sima ghezelbash

The diagnosis of childhood cancer can be considered a multidimensional crisis for parents, particularly mothers.

This study aimed to determine the predictive role of defense styles and resilience in the caregiver burden experienced by mothers of children with cancer.

This descriptive-analytical study focuses on mothers of children with cancer who were hospitalized in the pediatric wards of Seyed al-Shohada Hospital in Isfahan, Iran. A total of 136 participants were selected using convenience sampling. The study utilized the Defense Styles Questionnaire (DSQ-40), the Zarit Burden Scale (ZBS), and the Connor-Davidson Resilience Scale (CD-RISC) to collect data. The data were analyzed using STATA16.

On average, mothers had a caregiver burden score of 38.65 and a resilience score of 93.51. The majority of mothers (62.5%) exhibited neurotic defensive styles. The regression test results indicated a significant inverse relationship between caregiver burden and resilience (P = 0.002), as well as a significant relationship between the child’s sex and caregiver burden (P < 0.05).

Based on the study's findings, it is recommended that counseling and psycho-cognitive programs be designed, developed, implemented, and evaluated to enhance the resilience of mothers of children with cancer and thereby reduce their caregiver burden.

The prevalence of COVID-19 has caused stress, especially among nurses. On the other hand, the use of effective coping styles during the COVID crisis reduces stress in individuals.

The present study was conducted with aim to investigate the effect of coping styles training program on coping strategies for stress in nurses.

This experimental study was conducted on nurses working in COVID-19 departments in April 2021. After obtaining informed consent, 80 participants were randomly divided into intervention and control groups. In the intervention group, training sessions were held as webinars for 3 sessions, each lasting 2 hours over three weeks. The Stress Coping Styles Questionnaire designed by Endler and Parker was completed by participants before and after the intervention. Data were analyzed by SPSS software (version 16) and one-way analysis of variance and paired t-test. p<0.05 was considered statistically significant.

After implementing the intervention, problem-focused coping styles increased among nurses working in COVID departments, while emotion-focused and avoidance-focused coping styles decreased after training sessions.

Implications for Practice: 

Training the stress coping methods can lead to effective use of coping styles during crises such as COVID-19 among nurses working in COVID departments.

Given the limited presence of students in universities and the closure of educational centers, including nursing schools, during the COVID‑19 outbreak, there has been a significant shift toward e‑learning. However, there is a lack of research in this area. Therefore, this study aimed to explore the experiences of undergraduate nursing students with e‑learning during the COVID‑19 outbreak in 2020.

This qualitative‑descriptive study focused on 12 undergraduate nursing students from the School of Nursing and Midwifery at Isfahan University of Medical Sciences. The participants were selected using purposive sampling. In‑depth and semi‑structured interviews were conducted to collect the data. The collected data were analyzed using MAXQDA10 and conventional content analysis. The study was conducted between May and September 2020.

Analysis of the findings led to the emergence of 11 subcategories and two main categories: E‑Learning opportunities and Challenges of E‑Learning, providing a comprehensive description of the experiences reported by the participants.

Unforeseen crises, such as the current COVID‑19 pandemic, can significantly affect the quality of education by disrupting face‑to‑face learning. To mitigate such disruptions, it is crucial to plan and establish infrastructure that supports alternative modes of education, such as e‑learning. Additionally, providing training to students and educators on effectively utilizing digital platforms and producing electronic content can help ensure a smoother transition during crises.

It is widely acknowledged that family caregivers of patients with chronic mental disorders face numerous challenges that can jeopardize their mental well-being. Therefore, the adoption of effective coping strategies can equip them to navigate the difficult and stressful situations encountered in their daily lives.

The primary objective of this study was to assess the coping strategies employed by family caregivers of patients with chronic mental disorders who were receiving care at psychiatric centers in Isfahan, Iran.

This descriptive-analytical study involved 188 family caregivers of individuals with mental disorders selected through convenience sampling. Data were collected using a demographic characteristics form and the Endler and Parker Coping Inventory for Stressful Situations – Short Form (CISS-SF). The relationship between demographic variables and coping strategy scores was analyzed using independent t-tests, one-way analysis of variance (ANOVA), and Pearson and Spearman correlation tests in SPSS v. 20.

The results revealed that 55.1% of family caregivers utilized emotion-oriented coping strategies, 30.3% employed problem-solving coping strategies, and 14.6% adopted avoidance coping strategies. Furthermore, there was no significant relationship between the types of coping strategies and any of the demographic variables (P > 0.05).

Given the findings of this study, which suggest that family caregivers tend to use ineffective coping strategies, it is imperative to implement preventive and psychological interventions aimed at enhancing the utilization of problem-oriented coping strategies within this group. 

According to the literature, pre-hospital emergency medicine clinicians’ mental health has most likely been ignored during the COVID-19 outbreak.

This study aimed to investigate the correlation between mental health and corona anxiety among pre-hospital emergency medicine clinicians during the COVID-19 outbreak in Isfahan, Iran.

A cross-sectional study was conducted in Isfahan, Iran, from May to July 2020. All participants voluntarily participated in this study, and an informed consent was obtained. Data collection was done through completing two questionnaires, including the Corona Disease Anxiety Scale (CDAS) and the General Health Questionnaire (GHQ). Data were analyzed with SPSS version 18 using the Pearson correlation test and multivariate linear regression.

A preliminary data analysis of CDAS and GHQ showed a significant correlation between the total score of COVID-19 anxiety and general health (r = 0.6, P < 0.001). Also, multivariate analysis showed that field of study (B = 0.13; P-value = 0.005) and COVID-19 anxiety were significant predictors for general health (B = 0.6; P-value < 0.001).

According to the findings, the higher the anxiety score, the poorer one’s general health and the more likely they are to have mental disorders. Therefore, it is recommended to provide mental health services for pre-hospital emergency medicine clinicians during the COVID-19 pandemic.

 Caring for children with cancer has many tensions that can lead to deep emotional and emotional problems such as stress, anxiety and depression in their caregivers. This study aims to examine the effect of spiritual group therapy on depression, anxiety and stress of the mothers of children with cancer.

 The is a quasi-experimental study with a pre-test/post-test design conducted on 24 mothers as caregivers of children with cancer selected from among those in the children’s cancer association in Ardebil, Iran. They were divided into two groups of intervention and control. The intervention group participated in 8 sessions of spiritual group therapy. Depression, anxiety and stress were evaluated before and after intervention using the 42-item Depression Anxiety Stress Scale. Data were analyzed using Chi-square test, independent t-test, paired t-test, Mann-Whitney U test, and Wilcoxon test in SPSS v. 25 software.

 Mean±SD age of mothers in the intervention and control groups was 39.08±8.56 and 38.09±9.76 years, respectively. The results showed that the spiritual group therapy could significantly decrease depression (P=0.001), stress (P=0.001) and anxiety (P=0.001) in mothers.

 Spiritual group therapy can reduce stress, anxiety and depression of mothers as caregivers of children with cancer. The development of such programs is recommended for alleviating the psychological problems in caregivers of children with cancer and, thus, maintaining or improving the quality of care provided by them to the children.

Good mental health while studying in university makes students able to deal effectively with numerous stressors that they experience. The purpose of this study was to determine and compare the self-esteem and social anxiety of nursing students in grades one to four of medical universities in Tehran.

In this analytical cross-sectional study, 400 students of the medical universities in Tehran were selected, using stratified sampling with proportional allocation. They filled a demographic information form and Coopersmith Self-esteem Inventory and Liebowitz social anxiety questionnaire. Data for this study were collected during a semester.

The results showed that the overall mean score of self-esteem, and personal , social, parental self-esteem in the first and fourth year students did not differ statistically. There was no statistically significant difference in the total scores of social anxiety of first- to fourth-year students. The mean score of the avoidance of social interaction dimension in fourth-year students was significantly lower than in first year students (p<0.05).

Mental health of nursing students is an important issue needs to receive special attention from the educational systems responsibles. With early interventions such as screening and identifying individuals at risk and providing effective strategies in the form of counseling services and holding workshops in order to increase awareness and updating students information in the fields of mental health an effective step has been taken towards mental health maintenance of students as members of an important social groups.

Taking caring of patients with mental disorders is stressful and people who take care of these patients need to receive enough support and training to overcome this challenging situation. The present study was aimed at investigating the effects of a psychosocial support program on perceived stress of family caregivers of patients with mental disorders.

This randomized controlled clinical trial was performed on 64 family caregivers of patients with mental disorders referred to Noor and Hazrat‑e‑Ali Asghar hospital in Isfahan, Iran, in 2018‑19. The participants were randomly assigned to the intervention and control groups using a random number table. In the intervention group, the training program was held in 6 sessions of 90‑minute training classes twice a week. Data were collected using a demographic characteristics form and the Perceived Stress Scale (PSS) before, immediately after, and 1 month after the intervention. Descriptive and inferential statistical tests such as Chi‑square, Mann‑Whitney, independent t‑test, repeated measures ANOVA, and Kolmogorov‑Smirnov test were used to analyze the data in SPSS software.

The result of the study showed that the total mean score of perceived stress in the intervention group was significantly less than the control group immediately after (F2 =66.29, p<0.001) and 1 month after the intervention (F2 =66.29, p<0.001).

Delivering a training program on the different dimensions of support family caregivers need will reduce the perceived stress of family caregivers of patients with mental disorders. Therefore, the implementation of this intervention is recommended in this group of caregivers.

Non-steroid anti-inflammatory drugs (NSAIDs) are a widely used self-medication group among different classes of communities, including university students. Therefore this study is conducted to determine the rate of NSAIDs self-medication among student in khalkhal in 1396.

This was a Descriptive-analytical study, conducted on 400 university students who selected randomly from medical sciences, azad and payame noor universities in khalkhal city. Data were collected by demographic and self-medication questionnaire then, the obtained data analyzed by descriptive and inferential statistics (chi- square) at a significant level, p <0.005 by SPSS software (V.18).

The rate of self-medication with NSAIDs was 73.6% among university students. The most used medicine were Jelofen (47.7%) and ibuprofen (44%). The major underlying condition motivating NSAIDs sought were dysmenorrhea (46.7%), headache (42.8%). More than half (57.8%) use NSAIDs without any specific pattern and (38.6%) selfmedicated by their own Initiative 74.2% knows herbal medicines and their benefits and (93.5%) agree to use herbal medicines instead of chemical.

The findings of this study showed a high prevalence of selfmedication among university students. Considering the complications caused by this phenomenon, it is suggested Teaching students with the goals of modifying drug-related behaviors and discounting the complications of arbitrary and self-medication costs should be addressed to the authorities in advance.

Pre-hospital emergency care technicians are faced with a high level of physical and mental stress because they must quickly attend emergency situations, and this high level of stress can lead to occupational stress in them. Occupational stress is the result of an interaction between job conditions and personal factors, when the demands of the workplace and the related pressures are higher than the degree tolerated by the individual. Research shows that prolonged and continuous stress in the workplace can result in reduced productivity, decreased job satisfaction, poorer quality of service provision to patients, fewer accurate and timely decisions, a sense of job-related incompetence, occupational fatigue, a higher degree of absenteeism, and finally the occupational burnout syndrome. If occupational burnout is not identified and an effective solution is not proposed to reduce or prevent it, the physical and mental health of the employees will be threatened, and their performance efficiency and quality will suffer. Having a skillful and efficient human force is an important factor contributing to the efficiency of organizations; therefore, it is necessary to implement personal interventions to enhance the capacity of the employees in the face of stress, and maintain and promote their mental health. One such intervention which may help mitigate occupational stress is the use of positive psychology. In positive psychology, one’s higher focus on the positive aspects of events and less focus on negative aspects create a positive feeling, promote effective relationships with others, contribute to rational decisions, improve one’s resilience in the face of problems, and help one resolve life challenges and better manage problems. A gratitude program is a positive psychology skill which serves as a mental health indicator and complements psychotherapy and cognitive therapy interventions. Gratitude is not compatible with negative feelings and emotions such as stress, and even protects one from the impact of mental distress. It empowers people in fighting stress and promotes their general positive attitude by improving mental, spiritual, and physical well-being. It is evident that emergency care technicians experience high levels of stress and occupational burnout as a result of the stressful nature of their job. Thus, it is highly important to study the mental health of these technicians. The present study examined the effect of a gratitude program on the stress and occupational burnout of pre-hospital emergency care technicians.

This was a randomized two-group ad three-phase field trial with a pretest-posttest (immediately after intervention) design and one-month follow-up. Eighty pre-hospital emergency care technicians in the south of Isfahan Province, Iran, were randomly selected. After explaining the study to the participants and receiving their written informed consent for participation, they were randomly allocated to the experimental and control groups based on the inclusion criteria. The demographic information form, the Occupational Stress in Emergency Technicians Questionnaire, and the Maslach Burnout Inventory were completed by both groups in the introductory session and before implementing the intervention. The demographic information form examined the participants’ age, marital status, job experience, working hours, level of education, type of employment, and type of the emergency base. The occupational stress questionnaire was developed and standardized by Danesh. It comprised 46 items examining stress in four dimensions of physical, occupational, group-related, and organizational. The reliability of this questionnaire was examined in the present study by checking its internal consistency, and the Cronbachchr('39')s alpha of 0.86 was obtained. The Maslach Burnout Inventory consisted of 22 items which assessed the three dimensions of occupational burnout: emotional exhaustion, lack of personal accomplishment, and depersonalization. Maslach and Jackson reported the internal consistency coefficient of 9.0, 0.79, and 0.71 for emotional exhaustion, depersonalization, and personal accomplishment, respectively. The reliability and validity of this questionnaire were confirmed by numerous studies in Iran, and Cronbach’s alpha of 0.75-0.87 was reported for it, indicating its reliability. The intervention comprised six sessions of in-person gratitude program as a positive coping technique in stressful and difficult situations, developed based on the models of verbal gratitude (Emmons & McCullough, 2003), behavioral gratitude (Tsang, 2002), and practical gratitude (Seligman, 2005), and approved by the Department of Psychiatric Nursing,  School of Nursing and Midwifery, Isfahan University of Medical Sciences. The educational content consisted of writing a letter of gratitude to significant people in onechr('39')s life, consciously searching for gratitude in daily life, recalling memories of gratitude by people and the organization during onechr('39')s work life, increasing attention to the smallest positive events during missions despite a high level of stress and recording them. Next, the program was followed for four weeks online by using the Telegram app. For the experimental group, five in-person sessions of gratitude were held at the Accidents and Emergencies Educational Center in the south of Isfahan Province. At the end of the fifth session, the participants joined a Telegram channel and were requested to record the positive aspects which merited gratitude encountered in their missions for four weeks (twice a week). The person in charge of education at the center reminded the participants of sending their messages to the Telegram group once before the shift was started and once at the time of shift change. After four weeks of online program, the sixth session was held at the center, in which the content provided throughout the program was summarized, and the messages sent to the Telegram group were examined in terms of their positive and negative load. The participants were then asked to fill in the same questionnaires once more. To eliminate the cohort effect of the intervention group, the control group also received two sessions in which general topics related to the missions and the importance of implementing mental health interventions for the personnel were discussed. The control group joined another Telegram group and their requested to record the events related to their missions for four weeks (twice a week). At the end of this program, the control group also filled in the questionnaires, and their messages were examined in terms of negative and positive loads. One month later, all the participants in the experimental and control groups completed the questionnaires for a third time without receiving any additional intervention. The questionnaires were distributed and collected in all three phases by the person in charge of education at the center. The data were inputted in SPSS 18 and analyzed by using t-test and ANOVA.

The highest frequency in both groups belonged to married people who worked in urban bases on a 24-hour basis. In terms of level of education and type of employment, the highest frequency belonged to those with a bachelorchr('39')s degree and full employment (experimental group), and an associate degree and contractual employment (control group). Results of the t-test indicated that the mean scores of the dimensions of occupational stress and burnout did not significantly differ before the intervention between the two groups (p>0.05). However, this difference was significant immediately after and one month after the intervention (p<0.001), demonstrating the effect of the gratitude program on the dimensions of occupational stress and burnout in the experimental group.  One-way ANOVA showed that, in the experimental group, the mean difference in the scores of the dimensions of occupational stress and burnout before, immediately after, and one month after the intervention was significant in all the dimensions of occupational stress, except for the group-related dimensions (p<0.05).  In other words, the intervention affected the physical, occupational, and organizational dimensions of occupational stress. Findings also showed that gratitude was effective only on the emotional exhaustion dimension of occupational burnout (p<0.05).

Based on the findings, implementation of the gratitude program reduces occupational stress and also affects emotional exhaustion which is a dimension of occupational burnout. Based on the nature of the emergency care technicians’ job and the inadequate time they have to spend on mental health programs, the implementation of such programs over messaging services such as Telegram is cost-effective and practical in a short period. It can also help these technicians overcome occupational stress in the first stages, preventing it from progressing to more advanced levels which lead to occupational stress. The effect of interventions is stronger in the first stages of a problem than the final and progressed stages. This must be kept in mind when trying to prevent occupational burnout which has negative effects on organizational productivity and personal relations. It is recommended that such programs be implemented to maintain and promote the mental health of pre-hospital emergency care technicians.

The research aimed to investigate the effectiveness of emotional schema therapy on the mood symptoms and impulsivity of women with bipolar disorder (I, II).

Methods and Materials: 

Present research was semi-experimental study with pretest-posttest design and follow-up with control group that was performed on 30 female patients with bipolar disorder referring to the Farabi hospital in Isfahan in 2016. Participants were selected by available sampling, then they were randomly assigned to experimental (n=15) and control group (n=15). Participants responded to Barratt Impulsiveness Scale (2004), Hamilton Questionnaire and Young Mania Scale in three steps pretest, posttest and follow-up. Experimental group in addition to medication, they received emotional schema therapy in group method during 14, 90-minute sessions while the control group did not received any cognitive intervention. Descriptive statistics methods and analysis of multivariate Covariance and were used for analyzing the data

Findings showed that emotional schema therapy had impact on the dimensions of impulsivity and mood symptoms (depression and mania) of bipolar patients and this effectiveness continued to be sustained in fallow up 3 months later.

Applying emotional schema therapy along with drug therapy can be effective intervention for treatment of mood symptoms and impulsivity in patients with bipolar disorder.

Marriage is one of the supreme social customs that satisfies emotional needs such as the establishment of intimate relationships. Regarding the role of quality, a close and sincere relationship in the overall quality of happiness and general satisfaction of spouses, the purpose of this study was to examine the effectiveness of training encouragement skills on eight special needs of women referring to counseling centers in Isfahan.
In this semi-experimental study with pre-test post-test design, 30 women selected through the available sampling method. Also, they were referred to the Farabi hospital in Isfahan and, divided into experimental and control groups. Then, they have completed the questionnaire of the Bagarozy's intimacy needs (2001). The experimental group trained encouragement skills in 10 sessions. Data analysis utilized descriptive and inferential statistical methods in SPSS-18. 
Results of Covariance analysis indicated that educational sessions had a significant effect on the eight intimacy needs of women in the experimental group (p˂0.05). The education of encouragement skills was active on the total score on intimacy and dimensions of emotional closeness, psychological intimacy, intellectual intimacy and aesthetic intimacy (P <0.05).
According to the results of this study, design and development of such programs by enhancing the intimacy and satisfaction of their spouses can help them to improve relationships with others.

Context: Chemotherapy induced nausea vomiting and fatigue are prevalent problems following chemotherapy and pharmacologic methods are moderately efficient in alleviating them. Acupressure is a substitute approach.
Aims: This paper sought to determine the effectiveness of acupressure application in relieving nausea vomiting and fatigue among children with acute lymphoblastic leukemia in compression with a placebo treatment. Settings and Design: In this single blind, randomized, placebo controlled clinical trial, 120 hospitalized school age children with ALL, randomly divided into experimental and placebo groups. Subjects rated the intensity of nausea and fatigue by visual analog scales.
Material and In the experimental group, finger acupressure on p6 and ST36 (true points) and in the placebo group on SI3 and LI12 (sham points) was applied. Symptoms of nausea and fatigue intensity immediately and an hour postintervention evaluated. Then variable of nausea vomiting and Fatigue was also measured 12 h postintervention by the instruments of Adapted Rhodes Index of Nausea and Vomiting for Pediatrics by Child and Fatigue Scale Child, Respectively. Statistical Analysis Used: Data were analyzed by SPSS version 16.0.
Significant differences were observed between two groups based on the fatigue and nausea intensity immediately and an hour postintervention with confidence interval 95% and P Applying one time acupressure may reduce the intensity of nausea immediately postintervention and fatigue and nausea at one hour post treatment. Hence, acupressure could be recommended as a helpful, nonpharmacologic method for some cancer related fatigue and chemotherapy induced nausea vomiting management.

Social anxiety is an important factor in peoples’ mental health. Good mental health while studying in university makes students able to deal effectively with numerous stressors that they experience. The purpose of this study was to determine and compare the social anxiety of nursing students in grades one to four of medical universities in Tehran. In this analytic cross-sectional study, 400 students from universities of medical sciences in Tehran were recruited by stratified sampling with proportional allocation. Data were collected during the first semester in 2010. Students completed a two-part questionnaire including the Liebowitz social anxiety questionnaire and a demographic information form. Data were analyzed using descriptive statistics methods and an analytical test by SPSS statistical software. There was no statistically significant difference in the total scores of social anxiety of first- to fourth-year students. The mean score of the avoidance of social interaction dimension in fourth-year students was significantly lower than in first year students (p<0.05). In regard to the relationship between social anxiety and interpersonal communication as an associated part of nursing care, decrease of social anxiety of students could play an important role in their mental health. According to the results of this study, it seems that the placement of students in the nursing education system does not produce any changes in their social anxiety.

Self-esteem plays a critical role in promoting mental health and affects performance, development patterns, interaction with others and the mental health. Accordingly, improving the self-esteem of students, as future builders of the community, is very important. The purpose of this study was to determine and compare the self-esteem of nursing students in grades one to four of medical universities in Tehran. In this analytical cross-sectional study, 400 students of the medical universities in Tehran were selected, using stratified sampling with proportional allocation. They filled a demographic information form and Coopersmith Self-esteem Inventory. Data for this study were collected during a semester in 2010. The results showed that the overall mean score of self-esteem (P = 0.3), and personal (P = 0.3), social (P = 0.5), parental self-esteem (P = 0.5) in the first and fourth year students did not differ statistically. The first and fourth year students presented the highest levels of social self-esteem. Fourth year students showed the highest academic and parental self-esteem compared to students in other academic years. In addition, the variables of grade point average (P = 0.02), residence (P = 0.003), family economic status (P = 0.001) and marital status (P = 0.04) had a statistically significant influence on students’ self-esteem. Given the undeniable relationship between self-esteem and interpersonal ability to interact, as an inseparable component of effective care process, assessing and identifying factors associated with nursing students is a valuable step in improving the quality of nursing care provided in a future career of this major segment of the community.

providing care of patient with Alzheimer disease in long term associates with an increase in physical and mental health problems for caregivers. The study purpose was to assess the relationship between general health and burden in women as caregivers of patient with Alzheimer disease. In this cross sectional and study, 150 women who had 18-60 years old and were the first-degree relatives of elderly patient with Alzheimer and also being direct caregivers for at least six months were selected through the convenience method. The data were collected using general health and burden questionnaire and then analyzed using by SPSS 16 and some tests like independent T-test, ANOVA and Regression analysis with Pvalu of. 05. The results indicated that 38% of caregivers were in a range age of 51-60 years old. In addition, 75.3% of theme were married and 72.7% had moderate economic status, 82% were house holder, 65.3% of them had diploma education, and 66% were elder’s daughter and took care of their old patients for 6-12 months. Results showed that 24% of participants were in a good level of general health and 62% experienced a high level of burden. Pearson’s correlation coefficient created a significant negative correlation between general health and burden (P≤0/000,r= 0/661). According to the correlation between level of general health and burden in this study, health level of care providers is an important health problem requiring to receiving attention from healthy services and professions as a priority in health caring.

Hypertension, a clear risk factor for cardiovascular diseases, affects nearly one billion people worldwide. Recent statistics have reported increasing mortality due to hypertension which reveals the importance of prophylactic strategies in controlling blood pressure. Lifestyle changes are one of the most effective ways to prevent and control hypertension. This study was a comprehensive literature review performed through searches in databases such as Medline, PubMed, Science Direct, Scopus, and Google Scholar using the terms «lifestyle», «hypertension», «lifestyle modification», «risk factors for hypertension», «nonpharmacologic treatment of hypertension», and «dietary and activity factors». Lifestyle factors such as dietary behaviors and physical activity are associated with hypertension. Several studies have indicated direct and indirect associations between overweight and increased risk of hypertension. Increased consumption of grains, fruits, vegetables, and milk and reduced consumption of sodium, fat, and alcohol are effective in preventing and controlling hypertension. In addition, some studies have reported a 35% reduction in risk of developing hypertension among individuals who engage in regular physical activity compared to sedentary people. Since lifestyle- and diet-related factors are often modifiable, perceptions of their effects have specific importance in hypertension prevention and treatment.