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Sleep is not often used to indicate Pain Relief in infants.If Infants and childeren "s sleep Patterns are Distured by Painful Procedures they dont experience Restful sleep . Further more if Pain and lack of sleep are Continuous, other more global! Functional beheriors Such as Sociability and Consolability may be affected because lack of and disturbed sleep were Cues of infant Pain.There fore if rest Ful sleep is increased, Pain is decreased. Similar Study in adults were observed that who received Patient Controlled analgesia had less nocturnal awakehing and less interference with spontaneous move ment such as moving and walking secandory to build and repair tissue.Several abutt studise Provide evidence of tissue remeval a ssocited with release of the growth hormone during deep sleep and %70 of the total Secretion of this hormone occurs during sleep .in this Case Study infant 's increased sleep was used as an indicator of Pain relief for an 8-month old female infant with respiratory Failure Secondary to Sepsis. A sleep activity record documented total hours of sleep and longest hours of Sleep after nonana Igesic and analgesic interventions to mediate the infant 's Pain, sleep appeare to be a useful indicator of the afficacy of pain treat ment for infants.

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Introduction: It has been estimated that 335 million elderly, about 13 percent of general population, live in developing countries. It has been predicted that in 2040, this percentage will rise to 20 percent. Psychophysical complains are common in elderly and investigation of quality of life (QOL) in these samples of population is very important.

Materials and Methods: This research is a descriptive analytical study carried out to investigate the QOL of elderly residents of Zahedan city. In this study a short form questionnaire (SE 36) of QOL was used. Estimated required number of the samples was 200 that were selected with random cluster sampling.

Results: Average age of studied population was 72.3 years and their mean number of children was 6.7. Mean scores of the general health perception, physical activity, physical role function, bodily pain, social function, emotional role function, vitality and mental health were 38.6, 42.7, 36.8, 37.8, 43.9, 45,46.7 and 42.7, respectively.

Conclusion: Since currently there are no sound data for elderly QOL in Iran, considering mean QOL score of 50 and standard deviation of 10, all observed QOL scores (in eight dimensions) were low. These findings show importance of attention to QOL in elderly clients.

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Introduction: Education of patients and helping them to be independent in process of self-care in both health and disease is one of the basic responsibilities of nurses.

Methods and Materials: This descriptive-analytic research was done to study perceptions of 317 nurses working in hospitals of Tehran University of Medical Sciences of factors affecting the process of patient education. Data was gathered by means of a questionnaire containing 30 questions about facilitating factors and 17 about inhibiting factors. We used Likert score to measure questions. Data analysis performed by SPSS software. Statistical test were Chi square, t test, variance analysis and correlation of variance.

Results: The highest percentage of nurses (52.1%) believed that enough attention is not being paid to facilitating factors such as considering patient education as priority in patient care, nurses being responsible for patient education, considering patient education as a criteria in nurses annual evaluation, importance of patient education for nurse administrators, having in-service education about patient teaching and having proper time, place and personnel for patient education. Majority of nurses (57.4%) believed factors such as shortage of nurses, lack of proper place, time and patient motivation for receiving education, nurses and nurse administrators’ inattention to patient education and negative attitude of doctors toward patient education by nurses are inhibiting factors in process of education. Statistical tests showed a meaningful relation between demographic variables such as sex, clinical background, shift work and position and facilitating factors. There was also a meaningful relation between variables like working in more than one shift, having clinical experience of patient education and being evaluated for patient education during study of nursing and inhibiting factors.      

Conclusion: This study shows low level of facilitating factors for patient education in hospitals of Tehran University of Medical Science. To improve patient education in these hospitals it is necessary to improve facilitating factors.

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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.

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Background & Objective: Labor pain is usually the most severe pain women experience in their lives. Most women suffer from low back pain during first stage of labor. The pain can produce adverse effects on delivery procedure. Because of potential side effects of medications used in labor, alternative methods for pain relief have received more attention nowadays. The aim of this study was to evaluate the effect of subcutaneous injection of sterile water on labor pain, type of labor, and satisfaction with pain management in nulliparous women.
Methods & Materials: This was a randomized single-blind study. Samples were consisted of 80 women who were randomly allocated to two intervention and control groups. In the intervention group (40 women) sterile water was injected subcutaneously in four sacral regions during first stage of labor. In the control group, we just inserted a needle in the same area. Low back pain intensity was assessed before and 10, 45, and 90 minutes after the injections using visual scales in both groups. Data were analyzed using descriptive (relative & absolute frequencies, mean and standard deviation) and inferential statistics (t-test, paired t-test and c²) in the SPSS.
Results: There was no significant difference between two groups at baseline. The mean of pain intensity in 10 and 45 minutes after the injection was decreased significantly in the intervention group (P=0.00). There was no significant difference between two groups in the 90^th minute. There was no difference in the type of labor between two groups. The mean of the satisfaction score was higher in the intervention group than in the control one.
Conclusion: It seems that subcutaneous sacral injection of sterile water might be an effective and safe method to alleviate labor pain in women

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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.

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  Background & Aim: The effect of perceived stress on students’ health depends on their coping abilities. Resilience is a coping strategy for dealing with the stress. The aim of this study was to determine the relationship between the perceived stress with resilience in undergraduate nursing students .

  Methods & Materials: In this cross-sectional study, 309 undergraduate nursing students of Tehran University of Medical Sciences were selected during the first semester of 2012-2013 using the stratified sampling method. Data were collected using the Perceived stress scale and the Connor-Davidson Resilience Scale (CD-RISC). The data were analyzed using descriptive and inferential statistics in the SPSS-14 . 

  Results: Findings revealed that most of the students (99.3%) had a moderate or high perceived stress. There was a statistically significant relationship between the perceived stress with the resilience (P £ 0.001, r=-0.38) .

  Conclusion: The school of nursing should provide facilities and opportunities for students in their 4-year educational program to learn stress management strategies including increasing resilience ability.

  

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  Background & Aim: Oral health is one of the most important components of personal health. Understanding current status of oral health is necessary to provide future oral health interventions. The aim of this study was to determine factors influencing tooth brushing behavior based on the health belief model (HBM) among 5- and 6-grader students.

  Methods & Materials : : In this cross-sectional study, 370 primary school students were selected using the stratified cluster sampling method. Data were collected using a questionnaires based on the HBM. The obtained data were analyzed in the SPSS-20.

  Results: The results showed that 95.7% of the students brushed their teeth once or more daily. Mean and standard deviation of the brushing frequency in one week was 8.66±3.54. There was a significant correlation between the perceived barriers (P=0.00, r=-0.14) and self-efficacy (P=0.04, r=0.10) with the brushing behavior.

  Conclusion : According to the results, educating students and decreasing different barriers seems to be necessary to improve brushing behavior.

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  Background & Aim: Although breast self-examination (BSE) is no longer recommended for screening of breast cancer, its training and practicing is a gateway to health promotion and provides women with knowledge and attitudes that set the stage for clinical breast examination and mammography screening later in life. The aim of this study was to recognize predicting factors of the BSE based on the Health Belief Model (HBM) and the locus of control model among women aged 20-50 years old.

  Methods & Materials : Inthis cross-sectional study,400 women were selected through theconvenience sampling method from health centers. Data were collected using four questionnaires including the Champion’s Scale, health locus of control, and demographic and functional questionnaires. Data were analyzed in the SPSS using independent T-test, Chi-squared test, logistic and linear regression models.

  Results: The results showed that 10.9% of the participants reported performing BSE regularly. Perceived self-efficacy was the strongest positive predictor in the BSE performance (Exp (B) =1.863). Awareness had direct and indirect effects on the BSE. The locus of control did not predict the BSE (p=0.05).

  Conclusion : Improving self-efficacy, especially in young women, and increasing awareness about cancer among women is necessary to increase the rate of the BSE.

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  Background & Aim: Nurses’ hands are important channels of micro-organisms transmission and hospital acquired infections. This study aimed to investigate knowledge, beliefs and practices of nurses regarding hand hygiene .

  Methods & Materials: This was a cross-sectional study conducted in 2012. All nurses (n=282) working in three hospitals of Lorestan University of Medical Sciences participated in the study. Data were gathered using a demographic form, social desirability questionnaire, and hand hygiene knowledge, belief and practice questionnaire. Data were analyzed through descriptive and statistical tests (Independent t-test, ANOVA, Pearson Coefficient) in the SPSS-PC (v.21.0). The level of significance was set at below 0.05 . 

  Results: The mean scores of nurses’ hand hygiene knowledge, beliefs and practices were 4.6±2.00, 3.8±0.40, and 4.33±0.50, respectively. Nurses washed their hands after contact with patients more often in compare with prior to contact with patient. There was a statistically positive and significant correlation between nurses’ practice in required situations and nurses’ beliefs regarding hand hygiene .

  Conclusion: According to the results, nurses’ knowledge regarding hand hygiene was low and hand hygiene practice in required situations was undesirable. Many nurses had negative and false beliefs regarding hand hygiene. Based on these results, it is necessary to plan programs to increase nurses’ knowledge, belief and practice regarding hand hygiene .

  

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Background & Aim: Pap smear test is an effective screening method for early detection of cervical cancer. This study aimed to determine the effect of education based on the health belief model on women’s belief and practice regarding Pap smear test.

Methods & Materials: In this quasi experimental study, 100 married women under coverage of Bushehr health centers participated in the study in 2014-2015. The data collection instrument was a questionnaire consisted of demographic information, the questions concerning knowledge and the HBM constructs regarding Pap smear. The training program was performed in two group sessions. Three months after the intervention, women’s practice about Pap smear test was evaluated in both groups. After data collection, data were analyzed by descriptive statistics, repeated measure analysis of variance, independent t-test and Chi square on SPSS software v.20.

Results: Before the study, both groups had not any significant differences in all variables and constructs. After the intervention, the mean scores of knowledge (P<0.001), perceived seriousness (P=0.015) and perceived barriers (P<0.001) were significantly different between two groups. Three months after the intervention, 42 (85.7%) in the intervention group and 4 (8.2%) in the control group had performed Pap smear test (P<0.001).

Conclusion: Designing and implementing educational program based on health belief model can promote women’s awareness and reduce their perceived barriers and as well as enhance their practice regarding Pap smear test.

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Background & Aim: Reducing water-pipe use is among the most effective ways to reduce chronic disease and some cancers. The aim of this study was to determine effect of education based on Health Belief Model (HBM) by health volunteers on water-pipe use among women.

Methods & Materials: This Quasi-experimental study performed on 127 women who used water-pipe (63 in the intervention group and 64 in the control group) in Bushehr in 2014. The data collection tool included demographic characteristics, the HBM constructs about water-pipe use, knowledge about water-pipe complications, and behavior (frequency of water-pipe use in last week and nicotine dependence scale). Intervention group received two sessions of education based on HBM by health volunteers. Data were analyzed using descriptive statistics, Chi-square test, Mann-whitney test, independent t-test, repeated measures ANOVA, and Friedman test on SPSS software version 18.

Results: Before education, both groups were similar in terms of demographic variables, the mean score of knowledge and all the HBM constructs (P>0.05). After education, the mean scores of HBM constructs and knowledge significantly increased and nicotine dependence decreased in the intervention group compared to the control group (P<0.001). After 3 months, the frequency of water-pipe smoking significantly reduced in the intervention group (P=0.007). But in the same period, there was no significant difference in term of the frequency of water-pipe smoking in the control group.

Conclusion: The results show that education based on the behavior change patterns by health volunteers can be effective in changing beliefs and reducing water-pipe use among women.

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Background & Aim: Exposure to high stress in the work environment among the intensive care unit nurses results in leaving the profession and their unwillingness to continue their activities. This is one of the major challenges in the nursing profession and has a great effect on the effectiveness of health systems. Despite the importance of resilience, there is few studies on the intensive care unit nurses’ resilience. The aim of this study was to determine resilience and its association with the intensive care unit nurses’ intention to leave their profession.
Methods & Materials: This is a cross-sectional, descriptive analytical study on 400 nurses working in the intensive care units of teaching hospitals affiliated to Tabriz University of Medical Sciences in 2016. Data were collected through a modified form of Anticipated Turnover Scale designed by liou and a summarized form of Connor-Davidson’s resilience scale". Descriptive and inferential statistics (Mann-Whitney, and Kruskal-Wallis) were used for data analysis through SPSS version 13.
Results: The mean rank for intention to leave and resilience was 2.83 (IQR: 0.67) and 25.50 (IQR: 8) respectively. Also, there was a negative, significant correlation between resilience and intention to leave (P<0.001, R=-0.173).
Conclusion: Considering the rate of intention to leave the profession, more attention is needed to the factors affecting the intention to leave. In addition, due to the significant relationship between resilience and intention to leave, incorporating resilience-promoting strategies into nursing curriculum is recommended.
 

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Background & Aim: Prostate carcinoma is the most common cancer among men and the second lethal cancer. The present study aimed to investigate the prostate cancer screening behaviors and its related cognitive psychological factors among men over 50 years of age using the health belief model.
Methods & Materials: This cross-sectional study was performed on 300 men over 50 years of age in Hamadan, selected by cluster sampling method. Data collecting tool was a questionnaire consisted of three sections: demographic information, prostate cancer screening behaviors and health belief model constructs. Data were analyzed using Chi-square test, Fisher's exact test and logistic regression through the SPSS software version 18.
Results: Findings revealed that 12% and 9% of the participants reported having a digital rectal examination (DRE) and prostate specific antigen (PSA) testing respectively. Perceived benefits and perceived barriers were the predictors of prostate cancer screening behaviors (P<0.05). Also, there was a significant relationship between prostate cancer screening behaviors and age and a history of prostate problems (P<0.05).
Conclusion: Given that the health belief model is effective in predicting prostate cancer screening behaviors, using these findings in designing educational interventions for people over 50 is recommended.
 

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Background & Aim: White lie is one of the inevitable challenges that creates an ethical dilemma during the patient care process. White lie remains an abstract concept in caring process. The aim of this study was to analyze the concept of white lie in the caring process using a hybrid model.
Methods & Materials: A hybrid model of concept analysis including three phases was used in this study. In the theoretical phase, different databases including PubMed, CINAHL, Scopus, Science Direct, Google scholar, SID and Magiran were searched for finding relevant articles published in 1980-2018. The keywords were truth, white lie, care and deception (in Persian and English). In the fieldwork phase, semi-structured in depth interviews were conducted with nurses. In next step, by combining the two previous stages, the final analysis was performed.
Results: In the theoretical phase, the attributes of the concept were determined, including “harmlessness”, “without personal motivation” and “use in compulsion situations”. In the fieldwork phase, three main categories such as “the sweetness of the bitter truth”, “harmless sentences to prevent harm” and “temporary relief to balance the situation” were identified from the data analysis. By merging the concepts extracted from the theoretical and fieldwork phases, “white lie in the patient care process” was defined as “an ethical decision without personal motivation, which is chosen in unstable situations to prevent predictable harms to the patient in facing the bitter truth”.
Conclusion: Although a definition of white lie was developed based on the above three phases, the further development of this concept requires a deeper look at the Iranian-Islamic culture. Therefore, further research is recommended in other medical centers in the country.
 

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Background & Aim: Pre-hospital emergency staff, as the first responder group at the scene of emergencies and disasters, should be able to cope with, and maintain their physical and mental health. The aim of this study was to investigate the relationship between resilience and self-efficacy of pre-hospital emergency staff with their professional quality of life.
Methods & Materials: The present study is a cross-sectional, descriptive study that was conducted in 2019. A total of 200 pre-hospital emergency operational staff from Alborz province participated in the study using proportional and convenience sampling. Data collection tools were a demographic form and three standardized questionnaires including the emergency medical services resilience scale, the Schwartz and Jerusalem self-efficacy scale, and the Stamm professional quality of life scale. Data were analyzed through the SPSS software version 20 using descriptive statistics (mean and standard deviation) and analytical statistics (Spearman correlation, one-way ANOVA and linear regression) at the significance level of P less than 0.05.
Results: The mean and standard deviation of self-efficacy (29.67±5.82), resilience (123.14±17.07), compassion satisfaction (39.81±8.09), burnout (12.06±4.76), and secondary traumatic stress (23.61±7.27). There was a significant correlation between self-efficacy and three components of professional quality of life (P<0.05). Self-efficacy was positively related to compassion satisfaction and negatively related to burnout and secondary traumatic stress. Self-efficacy and resilience were also predictors of compassion satisfaction and burnout (P<0.05). The effect of self-efficacy and resilience on compassion satisfaction was positive. The results of stepwise multiple linear regression analysis showed that five components of resilience including self-management, stress outcomes, communication challenges, maintaining peace of mind and job motivation had an effect on compassion satisfaction (P<0.05). The effect of all resilience components on compassion satisfaction was positive.
Conclusion: Alborz pre-hospital emergency operational staff were at an acceptable level in terms of resilience, self-efficacy and professional quality of life.
 

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Background & Aim: Pre-hospital emergencies are one of the most stressful medical professions. Stressful jobs affect employees’ resilience and their ability to control anger. The aim of this study is to determine the effect of psycho-education on the level of anger and resilience among pre-hospital emergency staff.
Methods & Materials: In this quasi-experimental study, 120 people employed in urban and road centers in Zahedan were included through the convenience sampling method. To determine the intervention and control group, out of 24 available centers, 12 centers were randomly assigned to the intervention group and 12 centers to the control group. First, a demographic information form and the self-reported anger and resilience questionnaires were completed by both groups. Then, the intervention group participated in five sessions of psycho-education in groups of 8-12 people. The questionnaires were completed again by both groups two months after the intervention. Data was analyzed by the SPSS software version 16 using descriptive (mean and standard deviation) and inferential statistics (Chi-square test, independent t-test and paired t-test).
Results: The results of independent t-test showed no significant difference in the mean and standard deviation of resilience score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.492), but after the intervention the difference was significant (P=0.009). Also, the results of independent t-test showed no significant difference in the mean and standard deviation of anger control score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.672), but after the intervention, mean and standard deviation of anger control score in the intervention group were significantly higher than those of in the control group (P<0.001).
Conclusion: The present study showed that psycho-education improved the resilience of emergency workers, and the employees were able to control their anger by enhancing resilience. It is suggested that in-service training programs for pre-hospital emergency staff include a psycho-education program to enhance resilience and control anger in those who face many stressful situations.
 

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

 

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

 

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