The Assessment of Health-Promoting Lifestyle Status and Its Determinants among Students of Iran University of Medical Sciences

Careful assessment of lifestyle status among students is a necessity for identifying lifestyle problems and, it is an essential prerequisite for more efficient planning and implementing health promotion interventions among them. This study performed to estimate the current status of a health-promoting lifestyle among students of Iran University of Medical Sciences. This cross-sectional study was performed on 250 students of Iran University of Medical Sciences. By performing a proportional stratified random sampling method according to the number of students in each academic discipline, samples were chosen. The data gathering tool was a two-part questionnaire. The first part was related to demographic and socioeconomic information. The second part consisted of the Health-Promoting Lifestyle Profile (HPLP-II) questionnaire. The data were analyzed using SPSS version 23 through descriptive and inferential statistics. The results were statistically observed as significant at p < 0.05. The mean score of health-promoting lifestyle was 124.36 ± 18.41. The highest mean score was for the nutrition dimension (23.67±4.91) and the lowest was for the physical activity dimension (15.08±5.16). This research showed that a statistical proper correlation was found between marital status and spiritual growth. Also, there was a relationship between academic discipline and health responsibility. Additionally, another statistical significant relationship between financial status and health-promoting lifestyle, health responsibility, spiritual growth, and stress management was observed. Since the status of a health-promoting lifestyle is not satisfactory, a wide range of planning and implementing health interventions are needed to improve the health-promoting lifestyle among the students

Качество жизни и связанные с ней факторы у реципиентов почечного трансплантата

Patients undergoing transplantation, experience significant changes in their quality of life. The aim of this study was to determine the quality of life and related factors in kidney transplant recipients. This descriptive-analytic cross-sectional study was performed on 136 kidney transplant recipients referring to nephrology clinic of Imam Khomeini Hospital in Ardabil through convenience sampling method in 2016. Data was collected by using a demographic form, Short Form Health Survey (SF36), physical stress index, Kidney Transplantation Self-Management Scale, Kidney Transplantation Self-Care Self-Efficacy Scale and Beck's Depression Inventory. Data were analyzed by SPSS software version 16 using descriptive and analytical methods. The mean score of physical health (55.01 ±19.48) was slightly higher than the mental health (42.86 ± 20.91). Self-efficacy (β = 0.29), depression symptoms (β = -0.34), age (β = -0.36) and gender (β = 0.15) were as predictors of the physical health component of quality of life. Self-efficacy (β = 0.58), depression symptoms (β = -0.25), age (β = -0.16) and education level (β = -0.28) were determined as predictors of the mental health component of quality of life. It is imperative that the kidney transplant care team improve patients' quality of life by teaching self-care behaviors to improve patients' self-efficacy and early screening for depression symptoms. On the other hand, care services should be provided with greater support from women and the elderly&nbsp;patients in order to improve their physical and mental health.Los pacientes sometidos a trasplante experimentan cambios significativos en su calidad de vida. El objetivo de este estudio fue determinar la calidad de vida y los factores relacionados en los receptores de trasplante renal. Este estudio transversal descriptivo-analítico se realizó en 136 receptores de trasplante de riñón que se referían a la clínica de nefrología del Hospital Imam Khomeini en Ardabil a través del método de muestreo de conveniencia en 2016. Los datos se recopilaron mediante un formulario demográfico, Short Form Health Survey (SF36), físico índice de estrés, Escala de autogestión de trasplante de riñón, Escala de autoeficacia de autocuidado de trasplante de riñón e Inventario de depresión de Beck. Los datos fueron analizados por el software SPSS versión 16 utilizando métodos descriptivos y analíticos. La puntuación media de salud física (55.01 ± 19.48) fue ligeramente mayor que la salud mental (42.86 ± 20.91). La autoeficacia (β = 0.29), los síntomas de depresión (β = -0.34), la edad (β = -0.36) y el género (β = 0.15) fueron predictores del componente de salud física de la calidad de vida. La autoeficacia (β = 0,58), los síntomas de depresión (β = -0,25), la edad (β = -0,16) y el nivel educativo (β = -0,28) se determinaron como predictores del componente de salud mental de la calidad de vida. Es imperativo que el equipo de atención de trasplante de riñón mejore la calidad de vida de los pacientes al enseñar comportamientos de autocuidado para mejorar la autoeficacia de los pacientes y la detección temprana de los síntomas de depresión. Por otro lado, los servicios de atención deben proporcionarse con un mayor apoyo de las mujeres y los pacientes de edad avanzada para mejorar su salud física y mental.Пациенты, перенесшие трансплантацию, испытывают значительные изменения в качестве своей жизни. Целью данного исследования было определение качества жизни и связанных с ней факторов у реципиентов почечного трансплантата. Это описательно-аналитическое перекрестное исследование было проведено на 136 реципиентах почек с обращением в нефрологическую клинику имам Хомейни в Ардебиле методом удобной выборки в 2016 году. Данные были собраны с использованием демографической формы, Краткого обследования состояния здоровья (SF36), физического индекс стресса, шкала самоуправления трансплантации почки, шкала самоэффективности самообслуживания трансплантации почки и опись депрессии Бека. Данные были проанализированы с помощью программного обеспечения SPSS версии 16 с использованием описательного и аналитического методов. Средний балл физического здоровья (55,01 ± 19,48) был несколько выше, чем психическое здоровье (42,86 ± 20,91). Самоэффективность (β = 0,29), симптомы депрессии (β = -0,34), возраст (β = -0,36) и пол (β = 0,15) были предикторами физического здоровья, составляющего качество жизни. Самоэффективность (β = 0,58), симптомы депрессии (β = -0,25), возраст (β = -0,16) и&nbsp;уровень образования (β = -0,28) были определены в качестве предикторов компонента качества жизни для психического здоровья. Крайне важно, чтобы команда по уходу за трансплантацией почек улучшала качество жизни пациентов, обучая поведению по уходу за собой повышать самоэффективность пациентов и проводя ранний скрининг на симптомы депрессии. С другой стороны, услуги по уходу должны предоставляться при большей поддержке со стороны женщин и пациентов пожилого возраста с целью улучшения их физического и психического здоровья

The Cost of Services Provided in the Physiotherapy Department of Shafa Yahyaian Hospital

Background & Objectives: Our country is facing increasing costs of treatment and funding shortages. The reason for this crisis is the increase in the cost of medicine, medical equipment, and skilled manpower. The physiotherapy unit is one of the cost centers and accounts for a large share of hospital costs. Managers and policymakers must pay special attention to cost centers in order to make decisions about reducing costs and increasing efficiency. Methods: The present study was a retrospective economic evaluation that was conducted in 2018 based on activity-based costing. The data were collected by referring to the Physiotherapy, Employment, Finance, Medical Equipment and Warehouse Units. To calculate the cost of physiotherapy services, the salaries of staff working in the units as well as the cost of the consumables, depreciation of buildings and equipment and energy were estimated in detail. Results: The total annual costs of the physiotherapy unit amounted to 8415722668 rials and the annual loss of the mentioned unit amounted to 1287632108 rials. The highest costs were for physiotherapists, accounting for 82% of the total costs, overhead costs, accounting for 8.1%, and depreciation of medical equipment. Conclusion: According to the losses imposed on physiotherapy unit, one of the suggested options is unit outsourcing. Running evening shifts, paying fee-for-service due to high personnel costs, and hiring a non-faculty technical manager with a lower salary can be effective in reducing the average unit cost. Key­words: Activity-Based Costing, Tariff, Physiotherapy, Teaching Hospital, Overhead Cost Citation: Golmohammad A, Ebadi Fard Azar F, Abutorabi A. The Cost of Services Provided in the Physiotherapy Department of Shafa Yahyaian Hospital. Journal of Health Based Research 2020; 5(3): 355-367. [In Persian

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. Trial Registration Number: IRCT2017030415650N

The Effect of Educational Intervention based on Social Support Theory on Improvement of Hemodialysis Patients’ Quality of Life

Chronic kidney failure is a progressive and irreversible degeneration of renal function that affects the quality of life of patients. Social support as a coping mechanism can help promote health and improve the quality of life of a person. The purpose of this study was to determine the effect of educational intervention based on social support theory on the improvement of hemodialysis patients’ QOL. This is a controlled quasi-experimental conducted in 2015 in Sari and with the participation of 100 hemodialysis patients that were randomly assigned to 2 groups. Prior to education, the patients were evaluated with demographic form, quality of life (WHOQOL-BREF) and social support (MOS-SSS) questionnaires. Then, an educational program was developed based on social support theory and implemented for the intervention group. The two groups were re-evaluated with the same questionnaires after 1 and 3 months and the data were analyzed in SPSS. In the intervention group compared to the control group, the mean scores of quality of life and social support increased significantly after the intervention (

Association of self-care status with some relevant factors in middle-aged women in their early menopausal stage

BACKGROUND: Through self-care, people can solve their health-related problems through increasing their awareness and correcting their lifestyles. OBJECTIVES: To determine the association of self-care status with some relevant factors in Kashanian middle-aged women in their early menopausal stage. METHODS: This is a cross-sectional study on 351 women in the age range of 45–60 years. Women were selected based on cluster sampling method from the individuals at health-care centers in Kashan, Iran. Researcher-constructed questionnaire on self-care was used. The validity and the reliability of the questionnaire were calculated. The information gathering method was questionnaire completion by the study participants or interview with them. Collected data were analyzed with SPSS 16 software. T-test, ANOVA, Spearman correlation, and linear regression analysis were applied. RESULTS: The mean (±standard deviation) of the self-care score was 108.14 ± 20.43. Self-care scores were weak in 13.92%, intermediate in 71.02%, and good in 15.06%. Regression analysis showed that the mean of self-care was significantly higher in those with higher educational level of women's (P = 0.045) and their spouses (P = 0.001). Women who were covered by insurance also showed higher self-care; in addition, there was no significant relationship between self-care and participants' job, spouses' jobs, marital status, marital satisfaction, economic satisfaction, number of children, number of households, and type of accommodation (P > 0.05). CONCLUSION: The results indicate that self-care is inadequate and that the level of education of couples and insurance coverage has a positive effect on the level of self-care in postmenopausal women. To promote self-care in old age, education and empowerment can be considered

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

Exploring the Consequences of Early Marriage: A Conventional Content Analysis

Early marriage is one of the most important social issues for young women and can have many consequences. The present study aimed to explore the consequences of early marriage among Kurdish women in western Iran who were married under the age of 18. This qualitative study was conducted with the approach of conventional content analysis. The data were collected through semi-structured interviews with 30 women selected by purposeful sampling. Data analysis was performed using Graneheim and Lundman’s method. A total of 389 codes, 12 subcategories, 4 sub-categories, and 2 main categories were extracted from the data analysis. Negative consequences of early marriage include: 1—physical and psychological problems (high-risk pregnancy and childbirth, physical illnesses, depression, and emotional distress); 2—family problems (dissatisfaction with married life, experience of having lots of responsibility, lack of independence in family life); 3—social problems (risky social behaviors, lack of access to social and health services, social isolation, lack of access to a job, and educational opportunities); and 4—positive consequences, including receiving intra-family support, improving living conditions, and opportunities for progress and empowerment. It is possible to reduce problems and challenges after early marriage by increasing the awareness and knowledge of young women about contraceptives and providing appropriate social and health facilities, and services during pregnancy. Providing the necessary training and psychological counseling for them and their husbands on how to deal with personal problems and marital life will be effective to a great extent