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Background: Today, methods that enable students to benefit from online programs to the fullest and learn independently and self-directed are of critical importance. Many scales have been developed to measure self-directed learning in the physical classroom. This study was conducted to design and assess the psychometric properties of an instrument to assess learning process in a virtual environment. Materials and methods: A questionnaire for assessing s learning process in a virtual environment was developed following six steps. The process began with a systematic search for related articles. A qualitative study was then conducted to identify self-directed learning strategies and processes in virtual environments. The identified strategies were then compared with those from a literature review, and the scale items were developed accordingly. Expert validation, exploratory factor analysis, and reliability analysis were conducted to ensure questionnaire validity and reliability. This study included online postgraduate students from Iranian medical science universities in 2019. Results: The scale consisted of 5 factors and 44 items. In exploratory factor analysis, five subscales explained 90% of the total variance. Cronbach's alpha was 0.91 for the total scale. The interclass correlation coefficient between the test and retest was 0.77. Conclusion: A questionnaire designed to assess learning process in a virtual environment for postgraduate virtual students has reasonable psychometric properties, including reasonable internal reliability and construct validity.

The increasing growth of technology affects all aspects of life, including the system of education, and requires the implementation of a new education system. Since Electronic-learning (E-L) is a new and mutated form of education in Iran, its professional functions approach is different from that of traditional education. The present article aims to explain the concept and dimensions of professional functions in this field. Through a qualitative study, method and data source triangulation were used. To do so, the data sources were the professors, scholars, students, and graduates of this educational system in the field of medical sciences. To triangulate the methods, in-depth semi-structured interviews as well as focus groups, note-taking and reminders were used. The purposeful sampling consisted of 10 professors and scholars. Fifteen students and graduates participated in the four-session focus group discussions purposeful, and the sample consisted of 10 professors and scholars as well as seven students and graduates, and a total of 15 students and graduates were willing to participate in the focus group discussions. Inductive content analysis was used for the analysis of data. Three themes arose from the study as follows: E-learning prerequisites, E-Leaning enabling factors, and E-Learning obstacles. Each of the themes is explained along with the relevant categories and subcategories. Discovering the dimensions and elements affecting professional functions in the E-L system of medical sciences, this study provided documented meanings and dimensions of this phenomenon beyond the conventional sense. These dimensions can have direct or indirect impacts on professional functions in this field.

Low health literacy is one of the social health determinants associated with cancer-related disparities. The aim of this study is to explore the relationships between health literacy and theory of planned behavior in performance of cancer screening tests by person undercover of rural health centers in Fasa, Fars Province, Iran in 2018. In this cross-sectional study, 850 persons older than 18 years of age were selected with cluster sampling. Data were collected by a questionnaire consisting of four sections evaluating demographic information, cancer screening behaviors, subjects' health literacy and constructs of theory of planned behavior. The frequency of acceptable health literacy was respectively in Comprehension (39.41%), Reading (37.41%), Decision making (36.70%), Availability (36.23%) and Evaluation (35.76%). 37.65% of subjects (n = 320) had an acceptable health literacy level (n = 320), 46% (n = 391) had medium level and 16.35% (n = 139) had weak level. Results indicated that, there is significant relationship between health literacy and undergoing breast self-examination, Pap smear test, prostate specific antigen test (PSA) and Fecal occult blood test (FOBT). Also, theory of planned behavior predicted 41% variance in breast cancer screening behavior, 39% in cervical cancer screening, 40% PSA, 37% in mammography and 42% in FOBT. In each four cases, the role of behavioral intention was considerable. This study confirmed the correlation between cancer screening behaviors, health literacy and constructs of theory of planned behavior. Therefore, for promoting cancer screening behaviors and health literacy, theory of planned behavior can be used as a principle in health education and promotion programs., Author(s): Ali Khani Jeihooni [sup.1] , Ali Asghar Khaleghi [sup.2] , Bárbara Piñeiro [sup.3] , Pooyan Afzali Harsini [sup.4] , Tayebeh Rakhshani [sup.5] Author Affiliations: (1) grid.412571.4, 0000 0000 8819 [...]

Background: Musculoskeletal disorders (MSDs) are common among nursing professionals and require effective management strategies. Implementing targeted training programs for nurses is a vital approach to reduce these problems. Aim: This study aimed to evaluate problem‐based learning (PBL) effectiveness in reducing work‐related musculoskeletal symptoms (WMSs) among nurses. Methods: Fifty Iranian nurses participated in this interventional study. Some data were collected by a demographic/occupational questionnaire and a Persian version of the Nordic Musculoskeletal Questionnaire (P‐NMQ). Some other was gathered by Rapid Entire Body Assessment (REBA) and PBL method. Results: The prevalence of WMSs during the last 12 months in the subjects was related to the lower back (76%), wrists/hands (70%), neck (64%), and knee (64%), respectively. The results showed that the prevalence of WMSs decreased significantly only in the subjects' elbow region in the postintervention (p = 0.031). Although the prevalence decreased in the postintervention stage in other regions, this decrease was not statistically significant (p > 0.05). Conclusions: This study showed that the implementation of PBL could reduce the WMSs prevalence and the level of nurses' exposure to risk factors for MSDs. [ABSTRACT FROM AUTHOR]

Background: Marital satisfaction is one of the important components of quality of life. Women's marital satisfaction is affected when they enter the middle age period, due to the mental and emotional tensions caused by the physical changes. In this regard, the present study aimed to investigate the association of quality of life with marital satisfaction, stress, and anxiety in middle-aged women referring to health centers of Ahvaz city, Iran. Methods: This cross-sectional descriptive-analytical study was conducted on 1,000 middle-aged married women (30-59 year of age) under the auspices of health centers of Ahvaz city, Iran in 2019. The subjects were selected by simple random sampling method, and were asked to complete demographic characteristics, quality of life questionnaire, Enrich marital satisfaction questionnaire, Holmes-Raheh stress questionnaire, and Spielberger state-trait anxiety inventory. The data were analyzed by using SPSS 0.22 software through mean, standard deviation, frequency, Pearson correlation and regression (p = 0.05). Results: Based on the results, 42.4% of the participants were between 40 and 50 years of age, 35.6% had a high school diploma, and 50% of them were housewives. Also, the results of Pearson's correlation showed a positive and significant relationship between quality of life and marital satisfaction (r = 0.178) (p < 0.001). However, quality of life had a negative and significant relationship with anxiety (r = -0.552) (r < 0.001) and stress (r = -0.188) (p < 0.001). Conclusion: Given the positive and significant relationship between quality of life and marital satisfaction, appropriate trainings are highly recommended for couples to increase the quality of life and marital satisfaction of middle-aged women and thus strengthen the health of family and society. [ABSTRACT FROM AUTHOR]

Background: One of the most crucial and essential methods for the prevention and management of respiratory infections is for healthcare professionals to take precautions for their own safety. Using Protection Motivation Theory (PMT), the current study looked into effective elements influencing the staff at Kazeroon's Valiasr Hospital's preventive actions against respiratory diseases. Methods: One hundred ninety‐two male and 108 female employees of the Valiasr Hospital in Kazeroon, Iran, participated in this cross‐sectional study, in May 2022. Census data were used as the sample technique. A questionnaire based on the PMT and a questionnaire collecting demographic data served as the data collection method. The study's content validity was confirmed by 10 health education experts, and its reliability was assessed using internal consistency techniques, resulting in a Cronbach's alpha coefficient of 0.87.The statistical program SPSS 24 was used to examine the data using the independent t test, logistic regression, and Pearson correlation. Results: The average age was 34.11 ± 8.91 for men and 32.77 ± 6.09 for women. The majority of participants were married (73.3%), had university education (76.7%), and earned a monthly income between 10 and 15 million Tomans (75%). Notably, 97.7% of participants had received the COVID‐19 vaccine, and 77.7% had undergone training related to respiratory infections. The most common preventive practices included avoiding touching the eyes, noses, or mouths, wearing appropriate protective gear, and maintaining a safe distance of 1–2 m from others. Analysis of PMT constructs showed that participants had a generally positive perception toward preventive behaviors. Perceived vulnerability (P = 0.02), perceived cost (P = 0.03), and motivation (P = 0.001) were the three analyzed components that had the greatest impact on respiratory infection preventative behavior. Logistic regression revealed that perceived susceptibility, cost, and motivation significantly predicted the prevention of respiratory infections, with a predictive power of 45%. These findings highlight the importance of understanding the factors influencing preventive behaviors among hospital staff, from respiratory infections like COVID‐19. Conclusion: According to the findings, the personnel at Kazeroon's Valiasr Hospital wore gloves, goggles, and other appropriate personal protective equipment. The individuals' decision to wear personal protection equipment was also impacted by perceived susceptibility, cost, and motivation. [ABSTRACT FROM AUTHOR]

Background. Emergency physicians are at the forefront of the medical system in the face of the COVID-19 crisis. Identifying the challenges, along with the strategies and effective measures implemented by them in the face of the COVID-19 crisis, can be a roadmap for future crisis management planning. This study aims to explain the challenges faced by emergency physicians regarding COVID-19. Methods. This study is a qualitative content analysis. Data were collected using individual and semistructured interviews. Twenty-seven emergency medical specialists in Fars University of Medical Sciences, Iran, participated in the study by purposive sampling method and were interviewed using semistructured interviews. Results. Participants' experience of COVID-19 led to the extraction of four main themes, including structural factors, threats to the health of the medical team, fluctuations of extremism and wastage in the face of COVID-19, and the country's policymaking hierarchy. Conclusions. Emergency physicians face challenges such as structural factors, health threats, extreme fluctuations, and national policymaking. To avoid surprises and threats, they must predict acute scenarios, provide necessary equipment, address skilled manpower shortages, and adopt appropriate management policies. This includes culture-building, cross-sector coordination, planning, and efficient management to prevent virus spread. [ABSTRACT FROM AUTHOR]

Background: Topic of e-learning and virtual university in recent years is one of the important applications of information and communication technology in the world and most famous universities in the field of education development have done important steps. For as much as the importance of learning and development in every community, and to keep pace with global developments in the field of learning and teaching, becoming familiar with this area and its implementation are necessary. Purpose: The present research is an attempt to describe the quantity and quality of publication trends of E-learning based on Scopus reports. The population under study published through 2013. Methods: The population under study was composed of 23805 documents on E-learning published through 2013. The results were analyzed based on date of publication, type of document, language of the documents, source of publications, subject areas, authors and their affiliations, and the countries involved in developing the articles. Citation indicators formed the second phase of investigation in the present study. Results: With a negligible amount of fluctuation, the number of publications on E-learning has increased steadily over the years, with the greatest number occurring in 2012. In Iran, the first article to be found on Electronic Learning belongs to the year 2002 and the greatest number occurring in 2012 (47 documents, 24.6%). The analysis of data based on document types indicated that, of the 23805 documents, 11336 were conference papers (48%), 9548 were articles (40%). Also in Iran, of the 191 documents under study, 92 were conference papers and articles (48.16%). 23077 documents (97%) were published in English and the rest presented in other languages. The United States with 6238 documents (38%) was the most represented country, with the most prolific authors known as Shih. Thematically, the greatest number of documents was produced in computer Sciences with 11659 documents (35%). The largest number of documents has been published in Lecture Notes in Computer science followed by Computers and Education. The most cited articles from 1996 up to 2013 included 20 documents on the H-index zone. According to the results, from early 1996 to 2013 (when the data was retrieved), the 23411 documents had received a total of 69939 citations and production of Iran, the 191 documents had received a total of 241 citations, which means an average of 1.2 citations per document. Conclusion: The steady growth in publishing Electronic Learning in this period has apparently coincided with the development of Electronic Learning. But In Iran, we have witnessed a slow growth in production in this area as well.

Metabolic syndrome is a cluster of risk factors associated with cardiovascular disease and diabetes. Lifestyle modification and management of health-promoting behaviors (HPB) are the most important measures to control metabolic syndrome. This study aimed to investigate the effect of the WhatsApp-based self-care educational program on HPB in individuals with metabolic syndrome. The present study was a quasi-experimental performed on individuals with metabolic syndrome referred to comprehensive urban health centers in Iran. The samples consisted of 100 individuals with metabolic syndrome randomly assigned to either the experimental (n=50) or control (n=50) group. Data collection instruments included a demographic questionnaire and the Health Promoting Lifestyle Profile-II (HPLP-II) to determine health-promoting status behaviors. The control and experimental groups were similar in terms of the total mean scores of HPB before the intervention. However, after performing it, the total mean scores of the HPB scale and its subscales were statistically significant in the intervention and control groups. In the intervention group, it was significantly higher than the control group (p<0.0001). The results of the present study showed the positive effect of educational intervention using WhatsApp messenger on the HPB of individuals with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Marital satisfaction is important for health and well-being among aged couples. The aim of this study is to explore the relationship between knowledge, sexual attitude, and quality of life with marital satisfaction of aged couples of over 60 years in southern Iran. This APIM analytical study was performed on 510 aged couples in southern Iran in 2020. Proportionate stratified sampling was randomly performed in three stages relative to the aging population in main cities in the south Iran. Data collection tools included demographic information (age, education, occupation, living alone, type of disability, etc.), sexual knowledge and attitude scale (SKAS-10), quality of life scale (SF-12), and marital satisfaction questionnaire. Mean score of marital satisfaction, sexual attitude, sexual knowledge, and QoL (SF-12) was 49.71 (SD = 14.8), 27.5 (SD = 7.3), 24.7 (SD = 8.5), and 31.49 (SD = 3.2), respectively. The present study showed that sexual knowledge and attitude, quality of life, are among the estimators of marital satisfaction in aged couples. [ABSTRACT FROM AUTHOR]

Background: In all countries, the knowledge of driving guidelines is the most important and critical mechanism to ensure the safety of drivers. Naturally, it is expected that more knowledge and attitude towards driving laws would result in fewer driving violations. The aim of this research is to investigate both the knowledge and attitude of taxi drivers in the field of traffic rules and regulations in Shiraz city, Fars province, in 2019.Methods: This research is a cross-sectional study, based on which about 1077 taxi drivers were randomly chosen in Shiraz city, Iran. The data collection tool is a demographic information questionnaire and a questionnaire on driving guidance. After collecting these questionnaires, the obtained data were entered into SPSS version 20 and then analyzed by descriptive analyses (mean, standard deviation, and percentage). Afterward, the independent t-test, one-way ANOVA, and Pearson correlation coefficient are implemented and investigated.Results: The mean and standard deviation of knowledge score in drivers were about 26.8 ± 55.2 while the mean and standard deviation of drivers' attitude were about 98.16 ± 59.3. The results showed that there was a significant relationship between the variables studied (R = -0.07; P=0.02) and drivers' attitudes toward driving (P=0.01).Conclusion: The results of this research show that the mean scores of knowledge and attitude of taxi drivers in Shiraz city are moderate in terms of driving rules and regulations; moreover, among taxi drivers of increasing age, the average score of knowledge was lower. [ABSTRACT FROM AUTHOR]

Objective: Diabetes is closely related to oral and dental health. Several oral diseases and disorders are associated with diabetes. The present study was conducted to compare the effectiveness of face-to-face and non-face-to-face training of oral and dental health behaviors based on the Health Belief Model (HBM) in patients with type 2 diabetes. Materials and methods: This study was conducted among patients with type 2 diabetes referring to comprehensive health centers in Andimeshk in 2021. One hundred twenty patients with type 2 diabetes were randomly divided into two groups: a face-to- -face (60 patients) training group and a non-face-to-face (60 patients) training group. For the face-to-face training group, training programs were conducted through lectures with questions and answers, group discussions, and videos in three 60-minute sessions; and for the other group through the presentation of patient education pamphlets. The results were collected in two stages before and two months after the intervention using a questionnaire. Then the data were analyzed using a chi-squared test, t-test, and paired t-tests in SPSS Statistics 22.0. Results: A total of 120 patients participated in this study. The patients' mean age was 51.5 ± 8.57 and 51.9 ± 10.1 years in the control and the intervention group, respectively. In both groups, 60% of the participants were female and 95% were married. The duration of diabetes in 57.5% of them was 5-10 years. After the implementation of the intervention, a significant increase was observed in the mean scores of all HBM constructs in the face-to-face training group (p < 0.001). However, there was no significant change in the mean scores of the HBM constructs in the non-face-to-face training group after the intervention (p > 0.05). Conclusions: This study showed that the design and implementation of an in-person training program had a positive effect on improving oral and dental health behaviors in patients with diabetes based on the HBM. [ABSTRACT FROM AUTHOR]

In this experimental study, 200 cancer patients (100 subject in experimental group and 100 subjects in control group) referred to Amir Oncology Hospital in Shiraz were investigated. Educational intervention for experimental group consisted of 12 educational sessions for 50 to 55 minutes. A questionnaire including demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure health promotion behaviors, patients' hope, and mental health before and 6 months after intervention. Six months after intervention, experimental group showed significant increase in knowledge, attitude, self-efficacy, enabling factors, social supports, health promotion behaviors, patients' hope, and mental health compared to the control group. This study showed the effectiveness of intervention based on PRECEDE constructs in mentioned factors 6 months after intervention. Hence, this model can act as a framework for designing and implementing educational intervention for health promotion behaviors of cancer patients. [ABSTRACT FROM AUTHOR]

Background Cutaneous leishmaniasis (CL) is a tropical infection with a relatively high incidence rate in Iran. The present study aimed to explore the time trend and associated factors of CL in Dezful, in southwest Iran. Methods This case series study was conducted on all CL patients registered from 2014 to 2019. The descriptive analysis of the data was done using SPSS 20 software and the time series model on the number of cases was run through Interactive Time Series Modeling software. Results A total of 5349 leishmaniasis cases were identified in the study area during 2014–2019. The highest incidence rate was 35 840 per 100 000 in 2014. The fitted time series model revealed a decreasing trend with an annual periodic pattern. The mean age of infection was 19.82 y (standard deviation 21.87). The infection was most frequent in the 1–10 y age group (41.7%). Also, females were more prone to leishmaniasis (54.7%). Most lesions were located on the hand (23.1%), face (19.7%), and forearm (17.75%) and 48.5% of patients had only one lesion. Conclusions The results revealed a decreasing trend of leishmaniasis in Dezful. It has been predicted that this infection will reach a minimum rate (300 per 100 000) in the winter of 2021. [ABSTRACT FROM AUTHOR]

Background. Early identification of breast cancer may result in earlier treatment and a lower mortality rate. This fact has resulted in the development of screening programs to detect breast cancer in its early stages; thus, the current study sought to investigate the influence of educational intervention on knowledge, attitude, and practice about breast cancer screening in Izeh, Khozestan Province, Iran. Materials and Methods. This experiment was carried out on the women of Izeh city in 2019. This study included 120 women who were randomized into the experimental and control groups at random (60 in the experimental and 60 in the control groups). Before and two months after the intervention, data were collected using a researcher-created questionnaire by the control and education groups. The intervention program for the intervention group included eight educational sessions over the course of two months. The SPSS 20 statistical program was used to examine the data, as well as the paired t -test, independent t -test, and Chi-square. Results. There was no significant difference between the experimental and control groups' mean scores of knowledge, attitude, and practice prior to the educational intervention, but a significant difference was observed after the intervention, with the experimental group obtaining significantly higher mean scores of knowledge, attitude, and practice (P = 0.05).Conclusion. In the present study, the educational intervention on the knowledge, attitude, and practice towards breast cancer screening led to the increased scores of the experimental group compared to control group. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQoL) is one of the most important indicators in assessing the health and well-being of HIV-positive patients. The present study investigated the HRQoL of HIV patients referred to Abadan's Voluntary Counseling and Testing (VCT) center in 2019. In this cross-sectional study, a total of 134 HIV+ patients referred to Abadan's VCT center were selected through convenience sampling. Demographic information was collected through a researcher-made checklist; the patients' status and health information were collected through electronic medical records of HIV+ patients and their records at the VCT center. The HRQoL index was assessed using the World Health Organization (WHOQOL-BREF) questionnaire. Data analysis was carried out using simple and multiple linear regression as well as a t -test in SPSS software. A P value < 0.05 was considered as the significance level in all tests. The mean of the HRQoL in all the participating patients was 56.42 ± 22.66. The highest and lowest mean scores of HRQoL domains were related to social relationships (57.53 ± 24.73) and environmental health (53.68 ± 19.07). There was a positive significant relationship between the marital status, residency, years of education, duration of infection, transmission route, and antiretroviral (ARV) therapy with the score of the HRQoL. The results showed a moderate score for the mean HRQoL and its domains. The present study revealed the necessity of improving HIV+ patients' living conditions, employment status, health education, and mental health care. [ABSTRACT FROM AUTHOR]

There has been a growing interest in assessing the condition and quality of life in older adult population, and factors contributing to it. In this context, fear of falling syndrome is introduced as one of the main factors that can affect the quality of life in the general adult population. However, little is known about the relationship between fear of falling and other disorders in older adults, particularly among the Middle East population. Here we investigated the associations between fear of falling and anxiety and depression disorders. A standardized questionnaire was used to assess sociodemographic variables and physical health condition. Subsequently, fear of falling and anxiety and depression scales were assessed using the Falls Efficacy Scale International and the Hospital Anxiety Depression Scale, respectively. Our results highlighted the high risk of having anxiety and depression disorders among older adults. The findings also indicate that physical and mental health disorders play a significant role in incident fear of falling. Therefore, improving mental health might lend controlling fear of falling syndrome, which then preventing falls incident and subsequent injury in older adult population. [ABSTRACT FROM AUTHOR]

Background: Nursing is a stressful occupation, and nurses face multiple stressors daily. Emotional intelligence causes an individual to overcome environmental stresses. The aim of the present study was to determine the relationship between emotional intelligence and job stress among nurses in Shiraz. Methods: A cross-sectional study was conducted with 500 nurses, selected through multistage cluster sampling, from the hospitals in Shiraz in 2017. The data collection tools were the Siberia Schering's Emotional Intelligence Standard Questionnaire and the Hospital Job Stress Standard Questionnaire, completed through the self-report method. The data were analysed using SPSS 22 software. Results: The mean scores of emotional intelligence and job stress were 113.59 ± 14.70 (total score = 165) and 97.10 ± 14.27 (total score = 175), respectively. The correlation test showed that there was an inverse relationship between emotional intelligence and job stress (r = -0.474, P < 0.001). Also, the multiple linear regression analysis showed that self-awareness, social consciousness, and income predicted 25% of the job stress in the subjects under study (r² = 0.25). Conclusion: Regarding the relatively strong and inverse relationship between the nurses' emotional intelligence and job stress, it is suggested that emotional intelligence workshops be included in the in-service training programs of the nurses. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to examine emotional intelligence components and the impact of education in residents on emergency medicine wards. Materials and Methods: The study consists of two descriptive and interventional parts. The first part aimed to determine the IQ in emergency department residents and the second part -- the effect of education on emotional intelligence of residents. To collect the required information, Sheering Emotional Intelligence Inventory was used. SPSS version 16 was used for data analysis. Results: Among the components of emotional intelligence in 120 residents of emergency medicine, the highest mean score was that for self-awareness (mean and standard deviation at 24.8 ± 3.7), and the lowest score was for social skill (mean 16.2, SD ± 3.4). There was no significant difference between the components of emotional intelligence in the intervention group and the control group before an educational intervention (P = 0.05), but after the intervention the difference between the groups became significant (P ≤ 0.05). Discussion: The descriptive findings of this study showed that among the emotional intelligence components, self-awareness and social skills of the residents had the highest and the lowest mean scores, respectively. Conclusion: This study showed that teaching emotional intelligence to emergency medicine residents had a significant role in increasing their emotional intelligence. [ABSTRACT FROM AUTHOR]