Meaning of self-care: Lived experiences of Iranian diabetic patients

BACKGROUND: Diabetes continuously disrupts a patient’s well-being and quality of life. Successful self-care could potentially decrease overall costs and rates of mortality and morbidity. Patients’ experiences could be used to elucidate what they believe about illness and its management. The overall aim of this study was to illuminate the meaning of self-care among diabetic patients in Southeast of Iran.METHODS: Sixteen diabetic patients with a mean age of 34 and 10 years’ experience in self-care for their disease were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a Ricoeur’s phenomenological hermeneutic method.RESULTS: The meaning of self- care was comprehensively understood as being empowered. This can be divided into four themes: seeking information, being independent, being optimistic or pessimistic and trust in God.CONCLUSION: The results in this study suggest that cultural and religious components could affect diabetic patients' self-care. Nurses might use patients’ religious beliefs to relieve their stress, help them to retain a sense of control, maintain hope and sense of meaning and purpose in their life.KEYWORDS: self-care, Diabetic patients, IRA

A Comprehensive Perspective on Medical Tourism Context and Create a Conceptual Framework

This study developed a theoretical structural model to examine the influence of motivational factor and perceived destination image in the perceived service quality and overall satisfaction of medical tourists who have travelled to a foreign country to obtain a medical treatment. The theory of motivation, perception was combined in this research. This study included customer perceptions based on motivational factor, destination image, quality, value, and satisfaction which occurred after the medical trips. This is a quantitative study and survey method is used to collect data. The instrument of this study is developed based on the review of previous literature. There were only 260 completed responses that met all the required criteria. After data collection was completed, the Statistical Package for Social Sciences (SPSS) and SPSS AMOS 22.0 will be used to analyze and interpret the result. The results show that there were positive impact of Destination Image and Motivational Factor on Perceived Value, and positive impact of Perceived Value on Overall Satisfaction. Once again, it can be confirmed that Destination Image has the strongest impact on Perceived Quality, illustrated by the highest standardized value of .473. Keywords: medical tourism, motivational factor, perceived destination image, perceived service qualit

Investigation of migration-related challenges in order to develop an online information network for Persian immigrants

Dissertação de mestrado em International BusinessInternational migration is one of the most challenging issues of recent decades which has led to plenty of research on various aspects of migration. Many researchers conducted investigations to recognize the needs and impediments in the migration process as well as proposing suggestions to tackle the problem of adaptation and integration of immigrants to the new environment. Internet as a vehicle of communication and a platform for information retrieval has become the most popular medium among immigrants, facilitating the transnational practices and their adaptation process to the new society. Iran is one of the countries with the high rate of immigration, intensified following the 1979 Islamic revolution. While the Iranian immigrants as a minority group in most countries are not well organized and suffer from lack of social supports, there is no comprehensive informative online platform in which they can acquire their necessary information and communicate with fellow immigrants. We therefore aimed to propose a Persian information network for Iranian immigrants to meet their needs of information and communication in their new society. The first part of this study was investigating the literature upon different aspects of migration and Iranian immigrants‟ needs and barriers throughout their migration process. The second part included the development of a survey to explore the sample of Iranian immigrants‟ needs and impediments during their post-migration life and their attitude and behavior toward an online co-creative website. To this aim, we recruited 201 Persian immigrant individuals to participate in our research for examining the possibility of developing a Persian information network in order to present free information and social support to Iranian immigrants. Our results showed that the majority of the sample population had positive attitude toward using and contributing to such a network with the purpose of value co-creation through exchanging and integrating of knowledge and experiences.A migração internacional é um dos maiores desafios das últimas décadas, a qual tem levado a várias pesquisas sobre os vários aspetos relacionados com a migração. Muitos investigadores levaram a cabo investigações de modo a reconhecerem as necessidades e impedimentos associados ao processo de imigração, bem como propuseram sugestões sobre como enfrentar o problema da adaptação e integração dos imigrantes ao novo ambiente. A internet é um veículo de comunicação e uma plataforma de recuperação de informação que se tornou no meio mais popular entre os imigrantes, facilitando as práticas transnacionais e o seu processo de adaptação à nova sociedade. O Irão é um dos países com maior taxa de imigração, a qual se intensificou após a revolução Islâmica de 1979. Os imigrantes iranianos como grupos maioritários na maioria dos países não se encontram bem organizados e sofrem com a falta de apoios sociais, não existe nenhuma plataforma online que os permita adquirir as informações necessárias e comunicar com os seus companheiros imigrantes. Por isso no presente trabalho de investigação temos como objetivo propor uma rede de informação persa para os imigrantes iranianos, de modo a satisfazer as suas necessidades de informação e comunicação na sua nova sociedade. A primeira parte deste estudo recaiu sobre a investigação da literatura sobre os diferentes aspetos da migração e as necessidades e barreiras que os imigrantes iranianos enfrentam ao longo do seu processo de migração. A segunda parte incluiu o desenvolvimento de uma pesquisa através do uso de uma amostra de modo a explorar as necessidades e impedimentos da vida dos imigrantes iranianos após a sua migração, bem como as suas atitudes e comportamentos em relação a um site online co-criativo. Para este fim, recrutamos 201 imigrantes persas para participar numa pesquisa exploratória com o intuito de examinar a possibilidade do desenvolvimento de uma rede de informação persa que ofereça informação e apoio social gratuito aos imigrantes iranianos. Os nossos resultados mostraram que a maioria da população da amostra tinha uma atitude positiva relativamente ao uso e contribuição de uma rede que tenha como objetivo a cocriação de valor através da troca e integração de conhecimentos e experiências

Infertile couples' perceived needs after unsuccessful fertility treatment: A qualitative study

Introduction: Infertility is a major medical issue. Investigations and treatment of infertility are the beginning of a complex, time-consuming and stressful process for couples that may fail well. The present study explored the needs of infertile couples following treatment failure with Assisted Reproductive Technologies (ARTs). Methods: A descriptive qualitative study was conducted in an Iranian infertility center, in the Northeast of the country between April 2016 and June 2017. The researchers recruited 29 individuals including 9 couples, 9 women and two men with primary infertility through purposive sampling. The data were collected using semi-structured interviews and analyzed iteratively, using conventional content analysis with MAXQDA software. Results: The main concepts obtained from the data were classified into one theme titled: ""The need for support"" and four main categories along with their subcategories, and included the need for psychological support, the need for more useful information, the need for social support and the need to access to supplementary services. Conclusion: The findings show that following treatment failure, the infertile patients’ expressed needs and preferences were not met. Identifying and meeting their needs may help the infertile couples to deal with ARTs failure and to reach a decision about future treatment

HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran

<p>Abstract</p> <p>Background</p> <p>People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran.</p> <p>Methods</p> <p>In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach.</p> <p>Results and discussion</p> <p>Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress.</p> <p>Conclusions</p> <p>While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context.</p

HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

Life satisfaction and self-efficacy in patients affected by a first stroke living in Kuwait: A two-phase study

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Informa Healthcare USA, Inc.Life satisfaction and self-efficacy are important aspects of stroke rehabilitation. Previous research focuses on Western stroke survivors, neglecting the stroke experience in the Middle East. This research was conducted in Kuwait and entailed both quantitative and qualitative phases to obtain a more comprehensive, clinically relevant understanding of self-efficacy and life satisfaction during stroke rehabilitation in this culture. The aims were to: 1) investigate the relationships between self-efficacy and life satisfaction in female patients affected by stroke (Phase 1); and 2) explore health professionals' views regarding the importance of self-efficacy and possible strategies for enhancing self-efficacy during rehabilitation, through semi-structured interviews (Phase 2). Significant correlations were found between patients' general self-efficacy, and psychosocial adaptation self-efficacy following stroke. Self-efficacy (both general and psychosocial adaptation) showed significant correlations with life satisfaction post-stroke. Health professionals (more than half of whom were physiotherapists) recognised the importance of self-efficacy within stroke rehabilitation and identified five main ways to increase self-efficacy during stroke rehabilitation. These were to: 1) motivate and encourage patients; 2) provide more education about stroke and rehabilitation; 3) identify change; 4) offer a high-quality environment and therapy; and 5) set goals. In conclusion, psychosocial self-efficacy was identified as having a stronger relationship to life satisfaction compared with general self-efficacy within this sample of Kuwaiti female patients. Health professionals suggested various strategies for enhancing self-efficacy and thereby life satisfaction post-stroke during the rehabilitation process in Kuwait. Despite the collectivist culture of Kuwait, the findings indicate that the patient's own confidence and sense of responsibility for progress may be relevant to rehabilitation

Health system barriers influencing timely breast cancer diagnosis and treatment among women in low and middle-income Asian countries: evidence from a mixed-methods systematic review.

Globally, breast cancer is the most common cancer type and the leading cause of cancer mortality among women in developing countries. A high prevalence of late breast cancer diagnosis and treatment has been reported predominantly in Low- and Middle-Income Countries (LMICs), including those in Asia. Thus, this study utilized a mixed-methods systematic review to synthesize the health system barriers influencing timely breast cancer diagnosis and treatment among women in Asian countries. We systematically searched five electronic databases for studies published in English from 2012 to 2022 on health system barriers that influence timely breast cancer diagnosis and treatment among women in Asian countries. The review was conducted per the methodology for systematic reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, while health system barriers were extracted and classified based on the World Health Organization (WHO)'s Health Systems Framework. The mixed-methods appraisal tool was used to assess the methodological quality of the included studies. Twenty-six studies were included in this review. Fifteen studies were quantitative, nine studies were qualitative, and two studies used a mixed-methods approach. These studies were conducted across ten countries in Asia. This review identified health systems barriers that influence timely breast cancer diagnosis and treatment. The factors were categorized under the following: (1) delivery of health services (2) health workforce (3) financing for health (4) health information system and (5) essential medicines and technology. Delivery of health care (low quality of health care) was the most occurring barrier followed by the health workforce (unavailability of physicians), whilst health information systems were identified as the least barrier. This study concluded that health system factors such as geographical accessibility to treatment, misdiagnosis, and long waiting times at health facilities were major barriers to early breast cancer diagnosis and treatment among Asian women in LMICs. Eliminating these barriers will require deliberate health system strengthening, such as improving training for the health workforce and establishing more healthcare facilities. [Abstract copyright: © 2022. The Author(s).