Promoting Health Literacy and Perceived Self-Efficacy in People with Chronic Obstructive Pulmonary Disease.

Background: Chronic Obstructive Pulmonary Disease (COPD) is an irreversible condition and it is of great importance for the patients to practice self-care. Given the impact of inadequate health literacy on people's self-efficacy in a self-care program, the aim of this study was to improve health literacy and self-efficacy in people with COPD. Materials and Methods: The present quasi-experimental study was conducted on 70 patients with COPD admitted to Shahrekord educational hospitals in 2019. Using random allocation software, the samples were randomly divided into intervention and control groups. Data collection tools included three questionnaires including demographic, health literacy, and perceived self-efficacy questionnaires. A training program, with three weekly sessions of theoretical and practical trainings, was conducted for the intervention group in classes in the hospital. The time of each session was 40 min. Data were collected three times i.e., before, immediately after, and three months after the trainings. Data were analyzed by means of SPSS 21 statistical software using descriptive and inferential statistics. Results: Before the intervention, the mean scores of perceived self-efficacy and health literacy did not differ significantly between the two groups, but after the intervention, the scores of the members in the intervention group increased significantly (f = 62.15, p < 0.05). Conclusions: The results of the study indicated an increase in the scores of perceived self-efficacy and health literacy in people with COPD. The use of targeted educational interventions can have a positive effect on the treatment and control of the disease.

Knowledge, skill, and preventive behaviors regarding COVID-19 among the public in Shahrekord of Iran.

BACKGROUND: COVID-19 is a serious and costly problem for communities. Observing health issues and performing preventive behaviors is influenced by their knowledge and skills of people toward COVID-19. Hence, this study investigated the knowledge, skill, and practice of the public of Shahrekord toward COVID-19. MATERIALS AND METHOD: The present study was performed as a cross sectional. Data were collected using an online questionnaire from 540 Shahrekord residents who were selected via convenience sampling in 2020. Knowledge, skill, and practice toward COVID-19 were assessed using a prevalidated questionnaire. Collected data were analyzed by SPSS-21 software (one-way analysis of variance, Pearson test, and regression test). RESULTS: In this study, 39.1% were male, and 60.9% were female and 46.3% were 20-25 years. The mean score of knowledge, skill, and preventive behaviors was 75.69 ± 17.85, 53.87 ± 27.40, and 59.97 ± 23.79, respectively. There was a significant direct relationship between knowledge and skill (P = 0.05 and r = 081) so that public with more knowledge had a better skill as well. There was a significant association between age (P = 0.036), education level (P = 0.019) , and job (P = 0.014) with knowledge. In addition, a significant association between job (P = 0.027) and marital status (P = 0.014) with skill was observed. Knowledge, skill, and demographic variables predict 37.6% preventive behavior. CONCLUSION: The majority of the participants had good knowledge, moderate skill, and relatively enough practice. Government and policymakers must consider these knowledge levels, skill, and practices to implement productive interventions for preventing the COVID-19.

Predictors of safe road-crossing behavior among female high school students of Shahr-e Kord: an application of the theory of planned behavior.

OBJECTIVES: Traffic accidents in pedestrians is one of the most important causes of death. Understanding the status quo and identification of effective factors are necessary for the management and planning of efficient training interventions in the prevention of traffic accidents for pedestrians. Hence, the present study aimed to determine the predictors of safe road-crossing behavior among female high school students of Shahr-e Kord. METHODS: The present research was a descriptive-analytical study which was conducted on 347 female high school students of Shahr-e Kord in the academic year 2016-2017. The participants were selected using random sampling method and the required data were collected through a standard questionnaire based on the theory of planned behavior. The obtained data were statistically analyzed using Pearson correlation test and regression analysis. RESULTS: The mean score of participants on the adoption of safe road-crossing behavior was equal to 57.06 ± 14.74. Among the independent variables of this study, the lowest and the highest scores were related to behavioral intention and outcome expectancy, respectively. The results of multiple regression test showed that behavioral beliefs, outcome expectancy, compliance motivation and behavioral intention are predictors of the adoption of safe road-crossing behavior. In total, these constructs were able to predict 25.8% of behavioral changes. CONCLUSIONS: Based on the study findings, the theory of planned behavior can be considered an appropriate framework for designing training interventions in order to improve students' road-crossing behavior.

Role of self-efficacy, outcome expectation, and outcome expectancy in promoting oral health behaviors in adolescent girls.

INTRODUCTION: Oral health is a very important issue for different groups, especially adolescents. Social cognitive theory seeks to describe and promote people's health behaviors in a variety of ways. The aim of this study was to determine the role of self-efficacy, outcome expectation, and outcome expectancy in promoting oral health behaviors in adolescent girls in Shahrekord. METHODS: The present study was performed as an intervention in junior high schools in Shahrekord (school year: 2018-2019). Using cluster sampling method, a total of eighty adolescent girls studying in Shahrekord public schools were selected and randomly divided into two groups of intervention and control. A researcher-made questionnaire was used to collect data on demographic variables, outcome expectation, and outcome expectancy constructs. In addition, a checklist was used to assess the status of oral health among the participants. Education for the experimental group was held in four sessions, each lasting 50-60 min. The data required for the study were collected in three stages: before the intervention, immediately after, and 2 months after the intervention. Using SPSS statistical software version 18, the collected data were analyzed through paired t-test and analysis of variance via repeating the observations. RESULTS: There was no significant difference between the two groups in terms of demographic variables. Before the intervention, there was no significant difference between the two groups in terms of the mean scores of outcome expectation, outcome expectancy, and self-efficacy; however, after the intervention, there was an increase in the scores of the experimental group (P < 0.001). Two months after training, there was also a significant increase in the mean score of oral health behavior in the experimental group (P < 0.001). CONCLUSION: Training based on perceived self-efficacy, outcome expectation, and outcome expectancy played an important role in creating the desired attitude toward oral health-promoting behavior among students.

The effect of empowerment program based on the social cognitive theory on the activity of daily living in patients with chronic obstructive pulmonary disease.

OBJECTIVE AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The patient's fear and anxiety of shortness of breath and coughing during exercise may lead to a decrease in patients' daily activities. Therefore, the present study aimed to determine the effect of empowerment program based on the social cognitive theory (SCT) on the daily activity of patients with COPD. METHODS: This quasi-experimental study was performed on 70 patients with COPD referred to Kashani and Hajar centers in 2019. Samples were randomly divided into two groups of experimental and control. Data collection tools included demographic information questionnaire and activity of daily living questionnaire, specific for COPD, and a researcher-made questionnaire for measuring SCT constructs. For the experimental group, the training program consisted of four theoretical and practical sessions of 40 min/week. The data were collected at three time points, before, immediately and 3 months after the training are 3 time. The data were analyzed by SPSS software using descriptive and inferential statistics. RESULTS: The difference between the mean scores of behavioral ability, self-efficacy, and empowerment in the three stages was significant only in the experimental group (P < 0.001). The mean daily activity score of patients before, immediately, and 3 months after intervention showed a statistically significant difference between the two groups (52.46 ± 21.98, 63.36 ± 21.95, and 71.34 ± 19.02), respectively, in the intervention group, and (51.79 ± 19.29, 53.70 ± 19.28, and 53.82 ± 19.26), respectively, in the control group (P < 0.001). CONCLUSION: The results of this study showed that empowerment of patients through interventions based on SCT can increase the daily activity of patients with COPD. Because nurses play an important role in patient education and improvement, it is hoped that the findings of this study will be used as a strategy to increase the daily activity and ultimately improve the quality of life in these patients.

Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes.

OBJECTIVES: Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. METHODS: We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. RESULTS: Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. CONCLUSIONS: This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient's HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance.

The Effect of nutrition education on knowledge, attitude, and performance about junk food consumption among students of female primary schools.

BACKGROUND: Undoubtedly, proper nutrition has important role in safeguarding the individual from many diseases, especially chronic ones, and increasing ones physical and intellectual efficiency. Considering the importance of nutrition education to school-age kids, this research was done with the purpose of determining the effect of nutrition education on the knowledge, attitude, and performance of female students at primary school about junk food consumption. MATERIALS AND METHODS: This is an experimental intervention study in Shahr-e-kord city about the reduction of junk foods consumption in 2011. Seventy-two primary girl students were randomly divided into 2 groups, experimental (36) and controls (36). Before of the educational program, self-administrative questionnaire and FFQ (Food Frequency Questionnaire) questionnaire were filled out for both the groups. The self-administrative questionnaire was completed 3 times (before, immediately, and 2 months after education), and FFQ questionnaire was completed 2 times (before and 2 months after education) by students. After pre-test, 4 educational session classes in experimental group were performed. Finally, data were collected and analyzed by SPSS 16 computer software. RESULTS: Demographic variables of the studied population in 2 groups were similar. Before intervention, there were no significant differences regarding the knowledge, attitude, and performance in 2 groups (P > 0/05). After intervention, there were significant differences in the levels of knowledge, attitude, and performance between experimental and control groups (P < 0.001). CONCLUSION: According to the results, intervention has positive impact on pattern of nutrition, and it can be concluded that intervention is effective on increasing or improving the knowledge, attitude, and performance of the students.

The effect of education on improvement of intake of fruits and vegetables aiming at preventing cardiovascular diseases.

BACKGROUND: Cardiovascular diseases refer to a group of diseases that affect the cardiovascular system; principally cardiac diseases, vascular diseases of the brain and kidney and peripheral arterial diseases which are caused by various factors. Considering the importance of nutrition education, especially the intake of fruits and vegetables, this study was performed to determine the effect of health education, Based on the Health Belief Model, on the improvement of intake of fruits and vegetables aiming at preventing cardiovascular diseases among high school girls in the city of Shahre- Kord, Iran. METHODS: This was a quasi-experimental intervention study, in which 120 female students of high schools in Isfahan were selected through convenient sampling and were divided into two groups of experimental (60) and control (60). The instruments for data collection were the Health Belief Model and FFQ questionnaires. The HBM questionnaire was completed three times (before, immediately and two months after the intervention) and the FFQ questionnaire was completed two times (before and two months after the intervention) by the students. After the pre-test, six educational sessions were provided for the experimental group. Finally, data were collected and analyzed by SPSS 16 (ttest, paired t-test and repeated measure ANOVA). RESULTS: There were no differences between the two groups in terms of demographic variables. Before the intervention, there were not any significant differences between the scores of different structures of this model between the two groups (p>0.05); however, after the intervention, significant differences were found between the experimental and control groups in the levels of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived efficacy and performance (p<0.001). CONCLUSION: According to the results, the intervention had a positive impact on the improvement of intake of fruits and vegetables among the students.

Investigation of educational intervention based on Theory of Planned Behavior on breakfast consumption among middle school students of Qom City in 2012.

BACKGROUND: Eating breakfast is crucial for adolescents to be healthy. It also improves students' capacity of learning and doing school homework. Although healthy habits such as eating breakfast, weight control, and regular sleep increase the lifespan in adults, the effects of healthy habits on school-age children have not been studied much. The present study aimed at investigating the impact of an educational program based on Theory of Planned Behavior (TPB) on eating breakfast among middle school students. MATERIALS AND METHODS: This interventional study was conducted on sixth-grade students in Qom City during the academic year 2012-2013. First, 97 students were randomly assigned to the experimental group and 97 other students were assigned to the control group. Then, a questionnaire was developed on eating breakfast by the researchers according to the TPB. A pilot study was conducted to assess the reliability of the questionnaire. To assess the validity of the questionnaire, advice by a panel of experts was sought. To carry out a pre-test, both groups answered the questions. After analyzing the pre-test results, the required content was developed for the experimental group. Educational methods included delivering speech, discussion groups, pamphlets, and posters. The required educationalcontent was provided for students during five sessions and for parents in one session. To determine the effect of educational intervention, a post-test study was carried out 2 months after the intervention. Collected data were analyzed using independent t-test, χ,([2]) and repeated measures. RESULTS: In the experimental group, 36.7% of students were eating breakfast at least in a day of a week, before educational intervention. After implementation of the educational program, only 32.7% of them were continuing their past habit. There was a significant difference between themean scores of attitudes, perceived behavioral control, intention, and practice of eating breakfast in the experimental and control groups (P < 0.05), while there was no significant difference between the mean scores of subjective norms after implementing the educational program in both groups (P < 0.26). CONCLUSION: Using the TPB improved students' intentions and behavior of eating breakfast. Thus, it seems necessary to consider all effective environmental factors on the subjective norms in the education of healthy eating behaviors or improving breakfast-eating practice among students.

The effect of preventive educational program in cigarette smoking: Extended Parallel Process Model.

BACKGROUND: Cigarette smoking is one of the preventable causes of diseases and deaths. The most important preventive measure is technique to resist against peer pressure. Any educational program should design with an emphasis upon theories of behavioral change and based on effective educational program. To investigate the interventions through educational program in prevention of cigarette smoking, this paper has used the Extended Parallel Process Model (EPPM). MATERIALS AND METHODS: This study is a quasi-experimental study. Two middle schools were randomly selected from male students in Shiraz. Therefore, we randomly selected 120 students for the experimental group and 120 students for the control group. After diagnostic evaluation, educational interventions on the consequences of smoking and preventive skills were applied. RESULTS: Our results indicated that there was a significant difference between students in the control and experimental groups in the means of perceived susceptibility (P < 0.000, t = 6.84), perceived severity (P < 0.000, t = -11.46), perceived response efficacy (P < 0.000, t = -7.07), perceived self-efficacy (P < 0.000, t = -11.64), and preventive behavior (P < 0.000, t = -24.36). CONCLUSIONS: EPPM along with educating skills necessary to resist against peer pressure had significant level of efficiency in improving preventive behavior of cigarette smoking among adolescents. However, this study recommends further studies on ways of increasing perceived susceptibility in cigarette smoking among adolescents.

The relationship between functional health literacy and health promoting behaviors among older adults.

BACKGROUND: Health literacy is a measure of individual's ability to read, comprehend, and act on medical instructions. Older adults are one of the most important at risk groups affected by the impact of inadequate health literacy. Health promoting behaviors in older adults have potential impact on their health and quality of life and reduce the costs incurred to health care. Given the paucity of information health literacy and health promoting behavior, the purpose of this study was to examine health literacy level in older adults and the relationship between health literacy and health promoting behaviors. MATERIALS AND METHOD: A cross-sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected via home interviewing. Health promoting behaviors were measured based on self-reported smoking status, exercise, and consumption of fruit and vegetables. The collected data were analyzed using descriptive statistics and one-way ANOVA and χ2 tests under SPSS 18 software. RESULTS: The sample group averaged 67 ± 6.97 years in age. Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, have fewer years of schooling, lower household income, and being female Individuals with inadequate health literacy were more likely to report limitations in activity and lower consumption of fruit and vegetables (P < 0.001). No significant association was found between health literacy and smoking status. CONCLUSION: Considering high prevalence of inadequate health literacy among older adults, and its inverse relationship with some health promoting behaviors. Simple educational materials and effective interventions for low health literacy people can improve health promotion in society and mitigate the adverse health effects of low health literacy.

Barriers related to fecal occult blood test for colorectal cancer screening in moderate risk individuals.

INTRODUCTION AND OBJECTIVE: Colorectal cancer is one of the most important and most common cancer and second leading cause of cancer deaths worldwide. Through secondary prevention of this cancer, effective proactive measures would be taken to treat and to prevent the incidence of the disease. The fecal occult blood test (FOBT) has priority over other methods and is recommended for adults above 50 years. This study was carried out to assess perceived barriers related to participating in colorectal cancer screening programs among average risk population, based on health belief model. MATERIALS AND METHODS: A cross-sectional survey of 196 individuals of more than 50 years was conducted in Isfahan. The target group consisted of people going to laboratories for doing FOBT test (n = 98), and those who refrained from going to laboratories (n = 98). The questionnaire was used based on barrier assessment question associated with performing fecal occult blood test. The data collected were analyzed using descriptive and inferential statistics methods. RESULTS: The mean score of perceived barriers in the first group was 40.9 and in other group was 56.54, with significant difference statistically (P < 0.001). Lack of information, fear of cancer diagnosis, lack of recommendation by doctors, and not setting the priority of time for doing the test were some of barriers reported by the nongoing group. DISCUSSION AND CONCLUSION: According to this study, it seems that there is an urgent need to more information to be provided for the public about colorectal cancer and its prevention through screening, as important step to increase the rate of early detection and curb the mortality rate, costs, and improve community health outcomes.

The effect of education on the improvement of fruits and vegetables consumption aiming to preventing colorectal cancer.

AIM: This study was performed to determine the effect of health education on the improvement of intake of fruits and vegetables aiming at preventing colorectal cancer among high school girls in the city of Shahr-e-kord. BACKGROUND: Colorectal cancer is one of the most important and most common cancers and the second leading cause of cancer death worldwide. Every year, nearly one million new cases of colorectal cancer are recognized around the world and nearly half of them lose their lives due to the disease. PATIENTS AND METHODS: 130 students were randomly divided to two groups, which experimental (65) and controls (65) were chosen from the city of Shahr-e-kord for this experimental study. The instruments for data collecting were self-made questionnaire health belief model based and food frequency questionnaire. The HBM FFQ questionnaires were completed before, immediately and two months after education by participants. After pre-test, 5 educational session classes in experimental group were performed. Finally, data collected and analyzed by SPSS16 computer software (T- test, T-Paired, repeated measure ANOVA). RESULTS: Findings of the study showed that before the intervention there was no significant differences between the scores of different structures of HBM model in two groups (P > 0.05), after the intervention there was significant differences between experimental and control groups in the levels of knowledge, structures of HBM model and performance for preventing colorectal cancer (p < 0.001). CONCLUSION: Performing educational programs based on health belief model increases the knowledge and improves the attitudes and practices of students regarding prevention of the colorectal cancer.

Quality of life in peptic ulcer patients referring to Al-Zahra hospital of Isfahan, Iran.

AIM: The purpose of this study was to determine quality of life in peptic ulcer patients referring to Al-Zahra hospital of Isfahan. BACKGROUND: Peptic ulcer disease (PUD) is one of the most prevalent diseases. Its prevalence is 6-15% and about 10% of people experience its symptom in their life. PUD can have a considerable impact on patients' quality of life (QOL). PATIENTS AND METHODS: This descriptive- analytic survey was done on 93 randomly patients referred to Al-Zahra hospital of Isfahan city in Iran. Data gathering was done via questionnaire including five domains: physical, psychological, social, behavioral and economical. For data analysis, t-test, Pearson correlation and ANOVA test were used. RESULTS: 93 patients with mean age of 38.54 years, including 43 (46.2%) women and 54 (53.8%) men, were studied. There was a negative significant between quality of life and age and between disease duration and psychological, economical domains and between the mean of QOL scores in physical and social domains with the number of cigarette per day, also there was significant relation between social domain and gender, and physical, psychological and behavioral domains with marital status; Physical, social domains with smoking. Also there was a negative significant between physical, social and behavioral domains with years of smoking. CONCLUSION: Study results showed that quality of life is in a relatively good level among patients, thus some diseases such as peptic ulcer can effect on quality of life. So, treatment and prevention of these diseases may improve their quality of life.