Background: Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study. Aim: To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas. Materials and Methods: A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences. Result: The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively). Conclusion School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.

Background: The patients’ view, perception, and evaluation of illness as an individual, as well as their emotional and behavioral responses, are among the criteria predicting the QoL. Increased illness perception and adjustment are emphasized to ensure patients to return to their active life after acute myocardial infarction (AMI) continue their lives more healthily, and have higher levels of physical, mental, and social well-being. Aim: This study aimed to evaluate the illness perception and quality of life of patients who had an AMI. Materials and Methods: This descriptive study included 100 patients diagnosed with AMI at the cardiology department of Third State Central Hospital and Second State Central Hospitals. The data were collected using Illness Perception Questionnaire-Revised and Myocardial Infarction Dimensional Assessment Scale. Result: The mean age of the patients with AMI was 52.2±12.01 years, and 51% were male. Among the subscales of the illness perception questionnaire, the highest mean score was observed for Illness Identity (13.99±5.01), while Treatment Control (19.10±3.18) had the lowest. The lowest score was for Illness Coherence (10.31±2.16). The overall Myocardial Infarction Dimensional Assessment Scale score (43.00±13.10) of the patients was observed to be moderate. The Illness Perception Questionnaire-Revised subdimensions were observed to have a positive and significant correlation with Myocardial Infarction Dimensional Assessment Scale total score and subscales mean scores. Regression analysis revealed that Illness Coherence and Emotional Representation were significant predictors of QOL. Patients scoring high in these areas reported better QOL. Patients with recurrent infarctions showed significantly lower scores in quality of life (t=-2.234, (p=0.029) and illness perception (t=-3.809, p=.001). Conclusion The study demonstrates that illness perception in AMI patients has a significant positive relationship with their quality of life. Specifically, understanding of the illness and emotional representation were key predictors of better quality of life. This suggests that nursing care and psychosocial support targeting patient understanding and emotional coping can play a crucial role in improving post-infarction quality of life.

Background: School health services play a critical role in protecting and promoting students’ health, thereby contributing to improved academic performance. School nurses provide a wide range of services, including preventive care, health education, and management of chronic conditions among students. Aim: This review aimed to synthesize existing evidence on the effectiveness of school-based nursing interventions based on published research. Materials and Methods: A literature review was conducted using international databases, including PubMed, Scopus, and Web of Science. Relevant studies on school-based nursing interventions were systematically analyzed. The findings indicate that school nursing interventions positively impact the management of chronic diseases, promotion of mental health, and development of healthy behaviors among students. Additionally, reductions in school absenteeism and emergency incidents were consistently reported. Results: The reviewed studies demonstrated that school-based nursing interventions significantly improve students’ health outcomes. These include better chronic disease control, enhanced mental well-being, and increased adoption of healthy lifestyles. Furthermore, students receiving such interventions showed decreased absenteeism and fewer emergency health events at school. Conclusion School-based nursing interventions have a positive impact on students’ health and well-being. Strengthening school nursing services and enhancing collaboration between the education and health sectors are essential to promote the health of children and adolescents and to ensure a healthier future generation.

Background: Health literacy is a multidimensional concept encompassing the knowledge, attitudes, and skills required for individuals to obtain, understand, appraise, and apply health-related information. It is essential for accessing quality healthcare services and making informed health decisions in daily life. Aim: This study aimed to evaluate the level of health literacy among the adult population of Mongolia. Materials and Methods: A cross-sectional quantitative study was conducted involving 1,500 Mongolian adults. Data was collected using the Health Literacy Survey European Questionnaire (HLS-EU-Q47), which evaluates four core competencies: accessing, understanding, appraising, and applying health information. Responses were measured on a 4-point Likert scale ranging from 1 (very difficult) to 4 (very easy). Health literacy levels were categorized based on standardized scores: inadequate (0–25), limited (25–33), sufficient (33–42), and excellent (42–50). Results: The mean age of the participants was 34.79±15.04 years, with 42.1% being male and 57.9% female. Socioeconomic data showed that 52.1% were married, 37.7% were single, 43.2% had completed secondary education, and 40.5% held a university degree. Lifestyle assessments revealed that 16.4% were daily smokers, 7.0% consumed alcohol daily, and only 12.5% engaged in regular physical exercise. Regarding education, 50.7% of participants with higher education demonstrated “sufficient or excellent” health literacy, whereas only 27.1% of those with secondary education reached this level. The 18–30 age group exhibited the highest capacity to receive health information (44.0%), with a significant decline in health literacy levels observed as age increased (p=0.014). Conclusion Although the overall health literacy level among the adult population of Mongolia is generally sufficient, the capacity to access health information remains limited.

Background: Although early attention to children’s and adolescents’ health education is important, research assessing the health knowledge of children under 13 is limited, and a validated assessment tool has not yet been developed; this forms the rationale for the present study. Aim: Assessing the Reliability of the Mongolian Translation of a Questionnaire for Evaluating Children’s Fundamental Health Concepts. Materials and Methods: This cross-sectional study was conducted in May–June 2025 among children aged 8–11 years attending public general education schools in the Khan-Uul, Bayanzurkh, and Sukhbaatar districts of Ulaanbaatar. Of a total population of 459 eligible students, 352 participated in the study. Data were collected using a structured questionnaire consisting of 12 sociodemographic items and 15 items from the Health Literacy Assessment Tool for Children (HLSChild- Q15), resulting in a total of 27 items. Statistical analyses were performed using SPSS version 21.0, with p-values less than 0.05 considered statistically significant. Results: A total of 352 students participated in the study. By gender, the majority were girls, accounting for 57.1% (n=201), while boys comprised 42.3% (n=149). Regarding grade level, 24.7% (n=87) were in third grade, 60.5% (n=213) in fourth grade, 11.4% (n=40) in fifth grade, and 3.1% (n=11) in sixth grade. By age, 9.1% (n=32) were 8 years old, 36.4% (n=128) were 9 years old, 43.2% (n=152) were 10 years old, and 11.4% (n=40) were 11 years old. Internal consistency was acceptable, with Cronbach’s α=0.82. Exploratory factor analysis revealed three factors, explaining 56.3% of the total variance. The sampling adequacy was acceptable (KMO=0.596), and Bartlett’s test of sphericity was significant, χ²(105)=2615.78, p<0.001, indicating suitability for factor analysis. Conclusion This study demonstrated that the Mongolian version of the HLS-Child-Q15 questionnaire meets the requirements of reliability and construct validity, indicating that it is an appropriate instrument for assessing the foundational concept of health literacy among children in Mongolia.

Background: Diabetes mellitus (DM) is a chronic progressive metabolic disorder. According to International Diabetes Foundation (IDF) estimation in 2019, globally 463 million adults have diabetes among the population aged 20-79. If this trend continues, 700 million of people will have diabetes by 2045, and the larger increases will occur in low- and middle-income countries. In Mongolia, the prevalence of Diabetes 5.4%. Regularly assessing the quality of life (QOL) in the control of patients with diabetes is important to evaluate the effectiveness of management, to plan treatment and thus to improve monitoring. Meaningful. The purpose of our study was to evaluate the Validity and Reliability of the Mongolian Version of the World Health Organization’s Quality of Life Questionnaire (WHOQOLBREF) in patients with Type 2 Diabetes. Methods: The cross sectional survey was conducted in Ulaanbaatar. For the study 150 patients with T2DM were recruited, who have met the inclusion criteria and agreed to the informed consent. In the study, self-management control, beliefs about illness, depression were assessed. Additionally, anthropometric measurements, blood pressure (BP), levels of glucated hemoglobin level (HbA1C), lipids and fasting blood glucose (FBG) at the baseline and after 3 months follow ups were measured. Statistical analyses was performed using SPSS 21 software. Results: The study involved newly diagnosed Type 2 diabetes with mean age of 49,4±8,9 years. 65 men (43,6%), 85 women (56,7%) and 39,3% of the participants had a family history of diabetes. The Cronbach’s alpha for analysis of the reliability of the WHOQOLBREF was a=0.74-0.84. The patient’s fasting blood glucose FBG, HbA1c, and low-density lipoproteins (LDL) were statistically significantly higher (p <0.05) than normal and the triglyceride (TG) was increased, but it was not statistically significant (p> 0.05). The mean TG had statistically significant (p <0.05) increase by sex. There is a need for further study of the specific questionnaire of QOL people with diabetes. Conclusion The Mongolian version of the WHO Quality of Life Questionnaire evaluating diabetes patients, the internal consistency of the questionnaire was reliable and the validity was a = 0.74-0.84.

Background: Pressure ulcer is the worldwide problem which does not depend on age group and any patients could suffer from. Nursing human resource, working load, hospital equipment supply, well-organized training, lack of scientific study are influencing the prevention and nursing care for patients with pressure ulcer although the prevention of ulcer’s depends on continuous nursing care. Therefore, we aimed to improve participation of nurses and evaluate knowledge of nurses on pressure ulcer. Methods: Total of 249 nurses who are working in primary and referral level were chosen as study participants. We used cross-sectional study of analytic study and standard questionnaire with Likert scale. Furthermore, we operated evaluative standard questions of Pieper and Mott (PUKT; 1995), standard questions of pressure ulcer evaluation and nurse’s knowledge. All statistics analysis done by using SPSS 21.0 program. Results: 237 (95.2%) were females, 12 (4,8%) were males were participated in the study and 122 (49,0%) had received Diploma, 125 (50,2%) of them had received bachelor degree and 2 (0,8%) had master degrees. Furthermore, 175 of all participants were nurse practitioners and 74 of them were clinical nurse specialists. The knowledge regarding nursing care on pressure ulcer was evaluated as 2,41% were excellent, 20,88% were with average-knowledge and 76,71% were with poor-knowledge. Nurse’s knowledge regarding Evaluation of pressure ulcer were measured as 65,68% were with poor-knowledge, 33,33% were with average, and 0,8% were with excellent knowledge. Finally, knowledge about nursing care on pressure ulcer, 14,86% were evaluated as average, 85,14% were with poor-knowledge. Conclusion Most of nurse’s knowledge regarding prevention and nursing care for pressure ulcer is inadequate. Therefore, there is a need to improve nurse’s knowledge about prevention and nursing care on pressure ulcer.

DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.

DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.

Diabetes is known to be directly and indirectly associated with stress. Many researchers have reported that diabetes is actually induced by stress and several hormones includ¬ing cortisol are known to be involved.14 Though tight glycemic control is viewed as a primary indicator of favorable diabetes outcomes metabolic control , medication, and physical activity, contribute to a patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improves depressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI -1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.