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BACKGROUND: Nursing education faces many challenges that must be identified and removed to improve nursing education and promote the quality of nursing care. Identifying the challenges of nursing education helps to solve or correct the weaknesses and achieve educational goals, which ultimately help to train skilled professionals capable of providing higher quality care to patients. The present study was conducted with the aim of explaining the experiences of nursing tutors in regard to the process of challenge formation in nursing education in Iran. MATERIALS AND METHODS: This is a qualitative study with a grounded theory approach that was conducted in two stages. In the first stage, which took about 9 months, 18 experienced nursing tutors with managerial positions were selected by purposeful sampling from universities across the country. Data were collected through semi-structured interviews, field notes, observation, and memos. Data analysis was done by Corbin and Strauss method through MAXQDA software version 10. In the next step, using the method of Walker and Avant (2011), concepts and statements were gathered within a whole and a model was presented. RESULTS: Twelve male university tutors and six female tutors participated in this study. The mean age of the participants was 45.38 ± 2.1 years, and their mean work experience was 18.66 ± 3.8 years. The findings showed that the challenges of nursing education could be categorized into three categories (defective educational cycle, efforts to restore the educational structure, and learning is a member of educational family), and 12 subcategories. After analyzing the data, trying to provide a need-based education was determined to be the central theme of this study. The components of model developed in this study were presented in the three axes of improving the tutor’s teaching skills, managing the situation and educational facilities, and facilitating student’s participation in the education process and decision-making. CONCLUSION: Identifying barriers and facilitators of need-based education in health policy making can enable nurses to build a better future for their nursing position. To provide need-based education, it is necessary to create a suitable ground and platform for proper education. Such platform and ground are a necessity of educational, therapeutic, and community environments. To achieve this goal, it is recommended to improve the professional capabilities of tutors and support educational organizations.

BACKGROUND: Physical changes in high-risk pregnancy (HRP) can lead to changes in mood and social relationships and negative effects on women's well-being. Individuals in different sociocultural contexts have different perceptions of well-being. Yet, there is limited information about perceptions of well-being in HRP. This study aimed to explore the Iranian women's experiences of well-being in HRP. MATERIALS AND METHODS: This qualitative study was conducted in 2019–2020 through directed content analysis based on the conceptual framework of well-being in HRP. Participants were 26 women with HRP purposively recruited from public and private healthcare settings in Mashhad, Iran. Face-to-face semistructured interviews were held for data collection until data saturation. Data were analyzed through directed content analysis proposed by Elo and kyngäs (2008) and were managed using the MAXQDA (v. 10) program. RESULTS: Well-being in HRP had seven attributes in the five main dimensions of physical, mental-emotional, social, marital, and spiritual well-being. The seven attributes of well-being in HRP were controlled physical conditions, controlled mood, emotions, and affections, perceived threat, self-efficacy, and competence for multiple role performance, maintained social relationships, meaning seeking and relationship with the Creator, and positive marital relationships. CONCLUSION: The present study provide an in-depth understanding about well-being in the Iranian women with HRP. It is a complex and multidimensional concept with physical, mental-emotional, social, marital, and spiritual dimensions. Comprehensive multicomponent interventions are needed to promote well-being among women with HRP and designed the guidelines to provide woman-centered care.

BACKGROUND: Facilitating the healing process of patients with psychiatric disorders depends on high-quality mental health care and expert psychiatric nurses. A valid tool is required to objectively evaluate the quality of performance and competency of psychiatric nurses. This systematic review aimed to investigate and critique the psychometric properties of some psychiatric nursing clinical competency assessment instruments with Consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist and according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). MATERIALS AND METHODS: To retrieve published articles using Persian and English keywords “psychiatric nursing,” “competence,” “competency,” “tool,” “checklist,” “scale,” “questionnaire,” “psychiatric mental health nurse,” were searched in databases without time limitation. Then, psychometric properties of selected instruments were evaluated using the COSMIN checklist and reported according to the PRISMA statement. RESULTS: Most of these tools did not entirely and desirably report psychometric properties. It is not designed as a special tool for postgraduate psychiatric nursing. CONCLUSION: The methodology of existing instruments does not meet the COSMIN checklist criteria; therefore it needs to develop. To assess the competency of psychiatric nursing postgraduate, a tool tailored to the cultural and social context and with acceptable psychometric properties is necessary.

BACKGROUND: Technical skills result in the patient's safety. Psychiatric nurses need to learn and apply them to provide effective and secure cares. This study explains the technical competency required for postgraduate psychiatric nursing students. MATERIALS AND METHODS: This conventional qualitative content analysis study is part of a larger study on the clinical competency of postgraduate psychiatric nursing students performed in Iran in 2020. A qualitative study was conducted at universities holding master's degree courses in psychiatric nursing. Participants were instructors and postgraduate psychiatric nursing students, psychiatric nurses, psychologists, and psychiatrists selected by purposeful sampling method. Sampling continued until data saturation was achieved. Data were collected through a semi-structured individual interview and were analyzed by conventional qualitative content analysis. RESULTS: The “technical competency” has two subcategories of “specialized knowledge” (including general nursing knowledge, psychiatric nursing knowledge, and basic knowledge of psychology) and “application of knowledge in practice” (including clinical experience, skills of psychiatric nursing interventions, educational skills, and research and evidence-based practice skills). CONCLUSION: The psychiatric nursing student learns and operates knowledge of psychiatric nursing, psychology, education, and research, besides improving their knowledge of general nursing.

BACKGROUND: Health is a complex structure and has physical, psychological, and social approaches. The importance and impact of health assessment have caused considerable attention to be paid to the employees of the health system and the determining factors of this relationship. Hence, the main purpose of this study was to find out the bio-psycho-social health situation in prehospital emergency technicians as the research question staff. MATERIALS AND METHODS: The present study is a systematic review and data have retrieved through extensive search in Scopus, Web of Science, PubMed (including Medline), Cochrane Library, Irandoc, Magiran, MedLib, and SID databases with a combination of keywords of “Health, “ “Assessment, “ “Social,” “Psychological,” “Biological,” “Emergency,” and “prehospital,” according to the search strategy, between 2000 and 202111 studies were reviewed; then, they were entered based on the objectives of the study and narrative analysis was performed by the researcher. RESULTS: After analyzing the articles, a total of 4 factors affecting bio-psycho-social health in prehospital emergency technicians have been extracted and identified, which included health management, bio-psycho-social factors, occupational factors, and behavioral factors. CONCLUSION: This research showed four factors, namely health management, bio-psycho-social factors, occupational factors, and behavioral factors which could be effective in Bio-Psycho-Social health. Since prehospital emergency services have an important role in maintaining the health of the community, which requires attention to the bio-psycho-social health of emergency personnel, more studies have focused on health management among the four mentioned factors, but the need to examine the other three factors for a more accurate assessment of the health of emergency personnel seems necessary. Therefore, prevention and response strategies based on bio-psycho-social health assessment models are proposed to promote the health of prehospital emergency technician staff.

BACKGROUND: Nurses are in close contact with COVID-19 patients and due to the high risk of infection, they experience fear and anxiety that can result in burnout. This study aimed to review the studies on burnout among nurses during the COVID-19 epidemic. MATERIALS AND METHODS: The study followed the guideline for Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). Using the keywords: “burnout,” “nurse,” and “COVID-19” and with the help of Boolean operators, “AND” and “OR” the online databases, namely PubMed, Scopus, Google Scholar, Web of Science, and Science Direct were searched. Articles published from the first of February 2020 to 30 October, 2020 were retrieved. After the quality appraisal, the required data were extracted and analyzed. RESULTS: Out of 85 articles identified in the initial search, and after removing duplicates and those that did not have the required data, seven articles entered the analysis. Among these articles, four (57.14%) reported moderate burnout and three articles (42.86) reported high level of burnout among nurses during the COVID-19 pandemic. CONCLUSIONS: A majority of the studies reported that nurses experienced a moderate level of burnout during the COVID-19 pandemic. Given the prevalence of burnout in nurses and because nurses are the largest portion of the healthcare providers who are in close contact with patients infected by COVID-19, it is necessary for health care policymakers to adopt strategies for preventing or reducing burnout among nurses.

BACKGROUND: Satisfaction of patients is among the top priorities of health-care providers. Meeting with families is essential for patients who are admitted to various wards, although it has been restricted for many reasons such as its impact on physiologic indicators. This present research study aimed to exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit. MATERIALS AND METHODS: This study was a nonrandomized clinical trial with a control group conducted in the cardiac care unit ward of Hamadan's Ekbatan Hospital. Sixty patients with acute myocardial infarction were chosen through convenient sampling and assigned to intervention (planned meeting) and control (routine meeting) groups in a nonrandomized manner. Data were collected by a researcher-made questionnaire of patient satisfaction and the observatory checklist of physiologic indicators and then analyzed in IBM SPSS Statistics v23. RESULTS: The total mean score of satisfaction did not significantly differ between the two groups (P = 0.921). The satisfaction of patients for “the conduct of visitors” was significantly higher in the intervention group (P = 0.005). During the study, no meaningful difference was found between the two groups for physiologic indicators (P > 0.05), while these indicators, except for blood O2 saturation, were meaningfully increased in the control group during routine meetings (P < 0.05). CONCLUSION: Planned meetings did not promote total satisfaction of patients with meetings, but improved some aspects of satisfaction, such as the conduct of visitors. The planned meeting is recommended as an alternative for a routine meeting, as it did not affect the physiologic indicators of patients in the intervention group.

BACKGROUND: Many patients suffer from sexual dysfunction after coronary artery bypass graft surgery, but they refuse to propose and follow up on the problem due to the cultural structures prevailing in Iranian society. Untreated sexual dysfunction will disturb the quality of life of these patients. This study was performed to explain the experiences of male patients from sexual problems after coronary artery bypass graft surgery. MATERIALS AND METHODS: This qualitative study was performed with the approach of conventional content analysis in Tehran in 2020. The data were collected through semi-structured interviews with 12 men after coronary artery bypass graft surgery at the hospital's cardiac surgery clinic, as well as the surgeon's clinic. Participants were selected by the targeted sampling method. After obtaining informed consent, the collected data were written word by word, and the content analysis approach was used to name the data, create analytical codes, and determine subcategories and categories. The data were analyzed by MAXQDA 10 software. RESULTS: The findings of this study show that the dimensions of confusion in patients' sexual intercourse after coronary artery bypass graft surgery in four subcategories of challenges of the first intercourse after surgery, ambiguity in how to obtain information, the ambiguity of sexual issues after surgery, and spouse are concerned about having sexual intercourse. CONCLUSION: The results of this study show that male patients who have undergone coronary artery bypass graft surgery have many ambiguities in the process of sexual intercourse, which passes the beginning of sexual intercourse with fear and avoidance of intercourse. Postoperative patients do not propose these problems with the medical staff when they suffer from sexual dysfunction or ambiguity due to the taboo of talking about sexual intercourse. Eventually, the patient and his or her partner become confused about sexual intercourse after surgery. Therefore, it is recommended that policymakers in the field of health create the culture and planning for solving the ambiguities created in the path of sexual intercourse of these patients.

BACKGROUND: Breast cancer is the most common type of cancer among women. Mammography is the most sensitive and important method for screening and early diagnosis of breast cancer. Considering the importance of using mammography in breast cancer screening, this study was performed to evaluate mammographic determinants. MATERIALS AND METHODS: In the cross-sectional study, we surveyed 985 women over 40 years in Tehran concerning demographic characteristics: age, socioeconomic status, a problem in the breast, alcohol use, drug use, and health belief model. Logistic regression was used to identify determinant factors associated with mammography performance. RESULTS: The results of this study showed that 42.1% (95% confidence interval [CI]: 38, 45) participant performed mammography at least once during their lifetime. Age (odds ratio [OR] = 4.252; 95% CI = 2.041–8.857); housing situation (OR = 1.706; 95% CI = 1.178–2.469); having breast problems (OR = 5.224; 95% CI = 3.501–7.795); socioeconomic status (OR = 1.855; 95% CI = 1.035–3.325); family income level (OR = 1.998; 95% CI = 1.028–3.884); alcohol consumption (OR = 2.676; 95% CI = 1.344–5.328); smoking (OR = 2.824; 95% CI = 1.418–5.623); self-efficacy (OR = 1.935; 95% CI = 1.242–3.015); perceived barriers (OR = 2.017; 95% CI = 1.348–3.019); self-care (OR = 4.901; 95% CI = 3.152–7.620); perceived susceptibility (OR = 1.971; 95% CI = 1.271–3.057) and perceived severity (OR = 1.830; 95% CI = 1.170–2.860) were mammography behaviors determinants. CONCLUSION: The findings indicated that the rate of mammography screening among Tehranian women is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the priority for health-care providers. Furthermore, the identification of these factors can help to design an appropriate educational intervention that focuses on the benefits of mammography screening.

BACKGROUND: This research is one of the very few studies, which seeks a focalized examination to observe the effects of the backpack on the teenager students. Adolescents prefer rucksacks as one of their favorite school bags during their school studies. This study inspects how knapsacks gradually bring changes as injuries in the bodies of school-going adolescents. There are ample studies in the past literature, which evidence the injuries of backpack among adolescents, such as backache, neck pain, and shoulder pain. The principal objective of this study is to determine the effects of backpacks on musculoskeletal injuries among school-going adolescents based on previous studies support in this research field. MATERIALS AND METHODS: This review study selected observational studies from the past literature indexed in the databases of Scopus, PubMed, ScienceDirect, and CINAHL during 1999–2020. This review focused on the keywords of “Backpack,” “Musculoskeletal Injuries,” and “Adolescent” from MESH and selected 14 out of 210 articles based on the research objective. According to the Crombie Checklist, inclusion and exclusion criteria, and investigating the quality of the report, this review focused on literature evidence to the field under investigation. RESULTS: Based on the chosen 14 articles, the findings of the present review indicated two outcomes by considering the impact of the backpack on musculoskeletal injuries and pains among adolescents. The results of the review studies specified that there was a statistically significant positive relationship between the prevalence of musculoskeletal injuries and pain using a backpack among most of the male and female adolescents. The findings also stipulate that injuries and pain intensity among female adolescents were higher than the male students. CONCLUSION: The results of this review study specified that improper use of the backpack, which exceeded the standard weight, caused chorionic pain and injuries between both genders of adolescents. The generalizability of the results is suitable for this review study.

The Emergency Medical Services (EMSs) are in the frontline between the health-care systems and people in emergencies and disasters. With the increase in the frequency of natural or man-made disasters around the world, the need for prepared EMS services is increasing. This study aimed to evaluate the current disaster preparedness status of the EMS agencies in the literature and exploring the key preparedness elements and the strategies to improve the EMS disaster preparedness. The electronic database such as PubMed, Web of Science, Scopus, and Google Scholar was searched from 2000 to 2019. The searching keywords included: “EMS,” “Disaster,” “Preparedness,” “Emergency” “Preparedness,” “Disaster Preparedness,” “Readiness,” and the terms related to “disaster types” were used in combination with Boolean operators OR and AND. Out of 1412 articles, 7 articles were included in the review. The most important elements of the EMS disaster preparedness include the size and scope of the incident, surge capacity, planning, communication, training and education, policymaking, financial support, coordination, safety and security, early warning system, disaster response experience, and legal considerations. This systematic review showed that the EMS agencies in the world generally are inadequately prepared for an effective response to major emergencies and disasters. This study provides valuable information to EMS educators, EMS administrators to adopt and perform appropriate activities to improve the EMS disaster preparedness.

BACKGROUND: The long-term outcomes are important concepts for cost-effectiveness analysis in patients with premature coronary artery disease after revascularization (coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]) and medical therapy (MT). The finding of this study will be used to calculate the events probabilities for cost-effectiveness study. METHODS AND ANALYSIS: This systematic review will use studies in which patients age must be 18–60 years in eligible studies that obtained from PubMed, Web of Science, Scopus, and Embase. We will assess the long-term outcomes after CABG, PCI, and MT by random-effects meta-analysis and effects will be shown by risk ratio. We will ascertain the probabilities of adverse events during certain periods and then outcomes will compare separately based on specific characteristics. CONCLUSION: This study will provide information related to outcomes of CABG, PCI, and MT in patients with premature coronary artery disease. Doing this systematic review is valuable from clinically and economically aspects such as cost-effectiveness and cost-utility analysis.

INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medical care in threatening conditions are more at risk of displaying psychological distress presentations in disaster situations. Problem-solving strategies are essential for effective and efficient management of event position. Therefore, the present study aimed to explore psychological distress promotion in Iranian EPHP. MATERIALS AND METHODS: A qualitative content analysis study was conducted based on 24 semi-structured interviews. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then, data condensing, labeling, coding, and defining categories were performed by the qualitative content analysis recommended by the Landman and Graneheim approach. RESULTS: Based on the experience of study participants, two main themes with six categories developed. The main themes included emotion-based management and problem-based management when confronting with incidence scene. CONCLUSION: The main problems of EPHP in confronting with incidence and disasters scenes are psychological distress which some rescuers have emotional reactions while some others who are more resilience and experience manage this problem in the form of problem-based approach. It is recommended these practical strategies to be taught to less experienced rescuers for avoiding emotional-based reactions and better management of disaster scene.

Today, as age increases, the demand for independent living has increased. Since driving is one of the safest and preferred ways for the elderly to travel, paying close attention to the accurate assessment of the elderly's driving ability can prevent traffic accidents in this age group. The purpose of this study was to identify and introduce practical tools for drive assessment fitness of the elderly. This systematic review was conducted according to Cochrane methodology and reported findings according to PRISMA. The following databases were searched from PubMed, ISI web of knowledge, Scopus, ProQuest, Medlib, SID, Magiran, Iran doc, and Iran Medex based on the population intervention comparison outcome method. The total records involving 12 main tools were assessed from 26 selected records in the final evaluation. The research findings indicated the selection of seven tools in the psycho-cognitive function domain such as TMT-B, Clock Drawing Test, MAZE, Montreal Cognitive Assessment, GDS-15, MMSE, and ACE-R, three tools in the sensory function domain such as Snellen, Confrontation Visual field, and Whispered Voice Test, and also two tools in motor function domain such as Rapid pace walk, and Manual test of the range of motion. The findings led to selecting practical, accurate, and fast tools for widespread use for the assessment of driving competencies of the elderly. Therefore, it is recommended that the selected tools be used in practical batteries to assess the driving skills of the elderly.

A valid tool is of paramount importance in determining women's sexual and reproductive health status, meeting their health needs, and recognizing the effectiveness of some interventions. This review study aimed to assess sexual and reproductive health dimensions tools in women with type 1 diabetes mellitus with regard to Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist. In this review study, in addition to Iranian databases (MagIran, Sid, Irandoc), non-Iranian databases (PubMed, Scopus, Embase, and Web of Science) and Google Scholar search engine were considered. The mentioned databases were searched for articles in English and Persian published within 2000–2019, using the search strategy for each database and Boolean operators along with appropriate keywords according to the MESH term. Articles with nonresearcher-made tools measuring the sexual and reproductive health concepts and dimensions were included in the present study. Afterward, the psychometric properties of the tools were assessed according to the COSMIN checklist. In the selected articles, there were 14 psychometrically valid tools to be assessed from 151 articles containing the sexual and reproductive health dimensions; among which, seven tools were evaluated with regard to COSMIN. None of the tools also had all the features noted in COSMIN. Moreover, all the concerned scales were not interpretable and accountable; however, a majority of them had internal consistency and construct validity. In this study, there was no valid and specific tool for measuring sexual-reproductive health status in this population group. Therefore, it is necessary to develop a valid tool according to the dimensions and needs of specific reproductive health in type 1 diabetes.

INTRODUCTION: Disasters occur almost everywhere in the world, and preparation is essential. Preparedness is an effective approach for disaster management, and it is crucial for the health systems, especially the Emergency Medical Service (EMS) agencies. This systematic review will be conducted to assess the preparedness levels of EMS agencies in the world for the response to disasters and explore the key dimensions and strategies to enhance it. METHODOLOGY: This systematic literature review will be conducted to search comprehensively the articles published between 2000 and 2019 to explore the disaster preparedness of EMS Agencies. To this end, PubMed, Scopus, Web of Science, and Google Scholar will be thoroughly assessed. The following terms and expression will be used for searching the databases: “EMS” and other keywords “Disaster Preparedness,” “Mass Casualty Incident,” “Mass Gathering,” “Terrorist incident,” “Weapons of Mass Destruction,” and CBRNE, Disaster, included: 'Emergency Preparedness, Preparedness, Readiness. DISCUSSION: To the best of our knowledge, no systematic review study has been conducted on disaster preparedness of EMS agencies in the world. This is the first study to address this gape. It will also explore the key dimensions of disaster preparedness in EMS services and the strategies to enhance their preparedness. CONCLUSION: Identifying the key dimensions of disaster preparedness is the first step in designing valid assessment tools to evaluate disaster preparedness of EMS service. This study will provide valuable guides for EMS administrators and researchers in an attempt to enhance of preparedness of EMS systems in disasters.

BACKGROUND: Morbid obesity is rising around the world. Surgery is a selective treatment intervention for it. Since most of the surgeons use weight loss for evaluating of the morbid obesity surgical outcomes and paying attention to the the quality of life (QOL) and body image evaluation are rare, this study aimed to assess the QOL and body image in pre- and postsurgery with other interventions. MATERIALSs AND METHODS: This case–control study was done on 200 morbidly obese patients (n = 100 in each group) who referred to the obesity clinic in Shiraz. The data were collected by Body Image Concern Inventory and 12-item Short Form Survey. The data were analyzed by t-test, Pearson correlation coefficient test, analysis of variance, and regression analysis. P = 0.05 was considered as significant. RESULTS: The paired t-test showed a significant difference in mean scores of body image (P < 0.001) and all dimensions of the QOL (P < 0.001) in the case and control groups. In the case group, there was a significant difference between the mean scores of the QOL and the different categories of body mass index (BMI) in postsurgery (P < 0.05) and the different mean scores of body image and the different categories of BMI in pre- and postsurgery wasn't significant (P > 0.05). Age was a predictor variable for the QOL of morbidly obese persons after surgery (P < 0.001). After surgery, men showed better QOL than women (P < 0.001). CONCLUSION: Final results indicated that body image and QOL defects caused by obesity could be more improvement after surgery. This study can promote health-care team's knowledge about holistic supporting of all dimensions' QOL of obese individuals. It is suggested that supporting interventions should be done as effective methods of maintenance for effects of weight loss methods such as surgery.

CONTEXT: The 30-item nurses' observation scale for inpatient evaluation (NOSIE-30) developed for the behavioral and observational rating of psychiatric inpatients. AIMS: The purpose of this study was to evaluate the validation of the NOSIE-30 and mental health-care promotion. MATERIALS AND METHODS: The participants with psychiatric disorders were selected from 310 inpatients referred to the military educational hospital in Iran. This study was carried out in two phases: First, translation of the NOSIE-30 into Persian followed the stepwise, iterative procedures developed by the International Quality of Life Assessment project approach. Second, face validity, criterion-related validity and construct validity, and reliability of the Persian version were determined. The concurrent validity was assessed by using the global assessment of functioning (GAF) instrument. Data were analyzed with the SPSS software of version 22. Exploratory factor analysis, the Cronbach's alpha coefficient, and interrater agreement with intraclass correlation coefficient and Pearson's correlation coefficient were used to data analysis. RESULTS: Pearson's correlation coefficient between the NOSIE and GAF was 0.75. The interrater reliability for subscale scores and structure of the NOSIE were ranging from 0.70 to 0.94 and Cohen's kappa = 0.74. Furthermore, the internal consistency of the scale's total scores was estimated by Cronbach's alpha = 0.85. CONCLUSIONS: The finding indicated that NOSIE-30 Persian version scale has the desirable validity and reliability for evaluating the nursing care of inpatients. Thus, nurses can promote mental health care by applying this scale in the psychiatric setting.

BACKGROUND: The health-promoting lifestyle by empowering individuals will increase control over their health, improve quality of life, and prevent diseases. The purpose of the present study was to determine the effect of the educational intervention based on the intervention mapping approach on health-promoting lifestyle in Iranian college students. METHODS: This study is a quasi-experimental control study that was conducted in two groups of 65 students of Iran University of Medical Sciences in 2018–2019. The data were collected using the Health-Promoting Lifestyle Standard Profile II questionnaire and a researcher-made questionnaire based on the mapping approach, whose validity and reliability were confirmed. The educational intervention was designed according to the pretest results, including five training sessions and performed for the intervention group. The two groups were evaluated with the same questionnaires 1 month and 3 months later, and the data were analyzed using independent t-test, Spearman, ANCOVA, ANOVA test, and covariance. Results: Before the intervention, no significant difference was observed between the mean scores of health-promoting behaviors in the two groups, but after the intervention, the mean scores of attitude, subjective norms, enabling factors, and perceived self-efficacy and mean scores of health-promoting lifestyle and its dimensions increased significantly in the intervention group (P < 0.001) compared to the control group. Conclusion: The educational intervention is effective in improving behaviors related to health-promoting lifestyle and its dimensions. Therefore, performing educational interventions are suggested to adopt and adhere to behaviors related to health-promoting lifestyle by utilizing and reinforcing perceived self-efficacy, subjective norms, enabling factors, and attitudinal change.

INTRODUCTION: Hypertension is one of the most critical factors for chronic diseases such as cardiovascular disease, stroke, arrhythmias, heart failure, and renal disease. The aim of this study was to evaluate the quality of life and its related factors in hypertensive patients. MATERIALS AND METHODS: This study was descriptive research. The sampling method was simple random, i.e., 137 were selected among the ten health centers of the list of the existing patients by simple random sampling. Data were collected using a questionnaire World Health Organization Quality of Life-BREF (Short Form-26). After collecting the questionnaires, the data analysis was carried out using SPSS software and using statistical methods (e.g., number, percentage, mean, standard deviation, and MANOVA tests). RESULTS: The results showed that the mean score for the physical domain (52.82), the psychological domain (50.26), the social domain (48.33), the environmental domain (46.1), and the total quality of life (49.60). Among the demographic variables, the education level variable (P =0.000), job (P = 0.013), and the duration of hypertension (P = 0.039) were significantly correlated with the quality of life of patients. The “levels of education” variables are significantly correlated with the physical domain (P = 0.000), psychological domain (P = 0.000), social domain (P = 0.000), and environmental domain (P = 0.000) of the quality of life. The “job status” variable is only significantly correlated with the social domain of the quality of life (P = 0.005). The “duration of hypertension” variable is only significantly associated with the physical domain of the quality of life (P = 0.011). CONCLUSION: The findings of the present study show that demographic variables such as educational level, occupation, and duration of hypertension have a significant relationship with the quality of life domains of hypertensive patients. It is recommended that the principled education of patients is a step toward the improvement of the quality of life of patients.

INTRODUCTION: One of the most thought-provoking problems in the world is child marriage that is affected by various factors. Therefore, the purpose of this study is to identify the social determinants of child marriage in Kurdish regions of Iran. MATERIALS AND METHODS: This qualitative study was conducted using conventional content analysis approach. The participants of the study were 30 Iranian-Kurdish women married under the age of 18 who were selected through purposeful and snowballing sampling. Data collection was conducted through semi-structured interviews and face-to-face interviews and continued until the saturation of concepts was achieved. Graneheim and Lundman method was used to analyze the data, and Guba and Lincoln criteria were used to strengthen the research. RESULTS: In general, findings include 5 categories and 17 subcategories: 1 – economic factors (financial problems and economic benefits); 2 – sociocultural factors (social customs, cultural beliefs, community encouragement, social learning, gaining prestige, and social support); 3 – individual factors (physical characteristics, personality traits, lack of awareness of the damaging consequences of early marriage, and fear of the future); 4 – family factors (dysfunctional family, weak awareness of parents, and harm prevention); and 5 – structural factors (high demand, limited access to educational services, and the lack of supportive social and legal structures). CONCLUSION: By raising the level of awareness and attitude of girls and their families about the consequences of early marriage, creating the culture of correcting cultural beliefs and social misconceptions, passing appropriate laws, and the use of local and national media to prevent child marriage, this social harm can be reduced.

BACKGROUND: Today, one of the biggest concerns of parents is protecting their children and properly educating them about sex. The aim of this study was to determine the effect of educational intervention on parental skills in sex education on their children in elementary schools in the northwest of Tehran-Iran in 2019 based on literature. MATERIALS AND METHODS: This quasi-experimental study was conducted on 125 parents of elementary schoolchildren in the northwestern of Tehran. The data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled up the pretest questionnaire; the data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled the pretest questionnaire, and then the parents participated in the educational program based on dramatic literature. Two months later, the same questionnaire was completed by the control and intervention groups. Finally, the data were analyzed by regression and one-way ANOVA test. RESULTS: The results showed that there was a statistically significant difference between the mean scores of knowledge in the experimental and control groups in the posttest (P < 0.01). There was also a statistically significant difference between the mean scores of attitude in the experimental and control groups at the posttest stage (P < 0.01). There was also a statistically significant difference between the mean scores of performance based on group membership (experimental group and control group) in the posttest phase (P < 0.01). CONCLUSIONS: The findings of the study showed that educational intervention on parental skills in sex education based on the dramatic literature to their children has significant effect on parental knowledge, attitude, and performance.

INTRODUCTION: The objective of the present study was to systematically review the current research knowledge on hospital preparedness tools used in biological events and factors affecting hospital preparedness in such incidents in using a scoping review methodology. MATERIALS AND METHODS: The review process was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. Online databases (PubMed, Scopus, Web of Science, and Google Scholar) were used to identify papers published that evaluated instruments or tools for hospital preparedness in biological disasters (such as influenza, Ebola, and bioterrorism events). The search, article selection, and data extraction were carried out by two researchers independently. RESULTS: A total of 3440 articles were screened, with 20 articles identified for final analysis. The majority of research studies identified were conducted in the United States (45%) and were focused on CBRN incident (20%), Ebola, infectious disease and bioterrorism events (15%), mass casualty incidents and influenza pandemic (10%), public health emergency, SARS, and biological events (5%). Factors that were identified in the study to hospitals preparedness in biological events classified in seven areas including planning, surge capacity, communication, training and education, medical management, surveillance and standard operation process. CONCLUSIONS: Published evidences of hospital preparedness on biological events as well as the overall quality of the psychometric properties of most studies were limited. The results of the current scoping review could be used as a basis for designing and developing a standard assessment tool for hospital preparedness in biological events, and it can also be used as a clear vision for the healthcare managers and policymakers in their future plans to confront the challenges identified by healthcare institutes in biologic events.

INTRODUCTION: Hospitals are the main axis of health-care reforms or national health plans; therefore, accurate recognition of hospital costs based on operational indexes to these plans is necessary. The impact of implementing national health plans on the performance of health systems is ambiguous and misleading; therefore, the aim of this study was to assess the impact of Healthcare Reform Plan (HRP) on the micro level (e.g., educational or university hospitals). METHODS: This study was a descriptive retrospective study that research variables are checked in 1 year before and mean of 3 years after implementation of HRP by self-administrated checklist in selected public-educational hospitals covered by the medical universities in Tehran. The final analysis of the data was performed using cost–performance ratio and independent t-test for comparing the variables' changes before and after HRP. RESULTS: Unlike adjusted hospitalization costs, most operational indexes were not significant. The per capita cost adjusted of hospitalization in first and mean of 3 years after HRP increased 49.49% and 16.31%, respectively (P < 0.001), the adjusted cost per day was increased by 24.48% and 21.46% (P < 0.001), and adjusted cost per bed was increased 47.06% and 20.07% compared to before HRP (P < 0.001). CONCLUSION: Given the lack of alignment in adjusted cost changes in exchange for functional indicators, certainly, it cannot be argued that HRP had a favorable or undesirable effect on the hospitals.

Introduction: The importance of life skills and their application in promoting personal, family, and occupational health in military personnel is well recognized. It is, therefore, important to identify and assess life skills in military personnel with a valid and reliable tool. The present study aims to develop such a tool and evaluate its psychometric features in military personnel. Materials and Methods: As part of a mixed study, a qualitative concept analysis study was conducted using hybrid approach to redefine life skills in military personnel, and results obtained were used to form a pool of items. Next, in a methodological study, psychometric evaluation, qualitative and quantitative face validity, qualitative and quantitative content validity, and construct validity (exploratory factor analysis), and reliability (using test-retest and internal consistency) were performed on the inventory. Results: Initial pool of items was designed with 156 items, which were reduced to 93, following qualitative face validity, and further reduced to 80 after quantitative face validity (item impact score). No further reduction was implemented after qualitative and quantitative content validity (content validity ratio and content validity index ratio). Following construct validity (factor analysis), the remaining 80 items were summarized in 5 factors. Cronbach's alpha for the 5 factors was found 0.7, and correlation coefficient of test-retest results exceeded 0.9 and was significant at 0.01. Conclusion: Given the acceptable results of psychometric features, this tool can be used as a valid and reliable tool for assessing life skills in military personnel.

Background: Menopause and its complications could disturb the sense of well-being and health and affect the quality of life. The present study was performed to review the conducted interventional study related to the quality of life in menopausal women in Iran. Methods: In the present systematic review, to achieve the intended studies, Iranian Registry for Clinical Trials and Magiran, SID, Google Scholar, Scopus, PubMed, Proquest, ScienceDirect, and Web of Science databases were searched using: menopause” and “quality of life” keywords without any time limitations. Based on Jadad criteria, studies with a score of 3 or more were enrolled in the study. Results: From all the achieved studies at primary search, 12 were selected and enrolled in the study. Reviewing the results of the studies showed that participating physical exercise, using products containing phytoestrogens and isoflavones and participating in educational and counseling sessions have an effective role in the improvement of quality of life in menopausal women. Conclusions: Evidence indicated that from the existing strategies to improve the menopausal quality of life, using complementary medicine is an efficient method and could be more effective when consumed along with performing physical exercises and participating in educational programs.

BACKGROUND: Through self-care, people can solve their health-related problems through increasing their awareness and correcting their lifestyles. OBJECTIVES: To determine the association of self-care status with some relevant factors in Kashanian middle-aged women in their early menopausal stage. METHODS: This is a cross-sectional study on 351 women in the age range of 45–60 years. Women were selected based on cluster sampling method from the individuals at health-care centers in Kashan, Iran. Researcher-constructed questionnaire on self-care was used. The validity and the reliability of the questionnaire were calculated. The information gathering method was questionnaire completion by the study participants or interview with them. Collected data were analyzed with SPSS 16 software. T-test, ANOVA, Spearman correlation, and linear regression analysis were applied. RESULTS: The mean (±standard deviation) of the self-care score was 108.14 ± 20.43. Self-care scores were weak in 13.92%, intermediate in 71.02%, and good in 15.06%. Regression analysis showed that the mean of self-care was significantly higher in those with higher educational level of women's (P = 0.045) and their spouses (P = 0.001). Women who were covered by insurance also showed higher self-care; in addition, there was no significant relationship between self-care and participants' job, spouses' jobs, marital status, marital satisfaction, economic satisfaction, number of children, number of households, and type of accommodation (P > 0.05). CONCLUSION: The results indicate that self-care is inadequate and that the level of education of couples and insurance coverage has a positive effect on the level of self-care in postmenopausal women. To promote self-care in old age, education and empowerment can be considered.