Journal of Health System Research
Year:2011 | Volume:7 | Issue:4|Papers Count:14

Background: Early and late menopauses result in various physical and mental complications. On the other hand, family health primarily depends on mothers' health. Therefore, the present study aimed to determine the social factors related to age of natural menopause in Zahedan.Methods: This cross-sectional study was carried out on 300 menopausal women in Zahedan during 2008.Subjects were randomly selected from 38 health centers. The sampling was started from a random point near each health center continued until 13 appropriate individuals were selected from every center. The data were collected by interviews with women. Data analysis was conducted in SPSS using independent t test, analysis of variance (ANOVA), and principal component analysis.Findings: This study showed mean±SD and median age of menopause as 47.3±6.3 and 48 years, respectively.The socioeconomic and menstrual-reproductive factors that were significantly related to early mean age of menopause were celibacy (44.6 years, P=0.04), low income level (45.3 years, P=0.043), low social class (45.2 years, P=0.048), and smoking (45.8 years, P=0.039).Conclusion: In addition to genetic and menstrual-reproductive factors, social factors especially socioeconomic factors can also affect the age of natural menopause. Since of menopause is related with some diseases, complications and mortality among women, this phenomenon should be noticed as an epidemiological issue in societies and early menopause should be prevented.

Background: Fast food consumption has increased greatly among adolescents in recent years. About 30% of children and adolescents in the United States consume fast food on a typical day. Fast food consumption is linked with weight gain, poorer dietary indicators, and insulin resistance. The purpose of this study was to assess predictors of fast food consumption among high school students in Isfahan based on the Theory of Planned Behavior (TPB).Methods: This descriptive-analytic study comprised a sample of 521 high school students, aged 15-18 years, selected by multistage sampling. Descriptive statistics were used to examine demographic characteristics and study variables. TPB-based variables were assessed through a questionnaire evaluating attitudes, subjective norms, perceived behavioral control (PBC), intention to consume fast food, past behavior and actual behavior control as independent variables. The data collected were analyzed using descriptive and inferential statistics in SPSS14.Findings: The mean age of students was 16.28±0.89 years. There were significant relationships between behavior (fast food consumption) and high level of education and higher income of the family (P<0.01).The combination of attitude, subjective norms, and PBC accounted for 25.7% and 6% of the variance of behavioral intention and behavior, respectively. Moreover, attitude was the most significant predictor of intention (b=0.331).Conclusion: Our findings were consistent with other research showing that TPB offers a good prediction of fast food consumption intentions but falls short in predicting behavior.

Background: Menopause is a normal developmental transition happening as a result of aging in all women. During menopause, women may experience certain physical, mental, social and psychological changes. Getting familiar with these changes and understanding their reasons would help women be better prepared to adapt themselves with the changes. Health education is one of the most important ways to empower women. Since the first step in any training is recognition and analysis of subject's knowledge and attitude, the purpose of this study was to assess the knowledge and attitude towards menopause among premenopausal women.Methods: This cross-sectional study was conducted among 400 healthy, non-menopausal women aged 40-45 years attending urban primary health care centers. Subjects were selected based on stratified sampling.Written informed consents were obtained from all participants. Data was collected by a three-part questionnaire including demographic characteristics, questions to assess knowledge, and attitude questions.The collected data were analyzed by Pearson correlation, independent t-test, Spearman correlation and analysis of variance (ANOVA) in SPSS.Findings: The results of this research showed the average scores of knowledge and attitude to be 63.57±10.79 and 61.21±12.73, respectively. In this study, 8% of the subjects had poor, 68% moderate and 38.5% good knowledge. Furthermore, 81.5% of women had positive attitude and 18.5% had negative attitudes towards menopause. Pearson correlation showed an insignificant relationship between knowledge and attitude. Spearman correlation showed knowledge and attitude to be significantly related with economic status and level of education (P<0.001).Conclusion: Providing greater access to information and supporting women are essential steps in improving women's health during menopausal years.

Background: Cancer occurs when cells divide uncontrollably. These abnormal cells can invade nearby tissues or travel to distant sites by entering the bloodstream or lymphatic system. Incidence rate of cancer has increased constantly during the past 50 years. Nutrition, physical activity and hope are significant factors in cancer. However, patients do not have enough knowledge and correct attitude toward these important factors. In this study, instead of unidirectional conveyance of educational subjects, patients and their families were invited to actively participate in learning process by the Problem-Based Learning (PBL) method. PBL is in fact a kind of preparation for life because life means encountering problems and trying to solve them. The aim of this study was knowledge promotion and attitude modification in patients and their families about the importance of nutrition and physical activity during disease and treatment by the PBL method. Increasing hope in patients was another aim of this study.Methods: This study was a randomized controlled trial. Knowledge and attitude were assessed based on BASNEF model and Herth Hope Index (HHI) questionnaire. These questionnaires, as well as a knowledge and attitude questionnaire for families, were completed by the two groups of case and control (each including 25 persons) before and after the intervention. The educational and promotional interventions for patients and their families in the case groups were performed face to face and individually based PBL method. Data was analyzed by chi-square test and analysis of covariance in SPSS. The significance level was considered as a=0.05.Findings: Mean score of knowledge in the case group was significantly more than the control group (P< 0.001). In addition, interventions led to better attitudes in the case group (P<0.001). Mean scores of subjective norms (P<0.12) and enabling factors (P<0.08) were not significantly different between the two groups. However, mean scores of hope was significantly more in the case group than the control group (P<0.008). Mean scores of knowledge among the families in the case group were higher than those in the control group (P<0.001). Moreover, interventions led to better attitudes among the families in the case group (P<0.001).Conclusion: Educational and promotional interventions based on PBL method increase knowledge and hope levels and improve attitudes in cancer patients and their families. Therefore, such interventions are suggested in order to enhance quality of life among cancer patients.

Background: Technology-related tools, including computers and video display terminals (VDTs), are rapidly expanding as a result of the quick growth of technology itself. Investigation on the complaints of VDT users reported visual discomfort. This study aimed to design an appropriate tool to assess visual fatigue of VDT users.Methods: This cross-sectional study was performed on 248 VDT users in different professions during 2011. After reading books, articles, and similar questionnaires, question banks were provided and an initial questionnaire was developed. Validity and reliability of the questionnaire were evaluated by Cronbach's alpha coefficient and content validity index (CVI). A theoretical model based on four categories of symptoms of visual fatigue, extracted from previous studies, was designed. AMOS software was used to assess the validity of its constructs using confirmatory factor analysis and fitted parameters. Using the SPSS18, internal correlation coefficients of the domains were calculated. In order to investigate the reliability and grade the final scores of the questionnaire, visual fatigue was simultaneously assessed by the questionnaire and the VFM-90.1 device and the results were compared. In addition, cutting points were determined by the ROC curve.Findings: A minimum CVI of 0.75, reliability coefficient of 0.755, model fit indices of RMSEA=0.026, GFI=0.96 and AGFI=0.92 were found. The correlation between the results measured with a questionnaire and VFM-90.1 was -0.87 and the cut-off points were calculated as 0.65, 2.36 and 3.88. Four main domains of the questionnaire, including eye strain (4 questions), visual impairment (5 questions), surface related impairments of the eye (3 questions) and problems outside the eye (3 questions), were approved.Conclusion: The questionnaire contained 15 questions to assess visual fatigue. It had excellent reliability and validity. Therefore, VDT users can easily assess their extent and level of visual fatigue by this relatively short and simple questionnaire.

Background: Health literacy is a measure of an individual's ability to read, comprehend, and act on medical instructions. Limited health literacy can reduce adults' ability to comprehend and use basic health-related materials, such as prescription, food labels, health education pamphlets and articles, appointment slips and health insurance plans. Therefore, it can reduce their ability to take appropriate and timely health care actions. Nowadays, low health literacy is considered a worldwide health threat. Thus, the purpose of this study was to assess health literacy level in elderly and to investigate the relationships between health literacy and health status, as well as health care utilization and health preventive behaviors.Methods: A cross-sectional survey of 354 elderly individuals was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data was collected using home interviewing. Health status was measured based on self-rated general health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations. Moreover, health preventive behaviors were measured based on self-reported use of preventive health services.Findings: Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, have fewer years of schooling, lower household income, and being female. Inadequate health literacy was associated with poorer general health (P<0.001). In addition, health literacy level was negatively associated with outpatient visits (P=0.003) and hospitalization (P=0.01). No significant association was found between health literacy level and emergency room utilization. Individuals with higher levels of health literacy have performed PSA (P<0.001) and FOBT (P=0.003) tests (in order to diagnose prostate and colorectal cancers, respectively) more than others. No significant association was found between health literacy level and mammogram in the last 2 years.Conclusion: Low health literacy is more prevalent in older adults. This emphasizes the importance of health literacy issue in health promotion. Therefore, with simple educational materials and effective interventions for low health literacy group, we can improve health promotion in society and mitigate the adverse health effects of low health literacy.

Background: Maintaining health, as one of the main and old concerns of mankind, is influenced by various factors. Therefore, global health-related declarations and strategies emphasize proper drug provision and consumption, as well as effective treatments. Self-medication, a controversial health issue, is three times commoner in Iran than the world average record which makes the country stand the second in Asia. Investigating the causes of self-medication based on the Health Belief Model (HBM) is a scientific and effective method to control the problem. Thus, this study attempted to identify and rank the factors associated with self-medication.Methods: In this cross-sectional descriptive-analytic study, 380 elderly adults were selected based on stratified random sampling with proper ratios. The data were collected through structured interviews using a 47-item questionnaire which covered the HBM subsections. The validity and reliability of the questionnaire were confirmed. The data were analyzed through SPSS16.Findings: The age average of the participants was 66±5.31. Moreover, 36.10% of the subjects were retired, 29.40% had an education of primary school level, 53.90% were under the support of social insurance, 77.60% consumed over-the-counter drugs, 85.30% kept drugs at home, 42.30% took sedative drugs, and 15.10% consumed psychiatric drugs. The score for perceived sensitivity and barriers were 50.21 and 70.23, respectively.Self-medication was found to be significantly related with gender, marital status, and education level. In addition, a successful previous experience of self-medication and considering drugs as harmless were suggested as the main causes of self-medication. Furthermore, mass media were discovered to be the most effective solution to prevent self-medication.Conclusion: In this study, the prevalence of self-medication was high and the alterable factors were in undesirable conditions. Although the subjects did not show a minimum score of 50% in different subsections of HBM, the self-efficacy average was desirable which could lead a false sense of confidence and increased self-medication.

Background: Health promoting lifestyle (HPL) consists of six aspects including physical activity, nutrition, health responsibility, spiritual growth, interpersonal relations and stress management. This lifestyle promotes health and welfare, induces satisfaction, self-persuasion and self-improvement. Therefore, this study aimed to determine the relation between health-promoting lifestyle behaviors and quality of life among undergraduate students at School of Health, Isfahan University of Medical Sciences.Methods: This cross-sectional study was conducted on undergraduate students at School of Health, Isfahan University of Medical Sciences. A census sample of 81 subjects completed a survey questionnaire.Health Promoting Lifestyle Profile 2 was used in order to measure health promoting lifestyle behavior.Quality of life was measured the Farsi version of QLQ-C30 questionnaire whose validity and reliability have been confirmed before. Data analysis was performed using descriptive and inferential statistical tests in SPSS.Findings: Mean age of participants was 21.12 years. In addition, 54.3% of the subjects were female and 45.7% were male. Spiritual growth and physical activity were respectively the most and least common subscales of HPL practiced. General quality of life of the majority of cases was good (40.7%). The highest and lowest frequencies of health-related quality of life belonged to very good (58.6%) and excellent (9%) scores, respectively. Except for stress management (P=0.05), there were no significant relations between HPL aspects and gender. Female students performed self-care behaviors and relaxation techniques more than male students. Although spiritual growth was significantly related with general quality of life (P=0.006), no significant differences were found between other subscales of HPL and general quality of life. In addition, health-related quality of life was significantly related only with stress management (P=0.03).Conclusion: According to our findings, the majority of students had good general quality of life since 58.6% scored very good and 9% scored excellent in health-related quality of life. Finally, our findings showed that HPL, spiritual growth and stress management were positively related with global quality of life.

Background: Excessive salt consumption is associated with the severity of arterial hypertension and ventricular hypertrophy. This study tried to assess determinants of salt consumption based on reasoned action theory among women who referred to health care centers in Yazd.Methods: This descriptive-analytic study was conducted on 247 women who referred to health care centers in Yazd. Subjects were selected by multistage random sampling. Data was collected by a questionnaire designed based on constructs of reasoned action theory on three salt consumption behaviors. Data were analyzed using student t-test, chi square test, one way analysis of variance (ANOVA), Pearson and Spearman correlation coefficients and linear regression.Findings: Mean age of participants was 29.91±6.75 years. A significant correlation was seen between using less than 6 g of salt in cooking and its intention (r=0.132, P<0.05), and between table salt avoidance and its intention (r=0.422, P<0.05) and its attitude (r=0.411, P<0.05), as well as between salty food avoidance and its attitude (r = 0.169, P < 0.05). Regression analysis indicated that 43% intention of using less than 5 g of salt in cooking, 37% intention of table salt avoidance, and 18% intention of salty food consumption was predicted by attitude and subjective norms.Conclusion: Since attitude is the most important predictor of salt-related behaviors, proper planning needs to be conducted to change of attitudes of people.

Background: In many work environments with sensitive and complex technologies, human errors are very important since they may lead to catastrophes. Therefore, it is necessary to recognize and find out causes of human errors to prevent and limit their dreadful consequences. This study aimed to identify, assess and control human errors in the distillation unit of Isfahan Oil Refinery.Methods: This study was performed in 2010. Data was collected using task observation and interviewing safety authorities, unit and shift supervisors and operators. Finally, 8 critical tasks were determined. Then, Hierarchical Task Analysis (HTA) was conducted and human errors in each task were identified by Systematic Human Error Reduction Prediction Approach (SHERPA) technique.Findings: After analyzing SHERPA work sheets, 198 human errors were identified including 134 (67.64%) action errors, 23 (11.61%) checking errors, 11 (5.6%) communication errors, 24 (12.12%) retrieval errors and 6 (3.03%) selection errors. Overall, the possibility of 64% of human errors among control room operators was assessed as "low" while 36% had a "moderate" possibility. In addition, although 59% of the identified errors of control room operators required no recovery, 29% resulted in sensitive outcomes.Conclusion: The results showed that SHERPA technique can be used as an effective method to detect human errors in the control room of sensitive units of oil refineries.

Background: The relationship between leisure time and work time has long been considered as an important factor in creating job motivation and job satisfaction. Leisure time physical activity can promote mental and physical health among personnel working in stressful atmospheres, including hospitals.Therefore, this study aimed to examine the factors inhibiting leisure time physical activity among the personnel of Isfahan educational hospitals.Methods: The present descriptive cross-sectional included 345 people randomly selected by multistage cluster stratified random sampling from the personnel of educational hospitals in Isfahan. Data was collected by a questionnaire. Descriptive statistics and explanatory factor analysis were used for analyzing data.Findings: The results demonstrated the sequence of personal, interpersonal and structural functions of the hierarchical model as inhibiting factors for leisure time physical activity. Structural, personal and interpersonal factors were respectively the most important factors. Among structural factors, economic factors were the main inhibiting factors for participating in leisure time physical activity.Conclusion: According to our results, hospital managers must try to decrease inhibiting, especially structural, factors. They should pay attention to demographic and professional characteristics of their personnel in decision-making in order to have more energetic and highly productive workforce.