[Effect of education based on health belief model with relaxation on anxiety of nulliparouse women]

Background and Aim: Scientific literature has emphasized the role of education and nonpharmacological methods such as relaxation techniques as the priority treatment for anxiety in pregnancy. This study aimed to determine the effect of education, based on the health belief model [HBM] associated with relaxation on anxiety of nulliparous women

Materials and Methods: In an experimental study, 120 nulliparous women referring to health centers in Qazvin City were assigned randomly to experimental and control groups by means of multi-stage sampling. Intervention course included 3 sessions of group education and a relaxation training session in addition to an educational CD and theory-based training booklet. The data collection tools included demographic questions, 58 item Pregnancy Related Anxiety Questionnaire [PRAQ], Knowledge scale and HBM related questions which were filled out by the participants in a self-reported manner before and after the intervention. Using SPSS 20.0, data were analyzed by analytical tests such as T-test, chi-square, Mann-Whitney U and ANOVA

Results: The mean scores of knowledge, perceived sensitivity and severity, perceived barriers and benefits, self efficacy and cue to action constructs improved significantly in the experimental group after the intervention [P<0.001]. Results revealed a significant decrease in the total anxiety score [from 241.9 +/- 42.3 to 164.1 +/- 40.4, P< 0.01] and its dimensions in the experimental group after the intervention

Conclusion: Regarding the effect of theory based relaxations training on reduction of anxiety in nulliparous women, use of these interventions to improve the health of women during pregnancy is recommended

[Effect of an educational intervention based on the theory of planned behavior on the use of hearing protection devices]

Background and Aim: Noise is the most common and also preventable harmful physical pollutant in the workplace in the world. Although the hearing protection devices are the last way to prevent hearing loss, most people do not use the equipment properly and consistently. The aim of this study was to determine the effect of theory-based training on the rate of using hearing protection devices in workers of auto parts factories in Qazvin Industrial Towns

Material and Methods: Using random sampling method, 120 workers from two auto parts factories in Kaspian and Alborz Industrial Towns were entered into this experimental study. Data collection tools included demographic questions and self-reporting questionnaire to measure TPB related constructs indirectly. The intervention program was composed of two 90 minute group discussion along with targeted educational booklet. Using SPSS version 20, data collected at different times were analyzed by chi-square, independent t-test and ANOVA

Results: After the intervention, we found increased mean scores for: attitude [from 36.0 +/- 17.3 to 64.5 +/- 22.8], subjective norms [from 28.5 +/- 10.7 to 46.8 +/- 12.4], perceived behavioral control [from 41.8 +/- 19.3 to 72.1 +/- 21.5], behavioral intention [from 3.6 +/- 3.1 to 7.5 +/- 3.8]. Also use of hearing protection devices significantly increased in the experimental group [P<0.001]

Conclusion: Educational intervention based on the theory of planned behavior led to increased use of hearing protection devices among workers. Designing educational programs based on the above mentioned theory in order to increase the use of personal protective equipment in workers is recommended

[Comparison the childbirth outcomes between early amniotomy and premature rupture of membranes]

The aim of amniotomy is to speed up contractions and shorten the length of labor. However, there are concerns regarding unintended adverse effects on the mother and neonate. The aim of current study was to compare maternal and childbirth outcomes of early and late amniotomy with premature rupture of membranes [PROM]. This cohort study was carried out among 200 term pregnant women with singleton fetus and cephalic presentation at shahid Raajaee hospital, Tonekabon, Iran. Statistical analysis was performed by Chi-square, exact Fisher test and ANOVA using SPSS. version 17.0. Duration of the first stage of labor was significantly longer in the early amniotomy group [15.29 +/- 14.22 hours] as compared with the late amniotomy group [10.27 +/- 5.58 hours] and the PROM group [10.81 +/- 5.30 hours] [P<0.0012]. Higher rates of Cesarean section were found in the early amniotomy group [17.38%] as compared with the others [4/2% in late amniotomy group and 2.37% in PROM group, P<0.018]. Regarding abnormal fetal heart rate [FHR], there was significant differences between early amniotomy group [15.01%] and PROM group [3.36%] [P<0.0001]. There was no significant difference in other neonatal and maternal outcomes between three groups. Regarding current findings, cervical ripening techniques in order to improve the Bishop scores should be applied before amniotomy

[ effect of an educational intervention based on the theory of planned behavior to improve safety climate]

Annually, occupational accidents have a major impact on workers health and Impose large costs on employers. The current study was designed to evaluate the efficacy of the theory of planned behavior-based intervention to improve workers safety climate in industrial city of Qazvin in the first half of 2010. A number of 75 workers in each of the control and intervention groups participated in a quasi experimental study. With respect to the fact that the changes of safety climate usually take place in the long term, and for the longer follow-up of participants, data were collected through selfreport questionnaires in three different time intervals including initial followed by, 3 and 6 months after the intervention. The intervention consisted of four training courses with 8-15 trainees in each group and its duration was 45-69 minutes. The data were entered into SPSS 16.0 software and were analyzed using statistical tests. The score of Management commitment was significantly increased in the three and six month evaluation in intervention group [p< 0.001]. Also, results showed a significant increase in other dimensions such as safety communication, secure environment, responsibility, risk perception, safety climate [p<0.05]. Results also indicate a significant change in mean scores of attitude, subjective norm [p<0.05], perceived behavioral control [p<0.001] and attempted [p<0.05] in the intervention group and no significant change in these variables in the control group. Results showed an improvement of workers' safety and common perceptions of workplace safety policies and procedures due to educational intervention based on theory of planned behavior. Thus, the theory of planned behavior can be used as a theoretical framework for the design and implementation of workplace safety interventions.

Psychometric properties of the national eye institute refractive error correction quality-of-life questionnaire among Iranian patients

To evaluate the psychometric properties of the national Eye Institute refractive error correction quality of life questionnaire [NEI-RQL-42] among Iranian patients with refractive errors. Two samples of patients [n1 = 296, n2 = 95] were consecutively selected from the eye clinic of the Boo-Ali Hospital, Qazvin. A forward-backward procedure was conducted to translate and cross-culturally adapt the Iranian version of the NEI-RQL-42. A homogeneity, stability, and reliability test was conducted for the first sample after a two-week interval. Convergent validity was computed using the correlation between the NEI-RQL-42 subscale scores, National Eye Institute-Visual Functioning Questionnaire [NEI-VFQ-25], and the Short Form-36 [SF-36]. Furthermore, Known-group analysis was performed, to determine the discriminant validity between the subgroups of patients with hyperopia, emmetropia, and myopia. Responsiveness to clinical change was tested by administering NEI-RQL-42 on the second sample that was scheduled for surgery. Homogeneity was satisfactory with the Cronbach's alpha coefficients ranging between 0.70 and 0.92. The 13 subscales of the NEI-RQL-42 showed a considerable stability in intra-class-correlation [ICC] ranging between 0.70 and 0.89. Positive correlation coefficients were found among all subscales of the NEI-RQL-42 and the other quality-of-life instruments [NEI-VFQ-25 and SF-36]. The NEI-VFQ-25 displayed excellent discriminant validity to differentiate the subgroups of patients, and was found to be responsive to change after the surgical correction at three months. The Iranian version of the NEI-RQL-42 is a valid and reliable instrument to assess refractive error correction quality-of-life in Iranian patients. Moreover this questionnaire can be used to evaluate the effectiveness of interventions in patients with refractive errors

[ impact of health education based on theory of planned behavior on the prevention of AIDS among adolescents]

Adolescents are among the most vulnerable age groups against AIDS and other sexually transmitted diseases. The aim of this study was to assess the impact of health education based on Theory of Planned Behavior on the prevention of AIDS among high school students in Qazvin city. It was a quasi experimental study that was conducted on 120 students in boys' high schools in Qazvin. The students were randomly assigned into either control or experimental groups [each 60]. Data was gathered before and after educational program. The instruments included questions related to demographic characteristics, a questionnaire for assessing constructs of theory of planned behavior and an observation checklist to assess refusal skills and stalling risk suggestions. Educational intervention was conducted in 5 focus group discussions each lasting for 45-60 minutes with emphasis on the above mentioned theory. An educational pamphlet also was given to the subjects. Data were collected before and 3 months after training and was analyzed by Mann-Whitney U test, Wilcoxan test, paired t test, Chi-square and ANOVA using SPSS-PC [v.17.0]. The average age of the subjects was 16 +/- 3.29 years. No difference was detected between demographic characteristics of the control and experimental groups. There was also no difference between the groups regarding cognitive variables [knowledge, attitude, perceived behavior control and intention] before the intervention. The adolescents in the experimental group reported higher scores for the cognitive variables compared with the control group [P=0.001]. The results related to refusal skill and stalling risk suggestions indicated that the educational intervention increased these skills at the end of study [P<0.05]. The findings revealed that an educational intervention based on the theory of planned behavior results in the formation of refusal skills and stalling risk suggestions related to HIV/AIDS behaviors among male adolescents

[Assessment of psychometric properties [validity and reliability] of safety climate questionnaire: factor analysis application]

Safety climate has shown its ability to predict important safety results, such as perceived risk, accidents and injuries. It is important to understand the psychometric properties of instruments used to measure safety climate before they are used in the setting of factories and workplaces. We explore the reliability and validity of safety climate questionnaire in Qazvin industries. Furthermore, correlations between accident rate and safety climate factors were explored. A study using a questionnaire was conducted on 380 employees in eight major companies in Qazvin, Iran. A 43-item safety climate questionnaire was developed after a scientific literature review and consultation with safety experts. Seventy five percent of the data gathered were subjected to principal component factor analysis with varimax rotation, using SPSS software. The remaining data [25%] applied for running confirmatory factor analysis using the AMOS 16.0 structural equation modeling program. Explanatory factor analysis displayed 8 factors with together explained 68.46% of the total variance. Cronbach Alpha [Internal consistency] across items in each of the 8 factors and the total scale were found acceptable. A 37 item questionnaire measuring safety climate was extracted from the original 43 items. Finding of confirmatory factor analysis was revealed to be a satisfactory fit index [CFI=0.91, TLI=0.93, RMSEA=0.044, Chi[2]/df =3.41]. The safety climate score calculated were found to have significant negative correlation with self-reported accident rates showing good predictive validity. One way ANOVA results display that the companies' mean safety climate scores vary significantly from each other indication that companies have different safety climate levels. The Safety Climate Questionnaire demonstrated good psychometric properties. This study has recognized Management commitment for safety and safety priority in workplace, employees knowledge and compliance from safety rules, employees attitude toward safety, workers participation and commitment to safety, safeness of work environment, and emergency preparedness in the organization, priority for safety over production and risk justification as the 8 safety climate factors in the Qazvin industries. This study provides benchmark scores for each safety climate factor with which organizations or even individual departments can be compared based on factor scores

[Assessing the readiness of assembly line workers to adopt the upright posture]

Based on a biomechanical model, an upright body posture has an important contribution to the prevention of musculoskeletal disorders and back pain. This study was conducted to determine the relationship between the constructs of theory of planned behavior and the stage of readiness for maintaining correct body posture among the assembly line. In this cross-sectional study, a total of 264 workers from Pars Electric and Kachiran factories with an average age of 35 years and selected by convenient sampling method were investigated in 2009. Data were collected using a questionnaire with appropriate psychometric properties of 5 parts including the demographic information, attitude, perceived behavior control, subjective norms, and intention as well as a staging algorithm for maintaining an upright posture during a 6-month period. The results of analysis of variance [ANOVA] showed that all selected variables shared a significant variance with the stage of readiness and that the discrimination between the stages by the selected variables was successful. Structural equation modeling was indicative of a direct relationship between the intention and the stage of readiness. Also, the subjective norms and perceived behavior control which showed to have direct relationships with intention exerted their effects on stage of readiness through intention mediation [P<0.05]. Perceived behavior control, subjective norms, and intention are beneficial to understand the individual differences in stage of readiness for maintaining upright body posture and considering the subjective norms and managerial supportive network is essential to promote safe behavior

[Psychometric properties of iranian version of female sexual function index]

Sexual problems in women are highly prevalent and frequently are associated with personal distress and impaired quality of life. The aim of the study was the validation of a translated and culturally adapted Iranian version of the FSFI-the IV-FSFI [Iranian Version of the Female Sexual Function Index]. In this cross-sectional study, 448 women [19 to 54 yr], after applying inclusion and exclusion criteria were eligible for this study. The instrument was translated into Persian, back-translated, and pilot tested to ascertain cultural sensitivity. Construct validity was evaluated by explanatory and confirmatory factor analysis and internal consistency was estimated with Cronbach's alpha and the average inter-item correlation. In addition, the test-retest reliability of the measure was determined at a 4-week interval [n=362]. Discriminant validity was assessed with betweengroups analysis of variance The overall test-retest reliability coefficients were high for each domain of the IV-FSFI [r ranging from 0.73 to 0.86] and the internal consistencies within the acceptable range [from 0.72 to 0.90]. Principal component analysis with varimax rotation revealed a best fitting five-factor structure similar to the original FSFI. CFA confirmed the underlying domain structure, supporting the factorial validity of the IV-FSFI. In conclusion, the newly developed IV-FSFI has demonstrated to be a reliable and valid instrument with good psychometric properties that allows a quick and accurate preliminary screening of women with unknown sexual health status in clinics and others medical settings

[Predicting the stages of change in physical activity behavior of QUMS students with Pender's model]

Low level physical activity is a risk factor for several chronic diseases and evidences suggest that the level of physical activity is decreasing. Reversing the trend depends on a behavior change by most people. However, the association between various psychosocial determinants and physical activity are not well understood. The aim of this study was to predict the stages of change in physical activity behavior of QUMS students by Pender's model. This cross-sectional survey was carried out at Qazvin University of Medical Science in 2008. A total sample of 222 students completed a self-report questionnaire consisting of an exercise change. A test-retest method was applied to determine the reliability while the Cronbach's Alpha used to confirm internal consistency. Face and content validity were confirmed in this study. Also, ANOVA and Path analysis were performed to determine the association between these constructs and stage of physical activity behavior change. More than half of students were in inactive stage and exercised for 41.62 minutes a week on average. Exercise self-efficacy, perceived barriers, and perceived benefits were found to be significant predictors of the stage of exercise behavior change among medical students. Only self-efficacy and stages of change [P<0.001] could directly predict the significant variance of physical activity while other constructs from Pander's model indirectly influenced the physical activity behavior through mediating stages of change construct. Perceived benefits [P<0.001] directly and perceived barriers inversely [P<0.001] were predictor of stage of exercise behavior. Perceived health status could indirectly influence the stage of change via perceived benefit. Our results indicated that the change in stage of readiness for exercise is probably dependent on the student's perceptions of exercise self-efficacy, benefits and barriers as well as the perceived health status to engage in physical activity. Furthermore, the results of this study made moderate support for the health promotion model constructs to predict physical activity and exercise stage of change

[ effects of an educational intervention on knowledge, attitude and ergonomic behaviors]

Obviously, decreasing the work-related musculoskeletal disorders is well achieved through the application of ergonomic design principles however, there are occasions in which the existence of some barriers [technical and economical] can preclude ergonomic improvement and therefore, some organizations rely on correct task performance methods. The aim of this study was to assess the effect of educational intervention on worker's knowledge increase, attitude change, and ergonomic habits promotion. In this interventional study, workers were randomly assigned to one of the two study groups: a case group receiving the ergonomic training [n=75], and a control group [n=75]. Ergonomic training program composed of five sessions of 30-45 minutes duration containing issues such as ergonomic science, human body mechanic, upright and awkward postures, pros and cons of upright posture maintenance, and solutions for removal of obstacles, stretch exercise for prevention of musculoskeletal disorders, and workstation adjustment. Data were gathered before and 3 months after intervention by self-reporting questionnaire and checklist. Reliability was assessed by test-retest method and the internal consistency evaluated by Cronbach's Alpha. Statistical analysis was performed using X[2] test, McNemar test, independent t-test, and paired t-test. Worker's knowledge significantly increased from 7.97 +/- 2.91 to 14.07 +/- 1.98 and the attitude change from 14.29 +/- 6.5 to 21.63 +/- 4.7 three months after educational intervention [p> 0.05]. No significant change was observed in control group. Regarding the ergonomic risk factors, our findings were indicative of significant change in general body and feet posture, trunk, neck, and wrist and hands postures while other ergonomic risk factors remained unchanged Results from this study emphasize on necessity of integrated educational-managerial and engineering approach to promote the workplace ergonomic condition as well as considering the substantial role of psychosocial factors such as knowledge and attitude and focusing on personal skills for improving ergonomic habits to achieve a higher level of health promotion among human power

[Effectiveness of an ergonomic education to modify of body posture, ergonomic risk factors and musculoskeletal pain severity in computer users]

Use of computers with disregard ergonomics may lead to health problems, long-term discomfort and physical disabilities and lose workdays. To assess the effectiveness of an ergonomic education to modify of body posture, ergonomic risk factors and musculoskeletal pain severity in computer users. In this Quasi-experimental randomized controlled study, computer users were assigned to two groups: case group [n=75] receiving the theory based on intervention by using construct of theory of planned behavior and stage of change, and control group [n =75]. Both groups were evaluated at the beginning of the study and 3 and 6 months later. The following tools were used: the Rapid upper limp Assessment [RULA] method to assess upper-extremity work-related posture, self administrated questionnaire that evaluated TPB constructs, stage of change algorithm, ergonomic risk factors checklist, ergo- knowledge quiz and VAS for assessing musculoskeletal pain severity. The intervention included two program elements: staged matched informative brochure and personalized preventive educational counseling. The intervention group had significantly higher scores than controls in ergo-knowledge, attitudes, perceived behavior control, intention, as well as non natural posture maintenance as goal behavior [P<0.05] Also, finding showed the significant diminish in musculoskeletal pain severity [P<0.05]. At 3 and 6 months follow up, no significant differences were found between the two groups for subjective norms constructs. Intervention couldn't improve RULA risk level to low and very low area [1, 2 level] and only decreased risk exposure to medium level. According to the results preventive ergonomic campaigns would be more successful if educational intervention regarded as a part of multifaceted interventions: analysis and elimination of risk factors, engineering controls and administrative controls