Using education based on the health belief model to modifications in performance of behaviors related to sexually transmitted infections in vulnerable women.

BACKGROUND: Sexually transmitted infections (STIs) have always been considered as a health problem in the world. Also, vulnerable women (addicts, jail breakers, and prostitutes) are at the highest risk. According to the World Health Organization's (WHO) approach, the only effective way to prevent and control this disease is public health education, and high-risk and vulnerable groups should be prioritized in educational programs. The aim of the study was to investigate the effect of health belief model (HBM)-based education on changing the behaviors related to STIs in vulnerable women. MATERIALS AND METHODS: The present study is an intervention (field trial) study in vulnerable women. Convenience sampling method was used in this study and the sample size was determined to be 84 subjects. Through tossing a coin, the social support center was selected as the intervention group and the drop-in center as the control group. Quantitative data analysis was performed, and descriptive and inferential statistical methods were used. RESULTS: The mean scores of perceived threat, perceived benefits, perceived barriers, and perceived self-efficacy and changes in performance between the three measurement stages, as well as changes in the scores of perceived threat, perceived benefits, perceived barriers, and perceived self-efficacy over three measurement times were significantly different between the two groups (interaction) (P < 0.001). The mean score of performance 3 months after the intervention was significantly higher than before the intervention (P = 0.001). CONCLUSIONS: The present study confirmed the effectiveness of the HBM in promoting behavioral modifiers that lead to STIs. Therefore, educational interventions with emphasis on understanding the threats, benefits, barriers, and self-efficacy and, ultimately, performance improvement in relation to STIs are recommended.

The effect of problem-solving and assertiveness training on self-esteem and mental health of female adolescents: a randomized clinical trial.

BACKGROUND: Children and adolescents are the assets of the society and their mental and physical health ensures the future health of next generations. The aim of the current study was to evaluate the effect of problem-solving and assertiveness skill training on improving self-esteem and mental health in high school female students of Isfahan city in 2019. METHODS: This study was a randomized clinical trial. The target population was 10th grade female high school students in Isfahan city of Iran. 96 students of a female public high school were included in  the study, allocated to two groups, 32 for intervention group and 64 for control group. Six 90-min sessions were considered for problem-solving and assertiveness skill training which included lectures, question and answer, movie displaying, brainstorming and role-play. The Coopersmith Self-esteem Inventory Questionnaire (CSEI) and General Health Questionnaire (GHQ) were used in order to evaluate the variables of the study before and one month after the intervention. RESULTS: Mean scores of the self-esteem variable changed significantly in the intervention group compared to control group before (25.2 ± 2.905) and after (29.9 ± 4.155) the intervention (p < 0.05). Mean scores of mental health also changed significantly before (27.67 ± 5.42) and after (19.033 ± 4.9) the intervention in comparison with the control group (p < 0.05). CONCLUSION: The findings of the present study showed that educational intervention based on problem-solving and assertiveness can  enhance self-esteem and mental health in students. Future studies are needed to confirm and determine the structure of these associations. Trial Registration IRCT Code: IRCT20171230038142N9. Registration Date: 07/07/2019. Ethics Code: IR.MUI.MED.REC.1398.130.

Effect of self-efficacy-based training on metabolic control of patients with type 2 diabetes.

BACKGROUND: Type 2 diabetes is a significant problem in today's society. Considering the possible effect of self-efficacy training on diabetes control, we aimed to investigate its impact on type 2 diabetes control. METHODS: This randomized controlled clinical trial was performed in 2018 in Isfahan city. Iranian Registry of Clinical Trials (IRCT) code for this study is IRCT20190219042762N1 (https://en.irct.ir/trial/37677). In so doing, 161 patients with diabetes were divided into two groups: intervention and control. The intervention group received six self-efficacy and healthy lifestyle training sessions, and self-efficacy strategies were taught in all sessions. Metabolic indices and the data collected by Diabetes Management Self-Efficacy Scale (DMSES) were analyzed before and three months after training by descriptive and inferential statistics. RESULTS: The self-efficacy score of the intervention group was significantly higher after training (175.7±18 vs. 163.7±26, P = 0.001). Also, the cholesterol level, LDL, and systolic blood pressure reduced significantly in this group after the intervention (167±39 vs. 179±43.7 mg/dl, 94.2±31 vs. 102.6±39 mg/dl, 115.6±1.4 vs. 120.1±1.8 mmHg, respectively. P<0.05). CONCLUSION: Generally, self-efficacy training effectively improved metabolic control in patients with type 2 diabetes.

Strategies to increase social capital and interaction of faculty members of medical universities.

BACKGROUND: Social participation and group interaction are the basic and expected indicators of serving in the job of the faculty. Some improvements are needed for universities and professors in this area, which they can be better identified by studying the main beneficiaries. In this regard, this study was aimed to identify strategies to increase social capital and interaction of medical universities' faculty members. MATERIALS AND METHODS: This qualitative study which was a qualitative content analysis type was performed on 22 faculty members of Isfahan, Mashhad, Tabriz, Iran, Army, Shahrekord, Sabzevar, Arak, and Khomein universities through semi-structured interviews and purposive sampling. Data were analyzed using qualitative content analysis. RESULTS: According to finding, in order to improve the social interactions of medical universities' faculty members, there were 2 factors and 8 main categories including organizational factors ("organizational dynamics," "organizational security," "standardization of selection and evaluation," "value creation," and "establishing a compensation system") and individual social factors ("education and social programs," "personal skills and beliefs promotion," and "personality and learning"). CONCLUSIONS: The obtained strategies in this study to improve social capital and group interactions and group participation of medical universities' faculty members can be planned and implemented by managers and can be used for faculty members themselves.

Prediction of mortality and morbidity following paraquat poisoning based on trend of liver and kidney injury.

BACKGROUND: Paraquat is a non-selective herbicide that causes severe tissue damage in various organs including the liver and kidney. The aim of this study was to determine the trend of the liver and kidney injury in patients with paraquat poisoning. METHODS: This retrospective cross-sectional study was performed at the Khorshid Hospital referral poisoning emergency center. The medical records of all patients with acute paraquat poisoning admitted from March 2017 to October 2020 were reviewed. Demographic factors, liver and kidney function tests and outcomes were recorded. Patients were divided into two groups based on the outcome of mortality (death or survived). The two groups were compared in terms of changes in creatinine and liver enzymes during hospitalization. RESULTS: A significant difference in mean creatinine levels between the two groups was observed from the third day after admission. The peak median Cr was 3.5 mg/dl for deceased patients in day 6 and 1.47 mg/dl for survived patients on 4th day. Minor elevations of ALT and AST were present in those who died. Logistic regression analysis shows patients who had level of creatinine higher than normal from the 2nd to 6th day post overdose, the risk of mortality was 4.83 to 7.44 times more than patients with normal creatinine level. The mean (SD) area under the curve for outcome prediction was reported to be excellent for creatinine on the 8th day post overdose (85.7 ± 13.2). Creatinine was higher than 2 on the 8th day post ingestion and had a sensitivity 100% and specificity 85.7% for mortality prediction (P value, 0.05). CONCLUSIONS: The risk of mortality secondary to paraquat ingestion was highly associated with a rise in creatinine. Minor elevations of ALT and AST were also present in those who died. The creatinine concentration on different days post overdose can be helpful in predicting the severity of poisoning especially when the serum paraquat levels are not available.

An Evaluation of the Relationship between Mental Disorders and Driving Accidents among Truck Drivers.

INTRODUCTION: A review of the existing literature shows the importance of mental health in preventing traffic accidents. Therefore, the current study aims to determine the mentioned mental disorders in relation with the history of accidents among truck drivers. METHODS: This cross-sectional study was done with two groups of truck drivers (with and without a history of accidents) in Iran. 56 people with a history of accidents and 410 people without a history of accidents participated in this study. At first, using questionnaires, the demographic information of the participants including age, education level, cigarette use, and addiction to drug was collected. Then, the mental disorders of the participants were evaluated by a 71-question, short form of the multidimensional Minnesota Multiphasic Personality Inventory (MMPI). The evaluated disorders are the HS or hypochondria, D or depression, HY or hysteria, Pd or social mental deviation, Pa or paranoia, Pt or mental weakness, Sc or schizophrenia, and Ma or hypomania. The tests used for data analysis include descriptive tests and Chi square. RESULTS: Man-Whitney U test showed that status of mental disorders, as revealed by the MMPI questionnaire, had a significant difference between the two groups with and without history of driving accidents (P < 0.001). The results showed that mental disorders of depression, hysteria, social mental deviation, paranoia, schizophrenia, and hypomania in individuals with history of driving accidents led to meaningful differences from individuals without history of driving accidents (P < 0.048). CONCLUSION: The results of the current study showed that generally, individuals with history of driving accidents had significantly more mental disorders than people without history of driving accidents.

The effects of educational intervention on breast self-examination and mammography behavior: Application of an integrated model.

BACKGROUND: Breast cancer is the most common type of cancer among women and it is the second leading cause of mortality among cancers in women and a major health issue in developed countries. Although there are simple and effective screening methods, just minority of women use them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of screening behavior, the present study aimed to determine the impact of theory-based educational intervention on breast self-examination (BSE) behavior and mammography. MATERIALS AND METHODS: The present experimental study was conducted on 93 women referred to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women were included in the control group and 47 in the intervention group. Data collection was done by a valid and reliable questionnaire. Furthermore, educational interventions were performed for the intervention group in three sessions. Furthermore, the data were completed in the intervention group before, immediately after, and 3 months after intervention and before and 3 months after intervention in the control group. The data were analyzed by SPSS (16); and paired t-test and repeated measure test were used for analysis in the intervention group and also independent t-test and paired t-test were employed to analyze data of the control group. RESULTS: The results showed significant changes in perceived benefit constructs (P = 0.023), knowledge (P < 0.001), self-efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035) in the intervention group over time, but changes were not significant in both perceived susceptibility and severity in the intervention group. As far as mammography behavior is concerned, only the perceived benefit construct in the intervention group had significant changes. In terms of the screening behavior, only BSE behavior significantly changed before and after intervention. CONCLUSION: The study showed that theory-based education by applying of constructs such as perceived benefits and self-efficacy and intention for BSE model could promote breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational texts based on these constructs to increase their influence on individuals via screening behavior for breast cancer.

Effect of lifestyle modification education based on health belief model in overweight/obese patients with non-alcoholic fatty liver disease: A parallel randomized controlled clinical trial.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common emerging liver disease worldwide. Lifestyle modification is the most emphasized method on management of this disease. METHODS: In order to conduct this parallel, randomized controlled trial study, eighty-two NAFLD patients recruited and allocated to intervention group or the control. RESULTS: After two months of intervention, significant improvements in all health belief model (HBM) variables and knowledge were seen within the intervention group (p < 0.001) and also the improvements were significantly superior between two groups (p < 0.001). Furthermore, prominent significant reduction for liver enzyme was observed in the intervention group compared to the controls. Similarly, ultra-sonographic findings revealed a significant improvement in the intervention group versus control. CONCLUSIONS: This HBM-based lifestyle modification education could be effective not only in the HBM domains but also in the improvement of NAFLD parameters. Therefore, it could be useful to use this educational program for NAFLD patients in order to impact on their beliefs and body together. REGISTRATION: Iranian Registry of Clinical Trials (IRCT2014101811763N17).

Evaluation of the effect of fatigue on the coping behavior of international truck drivers.

BACKGROUND: Fatigue can affect the behavior of drivers. While the driver must be able to respond and cope appropriately to the critical situations, which is known as the ability to cope with a crisis. It is likely that the fatigue can change the people's coping style and thereby increase the chance of the crashes. Therefore, the present study aimed to investigate the effects of fatigue on the coping behavior of international truck drivers. METHODS: This study was conducted on 239 of international truck drivers employed in Iran. The Endler and Parker coping strategies questionnaire (CISS) and Persian version of the Fatigue Multidimensional Fatigue Inventory (MFI) were used to evaluate the coping styles of the drivers and the drivers' fatigue, respectively. RESULTS: The mean values of the total fatigue before and after traveling were 36.77 and 76.13, respectively. The mean values of coping styles of the problem-oriented, emotion-oriented, and avoidance before traveling were 53.66, 40.91, and 38.17, respectively, and those after traveling were 45.59, 51.18, and 36.45, respectively. The chi-square test demonstrated that there was a significant difference in the coping style of drivers before and after the trip (P <  0.001), and the percent of individuals with emotion-oriented increased. CONCLUSIONS: In general, the results showed that fatigue due to traveling could change the coping styles of subjects from problem-oriented to emotion-oriented and avoidance. This can increase the statistics of driving accidents.

Overweight, underweight, and obesity among male long-distance professional drivers in Iran.

OBJECTIVE: Long-distance professional drivers, as an occupational group, are hypothesized to have a higher risk of overweight and obesity. The aim of this study was to estimate the prevalence and risk factors of overweight, underweight, and obesity in long-distance professional drivers. METHODS: A cross-sectional study was conducted on 36 625 male long-distance professional drivers age ≥20 years, from April 2013 to Sept. 2016. Drivers were interviewed and underwent clinical and laboratory examinations including measures of blood pressure (BP), blood tests, anthropometric data, and visual and hearing acuity. The mean (standard deviation [SD]) age of participants was 41.9 (10.2) years with a mean (SD) duration of a professional driving of 15.3 (9.6) years and mean (SD) body mass index (BMI) was 25.7 (4.0) kg/m2 . RESULTS: The prevalence of overweight and obesity was 39.1% (95% confidence interval (CI) 38.6, 39.6) and 10.8% (95% CI 10.5, 11.1), respectively. A total percentage of 2.7 (95% CI 2.5, 2.9) were underweight. A total percentage of 10.6 had BMI 30-40 kg/m2 and 0.2% had BMI ≥40 kg/m2 . Using a stepwise binary logistic regression model for overweight, underweight, and obesity, age had a significant independent relationship with underweight, overweight, and obesity. Duration of work, BP, fasting plasma glucose, triglyceride, and cholesterol had significant independent positive association and smoking had a negative association with overweight/obesity when other covariates were considered. CONCLUSIONS: These findings indicate that overweight and obesity are prevalent among long-distance professional drivers in Iran and appears to be similar to the general population.

Nurses' consultative role to health promotion in patients with chronic diseases.

AIMS: Although chronic diseases are the most common and expensive health problems, they are preventable too. Nurses play a key role in the care of these patients. One of the important roles of nurses is consultation role. Due to the high impact of nurse consultant role on health promotion and also the fact that this role is not fully understood in Iran, this study aims at clarifying the role of nurse consultant. MATERIALS AND METHODS: This is a qualitative study with content analysis approach conducted through semi-structured interviews in Isfahan University of Medical Sciences from April to December 2017. A total of 35 participants (11 patients, 9 nurses, 6 faculty members, 4 postgraduate students, and 5 nursing managers) were included in the study. Sampling was done based on purposive sampling method, and participants were asked to express their opinions about nurse consultant. RESULTS: In this article, we discussed the following three categories and seven subcategories: (1) nursing consultation as a treatment facilitator (nursing consultation as a way to reduce the treatment course, nursing consultation as a way to reduce complications, and nursing consultation as a way to reduce costs); (2) professional performance in nursing consultation (nursing consultation based on problem-solving and evidence-based practice and management and teamwork in nursing consultation); and (3) prerequisites for the nursing consultation role (supporting nurses and introducing the role in decision-making units and creating demand). CONCLUSION: Nursing consultation has an essential role in patient health promotion. Therefore, it is better that nurses and other health-care team should be familiar with this vital role.

Prevalence hearing loss of truck and bus drivers in a cross-sectional study of 65533 subjects.

BACKGROUND: Noise pollution is one of the most important occupational pollutants in heavy-vehicle drivers. Therefore, this epidemiological research was conducted with the aim of determining the prevalence of hearing loss in heavy-vehicle drivers in Iran. METHODS: This cross-sectional research was conducted on 65,533 heavy-vehicle drivers including truck and intercity bus drivers from February 2006 to March 2016. The air and bone threshold of pure tone was measured for each ear at 0.5, 1, 2, 3, 4, 6, and 8 kHz by a skillful radiology expert. The obtained data from this research was analyzed in SPSS software using statistical tests such as descriptive analysis and paired t test. RESULTS: Mean (standard deviation) of hearing loss in left and right ears of all people was 23.02 (8.25) and 22.48 (7.86), respectively. Paired t test showed that hearing loss difference in left and right ears was significant (P < 0.001). Mean and standard deviation of paired t test showed that hearing loss difference in left and right ears was significant in all frequencies except 1000 Hz (P < 0.001). CONCLUSION: The findings of this research generally showed that 26.8% of the studied drivers have hearing loss. Hearing loss in the left ear was more than right ear.

The Role of Nursing Consultant in Iran: A Qualitative Study.

BACKGROUND: Nursing consultation is one of the important roles of nurses and is very effective in improving care results. But this role is unknown in Iran and there are no respective organizational positions. The purpose of this study is to examine the factors affecting the position of this role. MATERIALS AND METHODS: This study, as a qualitative research was conducted from April to December 2017 using content analysis approach. We performed semi-structured in-depth interviews with 23 participants who were selected using purposeful sampling and were asked to describe the factors affecting the organizational position of nurse consultant. RESULTS: The mean (standard deviation) age of the participants was 44.5 years (10.68). 279 meaning units, 39 codes, 6 subcategories and two categories were obtained in this essay. The two main categories include necessity for nursing consultation role with two subcategories (nursing consultation role as one of the main roles in nursing, and the need for nursing consultation in healthcare system in Iran), and the obstacles of nursing consultation role with four subcategories (healthcare system problems, problems associated with physicians, problems associated with nurses and problems associated with patients' culture). CONCLUSIONS: Considering the importance of nursing consultation role in improving the health of the patients, the policymakers should take into account the consultant role of nurses and they should understand the importance of and the need for this role. As such, we hope that managers and policymakers create a role position by removing the obstacles and considering the necessity of this role.

Youth Violence and Related Risk Factors: A Cross-sectional Study in 2800 Adolescents.

BACKGROUND: Youth violence is an important public health challenge, and the literature on this problem in developing countries has been limited. The present study aims to determine the prevalence of violence its related risk factors in in a sample of students in Isfahan, Iran. MATERIALS AND METHODS: In this cross-sectional study, 2800 middle and high school, aged 11-18 years in urban and rural areas selected in a multistage sampling procedure and were questioned using a self-administered questionnaire. Collected data included sociodemographic and family characteristics, students' knowledge, verbal and physical violence (as a perpetrator and/or victim), risk-taking behaviors (weapon carrying, threatening behaviors), family violent status, watching movies, and accessibility of sport facilities. RESULTS: The prevalence of verbal and physical violence in studied students was 45% and 33.3%, respectively. The prevalence of verbal and physical victimization was 45.8% and 23.6%, respectively. The prevalence of physical violence was higher in middle school students than high school students (P = 0.0001) and in boys was higher than in girls (P = 0.0001). Being boy, carried a weapon out of home or in school, victimization, feel unsafe at school, and violence in the family are the significant related risk factors with students violence (P < 0.05). CONCLUSION: The prevalence of students' violence in Iranian students is similar to the most of other developing countries, although, high rate violence and related risk factors emphasize the need for comprehensive and interventional prevention programs to reduce and manage student violence and associated risk behaviors.

Barriers to medication adherence in patients with hypertension: A qualitative study.

INTRODUCTION: Barriers to medication adherence in patients with hypertension can have significant differences that made researchers confute to conclude that medication adherence is required to be more explored, and then, beneficial interventions develop to decrease these barriers. Thus, the current study was aimed to identify barriers to adherence in Iranian society. MATERIALS AND METHODS: A qualitative content analysis was carried out. Participants were as follow: Patients with hypertension who had clinic records in the health centers of Isfahan University of Medical Science. Purposive sampling method was conducted and continued until data saturation, as well. Semi-structured interview was selected as the best-qualified technique to select data. Data were analyzed using qualitative content, constant comparative analysis, and MAXQDA (Ver 10) software. RESULTS: After study and separation of basic concepts, 1620 basic codes were extracted from interviews. Classes were made based on codes and after multiple reviews, summarizing as well as similarity. Primary themes were identified using more explorations and comparison of classes. Based on the nature, the conceptual themes were named. These themes include (1) environmental challenges of life, (2) incompatibility of patients; (3) forget to take medicine, and (4) inefficient recommendations of family. CONCLUSION: Findings revealed that barriers to patient adherence to the treatment had four dimensions that may be likely useful for managers and planners in the health field to plan and intervene regarding medication adherence as the most critical preventing factor for patients with hypertension.

Development and study of self-efficacy scale in medication adherence among Iranian patients with hypertension.

BACKGROUND: This study was aimed at developing and studying the scale of self-efficacy in adherence to treatment in Iranian patients with hypertension. METHODS: A mix-method study was conducted on the two stages: in the first phase, a qualitative study was done using content analysis through deep and semi-structured interviews. After data analysis, the draft of tool was prepared. Items in the draft were selected based on the extracted concepts. In the second phase, validity and reliability of the instrument were implemented using a quantitative study. The prepared instrument in the first phase was studied among 612 participants. To test the construct validity and internal consistency, exploratory factor analysis and Cronbach's alpha were used, respectively. To study the validity of the final scale, the average score of self-efficacy in patients with controlled hypertension were compared with patients with uncontrolled hypertension. RESULTS: In overall, 16 patients were interviewed. Twenty-six items were developed to assess different concepts of self-efficacy. Concept-related items were extracted from interviews to study the face validity of the tool from patient's point of view. Four items were deleted because scored 0.79 in content validity. The mean of questionnaire content validity was 0.85. Items were collected in two factors with an eigenvalue >1. Four items were deleted with load factor <0.4. Reliability was 0.84 for the entire instrument. CONCLUSION: Self-efficacy scale in patients with hypertension is a valid and reliable instrument that can effectively evaluate the self-efficacy in medication adherence in the management of hypertension.

Evaluating the Effect of Lifestyle Education Based on Health Belief Model for Mothers of Obese and Overweight School-age Children on Obesity-Related Behaviors.

BACKGROUND: Nowadays, childhood obesity is a matter of significant concern because of its negative effects on personal health and harmful socioeconomic consequences. The purpose of the present study was to evaluate the effectiveness of lifestyle education based on the health belief model for mothers of obese and overweight school-age children on obesity-related behaviors. MATERIALS AND METHODS: In this quasi-experimental study, 64 obese and overweight elementary students and their mothers who met the inclusion criteria participated. The participants were randomly categorized into two groups (experimental and control). The experimental group received the considered interference, which consisted of four educational sessions based on the health belief model. Data collection tool was a standard questionnaire. The questionnaire filled by the participants during interviews conducted before, immediately after, and two months after the intervention. Data were analyzed using Mann-Whitney, Chi-square, student's t-test, repeated-measures analysis of variance, and least significant difference tests. RESULTS: Mean scores of obesity-related behavior before the intervention were not significantly different between the experimental and control group (53.41 (6.78). vs 54.72 (4.63); P = 0.37), however, were different immediately after (58.41 (6.88) vs 54.81 (4.66); P = 0.02) and two months after the intervention (62.34 (8.62) vs 55.84 (7.59); P = 0.002). CONCLUSIONS: This study indicated the effectiveness of lifestyle education based on the health belief model for improving obesity-related behaviors. Therefore, the use of this educational program is recommended for mothers.

The Effect of a Lifestyle Modification Education on Adiposity Measures in Overweight and Obese Nonalcoholic Fatty Liver Disease Patients.

BACKGROUND: Obesity is increasingly associated with nonalcoholic fatty liver disease (NAFLD) and weight loss through a combination of dietary modifications and increased physical activity is a primary goal of therapy in this disease. Therefore, this study was conducted to evaluate the effects of a lifestyle modification education on adiposity measures, physical activity, and total calorie intake in overweight and obese NAFLD patients. METHODS: During 8 weeks, 82 obese patients were randomly assigned into either an intervention group (n = 41) receiving a lifestyle modification education or to a control group (n = 41) receiving usual care. Total calorie intake, physical activity, and body composition indices were measured before and after the intervention. RESULTS: Thirty-six patients in intervention group and 33 in control group completed the study. The analysis of body composition variables did not show any significant reduction for percent of body fat, abdominal circumference, waist to hip ratio, visceral fat area, age matched of body, and soft lean mass (SLM) of the trunk (P > 0.05). On the other hand, a significant reduction in weight, body mass index, mass of body fat (MBF), SLM, and MBF of the trunk was observed after 2 months of intervention compared to the controls (P < 0.05). A significant reduction was observed in total calorie intake of intervention group as compared to the control group. Physical activity status did not show any significant improvements after 2 months of intervention. CONCLUSIONS: Our lifestyle modification education and its guidelines could be used in obese patients with NAFLD to improve their body composition measurements and to lose weight. This could result in significant long-term benefits in NAFLD patients.

Case-control study of risk factors for suicide attempts in Isfahan, Iran.

BACKGROUND: Suicide is an important, preventable, public health problem worldwide, caused by the interaction of numerous environmental, biological and psychosocial factors. AIMS: This study aimed to identify the factors associated with suicidal attempts in Isfahan, Iran, in 2015. METHODS: In this case-control study, 175 cases who committed suicide and were admitted to emergency services were compared with 175 controls selected among outpatients from the same hospital without any history of suicide attempt. Demographic, psychosocial, personality traits, religiosity, coping skills, stressful life events, socioeconomic status and psychiatric distress were compared between groups. Multivariable logistic regression was used to identify independent risk factors for suicide. RESULTS: Marital status, education, socioeconomic status, psychological distress, perceived social support, stress coping strategies, personality, religious beliefs, stress life events and general health condition were significantly different between groups. The regression analysis revealed that perceived social support (odds ratio (OR) = 0.962, 95% confidence interval (CI): 0.94-0.984), religious beliefs (OR = 0.923, 95% CI: 0.867-0.984) and stressful life event (OR = 1.524, 95% CI: 1.251-1.856) were significantly associated with suicide attempts. CONCLUSION: Our finding showed that religious beliefs, perceived social support and stressful life events are the main factors associated with suicide attempts. So, positive strategies such as improvements in life skills to control stressful life events, religiosity and perceived social support can be used to control suicide attempts.

Effect of self-care training program based on Orem's model on the behaviors leading to sexually transmitted disease in vulnerable women.

BACKGROUND: Vulnerable women are prone to sexually transmitted diseases due to their high-risk behaviors. The present study aimed to investigate the effect of self-care training program based on Orem's model on the behaviors leading to sexually transmitted diseases in vulnerable women. MATERIALS AND METHODS: This field trial was initially conducted on 100 women covered under health services and welfare organization in Isfahan city, who were selected by rationing ssampling. For needs assessment, they filled the self-care needs assessment questionnaire in three domains of knowledge, attitude, and practice. Then, at the stage of intervention (self-care training), 64 subjects were selected through convenient sampling and were assigned to experimental and control groups by random allocation. Data were analyzed by descriptive and analytical statistical tests through SPSS 18. RESULTS: Results showed that mean scores of knowledge (P < 0.001), attitude (P < 0.001), practice (P = 0.04), and behavior change (P = 0.01) were significantly higher immediately after and 3 months after intervention, compared to before intervention, but there was no significant difference in mean scores between immediately after and 3 months after intervention. CONCLUSIONS: With regard to these results, it can be concluded that if the educational programs are planned based on clients' real needs assessment, the learners follow the educational materials, related to their problems, more seriously and it results in a notable behavior change in them.