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Abstract Background Due to the burden of musculoskeletal diseases in the elderly and the multifactorial nature of such conditions, controlling the pain caused by these disorders requires multidisciplinary approach. This approach requires the participation of the elderly in applying effective prevention measures. This study aims to design a multidisciplinary educational intervention based on health belief model (HBM) for elderly residents of nursing homes. Methods This is a parallel randomized clinical trial among elderly people aged 60 years and over living in a nursing home who suffer from musculoskeletal pain. Eligible participants will be divided into two groups including the intervention group who will receive a multidisciplinary intervention (vitamin D consumption, psycho-social stress management, and physiotherapy) and the control group who will receive usual care. Data collection instruments will include demographic data, the Depression, Anxiety, and Stress Scale (DASS), the visual analogue scale (VAS), and a self-designed questionnaire containing the HBM constructs. The interventions will be carried out by the educational team (general practitioner, psychologist, physiotherapist, and health education specialist). Interventions include changing the wrong beliefs of the elderly, taking 800 units of vitamin D daily, daily walking exercise by the elderly for at least 30 min and maintaining proper body posture during daily activities, muscle relaxation, relaxation techniques, regular exercise, examining their diet and eliminating stimulants (such as smoking and coffee), regular visits with friends and family, and deep breathing techniques. All questionnaires will be completed by the elderly before, after, 3, and 6 months after the intervention. Discussion The present study will evaluate the effect of an educational intervention based on a multifaceted pain control approach for elderly people who reside in nursing homes in order to reduce musculoskeletal pain in the elderly living in nursing homes. One of the features of this study is its focus on improving the health of elderly residents in nursing homes. Given the increase in the elderly population worldwide, the findings from the current trial might benefit elderly populations. Trial registration IRCT20220904055881N1 . Registered on 11 February 2023.

Abstract Background Ergonomic behaviors play a crucial role in preventing work-related musculoskeletal disorders (WMSDs). To measure these behaviors, this research aimed to develop and evaluate an ergonomic behaviors tool (EBET) based on the Social Cognitive Theory (SCT) among women workers on assembly lines (WwAL). Methods The study was conducted from December 2022 to January 2023 with a focus on the psychometric assessment of EBET. Initially, a literature review and interviews were carried out to identify crucial concepts and primary items. The questionnaire’s validity was evaluated using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). To determine the domains of the tool, construct validity was examined by administering the items to 270 eligible women. The reliability of the tool was assessed using McDonald’s Omega coefficient. Results From a total of 67 primary items, 50 were confirmed. The study demonstrated good validity with CVR = 0.92 and CVI = 0.97, along with reliable results indicated by McDonald’s Omega coefficient of 0.74. The exploratory factor analysis (EFA) revealed ten distinct dimensions: outcome expectations, outcome expectancies, normative beliefs, perceived barriers, social support, observational learning, reinforcement, behavioral skills, self-efficacy, and intention. Together, these dimensions accounted for 66.25% of the variance in the data. Additionally, the confirmatory factor analysis results supported the presence of these ten constructs and demonstrated a satisfactory fit. Conclusions EBET is a dependable and valid instrument for evaluating the ergonomic behaviors of workers, utilizing the principles of SCT. Researchers can employ EBET to gather data and implement suitable training interventions to enhance ergonomic behavior among WwAL. However, it is crucial to recognize that EBET may not encompass all facets of ergonomic behaviors. Therefore, it is imperative for future research to prioritize the evaluation of EBET’s suitability among diverse worker populations and to consider additional dimensions of ergonomics to ensure its wider applicability and effectiveness.

Abstract Background This study focuses on identifying the key factors associated with ergonomic behaviors (ERBE) among women workers on assembly lines (WwAL) to prevent musculoskeletal disorders (MSDs) caused by repetitive motions and unfavorable body postures. To achieve this objective, this study employed Bayesian networks (BN) analysis based on social cognitive theory (SCT). Methods A cross-sectional study was conducted to examine the predictive factors of ERBE among 250 WwAL from six different industries located in Neyshabur, a city in northeastern Iran. The study used a two-stage cluster sampling method for participant selection and self-report questionnaires to collect data on demographic characteristics, variables associated with SCT, ERBE, and the standard Nordic questionnaire. The collected data were analyzed using Netica and SPSS version 21, which involved statistical analyses such as independent t-tests, Pearson correlation, and ANOVA tests at a significance level of p

Abstract Background The use of preventive behaviors of musculoskeletal disorders (MSDs) requires proper training, which leads to correct decisions regarding maintaining postures at work and performing stretching exercises. Due to very repetitive work, applying manual force, improper postures, and static contractions of proximal muscles, assembly-line female workers suffer from musculoskeletal pains. It is assumed that structured and theory-based educational intervention using a learning-by-doing (LBD) approach may increase the preventive behaviors against MSDs and reduce the consequences of these disorders. Methods This randomized controlled trial (RCT) will be conducted in three phases: phase 1: validation of the compiled questionnaire, phase 2: determining the social cognitive theory (SCT) constructs that predict the preventive behaviors of MSDs in assembly-line female workers, and phase 3: designing and implementing the educational theory. The educational intervention is based on the LBD approach, and the study population includes assembly-line female workers in electronic industries of Iran, who are randomly divided into two intervention and control groups. The intervention group received the educational intervention in the workplace and the control group does not receive any intervention. The theory-based educational intervention includes evidence-based information along with pictures, fact sheets, and published literature about a good posture at work and the need to perform proper stretching exercises. The educational intervention aims to improve the knowledge, skills, self-efficacy, and intention of assembly-line female workers to adopt preventive behaviors of MSDs. Discussion The present study will evaluate the effects of maintaining a good posture at work and performing stretching exercises on the adherence to preventive behaviors of MSDs among assembly-line female workers. The developed intervention is easily implemented and evaluated in a short period of time based on the improved score of the rapid upper limb assessment (RULA) method and the mean score of adherence to stretching exercises and can be provided by a health, safety, and environment (HSE) expert. Trial registration ClinicalTrials.gov IRCT20220825055792N1. Registered on 23 September 2022 with the IRCTID.

Abstract Background Chronic musculoskeletal problems are a major source of disability, reduced productivity and poor quality of life. Prevalence of musculoskeletal disorders among Iranian housewives is particularly high. Understanding how housework causes the injuries, mobility restrictions and pain associated with musculoskeletal disorders is vital to developing health promotion behavior models to support intervention. The aim of this qualitative study was to explore the experiences of housewives with musculoskeletal disorders and, according to the risk factors identified, to develop a comprehensive behavior change framework to facilitate implementing a musculoskeletal health-promoting training intervention for women. Methods Twenty-four in-depth interviews were conducted with Iranian housewives aged 20–65 years experiencing musculoskeletal pain over a 13-month period from September 2020 to October 2021. The conventional content analysis approach was used to interrogate the data. The transcript of each interview was considered a unit of analysis, and data analysis was performed using MAXQDA2018 software. Results The analysis of the interview data provided 1432 meaning units. From these codes, a conceptual framework was developed. This comprehensive model is comprised of 24 subcategories, eight categories and three themes: Individual and social predictors of MSDs and their control, Risk factors for MSDs, and Prevention and treatment of MSDs. Altogether the developed conceptual framework specified the multiple risk factors for MSDs in housewives. The findings were aligned to various health promotion models, and it was seen that ecological models, especially the Theory of Triadic Influence, can be very helpful as a supportive roadmap to implementing multilateral interventions to improve the quality of life of housewives. Conclusions This study developed an evidence based comprehensive model that identifies the individual, psychosocial, and cultural factors that influence the status of MSDs in women’s domestic work to support the development and implementation of effective ergonomic interventions to manage potentials for MSDs.

Abstract Background Prevention of musculoskeletal disorders as one of the most common occupational health problems among the working population in both developed and developing countries is an important necessity and priority. The aim of this study was to evaluate the effectiveness of an educational intervention program based on the Health Belief Model (HBM) to increase awareness, perceived sensitivity, perceived severity, perceived benefits, and self-efficacy in adopting neck health-promoting behaviors in school teachers. Methods The present study was a quasi-experimental of the randomized clinical trial that was conducted for 6 months (December 2020 to July 2021). Participants were 146 junior high school teachers were selected from 26 schools through random sampling and divided into two groups of intervention and control. The data collection instrument was the self-design questionnaire and was completed in three points of time (before, immediately, and 3 months after the intervention). The data were analyzed by software version 24 SPSS. Results The results showed that awareness, perceived sensitivity, perceived severity, perceived benefits and barriers, and self-efficacy in adopting neck health-promoting behaviors in the intervention group increased in two points of time (immediately after the intervention and 3 months of follow-up) (P

Abstract Background Musculoskeletal pain (MP) has today intensified in a large proportion of music students in Iran. Poor posture while playing an instrument is thus assumed as a very significant risk factor affecting such a condition in this population. The present study aims to evaluate the impact of electronic learning (e-learning) for postural education to music students on posture behavior and MP (abbreviated as an El-Poems study). Methods This study is a matched-pair, two-arm, parallel randomized controlled trial (RCT). The participants, as the 7th-to-12th-grade music students, will be accordingly assigned to intervention (n = 204) and control (n = 204) groups, based on the inclusion and exclusion criteria. The postural education will be also presented through the web-based Student Education Network (with the acronym, SHAD) at the Tehran Conservatory of Music, Tehran, Iran. The intervention program consists of four sessions, using the Integrated Change (I-Change) model. It will be also implemented by a trained physical education instructor and a health educator. The content of the program includes raising awareness, building motivation, and developing skills. Besides, its components are comprised of specific proper postures viz. standing, sitting, lifting, carrying, and hand position while playing a musical instrument. The primary outcome is the MP that will be assessed by the Nordic Body Map (NBM) questionnaire and a numerical rating scale (NRS), and the secondary outcome is the posture behavior that will be evaluated objectively, using the Rapid Entire Body Assessment (REBA) tool. The data will be also collected at baseline and after a six-month follow-up. Conclusion This RCT is an innovative study as a pioneer to represent the first attempt for web-based postural education as well as an attractive intervention to prevent MP in Iranian music students. Trial registration Current Controlled Trials IRCT20180528039885N2 . Prospectively registered on 11 September 2021

Abstract Background Neck pain is one of the most common work-related musculoskeletal disorders (WMSDs). It has important social and economic consequences such as reduced productivity due to absenteeism, leave, and early retirement and financial losses due to medical expenses for the workforce especially teachers. This study aims to evaluate whether a model-based social media intervention could change the high-risk behaviors that cause work-related neck pain among teachers. Methods This is a randomized controlled trial that will be done in three steps. The first stage is a qualitative study to obtain the items and areas of the researcher-made questionnaire based on the health belief model (HBM), the second stage is the psychometric evaluation of the questionnaire, and the third stage is designing and implementation of model-based educational intervention in social media context. The study population is teachers who working in junior high school in the 19th district of education minister in Tehran, Iran, which are randomly divided into two groups of intervention and control. The intervention group receives training packages on social media, and the control group does not receive any training. The educational intervention tries to improve the knowledge, attitude, skills, and self-efficacy in adopting neck pain prevention behaviors among teachers. The study will also assess whether the intervention can promote preventive neck pain behavior among teachers. Discussion Work-related neck pain can have a negative impact on teachers’ health. This study is an attempt to investigate the impact of developed interventions in promoting preventive behavior regarding work-related neck pain through social media context. Trial registration Iranian registry of Clinical Trial (IRCT) IRCT20210301050542N1 . Registered on 16 March 2021 Ethics code: IR.MODARES.REC.1399.163

Objective (s): Neck pain is one of the most common musculoskeletal disorders associated with work that leads to important social and economic consequences such as reduced productivity due to absenteeism, early leave and retirement, missed working days, financial loss. Due to medical expenses and poor work ethic due to discomfort when working in the workforce, especially teachers. The aim of this study was to identify and explain the causes of occupational neck pain and promote preventive behaviors based on the health belief model in teachers. Methods: The was a qualitative study using the directed content analysis approach by telephone interviews with 25 high school teachers working Tehran, Iran, in 2020. Teachers were selected based on simple random sampling. Interview questions were designed based on the constructs of the health belief model and the information was analyzed using MAXQDA software. Results: Based on the health belief model the following factors including awareness, sensitivity and perceived severity, perceived benefits and barriers, cues to action and self-efficacy emerged as effective factors causing occupational neck pain in teachers. Conclusion: Teachers expressed a number of reasons for neck pain experiencing. Due to the important role of teachers in educating children, adolescents and young people, their health should be considered a priority.

Abstract Background A variety of household chores expose women to a variety of biomechanical and psychosocial risk factors. A result of this is many housewives with musculoskeletal disorders. Given the interactive effects of these risk factors, it is necessary to consider multiple strategies to mitigate their effects. Accordingly, the present study will investigate the impact of a health promotion training program based on a participatory ergonomic approach towards a reduction in the prevalence of musculoskeletal disorders and an improvement in the quality of life of housewives. Methods Iranian housewives aged 20–65 years currently attending a specialist health clinic due to a painful musculoskeletal complaint will be invited to join the study. Recruitment will continue until a sample of 160 women provides informed consent to participate. The study will be conducted using a mixed-methods protocol in two phases. In the first phase, psychosocial and biomechanical risk factors will be identified using a qualitative approach. In the next phase, the results from the qualitative approach will be used to develop a conceptual framework based on health promotion theories and an intervention program based on a participatory ergonomic approach designed. Participants will be randomly allocated into one of four groups: (1) biomechanical intervention group, (2) psychosocial intervention group, (3) multidisciplinary intervention group (both biomechanical and psychosocial intervention), and (4) a control group. Data will be collected using Rapid Entire Body Assessment (REBA), Visual Analog Scale (VAS), Work Ability Score (WAS), Hospital Anxiety and Depression Scale (HADS), and the 36-item Short-Form health survey (SF-36) at baseline in 3-month and 6-month follow-up assessments. The impact of the three interventions on musculoskeletal disorders, work ability, stress, and quality of life will then be evaluated. Discussion The study will provide a practical approach to reducing stress, reducing musculoskeletal disorders, enhancing the ability to work, and improving the quality of life of women with musculoskeletal disorders associated with housework. If the designed interventions in the present study are effective, they will have the great practical potential for generalization to all housewives. Trial registration ClinicalTrials.gov IRCT20200602047640N . Registered on 07 September 2020 with the IRCTID.

Objective (s): Low back pain is a common disorder of spine. One of the most important concerns is the increasing rate of low back pain in schoolchildren that might predict adult disability. The purpose of this study was to explain the structural relationship between low back pain and spine-related behavior among pupils via structural equation modeling based on social cognitive theory (SCT). The hypothesized model included skills, knowledge of spine care principals, self-efficacy, and expectation beliefs as independent variables, and spine-related behavior as a dependent variable. Methods: We collected data from 204 students attending public elementary schools using a structured questionnaire in Tehran, Iran from October 2018 to March 2019. The hypothesized model was examined via a structural equation modeling (SEM) analysis using SPSS, version 24.0, and LISREL, version 8.80. Results: The effect of skills, knowledge, self-efficacy and beliefs on spine-related behavior was 0.73 (t-value=13.09), 0.42 (t-value=6.71), 0.87 (t-value=16.67), and 0.55 (t-value=4.95) respectively. In addition, various indicators, such as Comparative Fit Index (CFI), Normed Fit Index (NFI), χ2/df, and Root Mean Squared Error of Approximation (RMSEA) showed the good fitness of the models. Conclusion: The results revealed that the pupils who had more confident, skills, expectation beliefs, and knowledge were more likely to perform proper spine-related behavior. In this regard, school-based low back pain prevention interventions should be addressed using key cognitive factors that consider the potential change strategies.

One of the most serious issues is the growing prevalence of backaches among adolescent students as a result of carrying backpacks. The purpose of this study was to examine the impact of an education program (remedial information) on the school backpack carrying habits of adolescent students. The study sample consisted of 138 adolescent students aged 12 to 16 from 4 schools who were randomly assigned to either the experimental (N = 69) or control (N = 69) groups. The experimental group was subjected to a 6-week education program consisting of 6 sessions, whereas the control group received no educational intervention. During the pre-test and 3 months after the intervention, participants completed a questionnaire. The results (healthy items) were as follows: (1) carry as little as possible, (2) carry a school backpack on both shoulders, and (3) use lockers or something similar. After a 3-month follow-up, healthy items in the experimental group improved, but no significant changes were observed in the control group. When compared to the baseline, the experimental group’s healthy backpack usage habits improved significantly at the post-test ( P = .001). The current study’s findings show that school-based education interventions on backpack behaviors improve the school-bag carrying habits of adolescent students.

Abstract Background Back pain is an important public health problem and the leading cause of adult disability worldwide and is rising among schoolchildren populations. Despite numerous studies reporting on back care interventions in pediatric population; there is currently no existing theory-based instrument to assess impact and outcome of these programs. This paper reports on development and psychometric testing of a theory based back-care behavior instrument for use among elementary schoolchildren. Methods This was a three-phases study that included the following steps: a) a literature research to review existing instruments that assess healthy spine-related behavior in elementary schoolchildren; b) development of a new instrument namely the Back-care Behavior Assessment Questionnaire (BABAQ) based on the Social Cognitive Theory and existing instruments, and c) conducting a cross sectional study to test psychometric properties of the BABAQ by estimating the content validity ratio (CVR), the content validity index (CVI), performing confirmatory factor analysis (CFA), reliability analysis, and convergent validity as estimated by the Average Variance Extracted (AVE). Results First, a questionnaire (the BABAQ) was developed. It contained of 49 items tapping into 5 pre-defined constructs (skills, knowledge, self-efficacy, expectation beliefs, and behavior). Then, 610 fifth-grade female schoolchildren were entered into a cross sectional study and they completed the BABAQ. The CVR and the CVI of the questionnaire was found to be ≥0.54 and > 0.7, respectively. The CFA confirmed the five constructs and showed good fit for the data. The intraclass correlation (ICC) and the Cronbach’s alpha coefficients for the BABAQ were 0.84 (P

Abstract Background Children’s health and welfare have a special place in research and policy in many countries. One of the most important concerns is the increasing rate of backache in children due to many of behavioral risk factors. The aim of this study was to evaluate the effectiveness of an educational program on promoting back-related behavior as well as knowledge, skills, beliefs, and self-efficacy among fifth grade girls. Methods The theory-based back care (T-Bak) study was a school-based randomised controlled trial (RCT) that assessed the effectiveness of developing a back care training program based on the social cognitive theory (SCT). A total of 104 schoolchildren aged 11 ± 1.0 years were assigned to intervention (n = 52) and control (n = 52) groups. The intervention group received six sessions training on proper lifting and carrying techniques, having proper posture during daily activities, and correct backpack wearing techniques with a 1-week interval while the control group received nothing. Then, the two groups were assessed for knowledge, skills, self-efficacy, beliefs, and behavior at four points in time: baseline, immediate, three and six-months post-intervention. The changes of the outcomes investigated using univariate repeated measures analysis of variance. Partial eta squared measure (ηp 2) was used to calculate effect sizes. Results A positive change was found for the intervention group back-related behavior from baseline to immediate post-intervention and follow-ups (F = 78.865, p

Abstract Background This study aimed to investigate the educational needs of 10–14-year-old girls about adolescent puberty health in Ardabil City in Iran, the matter of adolescent puberty health is one of the most important health priorities, especially for girls. Methods This cross-sectional descriptive-correlational study was performed on girl students through stratified-cluster sampling in Ardabil city. The data gathering tool was a self-reported researcher-designed questionnaire consisting of 10 demographic questions and 35 self-care questions in 5 domains of self-care awareness, self-efficacy, enablers, enhancers and behaviors, based on the reviewed articles and resources. Descriptive statistics and chi-square test, correlation coefficient and regression were used to analyze the quantitative data. Results The mean age of the girls was 12.98 ± 4.67. There was a significant relationship between the mother’s level of education (p

For downloading the full-text of this article please click here. Background and Objective: Spirituality in job is a new topic but with a limited theoretical-scientific development in organizational literature. The importance of this issue and its impact on work efficiency call for a proper instrument for evaluation purposes. Longevity and incomprehensiveness of some of the questionnaires motivated the authors to provide an Intercultural Translation and psychometric analysis of the standard comprehensive instrument of Spirituality at Work. Methods: In this cross-sectional descriptive study, English version of Spirituality at Work scale, adopted from Val Kinjersk’s study, was used as the main instrument. An attempt was made to complete English-to-Persian translation as well as to provide cultural conformities using the Wild pattern and recursive translation method and retranslation phases, respectively. Afterwards, face validity was performed based on 10 experts’ views and 18 accessible samples and then reliability and validity of the questionnaire were examined and internal correlation was determined in a cross-sectional study on 393 health workers. Construct validity was assessed with a sample size of 268 people through factor analysis. In this study, all the ethical considerations have been observed and no conflict of interest was reported by the authors. Results: To determine construct validity, principal components analysis was performed using Varimax rotation method, in which 70.31% of total variance was explained by two factors. Its face validity was also desirable. In assessing the questionnaire’s reliability using internal consistency method, Cronbach’s alpha coefficient was found to be 96%, which ranged from 78% to 91% for the subscales. There was a high correlation among subscales of this questionnaire (0/82-0/97). Conclusion: The questionnaire had good consistency and the high correlation between the subscales is indicative of a god cultural consistency in translation of the questionnaire. The questionnaire of Spirituality at Work, which aimed at assessing the experience of spirituality in job based on individuals’ experience of spirituality and workplace morale has proper construct validity and face validity.For downloading the full-text of this article please click here. Please cite this article as: Shojaei S, Tavafian SS, Wagner J, Jamshidi AR, Mohammadi-Valadani A. An Intercultural Translation and Psychometric Analysis of 18-item Spirituality at Work Questionnaire. Pizhūhish dar dīn va salāmat. 2020; 5(4): 114-126. https://doi.org/10.22037/jrrh.v5i4.22349

Background:Situational influences can facilitate or impede stretching exercise behaviours. However, since there is no measurement to assess situational influences among office employees, it might be difficult to understand the role of situational influences on stretching exercises. The current study aimed to evaluate the psychometric characteristics of Short Form of Situational influences Scale for predicting Stretching Exercise among office employers based on the Health Promotion Model (HPM). Method: By multistage cluster sampling method, this cross-sectional study was conducted among 385 office employees selected from the health networks at Shahid Beheshti University of Medical Sciences of Iran (SBUMS) who were assessed through the Short Form of Situational influences Scale. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach’s alpha were employed. Results: The mean age of the office employees was 39.4±7.76 years. Content Validity Index (CVI) and Content Validity Ratio (CVR) of each question were greater than 0.79. The result of EFA with principal component analysis showed one factor (Situational influences) with 43.6% cumulative variance and KMO with 90.4% (P < 0.001). This was a good fit index in CFA. The reliability of the questionnaire was confirmed through acceptable Cronbach’s alpha (α = 0.79). Regarding CFA, the result showed REMSEA = 0.048, GFI = 0.978, AGFI = 0.986 confirmed with Cronbach’s alpha (α = 79 %) and ICC =0.71 95% CI (0.69, 0.79). Conclusion: The current study revealed that the Short Form of Situational influences Scale for Stretching Exercise is a valid instrument. Therefore, it can be used as a reliable and valid instrument to investigate Stretching Exercise behaviours among office employers.

OBJECTIVE: To determinant the influencing factors on Stretching Exercise (SE) among office employees working in Shahid Beheshti University of Medical Sciences (SBUMS) in Iran through Health Promotion Model (HPM) with added constructs. METHODOLOGY: Data were collected by a researcher-made and standard questionnaires based on HPM and added constructs of self-regulation, counter-conditioning, and stimulus control questionnaire regarding stretching exercise behavior among office employees working in comprehensive service centers affiliated to SBUMS. A multistage cluster sampling from May to Sep 2017 was done. To determine the factors which effect on doing stretching exercise behavior; regression analysis was done through using SPSS 19 software. RESULTS: Totally 420 office employees with mean age of 37.1±8.03 years participated in this study. Perceived barriers to action (B =-0.106, P

Background: Physical activity affects office employees in achieving a healthy lifestyle and preventing diseases such as Musculoskeletal Diseases (MSDS). Combining sports such as stretching exercises in healthy lifestyle programs is one of the most important decisions to prevent such disease. Purpose: This study aimed to predict factors of interpersonal and situational influences for stretching exercise (SE) among office employees at Shahid Beheshti University of Medical Sciences. Methods: A cross-sectional study was conducted among 420 office employees recruited by multi-stage cluster sampling. Self-administered questionnaires of SE and interpersonal and situational influences based on Pender’s Health Promotion Model, as well as socio-demographic data, were used in this study. The collected data were analyzed using Spearman correlation and logistic regression tests. Results: Results showed that among 420 participants, the scores of interpersonal and situational influences, and SE were 4.6±11.52, 4.5±14.21, and 2.48±17.64, respectively. There was a significant relationship between interpersonal influence and SE (r=0.54; p0.05), and interpersonal influences were a strong predictor for SE behavior. Conclusion: This study showed that the office employees who were more interpersonal influencers were more likely to do stretching exercise behavior. Therefore, interpersonal factors could be used as an educational principle in facilitating admission behavior of SE regarding Pender’s Model.

The PRECEDE-PROCEED model is an adaptable planning model that could be served in public health issues. The purpose of this study is to investigate the effects of an educational program based on Precede-Proceed model on promoting Low Back Pain (LBP) behaviors among health care workers (HCWs). This Double-blinded randomized trial study was conducted on 112 from 120 HCWs aged from 30 to 55 years The eligible HCWs were randomly divided to intervention group 1 (N = 38), respectively intervention group 2 and control group (N = 37) for which the Precede-Proceed - based educational program was implemented and control group (N = 37). The random multi-stage cluster sampling method was used to recruit HCWs. HCWs completed a self-reported questionnaire on their Low Back Pain Behaviors assessment questionnaire based on the Precede-Proceed Model and a visual analogue scale (VAS) was also used. The data were gathered at initial of the study, 6 and 12 months follow-ups from three groups and were analyzed through SPSS version 19. There was a significant interaction between the factors “group” and “test time” (p < 0.05, p < 0.001) of knowledge, perceived self-efficacy, and attitude, reinforcing factors, enabling factors, public health, quality of life and LBP preventive behaviors of the intervention group., although, no significant alternate became located in the mean score of above structures of the control group. The findings of the present study confirmed the effectiveness of the PRECEDE-PROCEED model-based educational program on preventing LBP by enhancing scores of model constructs. However, these results should be repeated in further studies to be able to apply this program in health system.

Aim: The purpose of this examination is determining the predictors of oral health behaviors among Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study was conducted on 351 four grade female students in the first district of Tehran, Iran in 2017. The multi‑stage random cluster sampling method was used to recruit students. The inclusion criteria were being in four – graded level of elementary schools of the 1st district in Tehran, being female students aged between 9-11 years and being physically and psychologically healthy student. Logistic regression analysis was used to identify the variables that predict oral health behaviors. Results: Totally, (N= 31.8%) students reported that they were brushing less than twice a day and (N= 55.2% ) students claimed using of dental floss once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P

Background and Objective: Preeclampsia (PE) is the most common complication of pregnancy and one of the top three causes of maternal death. Considering the high prevalence of PE, this study was conducted to determine the effect of nutrition training program for the prevention of PE on the nutritional behaviors of pregnant women in Pol-e dokhtar, Iran, 2017. Materials and Methods: This quasi-experimental study was carried out among 120 pregnant women in their third trimester of pregnancy referred to the healthcare centers of Pol-e dokhtar, Iran, in 2017. The participants were randomly assigned into two groups of intervention and control (60 individuals per group). The subjects were selected through cluster sampling method, and data were collected using a questionnaire developed by the researcher including questions about the participants’ demographic characteristics, knowledge, attitude, and function. Data analysis was performed using Chi-squared, Fisher’s exact test, independent samples t-test, and paired t-test by the help of SPSS software, version 16. Results: The results showed significant differences between the groups in terms of the level of knowledge, attitude, and function (P

Study DesignInterventional research with a 6-month follow-up period.PurposeWe aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory.Overview of LiteratureWRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP.MethodsWe included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data.ResultsThe comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group (p

Compliance with preventive behaviors is essential to control hypertension among suffered patients. This study aimed to assess the effect of a designed educational program on nutrition behaviors among patients with primary hypertension referring to the hospitals in Qazvin, Iran. In this study, a number of 68 eligible patients suffering from primary hypertension was recruited from an intervention hospital (N=34) and a control hospital (N=34). Before the intervention, data on demographic characteristics and main variables including knowledge, attitudes, self-efficacy, and behaviors of the participants were gathered through the questionnaires. Then, the intervention group was provided by the educational program. The same data were collected 4 weeks after the intervention. The mean age was 53.59±7.33 for the intervention group and 52.15±8.68 for the control group. The two groups were equal in terms of all demographic and main variables except for attitude before the intervention. The results showed all variables such as knowledge, attitude, self-efficacy, and behavior were improved in the intervention group compared to the control group. In conclusion, this study verified the educational program could improve knowledge, attitudes, self-efficacy as well as behaviors regarding nutrition behaviors among patients suffering from hypertension.

Study DesignClinical trial.PurposeTo evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran.Overview of LiteratureAlthough low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities.MethodsOverall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16.ResultsThere were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (p

Abstract Background Pregnant women and their fetus belong to a sensitive group in response to air pollution hazards. The aim of this study was to evaluate the effectiveness of a theory-based educational program to change pollution exposure behavior in pregnant women. Methods In this randomized controlled trial, pregnant women attending a prenatal clinic in Tehran, Iran were selected and randomized into the experimental and control groups. The inclusion criteria were age between 18 and 35 years, having a history of pregnancies without adverse outcomes and not suffering from chronic diseases. Data collected at baseline and 2-month follow-up. At baseline face-to-face interviews were conducted using a valid and reliable questionnaire including items on demographic characteristics, stages of change, self-efficacy, decisional balance and practice regarding air pollution preventive behaviors. The intervention composed of three parts: motivational interviewing, a booklet and daily small message service (SMS). The control group received no intervention except receiving usual care. Follow-up data were collected after the intervention. Data were analyzed performing t-test, Mann–Whitney U test, and chi-squared. Results In all the data for 104 pregnant women (53 in the intervention and 51 in the control group) were analyzed. The mean age of participants was 27.2 (SD = 4.11) years and it was 22.89 (SD = 8.75) weeks for gestational age. At baseline there were no significant statistical differences between intervention and control groups on the study measures while we found significant group differences in terms of stages of change, self-efficacy, perceived benefits and practice regarding air pollution preventive behaviors at follow-up assessment (P

Aim: The main aim of this study was to Evaluate of Decayed, Missing and Filled Teeth (DMFT) Index in 12 Year Old Students of Tehran City, and to identify related factors that affect dental caries within this group. Methods: A cross-sectional survey was conducted among students of 12 years old in Tehran, Iran. Dental caries status was assessed in terms of decayed teeth (DT), filled teeth (FT) and decayed, missing and filled teeth (DMFT). “Data were analysed using SPSS version 22; a multivariate regression analysis was used to determine statistically significant associations between DMFT and other variables (p < 0.05). Results: A total of 416 respondents participated in the study. The mean age of the students was10.94 (SD=0.628) years, and the mean DMFT was 1.03 (SD=1.41). So that, in this study DT (0.53 ± 0.95) had the highest and MT (0.14 ± 0.47) had the lowest mean. A multivariate regression analysis model results showed a significant relation between high DMFT scores and such variables as increasing age, lower levels of mother's education, higher family income, lower frequency of tooth brushing and dental flossing, having a history of no visits to the dentist (P

Study DesignDevelopment and psychometric evaluation.PurposeDesign and psychometric assessment of the Nursing Low Back Pain Predictor Questionnaire addressing nurses suffering from chronic low back pain in Iran.Overview of LiteratureLow back pain is the most prevalent behavior-related health problem among nurses, and it needs to be assessed through a validated multi-factorial questionnaire, using the premises of the social cognitive theory.MethodsThis was a cross-sectional study carried out in Tehran, Iran from April 17, 2014 to July 16, 2014. A 50-item questionnaire based on the social cognitive theory was generated. The questionnaire was distributed among 500 nurses working in hospitals located in different geographically areas in Tehran. Exploratory factor analysis was used to determine the factors and their related items. Cronbach's alpha was calculated to assess reliability.ResultsThe exploratory factor analysis loaded six factors, named observational learning, outcome expectations, self-efficacy, self-regulation, and self-efficacy in overcoming impediments in the working environment and emotional coping. All factors were jointly accounted for 67.12% of behavior change variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.91). Test and retest analysis with 2-week intervals indicated an appropriate stability for the questionnaire (intraclass correlation coefficient=0.94).ConclusionsAccording the results, the developed questionnaire is a reliable and validated theory-based instrument, which can be used to predict the work, related factors for low back pain among nurses.

Study DesignClinical trial.PurposeTo compare the multidisciplinary educational program versus physiotherapy education among Iranian nurses.Overview of LiteratureLow back pain (LBP) can accompany significant occupational injuries in the nursing profession. There is no agreement on the most effective educational practice.MethodsThis study was conducted from August 17, 2014 to September 22, 2014 in Tehran, Iran. Eligible nurses with chronic mechanical LBP (n=136) were classified into an intervention group (n=66) or the control group (n=70). The intervention group received physiotherapy education for 120-minutes followed by a 120-minute health education session based on predictive constructs of social cognitive theory (SCT). The control group received the 120-minute physiotherapy education. Disability rate, pain severity and back pain prevention behavior were measured at initially and 3 months after intervention using visual analogue scale, Roland-Morris disability questionnaire and nursing low back pain preventive behaviors questionnaire.ResultsThe two groups were the same in terms of all studied variables at the initiation of the study. At the 3-month follow up, predictive constructs of LBP preventive behaviors of participants in the intervention were improved (p

An amendment to this paper has been published and can be accessed via the original article.

Objective (s): To determine the predictors of condom use intention among Iranian men with history of addiction. Methods: This was a cross sectional study of a sample of 128 men with history of addiction attending to slef-hep groups in Qom, Iran. Data were collected through a valid structured questionnaire based on the health belief model. Results: The results showed the perceived benefits and perceived barriers were the strongest predictors of condom use intention. According to the results, the most important perceived benefit of condom use was HIV prevention and for the perceived barrier it was sexual pleasure reduction. Conclusion: This study indicated that perceived benefit and perceived barrier could predict intention of condom use.

Objective (s): Functional dependence in physical activities is one of the most important health problems among elderly people. This study aimed to examine functional independence level of physical activities among elderly people living in Bandar Abbas, Iran. Methods: This cross-sectional study was conducted among 421 old adults aged over 60 living in Bandar Abbass, Iran. Using multi-stage sampling method, the participants were randomly selected and completed two valid questionnaires of the Activities of Daily Living (ADL) and the Instrumental Activities Daily Living (IADL). Data were analyzed using SPSS17 software. Results: The mean age of participants was 66.7 ± 6.9) and %49.9 was male and % 50.1 was female. According to the results, 1.9 % of elderly (n=8) and 22.1% (n=92) were dependent while doing their daily and instrumental activities respectively. There were significant differences between different groups of participants in terms of doing daily activity due to their age, marital statu, education level and socio-economic factors (P

Objective (s): To explore perceptions of men living with HIV regarding perceived susceptibility to sexually transmission of HIV. Methods: In-depth, semi-structured interviews were held with a purposively selected group of individuals living with HIV recruited from three HIV care clinics in Tehran, Iran. Participants were initially selected from HIV-positive male patients by convenience sampling and narrowed-down by maximum diversity sampling. All interviews were recorded and typed, and the codes were extracted from reviews. Data were analyzed using the content analysis approach. Results: In this study 32 participants were interviewed. Half of participants did not know that they are at risk of AIDS and indicated that they did not use condoms in their sexual relationship. The majority of participants did not believe that the disease could be transmitted during unprotected sexual contact and thought that only men who have sex with men could be affected with HIV. In contrast, others knew themselves at risk of AIDS, but believed that this is out of their control and it depends on God’s willing. Conclusion: Extensive public education on prevention of HIV transmission. for all groups especially thos who are at higher risk is recommended.

Introduction: There are substantial evidences that unhealthy behaviors regarding hypertension disease could result in consequences of the disease and increased mortality rate. This study aimed to assess the efficacy of health education program to improve knowledge and attitudes of patients regarding due self cares. Material and method: This is a before and after interventional trial that was undertaken among hypertension patients who referred to health centers in south Tehran, Iran. Totally, 60 eligible patients were randomly selected for them a designed educational program was accomplished. Then knowledge, attitudes of participants regarding hypertension was assessed before and after intervention through a self administered questionnaire. Results: The results of this study showed mean scores of knowledge and attitudes were significantly improved after intervention (67.6±18.8 vs 92.0 ± 5.4 for knowledge and 55.3 ± 15.4 vs 87.8 ± 8.6 for attitude) (all P value< 0.0001). Conclusion: The findings of this study suggest that the designed educational program is an effective intervention and could play an important role in improving knowledge and attitudes of hypertension disease.

Introduction: Dental caries and obesity are multifactorial diseases with diet being a common contributory factor. Many studies have reported varied outcomes about the association between dental caries and body mass index. But, there is no published study that investigates this association among female students in Tehran. The main aim of this study was to examine the relationship between dental caries and body mass index (BMI) in a sample of female students in Tehran. Methods: In this cross-sectional study, 416 students aged between 10 to 12 years was examined for dental caries using WHO standard diagnostic criteria. The Decayed, missing and filled of permanent teeth (DMFT) were recorded. The student's weight and height were measured by two trained examiner and their BMI were calculated. BMI-for-age and dental caries categories were analyzed with Pearson correlation coefficient, Chi-square, and t-tests using SPSS computer software. Results: The mean DMFT score and BMI of the study population was 1.03 ± 1.41 and 18.11 ± 3.33 respectively. The findings showed that 58.9% of the children had a normal weight, 27.9% were overweight, 10.3% were obese, and only 2.9% of the students were thin when they were compared with WHO standard of BMI for children with the same age. The respective mean DMFT values for BMI groups (thin, normal, overweight and obese) were 1.25, 0.73, 1.42, and 1.65, respectively. There was a significant association (P < 0.05) between dental caries and high BMI. Conclusions: This study demonstrated a significant association between caries frequency with high body mass index. For these reasons, the evaluation of nutritional status in students should be implemented in control programs for dental caries both on the community, schools, and individual levels.

INTRODUCTION: The aim of this study is assessing predictors to oral health behavior in Iranian students based on the health belief model. MATERIALS AND METHODS: This cross-sectional study was conducted on 416 (applying the statistical estimation) of fifth-grade female students of Tehran in 2016. Random cluster sampling method was used to recruit students. The inclusion criteria were being grade five female student (aged 10–12 years), and studying in governmental schools, and having a signed consent from the child's parent or legal guardian. Logistic regression analysis was used to identify the variables that predict oral health behaviors. RESULTS: Overall, 416 female students were entered into the study. Of these, only 55.3% of the students reported that they were brushing at least twice a day, 22.4% were using dental floss at least once a day, and 23.1% reported checking their teeth every 6 months. The results obtained from the logistic regression analysis indicated that perceived self-efficacy, was the significant predicting factor for brushing at least twice a day (odds ratio [OR] = 1.34, 95% confidence interval [CI] =1.06–1.69, P = 0.012) and use of dental floss at least once a day (OR = 1.61, 95% CI = 1.14–2.27, P = 0.007). Furthermore, mother's job predicted use of dental floss at least once a day by (OR = 1.83, 95% CI 1.07–3.10). Perceived benefits were the significant predicting factor for 6 months check (OR = 1.78, 95% CI = 1.14–2.77). CONCLUSION: The current study provides evidence oral health can be promoted by increasing perceived self-efficacy and enhancing perceived benefits in female students.

Objective (s): Exposure to air pollution has been associated with higher adverse pregnancy outcomes. This study aimed to investigate the stages of behavior change towards air pollution among pregnant women using the stage of change theory.Methods: In this cross sectional study a sample of pregnant women who referred to three health centers located in different geographic regions of Tehran were randomly selected and assessed. The inclusion criteria were age between 18 and 35 years, having the history of pregnancies without adverse outcomes, not suffering from chronic disease during the present pregnancy and being satisfied to taking part in the study. Data were collected by a standard questionnaire based on stage of change theory.Results: In all 200 eligible pregnant women with mean age of 26.9±4.8 participated in the study. The analysis of data showed that most women (51%) were at pre-action stages. Only 16% of pregnant women were identified at action stage.Conclusion: The findings suggest that a relatively high proportion of pregnant women are at pre-action stages of behavior changes towards exposure to air pollution. The need for further investigation and perhaps necessary action is recommended.|

Objective (s): To investigate on consequences of living with HIV/AIDS. Methods: This was a qualitative study. Initially we selected a convenience sample and then narrowed-down the sample by maximum diversity in terms of age and education. Data was collected via semi-structured interviews. All interviews were recorded and transcribed, and the codes were extracted after reviewing them several times. Content analysis was performed to explore the data.Results: In all 34 participants were interviewed: 32 HIV positive men (with age average: 37.5 years and standard deviation: 7.13) and 4 HIV positive women (with age average: 34 years and standard deviation: 3.04) Participants indicated the following consequences: social, psychological, physical and economic. Most participants referred to adverse social outcome as the most important consequences of living with HIV/AIDS. The most important social adverse effect mentioned by participants was stigma, discrimination and exclusion. Conclusion: The findings suggest that stigma and discrimination should be lessening for people who live with HIV/AID. Perhaps media could play an important role to achieve this.

Background & Aim: This study aimed to assess relationship between perceived benefits/barriers and decisional balance with stages of change for physical activity among high school students in Bandar Abbas, Iran. Methods & Materials: This cross-sectional study was conducted in high schools of Bandar Abbas, in the south of Iran. A total of 422 high school students were selected. Twenty two participants did not fill out questionnaires completely. A total of 400 questionnaires were analyzed (response rate=94.8%). The perceived benefits/ barriers to exercise and decisional balance were assessed using the Exercise Benefits/Barriers Scale and stages of change were assessed using the Physical Activity staging. Data were analyzed in the SPSS v.16. Results: The mean age of the participants was 15.9 (SD=1.1) ranging from 14 to 18 years. More than half of the participants (51.8%) were male and 48.2% were female. About half of the participants (49.2%) were engaged in regular physical activities. Fifteen per cent of the participants in the precontemplation stage, 15.8% in the contemplation stage, 20% in preparation stage, 15.8% in action stage, and 33.4% in maintenance stage for physical activity. From precontemplation stage to maintenance stage, the perceived benefits and decisional balance were increased and the perceived barriers was decreased. Conclusion: The results of this study are in line with the Transtheoretical model. This model can be used as a framework to design interventions for improving physical activity in population.

Background and Aim: Cardiovascular diseases are the most prevalent and important cause of death all over the world, which affect the patients' quality of life. These diseases involve many problems for patients and a lot of cost for the society. The aim of the present study was to determine the quality of life and factors related to it in cardiovascular patients after heart surgery. Materials and Methods: This study was a descriptive cross-sectional one in which. 110 cardiovascular patients from Rasht Heshmat hospital randomly participated after heart surgery. The necessary data was collected through interview and SF-36 quality of life questionnaire, patients self-report, and referring to their own hospital records. The obtained data was analyzed by means of kolmogrov smirnov test, ANOVA and Duncan test, using SPSS software (V: 16) and P…………was taken as the significant level. Results: Mean age of the subjects was 57.04±9.37 yrs and their mean quality of life was 50.27±8.55. There was a statistically significant relationship between quality of life and variables such as age (P

Background & Aim: This study aimed to assess relationship between perceived benefits/barriers and decisional balance with stages of change for physical activity among high school students in Bandar Abbas, Iran.Methods & Materials: This cross-sectional study was conducted in high schools of Bandar Abbas, in the south of Iran. A total of 422 high school students were selected. Twenty two participants did not fill out questionnaires completely. A total of 400 questionnaires were analyzed (response rate=94.8%). The perceived benefits/ barriers to exercise and decisional balance were assessed using the Exercise Benefits/Barriers Scale; and stages of change were assessed using the Physical Activity staging. Data were analyzed in the SPSS v.16.Results: The mean age of the participants was 15.9 (SD=1.1) ranging from 14 to 18 years. More than half of the participants (51.8%) were male and 48.2% were female. About half of the participants (49.2%) were engaged in regular physical activities. Fifteen per cent of the participants in the precontemplation stage, 15.8% in the contemplation stage, 20% in preparation stage, 15.8% in action stage, and 33.4% in maintenance stage for physical activity. From precontemplation stage to maintenance stage, the perceived benefits and decisional balance were increased and the perceived barriers was decreased.Conclusion: The results of this study are in line with the Transtheoretical model. This model can be used as a framework to design interventions for improving physical activity in population.

Background: self care empowers individuals to self manage their minor ailments, chronic conditions, and to exert more control over their lives. Self care includes activities such as influencing prevention, health maintenance, and treatment of illness by individuals, this study was conducted to assess views about self care among the general population living in south of Tehran. Materials and Methods: This survey was cross-sectional study by using of two-stage random cluster sampling, 1200 individuals aged 17 years and over was surveyed regarding self care. A structured closed validated questionnaire was used to collect data. Data were finally analyzed by Kruskal-Wallis, Pearson Chi-square, Fisher exact test and linear by linear association. Questionnaire has totally five parts including knowledge, attitude, performance toward self care, views regarding general health and demographic characteristics as well. Furthermore; project number is 4276-62-02-85. Results: The mean age of subjects was 27.9 years (SD = 5.2); 50.2% ( n = 603) were female; 54% ( n = 643) were married (deleted), (55%, n = 658) reported that they were not knowledgeable about self care and (82%, n = 986) were interested in self care. Only 4% ( n = 53) of subjects indicated they drank ≥ 7 glasses of water daily; fewer reported they consumed at least five portions of fruits/vegetables daily (3%, n = 31; and (4%, n = 51) engaged in physical activity more than 3 h weekly. There were statistically significant relationships between knowledge and interest ( P < 0.01), knowledge and practice ( P < 0.001), and interest and practice regarding self care ( P < 0.001). Conclusion: The vast majority of subjects approximately two third felt satisfied with their health, most of subjects reported "feeling healthy" despite engaging in unhealthy life styles, it is revealed that more educated people, and likely those with more income, were interested in and knowledgeable regarding self care and were actually active in healthy life styles. In brief; this study suggests that physicians could support self care through their consultations with patients.

Background: Cardiovascular disease is one of the important worldwide chronic diseases. Education program through different copying styles is one of the major needs of cardiovascular patients. The aim of this study was to assess the effectiveness of a self-care education program on coping with problem in cardiovascuar patients after heart surgery. Methods: This study was a clinical-trial in which 110 cardiovascular patients were selected according to inclusion and exclusion criteria and randomly divided into case and control groups with 55 patients in each group. The case group received the educational interventio, however the control group did not receive any educational intervention. Data were collected through a three part questionnaire including demographic specifications, self-care as well as standard Jalowiec questionnaire that were filled out for both group before and after two month after education program. Collected data was analyzed through descriptive and analytical statistics. χ2, Fisher test, Student–t test and Paired–t test were used to analyze the data. We used Excel and SPSS software. Finding: This study showed significant difference between two group after intervention in terms of applying problem-coping style (P < 0.000) and emotional-coping style (P < 0.001). Problem-coping style was increased significantly in case group where as emotional-coping style was decreased in this group. This changes were not seen in control group. Conclusion: This study showed that self-care education could improve coping with the problem among cardiovascular patients after surgery.

Background: Chronic low back pain is one of the most health problems worldwide. This study aimed to examine the effects of a designed multidisciplinary program on quality of life and disability among chronic low back pain patients up to 18 months. Methods: This study followed the participants in previous randomized controlled trial up to 18 months. Therefore, data at 18- month follow up, were collected through SF-36, Ronald –Morris Disability Questionnaire, and Quebec low back pain Disability Scale and then analyzed in five stages of 0, 3, 6, 12, and 18 months through repeated measure ANOVA. Finding: Repeated measures ANOVA showed that interactions between time and group were different in all subscales of SF-36 scale (all P ≤ 0.05).The disability of patients was decreased over time in intervention group that was significantly different from control group (P < 0.01). Conclusion: The findings of this study suggest that the designed multidisciplinary program could improve quality of life and decrease disability even up to 18 months in chronic low back pain patients.

Objective(s): To investigate the individual factors which lead to the occurrence of high risk behaviors among HIV/AIDS patients and vulnerable people. Methods: This was a qualitative study approach carried out in 10 month in tow public counseling clinic in Tehran. Data were obtained from 102 in depth and semi-structured interviews. A convenience sample of HIV/AIDS patients, clients and specialist took part in the study. Interviews were transcripted and then open coding and axial coding were performed. Results: In all 69 HIV/AIDS patients and 19 high risk clients, 6 family members and 8 experts were interviewed. The majority of participants were male and single. Sexual high risk behaviors and drug use were the commonest ways of HIV/AIDS transition. Individual factors predisposing HIV/AIDS high risk behaviors included: 1. Predisposing perceptions 2. Personal factors 3. Decision and will Conclusion: The results indicated that the beliefs, decision and individual factors might be the most underlying contributing to high risk behaviors.

"nMeasuring health related quality of life of old people has become an important public health issue with the aging of population in developing countries. The aim of this study was to examine the health related quality of life of old people living in Bandar Abbas, Iran. This was a population-based study in which a random sample of 1000 individuals of the community aged over 60 years were interviewed using SF-36 questionnaire. Overall health related quality of life and relative differences between men and women and also between different age groups (60-75 years vs. >75 years) was assessed in this study. A total of 1000 elderly individuals completed the SF-36 questionnaire. Of all participants 499 (49.9%) were men, 501(50.01%) women, 789 (78.9%) aged 60-75 years, and 211 (21.1) aged over 75 years. The logistic regression analysis showed the age over 75 years could increase the risk of lower score of physical [OR: 2.69, CI; (1.96-3.73] and mental [OR: 1.58, CI (1.16-2.15)] component summaries of SF-36 regardless other factors. Additionally, suffering from chronic diseases could decrease physical and mental scores of health related quality of life separately [OR: 8.6, CI; (4.37-16.94) and OR: 1.8, CI (1.1-2.99) respectively]. Women compared to men and illiterate old people compared to literate ones are more likely to perceive worse health related quality of life especially in physical component [OR: 1.35, CI; (1.01-1.81) and OR: 1.59, CI (1.12-2.24) respectively ]. The findings of this study suggest that health related quality of life in old people is not only decreased by aging, but each of other factors such as female gender, illiteracy, and chronic diseases could decrease health related quality of life of old people.

Payesh2009; 8: 263-269Accepted for publication: 18 March 2008[EPub a head of print-14 Jul. 2009] Objective(s): Transtheoretical Model is a behavior change model that incorporates the stages of change for the process of quitting smoking. The aim of this study was to determine these stages in smokers living in Bandar Abbass, Iran.Methods: This was a cross sectional study. Using cluster random sampling, 1810 subjects aged 15 years and over, were studied from April to May 2007 in Bandar Abbass, Iran. Economy Model Questionnaire was used to collect data regarding three stages of change including precontemplation, contemplation and preparation within current smokers to describe different levels of readiness to quit smoking.Results: In all, 1810 individuals were studied. Two hundred and twelve participants (11.7%) were smokers, among them 204 (96.2) were men. There were statistically significant differences between smokers and non-smokers in terms of gender, age and education (P

Objective:Despite the benefits of mother-newborn skin-to-skin contact (SSC) immediately after birth, the process has not been universally implemented as routine care for healthy term neonates. The purpose of this study was to determine opinions of the midwives about enabling factors of SSC immediately after birth in Tehran hospitals in 2012- 2013. Materials and methods:This study has been conducted in a descriptive method based on PRCEDE-PROCEED model. The samples were 292 midwives from 18 hospitals. We used stratified and then simple random sampling. In this study midwives were working at delivery room; deliveries were conducted by midwives or they were in charge of the newborn immediately after birth. Data collection instrument was a self developed questionnaire concerning the enabling factors in the SSC. We applied face and content validity ratio (CVR), content validity index (CVI) and item impact method for the instrument's validity and Cronbach's Alpha for reliability. Finally, data were analyzed and interpreted using spss-18 through descriptive statistics. Results:The results show that 90.4% of the midwives believed in necessity of a plan, 96.2% believed that good services should be provided to mothers, and 97.9%, 85.3% and 93.8% of them believed there is a need for private space, essential facilities and essential equipment for skin contact process; with Cronbach's Alpha of 0.731, 0.551, 0.501, and 0.600 respectively. Conclusion:Most of the midwives believed that enabling factors concerning the successful SSC are effective. We suggest further studies on other enabling factors effective in SSC from the view point of midwives, gynaecologists and caregivers.