Journal of School of Public Health and

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Background and Aim: The aim of this study was to assess the adherence to anti-retroviral prophylaxis after occupational and non-occupational exposure to human immunodeficiency virus (HIV) in patients consulting the Voluntary Counseling and Testing Center (VCT) of Imam Khomeini Hospital, Tehran during the period 2008 to 2009.

Materials and Methods: In this prospective study, patients were selected, the required information about them was recorded, and adherence to anti-retroviral drugs (including Ziduvudin, Lamivudin and Efavirens) was determined based on self-report by the patients. Eighty-nine exposed patients were followed monthly for 4 months, and in the case of low-adherence (less than 95%) they were asked for the reason(s) for noncompliance.

Results: Of the 89 patients, 55 were men (61.8%) and 34 (38/2%) were women with a mean age of 30.16± 8.39 years 47 participants (52.8%) were single and 42 (47.1%) married 27 subjects (30.3%) were physicians, 35 (39.3%) nurses and 27 (30.3%) had occupations outside the healthcare system. From among the 36 subjects (40.5%) who stopped the treatment, 24 (27.0%) stopped it correctly (that is, when the serological test proved to be negative), while 12 (13.4%) did not stop it on a sound basis. Fifty-three subjects (59.6%) completed the prophylaxis. Adherence was found to be significantly associated with age and marital status (p<0.05).

Conclusion: The main reason for stopping the prophylaxis (a negative serological test result of the resource patient) was more pronounced than previous studies, which indicates the higher availability of the resource patient.

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Background and Aim: Self-care has a vital role in the control and prevention of complications in patients with Type-2 diabetes mellitus (T2DM), two important behaviors in self-care being medication adherence and physical activity. Regular physical activity has been shown to improve glycemic control, reduce blood pressure, reduce lipids and improve cardiorespiratory fitness in individuals with T2DM. In addition, medication adherence is a key factor in controlling and decreasing the risk of related complications. This study aimed to determine and predict the most important factors affecting the levels of physical activity and medication adherence in patients with T2DM based on the theory of planned behavior.

Materials and Methods: This cross-sectional study, based on the planned behavior theory, was performed on 160 selected men and women with T2DM referring to urban health centers in Yasuj, Iran in 2016; the selection was done by random cluster sampling. Data on medication adherence and physical activity were collected using questionnaires and analyzed using SPSS version 20 software, the statistical tests being descriptive statistics, Pearson correlation coefficient and multiple linear regression; a p<0/05 was considered to indicate statistical significance.

Results: Altogether, 45% and 43% of the patients had a low and medium level of physical activity, respectively, only 12% having an acceptable level. The adherence to medication was much better ─ 76% had a good adherence. As regards the planned behavior theory constructs, perceived behavior control had a significant relationship with physical activity and medication adherence. Results of multiple linear regression also showed that perceived behavior control was a predictive variable for physical activity level and medication adherence in the patients.

Conclusion: Based on the findings, which indicate that the most important construct is perceived behavior control as regards medication adherence and level of physical activity, it is concluded that it is vital to strengthen the self-care component of health programs and support such programs.

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Background and aim: Despite rapid diagnostic and therapeutic advances, patients with chronic coronary artery disease (CCAD) should adopt self-care behaviors. This study aimed to determine predictors of perceived health competence among CCAD patients in Tehran, Iran in 2019-2020.
Materials and Methods: This cross-sectional study was conducted among 700 patients with CCAD referred to Shahid-Rajaie Cardiovascular Center in Tehran selected using the available sampling method. Data were collected using the perceived health competence scale (PHCS), 12-item quality of life scale and Modanloo's adherence to treatment scale questionnaires. The content validity ratio and content validity index were used to determine validity, and the Cronbach's alpha to determine reliability, of the PHCS questionnaire. Data analysis was performed using descriptive statistics, Pearson correlation coefficient, Structural Equation Modeling (SEM), the software being SPSS₂₅.
Results: The multivariate regression analysis showed that perceived health competence had statistically significant direct associations with physical (β = 1.08, p< 0.001) and psychological (β = 0.85, p< 0.001) domains of quality of life, commitment to treatment (β = 0.12, p =0.01), willingness to participate in treatment (β = 0.12, p = 0.05) and uncertainty about implementation (p = 0.1, p‹ 0.001) of adherence to treatment. There was a significant indirect association between age and perceived health competence (β = -0.13, p = 0.03).
Conclusion: Based on the findings, considering a “very good” and a “poor” mean score for adherence and the quality of life among the patients, respectively, adopting strategies for promoting quality of life in both the physical and mental dimensions can lead to improvements in perceived health competence in cardiovascular patients. In addition, it seems that focusing on subscales of “willingness to participate in treatment” might help in improving the patients' perceived health competence.