Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study.

BACKGROUND: This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran. MATERIALS AND METHODS: This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework. RESULTS: Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes. CONCLUSION: Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people's psychological and social stress through providing financial aid, the right information, and training.

Experiences of students on virtual education in Iranian medical science universities during the COVID-19 pandemic: A qualitative study.

BACKGROUND: Due to the changing environment and responding to the needs of the society, change in the traditional education system is inevitable. Also, the occurrence of events such as the COVID-19 pandemic showed that the existence of a virtual education system to prevent the cessation of education is the need of today's society. OBJECTIVE: This study aimed to investigate the students' experiences of virtual education in Iranian universities of medical sciences during the COVID-19 pandemic. METHODS: This qualitative study was conducted on 28 students studying in Iranian universities of medical sciences from October 2021 to January 2022 to investigate their experiences of virtual education during the COVID-19 pandemic. The participants were selected by purposive sampling. An interpretive phenomenological approach and semi-structured, face-to-face, in-depth interview were used to collect the data. The data were analyzed by Colizzi's seven-step method. RESULTS: Students' experiences of virtual education during the COVID-19 pandemic were categorized into three themes and seven sub-themes, including the strengths of virtual education (sub-themes: individual and educational dimensions), the weaknesses of virtual education (sub-themes: infrastructural, educational, tests and assignments fields), and suggestions to improve virtual education (sub-themes: infrastructural development and educational planning). CONCLUSION: According to the study results, the virtual education during the COVID-19 pandemic led to students staying away from the crowded centers. However, some weaknesses were also mentioned by the participants. Therefore, by anticipating requirements and needs, planning and policy making, and seriously reviewing human, financial, and support resources, virtual education can be developed and used as a supplement to face-to-face education in the future.

The role of e-health literacy and some cognitive factors in adopting protective behaviors of COVID-19 in Khalkhal residents.

Background: Several vaccines have recently been generated and are being utilized to prevent COVID-19 mortality. Although the disease is causing many fatalities worldwide, preventative practices should be prioritized, even if vaccines are available. Therefore, this study aimed to identify the role of e-health literacy and some cognitive factors in adopting protective behaviors against COVID-19 in Khalkhal residents. Methods: In the present cross-sectional study we recruited 380 people aged 18-65 according to cluster sampling from September 2021 to December 2021 in Khalkhal County, Iran. Reliable and validated tools were applied to data collection, including the eHealth Literacy Scale (eHEALS) in Persian and the Cognitive factors assessment questionnaire based on the Health Belief Model (HBM). Data were analyzed using Chi-square, one-way ANOVA, independent samples t-test, and bivariate correlation. The predictors were also determined using hierarchical linear regression analysis. Results: The average age of the participants was 35.26 ± 11.51 years. The regression analysis implied that gender (p-value = 0.032), education level (p-value = 0.001), occupational status (p-value = 0.002), income (p-value = 0.001), and marriage (p-value = 0.001) had statistically significant associations with e-HL. Additionally, education level (p-value = 0.001), occupational status (p-value = 0.001), income (p-value = 0.001), and marriage (p-value = 0.002) revealed statistically significant associations with COVID-19 preventive behaviors. Approximately 16.5% of the variation in the COVID-19 protective behaviors is explained by the cognitive factors and the demographic variables. Overall, demographic, cognitive, and e-HL variables were able to explain roughly 35.5% of the variation in COVID-19 protective behaviors. Furthermore, self-efficacy was the strongest predictor of protective behaviors (ß = 0.214). Conclusions: HBM constructs successfully predicted the role of e-health literacy and some cognitive factors in adopting COVID-19 protective behaviors. People with high socioeconomic levels were better at e-health literacy and COVID-19 protective behaviors during the pandemic. Moreover, applying approaches to adopting COVID-19 protective behaviors is essential, especially in low socioeconomic status (SES) groups.

Determining the Predictors of Self-Management Behaviors in Patients With Type 2 Diabetes: An Application of Socio-Ecological Approach.

Background: Type 2 diabetes complications are responsible for 2% of hospital emergency visits. Self-management practices are one of the most essential approaches to control type 2 diabetes. The goal of this study was to use an ecological approach to investigate the predictors of self-management behaviors in diabetes patients referred to the emergency department in Ardabil in 2020. Methods: In this cross-sectional study, 273 individuals with type 2 diabetes who were sent to the emergency department of Imam Khomeini Educational and Medical Center in Ardabil were included using the available sample method. Demographic information questionnaires, including the Diabetes Distress Screening Tool (DDS2), General Diabetes Knowledge (DKT2), Diabetes Empowerment Questionnaire (DES-SF), Patient Health Questionnaire 9 (PHQ 9), Beliefs to Treatment Effectiveness Scale (BTES), Diabetes Self-Efficacy Scale (DSES), Chronic Illness Resources Survey (CIRS), Situational Effects Questionnaire, and Diabetes self-management support (DSMS), were all used to collect data. The independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression were used to analyze the data. Results: The results of the study showed that in the framework of ecological approach, predictors of self-management behaviors at the four levels are as follows: at the individual level-gender (p = 0.025), education (p = 0.002), duration of diabetes (p = 0.38), having a glucometer at home (p < 0.001), diabetes empowerment (p < 0.001), personal support (p = 0.002), and self-efficacy (p = 0.047); at the interpersonal level-the main health support (p < 0.001), membership in social networks (p < 0.005), family/friends support (p < 0.001), and neighborhoods support (p < 0.001); at the group and organizational level-organizational support (p = 0.013); at the community and policy level-the impact of mass media in health (p < 0.001) and situational influence (p < 0.001). Conclusion: The impact of non-individual levels, such as the environment, on a person's decision to manage diabetes is crucial. Diabetes management necessitates a significant amount of effort, which involves maintaining the health of diabetes patients and the community while also minimizing emergency department workload.

Identifying the predictors of turnover intention based on psychosocial factors of nurses during the COVID-19 outbreak.

AIMS: Because of the direct contact nurses have with patients, they are exposed to more stressful events during the outbreak of infectious diseases, which increases their turnover intention, highly impacting not only nurses, but also patients and organizations. The present study aimed to identify the predictors of turnover intention based on psychosocial factors in nurses of Ardabil pre-hospital emergency and educational and medical centres during the COVID-19 outbreak. DESIGN: The present descriptive-analytical study was conducted in June, 2020. METHODS: A total of 479 nurses working in Ardabil pre-hospital emergency and educational and medical centres to fight COVID-19 were recruited for this study using the census method. Data were collected using the Demographic Information Questionnaire, Turnover Intention Questionnaire, Weiss & Marmar Impact of Event Scale-Revised (IES-R), General Health Questionnaire (12 C-GHQ) and Job Content Questionnaire (JCQ). Data were analysed with SPSSv.22 software using correlation, t test, analysis of variance, multiple regression and descriptive tests. RESULTS: The mean turnover intention score of nurses was 41.73 with a standard deviation of 12.11. The results of correlation coefficient revealed a positive relationship between PTSD, general health, job demand and job strain with turnover intention (p ≤ .01) and a positive and significant relationship between social support and turnover intention (p ≤ .01). Multiple regression analysis showed that the variables of gender, marital status, work position, decision latitude, social support, job strain, general health and post-traumatic stress disorder (PTSD) were predictors of turnover intention. CONCLUSION: Job stressors during the COVID-19 outbreak have led to an increase in nurses' turnover intention. Identifying and managing the factors related to job stressors will make it possible to prevent nurses' turnover intention in such critical situations.

The Effectiveness of Health Belief Model Initiative in Breast Cancer Screening Behaviors among Women Health Volunteers.

Knowledge of screening methods and regular diagnostic tests play an important role in reducing the incidence of cancers and their mortality. We investigated the effectiveness of health belief model initiative in breast cancer screening behaviors among women health volunteers. A quasi-experimental design and non-probability sampling technique was conducted during 2019 in Abhar, Iran. Two out of six health centers were approached and each was recruited in either experimental or control group. Based on the Iranian and standardized version of the Champion's Health Belief Model Scale, the different domains of the scale and breast cancer screening behaviors of eligible women health volunteers (n = 72) were evaluated. Then, seven training sessions were designed and implemented for the intervention group using local language and different educational approaches. The participants were reevaluated according to the same questionnaire three months after the intervention. There was a meaningful difference regarding breast self-exam, knowledge, perceived susceptibility, perceived severity, perceived benefits, and perceived barriers among both the control and intervention groups before and after the intervention. Training programs using health belief model are crucial in developing breast cancer screening behaviors for women health volunteers. Thus, it is recommended that training programs should be conducted using individual behavioral models.

The Iranian Protocol of Group Reminiscence and Health-Related Quality of Life Among Institutionalized Older People.

PURPOSE: Reminiscence has a positive role in improving memory performance. It may increase the attention of the older adults to themselves, helping them to cope with the crises and the process of aging. We aimed to investigate the impacts of memory recalling, sharing life experiences and stories confidently from the past on promoting numerous domains of quality of life (QoL), among institutionalized older people in the Ilam province of Iran. METHODS: The study was carried out, using a quasi-experimental approach (a pre- and post-one group design). The statistical population consisted of all older people who were institutionalized in nursing homes. Based on inclusion and exclusion criteria, 43 potential participants were recruited, and the status of QoL was assessed, using the Iranian short-form health survey (SF-36) and face to face interviews. Then, eight sessions were designed and implemented. The participants expressed their memories such as bitter and sweet memories at various periods of life, and finally, the QoL of the participants was re-evaluated according to the same questionnaire, three months after the intervention. RESULTS: There was a significant difference between the scores of pre- and post-intervention in most of the sub-scales of QoL, including physical functioning, role limitations due to physical health and emotional problems, emotional well-being, social functioning, and general health. CONCLUSION: Reminiscence may, in certain circumstances, be an effective care option for people living in long-term care with the potential to impact positively on the QoL of residents.

Challenges Faced by Nursing Students to Work with Nursing Personnel: A Qualitative Study.

PURPOSE: Nursing is a practice-based discipline. Clinical education is one of the most important parts of nursing education; nurses play an important role in the learning of nursing students. This study was carried out to unveil the challenges of nursing students' learning through working with nurses. METHODS: A qualitative design was used to conduct the study in city of Khalkhal, Ardabil province, Iran. In order to collect data through purposive sampling, twenty students were interviewed using in-depth semi-structured individual techniques. Data analysis was done using MAXODA 12. RESULTS: Challenges of nursing students' learning were generally categorized into three main themes including inappropriate social norms, inadequate organizational atmosphere, and inadequate resources. CONCLUSION: It seems that inappropriate organizational culture in the clinical setting and wrong distribution of resources will lead to disruption of student-nurse relationships and ultimately disruption of clinical education.

Cognitive factors associated with brucellosis preventive behaviours among diagnosed patients: an application of Empowerment Model.

BACKGROUND: Brucellosis is an endemic disease in many countries, especially in the Mediterranean region, as well as countries such as the Islamic Republic of Iran. Despite the preventive measures against brucellosis adopted in different countries throughout the world, the disease is still a public health concern. AIMS: Our aim in the present study was to examine the cognitive factors associated with Brucellosis Preventive Behaviours (BPBs) among diagnosed patients utilizing Empowerment Model. METHODS: In 2013, applying a cross-sectional study, all 238 patients with brucellosis in Chaldoran County, Islamic Republic of Iran, were recruited to answer a researcher-made EM-based questionnaire and BPBs Scale through interview. RESULTS: Hierarchical multiple linear regressions were performed with BPBs as the outcome variable. Predictors for this variable, according to their natures, were classified in two different blocks. In the first block, significant effect was found on BPBs by demographic variables (ΔR2 = 0.301). In the second block, the level of education, knowledge, and self-efficacy were significant predictors (P < 0.001) of BPBs (ΔR2 = 0.808). CONCLUSIONS: The Empowerment Model was found as a helpful framework in predicting the risk factors of BPBs. Health care providers in low- and middle-income countries should consider the patients' knowledge on the disease and their level of self-efficacy to perform BPBs as the core categories of empowerment while designing brucellosis prevention programmes.

Why People Choose to Volunteer? Women Health Volunteers' Activities, Reasons for Joining and Leaving.

Introduction: Women health volunteers are the link between people and healthcare workers. They play an important role in health education activities, following up families under coverage, and updating the demographic data to health centers. This study was performed to uncover women health volunteers' activities, reasons for joining and leaving from the program. Methods: A qualitative study design was used to conduct the study. Through purposive sampling technique, twenty -four in-depth semi-structured individual interviews and two focused group discussions with women health volunteers and their supervisors were conducted in Tabriz, Iran. Data analysis implemented thematic analysis, using MAXQDA10. Results: The findings were generally categorized into three major themes, participation in promoting health, perceived benefit, and perceptual- environmental inhibitors. Participation in promoting health consisted of the sub-themes participation in educational programs, participation in health care. The sub-themes of perceived benefit included benefits from health care services and interest in having an active role in the community. The theme perceptual- environmental inhibitors involved the subthemes participation barriers and lack of innovation and inconsistency with social changes. Conclusion: Culture-building about the role of health volunteers, the valuing on their activities in the community, and informing program supervisors about the health volunteer's duties would help to retain health volunteers and also sustain their activities at the community level.

Mental Health-Ill Health Differences in Disease Severity and Its Sociodemographic Biobehavioral Predictors Among Patients With Knee Osteoarthritis.

Our aim in this cross-sectional study was to investigate mental health-ill health differences in disease severity and its sociodemographic biobehavioral predictors among patients with knee osteoarthritis (OA). Applying convenient sampling, 180 patients with knee OA in Tabriz, Iran, were recruited to participate in completing a three-section questionnaire (SF-12, Lequesne Algofunctional Index and Self-Management Behaviors Scale). Separate hierarchical multiple linear regressions were performed with OA severity as dependent variable: one for OA patients with positive mental health and other for OA patients with mental disorders symptoms. Among the patients with positive mental health, but not those with symptoms of mental disorder, pain management, duration of OA, physical activity management, living alone, and level of education were significant predictors of disease severity. Health care providers with a better understanding on the determinants of disease severity by mental health status may identify vulnerable patients and develop targeted interventions to foster disease management behaviors among OA patients.

Barriers to Women's Participation: Experiences of Volunteers and Community Healthcare Authorities.

Along with health development in general terms, women's involvement in health programs can be effective in raising their self-confidence and their health promotion. This study was carried out to unveil the barriers to and challenges of the health volunteers and to present the solutions to its promotion using active women participants' experiences and the authorities of the program. The study was carried out using qualitative method along with content analysis in city of Tabriz East-Azerbaijan province, Iran. Data collection was conducted utilizing semistructured individual interviews and focus group discussions with the participation of 29 health volunteers and responsible authorities. The participants were selected using purposive sampling with maximum variation. Data analysis implemented conventional content analysis using MAXODA. Barriers to and challenges of health volunteers were generally categorized into four main themes including volunteers and trainers' inadequate capabilities, inadequate acceptance of the volunteers, restrictive social norms, and organizational problems. It seems that interaction among health system, people, and health volunteers should be improved. Holding training programs about the activities of health volunteers at the society level leads into the better utilization of society sources in health programs.

Cognitive determinants of cervical cancer screening behavior among housewife women in Iran: An application of Health Belief Model.

Our aim in this cross-sectional study was to assess the cognitive determinants of Cervical Cancer Screening Behavior (CCSB) among housewife women in Islamabad County, Iran. Through multistage random sampling we recruited and interviewed 280 housewife women. The women who perceived more benefits of performing the Pap test (OR = 1.11), and perceived fewer barriers (OR = 0.915), and higher self-efficacy to perform the test (OR = 1.12) were more likely to have a CCSB in the previous three years. Our findings are informative for the development of targeted interventions to foster CCSB among housewife women.

Skin cancer preventive behaviors among rural farmers: An intervention based on protection motivation theory.

Background: Skin cancer is a serious public health problem in the world. Its prevalence in many countries has been increased in recent years. This study aimed to assess the effects of a theory-based educational intervention to promote skin cancer preventive behaviors (SCPBs) among rural farmers in Chalderan County, Iran. Methods: This was a quasi-randomized controlled field trial study conducted on 238 rural farmers. The data were collected by a questionnaire containing the constructs of the Protection Motivation Theory (PMT) as well as the items of SCPBs. The differences between the groups before and 3 months after the intervention were determined by independent t-test, paired t-test, and chi-square applying SPSS software. Results: Before the intervention, no significant difference was found in the scores of the PMT constructs between the two groups (p>0.05). However, significant differences were found between the scores of all the variables, as well as SCPBs, in the two groups after the intervention (p<0.05). Conclusion: The PMT was found to be an appropriate framework for designing educational interventions aiming at promoting SCPBs among rural farmers. It was concluded that designing an educational program with a focus on promoting perceived susceptibility increased the level of performing SCPBs among the rural farmers.