cents after an HBM based educational intervention in 2011, also revealed the positive change in practice among
the subjects [17].
Shakerinejad et al. evaluated the impact of an HBM based education on KAP variables in adolescent girls
about dietary calcium in 2011. They also observed statistically significant improvements in the scores of these
variables [18]. In another study investigating the effect of an HBM based educational program about gastric
cancer on knowledge, attitude and practice of housewives in 2012 by Alidosti et al. the results showed patterns
of improved KAP variables in subjects compatible with our results [19].
Effects of an HBM based education program on screening behavior in high risk women for breast cancer were
assessed in a study conducted by Hajian et al. in 2011. After the educational sessions they found elevated rates
of breast self examination and clinical examination due to increased scores of knowledge, attitude and practice
of the patients [20].
Mahmoodi et al. also verified these findings by inspecting the changes in KAP scores after an HBM based
educational program regarding osteoporosis prevention in women with low socioeconomic status in 2011 [21].
Knowledge, attitude and practice of the pharmaceutical industry employees in Tehran concerning breast cancer
and the benefits of mammography were found to be improving after an educational program based on health belief
model in a study conducted by Hatefnia et al. in 2010 [22].
In another survey, Goodarzi et al. assessed the impact of distance education via mobile phone text messaging
on knowledge, attitude, practice and self efficacy of patients with type 2 diabetes mellitus in Iran. Their results
also showed improvements in these variables confirming the effect of education via any means on improving
knowledge, attitudes and practice of the patients [23]. As can be seen, all of the studies conducted to investigate
the effects of education programs based on health belief model on knowledge, attitude and practice of the subjects,
yield similar results, showing improvements in these variables after educating the patients. As discussed
before, many studies have evaluated the effects of educational programs on promoting self care behaviors, but
no similar study have investigated this effect in PV patients, so we used a unique study population for our survey.
Regarding the low prevalence of PV in Iran, finding these many patients was a great challenge for our survey,
so selecting Razi hospital as our research department was one of the strengths of this study, since it is a
dermatology referral center. Applying more interactive educational methods such as group discussion and problem
solving that are believed to be more effective than lecturing method, was another positive aspect in our survey.
Not being able to directly observe the changes in the behaviors of our patients can be mentioned as an important
limitation in our study, since our data are basically subjective and given to us by the subjects, so they
might differ from the reality.
5. Conclusion
This study shows the effectiveness of an HBM based educational program on the patients’ knowledge, attitudes
and practice regarding their disease. This improvement can lead to adoption of self care behaviors and help them
achieve self efficacy in controlling their disease and assisting their treatment process, counting as a tertiary preventive
measure. As stated above according to inadequate preventive measures for chronic diseases such as PV
in routine clinical practice, self-care behaviour programs are viable substitute choices for helping these patients.
The management of chronic conditions is generally based on the patient adopting self care behaviors and based
on the late onset of PV in the fourth decade of life and concurrence of other chronic diseases during this period,
the necessity of self-care behavior is more eminent. So as shown in this article, educational interventions can be
utilized to enhance the knowledge of these patients as well as their attitudes and their practice.
Acknowledgements
The authors appreciatively thank all the personnel of Pemphigus Research Unit of Razi hospital, since this study
could not have been carried out without their cooperation. Tehran University of Medical Sciences supported this
survey as a part of MSPH thesis.