[Relationship of spirituality and quality of life in patients with type 2 diabetes]

Introduction: Diabetes and its complications have a significant impact on patients' quality of life and spirituality can help improve the quality of life in such patients. The purpose of this study was to determine the relationship of spirituality with quality of life in patients with Type 2 diabetes

Materials and Methods: This was a descriptive-correlation study. Participants were 145 individuals with type 2 diabetes, patients of rural health clinics and the Valiasr hospital in Khorramshahr city, selected via stratified random and sampling methods. Data collection tools were a version of 29- item of the spiritual questionnaire [Parsian and Dunning] and a version of 26-item of the Quality of Life Questionnaire [World Health Organization], both questionnaires with previously confirmed validity and reliability in numerous studies. Data were analyzed using SPSS version 16 software and Pearson's correlation, T-test, ANOVA, Post Hoc and Stepwise Regression analytical statistics

Results: There was a significant positive relationship between spirituality and quality of life [p<0.0001]. The results show a statistically significant relationship between spirituality and quality of life with both education and age

Conclusion: A strong correlation between spirituality and quality of life in patients with type II diabetes, demonstrates the roles and responsibilities of healthcare providers, including physicians, nurses and patients' families in meeting the varied spiritual and religious needs of patients along with their therapeutic management. Focusing on improving spiritual health is also important in education programs for these patients

[Iodine intake knowledge, attitude and practice in pregnant women and its relation to iodine status during pregnancy]

Introduction: Previous research shows that pregnant women, due to their increased need for iodine, are among the high risk groups for iodine deficiency. This study hence aimed to evaluate the status of women's knowledge, attitude and practice [KAP] regarding iodine and iodized salt intake and its association with iodine nutrition levels

Materials and Methods: In this observational analytical study, 100 pregnant women, residents of southern Tehran were randomly selected from five health care centers. Data collected included the general information and demographic characteristics and KAP questionnaires regarding iodized salt intake. Urine assessments of pregnant women and household salt samples were collected and evaluated

Results: Mean age of participants was 27.16 +/- 5.58 years, and their mean +/- SD knowledge, attitude and prachie scores were 62.5 +/- 20.8, 85.2 +/- 12.3, 64.7 +/- 14.3, respectively. Median urinary iodine concentrations and salt iodine content were 25.9[20.6-29.6] ppm and 109[60-160] micro g/L, respectively with 74% of women consuming salt containing 20-40 ppm iodine and 29% had urine iodine concentrations >/= 150 8g/L. Urine iodine concentration was significantly associated with practice score as well as with iodine content of salt

Conclusion: Although women suffered from iodine deficiency, their KAP scores regarding iodine and iodized salt consumption were adequate. Further assessment of other personal and social factors which could affect iodine nutrition status of pregnant women is recommended

[Inefficient education and process of obesity in Tehranian adolescents: a qualitative study]

This study aimed to determine inefficiencies in current educational programs for promoting of healthy lifestyles and prevention of obesity from the perspective of adolescents and mothers. This was a qualitative study conducted based on a grounded theory approach. To collect data, 23 personal interviews and 12 semi-structured focus group discussions were conducted with overweight/obese adolescents and mothers who had at least one overweight/obese child. To maximize the variation of participants' experiences with different socio-economic backgrounds, two demographically diverse areas from the north and south of Tehran were selected and followed with theoretical sampling. All the interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously, using the Strauss and Corbin analysis method. In the current study, inefficient education was explored using two main themes including "Single dimensional curriculum of schools" and "Inefficient public education". The single dimensional curriculum of schools was found to be characterized by "lesson-based curriculum" and "burdensome educational programs" and the inefficient public education was characterized by "inappropriate content", "lack of comprehensive educational program", "inappropriate ways of messaging" and "contradictory messages". Based on the findings of this study, "single dimensional curriculum of schools" and "Inefficient public education" were the main correlates of inefficient education in our society, which led to obesity-related behaviors and consequently excessive weight gain in Tehranian adolescents. The results of this study may be effective in prioritizing and designing health promotion programs aimed at promoting healthy lifestyles and prevention of obesity in children and adolescents

[Adolescent's perspectives on the factors that influence caries development: a qualitative study]

Oral and dental diseases limit an individual's activities at the school, work place and home, leading to a loss of millions of work and school hours all over the world. The period of adolescence is critical as regards shaping of healthy behaviors related to oral and dental diseases. The purpose of this study was to explore and describe school pupils' viewpoints on factors influencing development of dental caries. A qualitative study with a content analysis approach was conducted to collect the perspectives of 18 Iranian students in 8 guidance schools selected by purposive sampling. Structured and semi-structured interviews were held to collect data. An informed consent was obtained and the interviews were recorded and transcribed. The data was analyzed through an inductive approach of content analysis. In order to support the validity and rigor of the data, different criteria such as acceptability, confirmability and transferability were utilized. Data analysis could identify four major factors influencing dental caries development: "family interactions in dental health", "role of school in caring for teeth", "role of dentists in caring for teeth" and "effect of education in caring for teeth". The factors influencing caring for teeth and mouth had a greater significance. The students' experiences, as observed in this study, can help in developing mutual trust between students and dentists, delivering better services in schools by relevant organizations, and designing more effective oral health interventions, with due consideration of vital role of the parents

[Decision making process and related factors in adolescents with premenstrual syndrome]

Decision making for adopting a health behavior is a process involving passing through different stages. This study was conducted to determine the decision making stages based on Precaution Adoption Process Model [PAPM] in female students with premenstrual syndrome [PMS]. In this quasi-experimental within-subjects study, the PAPM stages were assessed in 317 high school students with PMS, who were exposed to an educational intervention based on PMS concepts. Decision making stages before and after the educational intervention were assessed based on PAPM. All the participants in pretest assessment were at the stage 0 of decision making. None of them had changed her decision making stage during a one-week posttest assessment. After exposure to educational intervention, about 10.1% were assessed as stage two, 26.8% were in stage three, 1.9% reached stage four, and 61.2% were at stage five. In a regression model, PMS scores could predict 2% of variance in decision making stages. PMS severity and sign interference with social and school performance had a significant correlation with the individual's decision making stage [p < 0.05]. Adolescent girls with PMS are not in the same stage of decision making after exposure to educational intervention and obtaining the necessary knowledge about PMS. Based on this finding, the design of educational interventions for PMS students must be stage-based. Perceived severity of PMS symptoms and PMS sign interference with school and social activities are among the variables that can be considered as PAPM constructs

Stress, coping strategies and related factors in a sample of Iranian adolescents

Since the stress and coping are the most reported problems by adolescents, this study aims to apprise the stressors, coping strategies and influential factors among male adolescents. The effect of stressors, coping strategies and some demographics variables were studied in 402 male adolescents in Tehran, Iran. A self-administered questionnaire was used to collect the data. A multiple regression was performed to assess factors related to perceived stress. The mean age of adolescents was 15.44 [SD=0.68] years. The mean value of perceived stress for the whole sample was 17.99 [SD=6.02]. Cognitive/emotional coping was the most frequent coping style. The findings revealed that there was a significant correlation between perceived and accumulative stress. In multiple regression analysis, the accumulative stress, social resources, parent's education and grade point average were found to be significant predictors of perceived stress. The findings suggest that increased level of perceived stress is associated with accumulative stress, social resources and parent's education that are modifiable factors. Stress management education might be a solution to overcome increased perceived stress

Effect of health promotion model [HPM] based education on physical activity in diabetic women

Diabetes is a serious problem. Although physical activity is very useful for control of diabetes, motivating change in physical activity is very difficult. The aim of this study was to determine the effects of education, based on Health Promotion Model [HPM] in physical activity among diabetic women. In this clinical trial study, 80 women [40 patients in each groups] evaluated. All patients in the case group were educated for 1 session of group education, and 3 sessions of individual counseling with the 5 A's method, based on HPM. Then patients in both groups, in the first, 3 and 6 months after education, were evaluated for changes and physical activity. Statistical tests included Repeated Measurement ANOVA, Mann-Whitney and Friedman with SPSS, version 16 were used for data analysis. The results of repeated measurement ANOVA showed that the effects of time-group interaction effects education were significant for physical activity in the case group, the difference between case and control groups in physical activity being significant. Three and six months after education, the case and control groups had progressive stages of change. Intervention with the Health Promotion Model increased physical activity and improved stages of change for physical activity behavior in diabetic women

[High risk behaviors among Iranian motorcyclists: a qualitative study]

To explore risk behaviors among Iranian motorcyclists. This was a qualitative study based on grounded theory to identify factors influencing Iranian motorcyclists' risk behaviors. In all, 22 participants took part in the study. To collect data, two focus groups and 13 in-depth interviews with key informants were conducted in Tehran, Iran. Moreover, thirty two observations regarding motorcyclists' behaviors were assessed to increase trustworthiness of the collected data. All interviews and discussions were transcribed and analyzed. A total of 22 participants with an average age of 26.4 years shared their experience regarding motorcyclists' risk behaviors factors while riding. Among all participants, 16 participants were riders or pillions and family members of riders and 2 participants were policemen. Of all, 4 participants were female and 41.7% were single. The findings of this study revealed that personal characteristics, environmental factors, vehicle related factors and abuse of safe equipments could cause risky behaviors while riding. The findings of this study indicated that different factors might influence risky behaviors. Thus a multidimensional and comprehensive approach should be designed to prevent risky behaviors

[Implementation of participatory-educational program based on Precede model for self-esteem and psychological well-being enhancement of university students]

Students are susceptible to mental health and psychological problems in different situations. The purpose of this study was to use a participatory-educational intervention for enhancement of self-esteem and psychological well-being of the students of Gonabad and Birjand medical sciences universities. This experimental study was based on Precede model in which 154 university students were randomly selected for the case and control groups. The data were collected by GHQ>-28, Rosenberg's self-esteem scale, enabling, predisposing and reinforcement factors questionnaires. The skill training program was used based on focus group discussion method in the sub-group of 12 participants. Then planned and implemented program was evaluated in the groups. The data were analysed using SPSS software. The results showed that there are significant differences between predisposing, enabling and reinforcement factors, self-esteem and psychological well-being variables before and after intervention. Moreover, after intervention, differences in psychological well-being [P<0.0001], self-esteem [P<0.001], predisposing factors [P<0.01], enabling and reinforcement factors [P<0.02] in case a and control groups, were significant. The study showed that skill training based on Precede Model can enhance self-esteem and psychological well-being and leads to empowerment and participation

[Modification of reasoned action theory and comparison with the original version by path analysis for substance abuse prevention among adolescents]

Objective of present study was assessing the competence of self efficacy to development of theory of Reasoned Action [TRA] and comparison with original version by path analysis for substance abuse prevention among adolescents. In this analytic study, 433 randomly selected adolescents [range of age 15-19] from Tehran participated in study. The study design was based on the theory of Reasoned Action and other self efficacy methods. Validity and reliability of the study questionnaire was assessed. Then the collected data were analyzed by using path analysis method The results indicated that the reasoned action developed by self efficacy, has a better fitness [RMSEA=0.043-df / chi[2]=1.77-P-value=0.1829] compare to the original [RMSEA=0.128-df / chi[2]=7.96-P-value=0.00479] in path analysis. In this study self efficacy become effective construct for fitness of model and powerful predictors for intention [beta=0.35] and behavior [beta=0.20]. The model covered 36% of intention variance and 28% of behavior variance. The reasoned action was developed by self efficacy and increased its prediction

[Mothers' perceptions on familial correlates of overweight and obesity related behaviors in adolescents: a qualitative study]

There is convincing evidence that family environment plays an important role in influencing the obesity related-behaviors in adolescents. Considering the necessity of understanding the familial correlates of obesity in adolescents, and the lack of related studies in Iran, this study aimed to explore mothers' perceptions and experiences regarding these associated factors of overweight and obesity related behaviors in adolescents. A grounded theory approach was used for analyzing the participants' experiences, and their perceptions. To collect data, 6 semi-structured focus group discussions were conducted with 25 mothers who had at least one overweight or obese child. Based on open sampling, with the aim of maximal variation of the participants' experiences, two demographically diverse areas from the north and south of Tehran were selected and then followed with theoretical sampling. All the focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously using the Strauss and Corbin analysis method. Five main familial correlates of overweight and obesity in adolescents emerged from data: 1] Parents with inadequate knowledge, 2] Parents' modeling of unhealthy behaviors, 3] Dissimilarity of members, 4] Maternal employment and 5] Children's studies being the top priority for parents. Conclusion: Findings demonstrate familial correlates of overweight and obesity in adolescents as perceived by mothers, correlates that must be addressed by effective interventions for tackling overweight and obesity in adolescents

[Design and determine validity and reliability of safety locus of control scale in Isfahan steel company workers]

The degree to which a person perceives that the outcomes of the situations they experience are under their personal control is a psychological variable known as Locus of Control [LOC]. Safety LOC is the construct that specifically address the internal and external LOC in industrial domain. Previous research suggest that safety locus of control can be assessed and used to predict safe behaviors. The main aim of this study was designing, validating, and determining the reliability of safety locus of control scale. Four hundred workers of Isfahan Steel Company participated in this study. The reliability coefficients were calculated in two different methods: test-retest and Cronbach alpha. In order to survey validity of the scale we used three methods including face validity, content validity and construct validity. We established the content validity of the Persian translation by translating [and then back-translating] each item from the English version into the Persian version. Exploratory principal components analysis yielded a three-factor structure that explaining a considerable proportion of the total variance [63.5]. Moreover the fit indices of the Confirmatory Factor Analysis turn out were sufficient to support three-factor structure. In addition, the reliability results were acceptable, too. In most studies, designing, validating and determining the reliability of scales are time consuming and costly and if there are valid and reliable scales in different topics, could avoid repetitious works in researches. The results showed that the reliability and validity of Safety Locus of Control was acceptable and respectable and is suggested as an applicable scale for industrial psychology and safety studies in Iran

Personal barriers to life style modification in overweight/obese adolescents: a qualitative study

Existing data show a rising prevalence of overweight and obesity among Iranian adolescents. Considering the lack of related studies from Iran, the current study investigates personal barriers to life style Modification among overweight/obese adolescents. This is a qualitative study, conducted according to the grounded theory approach. Participants were 35 school children [19 girls and 16 boys], aged 15-17 years, who were either overweight or obese. To collect data, 5 semi-structured focus group discussions and 10 in-depth interviews were conducted. To obtain views across a range of socioeconomic backgrounds, two demographically diverse areas in Tehran were selected, and in each area, participants were recruited from schools. All interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously according to the Strauss and Corbin analysis method. Based on data analysis, positive perception of conditions, priority of studying, lack of willingness, negative experiences, low self-esteem, and perceived lack of control were the major personal barriers to adolescents' healthy lifestyles. Study results demonstrated the main personal barriers for a healthy life style as perceived by adolescents, barriers that any effective interventions require to address for tackling overweight and obesity in adolescents

effect of intervention on the implementation of an incident reporting system in Isfahan steel company

Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. The aim of this study was to determine the effect of a training intervention on the implementation of an incident reporting system, perceived management commitment to safety and employees motivation to report incidents in Isfahan Steel Company. A quasi experimental research with case [185] and control [209] groups with measurements before the implementation of the incident reporting system and one year later was used to evaluate the effect of training intervention on the implementation of the incident reporting system, motivation to report incidents and perceived management commitment to safety. The results showed that the implementation of the incident reporting system was more successful in case group than the control group especially on reporting NM's, MI's. In case group, perceived line management commitment to safety and employees motivation to report NM's, MI's significantly increased after the training intervention. Training intervention could promote implementation of the incident reporting system as a key factor of management support. Although the study shows some encouraging results concerning the reporting NM's, MI's, further studies are needed to evaluate whether the introduction of an incident reporting system with feedback has an effect on the number of major incidents

Evaluation of knowledge, attitude and behavior of workers towards occupational health and safety

Studies show that about 90% of accidents occur because of unsafe behavior and human errors. Even if workers do not have the right knowledge, attitude and behavior toward safety measures in a safe workplace, all efforts for an accident-free workplace will be in vain. This study aims to determine the level of knowledge, attitude and behavior of workers toward occupational health and safety. This descriptive cross-sectional study was carried out on workers in Mahshahr Razy Petrochemical Complexm Ahwaz, Iran. A sample size of 210 was randomly selected. Data collection tool was a researcher-made questionnaire. Questionnaire's validity was gained by content-validity and its reliability was validated by Kronbach's alpha. Data was analyzed using SPSS 13. Mean age of workers was 31.1 years. The mean of their knowledge, attitude and behavior was reported 26.02, 153.18 and 36, respectively. 52.9% of workers had low, 36.7% moderate and 10.5% high level of knowledge. In addition, 75.7% of the subjects had a positive attitude towards occupational health and safety; 30% of workers had low safety behavior and 70% had safe behavior. The mean of knowledge grade shows a significant relationship with education level. A same relationship was reported for the mean of attitudes and behavior with age. Managers should design and implement educational interventions to promote knowledge, attitude and safe behaviors of workers

[Regular physical activity from perspective of females with diabetes: a qualitative study]

An active lifestyle is a critical determinant of overall health, but females engage in less vigorous exercise and leisure-time physical activity than males, and their level of activity decreases further as they age. These low levels of activity lead to loss of muscular strength and flexibility, as well as overweight and obesity, and result in disability and premature mortality from coronary heart disease, cancer, osteoporosis and non-insulin-dependent diabetes mellitus [USDHHS, 2000]. So, we want to study the exercise beliefs of females with diabetes for intervention on their physical activities. In this study we conducted personal in-depth interview with 50 females in preparation stage to assess Regular physical activity from diabetic females' perspectives. We use qualitative approach to gain insight regarding behavioral beliefs, normative beliefs and control beliefs that may influence diabetic females' physical activity. Duration of each interview lasting 45 minutes and all interviews had written, and analyzed with content analysis method consecutively. We found that: [a] the most salient behavioral beliefs that participants of this study said: exercise improves physical/ psychological/ social and spiritual health. physical health includes blood sugar decrease, Weight control, decrease in blood pressure, and lipid profile psychological health includes prevention of depression, stress, anxiety, improves mood social health include increasing relationship and collaboration with others, and promotion of relationship with God in spiritual health [b] relating to normative beliefs, at first family members, and secondly physician have the strongest normative influence on exercise, [c] and regarding control beliefs, psychosocial problems, Lack of access to exercise facilities for females, too expensive exercise facilities and lacking money, Other commitments [caregiver for others, work], family responsibilities, Weather [bad or poor weather], and lacking time obstruct exercise. Regularly Diabetic females have varied beliefs about exercise include positive to negative. Researcher intended to promote exercise behavior, should targeting these beliefs, weak negative beliefs, emphasis to positive beliefs and use these results in their interventions

Application of the health promotion model to predict stages of exercise behaviour in Iranian adolescents

A cluster random sample of 1073 students in the Islamic Republic of Iran [mean age 14.37 years] completed a self-report questionnaire consisting of an exercise measure, selected constructs of Pender's health promotion model and an assessment of stages of behaviour change in exercise. In multivariate discriminant analysis, exercise self-efficacy, perceived barriers to exercise, perceived benefits of exercise and exercise behaviour were significant predictors of the stage of exercise behaviour change for both female and male adolescents. The findings support the importance of self-efficacy for engaging in physical activity for both sexes of Iranian adolescents. The barriers faced by Iranian girls should be considered in interventions to increase physical activity rates

Self-efficacy: does it predict the effectiveness of contraceptive use in Iranian women?

This study explored the relative effects of self-efficacy on oral contraceptive use among a sample of 352 Iranian married women aged 18-49 years. In structured interviews 5 variables based on the Steps to Behaviour Change model [knowledge, approval, intention, practice and advocacy] were assessed and correlated with measures of family planning self-efficacy and general self-efficacy. The results indicated that the 2 independent measures, when taken together, were more effective in predicting behavioural intentions for effective use of oral contraceptives, with family planning self-efficacy making the strongest contribution. It is suggested that self-efficacy intervention techniques will benefit oral contraceptive users in preventing unintended pregnancies

Assessment of health belief model structures along with HbAlC in diabetic patients with optimum and unfavorable diabetes control

Nowadays implementing educational models for identifying reasons of rejecting health issues in the treatment process is increasingly concerned. One of the models which has been a matter of concern in recent years is health belief model. The objective of this study is assessing the structures of this model along with HbAIC in diabetic patients. In this cross-sectional study 76 [insulin dependent and non-insulin dependent] diabetic patients who referred to diabetes clinic of Hormozgan University of Medical Science during July and August 2006 and had been detected as diabetic at least one year prior to recruitment, entered the study after filling consent form. Data collection was performed via 3 questionnaires including demographic information, health belief model and self-efficacy questionnaires. HbA1C was calculated by calorimetry and body mass index [BMI] were calculated. Data by SPSS software, using t-test and pearson's correlation coefficient. 46 women [60.5%] and 30 men were studied. Data analysis revealed that there is no significant difference between HbA1C and the following factors: amount of perceived barriers according to sugar control, amount of perceived self-efficacy based on sex, rate or perceived self-efficacy on the basis of literacy and sensitivity rate perceived by the number of years inflicted with diabetes. Diabetes control is not satisfactory in patients despite long term medication and prejudiced diets. The level of health belief model structures in patients with unfavorable diabetes control is lower than those with optimum control. Hence, a precise educational program based on health belief model is necessity for excelling severity and sensitivity perceived by patients, increasing the perceived benefits and removing perceived barriers

effect of childbirth preparation classes on childbirth fear and normal delivery among primiparous women

There has been an increase in the number of women willing to have a caesarean birth because of their fear of childbirth. It seems the childbirth preparation educational class is a good way to remove or alleviate fears associated with pregnancy and childbirth.This research designed to identify the effect of childbirth preparation classes on childbirth fear on the primiparous women. The present study is a clinical trial which was carried out in 2007 at Milad Hospital, with 100 nulliparous pregnant women. Childbirth fear was measured by childbirth attitudes questionnaire. Normal pregnant women in the second trimester with childbirth fear score was 28 or more were randomly selected and dirided into experimental and control group with 50 subject in each qroup. The experimental group attended nine childbirth preparation class sessions and control group received routine antennal care. The mean scored fear of childbirth in case and control group were 39.35 +/- 6.96 and 40.71 +/- 6.23 respectively. There was not significant difference between two groups. After the sessions, comparing childbirth fear score between two groups in third trimester showed the mean score of childbirth fear among experimental group was lower than control group [29.82 +/- 7.18 compare to 38.03 +/- 9.27], and the differences statistically was significant [p < 0.001]. Mode of delivery was significantly different between the two groups. Primiparous women attended childbirth preparation classes acquired lower score of childbirth fear in compare to women received routine prenatal care. The results of this research showed relaxation training decreased childbirth fear and increased normal vaginal delivery