[Patients, experiences with cardiovascular disease risk factors and healthcare providers of determinants of the nutritional behavior: a qualitative directed content analysis]

Unhealthy nutrition plays an effective role in increasing non-communicable diseases. The aim of this study is to assess the experiences of patients with cardiovascular disease [CVD] risk factors, and healthcare providers working in diabetes unit of health centers, to ascertain the defeaminants of nutritional behavior based on the Health Belief Model. This qualitative study utilized the content analysis approach, conducted over a six month period in 2012, at the diabetes units of health centers, associated with Alborz University of Medical Sciences, located in Karadj- Iran. The data was collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers in the diabetes unit. Data analysis was performed simultaneous with data collection, using the content analysis directed method. Analysis of the data resulted in finding 54 primary codes, all of which were placed into predetermined categories of the Health Belief model, including threat perceived, benefits and barrier perceived, self efficacy and social support. Most patients were unable to follow healthy diets on a regular or continuous basis. Study results demonstrate the determinants of nutritional behavior as perceived by patients and healthcare providers and can help program planners in designing programs to select the most appropriate methods and applications to address these determinants in order to reduce unhealthy nutritional behavior and to eventually prevent CVDs

Patients' perspectives on factors that influence diabetes self-care

Although diabetes mellitus is of high concern in Iran, and the level of control is unacceptable, few qualitative studies have been carried out to reflect the experiences of patients on the barriers and motivators to self-care. This study aimed to explore a culturally based experience of Iranian diabetic patients regarding the personal and environmental barriers to and facilitating factors for diabetes self-care. Six focus groups were conducted among type 2 diabetic patients in the Charity Foundation for Special Diseases' diabetes clinic. Purposeful sampling was used. Newly diagnosed patients [less than six months] and all type 1 diabetic patients were excluded. Three focus groups were held on for each sex. A total of 43 patients participated in the study. Framework analysis was used to extract the themes from the data. Data analysis showed five main barriers: physical barriers [such as physical effects of diabetes]; psychological barriers [such as health beliefs]; educational barriers [such as lack of knowledge about diabetes]; social barriers [such as group pressure]; and care system barriers [such as service availability]. Along with the barriers, there were some motivators that the participants mentioned as a stimuli to control their diabetes. They include beliefs about diabetes, perceived responsibility for family, religious beliefs, and the views of significant others. Culturally based interventions are needed to improve diabetes care management in Iran. In addition to personal factors, diabetes health educators should pay attention to the environmental factors when they develop programs

Barriers and facilitating factors for cervical cancer screening: a qualitative study from Iran

This study aimed to explore the experiences of Iranian women regarding the barriers to and facilitating factors for cervical cancer screening. Eight focus groups [N= 86 participants] were conducted with women referred to a health center in Karaj, Iran from January to March, 2007. Purposeful sampling was used. Married women aged 18 years old and over, not suffering from Obstetrics/ Gynecological disease during last two years and being willing to participate in the study were included. Framework analysis was used to extract the themes from the data. In general, the participants stated that they were not knowledgeable regarding cervical cancer. Moreover, most of the participants had negative beliefs regarding cancer prevention, including lack of free time to do the test, cost of the test, no symptoms cue. The perceived facilitating factors verified by the participants were cues to action, health care motivator, and perceived threat. The findings of this study revealed that there are various psychosocial barriers to cervical cancer screening among Iranian women. High accessibility and availably of the test as well as health care providers' encouragements may improve the rate of cervical cancer screening

[Barriers and motivating factors related to cervical cancer screening]

Although cervical cancer has high prevalence, few qualitative studies have been carried out to reflect the perceptions of women on the influential factors that affect cervical cancer screening in Iran. The aim of this study was to explore a culturally-based experience of Karaji women regarding the barriers to and motivating factors for Pap smear screening test among Karadj women in 2007. In this content analysis, eight focus groups were conducted using semi-structured guide questions [n=86]. Findings revealed that factors such as medical advice, advice from friends and family, knowledge about symptoms and pap smear screening method, free and accessible services, and perceived threats would influence the women to undergo a Pap test. Major barriers were lack of knowledge about cervical cancer and its causative factors, inappropriate beliefs, fear from cancer diagnosis, and pain related to the procedure. Regarding the influencing factors on the rate of Pap smear screening test, it seems that designing appropriate educational programs in order to promote knowledge and correct health beliefs using mass media and local communications will result in referring more women to undergo Pap smear screening test

Education-based needs assessment: a step toward effective prevention of AIDS

The prevalence of HIV/AIDS is dramatically increasing worldwide. Iran and the other Middle East countries have also encountered this increasing pattern. The aim of this study was to assess the educational needs of Bandar-Abbas people about HIV/AIDS. This descriptive analytical research was carried out on a sample population of 2123 persons who were randomly recruited for the study in 2003. A structured questionnaire was used for data collection. HIV/AIDS knowledge, attitude, self-efficacy, perceived susceptibility, perceived severity, and the information resource for HIV/Aids were assessed through interviews. Our data showed that people had a good level of knowledge about HIV/AIDS, however no positive attitude toward this disease was observed. There was a relationship between age and the knowledge on transmission routes [P=0.03, r=0.65]. Also, a significant correlation between education and the knowledge on different ways of transmission was demonstrated. No significant relationship between sex and the knowledge was established. Approximately, 40% of people were shown to have high level of self-efficacy in preventing the disease. Regarding the perceived severity, 48.7% believed that HIV/AIDS causes the patients to become weak and 34.7% thought that HIV/AIDS can expose people to other diseases. Most people described that their information on HIV/AIDS was obtained through mass media. Promoting the level of social health is in close association with publicizing the level of knowledge among people and correcting their attitudes toward the disease. This topic should be highlighted in health promoting educational programs