مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال پانزدهم شماره 3 (پیاپی 59، پاییز 1396)

Families with diabetic children face various problems and challenges such as child psychological problems, behavioral problems and a low quality of life. The aim of this study was to investigate the effects of promoting the quality of life of parents of diabetic children on clinical symptoms in their children.
This was a pre-test and post-test semi-experimental research with a control group. The statistical sample included 32 diabetic children and their parents, selected in 2 stages using the convenience random sampling method from among Tehran Diabetes Association members, randomly assigned to either an experimental or a control group. The experimental group received education about quality of life promotion in ten 2-hour sessions. Data were collected using the child clinical symptoms questionnaire (CSI-4-Child Symptom Inventory) and analyzed by multi-variate analysis of covariance using SPSS 20.
The average post-test scores of emotional-behavioral symptoms in the experimental and control groups were significantly different (F=19.20, F=24.53, F=21.01, P Education about promoting the quality of life imparted to parents of diabetic children can significantly affect clinical symptoms in the diabetic children, decreasing the symptoms. Therefore, such education is recommended in order to promote the quality of life and reduce psychological distress in families of children with diabetes.

The objective of this study was to assess the psychometric properties of the Adolescent Depression Scale (ADS) based on the item-response theory and compare the results with those based on the classic test theory.
A total of 750 students (364 males and 386 females) were selected through multistage random clustering (levels proportional to size) and completed a questionnaire comprising 46 questions developed by the investigators.
Results of factor analysis and questions structure showed that the important item-response theory presumptions, namely, unidimensionality and local independence, are contained in ADS. As regards the psychometric characteristics of the questions, results from the two theories were similar, except that the item-response theory provided more valid indices for assessing the questions. Further analysis of the data indicated that the two theories showed close values for internal consistency with regard to psychometric characteristics, such that values of 0.933 and 0.947 were obtained for Alpha Cronbach and marginal validity, respectively. Finally, the normality scores were calculated based on the Item Response Theory with those based on the Classic Test Theory. Ranking the individuals by the two theories showed considerable differences as regards the depression construct continuum, such as a difference of 86, 92, or 93 individuals.
Based on the findings, it can be concluded that the item-response theory models provides a higher number of more exact indices for judgment and making decisions about questions, tests and individual ranking. Therefore, application of the item-response theory for assessment of other educational and psychological constructs is recommended.

Following the deployment of the Health Transformation Plan (HTP) in most of the public hospitals, various changes occurred in the relationships between insurance organizations and hospitals. The purpose of this study was to find the obstacles and challenges facing the two types of organizations and suggest solutions.
This was an exploratory study. The research population was a total of 74 participants from Tehran public, private and military hospitals (managers, senior nursing officers, financial officers, and chiefs of accounting) and basic and complementary insuring organizations (insurance agents in hospitals, insurance officers from insuring organizations, and insurance managers). Data were gathered through semi-structured interviews and analyzed using thematic analysis.
The most important challenges were as follows: acting on one’s own preferences, deductions, delays in the payments of hospital expenditures, an insufficient number of insurance agents in some hospitals, insufficient accountability of hospital personnel in expenditure management, lack of sufficient interaction between the two organizations, and lack of contracts between complementary insurance companies and public hospitals and between private hospitals and basic insurance organizations.
Given the importance and sensitivity of the relations between the health service providers and receivers and considering further the complexity and challenges that appeared after HTP and hospital accreditations, a knowledge of the challenges identified in this research can help policy-makers and managers to find suitable, effective strategies for enhancing relations and communication between insurance companies and hospitals.

The hypersexual disorder is described as multiple unsuccessful attempts to control or diminish the amount of time spent on engaging in sexual fantasies, urges, and behaviors in response to dysphoric mood states or stressful life events. The purpose of the present research was to determine the validity, reliability and factor structure of the Hypersexual Behavior Inventory (HBI) for use for students, developed by Reid and colleagues.
In this descriptive study, 300 male students of Azarbaijan Shahid Madani University were selected by cluster random sampling on the basis of school and field of study. Data were collected using the HBI, and its reliability and validity were determined using Cronbach’s alpha and confirmatory factor analysis (CFA).
The reliability coefficients obtained for control, consequences, coping components and total scale were 0.82, 0.80, 0.86 and 0.90, respectively, which showed good reliability. In addition, the results of factor analysis showed a statistically significant association between observed variables (questions) and the latent structures (factors), indicating an appropriate/desirable fitness for the three-factor structure in the sample (GFI = 0.91, AGFI= 0.88, CFI= 098, RMSEA= 0.057).
The Hypersexual Behavior Inventory is a valid and reliable tool to be used for the students, and, therefore, the use of this tool in future research is recommended.

Medication is a very important part of care and therapeutic services in health service delivery units. Therefore, medication errors in hospitals may cause serious problems in patient care and, even, death. This study aimed to determine the relationship between the type of medication errors reported and patient safety standards in a public hospital in Tehran, Iran.
In this study, the establishment of safety standards in 30 departments of Rajaee Hospital in Tehran, Iran and its relation to quality reporting medication errors by the hospital medical staff during the period 1391-1395 were investigated. Data were collected using two separate checklists, namely, "The establishment of medication safety” using the model 6R" and "The quality of reporting medication errors" and analyzed using the SPSS software, the statistical tests being inferential statistical tests including chi-square, phi coefficient and Cramer’s V.

The data showed that the drug safety standards were established as regards five of the six components in this hospital (the sixth was safe patient positioning). The patient safety establishment was statistically significantly associated with the type of medication errors reported in the hospitals.
Since the process of drug therapy is a common practice in nursing services in the cardiac intensive care units, increased knowledge of nurses about the causes of medication errors, in order to prevent and reduce the occurrence of these errors, is considered quite necessary. Recommendations were made to reduce medication errors in hospitals.

Sexuality education is one of the most important educational needs of adolescents, and mothers can have a key role in sex education of their daughters. This study aimed at developing, implementing and evaluating a skill-based training program for mothers for sexuality education of adolescent girls in Mahshahr, Iran.
This was a field trial conducted on 140 mothers having 12- to18-year-old girls between September and March 2012. Data were collected using two reliable questionnaires developed by the investigators ─ a "Parent-Child Relationship: Mother" questionnaire for assessing the mothers’ communication skills completed by the adolescent girls, and a "Knowledge and attitude about sexuality education of adolescents" questionnaire for assessing the mothers’ knowledge and attitude about sex matters and communication, skills completed by the mothers themselves. Based on the results, an educational intervention for mothers was designed consisting of three training sessions and implemented. The mothers’ knowledge, attitude and communication scores after a period of three months were compared with the respective baseline scores.
Three months after the intervention, the mean scores of mothers’ knowledge and attitude about sexuality matters increased significantly (in both cases p Based on the findings it can be concluded that the designed educational program was effective in improving the knowledge and attitudes of the mother about sexuality matters although it did not affect their communication skills. Promoting communication skills of mothers as an important factor for sexuality education of their daughters requires regular, continuous educational sessions, as well as practice and experiences.

Emotional intelligence is one of the psychological dimensions which plays an important role in emotional regulation. In this study the role of spiritual orientation in predicting cognitive emotion regulation strategies among the students of Tabriz University of Medical Sciences was investigated.
This was a cross-sectional study conducted on 250 students of Tabriz University of Medical Sciences selected through simple random sampling in 2015. Data were collected using the cognitive emotion regulation strategies questionnaire (Garnfsky et al., 2002) and the spiritual intelligence questionnaire (Shahidi and Farajnia, 1391) and analyzed using SPSS 23, the statistical tests being the Pearson correlation coefficient and canonical correlation.
Results. A statistically significant positive association was found between spiritual attitude and emotion regulation. Based on canonical correlation, of the two canonical roots only root 1 was significantly associated with emotion regulation (p= 0.03; f, 0.90), explaining 7% of the emotion regulation variance. The second root had no statistically significant correlation with emotion regulation.
The deeper the religious beliefs of a person, the higher he will value himself and the world around. Consequently, he will have more satisfaction in life and, therefore, can better control his emotions and feelings.

In the last few decades co-trimoxazole, an antibacterial combination of trimethoprim and sulfamethoxazole, has been used for treatment of bacterial infections, but due to the vast usage of these drugs, resistant strains have appeared throughout the world. One of the reasons for resistance to co-trimoxazole is related to drf genes, which are responsible for trimethoprim resistance, while the sulfamethoxazole resistance is due to sulfonamide sul genes. The aim of this study was to investigate drug resistance and frequencies of resistance genes in gram-negative bacteria isolated from clinical specimens.
Clinical samples were collected from patients in Pars Hospital, Tehran, Iran, in which presence of gram-negative bacteria was confirmed by biochemical tests. Then antibiotic susceptibility tests were performed for 5 antibiotics by disk diffusion agar technic. DNA was extracted from bacteria resistant to co-trimoxazole, followed by PCR using specific primers for sul1, sul2, sul3, and drf7 genes.
In the co-trimoxazole-resistant bacteria, 26%, 74%, 2% and 16% of the isolates contained sul1 gene, sul2 gene, sul3 gene and drf7 gene, respectively. Further analysis of the data showed that 51% of the isolates were resistant to gentamicin, 74% to ceftriaxone, 65% to ciprofloxacin and 3% to colistin. For resistance to trimethoprim only the drf 7 gene was used.
The results of this study show that in the isolates of co-trimoxazole-resistant gram-negative bacteria, the sul 2 gene has a major role in development of resistance to sulfonamides. In this study only the drf 7 gene was used to assess the resistance of trimethoprim, so we recommend to conduct studies also on other drf genes, so that the importance of each in resistance to co-trimoxazole can be determined.