mohammad ali morowati sharifabad

The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is one of the most important scales for measuring mental well-being, and it has been translated into various languages.

This study aims to examine the psychometric properties of the Persian version of the Warwick-Edinburgh Mental Well-being Scale (Pr-WEMWBS).

Face and content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach’s alpha coefficient, and intraclass correlation coefficient (ICC) were assessed. The WEMWBS was translated using the forward-backward translation method. Eleven employees and eight experts evaluated the face and content validity of the scale. A total of 193 employees were recruited for construct validity, and 36 employees were involved in the test-retest reliability assessment.

The impact score for all items was above 4.30. In the EFA, the Kaiser–Meyer–Olkin (KMO) value was 0.87, and Bartlett's test (χ 2 = 1216.28, P ≤ 0.000) confirmed the adequacy of the sample size. Using direct Oblimin rotation, three latent factors were extracted with eigenvalues greater than 1. In the CFA, the model fit summary indices were satisfactory (GFI = 1.000, RMSEA = 0.10, CFI = 1.00, CMIN/DF = 2.91, PNFI = 0.673, PCFI = 0.714). Cronbach's alpha coefficient was 0.901. The mean ICC was 0.889 (range: 0.863 to 0.912).

The Pr-WEMWBS demonstrates good validity and reliability across most psychometric indices, making it suitable for use in Persian-speaking communities.

Social support is a crucial factor in how well older adults adjust to the aging process and related challenges, such as anxiety about death. Body image in older adults is a complex and important concept, yet it has been under-researched. This study examined the correlations between social support, death anxiety, and body image in older adults residing in Yazd City, Iran.

This cross-sectional study involved older adults from Yazd City, Iran, who visited comprehensive urban health centers in 2022. A convenience sample of 200 participants was selected. They completed questionnaires on demographics, social support perception, body image concerns, and death anxiety.

The total social support score (p < 0.01) as well as the score of family support (p < 0.05) and others' support (p < 0.01) showed a significant negative correlation with death anxiety. However, no significant association was found between death anxiety and body image, nor between social support and body image. Regression analysis revealed that only "support from others" was a significant predictor of death anxiety (p < 0.01). Men reported receiving more friends' social support than women (p < 0.05). Participants with higher socioeconomic status were more likely to receive greater family’s social support (p < 0.01) and experience less death anxiety (p < 0.05).

Social support positively impacts the mental well-being and morale of older adults. It can, therefore, be considered a readily available resource and a form of social capital to reduce death anxiety, enhance their sense of purpose, and improve their quality of life.

Stress and anger are among the most common mental health problems in adolescents. The skill of coping with stress and controlling emotions is one of the vital skills in adolescence. This study aims to investigate the effect of educational intervention on anger and stress management skills in female adolescents based on social cognitive theory (SCT).

The present pre-test post-test clinical trial was conducted among 12-14-year-old girls in Birjand City, Iran in 2019. One school was randomly selected as intervention and one school as control. The participants included 80 girls randomly selected and assigned to the intervention and control groups. The data collection tool was a researcher-made questionnaire investigating the effective factors on anger and stress control skills based on the SCT. The validity and reliability of this scale were confirmed by a panel of experts and Cronbach’s α was above 0.7. Questionnaires and informed consent forms were completed by participants in the pre-test stage and two months after the educational intervention. Seven training sessions were held in two months. The implementation of the project lasted for four months. The collected data were analyzed using SPSS software, version 22 and t-test.

The results showed that the mean scores of perceived social support (P=0.003), perceived reinforcement (P=0.03), and self-control (P<0.001) increased significantly in the intervention group after the intervention. Moreover, the mean score of self-efficacy (P=0.007) changed significantly in the control group after the intervention. 

Parent training has been effective in promoting social support and perceived reinforcement. Paying attention to the role of parents, preparing a suitable training package, and using active training methods have played a role in the effectiveness of the intervention. Therefore, the application of this educational package is recommended in future related interventions and similar studies.

 The early diagnosis of breast cancer through mammography is effective in reducing death. Therefore, this study aimed to determine the effect of an educational program based on the protection motivation theory (PMT) on mammography adherence among women in Yazd, Iran.

 In this experimental study, 144 women referring to the clinic were randomly assigned to test and control groups. The data collection tool was a valid and reliable researcher-made questionnaire with 56 items and 8 dimensions. The educational program was held in the form of 6 sessions for the test group, which included PMT–based essays, infographics, and videos. The 12-week follow-up period continued as telephone consultation, and then the data were collected and analyzed by SPSS software version 21 with a 95% confidence interval.

 The results showed that in the pre-training phase, the Mann-Whitney U statistical test did not reveal a significant difference between the two groups of women in terms of the mean mammography intention score (Z=2523.000, P value=0.775). Based on the results of the Wilcoxon test before and after the intervention, the protection motivation of women for mammography for the next month showed a significant difference in the test group. Furthermore, none of the women in the two groups were referred for mammography three months after the implementation of the training. In addition, the McNemar test results did not indicate a significant difference regarding mammography behavior in the two groups before and after the educational intervention.

 According to the results, the protection motivation of the majority of the women in the test group was in the stages of possible and definitive referral for mammography after the educational intervention, which indicates the effectiveness of the tailored educational program. In this study, all the constructs of the PMT act as interconnected building blocks with logical action and interaction to promote mammography adherence in women in Yazd.

Active aging is among the important concepts of health influenced by effective public services; understanding adults' needs and services are of great importance. This study aims to explain understanding older adults' needs for services in public places in Yazd city.

This qualitative study was done as conventional content analysis. Participants were 20 elderly people from Yazd selected by purposive sampling.  Data were collected through semi-structured interviews. Data analysis was done in three levels of open coding and formation of sub categories and main categories. The study was evaluated and approved by four criteria of creditability, tranformability, reliability, and confirmability.

In total, 564 open codes were extracted. Then, primary codes were compared based on similarity, compatibility, and appropriateness, and 66 subclasses were obtained. 14 main categories were obtained by compressing the subcategories. The 8 main categories regarding different services included:  healthcare, recreational, government agencies, transportation, communication and interaction, educational and research, religious and pilgrimage. In addition, regarding the older adults' needs, the 6 main categories included: improving the safety of places; providing effective education, mental, spiritual and social health development programs; improving services quality, reorganizing municipal services and provision of amenities.

Paying attention to the needs of the elderly is necessary in planning for  public spaces in cities. Regarding the need for comprehensiveness of services, it is suggested that the findings of this study be used in designing, implementing, and evaluating services in public places to their service needs and solve their problems.

Restless legs syndrome (RLS) is a neurological sensory-motor disorder that is observed as an unpleasant sensation in the legs, especially when sitting or lying down and at rest. This study aimed to determine the prevalence RLS and its related factors among older adults in Eslamabad-e-Gharb, Kermanshah province, Iran in 2021.

Totally, 240 elderlies entered the study using two stages random sampling. The instruments used in the study included the International RLS Questionnaire, Pittsburgh Sleep Quality Index, Mind Wandering Questionnaire, Epworth Sleepiness Scale and Pain Self-efficacy Questionnaire.

Symptoms of RLS were mild in 68.3% of the participants and severe in 14.2% of them. There was a statistically significant relationship between RLS and sleep quality (p = 0.001) and daily drowsiness (p = 0.034). The chance of developing RLS in the group with poor sleep quality was 22% higher than the group with good sleep quality (OR = 1.22). Also, people with drowsiness were 13% more likely to develop RLS than others (OR = 1.131), and in the age group of 71-80 years and over 80 years, 6% and 2% higher than the 60-70 years respectively (OR = 1.068 and 1.023). No statistically significant relationship was found between RLS with mind wandering and pain self-efficacy.

Due to the high prevalence of RLS and its relationship with sleep quality and daily drowsiness among older adults, implementation of RLS screening to identify patients to prevent sleep disorders seems necessary. The relation of RLS with mind wandering and pain self-efficacy need further studies.

Knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are important factors for adherence to protection strategies. The aim of this study was to construct and validate a questionnaire about the KAP of Iranians regarding COVID-19. 

Initially, a questionnaire about the KAP with regard to COVID-19 was constructed in this cross-sectional study. The initial questionnaire was prepared based on a review of the extensive research literature and global and national guidelines. This researcher-made questionnaire was developed using the COVID-19-KAP questionnaire, which was originally used in China in 2020, and the influenza epidemic KAP Questionnaire (2015), the MERS KAP Questionnaire (2015), the H1N1 flu KAP questionnaire (2017), and the WHO KAP questionnaire about COVID-19. The applied questionnaire consists of three parts including knowledge- (n = 26), attitude- (n = 8), and practice-related (n = 11) questions, respectively. Then, the face, content, and construct validity and the reliability of the questionnaire was determined, and analyzes were performed using SPSS v. 26 and AMOS v. 24 software. 

In the face validity stage, 2 questions with an impact score of less than 1.5 were excluded from the questionnaire. In the content validity check, all questions had a content validity index (I-CVI) of more than 0.7. However, the content validity ratio (CVR) for 6 questions was less than 0.51, and these questions were removed accordingly. The compliance of the CVI with the chance agreement was close to one for all questions, indicating the lack of a chance agreement. In the exploratory factor analysis stage, the Kaiser-Meyer-Olkin (KMO) value of 0.90 was obtained, implying the adequacy of the sample size for factor analysis. The significance of the Bartlett test (chi-square: 5820.06, df: 630, P<0.001) indicated a strong correlation between the questions and the appropriateness of factor analysis. Finally, 34 items in 4 domains remained in the questionnaire. 

The validity and reliability of this questionnaire were confirmed based on the findings. This Farsi KAP questionnaire can be used to assess the level of knowledge, attitude, and practice of people about COVID-19.

Menstrual hygiene is a complex phenomenon which is affected by various factors especially cultural factors, and poor menstrual hygiene can be a major cause for infertility and other problems. This study aimed at developing and psychometrically evaluating a cultural instrument for comprehensive measurement of menstrual hygiene.

This study was performed in two phases based on the PEN3 cultural model. The first phase was a qualitative study and literature review for the initial development of the instrument. The second phase was to determine the validity and reliability of the instrument. In order to determine the validity, we used the expert panel, impact score, Content Validity Ratio (CVR), and Content Validity Index (CVI); to determine the reliability, we used the test-retest method and Cronbach's alpha coefficient.

The instrument (questionnaire) has two parts; the first part consisted of 10 demographic questions and the second part was constructed based on PEN3 cultural model structures. After measuring the validity, Score Impact results suggested that all Items had a score of 1.5 or above. In the content validity index, we omitted 2 Items with CVI lower than 0.79 and 11 Items with CVR lower than 0.49. As for the reliability of the questionnaire (Cronbach's alpha), the items with the reliability coefficient higher than 0.7 were confirmed. So the reliability of the Acknowledge section was 0.87, Attitude 0.92, Practice 0.90, and the score for Enablers was 0.87.

This study presents a reliable and valid cultural instrument for comprehensive measurement of menstrual hygiene. Thus, it can be used to assess needs or investigate the effects of executive and educational interventions.
Key Words: Cultural instrument, Instrument development, Menstrual hygiene, Psychometrics.

The body's response to noise pollution is very similar to the way the body responds to stress, which can lead to poor health over time. In this regard, this study was conducted to determine the general health of the elderly and its relationship with traffic noise pollution in Ardakan.

This descriptive cross-sectional study was conducted in 1399. Participants were 200 elderly people in Ardakan chosen by random sampling. Data were collected through sound measurement with SVANTEK device, General Health Questionnaire 28 (GHQ-28). After completing the questionnaires and measurements, the collected data were entered into SPSS-19 software and descriptive statistics as well as analytical statistics such as Chi-square, regression and analysis of variance were used to analyze them.

The overall average sound level equivalent in decibels at all measuring stations was within the standard range. There was a significant relationship between noise annoyance, the dimensions of "anxiety symptoms  ,sleep disorders" ,and "depressive symptoms" of general health (p <0.001).

People with more noise annoyance experience more anxiety, sleep disorders and depression. Existence of noise pollution levels in the allowable or standard level can lead to the observation of no significant relationship between traffic noise pollution levels and general health. Reducing anxiety, depression and sleep disorders in the elderly is possible with interventions to reduce  noise annoyance in them.

Breast cancer is the leading cause of cancer death among women in Asia, including Iran. Mammography is used for the early detection of breast cancer for about 73% of cases. This study aimed to determine the effect of educational intervention on mammography among women referring to health centers using planned behavior theory.

This randomized controlled trial study was conducted on 140 women referring to Health Centers in Khorramabad in 2018 who were randomly selected and divided into two experimental and control groups. Data collection tools consisted of a demographic information questionnaire, knowledge, and researcher-made questionnaire based on the TPB structures. The intervention was held in four 45 minute sessions for four weeks. Both groups completed the questionnaires before and three months after the intervention. The data were analyzed by SPSS 23 software using chi-square, independent t-test, and paired t-test.

After the educational intervention, Mean±SD constructs of knowledge, attitude, subjective norms, perceived behavioral control, and the behavioral intention was 10.97±5.07, 41.24±3.44, 26.54±5.3, 47.36±3.91, and 8.87±2.78, respectively. All the mentioned constructs were statistically significant (p<0.05). Moreover, the rate and percentage of mammography in women in the experimental group (31=44.3%) compared to the control group (3= 4.3%) was significantly different (p<0.001).

The present studychr('39')s findings confirmed the effectiveness of an educational program based on the TPB in promoting mammography.

Regular physical activity (PA) is one of the most effective recommendations to prevent diabetic complications. However, the reported level of PA is low in this group. This study evaluates intervention based on the implementation intention (II) theory, to improve the level of PA and the health of patients with diabetes.

This randomized control study was conducted on 124 patients with type 2 diabetic. The participants were randomly assigned in to two groups. PA level was measured by using International Physical Activity Questionnaire (IPAQ). The Rockport test was used in order to measure Maximal oxygen consumption volume (vo2max). In the intervention group, Individuals were asked to identify details of the behavior of PA and their own strategies for removing the barriers of exercise. Post-tests took place 3 month later. Normal distributed data were analyzed using two independent and paired sample T-test. Wilcoxon, Mann-Whitney tests were used to compare PA level.

The results showed that although the median level of PA after the intervention (396) had increased. This difference was not statistically significant (P-value= 0.12). Also, after three months vo2max score (19.91) was not significantly different from before (P-value= 0.30).

Intervention based on II had no significant effect on level of PA in patients with type 2 diabetes. Using multiple methods, as well as incorporating it with motivating interventions should be investigated to increase the level of PA in this group.

Perceived threat is particularly important in health-related behaviors. The aim of this study was to explain the perceived threat of unhealthy and unsafe eating behaviors in Iranian adolescent girls.

In this qualitative study, directed content analysis was used and participants were selected by purposeful sampling. Data were collected using focus groups and semi-structured, in-depth individual interviews with 60 girl students of the eighth grade who studied in the government schools of Shiraz City, Iran in 2019. Sampling continued until data saturation was achieved. Data were analyzed by Graneheim and Lundman's approach of conventional content.

From the data analysis, five categories were drawn. Perceived susceptibility comprised of (1) disease risk-increasing factors and (2) disease risk-decreasing factors and perceived severity consisted of (3) individual, (4) familial, and (5) social consequences of the disease. The perceived susceptibility consisted of the subcategories, namely, biological susceptibility or body's protective mechanisms, individual behaviors, and risky or protective environmental factors for food and health safety. Perceived severity included the subcategories: physical, mental, educational, and medical problems for the individual, psychosocial problems, and imposing heavy treatment costs on family, economic, and social problems for the community.

The perceived threat of unhealthy and unsafe eating behaviors in adolescents includes perceptions of disease risk increasing and disease risk-decreasing factors, as well as personal, familial, and social consequences following disease development. Understanding these perceptions can help adolescents engage in health-promoting eating behaviors.

Self-concept plays an important role in understanding behavioral patterns. The purpose of the present study was to explain Iranian adolescent girls' self-concepts of eating behaviors.

In this qualitative study, conventional content analysis was used and participants were selected through purposeful sampling. This study was conducted in the government girls’ schools of Shiraz City, Iran from October 2018 to March 2019. Data were collected through in-depth, semi-structured individual interviews with 42 girl students. Interviews were recorded with the audio recorder and continued until data saturation was achieved so that no new conceptual information was obtained after 35 interviews, while individual interviews were conducted with seven other individuals to ensure data saturation, and no additional conceptual information emerged from the seven interviews. The data were analyzed according to the conventional content analysis approach.

From the analysis of the data, six categories for adolescent girls' self-concepts were drawn including: (1) physical self-concept, (2) social self-concept, (3) academic self-concept, (4) self-satisfaction, (5) self-confidence, and (6) self-esteem. These self-concepts included subcategories of effective eating behaviors on appearance, physical energy status, morals, academic performance, satisfaction and happiness, self-confidence and popularity and respect.

Adolescent girls' self-concepts of eating behaviors encompass a wide range of dimensions such as physical, social, academic, self-satisfaction, self-confidence and self-esteem, and their identification is one of the determinants of the development of intention to adopt healthy eating behaviors.

Dust particles are one of the most important environmental problems that are threatening many countries, and patients with cardiovascular diseases (CVDs) are a vulnerable group in this respect. The present study was conducted to examine the protective strategies among patients with CVDs against exposure to dust phenomenon based on the protection motivation theory (PMT).
This cross-sectional study was performed on 183 patients with CVDs who referred to health care centers in Ahvaz city, Khuzestan province, southwest of Iran. Participants were selected from patients with CVDs recruited for routine national Package of Essential Non-communicable Disease (IRA PEN) through random cluster sampling. Data were collected using a researcher-made questionnaire based on the PMT. Data were analyzed using descriptive and analytical tests such as Pearson correlation coefficient and multiple linear regressions by SPSS version 22.
The mean scores of the constructs of perceived response efficacy (4.06 ± 20.06) and sensitivity (19.89 ± 4.30) were higher than those of other constructs. Correlation coefficient test showed a significant positive correlation between risk behaviors of exposure to dust phenomenon and self-efficacy, response efficacy and protection motivation, but negatively correlated with cost response. Also, self-efficacy variable, type of health insurance, and protection motivation were the predictive indicators of behavior.
The constructs of the PMT explained the risk reduction behaviors of exposure to dust phenomenon in patients with CVDs. Therefore, this theory can be used as a framework for designing educational programs to increase the motivation of patients with CVDs to adopt risk reduction behaviors for exposure to dust.

Smoking is one of the greatest challenges for public health. It is estimated that 7% - 25% of adolescents have experienced smoking in Iran.

The present study aimed to investigate the viewpoints of high school male students, their parents, and teachers about smoking by adolescents based on four components of the social marketing mix.

A qualitative study with a phenomenological approach was conducted via 12 focus group sessions in Persian language. To this end, 82 participants (30 students, 28 parents, and 24 teachers) were selected based on purposive sampling method in 2015.The data were analyzed through directed content analysis.

All the three studied groups viewed “looking older” as the major cause of adolescent smoking, other factors included getting others’ attention, looking smart person, calmness, decreasing pain, and attractive packaging of cigarette. Some differences were observed between the viewpoints of students, parents, and teachers about the complications of cigarette. The students focused on the social consequences of smoking, but the parents and teachers were more worried about its long term physical side effects and addictive properties. Unlike parents, the teachers and students considered imitating from parents and famous people as the main socio-environmental factor of smoking. All three groups believed that people’s negative social image and negative attention towards smokers should be included in smoking prevention educational programs. However, some differences were reported between their ideas in other educational subjects.

Evaluating factors related to tobacco use from three different perspectives can provide a more comprehensive view of these factors and show the reason for the failure of many efforts to prevent student tobacco use and develop a more effective program to promote health.

Dust phenomenon is a major environmental problem in world that threatens the middle-east countries specifically. In order to develop a need-based policy and regulate the supporting health program to reduce dust effects requires a proper understanding of the public beliefs about threats posed by this issue. The purpose of this study was to explain the threat appraisal patients with cardiovascular diseases regarding exposure to dust phenomena.

This qualitative content-analysis study was conducted from January to June 2018. The participants included 28 cardiovascular patients who referred to the healthcare centers in Ahvaz City. Semi-structured interviews were conducted with open-ended questions and inspiration from threat appraisal process constructs were used to collect data. All data were gathered, transcribed, and analyzed using MAXQDA-10 software and in-depth analysis.

Perceived threat constructs were used and 4 categories and 9 subcategories were extracted: perceived likelihood of exposure to dust (perceived likelihood of increased non-respiratory problems, perceived likelihood of increased respiratory problems), belief in seriousness and danger of exposure to dust (understanding the severity of physical complications, understanding the severity of mental and psychological complications, understanding the severity of economic complications), external reward of exposure to dust (improving personal and social relationships, improving financial problems), internal reward of exposure to dust (pleasant feeling).

This study provided a clearer and deeper understanding of the threat posed by exposure to dust among cardiovascular patients. Based on the results, the authorities can design more targeted and more effective protective plans to raise awareness among community members, especially cardiovascular patients about the negative effects of exposure to dust and the ways to reduce its exposure.

The purpose of this study was to investigate the effect of therapeutic recreation on the quality of life in the elderly. This study aimed to examine the effect of therapeutic recreation on the quality of life among older women in the daycare center.

It was a randomized controlled trial. The research population consisted of all older women over 60 years of age who were referred to the elderly center. A total of 64 people were randomly selected based on the sample size, and then the sample members were randomly divided into two groups (32 subjects) and control (32 subjects). The intervention consisted of 10 sessions of therapeutic recreation for 10 weeks for the experimental group. Life expectancy was measured before, after the intervention, and follow up in both groups. The research tool was SF-36 quality of life questionnaire. SPSS 20 software was used to analyze the data.

Mean scores of quality of life before intervention after intervention and follow up were 41.52, 55.07, and 72.43, respectively, and in the control group, 45.44, 45.16, and 45.81, respectively. In addition, the findings of this study showed that before the intervention, the mean quality of life in the two intervention and control groups was not significant (P = 0.293). Still, there was a significant difference after the intervention and follow up (P<0.001).

Recreation therapy improves the health of older women, so it is recommended that recreational treatments be used in various age-care settings.

Adolescence is a critical period of life for all people. Self-esteem is also a basic human need that affects one’s growth, development, and identity. This study aimed to explain 12-14 year-old female adolescents’ experiences regarding selfesteem.

In this qualitative content-analysis study, adolescent girls aged 12-14 years were selected by the purposeful sampling method. The data were gleaned using individual interviews and focus group discussions. The recorded audio files were transcribed and the information was compared and merged with available related literature. The derived ideas were compared and the codes were integrated to form categories. Ultimately, we extracted more abstract categories and sub-categories.

The concept of self-esteem in adolescents is defined as an intellectual approach to oneself. Adolescents considered perceived benefits and good feelings as the outcomes of high self-esteem. From their perspective, interpersonal and intrapersonal influencers contribute to self-esteem.

Attention should be paid to adolescents’ self-esteem and its effective factors, including interpersonal and intrapersonal influencers. Therefore, appropriate conditions should be provided for adolescents to promote their self-esteem.

HIV‑infected patients with poor antiretroviral therapy (ART) adherence are prone to depression, and depression can exacerbate the disease condition. This study was conducted to determine ART Adherence based on Information, Motivation, and Behavioral Skills (IMB) Model and its association with depression among HIV‑positive patients.

This descriptive–correlational study was carried out on people over the age of 18 years with HIV/AIDS, who referred to the Behavioral Diseases Counseling Center in Kerman City, Iran, in 2017. In this regard, 119 patients were selected using the table of random numbers. To collect the data, we used the Beck’s depressioninventory‑II and the IMB researcher made questionnaire to evaluate the ART adherence.

The results of the study reveal that a significant association was observed between the total adherence and all constructs of the IMB model (P < 0.001). Risk perception and self‑efficacy had the highest mean scores regarding the ART adherence. The prevalence of depression was 71.5% among patients. Information, personal motivation, and total adherence had a significant association with depression.

IMB model was an appropriate and practical strategy with regard to the ART adherence among people living with HIV who are prone to depression and drug consumption is crucial for them to achieve the 90‑90‑90 target. This article created a questionnaire to assist policy‑makers and health professionals designing interventions to improve adherence and health outcomes of ART.

The main life skills could promote adolescents' self-esteem. However, to teach all skills requires many resources and prioritization. Therefore, the aim of this study was to investigate on factors that predict self-esteem in adolescent girls.

A cross-sectional study was conducted on 364 student girls aged 12-14 years old in Birjand, Iran  in 2018 using cluster sampling. Data collected using the Life Skills and the Rosenberg Self-Esteem Questionnaires. Self-esteem was the dependent variable and the ten main life skills were the independent variables. Statistical analysis was performed using regression in order to assess the predictive factors of self-esteem in adolescent girls.

The mean life skills scores was 138.23 ± 80.26 and the mean self-esteem score was 4.98 ± 4.41. Regression analysis showed that among the ten main life skills, self-awareness (p<0/001), interpersonal relationships (p=0/004) and creative thinking (p=0/005) had a significant relationship with self-esteem. Interpersonal relationships influences creative thinking, and they both influence self-awareness. Self-awareness was the strongest predictor. In other words, the adolescent will have a higher self-esteem by knowing more about strengths and weaknesses and desire of themselves.

The findings suggest that in order to improve self-esteem among adolescents the focus should be on teaching self-awareness, interpersonal relationships and creative thinking skills.

Health care providers play a central role as the main members of the health care service providers team for the elderly and their knowledge and attitudes towards the aging phenomenon can play an important role in the quality of health care services provision for the elderly. Therefore, the present study aims to comparatively investigate knowledge and attitude of health care providers about the aging phenomenon in comprehensive health centers of Yazd and Hamadan, Iran.

The cross-sectional study conducted on 220 health care providers who were enrolled in the study from comprehensive health centers in Yazd and Hamadan by cluster sampling. The data were collected by a questionnaire including demographic information, Kogan's attitude towards old people scale, and Palmore Facts on Aging Quiz .Data were analyzed by SPSS using descriptive statistics, independent t-test, ANOVA, and Pearson correlation coefficient.

Mean score of knowledge about aging (range: 0-25) was 12.24 ± 2.43 in Yazd and 12.17 ± 2.51 in Hamadan. Mean score of attitude towards aging (range: 34-204) was 121.49 ± 10.53 in Yazd and 119.40 ± 11.21 in Hamadan. There was no statistically significant difference in knowledge (p = 0.828) and its three dimensions (misconceptions about aging, psychosocial status and physical condition), and attitude (p = 0.152) and its three levels (negative, neutral and positive attitude) between health care providers in Yazd and Hamadan. There was a significant, positive correlation between knowledge and attitude in both Yazd (p < 0.01, r = 0.656) and Hamadan (p < 0.01, r = 0.718).

The knowledge of health care providers in both cities was moderate and had positive attitude towards aging. Considering the moderate knowledge of health care providers about the aging, effective steps can be taken to promote knowledge and improve the attitudes of health care providers by providing educational curricula on physical, psychological, social and spiritual health of the elderly people and holding in-service training programs.

Drivers are more exposed to unhealthy lifestyle due to their working conditions. Therefore, the present study was aimed to investigate the relation between lifestyle and high-risk behaviors in drivers visiting the Cargo Terminal of Yazd.

This cross-sectional study was carried out in 2017 in the Cargo Terminal of Yazd. Convenience sampling was performed. Data were collected using two questionnaires, a lifestyle and a researcher-made high-risk behaviors questionnaire. Data were analyzed by independent t-test, one-way ANOVA and Logistic Regression using SPSS version 22.

The results indicated that 59.3% were smokers, 44.9% hookah users, 24% drug users, and 65.3% had relation with someone other than. There was a significant correlation between lifestyle and smoking and also drug use. Income and the number of days away from family showed a significant relation with all the high-risk behaviors. Marital status had a significant relation with hookah use and the relation with their wife. Also, education had a significant relation with hookah use and drug use.

Conducting intervention programs to prevent the use of various tobacco products and also the use of appropriate preventive measures to prevent the transmission of sexually transmitted diseases can play an important role in improving lifestyle and reducing high-risk behaviors in drivers.

Adolescence is an important period in life cycle. However, the fast social and cultural changes plus the complexity and diversity of human relationships put pressure on an adolescent, which require psychosocial abilities to cope with. This study investigated the impact of life skills’ training on adolescent girls.

This was an experimental study with pre- and post-test design. The population included student girls aged 12-14 years old in Birjand, Iran, in 2018. The life skills questionnaire of Saatchi and colleagues was used for data collection. The participants completed the questionnaire before and two months after the training. The training included six sessions of a theory-based educational intervention for the adolescents on anger management and stress control skills and a session for their parents.

The mean life skills scores were 124.57 ± 43.28 and 148.35 ± 85.25 in the intervention group and 142.4 ± 34.10 and 139.79 ± 95.13 in the control group, respectively indicating that life skills significantly increased in all aspects in the treatment group.

The findings suggest that training on anger management and stress control based on social cognitive theory is effective on improving life skills in adolescents.

Nowadays, the prevalence of chronic diseases, such as chronic renal failure, is rising. These patients need hemodialysis to continue their treatment, which is a stressful process. This research was conducted with the purpose of explaining coping styles in hemodialysis patients regarding stress factors based on the Lazarus and Folkman’s transactional model.

This qualitative study was conducted as a content analysis. The data collection method was semi-structured interview with 22 patients from dialysis centers in Tehran. The data were collected from October to January 2017. Sampling was purposive and continued until data saturation. Data were analyzed using the directed content analysis method. The process of data analysis proposed by Hsieh and Shannon’s was followed.

106 codes and 24 sub subcategories were obtained through this research and classified into 8 sub-categories of transactional stress model including: problem management, emotional regulation, social support, dispositional coping styles, positive reappraisal, revised goals, spiritual beliefs and positive events; and 3 categories of coping structures that included coping efforts, meaning-based coping and moderators.

Dialysis patients are making efforts to cope with their stress in order to reduce their stress; in some cases, these efforts lead to reduction in stress, and in some cases, due to using unsound coping style, they are ineffective or even harmful. Therefore, the necessity of planning and proper interventions is felt by health care providers to control stress in dialysis patients.

Mammography is one of the best methods to screen breast cancer. Because mammography screening is not entirely under the control of the person, the study of perceived behavioral control (PBC) is valuable in this regard. The aim of this study was to investigate PBC in mammography in women in Khorramabad, Lorestan province, Iran (550 kilometers north of Persian Gulf). In this qualitative study conducted using semi-structured and in-depth interviews, 22 women, a gynecologist, and a general surgeon were interviewed purposively. The interviews were recorded, transcribed, and analyzed, using the directed qualitative content analysis. The MAXQDA10 software was used to analyze the data. Two categories, namely facilitators and barriers to mammography screening and 5 subcategories, namely individual facilitators, social facilitators, psychosocial barriers, barriers related to mammography technique, and structural barriers were drawn from the data. Individual facilitators included having faith and heart belief in God (Faith in God was a comfort for the participants and the acceptance of God’s favor), family support, and follow-up; the only social facilitator drawn was respecting the rights of the referring people; psychosocial barriers were embarrassment, fear of breast cancer diagnosis, and belief in fate; the barriers related to mammography technique were radiation and painful mammography and lack of insurance; and high costs and long wait in public mammography centers were drawn as structural barriers. The results of this study provided useful information about the experiences regarding mammography. Psychological barriers may be reduced by changing women’s knowledge and attitudes toward mammography, as well as by changing the national health system infrastructure. It is also recommended to strengthen cultural and religious beliefs along with holding training programs regarding mammography performing.