leili rabiei

The spread of COVID-19 caused many problems in the field of emotional, behavioral and social adjustment, especially in teenagers and young people. This study aims to assess the effect of coping skills training on the indididual and social adjusment of college students durring the COVID-19 pandemic.

This is a quasi-experimental study. The study population consists of the students of Shahrekord University of Medical Sciences, Shahrekord, Iran in 2022. Eighty eligible students were selected and divided into two groups of intervention (n=40) and control (n=40).  The coping skills training with a positive cognitive-behavioral approach was provided to the intervention group at 10 training sessions for two months. The data collection tool was the California indididual-social adjusment scale. Data were collected before, immediately after, and one month after the intervention. The collected data was analyzed in SPSS software, version 18. 

There was no significant difference in the mean scores of social adjusment and its subscales (social patterns, social skills, family relations, educational relations, and social relations) between the two groups before the intervention (P>0.05). This difference was significant in the post-test and one-month follow-up phases based on independent t-test results (P<0.05). The results of repeated measured analysis of variance showed a significant difference in the mean scores of above mentioned variables among three measurement phases (P<0.001). However, this test did not show a significant difference in the mean score of the subscale of antisocial tendencies among three phases (P>0.05).

The coping skills trainig with a positive cognitive-behavioral approach can increase the indivdual-social adjustment of college studentsdurring the COVID-19 pandemic. The results can help planners and policy makers in Iran to adopt effective intervention programs to increase mental health, coping skills, and ultimately the quality of life of college students.

COVID-19 has adverse effects on health. The best way to prevent it is vaccination. One of the high-risk groups for COVID-19 is pregnant women. Self-care of pregnancy can reduce the adverse consequences of pregnancy, which are affected by many factors. The present study aims to investigate the self-care status of pregnancy and its relationship with social support and anxiety caused by Corona in pregnant women following the implementation of the national vaccination program for COVID-19.

A total of 199 pregnant women from comprehensive health service centers were included in the study and completed self-care questionnaires during pregnancy, social support, and anxiety questionnaires caused by corona. Data were analyzed by SPSS 18 software.

The average score of self-care was 41.19 ± 5.21, the average score of social support was 65.14 ± 11.45, and the average score of anxiety caused by Corona was 10.64 ± 8.93. The Pearson correlation test showed that self-care was significantly associated with social support (P < 0.05, r: 0.347) but not coronavirus anxiety. The regression model showed that social support is the strongest predictor of pregnancy self-care (P < 0.001).

Considering the favorable score of self-care and social support and the low score of corona anxiety of the participants in the study and comparing with the results of other studies in the COVID-19 pandemic and before vaccination, it seems that COVID-19 vaccination had a significant effect on the results. However, longitudinal studies are suggested to ensure the results.

Objective (s): The Covid 19 pandemic is highly contagious and may increase the likelihood of transmitting the disease to others especially to young people. Therefore, raising the awareness of young people about the preventive behaviors of the Covid 19 is very important. The present study was conducted with the aim of assessment of the effectiveness of a program based on the Health Belief Model on the promotion of preventive behaviors of Covid 19 in young people.

This was a quasi-experimental study that was conducted among a sample of young married people aged 25-35 years in Shahrekord, Iran by simple random sampling method. For the intervention group, 6 virtual training sessions were held based on the structures of the health belief model during one month. Data collection tools included demographic information, a questionnaire based on health belief model constructs and a questionnaire of preventive behaviors. Data analysis was performed using SPSS software version 18.

In all we recruited 100 young people into the study (50 in intervention and 50 in control groups). The results showed that there was no significant difference between the dimensions of the health belief model in the two groups before the intervention (P <0.05). This difference was significant in the assessment one month after the intervention (P <0.05). Regarding the structure of perceived barriers, despite the decrease in the mean score, this difference was not significant (P = 0.07). Also, there was no significant difference in the mean scores of preventive behaviors between the two groups before the intervention (P <0.05), while this difference was significant in the 1-month measurement (P <0.05).

The implementation of a program based on the Health Belief Model raises the level of awareness and, consequently, creates favorable attitudes towards performing Covid 19 preventive behaviors.

 Cervical cancer is one of the most common cancers in women. Cervical cancer screening is one of the essential measures for preventing this disease, and its purpose is to detect lesions in the premalignant stage and reduce the risk of death from this cancer. This study aimed to predict the factors related to cervical cancer screening in secondary school teachers using the PEN-3 model in Shahrekord, southwest Iran.

 This descriptive-analytical study was conducted on secondary school female teachers in the academic year 2019-2020. The samples were 228 individuals who were selected by convenience random sampling. The research tools were a demographic information checklist, uterine screening performance information, and a questionnaire based on PEN-3 model constructs (perceptual, enabling, and reinforcing factors). Data analysis was done using SPSS version 22.

 Regarding cervical cancer screening (Pap smear test), 59.82% of the teachers had a history of undergoing Pap smear tests, of which 35.43% had performed the test regularly. Pearson’s correlation coefficient showed a direct and significant correlation between PEN-3 model constructs (perceptual, enabling, and reinforcing factors) and a history of cervical cancer screening (P<0.001). In the regression analysis of demographic variables and PEN-3 model constructs, the predictive value of these variables for cervical cancer screening was obtained at 0.57%.

 Based on the findings of the study and given the role of PEN-3 model constructs (perceptual factors, enabling factors, and reinforcing elements) in predicting cervical cancer screening behavior, comprehensive planning for intervention and use of this educational model and gaining knowledge about the cultural and socioeconomic factors for cervical cancer screening seems useful.

Dyslipidemia is one of the major causes of cardiovascular disease (CVD); however, it can be prevented and controlled via observing and adherence to a diet. This study aimed at determining the effect of nutrition education based on BASNEF model on decreasing blood lipid profile.  This clinical trial study was conducted on 150 people with a high blood lipid profile who referred to Shahrekord laboratories in 2020. The samples were randomly divided into intervention and control groups. In order to measure blood lipids such as high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC), 15 mL of venous blood samples were collected after 12 hours fasting before the intervention and again 2 months after the intervention. The intervention group received nutrition education based on BASNEF model, and the collected data were analyzed using SPSS version 20 software.  There was no significant difference between the two groups in terms of demographic variables. TG levels in the intervention group decreased significantly after the intervention (P < 0.001). In addition, TC and LDL levels decreased significantly in the intervention group after the intervention (P < 0.001), while the level of HDL index in the intervention group increased significantly after the intervention. Nonetheless, there was no significant difference in these indices in the control group after the intervention (P > 0.05).  The significant decrease in blood lipids after a short period indicates the effect of nutrition education based on BASNEF model and adherence to proper diet on controlling blood lipids. Therefore, recommending people to adhere to a proper diet can help raise people’s nutritional awareness and reduce blood lipids.

Students on campus are exposed to drug abuse and mental health disorders due to various challenges and motivating factors. This issue requires attention to interventions based on coping skills training. The present study was conducted with the aim to investigate the effect of an assertiveness program on the drug use tendency, mental health, and quality of life in clinical students of Shahrekord University of Medical Sciences in 2020.

This is a quasi‑experimental study. Seventy clinical students (nursing, midwifery, and intern students) attending Ayatollah Kashani and Hajar teaching hospitals of Shahrekord were included into the study and randomly assigned into an intervention group and a control group. The assertiveness training program was implemented for eight 1‑h sessions (one session per week for 2 months) for the intervention group, while the control group received no programs. Both study groups completed drug tendency questionnaire, depression, anxiety and stress scale, and quality of life questionnaire in pretest, posttest, and 2‑month follow‑up. The data were analyzed using SPSS software (v22), analysis of variance repeated measures, and t‑test.

The mean scores of drug use tendency (P = 0.26), stress (P = 0.31), anxiety (P = 0.29), depression (P = 0.43), and quality of life (P = 0.33) showed no statistically significant difference between the intervention and control groups in the pretest, but the scores of the drug use tendency, stress, anxiety, and depression were statistically lower and the score of quality of life was statistically higher than that of the control group in the posttest and 2‑month follow‑up (P < 0.05).

The findings of the study showed that assertiveness skill training as a preventive program can reduce the students’ tendency to addiction and improve their mental health and quality of life. Considering the effectiveness of the program, planners and policymakers can use it to plan for reducing the youth tendency to drugs.

BACGROUND: Low back pain (LBP) has been regarded as one of the musculoskeletal problems which is affecting more than three‑quarters of individuals in their lifetime. Nowadays, various pharmacological and nonpharmacological therapies are employed for relieving and treating LBP. This study was conducted to compare the effects of topical hot salt and hot sand on patients’ perception of LBP.

In this, quasi‑experimental study patients with LBP referring to the orthopedic clinic of Shahrekord educational hospital were divided randomly into two interventions and one control group in 2020. All three groups were received naproxen cream and daily physiotherapy in the same manner, the interventional groups in addition either topical hot salt or topical hot sand. Data gathering tool for measuring patients’ perception of LBP was the McGill Pain Short Form Questionnaire to be completed at the beginning, immediately at the end, and 2 months after the intervention. The data were analyzed using SPSS statistical software (version 21.0).

Totally, 90 patients were randomized based on the table of random numbers (mean age 51.1 + 11.1), and finally, 87 patients completed the study. Patients’ perception of LBP before the intervention was homogenous in hot salt, hot sand, and the control group The mean score of total pain experience before the intervention was 14.1 ± 11.3 for hot sand, 13.9 ± 10.7 for hot salt and 13.7 ± 10.1 for control group The mean scores of these three groups were not significant before the intervention (P > 0.05). The mean score of total pain experience immediately after the intervention was 6.7 ± 4.2 for hot sand, 5.2 ± 3.1 for hot salt and 13.9 ± 9.8 for control group. The mean scores of the hot sand group and the hot salt group were significantly decreased compared with control group (P > 0.05). The mean score of total pain experience two months after the intervention was 5.6 ± 3.27 for hot sand, 4.21 ± 2.14 for hot salt and 13.8 ± 10.4 for control group. Mean score of total pain experience in both intervention groups had significantly reduced two months after the intervention compared to control group (P ≤ 0.001); so that the effect of hot salt treatment on reducing total pain experience was larger than hot sand (P ≤ 0.001). The same trend was observed for VAS and Present pain intensity variables.

The findings have revealed that the topical treatments with hot salt and hot sand could have a significant effect on the perception of LBP compared to those in the control group; whereas hot salt might be stronger effects than hot sand on reducing LBP.

The complex, multifaceted care environment and the threatening situation of caring for hemodialysis patients cause tension in their family caregivers. Due to the severe tension, family caregivers are likely to ignore their basic needs and only pay attention to the patient’s needs and related issues. This study was conducted with the aim of designing and evaluating the Perceived Care tension Questionnaire for Caregivers of Hemodialysis Patients (PCTQHFC).

The present study was a sequential exploratory mixed methods study of scale development variant conducted in two phases: qualitative and quantitative. This study was conducted in 2019 in Shahrekord. The qualitative phase included item development and scale development. In the quantitative phase (Item Analysis), the validation characteristics of the tool were examined using face, content and construct validity, and its reliability by internal consistency and stability. Findings were performed using software SPSS 18.

Principal components analysis with orthogonal rotation to generate factors, showed that five factors, namely emotional exhaustion, inadequate social support, care burden, confusion and ambiguity and lack of adaptability skills had an eigenvalue of higher than 1, so that they explained, respectively, 75.98%, 61.36%, 72.49%, 76.33%, and 70.31% of the total variance. The internal consistency was obtained 0.811 and the inter‑class correlation coefficient for the whole instrument 0.832.

PCTQHFC is a culturally appropriate measure with strong psychometric properties. The instrument designed in this study measures the care tension of hemodialysis patients. Therefore, researchers, health‑care providers, and community health policymakers can plan and implement interventions to reduce the tension of caregivers of hemodialysis patients by analyzing and identifying the tensions of caregivers.

Type 2 diabetes is the most common type of diabetes in the world. Health education can prevent complications or disease progression in patients by changing their behavior. Therefore, this study was conducted to investigate the effect of applying the health belief model on the change of nutritional behavior in women with type 2 diabetes in Shahrekord.

This study is a quasi-experimental study with control group. The target group is patients referring to health centers in Shahrekord. The instrument of study is a 3-part questionnaire including demographic information, model constructs Health Belief and self-assessment checklist of nutritional behaviors. The intervention was conducted in 40-minute six sessions. Data were analyzed by SPSS software and statistical tests before, immediately and three months after the intervention.

The difference between the mean scores of nutritional behaviors and structures of the health belief model, which included: awareness, perceived sensitivity, perceived benefits, perceived barriers before, after and 3 months after the intervention was significant (P <0.05). Among the constructs of the health belief model, the perceived intensity construct was not significant despite the increasing trend (P <0.05).

The findings of this study indicate that education based on the Health Belief Model will improve the nutritional behaviors of female patients with type 2 diabetes and help planners and policymakers to take fundamental steps to change the behavior of this group of patients.

The COVID‑19 epidemic is a global health crisis that, in addition to physical health, has affected the mental health of all individuals, especially health‑care workers, including nurses and family members. In this regard, the present study aimed to investigate the effect of COVID‑19 epidemic on mental health of nurses’ family members.

The present descriptive‑analytic and cross‑sectional study was conducted in 2020 year on family members of nurses working in Hajar Hospital for admission and hospitalization of patients with COVID‑19, after obtaining the necessary permits and coordination. To prevent the spread of COVID‑19 through respiratory or contact droplets, a blog was designed to collect data using software. Participation in this study was voluntary. Data collection tools included consent, demographic questionnaire, and mental health questionnaire (Patient Health Questionnaire‑9). Data were analyzed by SPSS version 22.

Findings of this study showed that out of 208 family members of nurses participating in this study, 96 were male and 112 were female and their mean age was 35.78 years, and 55.3% of the participants had university education. Their mean mental health score was 12.91 ± 3.75, so that 22.6% of people had mild depression, 71.4% of people had moderate depression, and 1.8% of people had severe depression. Independent t‑test showed that there is a statistically significant relationship between mental health and gender and marital status (P < 0.001). Furthermore, one‑way analysis of variance test showed that there is a significant relationship between mental health and age (P < 0.001); this test also showed that there is no relationship between education and mental health (P = 0.75).

The results indicate that the mental health of nurses’ family members is affected by the challenges of COVID‑19 epidemic time, so that many of them suffer from some degree of depression. Therefore, supporting this population requires urgent action.

Professional behavior, as one of the fundamental elements of professional training, obliges nursing and midwifery staff to follow the principles that make them receive care with more confidence and trust along with the clients. This study aimed to evaluate the psychometrics of a questionnaire and determine the professional behavior of midwives working in the delivery wards of medical centers and hospitals under the auspices of Shahrekord University of Medical Sciences, Shahrekord, Iran, in 2019.

This descriptive-analytical study evaluated 200 midwives working in delivery units with a standardized checklist assessing the professional behavior of health care providers.

The results obtained in the areas of confronting with the client, being responsible and having interaction with colleagues, and considering the patient as a human, being trustworthy, identifying and satisfying the patientchr('39')s needs, paying attention to the patientchr('39')s conversations and having a respectful behavior with him/her, performing tasks properly, providing appropriate feedback, observing hospital rules, and respecting colleagues were among the most important priorities of the study findings.

Based on the findings of this study, the factors requiring attention included confronting with the client, considering the patient as a human, paying attention to the patientchr('39')s conversations and having a respectful behavior with him/her, being trustworthy, identifying and satisfying the patientchr('39')s needs, providing continuing care to clients, and observing the morals in interaction with clients.

Health promotion through lifestyle improvement is an important topic that has received considerable attention from the scientific community worldwide. This study aimed to determine the effect of Pender’s health promotion model on self-efficacy and treatment adherence behaviors of hemodialysis patients in Shahrekord, Iran, in 2018–2019.

This quasi-experimental study was performed on 70 hemodialysis patients who were attending routine hemodialysis sessions in Hajar hospital in Shahrekord. Individuals were selected by simple random sampling and randomly assigned to two groups of control and intervention. In the preintervention stage, all patients completed a questionnaire that was prepared to collect demographic information and measure health-promoting behaviors, self-efficacy, and treatment adherence. The intervention group participated in eight sessions of a health promotion model-based education program. Both groups were asked to complete the questionnaire again immediately after the intervention and also 2 months later.

The repeated measures analysis of variance (ANOVA) showed a significant difference between the two groups in terms of the extent of change in mean scores over the three measurement stages (before the intervention, after the intervention, and 2 months after the intervention) (P < 0.001). A statistically significant difference was observed between the two groups in terms of self-efficacy scores in the postintervention and follow-up stages (P < 0.05). The repeated measures ANOVA also revealed a significant difference between the two groups in terms of the extent of change in mean treatment adherence scores over the three measurement stages (P < 0.001).

Considering the positive effects of the program on patients undergoing hemodialysis, it is recommended to use the program to promote the well-being of these patients without time restrictions.

Dysmenorrhea is one of the most common problems that women experience. Dysmenorrhea brings about psychological problems for women and adversely affects their performance. Therefore, providing, maintaining, and promoting the health of women is an important goal. The present study was conducted to determine the relationship between general health and Dysmenorrhea in students of Shahrekord University in 2018.

In the present cross-sectional study, 245 female students were selected by random cluster sampling method from Shahrekord University in 2018. Data were collected using the GHQ28, visual analogue scale (VAS), and a reliable and valid questionnaire designed by the researchers to determine menstrual pattern. Data were analyzed using descriptive statistics, chi-square test, and independent samples t test.

The mean age at menarche was 13.5 years. Dysmenorrhea was observed in 82.8% of students. The severity of pain was measured by the VAS scale, indicating that 22.3% of the participants had severe menstrual pain. The prevalence of dysmenorrhea in participants with a family history of Dysmenorrhea was greater and statistically significant. The result of the t-test showed that there is a relationship between dysmenorrhea and the general health of the participants (P=0.036). There was also a significant relationship between menstrual cycle regularity and physical characteristics of the participants (P=0.019). Significant relationships were also found regarding the interval between menstrual cycles and physical symptoms (P=0.026), and depression and general health (P=0.0001).

Due to the importance of dysmenorrhea and its high prevalence among female students, it is important to provide education and control on this disorder to improve the quality of life of women. It is also beneficial to create counseling centers to raise awareness of the psychological health of female students suffering from dysmenorrhea

Patients undergoing hemodialysis are exposed to various physical, psychological, and social stressors. Self-care activities can play a significant role in adapting to the disease process and improving their quality of life. In addition, using the PRECEDE-PROCEDE model, an appropriate scale can be obtained from these patients chr('39')perceptions, knowledge and attitudes toward their self-care and self-care knowledge, and based on this model, the relationship between factors and patientschr('39') self-care ability can be assessed. Therefore, the researchers decided to conduct a study predicting PRECEDE model constructs with self-care in patients undergoing hemodialysis.

This cross sectional study was performed on 80 patients referred to the Lordegan hospital. Life, health status, predisposing factors (knowledge and attitude), enabling, and enhancing along with self-care behaviors of hemodialysis patients were completed by interview. The reliability and validity of the questionnaires were confirmed. Data were analyzed by SPSS software using Pearson correlation coefficient, ANOVA, t-test, and regression analysis.

 The mean and total deviation of self-care behaviors score was 32.38 12 12.83. 56.5% of people had poor self-care, 42.5% had moderate self-care, and 0.2% had good self-care. In addition, Pearson correlation test showed a significant relationship between PRECEDE-PROCEDE model items (reinforcing factors, enabling factors, and predisposing factors) and self-care (P <0.05). According to the results of regression analysis, the predictive power of the items of precession-process model (reinforcing factors, enabling factors and predisposing factors) was found to be 0.419.

 Considering the lack of self-care, behavior of hemodialysis patients and the need for a direct correlation between PRECEDE model constructs, appropriate interventions are recommended, especially educational interventions to promote self-care and increased emphasis on self-care.

Assessing the health literacy of diabetic patients requires the availability of a tool specific to this group. The Diabetes Health Literacy Assessment Questionnaire (LAD) is one of the tools used to measure the health literacy of diabetic patients. The present study was conducted with the aim of translating and validating the Persian version of the LAD questionnaire.

The present study aimed to determine the validity and reliability of the Persian version of the Health Literacy Assessment Questionnaire for diabetic patients on 300 patients with diabetes in 1398, by sampling. Stages of study: First: Translation and preparation of the Persian version of the health literacy questionnaire in order to design and select items and their qualitative evaluation by the second group: Quantitative evaluation of narrative features using the opinions of the third group of experts: Formal narrative evaluation (comprehensibility) and The reliability of the questionnaire was assessed by a small group of the target population in a fourth experimental study: analysis of items, validity assessment and reliability of the final questionnaire.

In the analysis of organizational structure items, the effects of roof and floor were not observed. The highest averages were for items 8 and 12 and the lowest averages were for items 6. According to the Skewness Index, no deviation was observed in the items. Based on the results, the instrument had acceptable internal stability. Detective factor analysis identified two factors for the Diabetes Health Literacy Questionnaire: one was individual understanding and the second was social support.

The results of exploratory factor analysis, Diabetes Health Literacy Questionnaire (LAD) have good validity and reliability and can be used to measure the health literacy of diabetic patients.

Patients undergoing hemodialysis due to multiple drug therapies, special diet plans, and need to acquire the ability to adapt to physical and mental disabilities require special monitoring. The PRECEDE‑PROCEED model is a process for behavior change and can lead to the promotion of self‑care behavior. The aim of this study was to evaluate the effect of a health promotion program based on the PRECEDE‑PROCEED model on self‑care behaviors in hemodialysis patients.

This was a clinical trial study that was performed on 67 patients undergoing hemodialysis in Lordegan Hospital that has been distributed in two groups randomly. Data were collected using self‑care assessment form according to the PRECEDE‑PROCEED model. Based on the results of this questionnaire, five educational sessions were held in the fields of knowledge, attitude, enabling factors, reinforcement, and behavioral factors for the samples. Data were analyzed using descriptive and analytical statistics with SPSS version 21 software.

According to statistical analysis before intervention, no significant difference was observed between the mean scores of self‑care among the two groups. However, instantly and 3 months after intervention, the mean score of self‑care (P = 0/03), knowledge, attitude, reinforcement factors, and behavioral factors (P < 0.05) significantly increased in the experimental group.

Based on the results of this study PRECEDE‑PROCESS model, the health promotion program increased the mean self‑care score of hemodialysis patients. This program has been able to improve their self‑care behaviors by changing knowledge, attitudes, and reinforcement and behavioral factors of patients and is recommending as an application in the nursing of these patients.

Spinal cord injury is an acute, debilitating event, which leads to significant and permanent changes in the life of the patients. The present study aimed to determine the predictive power of the dimensions of the Pender health promotion model in relation to the daily activities of patients with spinal cord injury in Shahrekord, Iran in 2019.

This descriptive-analytical study was conducted on 70 patients with spinal cord injury in the teaching hospitals of Shahrekord in 2019. The patients were selected via census sampling. Data were collected using a researcher-made questionnaire based on the constructs of the Pender model and a standard questionnaire of daily activity measurement. Data analysis was performed in SPSS version 21 using descriptive and analytical statistics.

The mean scores of daily activity and health promotion were 10.03±4.50 and 127.46±24.19, respectively. The results of the Pearson correlation-coefficient test indicated significant associations between daily activities and the constructs of the Pender health promotion model, including spiritual growth, health responsibility, physical activity, nutritional status, interpersonal relations, and stress management (P<0.05). In addition, the results of the regression analysis indicated the predictive power of the Pender pattern items to be 0.542, while the predictive power of the spiritual growth dimension was higher than the other dimensions.

According to the results, the level of health promotion behaviors in the patients with spinal cord injury was moderate, and the spiritual growth and stress management dimensions were the strongest predictors of daily activities. Therefore, it is recommended that interventions based on health promotion lifestyle be implemented in order to enhance the daily activities of these patients, with the main focus on planning on these two dimensions through the six constructs of the Pender health promotion model.

Clinical competence of nurses is an effective factor in ensuring the quality of care in a competitive modern world. Given the vital role of nurses and the weakness of existing assertiveness, this concept as a communication style can play an important role in improving performance and improving the quality of care in tense stressful care settings. The purpose of this study was to determine the effect of the assertiveness program on the clinical competence of nurses in intensive care units.

In this clinical trial, 70 nurses of ShahreKord in 2018 were randomly allocated into two groups experimental and control. The experimental group was trained in 6 sessions of ninety minutes, while the control group did not receive the training. Data was collected before, immediately and 3 months after intervention by demographic and CIRN Clinical Competency Questionnaire and analyzed using SPSS 17 with independent t-test, ANOVA with repeated measurement and Chi-square.

There was no significant difference between the mean scores of clinical competency between the two groups before intervention, but this difference was significant in the immediately and 3 months after intervention based on independent t-test (P<0.05). ANOVA test with repeated measurement showed a significant difference in the process of changes in mean scores in the three stages of measurement (before, immediately and three months after the intervention) (P<0.001).

Assertiveness education leads to increasing the clinical competence of nurses in intensive care units. Therefore, it is suggested to be used in nursing education courses.

Maintaining the health of diabetic people depends on the self-management of the disease. This study aimed to evaluate the relationship of distress, self-efficacy, perceived social support, and self-care with self-management behaviors in the patients with type 2 diabetes. The present analytical-descriptive study was conducted on 228 diabetic patients, during 2016-2017. Most of the participants were male (60.6%) and the mean age of them was 51.95±15.04. The participants were selected based on a simple random sampling method after completing the consent form. The required data were collected through questionnaires of distress, self-efficacy, perceived social support, self-care, and self-management. The data were statistically analyzed using SPSS software version 22.0. Out of 228 participants, 77.3% were married and the highest frequency in terms of educational attainment was related to those with a high school diploma. The results indicated that the duration of affliction with diabetes was less than 10-15 years in 88.9% of the participants. Pearson correlation test demonstrated that the total score of self-management had a significant relationship with the total scores of distress, perceived social support, self-efficacy, and self-care (P<0.005). The results of regression analysis also indicated that distress, perceived social support, self-efficacy, and self-care had a predictive power of 0.43% for self-management. Among these variables, the predictive powers of self-efficacy and self-care were statistically significant, and the prediction rate of self-efficacy was more than that of other ones (β = 0.17). The study findings showed that the researchers who want to perform interventions based on cognitive-social theory should mainly focus on self-care and self-efficacy.

Obesity in adolescents leads to physical and mental complications. Exercise is one of the main components of weight control programs. This study aimed to evaluate the effect of physical activity programs on self-esteem and Body Mass Index of overweight adolescent girls.
This study was a semi experimental study.The subjects were 140 second grade student girls from two high schools in 5th district of Isfahan. Data collection scales included: tape measure, carriage scale, questionnaire to collect background and personal information, designed questionnaire based on Health Belief Model, weekly physical self- reportedand adolescent weekly food record form, parent’s nutritional performance questionnaire, teachers’ attitude on adolescents’ nutrition questionnaire and Cooper Smith's Standard Self-esteem questionnaire. Education based program on Health Belief Model for improving nutritional status consistent with model structures during six sessions each 60-minute was conducted with emphasis on diet to control weight in overweight and at-risk adolescents. Questionnaires were compared immediately afterand two months after intervention.
Average score of model structures and self-esteem of students in both groups had no significant difference at baseline, but immediately after and 2 months after the intervention, the mean component scores were significantly higher in intervention group in comparison with the control group. There was a significant difference in component scores at different times in the experimental group. Significant difference in BMI scores was seen at different times in experimental group.
Findings of this study showed that school based approach of physical activity training leads to increase in knowledge, sensitivity, severity and perceived benefits and eventually increase in self- esteem and physical activity in students.

Due to significant increases in the prevalence of overweight and obesity in adolescents in developed countries, much attention has been focused on this issue. This study aimed to determine the effectiveness of nutritional education based on Health Belief Model (HBM) on self-esteem and body mass index (BMI) of overweight and at risk of overweight adolescent girls.
The study subjects consist of 140 female students recruited from two high schools, who were randomly allocated to the intervention (n=70) and control (n=70) groups. The data collection instrument included sections on socio-demographic status, transportation method, physical status, and knowledge and attitudes of the students towards nutrition, which was designed according to HBM. As the intervention, model-based educational program was implemented through six 60-minute sessions, focusing on the overweight and at-risk students. Results were compared in the beginning, and three months after the intervention to find the possible impacts.
Average score of model structures and self-esteem of students in both groups had no significant difference at baseline, but immediately after the intervention and 3 months after treatment, the mean component scores were significantly higher in intervention group than controls (P The positive effect of this program was seen among the participants. Therefore such interventions in schools for developing effective long-term healthy behaviors have preventive and controlling effects on overweight.

The prevalence of obesity among children and adolescents is increasing worldwide. One of the key lifestyle behaviors that helps prevent obesity and being overweight among children and adolescents is to avoid drinking sugar-sweetened beverages (SSBs) or to take, at most, one serving per day. The present study intended to evaluate knowledge and perceptions of high school girl students in Shahrekord on reducing SSBs consumption based on the health belief model (HBM).
The present descriptive-analytical study, conducted in 2013–2014, randomly recruited 308 female students aged 13–14 years. The data were collected using a researcher-made questionnaire based on HBM and a food frequency questionnaire (FFQ). The validity and reliability of the questionnaire were evaluated using face validity, content validity, and inter-rater reliability. The Chi-square test, Pearson’s correlation, and Spearman’s correlation tests were used in SPSS software to analyze the data. The participants declared their informed consent for participation.
The research findings showed that the mean score of students’ knowledge was 36.53 ± 21.87; mean scores of perceived susceptibility and perceived severity were 31.88 ± 15.04, and 34.76 ± 19.82, respectively; perceived benefits of reducing the consumption of SSBs was 43.51 ± 20.18, and perceived barriers was 41.56 ± 15.69. There was a direct significant relationship between knowledge and perceived susceptibility as well as between perceived susceptibility and perceived severity. The students’ intake of SSBs was calculated as 2.95 glasses per day. There was a direct significant relationship between perceived benefits and mother’s job, between perceived barriers and father’s job, and between knowledge and mother’s age. There was an inverse relationship between perceived susceptibility and father’s job.
Considering the high intake of SSBs among students, along with their little knowledge and perception about its negative effects, it seems necessary to plan for proper educational and theory-based interventions for adolescents in order to improve their knowledge and develop a positive attitude toward reducing SSBs consumption.

Adolescence is a transition period from childhood to early adulthood. Because of the immense pressure imposed on adolescents due to the complications and ambiguities of this transition, their level of excitement increases and sometimes it appears in the form of sensitivity and intense excitement.. This study aimed at determining the effectiveness of assertiveness training on the levels of stress, anxiety, and depression of high school students.. This quasi-experimental study was conducted on high school students of Isfahan in academic year 2012 - 13. A total of 126 second grade high school students were collected according to simple random sampling method and divided into two groups: experimental with 63 participants and control with the same number. Data gathering instruments included a demographic questionnaire, Gambill-Richey assertiveness scale, and depression anxiety stress scales (DASS-21). Assertiveness training was carried out on the experimental group in 8 sessions; after 8 weeks, posttest was carried out on both groups. Statistical tests such as independent t test, repeated measures ANOVA, Chi-square test, and the Mann-Whitney test were used to interpret and analyze the data.. The Chi-square and Mann-Whitney tests did not show significant statistical differences between the two groups in terms of demographic variables (P ≥ 0.05). Repeated measures ANOVA showed no significant difference between the mean scores for assertiveness before (100.23 ± 7.37), immediately after (101.57 ± 16.06), and 2 months after (100.77 ± 12.50) the intervention in the control group. However, the same test found a significant difference between the mean score for assertiveness in the experimental group before (101.6 ± 9.1), immediately after (96.47 ± 10.84), and 2 months after (95.41 ± 8.37) implementing the training program (P = 0.002). The independent t test showed no significant difference in the mean score for anxiety and stress between two groups before the assertiveness training program; however, 2 months after the intervention, the mean score for anxiety in the experimental group was found significantly lower than the control group. As for the mean score for depression, the independent t test showed no significant difference between two groups before training; however, despite the decrease in the mean scores for depression in the experimental group following the intervention, the difference was not significant (P = 0.09).. The results of the current study show that conducting assertive training in high school students decreases their anxiety, stress, and depression. Given that high school years are among the most sensitive stages of one’s life plus the fact that conducting such training programs besides their safe and low cost nature are effective and practical, it is highly recommended that such programs be carried out among high school adolescents..

Depression is one of the most common and specific problems during pregnancy and after it. Maternal postpartum depression compromises mother's health and affects social relationship, and has negative effect on infant development. The aim of this study was to investigate the prevalence of postpartum depression and its related factors in Isfahanian mothers.

This is a cross - sectional study. The study populations were 133 women who at the last 8-4 weeks of labor referred to Isfahan health centers. Demographic information and obstetric and Beck Depression Inventory were applied. Three categories emerged according to the degree of scale: Mild, moderate, and severe depression. Statistical analysis was used with the Pearson correlation and linear regression in SPSS version 18.

A total of 73 mothers had mild depression (10-19) and 56 had moderate depressions (20-29). Among the factors related to depression such as maternal education, financial status, unwanted pregnancy, premenstrual syndrome, and maternal occupational history, there was a significant correlation with postpartum depression (P > 0.05). Variables in the regression analysis include maternal education, financial status, unwanted pregnancy, history of premenstrual syndrome, maternal occupation, type of delivery, history of miscarriage, and having a satisfaction with baby gender. And, a total of 27.7% variance explains the postpartum depression. Among these factors, the predictive variables of maternal education, type of delivery, financial condition, unwanted pregnancy, premenstrual syndrome, and maternal occupational history were significant in the meantime; the prediction of unplanned pregnancy was more than other variables (ί = 0.24).

With attention to factors associated with postpartum depression, the healthcare planner will help to better manage the problem. The results of this study will help to better understand the factors influencing mothers in the labor process, and mothers in the labor process, experiences minimum mental health disorders.

Sleep disorders are considered as one of the most important problems in hemodialysis patients, making their everyday life a serious hazard. Sleep quality of hemodialysis patients and consequences of sleep disorders on other aspects of health such as spiritual well-being are important issues. This study examined the relationship between spiritual well-being and quality of sleep in hemodialysis patients in Isfahan, Iran.Patients and This study was a correlation research, carried out on 190 hemodialysis patients. Data collection Questionnaires included demographic forms, Pittsburgh sleep quality index (PSQI), and Ellison and Paloutzian spiritual well-being scale. Data were analyzed using descriptive and inferential statistics (Pearson correlation and linear regression analysis) at P < 0.05 significance level, by SPSS software version 18. Of 190 study participants, 163 (85.78%) with scores more than five index had sleep disturbances and 27 (14.12%) had no sleep disturbance; 3 (1.52%) had mild, 163 (85.78%) moderate, and 24 (12.30%) good spiritual health conditions. Pearson correlation test showed significant relationship between the sleep quality items of Pittsburg and spiritual well-being (P < 0.04, r = 0.149). Through the regression analyses of spiritual health, family, education, financial status, marital status, occupation, and use of sleep medication, the predictive power of these variables was found 0.417% and prediction of spiritual well-being was more than others (ß = 0.209). Considering bed as one of the most vital physical, mental, and emotional needs, it is very important in mental and spiritual well-being of hemodialysis patients as an influencing factor in mental relaxation and reducing disease tensions. Paying attention to sleep quality and spiritual well-being components of hemodialysis patients in formulating and promoting healthcare programs is recommended.