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Background & Aim: Depression is a common situation in patients with diabetes that may reduce the ability of individuals to engage in self-care behaviors. The present study was performed to investigate the relationship between depression and self-care in patients with type II diabetes.
Methods & Materials: This descriptive, cross-sectional study was performed with convenience sampling on 200 patients with type II diabetes who were referred to Saqqez Imam Khomeini Hospital, Sanandaj, Iran, in 2012. The data collection instrument consisted of three demographic information, depression, and self-care questionnaires. Data were analyzed by SPSS for Windows (version 16; SPSS Inc., Chicago, IL, USA) using chi-square and descriptive statistics. P values less than 0.05 were considered statistically significant.
Results: Diet in 5-7 days a week (P = 0.002) and adherence in 5-7 days a week (P = 0.03) were significantly lower in patients with diabetes and depression than in diabetic patients without depression. In the areas of exercise, foot examination, and self-monitoring of blood glucose there was no significant difference between the two groups.
Conclusion: Given the high prevalence of depression in diabetic patients, using screening methods such as HANDS scale seems to be necessary for disorder identification and promoting self-care activities.

Background & Aim: Perceived self-efficacy could lead to self-management behaviors among diabetic patients and the Diabetes Management Self-efficacy Scale (DMSES) assesses the extent to which diabetic patients are confident that they can manage diabetes. However, the Iranian version of DMSES was not available. The objective of this study was the translation and psychometric evaluation of the Iranian version of the DMSES .
Methods & Materials: Using a standard forward-backward translation procedure, the original English language version of the questionnaire was translated into Persian (Iranian language). Then, a convenient sample of diabetic patients, who referred to a diabetes outpatient clinic and were aged 15 to 81 years, completed the questionnaire. Validity was evaluated by content validity ratio and then using factor analysis. To test the reliability, internal consistency was assessed by Cronbach’s alpha.
Results: In total, 332 diabetic patients entered into the study. The mean age of respondents was 1.8 ± 12.3 years. Employing the recommended method of scoring (ranging from 1 to 5), the mean DMSES score was 2.24 ± 0.54. Reliability analysis showed satisfactory results (Cronbach’s alpha = 0.92). Exploratory factor analysis showed 20 items of the scale could converge to 5 factors with rotation. Confirmatory factor analysis supported modified model of DMSES through which one item (item 20) moved from blood glucose factor to medical control factor. Criterion-related validity showed that the DMSES was a significant predictor of the diabetes self-management (R = 0.61; P < 0.001).
Conclusion: The study findings showed that the Iranian version of the DMSES has a good structural characteristic and is a valid and reliable instrument that can be used for measuring diabetes management self-efficacy.

Background & Aim: Adolescence is a sensitive period and psychological health during this period is of significant importance. Several studies suggest that self-esteem is a better predictor of success in studying than intelligence scores. Having assertiveness is considered important in having a high self-esteem. This study has been carried out in order to determine the influence of assertiveness training on self-esteem in high-school female students.
Methods & Materials: In this semi-experimental study, two female schools with 751 students were selected randomly from one of the four education regions of Shiraz, Iran. All of the students were evaluated using Coopersmith Self-Esteem Inventory (CSEI) and Gambrill-Richey Assertion Inventory (GRAI). Students who had a test score of less than 25.4 were identified students with low selfesteem. Among whom, those who possessed low assertiveness means, their test scores were less than 44, were also characterized. Finally, 60 students were selected and allocated to intervention and control groups. No training was conducted for the control group, but the case group undertook assertiveness training for a period of 4 weeks, 2 times a week for 90 minutes. The Coopersmith selfesteem
and Gambrill-Richey Assertion Inventories were repeated after finishing 8 sessions. These tests were also repeated after 2 weeks to evaluate the rate of training continuity.
Results: T-test did not show a significant statistical difference between the mean and standard deviation of the scores of self-esteem and assertiveness before training among research samples between case and control groups (P = 0.30). The mean scores of self-esteem and assertiveness of the experimental group had significant differences immediately (34.1 and 92.8, respectively) and after 2 weeks of training (32.2 and 93, respectively) comparing with before training and with control group (respectively, P = 0.035, P = 0.045). Assertiveness of the control group did not show any significant statistical difference during the aforesaid three times (P > 0.05).
Conclusion: The obtained results indicate an increase in the rate of self-esteem and assertiveness after a period of assertiveness training among the case group. Actually, assertiveness training is significantly effective on the rate of assertiveness and self-esteem of students. In addition, results show that the influence of assertiveness training does not last for a short  duration but its effect has remained as such after 2 weeks of training.

Background & Aim: Dietary behavior modification has an important effect on chronic disease occurrence. This study aimed to examine the effects of an education program on nutritional knowledge, attitude, and behavior among female students studying in Bojnord, Iran.
Methods & Materials: This was a clinical trial that was conducted in 2009. Of all secondary schools, 2 classes were randomly selected from which 115 students were recruited and randomly divided into intervention group (n = 55) or control group (n = 60). The intervention program was administered to the intervention group, whereas the other group just received routine education. Data were collected at baseline, and after 45 days and 360 days of follow up via a self-administered questionnaire regarding knowledge, attitude, and practice variables. Repeated measure ANOVA was used to analyze data.
Results: As the results showed, there were significant differences within each group over time in terms of knowledge, attitude, and behavior (P < 0.001). Furthermore, the two groups, regardless of time, were different in all studied variables (P < 0.001) and also the interaction between time and group were significantly different regarding the three studied scales (P < 0.001).
Conclusion: This study indicated that the designed educational program could improve the knowledge, attitude, and nutrition behavior of female students of Birdjand up to 12 months. Therefore, this program could be conducted in primary schools of Bojnord city to improve nutrition behavior of the students.

Background & Aim: The health of women, as half of the world’s population and the foundation of families and societies, has played a significant role in securing and stabilizing of the health of families and societies. The increasing rate of divorce in Iran caused us to perform this study aimed to explore the challenges of divorced women.
Methods & Materials: This was a qualitative study which was carried out through in-depth semistructured interviews with 12 divorced women whose divorce decree was issued in the Family Court of Shahrood, Iran, at least one year ago. Participants were selected purposefully and the data was analyzed using qualitative content analysis.
Results: The results of the study revealed the 4 following themes of health meaning from divorced women's experiences, causes of divorce, divorced women's problems, and divorced women's expectations from the society and authorities.
Conclusion: Adverse consequences of divorce on women's health including physical, mental and venereal diseases, and other serious social problems should be considered as the main and most important priority of the country by the authorities. Paying attention to the major and underlying grounds of divorce, also the most important problems of youth of the country, including addiction, superficiality, negligence of basic criteria in marriage, and infidelity, can be helpful in solving the problem of divorce.

Background & Aim: Despite the well evidenced health benefits of regular physical activity, many Iranian college students do not engage in physical activity sufficiently. The aim of this study was to assess cognitive factors related to regular physical activity in college students in Hormozgan University of Medical Sciences, Bandar Abbass, Iran.
Methods & Materials: A total of 314 students from three schools of the Hormozgan University of Medical Sciences were selected randomly. Of the total number of students, 249 students filled out the questionnaires completely (response rate = 79.3%). Exercise Benefits/Barriers scale, Selfefficacy scale, Exercise norms scale, and Planning for exercise scale were used to assess cognitive factors regarding physical activity; the Cronbach's alpha of these scales were 0.87, 0.83, 0.73, and 0.82, respectively.
Results: The mean age of participants was 21.7 ± 2.7. Of all the participants, 46.2% were male. Only 26.5% (n = 66) were engaged in regular physical activity. Perceived barriers to exercise, selfefficacy to exercise, planning for exercise, and exercise norms had a significant relationship with physical activity (P < 0.05). However, there was no significant relationship between perceived benefits to exercise and physical activity.
Conclusion: For increasing physical activity in college students, self-efficacy and social support improvement is suggested.

Background & Aim: Worldwide prevalence of infertility has been reported to be 3-7% of all couples. There are varieties among the results of studies conducted on the prevalence of infertility in Iran. The present study aimed to evaluate the trend of infertility using meta-analysis method in Iran.
Methods & Materials: We systematically reviewed all published papers in Medline database of the National Library of Medicine and their Persian equivalents (2001–2011). Findings which met the inclusion criteria were included. Random effects meta-analysis was applied to the data of 13 selected populations. Data manipulation and statistical analyses were performed using STATA.
Results: Overall, 13 studies met our inclusion criteria. The pooled prevalence of infertility was 13.2% (95% CI: 8-18.3). The pooled prevalence of primary and secondary infertility were reported to be 5.2% (95% CI: 3.7 - 6.6) and 3.2% (95%CI: 2 - 4.4), respectively. The lowest and highest frequency of lifetime prevalence of infertility was 2.8% in 2001 and 24.9% in 2010, respectively. Meta- regression scatter plot showed an increasing trend in the prevalence of infertility during 2001- 2011 (P = 0.58). Meta-regression did not indicate a significant correlation between the sample sizes and the prevalence of infertility (P = 0.64).
Conclusion: The pooled infertility prevalence in Iran is higher than its mean worldwide, and lifetime infertility is increasing in recent years compared to the past in Iran.