فهرست مطالب مهدی جعفری عوری

Motivation is one of the most important issues affecting academic achievement. The aim of this study was to investigate academic motivation and its related factors in students of Baqiyatallah University of Medical Sciences.

In the present cross-sectional descriptive study, 180 students were randomly selected. The study survey consisted from the demographic section, academic motivation questionnaire and a four-item section related to satisfaction with welfare and educational status, job future and field of study. Significance levels was considered less than 0.05.

The students were 50 medical, 34 nursing, 24 operating room, 43 anesthesia and four pharmacy students participated. The mean (SD) age of subjects was 21.66 (1.55). In addition, out of them, they were 82.2% male, 90.6% single, 51.1% undergraduate, 93.3% non-scholarship holders and 88.3% dormitories' residents. The mean (SD) scores of internal and external motivation, lack of motivation, and total academic motivation were 52.77 ± 13.90, 55.08 ±14.07, and 14.98 ± 6.32, and 122.84 ± 29.48, respectively. Academic motivation was statistically significant with respect to different age levels (p ‹ 0.05). External motivation also showed a significant correlation with job satisfaction (p ‹ 0.05) and satisfaction with the field of study (r = 0.15) (p ‹ 0.05).

Findings showed that students' academic motivation is not desirable and needs attention. Providing a basis for students to study in the field of interest, paying more attention to the welfare of students can be effective.

Caring for patients with Covid-19 is a challenging issue. Not only does Covid-19 disrupt the lives of patients, it may also have an unpleasant effect on their caregivers. The present study was conducted with the aim of explaining the caregivers' lived experience of caring for a family member infected with Covid-19.

The present descriptive phenomenological study was conducted using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Inductive and in-depth interviews were conducted with 17 caregivers of family members from April to July 2019 in Tehran.

In the present study, 17 caregivers of family members with the age range of 28 to 52 years who had the experience of directly caring for a family member infected with Covid-19 participated. Caregivers' experiences were classified into four themes and 11 sub-themes. The themes were: "heavy and dangerous care", "negative consequences", "helplessness" and "sacrifice".

The present study showed the challenges of caregivers of family members of patients with covid-19 during the epidemic period. As the Covid-19 pandemic continues, the situation for caregivers may become more difficult and challenging. The most important issue in such a situation can be support, which in the form of government support in the form of financial and equipment, the support of the treatment staff in the form of training and the support of close acquaintances of the caregiver can moderate the challenges raised to some extent.

Due to the significant effect of motor skills on developmental areas in children with visual impairment, the need to measure gross motor skills and the lack of valid and reliable tools in this field is essential. This study conducted with the aim of determining psychometric characteristics of the second version of the Test of Gross Motor Development (TGMD-2) in children with visual impairment aged 7-10 years in Tehran.

In this descriptive and psychometric analysis study, criterion-related validity and Spearman correlation were used. Concurrent validity was assessed using the second edition of Movement Assessment Battery for Children (MABC-2). In previous studies, content and face validities were performed and construct validity was not possible to measure because of the limited sample size. To evaluate the reliability of the TGMD-2, a one blinded researcher measured the gross motor skills of 50 girls and boys aged 7-10 years with visual impairment with a one-month interval in three schools of visual impaired children (Mohebbi, Khazaeli and Narjes). Cronbach's alpha for internal reliability and Intraclass Correlation Coefficient (ICC) for external reliability were used. Data were analyzed using SPSS version 22 with a 95% confidence interval and a significance level of 0.05.

Concurrent validity of the sub-scales of TGMD-2 and MABC-2 tests were significant (P <0.05) in a high level. Pearson correlation coefficient between subscales of locomotion and balance and between object control and aiming-catching of the TGMD-2 and of MABC-2 were 0.80 and 0.75, respectively. Internal and external reliability of TGMD-2 were confirmed. Cronbach's alpha for the locomotion and object control subscale were 0.97 and 0.96, respectively. The Intra Class Correlation Coefficient (ICC) of the TGMD-2 was 0.97(P <0.05).Also, inter rater and intra rater were 95% and 97%, respectively for TGMD-2.

The TGMD-2 can be a useful tool for measurement of the gross motor skills of children with visual impairment in 7-10 years old. This tool can be used in clinics and treatment centers; it can also be used for research purposes.

 The integration of various senses with each other in the form of perceptual-motor activities can lead to the promotion of different aspects of physical, perceptual, cognitive, and psychosocial development. Decreased visual acuity in children with visual impairment makes it difficult to develop motor skills, including gross motor skills. A few studies have used perceptual-motor interventions in these children with no specific framework. The purpose of this study is to evaluate the effect of a perceptual-motor intervention based on Johnstone and Ramon’s method on the gross motor skills of children with visual impairment.

In this randomized controlled trial, the study population consisted of children aged 7-10 years with visual impairment (blind or with low vision) studying in three schools of Narjes (Girls’ school), Shaid Mohebbi, and Shahid Khazaeli (Boys’ schools) in Tehran City, Iran in 2018 (n=140). Of these children, 24 who had met inclusion criteria were selected and randomly assigned into two intervention (n=12) and control (n=12) groups. The perceptual-motor program was designed based on Johnstone and Ramon’s method and validated by a panel of experts that included four members of the Department of Occupational Therapy, the University of Social Welfare and Rehabilitation Sciences, and one optometrist from the Baqiyatallah University of Medical Sciences. The intervention group received the perceptual-motor program for two months, three 45-min sessions per week (24 sessions in total). The gross motor skills of both groups were measured by the second edition of Movement Assessment Battery for Children (MABC-2) test (aiming/catching and balance subscales) and the second edition of Test of Gross Motor Development (TGMD-2) (locomotor and object control subscales) in three stages: Pre-test, post-test, and 1-month follow-up. Data analysis was performed using the Shapiro-Wilk test, Mann-Whitney U test, Friedman test, Bonferroni test, and generalized estimating equation in SPSS v. 22. The significance level was set at 0.05.

 The mean±SD ages of children in the intervention and control groups were 9.2±1.1 and 8.3±1.2 years, respectively. The mean±SD scores of aiming/catching skill in the intervention group reached from 4.17±2.82 in the Pre-test phase to 11.17±1.95 in the post-test and 10.92±1.62 in the follow-up phases. In the control group, the mean±SD scores were 3.83±2.79 in the Pre-test, 4.25±3.08 in the post-test, and 4.67±2.93 in the follow-up. The mean±SD scores of the balance skill increased from 6.25±2.42 in the Pre-test to 10±2.13 in the post-test and 9.92±2.19 in the follow-up phase. In the control group, the scores were 3.50±3.09) in the Pre-test, 3.83±3.46) in the post-test, and 4±3.36) in the follow-up phase. The mean±SD score of the locomotor skill was 40.92±9.34 in the Pre-test, 47.58±1.17 in the post-test, and 47.42±1.08 in the follow-up phase. In the control group, these scores increased from 35.83±12.92 in the Pre-test to 36.83±13.17 and 37.67±13.24 in the post-test and follow-up phases, respectively. The mean±SD scores of object control skill increased from 32.50±14.74 in the Pre-test to 47.50±1.24 in the post-test and 47.66±1.15 in the follow-up, while in the control group, the scores were 29.25±12.93 in the Pre-test, and 30.17±12.89 and 30.08±13.34 in the post-test and follow-up phases. The aiming/catching, balance, and object control skills of children were significantly improved after the intervention (P<0.05), and continued after one month. In contrast, the locomotor skill was not improved after the intervention (P>0.05).

 The perceptual-motor interventional program can be useful in promoting the gross motor skills of children with visual impairment. It is suggested that this program be used in other studies on visually-impaired children.

An important part of patient satisfaction in health care centers, is the concern to protect their rights from health care providers. By observing the Patient Bill Rights,they can effectively take care of patients. This study aimed to assess the inpatients awareness from patients rights and their satisfaction from observance of that rights.
This cross-sectional study was conducted in three hospitals affiliated to Tehran University of Medical Sciences. The estimated sample size was 306 patients and with regard to the assessment of patient's awareness and also, total of questionnaires were 612. The data analyzed by using T Test and ANOVA in SPSS.18 software.
Average of patient's awareness from patient rights obtained 83.4% and average of patient's satisfaction from observance of that rights were 68.9%. The highest average of awareness was related to the first axis, lowest level of awareness related to the third axis, the greatest satisfaction related to the fourth axis and the lowest level of satisfaction is also related to third axis of the patient bill rights.
Regarding to the lowest average in the awareness and satisfaction of the patient's was related to the third axis of patient bill rights, it seems that hospital managers for increasing patient satisfaction, must pay further attention both to training of this axis to patient, and Also to The observance of this axis from health care providers.

Fear of falling may restrict activities that can increase risk of falls. The aim of this study was to investigate the incidence of fall and fear of falling and their relationship. This descriptive cross sectional study was performed on 160 institutionalized old people (130 females, 30 males) with aged 65 and older that enrolled by all number of sampling. after receiving informed consent. Data were collected by demographic and illness form, fall frequency form and FSE questionnaire. Descriptive statistics for data classification and inferential statistics including one-way ANOVA, t-test and Pearson correlation were used for data analys. Validity and reliability of FSE questionnaire was confirmed after analyzing (Cronbach's alpha = 95%).It should be noted that the level of significance in this study is considered 0/05. Among 160 subjects, the majority of the elderly were women (81/2%) and with mean (SD) of age 67/63 ± 9/07 years. mean and SD of fall was 2.6 ± 0.85. 46/9% of the elderly have fallen three times in the past six months, while the majority of the elderly (76/2%), have moderate fear of falling. there was significant difference Between sex and using of drugs with the number of falls (p< 0.001). Between fear of falling and sex (p< 0.05) and residence time(p= 0.02) significant difference was seen. Pearson correlation showed a significant relationship between the number of falls and fear of falling With confidence of 99 percent. (p< 0.001). Due to the prevalence of falls and fear of falling in elderly and direct relationship with each other plan should be done for prevention and control them to improve the welfare of elderly life.

Imbalance is the main cause of the fall in elderly. Falling have physical, spiritual, economic complications. The study aimed to determine the effect of multi-dimensional falling prevention on static and dynamic balance in the elderly. This quasi-experimental study with pre/post design was conducted on 60 older people living in nursing home that met the study inclusion criteria. The multidimensional intervention focused on the education of the older adults and caregivers, exercise (stretch, balance, and power exercises), and environmental modification. Intervention was carried out after obtaining informed consents, and data were collected before the intervention, and 6 months later by using demographic information form, Timed Up and Go test (TUG), and Performance Oriented Mobility Assessment (POMA). Descriptive statistics were used for classification of data, and inferential statistics for analysis of data including Mann-Whitney, and Kruskal-Wallis, and Kolomogorov-Smirnov tests to confirm normal distribution of the data. P<0.05 was considered significant. Mean mobility assessment (POMA) scores in older adults, before and 6 months later intervention were17.21±3.68 and 24.54±1.88, respectively. Also mean recorded time for the elderly in TUG test before and 6 months after intervention were 21.55±6.99 and15.11±3.54, respectively. Results revealed a significant difference between before and after intervention among participants in mobility assessment test (P<0.001) and Timed Up and Go (P<0.001). After the intervention, the balance in the elderly increased. Implementation of multidimensional fall prevention program led to the improvement in static and dynamic balance in older people. Health care providers, especially nurses can use fall prevention program to improve balance and subsequently reduce falls in the elderly living in nursing homes.

Falling is common among elderly due to changes in sensory–motor function. Falling causes physical، emotional and financial problems and decreases the quality of life in elderly. Since the causes of falling are multifactorial، multi-dimensional approaches should be considered to prevent it. This study aimed to investigate the effect of a multidimensional fall prevention program on the incidence of falling and quality of life among old people living in nursing homes. Methods & Materials: This before-after quasi-experimental study was conducted on 60 old people living in nursing homes who met the inclusion criteria. Multidimensional fall prevention program was focused on: 1- exercise (stretching، balance، and strength); 2-training classes for caregivers and elderly and; 3-environmental modification. Data were collected before and six months after the intervention using demographic and illness form، fall frequency form and the LEIPAD questionnaire. Collected data were analyzed using the paired t-test، one-way ANOVA، Mann-Whitney and Wilcoxon tests in the SPSS-16.

Before and six months after the intervention، the mean frequencies of falling were 2. 00 (±0. 70) and 0. 20 (±0. 55)، respectively. The mean scores of quality of life before and six months after the intervention w ere 56. 48 (±10. 45) and 77. 43 (±10. 45)، respectively. Results indicated that there were statistically significant difference between the study participants before and six months after the intervention regarding falling frequency (P<0. 001) and quality of life score (P<0. 001).

The multi-dimensional fall prevention program decreased the fall frequency and increased quality of life of participants. Health care providers، particularly nurses can use the prevention program to diminish falling incidence among elderly and improve their quality of life.