Journal of Education and Health Promotion
Volume:12 Issue: 6, Jul 2022

Vaginal childbirth is the most stressful physical and mental event for most women, which necessitates the use of coping styles. Furthermore, childbirth self‑efficacy will be one of the effective factors to cope with this stressful situation and doing compatible behaviors with childbirth pain. Therefore, the aim of this study was to determine the relationship between childbirth self‑efficacy and coping styles of problem based and emotive based in nulliparous pregnant women.

This study is a descriptive‑correlational study that is done over 323 nulliparous pregnant women attending the health centers in the city of Zahedan in 2020–2021. Data were collected by participants’ demographic questionnaire, childbirth self‑efficacy questionnaire of Lowe, and coping styles questionnaire of Folkman and Lazarus. The data were analyzed using Spearman’s correlation coefficient test, linear regressions model, and multiple regression in SPSS software version 22. P < 0.05 was considered statistically significant.

Results of Spearman’s correlation coefficient test showed a significant direct correlation between problem‑based coping style and childbirth self‑efficacy (P = 0/017, r = 0.13); but, there was no significant direct correlation with emotive‑based coping style (P = 0/782, r = 0.01). According to the linear regressions model, just the problem‑based coping style is predicted childbirth self‑efficacy (P = 0/006).

According to the findings, nulliparous pregnant women should be responsible, have a positive reassessment of vaginal childbirth, plan to solve their problems, and look for social support (all of these are part of a problem‑based coping style) to increase and improve their childbirth self‑efficacy. Furthermore, designing appropriate educational interventions based on problem‑based coping style is necessary

Medical students who are prone to psychological stress due to their overburdened curriculum, are at an increased risk of getting adversely affected by the pandemic. The present study was planned to assess the anxiety level among undergraduate medical students across the country using generalized anxiety disorder scale (GAD‑7).

In this online survey, anonymous data was collected through Google forms from undergraduate students from all the phases of MBBS course across the country from August 15, 2020, to October 15, 2020. Section I collected various demographic information, section II included GAD‑7 questionnaire for assessing anxiety and section III had open‑ ended questions about their impending fear, uncertainties, and apprehensions. The data was expressed in percentage and association among the variables was determined using Chi‑square test. Thematic analysis of the open‑ended responses was done.

Among the sample of 1208 students, 81% were from urban areas. During the pandemic, 77% were residing with their parents and 71% parents having stable jobs. Eighty percent students had no relative diagnosed with COVID‑19, whereas 52% students had family members with comorbidity. The GAP score showed mild, moderate, and severe anxiety in 27, 24, and 16% students, respectively. Anxiety was significantly associated with rural setting and with COVID‑19 positive or comorbid family member (P < 0.05). Open ended responses revealed that majority of the students were finding it difficult to cope with the academic stress at home but still did not want to join back.

With such a high incidence of anxiety among medical students, it is pertinent to safeguard the mental health and implement efficient approaches to upkeep the scholastic, physical, emotional, and professional well‑being of medical students during such vulnerable times.

The small group teaching (SGT) is gaining popularity in medical education since it improves the student’s thinking capacity and aids knowledge retention. Several studies have been conducted to analyze students’ attitudes regarding SGT. Faculty, on the other hand, have mixed perception about SGT methodology. Therefore, the main objective of this study was to explore medical faculties’ perceptions of SGT effectiveness in the medical curriculum.

Across‑sectional, descriptive survey was conducted among 50 medical college teachers. We have developed set of 12 questionnaires to assess the perception of teachers on SGT methods. Content validation of the survey questionnaire was done by Lawshe method, and Cronbach’s alpha was calculated for estimating the internal consistency. Teacher’s perception responses were presented as proportion and percentage. We performed principal component analysis, structural equation modelling, Chi‑squared test (χ2 /df), goodness‑of‑fit index (GFI), adjusted GFI, comparative fit index, and root mean square error of approximation.

The validation resulted in the 12 items model indicated superior goodness of fit for sample data. All the extracted factors had good internal consistency of >0.9. Majority of the teachers strongly agreed that the SGT method enhances the student intrinsic motivation (n = 42, 84%), self‑confidence (n = 40, 80%) self‑directed learning (n = 35, 70%), and student teacher interaction (n = 38, 76%).

Teaching faculties’ perception reflected that SGT is an effective method to impart knowledge to the students and also helps in improving their understanding of their subject. It helps in developing intrinsic motivation to do self‑learning in the students. It also helps in developing good peer interaction and improves the communication skills.

Coronavirus disease 2019 (COVID‑19) is a global pandemic that has modified all social and, especially, learning instances. The purpose of this study was to determine the perception of final‑year nursing students at a university in southern Chile regarding the impact of the pandemic on their learning, and consequently on their quality of life, in the context of the COVID‑19 pandemic.

This is a qualitative study. The research was conducted on 14 nursing students who were selected from a university located in the province of Talca, Maule Region, Chile. Data collection was done through semi‑structured interviews conducted during July and September 2021. The data were analyzed using the inductive logic of theoretical categorization; this process was assisted by the Nvivo 10 program.

Two mega categories were generated that accounted for the nursing students’ experience during the COVID‑19 pandemic: objective factors category and subjective factors category. Six subcategories were derived from these two categories: free time, social relationships, learning from practice, physical exercise, eating habits, and emotional state.

The research findings indicate that the students, in addition to feeling upset about not being able to do the internship, also feel that they have not been able to acquire all the knowledge necessary for their training and professional development, since the virtual classes fail to deliver adequate learning as they lack the practical component that is so important in their careers. This has repercussions in the physical, social, and psychological areas, affecting their quality of life.

Continuous evaluation is necessary to achieve appropriate quality in educational programs. The aim of this study was to evaluate the doctoral program of medical education at Isfahan University of Medical Sciences based on the CIPP model.

This descriptive and educational evaluation study was conducted in 2020 at Isfahan University of Medical Sciences. The study population consisted of all heads of department, faculty members, students, and PhD graduates of medical education from 2010 to 2020 who were enrolled in the study by census method. The data collection tool was a researcher‑made questionnaire of CIPP evaluation model which was used when validity and reliability of them were confirmed. The data obtained from the questionnaires were analyzed in two levels of descriptive statistics of mean and standard deviation and inferential statistics one‑sample t‑test.

Based on the CIPP model, the mean evaluation scores from the perspective of the heads of department, faculty members, and graduates were 4.1 ± 0.1, 3.64 ± 0.42, and 3.33 ± 0.66, respectively, which were significantly higher than the average (P ≤ 0.05). However, the mean evaluation score was not significantly higher than the average from the viewpoint of the students (3.24 ± 1.17).

Based on the results of the study, the status of the doctoral course in medical education at Isfahan University of Medical Sciences was assessed as appropriate by the subjects of the study including the heads of department, faculty members, and graduates. It was not, however, acceptable according to the students. Based on the results, it is suggested that evaluation be done continuously and measures are taken to correct the weaknesses and enhance the strengths.

Vaccine hesitancy leads to an increase in morbidity, mortality, and health‑care burden. Reasons for vaccine hesitancy include anti‑vax group statements, misinformation about vaccine side effects, speed of vaccine development, and general disbelief in the existence of viruses like COVID‑19. Medical students are future physicians and are key influencers in the uptake of vaccines. Hence, investigating vaccine hesitancy in this population can help to overcome any barrier in vaccine acceptance.

In this paper, we review five articles on COVID‑19 vaccine hesitancy in medical students and consider potential future research. All published papers relevant to the topic were obtained through extensive search using major databases. Inclusion criteria included studies that specifically investigated COVID‑19 vaccine hesitancy in medical students published between 2020 and 2021. Exclusion criteria included studies that investigated vaccine hesitancy in health‑care professionals, allied health, and viruses apart from COVID‑19. A total of 10 studies were found from our search.

Based on our exclusion criteria, only five studies were included in our review. The sample size ranged from 168 to 2133 medical students. The percentage of vaccine hesitancy in medical students ranged from 10.6 to 65.1%. Reasons for vaccine hesitancy included concern about serious side effects, vaccine efficacy, misinformation and insufficient information, disbelief in public health experts, financial costs, and belief that they had acquired immunity.

These results suggest that vaccine hesitancy is an important cause of the incidence and prevalence of COVID‑19 cases. Identifying the barriers of vaccine hesitancy in prospective physicians can help increase vaccination uptake in the general public. Further research is necessary to identify the root cause of these barriers.

Sufficient interaction between the trainers and the trainees in medical education is always one of the biggest challenges for an educational system. This study was designed to evaluate the effect of virtual interactions within the educational content of stroke on the effectiveness of teaching for general medicine students during COVID‑19 crisis.

Eight medical students applying for stroke education were divided into two groups by simple random sampling (Rafsanjan Medical School, 2020). The first group participated in an online classroom via the Adobe Connect platform without virtual interaction. The second group used a video presentation containing interaction scenarios. The effectiveness evaluation of each type of educational content was done by comparison of the final exam scores and the results of an electronic satisfaction questionnaire in each group. Finally, using SPSS software version 18, the data were analyzed with independent samples t‑test.

This study showed that the mean of the examination scores of the interactive virtual content group (6.14 ± 1.46) was significantly higher than the online class group (4.50 ± 1.50) (P < 0.001), and also the results of satisfaction assessment showed that this group was more satisfied with their educational content (P = 0.005).

Evaluation of the virtual stroke training effectiveness for general medical students shows that the educational approach of video with virtual interactions is an effective learning method in medical topics and can be considered as an efficacious educational model in online teaching.

Addiction refers to the irresistible urge to engage in certain actions or dependence on a particular substance despite knowing negative consequences. The current study evaluated the severity of Smartphone addiction and the factors associated with cell phone‑like activity.

This cross‑sectional study was conducted from July to August 2019 among medical and dental students in Karachi, Pakistan. A pretested self‑administered questionnaire was used among 400 students. The mobile phone addiction was assessed using a 20-item, Mobile Phone Addiction Scale. A two‑stage cluster analysis was used to assess mobile phone addiction‑like behaviours. Chi‑square test was used to find associations between categorical variables. Kolmogorov–Smirnov to test normality of data were also used. A P < 0.05 was considered to be statistically significant for all tests.

Out of the total 400 students, the majority 316 (79%) comprise female students. The mean age was 20.54 ± 1.59 years. In 184 (48%) students, there was evidence of mobile phone addiction‑like behavior. The prevalence was higher in female than male students and among older compared to adolescent students; the differences were statistically nonsignificant. A higher median score ≥ of 4 is found in questions related to components reflected intense desire, impaired control, and tolerance and harmful mobile use.

This study highlights that a large number of students are addicted to their smartphones. Smartphone addiction continues to be the most problematic addiction aided by the presence of intense desire, impaired control tolerance, and harmful mobile use. The phenomenon must be fully understood to draw deeper and richer inferences about the origins of this addictive behavior, which is becoming more prevalent in our Pakistani society on a daily basis.

Due to the rapid advancement of medical knowledge, promotion in research is necessary to have the best clinical practice. Research Self‑efficacy (RSE) is the researcher’s confidence in their ability to conduct a specific study. The Evidence‑Based Practice (EBP) represents how to improve the quality of care and treatment of patients. RSE and EBP are the cornerstones of successful research and then efficacious medical practice.This study aims to evaluate RSE and acceptance of EBP and their correlation among medical students.

This is a cross‑sectional study designed on 600 clinical students at the medical school of Shiraz, using a census method in 2020. Students were invited to fill out the standardized Phillips and Russell’s questionnaires about RSE (4 domains, 33 questions) and Rubin and Parrish’s questionnaire of EBP (10 questions). The gathered data were analyzed through the SPSS at α = 0.05 using descriptive statistics, t‑test, Chi‑square, and multiple linear regressions.

There was a positive correlation between EBP and RSE score (P < 0.05). The results of linear regression test showed that all variables had a significant effect on our response variables and their effect were significant (P < 0.05). The highest mean score in RSE was shown in the subscale of writing skills (52.54). The lowest score was observed in the subscale of quantitative (student’s subjective assessment of their ability to work with statistically related data and formulas) as well as computer skills (35.61).

Students who participated in a research project, workshop, or Master of Public Health program got a higher RSE and EBP. Due to the positive correlation between RSE and EBP, we conclude that trained physicians who can research independently and use research evidence can find the best treatment approach for patients. These finding support the importance of integrating research education in medical curriculum to increase RSE and finally improvement of EBP among medical students.

Nurse managers are the frontline leaders in the ward that directly impact the quality of care services. Many nurse managers in Indonesia were inadequately prepared to fulfill this role, especially during this crisis. The objective was to develop blended learning an Integrated Nursing Leadership Training (INLeT) using web based and test the effectiveness.

This research is a research development using modified Borg and Gall by researcher, namely, Planning, Redesign, Intervention, Modify, and Evaluation. The INLET model was validated by nine experts in health and media technology design. Data were tested using quasi‑experiment research in Sanglah General Hospital and Wangaya Public Hospital in Bali.

The results of analysis of the content validity of all items valued V index 0.96 (high category) from design experts and V Index 0.92 (high category from health experts. The experiment group obtained N Gain scored 0.5603 at medium level, and the control group result of N Gain Score was 0.2845 in the low‑level category. Using t‑test, both the experiment and control group showed significant improvement of score test with P = 0.000 (P < 0.005). Bivariate analysis using independent t‑test result P = 0.000 (P < 0.005) means significant difference score test compared between experiment and control group.

Using the web, this blended learning INLeT Model is effectively applied for nurse manager professional development; therefore, this study can prepare nurse managers into a leadership role by integrating moodle web‑based into nursing training.

Medication adherence means compliance with patient adherence to medication orders, including timely and correct consumption of medication prescribed by a physician. The present study aimed to determine the extent of adherence to hypertension drug medication in patients covered by comprehensive health service centers of Shahrekord, Iran.

A cross‑sectional study examined 401 hypertensive patients registered in the Integrated Health Record System (SIB). SIB is a Persian term related to Health Record System. To collect data, Morisky Medication Adherence Scale was used. The questionnaire was completed by the patients and analyzed using SPSS (SPSS Inc., Chicago, Illinois, USA, version 26), Chi‑square test, independent t‑test, and analysis of variance.

The results indicated that adherence to antihypertensive medication was low in 5.7% of patients, while 63.3% of patients had sufficient compliance. Forgetting to take medications (52.9%) was the most common reason for nonadherence to medication in hypertensive patients.

Given that forgetting to take medications was the main reason for nonadherence to medication in hypertensive patients, designing and implementing necessary trainings by comprehensive health centers to realize the importance of daily use of medication by hypertensive patients and their families are recommended.

The current study measured the executive tasks and cognitive flexibility and their relationship to the academic achievement of female students of the College of Education at Imam Abdulrahman Bin Faisal University in the Kingdom of Saudi Arabia.

This research is a descriptive quantitative design. The study sample included 200 female students using purposive sampling. The study applied a test of executive tasks, cognitive flexibility, and a scale of attention deficit hyperactivity disorder for adults prepared by the researchers. Data were analyzed using several tests, namely descriptive statistics, Pearson correlation at the level of <0.05.

The results showed a statistically significant relationship between the scores of students with attention deficit and hyperactivity on the executive tasks scale and its dimensions (planning, organization, purposeful action, self‑monitoring, and total score), cognitive flexibility, and academic achievement, which necessitates the need to design empirical research to reduce the severity of attention deficit hyperactivity disorder among undergraduate students because it will have a positive impact on their academic achievement.

The researchers highlight the necessity for conducting empirical research to improve the executive tasks of students as it will have a positive impact on their lives.

With the outbreak of the COVID‑19 virus crisis worldwide, including Iran, the need for corona prevention and treatment has become a national priority. With many businesses closed in the wake of COVID‑19 and job losses and declining incomes, vulnerable individuals’ and families’ access to the minimum wage and healthcare facilities is falling, and their health is exposed to a great risk. In Iran, a significant number of vulnerable groups are supported by nongovernmental organizations (NGOs). This study is designed to understand the performance of NGOs after the onset of the COVID‑19 crisis.

This study was carried out based on qualitative research between June and September 2020 in Tehran. This study was conducted using individual interviews with 33 managers and experts of 24 active NGOs providing services to vulnerable groups and a member of an NGO network. Data were analyzed using content analysis.

Two main themes of service initiatives were extracted: (a) service initiatives to protect the target population against COVID‑19 infection and its aftermath and (b) management initiatives to retain staff, finance, and adapt the organization to crisis situations. Service initiatives included five categories of health service initiatives, livelihood, employment, education, and leisure initiatives, while organizational management initiatives include human resource management, financial management, and communication with organizations.

The COVID‑19 breadth and its special features have set it apart from other crises and have led NGOs to work hard on several fronts to care for the most vulnerable people against the epidemic and its consequences and maintain the performance of their organizations. The unique role of cyberspace has made it one of the definitive pillars of the activities of NGOs, not only during the epidemic but also after its end.

A structured physical activity program has many health benefits. Physical activity improves the functional ability of a patient with mental illness as an adjunctive treatment. This study aimed to evaluate the efficacy of a physical activity program on the level of functional ability of patients with mental illness.

A pre‑experimental research design and one group pre‑post design were adopted. Thirty‑one in‑patients with mental illness who met the inclusion criteria were recruited for the study using convenient sampling. Baseline data were collected using sociodemographic and illness profiles developed by the researcher and validated by the experts. Functional ability and illness severity were assessed using the standardized World Health Organization Disability Assessment Schedule (WHODAS) (36‑item version) and the Clinical Global Improvement Scale. Pretest, i.e., intervention with structured physical activity, was administered for 40 consecutive days. A posttest was given 30 days after the intervention ended to assess the impact of the structured physical activity program on the level of functional ability among the study participants.

The impact of structured physical activity on functional ability was measured using the WHODAS 2.0, a 36‑item version. The paired Sample t‑test and the Wilcoxon Rank test analyzed the data. There was a significant improvement in the overall functional ability of study participants at P = 0. 001.

The study findings support that structured physical activity substantially impacts functional ability among patients with mental illnesses

Identifying and addressing the needs of Colorectal cancer (CRC) patients/survivors’ is important to improve patients/survivors’ quality of life (QoL) and health. The present study aimed to review studies that have investigated CRC patients/survivors’ needs.

In this narrative review, databases including PubMed, Scopus, Web of Science, Iranmedex, ISC, SID, and Magiran were searched during 2011–2021 using keywords included need, CRC, colon cancer, rectal cancer.

The findings of the studies showed that the needs of the CRC patients/survivors’ can be categorized into the 6 domains including informational, psychological, social, physical, financial, and spiritual needs.

By identifying CRC patients/survivors’ needs, healthcare providers particularly nurses can develop and design comprehensive care programs tailored to the needs and priorities of these patients/survivors to improve their QoL and health.

Informal and formal caregivers of older adults with noncommunicable diseases (NCDs) are important in every aspect of current caregiving for older adults by understanding reality specific to direct experiences perceived by each person in caring for older adults in order to develop nursing knowledge and using knowledge to plan care for older adults with NCDs to have a good quality of life. The current study aimed to investigate the points of view on factors concerning the care provided by informal and formal caregivers providing care for older adults with chronic diseases in the community.

This study was conducted with a qualitative design. The sample was 5 informal and 20 formal caregivers providing care for patients with chronic diseases, namely hypertension and diabetes mellitus. Furthermore, a qualitative approach was used with four focus groups (FGs) with 25 informants. Data were collected during March–August 2021 in rural communities of Nakhon Phanom Province, Thailand. Finally, the qualitative analysis used content analysis; FG data were analyzed using content analysis in which a preliminary set of codes was determined according to other documented experiences of patients.

The findings revealed three main themes emerging in the data obtained on the perceived factors contributing to the care provided by informal and formal caregivers: “caregivers’ knowledge,” “factors related to caregivers” and “community factors.”

Points of view on the factors correlated with the care provided by informal and formal caregivers of older adults with chronic diseases that explain and confirm the findings can be used to plan care with effects on quality of life among older adults with chronic diseases.

COVID‑19 has affected the quality of life of all age groups. Medical education during the pandemic shifted to online mode due to lockdown restrictions. The stress felt by medical students during the pandemic has been studied less. The current study aimed to assessed the stressors and de‑stressors for undergraduate medical students during the COVID‑19 pandemic.

A cross‑sectional online survey was conducted for the undergraduate medical students of a tertiary care institute of eastern India. A total of 307 medical students were included in the study by convenient and snowball sampling. A self‑designed semi‑structural questionnaire was created as a Google form and circulated among the students between September and October 2020. A combination of purposive and snowball sampling was adopted. Responses regarding stressors and de‑stressors were recorded on a Likert scale. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. Categorical variables were presented as percentages and descriptive statistics were performed.

A total of 307 students responded and 64.5% of them were men and 35.5% were women. 47.6% of the students experienced stress due to changes brought about by COVID‑19. Risk of parents getting infection (63.2%), fear of not easily returning home (53.1%), lack of clinical exposure (52.7%), and financial impact (47.9%) were the major stressors perceived by the students. Connecting with family and friends through social media (47.5%), gaming (45.0%), online streaming platform (51.2%), spending time with family members (54.4%) were the coping strategies adopted by these students.

Higher level of psychological stress perceived by the undergraduate students needs psychological intervention. Academic revamp and adaptation of coping strategies are required for the medical under‑graduates.

Academic stress is a predominant phenomenon among grade 11 and 12 students. The performance in Grade 12 is important for entry to higher education programs in India. The purpose of the study was to assess the magnitude of the perceived academic stress and identify the main stressors and the sociodemographic variables associated with the perceived academic stress among adolescents enrolled in the science stream in coastal Karnataka.

Upon Institutional Ethical Committee approval, a cross‑sectional survey was carried out among pre‑university students (science stream) of coastal Karnataka during February–April 2021. The study used Manipal Inventory of Academic Stress (MIAS) scale to collect data on perceived academic stress from 1859 students (response rate 68.3%). Stratified cluster sampling method was used to collect data from the study participants. IBM Statistical Package for the Social Sciences (SPSS) 26.0 was used to analyze the data. Descriptive statistics, unpaired t‑test, one‑way analysis of variance (ANOVA), and multiple linear regression analyses were used to study the association between academic stress and various demographic variables.

The study revealed that 28% of the Grade 11 students and 26% of the Grade 12 students experienced high or extreme stress. The significant stressors were lack of time for revision, queries from neighbors or relatives, and parental expectations on academic performance. Gender, residence, and the medium of instruction until Grade 10 were associated with academic stress.

Measures at the institutional and national levels are necessary to reduce the academic stress in higher secondary education. The integrated curriculum proposed in the National Educational Policy 2020 addresses a few stressors identified in this study.

Sleep disturbances as a major health problem are common in patients hospitalized in critical care units. This study examined the effects of a team‑based care plan on the quality of sleep in patients hospitalized in a cardiac surgery intensive care unit (CSICU) of a multidisciplinary hospital.

In this clinical trial, 100 patients with cardiac surgery were selKMected through convenience sampling and then nonrandomly allocated to the intervention and or the control group. A plan of care with the recommendation of all intensive care unit care teams was designed and then applied. In this study, the Richards‑Campbell Sleep Questionnaire was used to evaluate sleep quality. Patients in the intervention group received the care plan for two consecutive nights. The study’s national approval code is IRCT2017091915512N2. Collected data were analyzed using SPSS software (v. 21), and by paired, independent t, Chi‑square, and Fisher’s exact tests.

Quality of sleep in patients admitted to the CSICU is significantly improved by noise reduction both in the first and second nights. Moreover, the team‑based care plan requires good coordination between all team members taking care of cardiac surgery patients admitted to the CSICU (P < 0.001).

The team‑based care plan significantly improves the quality of sleep. It may be due to the close coordination between all team members to avoid sleep disturbances

Training of health profession students in telehealth is important to ensure proper implementation for healthcare delivery. This prospective study aimed to analyze the effects of didactic and experiential learning on knowledge, confidence, and attitudes of telehealth among health profession students (Survey 1). The perceptions of a mixed model telehealth platform were also considered among these students and community clients (Survey 2).

A quasi‑experimental repeated‑measure study was conducted on 153 university health profession students in physician assistant, physical therapy, occupational therapy, and nursing (NR) across the 2020–2021 academic year. Survey 1 was administered to students pre/postdidactic telehealth training and at two sequential points within two semesters of telehealth experiential learning. Survey 2 was distributed among students and a pool of 19 community clients at 4 time points across the experience. Survey data were analyzed using R software.

There was a significant improvement in telehealth knowledge, confidence, and attitudes among all student disciplines after the didactic module with marginal means ranging 3.313/5–4.318/5 for pretest to posttest 1. Improvement continued through experiential learning with marginal means ranging 4.170/5–4.369/5 in posttest 3. There was also a significant student and client approval of the telehealth platform with a student mean high of 3.962/5 ± 0.527 and client mean high of 4.727/5 ± 0.238.

A didactic training module combined with experiential learning is effective for health profession students’ improvement in perception, knowledge, and attitudes toward telehealth. Health profession students and community clients approve a mixed model telehealth platform.

Most patients experience anxiety before heart surgery. On the other hand, spiritual health can improve the candidate patient’s adaptation to surgery. Therefore, this study aimed to investigate the effect of group logotherapy on spirituality and anxiety of patients undergoing cardiac surgery.

In this quasi‑experimental study, 60 hospitalized candidates for cardiac surgery were randomly assigned to two groups (30 in the experimental group, 30 in the control group). To measure anxiety and relationship with God, Beck Anxiety Questionnaire and the researcher‑made scale about relationship with God (reconstruction of Lawrence’s scale of perception of God) were used, respectively. In the intervention group, in addition to drug therapy, individuals received two sessions of group discussion and spiritual skills training using the behavioral‑cognitive method with emphasis on spiritual thoughts and problem‑solving methods, but the control group received only drug therapy. Data were analyzed using SPSS software.

In the experimental group, the anxiety scores mean in the posttest and follow‑up were significantly lower than the pretest (P < 0.05), while the mean anxiety in the control group in the posttest stage was not significantly different, but at the follow‑up stage, it was significantly lower than the pretest, but the decrease in mean anxiety in the experimental group was greater (P < 0.05). The mean subscales of relationship with god (influence, divine providence, acceptance, presence, challenge, benevolence) were significantly higher in the experimental and control groups in the follow‑up stage than the pretest, but the increase in the mean of these variables was more in the experimental group in the follow‑up stage (P < 0.05).

Findings showed that the components of relationship with God are a good predictor of pre‑surgery anxiety, so by focusing on spiritual training of patients who are candidates for surgery, the incidence or severity of anxiety can be reduced.

The therapeutic environment is commonly acknowledged as a significant influence on mental inpatient treatment experiences and outcomes. Therapeutic milieu interventions provide a distinct, secure hospital ward/unit atmosphere where patients with mental illness receive therapeutic interactions and collaborative attentiveness. The review aimed to explore the studies related to the role of a nurse using therapeutic milieu/milieu therapy in a psychiatric setting.

A systematic literature search was conducted between 1976 and 2021 using PsycINFO, Medline, Embase, and Scopus. A total of 13 papers were identified for a full review.

A total of 70 studies were found, out of which 13 of them were analyzed. These studies looked at several therapeutic milieu concepts, such as therapeutic communication, patient satisfaction, nurse involvement, ward design and structure, and a mixture of therapeutic milieu concepts. Most of the studies explored the concepts of milieu therapy in community settings.

In the mental health nursing literature, the milieu, as well as milieu therapy, is a well‑debated subject. Though the importance of therapeutic milieu in psychiatric settings is recognized, empirical studies on milieu implementation are scarce. Therefore, research is needed to explore the effectiveness of milieu therapy in inpatient psychiatric care, which facilitates patient recovery, safety, and good interpersonal relationships.

This systematic review protocol is developed with the objective to identify the strategies, facilitators, and barriers to interaction between researchers and policy makers to use research evidence in health policy making. It seems that review of interactive methods between researchers and policy makers can help to understand the role of researchers on evidence‑informed policy making. Moreover, identifying barriers and facilitators of these interactions can help universities and institutions associated to health policy making in planning to improve the interaction between researchers and policy makers to facilitate evidence‑informed policy making.

Severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) causes COVID‑19. On March 11, 2020, the WHO declared it a pandemic. SARS‑CoV‑2 indicates that it poses a significant threat to public health and global economy. The aim of the study was to determine (a) patient characteristics, (b) demographic characteristics, (c) comorbidities, diagnostic methods used, treatment, and outcomes, and (d) mortality rates of patients.

This retrospective cohort study included 352 hospitalized adult patients from Baskent University Hospital in Ankara who were confirmed cases of COVID‑19 between March 2020 and March 2021. SPSS v. 14.0 was used for statistical analysis.

Out of 352 patients, 55 died (males: 37, females: 18), while 297 survived (males: 162, females: 135). The most common comorbidities were hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), cancer, Vitamin D deficiency, and chronic obstructive pulmonary disease. Comorbidities associated with mortality rate were obesity (33%) (P = 0.118), Vitamin D deficiency (28%) (P = 0.009), DM (25%) (P = 0.004), CAD (21.2%) (P = 0.142), cancer (20.9%) (P = 0.084), and HT (16.6%) (P = 0.90). Normal ward admission resulted in death in 67.3% and survival in 93.9% (P = 0.001), intensive care unit (ICU) admission resulted in death in 69.1% and survival in 18.5% (P = 0.001), and oxygen therapy was used in 80% death and survival in 39.4% (P = 0.001).

Our study shows that male gender, advanced age, and presence of comorbidities in COVID 19 patients are at higher risk for severe disease, ICU admission, and death. We emphasize that morbidity and mortality can be reduced by early and comprehensive identification of risk factors and the warning systems that will meet the ICU needs of these patients.

Human papillomavirus (HPV) is the most common sexually transmitted infection and causes more than 90% of cervical cancers. The highest rate of infection occurs between the ages of 18 and 28. This study aimed to determine the effect of education based on the theory of planned behavior (TPB) on the intention of vaccination against HPV in female students.

This controlled educational trial study was performed on 72 female students aged 18–26 years of Mashhad University of Medical Sciences by random assignment to intervention and control groups. For random assignment in the intervention and control groups, random blocking with four blocks was performed using a random number table with a ratio of 1:1. Data collection tools included demographic questionnaire, awareness about HPV vaccination, and TPB theory constructs. The control group was received the university routine training. The intervention group was received the virtual group training in four sessions, 60–90 min at weekly intervals and with educational content including TPB constructs on HPV vaccination with the method of lecture training, group discussion, questions and answers, and presentation of training package. Questionnaires were completed before, instantly, and 1 month after the educational intervention. Data were analyzed using the Chi‑square test, Fisher’s exact, t‑test, Mann–Whitney test, and Friedman test.

The mean age of students was 18.9 ± 1.1 years. The intervention and control groups were homogeneous in terms of demographic characteristics (P > 0.05). Before the intervention, the mean score of model constructs did not show a statistically significant difference between the two groups (P > 0.05), but after the intervention, in the intervention group, mean scores of attitude, subjective norms, perceived behavioral control, and behavioral intention in the intervention group was significantly higher than the control group (P < 0.001). In the intervention group, the difference in the mean score of HPV vaccination intention instantly (P < 0.001) and 1 month (P < 0.001) after the intervention significantly increased.

TPB‑based education was effective in increasing attitudes, subjective norms, and perceived behavioral control and the intention to vaccinate against HPV in the female students of Mashhad University of Medical Sciences. Therefore, it is suggested that the present educational intervention be widely used to educate female students.

The Iran Package for Essential Noncommunicable Disease (Ira‑PEN) program has been established since 2018 with the aim of controlling and caring of noncommunicable diseases (NCDs) as well as their underlying causes in Iran. In this study protocol, a healthy lifestyle module will be used for the first time in Iran, which was recommended in 2018 by the World Health Organization to train health workers. This module relies on the 5As model, a training intervention design, then, implement, evaluate, and present the results to the managers and decision makers of the Ira‑PEN program.

This study will be performed in 2 stages, including 2 steps per stage. The first stage involves designing the 2 steps and validation of the healthy lifestyle counseling skills tool. The tool will encompass a health counseling evaluation checklist and a counseling assessment questionnaire according to the counseling recipients. The second stage also entails 2 steps; designing a training program for health workers in the field of healthy lifestyle counseling based on the Oles‑Cement model followed by implementation and evaluation.

The training program and the results obtained in this study will be presented to the managers and decision makers of both the Ira‑PEN program and NCDs control in Iran, and it is suggested to enhance the training program, network, and educational curriculum of health workers in providing healthy lifestyle counseling to play a more effective role in changing the public behavior toward a healthy lifestyle and preventing the risk factors of NCDs.

COVID‑19 pandemic pushed all educational institutions to rely exclusively on technology‑based learning. As this was done for the first time, it is ideal to evaluate the e‑learning program to refine and consolidate the learned experience. Hence, the current study was undertaken to evaluate the online learning and teaching experiences of students and teachers.

This program evaluation on e‑learning was carried out in the department of Community Medicine (DCM) in a private medical college using context/input/process/ product framework among IV, VI, and VII semester undergraduate students and faculties in DCM who were exposed to e‑learning for the period of 2 months since April 2020. Google Forms was used to design a survey questionnaire that was conceptualized as per the needs of the evaluation framework. Ethics Committee approval was obtained. Descriptive analysis was done for quantitative variables and manual content analysis using Lewin’s force field framework was performed for the qualitative data.

Out of 301 undergraduates contacted, 196 (65.1%) responded to online survey. Their mean age was 19.9 years and 128 (65.3%) were females. Mobile phone was used by 93.4% to access e‑learning. Combined modality of learning was preferred by 58.2% of them in future. Six “for” and “against” factors on e‑learning emerged out of content analysis pertaining to three main stakeholders, namely administrator, faculty, and student.

Our evaluation conveys that for effective e‑learning in any subject, the students, educators, and institutional factors that were identified need to be considered throughout all phases of program development with careful assumptions about its acceptance by the millennial.

Preconception reduces unplanned pregnancies and plays an important role in reducing maternal and infant mortality. Considering the importance of these care services, this study was conducted to determine the status of preconception care (PCC) model with Structural Equation Modeling (SEM).

This cross-sectional descriptive study was conducted on 394 pregnant women referring to Gorgan’s health centers. Samples were selected by multi‑stage stratified sampling method. The instrument used in this research was a researcher-made questionnaire by Bayrami. Data were analyzed using R software version 4.1.4. Structural equation modeling (SEM) with weighted least square mean and variance method was used to fit the conceptual model and the significance level of the tests was considered 0.05.

The results showed that PCC model was deemed appropriate as optimum conditions indicators of goodness of fit; knowledge with a coefficient of 0.182 leads to self‑efficacy (SE), and SE affects the accessibility of facilities with a coefficient of 0.465 and the expected outcome with a coefficient of 0.500. After facility structure with a coefficient of 0.500, SE construct with a coefficient of 0.215 had the most effect on performing PCC behavior.

Facilities and SE as a key element of empowerment have an important role in promoting PCC. Identifying the factors associated with this care appears to help health policymakers to planning for these caregivers more precise and sensitive.

Pregnant women experience falls, particularly in the third trimester. In this population, physiological changes, as well as ligament laxity, might influence joint proprioception and do not return to normal during the postpartum period. The prevalence of falls during pregnancy and postpartum periods imposes a need to study proprioception in pregnant women and the postpartum period.

An observational longitudinal study was conducted in June 2018 in outpatient clinic Chinchwad Pune. A total of 36 primiparous women were included in the study by using purposive sampling. The mean and standard deviation of the age was 25.92 (2.59). Proprioception was assessed for the knee joint and the ankle joint during the third trimester of pregnancy and 6th and 12th week postpartum. Outcomes included were the Joint Reposition Test for both knee and ankle joints using UTHSCSA Image Tool Software 3.0. Repeated‑measure ANOVA was performed for the normally distributed data, and nonparametric test Friedman’s test was performed for data that were not distributed normally. The data was statistically analyzed using the SPSS software version 26. The level of significance was set at 0.05, confidence intervals of 95% were used.

The result revealed significant (P < 0.05) improvement in both knee and ankle proprioception during the third trimester of pregnancy and postpartum period 6th and 12th week.

Knee proprioception and ankle proprioception were found to improve significantly during the postpartum period 6th and 12th weeks compared to the third trimester of pregnancy but do not return to the prepregnancy state.

Visual impairment (VI) is one of the major public health problems that cause suffering, disability, loss of productivity, and reduced quality of life (QoL). This study aimed to evaluate the health‑related QoL (HRQoL) among adults with visual problems in 2021.

This analytical cross‑sectional study was conducted on 300 patients with VIs referring to ophthalmology centers in Yazd, Iran. Data were collected through face‑to‑face interviews using EQ‑5D, visual analog scale (VAS), and demographic information questionnaires. The results were analyzed using independent sample t‑test, one-way analysis of variance, Pearson correlation coefficient, and adjusted limited dependent variable mixture model (ALDVMM) model by STATA, and SPSS.

The mean and standard deviation of EQ‑5D‑5 L index and EQ‑VAS score in the studied patients were 0.68 ± 0.25 and 72.46 ± 19.36, respectively. Most problems at unable/extreme level were related to the mobility dimension (12%) and the usual activities dimension (9%). Factors related to HRQoL scores using ALDVMM model showed that divorced or widow marital status, age over 50, having strabismus, and acuter visual problems had significant negative effects on EQ‑5D‑5 L index values (P < 0.05).

The results showed that HRQoL was moderate in patients with VIs and reduced in patients with high disease severity, old age, lack of a spouse, retirement, and nonuniversity education. As a result, socioeconomic and demographic characteristics were required to be considered in visual health policies.

Mothers play an important role in oral health of children. The present study was planned, implemented, and evaluated to determine the impact of mothers’ educational program based on PRECEDE–PROCEED model on oral health promotion of Rafsanjan 3–6‑year‑old children, in 2020.

This quasi‑experimental study was conducted on 100 mothers with children aged 3–6 years divided into two groups. The research tool was developed and approved based on the model phases in the form of demographic information, predisposing, enabling, and reinforcing factors. At phase five, intervention planning was conducted and the program was implemented in four sessions (45 min each) in 30 days. Follow‑up was done 2 months after the last training session. The data were analyzed by SPSS18, using Chi‑square, paired t‑test, and independent t‑test at the significance level of 0.05.

After implementing the program, a significant difference was observed between predisposing, enabling, and reinforcing factors, as well as oral health‑related behaviors of the two groups (P < 0.05). Finally, 30.4% of the changes in oral health‑related behavior resulted from the implementation of the designed educational program.

Considering the importance of planning to promote children’s oral health and hygiene, it is recommended that the PRECEDE–PROCEED model be used to design, implement, and evaluate health evidence‑based interventions.

Vaccination has been appraised to be one of the most significant public health achievements in human history. However, in countries like Nigeria, vaccine hesitancy is a public health challenge that has consistently forestalled concerted efforts made by health authorities to curb the spread of communicable diseases such as COVID‑19. To improve COVID‑19 vaccine acceptance via targeted interventions, it is imperative to examine the public’s perception. Thus, this study aims to evaluate vaccine hesitancy among university students in Southwestern Nigeria.

The study utilized a descriptive cross‑sectional design. A self‑administered questionnaire was administered to a total of 366 respondents who were recruited using the convenience sampling technique and snowball approach. Data were entered and analyzed using SPSS.

The majority of the respondents were over 18 years (88%) and were between their first and third years (81%). Over a tenth of the respondents reported having at least a loved one that had tested positive for the virus, while only 88% believed the virus is real. Furthermore, only 17% of the students had a positive attitude toward the vaccine. Although 90% of the respondents were aware of the administration of COVID‑19 vaccine in Nigeria, only around a quarter were willing to take the vaccine, while 5.5% had been vaccinated. The major reasons for COVID‑19 vaccine hesitancy highlighted by the respondents were concerns about vaccine side effects (21.3%), lack of trust in the authorities (26.5%), vaccine efficacy (13.1%), and diverse mystical possibilities (39.1%).

The results indicate that a significant communication gap exists between the respondents and local health authorities. To enhance the acceptance of COVID‑19 vaccines, extensive and targeted health promotion campaigns are required to allay specific concerns raised by the public.

Cardiovascular diseases (CVDs) are among the most important causes of premature death, disability, disease burden, and increasing the cost of healthcare worldwide. Having an overview of service utilization can help policymakers to plan more effective use of those services and to cut costs. Thus, this study aims to determine the amount of use as well as the cost of various outpatient diagnostic procedures for CVDs in Isfahan province of Iran from 2011 to 2017.

This descriptive study used insurance claim data (time period: 2011–2017) from Health Insurance Organization in Isfahan province to determine the amount of use and the cost of various outpatient diagnostic procedures for CVDs. Afterward, based on these data, the use and the cost of various outpatient diagnostic procedures for CVDs were estimated for the total population of Isfahan province. The list of outpatient diagnostic procedures for CVDs was carefully chosen according to experts’ opinions.

The use and the cost of outpatient diagnostic procedures for CVDs have drastically increased in the study period (2011–2017). Since 2011, the number of procedures and their related costs have increased 6.6 and 30.76 times (11.74 times, adjusted with PPP conversion factor), respectively. Per capita use (per thousand people) was 18.75 in 2011, reaching 116.51 in 2017. Per capita cost (per thousand people) was 1,887,660 IRR (355 PPP$) in 2011, reaching 54,660,365 IRR (3920 PPP$) in 2017. The highest cost and use were related to echocardiography and electrocardiography, respectively. A notable increase has been observed in the share of radionuclide myocardial perfusion scan and analysis of pacemakers and ICDs of the total cost.

The use of outpatient diagnostic procedures for CVDs has drastically increased during the studied period. Consequently, the cost borne by the health system and the patients have notably increased. This may be because of the increase in the incidence and prevalence of CVDs during the study period. Greater access to related health services can be mentioned as another reason for this increase. Further research is needed to explain all potential reasons and their importance, which can provoke a suitable health policy reaction.

Financial literacy is a person’s capability to manage their own monetary matters. There was no information available on financial literacy status of healthcare professionals (HCPs) of India. So, the current research was formulated to assess the financial literacy status and its correlates among HCPs of India.

It was an observational study, cross‑sectionally designed, conducted among 524 HCPs of India using a structured Google form during July 2020. For data analysis, SPSS (version 22) was used.

Among the study participants, 68.3% were found to be financially literate. Among the various subdomains of the total financial literacy, knowledge regarding general domain was observed to be the best (69.3%) followed by savings (63.7%) and investment (58.0%) domains, respectively. The total financial literacy score was found to be positively correlated with higher age [spearman rho correlation co‑efficient (ρ) = 0.25; P =< 0.01], qualification [(medical postgraduate) (ρ = 0.16; P =< 0.01); (medical super speciality) (ρ = 0.14; P =< 0.01)], and annual family income (ρ = 0.29; P =< 0.01). Moreover, males (ρ = 0.23; P =< 0.01)], currently married (ρ = 0.19; P =< 0.01), and surgeons (ρ = 0.12; P =< 0.01) were found to be more financially literate compared with others. Positive financial attitude (ρ = 0.26; P =< 0.01) and regular maintenance of financial record (ρ = 0.21; P =< 0.01) were the other enabling factors of financial literacy observed in the study.

Financial literacy was found to be quite low in the surveyed HCPs as every third study participant were found to be deficient in knowledge regarding one or more financial attributes. Incorporation of finance management in curriculum of the healthcare allied courses and repeated sensitization of the graduated HCPs are warranted to enable them to take effective financial decisions to meet their personal and organizational financial goals.

Online teaching has been practiced after lockdown due to Coronavirus Disease 2019 (COVID‑19) pandemic which has replaced conventional classroom teaching. The aim of the present study was to know the perceptions regarding online learning as perceived by both teachers and students during COVID‑19 pandemic.

The present study was cross‑sectional and questionnaire‑based. Web‑based respondent‑driven sampling technique was used to recruit participants for the present study. Three hundred and thirty‑two students and 130 teachers of varying ages and gender participated in the study. The link of web‑based questionnaire was sent to respondents through WhatsApp/ Facebook. Responses from all the participants were tabulated and analyzed using univariate analysis (Chi‑square test).

Prerecorded lectures (38.9%) and Webinar apps (35/8%) were the most common modules of online teaching by students. One‑third (34.3%) had the convenience to attend lectures from home whereas 44.3% had difficulty in concentration. Commonly cited disadvantage by students was inability to do practical work (37.9%). Regarding teaching faculty, 43.8% had no prior knowledge of online teaching. Sixty percent of teachers had 4 h/week of online teaching. No face‑to‑face interaction (67.7%) and internet issues (26.9%) were commonly stated barriers by faculty.

The pandemic has pushed the teachers and students toward newer teaching avenues. However, more needs to be done to supplement the existent teaching pattern and preparedness of teaching faculty by incorporating online assignments and assessment methods, strengthening digital infrastructure in medical schools, and training support for teachers.