Exploring the adaptive experiences of children with parents of myocardial infarction: A Qualitative Study.

BACKGROUND: Cardiovascular diseases are the world's leading cause of mortality. These diseases are rooted in an unhealthy lifestyle. In order to confront this subject, it is essential to identify several risk factors that contribute to heart disease (HD) in people with different attitudes, values, beliefs, expectations and motivations. This study was therefore an attempt to explain the adaptive experiences of children whose parents were involved in myocardial infarction since they were more likely subjected to get the so-called disease. OBJECTIVE: To identify the risk factors and to clear ambiguity using a qualitative research method from the experiences of people at risk of the above mentioned disease. METHODS: This qualitative study was a directed content analysis. Eighteen children (above 18 years old) of parents with a history of myocardial infarction participated, and were chosen with purposive sampling and the highest diversity. Data were collected through deep and semi structure interviews based on Protection Motivation Theory (PMT) from March to November 2015, and were analyzed along with their data collection and with usage of Lundman and Graneheim method. Interviews were conducted in non-stressful conditions with a place and time agreement. RESULTS: During content analysis process, 220 codes were extracted. After reviewing several times and summarizing, the codes were categorized based on similarity and proportion, and finally 12 subcategories and three categories were elicited including efforts to perform self-care in order to prevent HD, poor life style as a factor not to do preventive HD and health continuation with positive changes in life style. CONCLUSIONS: Most participants, despite intending to do self-care behaviors to prevent HD, due to factors such as time constraint, high costs, laziness, impatience and prioritizing other life affairs, did not pay attention to their health. Therefore, providing the training programs with an emphasis on life skills can play an important role in reducing perceived response cost and promoting health.

A Survey of Knowledge, Individual Perceived Risk, General Perceived Risk, and Behavioral Intentions Regarding Hepatitis B among Students in the Faculty of Nursing, Midwifery and Health at Shahrekord Islamic Azad University in 2014.

BACKGROUND: Hepatitis B is the most common cause of liver disease, and medical students are a risk group for the disease given their future occupations. OBJECTIVES: The aim of the study was to assess of predictors of hepatitis B in the Faculty of nursing, midwifery and health at Shahrekord Islamic Azad University in 2014. MATERIALS AND METHODS: This cross-sectional study was conducted with 300 students from the Faculty of nursing, midwifery and health at Shahrekord Islamic Azad University. The students answered questionnaires with items covering demographic characteristics, individual knowledge, public risk perception, perceived personal risk, and behavioral intentions regarding hepatitis B. The data were analyzed with SPSS version 18 software. RESULTS: The mean knowledge score of the students was 4.77 ± 1.71, the mean public risk perception score was 24.22 ± 3.44, the mean perceived personal risk score was 6.51 ± 1.97, and the mean behavioral intention score was 12.06 ± 2.97. There were significant differences in the mean knowledge scores in terms of gender, level of awareness, and level of education. There were also differences in the mean behavioral intention scores in terms of gender and field of study, the mean perceived personal risk scores in terms of level of education and field of study, and the mean public risk perception scores in terms of field of study. CONCLUSIONS: According to the results of this study, it is necessary to implement educational intervention in order to allow students to identify risk factors and overcome barriers to understanding the implications of the disease in this context.

Self Management Behaviors in Rheumatoid Arthritis Patients and Associated Factors in Tehran 2013.

INTRODUCTION: Rheumatoid Arthritis (RA) is a systemic, autoimmune and inflammatory disease with an unknown etiology that is associated with progressive joint degeneration, limitation of physical activity and disability. The aim of the study was to evaluate self-management behaviors and their associated factors in RA patients. MATERIAL & METHOD: This cross-sectional study was performed in 2013 on185 patients in Iran. Data were selected through convenient sampling. The collected data included demographic variables, disease related variables, Arthritis Impact Measurement Scale 2 (AIMS-2SF), and Self-Management Behaviors (SMB). Data were analyzed by SPSS17 using Spearman correlation and logistic regression test. RESULT: In this study drug management, regular follow-up, and food supplement were used as the most frequently applied SMB and aquatic exercise, diet, massage therapy, and relaxation were the least common SMBs. Age, education, health status, occupation, marital status, sex, DAS28 (Disease Activity Score 28 joints), and PGA (Physician Global Assessment) were significantly related with SMB. CONCLUSION: The result of the study highlight the influence of demographic variables, health status, and disease related data on SMB. Thus, more studies are required to find factors influencing SMB in order to improve SMB.

Risk factors of low birth weight and effect of them on growth pattern of children up to sixth months of life: A cross-sectional study.

INTRODUCTION: Children are more risk-prone group of the population and low birth weight (LBW) is the leadingcause of newborns' mortality and morbidity. LBW is defined as child's birth weight lower than 2500 g. Many maternal and fetal factors are determined as risk factors of LBW. This study tries to detect related factors to LBW and effect of them on children's growth pattern up to sixth month of life in Health centers of Urmia city, Iran. MATERIALS AND METHODS: A cross-sectional study was carried out in Urmia city using registered data from mothers' documents. All related data such age and weight of infants, mothers' age, gestational age (GA) at the time of delivery, time gap between two pregnancies, past history of abortion, prenatal care history, systemic and underlying diseases, hemoglobin of mothers during pregnancy, and pattern of infant's growth up to sixth month of age were registered in a questionnaire. All registered data were transferred to SPSS 15 software and analyzed. RESULTS: Mean ± SD of birth weight was 3071 ± 625.66 g. There was a significant relationship between birth weight and mother's age (P < 0.001) and weight (P < 0.001). Children of mothers younger than 18 years had much birth weights. There was a significant relationship between birth weight and GA during delivery (P < 0.001). Children of preterm labor had lower birth weights. In twins, LBW was more prevalent (P < 0.001). CONCLUSION: Our results show that LBW is related to multiple causes and that most of them are preventable with educational programs and also strict and regular prenatal care. Decreasing incidence of LBW children can be achieved by cooperation between different parts of health and clinical systems.

Attitude and practice of pregnant women regarding self-medication in Yazd, Iran.

BACKGROUND: Medications, a main strategic commodity in any country, are strictly related to community health and sustainable development. Self-medication and irregular use of medications can increase their adverse effects. This study investigated the factors related to irregular and arbitrary use of medications in pregnant women admitted to health centers and clinics of Yazd, Iran, and their practice in this context. METHODS: This was a descriptive- analytic cross-sectional study conducted among 180 pregnant women. Participants were selected by cluster sampling. We chose six health centers and clinics from all medical centers in Yazd by a simple random method. A questionnaire was completed by the pregnant women who were consecutively admitted to each center. Data were analyzed by ANOVA, t-test, Chi-square, and Pearson tests with SPSS-15 software. RESULTS: More than 35% of the women self-medicated during pregnancy. Women with academic degrees scored higher in the knowledge section; however, this difference was not significant.  The mean attitude scores for academic and nonacademic graduates were 34.92 (from 60) and 29.87, respectively while the mean practice scores were 15 (from 20) and 14.25 for academic and non-academic graduates, respectively. CONCLUSION: The results of this study showed an increased prevalence of self-medication among pregnant women. Because of potential fetomaternal hazards related to medications, it is necessary to conduct educational programs to prevent this harmful habit and attitude in pregnant women.

Related factors to choose normal vaginal delivery by mothers based on Health Belief Model.

BACKGROUND: Normal vaginal delivery (NVD) is the best method of delivery, but its rate is decreasing. Results of many studies have shown that the risk of cesarean section (CS) for both mother and child is more than that of NVD. The World Health Organization's (WHO) goal was to achieve a CS rate of 15% in 2010, but this rate in most of the developing countries is over than 50%. In this study, we try to determine the related factors influencing the method of delivery selection by mothers in Yazd city, Iran, based on Health Belief Model (HBM). MATERIALS AND METHODS: This was a cross-sectional study done on 130 pregnant women who presented in four clinics of Yazd. The mothers were in 32-37 weeks of gestational age. Samples were selected by simple randomized method. Data were collected by questionnaire by interviewing and then analyzed by analysis of variance (ANOVA) and t-test. RESULTS: Mean age of samples was 42.23 ± 4.52 years. Eighty-four (64%) women were primigravids and 49 (37.7%) mothers were multigravids. Of them, the method of delivery in previous pregnancy was NVD in 29 (22.3%) and CS in 20 (14.3%). In their present pregnancy, the method of delivery was NVD in 88 (67.7%) and CS in 42 (32.3%). The Pearson test showed a significant correlation between perceived barriers and behavior (P=0.012). Also, there was significant relationship between perceived susceptibility and behavior (P=0.03). There was no significant relation between other variables (perceived benefits and perceived severity). CONCLUSION: Based on the results of this study, perceived susceptibility and perceived barriers were related to behavior significantly, so we must educate mothers using HBM to influence their behavior toward selecting NVD as their delivery method.

Health related quality of life in children with thalassaemia assessed on the basis of SF-20 questionnaire in Yazd, Iran: a case-control study.

BACKGROUNDS: Thalassaemia is becoming serious public health problem throughout the Mediterranean region, Middle East, Indian subcontinents and also South East Asia. Its' global prevalence is about 2 per 1,000 newborns while its' prevalence in Iran is 8-4 per 1,000 newborns. The aim of this study was to compare the Health Related Quality of Life (HRQOL) of thalassaemia patients with the HRQOL of healthy children in terms of essential core domains for pediatric HRQOL measurement. METHODS: This cross sectional study has been done in Yazd, Iran. 60 thalassaemia patients were selected randomly as case group and 120 healthy children as control group who were matched with respect to age and gender. The health related quality of life was measured with a self - administrated short - form questionnaire of Medical Outcomes study (SF-20). The SF-20 measure contains three dimensions about function (physical, social and role) and well-being (mental health, health perception and pain). RESULTS: The results of this study showed significant difference between all dimension of SF-20 and QOL of patients in the case and control group (p<0.001). The QOL in the case group was 75.05 (SD=9.38), but in the control group was 93.4 (SD=6.42) out of 100. CONCLUSIONS: The effect of thalassaemia on the HRQOL in affected children has been related to reduction of their physical, social and mental capabilities.

Immunity to hepatitis B vaccine among health care workers.

The aim of this study was to determine the level of anti-HBsAg (hepatitis B surface antigen) in vaccinated high risk group. We measured anti-HBsAg concentration in blood sera of adult students aged from 19 to 37 years old. Five milliliters (5ml) of blood sample was taken from 210 cases four months after the second dose and 126 out of 210 cases three months after the third dose of hepatitis B vaccination. All blood samples were analyzed for anti-HBsAg by ELISA method. 125 out of 210 samples (59.5%) showed anti-HBsAg concentrations higher than 20mIu/ml and considered immune after the second dose of hepatitis B vaccination. Also, 99.2% of samples had anti-HBsAg higher than 20mIu/ml three months after the third dose of the vaccination. Non-immune cases in males were more than females (41.2% vs.40.1%). In conclusions, our results reinforce the importance of hepatitis B vaccine in adolescents and suggest that three dose of hepatitis B vaccine is necessary to increase the seropositive rate of anti-HBsAg in adults.

Relationships between locus of control and adherence to diabetes regimen in a sample of Iranians.

BACKGROUND: Adequate self-care in diabetes improves quality of life and decreases the number of inpatient cases. The health locus of control theory is used to assess adherence to diabetes regimen in some studies in developed countries. The primary purpose of this cross-sectional study is to determine the status of diabetes locus of control in a sample of diabetic patients in Iran as a developing country. We investigated selected factors contributing to locus of control and adherence to diabetes regimen. MATERIALS AND METHODS: This cross-sectional study was carried out on 120 patients referred to Yazd Diabetes Research Center. The Iranian versions of Diabetes Locus of Control scale and Diabetes Self-care Activities scale were used for data collection. RESULTS: Men revealed more internal locus of control and women revealed more chance locus of control. The attributions of external locus of control increased by age, while the internal locus of control increased by education level and chance locus of control decreased by education level. A positive association between internal locus of control and adherence to diabetes regimen was found and there was a negative association between chance locus of control and adherence to diabetes regimen. CONCLUSION: Findings suggest that interventions aimed at improving internal locus of control may improve adherence to diabetes regimen but different diabetic patients have different attribution styles and interventional programs to enhance diabetes self-care will be more successful if patient's locus of control is addressed.

Effects of education on self-monitoring of blood pressure based on BASNEF model in hypertensive patients.

BACKGROUND: Hypertension is one of the most important health problems. Self-monitoring may be an effective method for controlling this disease. The aim of this study is to determine the effectiveness of education on blood pressure self-monitoring in patients with hypertension based on BASNEF model. METHODS: In this clinical trial, 150 outpatients with hypertension were randomly selected from those referred to private clinics in Yazd, Iran, during 2008. They were divided in two groups. The data were collected by a validated and reliable questionnaire. The implementing educational program was continued for 2 months and the pre-test and post-test had an interval of 2-months. BASNEF model was applied to explain the motivation of a behavior. Descriptive analysis, correlation test and also regression analysis were used to analyze data. RESULTS: The respondents acquired 17.72% of total score for self-monitoring behavior, 47.03% of attitude, 12.37% of subjective norms, 33.46% of intention and 50.95% of enabling factors. After intervention, there were significant increases in self-monitoring behavior (173.31%), attitude (62.60%), subjective norms (54.70%), intention (129.93%) and enabling factors (46.62%) in the intervention group. There was no significant difference between the constructs of BASNEF model in the control group after intervention compared to the baseline values (p > 0.05). CONCLUSIONS: The results of this study showed that the level of self-monitoring behavior in the patients was low. Educational programs are helpful and necessary to improve self-monitoring behavior in patients with hypertension.