The effect of educational intervention based on social support theory on the perceived stress caused by the covid-19 pandemic in patients with diabetes in hormozgan (2020-2021).

BACKGROUND: People with diabetes are more at risk of covid-19. Perceived social support plays an important role in maintaining people's health and reducing the negative effects of stress caused by the environment and society. The present study was designed and implemented with the purpose of determining the effect of educational intervention based on social support theory in reducing stress caused by the covid-19 pandemic in people with diabetes. METHODS: The current investigation was an interventional and semi-experimental study conducted on 212 patients diagnosed with type 2 diabetes. Eligible participants were diabetic individuals capable of utilizing virtual platforms and not afflicted with COVID-19. Exclusion criteria encompassed unwillingness to continue study participation, absence from multiple training sessions, and development of a specific illness during the study period. Random allocation placed patients into either the control or intervention group. The intervention group received educational materials via WhatsApp, while the control group did not receive any intervention. The researcher administered a questionnaire to collect demographic information and assess perceived social support among the patients. Data analysis involved the use of chi-square tests, independent and paired t-tests, as well as ANCOVA. RESULTS: This study revealed that the mean age of patients in the control and intervention groups was 46.35 ± 14.15 and 51.72 ± 11.57, respectively. Most of the diabetic patients in both groups were female, married, had a diploma, were housekeepers, and had an income between 2 and 5 million Tomans. According to the results obtained in all subscales of social support theory as well as the perceived stress score due to the corona pandemic after the educational intervention, a statistically significant difference was observed between the two groups (P < 0.05), so that the score of all subscales of social support theory in the intervention group was higher than the control group. But the perceived stress score caused by Corona in the intervention group was significantly lower than the control group. CONCLUSION: The results of this study illustrate the noteworthy influence of social support training in lessening perceived stress among patients with diabetes during the COVID-19 pandemic. Consequently, healthcare providers are encouraged to integrate social support education programs into comprehensive care initiatives for diabetic patients, particularly during periods of heightened stress like the current coronavirus pandemic.

An intervention to improve antibiotic prescription behavior in veterinary students: A protocol based on the multi-theory model to tackle antimicrobial resistance.

Background and Aims: Antimicrobial resistance (AMR) is a global health threat. Moreover, incorrect and inappropriate drug prescription behavior is considered a fundamental risk factor. Thus, the present study aims to develop, implement, and evaluate the effectiveness of an educational program based on the multi-theoretical model (MTM) in improving antibiotic prescription behavior in veterinary students of Iran. Methods: The present study will include four phases including a qualitative phase, an instrument design and psychometric test phase, and a cross-sectional, and an interventional phase. In the first phase, the sampling will be purposive with a maximum variety. The interviews will be conducted with a sample of veterinarians. Results: The data will be analyzed in MAXQDA 10. In the second phase, the face and content validity will be tested by a panel of experts as field specialists. A confirmatory factor analysis will be used to test construct validity, and Cronbach's alpha coefficient and intracluster correlation coefficient will be used to determine the internal consistency of the instrument. Then, at this stage, a number of veterinary students will be selected through a multi-stage sampling method. In the cross-sectional phase, another sample of veterinary students will complete a researcher-made questionnaire. Then, Spearman's correlation coefficient test will be used to test the relationship between the two stages of behavior initiation and behavior continuation. The data will be analyzed in SPSS 22. In the third phase, some veterinary students will be selected through a census and will be randomly divided into a control and an intervention group. To collect data in the final phase, the researcher-made questionnaire that was designed in the second phase of the study based on a multi-theory model will be used to extract data. To compare demographic characteristics, compare the correlation between the constructs of the multi-theory model with antibiotic prescribing behavior in the cross-sectional phase and compare the scores of the constructs of the MTM in two intervention and control groups paired-samples T test and independent-samples T test will be used. Conclusion: The present study will aim to improve antibiotic prescription behavior in veterinary students based on a MTM. The findings can be used as a model for training students in clinical fields such as veterinary medicine and general medicine at university at a national level. After verification and approval by experts and university professors, we can expect a change in the educational curriculum to include instructions on how to write out prescriptions for students. There are hopes that the present study if conducted accurately and widely to help prevent AMR in livestock, humans, and society.

Effect of Educational Intervention Based on Self-Efficacy Theory on the Caring Behaviour of Mothers Who Have Children With Cancer.

Self-efficacy, as one of the concepts of the empowerment model, plays a role in increasing caring behaviour. Accordingly, our study aimed to evaluate the effect of educational intervention based on self-efficacy theory on the caring behaviour of mothers who have children with cancer. This quasi-experimental study was conducted on all mothers (N = 86) of children with cancer undergoing chemotherapy who were referred to Bandar Abbas Children's Hospital. All mothers participated in 10 training sessions based on the four foundations of self-efficacy theory. The results indicated a significant increase in the mean score of mothers' self-efficacy at first and second follow-ups respectively by 10.2 and 10.9 after intervention (P < 0.001). Furthermore, the mean score of caring behaviour was increased after the intervention for the first and second follow ups by 24.6 and 25.9 from the baseline respectively (P < 0.001). The results of the present study indicated that an educational program for mothers increased their caring behaviour and self-efficacy with the increase of self-efficacy, mothers' caring behaviour was promoted. Authorities and practitioners are suggested to pay more attention to designing educational programs based on health models and theories.

Investigating the predictors of perceived social support to control COVID-19: A qualitative study.

Background: Considering the adverse effects of COVID-19 pandemic, the present study aimed to explore the barriers and facilitators of perceived social support to prevent the further spread of the disease. Methods: In the present qualitative study, a content analysis was done. To this aim, 37 Iranian subjects who had active accounts on Instagram were initially invited to participate in the study. The data were collected through face-to-face (n = 25) and telephone conversations (n = 12). A purposive sampling was used and the data collection continued until data saturation. Finally, 41 interviews were held which took 17-48 min. Results: The data analysis led to the extraction of two main categories, the barriers and facilitators of perceived social support, as well as 12 subcategories. Economic issues, familial factors, socio-cultural factors, personal and psychological factors, ineffective quarantine rules, and poor management were the main barriers to perceived social support. The facilitators were divided into six categories, including familial influences, personal factors, government support, and improved occupational, social, spiritual, and emotional condition. Conclusion: The findings showed that a combination of environmental and social variables might influence the COVID-19 disease, either decreasing or increasing its spread. A sound knowledge of these variables, influenced by the social context and real-life experiences during the pandemic, allows to take the right measures and enrich training programs. The prevalence of the disease can be controlled by increasing environmental and social facilitators and decreasing the influence of barriers.

Determinants of antimicrobial resistance occurrence in animal-based food, perceived by livestock farmers: A qualitative phenomenological study.

Background and Purpose of the Study: The determinants of antimicrobial resistance in human medicine have been copiously explored. On the other hand, the existing research in veterinary medicine and animal husbandry is in its infancy. The present qualitative study used the one-health approach to explore farmers' attitudes toward antimicrobial use and antimicrobial stewardship. Methodology: The present qualitative study was phenomenological in type. It was conducted in 2022 in the two cities of Kerman and Bandar Abbas in Iran. The data were collected through in-depth interviews by semistructured interviews with 17 livestock, poultry, and aquatic animal breeders selected through purposive sampling. The interviews lasted between 35 and 65 min in the Farsi language. The data were analyzed using conventional qualitative content analysis and Colaizzi's seven-step analysis technique. Results: The open coding was done in MAXQDA 10 and the results of data analysis were classified into five main themes and 17 subthemes subcategories. The main categories include personal determinants, contextual determinants, legal and regulatory determinants, social determinants, and economic determinants. Conclusion: Considering the increasing use of antibiotics among livestock farmers and breeders of animals used as human food, different measures such as educational, regulatory, social, and even cultural interventions may be able to control and prevent antimicrobial resistance.

Prediction of self-care behaviors among diabetic patients based on social cognitive theory.

Background: Diabetes is a global health issue and the most prevalent chronic metabolic disease, which requires lifelong self-care behaviors. Thus, the present study was conducted with the aim of predicting the factors of self-care behaviors based on social cognitive theory in diabetic patients referred to comprehensive health service centers in Fasa. Methods: This cross-sectional research comprised 106 type 2 diabetes patients who were referred to Fasa service providers to determine the optimal solution. Outcomes were assessed using an existing demographic questionnaire, the diabetic self-care questionnaire, and a unique questionnaire to assess social cognitive theory, the validity and reliability of which were estimated. SPSS21 software with a Chi license was used for data analysis, and Spearman correlations, independent t-tests, and one-way ANOVA were performed. Results: The age range of patients was between 33 and 67 years. There was a significant relationship between gender, education, and type of treatment with self-care. According to the findings, the variables of self-efficacy (r = 0.200), self-efficacy of overcoming obstacles (r = 0.285), environmental factors (r = 0.334), observational learning ability (r = 0.148), situational perception (r = 0.297), emotional adaptation (r = 0.051), outcome assessment (r = 0.114) and outcome expectation (r = 0.082) had a positive and significant correlation with self-care behaviors. Also, the self-efficacy variable (Beta coefficient = 0.340) had the highest predictive value. Conclusion: In designing and implementing educational interventions for self-care of diabetic patients, the theory of social cognition can be used as a framework to promote and maintain public health in patients.

Perceived stress among older adults during COVID-19 outbreak: A cross-sectional study in Southern Iran.

Background and Aims: The stress associated with the coronavirus disease 2019 (COVID-19) pandemic significantly affects people's lives, especially older adults. The present study aimed to identify risk factors leading to the perceived stress associated with COVID-19 among the adults over 60 years old of Southern Iran. Methods: This cross-sectional study was conducted in December 2021 in Bandar Abbas among older adults. The COVID-PSS-10 (Perceived Stress Scale) questionnaire was distributed among the older adults receiving healthcare services from health centers in Bandar Abbas selected through a convenient sampling method. Then, answers to the questions resulted in the score (without units). Results: A total number of 456 participants between 60 and 90 years with an average age of 64 ± 5.12 years took part in this study. The mean ± SD score of total perceived stress was 16.45 ± 8.36 (the mean score of stress was 10.30 ± 6.16 and coping was 6.15 ± 3.83). Of the total, 129 participants (28.28%) were grouped as the high-stress group. Results showed that the 70-79 years age group had higher odds of belonging to the stressed group than the 60-69 years age group (odds ratio = 2.336). Moreover, participants with a diploma were 57% more stressed than illiterate participants. The latter perceived less stress and had lower odds of belonging to the high-stress group. The employed were 61% less likely to be categorized in the stressed group than the unemployed. Among women, 43% were less likely than men to be in the high-stress group. Conclusion: As the present findings showed, the risk factors of perceived stress induced by COVID-19 are old age, low education, unemployment, and masculinity. Therefore, planning to improve stress-coping skills such as entertainment, strengthening social relationships, physical activity, and the peace of mind of this population are suggested under the supervision of geriatric specialists and psychiatrists.

The Effect of an Educational Intervention Based on the Health Belief Model on Preventive Behaviors of Prostate Cancer in Military Men.

BACKGROUND: Prostate cancer is the most common malignant cancer, and after lung cancer, is the second cause of death among all types of cancer in men. This study was done to assess the educational intervention based on the Health Belief Model on the promotion of preventive behaviors of prostate cancer among military men. METHODS: The present study is a semi-experimental study that was conducted on 80 men of a military collection by using randomized-stratified sampling with proportional allocation approach in BandarAbbas in 2017. The individuals were randomly divided into two groups, intervention (n = 40) and control (n = 40). The data collection tool was a questionnaire including demographic questions, knowledge questions and questions about Health Belief Model constructs and efficiency of preventive behavior that was completed in two stages and PSA Test doing. Data were analyzed by using SPSS software-version 21-, descriptive statistics (frequency, mean and standard deviation) and inferential statistics (independent T-test and paired T-test). RESULTS: After three months intervention, the mean score of Perceived Susceptibility, Severity, Benefits, Barriers, Self-Efficacy, and preventive behavior performance were seen significantly different between the two groups (p < 0.05), 52.5% of them was done PSA Test. CONCLUSIONS: Based on the health belief model, educational intervention has been effective in promoting preventive behaviors. According the effect of Health Belief Model components on preventive behaviors it is suggested that health care providers identify the benefits and barriers of preventative behaviors and through enhancing the benefits and reducing the barriers, help men to prevent prostate cancer.

Evaluation of the educational services quality from the viewpoint of postgraduate students at Kermanshah University of medical sciences in 2019.

BACKGROUND: At present, the SERVQUAL model is one of the most significant tools for measuring customers' expectations and perceptions in organizations. Determination of expectations and perceptions of students who are the main university customers from educational services can provide valuable information to the programmers to improve the condition of educational services. Therefore, this study aims to measure the quality of education services from the viewpoint of postgraduate students at Kermanshah Medical Sciences University using the SERVQUAL model in 2019. MATERIALS AND METHODS: This was a descriptive cross-sectional study. The population under the study consisted of 162 students at the postgraduate education section (Master's degree and Ph.D.) studying in the second semester of the academic year of 2019 at Kermanshah Medical Sciences University. The standard SERVQUAL questionnaire was used for data collection, which included five dimensions of the quality of educational services, and the random-stratified sampling method was employed. The data were analyzed using the SPSS Statistics software (version 23.0, SPSS Inc., Chicago, IL, USA), and descriptive and other statistical tests, including the Pearson correlation coefficient, and paired and independent t-tests were performed. RESULTS: Based on the students' perspective in the provision of service there was quality gap existed in all services, and the largest gap was in the reliability dimension (-0.37), and after that, empathy (-0.37), guaranty (0.27), and responsiveness (-0.24) dimensions, respectively, and the lowest one was in the tangible dimension (0.15). There was a statistically significant observed difference between the quality gap in different educational dimensions (P > 0.001). CONCLUSION: Research findings showed that students were not meeting their expectations from the presented educational services. Hence, holding a training workshop is suggested in the field of how to serve and enhance communication skills for employees and teachers.

Effect of educational intervention on safe traffic behaviors of high school male students in Iran, using the theory of planned behavior: a quasi-experimental study.

BACKGROUND: Behavior change interventions in tackling road traffic injuries are a public health concern. Thus, this interventional research was to survey the effect of safe traffic behaviors among male students in Hamadan, Iran, utilizing theory of planned behavior. METHODS: In this quasi-experimental study, 204 students were randomly selected through multistage sampling from male high school students of Hamadan city, west-central of Iran, and non-randomly allocated to control and intervention groups (102 students in every group). The self-administrate questionnaire was used for data collection in this research. Frequency (percentage) and mean (SD) were used for description. Cronbach alpha coefficient, content validity ratio (CVR) and content validity index (CVI) were used for psychometric evaluation of questionnaire and paired/independent sample t-test was used for data analysis. All statistical analyses were done in SPSS 19 and significant level was considered 0.05. RESULTS: In both groups, more than 50 % of students walked to school. The two study groups were homogeneous in terms of confounding variables (p >  0.05). The validity of the questionnaire was confirmed and the total Cronbach's alpha value was equal to 0.97. There was no significant difference in the score of safe traffic behaviors between the two groups before the intervention (p >  0.05). But after the intervention, the score in the intervention group was significantly increased (p < 0.05). Intragroup comparison also showed that only in the intervention group the score was significantly changed (p < 0.05). CONCLUSION: Theory of planned behavior is a suitable conceptual framework for planning the interventions to increase safe traffic behaviors in students.

Effect of A Mobile-Phone Mediated Based Education on Self-Care Behaviors of Patients With Thalassemia Major.

Introduction: One way to improve the quality of life of the patients with thalassemia major is to enable them through education. The present research aimed to explore the effects of an educational intervention through mobile phones on self-care behaviors of the patients with thalassemia major Methods: In this quasi experimental study, which was done from May to January in 2017, 91 patients were enrolled who were suffering from thalassemia major.The census sampling method was performed with random allocation of interventional and control groups. Educational intervention was only applied to the intervention group. The study instrument was a questionnaire which was filled out by the patients before and two months after the educational intervention. For data analysis, statistical tests including independent samples t-test, paired-samples t-test, Mann-Whitney test and Wilcoxon test, were used through SPSS ver.13 software. Results: Prior to the intervention, the mean scores of knowledge, attitude and self-care behaviors were not significantly different between the intervention and control groups. After the intervention, , however, there was a statistically significant increase in the aforementioned scores in the intervention group, but there was no statistically significant increase in scores of the control group. Conclusion: The present findings showed the positive effect of the mobile-phone mediated education on knowledge, attitude and self-care behaviors of the patients with thalassemia major. Therefore, the use of mobile phone is recommended as an effective way of transferring instructional material as related to self-care to patients with thalassemia major particularly when access to them is limited.

Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data.

BACKGROUND: Dialysis is a dominant therapeutic method in patients with chronic renal failure. The ratio of those who experienced the event to the predictor variables is expressed as event per variable (EPV). When EPV is low, one of the common techniques which may help to manage the problem is penalized Cox regression model (PCRM). The aim of this study was to determine the survival of dialysis patients using the PCRM in low-dimensional data with few events. STUDY DESIGN: A cross-sectional study. METHODS: Information of 252 dialysis patients of Bandar Abbas hospitals, southern Iran, from 2010-16 were used. To deal with few mortality cases in the sample, the PCRM (lasso, ridge and elastic net, adaptive lasso) were applied. Models were compared in terms of calibration and discrimination. RESULTS: Thirty-five (13.9%) mortality cases were observed. Dialysis data simulations revealed that the lasso had higher prediction accuracy than other models. For one unit of increase in the level of education, the risk of mortality was reduced by 0.32 (HR=0.68). The risk of mortality was 0.26 (HR=1.26) higher for the unemployed than the employed cases. Other significant factors were the duration of each dialysis session, number of dialysis sessions per week and age of dialysis onset (HR=0.93, 0.95 and 1.33). CONCLUSION: The performance of penalized models, especially the lasso, was satisfying in low-dimensional data with low EPV based on dialysis data simulation and real data, therefore these models are the good choice for managing of this type of data.

Barriers to Pap Smear Test for the Second Time in Women Referring to Health Care Centers in the South of Tehran: A Qualitative Approach.

BACKGROUND: Cervical cancer is a preventable disease with a regular screening program. Many studies have reported a large number of barriers that women had for the first time, but this study decided to find other barriers for the second time pap smear. METHODS: In this qualitative research, data were gathered through in-depth interviews and expressed through conventional content analysis in the form of constant comparison. The participants were 15 women with family profile at 30 health care centers who lived in the south of Tehran and had done Pap smear for one time but didn't do it for the second time. RESULTS: Three main themes emerged from the analysis of the interviews: negative experiences of the first Pap test were as follows: results of the first time test, readiness for performing the test, getting the test itself, and the site of the first Pap test. Personal barriers to getting the second Pap test were: inattention to time, physical barriers to the second Pap test, and inhibitory beliefs. Perceived social barriers to getting the second Pap test with two sub-themes included social supports and abstract norms. CONCLUSION: This study provided other barriers about Pap smear including lack of the spouse's support, the role of health care providers and physicians in screening program for early diagnosis in women.

The effect of an instructional program based on health belief model in decreasing cesarean rate among primiparous pregnant mothers.

INTRODUCTION: Although cesarean section has saved many mothers' and infants' lives, the problem is in its increasing prevalence. According to recent statistics, the current rate of cesarean in Iran is in fact 3-4 times as more than the standard rate defined by WHO. Therefore, the present study is aimed to estimate the effect of an instructional program based on health belief model on reducing cesarean rate among primiparous pregnant women. MATERIALS AND METHODS: In this semi-experimental research, 60 primiparous women who had visited Bandar Abbas Healthcare Centers were selected as the subjects. They were in their 26-30(th) week of pregnancy. They were selected in a multi-stage cluster sampling method (a combination of clustering and simple randomization), and were divided into two groups, subjects and control group. The data were gathered using a valid and reliable questionnaire. The instructional intervention was done after the completion of the pretest questionnaire based on the sub-constructs of the health belief model in six instructional sessions. 1 month after the intervention, posttest questionnaires were completed by the subjects in both groups. The data were analyzed using descriptive statistics, standard deviation, independent t-test, and paired t-test. The significance level was set at <0.05. RESULTS: Two groups had a significant difference between awareness score, perceived sensitivity, intensity, benefits, barriers, self-efficacy, and the performance (P < 0.001). In the experimental group, nine subjects (30%) had a natural delivery. CONCLUSION: According to the findings of the current research, an instructional program illuminated (designed) by the health belief model can significantly influence pregnant women's awareness, intention, and choice of delivery type.

Effects of an educational intervention based on the protection motivation theory and implementation intentions on first and second pap test practice in Iran.

BACKGROUND: Few Iranian women take the Papanicolaou test despite its important role in preventing cervical cancer. This study aimed to determine the effectiveness of an educational intervention based on the protection motivation theory (PMT) variables and implementation intentions in the first and second Pap test practice among Iranian women. MATERIALS AND METHODS: In this quasi-randomized controlled trial, 200 women who were referred to 30 primary health care clinics in Tehran were randomly selected. PMT variables and Pap test practice were measured at baseline and again after 3 and 15 months. The 4-week educational intervention program was conducted for the intervention group. RESULTS: Following the intervention, the mean scores of self-efficacy, perceived vulnerability, and behavior intention variables were significantly higher in the intervention group when compared to the control group (p<0.05). No significant differences were found in the perceived severity, response efficacy, response cost, and fear between the two groups following the intervention. Higher percent of women in the intervention group had obtained first and second Pap test compared to the controls. CONCLUSIONS: The PMT and implementation intentions provide a suitable theory-based framework for developing educational interventions regarding Pap test practice in Iran.