Jundishapur Journal of Chronic Disease Care
Year:2024 | Volume:13 | Issue:4|Papers Count:10

Background: The treatment of acute dislocation of the acromioclavicular joint, specifically types III to V, involves various methods, each with its own advantages and disadvantages. Objectives: This study aims to investigate the treatment outcomes of acromioclavicular joint dislocation after hook plate removal, focusing on the recurrence of dislocation and pain in the affected area. Methods: A retrospective statistical study was conducted on 40 patients (18-40 years old) who presented with acromioclavicular joint dislocation and received treatment at Golestan and Imam Khomeini (RA) hospitals in Ahvaz between 2013 and 2021. Among the patients, 28 were male and 12 were female, and all were treated using the hook plate method. A follow-up was conducted on all patients after an average duration of one year. Patient data were collected through radiographic analysis and completion of relevant questionnaires to assess the specific objectives of this research. Results: None of the patients treated with the hook plate method required additional surgery due to reduction loss. All patients who underwent re-surgery had their hook plates removed after an average of six months. There were no cases of plate breakage or recurrence after the operation. However, four cases (10% of all patients) reported partial dislocation. The average duration of the hook plate procedure was estimated to be 45 minutes, with an estimated blood loss of 100 cc. Furthermore, complete immobilization after the hook plate procedure lasted between three days and one week. Conclusions: The hook plate method exhibits favorable outcomes, including lower complication rates, reduced postoperative pain, minimal blood loss, shorter treatment duration, and lower surgical costs. Therefore, it is considered a preferred and economically viable treatment option.

Background: Surgery for children with congenital heart disease (CHD) elevates maternal physical and mental stress, potentially impacting the quality of care provided to the child. Objectives: This study aimed to elucidate mothers' experiences surrounding their child's CHD surgery. Methods: In this qualitative content analysis study, we included 20 mothers of children admitted to Tehran Children's Medical Center Hospital for CHD surgery using purposive sampling. Unstructured interviews and field notes were utilized perioperatively for data collection. Analysis was conducted concurrently with data collection employing the Graneheim and Lundman content analysis approach. Rigor was ensured using Lincoln and Guba’s criteria. Results: The findings were categorized into four themes: (1) "The Bitter and Difficult Motherhood Experience" stemming from the shock of the child's abnormality and subsequent challenges in caregiving,(2) mothers engaged in "In Search of Reassurance, " striving for accurate diagnosis and optimal treatment quality through information seeking and accessing superior medical services,(3) "Tides in Supportive Networks" reflected varying degrees of support from personnel, peers, and surrounding individuals, ranging from conscientiousness to stressfulness,(4) Mothers attained a state of "Relative Calm After the Storm" by navigating through the surgery or deal with spirituality and hope despite enduring anxieties. Conclusions: The journey through a child's CHD surgery proved harrowing for mothers due to the initial shock and ongoing caregiving challenges. Care provision should prioritize maternal readiness and empowerment, emphasize professional conduct, reassurance, spiritual care, and steer social support networks toward positive contributions.

Background: Understanding the information needs of caregivers in cancer care and managing their anxiety are crucial aspects of comprehensive nursing care. Nurses need to identify effective strategies to achieve this objective, yet there are limited studies in this area. Objectives: This study was designed to compare the effects of providing structured education versus needs-based education on the anxiety levels of cancer family members. Methods: In this randomized controlled trial, 80 primary caregivers of cancer patients were equally assigned to two study groups (group A: Education based on family members' needs, group B: Structured education) using a randomized minimization method. The Spielberger State-Trait Anxiety Inventory (STAI) was used for data collection. Data analysis employed descriptive statistics, Shapiro-Wilk test, chi-square test, Fisher’s exact test, Wilcoxon test, and Mann-Whitney U test at a significance level of 0. 05. Results: The results indicated that the study groups were similar in terms of demographic characteristics. In group A, the mean ± SD of the STAI score was 54. 2 ± 6. 09 at baseline and decreased to 45. 13 ± 3. 87 after intervention (P = 0. 001). In group B, the mean ± SD of the STAI score was 54. 00 ± 4. 92 at baseline and decreased to 51. 68 ± 5. 91 (P = 0. 006). There were no statistically significant differences between the two groups at baseline (P = 0. 872). However, a statistically significant difference in the STAI score was observed after intervention, and there was a significant difference in mean changes of the STAI score between groups (P = 0. 001). Conclusions: Tailoring educational content according to the needs of cancer family members resulted in greater reductions in anxiety scores compared to the structured education method.

Background: The increase in the older adult population has resulted in a higher demand for outpatient health services and subsequently increased costs paid by older adults. Objectives: This study conducted in Rasht aimed to determine the utilization of outpatient health services among older adults covered by comprehensive health service centers and the factors associated with it. Methods: This cross-sectional analytical study was conducted on 384 older adults aged 60 years and older covered by comprehensive health service centers. The sampling method was stratified random sampling based on consecutive sampling. The information required was collected through a researcher-made two-part questionnaire, including individual-social characteristics and outpatient services, via interviews. Data were analyzed using SPSS version 21 software. The significance level of the tests was considered to be P < 0. 05. Results: The results showed that 82. 8% of the older adults required outpatient services and 90. 9% of them actually received these services. Out of the total, 65. 1% went to private sector facilities, 17% to public facilities, and the remaining 18% visited facilities in both sectors. The main reasons for not utilizing outpatient services were the lack of money and the inability to pay. Factors such as place of residence (P = 0. 014, OR = 2. 417), the presence of chronic disorders (P = 0. 047, OR = 1. 689), health status (P = 0. 012, OR = 0. 619), and education level (P = 0. 05, OR = 0. 763) were found to be associated with the utilization of outpatient services. Conclusions: Two-thirds of the sample had chronic diseases, most of them received outpatient services from the private sector, and about 75% of those who did not receive the service could not afford the costs. Therefore, it is necessary to improve the quality of outpatient services in the public sector and enhance their accessibility. Some individuals were unaware of health screenings for older adults in the comprehensive health services centers, so informing them about these services can be useful in promoting their utilization by older adults and reducing the costs of outpatient services.

Background: Multiple sclerosis (MS) is a chronic disease. Familiarity and awareness of self-care conditions and health-promoting behaviors contribute to patients’ self-efficacy. Objectives: This study examines the relationship between self-care ability and health-promoting behaviors in patients with Multiple Sclerosis. Methods: This descriptive-analytical study involved 112 MS patients from the MS Society of Khuzestan province, selected through convenience sampling. Data were collected using a demographic form, Weaver’s Self-Care Inventory (SCI), and Walker’s Health-Promoting Lifestyle Profile (HPLP), then analyzed with SPSS software at a significance level of 0. 05. Results: The mean self-care ability score was 104. 49 ± 12. 72 (range 40-240), and the mean health-promoting behavior score was 132. 52 ± 12. 72 (range 50-208), indicating overall poor health-promoting behaviors. Self-care ability was significantly related to health-promoting behaviors in MS patients (P < 0. 01). Age (P = 0. 001), education (P = 0. 002), and job type (P = 0. 017) showed significant relationships with self-care ability. However, there was no significant relationship between demographic variables and health-promoting behaviors (P < 0. 05). Conclusions: Multiple sclerosis patients exhibit poor health-promoting behaviors and self-care ability. Improving self-care ability and health-promoting behaviors requires ongoing education and culturalization. The MS Society can design and implement structured training programs by understanding the self-efficacy needs and abilities of patients and collaborating with other therapy group members.

Background: Antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disease primarily characterized by thrombosis. Previous studies have indicated that disorders in proteins S and C, Factor V Leiden, and homocysteine levels can contribute to the occurrence of miscarriage in patients with APS. Objectives: This study aims to determine the prevalence of protein S, protein C, Factor V Leiden, and homocysteine disorders in patients with APS. Methods: This research was conducted as a retrospective study, utilizing the clinical information of patients who were referred to Golestan Ahvaz Hospital and whose records were available. A pre-prepared checklist was used to extract and record patients' clinical information, including demographic data, prevalence of miscarriage, vascular disorders (arterial and venous), pulmonary and venous thrombosis, preterm labor, intrauterine fetal demise (IUFD), intrauterine growth restriction (IUGR), and disorders or deficiencies of proteins C and S, as well as homocysteine levels. Results: In the present study, the results showed that a reduction in proteins C and S was observed in 18 (15. 1%) and 20 (16. 8%) patients, respectively. Thrombosis was present in 103 (86. 6%) patients, and 27 (22. 7%) patients had Aps Ab. The results indicated a statistically significant relationship between protein C deficiency, thrombosis, vascular events, and the presence of Abs in patients (P < 0. 05) Additionally, a significant relationship was found between protein C deficiency and IUFD (P < 0. 05). However, no significant relationship was observed between Aps Ab and IUFD or IUGR (P > 0. 05). Conclusions: The results indicated that protein C can be used as a diagnostic factor in AP patients. Additionally, protein C was associated with IUFD in these patients.

Background: Valvular heart diseases (VHD) pose a significant global health challenge, leading to numerous cardiac surgeries. The quality of valve repair is typically assessed using transesophageal echocardiography (TEE) and saline injection tests intraoperatively. However, TEE is not universally available, particularly in resource-limited settings. Objectives: This study aimed to evaluate the effectiveness of saline injection tests as the sole method for assessing cardiac valve repair quality. Methods: This retrospective cohort study included patients who underwent cardiac valve surgery without intraoperative TEE assessment. Preoperative transthoracic echocardiography (TTE) was performed on all patients. A consistent team performed all valve repairs, and the quality of these repairs was assessed intraoperatively using the saline injection test. Postoperative TTE was also conducted to evaluate valve function and compare it with preoperative measurements. Results: The study comprised 16 patients (mean age: 63. 8 ± 10. 6), predominantly male. Mitral valve (MV) repair was performed on 11 patients, with nine showing improved function (P-value: 0. 006). Seven patients underwent tricuspid valve repair (TVr), all of whom exhibited improved function (P-value: 0. 01). Four patients received aortic valve repair, with three showing improved function (P-value: 0. 10). Additionally, significant improvements were observed in left ventricular end-diastolic diameter (LVEDd), left ventricular end-diastolic volume (LVEDV), inter-ventricular septal diameter, posterior wall thickness (PWT), tricuspid annular plane systolic excursion (TAPSE), right ventricular peak systolic myocardial velocity (RVSm), pulmonary artery pressure, tricuspid regurgitation (TR) gradient, and right atrium area. Conclusions: The saline injection test can be a valuable tool for assessing the quality of mitral and tricuspid valve repairs, particularly when TEE is unavailable. However, its reliability for aortic valve repair remains uncertain.

Background: Low back pain is a common musculoskeletal disorder among healthcare specialty nurses. Operating room staff are particularly susceptible to experiencing low back pain due to the nature of their work. Objectives: We conducted a study to investigate the prevalence of low back pain and the factors associated with it. Methods: A cross-sectional study was conducted on 323 operating room personnel from five hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. Data was collected using a questionnaire developed by Tavakol et al. This questionnaire included demographic information and assessed the prevalence and dimensions of low back pain. The data was analyzed using IBM SPSS v. 26. Results: The results showed that the prevalence of low back pain (LBP) was 74. 3%. In this study, 64. 8% of the personnel were women, 63. 5% were married, and 72. 4% had a bachelor's degree. Additionally, 87% had no history of smoking. The average age was 33. 83 ± 7. 02 years. There was a significant relationship between the prevalence of LBP and gender (P = 0. 044), marital status (P = 0. 001), BMI (P = 0. 008), age (P = 0. 001), shift work (P = 0. 001), work experience (P = 0. 001), and the average number of shifts (P = 0. 037). Conclusions: We found a high prevalence of LBP among operating room personnel, which is related to both individual and occupational factors. Our recommendations for nursing managers include modifying work shifts, allocating less physically demanding tasks to senior personnel and females, and implementing educational programs that focus on improving ergonomics and reducing physical strain.

Background: The popularity of hookah usage is on the rise in contemporary societies. Some individuals believe that using a hookah is less harmful than smoking traditional cigarettes. Objectives: The objective of this study was to examine the prevalence of oral mucosal lesions among individuals who use hookah and cigarettes. Methods: In a cross-sectional study conducted at Ahvaz Dental School, 102 individuals seeking examination and treatment for dental problems were recruited from spring 2022 to winter 2023 and categorized into three groups: Cigarette users (A), hookah users (B), and non-users of both (C). A thorough oral examination was performed on each patient to identify any oral mucosal lesions. If necessary, a biopsy was performed to confirm the diagnosis. The information for each patient was recorded on individual sheets and subsequently analyzed. To examine the relationship between qualitative variables, a chi-square test or Fisher's exact test was employed. Results: The most prevalent oral mucosal lesion observed in both group A (42%) and group B (27%) was hyperpigmentation of the oral mucosa. Notably, a premalignant lesion was exclusively observed in individuals belonging to group A (7%). Complaints of bad taste in the mouth were more common in tobacco users (in any form) than in non-users (P = 0. 004). Conclusions: Tobacco users (of any kind) have more oral lesions than non-smokers, although most of these lesions are harmless.

Background: Occupational settings expose workers to various substances linked to cancer risk, influenced by exposure intensity and duration. Considering the diverse work conditions across Iranian cities and the unexplored link between occupation and bladder cancer (BC) in Guilan Province, identifying high-risk occupations and industries is imperative for implementing preventive measures in the region. Objectives: To investigate the effect of people's occupations on bladder cancer in Guilan Province. Methods: The study encompassed 266 diagnosed BC patients in Guilan Province who received treatment at local healthcare centers, along with 191 control individuals aged 18 and over. Data for the cases were meticulously recorded in medical records at the Guilan Cancer Registry. The same checklists, including demographic characteristics, comorbidities, addiction status, water consumption habits, environmental exposures, current and previous occupation, previous history of cancer, and family history of cancer, were recorded for the controls. Odds ratios and their 95% confidence intervals were estimated using adjusted logistic regression (LR). Results: The study found that the odds ratio of bladder cancer (BC) was 2. 80 (95% CI: 1. 26-6. 21) for the age group 60-70 years and 18. 2 (95% CI: 7. 31-45. 6) for individuals above 70 years. Rural dwelling increased the risk by 5. 06-fold, while well water consumption and regular opium use amplified it by 6. 12-fold and 2. 58-fold, respectively. Exposure to tar and carbon derivatives led to a 3. 53-fold increase in risk, and exposure to combustion/greenhouse gases showed a 10. 72-fold increase. Chemical-related occupations, tar, carbon derivatives, smoking, and opium consumption were significant risk factors. Conclusions: Occupations involving chemical substances such as greenhouse gases, tar, and carbon derivatives are associated with a higher risk of bladder cancer (BC). Furthermore, smoking, opium use, and well water consumption significantly elevate the risk of this cancer.