HAYAT
Year:2018 | Volume:24 | Issue:2|Papers Count:8

The World Health Organization (WHO) has introduced palliative care as a way to improve the quality of life of patients with incurable diseases and their families. This care begins with the diagnosis of the disease, and continues throughout the illness (1). Palliative care improves the quality of life of patients with life-threatening diseases and their families. Its purpose is to relieve suffering through the identification, evaluation, and relief of pain and other physical, psychosocial and spiritual problems (2)...

Background & Aim: One of the important issues that affects the quality of hemodialysis is recirculation. Some researchers have suggested that the direction and distance of needle cannulation can affect the amount of recirculation. Therefore, this study aimed to investigate the effect of direction and distance of needle cannulation on recirculating of arteriovenous fistula in hemodialysis patients. Methods & Materials: This clinical trial was performed on patients referred to the dialysis ward of Kamkar-Arabnia hospital affiliated to Qom University of Medical Sciences in 2016. The amount of recirculation was measured in 22 patients by urea based method, in four consecutive sessions. In each session, the distance and direction of the needles were three centimeters in opposite direction, three centimeters in same direction, six centimeters in opposite direction, and six centimeters in same direction. Data were analyzed using Stata and GEE test. Results: The average age of participants was 53(16± 0. 75) years. In 41 dialysis cases (out of 88), the amount of recirculation was higher than 10%. The odds ratio for more than 10% recirculation for a distance of three centimeters compared to six centimeters was 2. 05 (1. 07-3. 93) and for same direction compared to opposite direction was 1. 98 (1. 03-3. 78). Conclusion: The results of this study showed that the insertion of needles at a distance of six centimeters in opposite position had the lowest chance of recirculation. Therefore, the attention to proper insertion of needles can be effective in reducing recirculation and increasing the quality of dialysis.

Background & Aim: Couples face many problems in pregnancies following In vitro fertilization (IVF) compared to normal pregnancies. The majority of studies have focused on women, and men have received less attention. So, this study aimed to explore the perceptions of men awaiting the first child following IVF. Methods & Materials: This qualitative study was carried out in Shahid Motahari hospital in Urmia during 2017-2018. Data were collected using 19 individual in-depth semi-structured interviews. Participants were selected among men whose wives got pregnant by IVF, through purposeful sampling, until data saturation was reached. Data were analyzed through conventional content analysis approach using the MAXQDA software version 10. Results: Four categories of "hope and fear of treatment outcome", "fear of social stigma", "financial concern", and "need for participation and training" were emerged from data analysis. Conclusion: Men whose wives got pregnant through IVF have expectations and needs that must be addressed. On the one hand, the men are concerned about the social stigma of infertility and donation, the outcome of treatment, and the economic problems of treatment, and on the other hand they expect to be involved in the process of treatment and prenatal care.

Background & Aim: Anxiety is one of the most common psychiatric disorders in the family of patients with traumatic brain injury. This study aimed to determine the effect of providing information about the patient’ s condition on the anxiety level of the family members of hospitalized patients with traumatic brain injury. Methods & Materials: This quasi-experimental study was conducted on 90 family members of traumatic brain injury patients admitted to Shahid Bahonar hospital in Kerman in 2016. The participants were selected by the consecutive sampling method and were assigned to intervention and control groups. In the intervention, the participants were informed by the nurse about changes in the patient’ s condition during the first three days of admission to intensive care unit. During this period, the control received routine care. Data collection tool was the Spielberger anxiety inventory. Independent and paired t-test were used to compare the mean scores of anxiety using the SPSS software version 16. Results: There was no statistically significant difference in the mean scores of overt, covert and general anxiety between the two groups before the intervention (P>0. 05). However, after the intervention in the experimental group, the mean scores of overt anxiety (45. 51± 7. 26), covert anxiety (45. 42± 6. 51) and general anxiety (90. 93± 12. 72) decreased (P<0. 05) compared to the mean scores of overt anxiety (49. 22± 9. 42), covert anxiety (49. 02± 9. 15) and general anxiety (98. 24± 17. 67) in the control group. Conclusion: Providing planned information on changes in the condition of hospitalized patients with traumatic brain injury can reduce the anxiety of family members of these patients.

Background & Aim: Needlestick injury is an occupational risk. Medical university students are more likely to prone to this kind of injury in comparison to other students due to their limited knowledge, skills and clinical experiences. The present systematic review and meta-analysis aimed to estimate the prevalence of needlestick injury in medical university students in Iran. Methods & Materials: In the present systematic review and metaanalysis, 22 papers written by Iranian researchers published in Persian and English, were included without time limitations. The articles were found by searching Iranian (Magiran, Scientific Information Databases (SID) and IranMedex) and international (Google Scholar, Web of Science, PubMed and Scopus) databases. Data were analyzed using meta-analysis method and the random effects model. Results: The overall prevalence of needlestick injury among medical university students was 47% (95% CI: 39-55). There was no relationship between vaccine coverage, age of samples, and sample size with the prevalence of needlestick injury. The prevalence of needlestick injuries significantly decreased with increase in the publication years of articles (P=0. 03), and significantly increased (P=0. 049) with lack of reporting. Conclusion: Considering the high prevalence of needlestick injury in the students of medical sciences universities, it is of great necessity to design educational programs focusing on the proper use of sharp and cutting instruments as well as the importance of reporting and modifying professional behavior such as avoiding the reinsertion of needles in order to reduce the incidence rate of needlestick injuries.

Background & Aim: Empowerment is a dynamic, positive, interactive and social process, leading to the improvement of quality of life (QOL) in patients with chronic disease. The purpose of this systematic review and meta-analysis was to determine the effect of family-centered empowerment model (FCEM) on QOL in adults with chronic diseases. Methods & Materials: By searching FCEM in Persian databases including SID, MagIran, IranMedex, IranDoc, and googlescholar, Scopus, Pubmed, Web-of-science, Proquest, and Sciencedirect, all relevant studies were extracted. The methodological quality of the papers was examined using Cochrane-risk-of-bias. Data analysis was carried out through the random effects model and heterogeneity by I2 index. The data were analyzed using the STATA software version 11. 0. Results: Of the 647 initial studies, only 8 studies examined the effect of FCEM on the QOL in adult patients using SF-36. The pooled standardized mean difference of the 8-dimensions of QOL included: social-functioning (1. 781), Physical role limitation (1. 416), bodily pain (0. 987), general health (1. 352), social functioning (1. 010), general health (1. 122), emotional role limitation (0. 656), and vitality (1. 361). Conclusion: The implementation of FCEM had a significant effect on the 8-dimensions of QOL based on the SF-36 questionnaire. The implementation of FCEM is recommended in order to improve the QOL of adult patients with chronic disease.

Background & Aim: Depression is common among cardiac patients, especially patients with heart failure and leads to a poor prognosis. This study aimed to assess the effect of exercise on depressive symptoms in patients with heart failure, attending the Cardiac Rehabilitation Center. Methods & Materials: In this clinical trial, 60 patients with NYHA class II and III heart failure who referred to the Cardiac Rehabilitation Center of Shafa Hospital affiliated to Kerman University of Medical Sciences in 2015 were randomly assigned into two groups of 30 patients. Subjects in the intervention group participated in a supervised 8-week exercise program, 3 days per week, while those in the control group only received standard routine care. Data were collected before and after the intervention by the demographic form and the Personal Health Questionnaire Depression Scale (PHQ-8). Data analysis was done by Chi-Square, Wilcoxon, Mann-Whitney U and Nonparametric ANCOVA tests using the SPSS version 21 and R software. Results: The two groups were homogeneous in terms of depression score before the intervention. The median and interquartile range of the score of depression were 10 (5. 25) in the control group and 8. 5 (9. 25) in the intervention group which showed a significant difference (P=0. 042). By adjusting the variables of the duration of the disease and the pre-test scores of depression symptoms by non-parametric covariance test, the difference between the two groups was also significant. Conclusion: Exercise can reduce depressive symptoms in patients with heart failure.

Background & Aim: Insufficient health literacy is a major barrier to self-care in patients with heart failure. The purpose of this study was to determine relationship between health literacy and self-care behaviors in patients with heart failure. Methods & Materials: In this correlational study, 100 patients with heart failure who were referred to teaching hospitals in Qom were selected through the convenience sampling method in 2017. The data collection tools were the heart failure-specific health literacy scale, the self-care of heart failure index (SCHFI) and the hospital anxiety and depression scale (HADS). Data were analyzed using descriptive statistics, the Pearson’ s correlation coefficient and multiple liner regression analysis on the SPSS software version 16. Results: More than half of the patients had a moderate level of selfcare. The highest and lowest health literacy scores were respectively related to critical health literacy (10. 47± 2. 56) and functional health literacy (9. 14± 3. 74). The result of multiple regression analysis showed that only functional health literacy was a better predictor of self-care behaviors in patients with heart failure (β =0. 30, P=0. 014). Conclusion: The findings showed that functional health literacy was an important predictor of self-care behaviors among patients with heart failure. It seems necessary to design effective interventions in order to improve patients’ skills for analyzing functional information and decision making in self-care.