International Journal of Community Based Nursing and Midwifery
Year:2020 | Volume:8 | Issue:2|Papers Count:8

Background: Despite the advances in treatment, fatigue is a common symptom experienced by many patients undergoing hemodialysis, and is associated with poor health-related quality of life. The aim of the present study was to explore the impact of foot massage with chamomile oil and almond oil on the severity of fatigue and quality of life of Hemodialysis patients. Methods: In these four parallel groups controlled clinical trial, 120 male patients under hemodialysis were randomly assigned to foot massage groups and control (30 in each group) from June 2016 to April 2017 in Urmia, Iran. foot massage using either chamomile oil, almond oil or no oils was provided to patients undergoing hemodialysis for two months. The primary outcome measures were the Fatigue Severity Scale (FSS) and secondary outcomes included quality of life using the Short-Form Quality of Life for Renal Patients questionnaire (KDQOL-SF). Data were analyzed using ANOVA, Tukey’ s and paired t-test in SPSS the (Version 16) at the significance level P<0. 05. Results: The mean FSS scores after the implementation of foot massage in all intervention groups were significantly lower than the control group (P=0. 005). Mean KDQOL-SF scores after the intervention in all intervention groups increased compared to the control group, but this increase was not statistically significant (P=0. 34). Conclusion: Foot massage appears to be effective in reducing fatigue and improving quality of life in patients undergoing hemodialysis. Further studies are needed to confirm and extend these results. Furthermore, involvement of patients’ companions as family caregivers in massage therapy can lead to continuation of this effective intervention at home.

Background: Serodiscordant couples are faced with many social, sexual and relationship challenges in all aspects of their lives. The sources of conflicts could be disease acquisition, transfer of HIV to the uninfected partner, and fertility decisions. The current qualitative study was designed to explore the challenges faced by HIV negative women in serodiscordant relationships. Methods: This qualitative description was conducted in Mashhad, Northeast of Iran, between October 2018 and June 2019. 15 HIV-negative women who were living with their HIV-positive husbands were selected through purposive sampling method. The data were collected using semi-structured interviews. Data were analyzed using conventional content analysis adopted by Graneheim and Lundman. MAXQDA version 12, was used for data organization. Components of rigor including credibility, dependability, confirmability and transferability were considered. Results: The main overarching theme which emerged from the qualitative study was “ threats to family life” , consisting of five categories along with their subcategories. These categories included stigmatic reactions followed by disclosure of the status, social misconceptions and limitation of information sources, psychological disruptions, hard decision making for fertility, and role conflict in the family. Conclusion: This study provides an insight into different aspects of challenges faced by Iranian women in HIV-serodiscordant relationships. Also, our study supports the view of other investigators who believe that there is an urgent need for provision of counseling and empowerment interventions for HIV-serodiscordant couples

Background: Sudden cardiac death is the most common cause of mortality worldwide. Most cases occur at home and the individuals most likely witnessed are family members. Spouses play a significant role in the recovery of such patients. We aimed to investigate the effect of Cardiopulmonary Resuscitation (CPR) and cardiac chest pain management trainings on the perceived control, depression, stress and anxiety in the spouses of the patients with Myocardial Infarction (MI). Methods: The present randomized controlled trial study was performed on 78 spouses of the patients admitted to Cardiac Care Unit of the hospitals affiliated to Shiraz University of Medical Sciences from August 2013 to April 2014. The subjects were randomly assigned into intervention (n=40) and control groups (n=38). The intervention group took part in educational workshop on CPR and cardiac chest pain management and followed-up for six weeks. Data were collected using Depression Anxiety Stress (DASS) Scale and Rotter’ s internal-external locus of Control Scale. Statistical methods of data analysis included descriptive statistics, Chi-squared test, paired sample t-test, independent sample t-test, one way analysis of covariance, and multivariate analysis of covariance. Results: There were significant differences between intervention and control groups in perceived control and DASS subscales. After the intervention, perceived control scores reduced from 9. 42± 3. 33 to 8. 15± 3. 65 (P=0. 001); depression from 28. 85± 11. 99 to 21. 65± 8. 64 (P=0. 001); anxiety from 26. 6± 9. 46 to 20. 70± 6. 29 (P=0. 02); and stress from 30. 20± 10. 91 to 24. 32± 10. 23 (P=0. 01) in the intervention group. Conclusion: CPR and cardiac chest pain management trainings could effectively improve the perceived control, depression, anxiety, and stress in the spouses of the patients with MI.

Background: The families of children with congenital heart disease experience significant stress as to the care of the child and need to cope with stress. Accordingly, understanding of how families cope and use coping strategies is more important to help them better cope with stressful situations caused by caregiving. This study aimed to explore coping strategies used by families in the face of caregiving stress. Methods: This qualitative study was conducted on 40 eligible participants from the families of children with congenital heart disease. They were recruited through a purposive sampling method from those referred to hospitals in Mashhad, Iran. In-depth and semi-structured interviews were used for data collection from November 2017 to December 2018. The data were analyzed using conventional content analysis, and MAXQDA software (Ver. 2010) was used to manage the data encoding process. Results: According to the results, effort to maintain well-being emerged as the main theme which included five categories: “ spirituality in caregiving” , “ acceptance and adjustment” , “ optimism and hopefulness” , “ self-control and patience” , and “ management of psychological needs” . Conclusion: Families used various coping strategies including spirituality, acceptance, optimism, patience, and management of psychological needs based on their beliefs, attitudes, abilities, and available resources for coping with caregiving stress. The results can help the nurses and health care professionals to develop appropriate educational, supportive, and psychological interventions based on the family’ s needs to cope effectively with caregiving stress.

Background: Improvement of the quality of life and self-efficacy of patients with hypertension is essential. The present study aimed to determine the effect of self-care education based on Orem’ s nursing theory on the quality of life and self-efficacy in patients with hypertension. Methods: This quasi-experimental study was conducted in Mamasani, Iran, 2015. Eighty patients were selected using convenient sampling and divided equally into two control and experimental groups based on random allocation. An educational program based on Orem’ s nursing theory and according to the needs of patients was conducted in the experimental group. Data were collected before, immediately after, and eight weeks after the intervention using “ Quality of Life of Cardiac Patients” and “ Strategies Used by People to Promote Health” Questionnaires. Data were analyzed using SPSS 18; Chi-square test, independent t-test, and Analysis of Variances with Repeated Measures were used to analyze the data. Results: The mean score of the quality of life in the experimental group was significantly higher than the control group eight weeks after the intervention (106. 5± 26. 5 vs. 85. 5± 22. 5, P=0. 03). However, this difference was not significant immediately after the intervention (94. 4± 25. 3 vs. 87. 2± 22. 8, P=0. 32). The mean scores of self-efficacy were not significantly different from those of the control group immediately after (68. 5± 12. 7 vs. 66. 5± 12. 2, P=0. 47) and eight weeks after the intervention (70. 5± 13. 5 vs. 65. 7± 12. 0, P=0. 10). Conclusion: The results showed that training self-care based on Orem’ s theory can improve the quality of life of patients with hypertension. Therefore, it is recommended that nurses in outpatient care of patients with hypertension should apply this theory.

Background: The purpose of this study is to construct and validate a measurement model of women’ s preferences in Obstetrician and Gynecologist (OB/GYN) selection in the private sector of non-clinical parameters. Methods: This methodological study included 462 respondents in OB/GYN’ s offices to a researcher-made questionnaire. The patients visited 57 offices of OB/GYNs in the city of Mashhad in Iran and completed women’ s preferences in OB/GYN selection questionnaire over a 2-month period from January to February 2018. Exploratory Factor Analysis (EFA) was conducted to verify the instrument’ s construct validity. Confirmatory Factor Analysis (CFA) was used to test whether the data fit our hypothesized model obtained from EFA model. Results: The first draft of the questionnaire was prepared with 118 items based on literature review. The outcome of content validity assessment was a 51-item questionnaire. Scale-Content Validity Index (S-CVI) turned out to be 0. 80. The results of EFA yielded an instrument with 33 items in six domains, which explained 52. 657% of the total variance of the questionnaire. With performing CFA, the 6-factor model with 29 items demonstrated a good fit with the data (CFI=0. 952, CMIN/DF=1. 613, RMSEA=0. 036). Availability and Accessibility, Communicational Skills, Office Environment, Recommendation by Others, Special Services, and Cost and Insurance were found to define the women’ s preferences in OB/GYN selection in private sector, Iran. Conclusion: The developed measurement model considers the patient’ s preferences that influence decisionmaking process on OB/GYN selection. It can provide useful knowledge for OB/GYNs and policymakers to design appropriate and efficient marketing strategies according to the consumer preferences priority.

Background: Family caregivers are important sources of care for hemodialysis patients. Although caring for a family member is a pleasant feeling, experiencing lots of physical and psychological caregiving burden influences the quality of life among family caregivers of hemodialysis patients. This study aimed to design and validate the quality of life inventory for family caregivers of patients on hemodialysis. Methods: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2017-2018. In the qualitative phase, the researcher conducted in-depth semi-structured interviews with 19 participants. Finally, a pool of 93 items was extracted from this phase. Then, psychometric properties such as face validity (Impact Score>1. 5), content validity ratio (CVR>0. 63), content validity index (Item Content Validity Index: ICVI>0. 78, Scale Content Validity Index/Average: SCVI/Ave>0. 8) and Kappa value (Kappa>0. 7, internal consistency (Cronbach’ s alpha>0. 7), relative reliability (ICC: interclass correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0. 4-0. 7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed Results: The quality of life inventory for family caregivers of hemodialysis patients was developed with 34 items and five factors (namely patient care burden, conflict, positive perception of situations, self-actualization, fear, and concern). The findings confirm that the scale is acceptable regarding validity, reliability and other measurement features. Conclusions: This inventory is consistent with the health care status in Iran. Therefore, it can be used to measure the quality of life among family caregivers of hemodialysis patients.

Background: Having a patient with borderline personality disorder (BPD) in the family is a complicated and stressful experience. The caregivers’ experiences and the problems they have in care of patient with BPD have remained unknown. The aim of this research was to explore the experiences of the caregivers while living with BPD patients in Iran. Methods: This interpretive phenomenological research was performed on 10 caregivers of patients with BPD at Ibn-sina Hospital in Mashhad, Iran, in 2019. Purposeful sampling was used for sampling. Data were collected through semi-structured interviews and saturated after 16 interviews. The analysis of data was concurrently carried out using the method proposed by Diekelman (1989). The MAXQDA software (Ver. 10) was used for data organization. Results: The participants in this study were aged 25 to 55 years. After data analysis, three themes (“ life in hell” , “ chain to the feet” , and “ black shadow of stigma” ) and six sub-themes (“ disrupted from the life” , “ self-discrepancy” , “ care bottlenecks” , “ in the fence of restriction” , “ society dagger” and “ resort to secrecy” ) emerged. Conclusion: The results of this study showed that the caregivers of patients with BPD during the period of care were faced with a variety of problems. It is suggested that health policy-makers should pay more attention to the problems related to the mental health of caregivers.