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Introduction: The COVID-19 virus spreads at a high rate, exerting many physical, mental and psychological effects on patients. Patients with COVID-19 have been reported to have high levels of interleukin 1 and interleukin 6. Therefore, this study was conducted to determine the association of physical, mental, and psychological problems with the levels of interleukin-1 and -6 in COVID-19 patients., Methodology: This is cross-sectional descriptive-analytical research on 121 COVID-19 patients selected using simple random sampling method. The patients were hospitalized in university hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences and Amir al-Momenin Hospital. Data collection tools included the depression anxiety stress scale (DASS), a demographic questionnaire, and a checklist of physical problems. Blood sampling was also done to perform an ELISA test and measure the level of interleukin-1 and -6. Data were analyzed based on independent t -tests, chi-square, regression, and Pearson's correlation coefficient, using SPSS ver. 22., Results: The average age of the 121 patients participating in this study was 53.31 ± 14.09. A direct and statistically significant correlation was observed between body temperature on the first day and interleukin 1 level. A statistically significant negative correlation was observed between blood oxygen saturation level and interleukin-1 and -6 on the first, third and fifth days. Shortness of breath and coughing had a statistically significant correlation with the level of interleukin 1 on the third and fifth days. A direct and statistically significant correlation was observed between body temperature on the first, third and fifth days and interleukin 6 level. Coughing on the third and fifth days had a statistically significant relationship with interleukin 6 level. No direct and non-significant statistical correlation was found between depression and stress and the serum level of interleukin 1, but a significant correlation was observed between anxiety and serum level of interleukin 1. Finally, the results showed that depression, anxiety and stress had a direct and statistically significant correlation with the serum level of interleukin 6., Conclusion: Given the relationship between interleukin-1 and -6 and most physical and psychological problems, level of the inflammatory biomarkers interleukin-1 and -6 can be used to estimate the severity of physical and psychological symptoms in COVID-19 patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bahadori-Birgani, Molavynejad, Rashidi, Amiri, Maraghi, Dashtbozorgi, Ulhaq and Alizadeh-Attar.)

Objective: The aim of this study was to investigate the psychological and personality characteristics of the applicants for facial cosmetic surgery., Methods: This descriptive-analytical study was conducted on 385 facial cosmetic surgery applicants who referred to medical centers in Ahvaz (south Iran). The data collection tool included three questionnaires: (1) demographic questions, (2) the General Health Questionnaire (GHQ), and (3) the NEO Five-Factor Inventory (NEO-FFI)., Results: The results showed that 45.2% of the participants had abnormal health status. The mean score of the participants on the openness subscale was insignificantly lower than that of the general population (p > 0.05). On the other hand, the mean scores of the participants on the conscientiousness and agreeableness subscales were significantly lower (p < 0.001). Finally, the mean score of the samples on the extroversion subscale was significantly higher than that of the general population (p < 0.001)., Conclusion: Given the results of the study, it is strongly recommended to address the personality and psychological characteristics of the applicants for cosmetic surgery before operating on them., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Families are considered as primary sources of care for individuals suffering from mental disorders. However, one of the major stresses in families is the infliction of a family member with mental illnesses causing dysfunction in health dimensions or generally their quality of life. Currently, most experts believe that religion can affect physical health and other aspects of human life. So, the aim of this study was to investigate "the relationship between care burden and religious beliefs among family caregivers of mentally ill patients." This cross-sectional study was carried out in Iran on 152 families with mentally ill patients who were hospitalized in psychiatric wards. The sampling method was nonprobability and consecutive sampling method. The data collection instruments included a demographic characteristic questionnaire, Religious Beliefs, and Zarit Care Burden Questionnaires. The mean score for care burden was 30.99 (SD = 16.45). 5.9% of the participants reported a low level, and 39.5% experienced a moderate level of care burden. Moreover, the mean score for religious beliefs was 115.5 (SD = 13.49), and majority of the participants (70.4%) were endowed with strong religious beliefs. There were no significant associations between care burden and intensity of religious beliefs among the study samples (P = 0.483). Considering the results of this study indicating experience of moderate-to-high levels of care burden in families with mentally ill patients, it is recommended to consider such families and their religious beliefs as contributing factors in coping with challenges of mental disorders.

Introduction: Despite the importance of cosmetic surgery in improving body image and promoting individuals' physical and mental health, it is accompanied with some physical, mental, and economic problems, because it is an invasive procedure. Considering such extensive consequences and given the rising demand for performing such surgeries, it is essential to consider programs for reducing such requests. The present study aimed to investigate the psychosocial causes of the tendency for facial cosmetic surgery in patients referred to medical centers in Ahvaz in 2016-2017., Materials and Methods: This study was conducted on 385 facial cosmetic surgery applicants referred to medical centers in Ahvaz and were selected using a sequential non-probability sampling method. The data collection tool was a questionnaire divided into two sections namely: (1) demographic questions and (2) a questionnaire on the psychosocial causes of the tendency for facial cosmetic surgery., Results: The mean scores of the psychological and social causes of the tendency for facial cosmetic surgery were 4.46 (SD = 1.67) and 3.44 (SD = 2.57), respectively. "Being interested in being beautiful" was the most frequent positive response of the participants regarding the cause of tending to undergo facial cosmetic surgery (88.6%) and the least frequent response was estimated to be 35.1% for the "inappropriate psychological state" cause., Conclusion: The results of this study showed that psychological factors affected the participants' tendency for facial cosmetic surgery more than social factors. Determining and identifying such psychological pressures and providing individual training and psychological support can prevent individuals from undergoing facial cosmetic surgery., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Objective: The purpose of this study was to determine the effect of education based on health belief model (HBM) on the behavior of breast cancer screening (bCS) in women., Methods: This quasi-experimental study was conducted on 226 women who were selected with cluster sampling method from those referred to Dezful health centers. Data collection tool was a researcher-made questionnaire. Demographic questionnaire bCS- scale, and the Knowledge about questionnaire, all given before and 3 months after the intervention., Results: According to the findings of the study, there was a significant relationship between women's performance and variables of knowledge, perceived sensitivity, perceived benefits, perceived barriers, self-efficacy, and cues to action., Conclusions: Poor knowledge of women indicates a crucial need for formal educational programs to sensitize women regarding the importance of bCS. These educational programs should consider factors affecting bCS behaviors., Competing Interests: There are no conflicts of interest.

Background: Breast cancer prevention is a globally significant and cost-effective public health priority, particularly in low- and middle-income countries. Empowering women through improved health literacy is a key strategy for reducing the disease burden. However, effective educational programs must be tailored to the specific cultural context and needs of the target community. This study explored the educational needs of Iranian women for a virtual breast cancer prevention program. Methods: A descriptive qualitative design was used from January to July 2022. Purposive sampling with maximum variation was utilized to recruit a sample of 28 participants. Data collection was conducted through semi-structured interviews. Following the method outlined by Graneheim and Lundman, qualitative content analysis was employed to analyze the interview data. MAXQDA 2020 software was used for data analysis. Components of trustworthiness, including credibility, dependability, confirmability, and transferability, were considered. Results: Our findings identified three primary categories: "developing women's scientific, practical, and attitudinal capabilities"; "features of program content"; and "principles of electronic content design". These results offer valuable insights into the educational needs of Iranian women for virtual breast cancer prevention programs. Conclusions: To design an effective virtual program, it is crucial to address all three domains: cognitive, emotional, and psychomotor. Program content should be organized and presented using methods that sensitize women to the importance of breast cancer prevention and motivate them to participate. Furthermore, the program's design should be grounded in evidence-based practices and principles of electronic content design, ensuring cultural sensitivity to the needs of Iranian women. [ABSTRACT FROM AUTHOR]

The Bee Cosmetic Surgery Scale (BCSS) is a novel clinical tool designed to assess the psychopathological, psychosocial, and decision-making factors involved in accepting cosmetic procedures. This prospective, multicenter study aimed to propose and validate the BCSS, which considers aesthetic aspects, personal pathological history, and psychopathological implications leading to the acceptance of invasive or non-invasive aesthetic interventions. The study included 281 participants aged 18–66 years, divided into three groups: non-invasive cosmetic surgery (NICS), invasive and non-invasive cosmetic surgery (INICS), and individuals who had not undergone cosmetic surgery (NCS). Participants were randomly selected from patients visiting plastic surgery services and various medical services in Oradea, Romania, between October 2022 and March 2024. The BCSS comprises 20 items with Likert-type responses, ranging from one to five. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support. The BCSS aims to elucidate the patient's desire for aesthetic procedures, whether it stems from an impulsive act, warrants a longer decision-making period, or necessitates addressing psychological or psychiatric conditions before scheduling the procedure. The scale enables cosmetic surgeons to assess whether the patient has been adequately informed and understands the risks and complications associated with the cosmetic surgical procedure. [ABSTRACT FROM AUTHOR]

Background: Various researchers have shown that the health level, performance status, and quality of life (QOL) are often less than expected especially in hemodialysis (HD) patients., Objectives: This study aimed to determine the effect of the two methods of educational programs on health- related QOL (HRQOL) in Iranian HD patients., Patients and Methods: In this quasi-experimental, pretest-posttest interventional study, we employed each subject as his/her own control. The study was conducted at the dialysis units in three major general hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. A total of 90 HD patients were randomly allocated to two 45-patient groups of oral and video education programs, respectively. The educational programs included dietary and fluid regimens, the care of fistula and skin, and stress management. HRQOL was assessed in both groups using a Farsi version of the Short Form Health Survey (SF-36) before and after the educational programs. Repeated measures analysis of variance and ANOVA were used for data analysis through SPSS., Results: SF-36 domains of physical functioning (P < 0.021), role physical (P < 0.031), social functioning (P < 0.001) and mental health (P < 0.001) were significantly increased in both oral and vide education groups after the interventions. There was no difference in the effectiveness of the two educational programs., Conclusions: Appropriate interventions may potentially lead to improvement in the HRQOL of these patients. Therefore, video education as an effective, inexpensive, simple, and attractive method is recommended for HD patients.

Background: The escalating importance of physical attractiveness, concerns regarding body image, and fear of bodily appearance can significantly influence the decision to undergo cosmetic surgery. While the efficacy of various interventions on variables such as body shame and signs of body dysmorphic disorder has been examined, the effectiveness of schema therapy has not received sufficient attention from researchers. Therefore, it is imperative to investigate the impact of this intervention on improving the psychological status of individuals seeking cosmetic surgery. Aims: The aim of the present study was to investigate the effectiveness of schema therapy on perfectionism, body shame and symptoms of body dysmorphic disorder in women seeking cosmetic surgery. Methods: This study employed a semi-experimental pretest-posttest design with a two-month follow-up period. The statistical population included all women seeking cosmetic surgery at the Fatemeh Zahra Beauty Clinic in Tehran during the first 9 months of 2021. Among them, 30 participants were selected based on the study's inclusion criteria and randomly assigned to either the experimental or control group. The experimental group received schema therapy sessions (Yang et al., 2006) for ten 90-minute sessions. All participants were evaluated using multidimensional measures of perfectionism (Hewitt & Flett, 1991), body image shame (Davard et al., 2014), and fear of physical deformity (Littleton et al., 2005). Data were analyzed using SPSS-24 software and multivariate analysis of variance with repeated measures. Results: The results indicated the effectiveness of schema therapy on reducing perfectionism, body shame and symptoms of body dysmorphic disorder (p<0.05). Also, the results related to the interaction effect between time and group show that this effect is significant in all variables (p<0.05). Therefore, there is interaction between different levels of time and groups. Conclusion: Considering to the effectiveness of schema therapy it is suggested to focus on this therapy as one of the auxiliary, supportive and rehabilitation therapy along with drug treatment in reducing the consequences of perfectionism, body shame and the symptoms of dysmorphic disorder. [ABSTRACT FROM AUTHOR]

Background: Adherence to diet is effective for metabolic control in patients on hemodialysis. There are educational pamphlets or booklets to improve patients' knowledge about healthy diets. As video presentation is more desirable than the presentation of readable materials, we designed an educational video on healthy diets in renal failure patients who was played during several sessions of hemodialysis. We compared the effect of this modality on the knowledge, attitudes and metabolic control of the patients before and after the intervention. Methods: In this interventional study, all the patients who were referred to the hemodialysis ward at Ashrafi-Esfahani Medical Center (Tehran, Iran) between May 2018 and March 2019 were enrolled (N = 190). Totally, 130 patients had inclusion criteria. An educational video about a healthy diet was shown seven times (once a week in the first month, once every two weeks in the second month, and once in the third month) during hemodialysis for the patients. The nephrologist prepared a video in the form of a lecture with graphic images for 20 min based on the healthy nutrition of the Kidney Federation of Iran's Guide for hemodialysis patients. The questionnaire was completed in terms of awareness and attitudes, and blood and urine tests were performed at the 1st, 3rd, and 12th months. Serum parameters, including electrolytes, lipid profile, CBC-diff, dialysis efficacy (Kt/V), and the URR (urine filtration rate) were examined. Pre and post intervention values were compared via the statistical analysis performed using IBM SPSS. P-Value < 0.05 was significant. Results: The data of 128 people were analyzed at the end of the study. 55% of patients were 10–40 years old and 60% were male. 56% of patients were illiterate or had an elementary school education. The most common underlying diseases were hypertension and diabetes mellitus. Ten to 19% of participants had enough knowledge about the various components of a healthy diet for patients on hemodialysis. Approximately 25%, 14%, and 45% of the participants consumed a healthy diet for breakfast, lunch and dinner, respectively. A comparison of the mean values of the serum parameters before and after the intervention revealed significant changes in phosphorus, blood urea nitrogen, and hemoglobin with mean differences of -118.41 ± 22.84, 21.51 ± 10.38 (both P < 0.001), and 0.29 ± 1.18 (P = 0.044), respectively. The mean Kt/V was similar at all phases. Conclusion: The use of an educational video was effective for normalizing the metabolic parameters in patients under hemodialysis and can be an appropriate option, especially for illiterate patients. Trial registration: IRCT2016082229481N1. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Early breast cancer detection is crucial for improving breast cancer outcomes. Breast Self-Examination (BSE) is a valuable tool that can empower Catholic nuns to take charge of their health, particularly in constrained resource countries like Tanzania. This study aims to use the Health Belief Model (HBM) to predict SBE practices among Catholic nuns in Tanzania's Lake Zone. Methods: This study employed a cross-sectional design whereby a total of 385 catholic nuns were enrolled to participate in the study. The Health Beliefs Model (HBM) guided the study of the interrelated variables related to self-breast examination. Data was collected using a self-administered questionnaire and analyzed using Stata version 18.0. Bivariate and multivariate logistic regression was used to test for association at a 5% significant level. Results: The prevalence of non-performance self-breast examination was 64.2% (95% CI, 59.1%-69.0%). The multivariate logistic regression revealed that nuns who are in the non-health field were more likely not to perform self-breast cancer examination with an AOR of 1.67 (95% CI, 1.02-2.73, p=0.041). Likewise, nuns with high barrier were more likely not to perform self-breast cancer examination with an AOR of 1.88 (95% CI, 1.17-3.02, p=0.009), also, an AOR of 2.25 (95% CI, 1.39-3.65, p=0.001) for nuns with low self-efficacy. Conclusion: The study revealed that the HBM constructs can predict the SBE behavior of catholic nuns. In addition, educational health interventions are highly recommended to enhance SBE practice among this special group. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. Methods: The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. Results: The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. Conclusions: The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association of religious belief on the postoperative psychological status and quality of life of parents of children with congenital heart disease (CHD). This was a cross-sectional study conducted at a provincial children's hospital in Fujian Province, China. Parents of postoperative children with CHD in the early postoperative period were included in this study between January 2020 and September 2020. The parents were divided into a religious belief group (n = 39) and a nonreligious belief group (n = 42) depending on whether they had religious beliefs. The Religious Coping Questionnaire, WHOQOL-BREF scale, Self-rating depression scale (SDS), and Self-rating anxiety scale (SAS) were used to evaluate psychological status and quality of life. The results showed that the SDS and SAS scores in the religious belief group were significantly lower than those in the nonreligious belief group (P = 0.012 and P = 0.003, respectively). The WHOQOL-BREF scale results showed that the religious belief group's score was significantly higher than those in the nonreligious belief group on the subscale scores of physiology, psychology, social relations, and environment on the WHOQOL-BREF. The total score of quality of life in the religious belief group was significantly higher than that in the nonreligious belief group. Religious belief was associated with lower SDS score (β = − 0.324, P = 0.005) and SAS score (β = − 0.245, P = 0.026), while religious belief was positively correlated with the score of WHOQOL-BREF (β = 0.506, P < 0.001). In this study, we concluded that comparing to those with no religious beliefs, parents with religious belief experienced more positive emotions and higher quality of life when taking care of children in the early postoperative period after congenital heart surgery. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are the most common mental health problems in adolescents. Uncontrolled anxiety disorders during this period not only negatively affect adolescents' current performance but can also have long-term negative consequences on their physical and mental health. Objectives: This study is designed to investigate the relative frequency of anxiety and its correlation with individual and family characteristics among first-grade high school students in Shiraz, 2020. Methods: This is a descriptive and analytical cross-sectional study, conducted on 360 first-grade high school students who were selected using a multi-stage sampling method in Shiraz, Iran. Data were collected through online questionnaire software, which included the Beck Anxiety Inventory and a Demographic Questionnaire, and were analyzed using SPSS software version 24. Results: The relative frequency of anxiety disorders in the study samples was 59.7% (60.9% in girls and 56.6% in boys); among them, 13.1% experienced severe anxiety, 16.9% had moderate anxiety, and 29.7% had mild anxiety. The results of univariate analysis showed correlations between anxiety disorders and factors such as father's unemployment (P = 0.04), a history of physical and mental problems in teenagers (P = 0.04 and P = 0.001, respectively), and the lack of friendly relations between family members (P = 0.001). Additionally, the results of logistic regression analysis indicated that adolescents with mental illness and those lacking friendly relationships within their family had higher chances of experiencing anxiety disorders compared to other participants (OR = 5.00, P = 0.04 and OR = 9.95, P = 0.002, respectively). Conclusions: In this study, mental illness and the lack of friendly relations between family members emerged as significant factors contributing to adolescents' anxiety. Therefore, identifying and addressing these related factors, along with timely diagnosis and treatment of this disorder in adolescents, should be prioritized by mental health officials. [ABSTRACT FROM AUTHOR]

Background: Severe mental illness (SMI) imposes a substantial worldwide burden of disability, highlighting the need for comprehensive and adaptable mental health services. This study aims to assess the efficacy and cost-effectiveness of community-based mental health services (CBMHS) in reducing relapse and rehospitalization rates among individuals with SMI in Iran. Method: A systematic review and meta-analysis were conducted. Medline, EMBASE, ISI, SCOPUS, and ProQuest were searched until December 2022. We focused on randomized controlled trials, quasi-experimental studies, or economic studies related to individuals with SMI. Out of 127 articles, 17 were selected for a full-text review. The primary outcomes were the severity of psychopathology, rehospitalization rates, and the mental health of caregivers. We also examined community-based interventions and their impact on various outcomes. Data extraction and risk of bias assessment were performed, and critical appraisal was conducted using JBI checklists. Meta-analysis was carried out using STATA software. (PROSPERO registration. CRD42022332660). Result: Rehospitalization rates among patients who received CBMHS were significantly lower, with an odds ratio of 2.14 (95% CI: 1.44 to 3.19), indicating a 2.14 times lower likelihood than those who received treatment as usual. A reduction in psychopathology accompanied this, SMD: -0.31, 95% CI: -0.49 to -0.13, I2 = 40.23%). Moreover, there was a notable improvement in social skills (SMD: -0.7, 95% CI: -0.98 to -0.44, I2 = 0.00%). The burden on caregivers also decreased (SMD: -0.55, 95% CI: -0.99 to -0.1, I2 = 63.2). The Incremental Cost-Effectiveness Ratio (ICER) for QUALY was acceptable, albeit with a wide range of 613 to 8400 Dollars. Conclusion: CBMHS has demonstrated effectiveness and efficiency in Iran as a developing country. Additionally, it shows promise in mitigating the shortage of acute psychiatry beds. Using multiple data collection tools poses a limitation regarding data consolidation and conducting a meta-analysis. [ABSTRACT FROM AUTHOR]

Background: Despite the important role of the Aesthetic Plastic Surgery (APS) journal in the field of aesthetic plastic surgery, there is a notable absence of literature that focuses exclusively on the bibliometric analysis of this journal. In recognition of APS's 48 years of publishing, this study aims to perform a bibliometric analysis of the articles published in the APS (1976-2023)., Methods: Articles published in the APS were extracted from the Web of Science Core Collection database. VOSviewer was employed to perform bibliometric analyses. Microsoft Excel was utilized to analyse the publication and citation trends., Results: From 1976 to 2023, 5134 articles were published in the APS. These articles were contributed by 12,963 researchers from 3354 institutions across 91 countries. The USA and China were the leading contributors. The most prolific author is Luan Jie from China. The co-citation networks highlighted the influence of the journal Plastic and Reconstructive Surgery. We categorized the articles into four groups, and the results show that articles with the highest publications and citations in the APS are related to facial cosmetic surgery. In terms of specific surgical procedures, breast augmentation surgery has garnered consistent attention from researchers over the past 48 years, ranking first in both the number of publications and citations., Conclusion: The findings of this study indicate that the APS is a significant scientific journal, is widely utilized by global researchers in the field of aesthetic plastic surgery, and spans diverse knowledge domains., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Introduction: Hemodialysis is frequently used as a primary treatment for individuals with end-stage kidney disease (ESKD), and it significantly impacts the quality of life in adolescents undergoing this procedure. Providing a hemodialysis education to these patients is a valuable strategy for enhancing their well-being. The aim of the study is to assess the effect of the video-assisted educational program on the quality of life among adolescents undergoing hemodialysis in Palestine., Methods: This study employed a quasi-experimental design, a pre-test-post-test interventional study, involving a sample of 68 adolescent patients between the ages of 13 and 18 diagnosed with ESKD. The quality of life level was assessed in both groups using an Arabic version of the Pediatric Quality of Life Inventory™ version 3.0 ESKD Module survey. The study was conducted at the dialysis units in four hospitals associated with Augusta Victoria Hospital, An-Najah University Hospital, Palestine Medical Complex/Ramallah, and Beit Jala (Al Housain) Hospital. The study involved providing tailored face-to-face educational sessions with video assistance to the experimental group, while the control group received regular face-to-face education., Findings: The Generalized Estimating Equation analysis revealed no significant differences in quality of life between the experimental and control groups over time, across pre-test, post-test, and follow-up periods (p ≥ 0.05). However, within the experimental group, there was a significant improvement in total quality of life scores between the pre-test, post-test, and post-test follow-up (p ≤ 0.001), although the difference between the pre-test and follow-up approached significance but was not statistically significant (p = 0.056). In contrast, the control group showed significant differences in quality of life across the pre-test, post-test, and follow-up time points (p ≤ 0.05)., Discussion: Implementing suitable interventions can potentially enhance the quality of life for individuals undergoing hemodialysis. Consequently, we suggest using video-based education as a cost-effective, uncomplicated, and engaging approach for educating hemodialysis patients., (© 2024 International Society for Hemodialysis.)

Copyright of Journal of Ege University Nursing Faculty (JEUNF) is the property of Journal of Ege University Nursing Faculty (JEUNF) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The increase in the average age of the population, the decrease in the size of the household and rising in the number of working women impose an increasing burden on home caregivers in Iran. The aim of this study was to measure care burden of informal caregivers in Iran through systematic review and meta-analysis of existing literature. Materials and Methods: A systematic review was conducted by using national and international databases of Scopus, PubMed, Embase, Web of Science, SID, Magiran, and IranDoc papers in English and Persian language up to the first half of 2020. In this meta-analysis, we calculated the pooled care burden and 95% confidence intervals in Statistical Software For Data Science (STATA) V.15. Results: Forty-four papers were included in the current study based on inclusion and exclusion criteria comprising of 8626 samples. Pooled mean of Burden of Care was 52.01 (95% CI: 48.21-55.82). Highest pooled mean(SD) of care burden (64.37) was related to caregivers of schizophrenia patients (95% CI: 56.09–72.64). Highest care burden (53.45) was observed in most deprived areas (95%CI = 47.05–59.86). A statistically significant relationship was observed between caregivers gender and care burden (p < 0.05). Conclusions: The reported care burden of informal caregivers requires the establishment of a support system to control mental and physical stress. Due to the dispersion and cultural diversity in Iran, more studies are needed to obtain more accurate data. [ABSTRACT FROM AUTHOR]

Early detection of breast cancer (BC) is important to increase the likelihood of treatment and improve the quality of life and survival. The study explored why symptomatic women linger to seek early screening for BC diagnosis based on the health belief model (HBM). In this qualitative study, 20 participants were selected using the purposive sampling method (9 health professionals and 11 female patients BC). Data were collected using in-depth, semi-structured interviews in 2019. Transcribed interview data were analyzed using the directed content analysis informed by HBM. According to the participants' experiences, although most patients comprehended the extent of the disease, they did not see themselves at risk of BC. Some were not adequately aware of the benefits of early diagnosis and did not have the self-efficacy required for early presentation. The main barriers to the early presentation included lack of awareness, financial problems, embarrassment over the clinical examination, and inadequate access to specialized centers. According to HBM, while designing and implementing educational programs, it is recommended to focus on reinforcing perceived susceptibility, perceived benefits, and perceived self-efficacy, providing access to facilities, and removing possible barriers and cultural issues to encourage women for timely referral for BC screening. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that reminiscence therapy can effectively reduce cognitive and psychological symptoms. This study was conducted to examine the effect of individual reminiscence therapy on cognitive level, quality of life and depressive symptoms in older adults with type 2 diabetes., Methods: This study is an experimental type, randomised controlled study designed in pre-test - post-test design. The sample size of the study consisted of 58 older adults with type 2 diabetes, consisting of 29 intervention and 29 control subjects. The older adults in the intervention group were individually subjected to 5 weeks of reminiscence therapy in two sessions (each session 40-45 min) per week. No intervention was applied to the control group. Personal Information Form, Standardised Mini Mental Test, SF-36 Quality of Life and Beck Depression Inventory were used to collect the data., Results: While there was no significant difference between the pre-test Mini Mental Test, Beck Depression Inventory total score and SF-36 Quality of Life Scale mental and physical health sub-dimension mean scores of the older adults in the intervention group and the mean scores of those in the control group (P > 0.05), the difference between the Mini Mental Test, Beck Depression Inventory total score and SF-36 Quality of Life Scale mental and physical health sub-dimension mean scores of the older adults in the intervention and control groups in the post-test was found to be statistically significant (P < 0.05). The post-test Mini Mental Test total score, SF-36 Quality of Life Scale mental and physical health sub-dimension mean scores of the older adults in the intervention group were higher than the older adults in the control group. It was determined that the post-test Beck Depression Inventory total mean scores of the older adults in the intervention group were lower than the older adults in the control group., Conclusion: Reminiscence therapy can positively affect cognitive levels, quality of life and depression symptoms of older adults living in the community. Individual reminiscence therapy can be used as a nursing intervention in primary healthcare., (© 2024 Japanese Psychogeriatric Society.)

Introduction: Colorectal cancer is the third most common malignancy in Iran. Self-care is one of the most effective non pharmacological interventions for controlling the effects of the disease and the side-effects of drugs. An educational intervention based on Pender's health promotion model, which predicts health behaviours and self-care, can be implemented. Aim: To investigate the effect of an educational intervention based on Pender's health promotion model on improving selfcare behaviours among patients with colorectal cancer. Materials and Methods: This quasi-experimental study was conducted at Omid and Imam Reza Hospitals in Mashhad, Iran from June to August 2021. A total of 160 participants were divided into two groups: the experimental group (n=80) and the control group (n=80). The experimental group received four self-care education sessions (two sessions by a nurse and two sessions by peers), while the control group received no intervention. Data were collected using a questionnaire before, immediately after, and three months after the educational intervention. Statistical analysis was performed using independent samples t-test and Repeated Measures Analysis of Variance (RMANOVA). Results: The study included 103 male patients (64.4%) and 57 female patients (35.6%). At one month and three months after the intervention, the scores for awareness, attitude, behaviour, and the constructs of Pender's health promotion model (self-efficacy, perceived social support, perceived benefits, perceived barriers, perceived emotions) significantly increased in the intervention group compared to the control group (p-value<0.001). Conclusion: The findings of this study indicate that the educational intervention based on Pender's health promotion model effectively promotes self-care behaviours among patients with colorectal cancer. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the high school females' cancer-preventive behavior-based Health Beliefs Model relative to its components of perceived susceptibility, perceived severity, perceived barriers, perceived benefits, selfefficacy, and cues-to-action in Dhi-Qar Governorate. Methodology: A descriptive correlational design was used to guide this study. The study included a probability simple random sample of 300 students. Results: Finding show participants characteristics, the mean age is 17.16 (±1.64), the age 16 years old were recorded the highest percentage (23.7%). In regards with the grade, most of participants were sixth grade (36%). Concerning family monthly income, female students expressed <300 thousand Dinars (35%). In the end with the type of family, from the findings that the most of families from nuclear type (49%). Conclusions: Cancer-preventive behaviours-based Health Believes Model is not satisfactory among high school female students due to public awareness of breast cancer is still very poor. [ABSTRACT FROM AUTHOR]

Mammogram screenings offer early detection of breast cancer; however, women continue to refuse mammogram recom - mendations. The purpose of this quantitative quasi-experimental project was to determine if or to what degree the implementation of the Champion's Health Belief Model Scale (CHBMS) impacted mammogram adherence rates when compared to those receiving usual care in Wisconsin over a four-week period. [ABSTRACT FROM AUTHOR]

Background and Objective: Breast cancer is one of the most common malignancies and leading cause of death among women worldwide. Increase awareness, change the attitude and practice of women on breast cancer screening are effective way to reduce mortality due to early detection and treatment of breast cancer. The aim of this study was to evaluate the effect of education on breast cancer screening by using WhatsApp platform among the staff of the Islamic Azad University of Hamadan. Materials and Methods: A quasi-experimental study was conducted among 236 staffs in Islamic Azad University, Hamedan. Participants were randomized to either intervention group (118 staffs) or control group (118 staffs). One month’s education via WhatsApp was delivered to the intervention group. The outcomes were assessed at baseline and three months after intervention. The data were analyzed using the Statistical Package for Social Science (SPSS) version 20.0, Chisquare, independent samples t-test and paired sample t-test were conducted in the course of the data analysis. Results: the results of this study showed; there were significant improvement in knowledge (p=0.02), attitude (p=0.01), breast self-examination practice (p=0.00), clinical breast examination practice (p=0.004) and mammography practice (p=0.03) after intervention. There were not significant changes in control group before and after intervention. Conclusion: Implementing educational intervention based on WhatsApp can improve knowledge, attitude and breast cancer screening among participants. A public health education program is essential to improve breast cancer prevention among different group of people in community. [ABSTRACT FROM AUTHOR]

Background: The demand for minimally invasive cosmetic procedures has rampantly increased in recent decades. The aim of this study was to evaluate the body image, personality traits and quality of life (QoL) in women consuming botulinum toxin type A for cosmetic purposes. Methods: This case–control study was conducted on 89 participants referring to outpatient dermatology clinics in Mashhad from 2019 to 2021. All participants completed a checklist of demographic and clinical characteristics, as well as three other questionnaires, including the World-Health-Organization Quality of Life-Short Form, Big 5 Inventory-10 (BFI-10) and Yale-Brown Obsessive-Compulsive Scale modified for body dysmorphic disorder (Y-BOCS-BDD). A control group of 101 sex and age-matched people from the general population also completed the questionnaires online. Results: All participants were females, and most of them in the case group were 31–50 years old (n = 68, 77.1%). Among the case group, QoL was reported higher in all domains; however, this was only significant in 'physical' (P = 0.003) and 'psychological' (P = 0.036) aspects. After considering the confounding factors, the case group was able to significantly predict increased QoL in the 'physical' (P = 0.019) and 'environmental' (P = 0.015) domains. In terms of BFI-10 scores, conscientiousness was notably higher among the case group (P < 0.001), while the control group scored slightly but significantly higher than the case group in neuroticism (P = 0.019). The control group scored significantly higher in Y-BOCS-BDD (P < 0.001). Conclusions: In clients receiving botulinum toxin injection for cosmetic purposes, QoL was higher than in the control group. No signs of body dysmorphia or pathological personality traits were found in these individuals. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Reminiscence therapy is known as an effective intervention method for elderly with various health conditions. This study was to provide basic data for contributing to the spread and development of effective intervention by analyzing the characteristics and effects of reminiscence therapy applied to the elderly at home. Methods: To select the article to be studied, literature published from January 2000 to January 2021 was searched through eight databases. A total of 897 articles were searched, and the collected papers were analyzed using the flow chart of Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Of these, 6 articles suitable for the selection criteria were selected by reviewing titles and abstracts, excluding duplicate papers, using EndNote X9 and Excel 2013. The quality of literature was evaluated using the critical appraisal checklist of the Joanna Briggs Institute. Results: For the characteristics of the selected literature, most of the literature published within the last 10 years was conducted, and the research design was conducted only in experimental research. The most common form of reminiscence therapy was group reminiscence, and the type was 'simple reminiscence'. The intervention method of reminiscence therapy was provided in various ways, but 'Sharing' was mainly used, and the representative topic of recall was 'Hometown'. Most of the intervention was performed less than 10 times and took about 60 min. Conclusion: According to the results of this study, reminiscence therapy provided to the elderly living in the community was effective in improving their quality of life and life satisfaction. Therefore, it is suggested that reminiscence therapy can be an intervention method that is helpful for positive psychological factors and health promotion by improving the quality of life and life satisfaction of the elderly living in the community, and further, it is considered that the elderly can contribute to non-pharmacologically healthy aging in the community. [ABSTRACT FROM AUTHOR]

Background: Parents play a critical role in caring for their children with diabetes and bear a significant burden of care. Health education has increasingly focused on empowering parents through new strategic methods. The present study aims to investigate the impact of a family-centered empowerment model on the burden of care in parents and blood glucose levels of children with type I diabetes. Methods: An interventional study was conducted in Kerman, Iran, where 100 children with type I diabetes and their parents were randomly selected as participants. The study aimed to implement a family-centered empowerment model in the intervention group, which consisted of four stages (educational phase, increasing self-efficacy, improving self-confidence, and evaluation) over a period of one month. The control group received routine training. The Zarit Caregiver Burden questionnaire and HbA1c log sheet were utilized to evaluate the effectiveness of the intervention. Questionnaires were administered before, after, and two months post-intervention, and data were analyzed using SPSS 15. Non-parametric tests were employed, and statistical significance was set at p < 0.05. Results: Before the study, no significant differences in demographic variables, level of burden of care, or HbA1C levels were observed between the two groups (p < 0.05). After the intervention, the burden of care score in the intervention group was significantly lower than that in the control group, both immediately post-intervention and two months later (P < 0.0001). Additionally, the median HbA1C levels in the intervention group were significantly lower than those in the control group after two months (6.5 in the intervention group and 9 in the control group) (P < 0.0001). Conclusion: The findings of this study suggest that the implementation of a family-centered empowerment model is an effective strategy for reducing the burden of care on parents of children with type 1 diabetes and for controlling the HbA1C levels of these children. Based on these results, it is recommended that healthcare professionals consider incorporating this approach into their educational interventions. [ABSTRACT FROM AUTHOR]

This research was carried out to identify the relationship between the spiritual well-being and caregiver burden in caregivers of patients with breast cancer. The study was conducted with family caregivers of patients with breast cancer who presented to the oncology clinic of a university hospital for treatment. The study sample included a total of 138 family caregivers who met the criteria for participation and agreed to participate in the study. The data were collected using a participant information form, caregiver burden scale and three-dimensional spiritual well-being scale. The caregivers have a moderate level of caregiver burden and their spiritual well-being was quite high. The caregiver burden of female caregivers was found to be significantly higher than that of male caregivers (p = 0.040). There is a negatively significant relationship between caregiver burden and spiritual well-being (p = 0.000, r = − 0.357). The caregiver burden is significantly higher among the 24-h caregivers compared to that among the 3-h and 4–6-h caregivers (p = 0.003). The spiritual well-being of the caregivers who provide care between 3 h and 4–6 h a day was significantly higher than that of those who provide 24-h care (p = 0.001). Increasing spiritual well-being may help to reduce caregiver burden in caregivers of those with breast cancer. [ABSTRACT FROM AUTHOR]

The risk factors assessed are the most adjustable, so students should be aware of them to deal with future changes addressed by the support program adopted by Bisha University and applied by the students themselves. Those who strongly intend to participate in a health promotion program are female students (OR=1.412844), rural residency (OR=1.707547), MAS students (OR=1.439252), and those who have already participated in awareness programs (OR=1.557143). Keywords: breast cancer; awareness; predictors; medical students; Saudi Arabia EN breast cancer awareness predictors medical students Saudi Arabia 271 279 9 05/08/23 20230401 NES 230401 Elhadi Miskeen, SP 1 sp Abdullah M Al-Shahrani SP 2 sp SP 1 sp Department of Obstetrics and Gynecology, College of Medicine, University of Bisha, Bisha, Saudi Arabia; SP 2 sp Department of Family Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia Correspondence: Elhadi Miskeen, Head Department of Obstetrics and Gynecology, College of Medicine, University of Bisha, P. O. Box 515, Bisha, 67614, Saudi Arabia, Email [email protected] Introduction Breast cancer (BC) is a major public health concern, with high mortality and morbidity rates worldwide. The total number of students at Bisha University is 17,000, of which 900 are medical students. [Extracted from the article]

Introduction: Extramarital affairs disrupt family functioning and have serious negative consequences for the family members. Aim: The present study aimed to compare the effectiveness of combined cognitive-behavioral couple therapy and integrated behavioral couple therapy in improving family functioning in couples with extramarital affairs. Method: In this quasi-experimental study, with a pretest-posttest control group design, the statistical population consisted of all couples, referred to the counseling centers of Mashhad, Iran in 2021. Thirty nine couples were selected using the convenience sampling method among people with extramarital relationships and randomly assigned to three groups: control group (13 couples), combined cognitive-behavioral couple therapy (13 couples), and integrative behavioral couple therapy (13 couples). The experimental and control groups completed the Family Functioning Scale by Epstein et al. (1983) before and after the interventions. In order to data analysis covariance analysis was performed in SPSS version 20. Results: Results indicated that the scores of all family functioning components significantly decreased in the intervention groups compared to the control group (P<0.05). Combined cognitive-behavioral couple therapy was more effective in the dimensions of problem-solving and communication, while integrated behavioral couple therapy was more effective in emotional companionship (P<0.05). Conclusion: According to the present results, both combined cognitive-behavioral therapy and integrated behavioral couple therapy had positive effects on improving family functioning. Therefore, depending on the conditions and type of marital problems, therapists are suggested to use a combination of these two methods to improve family functioning in couples with extramarital relationships. [ABSTRACT FROM AUTHOR]

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Introduction: Considering changes in the structure of Iran’s population, the prevalence of cancer is increasing. Increasing social awareness about cancer and screening for cancers are the most cost-effective approaches for breast cancer prevention. Studies show a significantly low rate of regular breast cancer screening behaviors. Given the importance of breast cancer and the decreasing effect of screening methods on the financial burden and disease complications, awareness about their attitude can provide appropriate information for Policy-making about breast cancer screening methods in Iran. This study aimed to investigate the attitude of women over 40 years-old visiting health centers affiliated toward breast cancer screening methods. Methods: This is a descriptive/analytical study performed cross-sectionally in the health centers affiliated with TUMS. Two hundreds fifty-five women from Imam Khomeini Hospital Complex and some health centers that were subsidiaries of the south health centers of TUMS, were enrolled. To collect the required data, we developed a questionnaire based on tools used in similar studies. We used the Chi-square test to investigate the relationship of the attitude score with demographic and socioeconomic variables. The statistical analyses were performed in STATA. Results: About 77.6% of the participants agreed that breast cancers detected earlier are almost treatable. About 18.9% of the participants believed that (agree and highly agree) they will not develop breast cancer in the future, and 47.8% had no idea; 68.2% of the participants disagreed with the item “breast cancer is almost incurable even if detected in early stages;” about 22.0% of them believed that they are at higher risks for breast cancer compared to other women, and 61.3% of the participants agreed to visit a physician in case of feeling pain or a mass in the breast Conclusion: The attitude of the Women participating in the study toward breast cancer screening is high; this finding can be used in plans aiming to raise awareness and conduct screening in Iran. [ABSTRACT FROM AUTHOR]

Materials of different allogeneic or xenogeneic or autologous origins are widely used as soft-tissue fillers or structural scaffolds in the field of cosmetic surgery, while complications including prosthesis infection, donor site deformity and filler embolization have always been difficult problems for plastic surgeons. The application of novel biomaterials may bring in hopeful solutions for these problems. Recently, some advanced biomaterials, such as regenerative biomaterials can effectively promote the repair of defective tissues, which have been proven to have good therapeutic as well as cosmetic effects in cosmetic surgery. Therefore, biomaterials with active compounds have drawn significant attention for the tissue regeneration of reconstructive and esthetic treatment. Some of these applications have achieved better clinical outcomes than traditional biological materials. This review summarized recent progress and clinical applications of advanced biomaterials in cosmetic surgery. [ABSTRACT FROM AUTHOR]

Background: Breast cancer screening can reduce mortality and improve the quality of life in affected women. The present study aimed to determine the predictive factors of breast cancer screening in Iranian women based on the health belief model (HBM). Methods: This review was conducted by searching electronic databases of Google Scholar; electronic databases, including Scopus, PubMed/MEDLINE, Cochrane Library, Web of Science, ProQuest, Embase, and Google scholar Magiran; and SID with the English keywords of "breast cancer," "mammography," "health belief model," and "breast self-exam" and the equivalent Persian keywords. The results were evaluated based on the health belief model (HBM) constructs. Articles were evaluated for quality and the findings were extracted and reviewed. Results: A total of 8 relevant articles were selected for review. Women's awareness of breast cancer screening methods was moderate in two studies and poor in two other studies. Among the constructs of HBM, knowledge, perceived susceptibility, perceived severity, perceived benefits, and action plan were poor in the majority of the studies, while perceived barriers, cues to action, and self-efficacy were mainly good. Conclusion: Considering the observed weakness of many HBM constructs, it is recommended that special attention be given to all HBM constructs in implementing HBM-based education programs. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is one of the most common diseases in all populations. Since people with hypertension have a lower quality of life (QoL) compared to healthy people, it is necessary to follow up these patients according to their conditions. This study aimed to investigate the impact of a continuous care model on blood pressure and QoL in hypertensive patients. Methods: Using a random sampling method, this randomized clinical trial (RCT) included 66 patients with hypertension referring to the clinic of Shahid Madani hospital in Tabriz, Iran in 2019. Data collection tools in this research were demographic information questionnaire, sphygmomanometer control device and stethoscope and Quality of Life questionnaire (The Short Form Health Survey-12, SF-12). The patients were randomly assigned into two groups of control and experimental. After the pre-test, the patients' needs in the experimental group were assessed and the problems were resolved. Then, the post-test was performed one month and two months after the intervention. Data analysis was performed using SPSS software version 13. Results: After the intervention, there was a significant difference in the QoL score and blood pressure in the experimental group. However, this difference was not significant in the control group. Conclusion: Results indicated that using a follow-up care model had a positive effect on the blood pressure and QoL of patients with hypertension. It is recommended that further studies examine the impact of the integrated care model on QoL in other chronic diseases. [ABSTRACT FROM AUTHOR]

The study aims to evaluate the effect of empowerment training in protecting adolescents from substance abuse on self-efficacy, self-esteem, and assertiveness levels. This a quasi-experimental research study with pretest-posttest design and a control group. The research sample was composed of 65 adolescents; 33 in the experimental group and 32 in the control group. The empowerment training program including 10 sessions in total, each lasting 45 minutes, was administered to the adolescents in the experimental group. Data were collected via the Adolescent Information Form, the Self-Efficacy for Protecting Adolescences from Substance Abuse Scale, the Rosenberg Self-Esteem Scale, and the Rathus Assertiveness Scale. In data analysis, variance analysis was used in repeated measures, and t test was used in independent groups. The increase in the self-efficacy mean scores of the adolescents in the experimental group in post-test and follow-up measurements was found to be statistically significant (p < .01). The difference between the experimental and control groups in terms of self-efficacy, self-esteem, and assertiveness scores was found to be statistically significant (p < .01). It was determined that the empowerment training program increased the self-efficacy levels of the adolescents in terms of protection from substance abuse, supported the development of selfesteem, and had a positive effect on their assertiveness. [ABSTRACT FROM AUTHOR]

The purpose of this study is to empirically examine the relationships between service quality, patient satisfaction, patient loyalty and medication adherence in the Syrian healthcare setting from a patient's perspective. Based on random sampling technique, data collection was conducted in six hospitals located in the Syrian capital Damascus. The reliability and validity of the theoretical model had been confirmed using quantitative analyses SmartPLS software. The study indicated that our proposed model can significantly explain (35) per cent of patient satisfaction, (55) per cent of patient loyalty and (46) per cent medication adherence in a statistically manner. Our results highlighted that patient satisfaction mediated the relationship between patient loyalty and service quality (assurance, reliability and financial aspect). Besides, patient satisfaction had mediation effect on the relationship between medication adherence and service quality (reliability and financial aspect). Financial aspect had the highest impact on patient satisfaction (β = 0.242) and medication adherence (β = 0.302). In addition, reliability was the only dimension of service quality that had a significant direct impact on patient satisfaction, patient loyalty and medication adherence. To increase patient loyalty in Syrian hospitals, healthcare professionals should place a greater emphasis on the reliability and responsiveness elements of service quality. To the author's knowledge, this is the first study conducted during the COVID pandemic to evaluate the mediating role of patient satisfaction in the relationship between service quality, patient loyalty and medication adherence in the Syrian healthcare sector. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the primary cause of mortality in female patients around the world and the second most common cancer after lung cancer in both sexes. Socio-cultural factors contribute to the development, maintenance, and change of health behavior; knowledge, attitudes, and motivation are important individual determinants of health behavior change. Therefore, this study aims to evaluate the effect of health belief model-based breast cancer education on knowledge, health belief, and breast self-examination among female students of Debre Markos University, Ethiopia, in 2021. Methods: A quasi-experimental study was conducted on 210 samples selected by simple random sampling; samples were assigned to an intervention group and a control group based on their cluster. Data were collected by self-administration questionnaire before and after intervention and then entered into Epi data version 3.1 and analyzed by SPSS version 25. A dependentt-test and an independentt-testwere used. Difference in difference was used to assess the effect of the intervention. Results: Statistically significant differences were observed between groups’ knowledge about breast cancer after educational intervention; monthly breast self-examination practice changes from 20.0% to 57.58% and 17.14% to 24.27% in intervention and control groups, respectively; and average scores of all health belief model constructs show a statistically significant change in the intervention group relative to controls after intervention. Overall knowledge increased by 6.24, perceived susceptibility increased by 4.67, perceived seriousness increased by 6.93, benefit of breast self-examination increased by 3.51, self-efficacy increased by 9.45, cues for action increased by 2.74, barriers of breast self-examination decreased by 3.61, and breast self-examination increased by 2.26 due to educational intervention. Conclusion: The health belief model-based education is an effective and efficient way to enhance students’ breast self-examination and promote knowledge and health beliefs about breast cancer. Based on the findings of this study, implementing a health belief model-based educational intervention about breast cancer at different phases of life is important to fight the disease. [ABSTRACT FROM AUTHOR]