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Fatemeh Khakshoor Mohammad Abadi, Sakineh Taherkhani, Abed Majidi, Azam Moslemi,
Volume 29, Issue 2 (7-2023)
Abstract

Background & Aim: In women experiencing intimate partner violence, resilience can serve as a protective factor against the worsening of psychological problems. Acceptance and Commitment Therapy has emerged as a potential means to enhance resilience in these individuals. The aim of this study is to determine the effect of Acceptance and Commitment Therapy on the resilience of women experiencing spousal abuse.
Methods & Materials: This is a quasi-experimental study. A total of 80 women experiencing spousal abuse were selected through quota sampling from the women referring to the health houses affiliated to the Mashhad ol-Kube health center in Arak, Iran between 2020 and 2021. The participants were then divided into intervention and control groups using the block randomization method. The intervention group received the Acceptance and Commitment Therapy in eight sessions, lasting 90 minutes each, once a week. The data collection tools included a questionnaire on personal and health characteristics, the Revised Conflict Tactics Scale, and the ConnorDavidson Resilience Scale. The Resilience Scale was completed by both groups one week and five weeks after the intervention. The data were analyzed through the SPSS software version 23 using descriptive statistics, independent t-test, Chi-square test, Fisher’s exact test, and two-way repeated measures ANOVA. A significance level of P<0.05 was used to determine statistical significance.
Results: The mean and standard deviation of the resilience score for the intervention group increased from 59.21±13.29 before the intervention to 64.31±11.27 and 72.34±10.49 in the post-test and follow-up periods. For the control group, these figures were 52.47±17.2, 51.94±14.72, and 52.47±15.3, respectively. Based on the results of the two-way repeated measures ANOVA, there was a statistically significant difference in the mean score of resilience between the intervention and control groups at the three time points examined (P<0.001).
Conclusion: The implementation of Acceptance and Commitment Therapy can significantly improve the resilience of women experiencing spousal abuse. This intervention holds great potential for being incorporated into mental health improvement programs specifically designed for women who have experienced spousal abuse.

 
Nasibeh Sharifi, Anvar-Sadat Nayebinia, Afsaneh Raiesifar, Tayebeh Rashidian, Zeinab Raiesifar, Azita Fathnezhad-Kazemi,
Volume 29, Issue 3 (10-2023)
Abstract

Background & Aim: Infectious diseases represent a significant health concern within human communities. Considering the importance of pregnancy, the present study was conducted with the aim of exploring the health behaviors exhibited by pregnant women during the COVID-19 pandemic.
Methods & Materials: This qualitative study employed the conventional content analysis approach to examine a cohort of 16 pregnant women in 2021. The research was conducted within the health centers of Ilam, employing the purposeful sampling technique and unstructured interviews to collect the data. Simultaneous to the data collection, conventional content analysis was employed to analyze the data. MAXQDA version 10 software was utilized for data management purposes.
Results: The participants had a mean age of 30 years, while the average gestational age was 30.38 weeks. Through analysis, three main themes and eight categories were derived from the collected data. The main themes identified were as follows: 1- self-care practices for disease prevention, 2-  the adverse effects of the pandemic on pregnancy, and 3- changes in the healthcare system.
Conclusion: The results of the present study highlight the emergence of a novel form of self-care among pregnant women as a consequence of the COVID-19 pandemic. The adverse effects of the pandemic, such as quarantine measures, were associated with the development of negative ruminations within pregnant women. Following the quarantine restrictions, significant modifications were observed in the ways through which women sought health-related information and engaged in daily activities. Moreover, alterations were made to care policies. Paying attention to the comprehensive health needs of pregnant women, including both physical and mental health, is imperative within the context of pandemic-related health services.

 
Maryam Khodaverdi, Sharareh Khosravi, Somayeh Karimi, Fatemeh Rafie,
Volume 29, Issue 4 (1-2024)
Abstract

Background & Aim: Parents of children with autism face numerous challenges that hinder their social adjustment. Spiritual health emerges as a relevant components that can potentially enhance their social adjustment. The present study was conducted with the aim of investigating the relationship between spiritual health and social adjustment among parents of children with autism.
Methods & Materials: This is a descriptive correlational study that investigates a sample of 194 parents of children with autism at Hekmat Autism Center in Borujerd and Yekta Autism Center in Khorramabad, during the period of March 2021 to April 2021. To collect data, a demographic information questionnaire, the Paloutzian and Ellison spiritual health questionnaire, and the personal resource questionnaire were employed. Data analysis was conducted using the SPSS software version 26, utilizing the Chi-square test, one-way analysis of variance (ANOVA), and Pearson's correlation coefficient.
Results: There was a statistically significant relationship between the scores of spiritual health (82.03±17.68) and social adjustment (78.52±15.59) among the parents (r=0.572, P=0.0001). The parents with low spiritual health had a mean social adjustment score of 65±0, while those with moderate spiritual health had a mean score of 76.63±15.76, and parents with high spiritual health had a mean score of 89.19±9.45. These results indicate that there was a statistically significant difference in the mean scores of social adjustment across different levels of spiritual health (P<0.001).
Conclusion: There was a significant correlation between spiritual health and social adjustment among parents of children with autism, suggesting that higher levels of spiritual health were associated with increased social adjustment. To enhance the social adjustment of these parents, it is advisable to implement appropriate planning aimed at improving their spiritual health.

 
Mahmoud Nekoei Moghadam, Mohammad Hossein Mehrolhassani, Rohaneh Rahimisadegh, Azam Parvaz,
Volume 29, Issue 4 (1-2024)
Abstract

Background & Aim: Given the importance of the emergency department in providing prompt and high-quality services, the emphasis on lean management has increased to minimize non-value-added and wasteful activities within a process. The aim of the study was to determine the process of patient flow and identify opportunities for its improvement using the Six Sigma method as one of the most important subsystems of lean management, in the emergency department of the selected teaching hospital in Kerman.
Methods & Materials: The current research is a sequential mixed-method study conducted in 2022 within the cardiovascular and neurological emergency department in Kerman. The Six Sigma method, specifically the DMAIC approach consisting of four steps, was employed in conjunction with spaghetti charts to implement lean management principles. The research population included 180 patients referred to the cardiovascular and neurological emergency department. The data were collected using researcher-developed forms, and Excel software version 2013 was used to analyze the data.
Results: By examining the processes and using the spaghetti chart, the main problems contributing to prolonged patient admission time in the cardiology and neurology emergency department were identified. The implementation of a strategy involving the presence of admission staff during triage for level 1 to 3 patients will eliminate the additional distance and time required for patient admission.
Conclusion: The use of lean thinking principles in the emergency department with the implementation of Lean Six Sigma and Spaghetti Chart by streamlining the service process, will result in improving patient flow, providing timely quality services, reducing service delivery time, and ultimately increasing patient satisfaction.

 
Zohreh Parsaeian, Nasrin Nikpeyma, Mohammad Salehpoor Emran, Farshad Sharifi, Shahzad Pashaeypoor,
Volume 29, Issue 4 (1-2024)
Abstract

Background & Aim: The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.
Methods & Materials: In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.
Results: Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).
Conclusion: The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.
Clinical trial registry: IRCT20201006048953N

 
Mahdi Shafiee Sabet, Fatemeh Bahramnezhad, Nahid Dehghan Nayeri,
Volume 29, Issue 4 (1-2024)
Abstract


According to a global report, 47 million people are currently living with dementia, and due to the aging population, its prevalence is expected to triple by 2050. In the future, Iran is expected to experience a significant increase in the elderly population. Currently, in Iran, the prevalence of dementia among individuals over 60 years old is 7.9%. Therefore, this group represents a significant population that warrants further research (1).
The best understanding and explanation of human experiences come from first-hand sources, specifically from people who have experienced those phenomena. Therefore, reliable research sources place great emphasis on including the voices of these individuals (2). Qualitative research out for its collaborative, inclusive, and flexible structure, enabling the exploration of complex issues, including mixed or ambiguous attitudes (2). It can reveal the profound experiences and core values of people with cognitive impairment that may not emerge in quantitative studies. Additionally, qualitative research excels in vividly portraying these experiences and values (3).
Throughout history, people with cognitive impairments have been marginalized from engagement in health and social research, resulting in their voices being inadequately represented in such studies. (2, 4). Instead, their perspectives have been channeled through their legal representatives or guardians, a practice that often entails constraints. These limitations include the inability to accurately predict the patient's decision-making process, the amount and manner of information provided, and the weight of decision-making responsibility placed on them (5).
Furthermore, excluding these individuals from the research process can dehumanize them and perpetuate negative stereotypes about people with cognitive disorders. This also contributes to power imbalances (2). Therefore, it is crucial to develop strategies that ensure the safe participation of these individuals in research endeavors. Through these efforts, we can improve our understanding of policy and measures aimed at promoting health and well-being (6).
 
Tahereh Abdian, Fatemeh Ebrahimi, Sareh Ghorbani, Najmeh Abedishargh,
Volume 29, Issue 4 (1-2024)
Abstract

Background & Aim: Breast cancer is the most common type of cancer in the world, imposing significant physical problems and psychological burdens on sufferers. Education is one of the ways to reduce the psychological problems of these patients. Therefore, the current study was conducted to compare the efficacy of Acceptance and Commitment Training (ACT) and Positive Psychology (PP) in enhancing the mental health and resilience among women with breast cancer.
Methods & Materials: This study employed a two-group quasi-experimental design with a pretest-posttest design, involving 60 women with breast cancer at Khatamolanbia cancer center in Jahrom during 2020-2021. Participants were selected through convenience sampling and randomly assigned to either the Acceptance and Commitment Training group (focused on accepting uncontrollable factors and committing to enriching life) or the Positive Psychology group (emphasizing individual abilities and positive emotions). Prior to and one week following the sessions, participants completed questionnaires evaluating resilience and mental health. Data analysis was performed using MANCOVA with a significance level set at 0.05.
Results: Based on the MANCOVA findings, there was no statistically significant difference in resilience and mental health scores (F=2.318, P=0.110) between the two intervention groups after adjusting for pretest scores. However, clinically significant improvements were observed in mental health and resilience for 75% and 42% of the ACT group, and 65% and 46% of the Positive Psychology group, respectively.
Conclusion: According to the findings, both group therapies, ACT and Positive Psychology, are effective in enhancing resilience and mental health in breast cancer patients. These findings provide more opportunities for healthcare providers to tailor interventions to the characteristics of caregivers and the personality characteristics of the patients.

 
Akram Rahimi Shandiz, Fatemeh Zahra Karimi, Raziyeh Masoumi, Seyed Reza Mazlom,
Volume 30, Issue 1 (3-2024)
Abstract

Background & Aim: Considering that a decline in sexual satisfaction after assisted reproductive treatment failure can cause a decrease in the overall quality and satisfaction of life, the present study was conducted to compare the effect of sexual counseling based on EX-PLISSIT and BETTER models on the sexual satisfaction of infertile women following the failure of assisted reproductive technologies.
Methods & Materials: This randomized clinical trial, conducted in 2022, involved 66 infertile women who had experienced unsuccessful assisted reproductive treatments and were referred to the Milad Infertility Center of Imam Reza (AS) Hospital in Mashhad, Iran. The participants were divided into two intervention groups – EX-PLISSIT and BETTER – and received individual sexual counseling across four weekly sessions, comprising two face-to-face and two virtual sessions. Data were collected using the Sexual Satisfaction Scale for Women (SSSW) and subsequently analyzed using SPSS software version 25, through chi-square, independent t-tests, Mann-Whitney, and Wilcoxon tests.
Results: After the intervention, there were no statistically significant differences in the total scores of sexual satisfaction and its components between the two groups (P>0.05), with the exception of relational anxiety (P=0.021). Intra-group comparisons revealed a significant increase in the total scores of sexual satisfaction and its components within each group after the intervention, as compared to before the intervention (P<0.05).
Conclusion: Sexual counseling utilizing the EX-PLISSIT and BETTER models was found to be an effective, affordable, and side-effect-free method in enhancing sexual satisfaction among infertile women after the failure of assisted reproductive methods, particularly by addressing relational anxiety.
Clinical trial registry: IRCT20210211050324N1

 
Salar Majidi Sakani, Jamileh Amirzadeh Iranagh, Hamidreza Khalkhali, Behrouz Fathi, Alireza Didarloo,
Volume 30, Issue 1 (3-2024)
Abstract

Background & Aim: Osteoporosis is a common problem in menopausal women, and adopting preventive behaviors is crucial in addressing this issue. The purpose of the study is to evaluate the effect of an educational intervention based on the health belief model (HBM) on promoting osteoporosis-preventive behaviors in menopausal women.
Methods & Materials: This quasi-experimental study with a control group was conducted on 64 menopausal women referred to Urmia urban health centers in 2023. Participants were selected using random sampling and then randomly allocated into two groups: control (32) and intervention (32). The data collection instruments included questionnaires comprising demographic information, knowledge assessments, Health Belief Model constructs, food frequency, and physical activity items. Following pre-test evaluations and needs assessment, a training program was designed and delivered to the intervention group. The collected data were analyzed using SPSS software version 26.
Results: The mean scores for knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, and cues to action in the intervention group significantly increased compared to both the pre-intervention assessment and the control group. Conversely, there was a significant decrease in the mean score for perceived barriers (P<0.05). These changes resulted in a significant increase in the mean score for osteoporosis preventive behaviors within the intervention group (P<0.05).
Conclusion: Education based on the HBM has been effective in shaping the knowledge and health beliefs of menopausal women concerning osteoporosis and its preventive behaviors. Therefore, it is recommended that health educators incorporate the approaches and findings of this study when developing educational interventions related to osteoporosis.

 
Zahra Ghaderi Nasab, Parvin Mangolian Shahrbabaki, Hamid Sharifi,
Volume 30, Issue 2 (6-2024)
Abstract

Background & Aim: Medication non-adherence remains a significant problem in managing the global epidemic of hypertension. This study aimed to explore the factors affecting medication non-adherence from the perspectives of both patients with hypertension and healthcare providers in Mahan health centers, located in Kerman province.
Methods & Materials: This qualitative study utilized a conventional content analysis method within healthcare centers in Mahan city in 2022. A total of 29 participants were included in the study, selected through purposive sampling. Data were collected through in-depth semi-structured interviews, with all interviews being recorded, transcribed verbatim, and utilized as the primary data for analysis. The trustworthiness of data was evaluated in accordance with the criteria established by Guba and Lincoln criteria.
Results: Three categories of factors contributing to medication non-adherence among patients with hypertension were identified: ""nature of the disease and treatment," "individual and family factors," and "organizational factors." Factors related to the "nature of the disease and treatment" included the asymptomatic and chronic nature of hypertension as well as fatigue stemming from continuous drug use. "Individual and family factors" encompassed fear and internal doubts, a desire for non-pharmacological treatments, and inadequate family support. "Organizational factors" comprised high treatment costs and access to specialized services, insufficient support from treatment and care teams, and inadequate disease monitoring.
Conclusion: Various factors across a spectrum of influences contribute to medication non-adherence in patients with hypertension. It is crucial for healthcare providers to engage in consistent patient education regarding the nature of the condition and the importance of medication adherence to enhance compliance among patients.

 
Kobra Akhoundzadeh, Sakineh Shafia, Zahra Abedini, Ashraf Khoramirad,
Volume 30, Issue 2 (6-2024)
Abstract

Background & Aim: Electrocardiography (ECG) is the most widely utilized diagnostic tool in medicine. However, nursing students often have problems with interpreting ECGs, highlighting the need for revised training methods. This study aimed to assess the effect of ECG drawing assignments on nursing students' learning and their perspectives on this teaching method in the context of a critical care nursing course.
Methods & Materials: This quasi-experimental study involved 52 fifth-semester BSc nursing students enrolled in the fall and spring terms at Qom University of Medical Sciences. For the fall group, traditional lectures and Q&A sessions were conducted during the first half of the semester, followed by an assignment requiring students to draw common ECGs in the second half. In contrast, for the spring group, students drew ECGs during the first half of the semester. Learning outcomes were assessed through a written test, while students’ perspectives on the drawing assignments were evaluated using a questionnaire. Data were analyzed using SPSS software version 22, employing Mann-Whitney and Wilcoxon tests to compare groups.
Results: The mean score from the perspective questionnaire regarding ECG drawing was 14.86±3.34 (maximum score of 18). In most cases, students had positive or relatively positive views towards this teaching method. A significant difference was observed between the course exam scores of students when they engaged in drawing ECGs compared to when they did not (P<0.001).
Conclusion: Drawing ECGs can be helpful in enhancing learning outcomes in the critical care nursing course and may increase students’ motivation to learn.

 
Fatemeh Bahramnezhad, Mahdi Shafiee Sabet, Nahid Dehghan Nayeri,
Volume 30, Issue 3 (9-2024)
Abstract

As explained in the first part, the acquisition of firsthand experiences is an essential element of qualitative research for uncovering and enriching study findings. However, individuals with cognitive disorders are often excluded due to various challenges. In these cases, researchers may rely on caregivers or close associates to understand their feelings and views. This approach not only reduces these individuals to mere objects but also presents ethical dilemmas, thereby impacting the depth and richness of study findings (1). Given that the methods of data collection significantly impacts the results of studies (2), it is imperative for qualitative researchers to strive towards directly gathering information from the individuals themselves. Understanding the experiences of people with cognitive impairments is crucial for providing evidence-based services. However, these patients often encounter challenges such as speech difficulties (3), ‘pseudo-reminiscences’ (4-6), mood fluctuations and behavioral problems (7), and other issues. Therefore, researchers should take into consideration certain factors when conducting interviews with these individuals as in-depth interviews aim to gain a deeper understanding of participants' life experiences (8,9). These interviews require specialized skills across various stages, encompassing the development of interview guides, participant recruitment, obtaining consent, conducting effective interviews, data analysis and interpretation, and proficient communication and dissemination of research findings. This section delves into the key aspects of each of these phases. During interviews, it is important to prioritize the well-being of both the researcher and the participant while reflecting on and ensuring the depth and richness of the interview content (6).
 
Faeze Mohammadi, Sakineh Taherkhani, Maryam Zamanian, Elaheh Elahy,
Volume 30, Issue 3 (9-2024)
Abstract

Background & Aim: The coping strategies employed by women in facing violence can influence the frequency and intensity of violence or related stress. Life skills training may serve as a way for improving these coping strategies. This study aims to determine the effect of life skills group counseling, using a cognitive-behavioral approach, on the coping strategies of abused women.
Methods & Materials: This quasi-experimental study involved 120 abused women who attended health centers affiliated to Arak University of Medical Sciences in 2022. Participants were assigned to an intervention group or a control group (60 people each). The intervention group participated in eight group counseling sessions focused on life skills training through a cognitive-behavioral approach. Data were collected using a demographic questionnaire, the Conflict Tactics Scale, and the Ways of Coping Questionnaire. Coping strategies were assessed at the end of the intervention and again 12 weeks later. Descriptive and inferential statistical analyses were conducted to analyze the data.
Results: The intervention led to a significant increase in mean scores for the subscales “distancing” (P<0.001), “planning” (P<0.001), “seeking social support” (P=0.002), and “problem-solving” (P<0.001) in the intervention group compared to the control group. Conversely, there was a significant reduction in the mean score for the “wishful thinking” subscale (P<0.001). The most substantial effect of the intervention was observed in the “planning” subscale, while the “seeking social support” subscale exhibited the least effect. Specifically, the mean±standard deviation scores for the “planning” subscale in the intervention group were 8.95±3.61 pre-test and 14.82±2.40 post-test. For the “seeking social support” subscale, the scores were 5.28±3.21 pre-test and 7.03±1.77 post-test.
Conclusion: Life skills group counseling, utilizing a cognitive-behavioral approach, significantly increased the adoption of coping strategies, such as distancing, planning, seeking social support, and problem-solving, while reducing reliance on wishful thinking among abused women. Therefore, this method can serve as a means to promote coping strategies for abused women.

 
Mohammadreza Shamshiri, Mahbobeh Sajadi, Sharareh Khosravi, Fatemeh Rafiei,
Volume 30, Issue 4 (1-2025)
Abstract

Background & Aim: Children are a particularly vulnerable group, and mothers' knowledge and awareness play a crucial role in fostering their developmental progress. Insufficient knowledge of the cognitive, emotional, and social aspects of child development may lead to a decrease in parental self-efficacy. This study aims to investigate the effect of a family-centered empowerment model on mothers' self-efficacy regarding the growth and development of toddlers.
Methods & Materials: This quasi-experimental study was conducted in 2022 at Amir Kabir Hospital in Arak. A total of 72 mothers of hospitalized toddlers were selected and randomly assigned to either a control group (n=36) or an intervention group (n=36) through block randomization. The control group received standard hospital care, while the intervention group participated in a five-session, family-centered empowerment model program, with each session lasting 60 minutes. Data were collected using demographic questionnaires and parenting self-efficacy assessments, administered before the intervention, immediately after, and one month post-intervention. Analysis was performed using SPSS version 26, incorporating both descriptive and inferential statistics.
Results: The results showed that the mean self-efficacy scores before the intervention had no statistically significant difference between the two groups (P=0.416). However, post-intervention, the mean parenting self-efficacy scores demonstrated a statistically significant difference between the groups (P<0.001). Additionally, the mean parenting self-efficacy scores measured one month after the intervention also showed a statistically significant difference (P<0.001).
Conclusion: The family-centered empowerment model significantly improved mothers' self-efficacy. It is recommended as an effective approach for improving the management of children's growth and development.

 
Saeideh Mazidi, Mohammad Ali Jahani, Seyed Amir Soltani, Golbahar Akhoundzadeh,
Volume 30, Issue 4 (1-2025)
Abstract

Background & Aim: Raising a mentally retarded child imposes significant psychological and economic burdens on families, which can adversely affect their sense of hope. The aim of the study was to determine the effect of a family-centered empowerment model on the hopefulness of parents with mentally retarded children.
Methods & Materials: This clinical trial was conducted in 2023 in Aliabad Katol, focusing on parents with mentally retarded children. A total of 48 participants were selected through simple random sampling from a list of these parents and were randomly assigned to either an intervention group or a control group. Pre-test and post-test evaluations were conducted before and after the intervention. The intervention group participated in six family empowerment sessions, while the control group received routine care training. Data were collected using the Schneider's Hope Questionnaire. Statistical analysis was performed using SPSS version 23, employing univariate analysis of covariance, paired t-tests, and independent t-tests, with a significance level set at 0.05.
Results: In the intervention group, the average age of mothers was 36.27±8.07 years, compared to 34.83±5.12 years in the control group. The average age of children was 11.88±2.88 years in the intervention group and 10.16±1.94 years in the control group. No significant difference was observed in the mean hope scores between the intervention and control groups prior to the intervention (P=0.582). However, post-intervention, the mean hope score significantly increased in the intervention group compared to the control group (P=0.021). After controlling for pre-test scores, a significant difference emerged between the groups (P<0.001, Eta=0.48), indicating that 48% of the variance in parents' hopefulness scores could be attributed to the effects of the family-centered empowerment model.
Conclusion: Considering the effectiveness of the family-centered empowerment model in enhancing parents' hopefulness, as well as the crucial role that parents play in caring for mentally retarded children, this low-cost and effective intervention should be incorporated into programs aimed at supporting and empowering these parents.
Clinical trial registry: IRCT20191229045934N1
Simin Kokabiasl, Ali Navidian, Nasrin Rezaee, Milad Amiri, Mahnaz Ghaljeh,
Volume 31, Issue 2 (7-2025)
Abstract

Background & Aim: Cognitive disorders and anxiety are known to adversely affect students' academic progress. Interventions that can be self-administered are particularly advantageous. This study aimed to evaluate the effect of mental imagery on anxiety levels and cognitive impairment among at Zahedan University of Medical Sciences.
Methods & Materials: This quasi-experimental study involved a sample of 100 students selected through convenience sampling and subsequently randomly assigned to either an intervention or control group. Data collection was conducted using personal information forms, the Beck Anxiety Inventory, and the Broadbent Cognitive Dysfunction Questionnaire. The intervention group attended an initial in-person session designed to familiarize participants with the mental imagery technique, followed by eight sessions of imagery training delivered via audio files on WhatsApp. After a two-week interval, both groups completed the anxiety and cognitive dysfunction questionnaires again. No intervention was administered to the control group. Data analysis was performed using descriptive and inferential statistics with SPSS version 21.
Results: The results demonstrated a statistically significant reduction in both anxiety and cognitive impairment within the intervention group (P<0.05). In contrast, the control group showed no significant change (P>0.05). The analysis of covariance, controlling for baseline pre-test scores, revealed that post-intervention mean scores of cognitive impairment and anxiety differed significantly between the two groups (P<0.001).
Conclusion: Mental imagery training appears to effectively reduce anxiety and cognitive impairment among students. Therefore, educational authorities may consider incorporating this intervention to enhance students’ mental well-being and cognitive functioning, thereby potentially improving academic performance.

 
Mehrnaz Miri, Mahnaz Ghaljeh, Farnoosh Khojasteh, Benyamin Saadatifar,
Volume 31, Issue 3 (9-2025)
Abstract

Background & Aim: Hypertension is a common, often asymptomatic chronic disease that can lead to severe complications if not properly controlled. Patient education plays a vital role in improving blood pressure management and preventing related complications. This study aimed to compare the effects of mobile health (mHealth) and face-to-face education on treatment adherence among patients with hypertension.
Methods & Materials: This quasi-experimental study was conducted on 110 patients with hypertension referred to teaching hospitals in Zahedan, Iran. Participants were selected using convenience sampling and randomly assigned to two groups. Data were collected using a demographic questionnaire and the Hypertension Treatment Adherence Questionnaire. In the mHealth group, patients received educational content via the Eitaa messaging application, and the adherence questionnaire was completed six weeks after the final message. In the face-to-face group, educational sessions were held once a week for three consecutive weeks, and the same questionnaire was administered six weeks after the last session. Data were analyzed using SPSS version 26 with independent and paired t-tests, chi-square test, Fisher’s exact test, and analysis of covariance (ANCOVA). A P-value<0.05 was considered statistically significant.
Results: Before the intervention, there were no significant differences between the two groups in total adherence scores and most of its subdimensions (except for dietary adherence). After the intervention, however, the difference between the two groups became statistically significant (P=0.001).
Conclusion: Both mHealth-based and face-to-face education effectively improved treatment adherence among patients with hypertension. However, mHealth-based education provides the additional advantage of flexible and continuous access to educational materials anytime and anywhere, making it a practical alternative for patient education.

 
Faeghe Shiranni, Mostafa Roshanzadeh, Somayeh Mohammadi, Zahra Tahmasebi,
Volume 31, Issue 3 (9-2025)
Abstract

Background & Aim: Nurses need up-to-date professional knowledge to deliver high-quality performance. Since knowledge within healthcare organizations requires effective management, identifying the level and relationship between knowledge management and nursing performance can play an important role in bridging the gap between knowledge and practice. Therefore, this study aimed to determine the relationship between knowledge management factors and nursing performance among nurses.
Methods & Materials: This descriptive-analytical study was conducted in 2023 at Shahrekord University of Medical Sciences. A total of 200 nurses working at Valiasr Hospital in Borujen were selected through simple random sampling. Data were collected using a demographic questionnaire, the Choi Knowledge Management Standard Questionnaire, and the Ko Nursing Performance Questionnaire. Data analysis was performed using SPSS version 16, employing independent t-tests, one-way ANOVA, and linear regression.
Results: The mean and standard deviation of knowledge management factors were 98.55±15.8, and the mean and standard deviation of nursing performance were 105.74±25.7. Pearson’s correlation coefficient indicated a significant positive relationship between knowledge management factors and nursing performance (r=0.72, P<0.001). The coefficient of determination (R²=0.518) showed that approximately 52% of the variance in nursing performance could be predicted by knowledge management factors (P<0.05).
Conclusion: Training in the knowledge management process and emphasizing dimensions such as promoting a culture of knowledge sharing, improving nursing management systems with a focus on process enhancement, and fostering creative management approaches can enhance knowledge management and thereby improve nursing performance.

 
Arezoo Rozbahani, Salam Vatandost, Bijan Nouri, Parvin Mahmoodi,
Volume 31, Issue 4 (1-2026)
Abstract

Background & Aim: The health of nurses’ work environments can influence their clinical competence and accordingly the quality of care they provide. Therefore, this study aimed to determine the relationship between a healthy work environment and clinical competence among nurses working in intensive care units of the teaching hospitals affiliated with Kurdistan University of Medical Sciences in 2023.
Methods & Materials: This cross‑sectional study was conducted using a census method on 245 nurses working in the intensive care units of Kosar, Tohid, and Besat teaching hospitals in Sanandaj during the winter of 2023. Data were collected using a demographic and occupational information form, as well as the Healthy Work Environment and Clinical Competence questionnaires. Data analysis was performed using STATA software version 12, using independent t‑test, one‑way analysis of variance (ANOVA), and Kruskal-Wallis statistical tests.
Results: In the present study, 198 nurses (81.1%) reported their work environment health as low, 43 nurses (17.6%) as favorable, and only 3 nurses (1.3%) as very favorable. Nurses reported their clinical competence as good (86.5±2.72). No statistically significant relationship was found between a healthy work environment and overall clinical competence or its dimensions (P>0.05).
Conclusion: The lack of a significant relationship between a healthy work environment and nurses’ clinical competence in this study does not diminish the importance of providing a healthy work environment for nurses. The findings indicated that the level of work environment health was not desirable, whereas nurses’ clinical competence was good. Considering the importance of a healthy work environment, implementing measures to improve work environment health is essential.
 
Zohre Maryami, Shahla Faal Siahkal, Razieh Peighambardoost,
Volume 32, Issue 1 (4-2026)
Abstract

Background & Aim: Fertility is one of the most important phenomena determining population changes and fluctuations. Therefore, considering the population decline in the world, including in Iran, this study aimed to determine the effect of e-learning on childbearing tendency in childless and single-child women.
Methods & Materials: In this experimental study, two-stage random sampling was performed on 128 childbearing-age women without children or with only one child (64 in the intervention group and 64 in the control group) from four health centers in Marand County in 2023–2024. The intervention group received e-learning in four sessions (one session per week) remotely via the Eitaa messenger. The control group received routine care. Childbearing tendency before and after the intervention was evaluated in both groups using Mann-Whitney and Wilcoxon statistical tests in SPSS version 24.
Results: The median scores of childbearing tendency in the intervention group before the intervention were 59.0 (range: 52.5-64.5) and one month after e-learning were 68.5 (range: 62.0-73.0). In the control group, the median scores were 64.0 (range: 58.0-69.0) before and 64.5 (range: 58.0-69.0) after the intervention. Statistical tests showed a significant improvement in childbearing tendency after the training (P<0.001).
Conclusion: The improvement in childbearing tendency resulting from e-learning can help enhance women's inclination toward childbearing.
Clinical trial registry: IRCT20190826044621N2
 

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