Introduction: Children&aposs health is an important issue in activities of many international organizations. To prepare the children to understand and practice the ways of healthy life, the schools should play their important role by planning and performing effective health education programs.         

Materials and Methods: This research is an analytical-descriptive study. The samples included 330 students who were selected through multistage stratified sampling method. The data was gathered by a questionnaire and were analyzed by using the inferential and descriptive statistics.

Results: The results showed that there was no statistically significant difference between health behaviors of students in schools with and without health educators in the domains of eye and skin health, nutrition, sleep, rest and physical activity, but there was a significant difference between health behaviors related to ear (2=8.58, p=0.014) and tooth (2=9.35, p=0.009) the students with educator had healthier ear and tooth behaviors than students who didn&apost have educator. In the domain of mouth and tooth the girls had healthier behaviors than boys. In the domain of physical activity the boys had better health behaviors than girls, having educator or not.

Conclusion: Overall, there was no significant difference between health behaviors of students in schools with and without health educators. Formation of healthy behaviors is a multifactorial issue and survey of all factors and variables affecting health behaviors can provide clearer measures for planning the health education programs and optimum usage of resources, manpower, budget and time to promote awareness and performance of health behaviors in schools.

Background & Aim: Epilepsy as the most important chronic neurological disease affects on child and his/her family therefore it can lead to occur some stresses in family particularly in parents. This study has been done to determine ideas of parents with epileptic children about stressors and their coping with this agent in those who come to the optional therapeutic centers in Tehran.

Methods & Materials: This is a descriptive-analytical research which 400 parents with epileptic children were selected based on aim. The method of collecting data was by questionnaire for literate persons and by interview for illiterates whose research tool was questionnaire. The questionnaire was prepared in three parts (demographic information’s, stressors questions, and coping questions for parents with epileptic children. The data was collected in one stage and analyzed with SPSS software. To analyze the data, descriptive and inferential statistical methods (t-test, analyze variance) have been used.

Results: Statistical analysis showed that there is significant differences in stress between parents (p=0.001). The most percentage (86%) of fathers in comparison mothers (81.9%) have moderate level of stress and least percentage (5.4%) fathers and (4.4%) of mothers have low level of stress. The level of stress in parents showed significant correlation with personal variables. Most percentage (69%) of fathers and mothers (66.1%) have low-moderate level of coping and it has significant correlation with some personal variables. The analyze variance test showed that there was significant and converse relationship between stress and coping in parents with epileptic children and increasing stress lead to decrease coping. Conclusion: The results of this study have been shown that the stress in father of epileptic children is more that mothers however there is no significant differences in the level of coping.

Background & Aim: Health is one of the vital concepts in every society which is affected by several factors including age, gender and social situation of the people. Individuals&apos perception of health concept is also of paramount importance. The main objective of this study is to determine health concept perceptions and health promoting behaviors among Tehran University medical and non-medical students

Methods & Materials: This is a descriptive- analytical study. Four hundred medical students and four hundred non-medical students were recruited for the study using stratified sampling. A three-section self-evaluating questionnaire including demographic information, health perception information and health promoting behaviors information was used to gather data. Data were analyzed using descriptive statistics, t-test and Pierson Correlation Coefficient.

Results: 49.7 percent and 6.8 percent of the medical students had good and excellent perceptions about health concept, respectively. In non-medical students, it was 49.4 percent and 8.6 percent, respectively. 57 percent of the medical students and 54.9 percent of non-medical students had good health promoting behaviors, respectively. There was significant relationship between perceptions of health concept and health promotion behaviors among both groups (P<0.001).

Conclusion: Based on the results, there is a direct relationship between perception of health concept and health promoting behaviors among both groups. There is no difference in all aspects of health promoting behaviors, except for cigarette smoking in which the medical students showed more healthy behaviors.

Background & Aim: Nutrition is a very important factor in toddler age growth. Getting started the first steps of the children with family in this period shows the necessity of paying attention to the correct nutritional behaviors. Therefore this research has been conducted for assessing the effect of nutritional behavior model on the quality of toddler&aposs nutrition and performance of their mothers.

Methods & Materials: This research is a semi-experimental study, in which sixty six children (12-36 months old) were selected from two health care centers in the southern part of Tehran. The subjects were selected using non probability-convenient sampling method. The data gathering tool was 3 questionnaires: 1. Mother and child demographic characteristics 2. Mother&aposs function assessment tool about toddler&aposs behavior during feeding 3. Reminding tool of 24 hours food. The tools were filled in using interviews. Then nutritional behavior model was instructed in a workshop during 2 days, 3 hours a day. After the intervention data were recollected again and were analyzed by descriptive and inferential statistics.

Results: The results showed a significant difference in mother&aposs function about toddlers nutritional behavior during nutrition before and after the intervention (P<0.001). Also a significant difference was seen in the toddlers nutrition pattern before and after the intervention (P<0.05).

Conclusion: Based on the research findings it can be concluded that nutritional behavior model is effective in improving the pattern of toddler&aposs nutrition and in increasing mothers&apos knowledge related to a correct function on toddler&aposs behavior during feeding. Therefore educational plan to mothers on correct nutritional behaviors is suggested in order to improving the quality of toddler&aposs nutrition.

Background & Aim: Healthy behaviors of teenagers are effective on the community development. This study was carried out in order to compare healthy behaviors of female teenagers living with their families and in orphanage centers in Tehran.

Methods & Materials: This was a cross-sectional study. The subjects were consisted of 110 female teenagers that 55 of them dwelled in the orphanage centers and the remaining lived with their families. Both groups were studying at the same schools. Samples were selected using stratified random sampling method. Questionnaire was used to gather data. The data were analyzed by descriptive and analytical statistical methods in SPSS software.

Results: There were statistically significant differences between two groups in nutrition (P<0.0003), sleep & rest (P<0.001), physical exercise (P<0.0013), and individual health (P<0.001). Total score of health behaviors were 112.3, and 87.8 in family group and orphanage group respectively (P<0.001).

Conclusion: The average score of health behaviors in girls that reside in orphanage centers was lower than the score of them who lived with their families. This shows the necessity of planning educational and managerial tools to improve their healthy behaviors.

Background & Objective: Osteoporosis is a metabolic disease which results from gradual destruction of bone mass. Prevention of osteoporosis should be started from childhood by getting adequate calcium and doing weight-bearing exercises. Participating of mothers in health education interventions is likely to promote longer-lasting health behaviors in their daughters. The aim of this study was to investigate the effect of simultaneous education of mothers and daughters on osteoporosis preventive behavior among high school female students.

Methods & Materials: In this interventional study, 400 female students were randomly selected via a two-phased sampling method. At first stage, four schools were selected randomly. At the second stage, 400 students were divided randomly into two groups. Their osteoporosis preventive behaviors were measured using a two-sectioned questionnaire: demographic section, and osteoporosis preventive behaviors assessment section. The first group participated in the educational programs with their mothers and the other group participated without their mothers. The educational program had two sessions, each one lasted 45 minutes. The second stage of the study was performed three months later. Data analysis was carried out using t-test and chi squared test.

Results: Results showed that in both groups, osteoporosis preventive behaviors scores increased significantly after intervention. It was higher in case group (P<0.001). Eating behavior was significantly different in two groups (P=0.003).

Conclusion: Results showed that simultaneous educational program for mothers and daughters promotes eating behavior in the girls.

Background & Objective: Physical activity is one of the main components of lifestyle. Lack of physical activity along with unhealthy eating result in chronic diseases such as heart diseases, diabetes, and osteoporosis. This study aimed to design an educational program for improving physical activity in secondary school female students in Tonkabon in 2008.
Methods & Materials: This study was an educational intervention in which 600 students enrolled in the study. The participants were allocated randomly in the intervention (n=300) and control (n=300) groups. Data were gathered using "International Physical Activity Questionnaire" and a standardized questionnaire -according to PRECEDE model- at baseline. The program was planned according to the PRECEDE model and was implemented in the intervention group students. Data were gathered two months after the intervention in both groups. Data were analyzed using Chi-Square, t-test, variance and regression analysis tests in the SPSS and STATA.
Results: Following the educational intervention, the mean scores of the predisposing factors (knowledge and attitude), enabling factors, and reinforcing factors as well as the behavior were significantly increased in the intervention group compared to the control group (P<0.001).
Conclusion: The findings showed that this structured program is useful in improving physical activity in female students.

Background & Objective: Regular and adequate physical activity is a major factor in maintaining good health throughout entire life course. Levels of inactivity are high in all countries. Effective educational interventions are needed to promote physical activity in all populations. The aim of this study was to determine the effect of a heath education intervention on physical activity knowledge, attitude, and behavior in health volunteers of Tehran in 2008.

Methods & Materials: All active female health volunteers of Tehran, district 14 (n=100) were recruited for this experimental study. Data were gathered using a questionnaire of knowledge, attitude, and behavior regarding physical activity. The questionnaire was completed by all participants in two phases of pre- and post-intervention (four weeks after the intervention). Health education intervention strategies were presented to the intervention group during three educational sessions with one week interval between the sessions. Data were analyzed using related statistical tests.

Results: Findings showed significant statistical differences in knowledge, total physical activity rate per week, and the mean sitting time per day between the control and intervention groups after the intervention (P<0.05). While, these variables were not significantly different before the educational intervention among both groups.

Conclusion: The health education intervention presented in this study was effective in promoting knowledge, total physical activity rate per week, and mean sitting time per day among the female health volunteers.

Background & Objective: Osteoporosis is a serious metabolic bone disorder and a major health concern in women. Osteoporosis affects the quality of life of women. Studying the osteoporosis related food habits and behaviors can promote health promotion program planning. It seems that female teachers are the best models and educational sources for female students. This study was carried out to determine the osteoporosis related food habits and behaviors among female teachers.

Methods & Materials: This study was a cross-sectional study in which 308 female teachers were randomly selected using stratified sampling method from the schools of the 6^th district of Tehran. Data were collected using a questionnaire and analyzed using student t-test, one-way analysis of variance and Tukey test.

Results: Mean score of osteoporosis related food habits and behaviors was 14.9±4.2 (out of a possible 24 maximum attainable score). Osteoporosis related food habits and behaviors score was significantly higher in the teachers who had higher knowledge score, aged more than 50 years old, had worked for more than 25 years , had used educational books and booklets as the first informational source, and among the post- menopausal teachers (P<0.03).

Conclusion: According to the findings, the teachers demonstrated average level of osteoporosis related food habits and behaviors, whereas their mean calcium intake was relatively adequate, but their other food habits and behaviors were relatively inappropriate. It seems developing and implementation of educational programs and offering educational booklets to teacher can help to promote their food habits and behavior which may be helpful in enhancing students&apos food habits.

Background & Aim: Pregnancy experience can be a kind of crisis in women&aposs lives. Different forms of anxiety can make problems in pregnant women. This study aimed to determine the effect of attachment education on anxiety and attachment behaviors of first-time mothers.

Methods & Materials: In this clinical trial, 84 primigravida women were selected from two hospitals in Shirazi using convenience sampling. The participants were randomly allocated to the test and control groups. Data were collected using a personal data form, the Anxiety Inventory Spielberger, and the maternal infant attachment tab view. The intervention group received four two-hour sessions during one month training course on attachment behavior. Maternal attachment behaviors were shaped Weekly on the forms. The control group received usual care of pregnancy. At the first day after the delivery, the researchers observed mothers attachment behavior during breastfeeding in all groups using Avant sheet without informing the mothers. Data were analyzed using statistical tests such as Chi-square, T-test, and paired t-test.

Results: The mean of the anxiety score was no significantly different before the intervention between the groups (P=0.59). The average anxiety scores was statistically significant after the intervention in the two groups (P=0.003). Also, average scores on the attachment of mothers with the breastfeeding infants was statistically different (P<0.001) in the intervention group.

Conclusion: Attachment behavior training reduces anxiety and increases maternal attachment.

Background & Aim: Although caring is a complex concept with various definitions, there are no agreement on the exact meaning among researchers. The aim of this study was to compare caring behaviors of nurses from patients&apos and nurses&apos perspectives.

Methods & Materials: The study was conducted among 150 patients hospitalized in Boushehr hospitals and 50 nurses caring for them. Data were collected using quota sampling method via Caring Behaviors Inventory (CBI).

Results: Findings showed that there were significant differences between patients&apos and nurses&apos perspectives on the subscales of the instrument including assurance of human presence and attentiveness to others&apos experiences. Moreover, there was significant difference in total scale of caring behaviors of nurses between patients and nurses (t=2.559, P=0.011).

Conclusion: Nurses believed that they provide care for patients without making estimations of their expectations. It seems that nurses should attend to standard care to fill the gap

Background & Aim: Quality of nursing care is a major issue in nursing management. In the last year of nursing studies (internships) in Iran, nursing students are going to independently carry out responsibilities of graduated nurses. Patients&apos satisfaction is a main indicator for nursing care quality. This study was to determine the correlation between the quality of caring behaviors among internship students with the patients&apos satisfaction with nursing care quality.

Methods & Materials: In this cross-sectional study, 200 patients were selected using convenience sampling method from the hospitals affiliated to the Tehran University of Medical Sciences. Data were gathered using two questionnaires including: 1) quality of the caring behaviors and 2) patient satisfaction with nursing care quality questionnaire (PSNCQQ). Data were analyzed using statistical tests in the SPSS-13.

Results: Regarding quality of caring behaviors, the subscale scores of the knowledge and skills were good and patient education was low. The relationship between the nurses and patients, and nursing morality were in average level. Regarding the patient satisfaction, the highest level of satisfaction was related to nursing knowledge and skills and the lowest level was related to the patient education. Significant correlation was found between the total quality of the caring behaviors with the patients&apos satisfaction and their subscales (P<0.001).

Conclusion: Based on the findings, patients are more satisfied with the caring behaviors of the students who focus on the communication with patients, nursing ethics, and especially patient education during the care.

Background & Aim: Pain is an unpleasant experience related to potential or actual tissue damage. Distraction is an effective technique to control pain. This study aimed to examine the effect of pressing a small soft ball during intravenous catheter insertion on pain related behavioral responses of children.

Methods & Materials: A randomized clinical trial study was conducted in surgical ward of the Qods hospital in Qazvin, Iran in 2010. Sixty children aged 4-6 were selected through a simple randomized sampling method. The children were allocated into two equal intervention and control groups. Data were collected using the FLACC scale. In the intervention group, children were asked to press a soft ball during IV catheter insertion. The researcher marked the FLACC during the procedure. In the control group, no distraction was made during the IV catheter placement. The data were analyzed using descriptive statistics, independent-sample t-test, Chi square at P<0.05.

Results: There was no significant difference between the two groups in terms of demographic variables including gender, birth order, race, age and type of disease. In the intervention group, none of the children experienced severe pain during IV catheter insertion and 63.3% of the children had moderate pain. In the control group, 50.0% of children had moderate pain and 23.3% of them experienced severe pain during IV catheter insertion. There was a significant difference in perceived pain between the children of two groups (P<0.001).

Conclusion: Distraction is an effective, non-expensive, and easy-to-access technique to control and reduce pain in children during IV catheter placement. This study showed that distraction through pressing a soft ball was effective in reducing the behavioral responses of pain in children who underwent IV catheter placement.

  Background & Aim: Need assessment for promotion reproductive health is important subject and development a questionnaire is essential. Thus the aim of this study was development of questionnaire of intention to use of oral contraception in withdrawal users based on construct of Theory of Planned Behavior (TPB).

  Methods & Materials : In-depth interviews were conducted to elicit the salient beliefs relevant to oral contraception among withdrawal users. Then a cross-sectional study carried out in Tehran, Iran for validate of questionnaire. Participants recruited from attending five family planning clinics of public health services in the Eastern district of Tehran, Iran. Validity and reliability was evaluated using concurrent, content validity and Cronbach's alpha and test- retest respectively. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) conducted to assess how well the EFA extracted model fits observed data. The SPSS version 16 and Lisrel programs were used to analyze the data.

  Results: Reliability and validity were confirmed. The principal component analysis revealed a three-factor structure for the questionnaire including attitude, subjective norm and perceive behavior control that explained 50.4 percent of the total of variance.

  Conclusion : In general, the findings suggest that questionnaire of intention to use of oral contraception in withdrawal users based on Theory of Planned Behavior is a reliable and valid measure.

  Background & Aim: Several studies have indicated that hospitalizing infants causes disruption on mother-infant attachment. The aim of this study was to assess the effect of infant massage by mothers on maternal attachment behavior in infants hospitalized in the neonatal care units .

  Methods & Materials: In this clinical trial, 42 mothers and their neonates were recruited and randomly allocated to the intervention and control groups. Mothers in the intervention group received training by means of educational movies about practical exercises on how to massage the infants. The trained mothers used massage techniques on their infants for five days. The process lasted 15 minutes. The attachment of the mothers on their infants was assessed before and on the day 5 after the massage. Data were collected using the scale of mother-to-infant attachment. Data were analyzed using the Chi-squared test, Fisher’s exact test and the t-test in the SPSS-19 . 

  Results: There were no differences between the two groups in terms of demographic variables and the mean of maternal attachment at baseline (P>0.05). Five days after the massage, there were statistically significant differences between the two groups in the mean maternal attachment (P<0.001) .

  Conclusion: According to the role of massage in attachment behavior, this traditional care is recommended to be used in neonatal units .

  Background & Aim: Medication usage is the bases of disease management in patients who undergo hemodialysis. Non-adherence to medication regimen increases the incidence of complications among the patients . The aim of this study was to investigate the effect of a cognitive-behavioral intervention on medication adherence in patients undergoing hemodialysis .

  Methods & Materials: In this clinical trial, 70 patients were selected from Imam Reza and Valiasr hospitals. Patients were assigned into two intervention (n=35) and control (n=35) groups. The intervention group received a cognitive-behavioral intervention including six steps: 1) Identifying the problem 2) Creating confidence and commitment 3) Increasing awareness of behavior 4) Developing and implementing the action plan 5) Evaluating the plan and 6) Maintaining the desired behavior. Adherence to medication regimen was assessed using a self-report questionnaire before and immediately after the intervention. Data were analyzed using the independent t-test . 

  Results: At baseline, there was no significant difference in adherence to medicine regimen between the intervention (20.77 ± 4.56) and control (22.34 ± 3.65) groups (P=0.1). After the intervention, significant difference was observed between the two groups in adherence to medication regimen (P<0.001) .

  Conclusion: Cognitive–behavioral intervention could improve medication adherence in patients undergoing hemodialysis. It is recommended for nurses to use this approach to improve medical care among the patients .

  Background & Aim: Breast cancer is the most common cancer diagnosed in women in both developed and developing countries. Long-term prognosis of breast cancer strongly depends on the stage of disease at diagnosis. More than three months after detecting breast symptoms by Iranian women, they go to visit a doctor. The understanding of life-threatening symptoms and the subsequent responses are differently affected by social interaction networks as well as cultural and social contexts. This study aimed to explore the role of social interactions on health-seeking behaviors among Iranian women with breast cancer symptoms .

  Methods & Materials: A qualitative study was conducted using purposive sampling method. Twenty Iranian w omen who attended the Cancer Institute in Imam Khomeini hospital at Tehran University of Medical Sciences and complained of symptoms of breast cancer were recruited to the study du ring 2012-2013. Data were collected through semi-structured and in-depth interviews. Interviews were transcribed and analyzed using conventional content analysis in the MAXqda . 

  Results: The results revealed three themes including: 1) effectiveness of social learning 2) seeking social support and 3) feedback with a supportive approach which included seven categories of informative social learning, reliable social learning, selective disclosure, seeking information, seeking emotional support , giving reassurance and social support for decision making .

  Conclusion: E ffective social learning and supportive interactions have influential role on health seeking behavior. Thus it is necessary to improve public awareness and correct clients' social beliefs about breast cancer to shorten the patients' delay .

  Background & Aim: Family caregivers play major role in caring for the patients with dementia. Meanwhile, they are at risks of various diseases. Caring for a person with Alzheimer’s disease carries a significant physical, socioeconomic and psychological burden. This study described the impact of cognitive-behavioral management on burden and problems borne by family caregivers of patients with Alzheimer's disease .

  Methods & Materials: This non-randomized controlled clinical trial was conducted on 70 family caregivers of patients with Alzheimer’s disease. The participants were subjected to experimental and control groups. The Zarit Burden Interview was used to assess the burden experienced by family caregivers of the patients. Data were then analyzed using inferential and descriptive statistical parameters (mean and SD) and paired sample t-test on the difference between the scores of pre-test and post-test . 

  Results: The mean level of caregivers’ burden as measured by ZBI was 44.56± 6.77 and 42.57±5.98, in experimental and control groups before intervention respectively. Caregivers’ burden score was 39.54±5.88 and 44.86±5.87, in experimental and control groups after intervention respectively. Results showed a significant decrease in the training group’s score (P<0.001) .

  Conclusion: Given the obtained results indicating the effectiveness of cognitive- behavioral management in reduction of caregivers’ burden, the present study can be helpful in achieving an effective solution to decrease stress among family caregivers of patients who suffer from Alzheimer's disease .

  Background & Aim: Psychological and social factors such as attachment styles may influence chronic diseases through self-care behaviors. This study was conducted to determine the relationship between attachment styles and self-care behaviors in patients with heart failure .

  Methods & Materials: In this correlational study, 180 patients with heart failure hospitalized in CCUs and Post CCUs of educational hospitals in Zahedan in 2014 were selected through convenience sampling. Data collection tools included the Experiences in Close Relationships-Revised (ECR-R) questionnaire and Self-Care of Heart Failure Index (SCHFIV6.2). Data were analyzed in the SPSS-20 using the descriptive statistics, independent T-Test, Pearson's correlation and regression analysis . 

  Results: The mean and standard deviation of self-care behaviors score of the group with secure attachment style (62.89 ± 12.66) was significantly higher than the group with insecure attachment style (40.43 ± 16.11) (P<0.05). Also, the regression model showed that the score of anxiety, attachment avoidance and age were as predictors of the self care scores in patients .

  Conclusion: Regarding the relationship between attachment styles and self-care behaviors and the low level of self-care in patients with insecure attachment style, psychological interventions should be considered through long-term treatment of chronic heart failure .

Background & Aim: Caring viewpoint is a requisite of high quality nursing care. It must be operational through the nursing education program. The present study was conducted to compare the viewpoints of undergraduate nursing students at the first, fifth, and eighth semesters about the importance of caring behaviors during their nursing education.

Methods & Materials: The present study is a descriptive-analytical study. In this study, three groups of 40 nursing students (semester one, five and eight) were selected by random sampling from Shahid Beheshti University of Medical Sciences in 2014. Caring Behavior Inventory completed through self-report by the students, was used for collecting data. Data were analyzed by the descriptive and inferential statistics (with the significance level<0.05) using SPSS software (version 20).

Results: The mean scores based on Caring Behaviors Inventory in three groups were: semester 1: 148.2, semester five: 123.6, semester eight: 122.05. ANOVA showed statistically significant differences between the mean scores for three groups of students (P<0.001). Also, the scores of students’ viewpoints were different in all instrument domains included respectful deference to the other (P<0.001), assurance of human presence (P<0.001), positive connectedness (P<0.001), professional skills and knowledge (P=0.004), attentiveness to the other’s experience (P<0.001). Considering the lack of homogeneity in the groups in terms of age and sex, analysis of covariance was used to eliminate their confounding effects on main variable, and despite controlling for the confounding role of age and sex, differences were significant (P<0.001).

Conclusion: The viewpoints of the higher-year students about the importance of caring behaviors not only had not promoted but also it had decreased compared to the lower-year students. Considering the fact that caring viewpoint is the requisite of high quality nursing care that must be operational through nursing education programs, and due to the fading of emotional aspect of care, more emphasis on clinical instructors and nurses and using mentors in clinical practice are needed to practically and concretely show nursing students the emotional aspect of caring.