Impact of health literacy and self-care behaviors on health-related quality of life in Iranians with type 2 diabetes: a cross-sectional study.

BACKGROUND: Regarding the importance of health literacy as a key factor in self-care, appropriate understanding of health information by patients with type 2 diabetes mellitus (T2DM) is fundamental for better management of risk factors, which can also benefit their quality of life. This study aimed to describe the relationship between health literacy (HL), and self-care behaviors with health-related quality of life (HRQL) in patients with T2DM. METHODS: A cross-sectional survey was done in Iran in 2019. Patients were recruited randomly from health centers by medical records (n = 192, 55.2% male, mean age 58.12 years). The data collection included demographic form, health literacy questionnaire, diabetes self-care behavior questionnaire, and world health organization's Quality of Life-BREF (WHOQOL-BREF). Analyses were adjusted for confounders using hierarchical regression analysis. RESULTS: HL as predictor variables explained 47.5% of variance in overall HRQL (p value < 0.001), reading health information was the strongest HL dimension (ß = 0.478). Self-care behaviors explained an additional 13.6% of the HRQL variance. In total, 65.5% of the variation in the HRQL is explained by the HL, self-care behavior, and the demographic variables. CONCLUSION: We found that more almost two-third of the HRQL explained by the HL and self-care behaviors. Given the importance of health literacy and self-care behaviors in the quality of life in patients with T2DM, adoption of health-promoting behaviors and increasing health literacy can be beneficial for promoting quality of life among these patients.

Predictors and incidence rate of suicide re-attempt among suicide attempters: A prospective study.

OBJECTIVE: Recent investigations and advances include improved understanding of trends, epidemiology, risk and protective factors on suicide. However, predictors of suicide re-attempt are poorly understood in a prospective design, at least in Iran. This prospective study was performed to investigate predictors and epidemiological aspects of suicide re-attempt during a 5-years of follow-up among Suicide Attempters (SAs). METHODS: All the 1034 SAs of Malekan County were followed up and interviewed from 2014 to 2018. Cox regression analysis was used to estimate crude and adjusted hazard ratios and 95% confidence intervals for suicide re-attempt risk. RESULTS: The overall prevalence of re-attempt was 117 (11.7%) over 5 years period. The overall incidence and person-time incidence rates of re-attempt were 113.15 per 1000 attempters and 7.1 per 100 person-year, respectively. The majority of re-attempts 161 (81.3%) took place within the first-18 months of follow-up while the peak of re-attempt was 6 months after attempts. In the final analysis, age ≤ 25, family income (≥ 10 million Rials), having any psychiatric disorder, poor education, stressful life events, alcohol abuse, and smoking were the most reliable predictors of suicide re-attempt. CONCLUSION: Health systems should be informed about the predictors for subsequent SA after any attempt. Appropriate suicide prevention strategies should be tailored to the specific profile of each group for moderating predictors of suicide re-attempt.

Adherence to a Health Literacy and Healthy Lifestyle with Improved Blood Pressure Control in Iran.

INTRODUCTION AND AIM: High blood pressure is the leading and most important modifiable risk factor for cardiovascular disease. Health literacy and lifestyle are two paramount key factors behind better control of hypertension. This study was conducted to examine the current situation of health literacy and health-promoting lifestyle and its association with blood pressure control among people affected by hypertension in the population over age 30 of Northwest Iran. PATIENTS AND METHODS: This was a cross-sectional study conducted in October and December 2018 on the over 30-year-old population among subjects suffering from hypertension (n= 210). A self-reported questionnaire was used for assessing health literacy dimensions and lifestyle. RESULTS: In hierarchical linear analysis, the HL explained 33.9% of the variance in healthy lifestyle. Among HL dimensions, the ability to access health information and decision-making were significantly associated with healthy lifestyle. The health literacy dimensions contributed to an additional significant increase in 4.7% of the variance explained in hypertension, furthermore, the health-promoting lifestyle items were explained an additional 14.8% of the hypertension variance. In total, lifestyle and health literacy dimensions were able to explain 21.7% of the variance in hypertension. CONCLUSION: Our study encourages efforts to monitor health literacy in people with hypertension and investigate associations with involvement with health-promoting lifestyle.

The Association of Health Literacy Level with Self-Care Behaviors and Glycemic Control in a Low Education Population with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Iran.

INTRODUCTION: Promoting Health Literacy (HL) can be a priority in strategic healthcare planning of the countries. Low HL is prevalent in some societies which make barriers to successful self-care of diseases. The aim of this study was to examine the association of HL with self-care behaviors and glycemic control in a low education population with type 2 diabetes mellitus. METHODS: This cross-sectional study was conducted in Sarab city, Iran. The 192 participants were patients diagnosed as type 2 diabetes and with low level of education. Convenient sampling method was applied and the participants were chosen by their medical records in health-care centers. To collect data a valid and reliable tool was used based on HL dimensions and self-care behaviors. Using hierarchical logistic regression, the possible association of variables with self-care behaviors and glycemic control was assessed. RESULTS: The mean age of study participants was 58.12 (±11.83) years. A 28.8% of the variation in the self-care behaviors is explained by the HL and the demographic variables (R= 0.288%; p-value<0.05). Furthermore, decision-making was the strongest predictor of self-care behaviors (ß= 0.451). Approximately 80% of the variation in the HbA1c is explained by the HL, self-care behaviors, and the demographic variables (R= 0.804%; p-value<0.05). CONCLUSION: This study revealed that the HL dimensions predicted approximately one-fourth of self-care behaviors and the self-care behaviors and HL dimensions about eight-tenths of HbA1c in this population. These findings call for the need for interventional programs on HL to improve the self-care behaviors and HbA1c control.

Assessing the link between head lice infestation and selected cognitive-behavioral factors in a sample of Iranian female adolescents.

BACKGROUND: Head lice infestation is a serious health issue among adolescents in Iran. The primary purpose of the study was to determine the association of head lice infestation with cognitive-behavioral factors in female adolescents. METHODS: The study was cross-sectional, took place between September and October of 2017 in Sarab, East Azerbaijan province, Iran. Using a multi-stage sampling to recruit the study's 226 female adolescents, five of the Sarab's 13 schools were selected through simple random sampling. In the second step, the students were randomly selected using the systematic random sampling method. A survey questionnaire was used to collect the data. FINDINGS: The prevalence rate of head lice was calculated 20.4%, and the subjects with head lice infestation had lower levels of severity, benefits, self-efficacy, and preventive behaviors. Those without head lice infestation reported adhering to preventive behaviors. The perceived severity and self-efficacy were the statistically significant predictors of head lice infestation and use of preventive behaviors. CONCLUSION: Public health authorities, with feedback from the community, must design and implement prevention programs, focusing on mothers and their school-aged children, school principals, and managers of public places as potential change agents. In addition to, perceived severity and self-efficacy should be considered as the key categories when developing these prevention programs.

The survival rate of hepatocellular carcinoma in Asian countries: a systematic review and meta-analysis.

Hepatocellular carcinoma or Liver cancer (LC) is the sixth most common cancer and the fourth cause of death worldwide in 2018. There has not been a comprehensive study on the survival rate of patients with LC in Asia yet. Therefore, the present study was conducted to evaluate the survival rate of patients with LC in Asian countries. The methodology of the present study is based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. The researchers searched five international databases including Medline/PubMed, Scopus, Embase, Web of Knowledge and ProQuest until July 1, 2018. We also searched Google Scholar for detecting grey literature. The Newcastle-Ottawa Quality Assessment Form was used to evaluate the quality of selected papers. A total of 1425 titles were retrieved. 63 studies met the inclusion criteria. Based on the random-effect model one-year, three-year and five-year survival rate of LC were 34.8 % (95 % CI; 30.3-39.3), 19 % (95 % CI ; 18.2-21.8) and 18.1 % (95 % CI ;16.1-20.1) respectively. According to the results of our study, the LC survival rate in Asian countries is relatively lower than in Europe and North America.