Journal of Education and Health Promotion最新文献

Background: Palliative care is an essential component of holistic health care that aims to improve the quality of life for patients with life-threatening illnesses. Nurses play a crucial role in delivering palliative care, yet knowledge gaps persist, particularly among nursing students. This study assesses nursing students' knowledge of palliative care and identifies areas for improvement to enhance nursing education.

Materials and methods: A cross-sectional study was conducted among 137 third- and fourth-year nursing students and interns from the Department of Nursing. A purposive sampling technique was used, and data were collected from November 2023 to January 2024. The Palliative Care Quiz for Nursing (PCQN) was used to assess knowledge, and descriptive and inferential statistical analyses, including one-way ANOVA and independent t-tests, were applied to evaluate knowledge scores based on year of study, prior educational exposure, and attendance in palliative care courses.

Results: The overall mean knowledge score was 9.94 of 15. Students showed strong knowledge in pain and symptom management (mean: 7.78); however, substantial gaps were evident in psychosocial and spiritual care (mean: 0.21). Most students (80.3%) scored within the 70-100% range, indicating generally satisfactory knowledge, but misconceptions regarding family presence at the bedside and opioid use were prevalent. Students who attended university-based or non-university palliative care courses had significantly higher knowledge scores (P < 0.05). Year of study was not a significant predictor of overall knowledge, although clinical exposure improved pain and symptom management understanding.

Conclusion: While nursing students exhibited satisfactory palliative care knowledge, critical deficiencies in psychosocial and spiritual care remain. Strengthening palliative care education through curriculum enhancements, interactive learning, clinical simulations, and interdisciplinary collaboration is essential. Increased exposure to clinical practice, structured mentorship, and continuous professional development programs are recommended to bridge existing knowledge gaps. These improvements will better equip future nurses to provide holistic, patient-centered care, thereby enhancing the quality of life for patients and their families.

Background: Age at menarche (AAM) is a critical marker of pubertal timing and has been associated with various health outcomes, including Body Mass Index (BMI) in adolescence and adulthood which is an early predictor of cardiovascular risk in later life. Differences in socioeconomic status, dietary patterns, and lifestyle factors between government and private school students may influence this association. To assess the relationship between AAM and post-pubertal BMI among students from a government and a private school in Bhubaneswar, Odisha.

Materials and methods: A cross-sectional study was conducted among 180 late adolescent girls (16-19 years) (90 each from a government and a private school) in Bhubaneswar between February 2024 and October 2024. Multivariate linear regression model was built to assess the association between AAM and post-pubertal BMI in both the type of schools and strength of association between the two were compared.

Results: Among late adolescent girls in the government and private school, early age at puberty contributed to higher post-pubertal BMI which is a potential risk factor for CVD in later life. On comparing the relationship of exposure and the outcome by the type of school, association was stronger among the private school students (β coeff. = -1.37, 95%CI: -2.59, -0.16) in comparison to government school students (β coeff. = -0.66, 95%CI: -2.57, -0.14).

Conclusion: AAM significantly influences post-pubertal BMI, with early menarche associated with higher BMI. Relationship is more pronounced among private school students, potentially reflecting socioeconomic and lifestyle differences.

Background: Grief, following the loss of loved ones, involves emotions from deep sorrow to intense anger. Various psychological interventions exist for bereavement, with emotion-focused therapy (EFT) being a notable choice. This study aimed to evaluate the effectiveness of EFT in addressing the psychological factors associated with prolonged grief disorder (PGD), specifically targeting anger, guilt, and self-destructive behaviors in individuals with PGD.

Materials and methods: The current study was a clinical trial design with an experimental and control group with a 3-month follow-up. Forty patients with prolonged bereavement disorder were selected based on their availability and randomly categorized into two experimental and control groups (20 people in each group) in Tehran, Iran, in 2022-2023. For the intervention (experimental) group, EFT was performed in the form of 10 1-h sessions (once a week individually and online), and the control group was not treated. Assessment tools included the Grief Experience Questionnaire (GEQ), State-Trait Anger Expression Inventory-2 (STAXI-2), Guilt Inventory, and Self-Harm Inventory (SHI). Analysis of variance with repeated measurements was used to analyze the data.

Results: Multivariate analysis of variance of anger, guilt, and self-destructive behaviors showed no significant difference found between the two groups in the pre-test (P > 0.05). However, the difference between the mean scores of the two groups was significant on these variables in the post-test and follow-up stages (P < 0.05).

Conclusions: The findings of this study demonstrate that EFT is an effective intervention for addressing anger, guilt, and self-destructive behaviors among individuals diagnosed with PGD.

Background: Pain from needle insertion during hemodialysis is a common challenge that requires effective pain management to ensure patient comfort. This study aimed to compare the effects of Hugo point acupressure and vapocoolant spray on pain intensity during needle insertion in hemodialysis patients with arteriovenous fistulas.

Method and materials: A randomized controlled trial (RCT) was conducted in Iraq. A simple random sampling of adult patients with hemodialysis was assigned in the current study from the previously mentioned setting. Ninety-six patients were classified into three groups (34 control, 35 Hugo point acupressure, and 27 vapocoolant spray). The Hugo point acupressure group performed an acupressure before 2 minutes and during needle insertion, while the vapocoolant spray group received a brief spray application before the procedure. The study data were collected using the Structured Information Form, VAS for Pain, and Pain intensity was measured immediately after needle insertion using the visual analog scale (VAS) in all groups. Data were analyzed using SPSS version 27.

Results: The primary outcome of the study showed that theapocoolant spray group experienced a significantly greater reduction in pain compared to the Hugo point acupressure group (P = 0.000). As for the secondary outcomes, pain intensity was not significantly influenced by sociodemographic factors and clinical characteristics (P ≥ 0.05).

Conclusion: Vapocoolant spray can be used as an effective and safe method to reduce pain during needle insertion in hemodialysis patients, showing greater pain reduction compared to Hugo point acupressure.

Background: While Caesarean Sections (C-sections) can be life-saving in complicated deliveries, their overuse is linked to significant maternal and infant morbidity and mortality. This highlights the importance of understanding the factors that drive preferences for C-section deliveries. States like Andhra Pradesh exhibit an alarming trend of rising rates of C-section deliveries in India. This study aimed to explore community health providers' perceptions regarding the preference for caesarean delivery in Andhra Pradesh and to identify the major determinants of C-section preferences.

Materials and methods: The study utilized a qualitative research design, with focus group discussions (FGDs) conducted among community health providers from four districts of Andhra Pradesh. Participants were purposively sampled to gather a variety of viewpoints. A validated semi-structured questionnaire was employed to collect data. Data were transcribed verbatim and analyzed thematically to extract key themes and sub-themes related to preferences for C-section deliveries.

Results: The study identified a combination of medical, cultural, and systemic factors influencing C-section preferences. Community health providers underscored the advantages of normal deliveries but acknowledged the challenges they face due to family pressures and socio-cultural practices. Systemic issues, such as financial incentives in private healthcare and the increasing popularity of convenience-type elective C-sections or those that align with auspicious dates, also contributed to the preference for C-section deliveries.

Conclusion: This study underscores the necessity for balanced, evidence-based practices to tackle the non-medical factors driving the rise in C-section deliveries. Promoting antenatal counselling, addressing maternal and familial concerns, and modifying institutional practices are critical for ensuring safe and well-informed delivery choices.

Background: The primary objective of medical universities is to foster the development of competent students. This study aimed to investigate the impact of an online flipped classroom (OFC) combined with case-based learning (CBL) in small groups on improving the knowledge of obstetric anesthesia among undergraduate anesthesia students.

Material and methods: This quasi-experimental study employed a pre-test, post-test design and was conducted in 2024 in Iran. It involved 48 fifth- and seventh-semester undergraduate anesthesia students recruited using a convenience sampling method and randomly assigned to intervention and control groups based on their GPA and academic year. The intervention group received obstetric anesthesia education using an OFC combined with CBL in small groups. The control group received the same content through conventional lecture-based instruction. Data were collected using a researcher-developed questionnaire on obstetric anesthesia knowledge. Data were analyzed using SPSS version 25, employing descriptive statistics, paired t-tests, and covariance analysis.

Results: Compared to pre-test scores, there was a significant increase in the post-test scores in both the intervention and control groups (P < 0.001). However, the mean post-test score of the intervention group was significantly higher than that of the control group (P < 0.001). In addition, comparing post-test scores using ANCOVA demonstrated significant improvements in the intervention group (P < 0.001).

Conclusion: This study demonstrated that an OFC combined with CBL in small groups has a positive impact on improving obstetric anesthesia knowledge among undergraduate anesthesia students and can be used as a complement to traditional teaching methods.

Background: The status and changes of intelligence are closely related to the treatment and quality of life of patients with type 1 diabetes mellitus (T1DM), but the relationship between the disease and the decline of patients' intelligence and the rise of the risk of intellectual disability (ID) is still uncertain.

Materials and methods: A Mendelian randomization (MR) analysis was conducted using the inverse-variance-weighted (IVW) method. Additional MR methods, including MR-pleiotropy residual sum and outlier (MR-PRESSO), radial MR, and other extended methods, were employed to address potential confounding factors.

Results: The MR analysis demonstrated a causal association between T1DM and lower intelligence (β = -0.030, 95% CI: -0.040 to - 0.020, P = 1.27E-08) as well as an increased risk of ID (β = 0.062, 95% CI: 0.037 to 0.087, P = 7.10E-07). Consistent results were observed with extended MR methods (all Ps < 0.05). In addition, T1DM significantly reduced the rate of structural changes in the brain during development and aging, including the changes in total brain volume, surface area, and volume of the hippocampus and thalamus, which also supported the causal relationship observed.

Conclusions: This MR study provided robust evidence that T1DM may lead to a decline in intelligence and an increased risk of ID. Future research, analyzing the mechanism of T1DM occurrence on patients' intellectual status and the characteristics of intelligence changes, would help improve the treatment effectiveness and quality of life of T1DM patients.

Background: Spinal cord injury (SCI) causes major changes in physical, psychological, and social dimensions, and simultaneously leads to changes in sexual performance and decreases the quality of sex life of people with SCI. The present research aims to recognize the physical, psycho-emotional, and social challenges in having sexual intercourse by people with SCI.

Materials and methods: The current qualitative study was conducted using the conventional content analysis method. The 25 participants were selected from June 2022 to May 2024 in Tehran, by purposeful and snowball sampling methods with maximum diversity from daily care centers, as well as referrals from friends, and were assessed through in-depth and semi-structured interviews. The data were analyzed using the method proposed by Graneheim and Lundman.

Results: The analysis of participants' interviews culminated in identifying four categories of psycho-emotional challenges, physical challenges against genital health, inaccessibility to reliable sexual knowledge, social inhibitors, and thirteen subcategories.

Conclusions: Precise and timely recognition of physical, psycho-emotional, sexual, and social challenges culminates in developing comprehensive educational programs and protocols with the cooperation of the government and health policymakers, non-governmental organizations, and the active engagement of people with SCI. Thereby, the quality of the sex life of people with SCI will be improved, the family's attitude toward the sexual performance of these individuals will vary, and mutual sexual intimacy and pleasure will be created in sexual and marital relationships.

Background: Periodontitis and gingivitis are two prevalent periodontal diseases caused by oral dysbiosis, which is mostly caused by the presence of tooth plaque. In periodontology, motivational interviewing (MI) is a patient-centered communication strategy that has been shown to improve patient motivation. The Short Message Service (SMS), in particular, has had enormous impacts on healthcare. The purpose of this study is to investigate how text message-based health guidelines reinforcement affects clinical results after non-surgical periodontal treatment in individuals with periodontal disease.

Methods: In this double-blind, randomized study, 36 patients with stage I and stage II periodontitis received non-surgical treatment and were randomly assigned to two experimental and control groups. The experimental group received a motivational-health text message intervention twice weekly for four weeks, whereas the control group did not receive text messages. Before and after the intervention, clinical parameters such as pocket depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival bleeding index (BI) were assessed.

Results: Periodontal parameters improved in both the experimental and control groups in this study. All parameters were improved significantly before and after the intervention in both the experimental and control groups (P- value < 0.001). Furthermore, it was revealed that the group who got scaling and root planning in addition to motivating text messages during the maintenance period had a significant reduction in BI (P value < 0.001) and PI (P value < 0.05).

Conclusion: Text messaging used in conjunction with a traditional approach (SRP + MI) may help patients achieve treatment objectives and aid in the management of periodontal disease.

Background: Health literacy encompasses a range of skills that individuals need to navigate the healthcare system effectively. One area where health applications can enhance health literacy is Sexually Transmitted Diseases (STDs). Therefore, this study aims to investigate research related to health literacy promotion systems in STDs through an altmetric method.

Materials and methods: This altmetric study, conducted in 2024, examines all scientific outputs related to health literacy systems for sexually transmitted diseases indexed in Scopus from 1992 to 2023. The Altmetric Explorer was utilized to gather altmetric scores and indicators. The data were analyzed in Excel to create tables and charts.

Results: A search in Scopus yielded 177 articles on health literacy systems for STDs from 1992 to 2023. Only 133 (75.14%) of them were mentioned in online social media and had altmetric scores. The majority of these studies originated from the United States and the United Kingdom, published in reputable medical journals, including NEJM. The high number of citations to these articles does not mean a higher Altmetric score.

Conclusion: The results showed that few studies have been published on the application of health literacy systems in STDs. It is suggested that future research should focus on increasing the presence of health literacy studies on STDs in social media and altmetric platforms. The presence of these studies on social media can help increase their visibility and improve society's health literacy in STDs.