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Introduction: Complications due to lack of awareness are one of the most important factors in re-hospitalization of these patients. This study conducted to determine effect of small group intervention program on knowledge and health literacy among patients with heart failure. Method: This randomized clinical trial carried out on 150 patients with heart failure hospitalized at hospitals affiliated to Tehran University of Medical Sciences. After obtaining informed consent, subjects randomly assigned to intervention and control groups. Before the study, demographic, health literacy, and knowledge questionnaires were completed by the participants. The control group received routine care while, in the intervention group training were conducted in small groups, in addition to the manual about disease and self-care that created by the research team. Finally after 6 months questionnaires were completed by two groups and the data were analyzed by SPSS software using descriptive and inferential statistics. Results: Mean and standard deviation of knowledge and health literacy in the control group were 1.78±0.87 and 1.77±0.83 and in the intervention group they were 2.48±0.68 and 2.53±0.72, respectively. Covariance analysis also showed significant differences in the level of knowledge and health literacy scores of patients in the intervention group compared to the control group (P=0.01). Conclusion: Improving knowledge and health literacy using small group education method is recommended in the care plane of patients in the hospitals and rehabilitation centers.

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Introduction: Determining the health literacy level of parents and their awareness of child health issues, helps to determine the educational needs of parents. Therefore, the present study aimed to assess the health literacy level of parents in School children of Ilam.

Methods: In this cross-sectional study which was conducted in 2015, a total of 300 couples with children 6 to 12 years were included in the study. To assess the Health Literacy of parents a questionnaire for parents of school age children were used. Data were analyzed using SPSS software version 20 using descriptive statistics (mean and standard deviation) and statistical tests (test ANOVA).

Results: The results showed that the average health literacy in fathers and mothers were 321.64 ± 19.74 321.71 ± 13.08. A significant difference was found between health literacy in parents. Fathers and mothers' health literacy increased with age, with increasing employment and education, was added (p<0.05).

Conclusion: Regarding the relationship between education and employment status with mother's health literacy, it is necessary to educate parents with low educational levels.

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Introduction: Women in the reproductive age are the first target group in the public health promotion plans, with regards to the importance of health literacy in this matter the present study aimed to determine the relationship between health literacy in women of reproductive age and its relationship with self-care.
Methods: In this descriptive-analytical study, 330 women who visited health centers in Lenjan (Isfahan) were examined. Data collection tools included a self care questionnaire and the Test of Functional Health Literacy in Adults (TOFHLA). The reliability and validity of both tools have been examined and confirmed in previous studies. ANOVA and multivariate regression were used for data analysis. The significance level of all tests was 0.05.
Results: The mean scores of health literacy and self-care were 41.05±9.23 and 67.91±23.55, respectively. In total, 28, 23 and 49% of the subjects had inadequate, borderline, and adequate literacy levels, respectively. ANOVA results showed that the scores of self-care, body care, vaccinations, and stress management are significantly different at different levels of health literacy. Regression model showed that linear combination of independent variables explains 13% of variance in self-care. ANOVA results also showed that the regression model is significant (P<0.001). Among the predictor variables, only health literacy in the reading skill had a significant coefficient.
Conclusion: Findings showed that women with inadequate health literacy have lower mean self-care, body care, and stress management scores, as compared to those with adequate health literacy. It seems that more attention to improving the level of health literacy, especially reading literacy, is necessary as factors affecting self-care in reproductive age.
 

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Introduction: Health literacy includes a group of skills of reading, listening, analysis and ability of using these skills in the health situations. The women have been identified as the initial population for emphasis on increase of health literacy. This study was applied with the objective of "The effect of small-group teaching on health literacy in pregnant women with nausea and vomiting: a clinical trial".
Method: This clinical trial was conducted, on 59 Pregnant women with the nausea and vomiting who referred to obstetrics ward of health and treatment centers in Neishabour County. The women were selected randomly in two intervention and control groups. In the intervention group, intervention by researcher was performed on a 5 to 12 member group of women in 8 training sessions 30-45 minutes. The control group received routine care. The study instruments were questionnaires STOFHLA^[1] and (modified-PUGE)^[2]. Data analysis done with independent t test, Wilcoxon, chi-square and Mann-Whitney.
Results: Research units, were no statistically significant difference of personal data at the beginning of the study (p>0/05). After intervention in the intervention and control groups, the mean change score of health literacy had statistically significant difference (P<0.001). Before and after the intervention in the intervention group, score of health literacy had statistically significant difference (P<0.001).
Conclusion: Promoting health literacy using small group training is recommended in pregnant women with nausea and vomiting in  the Health care center.

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Introduction: Inadequate health literacy and lack of information related to disease management can affect self-efficacy in care. The aim of this study was to determine the relationship between health literacy and self-efficacy in patients with cardiovascular disease.
Methods: In this descriptive study, 161 cardiovascular patients were selected using convenience sampling method from patients referring to two educational hospitals in Khorramabad city, in 1396. In this study the data collection was used personal and social information form, health literacy questionnaire and self-efficacy questionnaire. Descriptive statistics and Pearson or Spearman correlation coefficients were used for data analysis in SPSS software.
Results: The mean age of participants was 59.97 ± 12.68 years. Most of them were women (59%) and married (71.4%). most of them had less education than a diploma (78.9%). The findings showed that most of the subjects had a level of health literacy at the borderline / moderate level (75.2%). They also had a level self-efficacy at the borderline /moderate (70.2%). The main findings showed that there is a significant relationship between the total health literacy score and the self-efficacy (r = 0.001, p = 0.00), so that people with higher levels of health literacy had more self-efficacy.
Conclusion: The findings of this study showed that cardiovascular patients have a level of health literacy and self-efficacy at the borderline level. Considering the significant relationship between health literacy and self-efficacy, nursing interventions are needed to increase self-efficacy and health literacy for health behaviors.
 

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Introduction: Health literacy is an essential element in people's ability to contribute to health-related activities, health decisions, and the ability to prevent illness and lifestyle. Today, health literacy is a global issue because many unpleasant health outcomes result from inadequate health literacy. The purpose of this study was to investigate the relationship between quality of life and health literacy among students of Abadan Faculty of Medical Sciences.
Method: 250 undergraduate and graduate students were selected through stratified random sampling. Data were gathered using health literacy assessment and SF-36 quality of life questionnaires. Data were analyzed using SPSS version 19, Pearson correlation test and multiple linear regression coefficient.
Findings: There was a direct and meaningful weak relationship between the variables of health literacy and the quality of life (r=0.272). Also, there was a direct and significant correlation between mental health score and physical health (r=0.722), reading and access (r=0.604), understanding (r=0.654), evaluation (r=0.538), decision making and behavior (r=0.484). There was also a direct and significant correlation between understanding and reading (r=0.549) and evaluation (r=0.722). There was a direct and significant correlation between evaluation and reading (r=0.552), decision making and behavior and understanding (r=0.489) and evaluation (r=0.458).
Conclusion: Students with a low level of health literacy have poor quality of life and individuals with better mental health have a healthier physical form. Considering the students’ higher score of physical health than their mental health, it is recommended to hold training workshops on stress management, management of living plans, lifestyle in the dormitory, healthy relationships with others, and increased sports and recreational programs to improve the mental health and identify the problems accurately and solve them.
 

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Introduction: Exclusive breastfeeding (EBF) is infant’s breast milk consumption without supplementation of any kind of food or drink. Nowadays, EBF has been considered as a key strategy for ensuring the growth and survival of the child. This study aims to investigate the factors affecting exclusive breastfeeding in primiparous women referring to Tehran health centers.
Methods: In this analytical study, the sample consists of primiparous women in reproductive age who referred to Tehran health centers in 2015-2016 having a child aged 2-5 years. Health literacy was measured by Health Literacy for Iranian Adults (HELIA) questionnaire which measures health literacy with 25 items graded on a 5-point scale. The data were analyzed by binary Bayesian regression model and using OpenBUGS software.
Results: EBF was reported 50.5%. The variables of maternal age (OR=0.87, CI: (0.80, 0.97)) and health literacy score (OR=1.11, CI: (1.16, 2.01)) had significant relationship with EBF. The method of delivery had no significant effect.
Conclusions: Results showed that health literacy score played an important role in exclusive breastfeeding besides maternal age. Therefore, considering the importance of the effect of health literacy on breastfeeding, it is suggested that mothers have the ability to obtain a high score of health literacy before pregnancy time.
 

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Introduction: Health literacy is the capacity of each individual to obtain, interpret and understand the basic information of health services that is necessary for appropriate decision making in this area. Based on this, the researchers decided to conduct a study to investigate the relationship between health literacy and the quality of life of the elderly living in nursing homes in Guilan province in 2020.
Methods: The present study is a cross-sectional-analytical study. The statistical population included all the elderly living in nursing homes in Guilan province in 2020. The statistical sample consisted of 89 people from the mentioned statistical population who were selected through Cochran's formula and stratified-random sampling method. Data collection tools included the Health Literacy Questionnaire (HELIA) and the Quality of Life Questionnaire (SF-12). Data were analyzed using SPSS software version 20 and Pearson correlation coefficient, ANOVA, and t-test of two independent samples.
Results: The average health literacy of the elderly is 78.97 with a standard deviation of 5.249%. The average quality of life of the elderly is 37.40 with a standard deviation of 6.645%. The result of the Pearson correlation coefficient test showed that there is a positive and significant relationship between the overall score of health literacy level and the overall score of quality of life of the elderly living in nursing homes in Guilan province in 2020. Also, the relationship between health literacy and general comprehension score, physical performance score, physical health score, physical pain score, emotional problems score, social performance score, vitality and vitality score, and mental health score in the elderly living in nursing homes in Guilan province in 2020, There is a positive and meaningful. The results of the analysis of variance showed that there is no significant relationship between health literacy level and quality of life level with age and level of education. The results of the t-test of two independent samples showed that there is no significant difference between health literacy and quality of life of male and female elderly.
 
Conclusion: By planning and designing useful educational programs in the field of health literacy appropriate for the elderly, and effective step can be taken to develop health literacy skills in society and improve the quality of life of the elderly