Background: Health literacy is one of the most important determinants of noncommunicable diseases prevention. Health literacy is associated with elevated risks for poorer access to care, adverse health outcomes, and increased hospitalization and health costs. Aims: This study aimed to determine the level of health literacy among the general adult population in the Islamic Republic of Iran. Methods: Using a cross-sectional study during 2014-2015 with a multistage cluster sampling approach, we administered a pilot-tested standardized questionnaire to assess different domains of health literacy (i.e., reading, comprehension, communication/decision-making and Interpretation/judgment skills, individual and social empowerment, health information access and health information use) among 8439 (3935 males) individuals aged 18-60 years. Data were collected through face-to-face interviews. Descriptive statistics and multivariable linear regression method using SPSS (20) were applied to identify the factors associated with health literacy among Iranian adults. Results: The mean health literacy level was 10.2±3.8 (out of 20). Only 18% (95% confidence interval [CI]: 17.15-18.78) of the participants had adequate health literacy, while 45.7% (95% CI: 44.64-46.78) had inadequate, and the 36.3% (95% CI: 35.21-37.33) had moderate health literacy. In the adjusted linear regression model, education level (the smallest β = 4.35, P < 0.001), age (β = 0.01, P = 0.002), female sex (β = 0.45, P < 0.001), residency in rural areas (β = 0.26, P < 0.001) and having permanent job (β = 1.03, P < 0.001) were significantly associated with more health literacy. Conclusion: Our findings highlighted that the Iranian adult population has an insufficient level of health literacy, which calls for comprehensive education planning to improve the levels, with special attention to certain subpopulations (e.g. illiterate populations) and domains (e.g. individual empowerment).
Background:Self-regulation is one of the current psychological concepts that have been known as a determinant of leisure time physical activity. Due to cultural and social diversity in different societies and age groups, application of specific questionnaires is essential to perform investigations about physical activities. The aim of this study is development and evaluation of psychometric properties of a self-regulation questionnaire about leisure time physical activity in Iranian male adolescents.Materials and Methods:This cross-sectional study was conducted in 2013, and data of 603 male students from 12 high schools in Isfahan were collected. A comprehensive literature review and similar questionnaire review were conducted and 25 items were selected or developed to measure self-regulation. Comprehensibility of items was evaluated in a pilot study and an expert panel evaluated face and content validity. Exploratory factors analysis (EFA) was used for evaluation of construct validity and extraction of sub-constructs of self-regulation. Leisure time physical activity was assessed using International Physical Activity Questionnaire (IPAQ).Results:The mean age of the participants was 16.3 years (SD =1.0) and the range was 15-19 years. Cronbach's α coefficient of the questionnaire in the pilot and main study was 0.84 and 0.90, respectively. EFA resulted in four sub-constructs including “enlistment of social support”, “goal setting”, “self-construction”, and “self-monitoring”, which explained 63.6% of the variance of self-regulation.Conclusions:Results of this investigation provide some support to the validity and reliability of the 16-item questionnaire of self-regulation abut leisure time physical activity in the target group.
Background:Attention to different aspects of self-efficacy leads to actual evaluation of self-efficacy about physical activity. This study was carried out in order to design and determine psychometric characteristics of a questionnaire for evaluation of self-efficacy about leisure time physical activity (SELPA) among Iranian adolescent boys, with an emphasis on regulatory self-efficacy.Materials and Methods:This descriptive–analytic study was conducted in 734 male adolescents aged 15–19 years in Isfahan. After item generation and item selection based on review of literature and other questionnaires, content validity index (CVI) and content validity ratio (CVR) were determined and items were modified employing the opinions of expert panel (N = 10). Comprehensibility of the questionnaire was determined by members of target group (N = 35). Exploratory factors analysis (EFA) was operated on sample 1 (N1 = 325) and confirmatory factors analysis (CFA) on sample 2 (N2 = 347). Reliability of SELPA was estimated via internal consistency method.Results:According to EFA, barrier self-efficacy and scheduling self-efficacy are the two main aspects of SELPA with the total variance of 65%. The suggested model was confirmed by CFA and all fitness indices of the corrected model were good. Cronbach's alpha was totally estimated as 0.89 and for barrier and scheduling self-efficacy, it was 0.86 and 0.81, respectively.Conclusions:The results provide some evidence for acceptable validity and reliability of SELPA in Iranian adolescent boys. However, further investigations, especially for evaluation of predictive power of the questionnaire, are necessary.
Background: Psychological factors are important both as predisposing to and precipitating coronary artery diseases (CAD). These factors can also be a consequence of CAD, which may create a vicious circle. This paper presents a study on myocardial infarction (MI) patients, considering the relationship between perceived locus of control,social support and illness perception. Materials and Methods: 241 consecutive MI patients from Isfahan, Iran, participated in this study in 2016-17. Comprehensive questionnaires along with a medical interview were used to collect demographic and cardiological data during the first week of hospitalization. 3 to 4 months later information concerning perceived social support, perceived locus of control, and illness perception was collected at participants' houses. The data were analyzed by structural equation modeling to verify the interrelationships between the investigated variables. Results: The mean age of participants (83% of males) was 54.53±9.76 years. The participants with better illness perception regarding MI may have had better perceived social support and/or may had less chance locus of control and were more prone to be diagnosed as Diabetic. A positive correlation was found between powerful others locus of control and chance locus of control. Discussion: Our findings indicate a significant relationship between illness perception, perceived social support and perceived locus of control in MI patients. Conclusion: This study findings provide an overview of some of the psychological factors in MI patients. Consideration of these important factors could help physicians to provide better post MI care .
Background: Psychological factors play an important role as predisposing precipitating factors for coronary heart disease (CHD). Coping strategies, type D personality, illness perception (IP), and fatigue are among major psychological factors in myocardial infarction (MI) patients. Objectives: The study aimed to investigate relationships between coping strategies, type D personality subscales, illness perception, and fatigue in MI patients. Methods: In this cross-sectional study, we collected the demographic and clinical information of 241 consecutive MI patients (mean age: 54.53 ± 9.76 years) in the first week of hospitalization. After four months, we used questionnaires to collect information on type D personality subscales, coping strategies, illness perception, and fatigue at patients' houses. To verify relationships between the variables, the collected data were analyzed by structural equation modeling. Results: The participants with more positive illness perception regarding MI were less likely to be fatigued and/or less probably used emotion coping. Patients who experienced fatigue as a symptom after MI were probably inhibited socially. Social inhibition, negative affectivity, and emotion coping were seen more in women than in men and younger participants used task coping strategy more than older ones. Conclusions: Improving psychological factors such as illness perception, coping strategies, and type D personality may promote the health condition of patients in the post-MI period although these factors may influence the process of MI prevention.
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