Application of Freire\u27s adult education model in modifying the psychological constructs of health belief model in self-medication behaviors of older adults: a randomized controlled trial.

BACKGROUND: Self-medication by older adults has been always a public health concern. The present study aimed to modify the psychological constructs of Health Belief Model (HBM) in relation to self-medication behaviors using Freire\u27s Adult Education Model (FAEM) among older adults in Khorramabad, Iran, from 2017 to 2018. METHODS: The mean age of the older adults was 66.28 ± 7.18 years. This was a randomized controlled trial study conducted on 132 individuals older than 60 who were referred from different health care centers. The participants were selected using multistage sampling method and randomly divided into two groups of intervention and control. The data collection instruments included a questionnaire which was designed based on both HBM and self-medication behaviors questionnaire. The phase of adult education model (AEM) was used to modify the psychological constructs of HBM and self-medication behaviors. Data were analyzed using SPSS software version 20 with a significant level of 0.05. Descriptive statistical tests, chi-squared test, paired t-test, independent t-test, and univariate modeling were employed for the purpose of analyzing data. RESULTS: There was no significant difference between groups in terms of self-medication. Unawareness of the effects of medicine were the most important reason for self-medication (p = 0.50). The two groups were not significantly different in terms of knowledge, HBM constructs, and self-medication behaviors (p \u3e 0.05). However, they came up to be considerably different for the above variables after the intervention was implemented (p \u3c  0.05). When the findings were adjusted for the effects of confounding variables, there were significant differences between the two groups in almost all constructs of HBM and their behaviors (p \u3c  0.05). However, the perceived barrier modality of HBM did not reach to a significant level of difference between two groups. CONCLUSION: The educational intervention, which was based on Freire\u27s AEM, had positive effects on the constructs of HBM and consequently on self-medication behaviors. The psychological constructs of HBM were affected at the phases of listening to problems. Self-medication was tempered at the action-reflection phase with shared creation and evaluation of the action plan geared toward the achievement of the behavioral objectives. The results might be of importance to healthcare professionals involved in care of older patients. TRIAL REGISTRATION: Current Controlled Trials IRCT2013091814512N2. Registered on January 2 - prospectively registered, the trial was registered in the Iranian Clinical Trials Registry http://www.irct.ir

Assessment of Maternal Nutritional Intake of Some Nutrients and its Relationship with Anthropometric Indices of Newborn

Abstract Background: One of the factors determining the survival and neonatal health is maternal proper nutrition during pregnancy. The aim of the present study is to determine the maternal nutritional status with a view to the intake of some nutrients and its effect on anthropometric indices of newborn. Materials and Methods: In this cross-sectional analytical study, 500 pregnant women referred to Sina maternity hospital in Ahvaz were studied. Dietary intake of calcium, zinc, iron, vitamin D was measured and its relation to average weight, length and head circumference at birth in infants was evaluated. Data were analyzed by using Independent T-Test in SPSS 17. P-value less than 5% was considered statistically significant. Results: There was significant correlation between calcium intake rate, weight and length at birth. Between zinc intake rate, weight, length and head circumference at birth, there was a significant correlation. The maternal intake of vitamin D affected on birth weight(p0/05). Conclusion: The results of this study showed that the maternal nutritional intake of calcium, zinc and vitamin D influences on some infant anthropometric indicators

The Psychological Determinants of Self-Medication among the Elderly: An Explanation Based on the Health Belief Model

Introduction: Self-medication is one of the problems in the treatment cycle of patients. Aging is associated with increased drug use and adverse effects. The purpose of this study was to assess the factors influencing self-medication among the elderly referring to urban health centers in Khorramabad, Iran, based on the Health Belief Model (HBM) in 2016-2017. &nbsp;Methods: This cross-sectional study was conducted on 137 elderly individuals over 60 in Khorramabad. The participants were selected using the multistage sampling method. Data collection instruments included a questionnaire designed based on the HBM and a self-medication checklist. The data were analyzed using the SPSS software, descriptive statistical tests, Pearson correlation coefficient, and linear regression. Results: Among the constructs of the HBM, perceived severity alone could predict 31 percent of the self-medication behaviors, and perceived severity plus barriers could predict 40 percent of the self-medication behaviors. The overall prevalence of self-medication among the elderly was 39.4%. The most common reason for self-medication was previous experiences with self-medications (59.8%). Additionally, there were significant relationships among the constructs of HBM with the favorable practice of the elderly regarding self-medication (p < 0.001). Conclusion: The results indicated that perceived severity and barriers play a more crucial role in the development of self-care behaviors regarding self-medication among the elderly. &nbsp

بررسی میزان آگاهی دندان‌پزشکان عمومی در مورد رعایت منشور حقوق بیماران

Background and Aim: In order to ensure that the quality of health care improves, the observance of medical ethics and patients’ rights is inevitable. The present study was conducted to determine how much dentists practicing in Khorramabad, Iran, in 2020 complied with the Charter of Patients’ Rights. Materials and Methods: This was a descriptive-analytical study that was performed on 70 general dentists in Khorramabad from March 2019 to March 2020. The participants were selected by the census sampling method. Data were collected using the Patients’ Rights Questionnaire designed based on ethical codes approved by the American Dental Association (ADA). Data were analyzed using SPSS 20 at a significance level of 0.05. Findings: The mean age was 34.58±7.21 in women and 38.84±9.82 in men. The awareness level of the dentists regarding the Charter of Patients’ Rights was 47±0.12.The highest score was related to explaining and clarifying the charged expenses with 71.4%. The lowest scores were related to providing expert testimony about the illegal practices of a colleague with 22.9% and explaining the treatment method to patients with 25.7%. Work experience had a weak correlation with awareness levels (r=0.2, p=0.095). There was no significant difference between men and women in terms of awareness levels (p=0.139). Ethical Considerations: This article is the result of a research project with the ethical code IR.LUMS.REC.1397.190. Adequate explanations about the objectives of the research were given to the subjects. They were assured that all information collected in this study was confidential. Conclusion: The awareness level of general dentists who were examined, about the observance of the principles of professional ethics was below average. Therefore, it is necessary for medical universities to pay more attention to aspects of patients’ rights that are less observed by dentists. It is obvious that observing the principles of professional ethics will increasingly gain patients’ trust and as a result, will promote the health level of the society. &nbsp; Cite this article as: Qaruni K, Yaghoubipour F, Qaruni B, Bakhtiar M, Bakhtiar K, Birjandi M, Bastami F. Evaluation of the Observance of the Charter of Patients’ Rights by General Dentists. Majale "akhlāq-i pizishkī" (i.e., Medical Ethics) 2021; 15(46): e11.زمینه و هدف: رعایت موازین اخلاق پزشكی و حقوق بیمار در تأمین ارتقای كیفیت مراقبت‌های بهداشتی ـ درمانی اجتناب‌ناپذیر است. مطالعه حاضر به منظور تعیین میزان آگاهی دندان‌پزشکان عمومی در مورد رعایت منشور حقوق بیماران انجام شده است. مواد و روش‌‌ها: پژوهش حاضر، یک مطالعه توصیفی ـ مقطعی است که با استفاده روش نمونه‌گیری سرشماری بر روی 70 نفر از دندان‌پزشکان عمومی شهر خرم‌آباد از فروردین ماه تا اسفندماه در سال 1399 انجام شد. داده‌ها با استفاده از پرسشنامه رعایت حقوق بیمار که بر اساس کد‌های اخلاقی که مورد تأیید انجمن دندانی امریکا (American Dental Association) می‌باشند، جمع‌آوری گردید و با استفاده از نرم‌افزار SPSS 20 در سطح معنی‌داری 05/0 تحلیل شدند. یافته‌ها: میانگین سنی در زنان 21/7±58/34 بود و در مردان 82/9±84/38 بود. میزان آگاهی دندان‌پزشکان عمومی مورد بررسی از منشور حقوق بیمار 12/0±47 بود. بیشترین امتیاز مربوط به شفاف‌نمودن هزینه‌های دریافتی با 4/71 درصد بود. کمترین امتیاز مربوط به گواهی‌دادن فرد خبره درباره عملکرد غیر قانونی همکار با 9/22 درصد و بیان روش درمانی برای بیمار با 7/25 درصد بود. سابقه کاری با میزان آگاهی همبستگی ضعیف داشت (095/0=p، 2/0=r). بین زنان و مردان از لحاظ میزان آگاهی اختلاف معناداری وجود نداشت (139/0=p). ملاحظات اخلاقی: این مقاله حاصل طرح تحقیقاتی با کد اخلاقی IR.LUMS.REC.1397.190 می‌باشد. توضیحات کافی در خصوص اهداف پژوهش به افراد مورد مطالعه داده شد و به آن‌ها اطمینان داده شد کلیه اطلاعات گردآوری‌شده در این پژوهش محرمانه می‌باشد. نتیجه‌گیری: سطح آگاهی دندان‌پزشکان عمومی مورد بررسی در مورد رعایت منشور حقوق بیمار کمتر از حد متوسط بود. لازم است دانشگاه‌های علوم پزشکی در مورد جنبه‌هایی از حقوق بیمار که کمتر توسط دندان‌پزشکان رعایت می‌شوند، توجه بیشتری داشته باشند. بدیهی است که رعایت حقوق بیماران باعث جلب اعتماد آنان و در نتیجه ارتقای سطح سلامت جامعه خواهد شد

Formative Research on a Social Marketing Campaign to Promote the Consumption of Healthy Breakfast and Snacks: A Qualitative Study

Background: The elimination of breakfast and the high consumption of low-value snacks are becoming more frequent and common among adolescents. Nutrition is a complex behavioral phenomenon that is associated with the specific cultural and environmental issues of each society as well as psychological features.This qualitative research was conducted to identify factors affecting breakfast consumption behavior in adolescents using the social marketing framework. Materials and Methods: A qualitative research based on the social marketing framework was conducted through directed content analysis in the high schools of Isfahan and Khorramabad, Iran, in 2016. Data were collected through seven focus group discussions and 33 in-depth, semi-structured; interviews conducted in person with both male and female students, the parents, and the teachers and were analyzed simultaneously in three phases, namely preparation, organization and reporting. Results: The results obtained in the present study within the social marketing framework were coded into the four categories of product, place, price and promotion. The product category had four subcategories, including favorite taste sought in breakfast, breakfast preparation, breakfast serving style, variety and the healthful features of breakfast. The price category had four subcategories, including time, psychological, social and financial prices. The promotion category had three subcategories, including official channels, unofficial channels, and educational materials and equipment. The place category had two subcategories, including having breakfast at school or having breakfast in an outdoor space. Conclusion: The promotion of healthy breakfast as a product, requires that first its important features be considered, including the favorite taste sought in breakfast, second that it be promoted through channels most popular with students, and most importantly, that its price be reduced by using incentives such as serving breakfast at school as an attractive place for students

Investigating the level of knowledge and performance of postmenopausal women about breast self-examination in Khorramabad in 2019

Background: Due to usually late diagnoses, breast cancer is accompanied by a high mortality rate. Breast self-examination increases the success of treatment and survival rates. This study aimed to evaluate the knowledge and practice of postmenopausal women residing in Khorramabad, Iran, about breast self-examination. Materials and Methods: The present descriptive-analytical study was performed on 333 postmenopausal women referring to health centers in Khorramabad in 2019. The participants were selected using cluster sampling. The required data were collected using a questionnaire containing items on demographic characteristics as well as variables of knowledge and practice of breast self-examination. Data analysis was performed in SPSS software version 22 using the Spearman correlation coefficient, the Chi-square test, and Fisher's exact test. Results: The mean age of the subjects was 55.13±8.13. It was found that 55% of women had moderate knowledge and 43.8% had a moderate performance. The most common source of information was through health center staff (52.9%). Knowledge and performance showed a direct and significant correlation with breast self-examination (r=0.530, P<0.001). There was a statistically significant relationship between knowledge and performance on the one hand, and visiting a doctor and having a history of attending classes on the other (P<0.05). There was also a statistically significant relationship between performance and marital status (P<0.05). Conclusion: Due to the significant relationship between knowledge and performance variables and behaviors such as attending classes and visiting doctors, it is recommended to design educational programs to encourage postmenopausal women to perform breast self-examination

Sources of Health care providers’ Self-efficacy to deliver Health Education: a qualitative study

Abstract Background The self-efficacy of educators plays a crucial role in their professional competence and subsequent provision of care. The present study aims to explain the main sources contributing to the development of self-efficacy beliefs among healthcare providers in delivering health education. Methods This qualitative study was conducted from 2015 to 2016 in various settings of Isfahan such as hospitals, doctor’s offices, and healthcare centers. Twenty three health educators with an average of 10-year work experience in healthcare participated in the study. Data were collected using semi-structured in-depth individual interviews and were analyzed through conventional content analysis. Prolonged engagement with the participants, maximum variation in the participants’ characteristics, sampling, and member check were among the factors enriching the research. Results The six main categories extracted during data analysis included: 1) Quantity and quality of their experience; 2) Encountering unexpected events; 3) Client trust; 4) Self-concept; 5) Professional knowledge and skill; 6) Vicarious experiences. Conclusions The study results show two new findings, including “encountering unexpected events” and “client trust”, affecting professional self-efficacy beliefs among healthcare providers in the delivery of health education. The other main findings were extremely similar to Bandura’s theory. These results can be used as a basis in planning and implementing health development educational models for human resources

DMFT and OHIS Indexs in the Pregnant Mothers: An Explanation Based on the Health Belief Model

Introduction: Oral and dental health is one of the most important parts of public health. The purpose of this study was to assess the factors influencing oral and dental health among the pregnant mothers referring to urban health centers in Khorramabad, Iran, based on the Health Belief Model (HBM) in 2016. Methods: In this cross-sectional study, 340 pregnant mothers living in Khorramabad, Iran were selected from health centers using multi-stage random sampling. The decayed, missing, filled teeth (DMFT) index, the Oral Health Index &ndash; Simplified (OHIS), the health belief model (HBM) scale, and performance regarding oral and dental health care were measured and the data were analyzed. The obtained data were analyzed using the SPSS 20 software and descriptive statistical tests, Pearson correlation coefficient, and linear regression. Results: The mean DMFT score was 7.8 &plusmn; 3.27 and the mean OHIS score was 2.74 &plusmn; 1.65. Pearson correlation coefficient showed a direct and significant relationship between the constructs of the health belief model and performance (p< 0.05). Among the constructs of the health belief model, self-efficacy (22.2 %) had the highest predictive power. In addition, there was a positive correlation between the DMFT and OHIS scores. Conclusion: The present study showed that cognitive barriers are associated with oral and dental health behaviors and they should receive attention from the oral and dental health professionals. On the other hand, the most important predictor variable of oral health care among pregnant mothers is self-efficacy. Therefore, the self-efficacy of pregnant women should be boosted for them to practice good oral and dental health care

Experiences of Encountering Physical Trauma Caused by Traffic Accidents: A Qualitative Study

Background: Traffic accidents are the main cause of death and disability in the world and Iran. The Injuries caused by traffic accidents may result in severe limitations and worst outcomes in various aspects of lives of traffic accident injured people and their families. Therefore, understanding their experiences is very important to design better programs with regard to their treatment and returning to the society. In this regard, we conducted this study with the aim of understanding and describing the experiences of encountering with physical trauma resulting from traffic accidents. Materials and Methods: This study was conducted with qualitative research approach, using qualitative content analysis method. The study participants had a record of upper and or lower extremity injuries caused by traffic accidents of at least 3 months and at most 2 years after the accident. They were chosen by purposeful sampling method. Data were collected through semi-structured interviews and continued until data saturation. Data analysis was carried out using content analysis method. Results: The study findings based on the experiences of participants were conceptualized in three main categories; experiencing some limitations, disturbances in performing professional duties, and family problems caused by trauma. Conclusion: The study findings showed that injured people due to traffic accidents experience numerous constraints in different areas of their lives. Accordingly, proper interventions can be designed based on understanding these needs and experiences from participants&rsquo; own words to alleviate these problems. Finally, the study results provide a new insight to the medical team to understand these patients and their real health problems in a more realistic way

The effect of training interventions on the psychological factors of oral health in pregnant women

Background and aim: Oral health is crucial for high-risk pregnant women in order to preserve their health and the health of their infants. Therefore, this study aimed to determine the impact of training programs on the behavior of pregnant mothers concerning oral health in Khorramabad, Iran. Methods: This is an educational experimental study carried out in 2015 on 164 pregnant women referring to health centers in the city of Khorramabad who were randomly divided into two groups (each n=82). The instruments for data collection included a questionnaire based on the Health Belief Model regarding oral health and two checklists of oral health indexes (OHIS and DMFT). Data were analyzed using SPSS 20 via paired- samples t-test, independent-samples t-test and Chi-square. Results: The mean score of knowledge and performance, and the variables of the components of the Health Belief Model including the perceived susceptibility, severity, benefits, barriers and self-efficacy regarding the oral health care, significantly increased in the intervention group following the training intervention (p<0.001). However, the DMFT index did not show any changes after the intervention in the intervention and control groups (p=0.381). On the other hand, the OHIS index significantly decreased in the intervention group as compared with the pre-intervention scores (p=0.002). Conclusion: The results of this study showed that training based on the Health Belief Model leads to the enhancement of performance regarding oral health in pregnant women and thus prevents any increase in OHIS and DMFT levels during pregnancy