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1.
Health Sci Rep ; 7(7): e2260, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39040880

RESUMO

Background and Aims: Recognizing the ability to adapt coping mechanisms in response to the unique issues present in various Iranian societies underscores the importance of considering culture and religion when interacting with diverse groups of individuals. The objective of this study was to assess the reliability and validity of the fear of progression questionnaire-short form (FoP-Q-SF) in Iranian breast cancer patients. Methods: In this methodological cross-sectional research design, 400 Iranian breast cancer patients completed the FoP-Q-SF in 2023. We assessed the characteristics, content, and both exploratory and confirmatory construct validity of the measures. To evaluate the reliability and construct validity of the FoP-Q-SF, we calculated Cronbach's α, McDonald's omega, and the Intraclass Correlation Coefficient. Results: The average age of the patients was 49.18 (standard deviation = 16.14) years. The results of exploratory factor analysis revealed that a single-factor structure, specifically the self-efficacy scale, accounted for 65.045% of the total variance. The findings from the confirmatory factor analysis indicated a satisfactory model fit. The reliability analysis indicated that the internal consistency and stability of the measures were acceptable. Conclusion: The short Persian version of the FoP-Q-SF exhibits satisfactory validity and reliability. Thus, we recommend using this questionnaire to assess the fear of disease progression among breast cancer patients in Iran.

2.
J Nurs Meas ; 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38871483

RESUMO

Background and Purpose: The present study aimed to examine the psychometric properties of the Persian version of the Mendelson and White Body Esteem Scale in Iranian adults. Methods: This cross-sectional study design was used and carried out in 2023. Following the inclusion criteria, 500 adults were gathered from Tehran (Tehran, Iran) with an accessible sampling method. After translation of Body Esteem Scale to Persian language, construct validity (with factor analysis and exploratory graph analysis) and reliability were assessed. Results: The mean age of the participants was 30.66 (standard deviation = 7.40) years. The results of Maximum Likelihood Exploratory Factor Analysis (MLEFA) with Promax with Kaiser normalization rotation extracted three factors accounting for 43.4% of the variance comprising 21 items. Also, after necessary modifications during confirmatory factor analysis, the final model was approved. As for construct reliability, the Cronbach's alpha, Composite Reliability, and Maximal Reliability for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. Conclusions: According to results, the Persian version of Body Esteem Scale has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.

3.
Front Psychiatry ; 15: 1337938, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38863606

RESUMO

Objective: The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management. Methods: This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included "caring stress", "care", "stress", "nurse", and "stress management" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers. Results: Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress. Conclusion: Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.

4.
Asian Pac J Cancer Prev ; 25(5): 1787-1793, 2024 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-38809651

RESUMO

INTRODUCTION: Socio-psychological factors such as fear of recurrence and presence of social support may affect quality of life (QOL) of cancer patients. Identifying mediating factors that impact QOL are crucial for targeting vulnerability in patients undergoing cancer treatments. The study purpose was therefore to determine relationships between presence of fear of cancer recurrence and QOL of patients, with the mediating role of social support. METHODS: A predictive correlational design was used to conduct the study with 300 patients with cancer who were undergoing chemotherapy, radiotherapy, or surgery at two medical centers in Tehran. Measures included a demographic information form, the Fear of Cancer Recurrence Inventory (FCRI), the European Organization for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ-C30), and the Multidimensional Scale of Perceived Social Support (MSPSS). Data analyses included descriptives, and path analysis analyses. RESULTS: Higher fear of cancer recurrence predicted lower QOL (ß = -0.60, p < 0.001). Moreover, individuals with lower fear of cancer recurrence also perceived higher social support (ß = 0.32, p < 0.001). Additionally, individuals with higher perceived social support also reported better QOL (ß = 0.30, p < 0.001). CONCLUSION: Perceived social support plays a significant mediating role in the relationship between the fear of cancer recurrence and QOL in patients undergoing active cancer treatment. Enhancing social support among cancer patients may contribute to enhanced QOL, and as does reducing fears associated with disease recurrence.


Assuntos
Medo , Recidiva Local de Neoplasia , Neoplasias , Qualidade de Vida , Apoio Social , Humanos , Masculino , Feminino , Medo/psicologia , Recidiva Local de Neoplasia/psicologia , Pessoa de Meia-Idade , Neoplasias/psicologia , Neoplasias/terapia , Inquéritos e Questionários , Adulto , Seguimentos , Prognóstico , Idoso , Irã (Geográfico)
5.
Ann Med Surg (Lond) ; 86(5): 2976-2991, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38694299

RESUMO

Background: Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical. Objective: This review study aimed to evaluate the psychometrics quality of resilience scales. Methods: International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality. Results: Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent. Conclusion: The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

6.
Front Psychol ; 15: 1304555, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38434953

RESUMO

Background and aim: The correlation between eating attitudes, positive body image, and body esteem is a pivotal area of research that has garnered substantial attention in recent years, given its implications for both mental and physical well-being. The objective of this study was to examine the interplay between positive body image, body esteem, and eating attitudes within an Iranian population. Materials and methods: This study employed a cross-sectional study design and was conducted in the year 2022. A convenience sample of 752 participants residing in Tehran, Iran, was included in the study. The data collection tools were comprised of a demographic registration form, the Adolescence/Adults Scale (PBIAS), the Eating Attitudes Test (EAT), and the Body Esteem Scale (BES) as measurement instruments. Results: Mean age of participants was 26.36 (SD = 8.49). Significant relationships were found among positive body image (B = - 0.095, ß = -0.150, p < 0.001), and body esteem (B = 0.175, ß = 0.149, p < 0.001) with eating attitudes. Conclusion: These findings suggest that individuals with positive body image and high body esteem may have healthier eating attitudes, while those with negative body image and low body esteem may be more likely to have unhealthy eating attitudes.

7.
J Relig Health ; 2024 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-38555537

RESUMO

This systematic review aimed to summarize the evidence regarding the relationship between spirituality and religiosity with death anxiety (DA) among cancer patients. This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. An extensive search was conducted on electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) via keywords extracted from Medical Subject Headings from the earliest to February 9, 2022. The quality of the included studies was assessed using the appraisal tool for cross-sectional studies (AXIS tool). Fifteen studies were selected for inclusion in this systematic review. Nine and six studies assessed the relationship between spirituality and religiosity with DA in cancer patients, respectively. Most studies had a negative relationship between spirituality (n = 8) and religiosity (n = 4) with DA. In sum, most studies showed that religion and spirituality are negatively related to DA in patients with cancer.

8.
J Nurs Meas ; 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38519073

RESUMO

Background and Purpose: Patients on hemodialysis often struggle with their body image. This study was conducted with the aim of investigating the validity and reliability of the Persian version of the body image concern questionnaire for the first time in hemodialysis patients in Iran. Methods: In this cross-sectional study, 400 hemodialysis patients from Iran were assessed using the Body Image Concern Inventory (BICI). By using exploratory factor analysis (EFA; with Maximum Likelihood Factor Analysis and Promax Rotation) and confirmatory factor analysis, the construct validity of BICI was assessed. To check for internal consistency, the average interitem correlation, Cronbach's alpha, and McDonald's omega coefficients were used. Stability was assessed with intraclass correlation coefficient (ICC). Results: The participants' average age was 53.2 (SD = 13.2) years, and more than half of them were women (54.60%). Four factors extracted from exploratory factor analysis (EFA) show that the total cumulative variance explained by these factors was 44.46% of the total variance. Item factor loadings varied between 0.415 and 0.970. Internal consistency coefficients were considered acceptable (>0.7). Also, stability was evaluated as good (ICC = .839). Conclusions: The Farsi version of the BICI scale as a self-report measure of concerns about dysmorphic appearance has 19 items and shows acceptable reliability and validity. Consequently, the scale can be used by nurses to evaluate body image among Farsi-speaking hemodialysis patients, which can help them to take necessary actions to decrease the level of concerns in these patients.

9.
J Nurs Meas ; 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38519074

RESUMO

Background and Purpose: This study evaluated the validity and reliability of the Persian version of Positive Body Image among Adolescents Scale (PBIAS-P) in Tehran, Iran, in order to better understand adolescents' positive perceptions of their physical selves and the accompanying thoughts and emotions. Methods: This cross-sectional study was carried out involving adolescents from Tehran Province, Iran, in 2022. Both exploratory factor analysis and confirmatory factor analysis were performed in order to evaluate the construct validity of the PBIAS-P. Cronbach's alpha, McDonald's omega, and intraclass correlation coefficients were also used to confirm the internal consistency of the scale. Results: The findings indicate that three factors extracted from the PBIAS-P account for 50.1% of the total variance. The model fit is considered good based on cut points for various fit indices. All factors had values of Cronbach's alpha, McDonald's omega, and average interitem correlation above .73, .74 and .4, respectively. Also, test-retest reliability for three factors was acceptable. Conclusions: The PBIAS-P has acceptable validity and reliability in Iranian adolescents, making it useful for researchers, psychologists, and health care professionals.

10.
Asian Pac J Cancer Prev ; 25(3): 1087-1096, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38546091

RESUMO

BACKGROUND: A cancer diagnosis can be psychologically challenging to individuals due to perceptions that the disease is potentially incurable truncating life expectancy. The purpose of the study was to examine the relationships among religious well-being, existential well-being, fear of progression and quality of life in Iranian patients with cancer and to evaluate the potential mediating role of hope on these relationships. METHODS: This study with predictive cross-sectional design was done in 2023. Data was gathered from 398 patients with cancer that was selected with accessible sampling method from cancer center of Mazandaran university of medical sciences (Sari, Iran). Study constructs included the religious and existential wellbeing, cancer fear of progression, Snyder Hope, and quality of life. Analysis of a Moment Structures (AMOS) software (v27) was utilized for all study analyses. Covariance based-structural equation modeling (SEM) was used to assess the mediating role of hope. RESULTS: The mean age of patients with cancer was 49.14 (SD = 16.16). The results of the direct effect showed a significant positive relationship between religious well-being and hope (B = 0.164, p < .001), and between hope and quality of life (B = 0.212, p < 0.001). Also, significant negative relationship between fear of progression and hope (B = -0.147, p < 0.05) was founded. CONCLUSION: A significant positive relationship between hope and quality of life, as well as religious well-being and hope, suggests the influential effects of hope and religious well-being on improving quality of life in patients with cancer. Negative relationships between fear of progression and hope conclude that managing fear of progression may be an important factor in increasing hope and improving quality of life in patients with cancer.


Assuntos
Adaptação Psicológica , Neoplasias , Humanos , Qualidade de Vida , Estudos Transversais , Irã (Geográfico) , Medo
11.
Front Psychol ; 15: 1296498, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38348261

RESUMO

Introduction: The psychometric properties of the body esteem scale have not been assessed in Iran. Therefore, the aim of this study was to translate and determine the validity and reliability of the Persian version of the body esteem scale among Iranian adolescents. Methods: The sample of this methodological study consisted of 504 adolescents [mean age: 16.55 (SD = 1.54) years] living in Tehran City, Iran. After translation of the scale, its content validity (quantitative and qualitative) and structural (exploratory and confirmatory factor analysis), convergent, and discriminant validity were evaluated. Exploratory graph analysis was performed to determine the number of factors. Cronbach's alpha, composite reliability, and maximal reliability were calculated. Results: In the content validity evaluation step, all items had acceptable scores and were retained. The results of exploratory factor analysis with Promax rotation and exploratory graph analysis extracted three factors accounting for 49.49% of the variance, comprising 18 items. Furthermore, after necessary modifications during CFA, the final model was approved. Convergent and discriminant validity were confirmed. Cronbach's alpha, CR, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. Conclusion: According to the results, the Persian version of the body esteem scale has a valid structure and acceptable reliability. Health professionals, in many ways, can use this scale.

12.
J Nurs Meas ; 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38238033

RESUMO

Background and Purpose: The purpose of this study was to translate the Sherer Self-Efficacy Scale into Persian and assess its psychometric properties among Iranian patients with cardiovascular diseases. Methods: This cross-sectional research design was done in 2019. The Persian version of the Self-Efficacy Scale was completed by 400 cardiovascular patients. The scale's reliability and validity (face, content, and construct) were evaluated. Results: A four-factor structure of the Self-Efficacy Scale explained 39.22% of the total variance. Additionally, this Scale demonstrated good construct validity on the basis of the confirmatory factor analysis's findings. The reliability of the scale was assessed and proved with Cronbach's alpha, McDonald's and ICC. Conclusions: The Persian version of the Self-Efficacy Scale had acceptable reliability and validity. This Scale could be used by Iranian patients with cardiovascular disease to determine how effective they are at treating themselves.

13.
J Relig Health ; 62(5): 3546-3562, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37639165

RESUMO

The Spiritual Well-Being Scale (SWBS) is a widely used scale that requires evaluation for the Iranian population. This study aimed to determine the psychometric properties of the SWBS among a sample of potential Iranian organ donors. The research was conducted in 2022 in Iran using cross-sectional methodological design. The sample consisted of 316 individuals from the Iranian community who expressed willingness to donate organs. Convenience sampling was used to select the participants. The construct validity and reliability of the Persian version of the SWBS were assessed. The results from maximum likelihood (ML) and confirmatory factor analysis (CFA) revealed three factors labeled as higher power, the meaning of life, and the purpose of life, which explained 50.2% of the total variance in the concept of Spiritual Well-Being (SWB). The results indicated that the model was appropriate. Cronbach's Alpha and McDonald's Omega demonstrated an acceptable internal consistency of the scale. All the statistical analyses were performed using SPSS 27 and AMOS 27 software. These findings suggest that the Persian version of the SWBS is a reliable and valid scale for assessing the spiritual well-being of individuals who are willing to donate organs. The scale comprises 16 items related to higher power, meaning of life, and sense of life.


Assuntos
Doadores de Tecidos , Humanos , Estudos Transversais , Irã (Geográfico) , Psicometria , Reprodutibilidade dos Testes
14.
J Relig Health ; 62(3): 2226-2251, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36864237

RESUMO

Since spiritual well-being has a significant role in individual and social health, using a valid scale to identify these properties is essential. Comparing factor structure and differences in the number of dimensions and items of subscales could be an indicator of differences in individuals' attitudes toward spirituality among diverse cultures. The present review was performed for psychometric evaluation of the spiritual well-being measures. A systematic review of international databases and Iranian databases was conducted to evaluate studies published between January 1, 1970, and October 1, 2022. QUADAS-2, STARD, and COSMIN scales were used for risk of bias assessment. Following two rounds of screening, 14 articles entered quality assessment. According to the results, studies examining the factor structure of the spiritual well-being scale (SWBS) instrument have been conducted for the years 1998 to 2022. The mean age of the participants in these studies ranged from 20.8 to 79.08 years. During the process of exploratory factor analysis, the researchers reported the presence of two to five latent factors, and the range of explained variance was between 35.6 and 71.4%. However, most of the reports indicated the existence of two or three latent factors. The findings of the present study provide an image of the psychometric status of the SWBS for researchers and clinicians in this field and can help them make optimum decisions in selecting a scale or conducting additional psychometric studies or adopting this scale for studies in new populations.


Assuntos
Comparação Transcultural , Espiritualidade , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Psicometria , Irã (Geográfico) , Inquéritos e Questionários , Reprodutibilidade dos Testes
16.
Front Public Health ; 10: 825415, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35309198

RESUMO

Background and Aim: Hemodialysis treatment saves the life of people with end-stage renal disease (ERDS), but does not prevent the suffering of the disease, anxiety, hopelessness, and so on. Many studies have been performed on self-care behaviors as well as body image in different patients, but so far, no research has been done to investigate the relationship between self-care behavior and body image concerns in hemodialysis patients. Therefore, the aims of this study are to determine the relationship between self-care behavior and body image concern in patients undergoing hemodialysis. Materials and Methods: A cross-sectional design was used to evaluate Self-care Behavior and Concerns about Body Image in a convenience sample of 280 patients with ERDS. Measures included demographic factors, health characteristics, and validated instruments of the study constructs Body Image Concern Questionnaire (BICI) and Assessment of self-care behaviors with arteriovenous fistula (ASBHD-AVF). Results: This study showed that self-care behaviors have the ability to predict body image concerns. There was a negative and significant relationship between self-care behavior and body image concern (B = -0.162, ß = -0.140, p = 0.020). These variables explain 7.5% of predictors. Conclusion: Although the findings of the present study showed that increasing age and improving the level of self-care behaviors in patients undergoing hemodialysis reduces body image anxiety, but women were the strongest predictor of body image anxiety.


Assuntos
Imagem Corporal , Autocuidado , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Diálise Renal/métodos , Autocuidado/métodos
17.
Omega (Westport) ; 86(1): 312-337, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33106088

RESUMO

This review study fills an important gap by aiming to determine the age changes in attempted and completed suicide in Iran during the past decade. A systematic review of related articles in international and Iranian databases from January 2008 to January 2020 was first conducted and relevant studies were extracted based on established criteria. Results showed that the mean age of suicide in Iran is 29.8 (range 27.7 - 31.8) years old for men and 27.4 (range 25.8 - 28.9) for women (P < 0.0001). The youngest and oldest populations of completed suicide belong to eastern and central regions of the country respectively. Findings imply the critical importance of increasing awareness through educational programs and public health campaigns to increase awareness and reduce suicidal behavior in Iran.


Assuntos
Suicídio Consumado , Suicídio , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Ideação Suicida , Tentativa de Suicídio
18.
Omega (Westport) ; 85(4): 792-811, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32903153

RESUMO

According to the studies done in Iran, there has been no study investigating self-blame attributions in patients with cardiovascular disease. Moreover, there has been no standard scale for assessing self-blame attributions available in Persian. Hence, this study was conducted to determine the psychometric properties of the Persian version of Cardiac Self-Blame Attribution (CSBA-P) Scale in patients with cardiovascular disease. In this 2019 methodological study, 400 patients with cardiovascular disease completed the Persian version of the Cardiac Self-Blame Attribution scale. We evaluated the face, content, and construct validity (both exploratory and confirmatory) of the measure. The results of the confirmatory and exploratory factor analysis extracted a separate factor explained 56.249% of the variance. One factor fit model was confirmed according to standard measures such as RMSEA = 0.074, CMIN/DF = 2.454. The reliability of the scale was calculated and confirmed with a Cronbach coefficient of 0.938, construct reliability of 0.938, and ICC of 0.895. The Persian version of the Cardiac Self-Blame Attribution scale (CSBA-P) yielded acceptable validity and reliability. Thus, this scale can be used in future research to assess self-blame attributions among cardiac populations who speak Persian.


Assuntos
Doenças Cardiovasculares , Análise Fatorial , Humanos , Irã (Geográfico) , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários
20.
BMC Cardiovasc Disord ; 21(1): 563, 2021 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-34814834

RESUMO

BACKGROUND: Although various studies have been conducted on the effects of seasonal climate changes or emotional variables on the risk of AMI, many of them have limitations to determine the predictable model. The currents study is conducted to assess the effects of meteorological and emotional variables on the incidence and epidemiological occurrence of acute myocardial infarction (AMI) in Sari (capital of Mazandaran, Iran) during 2011-2018. METHODS: In this study, a time series analysis was used to determine the variation of variables over time. All series were seasonally adjusted and Poisson regression analysis was performed. In the analysis of meteorological data and emotional distress due to religious mourning events, the best results were obtained by autoregressive moving average (ARMA) (5,5) model. RESULTS: It was determined that average temperature, sunshine, and rain variables had a significant effect on death. A total of 2375 AMI's were enrolled. Average temperate (°C) and sunshine hours a day (h/day) had a statistically significant relationship with the number of AMI's (ß = 0.011, P = 0.014). For every extra degree of temperature increase, the risk of AMI rose [OR = 1.011 (95%CI 1.00, 1.02)]. For every extra hour of sunshine, a day a statistically significant increase [OR = 1.02 (95% CI 1.01, 1.04)] in AMI risk occurred (ß = 0.025, P = 0.001). Religious mourning events increase the risk of AMI 1.05 times more. The other independent variables have no significant effects on AMI's (P > 0.05). CONCLUSION: Results demonstrate that sunshine hours and the average temperature had a significant effect on the risk of AMI. Moreover, emotional distress due to religious morning events increases AMI. More specific research on this topic is recommended.


Assuntos
Mudança Climática , Pesar , Islamismo , Infarto do Miocárdio/epidemiologia , Tempo (Meteorologia) , Atitude Frente a Morte , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Infarto do Miocárdio/diagnóstico , Chuva , Medição de Risco , Fatores de Risco , Luz Solar , Temperatura , Fatores de Tempo
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