Search

Background: The role of nutrition is undeniable in controlling hypertension; diet is among the most effective non-pharmaceutical methods. The current study aimed to determine the role of illness perception on diet adherence in patients with hypertension. Materials & Methods: This cross-sectional study examined 268 patients with hypertension. The study sample was selected by convenience sampling method. The study tool consisted of the patients’ individual, social, and clinical factors, illness perception about hypertension, and adherence to the diet. The necessary data were analyzed using multiple logistic regression models. Results: The Mean±SD score of illness perception was measured as 37.09±4.91 out of 56. Adherence to the recommended diet was relatively desirable in the majority of the examined patients (62%). Multiple logistic regression analysis data revealed no significant relationship between the scores of illness perception and dietary adherence (Adjusted OR=1.038, 95%CI: 0.974-1.105, P =0.250). The main predictor of dietary adherence was having hypertension dietary knowledge (OR=2.198, 95%CI: 1.198-4.035, P=0.011). Conclusion: Our study data revealed that increasing awareness among patients with hypertension complications can improve self-care behaviors, including adherence to standard diets. Therefore, emphasis on increasing awareness among these patients and their continued follow-up seems necessar

Introduction: The World Health Organization recognizes oral health as an integral part of public health and believes that untreated oral diseases may greatly affect the quality of life, especially in pregnant mothers who should maintain their health and their babies’ health. Objective: This study aimed to determine the effect of educational intervention based on a health belief model on oral and dental health behavior in pregnant women. Materials and Methods: In this randomized clinical trial, 110 pregnant mothers attending 15 health centers in Rasht City, Iran (a total of 33 centers) were randomly allocated to case and control groups. After the analysis of pretest data (collected using a psychometric questionnaire), an intervention was designed and executed based on the Health Belief Model (HBM). Post-test was administered three months after the intervention and the obtained data were analyzed by using the Chi-square and independent and linear regression test. Results: The majority of the mothers in the case (83.6%) and control (89.1%) groups were 18- 30 years old and most mothers in the case (45.5%) and control (58.2%) groups had high school education. The Mean±SD score of awareness, different constructs of HBM, and performance increased significantly in the case group after the intervention (P

Objective School-based reproductive health education programs (RHEP) motivate adolescent girls to maintain and improve their health, and prevent diseases. The purpose of this PAR was to design, implement and evaluate RHEP to strengthen adolescent girl's reproductive health. Methods The PAR process was selected as an RHEP strategy, and it has four main phases, including: 1) assessment to explore the reproductive health education needs (RHEN) of adolescent girls. We collected data through in-depth individual interviews with 11 adolescent girls (12-18 years) in high school, 2 focus group discussions (FGD), and 4 interviews with the key informants. 2) Intervention design involved a Delphi approach to design an intervention that would address each need using 7 expert participants with a background in primary health, health promotion and other youth-focused professions. 3) In the action plan phase, the workshops, lecture meetings, counseling, and FGD were organized by the research team. 4) The impact of the intervention was evaluated through a mixed evaluation methodology, a semi-structured interviews with stakeholders and key informant, quasi-experimental assessment and FGD. Results There were three themes we extracted from the data: (a) the need for RHP for adolescent girls, (b) sources of information about RH, and (c) the need to empower teachers to provide RHEP to their students. a) Workshops, (b Counseling, c) Lecture Meetings, d) Focus Group. The study showed that the level of knowledge about RH in more than half of the participants was poor and only in nearly half of them it was moderate. Conclusion Results suggest that Iranian adolescents do not have adequate education regarding RH, and RHEP by PAR can be effective in improving the knowledge and behavior of female students.

Background: The success of a coronary angioplasty in the treatment of myocardial infarction is affected by patients’ experiences. However, the experiences of the people with an emergency angioplasty have remained unknown. Objective: This study was conducted to explore the patients’ experiences of an emergency angioplasty. Method: This study was performed using the qualitative research method and interpretive phenomenological approach. Nine patients under emergency angioplasty were selected using purposeful sampling. A total of 11 deep and semistructured interviews were performed with the patients. The data were analyzed using van Manen method. Results: Five subthemes of “diagnosis shock,” “being in an emergency situation,” “trying to self-control,” “the need for reassuring care,” and “stability” formed the structure of the patients’ experiences under the main theme of “water on fire”. Water on fire was the participants’ main perception of the emergency angioplasty. Patient-centered interactions and meeting the care, supportive, and educational needs of the patients in the case of diagnosis shock lead to a pleasant experience of returning to life. Conclusion: The findings of this study may have implications for care of patients undergoing emergency cardiovascular interventions.

Introduction: The surge in the aging population is a global phenomenon. Thus, it calls for attention to the issue of health, comfort, and welfare of the elderly in different aspects including Social Well-being (SW). Objective: In this regard, this study aims to investigate the SW status and its related areas in the elderly people living in nursing homes of Rasht City, Iran with respect to socio-demographic variables. Materials and Methods: This cross-sectional study was conducted on 185 elderly aged over 60 years living in the nursing homes in Rasht. Sampling was done by census method. Data collection tools were socio-demographic form and the Iranian social well-being questionnaire. For analyzing data, descriptive statistics and statistical tests of Mann-Whitney, Kruskal-Wallis, and logistic regression analysis were used. Results: The Mean±SD SW score of the participants was 4.64±0.91 (from 5), where the highest score was in the area of family, and the lowest in the area of friend/relative. The SW status of the majority of subjects in the area of family was “good” (56.2%); in the area of friend/relative, was “poor” (53.5%); and in the area of community, was “moderate” (63.8%). On the whole, the SW status of most subjects was moderate (56.2%). Among socio-demographic variables, the type of nursing home (OR=2.8, P

Lower Urinary Tract Symptom (LUTS) are common among female nurses. High levels of job stress in nurses may be associated with the prevalence of these symptoms. This study aimed to investigate the prevalence of LUTS and factors related to these symptoms in female nurses.A cross-sectional study in which 460 nurses and nursing assistants participated was conducted. A questionnaire consisting of socio-demographic data, International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms, and Toileting Behavior - Women's Elimination Behavior Scale was used. Data analysis was performed by descriptive and inferential statistical tests at a significant level ofThe highest and lowest scores of LUTS were related to the urgency and nocturnal enuresis with a mean (SD) score of 1.85 (1.03) and 0.05 (0.26), respectively. Concerning toileting behaviors, the highest score was for the place preference for voiding with a mean (SD) score of 4.13 (0.66), which correlated with LUTS. Among controllable variables, years of practice, urinary tract infections, use of perineal pads for urinary leakage, lifting heavy objects at work, and medical history were identified as predictors of LUTS (LUTS was highly prevalent in the female nurses. The results revealed that unhealthy toileting behaviors may contribute to the prevalence of LUTS. Early identification of these symptoms and the development of an educational intervention program to enhance the knowledge of healthy toileting behaviors may prevent the occurrence of urinary symptoms.

Backgrounds Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017). Methods This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22. Results The estimated total mean (SD) direct cost of patients who referred to the private hospital and the public hospital was $10,050 (19,480) and $3960 (6780), respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870 (15 % of total costs) and $22,350 (85 % of total costs), respectively. These differences were statistically significant (P Conclusions Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.

OBJECTIVE Training programs on sexual and reproductive health rank among the most effective strategies to empower individuals and engage in self-care in this field. This study aimed to explore the structure of a school-based sexual and reproductive health education program. METHODS A qualitative, inductive, content-analysis approach was used in this study. Participants were selected through a purposeful sampling method. Data were collected through individual in-depth interviews with 21 students; 7 key informants; and 3 focus group discussions with parents. Interviews were recorded and transcribed into text manually. Data analysis was carried out using the content analysis method and the MAXQDA11 software. RESULTS Three categories of health services emerged from the analysis of participant experiences: 1) empowerment-based education model; 2) optimal educational characteristics; and 3) adolescent-friendly sexual and reproductive health services. CONCLUSIONS The study found that sexual and reproductive health education programs for adolescent girls should be based on empowerment, desirable educational characteristics, and adolescent-friendly mechanisms.

Backgrounds Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017). Methods This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22. Results The estimated total mean (SD) direct cost of patients who referred to the private hospital and the public hospital was $10050 (19480) and $3960 (6780), respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870 (%15 of total costs) and $22350 (%85 of total costs), respectively. These differences were statistically significant (PConclusion Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.

Background: Increased life expectancy has increased the likelihood of chronic diseases. Depression, as the most common mental disorder for older adults, and fear of falling, which may lead to lower self-esteem and self-efficacy, can be barriers to proper physical activity. Objectives: The current study aimed to determine the relationship between depression and fear of falling in older adults. Methods: This descriptive-correlational study was conducted in 2018 on 90 randomly selected older adults aged 60 years and older referred to comprehensive health centers in the city of Rasht. Data were collected using a questionnaire on demographic information, a 15-item Geriatric Depression scale, and Falls Efficacy Scale-International Form. Data were analyzed through SPSS version 21 using descriptive and inferential tests (the Spearman and the Mann-Whitney U correlation coefficient). A P value of < 0.005 was considered as statistically significant. Results: Most of the participants (60%) were female. The mean age was 68.44 ± 7.60 years, the mean depression score was 7.40 ± 2.03, and the mean fear of falling was 36.97 ± 12.73. There was a significant positive correlation between depression and fear of falling (r = 0.420, P = 0.0001). Conclusions: These findings clarify the importance of proper planning by health authorities to prevent and treat mental disorders in older adults.

Backgrounds: Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017). Methods: This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22. Results: The estimated total mean ±SD direct cost of patients who referred to the private hospital and the public hospital was $10051.78±19484.61 and $3956.33±6783.02, respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870.89 (%15.69 of total costs) and $22348.5 (%84.95 of total costs), respectively. These differences were statistically significant (PConclusions: Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.

Introduction: Loneliness as a predictor of children and adolescents adjustment problems has been focused on by mental health researchers. Increasing virtual relationship instead of family and social relationship especially among adolescents has led to loneliness and other problems. Objective: The aim of this study was to determine the relationship between loneliness and associated factors of internet and cell phone usage in secondary high school students in Rasht city in 2014. Methods: This analytic cross-sectional survey was conducted on 581 students of second cycle high schools in Rasht city who were selected by cluster sampling. For collecting data a researcher made questionnaire for demographic and associated factors of internet and cell phone usage and University of California at Los Angles Loneliness Scale loneliness questionnaire were applied. Data were analyzed by descriptive and inferential statistics (Mann-Whitney U test, Kruskal-Wallis, Chi-square, Spearman correlation and multiple logistic regressions). Results: Findings indicated that 16.9% of the samples have gained more score than the mean of loneliness tools. Most students used the internet for downloading music, movies or books (68%) and participation in social networking websites such as face book (%36/1), and cell phone for texting ( 31.7%) and taking picture/ film (25.8%). There was a significant correlation between age (p=0.022), number of close friends (p=0.0001), field of study (p=0.002), father's education (p=0.003), mother`s education (p=0.006), visiting the scientific websites and doing homework (p=0.015), spending leisure time (p=0.0001) and downloading music, movies or books (p=0.029) and loneliness. Based on regression analysis, variables mother s education (having high school diploma) (OR=0.470, p=0.014). How to spend free time (OR= 2.391, P=0.0004) and the number of close friends (OR= 0.949, p=0.01) and Presence in social network such as Face book (OR=1.952, p=0.016) remained in the final model as significant predictors of loneliness. Conclusion: Because of the direct and significant correlation between loneliness and some personal and social characteristics and factors associated with internet and cell phone usage among students, it is necessary to focus more attention on the new communication technologies and to plan appropriate educational programs to prevent the adverse consequences of problematic use of them on the adolescents' mental health.

Background An important objective of health systems is financial protection against out-of-pocket health expenditure. In Iran, the Health Sector Evolution Plan (HSEP) has been implemented so as to achieve universal health coverage and decrease out-of-pocket health expenditure as a percentage of total health expenditure. Objectives This study aimed to compare the hospitalization costs of breast cancer before and after the implementation of the HSEP and its impact on patient co-payment in Iran (2017). Methods This study was a prevalence-based cost-of-illness study. A total of 151 patients (75 patients 3 years before and 76 patients 3 years after HSEP implementation) were included from a public hospital by the census method. Data were extracted from patients’ records and analyzed using SPSS software (Version 22). Results The total mean hospitalization costs increased significantly after the implementation of HSEP. Before and after the implementation of HSEP the total means (SDs) of hospitalization costs were estimated at 1489.44 (1609.33) PPP (purchasing power parity) and 4343.69 (5389.51) PPP, respectively. The percentage of patient co-payment decreased from 19.61% before the implementation of HSEP to 6.47% after its implementation, whereas the mean (SD) of patient contributions increased from 272.26 (334.50) PPP before the implementation of HSEP to 281.13 (307.22) PPP after its implementation. Conclusion The cost of breast cancer is substantial. After the implementation of HSEP, the percentage of patient co-payment decreased, but due to the increase in tariffs, hospitalization costs of breast cancer and the amount paid by a patient rose substantially. HSEP certainly requires more attention from health policy-makers.

Introduction: Health is the essential right of every human and a social goal to be considered by all states and organizations. Among this the health of nurses who are important part of country health system is under greater danger than other social groups due to a variety of reasons. Objective: This study aims to determine the level of health and its related factors in nurses employed in medical-educational hospitals in Rasht. Methods: In this cross sectional study, 374 employed nurses in 8 Medical- Educational Centers affiliated to Guilan University of Medical Sciences were selected by stratified sampling and evaluated using Bio- data questionnaire, and Goldberg General Health (GHQ) Questionnaire. Data were analyzed by using descriptive (mean, median, standard deviation) and inferential statistics (Mann-Whitney U, Chi square). Results: Findings showed that 111 (29.7%) nurses were healthy while 263 of them (70.3%) were unhealthy. The highest mean score of unhealthy nurses was related to social performance domain (11.35 ± 3.13) and the lowest mean was related to depression area (2.18 ± 2.86). The results also indicated a significant statistical relationship between the variables of general health with marital status (p=0.057), care of elderly and handicapped child (p

Multiple sclerosis (MS) is a chronic and progressive disease charachterized by disabilities which adversely affect individuals’ quality of life (QOL). In the present study, the effect size of exercise therapy on patients’ QOL in both physical and mental dimensions were investigated and the moderator effect of a number of selected theoretical and significant practical variables were assessed. Relevant studies, published before July 2015, were identified by searching PubMed, Scopus, Google scholar, and Persian medical databases including IranMedex, Irandoc, Magiran, Scientific Information Database (SID), and Medlib. Supplementary searches were also performed manually by reviewing the reference lists of the relevant articles. Next, using a randomized controlled trial (RCT) design, English and/or Persian-language articles conducted in Iran and evaluating the effect of exercise therapy on physical and/or mental aspects of QOL of MS patients were pooled. Afterwards, two competent reviewers in the field extracted the required data and rated the quality of the studies. Twenty-one journal articles were identified and reviewed, but only 13 of them contained the as much data as required to serve the purpose of the study. The mean effect size of exercise therapy on mental, physical, and overall QOL of the patients were 1.021 (95%CI 0.712–1.331, P

Background: Addiction is a primary, chronic disease of brain reward, motivation, memory and the related circuitry. Objectives: The purpose of the study was the measurement of effective components in addiction relapse, in Rasht city of Guilan province, Iran. Patients and Methods: This study was done in 2014 that has been performed by using the factor analysis method. In the qualitative stage the process owners were 45 experts, and in the factor analysis stage they were 1850 people who were under treatment at addiction treatment centers. The data collection tool was a Researcher-Made Questionnaire whose content validity was determined through expert panel, and its construct validity was determined through exploratory factor analysis by principal component analysis method with varimax rotation using SPSS16 software. Results: In exploratory component analysis, 4 main components were identified; Individual factors with 6 variables, 25.72% variance, and 17.81 eigenvalue as the most important factor, and Economic factors with 5 variables and 7.64% variance as the less important factor, clarified the Addiction Relapse changes; however, in the fitted model which is the most completely saturated model, 4 factors of Individual factors with s = 0.48, family factors with s = 0.23, occupational factors with s = 0.2, economic factors with s = 0.12 had the highest predictive power in the order of importance. Conclusions: According to the findings, individual, familial, social, cultural, and economic factors were the most important in relation to the addiction relapse.

MtDNA T4216C variation has frequently been investigated in Multiple Sclerosis (MS) patients; nonetheless, controversy has existed about the evidence of association of this variation with susceptibility to MS. The present systematic review and meta-analysis converge the results of the preceding publications, pertaining to association of mtDNA T4216C variation with susceptibility to MS, into a common conclusion. A computerized literature search in English was carried out to retrieve relevant publications from which required data were extracted. Using a fixed effect model, pooled odds ratio (OR), 95 % confidence interval (95 % CI), and P value were calculated for association of mtDNA T4216C variation with susceptibility to MS. The pooled results showed that there was a significant association between mtDNA T4216C variation and MS (OR = 1.38, 95 % CI = 1.13–1.67, P = 0.001). The present systematic review and meta-analysis suggest that mtDNA T4216C variation is a contributory factor in susceptibility to MS.

Admission to elderly homes brings with itself fear of losing home and many other mental consequences to both the elder and family members. The aim of this study was to explore the experiences of elders about factors influencing living in the elderly home. Using a qualitative design, 14 elder people living in elderly homes were chosen through purposive sampling based on defined criteria. Semi-structured interviews were held with the participants and field noting was taken during the interviews. Collected data was analyzed using thematic analysis, which resulted in the development of three main themes: “basic Predictors”, “self-care crisis”, and “role crisis”, which were consisted of a couple of subthemes. We conclude that nurses to better care in community and elderly homes, need to know that living in elderly homes has universal predictors; Of course their weight and position are different on different contexts.

The concept of blended learning in the field of nursing and medicine has been accepted. Blended learning has been extensively used thanks to the development of communication technologies and the availability of Internet services. Meanwhile, experiences-based research, by all accounts, can help the expansion of such a learning modality. Therefore, this study was designed to explain nursing doctoral students’ experiences of blended learning. To attain this goal, a descriptive phenomenology method was used to illustrate experiences as they are experienced by the participants in the study. With regard to the nature of the investigated phenomena and the existing methods for the inductive analysis, Colaizzi’s method of data analysis was used. The findings of the study led to the discovery of three main themes: "failure", "synergy" and "specific interaction". Each of the themes has been further divided into some sub-themes.