OTHERS_CITABLE
Association Between Perceived Social Support and Mental Health Status Among Older Adults
Introduction: The elderly need social support to reduce their physical and mental disabilities. Perceived social support is one of the effective factors in the lifestyle of older adults.
Objective: This study aimed to determine the association between perceived social support and mental health status among older adults.
Materials and Methods: This research is a cross-sectional analytical study. The study data were collected using a perceived social support (PSS) scale and general health questionnaire-12 (GHQ-12). A total of 302 eligible older adults were selected through a random sampling method from primary health centers in the north, south, east, west, and center of Tehran. The inclusion criteria were those community-dwelling older adults aged ≥60 years and with normal cognitive abilities. The collected data were analyzed using t test, ANOVA, the Pearson correlation, and multiple linear regressions.
Results: The mean ±SD age of older adults was 70.01 ±6.29 years. Their mean ±SD scores of the PSS and GHQ-12 were 130.95 ±16.05 and 7.29 ±5.55, respectively. The results showed no significant relationship between demographic variables and PSS. There was a significant inverse correlation between the PSS score and the GHQ-12 score (P= 0.01, r= -0.878). The PSS explained 0.66 of the total variances of “positively phrased items” of GHQ-12 (adjusted R2= 0.66) and 0.76 of the total variances of “negatively phrased items” of GHQ-12 (adjusted R2= 0.76).
Conclusion: Our findings showed that the PSS and mental health are at a desirable level in this study, and the PSS is not affected by demographic variables. The PSS is a promoting factor for mental health status among older adults.
http://hnmj.gums.ac.ir/article-1-1665-en.pdf
2021-06-20
147
154
10.32598/jhnm.31.3.2063
Aging
Mental health
Social support
Shima
Nazari
1
Assistant Professor, Department of Gerontology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
AUTHOR
https://orcid.org/0000-0002-6450-7084
Pouya
Farokhnezhad Afshar
farokhnezhad.p@iums.ac.ir
2
Assistant Professor, Department of Gerontological Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
https://orcid.org/0000-0001-7664-2710
Leila
Sadegh Moghdada
3
Assistant Professor, Department of Nursing, School of Nursing, Social Development and Health Promotion Center, Gonabad University of Medical Sciences, Gonabad, Iran.
AUTHOR
https://orcid.org/0000-0003-1808-7039
Alireza
Namazi Shabestari
4
Assistant Professor, Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
https://orcid.org/0000-0003-0817-0883
Akram
Farhadi
5
Assistant Professor, The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
AUTHOR
https://orcid.org/0000-0002-0655-8342
Narjes Khatoon
Sadeghi
6
Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
AUTHOR
https://orcid.org/0000-0002-0073-3648
OTHERS_CITABLE
The Effectiveness of Husbands\' Awareness of Menopausal Complications on Physical Psychological Experiences of Postmenopausal Women
Introduction: Women are subject to extensive changes during menopause. Life crises such as menopause can affect women's health and is a turning point in their lives. The husbands are the most important and closest people who can support their wives in this evolutionary crisis with their correct understanding of the situation.
Objective: This study aimed to determine the effectiveness of husbands' awareness of the physical and psychological experiences of postmenopausal women.
Materials and Methods: This randomized clinical trial study was performed on 150 married postmenopausal women in Kashmar City, Iran, in 2019. The husbands of the intervention group received three sessions (60 minutes) of the menopause training program with one-week intervals. The spouses of both groups received routine care at the health center. The questionnaire of psychological and physical experiences of postmenopausal women and measuring men's awareness of menopause in both groups was completed before the intervention and one month after the intervention. The collected data were analyzed using descriptive statistics and inferential statistics of the Chi-square, paired t test, independent t test, and analysis of covariance.
Results: The mean ±SD age of women in the intervention group was 51.13 ±2.68 years, and their mean ±SD menopausal age was 49.09 ±2.60 years. The mean ±SD score of menopausal experiences before the intervention was 144.99 ±38.09 in the intervention group and 143.47 ±28.48 in the control group and 105.53 (35.41) in the intervention group, and 118.82 (82.21) in the control group. The statistical test showed that the mean score of menopausal experiences and the range of adaptation after the intervention and also between the two groups have statistically significant differences with each other (P = 0.001).
Conclusion: Menopause has adverse physical and psychological symptoms. An intervention program to increase the awareness of men during menopause reduces negative menopausal experiences in women.
http://hnmj.gums.ac.ir/article-1-1668-en.pdf
2021-06-20
155
164
10.32598/jhnm.31.3.2070
Awareness
Spouse
Menopause
Women's experiences
Sedigheh
Shariat Moghani
s_shariat47@yahoo.com
1
Instructor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
https://orcid.org/0000-0002-6427-8912
Mahdieh
Ebrahimzadeh
2
Midwifery (MSc), School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
https://orcid.org/0000-0002-9032-7925
Ali
Safari
3
Nursing (MSN), Ayatollah Taleghani Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
https://orcid.org/0000-0002-3783-3538
Jamshid
Jamali
4
Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
https://orcid.org/0000-0002-9681-8231
OTHERS_CITABLE
Effect of Midwife-Led Counseling on the Quality of Life of Women With Body Image Concerns During Postpartum
Introduction: During pregnancy and postpartum, women bet more concerned and dissatisfied with their bodies. Primiparous women face more physical and mental health problems in the postpartum period.
Objective:This study aimed to investigate the effect of a midwife-based counseling program on the quality of life in women with body image concerns during postpartum.
Materials and Methods: This randomized controlled trial was conducted on 64 primiparous women with body image concerns who had been referred to the health centers in Alborz Province, Iran,in January 2019. The convenience sampling method was used for recruiting the study participants. Then, the samples were assigned to the intervention and control groups by random number table allocation. Next, the intervention group received a three-session counseling program.The data gathering questionnaire in this study included a Multi-Dimensional Body Self-Relation Questionnaire (MBSRQ) and a 36-item short-form quality of life questionnaire. Questionnaires were completed before, immediately after, and one month after the intervention.The obtained data were analyzed using descriptive statistics, the Chi-square test, Fisher exact test, and repeated measures test.
Results:The mean ±SD age of the study participants was 26.4 ±5.4 years. Also, 94%of the samples had wanted pregnancy, 54%had a vaginal delivery,and 59.4%were overweight.
There was no statistically significant difference between the control and intervention groups before the intervention regarding their demographic characteristics. The results of the analysis of variance (ANOVA) with repeated measures test indicated that the length of time affected the total scores of multi-dimensional body self-relation (P= 0.001). Also, the repeated measures ANOVA results showed that time significantly impacted the quality of life score (P= 0.001).
Conclusion: The study results showed that a midwife-led counseling program could affect the score of quality of life in women with body image concerns in postpartum.
http://hnmj.gums.ac.ir/article-1-1666-en.pdf
2021-06-20
165
174
10.32598/jhnm.31.3.2064
Body image
Quality of life
Postpartum
Sedigheh
Salehi
1
Midwifery (MSc) ،School of Nursing and Midwifery, Alborz University of Medical Sciences، Karaj، Iran.
AUTHOR
https://orcid.org/0000_0001_9517_8327
Zohreh
Mahmoodi
2
Associate Professor, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
AUTHOR
https://orcid.org/0000-0002-7868-6941
Alireza
Jashni Motlagh
3
Assistant Professor, Neonatal-Perinatal Medicine, Department of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
AUTHOR
https://orcid.org/0000-0001-6162-6056
Mitra
Rahimzadeh
4
Associate Professor, Social Determinants of Health Research Center, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran.
AUTHOR
https://orcid.org/0000-0002-9863-5949
Mina
Ataee
5
Assistant Professor of Obstetrics & Gynecology, Alborz University of Medical Science, Karaj, Iran.
AUTHOR
https://orcid.org/0000-0002-0935-7837
Sara
Esmaelzadeh –Saeieh
Esmaelzadeh1360@gmail.com
6
Associate Professor, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
AUTHOR
https://orcid.org/0000-0002-9262-5002
OTHERS_CITABLE
Midwifery Trained Registered Nurses\' Perceptions of Their Role in the Labor Unit
Introduction: A Midwifery Trained Registered Nurse (MTRN) is a member of the multi-professional maternity health care team in Sri Lanka. Her contribution to the maternity care team is poorly understood, often undermined, and undefined. In the context of low- and middle-income settings where traditional midwives play a crucial role in domiciliary care, the MTRNs role as a member of the multi-professional hospital-based maternity care team has not been well-described.
Objective: The study aimed to describe MTRNs' perceptions of their role in the Labor Unit within the multi-professional maternity health care team at five tertiary care hospitals in the Capitol Province of Sri Lanka.
Materials and Methods: A descriptive cross-sectional study was conducted among 186 MTRNs working in labor rooms in the study setting. All MTRNs in the selected hospitals were invited and included in the sample. A postal survey was carried out using a pre-evaluated, pretested self-administered questionnaire, and descriptive statistics were derived.
Results: All respondents were females, aged 27 to 60 years (mean ±SD 40 ±8.3 years). The majority (66%)was less than 45 years old. Almost all (>96%) MTRNs perceived 12 tasks of the listed tasks as their primary responsibility. Regarding other tasks, they perceived a high degree of overlap between their role and those of the doctors and midwives. Although almost all MTRNs rated the level of interprofessional collaboration from registered nurses (RNs) and doctors as average to good, nearly half (49%) of them rated support from midwives ranging from very poor to average.
Conclusion: A high degree of perceived overlap between MTRNs' tasks with those of the other members of the maternity care team can cause role confusion, conflicts, and poor patient care. MTRNs' role in the Labor Unit within the multi-professional maternity health care team was controversial. Clarifying the MTRNs scope of practice will help improve interprofessional understanding of roles and responsibilities and collaboration.
http://hnmj.gums.ac.ir/article-1-1671-en.pdf
2021-06-20
175
183
10.32598/jhnm.31.3.2078
Midwifery
Work performance
Obstetrics
Parturition
Sunethra
Jayathilake
sjayathilake@sjp.ac.lk
1
Senior Lecturer in Nursing, Ph.D. University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
AUTHOR
https://orcid.org/0000-0003-0361-7076
Vathsala
Jayasuriya-Illesinghe
2
National Programme Manager, Ryerson University, MD, Toronto, Canada.
AUTHOR
https://orcid.org/0000-0002-1382-3116
Kerstin
Samarasinghe
3
Lecturer in Nursing, Ph.D, Kristianstad University, Kristianstad, Sweden.
AUTHOR
https://orcid.org/0000-0002-5699-9621
Himani
Molligoda
4
Senior Lecturer, MD, Post Graduate Student in Institute of Medicine, Colombo, Sri Lanka.
AUTHOR
https://orcid.org/0000-0002-9216-9035
Rasika
Perera
5
Senior Lecturer, Ph.D, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
AUTHOR
https://orcid.org/0000-0002-1071-0933
OTHERS_CITABLE
The Effect of Zinc Oxide Scallop-Shell Powder and Complications After Coronary Angiography
Introduction: Coronary angiography is often associated with complications such as hemorrhage and hematoma that should be considered and be minimized.
Objective: This study aimed to determine the effect of Zinc oxide scallop-shell powder as a topical hemostatic agent (composed mainly of calcium) on complications after coronary angiography. These complications include hemostasis time, low back pain, hemorrhage, hematoma, the necessity of sandbags, and patient ambulation.
Materials and Methods: The current research was a blind, parallel, randomized clinical trial done on 150 patients under coronary angiography. They were randomly divided into three equal groups of A (control), B (case 1), and C (case 2). In group A, hemostasis was done with manual compression, use of ChitoHem powder, putting sandbag for 4-6 h in a supine position, and getting out of bed after 24 h. In group B, instead of ChitoHem powder, we used Zinc oxide scallop-shell powder. In group C, hemostasis was done with manual compression, Zinc oxide scallop-shell powder, putting sandbag for 1 h in a supine position, and getting out of bed after 2 h. The duration of hemostasis, bleeding, and hematoma after hemostasis and the severity of low back pain were investigated at 8 point intervals during 24 h. Data analysis was done using descriptive statistics indicators and Kolmogorov-Smirnov, ANOVA, Chi Square, Fisher exact test and Kruskal-Wallis tests.
Results: The mean ±SD ages of groups of A, B, and C were 60.08 ±11.32, 60.22 ±10.30, and 61.69 (10.61), respectively, which was not statistically different. Furthermore, there was no significant difference between these three groups regarding their demographic information. There were statistically significant differences between groups about the amount of low back pain at the second, third, and fourth hours after angiography (P= 0.001). There was a significant difference in the amount of bleeding between the three groups (P=0.017). The difference in time of hemostasis in the three groups was not statistically significant.
Conclusion: The Zinc oxide scallop-shell powder reduces catheter site bleeding after coronary angiography and bed rest time and ultimately the severity of low back pain. Performing a similar study is recommended.
http://hnmj.gums.ac.ir/article-1-1667-en.pdf
2021-06-20
184
193
10.32598/jhnm.31.3.2104
Zinc oxide scallop-shell
Coronary angiography
Hemostasis
Hemorrhage and hematoma
Low back pain
Marjan
Rahmani
1
Nursing (MSN), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
Arsalan
Salari
2
Professor, Cardiovascular Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-5821-6176
Mohammad-Taghi
Moghadamnia
3
Assistant Professor (Health in Disasters and Emergencies), Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-3380-5142
Saeed
Omidi
4
Instructor, School of Health. Department of Health Education and Health Promotion, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0001-7024-1625
Mehdi
Shirzad-Siboni
5
Assistant Professor, Department of Environmental Health Engineering, School of Health Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-2085-2548
Majid
Pourshaikhian
pourshaikhian_m@yahoo.com
6
Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0003-0213-4873
OTHERS_CITABLE
The Relationship between Living Environment and Life Satisfaction in Residents of Rasht City, North of Iran
Introduction: Life satisfaction reflects an individual's overall feelings about life, influenced by various factors.
Objective: This study aimed to identify and introduce the indices related to the living environment that affect life satisfaction.
Materials and Methods: This study was performed on 1000 residents of 55 neighborhoods of Rasht City (north of Iran) by an analytical cross-sectional method. The participants were chosen with a multistage cluster sampling method. The study data were collected using questionnaires, including the residents' characteristics, indicators of the living environment, and the satisfaction with life scale. The obtained data were analyzed using descriptive statistics, and inferential statistics, including the Pearson correlation coefficient, independent t test, analysis of variance, and linear regression.
Results: Based on the present study results, the mean±SD age of the subjects in the study was 43.73 ±15.55 years. The analysis showed that their level of life satisfaction was average mean ±SD: 19.41 ±7.63, range: 5-35). The regression analysis identified dissatisfaction of facilities (B= -0.366; 95%Cl : -0.434, -0.298; P= 0.001), satisfaction with living in the local area (B= 0.248; Cl: 0.123, 0.373; P= 0.001), duration of residence (B: -0.364;95% Cl: -0.625, -0.102; P= 0.006) and gender (women compared to men) (B: 0.896; Cl: 0.011, 1.781; P=0.047) as the predictors of life satisfaction.
Conclusions: According to the results, the life satisfaction of our study participants was at a moderate level and was affected by living environment indicators, especially facilities.
http://hnmj.gums.ac.ir/article-1-1673-en.pdf
2021-06-20
194
202
10.32598/jhnm.31.3.2083
Satisfaction with life
Physical environment
Social environment
Abolfazl
Etebarian Khorasgani
1
PHD Candidate, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
AUTHOR
https://orcid.org/0000_0003_2100_437x
Atefeh
Ghanbari Khanghah
at_ghanbari@gums.ac.ir
2
Professor, Social Determinants of Health Research Center (SDHRC), Department of Nursing (Medical- Surgical), Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-7949-5717
Ezzat
Paryad
3
Instructor, Department of Nursing (Medical- Surgical), GI Cancer Screening and Prevention Research Center (GCSPRC), Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0001-8823-3471
Zahra
Atrkar Roshan
4
Associate Professor, Department of Bio-Statistics, Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-1267-2133
Enayatollah
Homaei Rad
5
Assistant Professor, Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-9064-0380
OTHERS_CITABLE
Damask Rose Aromatherapy and the Anxiety of Endoscopic Candidate Patients: A Clinical Trial
Introduction: Anxiety is one of the common problems among patients before undergoing invasive diagnostic techniques. One of these diagnostic techniques is gastrointestinal endoscopy. Aromatherapy is one of the complementary therapies to reduce anxiety.
Objective: This study aimed to determine the effect of aromatherapy with Damask rose on the anxiety of the patients before undergoing endoscopy.
Materials and methods: This study is a clinical trial performed on patients referred to the Endoscopy Department of one of the educational and therapeutic centers in Rasht City, Iran, in 2019. The study sample was 70 patients divided into the intervention and control groups. After giving the informed consent form, the samples completed the demographic information questionnaire and Spielberger anxiety questionnaire. The intervention group received aromatherapy with 10% Damask rose essential oil, and the control group received aromatherapy with a placebo for 30 minutes. The anxiety questionnaire was completed again 30 minutes after aromatherapy. The data were analyzed using descriptive and inferential statistics (the paired t test, Chi-square, independent t test, and covariance test).
Results: Results showed that the mean ± SD age of participants was 41.05 ±13.15 years in the intervention (ranged 22-65 years) and 45.82 ±16.81 years in the control groups. Most participants were female (57.1%). After the intervention, the mean score of anxiety in the aromatherapy group (39.88±11.51) was lower than that in the control group with placebo (49.94±12.30), which was statistically significant (P=0.001).
Because of significant differences in hospitalization history between the two study groups before the intervention, the covariance test was performed. The results showed no interaction between aromatherapy and hospitalization history. So it seems that the hospitalization variable did not affect post-intervention anxiety.
Conclusions: This study showed that aromatherapy with Damask rose essential oil was effective on pre-endoscopic anxiety of the patients. Since complementary medicine is increasingly practiced in nursing care, Damask rose aromatherapy, because of its low cost, safety and simplicity, can be used as a complementary measure to reduce anxiety in patients before endoscopy. However, more studies with intervention, control, and routine groups are needed to confirm the effectiveness of aromatherapy in endoscopy.
http://hnmj.gums.ac.ir/article-1-1674-en.pdf
2021-06-20
203
211
10.32598/jhnm.31.3.2126
Anxiety
Aromatherapy
Endoscopy
Rosa
Maryam
Mirzaee Jirdehi
1
Instructor, Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Guilan, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0003-4004-0544
Arezoo
Monfared
a.monfared88@gmail.com
2
PhD Candidate of Nursing, Guilan University of Medical Sciences, Instructor, Islamic Azad University, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-5472-8369
Fariborz
Mansour Ghanaei
3
Professor, Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-6264-0025
Ehsan
Kazemnezhad Leili
4
Associate Professor, Biostatistics, Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-9195-9094
OTHERS_CITABLE
Predicting Tobacco Use Based on the Theory of Planned Behavior in Adolescent Girls
Introduction: Tobacco use poses a serious threat to global health. The tobacco epidemic is spreading in low- and middle-income countries, where the tobacco industries mainly target young people and women.
Objective: This study aims to determine the predictors of tobacco use based on the theory of planned behavior (TPB) in female high school students.
Materials and Methods: This cross-sectional study was conducted on 340 female high school students aged 14-18 years in Rasht City, Iran, who were selected using a multi-stage sampling method. The data collection tool was the TPB questionnaire for tobacco use in Persian. The obtained data were analyzed using the Mann-Whitney U test, Kolmogorov-Smirnov test, Spearman correlation test and logistic regression analysis.
Results: The TPB constructs of attitude (OR = 0.91, 95% CI: 0.85-0.97, P = 0.007) and behavioral intention (OR=0.75, 95% CI; 0.64-0.88, P = 0.001) could predict cigarette smoking. Also, constructs of perceived behavioral control (OR = 0.92, 95%CI; 0.87-0.97, P = 0.007), subjective norms (OR = 0.83, 95%CI; 0.70-0.97, P = 0.02), and behavioral intention (OR = 0.88, 95% CI; 0.78 - 0.99, P = 0.03) could predict hookah smoking in girls students.
Conclusion: Considering the predictive power of the TPB constructs in tobacco use by adolescent girls, it is possible to plan to reduce its rate in this group by a focus on the TPB constructs.
http://hnmj.gums.ac.ir/article-1-1675-en.pdf
2021-06-20
212
218
10.32598/jhnm.31.3.2058
Adolescent
Female students
Smoking
Tobacco
Maryam
Ghasemipour
1
Health Education and Promotion (MS), School of Health, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-3636-0046
Rabiollah
Farmanbar
rabi_1345@yahoo.com
2
Associate Professor, Dept. of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-7220-688X
Parisa
Kasmaei
3
Associate Professor, Dept. of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0001-6796-6422
Zahra
Atrkar Roshan
4
Associate Professor in Biostatistics, Dept. of Biostatistics, School of Medicin, Guilan University of Medical Sciences, Rasht, Iran.
AUTHOR
https://orcid.org/0000-0002-1267-2133
Sima
Nickandish
5
Midwifery (MSc), School of Nursing and Midwifery, Zanjan University of medical sciences, Zanjan, Iran.
AUTHOR
https://orcid.org/0000 0002 4721 0064