BackgroundPeople living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran.MethodsIn-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach.Results and discussionNearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress.ConclusionsWhile previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context.

Background:Disease preventing methods focus mostly on lifestyle factors such as physical activity, healthy diet and not smoking. Previous studies verified using theory and models to change unhealthy behaviors, so that health belief model (HBM) is a useful framework for describing the healthy nutrition behavior.Objectives:This study aimed to predict factors related to unhealthy nutrition and inactive life in students of Tehran University, Tehran, Iran based on the Health Belief Model (HBM).Patients and Methods:In this cross sectional study, proportional quota sampling from three different educational levels was conducted from October to December 2012. A self-administered validated instrument based on the Health Belief Model (HBM) with 69 items and four sections was used to collect data. In this study through using linear and logistic regression, the effect of body mass index, age, gender, marriage, self-efficacy, cues to action, knowledge, perceived severity, susceptibility, benefits and barriers on nutrition and physical activity behavior were assessed. SPSS version 18 was used to analyze data.Results:Totally, 368 students including 318 female students (86.4%) and 50 male students (13.6%) with a mean age of 24.9 years (SD = 4.55) took part in the study. Among all independent variables, gender (P < 0.001), knowledge (P = 0.023) and perceived barriers (P = 0.004) predicted nutrition behavior. In case of physical activity, knowledge (P = 0.011), perceived severity (P = 0.009), perceived barriers (P = 0.019) and self-efficacy (P = 0.033) had significance association with physical activity behavior.Conclusions:This study indicated that health belief model contrasts could predict the risky behavior of university students due to heart disease. However, more researches are needed to verify the predictors of high risky behaviors in students.

This study was conducted to determine the impact of education using the Health Belief Model on preventing osteoporosis among female students. This interventional study (quasi-experimental) was performed on 45 female students aged 15-16 years old who resided in a town near Tehran. The females participated in a threeweek educational programme based on the Health Belief Model. The data collection instrument was a validated and reliable questionnaire in five sections: demographics, knowledge, Health Belief Model constructs, physical activity and consumption of foods containing calcium. The mean scores of students' knowledge were significantly different before and after the educational intervention (P < 0.05). The mean scores of some Health Belief Model structures changed significantly after the intervention (P < 0.05). Also post-intervention, physical activity increased (P = 0.041) but calcium intake did not. The use of an educational intervention on osteoporosis seems to improve knowledge and health beliefs and may positively impact physical activity-related behaviour.

Background:Health-care acquired infections are significant given the risks and costs they impose. All previous studies indicate a poor level of knowledge and performance among the nurses in hospital infections; as such, educating nurses can play an important role in infection control. This study aimed at evaluating the effects of the health belief model (HBM) in making nurses adopting health-care behaviors needed to control nosocomial infections (Nis).Materials and Methods:The participants of the study were 135 nurses from two hospitals in Mashhad, Iran. A self-administered questionnaire was used to collect data. The questionnaire consisted of seven parts. The intervention group received four 45 min educational programs, both in individual and collective forms. After a 2-month interval, a post-test was conducted to see whether any difference has been resulted.Results:There was a significant relationship between knowledge (P = 0.001), perceived threat (P = 0.004), perceived benefits (P = 0.001), and practices (P = 0.001) in comparing to control and experimental groups after intervention. For the experimental and control groups, the most frequent cues to action at the preintervention stage were, respectively, related to the period of studying at university and in-service classes.Conclusion:According to this study, HBM-based education can increase knowledge, perceived threat, and perceived benefits of nurses. Additionally, it can reduce perceived barriers and improve the control of NIs among nurses.

Background:The 12-Item General Health (GHQ-12) questionnaire is one of the most commonly used instruments in screening studies on mental health.Objectives:The current study aimed to examine the factor structure of the GHQ-12 questionnaire among the students in Iran.Materials and Methods:It was a cross-sectional study in which 428 university students were recruited and completed the GHQ-12. Reliability of the GHQ-12 was evaluated using the Cronbach's alpha and the split-half method by applying the Spearman-Brown coefficient. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was conducted to assess how well the EFA extracted model fitted the observed data.Results:The mean age of the participants was 22.83 years (SD = 3.09). Most of them were female (56.1%) and 81% were unemployed. The Cronbach’s alpha coefficient for the Iranian version of GHQ-12 was 0.85. Using the split-half method, the alpha for the social dysfunction was found to be 0.77; it was 0.76 for the psychological distress. The principal component analysis revealed a two-factor structure for the questionnaire including social dysfunction and psychological distress that explained 48% of the observed variances. The confirmatory factor analysis was showed fit for the data.Conclusions:The current study findings confirm that the Iranian version of GHQ-12 has a good factor structure and is a reliable and valid instrument to measure psychological distress and social dysfunction.