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Achak D, El-Ammari A, Azizi A, Youlyouz-Marfak I, Saad E, Nejjari C, Hilali A, Marfak A. Lifestyle Habits Determinants of Health-Related Quality of Life in Moroccan College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2394. [PMID: 36767760 PMCID: PMC9915387 DOI: 10.3390/ijerph20032394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The transition to university is a critical period during which considerable life changes arise. Useful national data to design tailored interventions aimed at promoting health-related quality of life (HRQoL) among Moroccan students are lacking. The present study is aimed at filling this gap by investigating the levels and associated factors of HRQoL among a national sample of Moroccan university students. HRQoL was assessed using the EQ-5D-5L instrument. Data from 2759 university students were collected in a large, cross-sectional, web-based survey. All statistical analyses were conducted using the R software. The EQ-5D-5L findings showed that the majority of students rated level 1 (no problems) and level 2 (slight problems) for the "Mobility", "Self-Care", "Usual Activities", and "Pain/Discomfort" HRQoL dimensions. However, the "Anxiety/Depression" dimension was the exception; more than half (57.1%) of the students were slightly to extremely anxious or depressed. The levels of lifestyle habits were of concern among participants of this study. With respect to sedentary behaviors and physical activity, we found that approximately 80% of participants spent ≥2 h/day on different screen-based sedentary behaviors, and 60% were physically inactive. Lifestyle habits that were found to be associated with HRQoL are sleeping time, physical activity, leisure, hygiene, household activities, homework, and social media time. The multiple regression model explained 93% of the EQ-VAS score variance. The findings could be of great importance for researchers and policymakers interested in promoting health of university students.
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Affiliation(s)
- Doha Achak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | | | - Asmaa Azizi
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Ibtissam Youlyouz-Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Elmadani Saad
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Chakib Nejjari
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca 82403, Morocco
| | - Abderraouf Hilali
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Abdelghafour Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
- National School of Public Health, Ministry of Health, Rabat 10000, Morocco
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Poursadeqiyan M, Arefi MF, Pouya AB, Jafari M. Quality of life in health Iranian elderly population approach in health promotion: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:449. [PMID: 35233396 PMCID: PMC8826786 DOI: 10.4103/jehp.jehp_1546_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The quality of life (QOL) is essential in all different stages of life; however, It is more important for older people as it can be effective in promoting their health. Therefore, the present study aimed to review the literature on the QOL in the Iranian elderly population. MATERIALS AND METHODS The study was carried out as a systematic review. For this purpose, all databases were searched in March 2021. The keywords used for the search were "quality of life, elderly, older adults, aging, seniors, and Iran" along with the Persian equivalents. PRISMA protocol was used to screen articles. After removing duplicate and irrelevant items, two evaluators appraised the articles separately based on a researcher-made checklist derived from the SBEM and STROBE Statement standard checklists. RESULTS The initial search yielded 3734 studies on the QOL in the Iranian elderly population. After screening and assessing the studies based on inclusion and exclusion criteria, 22 articles remained in the study. Most of the studies (cross-sectional) were conducted in Tehran using a 36-item Short-Form Health Survey to assess the QOL. The studies investigated sociodemographic determinants, physical and health-related behaviors, and spirituality and psychological determinants of the QOL. The sociodemographic determinants were the most common factors under study. The results showed that the role of gender and socioeconomic status was the strongest among the sociodemographic characteristics. A significant association was found between the QOL in the Iranian elderly population and factors such as depression and religious confrontation. CONCLUSION In addition to chronic diseases, diseases of the oral and dental, as well as an unhealthy diet, should be considered in the elderly. Therefore, attention should be paid to all social, physical, and psychological variables that affect the QOL of older people.
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Affiliation(s)
- Mohsen Poursadeqiyan
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Occupational Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Maryam Feiz Arefi
- Department of Occupational Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydarieh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Amin Babaei Pouya
- Department of Occupational Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mojtaba Jafari
- Department of Nursing, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran
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Combination of self-management theory with PRECEDE–PROCEED model to promote life quality in patients with hypertension. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01246-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Toghroli R, Moradi F, Hassani L, Aghamolaei T, Mehedi N, Mahmoodi F, Faraji A, Hoseini AS, Soroush A, Ziapour B. Evaluation of the educational services quality from the viewpoint of postgraduate students at Kermanshah University of medical sciences in 2019. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:325. [PMID: 34761011 PMCID: PMC8552268 DOI: 10.4103/jehp.jehp_765_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/02/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND At present, the SERVQUAL model is one of the most significant tools for measuring customers' expectations and perceptions in organizations. Determination of expectations and perceptions of students who are the main university customers from educational services can provide valuable information to the programmers to improve the condition of educational services. Therefore, this study aims to measure the quality of education services from the viewpoint of postgraduate students at Kermanshah Medical Sciences University using the SERVQUAL model in 2019. MATERIALS AND METHODS This was a descriptive cross-sectional study. The population under the study consisted of 162 students at the postgraduate education section (Master's degree and Ph.D.) studying in the second semester of the academic year of 2019 at Kermanshah Medical Sciences University. The standard SERVQUAL questionnaire was used for data collection, which included five dimensions of the quality of educational services, and the random-stratified sampling method was employed. The data were analyzed using the SPSS Statistics software (version 23.0, SPSS Inc., Chicago, IL, USA), and descriptive and other statistical tests, including the Pearson correlation coefficient, and paired and independent t-tests were performed. RESULTS Based on the students' perspective in the provision of service there was quality gap existed in all services, and the largest gap was in the reliability dimension (-0.37), and after that, empathy (-0.37), guaranty (0.27), and responsiveness (-0.24) dimensions, respectively, and the lowest one was in the tangible dimension (0.15). There was a statistically significant observed difference between the quality gap in different educational dimensions (P > 0.001). CONCLUSION Research findings showed that students were not meeting their expectations from the presented educational services. Hence, holding a training workshop is suggested in the field of how to serve and enhance communication skills for employees and teachers.
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Affiliation(s)
- Razie Toghroli
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Farideh Moradi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Laleh Hassani
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nafiul Mehedi
- Department of Social Work, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Fatemeh Mahmoodi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Faraji
- Nursing Department, Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ava Sadat Hoseini
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Soroush
- Cardiovascular Research Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behdad Ziapour
- Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Garosi VH, Tanhaie S, Chaboksavar F, Kamari T, Gheshlaghi PA, Toghroli R, Soltaninezhad S, Azizi SA, Yazdani V, Mahmoodi F. An overview of 2019 novel coronavirus COVID-19 pandemic: A review study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:280. [PMID: 34485577 PMCID: PMC8395953 DOI: 10.4103/jehp.jehp_1403_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/25/2020] [Indexed: 05/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, was first reported in December 2019 in Wuhan, Hubei province, China. It is now known as a pandemic and a global crisis due to rapid human-to-human transmission with the vast expansion that has affected almost all countries. The primary source of the disease is still unknown, but it is possible that the virus was transmitted through bat to an intermediate host and then to humans. The main and early symptoms of COVID-19 infection are fatigue, fever, dry cough, myalgia, and dyspnea. The incubation period of the disease is about 2-14 days, which is one of the important parameters for planning to prevent disease outbreak. PT-polymerase chain reaction test is used to diagnose the disease; chest computed tomography scan, chest X-ray, blood tests, and symptoms are also very helpful in diagnosing the disease. There is a strong emphasis on controlling infections and hand hygiene to prevent the transmission of the disease. There is not enough knowledge about this disease yet, and there are no specific vaccines or medications available to prevent and treat this disease. The current review study uses articles indexed on databases of Embase, Elsevier, PubMed, and World Health Organization and Centers for Disease Control and Prevention, and keywords of coronavirus, COVID-19, acute respiratory distress syndrome and China.
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Affiliation(s)
- Vahid Hatami Garosi
- Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sepideh Tanhaie
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fakhreddin Chaboksavar
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Teymour Kamari
- Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Razie Toghroli
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Simin Soltaninezhad
- Department of Radiology, School of Medicine, Kerman University of Medical Science, Kerman, Iran
| | - Seyyed Amar Azizi
- PhD. Student of Social Welfare and Health, University of Social Welfare and Rehabilitation Sciences,Tehran, Iran
| | - Vahid Yazdani
- Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Mahmoodi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Kalhori RP, Najafi M, Foroughinia A, Mahmoodi F. A study of cardiopulmonary resuscitation literacy among the personnel of universities of medical sciences based in Kermanshah and Khuzestan provinces based on the latest 2015 cardiopulmonary resuscitation guidelines. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:29. [PMID: 33688538 PMCID: PMC7933618 DOI: 10.4103/jehp.jehp_645_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/18/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Cardiopulmonary resuscitation (CPR) is regarded as the most important skill of the medical staff who is required to be aware of the latest changes to the CPR guidelines so that they can take the most effective actions in the critical conditions of CPR. Therefore, the present study aimed to determine the levels of CPR literacy among the personnel of universities of medical sciences based in Kermanshah and Khuzestan provinces based on the latest 2015 CPR guidelines in 2019. MATERIALS AND METHODS In this descriptive, analytical, cross-sectional study, 525 subjects were selected as the sample population using the two-stage cluster sampling. For data collection, a researcher-made questionnaire was used, whose content validity and reliability were confirmed (r = 0.71). The study screened the data received and analyzed valid data set through the ttest and Spearman's correlation coefficient by incorporating SPSS Statistics software version 23.0. In addition, P < 0.05 was considered statistically significant. RESULTS The 2015 CPR literacy levels of the samples were as follows: excellent (85 subjects or 16.2%), good (404 subjects or 77%), and average (36 subjects or 6.9%). The results of Pearson's correlation coefficient revealed a weak and inverse relationship between the levels of CPR literacy and the age of samples (r = -0.092) and work experience (-0.029), which were statistically significant. In addition, the results of Mann-Whitney U-test demonstrated that the level of CPR literacy among the personnel of Ahwaz University of Medical Sciences exceeded that among the personnel of Kermanshah University of Medical Sciences (P < 0.001). CONCLUSION It is suggested that in retraining the nursing and paramedical personnel, CPR be carried out with more emphasis on the changes introduced in this guideline compared to that in 2010, including esophageal tracheal airway, reasons for the cessation of CPR, intraosseous infusion, and induced hypothermia.
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Affiliation(s)
- Reza Pourmirza Kalhori
- Department of Emergency Medicine, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Azadeh Foroughinia
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Mahmoodi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Almasi A, Zangeneh A, Saeidi S, Toghroli R, Teimouri R, Hoseini AS, Kinipour N, Mahmoodi F, Kiaee KG. A study of 0-14-year-old children's access to health centers in rural areas using a buffer model (a case study of villages based in Kermanshah province, Iran). JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:324. [PMID: 33426128 PMCID: PMC7774620 DOI: 10.4103/jehp.jehp_547_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/13/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Children are among the most vulnerable groups in society, whose health is of prominent significance. Moreover, as a group of clients with special needs in the health care system, they require special attention. Therefore, the present study aimed to investigate the 0-14-year-old children's access to health centers in rural areas of Kermanshah Province, Iran. MATERIALS AND METHODS In the present cross-sectional study, both the latest published demographic statistics related to the Population and Housing Census, announced by the Statistical Center of Iran in 2011, and the information about the public and private hospitals in the province, collected by Kermanshah University of Medical Sciences, were used as the basis for the analyses. In addition, given the importance of the spatial nature of the research, geographic information system was used for data analysis, and a buffer model was also applied. RESULTS The results revealed that out of the total population of 0-14-year-old children residing in rural areas within 15,000 and 30,000-km radii of Kermanshah Province, 87.94% and 75.11% of girls versus 88.15% and 75.38% of boys lacked access to health centers, respectively. CONCLUSION It was found out that the 0-14-year-old children's access to health centers was in poor condition in rural areas of Kermanshah Province, which would endanger the health of this age group.
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Affiliation(s)
- Ali Almasi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Zangeneh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Saeidi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Razie Toghroli
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Raziyeh Teimouri
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akram Sadat Hoseini
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Kinipour
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Mahmoodi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kobra Gholami Kiaee
- Department of Nursing, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
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Moradi F, Tourani S, Ziapour A, Abbas J, Hematti M, Moghadam EJ, Aghili A, Soroush A. Emotional Intelligence and Quality of Life in Elderly Diabetic Patients. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 42:15-20. [PMID: 33086936 DOI: 10.1177/0272684x20965811] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Coordination of various physical and mental aspects of individuals, including the ability to control difficult conditions and situations has an effect in the prevention and development of various diseases, such as diabetes, and the improvement of the quality of life. Therefore, the purpose of this study was is to determine the effect of emotional intelligence on the quality of life of elderly diabetic patients. METHODS This study was conducted in 2018. The statistical population in this cross-sectional study consisted of elderly people referred to the health centers of Kermanshah province in western Iran, who were divided via available sampling into two groups with diabetes and without diabetes. Data gathering tools were a couple of LIPAD Quality of Life and Shrink Emotional Intelligence standard questionnaires. The Data was analysed using software SPSS, 23 th version. Tests were used (T-test, Chi-square, Anova and regression). RESULTS Most of them were male (52.72%) and the mean age of the patients was 65.01(±6.08) years old and married. The quality of life score in diabetics and non-diabetics was respectively 51.9 and 50.37 with a standard deviation of 17.73 and 20.54. The mean total score of emotional intelligence in the elderly with diabetes was 99.42 with a standard deviation of 10.37 and non-diabetic subjects were 97.18 with a standard deviation of 18.4. CONCLUSION There was no significant difference between the mean scores of quality of life (0.652) and emotional intelligence (0.421) in diabetic and non-diabetic individuals. But, the emotional intelligence has an effect on the quality of life of the elderly people.
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Affiliation(s)
- Farideh Moradi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sogand Tourani
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Ziapour
- Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jaffar Abbas
- Antai College of Economics and Management/School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Maryam Hematti
- Clinical research development center of Imam Reza Hospital in Kermanshah University of Medical Sciences, Iran
| | - Elham Jamshidi Moghadam
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Aghili
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Soroush
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Azar FEF, Solhi M, Chabaksvar F. Investigation of the quality of life of patients with hypertension in health centers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:185. [PMID: 32953912 PMCID: PMC7482625 DOI: 10.4103/jehp.jehp_741_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/05/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Hypertension is one of the most critical factors for chronic diseases such as cardiovascular disease, stroke, arrhythmias, heart failure, and renal disease. The aim of this study was to evaluate the quality of life and its related factors in hypertensive patients. MATERIALS AND METHODS This study was descriptive research. The sampling method was simple random, i.e., 137 were selected among the ten health centers of the list of the existing patients by simple random sampling. Data were collected using a questionnaire World Health Organization Quality of Life-BREF (Short Form-26). After collecting the questionnaires, the data analysis was carried out using SPSS software and using statistical methods (e.g., number, percentage, mean, standard deviation, and MANOVA tests). RESULTS The results showed that the mean score for the physical domain (52.82), the psychological domain (50.26), the social domain (48.33), the environmental domain (46.1), and the total quality of life (49.60). Among the demographic variables, the education level variable (P =0.000), job (P = 0.013), and the duration of hypertension (P = 0.039) were significantly correlated with the quality of life of patients. The "levels of education" variables are significantly correlated with the physical domain (P = 0.000), psychological domain (P = 0.000), social domain (P = 0.000), and environmental domain (P = 0.000) of the quality of life. The "job status" variable is only significantly correlated with the social domain of the quality of life (P = 0.005). The "duration of hypertension" variable is only significantly associated with the physical domain of the quality of life (P = 0.011). CONCLUSION The findings of the present study show that demographic variables such as educational level, occupation, and duration of hypertension have a significant relationship with the quality of life domains of hypertensive patients. It is recommended that the principled education of patients is a step toward the improvement of the quality of life of patients.
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Affiliation(s)
- Farbod Ebadi Fard Azar
- Department of Health Services and Health Education, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Department of Health Services and Health Education, Iran University of Medical Sciences, Tehran, Iran
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