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Theory of planned behavior, self-stigma, and perceived barriers explains the behavior of seeking mental health services for people at risk of affective disorders
Maryam Damghanian, Mehran Alijanzadeh
October-December 2018, 1(2):54-61
Introduction: To use the theory of planned behavior (TPB) incorporated with self-stigma and perceived barriers to investigate the nature of help-seeking behaviors in a community sample at risk of anxiety or depression in Iran. Methods: Participants at risk of anxiety or depression screened by Hospital Anxiety and Depression Scale (n = 1011) completed the following questionnaires at baseline: Factors in TPB, Self-Stigma in Seeking Help Scale, and perceived barriers in seeking help. Two years later, their help-seeking behavior (i.e., visiting a specialist) was retrieved from their medical records. Models using TPB concepts and incorporated with self-stigma and perceived barriers were tested by structural equation modeling. Results: The effects of TPB concepts, self-stigma and perceived barriers on help-seeking behaviors (i.e., visiting a specialist for mental health problems) were supported by the excellent data-model fit indices: Comparative fit index = 0.997; Tucker–Lewis index = 0.965; root mean square of error approximation (RMSEA) = 0.028; and weighted RMSEA = 0.386. All the path coefficients were significant, except for the path between perceived barriers and help-seeking behavior. Perceived behavioral control had the strongest coefficient (standardized coefficient = 0.547); subjective norm had the weakest coefficient (standardized coefficient = 0.061). In addition, perceived barriers were indirectly associated with help-seeking behaviors. Conclusion: TPB is an effective model to explain the help-seeking behaviors for people at risk of anxiety or depression. In addition, self-stigma and perceived barriers may be simultaneously considered when clinicians want to prevent an individual with depression or anxiety from not seeking proper help on their mental health problems.
  2,273 314 2
Economic burden of obesity: A systematic review
Hasan Yusefzadeh, Ali Rashidi, Bahlol Rahimi
January-March 2019, 2(1):7-12
Obesity imposes considerably high economic costs on the health-care system. It is proposed that 10% of health-care costs belong to direct and indirect effects of obesity. Taking measures to prevent, manage, and treat obesity is costly. However, some benefits can be obtained by reducing economic costs and by improving health in the future. This study aimed to systematically review the costs caused by obesity. We systematically searched the English language literature indexed in PubMed, Scopus, and Web of Science databases (January 2000 to September 2017). Articles were included if direct and indirect costs of obesity were assessed among participants at the age of more than 18 years. Key terms including economic burden, medical cost, nonmedical cost, and obesity were used for this search. From a total of 20 studies, 9 papers found to be relevant for reviewing. According to these papers, obesity accounts for 31.8% of direct costs (health-care costs related to obesity) and 68.1% of indirect costs (costs related for reducing productivity and production value). Therefore, obese people spend 32% more for medical costs compared to people with normal weight. Due to great number of short-term and long-term complications of obesity and its potential economic impact, efforts are needed to be taken to facilitate health interventions and social policies. Nationally, as obesity imposes high costs on people and health-care system which should fund most of these costs, developing plans to decrease these costs are needed.
  1,651 251 4
Relationships among health-related behaviors, smartphone dependence, and sleep duration in female junior college students
Shang-Yu Yang, Kai-Li Chen, Pin-Hsuan Lin, Po-Yu Wang
January-March 2019, 2(1):26-31
Introduction: Inadequate sleep is common among adolescents. Females have been found to have higher sleep requirement than that in males. This study aimed at (1) investigating the associations of sleep duration with smartphone dependence and a health-promoting lifestyle, and (2) identifying predictor(s) of inadequate sleep among adolescent females. Methods: This questionnaire-based cross-sectional study recruited 385 female junior college students (mean age: 17.50 ± 3.30 years) at a single tertiary education institute in December 2014. The questionnaire comprised three parts: (1) demographic/anthropometric characteristics (i.e., age, body mass index) and habits of alcohol/tobacco consumption, (2) smartphone dependence score according to the participant's response to four questions rated with five-point Likert scale, and (3) scores on compliance with six dimensions of the health-promoting lifestyle profile (HPLP), including nutrition, health responsibility, self-actualization, interpersonal support, exercise, stress management, and total score. Correlations of the study parameters and sleep adequacy (defined as ≥7 h) were investigated. Results: The mean sleep duration of the participants was 7.35 ± 1.49 h. Logistic regression analysis demonstrated significant negative correlation between smartphone dependence and sleep duration (P < 0.01), as well as positive associations of sleep duration with the nutrition (P < 0.01), health responsibility (P < 0.05), stress management (P < 0.01) dimensions, and total score (P = 0.01) of HPLP. Stepwise regression further showed that smartphone dependence was the only significant predictor of inadequate sleep (B: −0.06; standard error: 0.02; P < 0.01). Conclusion: The results of the present study underscore the importance of promoting a healthy lifestyle including prevention of smartphone dependence in maintaining healthy sleep habits in adolescent females.
  1,544 169 1
The mental health needs of child and adolescent refugees and asylum seekers entering Europe
Supakyada Sapthiang, William Van Gordon, Edo Shonin, Mark D Griffiths
January-March 2019, 2(1):13-16
Children and adolescents constitute more than half of the global refugee population, and almost one-third of first-time asylum seekers in the European Union (EU) during 2015 were under 18 years of age. Syria, in particular, accounts for a substantial proportion of young refugees and asylum seekers because the ongoing civil war has led to almost 5 million Syrians fleeing their country and becoming refugees during the past 7 years. Being a child or adolescent refugee or asylum seeker carries an increased risk of developing mental illness, and such displaced young people are known to experience problems in accessing health-care support. The present article draws on examples from Syria in order to (i) Highlight mental health issues that typically arise in children and adolescent refugees and asylum seekers entering Europe and (ii) discuss how changes to health systems and policies in European countries receiving refugees and asylum seekers can be better aligned with global efforts to improve the mental health of young displaced immigrants. In general, research findings indicate that there is a need for better awareness, intra-agency collaboration, and cultural sensitivity toward the mental health needs of this immigrant population. Furthermore, there is also a need for EU countries to better respond to posttraumatic stress disorder and other typical refugee and asylum seeker mental health problems by more closely aligning national policies with global initiatives to improve the mental health of young displaced immigrants.
  1,344 177 1
Job stress, sexual harassment, self-harm behavior, and suicidal ideation among military personnel in Taiwan
Huei-Ting Jin, Yi-Ching Lin, Carol Strong
July-September 2018, 1(1):11-15
Introduction: The aim of this study was first to estimate the prevalence of having self-harm behavior and suicidal ideation in a sample of military personnel. Second, we examined whether work stress, sexual harassment experiences, and depression were associated with suicidal ideation and self-harm behavior. Methods: A cross-sectional survey was conducted in Taiwan between January and April 2016. Sample was recruited from large military bases in Taiwan, including army, navy, and air force using convenience sampling. Self-reported data on job stress, sexual harassment experiences, self-harm behavior, and suicidal ideation were collected. Multiple logistic regression was used to determine the risk factors associated with having had self-harm behavior or suicidal ideation. Results: Of 513 individuals surveyed, 4.5% had self-harm behavior in the past 12 months and 9% had considered suicide. The majority of the sample were male (81.9%), between 20 and 29 years old (87.7%), voluntary military service (79.7%), and single or not married (90.8%). A higher level of sexual harassment experiences, higher level of perceived work stress, interpersonal relationship, and a lower level of job satisfaction were associated with self-harm behaviors. In multivariate analysis, gender, education, perceived work stress, sexual harassment, and depression were significantly associated with having had considered suicide in the past 12 months. Discussion: Our study highlighted the importance of acknowledging the vulnerability of the military work environment, including self-harming tendencies and sexual harassment. Education and training to ensure gender equality should be provided through appropriate channels.
  1,313 193 -
Five myths about gaming disorder
Mark D Griffiths
July-September 2018, 1(1):2-3
  1,217 182 -
Association between sleeping duration and health-related behaviors in college student
Pin-Hsuan Lin, Chung-Ying Lin, Po-Yu Wang, Shang-Yu Yang
July-September 2018, 1(1):31-36
Introduction: Although the past studies have presented differences between sleep duration and health-related behavior, to the best of our knowledge, no studies have considered the different dimensions of adolescent health-related behavior according to gender. The current study aims to investigate the association between sleep duration and health-related behavior in both genders. Method: A cross-sectional study was conducted in a college in southern Taiwan. We used convenience sampling and invited all undergraduate full-time students in their 3rd year to participate in this study in 2014. There were three parts in our questionnaire, including participant's characteristics, the Adolescent Health Promotion (AHP) scale, and medication consumption habits. The participants were classified into two groups according to their sleep duration (<7 h vs. ≥7 h). We examined the predictors of sleep duration through the use of logistic regression analysis with the six AHP dimensions and unsafe medicine consumption habits as independent variables, respectively. Results: Using our whole sample, sufficient sleep duration was associated with higher AHP scores on nutrition and stress management and less unsafe medicine consumption habits (P < 0.05). For both males and females, sleeping more than 7 h was associated with better stress management (P < 0.01). Conclusions: Students whose sleeping duration was ≥7 h had a greater tendency to have good nutritional behavior and stress management behavior than those whose sleeping duration was <7 h. Moreover, students with insufficient sleep may have a significantly greater tendency to have unsafe medicine consumption habits.
  1,259 123 -
The professional quality of life among health-care providers and its related factors
Zohreh Keshavarz, Maryam Gorji, Zeinab Houshyar, Zeinab Talebi Tamajani, Jeno Martin
January-March 2019, 2(1):32-38
Introduction: The professional quality of life is a type of emotion that every person perceives to his/her job. This study aimed to evaluate the professional quality of life among health-care providers including physicians, nurses, and midwives and its related factors. Methods: This cross-sectional study was conducted in 2018. Participants were 464 doctors, nurses, and midwives working in educational hospitals of Qazvin University of Medical Sciences selected using a convenience method. Data were collected using demographic information questionnaire and Persian version of the professional quality of life questionnaire. Multivariate linear regression models were used to examine the related factors. Results: In the present study, 464 health-care providers including 150 doctors, 161 midwives, and 153 nurses participated. Their mean age was 32.29 ± 6.88 years. The majority of them (56.2%) reported a moderate job satisfaction. The mean (standard deviation) of participants' scores in the domains of compassion satisfaction, burnout, and secondary traumatic stress was 38.84 (6.23), 13.53 (4.34), and 27.05 (5.70), respectively. The regression model showed that high and medium job satisfaction, monthly income, and work shift arrangements were significant predictors for all domains of professional quality of life. Conclusion: Physicians, midwives, and nurses had a moderate professional quality of life. Factors such as high job satisfaction, monthly income, and work shift arrangements partly predicted their professional quality of life. Therefore, paying enough attention to improving job satisfaction and improving working conditions and income might improve the professional quality of life of health-care providers, and consequently, the quality of patient care.
  1,138 163 -
Child–Parent agreement on quality of life of overweight children: Discrepancies between raters
Xavier CC Fung
October-December 2018, 1(2):37-41
Introduction: Kid-KINDL, a health-related quality of life (HRQoL) instrument for children, contains paralleled child-reported and parent–proxy versions. However, parents may rate HRQoL differently from children do; thus, health-care providers may be misled by the parent-rated HRQoL to assess the health of children. Thus, understanding the agreement between parent- and child-rated HRQoL is important. This study aimed to investigate the agreement between child- and parent-rated Kid-KINDL, including total score and domain (physical, emotional, self-esteem, friend, family, and school) scores. Methods: A total of 96 dyads of 8 to 12-year-old overweight children were recruited. Child-reported and parent–proxy Kid-KINDL were completed by children and parents (70.8% mother; 19.8% father), respectively. Statistical significance of child–parent discrepancies was analyzed using paired t-test and magnitude of discrepancies was analyzed using Cohen's d. Regression analyses were used to examine the potential predictors (age, gender, body mass index, family income, and raters) on score differences. Results: Significant differences were found in total score (d = −0.26) and three subscales (emotional, d = 0.21; self-esteem, d = −0.33; and school, d = −0.56) with small-to-medium magnitudes. Regression analyses revealed that father as rater significantly explained the score differences in total (standard coefficient β = −0.266, P = 0.013), emotional (β = −0.224,P = 0.038), and school (β = −0.215, P = 0.045). Conclusion: Parents seemed to be optimistic when rating on their overweight children's HRQoL. Health-care providers should be aware of this issue when using parent-reported Kid-KINDL and do not miss out any risk on children's HRQoL. Furthermore, the results may suggest health-care providers improving child–parent interaction. They can not only align parent with child, but also align with every caregiver.
  1,091 169 3
Association between household food security and pregnancy complications
Khadijeh Sadat Hoseini, Farideh Kazemi, Zainab Alimoradi, Seyed Saeid Sedghi Oskoei, Hashem Alijani, Samaneh Zolghadr
July-September 2018, 1(1):26-30
Introduction: Despite the importance of the family food insecurity during pregnancy, there was no research in this regard in Iran, where generally has a modest food security status. The present study was designed to investigate the prevalence of household insecurity in pregnant women and found its relationship with pregnancy complications such as preeclampsia, gestational diabetes, and anemia during pregnancy. Methods: This cross-sectional study was conducted between December 2016 and December 2017. Samples were women after childbirth referred to health centers for postpartum care in the Qazvin province. The household food security status (using Household Food Insecurity Access Scale) and pregnancy outcomes including preeclampsia, diabetes during pregnancy, and anemia during pregnancy were investigated. Results: Overall food insecurity was observed in 32.3% of participants. The increased chance of having a total pregnancy complication rate was 64% (odds ratio [OR] [95% confidential interval [CI]] = 1.64 [1.06–2.54]) in food insecure group compared to food secure participants. Specifically, gestational hypertension was 24% (OR [95% CI] = 1.24 [0.58–2.69]), preeclampsia was nearly four times (OR [95% CI] = 3.88 [1.18–12.83]), gestational anemia was 24% (OR [95% CI] = 1.24 [0.58–2.71]), and gestational diabetes was 63% (OR [95% CI] =1.63 [0.81–3.30]). Conclusion: Food insecurity might increase the likelihood of pregnancy complications. Since the pregnant women's diet plays an important role in maternal and fetal health, the assessment of maternal nutritional status and household conditions regarding access to food supplies and the ability to supply diverse and balanced foods during pregnancy is important.
  1,092 162 -
Ethical issues of monitoring children's weight status in school settings
Chung-Ying Lin
January-March 2019, 2(1):1-6
  1,110 122 4
Nature walk decrease the depression by instigating positive mood
Atul Kumar Goyal, Arun Bansal, Jyoti Saini
October-December 2018, 1(2):62-66
Introduction: Depression the most common psychological problem prevails across the world. To deal with depression, psychotropic drugs are generally prescribed by the clinicians which have enormous side-effects. Nature walk refers to a walk in the natural area containing wild flora and fauna, undisturbed by the anthropogenic means. The nature walk is considered as a live meditation which imparts mental peace in the walkers. But limited evidence is availed till date reporting the role of a nature walk in instigating positive mood. Therefore, present work was carried out to evaluate the potential role of a nature walk in decreasing depression by instigating the positive mood. Methods: For this, a nature walk was organized for 20 participants in Chhatbir Zoo, Chandigarh. The mood of participants was assessed by using the BMIS instrument. Results: Results of the present study revealed that nature walks significantly instigate the positive mood. Conclusion: Based on our results, we suggest that nature walk can be used as an intervention to manage depression.
  1,041 123 1
The impact of environmental support on health for children with hearing impairment in Taiwan
Chung-Ying Lin, Xavier C.C Fung
July-September 2018, 1(1):4-10
Introduction: Children with hearing impairment (HI) often encounter difficulties in learning due to their language problems caused by HI. Therefore, children with HI also suffer from health problems, including psychological health, social relationship, and school performance. Given that the International Classification of Function, Disability, and Health proposed environment as a key element in promoting health. This study proposed to investigate the impacts of environmental support on health and learning abilities among a nationally representative sample with HI. Methods: A total of 163 children (94 boys; 88 first graders and 75 third graders) retrieved from the Special Needs Education Longitudinal Study were used for analysis. Questionnaire items on environmental support (3 items), impairment (1 item), learning ability (4 items), and health (4 items) were constructed in a structural equation model. Specifically, environmental support was linked to impairment, learning ability, and health; impairment was linked to learning ability and health. Results: Our results indicated that environmental support had positive effects on three dimensions of health (social relationship, β = 0.38; emotional functioning, β = 0.27; and school performance, β = 0.59) and learning ability (β = 0.26); negative effects on impairment (β = −0.62). Impairment had negative impacts on two dimensions of health (physical fitness and school performance, β = −0.18 and −0.22, respectively) and learning ability (β = −0.29). Conclusions: According to our findings, health-care professionals and school teachers may consider establishing good environmental support for children with HI. Thus, children with HI may have improved health and learning abilities.
  996 167 -
Fear of negative evaluation and social well-being in patients with multiple sclerosis: The moderating role of disease duration
Mohammad Ali Soleimani, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, Kelly AA Allen
October-December 2018, 1(2):48-53
Introduction: Diagnosis of multiple sclerosis (MS) can be accompanied by fear of negative evaluation (FNE). Emerging MS symptoms and FNE affect patients' health in dimensions including social well-being (SWB). The purpose of this study was to investigate the relationship between FNE and SWB among Iranian patients with MS. In addition, the moderating role of disease duration on this relationship was examined. Methods: In this descriptive correlational study, 200 MS patients were recruited from two clinics in Qazvin, Iran, through convenience sampling. Participants completed a demographic questionnaire, the Brief FNE Scale, and the SWB Questionnaire. Results: Mean scores for FNE and SWB were 35.12 ± 13.39 and 100.11 ± 9.81, respectively. We did not find a significant relationship between FNE and SWB (b = 0.092, P = 0.321). However, there was a statistically significant positive association between the duration of the disease and SWB (b = 0.928, P = 0.001). Moreover, there was a statistically significant interaction between the duration of the disease and FNE in predicting SWB (b = −0.025, P = 0.049). Conclusion: The study showed that the strength of the relationship between FNE and SWB depends on the disease duration. More specifically, FNE predicts well-being in patients with longer disease duration but not in patients with shorter disease duration.
  972 143 -
Comparing quality of life instruments: Sizing them up versus pediatric quality of life inventory and Kid-KINDL
Chung Ying Lin
October-December 2018, 1(2):42-47
Introduction: Children with overweight or obesity are very likely to experience health problems including low levels of psychological well-being and impaired quality of life (QoL). Given that the importance of QoL includes policymaking measuring QoL is especially crucial. Therefore, comparing generic (Kid-KINDL and Pediatric QoL Inventory [PedsQL]) and weight-related (Sizing Them Up) measures could provide insights for healthcare providers to decide how and when to use which QoL instrument. Methods: I recruited 199 school children studied between 3rd and 6th grades from 11 schools in Southern Taiwan, and all the children completed child depression inventory (for depression) and Rosenberg self-esteem scale (for self-esteem); one of their parents completed Sizing Them Up, PedsQL, and Kid-KINDL. Results: I constructed structural equation modeling to investigate the associations between these instruments, and the results indicated that self-esteem had the strongest relationship with Kid-KINDL; weight had the strongest relationship with Sizing Them Up. Moreover, both PedsQL and Kid-KINDL could observe the depression among children. Conclusion: Healthcare providers may have insights to select appropriate measure to assess QoL for overweight/obese children according to my findings.
  964 133 6
Epidemiological study of attempted suicide among children and teenagers in Qazvin Province, Iran
Manoochehr Mahram, Sonia Oveisi, Maryam Hosseinzadeh-Milani
July-September 2018, 1(1):16-21
Introduction: Suicide in children and young adolescents up to 14 years of age has been increased in many countries. This study aimed to determine the incidence, gender difference, timing difference, and cause of suicide attempts among children and teenagers in Qazvin Province, Iran, between 2007 and 2012. Methods: A descriptive-analytic study was performed in a register-based manner. In total, 2771 children and teenagers with suicide attempts who were referred to urban or rural health centers, hospitals, and legal medicinal centers in Qazvin Province were recruited. The residential background, the cause of suicide attempts, and the nature of the suicide acts were assessed. Results: Among all the children who had suicide attempts, 32.12% were male and 67.88% were female (sex ratio 0.47). Most of the suicide cases happened in autumn, and 786 (28.37%) were between 20:00 and 24:00 h. Swallowing poisonous drugs was the most prominent suicide methods, while hanging was the most dangerous method. In addition, familial dispute was the leading cause of suicide. Conclusion: It is a largely complex issue why some children attempt or commit suicide. The understanding of the pattern of suicide can help us provide suitable preventive programs.
  920 153 -
Social health and behavior needs more opportunity to be discussed
Amir H Pakpour, Chung-Ying Lin, Zainab Alimoradi
July-September 2018, 1(1):1-1
  906 166 -
Health-promoting lifestyle practices among patients with chronic diseases and its related factors
Fatemeh Samiei Siboni, Marzieh Khatooni, Vajihe Atashi
October-December 2018, 1(2):67-73
Introduction: Engaging in health-promoting lifestyle practices is one of the factors influencing the reduction of the burden of disease among individuals with chronic diseases. This study aimed to evaluate the health-promoting behaviors in individuals with chronic diseases and their related factors.Methods: In this cross-sectional study, health-promoting lifestyle practices in 625 individuals with a common type of chronic diseases in Qazvin city were investigated. Convenient sampling was used from May to December 2016 at specialized chronic diseases clinics of three university hospitals. The data collection was performed using a demographic questionnaire and the Farsi version of the health promotion lifestyle profile (HPLP II) questionnaire. Data were analyzed using descriptive and inferential statistics (independent t-test and stepwise multiple linear regression) via the SPSS version 21 software. Results: In the present study, 326 women and 299 men participated. The score of HPLP was 2.49 ± 0.37 in men and 2.47 ± 0.41 in women, with the highest score in nutrition and lowest score in physical activity. The results of the regression model showed that in women, the education of women and the spouse and satisfaction from the economic situation, whereas in men, the duration of the disease, unemployment, having chronic diseases in the digestive system and multiple sclerosis, age and education of the spouse, and satisfaction with the economic situation predicted health-promoting lifestyle practices. Conclusion: Given the low rate of health-promoting lifestyle practices, training and empowering these patients to promote lifestyle improvement of health-promotion behaviors, especially in physical activity, should be planned as part of the process of treatment and follow-up.
  853 139 -
On-campus promoting health literacy and behavior in adolescent athletes: A pilot study
Meng-Che Tsai
July-September 2018, 1(1):22-25
Introduction: Little is known about the profile of health-promoting behaviors in Taiwanese adolescent athletes. We codesigned a school-based extracurricular club with the adolescent athletes and aimed to examine the effect of program on the health-promoting behaviors among the participants. Methods: We recruited a sample of 40 athlete students: 20 participants from the health promotion club (intervention group) and 20 comparisons from other extracurricular clubs (control group). The content of health promotion program contained a wide array of health issues, such as growth, nutrition, sport injury, and life resuscitation. Certified physicians and physiotherapists provided lectures, workshops of experimentation, and forums of group discussion. We compared the health-promoting behaviors based on the Adolescent Health Promotion (AHP) scale before and after the program and between the intervention and control groups. Results: Athlete students scored higher in exercise (20.9 ± 3.6 vs. 16.3 ± 3.7, P < 0.01) but lower in nutrition (19.7 ± 3.4 vs. 22.1 ± 3.9, P < 0.01) among the AHP scale items than general students referenced in the literature. Athletes who participated in health promotion club showed improvement in AHP scores, particularly in the domain of health responsibility that was persistent up to 6 months after the intervention. Conclusion: We identified a general lack of healthy nutrition practices in these athlete youth. After 20 weeks' training, the participants adopted healthier behaviors that persisted even longer. Further research of larger participation is needed to evaluate the effectiveness of the scheme.
  846 98 -
Poor Activities of Daily Living Function Reflect Poor Quality of Life after Hip Fracture Surgery for Geriatric Patients
Wei-Ting Chang, Yi-Jie Kuo, Yu-Yun Huang, Ming-Jr Tsai, Yu-Pin Chen
April-June 2019, 2(2):41-46
Introduction: With the aging of the population, hip fractures have become a major public health issue in the elderly. It is important to examine the loss of activities of daily living (ADL) and the quality of life (QoL) among the elderly after repair of hip fracture. The correlation between ADL and QoL over time after hip fracture surgery was also our major concern. Methods: A prospective study enrolling 117 geriatric patients undergoing hip fracture surgery in a tertiary medical center was conducted between 2017 and 2018. All participants were evaluated with the EuroQol-5D for assessing QoL and the Barthel index for measuring ADL function at baseline, 3-and 6-month follow-ups after hip fracture surgery. Results: The mortality rate among geriatric patients after hip fracture surgery was 5.5% at 3 months and 9.1% at 6 months. In addition, both ADL function and QoL significantly deteriorated after 6 months of follow-up without improvement with time. After the 6-month follow-up, only 20% of geriatric patients undergoing repair for hip fracture were able to recover baseline ADL. The QoL at the 6-month follow-up was correlated with both cross-sectional and longitudinal ADL function after repair for hip fracture among geriatric patients. Conclusion: Functional impairment is common among geriatric patients after hip fracture surgery. Poor ADL could predict and reflect poor QoL after the 6-month follow-up. More emphasis should be put on preventing functional loss after hip fracture surgery in order for better QoL among geriatric patients undergoing hip fracture surgery.
  743 106 -
Effect of Peer Education on Physical Activity and Nutrition among Iranian Adolescents
Ali Damghanian, Gazal Sharietpanahi, Azita Khieltash, Hamid Barahimi
April-June 2019, 2(2):52-57
Introduction: Due to the high prevalence of sedentary lifestyle and inappropriate nutrition among adolescents, the present study aimed to investigate the effect of peer-based education on physical activity and nutrition among adolescents. Methods: In a randomized field trial with control group, a total of 223 students with a mean age of 16.52 (0.9) years participated in the study. Students were randomly selected from four high schools of Tehran's 17th district, Iran, using the multistage clustered sampling method. Two females and two males high schools were randomly assigned as an intervention or a control group. After selecting peer educators, they were educated about nutrition and physical activity at two 90-min sessions. Then, peer educators were asked to educate their classmates. Data were collected using demographic, nutrition, and physical activity subscales of Health Promoting Lifestyle Profile-II before and 3 months after the intervention. Data were analyzed using analysis of covariance in SPSS version 24 (IBM Corp., Armonk, New York). Results: Peer-based education improved girl's physical activity mean scores (16.19 ± 4.07–19.74 ± 4.25, P > 0.001), but no statistically significant effect on their nutrition. No statistically significant effect was observed after intervention on the nutritional status and physical activity of the male students. Conclusion: Peer education seemed to be a good method to improve physical activity among female students, but not their nutrition. In addition, physical activity and nutrition of male students were not improved by the peer education. Therefore, the future research using multidisciplinary approach which targets family involvement, and changes in physical activity and school nutrition policies are needed.
  698 99 -
Self-care behavior and self-care agency in lowering salt consumption in hypertensive older patients based on orem's self-care theory
Mina Hosseinzadeh, Nader Mahdavi, Sousan Valizadeh, Marjaneh M Fooladi, Farnaz Rahmani, Farnaz Ghanouni, Parvaneh Aghajari
July-September 2019, 2(3):89-95
Introduction: Hypertension is a common chronic disease with multiple systemic complications. Reducing dietary salt intake is one of the most effective and economical methods for managing hypertension. The aim of this study was to investigate self-care agency and self-care behaviors of patients with hypertension in reducing dietary salt and its related factors in Tabriz. Methods: In a cross-sectional study, 250 hypertensive adults were selected in June 2016–2017 from a pool of referred patients to the general clinic at one large teaching hospitals in Iran. They were selected through purposive sampling method. The data collection tools included a demographic questionnaire, self-care agency scale, and self-care behaviors scale. Statistical analysis included simple and multiple (multivariable) linear regression. Results: For dietary sodium reduction, the mean scores (standard deviation) of self-care agency and self-care behaviors were 37.4 ± 10.04 and 36.5 ± 7.8, respectively. Variables with a significant correlation with self-care agency were marital status, age, and the years of hypertension diagnosis (P < 0.001), and for self-care behaviors were marital status and self-care agency (P < 0.001). Conclusion: The findings of this study showed that single and older patients with a recent diagnosis of hypertension had a low score in self-care agency and self-care behavior. Therefore, health-care providers can focus their educational activities on these individuals to enhance their self-care behaviors and agency.
  656 132 -
Social support and mental health in patients with hematological diseases: The moderating role of insomnia
Karin Hogberg, Anders Brostrom
January-March 2019, 2(1):17-25
Introduction: Patients with hematological diseases (HDs) experience a variety of physiological and psychological symptoms. The purpose was to examine how anxiety, depressive symptoms, insomnia, and mastery are associated with perceived social support and mental health in patients with HDs. Methods: In this cross-sectional study, a convenience sample of 120 patients with HDs participated at a Swedish University hospital. Anxiety and depressive symptoms were measured by the Hospital Anxiety and Depression Scale. Perceived social support, mental health, insomnia, and mastery were measured using Medical Outcomes Study Social Support Survey, the Mental Component Score from the Short-Form Health Survey-12, and Minimal Insomnia Symptoms Scale and Pearlin Mastery Scale, respectively. Structural equation modeling was performed to analyze the data. Results: Associations between depressive symptoms and perceived social support differed depending on the insomnia symptom scores. Conclusion: Health-care personnel should routinely assess not only patients' levels of anxiety and depressive symptoms but also their insomnia to identify areas suitable for interventions to improve social support, as well as patient's mental health.
  674 91 -
Mental Health and Its Sociodemographic Determinants among High School Students: A Cross-Sectional Survey in Qazvin City of Iran
Mehran Alijanzadeh
April-June 2019, 2(2):58-63
Introduction: Adolescence is one of the most important stages of human life, and there is a lot of evidence in the literature that psychiatric disorders can be transmitted through adolescence social interactions in high school. The present study aimed to assess mental health and its sociodemographic determinants among high school students in Iran. Methods: In this cross-sectional study, 600 female high school students from Qazvin were selected using cluster sampling. The 28-item General Health Questionnaire was administrated to collect data. t-tests, analysis of variance, and Pearson's correlation analysis were applied to analyze the data. Results: Mental disorders were found in 60% of the students with 3.3% suffered from severe disorders. The participants' mean score of mental health was 29.31 ± 14.63. Somatic symptoms, anxiety, social dysfunction, and depression were presented in 36%, 49.7%, 50%, and 41.3% of the students, respectively. Students' mental health was significantly related with their father's education and household income. However, students' season of birth, school grade, body mass index, grade point average, mother's education, and father's occupation were not significantly related with their mental health. Conclusion: Poor mental health was found to be highly frequent among female students. Low income and father's low education level were identified as the risk factors of poor mental health among female students in Qazvin.
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The Association between Religious Belief and Drug Adherence Mediated by Religious Coping in Patients with Mental Disorders
Mohadeseh Movahedizadeh, Mohammad Reza Sheikhi, Saeed Shahsavari, Hui Chen
July-September 2019, 2(3):77-82
Introduction: Adherence to drug regimen is an important factor in the treatment of patients with mental disorders. In some studies, religious beliefs have been shown to be effective for treatment adherence. This study aimed to investigate the association between religious beliefs and adherence to the medication regimen mediated by religious coping in patients with mental disorders. Methods: In this cross-sectional study, 164 patients with mental disorders were selected through convenient sampling from educational centers in Qazvin city. Data were collected using a demographic questionnaire, March Drug Adherence Questionnaire, Santaklara's Religious Faithfulness questionnaire, and Pargament Religious Coping questionnaire. Data were expressed as mean ± standard deviation and analyzed using descriptive and inferential statistics. Results: The mean age of the patients was 38.87 ± 14.42 years. The mean duration of the disease was 5.71 ± 5.78 years. The mean of the religious belief score was 30.90 ± 5.96, the mean of the negative religious coping score was 2.17 ± 2.94, and the mean of positive religious coping score was 6.83 ± 4.69. There was a significant positive correlation between religious beliefs, adherence to medication regimen, and positive religious coping. There was a significant negative correlation between religious beliefs, adherence to medication regimen, and negative religious coping. Conclusion: There was a significant positive correlation between religious beliefs and adherence to medication regimen in patients with mental disorders. Religious beliefs were directly associated with positive religious coping, and adherence to medication regimen was indirectly associated with negative religious confrontation.
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