Predicting psychological factors affecting regular physical activity in hypertensive patients: Application of health action process approach model.

Aim: The aim of this study was to determine the factors affecting the behaviour of regular physical activity in patients with hypertension using the health action process approach (HAPA) model. Design: This cross-sectional study was conducted on 176 hypertension patients, in Astaneh-e-Ashrafiyeh, Guilan, Iran, 2018-2019. Methods: Data collection tools included demographic characteristics, medical history, the short form of International Physical Activity Questionnaire (IPAQ) and scales related to the HAPA model. The data were analysed using chi-square, independent t test, one-way ANOVA, Pearson's correlation coefficient and path analysis on AMOS, version 23.0. Results: Action self-efficacy (ß = 0.59), outcome expectancy (ß = 0.20) and risk perception (ß = 0.18) had a statistically significant effect on intention. Moreover, the path coefficient between intention (ß = 0.35) and coping self-efficacy (ß = 0.29) with physical activity was statistically significant. The results revealed that HAPA constructs were able to describe 45% of the variance in intention and 31% of the variance in physical activity behaviour. Conclusion: The HAPA model is a useful framework for describing the factors affecting physical activity in hypertension patients.

A theory of planned behavior-enhanced intervention to promote health literacy and self-care behaviors of type 2 diabetic patients.

BACKGROUND: Improved health literacy and awareness could help type 2 diabetic patients to control the disease complications. OBJECTIVE: The current study aimed to evaluate the impact of theory-based educational intervention on health literacy and self-care behaviors of type 2 diabetic patients in Tonekabon city. METHODS: This randomized controlled trial study was conducted at health care centers in Tonekabon city, Iran, from April 5, 2017, to October 22, 2018. Using multistage random sampling, 166 patients with type 2 diabetes divided into two groups: theory-based intervention (n = 83) and custom education (n = 83). The data collection tools consisted of demographic information, Theory of Planned Behavior (TPB) measures, health literacy for Iranian adults (HELIA) and summary of diabetes self-care activities (SDSCA). The five 45-minute group training sessions based on the baseline assessment and model constructs along with the targeted pamphlet and m-health strategy were designed for the experimental group. Data were analyzed using chi-square, independent and paired t-test and Analysis of covariance (ANCOVA). RESULTS: After controlling for pre-test effect, there was a significant difference between the two groups in terms of mean scores of attitudes, subjective norms, perceived behavior control and intention in post-test (P < 0.001). Also, after controlling for the pre-test effect, the results showed a significant difference in the self-care domain in the post-test (P < 0.001). Finally, after controlling for the pre-test variable effect, covariance analysis reflects significant difference in total health literacy score and its dimension at posttest (P < 0.001). CONCLUSIONS: Applying TPB based education is suggested to maintain and improve self-care behaviors and health literacy in type 2 diabetic patients and other chronic diseases.

The Female Sexual Function Index: translation and validation of an Iranian version.

INTRODUCTION: Female sexual dysfunction (FSD) is a prevalent problem in the female population in Iran. A subjective assessment instrument that allows cross-cultural comparison of FSD is urgently needed. AIM: The aims of the study were to translate, validate, and enhance cross-cultural comparability of an Iranian version (IV) of the Female Sexual Function Index (FSFI)-the IV-FSFI. METHODS: A total of 448 women (19-54 years, mean 29.7, standard deviation 7.3) from five different Iranian outpatient obstetrics and gynecology clinics were eligible for this study. The IV-FSFI was developed through forward and backward translation, revision by a research team, and a subsequent pilot study. After an interview for clinical diagnosis of FSD based on the Diagnostic and Statistical Manual of Mental Disorders, all participants completed the IV-FSFI for the validation study. Three hundred sixty-two women completed the IV-FSFI again, 4 weeks after the first visit. MAIN OUTCOME MEASURES: Test-retest reliability was determined by Pearson's product-moment correlations. Reliability was tested using Cronbach's alpha coefficient. Construct validity was evaluated by principal component analysis using varimax rotation and by subsequent confirmatory factor analysis (CFA). Discriminant validity was assessed with between-groups analysis of variance. RESULTS: 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 (α from 0.72 to 0.90). Principal component analysis with varimax rotation revealed a best fitting five-factor structure similar to the original FSFI (χ(2) = 2.1, degree of freedom = 17, P < 0.001). CFA confirmed the underlying domain structure, supporting the factorial validity of the IV-FSFI. CONCLUSIONS: 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 other medical settings.