construct validity were assessed by short form health survey scale (SF-36), general self-efficacy scale (GSES), hospital anxiety and depression scale (HADS), respectively. Replaceable exploratory factor analysis was evaluated. SPSS software was used for statistical analysis. RESULTS: There were acceptable face and content validity, and reliability. Furthermore, significant correlation was found between PSES and SF-36 (p < 0.001). Self-efficacy was statistically different among the disability levels (p = 0.02), physical activity levels (p < 0.001), and health status (p = 0.001). The correlation of Persian Self-Efficacy Scale (PSES) scores with GSES (r = 0.61, p < 0.001), and HADS (R = -0.53, p < 0.001) was significant. This scale yielded a two-dimensional structure, with a good internal replicability. The external replicability was satisfactory when we compared factor loadings with the original study. CONCLUSIONS: The PSES is a valid, reliable and sensitive tool to measure the self-efficacy among SWPD for planning and managing of disability problems. Implications for rehabilitation Psychometric properties of the Persian version of self-Efficacy scale (PSES) appear to be similar to original, English version. The PSES has been shown to have validity and reliability in Persian physical disables and can be used for patients with more different types of physical disability than individuals suffering from only Spinal Cord Injury (SCI). The PSES can be used in clinical practice and research work to evaluate the patients' confidence in performing daily activities.

Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students.

BACKGROUND: Self-esteem and behavioral consequences, which are due to external or internal locus of control, are effective on academic achievement of students. OBJECTIVES: The aim of this study was to determine the prediction of locus of control and self-esteem in academic achievement among the students. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 college students in Kermanshah University of Medical Sciences in 2014. Data collection tools were in three sections: demographic, Rotter internal-external locus of control scale and Coopersmith self-esteem inventory. Data were analyzed using the SPSS software version 21. RESULTS: Results showed that 29.8% and 76.2% of the participants had internal locus of control, and high self-esteem, respectively. There was a significant correlation between self-esteem, locus of control and academic achievement of the students. Self-esteem accounted for 39.5% of the variation in academic achievement. CONCLUSIONS: It seems that interventions to increase self-esteem among student can help improve academic achievement among them.

Different Nursing Care Methods for Prevention of Keratopathy Among Intensive Care Unit Patients.

BACKGROUND: Patients with reduced consciousness level suffer from eye protection disorder and Keratopathy. This study was conducted to compare effect of three eye care techniques in prevention of keratopathy in the patients hospitalized in intensive care unit of Kermanshah.   METHODS: This clinical trial was conducted in 2013 with sample size of 96 persons in three random groups. Routine care included washing of eyes with normal saline and three eye care methods were conducted with poly ethylene cover, liposic ointment, and artificial tear drop randomly on one eye of each sample and a comparison was made with the opposite eye as the control. Eyes were controlled for 5 days in terms of keratopathy. Data collection instrument was keratopathy severity index. Data statistical analysis was performed with SPSS-16 software and chi-squared test, Fisher's exact test, ANOVA and Kruskal-Wallis one-way analysis of variance. FINDINGS: The use of poly ethylene cover (0.59±0.665) was significantly more effective in prevention of keratopathy than other methods (P=0.001). There was no statistically significant difference between two care interventions of liposic ointment and artificial tear drop (P=0.844) but the results indicated the more effective liposic ointment (1.13±0.751) than the artificial tear drop (1.59±0.875) in prevention of corneal abrasion (P>0.001). CONCLUSION: Results of the study suggest the use of poly ethylene cover as a non-aggressive and non-pharmaceutical nursing and therapeutic method for prevention of keratopathy in the patient hospitalized in intensive care unit.

Using the PRECEDE model in understanding determinants of quality of life among Iranian male addicts.

Quality of Life (QOL) in opiate-addicted patients who are receiving methadone maintenance therapy is one of the important issues to be considered in the treatment of addiction. To determine a needs assessment using the PRECEDE model to find out factors related to QOL among Iranian male opiate addicts. This cross-sectional study was conducted in Kermanshah, Iran in 2013. A total of 762 male opiate addicts, who were referred to addiction treatment centers for receiving methadone maintenance treatment, were randomly selected to participate voluntarily in the study. SF-12, predisposing factors, enabling factors, reinforcement factors, and methadone maintenance treatment intention were used to find the related factors. Data were analyzed by the SPSS software (ver. 21.0) using the t-test, one-way analysis of variance (ANOVA), bivariate correlations, and linear regression at 95% significant level. Linear regression analysis showed the determinant variable accounted for 17% of the variation in QOL. Our findings suggest, providing social support for addicts could be beneficial results for the increasing quality of life among them.

Factors influencing attendance at structured self-management education programs for diabetes.

AIMS: There are several structured self-management education programs which are available nationally for patients with diabetes in the UK. This study was aimed to determine the factors influencing participation of patients with diabetes in the programs. PATIENTS AND METHODS: A cross-sectional survey through semi-structured questionnaire distributed to 550 patients attending primary or secondary care diabetes services, as well to those in community venues, was conducted. The inclusion criteria were people ≥18 years with diabetes diagnosed for 1 year or longer. RESULTS: There was a lack of awareness of the programs among the respondents. There were statistically significant differences between tendency to attend the programs with demographic variables, qualification, and self-efficacy. The results also indicated that an individual will be more likely to participate in the structured self-management education programs if she/he feels at risk of complications, that diabetes complications are serious, and believes that the programs may help to avoid these risks. CONCLUSIONS: This study indicated the nature of multidimensionality of the factors influencing participation in the programs.