Effect of health literacy education on self-care in pregnant women: A randomized controlled clinical trial

Background: Prenatal care reduces the risk of adverse pregnancy outcomes. The present study aimed to determine the effect of health literacy education on self-care in pregnant women. Methods: The present randomized controlled clinical trial was conducted at two comprehensive health service centers in Pakdasht (Tehran province, Iran) during January-June 2016. Out of the ten comprehensive health service centers in the city, two centers were selected using a simple randomized sampling and randomly assigned to a control group and an intervention group. From each center, 40 pregnant women were recruited into the study. Dedicated questionnaires on self-care and health literacy during pregnancy were developed by the author as data collection tool. The validity and reliability of the questionnaires were confirmed using the test-retest reliability method and by the opinion of ten experts, respectively. The questionnaires were completed before the intervention, and at 1 and 2 months after the intervention. The intervention consisted of four 45-minute educational sessions and group counseling. The data were analyzed using the SPSS software (version 16.0) with the independent t test, Chi-square test, Mann-Whitney test, and repeated measures ANOVA. P<0.05 was considered statistically significant. Results: There was no significant difference between the groups before the intervention. However, 1 month after the intervention, there was a significant difference (P<0.001) in the mean scores of the total self-care and total health literacy between the control and intervention groups (65±6.23 versus 76.77±4.28 and 30.95±4.63 versus 40±3.54). Similarly, there was a significant difference (P<0.001) between the mean scores 2 months after the intervention. Conclusion: Intervention for the promotion of physical and mental self-care during pregnancy should emphasize on increasing health literacy in computational comprehension, reading comprehension, and behavior. © 2019 Shriaz University of Medical Sciences. All Rights Reserved

Causes and grounds of childbirth fear and coping strategies used by kurdish adolescent pregnant women in iran: A qualitative study

Background: Fear of childbirth is one of the most common problems among pregnant women that can threaten their and their baby's health. Therefore, the purpose of this study was to explore the causes and grounds of childbirth fear and the strategies used by pregnant adolescent women in Iran to overcome such fears. Methods: In this study, which was conducted among primiparous Kurdish women in Iran, conventional qualitative content analysis was used. Data were selected through purposive sampling and semi-structured interviews. Data saturation was reached with 15 participants. The Lincoln and Guba criteria were used to strengthen the research. Results: After analyzing the data, two main categories were resulted. The first category was fear of childbirth with subcategories of fear of child health, fear of childbirth process, fears about inappropriate medical staff performance, fears about hospital environment, and postpartum fears. The second category was strategies to reduce childbirth fear with subcategories of choosing appropriate medical centers, increasing information on childbirth, avoiding stressful sources, improving self-care, getting prepared for delivery day in advance, and resorting to spirituality. Conclusion: Pregnancy in adult age is better than adolescent age. The women's fear can be reduced by increasing their assurance about child health, providing appropriate training during pregnancy, explaining the whole process of childbirth and making it easier, improving the hospital environment and medical staff specialization, as well as providing appropriate conditions for further care and support after birth. © 2021 Avicenna Research Institute. All rights reserved

Proposal for a modernized iranian notifiable infectious diseases surveillance system: Comparison with usa and Australia Proposition en vue de la modernisation du système iranien de surveillance des maladies infectieuses à déclaration obligatoire: Comparaison avec les �tats-Unis et l'Australie

This article reports on a comparative study of the national notifiable infectious diseases surveillance systems currently employed in the United States of America, Australia and the Islamic Republic of Iran, with the aim of developing a modified system specific to the needs of the Iranian health system. Features of the surveillance systems examined in each country included: official data gathering structures; types of data collected; case definition and classification criteria; data collection processes; data analysis methods; disease classification systems; data dissemination and distribution methods; data quality control; and confidentiality procedures and guidelines. After consolidating the data, a model for an Iranian notifiable infectious diseases surveillance system was developed and was tested by the Delphi method in 3 stages

Cost-effectiveness of coronary artery bypass graft and percutaneous coronary intervention compared to medical therapy in patients with coronary artery disease: a systematic review

Coronary artery disease (CAD) has significant social and economic implications. It is necessary to create tools to identify the most cost-effectiveness treatments, which can assist clinicians in their therapeutic decisions so that the maximum possible benefit is reached with the lowest possible cost. Effectiveness must be measured by final treatment goals in which the most effective interventions are those with the lowest costs. This study is aimed to systematically review and compare the studies conducted on the cost-effectiveness of the three coronary artery disease treatment strategies (medical treatment, percutaneous coronary intervention, and coronary artery bypass graft). In this systematic review, the databases NHS Economic Evaluation Database, Embase, MEDLINE, Science Direct, and Scopus were searched for studies on the cost-effectiveness of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) compared to medical therapy (MT) in patients with coronary artery disease between 1 January 2004 to 30 September 2018. The quality appraisal of the included studies was examined using the Consolidated Health Economics Evaluation Reporting Standards (CHEERS) statement. Out of 186 unique retrievals, 8 studies were included. The results showed that the all studies clearly stated the time horizon of the study and included direct medical costs in their analysis. In addition, in most of the studies, quality-adjusted life years (QALY) were the main outcome used for measuring the effectiveness. The studies reported various ranges of the incremental cost-effectiveness ratio (ICER); accordingly, the highest ratio was observed in the USA (212,800) for PCI v MT and the lowest ratio was observed in Brazil (4403) for CABG v MT. Although the results of the studies were different in terms of a number of aspects, such as the viewpoint of the study, the study horizons, and the costs of expenditure items, they reached similar results. Based on the result of the present study, it seems that each three treatment strategies for CAD yielded improvements in QALY. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Development and psychometric evaluation of the menopausal self-care questionnaire in a sample of Iranian postmenopausal women

Background: Self-care assessment is a prerequisite to self-care promotion interventions. However, there is no specific measurement instrument for self-care assessment among postmenopausal women. Objectives: The aim of this study was to develop the menopausal self-care questionnaire and evaluate its psychometric properties in a sample of Iranian postmenopausal women. Methods: This methodological study was conducted in 2017 based on Waltz's method for instrument development. Questionnaire items were generated based on a literature review, and then, face, content, and construct validity of the questionnaire were assessed. For construct validity assessment, a sample of 357 women aged 45-60 years were selected through cluster and stratified sampling from health-care centers in Kashan, Iran. Then, exploratory factor analysis was conducted to determine the factor structure of the questionnaire. Moreover, reliability was assessed through calculating Cronbach's alpha and test-retest intraclass correlation coefficient (ICC). Results: The primary version of the questionnaire contained 36 items. Two items were deleted due to their limited content validity. The impact scores, content validity ratios, and content validity indices of the remaining 34 items were at least 2.84, 0.70, and 0.70, respectively. During factor analysis for construct validity assessment, one item was deleted and the questionnaire was found to have a seven-factor structure, accounting for 54.87 of the total variance. The factors were general health care, screening, nutrition, memory, hot flashes and night sweats, sexuality, and social communication. The ICC and Cronbach's alpha value for the questionnaire were 0.76 (P < 0.001) and 0.88, respectively. Conclusion: The menopausal self-care questionnaire is a valid and reliable instrument for self-care assessment among postmenopausal women. It can be used in health monitoring programs for middle-aged and elderly women. © 2019 Nursing and Midwifery Studies | Published by Wolters Kluwer - Medknow

The Impact of Educational Intervention Based on Theory of Planned Behavior for Promoting Physical Activity Among Middle-Aged Women Referring to Karaj (Iran) Health Centers

Background: Physical activity is the most critical determinant of physical health which reduces the health risks during life. This designed study aims to evaluate the effect of educational intervention based on the theory of planned behavior on promoting physical activity among middle-aged women attending the health centers in Karaj city during 2017�2018. Methods: This research was a quasi-experimental controlled trial, and the study incorporated 140 Middle-Aged Women Referring to Karaj Health Centers assigned randomly to a control and intervention group (70 each group). Participants enrolling in the survey were asked to complete the International Physical Activity Questionnaire and also the theory of planned behavior measures at the baseline and the end of the study. The SPSS software were used, to analyze the data. The study applied Nonparametric Wilcoxon and Mann-Whitney tests and ANCOVA to interpret the results. Results: The results revealed participants' age range between 30 to 50 years with the mean and standard deviation scores 40.07 (8.750) in training and 45.81 (8.513) at the control group. The intervention improved the theory of planned behavior measures and the physical activities of participants. The results showed a significant difference in the attitude score, the perceived behavioral control score, and the level of subjective norms between two training and non-training groups (P < 0.001). The followed-up physical activity score also showed an improvement in the IPAQ score of participants in the training group (p < 0.001). Conclusions: The results of this specific study support the effectiveness of the theory of planned behavior for promoting the physical activity of women. © The Author(s) 2020

A study of the communication skills in health care and the role of demographic variables (a case study of the nurses at the Educational, Therapeutic and Research Center of Imam Reza Hospital, Kermanshah, Iran in 2018)

Purpose: Nurses, as facilitators in hospitals, should be equipped with communication skills towards the realization of this goal. The present study aimed to investigate the status of communication skills in health care and the role of nurses� demographic variables at the Educational, Therapeutic, and Research Center of Imam Reza Hospital, Kermanshah, Iran in 2018. Methods: In this descriptive�analytic study, the statistical population was 926 nurses working at the Educational, Therapeutic, and Research Center of Imam Reza Hospital affiliated to Kermanshah University of Medical Sciences, Kermanshah, Iran in 2018. Moreover, the random sampling was used as the sampling method. As for data collection, a two-part questionnaire, containing the demographic questions and the Queendom Communication Skills Test, was used. Furthermore, the independent t-test and one-way ANOVA using SPSS Statistical Software Version 22.0 were used for data analysis. Results: The results of the present study demonstrated that the mean and standard deviation of the total score of communication skills measured 2.70 ± 0.43. The results also indicated that assertiveness and understanding verbal and nonverbal messages had the highest and lowest mean scores (3.20 ± 0.64 and 2.30 ± 0.58 respectively). Further, there was a significant relationship between the mean scores of communication skills and variables such as marital status, employment background, department, work shift, and type of employment (P < 0.05). Conclusions: The results of the present study revealed that nurses� knowledge of communication skills was moderate. Therefore, it is recommended that courses on communication skills training be considered in their continuing education and on-the-job training, with the aim of improving the quality of nursing care. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature