Sanaz Aazami

Sexual health education is an essential yet often neglected component of care for menopausal and postmenopausal women. Hormonal and psychosocial changes associated with aging may adversely affect psychological health, social well-being, and sexual self-efficacy, while many older women receive limited guidance in managing these concerns. Structured sexual health education may help address these unmet needs and promote healthy aging. This study evaluated the effect of a sexual health education program on psychological health, social well-being, and sexual self-efficacy among older women. This randomized controlled study (ISRCTN16519569) was conducted among 110 women aged 65 years and older recruited from urban health centers in Ilam, Iran. Participants were randomly assigned to an intervention group (n = 55) or a control group (n = 55). Eligibility criteria included being married, cognitively intact, and physically able to participate. The intervention group received six 30-minute face-to-face sexual health education sessions over a three-week period, together with an educational booklet, whereas the control group received routine health services. Outcomes were assessed at baseline and four weeks after the intervention using the Goldberg General Health Questionnaire (GHQ-28), the Keyes and Shapiro Social Well-Being Scale, and the Vaziri and Lotfi Sexual Self-Efficacy Scale. Data were analyzed using analysis of covariance (ANCOVA), controlling for baseline scores. No significant differences were observed between groups at baseline (p > 0.05). After adjustment for baseline values, participants in the intervention group demonstrated significantly higher post-intervention scores for psychological health, social well-being, and sexual self-efficacy compared with the control group (all p < 0.001). The intervention effects were large across all outcome measures. Participation in a structured sexual health education program was associated with improved psychological health, social well-being, and sexual self-efficacy among older women. These findings suggest that sexual health education may represent a useful strategy for supporting healthy aging; however, further studies with longer follow-up periods and more diverse populations are warranted.

Introduction: Nursing students often lack engagement and confidence in vaccination procedures, despite their critical public health importance. To address this gap, this study aimed to assess the effect of Kahoot!‐based gamification on nursing students’ knowledge, satisfaction, interest, and collaboration regarding vaccination. Methods: The students were randomly divided into two groups: case (Kahoot! game) and control (teaching in the traditional way). Eight different games were created based on vaccination topics. During each session, the case group played one of the games developed by Kahoot!. Then, at the end of 8 sessions, the posttest was taken from both controls and cases. Results: Findings from ANCOVA showed that the average knowledge after the internship in the group that used gamification with Kahoot! was significantly ( F [1, 69] = 27.208, p ≤ 0.001) increased even after controlling for the effect of baseline knowledge. An independent t ‐test was performed to compare the average satisfaction of the internship between the two groups of control (mean = 7.5, SD = 1.34) and intervention (mean = 8.7, SD = 1.04), which showed to be significant ( t (70) = 4.23, p ≤ 0.001). In addition, our results showed that the overall average interest in Kahoot!’s classes was 34.1 (SD = 2.03), ranging from 29 to 38. The average score for level of interaction at Kahoot!’s classes was 33.47 (SD = 2.36), ranging from 26 to 37. Conclusions: In general, our findings showed that nursing students’ knowledge and satisfaction significantly increased after the end of 8 weeks of Kahoot! gamification. Moreover, we found that the level of interest and collaboration among students after gamification with Kahoot! was significantly higher than the average score of 2.5.

Background: Effective self‐management behaviors are crucial for diabetes management. This study examines the mediating role of self‐efficacy in the relationship between compliance dimensions and self‐management activities in patients with Type 1 diabetes. Methods: The current study explores a baseline analysis from a randomized controlled trial but the intervention’s effectiveness is not reported here; the analysis focuses on elucidating potential mediating factors at baseline. The study investigated the relationships between seven compliance dimensions (treatment effort, intention, adaptability, integration, adherence, commitment, and indecisiveness) and six self‐management activities (diet, exercise, smoking cessation, blood sugar monitoring, and foot care) through the potential mechanism of self‐efficacy. Results: The analysis revealed an indirect association between three compliance dimensions (treatment effort, intention, and commitment) and foot care behavior, mediated by self‐efficacy. Additionally, self‐efficacy was identified as an indirect mechanism influencing the association between commitment and adaptability with dietary behaviors. Conclusions: This study highlights the importance of self‐efficacy in promoting self‐management behaviors in chronic conditions. By targeting specific compliance dimensions that influence self‐efficacy, healthcare professionals can potentially improve patient self‐management. Trial Registration: Iranian Registry of Clinical Trials number: IRCT20221029056335N1

Using cell phones by nurses can affect the quality of care. This study aimed to explore the consequences of using cell phones by nurses in hospitals. A qualitative approach was used. Data were collected through semi-structured interviews. Nursing staff, patients, and their relatives participated in this study. Categories of "emotionless care," "neglect in care," "impaired professional behavior" and a main theme of "Personal cell phone is a barrier to effective nursing care" extracted. Using cell phone during work could jeopardize patients' safety and ruins the nursing profession image. It is necessary to formulate guidelines on how to use cell phones in hospitals.

Background: In the Iranian context, no 360-degree evaluation tool has been developed to assess the performance of prehospital medical emergency students in clinical settings. This article describes the development of a 360-degree evaluation tool and presents its first psychometric evaluation.Methods: There were 2 steps in this study: step 1 involved developing the instrument (i.e., generating the items) and step 2 constituted the psychometric evaluation of the instrument. We performed exploratory and confirmatory factor analyses and also evaluated the instrument’s face, content, and convergent validity and reliability.Results: The instrument contains 55 items across 6 domains, including leadership, management, and teamwork (19 items), consciousness and responsiveness (14 items), clinical and interpersonal communication skills (8 items), integrity (7 items), knowledge and accountability (4 items), and loyalty and transparency (3 items). The instrument was confirmed to be a valid measure, as the 6 domains had eigenvalues over Kaiser’s criterion of 1 and in combination explained 60.1% of the variance (Bartlett’s test of sphericity [1,485]=19,867.99, P<0.01). Furthermore, this study provided evidence for the instrument’s convergent validity and internal consistency (α=0.98), suggesting its suitability for assessing student performance.Conclusion: We found good evidence for the validity and reliability of the instrument. Our instrument can be used to make future evaluations of student performance in the clinical setting more structured, transparent, informative, and comparable.

Background: High levels of depression and poor self-efficacy and self-management are associated with worse glycemic control, but the linkage and pathway between these variables are poorly understood. We conducted this study to investigate the hypothesis that self-efficacy and self-management mediate the influence of depression on poor glycemic control. Methods: We studied a purposive sample of 142 adults with type 2 diabetes attending a public clinic in Ilam, Iran. Hierarchical linear regression analysis and structural equation modeling were used to explore the relationships among the variables of interest. Result: Depression directly and negatively affects self-efficacy and indirectly affects self-management behaviors, which in turn have direct effects on hemoglobin A1c (HbA1c). Self-efficacy mediates the relationship between depression and self-management behaviors. Self-efficacy and self-management behaviors partially mediate the effect of depression on HbA1c. These results confirmed that the data fit the hypothesized model very well. Conclusion: Careful monitoring of glycemic control might be important in those individuals who exhibit clinical signs of depression. Effective treatment programs should probably pay close attention to not only screening and treatment of depression but also skills training to enhance patient self-efficacy and self-management of diabetes to improve HbA1c.