The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills / Efecto de una intervención educativa basada en el enfoque del proceso de acción en salud sobre las habilidades comunicativas de las enfermeras / Efeito de uma intervenção educativa baseada na abordagem do processo de ação em saúde nas habilidades de comunicação do enfermeiro. Estudo quase experimental com grupo controle

Objective. This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods.The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results. In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p<0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion. The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.

Objetivo. Evaluar el efecto del enfoque del proceso de acción sanitaria (Health Action Process Approach (HAPA), en inglés) en la promoción de la calidad de las habilidades de comunicación de las enfermeras. Métodos. La presente investigación cuasiexperimental se llevó a cabo con 148 enfermeras (76 en el grupo de intervención y 72 en el de control) de la provincia de Yazd (Irán). Los participantes fueron reclutados en los hospitales públicos de las ciudades de Ardakan y Meibod. El instrumento de recogida de datos fue un cuestionario basado en los constructos HAPA y un cuestionario de habilidades comunicativas. Se recogieron datos de los dos grupos antes, un mes después y cuatro meses después de la intervención. El grupo de control no recibió ninguna formación educativa durante el estudio. Resultados. En la preprueba, no se encontraron diferencias estadísticamente significativas entre los grupos de intervención y de control en cuanto a las etapas conductuales de la comunicación eficaz con los pacientes. En la prueba posterior, la puntuación media de autoeficacia en la tarea aumentó significativamente en el grupo de intervención en comparación con el grupo de control (p<0.001). La puntuación media de autoeficacia en el afrontamiento también fue significativamente mayor en el grupo de intervención que en el grupo de control en el postest (p<0.001). Además, la puntuación media en planificación del afrontamiento aumentó significativamente en el grupo de intervención después de la prueba (p<0.001). La puntuación media en habilidades comunicativas también aumentó significativamente en el grupo de intervención en comparación con el grupo de control después de la prueba (p=0.03). Conclusión.La intervención utilizada en el presente estudio basada en el modelo HAPA mejoró significativamente la autoeficacia y las habilidades comunicativas de las enfermeras del grupo experimental.

Objetivo. Avaliar o efeito da Abordagem do Processo de Ação em Saúde (HAPA) na promoção da qualidade das habilidades de comunicação dos enfermeiros. Métodos. A presente pesquisa quase-experimental foi realizada com 148 enfermeiros (76 no grupo de intervenção e 72 no grupo de controle) da província de Yazd (Irã). Os participantes foram recrutados em hospitais públicos nas cidades de Ardakan e Meibod. O instrumento de coleta de dados foi um questionário baseado nos construtos do HAPA e um questionário de habilidades de comunicação. Os dados foram coletados dos dois grupos antes, um mês depois e quatro meses após a intervenção. O grupo de controle não recebeu nenhum treinamento educacional durante o estudo. Resultados. No pré-teste, não foram encontradas diferenças estatisticamente significativas entre os grupos de intervenção e controle em termos de estágios comportamentais da comunicação eficaz com os pacientes. No pós-teste, a pontuação média de autoeficácia na tarefa aumentou significativamente no grupo de intervenção em comparação com o grupo de controle (p<0.001). A pontuação média de autoeficácia de enfrentamento também foi significativamente maior no grupo de intervenção do que no grupo de controle no pós-teste (p<0.001). Além disso, a pontuação média do planejamento de enfrentamento aumentou significativamente no grupo de intervenção após o pós-teste (p<0.001). A pontuação média em habilidades de comunicação também aumentou significativamente no grupo de intervenção em comparação com o grupo de controle no pós-teste (p=0.03). Conclusão. A intervenção usada no presente estudo com base no modelo HAPA melhorou significativamente a autoeficácia e as habilidades de comunicação dos enfermeiros do grupo experimental.

A Study of the Use of Medicinal Plants by Persons With Type 2 Diabetes in Iran.

Medicinal plants are used by many people with Type 2 diabetes in Iran. The aim of this study was to explore why this is so, from their perspective. Sixteen persons with Type 2 diabetes in Yazd City, Iran, were interviewed in April and May 2020 for this study. A thematic analysis of the transcripts of those interviews was done using MAXQDA 10 software. Six themes were identified: beliefs about medicinal plants, psychological factors, accessibility and economic barriers, patients' knowledge and awareness, social pressure, and the role of family culture. The recommendation of the study is that health counselors and specialists should provide needed information and skills for the proper use of medicinal plants, and the pharmaceutical infrastructures need to be expanded to provide enough drugs to facilitate better access to needed medication and reduce reliance on medicinal plants for persons with Type 2 diabetes.

Assessing the Effectiveness of COVID-19 Prevention Campaign in Health Volunteers of Urmia City.

Holding educational campaigns with the purpose of conveying message about one particular behavior in the target group, is one of the society-based educational strategies. This study aimed to investigate the efficiency of the Campaign of COVID-19 Prevention on Health Volunteers in Urmia. The present study was a semi-experimental research, in which the sampling was done in a census way with 200 people participated. In this study, which was done as pre- and posttest, the amount of knowledge, attitude and behavior of health volunteers were evaluated by the designed questionnaires. The campaign was held for 2 months, which has benefited from the five methods of pamphlet, banners, films, social networking sites, and educational classes. After the campaign, the knowledge level, attitude and behavior of Health Volunteers increased to 35.1%, 30.09%, and 29.2%, respectively, which was meaningful statistically. Holding the campaign can trigger positive changes in improving the knowledge, attitude, and behavior of health volunteers, leading to the prevention of a plethora of health problems in society.

Promoting health literacy through the teach back method among Iranian health ambassadors: A randomized controlled trial / Promoting health literacy through the teach back method among Iranian health ambassadors: A randomized controlled trial / Promoção da alfabetização em saúde mediante o método teach-back entre os embaixadores da saúde iranianos: Un ensaio controlado aleatório

Objective. Describe the effect the teach back method on promoting the health literacy of health ambassadors in Urmia County in 2020. Methods. In the present quasi-experiment, 200 persons over 14 years old participated. They were divided into two research groups, a control (n=100) and an intervention (n=100). The sampling method was simple randomization and the data collection instrument was a questionnaire comprised of demographic information and health literacy (HELIA). The educational intervention took 4 sessions each 45 minutes in length following the teach back method. The questionnaire-based data were collected once before the intervention and once again three months after the intervention. Results. The present findings showed that 54% of the control group and 50% of the intervention group had a good or very good level of health literacy before the intervention(p>0.05). However, after the intervention, 52% of the control and 78% of the intervention group had a good or very good level of health literacy. The present findings revealed that the mean scores of health literacy dimensions (access to information, reading, understanding, appraisal, decision-making) and the overall health literacy score were significantly higher in the intervention group than the control (after the intervention). Wilcoxon's test results showed that the mean difference of the overall health literacy scores and the dimensions before and after the intervention were statistically significant (p<0.001). Conclusion. In the light of the present findings, we can conclude that participatory methods and the teach back method can improve health literacy, acquire reliable information and adopt healthy behaviors.

Objetivo. Describir el efecto del método teach-back en la promoción de la alfabetización en salud de los embajadores de la salud en el condado de Urmia, Irán en 2020. Métodos. En el presente estudio cuasiexperimental participaron 200 personas mayores de 14 años. Mediante muestreo de aleatorización simple se asignaron los grupos de investigación: de control (n=100) y de intervención (n=100). Se empleó un instrumento para la recogida de datos que contenía información demográfica y el instrumento Health Literacy for Iranian Adults -HELIA-. La intervención educativa consistió en 4 sesiones de 45 minutos, siguiendo el método teach- back. Los datos basados en el cuestionario se recogieron antes de la intervención y tres meses después de la misma. Resultados. Los hallazgos mostraron que el 54% del grupo de control y el 50% del grupo de intervención tenían un nivel bueno o muy bueno de conocimientos sobre alfabetización en salud antes de la intervención (p>0.05). Sin embargo, después de la intervención, el 52% del grupo de control y el 78% del grupo de intervención tenían un nivel bueno o muy bueno de conocimientos sanitarios. Los presentes resultados revelaron que las puntuaciones medias de las dimensiones de la alfabetización en salud acceso a la información, lectura, comprensión, valoración, toma de decisiones y de la puntuación global fueron significativamente mayores en el grupo de intervención que en el de control a los 3 meses después de la intervención. Finalmente, los resultados de la prueba de Wilcoxon mostraron que la diferencia media de las puntuaciones de la alfabetización en salud y de las dimensiones antes y después de la intervención eran estadísticamente significativas (p<0.001). Conclusión. A la luz de los resultados, se pudo concluir que la aplicación del método teach-back puede mejorar los conocimientos sobre la alfabetización en salud, además de ayudar a adquirir información fiable y a adoptar comportamientos saludables.

Objetivo. Descrever o efeito do método teach-back na promoção da alfabetização em saúde dos embaixadores da saúde no condado de Urmia, Irã em 2020. Métodos. No presente estudo quase-experimental participaram 200 pessoas maiores de 14 anos. Mediante amostragem de aleatória simples foram designados aos grupos de investigação: de controle (n=100) e de intervenção (n=100). Se empregou um instrumento para o recolhimento de dados que continha informação demográfica e o instrumento Health Literacy for Iranian Adults -HELIA-. A intervenção educativa consistiu em 4 sessões de 45 minutos, seguindo o método teach- back. Os dados baseados no questionário se recolheram antes da intervenção e três meses depois dela. Resultados. As descobertas mostraram que 54% do grupo de controle e 50% do grupo de intervenção tinham um nível bom ou muito bom de conhecimentos sobre alfabetização em saúde antes da intervenção (p>0.05). Porém, depois da intervenção, 52% do grupo de controle e 78% do grupo de intervenção tinham um nível bom ou muito bom de conhecimentos sanitários. Os presentes resultados revelaram que as pontuações médias das dimensões da alfabetização em saúde acesso à informação, leitura, compreensão, valoração, toma de decisões e da pontuação global foram significativamente maiores no grupo de intervenção que no de controle aos 3 meses depois da intervenção. Finalmente, os resultados da prova de Wilcoxon mostraram que a diferença média das pontuações da alfabetização em saúde e das dimensões antes e depois da intervenção eram estatisticamente significativas (p<0.001). Conclusão. À luz dos resultados, se pôde concluir que a aplicação do método teach-back pode melhorar os conhecimentos sobre a alfabetização em saúde, além de ajudar a adquirir informação confiável e a adotar comportamentos saudáveis.

Determinants of Sailors' Protective Behaviors in Fishing Spots against the Risks of Sunlight and Skin Cancer: A Qualitative Study in Iran.

INTRODUCTION: The growing rate of nonmelanoma skin cancer (NMSC) and melanoma has been a great challenge for global health system. The present research aims to determine sailors' protective behaviors against the risks of sunlight and skin cancer in Iran. MATERIALS AND METHODS: The present research was qualitative in type, and its data were collected from August to December 2019. To this aim, 23 participants were recruited with whom semistructured interviews were held. The data collection continued until data saturation, and the interviews were coded in MAXQDA 10. Conventional content analysis was used to analyze the qualitative data. RESULTS: Analysis of sailors' perceptions and experiences revealed 7 categories: protective behaviors, hard personal and familial conditions, social interactions, poor social support, feeling of satisfaction, self-care, and fear. CONCLUSION: Sailors are prone to skin cancer due to their specific work conditions. Perceptions and determinants of skin cancer and protective behaviors against sunlight were identified among sailors. Promotion of protective behaviors and beliefs that impeded preventive behaviors are among issues that require special attention.

Determining Skin Cancer Protective Behaviors in the Light of the Protection Motivation Theory among Sailors in Bandar-Bushehr in the South of Iran.

BACKGROUND: Skin cancer is among the most prevalent cancers in Iran and worldwide. Due to the nature of work, sailors are constantly exposed to the ultraviolet rays of the sun, which in the long run damages their skin and raises the chances of skin cancer. Thus, the present research aimed to predict the skin cancer protective behaviors among sailors in the south of Iran in the light of the protection motivation theory. MATERIALS AND METHODS: The present analytical, cross-sectional research was conducted on 360 sailors in Bandar-Bushehr selected randomly from 4 border healthcare centers. To collect the required data, a reliable and valid questionnaire based on the protection motivation theory was used. The data were analyzed in SPSS21 using descriptive and inferential statistics including Pearson correlation coefficient and linear regression analysis. RESULTS: Pearson correlation coefficient showed a statistically significant positive correlation between protection motivation, perceived severity, fear, reward on the one hand and a statistically significant negative correlation between protection motivation and rewards and response costs. All constructs of protection motivation explained 43% of the variance of skin cancer protective behaviors. Among the influential predictors, perceived self-efficacy showed to be the strongest (ß=0.328). CONCLUSION: Considering the effectiveness of the protection motivation theory in determining skin cancer preventive behaviors among sailors, it can be concluded that this theory can be used as a framework in planning health education and promotion programs to motivate sailors to adopt more skin cancer protective behaviors.

Do Subjective Norms Predict the Screening of Cancer Patients' First-Degree Relatives? A Systematic Review and Meta-Analysis.

BACKGROUND: Early detection and preventive measures can reduce the risk of cancer among first degree relatives (FDRs) of cancer patients.Several studies investigated the effect of subjective norm in relation to FDRs' tendency to conduct preventive behaviors. Therefore, the purpose of this study was to systematically evaluate the effect of subjective norms on cancer patients' FDRs as well as their willingness for screening. METHODS: PubMed and Scopus were studied to investigate the effect of subjective norms on preventive measures such as breast cancer self-examination, colonoscopy, PSA testing, skin examination, and genetic testing. Odds Ratio (OR), correlation was and confidence intervals were extracted for meta-analysis. After reviewing the studies, only 16 studies met the criteria to be included in this systematic review. RESULTS: The meta- analysis and OR showed that Physician Recommendation (OR=6.98, 95% CI; 2.55-19.09, P<0.001), Health Care Provider (HCP) (OR=2.79, 95% CI; 1.26-6.16; P=0.011), family and friends (OR=1.82, 95% CI; 1.33-2.50, P <0.001) significantly enhanced the likelihood of referring for screening and preventive measures. CONCLUSIONS: The results of the current study indicated that subjective norms can significantly increase willingness to screening.

Determinants of effective nurse-patient communication based on the health action process approach in Yazd hospitals.

Background Nurse-patient communication is one of the most important care relationships that affects the treatment process. The health action process approach (HAPA) has been used to explain a number of behaviors. However, this approach has not been used to explain nurse-patient communication. Therefore, this study was conducted to investigate effective nurse-patient communication using this approach. Materials and methods In this cross-sectional study, 300 nurses from public hospitals in the center of Iran were enrolled in the study. A researcher-developed questionnaire was used to measure the HAPA constructs. The data were analyzed using Pearson's correlation coefficient and one-way analysis of variance with least significant difference (LSD) post hoc tests in SPSS as well as structural equation modeling using AMOUS software. Results In the motivation phase, risk perception, outcome expectancies and task self-efficacy predicted 19% of variance in intention to communicate effectively. In the volitional phase, planning and action self-efficacy predicted 22% of variance in effective communication. The scores of HAPA constructs were different depending on the levels of effective communication. Conclusions The model can serve as a reference framework to promote effective nurse-patient communication.