Predictors of Exclusive Breastfeeding among Nulliparous Iranian Mothers: Application of the Theory of Planned Behavior

Background Although exclusive breastfeeding (EBF) is highly emphasized by the experts, nulliparous women do not adhere to this behavior at a desirable level. Since it seems that mothers’ beliefs and values play an important role in their adherence to these behaviors, the present study, aimed to perform a careful analysis of the behavior and evaluation of factors associated with the EBF in nulliparous women referring to healthcare centers in Bushehr using theory of planned behavior. Materials and Methods This is a cross-sectional study, which was conducted on 400 nulliparous mothers with children less than six-months who referred to healthcare centers in Bushehr, Iran. Stratified random-sample was used and data were collected using a researcher-made questionnaire and were later analyzed using statistical tests, including Pearson, Spearman, linear regression and logistic regression in SPSS version 22.0 Software. Results The results showed that 62.5% of infants were exclusively breast-fed. Variables such as infant' gender, father's occupation and type of pregnancy were significantly related with EBF behavior. Constructs, including attitude (P< 0. 001, r=0.295), subjective norms (P< 0. 001, r=0.376) and perceived behavioral control (P< 0. 001, r=514) were significantly correlated with the EBF intention. Subjective norms, perceived behavioral control and behavioral intention predicted 13.8% changes in mothers' breastfeeding behavior. Conclusion The theory of planned behavior is an appropriate framework to identify factors associated with the EBF behavior among nulliparous Iranian mothers. Therefore, designing interventions based on this theory seems to have the potential to improve the EBF practice

Quality of life in peptic ulcer patients referring to Al-Zahra hospital of Isfahan, Iran

Aim: The purpose of this study was to determine quality of life in peptic ulcer patients referring to Al-Zahra hospital of Isfahan. Background: Peptic ulcer disease (PUD) is one of the most prevalent diseases. Its prevalence is 6-15% and about 10% of people experience its symptom in their life. PUD can have a considerable impact on patients’ quality of life (QOL). Patients and methods: This descriptive- analytic survey was done on 93 randomly patients referred to Al-Zahra hospital of Isfahan city in Iran. Data gathering was done via questionnaire including five domains: physical, psychological, social, behavioral and economical. For data analysis, t-test, Pearson correlation and ANOVA test were used. Results: 93 patients with mean age of 38.54 years, including 43 (46.2%) women and 54 (53.8%) men, were studied. There was a negative significant between quality of life and age and between disease duration and psychological, economical domains and between the mean of QOL scores in physical and social domains with the number of cigarette per day, also there was significant relation between social domain and gender, and physical, psychological and behavioral domains with marital status; Physical, social domains with smoking. Also there was a negative significant between physical, social and behavioral domains with years of smoking. Conclusion: Study results showed that quality of life is in a relatively good level among patients, thus some diseases such as peptic ulcer can effect on quality of life. So, treatment and prevention of these diseases may improve their quality of life

Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes.

OBJECTIVES: Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. METHODS: We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. RESULTS: Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. CONCLUSIONS: This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient's HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance

Predictive Factors of Stages of Change in Hookah Smoking Cessation Among Iranian Adults Based on the Transtheoretical Model

Background: Hookah, as a traditional method of smoking, is widely used in Iran, especially in Bushehr province. It is essential to identify the most important determinants of modifying hookah smoking behavior. This study aimed to investigate the predictors of the stages of change in quitting hookah smoking in 15-60-year-old individuals in Bushehr province, southern Iran, based on the transtheoretical model (TTM).   Methods: This descriptive-analytical study was conducted on 1173 Hookah smokers in Bushehr province. The samples were selected by two-stage random sampling from 10 cities. Data were collected using a valid and reliable questionnaire consisting of 5 sections (demographic characteristics, stages of change, processes of change, decisional balance, and self-efficacy). Data were analyzed by R version.3.3.1 using analysis of variance and ordinal logistic regression at a significant level of 0.05.  Findings: The data revealed 82% of the participants were in the preparatory phase (55.3% in pre-contemplation and 26.7% in contemplation stages). Marital status, family members smoking hookah, cigarette smoking, level of education, number of family members, number of quitting attempts, self-efficacy, self-reevaluation, counter-conditioning, reinforcement management, and stimulus control were predictors of quitting hookah smoking. Conclusion: Given that most study participants were in the inactive stages of quitting hookah smoking, it seems necessary to design and implement behavioral interventions based on the predictive TTM constructs in this population

A social work study on relationship between parenting styles and career aspirations as well as psychological well-being

We present a social work study on relationship between parenting styles and career aspirations as well as psychological well-being among third year high school female students in city of Khomeinishahr, Iran during the year of 2012. The study selects a sample of 300 students from 1260 female students who were enrolled in third year high school education, randomly. The study uses the Baumrind’s questionnaire on parenting style, which consists of 30 questions which equally measure three parenting styles including authoritarian, indulgent and authoritative in Likert scale. The survey also uses Gottfredson’s questionnaire to examine occupational aspirations. The study examines whether there is any relationship between parenting style from one side and three personal characteristics including gender, career aspiration and wishes type on the other side. Using Chi-Square technique, the survey examines three hypotheses and the results confirm all three hypotheses of the survey

Effects of an Educational Intervention on Self-Care and Metabolic Control in Patients With Type II Diabetes

Background: Although compliance with all self-care behaviors is necessary for successful management of diabetes, patients with diabetes often refuse favorable self-care. This article is aimed to test the effects of a theory-related intervention to conduce self-aid adherence and metabolic curb in patients having type-2 diabetes. Methods: In this randomized controlled trial, 80 patients suffering from type-2 diabetes were arbitrarily allotted to intervention and control group. The intervention group attended six sessions in a batch and one-on-one consultation and received an education on self-efficacy and outcome expectations on improving the strategies. Self-efficacy, outcome expectations, self-care behaviors and HbA1c were measured and compared in two groups in the starting, after three and six-months of the interventions. “Intention to treat” analysis was used. Data were analyzed using t test and ANOVA for repeated measures. Results: Mean score of self-efficacy, outcome expectations and self-care behaviors revealed significant differences between two groups in the results of three and six months after the intervention (P < 0.01). A major fall in HbA1c was noted in the intervention group. The mean scores of the HbA1c showed a significant difference between two groups, six months after the intervention (P < 0.05). After the intervention diet, physical activity and foot care improved significantly in the intervention group (P < 0.001). No significant improvement occurred in self-monitoring of blood glucose and medication adherence between two groups after the intervention Conclusion: It is concluded that implementing educational interventions based on the self-efficacy model and related strategies can be effective for patients with type-2 diabetes and is recommended to be used for patient education in the field of metabolic control

Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

Objectives: Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetesrelated behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. Methods: We conducted a crosssectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. Results: Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. Conclusions: This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient’s HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance

The relationship between functional health literacy and health promoting behaviors among older adults

Background: Health literacy is a measure of individual’s ability to read, comprehend, and act on medical instructions. Older adults are one of the most important at risk groups affected by the impact of inadequate health literacy. Health promoting behaviors in older adults have potential impact on their health and quality of life and reduce the costs incurred to health care. Given the paucity of information health literacy and health promoting behavior, the purpose of this study was to examine health literacy level in older adults and the relationship between health literacy and health promoting behaviors. Materials and Method: A cross‑sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected via home interviewing. Health promoting behaviors were measured based on self‑reported smoking status, exercise, and consumption of fruit and vegetables. The collected data were analyzed using descriptive statistics and one‑way ANOVA and χ2 tests under SPSS 18 software. Results: The sample group averaged 67 ± 6.97 years in age. Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, have fewer years of schooling, lower household income, and being female Individuals with inadequate health literacy were more likely to report limitations in activity and lower consumption of fruit and vegetables (P < 0.001). No significant association was found between health literacy and smoking status. Conclusion: Considering high prevalence of inadequate health literacy among older adults, and its inverse relationship with some health promoting behaviors. Simple educational materials and effective interventions for low health literacy people can improve health promotion in society and mitigate the adverse health effects of low health literac

The Effect of nutrition education on knowledge, attitude, and performance about junk food consumption among students of female primary schools

Background: Undoubtedly, proper nutrition has important role in safeguarding the individual from many diseases, especially chronic ones, and increasing ones physical and intellectual efficiency. Considering the importance of nutrition education to school-age kids, this research was done with the purpose of determining the effect of nutrition education on the knowledge, attitude, and performance of female students at primary school about junk food consumption. Materials and Methods: This is an experimental intervention study in Shahr-e-kord city about the reduction of junk foods consumption in 2011. Seventy-two primary girl students were randomly divided into 2 groups, experimental (36) and controls (36). Before of the educational program, self-administrative questionnaire and FFQ (Food Frequency Questionnaire) questionnaire were filled out for both the groups. The self-administrative questionnaire was completed 3 times (before, immediately, and 2 months after education), and FFQ questionnaire was completed 2 times (before and 2 months after education) by students. After pre-test, 4 educational session classes in experimental group were performed. Finally, data were collected and analyzed by SPSS 16 computer software. Results: Demographic variables of the studied population in 2 groups were similar. Before intervention, there were no significant differences regarding the knowledge, attitude, and performance in 2 groups (P > 0/05). After intervention, there were significant differences in the levels of knowledge, attitude, and performance between experimental and control groups (P < 0.001). Conclusion: According to the results, intervention has positive impact on pattern of nutrition, and it can be concluded that intervention is effective on increasing or improving the knowledge, attitude, and performance of the students