Payesh
Year:2017 | Volume:16 | Issue:4|Papers Count:15

Objective(s): During recent years fertility rate is decreasing in Iran. This study aimed to assess fertility desire, its correlates and reasons for fertility desire or fertility disinterest among Iranians.Methods: This was a population-based study. A sample of married individuals living in all 32 provinces in Iran were asked whether they intend to have a child at present. Participants were interviewed via a structured questionnaire including items on socio-demographic and reproductive information. Participants also were asked to indicate reasons for desire or disinterest for fertility. Participants were free to name several reasons as they wish. Descriptive analysis was used to explore the data. Logistic regression analysis was performed to assess the association between fertility desire and independent variables.Results: In all 20935 individuals (10388 male and 10547 female) were interviewed. The mean age of participants was 36.28 (SD=8.23) years. Overall 31.8% of the respondents indicated that they wish to have a child while the remaining 68.2 said that they did not. The most important reason for fertility desire was interest in having children (93.5%), followed by wish to experience parenthood (92.2%). The most important reason for disinterest was worry about the future of a new child (76.1%) followed by economic limitations (71.0%).The results obtained from logistic regression analysis showed that infertility disinterest was significantly associated with older age [OR=1.10, 95% CI (1.09-1.11)], younger age at marriage [OR=0.93, 95% CI (0.92-0.94)], female gender [OR=1.44, 95% CI (1.24-1.67)], having more children at present [OR=1.88, 95% CI (1.79-1.98)], lower number of abortion and stillbirth [OR= 0.86, 95% CI (0.82-0.92)] and living in urban areas [OR=1.36, 95% CI (1.26-1.47)].Conclusion: The findings suggest that willingness to experience parenthood and economic hardship are the most common reasons for fertility desire or fertility disinterest. The findings might help policy makers to implement appropriate interventions if they wish to improve population growth rate for the country.

Objective(s): In recent decades, rates of cesarean delivery as a percentage of all live births have increased in Iran. This study aimed to examine the effect of Health Sector Evolution (HSE) plan on prevalence and costs of different types of delivery in Ardabil University of Medical Sciences in 2015.Methods: This was a cross-sectional and retrospective study. The study population was all women who were admitted to the specialized hospital of obstetrics and gynecology of Ardabil University of Medical Sciences between May 2013 and May 2015. The sampling was done based on simple random sampling method and data was obtained by self-constructed checklist based on medical records. Also, data analysis was done by STATA software.Results: The descriptive results showed that about 55% of the participants were in age 25 to 30, 98% of them were married, and about 12% were covered by rural insurance, notwithstanding it shows their location. Analytical results showed that there was a significant difference between the prevalence of the Vaginal delivery (t=-7.987, p<0.001) and cesarean (t=6.988, p<0.001) before and after of HSE. Total cost of vaginal delivery and cesarean changed significantly before and after of HSE (p<0.001).Conclusion: This study showed that the prevalence of cesarean delivery was decreased, consequently we can understand that HSE had a positive effect on the prevalence of the cesarean and decreased it 0.79 relatively. Moreover, HSE decreased the cost of cesarean significantly but the cost of vaginal delivery was increased significantly after HSE implementation. We can conclude that the HSE achieved its objective greatly.

Objective(s): To study and compare the psychological status of male and female teenage victims of landmine and unexploded ordnances in 5 border states of Iran.Methods: This was a cross-sectional study. The Youth Self Report (YSR) test of Achenbach (YSR) questionnaire was used to collect data.Results: Of 68 injured adolescents 43 (35 boys and 8 girls) participated in the study and completed the Iranian version of YSR questionnaire (response rate=63.2%). The mean age of the samples was 16.18 (SD=2.30), girls 15.5 (SD=2.82) and boys 16.25 (SD=2.18). The mean percentage of injury was 42.67% (SD=16.65) ranging from 20 to 70%. Academic performance in most teenagers was moderate. Academic performance was not significantly different between girls and boys (p>0.05). Overall, the highest mean score of youth self-report questionnaire was observed for anxiety/depression 10.88 (SD=6.04) and aggressive behavior 8.67 (SD=7.15). The Achenbach mean score was higher in girls than boys (71.50 vs. 48.77). The disability rate had a negative impact on the overall Achenbach score and internalizing factor of the injured adolescents. Compared to boys, girls significantly had higher scores in anxiety/depression, thought problems and attention problems (p<0.05). The most important factors affecting the overall Achenbach score in adolescents injured by landmines and unexploded ordnance were age, educational level and family size (p<0.05).Conclusion: Injuries due to landmine and unexploded ordnances in adolescents were more associated with anxiety/depression, thinking and attention problems.

Objective(s): Health literacy is an important competency that influences health behavior and health outcomes. Because health behaviors are established during childhood and children spend most of their times at school, teachers play a critical role in improving health literacy among students. Currently, there is limited evidence regarding the impact of curriculum-based interventions on health literacy within teacher education programs.Methods: This study was a narrative inquiry into pre-service teachers experiencing a dialogic health literacy curriculum to test the feasibility of this curriculum as a means to improve health literacy among future teachers. Data sources include a critical incident questionnaire, reflective journals, student work samples, student correspondence and observational field notes made by the researchers. Data were analyzed using thematic analysis.Results: Overall, the findings indicated that the dialogic health literacy curriculum was well-accepted and has been proven to be feasible. By experiencing this curriculum future teachers reported improvement in different dimensions of health literacy including pre-service teachers’ abilities to access, understand, use, evaluate and communicate health information.Conclusion: A dialogic health literacy curriculum can improve students’ health literacy. This is the first study to demonstrate the positive impact of a curriculum-based health literacy program in an Iranian pre-service teacher population.

Objective(s): Data collection is one of the important stages of research process and requires valid and reliable instruments. The aim of this article was to introduce important steps of translation and construction process of a questionnaire. Adopting an appropriate instrument for research and developing an optimal instrument needs knowledge on psychometric criteria. The present paper explains the construct validity reliability and responsiveness as the important components of psychometric properties of health related instruments.Methods: The present paper was written based on exisiting documentaries.Results: There are different methods for evaluating construct validity, which include structural validity (factor analysis), hypothesis testing, convergent and discriminant validity, and cross-cultural validity. Criterion validity is also a type of validity, which can improve the quality of an instrument if being applicable. Reliability is an essential part of psychometric evaluation, which includes internal consistency, stability, equivalency and standard error of measurement. Instrument developers have often been concerned with internal consistency and stability. Examining standard error of measurement as an important component of reliability has been ignored in the development of most instruments. Responsiveness is approved if the smallest detectable change is less than the clinical minimal important change. Furthermore, the area under the ROC curve can also be used for examining responsiveness. Floor and ceiling effects exist if more than 15% of respondents get the highest or lowest possible scores.Conclusion: Psychometric knowledge should be considered as basic requirement of translation and development of health relate measures. This could help investigators to collect valid and reliable information when collecting the data.

Objective(s): Students research self-efficacy can be predict students’ tendency in research performance. Research self efficacy could help to distinguish the strength and weakness of students regarding doing research. This study aimed to evaluate psychometric properties of the research self-efficacy scale among medical post graduate students in Iran.Methods: This was a cross sectional study. 150 postgraduate students from Iran University of medical sciences took part in the study. Initial instrument was adopted from previous studies including eighteen items. Item impact score was used to assess face validity of the scale. 15 panelists evaluated content validity ratio and content validity index. Exploratory factor analysis with a sample of 150 students was performed to verify construct validity. Internal consistency (Cronbach’s alpha) and test–retest was used to verify reliability.Results: Of the original 18 items, all items showed the item impact score above 1.5, CVR above 0.49, and CVI above 0.7. The exploratory factors analysis with a minimum eigen value of 1 for each factor indicated a three-factor solution namely: problem identification, methodology; finding expression. The instrument showed 57.0% of the variance observed for research self efficacy score.Conclusion: The results indicated that the research self-efficacy scale is a valid and reliable instrument and can be used for assessing research self-efficacy among university students.

Objective(s): considering the verbal limitation in individuals and the lack of awareness of their emotions and their actions, their psychological assessment has been limited. There is an urgent need to identify and apply diagnostic tools that can assess the emotions and cognitive skills. Therefore, the aim of the current research was to investigate reliability, validity of the Silver Drawing Test (SDT) among students.Methods: A sample of 500 students was selected through multistage stratified random sampling in Shiraz, Iran. Students completed the Silver Drawing Test (SDT), the Depression Anxiety Stress Scales, the State-Trait Anger Expression Inventory-2, the Cattell's Culture Fair Intelligence test (scale3) and the Abedi Creativity Test. Data were analyzed using spearman correlation coefficient, kappa agreement coefficient, Cronbach's alpha and independent t-test.Results: Cronbach's alpha was 0.92 and 0.64 for emotional and cognitive scales respectively, and it was 0.83, 0.81 and 0.78 for predictive drawing test, drawing from imagination task and drawing from observation task, respectively. Depression Anxiety Stress Scales, the State-Trait Anger Expression Inventory-2, the Cattell's Culture Fair Intelligence test (scale3) and the Abedi Creativity Test. were used for evaluating the convergent validity.Conclusion: The study findings showed that the Silver Drawing Test has acceptable reliability for utilizing in psychological research and clinical diagnosis.

Objective(s): Equity in distribution of health services is one of the goals of health policy makers. Thus, an study entitled “modeling geographical access to medical laboratory services in Iran” was conducted in 2014. The present article is a case study using this model for site selection of new medical laboratories in Shiraz, Hamadan and Shushtar cities, Iran.Methods: The study units included medical laboratories located within the city borders but outside of hospital and clinic settings. The main analysis task was layer and maps creation based on Geographic Information System (GIS). Spatial analysis performed using the ArcGIS software.Results: According to the geographical accessibility model, total area of lands valued as excellent and good for the establishment of new laboratories (outside of hospital and clinic settings) were identified in Shiraz and Hamadan and Shushtar. In Shiraz, at the time of present study, there were 64 medical laboratories outside of hospitals and clinics and there was possibility of construction of approximately 241 new laboratories in the city. The total area of lands valued as excellent and good for the establishment of new laboratories were about 2661 square meters. Therefore it was possible to establish 120 out of 241 new medical laboratories in the horizontal expansion of the city in these lands in Shiraz. In Hamadan, there were 24 medical laboratories outside of hospitals and clinics and there was possibility of construction of approximately 143 new laboratories in the city. The total area of lands valued as excellent and good for the establishment of new laboratories were about 130700 square meters. Therefore, it was possible to establish all proposed new medical laboratories in these lands in Hamadan. In Shushtar, there were 3 medical laboratories outside of hospitals and clinics and it was possibility of construction of approximately 9 new laboratories in the city. The total area of lands valued as excellent and good for the establishment of new laboratories were about 36800 square meters. Therefore it was possible to establish all proposed new medical laboratories in these lands in Shushtar.Conclusion: It is possible to use geographical accessibility model for site selection of new medical laboratories in cities. The accuracy of selected sites should be confirmed with field visits.

Objective(s): Healthy lifestyle is an important factor to reduce the incidence, severity and complications of diseases. BASNEF model, as an educational framework, in addition to patients’ knowledge and attitude considers environment and social norms in changing behavior. This study aimed to assess the effectiveness of an educational intervention based on BASNEF model on lifestyle of patients with heart failure.Methods: In this quasi-experimental study, 60 patients with heart failure were enrolled in the study and allocated to intervention and control groups (30 per each group). The intervention group revived 4 sessions based BASNEF while the control group received nothing. To collect data participants completed a lifestyle and BASNED model questionnaires at two points in time: at baseline and 3 months follow-up. Data analysis was performed using descriptive and inferential statistics.Results: The mean scores of total lifestyle did not differ between the two groups after the intervention (p=0.16), However some aspects of lifestyle such as nutrition, sleep patterns, physical health, stress and tobacco use were significantly differed between the two groups (p<0.05). The analysis of data also showed that the mean scores of BASNEF structures before and after intervention significantly differed in intervention group (p<0.0001).Conclusion: The findings suggest that an educational intervention based on BASNEF might have some positive effect on lifestyle of patients with heat failure.

Objective(s): Inactive lifestyle is one of the most important risk factors to many diseases and disorders such as obesity, diabetes, heart failure, depression and osteoporosis. The aim of this study was to assess effectiveness of a training program on physical activity using the theory of planned behavior among high school female students in Ahvaz, Iran.Methods: This Controlled trial was performed on 163 high school female students. The study sample randomly enrolled in two groups (control and intervention). Data were collected by a questionnaire containing items related Theory of Planned Behavior and the International Physical Activity questionnaire. The questionnaires were completed at two points in time: a baseline and 3 months after intervention. The educational intervention was performed in 4 sessions for experimental group. The data were analyzed paired t–test, independent t test and Chi-square.Results: There were no significant differences between two groups at baseline. in terms of demographic variables, mean scores of different structures of the model and behavior. There were significant differences between experimental and control groups in attitude intention, subjective norms, perceived behavioral control and increased physical activity (p<0.05).Conclusion: The results indicated that the educational intervention was effective in changing physical activity among students in the intervention group.

Objectives: Elderly housing in Iran where elderly population is increasing is an important issue. The aim of this study was to investigate about elderly housing and physical and mental health of elderly in Iran.Methods: A sample of 35 of architectures, rehabilitation, medical, and nursing experts were interviewed. They were asked to indicate the best housing type that could improve physical and mental health among elderly.Results: The result showed that the ‘elderly villages’ had achieved the first rank among other choices. They believed that this could lead to better physical and mental health in elderly.Conclusion: Since the elderly village has not a long background in Iran we should pay attention to this type of housing policy.

Objective(s): The purpose of this study was to examine quality of life and its correlates in elderly in Tehran metropolis.Methods: This was a cross sectional study. A random sample of elderly living in Tehran was selected. from are randomly selected in proportional stratified and multiple-stage cluster sampling in this study. Data were collected using the health-related quality of elderly people life (EHRQOL) and Life Satisfaction Index-Z (LSI-Z).Results: In all 1147 elderly entered into the study. The highest score was for spiritual well being (mean: 90.76) while the lowest score were for social welfare and security (mean: 57.02) and healthy mind (mean 51.36) respectively. There was a positive correlation between higher life satisfaction and a better quality of life.Conclusion: Improving quality of life in elderly needs attention. Perhaps improving living condition in this population could lead to improved quality of life.