The performance of rural family physicians in Fars province, Iran.

BACKGROUND: Family physician (FP) program is a complete health-care system whose most important results are elimination of individuals' confusion when going to the doctor and increase in their satisfaction with health services. This study aimed to evaluate the performance, strengths, and weaknesses of FP program. MATERIALS AND METHODS: In this cross-sectional study, 52 FPs in Fars province were selected via stratified sampling and their performance was investigated. The data were collected using FPs performance questionnaire that included five domains, namely, management, performance, contract guidelines, community involvement, and outcomes. Then, the data were entered into the SPSS statistical software, version 19, and were analyzed using t-test, ANOVA, and Pearson's correlation coefficient. RESULTS: Among the 52 FPs under study, 56.9% were male and 43.1% were female. The lowest and highest scores were related to community involvement (3.93 ± 0.81) and outcomes (23.52 ± 3.04), respectively. The results showed significant relationships between most domains (P < 0.05). However, no significant correlation was found between gender and different domains (P < 0.05). CONCLUSION: Considering diverse activities done by FPs, the wide area of our country, and issues related to increasing satisfaction among physicians and individuals covered by the program, further researches are required in this area.

Promoting Preventive Behaviors of Nosocomial Infections in Nurses: The Effect of an Educational program based on Health Belief Model.

OBJECTIVES: To determine the effect of educational program based on Health Belief Model (HBM) on promoting preventive behaviors of nosocomial infections in nurses. METHODS: In this randomized controlled trial study, 120 nurses working in a hospital in Fasa City, Fars (Iran). Intervention group (n=60) received an educational program based on HBM while control group (n=60) did not received it. A questionnaire consisting of demographic information, HBM constructs (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, performance and cues to action) was used to measure changes toward the prevention of nosocomial infections before, immediately after intervention and four months later (of the end of the intervention). RESULTS: Immediately and four months after the intervention, the intervention group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, Self-efficacy, cues to action and performance compared to the control group. CONCLUSIONS: This study in nurses showed that the effectiveness of the Educational program based on HBM on promoting preventive behaviors of nosocomial infections. Hence, this model can act as a framework for designing and implementing educational interventions for the prevention of nosocomial infections.

Educational Intervention on Breast Self-Examination Behavior in Women Referred to Health Centers: Application of Health Belief Model

Introduction and aims: Screening can play a major role in reducing deaths associated with cancer. Breast selfexamination (BSE) is a cheap, non-complicated and non-invasive method for breast cancer screening. This study aimed to examine the effects of an educational intervention based on the health belief model (HBM) on BSE behavior in women referred to health centers in Fasa, Iran. Methods: This quasi-experimental study was conducted on 92 women, divided into an experimental and a control group. Data were collected using a validated questionnaire covering demographic characteristics, knowledge, HBM constructs and breast self-examination performance. An educational program was performed in five sessions through group discussion with questions and answers and training videos for participants in the experimental group. Questionnaires were filled before and three months after the intervention in the two groups. Data were analyzed with SPSS-22 software for descriptive and analytical statistics. Results: The results of this study showed that the mean scores for knowledge, HBM constructs and self-examination behavior in the experimental group were elevated compared to the control group after the intervention (P<0.001). Conclusions: Education based on the HBM is effective in promoting breast self-examination behavior. Thus development and implementation of training programs based on the model are proposed for officers involved in education and health promotion in Iran.

Investigating Factors Associated with FOBT Screening for Colorectal Cancer Based on the Components of Health Belief Model and Social Support

Introduction: This study aimed to investigate the factors associated with FOBT screening for colorectal cancer based on the components of Health Belief Model and social support in Fasa City, Fars Province, Iran. Materials and Methods: This was a cross-sectional study carried out on 240 subjects in people of Fasa city who had 50 years old and above. The subjects in this study were assigned to two groups of 120 patients. The first group included people over 50 years, who referred to the diagnostic laboratories for doing FOBT, but the second group included people aged 50 years and above who did not refer to a laboratory for doing FOBT and were assessed by questionnaires at home. Data were collected through a questionnaire based on health belief model and perceived social support. Results: The referring group included 61.3 percent women and 38.7 percent men, with a mean age of 65.24 ± 8.01. The non-referring group included 59.7 percent women and 40.3 percent men, with a mean age of 64.21 ±7.53 (p=0.24). In the referring group, 64.2 percent had undergone FOBT in the past year, while in the non-referring group only 12.72percent had done so (p=0.001).The results showed that the referring group obtained higher scores on awareness about CRC and ways to prevent it, and on HBM Model constructs, and social support compared to the non-referring group (p<0.001). In addition, the referring group reported significantly lower Perceived Barriers compared to the non-referring group (p<0.001). Conclusion: The results showed significant differences between the two groups in terms of HBM components and perceived social support for doing FOBT. Therefore, theory-based educational interventions can be used to increase individuals' Perceived Severity, Perceived Susceptibility, and Perceived Benefits and reduce their Perceived Barriers in order to empower and encourage people to perform FOBT.

Factors associated with prostate cancer screening behavior among men over 50 in Fasa, Iran, based on the PRECEDE model.

BACKGROUND: Prostate cancer is one of the most common and lethal cancers in the world. The incidence of prostate cancer has been increasing in recent years. The purpose of this study was to investigate factors associated with prostate cancer screening behaviors among men over 50 in Fasa, Iran, based on the PRECEDE model. METHODS: In this cross-sectional study, 400 men over 50 were studied in Fasa, Iran. Data were collected via a questionnaire on demographic characteristics, such as age, number of children, occupation, education, marital status, smoking, and prostate cancer screening behaviors. Data were analyzed using SPSS software, version 16. Independent samples t-test and the Pearson Product Moment correlation coefficient were used for the statistical analyses. RESULTS: Men in the study had little knowledge (34.11±8.22) and attitude (28.23±7.23) about prostate cancer and screening behavior. Their mean scores about prostate cancer, screening behavior, quality of life, and general health were moderate. The subjects had low self-efficacy and perceived social support. Their mean scores of enabling factors and screening behaviors were at a low level. Pearson correlation scores showed a significant correlation between cancer prostate screening behavior and demographic variables, such as age (p=0.04, r=0.136), occupation (p=0.01, r=0.121), educational level (p=0.02, r=0.211), and marital status of the subjects (p=0.01, r=0.112), but there were not significant correlations with the number of children (p=0.12, r=0.092) and smoking (p=0.09, r=0.002). The T-test results showed significant relationships between age, occupation, and education of the subjects, and the PRECEDE model structures were significant for predisposing factors, enabling factors, and reinforcing factors (p<0.05). CONCLUSION: The prostate cancer screening behaviors in men over 50 in Fasa, Iran, were at a low level. Due to predisposing factors, such as the knowledge, attitudes, and beliefs of individuals, reinforcing factors can have an important role in the behaviors related to prostate screening, such as their families and health staffs as well as enabling factors, such as health financing, access to medicines and learning self-care. Educational interventions to improve these behaviors and the quality of life of these people seem essential.

Coping strategies in people attempting suicide.

BACKGROUND: Having a set of effective coping skills can prevent suicidal behavior by increasing self-control and self-direction. This study examines coping styles used by suicidal patients. OBJECTIVES: The researchers in this study try to identify coping strategies used by suicide attempters admitted to Shiraz Shahid Faghihi Hospital emergency room. MATERIALS AND METHODS: This is a analytical cross-sectional study. Participants consisted of 50 suicide-attempted people admitted to Shiraz Faghihi Hospital. Instruments for data collections were a demographic checklist and the coping styles scale of Carver, Schier and Wintrope. Data were collected conveniently and analyzed using descriptive and analytic (Pearson Correlation, Student's t-tests, and ANOVA) statistical methods. RESULTS: Suicide attempted people used less useful coping strategies (Mean = 49.32) more than the other strategies (respectively mean of problem focused and emotion focused strategies were 30.27 and 27.83). Using ANOVA, in different educational level, problem focused and less effective coping skills of samples differed significantly (P = 0.009, P = 0.006, respectively). People with low educational level used less effective coping skills. There was a significant difference between men and women scores in use of less effective coping skills (P = 0.029). CONCLUSIONS: Teaching effective coping skills by psychological consultants in suicide attempted people, especially for women and people with low educational level, is important.