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Background & Aim: Nurses can support the patients’ rights advocacy, if they are informed of these rights. Furthermore in order to exercise and protect of these rights, the working environment should be appropriate.

Methods & Materials: The aim of this descriptive analytical study was to explore the nurses’ awareness of patients’ rights in Tehran teaching hospitals and the facilitators of observing theses rights from their perspective. To achieve this, 517 nurses were selected using multi stage stratified sampling method. Data were gathered utilizing a researcher made questionnaire with 3o statements regarding patients’ bill of rights, and an open question about patients’ rights facilitators at the end.

Results: The findings indicated that overall nurses had a high level of awareness regard patients’ rights. In addition nurses mentioned 17 factors as facilitators of patients’ rights practice. These were classified to three groups: organization related, personnel related and client/ patient related factors. The most frequent items were in the group of organization related factors.

Conclusion: Despite of nurses’ high awareness of patients’ rights, observing these rights in practice needs many other requirements. These requirements should be recognized and identified. This can be the first step for finding proper solutions by all health care providers and policy makers as well.

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Background & Aim: Development of an integrated health information system in order to prioritization of needs, sources devoting, diseases surveillance detecting and early responding is very important. Therefore, this comparative study has been done about natural disaster health information systems in Iran, Japan, and U.S.A in 2005. The aim is to provide logical proposes to reinforce for developing the Iranian natural disaster health information system.

Methods & Materials: This is a descriptive and comparative study that was accomplished in form of cross sectional survey. The data was extracted from literature, papers, Iranian & foreigner journals, e-mails and other related document.

Results: Natural disaster health information system in U.S.A illustrates that there is integration and consistency between responsibilities and roles are played between involving organizations and entities. The required data for natural disaster health information system collected through National Electronic Disease Surveillance System, Pulse Net, Bio Watch, Bio Net, Syndromic Surveillance System, and “the American Red Cross-Centers for Disease Control and Prevention health Impact Surveillance System” in U.S.A and Early Estimation System and Emergency Measures Support System in Japan and Diseases Surveillance in Iran. However, in spite of U.S.A and Japan there is no classification system in Iran.

Conclusion: According to the results, Iranian natural disaster health information system can be improved by using of different data gathering methods, systems and soft wares, also applying of geographical information system and establishing health and natural disaster network and using of classification of diseases advised to up grade natural disaster health information system for Iran.

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Background & Aim: Item analysis is a process in which both test items (questions) and students&apos answers are examined in order to assess the quality and quantity of the items and test as a whole. The purpose of this study was to investigate the effect of analysis of multiple choice test items of summative exams on quality of the test design by faculty members of Tehran Nursing and Midwifery School.

Methods & Materials: A quasi experimental method (pre-test and post-test) without control group was used in this study. After a pilot study, 33 nursing faculty members of school of nursing and midwifery at Tehran University of Medical Sciences were chosen through census sampling. Then one of their exams designed in the second semester (83-84) were chosen to be analyzed. The analysis results were reported to the faculty members. Then their designed tests for the next semester were analyzed again. The analysis was carried out using a checklist which included item structure, whole structure of exam, content validity, and levels of thinking skills reflected in questions and criteria for holding an exam. Moreover, for the quantitative analysis of questions, item difficulty and discrimination index were calculated. Item distracter analysis was examined by calculating the percentage of examinees who selected incorrect alternatives. Integrated t-test, Pearson and Spearman correlation coefficients, and Fisher&aposs exact test were used for the statistical analysis.

Results: 1056 questions before presenting the feedback and 803 questions at the end were analyzed and then the results were compared. According to the results, there was a significant difference between before and after intervention in variables item structure (P<0.001), levels of thinking skills (P<0.05), and item distracter analysis (P<0.001).While there was not significant difference between item difficulty, discrimination index, whole structure of exam, content validity, and criteria that should be considered on holding of an exam. Although, Pearson correlation coefficient showed that variables such as age (r=-0.535, P=0.004), and years of services (r=-0.546, P=0.003) with difficulty index were statistically significant.

Conclusion: The results emphasized that item analysis, providing feedback to the faculty members and offering educational booklets to assist them were effective means on improving some qualitative and quantitative items analysis measures.

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Background & Aim: Diabetes is the most common disease due to metabolism disorder with long term complications. Self-care is a basic factor in control of the disease. If diabetic patients perceive the benefits of self-care behaviors, then the perceived barriers will decrease(net benefit)  and the likelihood of engaging in self-care behaviors will increase. This study was carried out with the aim of determining perceived benefits/barriers to self-care behaviors and it&aposs relation with practicing self-care behaviors among diabetic patients referred to Yazd diabetes research center.

Methods & Materials: This is a cross-sectional study. Study subjects (n=120) were selected among patients referred to Yazd diabetes research center. Data were collected using a two-section questionnaire. The first section was to assess demographic characteristics of the subjects and the second section was to assess perceived benefits and barriers and self care behaviors constructs.

Results: Perceived benefits score among the patients was 88 per cent and perceived barriers score was 27.75 per cent. Self-care behavior was done by 62.79 per cent of the patients. There was a significant relationship between perceived benefits and diabetes duration. Perceived benefits was also positively correlated with self care behaviors (P=0.01). There was also a negative correlation between perceived barriers and self-care behaviors (P=0.01). Net benefit also had a direct correlation with self-care behavior with P=0.01. Perceived benefits and perceived barriers also had a negative correlation with each other with P=0.01. Perceived benefits and barriers accounted for 28.2 percent variance of self-care behaviors.

Conclusion: Perceiving benefits of self-care behaviors by diabetic patients will cause an increase on practicing self-care behaviors and this will be more possible if the barriers to self-care behaviors be minimized. Therefore, for promotion of diabetic patients&apos quality of life, attention to these important factors is recommended.

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Background & Aim: Asthma, as a chronic respiratory disease, is a major health problem worldwide. The quality of life of asthmatic patients is affected by long-term treatment and continuous episodes of asthmatic attacks. The aim of this study is to assess the quality of life in asthmatic patients.

Methods & Materials: This descriptive study carried out among randomly selected asthmatic patients (n=386) referred to lung clinic in Imam Khomeini hospital, Tehran. Data were collected using a two-section questionnaire. The first section was to assess demographic characteristics of the subjects and the second section was to assess the quality of life. Validity of the questionnaire was evaluated using content validity and reliability was determined using a-kronbach.

Results: The results showed that the majority of subjects were female, married, illiterate, and in the 41-50 age group. 45.1 per cent of study subjects had relatively appropriate quality of life. Quality of life in 45.3 per cent of the patients was inappropriate. There were significant statistical relationship between sex, age, education, economic status and quality of life (P<0.05).

Conclusion: According to the findings, in general, quality of life was inappropriate and relatively appropriate. So comprehensive programs for treatment and care of these patients should be planned.

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Background & Aim: Women with high risk pregnancy experience changes in their personal, family, and social life that affect their quality of life and mental status. The aim of this study was to determine the effect of type of pregnancy (normal or high risk) on quality of life and depression levels in pregnant women.

Methods & Materials: In this case-control study, a total of 100 women (50 women with normal pregnancies and 50 women with high risk pregnancies) who referred to the prenatal clinics of Kashan Medical University were studied. Subjects were randomly selected and then allocated in the normal (control) or high risk (case) groups. Data were gathered using a three-part questionnaire that included demographic characteristics, the Short Form 36 Health Survey (SF-36) to assess the quality of life, and the Beck Depression Inventory (BDI) to assess the levels of depressive symptoms. 

Results: In this study, the results revealed that the mean score of the quality of life was lower in the women with high risk pregnancy (53/20±16/83) in comparison with the women with normal pregnancy (62/18 12/48). The mean of the BDI scores in high risk pregnancies (15/34±9/15) were significantly higher than in normal pregnancies (9/8±5/44). Depression has strong negative correlation with quality of life in both women with high risk and normal pregnancies (P<0.001).

Conclusion: To sum up, it is very important to identify women that are at risk and help them to promote their quality of life.

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Background & Aim: Due to increasing urbanization, diet changes, and sedentary lifestyle in today&aposs world, the incidence of certain chronic diseases is dramatically increased. This study is designed to investigate the lifestyle of nurses as individuals that play an important role in educating healthy lifestyle in different groups of people.

Methods & Materials: This cross-sectional study was carried out on 300 nurses working in Shiraz University Hospitals as study group. Subjects were selected through stratified random sampling by means of a questionnaire including different questions about lifestyle. The statistical tests of the 11.5 version of SPSS software were used for data analysis these tests included t-test, One-Way ANOVA test, Kruskal Wallis H-test and Spearman correlation.  P-Value was considered statistically significant at >0.05.

Results: Research analysis showed that 54% of the study group had average conditions in their diet, 60.3% had moderate physical activity and 76% had intermediate and poor conditions in mental health. 44.6% of individuals had got poor grades in personal health care and 62% had got poor grades in disease prevention activities. 96.3 per cent of nurses did not smoke and 95.7 per cent of individuals did not ever consume alcohol.

Conclusion: According to the results of this study, nurses, in spite of being educated and having important role in patients&apos education, do not have desirable lifestyle.

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Background & Aim: It is important to identify modifiable causes of preterm delivery and low birth weight which are strong predictors of infants&apos later health status and survival. Research findings show that there are less low birth weight and preterm labors in the communities that have high intake of sea food. Consumption of Sea foods rich in w3 fatty acid can increase birth weight by prolonging gestation and reduce the risk of occurrence of preterm delivery.

Methods & Materials: In this prospective cohort study, samples (n=1200) were selected among pregnant women with different pattern of seafood intake at 16^th week of pregnancy receiving routine antenatal care in Gilan prenatal clinics. Subjects were selected by random sampling method. Women who had risk factors for preterm delivery or fish allergy were excluded. During 2004-2005 the pregnant women were visited monthly to determine their dietary habits (seafood intake). Infants&apos weight and mothers&apos gestational age were determined at the time of delivery. Data were collected by means of a validated self-determined questionnaire and a check- list.  Statistical analysis was carried out using SPSS statistical software package.

Results: Results showed that the per cent of term delivery (more than 37 gestational weeks) in women with more than 3 times, 1-3 times, and less than once sea food intake in a day is respectively 94.5%, 91%, and 91.5%. Moreover, birth weights more than 3000 gram in the neonates of these women were respectively 75.7%, 74.7%, and 71.2%. There was significant relationship between more than 3 times consumption of sea food in a month with gestational age (P<0.001) and birth weight (P<0.05).

Conclusion: Sea food consumption is effective in decreasing preterm delivery and low birth weight. Related nutritional educational programs for pregnant women are recommended.

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Background & Aim: Hemodialysis centers are highly susceptible to nasocomial infections due to application of hemodialysis machines, medical equipment, and invasive techniques and devices. This research was carried out in order to evaluate methods of infection control using by staff of hemodialysis centers.

Methods & Materials: In this descriptive study, all hemodialysis units in hospitals of Tehran University of Medical Sciences (n=4) were studied. Data were gathered using a 3-section questionnaire as well as five series of check-lists that were designed to evaluate physical characteristics of the units, methods of disinfection processes of the units, hemodialysis machines, and common equipment, and finally precaution measurements using by the staff. Data were described using SPSS statistical software.

Results: Research findings showed that just one of the study units was appropriate regarding physical characteristics of the units. Method of disinfection of hemodialysis centers was appropriate in 50 per cent of the study units and it was relatively appropriate in the rest. Disinfection of hemodialysis machines was appropriate in all units. Regarding disinfection of the shared equipment, all units were relatively appropriate. In 25 per cent of the units, staff had relatively appropriate precaution measurements and the rest (75 per cent) had inappropriate measurements.

Conclusion: Results showed that the methods of infection control using by the staff of hemodialysis centers in hospitals of Tehran University of Medical Sciences were not appropriate.

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Background & Aim: Working conditions in some professions particularly among health care providers result in exposure to various stressors in daily work life that can affect mental health status. Regarding specific conditions that midwives encountered in their workplace, this study investigates mental health status among midwives working in Tehran&aposs public hospitals and its related factors.

Methods & Materials: In this cross-sectional study all midwives working in Tehran&aposs public hospitals who had inclusion criteria (n=370) were studied. Data were gathered using GHQ-12 questionnaire and then were analyzed using chi-square statistical test.

Results: The results showed that 35.1% of subjects had not good mental health. Midwives&apos mental health was significantly related to their educational level (P<0.001), economic statue (P=0.04), marriage status (P<0.001) and shift work (P=0.02).

Conclusion: Regarding high prevalence of poor mental health status among midwives, it is recommended to investigate related occupational factors in order to improve working conditions of midwives working in hospitals.

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Background & Objective: The chronic diseases such as cancer could seriously affect health and consequently quality of life of individuals. The purpose of this study is to evaluate the quality of life in the patients who have been recently diagnosed with caner.
Methods & Materials: This research is a descriptive - analytical study aims to determine quality of life in newly diagnosed cancer patients in selected oncology clinics of Tehran University of Medical Sciences. In this research, 196 newly diagnosed cancer patients were selected by simple sampling method and based on aim. The data were collected by a questionnaire including demographic data, disease characteristic and questions about quality of life in physical, physiological and socioeconomic aspects. The socioeconomic questionnaire presented to the patients after his/ her permission and giving necessary descriptions to him/ her about the objectives of the research. The questions were read for illiterate patients by researcher. The SPSS program was used for data analysis. Descriptive statistics such as absolute/ relative and average sufficiency and deductive statistics such as 2 test were used as well.
Results: The research results show that the quality of life in physical aspect is desirable in majority (67/9%) of patients. The quality of life in physiological aspect is desirable in majority (63.3%) of patients and as well the quality of life in socioeconomic aspect is desirable in majority (76.5%) of patients. The research conclusion shows that there is a meaningful relationship between number of children and economic status (P<0.001) and quality of life in physical aspect. There is a meaningful relationship between economic status with quality of life in psychological aspect and with quality of life in socioeconomic aspect (P<0.05). There is a meaningful relationship between type of cancer, disease stage at the time of diagnosis (P<0.001), and quality of life in physical aspect. There is a meaningful relationship between disease stage (P=0.002), and quality of life in psychological aspect and quality of life in socioeconomic aspect (P<0.05).
Conclusion: The research result shows that the quality of life in physical, psychological and socioeconomic aspects is desirable in the society. Thus the nurses can play an important role in increasing the quality of life of such patients.

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Background & Objective: Administrators have to pay attention to nurses as an important group among hospitals employees in order to have better patient outcomes. Recently, nurses&apos quality of work life is a new concept that attention to it can improve organizational efficiency. This research is to investigate the quality of work life of nurses at Tehran University of Medical Sciences Hospitals in 2005-2006.

Methods & Materials: This is a cross-sectional study. The research was conducted among 349 nursing employees. Data were gathered using a questionnaire consisted of 30 elements of QWL. The respondents were asked to determine their overall quality of work life. Validity of the questionnaire was evaluated using content validity and reliability was determined using test-retest method. Statistical analysis was carried out using SPSS statistical software package.

Results: The results showed that the majority of nurses were dissatisfied with environmental health and safety at work, monetary compensation and job welfare. There was significant correlation between the executive position of nurses, years of experience and their salary (P<0.05).

Conclusion: The study findings showed that nurses had a poor quality of work life. This indicates that majority of employees are unsatisfied with the most aspects of their quality of work life.

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Background & Objective: Dysmenorrhea is a common problem in young women that affect their activities. Various alternative methods including relaxation have been proposed to manage primary dysmenorrheal. The objective of this research is to study the effects of relaxation on primary dysmenorrhea among first year nursing and midwifery female students at Tehran University of Medical Sciences.

Methods & Materials: This is a quasi-experimental study. The samples (n=80) were randomly assigned in two groups. Experiment group (N=40) received the relaxation technique. Relaxation technique was done twice a day each section lasted 20 minutes for 3 menstruation cycles. The questionnaire on pain measurement were completed in the first, second and third day of cycle. Control group (N=40), completed questionnaire in the same days. Data were analyzed using SPSS software and tested using chi-square, t-test - Willcoxcon and fisher exact tests.

Results: The result showed that relaxation therapy had no significant effect on primary dysmenorrhea in the first (P=0.149) and second cycles (P=0.390) in the Experiment group. It had a significant effect on primary dysmenorrhea in third cycle (P=0.023).

Conclusion: The results showed that relaxation technique is an effective method in reducing the symptoms of primary dysmanorrhea in the young women.

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Background & Objective: Studies show, clients&apos satisfaction is an important indicator for service quality assessment. Finding causes of dissatisfaction helps to promote health care services quality.  High quality prenatal care services and clients&apos satisfaction decreases maternal and neonatal mortality and morbidity. The perceived quality of the prenatal care by the mothers can not be effectively evaluated unless considering the opinions, demands and satisfaction rate of mothers who receive the care. The objective of this study is to measure prenatal care utilization rate and patients satisfaction in the clinics of Tehran University of Medical Sciences in 2005.

Methods & Materials: In this cross-sectional study, 380 pregnant women who had received prenatal care services in two hospitals and eight health centers were selected randomly and interviewed. Data were gathered using a questionnaire including demographic characteristics and satisfaction questions. Data were analyzed using SPSS and tested with chi-square and Pearson exact test.

Results: According to the results, 53.4 % and 14.8% of the pregnant women had received complete and incomplete prenatal care, respectively. Most of the pregnant women (54.7%) were completely satisfied, 23.7% and 21.6% were moderately and poorly satisfied, respectively. There was a significant relationship between the utilization rate and satisfaction of mothers (P<0.001). 53.4% of mothers in health centers and 46% in hospitals had received complete prenatal care. Satisfaction with prenatal care in health centers and hospitals were 57.5% and 47%, respectively. This difference was probably related to the amount of emotional and physical care received by the patients in the different settings and the characteristics of the centers in which these services are provided. The kind of setting had significant relationship with the utilization and satisfaction rates (P=0.003, P=0.005, respectively). The results showed that the utilization and satisfaction rates in the health centers in which health-care providers were midwives were better than the hospitals in which health-care providers were medical and midwifery students. But in both settings it was lower than 60%.

Conclusion: As a result, the utilization rate and satisfaction of mothers were inadequate in health centers and hospitals (lower than 70%). In the hospitals, they were lower than the health centers. The standardization of prenatal care and improvement of educational programs in hospitals should be considered.

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Background & Objective: Research utilization is a new phenomenon in Iran and the Iranian nurses tend to practice based on evidences. The objective of this research is to investigate nurses&apos attitude toward research utilization.

Methods & Materials: This research is an analytical-descriptive study. The sample included 410 clinical nurses and instructors who were selected through multistage stratified sampling method. Data were gathered using a two-section questionnaire and analyzed using statistical package for social sciences (SPSS).

Results: 91.2% of respondents believed in using research findings in practice. 77.6% of nurses agreed with the following statement: "Research is not applicable in practice". Furthermore 88.3% agreed that" Research helps to build a scientific base for nursing". The majority of respondents had positive attitude toward research utilization. There was a significant difference between attitude and kind of professional activity, setting and research activity.

Conclusion: It seems having positive attitude toward research utilization is not sufficient for applying research results in practice. In order to utilize the research findings, more relevant research in this field of nursing is required.

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Background & Objective: According to Iranian national statistics, every year 400 to 500 thousand unwanted pregnancies occur in Iran. The emergency contraceptive methods are easily accessible and affordable for the women of this region. Regarding the important role of health care providers in representing these methods, this study is to determine the knowledge and attitudes of these staff toward required contraceptive methods.

Methods & Materials: In this semi-experimental study, 216 health personnel working in south of Tehran health centers were randomly selected. Two 30- minute educational sessions were presented to the staff. The methods of education included face to face, and group discussion. At the end of each session a pamphlet was given to the staff. Data were gathered using a questionnaire before and 2-6 weeks after the education. Statistical analysis was carried out using statistical package for social sciences (SPSS).

Results: The results showed that there were significant statistical differences between the knowledge and attitudes (P<0.001) of personnel about the emergency contraceptive methods before and after education. There was no significant relationship between demographic characteristics and attitudes of personnel. There was a significant relationship between sex (P<0.001), educational level (P<0.003), educational major (P<0.001), with knowledge after intervention.

Conclusion: Knowledge and attitudes toward emergency contraceptive methods increased significantly after education. This finding reveals the importance of continuous education for health care staff such as midwives and physicians to facilitate successful guidance of their patients towards effective family planning.

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Background & Objective: Nursing and Midwifery students experience different and numerous sources of stress. Stress is a complex phenomenon that may be experienced by all. Nursing and midwifery students have multiple sources of stress due to their work environment. In order to reduce their stress and prevent the complications, all sources of stress should be recognized. This study was carried out to compare sources of stress between midwifery and nursing students of Tehran universities of medical sciences.

Methods & Materials: This is a cross-sectional study. All senior midwifery and nursing students of Tehran and Shahid Beheshti Universities were invited to participate in the study (n=380). Data were collected using a questionnaire including demographic section (15 questions) and sources of stress of educational environment, clinical environment, and social-personal problems (54 items). Data were analyzed using SPSS and tested with chi-square test.

Results: 363 students participated in the study. Research findings showed that the followings are the most cited sources of stress among the students: ambiguous professional view, incompetent professional knowledge after graduation, caring for terminally ill patients, discordance between theory and clinical education, concerns about employment. Also results showed that there were significant differences between some sources of stress and the study programs.

Conclusion: The nursing and midwifery students had numerous sources of stress in the educational, clinical, and social-personal domains of their life that can affect their physical and psychological health and cause learning problems. Using appropriate approaches to control and manage these sources of stress are recommended

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Background & Objectives: Successful breastfeeding is the result of right patterns of breastfeeding. This research aimed to study the patterns of breastfeeding in infants in Ray health centers.

Methods & Materials: This is a descriptive study. The cluster random sampling (CRS) technique was used to select 400 mothers who had children under one year. Data were gathered using a questionnaire. Validity of the questionnaire was evaluated using content validity and reliability was determined using test-pretest method. Statistical analysis was carried out using statistical package for social sciences (SPSS).

Results: The results showed that 34.5% of mothers breastfed their children exclusively for 6 months. In 58.7% of the samples, the first contact between mother and child was made in less than 2 hours. 95.2% of children were started their first feeding with colostrums and 59% of mothers fed their children with Manna and 54% with sugary water and 39.5% gave them water. 81.5% of children were breastfeed on demand and 18.5% of them were feed two to four times a day. There was no significant relationship between parent&aposs knowledge, child&aposs sex, parent&aposs age, child&aposs rank in the family and child&aposs race with breastfeeding (P>0.05).

Conclusion: The results showed that the mothers had wrong beliefs, low knowledge and inappropriate practice on breastfeeding.

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Background & Aim: Performance appraisal is one of the most important duties for nursing managers. This will improve the quality of nursing care, and it needs suitable approaches and effective strategies in nursing services. The aim of this study is to determine the impact of performance appraisal using management by objective approach on nursing care quality.

Methods & Materials: This was a quasi-experimental and single-blind study that was carried out in two surgical units of an affiliated hospital of Tehran University of Medical Sciences. 80 patients were selected using a randomized sampling. The quality of nursing care were controlled in both experiment and control units before and after the performance appraisal procedure. The procedure was programmed on the basis of management by objective approach for six months in the experiment unit. In the intervention unit, nursing performance appraisal was done three times and in every time head nurse and supervisors participated in giving feedbacks and recommendations for the nurses. At the end of the intervention, quality of nursing care was assessed in both groups blindly. The results were compared and statistically analyzed.

Results: Significant difference was found between quality of nursing care in the experiment and control units (P<0.001). Quality of nursing care was significantly different before and after intervention in the experiment unit (P=0.009).

Conclusion: Performance appraisal using management by objective approach could increase the quality of nursing care. As a result, using nursing performance appraisal plans according to the basis of MBO could be an effective evaluation way to access the quality of nursing care.

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Background & Aim: Obesity is increasing dramatically world-wide not only in adults, but also in children and adolescents. Nutritional and physical activity behaviors are related to the prevalence of obesity. Determining adolescents&apos behavioral patterns is important in preventing and adjusting this healthy problem. This study was carried out to assess lifestyle behaviors among girl adolescents and to determine the association between these behaviors and perceived parental lifestyle behaviors.

Methods & Materials: In this cross-sectional study, 270 students were selected using multistage random sampling from girls&apos schools in the areas covered by Tehran University of Medical Sciences. Data were collected using a questionnaire. Descriptive and analytical tests were used to analyze the data.

Results: Results showed that the mean age was 13.3 (10.7-16) years. Most of the adolescents&apos had normal limits of BMI. Only 9.2% of adolescents had optimal dietary behavior and 4.3% were physically active. There was not significant relationship between their nutritional behavior and their perceptions about parents&apos lifestyle. BMI and parents economic status was related to nutritional behaviors significantly. Physical activity was statistically related to BMI and mothers&apos education.

Conclusion: This study showed that the adolescents&apos nutritional and physical activity behaviors were not healthy. Some factors are related to the adolescents&apos healthy behavior. Teaching healthy behaviors and defining healthy behavioral patterns for adolescent are necessary.