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فهرست مطالب نویسنده:

mahdi moshki

  • طاهره خسروی اصل، مهدی مشکی، احسان موسی فرخانی، میترا دوگونچی*
    مقدمه

    بروسلوزیس یکی از شایع ترین بیماری های قابل انتقال از حیوان به انسان است که با وجود برنامه های ریشه کنی، همچنان به عنوان یک بیماری آندمیک و مشکل بهداشتی در مناطق مختلف جهان به ویژه در کشورهای در حال توسعه باقی مانده است. از آن جایی که آموزش یکی از راهکارهای اساسی در کنترل و پیشگیری از این بیماری به شمار می رود، پژوهش حاضر با هدف بررسی تاثیر برنامه های آموزشی بر سفیران سلامت مبتنی بر تئوری شناختی- اجتماعی در جهت ارتقای رفتارهای پیشگیری کننده از بروسلوزیس در ساکنان مناطق روستایی مشهد در سال 1399 انجام شد.

    روش ها

    این مطالعه از نوع کارآزمایی در عرصه شاهددار تصادفی شده بود و 120 نفر از ساکنان مناطق روستایی شهرستان مشهد به روش نمونه گیری تصادفی طبقه ای وارد تحقیق شدند. در مرحله اول طبقات به تصادف انتخاب و در مرحله دوم نمونه ها به صورت تصادفی از طبقات جمع آوری گردید. انتخاب افراد از دو روستا بود که به دو گروه آزمون و شاهد تخصیص یافتند. برنامه آموزشی اجرا شده شامل آموزش سفیران سلامت توسط محقق و در مرحله بعد، آموزش روستاییان توسط سفیران سلامت بود. داده ها با استفاده از پرسش نامه محقق ساخته شامل اطلاعات جمعیت شناختی، سازه های مدل شناختی- اجتماعی و رفتار جمع آوری گردید و با استفاده از آزمون های 2c، Fisher's exact و Mann-Whitney مورد تجزیه و تحلیل قرار گرفت.

    یافته ها

    میانگین سنی گروه های آزمون و شاهد به ترتیب 97/9 ± 90/33 و 35/9 ± 90/36 سال بود. بین میانگین نمرات سازه های آگاهی، انتظار پیامد، ارزش پیامد، خودکارامدی، خودکارامدی در غلبه بر موانع، خودتنظیمی، سازگاری عاطفی و سنجش رفتار پس از مداخله نسبت به قبل تفاوت معنی داری مشاهده گردید (001/0 > P)، اما در میانگین نمرات سازه های درک موقعیت و محیط، پس از مداخله آموزشی تفاوتی وجود نداشت (050/0 < P).

    نتیجه گیری

    بر اساس نتایج، در صورتی که برنامه های آموزشی جهت آموزش سفیران سلامت و مردم روستا با بهره گیری از تئوری شناختی- اجتماعی که بر شاخص های فردی، شناختی، محیطی و رفتاری تاکید دارد، طراحی و اجرا گردد، باعث ارتقای رفتارهای پیشگیری کننده از بیماری بروسلوزیس می شود. بنابراین، اجرای برنامه های مداخلاتی منظم در سطح وسیع با استفاده از تئوری های آموزشی به عنوان یک روش اثربخش توصیه می گردد.

    کلید واژگان: آموزش بهداشت, سفیر سلامت, تئوری شناختی اجتماعی, رفتارهای پیشگیری کننده, بروسلوزیس
    Tahereh Khosraviasl, Mahdi Moshki, Ehsan Mosafarkhani, Mitra Dogonchi*
    Background

    Brucellosis is one of the most prevalent zoonotic diseases that can be transmitted from animals to humans. Despite various eradication programs, it continues to be an endemic health issue in many regions worldwide, particularly in developing countries. Education plays a fundamental role in controlling and preventing this disease. Consequently, this study was conducted to assess the impact of educational programs for health ambassadors, grounded in cognitive-social theory, on promoting preventive behaviors against brucellosis among residents of rural areas in Mashhad City, Iran, in 2020.

    Methods

    This research is a randomized controlled trial (RCT). The study included 120 residents from rural areas of Mashhad City, selected through a stratified random sampling method. In the first stage, classes were randomly chosen. In the second stage, samples were randomly collected from these classes. Participants from two villages were assigned to either the intervention or control group. The training program implemented in this study involved training health ambassadors by the researcher, followed by the training of villagers by these health ambassadors. Data were collected using a researcher-developed questionnaire that included demographic information, constructs of social cognitive theory, and behavioral data. Chi-square test, Fisher's exact test, and Mann-Whitney U test were employed to analyze and compare the data.

    Findings

    The mean age of participants in the intervention group was 33.90 ± 9.97 years, while in the control group, it was 36.90 ± 9.35 years. A statistically significant difference was observed between the mean scores of constructs of knowledge, outcome expectations, outcome value, self-efficacy, self-efficacy in overcoming obstacles, self-regulation, emotional adjustment, and behavior measurement after the intervention compared to before the intervention (P < 0.001). However, no significant difference was found in the mean scores of constructs including situational awareness and environmental perception after the intervention (P > 0.05).

    Conclusion

    The results of this study indicate that educational programs designed to train health ambassadors and rural communities, when based on cognitive-social theory, which emphasizes individual, cognitive, environmental, and behavioral factors, effectively promote disease prevention behaviors, particularly for brucellosis. Therefore, we recommend the large-scale implementation of regular intervention programs grounded in educational theories as an effective strategy.

    Keywords: Health Education, Health Ambassadors, Social Cognitive Theory, Preventive Behaviors, Brucellosis
  • Narges Zamani, Hassan Rezaee Jamaoei*, Zahra Behboodi Moghadam, Mahdi Moshki, Hamidreza Peikari
    Background and Objective

    Women with diabetes often have concerns regarding their reproductive health and sexual well-being. These concerns represent all the important issues that affect the health of the reproductive system and its function, which can also affect the general and social health of the person. Therefore, the present study aimed to explain the reproductive health concerns of women with type 1 diabetes under treatment at Hami and Khazarian Clinic in Hamadan, Iran.

    Materials and Methods

    The present research was conducted using the exploratory qualitative method. An in-depth unstructured interview was carried out with 17 married women aged 20-45 years with type 1 diabetes, and the data collected was analyzed using the constant comparison method.

    Results

    The main themes obtained were sexual performance and satisfaction with six subcategories, including physical, psychological, social, reproductive, supportive, and informational, as well as the marital dimension (sexual performance, marital satisfaction).

    Conclusion

    Since diabetes at younger ages is spreading rapidly and this problem affects the quality of marital and sexual life, the need to identify the perceived priorities of reproductive health concerns and design necessary interventions is felt.

    Keywords: Health Concerns, Diabetes, Sexual Performance, Marital Satisfaction
  • Sedighe Badnava, Mahdi Moshki*, Majid Pakdaman, Hosein Sahebdel
    Background

    Spiritual health is one of the most important psychological factors for university students, and it is perceived differently in various cultures and societies. Accordingly, this qualitative study investigates the definition of spiritual health and the most important factors that affect the definition of spiritual health among Gonabad University students.

    Methods

    This is a qualitative-based study designed using semi-structured interviews with the faculty members and experts from Gonabad University of Medical Sciences and Gonabad Seminary from December 2022 to November 2023. For data collection, a total of 13 semi-structured in-depth interviews were conducted, and open-ended questions were asked. The data were analyzed using the framework analysis.

    Results

    A total of 13 participants (7 men and 6 women) with threatening behaviors took part in this study. The participants’ ages ranged from 30 to 60 years. After analyzing the data, the following 6 themes were identified through framework analysis: culture, family factors, education, justice, community characteristics, and modeling.

    Conclusion

    This qualitative study highlights diverse conceptions of spiritual health among Gonabad University students and provides valuable insights for promoting spiritual well-being in higher education settings and educating families on behavior guided by spirituality and corresponding values.

    Keywords: Spiritual Health, Health Literacy, Dimensions Of Health, Thematic Analysis
  • طاهره خسروی اصل، مهدی مشکی، احسان موسی فرخانی، میترا دوگنچی*
    مقدمه

    تب مالت یک بیماری با درگیری چند ارگان است. این بیماری در صورت عدم تشخیص و درمان به موقع به سمت یک بیماری مزمن و ناتوان کننده پیشرفت می نماید. مطالعه حاضر با هدف تعیین عوامل موثر بر رفتارهای پیشگیری کننده از تب مالت با استفاده از نظریه شناختی اجتماعی انجام شد.                                                

    روش کار

    این مطالعه یک پژوهش مقطعی می باشد که بر روی  100 نفراز ساکنین روستایی تحت پوشش دانشگاه علوم پزشکی مشهد در سال 1399 انجام شد. نمونه ها با استفاده از روش نمونه گیری تصادفی دو مرحله ای انتخاب شدند. جمع آوری داده ها توسط پرسشنامه محقق ساخته که شامل اطلاعات جمعیت شناختی، سازه های مدل شناختی- اجتماعی و رفتار بود، انجام گرفت. تحلیل های آماری با نرم افزار SPSS نسخه 16 انجام گرفت.

    نتایج

    میانگین سنی 70/9 ± 19/35 سال می باشد، 82 درصد از افراد شرکت کننده زن، 93 درصد دارای تحصیلات دیپلم و زیر دیپلم ، 87  درصد  متاهل و 78 درصد زنان خانه دار بودند. بجز سازه درک موقعیت، بین سایر سازه ها و رفتار پیشگیرانه از تب مالت همبستگی مثبت و معنی داری مشاده شد.  نتایج مدل رگرسیونی نشان داد پیش گویی کنندهای رفتار پیشگیرانه از تب مالت شامل سازه های آگاهی، انتظار پیامد، ارزش پیامد، درک موقعیت، خودکارآمدی، خودکارآمدی بر غلبه بر موانع، خود تنظیمی و سازگاری عاطفی می باشد(05/0 > P).  

    نتیجه گیری

    هر چه میزان آگاهی، انتظار پیامد، ارزش پیامد، درک موقعیت، خودکارآمدی، خودکارآمدی بر غلبه بر موانع، خود تنظیمی و سازگاری عاطفی بیشتر باشد رفتار پیشگیرانه از ابتلا به تب مالت هم بیشتر خواهد بود. اجرای آموزش های پیشگیرانه از تب مالت مبتنی بر تیوری شناختی اجتماعی توصیه می گردد.

    کلید واژگان: تئوری شناختی اجتماعی, رفتارهای پیشگیرانه, بیماری تب مالت
    Tahereh Khosraviasl, Mahdi Moshki, EHSAN MOSAFARKHANI, Mitra Dogonchi *

    Brucellosis is a multi-organ disease involving several organs. This disease progresses to a chronic and debilitating condition if not diagnosed and treated in time. Accordingly, this study aimed to examine the factors affecting preventive behaviors of brucellosis in villagers using social cognitive theory.

    Material and Method

    This cross-sectional study was conducted on 100 residents of rural areas under the coverage of Mashhad University of Medical Sciences in 2020. The participants were selected using two-stage random sampling. The data in this study were collected through a researcher-made questionnaire that measured demographic information and the constructs of the cognitive-social model. The collected data were analyzed using SPSS software (version 16).

    Results

    The participants' mean age was 35.19±9.70 years. Furthermore, 82% of participants were women, and 93% had high school diplomas or lower education. In addition, 87% of the participants were married, and 78% were housewives. Except for the construct of understanding the situation, a positive and significant correlation was observed between other constructs and preventive behavior for brucellosis. The results of the regression model showed that predictors of preventive behaviors for brucellosis were knowledge, outcome expectations, outcome value, self-efficacy, self-efficacy in overcoming obstacles, self-regulation, and emotional adjustment (P <0.05).

    Conclusion

    Higher levels of knowledge, outcome expectations, outcome expectancies, self-efficacy, self-efficacy in overcoming obstacles, self-regulation, and emotional adjustment are associated with higher levels of preventive behavior for brucellosis. Therefore, preventive education programs can be implemented based on social cognitive theory to prevent brucellosis.

    Keywords: Social cognitive theory, Preventive Behaviors, Brucellosis
  • مجتبی عربی، فاطمه محمدزاده، مهدی مشکی *
    مقدمه

     با توجه به این که کارکنان مراقبت های بهداشتی- درمانی در خط اول مبارزه با بیماری کووید 19 می باشند، اولین کسانی هستند که در معرض آلودگی به این ویروس قرار می گیرند و به دنبال آن، اضطراب ناشی از آن را به میزان بیشتری تجربه می کنند. پژوهش حاضر با هدف تعیین میزان اضطراب ناشی از کووید 19 و بررسی تاثیر برنامه آموزشی مبتنی بر مراحل تغییر بر میزان اضطراب ناشی از این بیماری در کارکنان مراکز خدمات جامع سلامت شهرستان گناباد انجام شد.

    روش ها

    این مطالعه از نوع کارآزمایی در عرصه بود و جامعه مورد بررسی را کارکنان مراکز خدمات جامع سلامت شهرستان گناباد در سال 1400 تشکیل داد. بدین ترتیب، افراد دارای اضطراب متوسط به بالا، با استفاده از مقیاس اضطراب کرونا ویروس (Coronavirus anxiety scale یا CAS) شناسایی شدند و جهت انجام مداخلات به صورت تصادفی در گروه مداخله و شاهد قرار گرفتند. برنامه آموزشی طراحی شده برای گروه مداخله به مدت یک ماه طی شش جلسه از طریق برنامه اسکای روم (Skyroom) به صورت مجازی اجرا گردید. جهت آزمون، معادلات برآورد تعمیم یافته (Generalized estimating equations یا GEE) مورد استفاده قرار گرفت.

    یافته ها

     نتایج مدل GEE نشان داد که پس از مداخله، به ازای هر یک واحد افزایش در زمان، میانگین نمره پیش تفکر در گروه مداخله 954/2 واحد، نمره تفکر 091/3 واحد، نمره آمادگی 924/2 واحد، نمره عمل 454/4 واحد و نمره نگهداری 136/3 واحد از گروه شاهد بیشتر بود. همچنین، به ازای هر یک واحد افزایش در واحد زمان، میانگین نمره اضطراب کل در گروه مداخله 727/6 واحد، اضطراب روانی 167/5 واحد و اضطراب جسمی 561/1 واحد از گروه شاهد کمتر بود (001/0 > P).

    نتیجه گیری

     نتایج تحقیق نشان داد که برنامه آموزشی طراحی شده بر مبنای مراحل تغییر، در کاهش اضطراب ناشی از کرونا موثر می باشد. بنابراین، طراحی مداخلات آموزشی مبتنی بر این تیوری به منظور کاهش سطح اضطراب در زمان همه گیری بیماری های مشابه کرونا، مناسب به نظر می رسد.

    کلید واژگان: اضطراب, کووید 19, مراحل تغییر
    Mojtaba Arabi, Fatemeh Mohammadzadeh, Mahdi Moshki *
    Background

    Healthcare workers play a crucial role in combating the coronavirus disease 2019 (COVID-19) pandemic, being at the forefront of the battle against this disease. Due to their direct exposure to the virus, they often experience heightened levels of anxiety. This study aimed to determine the anxiety levels caused by COVID-19 and assess the impact of an educational program, developed according to the stages of change model, on the anxiety levels of healthcare workers in the city of Gonabad, Iran, during the outbreak of COVID-19.

    Methods

    This study was conducted as a field trial. The population of this study consisted of the staff members working at the Gonabad Comprehensive Health Service Centers in 2021. In order to identify individuals with moderate to high levels of anxiety, the Coronavirus Anxiety Scale (CAS) was employed. Subsequently, participants were randomly assigned to the intervention or control group. A virtual training program was specifically designed for the intervention group and implemented over the course of one month, comprising six sessions conducted through the Skyroom application. Generalized estimating equations (GEE) were used for the test.

    Findings

    The results of the GEE model indicated that following the intervention, there was a significant increase in the average pre-thinking score (2.954 units), thinking score (3.091 units), preparation score (2.924 units), action score (4.454 units), and retention score (3.136 units) in the test group compared to the control group. Additionally, for each unit increase in time, the average total anxiety score in the test group was significantly lower (6.727 units), including mental anxiety (5.167 units) and physical anxiety (1.561 units), compared to the control group (P < 0.001).

    Conclusion

    The results of study showed that the educational program designed based on the stages of change was effective in reducing anxiety caused by COVID-19 disease. Therefore, it seems appropriate to design educational program interventions based on this theory to reduce anxiety levels during a similar epidemic to COVID-19.

    Keywords: Anxiety, COVID-19, Stages of change
  • Sedighe Badnava, Majid Pakdaman *, Mahdi Moshki, Hosein Sahebdel
    Background
    Health literacy involves the ability to obtain, comprehend, and use essential information and services to make informed decisions in various life contexts. Spiritual health literacy, specifically, relates to applying principles that foster a balanced and harmonious relationship with oneself and others.
    Objectives
    This study aims to explore the outcomes of spiritual health literacy among students.
    Methods
    The present study is a qualitative research of thematic analysis type. The data collection tool was a semi-structured interview conducted with 13 experts selected through purposive sampling. Thematic analysis involving descriptive coding, interpretive coding, and integration through overarching themes was used to analyze the interviews.
    Results
    Based on the interviews conducted with experts and the subsequent coding, eight main themes and 28 sub-themes were identified under the consequences of spiritual health literacy among university students in Gonabad city in Iran. These themes include self-management skills, self-awareness, self-control, problem-solving, personal development, social development, and cultural development.
    Conclusion
    The results of this study reveal the significant outcomes of spiritual health literacy among students, showing that it has a multifaceted impact on their personal and social development. Accordingly, incorporating various aspects of spiritual health literacy into educational policy is of particular importance.
    Keywords: Spiritual Health Literacy, Spiritual Health, Health Literacy, Thematic Analysis
  • Mahdi Moshki, Raziyeh Gholamiyan Bajestani, Hossein Hossein, Narjes Bahri*
    Background

    Healthy lifestyle affects the health of the mother and fetus during pregnancy. This study aimed to compare the effects of group discussion and multimedia package education interventions on healthy lifestyles among pregnant women.

    Methods

    This quasi-experimental study was conducted on 151 pregnant women during their 16-28 weeks of pregnancy who were referred to comprehensive health centers in Bajestan City, Iran. They were randomly allocated to three groups: Group discussion (n=50), multimedia package education (n=52), and control group (n=49). The demographic questionnaire and Walker’s health-promoting lifestyle profile II were used for data collection before and one month after the intervention. The educational intervention in the group discussion was held in 4 sessions. The multimedia package group received software consisting of text, video, animation, and audio materials. Finally, the control group received routine educational support in health centers. The study data were analyzed using descriptive and inferential statistics and at a significance level of 0.05.

    Results

    The result showed no significant difference between the three groups before intervention (P=0.073) regarding their mean lifestyle scores. However, the mean lifestyle score was significantly lower in the control group compared to the other two groups one month after the intervention (P<0.001). However, the mean lifestyle score was significantly higher in group discussion and multimedia groups (P<0.001).

    Conclusion

    The findings showed that multimedia package and group discussion methods improved lifestyle in pregnant women. Therefore, we suggest that health providers use these methods for pregnant women regarding their rationales and facilitations.

    Keywords: Pregnancy, Teaching materials, Multimedia, Focus group, Lifestyle
  • Mahdi Moshki, Khadijeh Seyedi*, Khosro Shafaghi, Samane Najafi
    Background

    The prerequisite of effective nutrition intervention is an appropriate education. This study aimed to evaluate the effectiveness of nutrition education based on discussion and multimedia in the learning of pregnant women. 

    Methods

    This randomized educational trial was conducted on 174 pregnant women in Gonabad City, northeast Iran. The study participants were randomly assigned into three groups (58, 57, and 59 women in the multimedia group, discussion group, and control group, respectively). The demographic information form and assessment of learning questionnaire were completed before the study for all three groups. In the intervention group, training was based on the discussion and multimedia packages. Multimedia packages were given to mothers in the intervention group for 2 weeks. In the discussion group, mothers were divided into subgroups of 8 to 12 members, and educational subjects were presented over three 90 min sessions. One month after the intervention, a post-test was administered to all groups.

    Results

    The mean gestational ages in the multimedia group, discussion group, and control group were 9.66, 9.54, and 9.40 weeks, respectively. The results showed that the difference between the multimedia and discussion groups (P<0.001) regarding the cognitive scores was significant before and after the intervention. There were significant differences between groups regarding affective domain scores before and after the intervention (P=0.03).

    Conclusion

    The effectiveness of multimedia learning in the cognitive domain and discussion in the affective domain was confirmed. Therefore, it is recommended to use innovative and effective methods such as multimedia packages for educating pregnant women.

    Keywords: Pregnancy nutrition, Educational program, Learning, Group discussion, Multimedia
  • Mahdi Moshki, Reza Yaghubi, Fariba Pariafsai
    BACKGROUND

    Positive psychology introduce mental health as a positive psychological functioning and represent it as well‑being psychology. From this point of view, psychological health is more supposed to be known as having positive characteristics such as self‑esteem, positive social relationships, and satisfaction. This study was conducted to compare the effect of education in two methods of person‑centered and supportive group based on the PRECEDE‑PROCEED model on women’s psychological well‑being during menopause.

    MATERIALS AND METHODS

    The present study was a clinical trial. One hundred and ten menopausal women have been placed in two groups (tests and control). The training program was designed according to the PRECEDE‑PROCEED model. The educational intervention was implemented for two groups (person‑centered and the supportive group) and the control group did not receive any training. Data analysis was used by descriptive statistics and in the case of normal distribution of alternative tests such as Kruskal–Wallis test, Man–Whitney test, Wilcoxon, spearman correlation, Spearman correlation was used.

    RESULTS

    Results of variance analysis showed that awareness, attitude, self‑efficacy, enabling factors, reinforcement, support, behavioral environment, six psychological well‑being factors were significantly different from the individual group and control group. Furthermore, the overall score of the psychological well‑being was significantly higher than the control group.

    CONCLUSIONS

    As a result of the design and deployment of health care monitoring system, building and reform of community beliefs toward women’s status in decision making and their role in menopause, the design and development of support group meetings in women’s health care system and enhancing women’s access to specialist and heterogeneous health services tailored to the needs of the menopause.

    Keywords: Menopause, person‑centered group, PRECEDE‑PROCEED model, psychological well‑being, support group
  • پژمان باقری، موسی قلیچی قوجق، وجیهه آرمان مهر*، علی دلشاد نوقابی، مهدی مشکی، نورالله مرادی
    Pezhman Bagheri, Mousa Ghelichi Ghojogh, Vajihe Armanmehr*, Ali Delshad Noghabi, Mahdi Moshki, Noorallah Moradi
    Background & objectives

    Emotional divorce, seems to be a reducing factor in the quality of marital life and mental health. This study aimed to design, construct and validate an emotional divorce instrument.

    Materials & Methods

    This study was an applied, psychometric survey using a multi-stage sampling method conducted on 805 women living in Iran between 2015 to 2018. After determining the items in a semi-structured qualitative study, face, content, structure, and concurrent validity as well as the split-half and Cronbach's alpha coefficient methods for reliability evaluation were used. For all analyses, the SPSS19 software (IBM Corp, 2013) and for confirmatory factor analysis (CFA) LISREL 8.8 was used.

    Results

    36.81% of the total variance was justified by 63 factors with Eigenvalues of less than 1 and 63.19% by the first 12 factors with an Eigenvalue of higher than 1. The final questionnaire consisted of 66 questions. The total Cronbach’s alpha coefficient was 0.979. The exploratory factor analysis (EFA) resulted in five factors consisting of "love and interest in the spouse", "attention to the needs and practice the tasks", "controversy and misbehavior", "mental health", and "respect and appreciation". The results of the CFA confirmed model derived from the EFA (Chi-Square=7653.70, df =2503, P-value= 0.0000, RMSEA = 0.051).

    Conclusion

    The reliability of this questionnaire was high in two consecutive evaluations. The structural validity also led to the identification of the desired number of items. Hence, this questionnaire seems to be an appropriate tool for assessing emotional divorce as a feature of quality of marital life. However, further investigation is needed for tool efficiency assessment in different communities.

    Keywords: Emotional divorce, Questionnaire design, Reliability, Validity
  • Mitra Tavakolizadeh, Mahdi Moshki, Mahdi Basiri Moghadam, Ali Delshad*
    Background

    The aim of this study was to determine the effect of continuous care model application on body mass index (BMI) and lifestyle of middle-aged obese.

    Methods

    105 obese middle-aged were selected and assigned randomly to two groups. The data were collected using a meter, scale, and Walker health promotion lifestyle questionnaire (HPLP II). participants completed the questionnaire before undergoing the intervention, one, two, and three months after the intervention.

    Results

    There was no significant difference between the experimental and control groups before the intervention considering all of the studied variables. However, a significant difference was observed between groups after the intervention in terms of lifestyle dimensions and obesity control performance.

    Conclusion

    Considering the results of current study, the continuous care model can be effective for improving the lifestyle and health of middle-aged obese. Therefore, this model is recommended as a framework to design an overweight and obesity prevention plan.

    Keywords: Continuous care model, Body mass index, Lifestyle, Obesity
  • Hamideh Sadat Moghaddam Ghadiri Jalali, Tahereh Sadeghi *, Hamidreza Zendehtalab, Mahdi Moshki, Najmeh Valizadeh Zare
    Background

    Breastfeeding is one of the most important aspects of the mental-cognitive development of the child. The most useful application of the PRECEDE model is to explain factors associated with behaviors.

    Aim

    This study aimed to investigate the effect of PRECEDE model-based education on the breastfeeding behavior of nulliparous mothers.

    Method

    This randomized clinical trial was conducted on 90 mothers referring to the health centers in Gonabad, Iran, in 2017-18. The participants were divided into intervention and control groups using a table of random numbers. The data were collected through a questionnaire based on the PRECEDE model including predisposing factors, reinforcing factors, enabling factors, self-efficacy, as well as behavioral and social evaluation. Breastfeeding behavior was also assessed using the standard infant breastfeeding assessment tool (IBAFT). Data were analyzed in SPSS 21 through independent t-test and Mann-Whitney test.

    Results

    No significant difference was observed between the intervention and control groups in terms of knowledge, attitude, reinforcing factors, and enabling factors (P<0.05) before the intervention. However, a significant difference was found between the two groups regarding knowledge, attitude, reinforcing factors, enabling factors, and breastfeeding behavior (P<0.001) after the intervention. The mean±SD of breastfeeding behavior showed a significant difference between the two groups (P<0.001).Implications for Practice: Due to the effectiveness of the PRECEDE model-based training in the breastfeeding behavior of nulliparous women, this educational content can be used to promote breastfeeding behavior in health centers and hospitals.

    Keywords: breastfeeding behavior, health education, Precede Model
  • Mahdi Moshki, Abdoljavad Khajavi, Homayoun Sadeghi Bazargani, Shahram Vahedi, Saeid Pour Doulati *
    Objective

    To develop a self-completion pedestrians’ red-light violation behavior questionnaire (PRVBQ) based on the theory of planned behavior (TPB) and assess the content validity and reliability.

    Methods

    This study was conducted in three phases of (i) PRVBQ development study; (ii) Content validity study including face validity; and (iii) Reliability assessment. The directed content analysis method was used for the analysis of the qualitative interviews. The item impact score was used for face validity. Content validity index (CVI) in the item level and average scale level, and content validity ratio (CVR) were determined. Intra-class Correlation Coefficient (ICC), and Cronbach’s alpha was assessed for test-retest reliability and internal consistency respectively.

    Results

    Draft questionnaire including 86 items was constructed. Sixteen items were eliminated due to low face and content validity, remaining 70 items in total. The PRVBQ was rated as having good content validity (individual items CVI ranged from .80 to 1, and overall PRVBQ CVI-Average=0.95, p=0.05). The direct measures (reflective indicators) showed excellent internal consistency with Cronbach’s alpha=0.9. All items showed excellent agreement.

    Conclusion

    This study using a comprehensive process of development and assessment of content validity and reliability developed a content valid and reliable questionnaire predicting pedestrians’ red light violation behavior.

    Keywords: Pedestrian red-light violation behavior questionnaire, Validity, reliability
  • مهدی مشکی، علی عالمی، مجید فلاحی، حسن سروری خواه*
    زمینه و هدف

    امروزه استفاده از کامپیوتر در هر کاری ضروری شده و کمتر شغلی را می توان یافت که درآن برای انجام وظایف از کامپیوتر استفاده نشود. کار با کامپیوتر در مدت طولانی در شرایط استاتیک و وضعیت بدنی نامناسب ممکن است منجر به اختلالات اسکلتی -عضلانی شود. کاربران رایانه با توجه به ماهیت کاری خود، شیوع زیادی از اختلالات اسکلتی -عضلانی را گزارش می کنند. از مهمترین استراتژی های پیشگیری از ابتلا به اختلالات اسکلتی -عضلانی مرتبط با کار آموزش است. جهت کسب نتایج مفید و موثر، آموزش می بایست بر مبنای نظریه ها و الگوهای تغییر رفتار طراحی گردد. لذا این پژوهش با هدف بکارگیری الگوی پرسید- پروسید در ارتقای رفتارهای پیشگیری کننده از اختلالات اسکلتی -عضلانی در کاربران رایانه انجام شد.

    روش بررسی

    در این مطالعه کارآزمایی تصادفی شاهددار 110نفر از کاربران رایانه ای انتخاب شدند. پس از بررسی انجام شده و تعیین ریسک فاکتورهای ایستگاه های کاری مورد بررسی با روش ارزیابی سریع تنش اداری  (ROSA)، کاربرانی که دارای سطح احتمال خطر زیاد ابتلا به اختلالات اسکلتی -عضلانی بودند و ایستگاه کاری آنها به اقدامات اصلاحی و مداخله ای نیاز داشت، وارد مطالعه شدند. ابزار گردآوری داده ها پرسشنامه استاندارد نوردیک، چک لیست ارزیابی سریع تنش اداری و پرسشنامه محقق ساخته بر اساس سازه های الگوی آموزشی پرسید- پروسید بود. روایی و پایایی پرسشنامه محقق ساخته در مطالعه مقدماتی بررسی شد. بر اساس نتایج به دست آمده از تکمیل اولیه پرسشنامه ها، مداخله آموزشی مناسب که شامل کتابچه آموزشی و فیلم های آموزشی در خصوص حرکات کششی و اصلاحی، آموزش و تمرین های صحیح نشستن در حین کار با رایانه بود، طراحی و در گروه آزمون اجرا شد. قبل و بعد از مداخله، داده ها در نرم افزار SPSS.24 با استفاده از آزمون های توصیفی (میانگین، انحراف معیار، تعداد و درصد) و آزمون های تحلیلی (آزمون من ویتنی، کای اسکویر و ویلکاکسون) تجزیه و تحلیل شد.

    یافته ها

    نتایج پرسشنامه نوردیک نشان داد که شیوع علایم اختلالات اسکلتی-عضلانی در کاربران رایانه به ترتیب در کمر (60درصد)، گردن (58درصد) و شانه (51درصد) از دیگر اندام های بدن بیشتر بود. تفاوت معنا داری بین شیوع اختلالات اسکلتی-عضلانی در دو گروه مورد بررسی وجود نداشت. قبل از مداخله بین میانگین نمرات نهایی ROSA، نمرات متغیرهای الگوی آموزشی پرسید -پروسید از قبیل عوامل مستعدکننده، عوامل تقویت کننده و عوامل قادر کننده در دو گروه تفاوت معناداری مشاهده نشد. پس از انجام مداخلات آموزشی بین میانگین نمره نهایی ROSA و اجزاء آن (0001/0=p) و همچنین میانگین نمرات عوامل مستعدکننده (آگاهی و نگرش)، عوامل تقویت کننده و عوامل قادر کننده الگوی پرسید-پروسید در دو گروه تفاوت معنادار مشاهده شد (0001/0=p).

    نتیجه گیری

    طراحی و اجرای برنامه های آموزشی ارگونومیک منطبق با اجزای روش ROSA بر اساس الگوی پرسید-پروسید با تغییر در عوامل مستعدکننده (آگاهی و نگرش)، عوامل تقویت کننده و عوامل قادر کننده کاربران رایانه نسبت به ارتقای رفتارهای پیشگیری کننده از اختلالات اسکلتی -عضلانی موثر است و می توان از آن به عنوان چارچوبی جهت طراحی مداخلات آموزشی برای کاربران رایانه استفاده کرد.

    کلید واژگان: کاربران رایانه, الگوی پرسید-پروسید, اختلالات اسکلتی -عضلانی مرتبط با کار, ارزیابی سریع تنش اداری
    Mahdi Moshki, Ali Alami, Majid Fallahi, Hassan Sarvari Khah*
    Background and aims

    Nowadays, using the computer in doing everything is necessary and there are fewer jobs that do not use the computer to perform tasks. Working with a computer for a long time under static conditions and inappropriate postures can lead to work-related musculoskeletal disorders (WRMSDS). Computer users report a high incidence of WRMSDS, depending on the nature of their work. One of the administrative control strategies to reduce or eliminate the risk factors for WRMSDS in computer users is applying education or training program. Also, providing the devices of office workstations such as chairs and tables adjustable. The results of various studies have been shown that ergonomic training, ergonomic design of workstations and office buildings can be useful in preventing and reducing WRMSDS and its associated symptoms in office settings. Since training is one of the main pillars of health care in our country, it is necessary to pay more attention to designing and planning educational programs based on educational models and theories of behavior and social sciences for various diseases and health issues. In this study, the PRECEDE-PROCEED educational model was used to plan for promoting preventive behaviors of WRMSDS among computer users. This model is introduced as a diagnostic framework for health education planning and health promotion. Model implementation stages include: social diagnosis, epidemiological diagnosis, behavioral and environmental diagnosis, educational diagnosis (identifying predisposing factors, enabling and enhancing health behaviors) and ecological, managerial and policy diagnosis, implementation, process evaluation, evaluation of immediate results and evaluation of long term results. The reason for using this model in this study is that the comprehensive nature of this model makes it applicable to different subjects and populations. This model has an ecological perspective and states that one should not only consider the behavior to change, but also the environment around the individual and the factors that influence behavior change, take into account also. Therefore, in order to obtain useful and effective results, education must be designed based on theories and patterns of behavior change. Therefore, this study was carried out with the aim of applying PRECEDE-PROCEED model in promoting preventive behaviors of WRMSDS among computer users. 

    Methods

    In this randomized controlled trial study, 110 computer users were selected. The risk factors of the workstations have been determined using the Rapid Administrative Stress Assessment (ROSA) method. Computer users who had a high risk of developing WRMSDS and their workstations needed corrective and interventional measures were included in the study. Data were collected using standard Nordic questionnaire, ROSA checklist, and researcher-made questionnaire based on PRECEDE-PROCEED educational model constructs. The validity and reliability of the researcher-made questionnaire were assessed in a pilot study. Individuals were also agreed to enter the study. Data collection tools were completed in three stages. In the first stage, Nordic musculoskeletal standard questionnaire was used to evaluate the prevalence of WRMSDS. To achieve better results, the questionnaire was completed through direct interviews with the participants under study, and the prevalence of WRMSDS was recorded over the past year. In the second stage, the risk factors for WRMSDS and determination of risk levels were determined by ROSA method. This method is proposed to identify the risk factors of computer users and to prioritize the optimal fit between users and workstation devices. In the third stage, the self-made questionnaire consisted of different parts of the PRECEDE-PROCEED model constructs such as individual questions, predisposing factors, enabling factors, and reinforcing factors has been applied. Content validity method was used for scientific validation of self-made questionnaire. The questionnaire was given to 12 professors related to this topic and their corrective comments were applied. Test-retest method was used to calculate the reliability of these questionnaire. The questionnaire was completed by 20 computer users and then completed in two weeks. Cronbachchr('39')s alpha for questionnaire was estimated 0.75. Finally, based on the results of the initial questionnaires, an appropriate educational intervention including training manuals and instructional videos on stretching and corrective movements, training and correct sitting exercises while working with the computer was designed and implemented in the experimental group. The control group received no training. After the implementation of the training program in the evaluation phase of the PRECEDE-PROCEED model, the process of intervention, design and implementation of the program was evaluated. Immediately after the training sessions and two months after the intervention, the impact of the training program on promoting preventive behaviors of WRMSDs of computer users was measured. Data were analyzed before and after the intervention using SPSS.24 software. Mann-Whitney and Wilcoxon tests were used to compare quantitative values ​​between the two groups before and after the intervention and chi-square test was used to compare qualitative values ​​between the two groups.

    Results

    In this study, 86 (78%) of the participants were men and 24 (22%) were women. The results of chi-square test showed that the distribution ratio of people with different gender was similar between the two groups and there was no significant difference between them (p> 0.05). Findings showed that the mean age of users was 39.7 years and there was no significant difference between the two groups in terms of age. Chi-square test results showed that there was no significant difference between the prevalence of musculoskeletal disorders in the two groups (P> 0.05). The results showed that the highest prevalence of disorders in the experimental group was in the low back, neck and shoulder respectively, and in the control group was in the low back, neck and shoulder, respectively. Before intervention, there was no significant difference between the mean of ROSA final scores, variables of PRECEDE-PROCEED model such as predisposing factors, reinforcing factors and enabling factors in the two groups. There was a significant difference between the mean scores of ROSA final score and its components (p = 0.0001) as well as the mean scores of predisposing factors (knowledge and attitude), reinforcing factors, and enabling factors of PRECEDE-PROCEED model (p = 0.0001). Before the intervention, the Mann-Whitney test results showed no significant difference in the mean scores of the predisposing factors (knowledge and attitude) and PRECEDE-PROCEED model reinforcement factors between the two groups (p> 0.05). There was a significant difference in the mean of the enabling factors in the two study groups before the intervention (p <0.05). The findings of the study showed a significant difference between the mean scores of the predisposing factors (knowledge and attitude), enabling factors and reinforcing factors of the PRECEDE-PROCEED model between the experimental and control groups.

    Conclusion

    In the present study, in accordance with the educational process of PRECEDE-PROCEED model, the enabling and reinforcing factors have been take into account. The mean of enabling factors had a significant increase in the experimental group after the intervention compared to before the intervention and in the control group there was no significant increase. Prior to training, 36% of the study participants had a background in television, health care, magazines, and newspapers. In the intervention program, 100% of the experimental group received an educational booklet called principles of ergonomics at the computer workstation also instructional videos (including stretching and correcting movements) which caused a significant difference in enabling factors. In this study, encouragement and support of family, coworkers, and verbal encouragement of the educator were considered as reinforcing factors. Results showed that there was a significant difference between the mean of these factors after the intervention in the experimental group compared to the control group. Finally, it was concluded that design and implementation of ergonomic training programs based on PRECEDE-PROCEED model with changes in predisposing factors (knowledge and attitude), reinforcing factors and enabling factors also considering the components of ROSA method is an effective method to promote preventive behaviors of WRMSDs and it can be used as a framework for designing of educational interventions among computer users.

    Keywords: Computer users, PRECEDE-PROCEED model, Work-Related Musculoskeletal Disorders, Rapid Office Strain Assessment
  • Marjan Mirzania, Abdoljavad Khajavi, Akram Kharazmi, Mahdi Moshki*
    Background

    Main health challenge of the 21st century is improving quality of life (QoL). This study aimed to investigate the mediating role of health locus of control (HLC) between health literacy and QoL among Iranian pregnant women.

    Methods

    In this cross sectional survey, 400 pregnant women referred to the community health centers of Gonabad, Iran, and completed the demographic, health literacy, QoL, and multidimensional HLC questionnaires during 2015-2016. Descriptive statistics and structural equation modeling were conducted using SPSS 22.0 version and AMOS 24.0 software.

    Results

    The findings showed that health literacy has a significant positive effect on the physical (β= 0.54, p< 0.001) and mental (β= 0.57, p< 0.001) health. Also, it has a significant positive effect on internal subscale (β= 0.42, p< 0.001) and a significant negative effect on the chance (β= -0.51, p< 0.001) and powerful others (β= -0.33, p< 0.001) subscale of HLC. From HLC subscales, internal HLC had a significant positive effect on physical (β= 0.26, p< 0.001) and mental (β= 0.12, p= 0.010) health, while the effects of chance and powerful others on QoL dimensions were not significant. The findings indicated that internal HLC is a partial mediator between health literacy and physical dimension of QoL.

    Conclusion

    The results indicate that health literacy can be considered as an effective factor in HLC orientations and can improve QoL. This reflects the need for more attention on health literacy and the recognition of the type of HLC beliefs, especially the internal belief in health promotion programs for pregnant women.

    Keywords: Health literacy, Quality of life, Locus of control, Pregnancy, Structural equation modelling
  • Ali Alami, Mahdi Moshki, Mohammad-Hadi Rezaeian-Kochi*
    Background

    It is estimated that tobacco use, as the second leading cause of death, is responsible for one-tenth of all deaths worldwide. This study aimed to determine the effectiveness of training based on the Theory of Planned Behavior (TPB) on tobacco consumption patterns among students of Gonabad University of Medical Sciences.

    Methods

      This study was quasi-experimental that was performed on 65 students of Gonabad University of Medical Sciences who were assigned by random sampling design with proportional allocation in the experimental and control groups. After collecting the baseline data, the researcher-made questionnaire was designed based on the Theory of Planned Behavior (TPB) and tobacco consumption’s questions with acceptable validity and reliability of the training program in six sessions for the experimental group. Two months after the training, the same questionnaires were completed by both groups. Data were analyzed by independent t-test, Chi-squared test, and Fisherchr('39')s exact test with SPSS-20 at a significance level of P <0.05.

    Results

      The mean (standard deviation) age of the participants in the experimental and control groups was 21.46 (1.96) and 22.22 (3.02), respectively (P = 0.076). Before the intervention, there was no statistically significant difference between demographic characteristics, pattern of tobacco consumption, and TPB model constructs. After the intervention, the mean score of the constructs of TPB, except for subjective norms, and knowledge of the intervention group increased (p<0.05). Besides, use of cigarette and hookah was significantly decreased in this group (P=0.003).

    Conclusion

    The results showed that training based on the Theory of Planned Behavior (TPB) and providing preventive skills is a significant effect on consumption and refusal to use tobacco.

    Keywords: Training, Theory of Planned Behavior (TPB), Tobacco consumption, Students
  • Mahdi Moshki, Abdoljavad Khajavi, Farveh Vakilian, Shima Minaee, Haydeh Hashemizadeh*
    Introduction

    Due to the necessity of assessing the health-related quality of life (HRQOL) in heart failure (HF) and the increased use of the International Classification of Functioning, Disability, and Health (ICF) for making a content comparison of measurement instruments, the present study aimed to evaluate the relationship between the instruments and ICF. To this aim, the disease-specific HRQOL instruments in HF were identified, and then psychometric properties and content comparison of included instruments were conducted by linking to ICF.

    Methods

    Disease-specific HRQOL instruments in HF were identified through a comprehensive and systematic search strategy. Then, the psychometric properties of included instruments were determined, and their contents were analyzed and compared based on the ICF coding system. In addition, each instrument was independently linked to ICF by two researchers based on standardized linking rules, and finally their degree of agreement was assessed by the Cohen’s kappa coefficient.

    Results

    Ten instruments including a total of 247 items and 417 concepts were linked to 124 different ICF categories. Further, 39 (31.5%), 65 (52.5%), 13 (10.4%), and 7 (5.6%) categories were linked to body function, activity and participation, environmental factors, and body structure, respectively. According to the content analysis approach and psychometric properties, the appropriate measurement instruments were Kansas City Cardiomyopathy and Minnesota living with HF questionnaires, respectively.

    Conclusion

    Content comparison provides researchers with valuable information on the instrument heterogeneity and overlapping, which results in selecting the most appropriate measurement instrument based on a specific clinical context.

    Keywords: Quality of Life, Health Status, Heart Failure, Content Analysis, Systematic Review
  • مهدی مشکی، سیده افروز موسوی، جواد مومن *
    سابقه و هدف

    بعد معنوی یکی از ابعاد سلامت است که به سبب فقدان تعریفی روشن و جامع از آن و وجود چالش در مفهوم پردازی آن با مشکل در اندازه گیری مواجه می باشد. در این راستا، پژوهش حاضر با هدف طراحی و ارزیابی ویژگی های روان سنجی ابزاری متناسب با معیارهای فرهنگی جامعه دانشجویان ایرانی به منظور بررسی سلامت معنوی آن ها انجام شد.

    مواد و روش ها

     آزمودنی های پژوهش حاضر 390 نفر از دانشجویان دانشگاه های شهرستان گناباد بودند که به روش نمونه گیری تصادفی طبقه ای (با توجه به رشته تحصیلی آن ها) انتخاب شدند. در این مطالعه برای بررسی روایی پرسشنامه منبع کنترل سلامت معنوی از تحلیل عاملی به روش تجزیه به مولفه های اصلی و نیز از آلفای کرونباخ برای بررسی میزان پایایی استفاده گردید.

    یافته ها

     نتایج تحلیل عاملی نشان دادند که با چرخش به روش واریماکس، چهار مولفه "زندگی معنوی فعال"، "ایمان/زندگی معنوی"، "معنویت انفعالی" و "رحمت الهی" آشکار می شود. همچنین مشخص شد که هم کل پرسشنامه و هم تمام خرده مقیاس های آن از ضریب پایایی بالایی برخوردار هستند. شایان ذکر است که بین نمره کل و مولفه های منبع کنترل سلامت معنوی (با توجه به جنسیت) تفاوت معناداری مشاهده نشد.

    استنتاج

    نتایج گویای آن بودند که آزمون فارسی منبع کنترل سلامت معنوی از روایی و پایایی خوبی در میان دانشجویان برخوردار است.

    کلید واژگان: روایی, سلامت, منبع کنترل, معنوی
    Mahdi Moshki, Seyyedeh Afrooz Mousavi, Javad Momen *
    Background and Purpose

    The spiritual dimension is one of the health dimensions; however, its measurement faces some serious problems, owing to the lack of a clear and comprehensive definition, as well as the challenges present in its spiritual conceptualization. Therefore, the present study aimed to design and evaluate the instrumental psychometric properties, which are matched to the cultural norms of Iranian students society, so as to assess their spiritual health.

    Materials and Methods

    This research was carried out on 390 university students in Gonabad who were selected by stratified random sampling (based on their field of study). In order to calculate the validity of the questionnaire (SHLCS(, the factor analysis method was used by principal component analysis, and Cronbach's alpha method was used to evaluate the reliability.

    Results

    The findings of the factor analysis section indicated that Varimax rotation revealed four components, including active spiritual life, faith / spiritual life, passive spirituality, and divine mercy. Moreover, it was found that the whole questionnaire and all sub-tests enjoyed a high reliability coefficient. It is worth mentioning here that there was no significant difference between the total score and the components of the spiritual health locus of control based on gender.

    Conclusion

    Based on the results of the study, the Persian version of the SHLCS has appropriate validity and reliability in students.

    Keywords: Health, Locus of control, Spiritual, Validation
  • محمد واحدیان شاهرودی، مهدی مشکی، حبیب الله اسماعیلی، سمیه مرادی قله زو*، الهه لعل منفرد، مریم دمیرچی
    زمینه و هدف
    همان طور که طول عمر افزایش می یابد، اهمیت رفتارهای ارتقاء دهنده سلامت نیز، با توجه به حفظ کارکرد و استقلال افراد و افزایش کیفیت زندگی آن ها، روزبه روز بیشتر آشکار می شود. پژوهش حاضر باهدف تعیین میزان انجام فعالیت بدنی بر اساس نظریه رفتار برنامه ریزی شده در سالمندان شهر کلات در سال 1393 انجام شد.
    روش تحقیق
    در این مطالعه توصیفی - تحلیلی که به صورت مقطعی انجام شد،371 نفر از سالمندان شهر کلات در سال 1393 به روش نمونه گیری مبتنی بر هدف انتخاب شدند. ابزار گردآوری داده ها پرسشنامه سه قسمتی شامل اطلاعات دموگرافیک، سوالات مربوط به سنجش آگاهی، سوالات مبتنی برسازه های نظریه رفتار برنامه ریزی شده (نگرش، هنجارهای ذهنی، کنترل رفتار درک شده و قصد رفتاری) بود. اطلاعات حاصل از پرسشنامه با استفاده از آمار توصیفی و استنباطی در سطح معنی داری 05/0 با استفاده از نرم افزار spss تحلیل شدند.
    یافته ها
    طبق نتایج میانه سنی سالمندان 69 سال بود که 53 درصد آن ها زنان بودند که 2/32درصد سالمندان لاغر، 33درصد طبیعی، 27درصد اضافه وزن و 8/7درصد چاق بودند. در این پژوهش قصد رفتاری با تمام سازه های نظریه رفتار برنامه ریزی شده همبستگی مثبت و معنی دار داشته، سازه کنترل رفتاری درک شده بیشترین پیشگویی کنندگی (38/0=2r) در واریانس قصد سالمندان نسبت به فعالیت بدنی را دارا بود. سازه های نظریه باهم توانستند 7/26درصد واریانس قصد را پیش بینی کنند.
    نتیجه گیری
    بر اساس نتایج پژوهش حاضر می توان گفت نظریه رفتار برنامه ریزی شده در پیش بینی قصد سالمندان در خصوص فعالیت بدنی موفق بوده و با توجه به نقش سازه کنترل رفتاری درک شده در پیشگویی قصد رفتار، لزوم توجه به مولفه مذکور به منظور آموزش قصد در سالمندان تاکید می گردد.
    کلید واژگان: نظریه رفتار برنامه ریزی شده, سالمندان, فعالیت بدنی
    Mohammad Vahedian, Shahroodi, Mahdi Moshki, Habibollah Esmaily, Somaye Moradi Gholezo*, Elaheh Lael, Monfared, Maryam Damirchi
    Today, with increasing the lifespan, the importance of health-promoting behavior and paying attention to maintaining individuals' function and autonomy are becoming increasingly evident and regular physical activity is considered as one of the important aspects of healthy lifestyle. This study aimed to apply the theory of planned behavior to predict the intention to do physical activity in the elderly. This study was conducted on the 371 elderly. A three-part questionnaire including demographic, knowledge, and theory of planned behavior questions was used. The views of the elderly were requested directly in this regard. According to the results, the elderly’s mean age was 69 and the sample included 53% women. The behavior intention in this study had a positive significant correlation with all planned behavior theory constructs. The perceived behavior control construct hold the most prediction power regarding the variance of the elderly’s intention of physical activity behavior. The constructs of theory could predict 26.7% of the variance of intention. Based on the results of this study, the theory of planned behavior was successful in predicting the elderly’s intention to do physical activity and the necessity of paying attention to the component is emphasized to teach intention to elderly people, considering the role of the perceived behavior control construct in predicting behavior intention.
    Keywords: Elderly, Physical Activity, theory of planned behavior
  • Marjan Mirzania, Abdoljavad Khajavi, Mahdi Moshki *
    Background
    The health locus of control (HLC) can indirectly determine the health status. The current study aimed to assess the validity and reliability of Form C of the Multidimensional Health Locus of Control (MHLC-C) scale in pregnant women.
    Methods
    554 pregnant women participated in this cross-sectional study conducted in 2017; they referred to community health centers affiliated with Mashhad and Gonabad Medical Sciences Universities. Multi-stage random sampling was done. In this study, first, the questionnaire was translated into Farsi; then, face validity and construct validity were done through exploratory factor analysis, and concurrent criterion validity was also examined. Moreover, the reliability was assessed through internal consistency and stability methods.
    Results
    The results of the exploratory factor analysis showed that the MHLC-C scale consisted of four subscales, i.e. Chance, Internal, Other People, and Doctors, which accounted for 51.18% of variance. The results of the reliability analysis showed an acceptable internal consistency for the scale (Cronbach’s alpha coefficient for subscales from 0.62 to 0.90). Also, the test-retest results showed good stability for all subscales other than Doctors (P<0.05). The concurrent validity of Forms B and C of MHLC scale showed a positive and significant correlation between subscales.
    Conclusion
    The results of this study showed that the MHLC-C scale had acceptable validity and reliability in pregnant women and is suggested as an applicable criterion for assessing individuals control beliefs with any medical or health-related condition in Iran.
    Keywords: Validity, reliability, Internal-external control, Pregnancy
  • Mahdi Moshki, Abdoljavad Khajavi, Leila Doshmangir, Saeid Pour Doulati*
    Background
    Pedestrians are amongst the most vulnerable road users and their unsafe behaviors have a major impact on traffic injuries. The aim of this study was to determine the underlying psychological factors behind red light violation in pedestrians’ crossing behavior based on the Theory of Planned Behavior (TPB) and to provide recommendations for preventive interventions.
    Methods
    This qualitative study was conducted in Tabriz, one of the metropolitan cities of Iran. 30 pedestrians were individually interviewed using semi-structured, open-ended questions to elicit salient consequences, social referents, and circumstances regarding pedestrians’ red light crossing behavior. The transcribed interviews were analyzed using directed content analysis followed by frequency analysis in order to detect modal salient beliefs.
    Results
    A total number of 115 sub-categories were identified which were then classified in the ten predetermined categories of the Theory of Planned Behavior: advantages, disadvantages, positive feelings, negative feelings, approving referents, disapproving referents, behaving referents, not-behaving referents, facilitators, and barriers. “Saving time” was elicited as the most important both the advantage and the positive feeling. “Getting injured” was identified as the most serious disadvantage. “Lowering the level of culture” was obtained as the main negative feeling. “Friends/Peers” comprise the most prominent group among both the approving and the behaving referents, whereas “Family members” constituted the most significant group both among the disapproving and the not-behaving referents. “Being in a hurry” was introduced as the most substantial facilitator and “The fear of accident” was identified as the most influential deterrent factor.
    Conclusion
    Based on the major findings, reducing pedestrians’ red light violations needs to focus: on the perceived negative and positive consequences and feelings of this behavior like getting injured, and saving time respectively; on the approval role of friends/peers, and the disapproval role of family; and on the fear of accident as a barrier, and rushing as a facilitating factor. More precise quantitative research is needed to determine the predictive power of these factors in such risky behavior.
    Keywords: Attitude, Theory of Planned-Behavior, Red light-Violation, Pedestrians
  • Mina Maheri, Shahrzad Nematollahi, Fatemeh Darabi, Mohammad Nabi Bahrami, Mahdi Moshki *, Hamid Joveini
    Use of the internet has regarded as an advantageous breakthrough which sometimes has led to over usage so-called "internet addiction". Increased prevalence of internet addiction among students and the necessity of acquiring information to design interventions have compelled us to design the present study on knowledge, attitudes and self-efficacy of students regarding the Internet addiction. This study was two‑stage cluster sampling consisted of 160 girl participants who were residing in selected dormitories of Tehran University of Medical Sciences. Data was collected through a structured questionnaire including demographic, knowledge, attitude and self-efficacy questions regarding the Internet addiction and. 49 participants (30.6 %) were at risk of the Internet addiction. Majority of the students were on the average national levels of knowledge (48.1%), attitude (49.1%), and self-efficacy (61.2%). We also found a statistically significant association between mean score of attitude with educational degree (p<0.003), and between the average daily hours of the Internet use with user type (p<0.001). Given the importance of knowledge, attitude and self-efficacy on the adaptation of healthy behaviors, the findings of this study revealed that extra educational interventions aiming to increase knowledge, improve attitudes and self-efficacy regarding internet use has a paramount importance.
    Keywords: Addictive Behavior, Attitude, Knowledge, Students
  • Marjan Mirzania, Maryam Eshghizadeh, Fateme Mousavinia, Mahdi Moshki*
    Background
    Adolescent obesity has become a serious public health challenge in the 21st century.The purpose of this study was to determine the effects of a participatory training program on the control of overweight and obesity in female adolescents.
    Methods
    One hundred female participants aged 12 to 14 years with overweight or obesity were recruited from four schools which were selected randomly from the list of all schools. The height, weight, and body mass index (BMI) of participants were measured. A training program which consisted of proper nutritional behaviors as well as balanced physical activities was proposed through educational tools and lectures to the experimental group. Besides, questioning and answering sessions as well as group discussion with health and nutrition experts were held.
    Results
    After the intervention, a significant difference was observed in the BMI of experimental group (26.39±3.06) compared with that of the control group (27.71±3.29). Also, the frequency of rice consumption (4.14±1.14), macaroni (121±0.40), eggs (2.15±0.92), meat (2.03±0.83) and chicken (2.06±1.008) significantly decreased after the intervention. Prior to the intervention, two groups were not significantly different in the terms of physical activity; however, a significant difference was found between the two groups after the intervention.
    Conclusion
    According to the results of this study and the observed positive impact on the nutrition and physical activity patterns of adolescents, it seems that such training interventions in schools would be effective on preventing and controlling obesity as well as long-term health.
    Keywords: Adolescent, Overweight, Obesity, Participation, Training
  • Mahdi Moshki, Abdoljavad Khajavi, Shima Minaee, Farveh Vakilian, Haydeh Hashemizadeh *
    Background
    Unraveling the relationship between health-related quality of life (HRQOL) instruments and the International Classification of Functioning, Disability, and Health (ICF) seems essential due to the increasing importance of quality of life evaluations in patients with heart failure (HF) and the use of the ICF for comparative purposes. The aim of this study is to identify and compare the content of HRQOL instruments for HF using the ICF coding system.
    Methods
    In a 2-stage design, first we will identify all measures used to assess HRQOL for patients with HF and second we will compare the content of those measures using the ICF coding system.  Systematic search will be performed in in MEDLINE, CINAHL, and Scopus databases using a combination of free texts and MeSH terms between January 1960 and January 2017. All instruments will be linked to the ICF separately by 2 reviewers according to 10 linking rules developed for this purpose. The degree of agreement between the reviewers will be calculated via the kappa statistic.
    Discussion
    The results of this study may help clinicians and researchers to select the most appropriate outcome measure according to the ICF-based content validity.   ROSPERO Registration number: CRD42015025380.
    Keywords: Quality of life, Health status, Heart failure, International Classification of Functioning, Disability, Health
  • سوگل ارجمند، شبنم محمدی*، بهاره رضوانی، مریم محمدی، زهرا خاکساریان، افسانه رستم کلایی، مجید غیور مبرهن، علی علی دلشاد، فاطمه محمدزاده، علی جوان دوست، مهدی مشکی

    چکیده

    مقدمه

    شیوع سندرم متابولیک در جهان رو به افزایش است. بیماران سندرم متابولیک دارای چاقی شکمی، دیس لیپیدمی، هایپرگلیسمی و فشار خون بالا می باشند. در این ارتباط هدف از پژوهش حاضر، تعیین عوامل پیش بینی کننده سندرم متابولیک در زنان مبتلای شهرستان گناباد است. مواد و روش ها: این مطالعه مقطعی در سال 1393 بر روی 239 زن مبتلا به سندرم متابولیک در شهر گناباد صورت گرفت. ابزار گردآوری داده ها پرسشنامه "سبک زندگی ارتقا دهنده سلامت" (HPLP2: Health Promoting Lifestyle Profile 2) بود. شایان ذکر است که داده ها وارد نرم افزار SPSS 16 شدند. یافته ها: ارتباط معناداری بین میانگین امتیاز کسب شده سبک زندگی با سن، مصرف سیگار، میزان در آمد و شغل بیماران مشاهده شد (05/0P<)؛ اما ارتباط معناداری بین میانگین امتیاز کسب شده سبک زندگی با مدت زمان ابتلا به بیماری، محل سکونت، سطح تحصیلات، نحوه زندگی، وضعیت مسکن و مصرف الکل وجود نداشت (05/0P<). از سوی دیگر کمترین امتیاز مربوط به فعالیت فیزیکی 99/2± 97/10 و بیشترین امتیاز مربوط به روابط بین فردی 19/7±38/27 بود. علا وه براین، تمام سازه ها بر سبک زندگی تاثیر مستقیم داشتند که بیشترین تاثیر مربوط به روابط بین فردی (329/0=r2) بود و کمترین آن به تغذیه (164/0=r2) تعلق داشت. شایان ذکر است که در بین سازه ها، روابط بین فردی با اثر (331/0r2=) قوی ترین پیش بینی کننده سندرم متابولیک بر اساس سازه های الگوی Walker بود. نتیجه گیری: با توجه به ارتباط بیماری سندرم متابولیک با سبک زندگی می توان در برنامه ریزی ها و مداخلات برای کاهش ابتلا به سندرم متابولیک، بیشترین تاکید را بر فعالیت فیزیکی در بیماران داشت.

    کلید واژگان: ارتقای سلامت, زنان, سبک زندگی, سندرم متابولیک
    Sogol Arjmand, Shabnam Mohammadi *, Bahareh Rezvani, Maryam Mohammadi, Zahra Khaksarian, Afsaneh Rostamkolai, Majid Ghayour Mobarhan, Ali Delshad, Fatemeh Mohammadzadeh, Ali Javandost, Mahdi Moshki

    Abstract

    Introduction

    Prevalence of metabolic syndrome is increasing in the world wide. Patients withmetabolic syndrome have abdominal obesity, dyslipidemia hyperglycemia, and hypertension. Thepurpose of this study was to determine the predictor factors of metabolic syndrome based on WalkerHealth-Promoting lifestyle in women in Gonabad, 2014.

    Materials and Methods

    This cross-sectional study was performed on 239 women who weresuffering from metabolic syndrome in Gonabad city, in 2014. HPLP (health promotion lifestyleprofile) questionnaire was used for data gathering. Data were analyzed using SPSS 16.

    Results

    Statistical analysis showed a significant difference between lifestyle average score and age,smoking, income, and occupation (P<0.05). There was not a significant association between lifestyleaverage score and the duration of illness, place of residence, education, type of living and alcoholconsumption (P>0.05). The lowest score was for physical exercising 10.97 ±2.99 and the highest forinterpersonal relationships 27.38±7.19. The most direct effect was social relations (R2= 0.329) andthe least direct effect was nutrition (R2= 0.164) and in the overall social relations (R2= 0.331) wasstrongest predictor of metabolic syndrome based on the Walker.

    Conclusion

    By considering relationship between metabolic syndrome and its life style, it seems necessary attention need to life style.

    Keywords: Females, Life style, metabolic syndrome
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