Khodarahmi the Role of Family Violence+iran Adolescence

The correlation between family function and health-promoting lifestyle among female adolescents in Iran

ⁱ Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Islamic republic of iran
ⁱⁱ Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran Academy of Medical Sciences, Tehran, Iran
³ Nursing Intendance Research Center, Islamic republic of iran University of Medical Sciences, Tehran, Iran

Date of Submission	18-Aug-2020
Date of Decision	01-Nov-2020
Date of Acceptance	10-May-2021
Date of Web Publication	25-November-2021

Correspondence Address:
Shahzad Pashaeypoor
Department of Community Health and Geriatric Nursing, Schoolhouse of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran.
Islamic republic of iran

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/nms.nms_71_20

Background: Health-promoting lifestyle (HPL) is a major health business concern among adolescents. Family unit function (FF) has potential effects on adolescents' lifestyle and health. Objectives: This written report aimed to evaluate the correlation between FF and HPL among female adolescents. Methods: This correlational study was conducted from January to February 2020 on 356 female adolescent students randomly recruited through multistage cluster sampling from four public junior high schools in the south of Tehran, Islamic republic of iran in 2020. Data were collected using a personal characteristics questionnaire, the Boyish Health Promotion Brusque Class, and the McMaster Family unit Cess Device. Data assay was performed through Pearson's correlation coefficient, the ane-way analysis of variance, the independent-samples t test, and the linear regression analysis. Results: The average age of adolescents was 14.16 ± 0.76 years. The total mean scores of participants' HPL and FF were 75.36 ± 12.43 (in the possible range of 21–105) and 3.02 ± 0.37 (in the possible range of ane–iv), respectively. There was a significant positive correlation between FF and HPL (r = 0.399, P < 0.001). Among demographic characteristics, adequacy of family income, and among dimensions, the trouble-solving, behavioral control, roles, and melancholia involvement dimensions of FF were significant predictors of HPL, explaining 24.5% of its total variance. Conclusion: The mean HPL and FF were greater than the possible median scores. Also, capability of family income and FF were significant predictors of HPL amidst female person adolescents. Healthcare authorities and policymakers are recommended to pay greater attention to FF in developing health-promoting programs for adolescents.

Keywords:Adolescent, Family function, Wellness-promoting lifestyle

How to cite this article:
Sarkhani Due north, Pashaeypoor South, Haghani S. The correlation between family part and wellness-promoting lifestyle amidst female adolescents in Iran. Nurs Midwifery Stud 2021;x:249-56

How to cite this URL:
Sarkhani N, Pashaeypoor S, Haghani S. The correlation between family unit function and wellness-promoting lifestyle among female adolescents in Iran. Nurs Midwifery Stud [serial online] 2021 [cited 2022 Mar 5];x:249-56. Bachelor from: https://www.nmsjournal.com/text.asp?2021/10/four/249/331295

Introduction

Adolescents institute around one-sixth of the global population.^[1] The national demography in Islamic republic of iran likewise revealed that in that location were 12 million adolescents aged x–xix years in Iran in 2016.^[2] Adolescence is associated with rapid physical and emotional changes and transition from childhood to machismo.^[3] Information technology is the period of forming attitudes and behaviors and thereby, determines lifestyle behaviors in adulthood.^[4]

Lifestyle is one of the main factors affecting wellness in all stages of life. Health-promoting lifestyle (HPL) is considered as the main cistron in the prevention of virtually health-related problems. It consists of half dozen main dimensions, namely nutrition, concrete activity, health responsibility, stress management, social support, and life appreciation.^[five] Most adolescents have an unhealthy lifestyle and are at risk for developing unhealthy lifestyle behaviors such as immobility, unhealthy eating, cigarette smoking, and alcohol consumption. These behaviors tin negatively affect their physical and mental health in adulthood, and thereby negatively affect family and public wellness.^{[half-dozen],[7],[viii]}

The term "family" is a societal construct whereby persons are related past beginnings, marriage, adoption, or option. The adolescents spend more time at family and set family members as function models, then, family unit is strongly linked to their health and wellbeing.^[9],[10] Family functioning is one of the factors with potential furnishings on adolescents' HPL. Good family function (FF) tin can promote the formation of healthy behaviors. FF is the ability of a family to meet the needs of its members by mutual dearest and support, emotional communication, and sharing life events and stress.^[11],[12]

The McMaster Model of FF (MMFF) is ane of the virtually well-known FF-related models. This model focuses on those aspects of FF that have the greatest furnishings on the physical and emotional wellness or problems of family members.^[13] MMFF states that FF has the following seven chief dimensions: problem-solving, communication, roles, affective responsiveness, melancholia involvement, behavior control, and general performance.^[14]

In families with good FF, individuals accept singled-out roles, clear relationships, and skilful furnishings on each other and tin can reach success through the successful performance of their activities. Contrarily, families with poor functioning are disorganized and accept weak relational patterns and weak relationships.^[15] A study showed that problems in families can be the main cause of failure in social relationships and loftier-run a risk behaviors such as alcohol consumption and drug corruption.^[16] Appropriately, some studies have compared the health-promoting behaviors and the FF, which shows that this comparison differs in various areas, and some dimensions of HPL are neglected. Fleming Megan's report showed that FF had pregnant relationships with some lifestyle behaviors such as physical activity and fruit and vegetable consumption amid adolescents.^[17] Several other studies likewise showed that FF had a pregnant relationship with wellness-related problems in adolescence such as emotional-behavioral bug,^[eighteen] anorexia nervosa,^[19] anxiety, and depression.^[20]

Although previous studies reported that FF can be a predictor of some wellness-related outcomes in boyhood, in that location are limited information nearly the role of FF dimensions in adolescents' HPL. Community health nurses, as evaluators, trainers, guides, and referrers, can communicate with families and can take effective measures to improve the level of performance and meet the health-related needs of family members. Moreover, reviewing the literature shows lack of studies related to the relationship between family functioning and HPL. Therefore, we conducted this written report to accost this gap.

Objective

This report aimed to evaluate the correlation between FF and HPL among female adolescents.

Methods

This correlational study was conducted from January to February 2020. The written report population comprised all female adolescent students in public inferior high schools in Tehran, Iran. Sampling was done through multistage cluster sampling. Initially, two districts (based on a larger population and demographically diverse) were randomly selected from all 11 districts in the south of Tehran city, and so, two junior high schools were randomly selected from each of these two districts. Three classes were selected from each of the schools through uncomplicated random sampling. All eligible students of these 12 classes were recruited for the study. In total, 360 students were assessed for eligibility. Selection criteria were an age of 13–15 years, consent for participation, and living in invulnerable families. Vulnerable families were unmarried-parent, no-parent, stride-parent, immigrant families as well as families with addicted or disabled members, and families with physically and mentally sick patients. Participants were excluded if they moved to another schoolhouse or voluntarily withdrew from the report.

The sample size was determined using the sample size formula for a two-variable correlation (i.e., n=[(Z_(i-α/2)+Z_(1-β))^two/(ω)^2] +3, where Ln〖(1+r)/(1-r)〗) considering the correlation coefficient of 0. 15 between FF and HPL besides every bit a confidence level of 0.95 and a test power of 80%.^[21],[22] Appropriately, 346 students were determined to be necessary for the study. Because possible attrition of 0.5%, 360 samples were recruited and finally 356 students completed the report questionnaire.

Data collection instruments

Data were collected using a personal characteristics questionnaire, the Adolescent Wellness Promotion Short Form (AHP-SF), and the McMaster Family Assessment Device (FAD). The personal characteristics questionnaire consisted of 10 items on age, body mass index, concluding-semester form point average, family size, birth club, adequacy of family income, and parents' educational level and occupation.

AHP-SF was used for HPL assessment. Chen et al.^[5] developed this scale in 2014 in Taiwan for high-school students anile 13–19 years. AHP-SF has 21 items in 6 dimensions, that is, diet (three items), social support (4 items), health responsibility (iv items), life appreciation (iv items), physical activeness (3 items), and stress management (iii items). Items are scored on a 5-signal scale from i ("Never") to 5 ("Always"). The possible total score of this scale is 21–105, with higher scores representing a healthier lifestyle. Chen et al.^[five] reported the acceptable validity and reliability of this scale with a Cronbach α of 0.xc. Sharkani et al.^[23] reported the acceptable validity and reliability of the Persian AHP-SF with a Cronbach α of 0.83 and a examination–retest intraclass correlation coefficient of 0.81.

FF was assessed using FAD. Epstein et al.^[24] adult this scale in 1983 based on MMFF. FAD has 53 items on organizational, transactional, and structural properties of families and addresses the 7 dimensions of FF, namely problem-solving (5 items), communication (6 items), roles (eight items), melancholia responsiveness (6 items), affective involvement (seven items), behavioral command (nine items), and general functioning (12 items). Particular scoring is performed on a four-point scale from i ("Completely disagree") to 4 ("Completely agree"). The total score of the scale is calculated by dividing the sum score of the items by 53 and ranges betwixt i and 4. College scores show improve FF. Epstein et al. reported that the Cronbach α values of FAD dimensions were 0.72–0.92. Zadehmohmmadi and Malekkhosravi^[25] reported the acceptable validity and reliability of the Farsi FAD with a Cronbach α value and the exam–retest intraclass correlation coefficient of 0.ninety and 0.81, respectively.

The data collection instruments were distributed amidst participants to complete them through self-study. The questionnaires were distributed during course time and the researcher was present and provided the participants with the necessary explanations, if needed.

Data analysis

The Statistical Package for the Social Sciences (SPSS) software program, version 16.0 was used for data assay. Information were described using the measures of descriptive statistics including frequency, mean and standard deviation. Starting time, the association between the independent variable (FF and characteristics) and the dependent variable (HPL) was examined. So the dependent variable and dependent variables were entered in the regression model. Pearson'due south correlation coefficient analysis was used to determine the correlations among HPL and FF. As well, the aforementioned test was used to decide the correlations amidst HPL and FF and variables such equally historic period and BMI. One-mode analysis of variance was used to decide the differences betwixt the mean scores of HPL and FF in terms of variables such as parent's educational level, birth rank, and adequacy of family income. The independent-samples t test was used to determine the difference between the mean scores of HPL and FF in terms of variables such equally parents' employment status, last-semester class betoken average, and family size. The multiple linear regression analysis was used to determine which demographic characteristics and FF dimension score predict HPL. The level of significance was prepare at less than 0.05.

Ethical considerations

This study has the approval of the Ideals Committee of Tehran Academy of Medical Sciences, Tehran, Iran (code: IR.TUMS.FNM.REC.1398.154). Necessary permissions were obtained from the regime of the written report setting. Participants and their parents were informed of their liberty to withdraw from the study and the confidentiality of their data. Written informed consent was obtained from participants and their parents.

Results

In full, 360 junior-high-school students were included and studied; of these, 356 completed the questionnaire. The mean age of the participants was xiv.16 ± 0.76 years. Nigh of them were the first kid of their families (56.3%), lived in families with less than iv members (77.5%), [Tabular array 1] shows their characteristics.

Table i: Participants' characteristics and their relationships with the mean scores of FF and HPL Click hither to view

The total mean scores of participants' HPL and FF were 75.36 ± 12.43 (in the possible range of 21–105) and three.02 ± 0.37 (in the possible range of ane–4), respectively [Tabular array 2]. The results of the independent-samples t exam and the one-mode analysis of variance illustrated that the mean score of participants' HPL had a significant relationship with the employment condition of their fathers (P = 0.04), adequacy of family income (P = 0.02), and family size (P = 0.03). Moreover, these tests indicated that the mean score of participants' FF had a significant relationship with their fathers' educational level (P = 0.02), adequacy of family income (P < 0.001), and terminal-semester form point average (P = 0.02) [Table 1].

The Pearson's correlation assay revealed that HPL had a meaning positive correlation with FF (r = 0.399, P < 0.02). Moreover, pairwise correlations between the dimensions of HPL and the dimensions of FF were meaning and positive (P < 0.05), except for the correlation between the communication dimension of FF and the nutrition dimension of HPL and the correlation between the effective interest dimension of FF and the diet, physical activity, and social support dimensions of HPL, which were not statistically meaning (P > 0.05; [Table two]).

The multiple linear regression analysis showed that amongst demographic characteristics, capability of family income, and among dimensions of FF, the problem-solving, roles, affective involvement, and behavioral control were significant predictors of HPL and explained 24.5% of its total variance (R ⁱⁱ = 0.245) [Tabular array 3].

Table three: The results of the multiple linear regressions for the predictors of HPL Click here to view

Word

The mean score of HPL was greater than the possible median score of HPL (in the possible range of 21–105). The highest dimensional mean score was related to the life appreciation dimension, which is in agreement with the findings of a written report on male adolescents in Iran^[26] and a study on female person and male adolescents in Turkey.^[27] The higher score of the life appreciation dimension might be attributable to the fact that adolescents proceeds many experiences through attention different social occasions and situations, hence have a good appreciation of life. On the reverse, the lower HPL dimensional mean score might be related to the health responsibility dimension. A study on Japanese adolescents^[28] and a written report on Chinese adults^[29] too reported the same finding. Experience of health-related bug are facilitators for the development of health responsibility.^[30] Then, the lower score of the health responsibleness dimension might be linked to the adolescents' limited experience of health-related problems.

The mean score of FF in this study was greater than the possible median score of FF (in the possible range of 1–iv). The highest and the lowest FF dimensional mean scores were related to the problem-solving and the communication dimensions, respectively. This is in line with the findings of a former study in Islamic republic of iran^[20] and contradicts the findings of a study in Thailand, which showed that the highest and the everyman dimensional mean scores were related to the communication and the effective responsiveness dimensions, respectively.^[31] This contradiction is attributable to the fact that FF is under the influence of sociocultural factors; hence, information technology varies in different countries.

The findings of this written report also indicated that HPL and its dimensions had significant positive correlations with FF and its dimensions. Moreover, FF and capability of family income level were significant predictors of HPL. Almost previous studies in this surface area reported the same findings. For case, a study on 2793 adolescents in Columbia showed that FF had significant relationships with lifestyle behaviors related to weight management, diet, and concrete activity among all racial and ethnic groups.^[32] Some other study reported that FF is a significant determinant of healthy behaviors amidst adolescents.^[17] Several other studies as well showed the negative correlation between FF and some aspects of HPL.^[33],[34] The differences between the findings may lie in samples, cultural bug, limitations in wellness equipment and facilities in Iran, lack of time direction, differences in the tools used, and lack of attention past people and authorities to the wellness of adolescents and FF.

The adequacy of family income was the only variable that showed a pregnant human relationship with FF and HPLs. Therefore, the adequacy of family income entered the regression model and the results showed that the HPL of students with relatively sufficient income was ameliorate than those with sufficient income. This finding contradicts the findings of studies by Amiri^[35] and Nacar.^[36] Information technology is clear that families with low-income accept more bug in coming together the needs of family members. However, loftier income may besides lead to family unit bug that touch FF.^[36] Unalan et al.^[37] in Kayseri observed no relationship between scores of the HPLPS and fiscal condition. However, we can conclude that the adolescent'south opportunities, in a broad sense, may be express by their parents' fiscal resources. So, social and economic factors should be handled together to improve families' healthy behaviors and functions.

Our findings revealed that FF is a meaning factor affecting lifestyle amid adolescents. Families with poor FF cannot effectively manage emotional and instrumental problems, do not accurately follow the steps of problem-solving, and cannot effectively fulfill the bones needs of children such as the demand for good for you diet and a safe living environment.^[32] Adolescents are usually seeking autonomy in communications and roles and role model from their parents. Therefore, parents' adequate knowledge virtually the negative and positive effects of their behavioral patterns and their furnishings on adolescents can help them promote their healthy lifestyle.^[38] Members in families with expert FF provide each other with adequate back up and kindness; hence, the family surround turns into a safe identify for adolescents to express their problems and concerns, receive acceptable attention, and feel worthy.^[39] Contrarily, inadequate behavioral control in families prevents the development of health-promoting habits and behaviors such as regular concrete activity, health responsibility, and stress management.^[34] Overall, families with poor FF accept children with unhealthy lifestyle manifested by escaping responsibility toward health, attempts to receive back up from people out of the family, limited engagement in physical action, unhealthy nutrition, and high levels of stress.^[17]

This written report had some limitations, which limit the generalizability of its findings. The written report was conducted only on female adolescents in a city. The samples were likewise done merely in the south of Tehran. Future studies are suggested to replicate this study on larger samples of adolescents from both genders and different areas. Also, it is necessary to study different historic period groups and compare the results to appraise the importance of FF.

Conclusion

This study concludes that HPL and FF are greater than the possible median scores. Also, FF tin be a significant predictor of HPL. In families with better FF, problem-solving is performed more effectively, roles and responsibilities are clear and flexible, interpersonal relationships are stiff and constructive, members effectively communicate their emotions and receive adequate support, and conflicts are clearly communicated and properly managed. The findings of this study can be useful for the managers of the health system, families, health educators, and researchers. Therefore, healthcare authorities and policymakers need to pay greater attention to FF and consider information technology in their programs for promoting a healthy lifestyle amidst adolescents.

Acknowledgement

This article is role of our search project approved by the Tehran Academy of Medical Sciences. The authors would similar to thank the research administration of the university, the staff of the report setting, and all students who participated in the report.

Financial support and sponsorship

This work was supported by Schoolhouse of Nursing and Midwifery, Tehran University of Medical Sciences nether grant number 98.02.28.42887.

Conflicts of interest

There are no conflicts of involvement.

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  [Table 1], [Table 2], [Tabular array 3]

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