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Background: Unwanted pregnancies in diabetic women can endanger the mother and the fetus. The present study was conducted to determine contraceptive methods for diabetic women referred to government diabetes clinics in the north of Iran. Methods: A total of 153 diabetic women referred to government clinics in Guilan were included in this cross-sectional study. A questionnaire made by the researcher regarding personal and social information and information related to contraceptive methods was administered. Data were analyzed analytically using SPSS version 19. Results: The findings of the present study revealed that 87.6% of diabetic women used contraceptive methods, of which 44.4% utilized low-effective contraceptive methods (withdrawal method and condoms), and 43.2% opted for highly effective contraceptive methods (tubal ligation, oral contraceptive pill, intrauterine device, and vasectomy). Decision regarding the choice of contraceptive methods was mainly made by couples, followed by consultation with a doctor. Conclusions: A relatively high percentage of diabetic women use less effective contraceptive methods, and the decision to use contraceptive methods is made mainly by couples. Therefore, targeted reproductive health interventions and providing counseling services as part of medical care for diabetic women seem necessary. [ABSTRACT FROM AUTHOR]

The level of knowledge people have about Covid-19 can affect their anxiety and worry about this disease. The present study was conducted to assess the relationship between knowledge and anxiety about Covid-19 in nurses at Guilan University of Medical Sciences, north of Iran. This cross-sectional study was conducted on 270 nurses working in selected hospitals of Guilan University of Medical Sciences in northern Iran using a questionnaire that included demographic characteristics, knowledge (21 questions), and anxiety about Covid-19 (18 questions with two components of physical and mental). The data were analysed in SPSS ver. 21 using descriptive and analytical statistics. The mean score of knowledge of subjects about Covid-19 was 18.65±1.5 (range: 0-21); the mean score of physical symptoms of anxiety was 3.31±4.77 (range: 0-27); and the mean score of mental symptoms was 10.77±5.61 (range: 0-27). The mean of general anxiety about Covid-19 was 14.08±9.54 (range: 0-54) and most participants had sufficient knowledge and mild anxiety about Covid-19. In the present study, there was no significant relationship between the level of knowledge and the level of anxiety about Covid-19. It was found in the present study that nurses were well aware of Covid-19 and mildly anxious about it, but there were mental anxiety symptoms present. It is more critical than ever to engage nurses in educational and practical programmes provided by disparate institutions, primarily educational departments of hospitals, in different domains of mental health. [ABSTRACT FROM AUTHOR]

Background: Knee osteoarthritis is a common musculoskeletal condition in elderly individuals. This survey was conducted with the aim to identify the problems of this group of patients for compilation of healthcare programs targeted at determining the outcome of osteoarthritis before and 3 months after knee arthroplasty. Materials and Methods: In the present cross-sectional study, 150 elderly individuals who had volunteered for knee arthroplasty were selected through nonrandomized sampling and were evaluated using the Knee Osteoarthritis Outcome Score (KOOS) questionnaire and a demographic characteristics form before and 3 months after the surgery via nonparametric statistical tests (Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests). Results: The mean (SD) age of the study subjects was 64.40 (7.20) years. A significant difference was observed between the mean scores of all subscales (pain with Z=10.62, knee pain/knee stiffness with Z=10.54, daily activity with Z=10.62, sport with Z=2.95, and quality of life with Z=10.48) before and after knee arthroplasty based on Wilcoxon test (<0.05). The results of the Mann-Whitney U test showed a significant statistical relationship between the difference in the mean score of daily activities and history of opium consumption (Z=1.90, p < 0.05) as well as that between knee pain/knee stiffness and gender (Z=2.57, p < 0.05) and educational level (Z=2.11, p < 0.05). Conclusions: Knee arthroplasty and history of opium consumption were correlated with improvement of patients' performance in their daily activities, and gender (women) and educational level (unread) were correlated with improvement of the score of the knee pain/knee stiffness subscale. [ABSTRACT FROM AUTHOR]

Colon cancer is the most commonly diagnosed gastrointestinal cancers in developed countries with varied incidence and the onset age of disease worldwide. Overall, 161 participants who were under patronage of a local relief foundation and referred to the endoscopy ward of Razi Hospital affiliated to the Guilan University of Medical Sciences. These patients have been aged more than 50 or more than 40 years with history of colorectal cancer in their first-degree family were enrolled from March 2016-March 2017. Demographic information were collected. Colonoscopy was performed and histopathological evaluation of observed lesions and polyps was done. Most of participants were female (113 individuals, 70.2%) and aged 50-60 years (83 individuals, 51.6%). Seventy-four (46%) had certain lesions. Most of colonoscopy findings were observed in the ascending colon in which depressed polyps and diverticulum were most frequent. However, rectum showed the most histological findings. All polyps of descending and ascending colons were neoplastic, while most of rectal polyps were non-neoplastic. Male patients, who were aged more than 60 years and smokers had significant higher percentage of both lesions and polyps in their colon (p<0.05). Moreover, significant positive association was detected between exposure to harmful industries and having polyps (p=0.01). We found male gender, higher age, smoking, and exposure to harmful industries as important risk factors for having colorectal lesions, which must be confirmed in further studies. [ABSTRACT FROM AUTHOR]

Introduction: Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated health problem that causes other liver diseases for the patient. Four anthropometric indices: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were analyzed as NAFLD predictors in the present study. Methods: From the total number of individuals who referred to the PERSIAN Guilan Cohort study (PGCS) located in the north of Iran during the period of study, a total of 960 people were enrolled in the present study. NAFLD was diagnosed using through an abdominal ultrasound exam. Height, weight, WC, BMI, WHR and WHtR were later calculated. Chi-square, ANOVA and logistic regression analyses were used to analyze the risk factors. Results: Out of the 960 individuals who were enrolled in the study, 597 (62.2%) were male and 363 (37.8%) were female (with an average age of 47.21 ± 7.29 years). There was a significant relationship between weight and NAFLD (P<0.001). There was also a significant relationship between BMI (OR= 8.41; 95% CI = 5.59-12.75), WC (OR= 2.67; 95% CI = 2.05-3.48), WHR (OR= 3.84; 95% CI = 2.26-6.52), WHtR (OR= 28.53; 95% CI = 6.94-117.31) and NAFLD (P<0.001). The results of the logistic regression analysis showed that WHtR, BMI and WC were effective predictors for the risk of NAFLD while WHtR played a more important role in the prediction of NAFLD. Conclusion: Anthropometric indices, especially WHtR, as a simple screening tool, seem to be an important criterion for the detection of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction helps healthcare organizations to improve their quality level and nurse-patient relationship is effective in increasing satisfaction. The aim of this study was to determine the effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults' patients in cardiac intensive care unit., Materials and Methods: This quasi-experimental study was conducted by available sampling method on 78 hospitalized older adults (39 interventions, 39 control) in cardiac intensive care unit of Guilan hospitals in north of Iran in 2021. In the intervention group, Peplau's communication theory (four stages of orientation, identification, exploitation, and resolution) was implemented and the control group received routine care. At the time of discharge, patient satisfaction questionnaire of quality of nursing care was completed for both groups. Data were analyzed through descriptive and inferential statistics (independent t test, Chi-square test)., Results: The mean score of nursing satisfaction in the intervention group (5.4 ± 93.0) was significantly higher than the control group (6.8 ± 75.7) (t (64) = 11.54, P < 0.001, d = 2.84). In other words, the mean satisfaction scores of nursing care in the intervention group were 17.4 units (95% confidence interval: 14.4-20.4) more than the control group., Conclusion: Using Peplau's communication theory in the care of hospitalized older adults in cardiac intensive care unit can lead to improvement of satisfaction, so it is suggested to use this communication method in the care of these patients to improve the level of satisfaction, quality of care, and functional independence., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Background: Hypertension is the main risk factor for cardiovascular disease. Low level of health literacy is more common in people with hypertension. Evidence suggests that hypertension is preventable and can be controlled by modifying lifestyle and improving self-care behaviors., Objective: This study aimed to determine the relationship between health literacy, self-efficacy, and self-care behaviors in older adults with hypertension., Methods: The present study was a cross-sectional study conducted with 150 older adult patients with hypertension admitted to the Cardiac Care Unit (CCU) and post-CCU wards in East Guilan public hospitals in the north of Iran in 2020. Sampling was conducted using a convenience method based on inclusion criteria (age 60 years and older, high blood pressure and taking antihypertensive drugs for at least 6 months, ability to speak and communicate, having the suitable physical condition (not ill) to participate in research and answer questions, and having informed consent to participate in the study). The research instruments included a Health Literacy Questionnaire for Iranian Adults, a self-efficacy questionnaire in patients with hypertension, and a self-care behavior questionnaire for patients with hypertension. Descriptive statistics and multiple linear regression were used to analyze the data using SPSS software version 19., Key Results: The results showed that most patients had adequate health literacy with a mean score of 116.77 (standard deviation [ SD ] = 8.34), excellent self-efficacy with a mean score of 23.06 ( SD = 1.99) and relatively desirable self-care behaviors with a mean score of 51.79 ( SD = 4.37). Findings also indicated that health literacy can predict self-efficacy (beta = 0.262, p = .001) and self-care behaviors (beta = 0.639, p = .000)., Conclusions: Based on results, health literacy is a predictor of self-efficacy variables and self-care behaviors. Therefore, planning to improve the health literacy of the older adult to promote self-efficacy and self-care behaviors and ultimately their health is recommended. [ HLRP: Health Literacy Research and Practice . 2022;6(4):e262-e269. ] Plain Language Summary: This study sought to determine the role of health literacy in predicting self-efficacy and self-care behaviors in older adults with hypertension admitted to CCU and post-CCU wards in East Guilan public hospitals in the north of Iran. Findings of this research demonstrate health literacy can predict self-efficacy and self-care behaviors.

Background: Dynamic aging depends on providing opportunities to improve the quality of life of the elderly. The objective of this study was to investigate the relationship between social support and quality of life in the elderly in Guilan., Materials and Methods: This descriptive-correlational study was conducted in the elderly who visited urban public places in the East of Guilan (mosques, parks, weekly markets, and clubs). A total of 168 elderly who met the inclusion criteria were selected through two-stage, cluster, and convenience sampling. Data were collected using Phillips Standard 23-item social support scale and 12-item quality of life scale-short form. Data were analyzed through descriptive and inferential statistics (Pearson correlation coefficient)., Results: The mean score of social support in the elderly in Guilan was 73.25 ± 9.18 and the mean quality of life was obtained at 24.67 ± 7.06. Data analysis showed that there was a significant and positive correlation between social support and quality of life (r = 0.29, P < 0.0001)., Conclusions: Increased social support leads to a higher quality of life in the elderly. Thus, it is necessary to timely identify the needs and promote comprehensive social support to improve the quality of life in the elderly., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Background: One of the main psychological problems in hemodialysis patients is hopelessness. Spiritual health leads the patients toward hope and goal in life. Given the importance of the issue and the little research in this area, this study aimed to assess hope and its relationship with spiritual health on hemodialysis patients in Rasht Razi Hospital of Iran., Materials and Methods: This correlational study carried out on 103 patients who admitted in Rasht Razi Hospital Hemodialysis Center by simple random sampling. The data were collected through Snyder's Hope Scale and Spiritual Health. The psychomotricity of these questionnaires has been confirmed in domestic studies. The data were analyzed by using descriptive and inferential statistics (Pearson correlation coefficient)., Results: The majority of the patients were male (59.2%), in the age group of above 60 (46.60%), married (83.5%), with low income (60.2%), and under diploma (53.4%). The mean of hope score was 36.36 (±9.10) that showed the high level of hope in the majority of the patients. The mean of the total spiritual health score was 227.93 (±19.01) that indicates the high level of spiritual health in hemodialysis patients. There was a positive and significant correlation between spiritual health and its dimensions and hope ( P < 0.05)., Conclusions: The results of this study approve the importance of spiritual health as an effective variable on hope among hemodialysis patients. Hence, health-care providers and clinical experts are recommended to focus on spiritual health to increase hope among such patients., Competing Interests: There are no conflicts of interest.

This survey was designed to determine the association between knowledge, locus of control and health belief with self-management, Hb A1c level and Number of attendances in type 1 diabetic patients in Rasht, Guilan Province - North of Iran. Data was derived from chart reviews of 92 patients. Patients' glycosylated hemoglobin level and their number of health care attendances during the last 6 months were recorded. The four part questionnaires covered patients' demographic data, knowledge, perceived control and health belief of diabetes. A blood sample was taken from each patient. There was no significant relationship between demographic data such as gender, age, marital status, education, occupation, duration of the disease, place of living and family history with knowledge, health belief and locus of control (P > 0.05). Also the results didn't show any significant association between the complicated group and their knowledge and health belief (P > 0.05) while it was significantly related to their locus of control (P < 0.004). The majority of the samples had poor knowledge (59.8%), health belief (71.7%) and locus of control (62%). There was no significant relationship between patients' knowledge, health belief and locus of control with their glycosylated hemoglobin level, number of referrals and self-management. It is suggested by the present survey that locus of control, health belief and knowledge of patients are not found to have no practical effect upon diabetic self-management behavior or outcomes, according to the variables used and care for the diabetic patients must be tailored to individual requirements.

The present survey aimed to determine the knowledge level and attitude of medical students in Guilan University toward Hepatitis B and C viruses' infections. In a cross-sectional survey, the knowledge and attitude of 424 medical science undergraduate students of nursing, midwifery, operating room technician, laboratory, anesthesiology and radiology in Guilan University of Medical Sciences toward Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections were investigated using a standardized questionnaire. The mean (SD) knowledge level of the medical students toward HBV and HCV were 17 ± 5 from 28 and 10.58 ± 6.7 from 29 questions respectively. Females, nursing students, forth year students, those who worked in hospital and those who had needle stick injuries (NSI) history showed significantly higher knowledge scores toward HBV (P< 0.05). Married students, anesthesiology students, those who were in their fourth year of study, and those who worked in hospital had significantly higher mean knowledge scores toward HCV (P< 0.05). Also students' attitude toward HBV and HCV was positively correlated with their mean knowledge level (r=0.14, p=0.004), (r=0.18, p=0.0001). Education on the nature, symptoms, transmission, prevention and treatment of HBV and HCV infections may increase the willingness of health care workers to care for infected persons.