Modification de l'attitude et de l'intention vis-à-vis d'une activité physique régulière à l'aide de la théorie de la motivation à la protection : essai contrôlé randomisé RÉSUMÉ Nous nous sommes servis de la théorie à la motivation à la protection pour tester l'impact des entretiens motivationnels sur l'attitude et l'intention des femmes obèses et en surcharge pondérale vis-à-vis de la pratique d'une activité physique régulière. Lors d'un essai contrôlé randomisé, 60 femmes obèses et en surcharge pondérale se présentant dans des centres de santé ont été sélectionnées par échantillonnage de commodité. Les femmes ont été réparties en deux groupes, chaque groupe comprenant 30 femmes suivant un programme standard de gestion du poids ou assistant à des entretiens motivationnels. Les composantes de la théorie (vulnérabilité perçue, gravité, auto-efficacité et efficacité de la réponse) ainsi que les caractéristiques anthropométriques (sauf l'indice de masse corporelle) étaient toutes significativement différentes entre les groupes à trois moments de l'étude. Les indicateurs de l'intention les plus forts concernant la pratique régulière de l'exercice physique étaient l'efficacité de réponse perçue et l'attitude lors du suivi à deux et six mois. Nous avons prouvé que la réalisation des entretiens motivationnels en mettant l'accent sur la théorie de la motivation à la protection s'est avérée profitable pour la conception et l'élaboration des interventions appropriées afin d'améliorer le statut de l'activité physique chez les femmes obèses et en surcharge pondérale. ABSTRACT We were guided by the Protection Motivation Theory to test the motivational interviewing effects on attitude and intention of obese and overweight women to do regular physical activity. In a randomized controlled trial, we selected using convenience sampling 60 overweight and obese women attending health centres. The women were allocated to 2 groups of 30 receiving a standard weight-control programme or motivational interviewing. All constructs of the theory (perceived susceptibility, severity, self-efficacy and response efficacy) and all anthropometric characteristics (except body mass index) were significantly different between the groups at 3 study times. The strongest predictors of intention to do regular physical exercise were perceived response efficacy and attitude at 2-and 6-months follow-up. We showed that targeting motivational interviewing with an emphasis on Protection Motivation Theory constructs appeared to be beneficial for designing and developing appropriate intervention to improve physical activity status among women with overweight and obesity. ‫شواهد‬ ‫ذات‬ ‫معشاة‬ ‫جتربة‬

Aims: As a growing problem, obesity is one of the most important worldwide health problems. One of the major factors leading to obesity is the sedentary lifestyle. The aim of this study was to investigate the effects of motivational interviewing on the physical activity intention in the obese or overweight women, using the protection motivation theory (PMT). Materials & Methods:In the clinical trial study, 60 obese or overweight women referred to the health centers of Gorgan were studied in 2015. The subjects, selected via non-probable and available sampling method, were randomly divided into two groups including control and motivational interviewing groups. Data was collected using a researcher-made questionnaire before the intervention and 2 and 6 months after in both groups. Data was analyzed by SPSS 18 software using independent T, Chi-square, repeated measures ANOVA, LSD, and one-variable and multivariable linear regression tests. Findings: The scores of all the constructs of PMT in motivational interviewing group significantly increased 2 and 6 months after he intervention (p<0.001) than control group. However, the reductions in the BMI and weight anthropometric indices were not significant 2 and 6 months after the intervention (p>0.05). The most powerful constructs predicting the intention towards the physical activities 2 months after the intervention were perceivedreply efficiency, self-efficiency, and perceived intensity, successively. In addition, such factors 6 months after the intervention were attitude and perceived intensity, successively. Conclusion: The motivational interviewing increases the scores of all the constructs of PMT, which leads to an increase in the physical activity intention in the obese or overweight women.

Background: The public sector of the health care system provides justice and access for all people who need more specialized services through the referral system. If the challenges of the referral system are not identified and addressed promptly, the system will not be efficient and effective. The purpose of this study was to rank the reasons for non-referral of outpatient level 1 to level 2 in the electronic referral system of Golestan province in 2019. Methods: In this descriptive and cross-sectional study, 431 outpatients participated from the pilot hospitals of the e-referral system in Golestan province, who did not refer to the level 2 specialist despite that an appointment was set by the system. The participants were selected using a stratified random sampling method. Data were collected using a questionnaire and analyzed by descriptive statistics and Friedman test in SPSS 23 software. Results: The most important reasons for patients who were not  referred from level 1 to level 2 in the electronic referral system included the presence of a trusted and familiar physician, inability to pay the visit of a specialist, and high cost of transportation from home to the designated specialist, respectively. The gender of the specialist physician and lack of guidance on referral to the specialist physician were indicated by the referral center. Patients ranked the reasons of not referring to the specialist differently (P < 0.001). Conclusions: The current status can be improved by increasing the public confidence in specialized physicians working in the electronic referral system and making the specialized services free for the poor patients. Furthermore, raising the patient's awareness about using Level 2 specialized services through the mass media can help patients to benefit from these services.

Background and objectives: Aging and its consequences are one of the major demographic issues in the world. The aim of this study was to determine quality of life and some related factors in elderly people living in Turkmen County (Iran) in 2017. Methods: This cross-sectional, descriptive-analytic study was conducted on 300 elderly people aged 60 years and older who were living in the Turkmen County, Iran. The subjects were selected via stratified random sampling. Data were collected using the World Health Organization Quality of Life-BREF Questionnaire. Data analysis was performed in SPSS software (version 16) using independent t-test, one-way ANOVA and nonparametric tests, such as Mann-Whitney U test and Kruskal-Wallis test. P-values less than 0.05 were considered statistically significant. Results: Of 300 subjects, 152 cases (50.7%) were women and 148 (49.3%) were men. The mean total score of quality of life was 54.4 ± 12.7. The mean standardized score of quality of life differed significantly depending on marital status, income level and number of children (P<0.05). There was a significant relationship between the mean standardized score of quality of life in terms of physical health and occupation status, age, income level and number of children. In addition, the mean standardized score of quality of life in the social relationship domain differed significantly based on gender, marital status, income level and number of children. Moreover, the mean standardized score of quality of life in the environmental health domain differed significantly based on occupational status and income level (P<0.05). Conclusion: Considering the impact of various factors on quality of life of the elderly, it is crucial to take measures for promoting quality of life in elderly women, unemployed elderly, people aged 80 years or older and those with a low income level.