Introduction: Evaluation of health care services is an essential step in improving health care quality and without it such an improvement could not be achieved.

Material and Methods: In this descriptive study, parent’s satisfaction of child’s health care in the health and treatment centers affiliated to Tehran University of Medical Sciences was evaluated. Four hundred parents who had attended 25 health and treatment centers were participated in this research. A questionnaire was completed through the interview with parents of 1 to 12 months old children. Analytical and descriptive statistics were used for the analysis of data.

Results: The finding of this study showed that the majority of parents had average levels of satisfaction concerning communication’s skills of health care providers and high levels of satisfaction about availability of these cares. Satisfaction of parents in the section of the vaccination was high and majority of samples had average levels of satisfaction about growth monitoring of children. There was a relationship between infant&aposs age and parent’s satisfaction.

Conclusion: Based on these findings recommendations have been made for future research. The findings of this study can be utilized in public health planning in order to improve the quality of the infant’s health care services.

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.

Introduction: Cesarean section (CS) is more dangerous than normal delivery for mothers and neonates. Rates of CS in our country are very high, especially in Guilan province (57.6% in urban areas). The claim that a major reason for these high rates is maternal request, hidden behind of the routine medical diagnoses, was the basis of present study.

Materials and Methods: A total of 210 pregnant women in Rasht who were at 36-40 weeks of pregnancy and had chosen CS as their delivery method without previous history of CS or any medical reason were included in this study. Cluster sampling was performed at health-treatment centers of Rasht. Data were collected by interview and a questionnaire was completed by the investigators. Statistical analyzing was performed by descriptive and analytic methods (Chi square and Fisher exact test).

Results: The majority of participants (68.6%) had moderate knowledge about benefits and harms of CS and most had taken their information from relatives and friends. The majority of women (71.4%) had moderate attitude toward CS. More than 50% of the mothers had chosen CS for following reasons, in decreasing order of frequency: child&aposs health, fear of pain, stress and anxiety, prevention of genital tears, fear of vaginal exams, prevention of deformity and relaxation of genitalia and shortening of delivery time. There was a significant relation between some of the demographic factors or obstetrical history, level of knowledge and kind of attitude with some of the reasons of choosing CS for example, age, level of knowledge (both p<0.05) and kind of attitude (p=0) with fear of pain.

Conclusion: Reasons for choosing CS by the medically low risk mothers are not medically acceptable and midwives and the other health workers can successfully explain this to mothers. They can also support pregnant women informationally, emotionally and socially in different ways such as holding childbirth preparation classes. In this way they can influence women&aposs decision about method of delivery and promote mothers&apos and neonates&apos health by decreasing CS rates.

Introduction: It is necessary to understand that psychological reactions after a natural disaster are as complex as disaster itself. Following a catastrophic earthquake like Bam’s, such reactions can be seen in nursing team members as well.

Materials and Methods: This study is a descriptive cross sectional analytic research, conducted with cooperation of Japanese Nursing Association to identify somatic and psychological problems of nursing team members of Bam. A total of 92 members of nursing team affiliated to healthcare centers of Bam were studied. Data collection tools were 2 questionnaires first for evaluating demographic characteristics and general health and second- questionnaire of Goldberg and Williams- for evaluation of four domains of psychosomatic problems, anxiety and insomnia, psychosocial functioning and severe depression. Each domain contained seven questions, each scored from 0 to 3 based on Likert score. Complete score of general health was 0-84. Scores were classified in four groups: 0-20 as optimal, 21-4 as approximately optimal, 41-6 as approximately suboptimal and 61 and higher as suboptimal.

Results: One year after the earthquake, evaluation of general health of nursing team members showed 30.3% of subjects had optimal psychosomatic status, 34.8% had moderate problems of anxiety and insomnia, 40.2% had approximately optimal psychosocial functioning and 44.2% of subjects were not severely depressed. Overall, 38.4% of nursing team members had approximately optimal general health.

Conclusion: This study showed that following a catastrophic earthquake, most of the victims suffer from several psychological and somatic reactions. In addition to on time rescue procedures, other important allaying factors are cultural and religious values and believing in God.

Introduction: Self-burning is a cruel method of suicide and prevention is the most effective way to decrease its morbidity and mortality.

Material and Methods: This investigation is a descriptive prospective study performed at Shahid Motahari Burn Center, Tehran, Iran from December 2001 to December 2002. Inclusion criteria included being female, married, having no history of medical and mental disorders and admission of self-burning. Data were collected by a questionnaire and interviews and were analyzed with descriptive statistics methods and chi-square test.            

Results: A total of 35 cases entered our study. The mean age of patients was 24.573.94 years and 48.6% of cases were in the 21-25 year age group, 80% had primary school education, 97.1% were housekeeper and 68.8% had low economical status. There were statistically significant differences in all of these variables. In 42.9% self-burning had happened at 12-18 hour period and in 45.7% it had occurred at yard. Kerosene had been used by 91.4% of the women as the burning agent 94.3% of the women had experienced husband’s violence (verbal and physical), 60% of the women stated that their husbands were guilty in their action and 91.4% of the women didn’t know any supportive sources in the society. The mortality rate was 100%.

Conclusion: This research showed that family violence and marital problems are the most important causes of self-burning in the married women. Because of close relationship to families, community health nurses can prevent self-burning in married women by detecting and eliminating these risk factors.

Background & Aim: Regarding the increase of sexual transmitted disease, high risk behaviour and unwanted pregnancy in one hand, and myth, incorrect believes and low knowledge about sexuality in the other hand, sexual health education is one the basic compartment of health promotion. The pre-marriage counseling is one of the best opportunities to reach our aim.

Methods & Materials: This was a semi-practical study. We had considered 32 case couples and 32 control couples randomly. The couples had been chosen from those, which have been contacted to the clinics of Tehran University of medical sciences. All cases had contributed to three lectures given by the researcher. The lectures were mainly based on the different aspects of sexual health, like: family plain, safe sex, different aspects of sexuality & physiologic different in men's and women’s. On the other hand the control group had taken the normal lectures, which presents in the clinics which were based on the family planning and pre-marriage experiments. Both groups (cases and controls) had been asked to fill a form six months after counseling. In this form, we had included 10 questions of sexual health and 10 demographic questions. We had finally analyzed our data by SPSS software where we had used descriptive and discriminated statistics.

Results: We have obtained a considerable difference in sexual health between the two groups by Man-Whitney test (p=0.000). The majority of case group (96.9%) showed a good sexual health whereas the most procent of control group (59.4%) had a moderate sexual health.

Conclusion: To improve the quality of pre-marriage counseling, the content of usual lectures should be modified in addition to consider more time for these lectures. The results revealed that the pre-marriage counseling enhances the sexual health that lead to marital satisfaction.

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.

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.

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: Youths are the most at risk group for HIV/AIDS in the world and education of the preventive measurements is the most effective way for decreasing the incidence of HIV/AIDS among them. Due to ever-increasing cases of HIV and the importance of education, we compared the effects of three educational methods (peer education, education by physician and giving pamphlets) on knowledge of female high school students&apos of Kerman shah on HIV/AIDS.

Methods & Materials: One thousand and five hundred female third grade students were recruited from 21 high schools using stratified random sampling method. An average of 73 students were selected from each school and participated in a pre-test exam using a questionnaire. Of 1500 students, 498 and 502 students were taught by general practitioners and peers, respectively. Pamphlets were presented to 500 other students. Twenty days after the educational intervention, the participants were contributed in a post-test exam using the very questionnaire. Data were analyzed using descriptive and inferential statistics via SPSS version 11.5.

Results: The students&apos mean age was 16.78 (SD=0.7). The mean scores of pretests and post-tests in all 3 groups were significantly different (P<0.001). The mean score for the group taught by general practitioners (10.7±3.6) was higher than the scores of other two group scores (8.8±3.4 and 7.3±3.9, respectively for peer education and pamphlet groups) after the interventions. Bonferroni statistical test showed the significant difference (P<0.001).

Conclusion: Education presented by general practitioners seems to be more effective than the other two ways in increasing students&apos knowledge about HIV/AIDS.

Background & Aim: Adolescents have important role in building the societies. Some deficits were observed in students&apos knowledge regarding puberty health. This study aimed to compare the effect of two educational methods (lecture-educational package) on girl students&apos knowledge about puberty health.

Methods & Materials: In this interventional study, 200 students were randomly selected through a multi stage sampling method. Data were collected using a questionnaire. One group received a self-learning educational package and the other group took part in two lecture sessions which totally lasted about four hours. The post test was taken 6 weeks later. Data analysis was performed using Descriptive and inferential statistics.

Results: Results of this study showed that after intervention, both groups&apos knowledge mean scores increased significantly. Also the average of package group&aposs score after the education was more than the other group&aposs score (P<0.001). The difference in knowledge mean scores before and after the intervention was significantly higher in the package group than in the lecture one. The comparison of scores in both groups before and after the education was significantly different (P<0.001).

Conclusion: Both educational methods can be considered to be effective in promoting students&apos knowledge however, the educational package was more effective than the lecture.

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 & Aim: Family-centered care, which has become the cornerstone for pediatric nursing practice, supports the integrity of child and family health. It brings families a unique care and improves child and family health. Families are recognized as an essential part of a specialized child care during illness. They are expected to be skilful in child care both in and out of health care facilities. This study was carried out to determine health caregivers&apos attitude toward parent participation in the care of their hospitalized children at Madani pediatric hospital- Khoramabad in 2004.

Methods & Materials: This is a descriptive-analytical study. One hundred and sixty nine caregivers were selected through convenient sampling method. Data were gathered using a questionnaire including demographic and parents&apos attitude questions. The questionnaire had 36-item. The data were analyzed via SPSS computer software and using descriptive and analytical methods.

Results: Results indicated that the average of participants&apos attitude score was 92.28±12.55. Most of subjects had neutral attitudes toward parents&apos participation in their children&aposs care. Positive attitude were significantly related with marital status (P<0.04), having children (P<0.04) and being a nursing student (in comparison with medical students) (P=0.04).

Conclusion: The caregivers&apos attitudes toward parents&apos participation in the care of their hospitalized children were neutral. The students&apos and staffs&apos attitudes should be modified by taking part in continuous training programs.

Background & Objective: High rates of cesarean delivery have worried health policy makers. One of the main reasons for cesarean section in Iran is cesarean election. Health Belief Model (HBM) is one of the most powerful models used in health education programs. The objective of this study was to determine the effect of education designed based on HBM on choosing delivery mode among pregnant women.

Methods & Materials: In this experimental study, 128 nulliparous women were recruited from Shahrood health care centers and private gynecologists' offices. Samples were randomly allocated into two equal groups. Women in the experimental group participated in two 40-minutes educational classes which were designed based on HBM. Data were gathered both before and after the classes, and then were analyzed using SPSS.     

Results: The results indicated that there were no significant differences between two groups in demographic characteristics, infertility history, disease history, perceived susceptibility, and perceived benefits and barriers. After the intervention, significant differences were found between perceived  susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P=0.004), with practice (choosing the delivery mode) (P<0.001).

Conclusion: The results showed that using HBM in program designing was effective in the pregnant women's decision-making toward delivery mode.

Background & Objective: Assessment of mental health is one of the most important aspects of assessing health status. Entering to the university is a challenging life event for young adults because students encounter with changes in social communication, expectations and roles. As a result, they are susceptible for experiencing stress and anxiety that could affect their functions. The aim of this study was to determine the mental health status and related stressors among Hamadan Medical Sciences University Students.

Methods & Materials: In this cross-sectional study, 180 medical sciences&apos students were selected using stratified sampling method. Data were collected using the Stressor questionnaire and the SCL90. Data were analyzed by SPSS.

Results: The study showed that 57.1 percent of the students were female. The ages ranged 18-22. Most of the students (94.8 percent) were single. Most of the students had no mental disorders (66.1%). Mild and moderate mental disorders were 29.4& and 4.4%, respectively. Mean of mental health score was 72.99 (±46.02). Mental health status was correlated with marital status, concerns about family, changes in religious activities, concerns about the future, working in the hospitals, problems with friends, sexual problems, and the number of experienced stressors (P<0.05).

Conclusion: Experiencing stressors threatens students&apos mental health status and provide a potential cause for mental disorders.

Background & Aim: Despite the advancement of medical science, readmission of the heart failure patient remains a serous problem. The aim of this study was to assess the effect of continuous care and educational intervention on the rate of readmissions, refers to physician, and health costs in patients discharged from hospital.
Methods & Materials: This study was a randomized clinical trial in which 110 patients were studied. The participants were allocated in two experimental and control groups. Data were gathered using questionnaires. Home visits were carried out in the experimental group during six months. At the end of the intervention, the rate of readmissions, referrals, and health care costs were compared in the two groups. Data were analyzed using independent t-test, Fisher&aposs exact test, and Chi-square test.
Results: Results indicated that the rate of readmissions (1.65±1.01 vs. 2.74±1.07, respectively), and refers to physicians (2.73±1.24 vs. 3.32±0.94, respectively) were lower in the experiment group than the control group (P<0.05) after the intervention. The average health care cost in the intervention group (2494000±172150 Rials) did not differ significantly with the control group (2736800±167360 Rials) (P>0.05).
Conclusion: The results of this study indicated that the nursing interventions such as home visits are effective in lowering readmissions and refers to physicians in patients with heart failure. It seems that home visits are necessary in promoting the patients health. 

 

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 & Aim: Early diagnosis of breast lumps through breast self-examination (BSE) is important for early detection of breast cancer. The aim of this study was to evaluate factors predict the BSE behavior using Health Belief Model constructs in women referred to health centers in Bandar abbas, Iran.

Methods & Materials: In this cross-sectional study, 240 eligible women were randomly selected from eight health centers. Data were collected using a self-administered questionnaire including demographic characteristics and Champion&aposs Health Belief Model Scale (CHBMS). The CHBMS measures the HBM concepts of susceptibility (3 items), seriousness (6 items), benefits (4 items), barriers (8 items) and self-efficacy (10 items). All items were ranged in a Likert scale ranging from ‘‘strongly disagree (score: one)&apos&apos to ‘‘strongly agree (score: five)&apos&apos.

Results: A total of 240 women took part in the study. The mean age of participants was 37.2 (SD=6.1). Of all, 32.5% had high school education and 95.8% were married. The results showed that 31.7% of the women had performed the BSE however, only 7.1% had performed it regularly. Perceived BSE benefits, perceived BSE barriers and perceived BSE self-efficacy of the participants who performed the BSE were significantly higher than those who did not (P<0.03). The results from regression analysis indicated that the perceived BSE self-efficacy and perceived BSE barriers predicted breast self-examination behavior (P<0.001).

Conclusion: The findings of this study indicated that perceived BSE barriers and perceived BSE self-efficacy were influencing factors in predicting the BSE behavior. Therefore, in order to improve self-efficacy and decrease the barriers, BSE training programs are strongly recommended.

Background & Aim: Web-based technologies provide new opportunities for education, research and professional development of nursing. Nurses have few opportunities to use the Internet due to managers&apos obligations not to use the Internet in work hours, and their traditional attitudes to nursing practice. Establishment of a national nursing portal is a useful way to resolve some of these problems. The purpose of the present study was to investigate the experiences of development of nursing portals in some countries and provide helpful recommendations.

Methods & Materials: This was a descriptive- comparative study. Using systematic review of the literature, the least features for nursing portal structures and contents were identified. Then, the identified features were assessed in selected countries through observation or communication with the portal board.

Results: Personalization, user&aposs profile, search engine, platform-independent display, SSO capability, security mechanisms and collaborative capabilities, clinical guidelines, continuing education, electronic learning courses, and evidence-based nursing processes were common features in the nursing portals.

Conclusion: Development of a specialized comprehensive portal that has all of the desirable features can be achieved through clear definitions of strategies on portal development, maintenance, and analysis of user&aposs requirements. The main requirement to integrate services and contents provided by the portal include specific and integrated structure of all entities in nursing services systems.

Background & Aim: It is crucial to assess communication skills among health workers using valid culture-based instruments. This study aimed to develop and assess psychometric properties of the Interpersonal Communication Skills Scale among Zanjan Health Volunteers.

Methods & Materials: In this study, a total of 191 health volunteers participated in a self-rating assessment of the Communication Skills Scale (CSS). Moreover, 14 experts were asked to rate each item based on the relevance, clarity, and simplicity. Through a literature review, we developed an instrument with 43 items. The validity of the instrument was determined using the impact item method, content validity ratio (CVR), content validity index (CVI), face validity and exploratory factor analysis. Reliability of the instrument was reported by Alpha Cronbach coefficient. The CSS finally contained 35 items, divided into two categories: general and specific communication skills.

Results: Of 43 items, those with impact item index over 1.5, CVR over 0.51, and CVI over 0.79 were considered as valid while the rest were discarded resulting in a 35-item scale. Factor analysis was carried out to determine the relationship among the items of the CSS. Exploratory factor analysis reduced the list of items to 30, which were divided into seven groups with a minimum eigenvalue of 1 for each factor, capable of predicting 68.8% of the variance. Internal reliability of the scale was determined by alpha Cronbach coefficient (0.91).

Conclusion: The results of this study indicated that the CSS is a valid and reliable instrument for assessment of the communication skills among health volunteers in Zanjan. These findings could be used for developing similar instruments in other health worker groups.