The effect of continuous-educational program in interferon therapy on quality of life in patients suffering from Hepatitis B and C.

چکیده: زمینه و هدف: مؤثرترین روش در درمان بیماران مبتلا به هپاتیت های مزمن B و C درمان ترکیبی با اینتروفرون می باشد. این درمان ها به هر حال درجات مختلفی از عوارض جانبی ایجاد می کنند که ممکن است تأثیر منفی بر روی حیات بیمار، تعاملات اجتماعی و توانایی انجام کار و دیگر فعالیت های آنها داشته باشد. هدف از این مطالعه بررسی تأثیر آموزش نحوه مصرف صحیح اینترفرون، کنترل عوارض جانبی و پی گیری بیماران به مدت 28 هفته بر روی کیفیت زندگی بیماران مبتلا به هپاتیت B و C بود. روش بررسی: این پژوهش یک پژوهش نیمه تجربی است که به صورت پیش آزمون- پس آزمون بر روی بیماران مبتلا به هپاتیت مزمن B و C کاندید اینترفرون تراپی در مرکز هپاتیت تهران صورت گرفت. تعداد 60 بیمار به روش نمونه گیری در دسترس با توجه به مشخصات نمونه انتخاب و به طور تصادفی در گروه شاهد و آزمون (30 نفر شاهد، 30 نفر آزمون) قرار گرفتند. ابزار گردآوری داده ها پرسشنامه اطلاعات دموگرافیک و پرسشنامه کیفیت زندگی ویژه بیماران کبدی ( CLDQ=Chronic Liver Disease Questionnaire) بود. برای گروه آزمون و همراهان برنامه آموزشی به صورت 4 جلسه 45 دقیقه ای اجرا شد و بیماران به مدت 28 هفته پیگیری شدند. کیفیت زندگی بیماران هپاتیتی در دو مرحله قبل و 28 هفته پس از شروع اینترفرون تراپی و اجرای برنامه آموزشی سنجیده شد و در پایان کیفیت زندگی در دو گروه با استفاده از آزمون های همبستگی و کای دو، من ویتنی و ویلکاکسون مقایسه گردید. یافته ها: قبل از اجرای مداخله متغیرهای دموگرافیک و امتیاز کلی کیفیت زندگی در دو گروه اختلاف معنی داری مشاهده نشد. میانگین امتیاز کلی کیفیت زندگی در گروه آزمون از 4/21±6/158 به 17±4/183 افزایش یافت (001/0p) امتیاز کلی کیفیت زندگی پس از مداخله بین دو گروه دارای تفاوت معنی دار بود (001/0

The Effect of Education on Quality of Life in Patients under Interferon Therapy

Background and Aims: The main purpose of treating and caring for patients with chronic viral hepatitis is to promote life satisfaction and a feeling of well-being in patients suffering from this disease. The aim of this study was to evaluate the effect of education on quality of life in patients with chronic hepatitis who were treated with Interferon alpha. Methods: This quasi-experimental study was conducted on 60 patients with viral hepatitis. The intervention included teaching them the method of self injection of Interferon alpha 2 b, giving them educational pamphlets and then following their continuing treatment with interferon. Patients were randomly assigned to two 30-patient groups. The data- gathering tool was a demographic characteristics questionnaire and the Quality of Life Questionnaire for Patients with Chronic Liver Disease (CLDQ). The educational program was done in four 45- minute sessions for the case group and their relatives. The follow-up period was 12 weeks. Quality of life in patients with chronic hepatitis was measured before initiating interferon therapy, and after the educational period. Quality of life in the two groups was compared. Results: The total quality of life score in the two groups before therapy did not show any significant difference (P = 0.351); while 12 weeks after education there was a significant difference between the two groups (P < 0.001) in three items including abdominal symptoms (P = 0.01), worry (P < 0.001) and emotional factors (P < 0.001). The other three items did not show a significant difference between the two groups. The total quality of life score in the case group was significantly different before and after education (P < 0.001), and improved after education. The total quality of life score in the control group did not differ significantly after 12 weeks (P = 0.143). Conclusions: Planning short and simple educational programs has a significant effect on the patient's control of his/her disease and its side effects; and can improve quality of life, life satisfaction, and mechanisms of coping with treatment in patients with viral hepatitis

A survey on quality of life in patients with myocardial infarction, referred to Shahrekord Hagar hospital in 2005

چکیده: زمینه و هدف: سکته های قلبی از جمله شایع ترین و خطرناک ترین اختلالاتی هستند که زندگی انسانها را تهدید می کنند و در دراز مدت با ماهیت ناتوان کننده خود محدودیت های فراوان در ابعاد مختلف زندگی فرد مبتلا بوجود می آورد. پژوهش حاضر به منظور بررسی کیفیت زندگی بیماران مبتلا به سکته قلبی مراجعه کننده به بیمارستان آموزشی درمانی هاجر شهرکرد انجام گرفته است. روش بررسی: در این پژوهش توصیفی – تحلیلی 150 بیمار مبتلا به سکته قلبی که در بخش مراقبت های ویژه بیمارستان آموزشی درمانی هاجر(س) شهرکرد بستری بودند، به صورت نمونه گیری آسان انتخاب شدند. اطلاعات با استفاده از پرسشنامه دو قسمتی شامل ویژگی های دموگرافیک و بررسی ابعاد کیقیت زندگی (پرسشنامه استاندارد SF36) از طریق مصاحبه و مراجعه به پرونده بیمار گردآوری و با استفاده از آزمون کای اسکور تجزیه و تحلیل گردید. یافته ها: میانگین سن بیماران 5/10±7/55 سال و کیفیت زندگی اکثریت واحدهای مورد پژوهش (53) نسبتاً مطلوب بود. اکثریت واحد های مورد پژوهش دارای کیفیت زندگی نسبتاً مطلوب در بعد وضعیت عمومی (62) و بعد وضعیت اجتمایی - عملکرد شغلی (65) بودند. وضعیت خواب 61 واحدهای مورد پژوهش مطلوب و فعالیت جسمی 62 واحدهای مورد پژوهش نامطلوب بود. بین طول مدت بیماری با کیفیت زندگی ارتباط آماری معنی دار وجود داشت (05/0

Factors influencing quality of life in patients with myocardial infraction

Background & Aim: Myocardial infarction is a common and dangerous life threatening disease with an impact on quality of life. The present descriptive-analytical study aims to determine quality of life in patients with myocardial infarction referring to Hadjar hospital affiliated to the Shahre-kord University of Medical Sciences. Material & Method: This was a descriptive-analytical study in which 150 patients admitted to cardiac care unit of Hadja hospital within 8 weeks post infarction were selected by non random sampling method. Data were collected through interview, patients’ medical records and patients self report. The tool for collecting data regarding quality of life was SF36 questionnaire. Data were analyzed by descriptive and inferential statistics. Results: Findings showed that the mean value of age was 55.7 ±10.5 and that quality of life in majority of subjects (%53) was fairly favorable. Regarding aspects of quality of life, most patients had fairly favorable general status (physical and psychological health) (%62) and social function (%65). Also, sleep pattern of majority of subjects (%61) was favorable and most of them (62%) had unfavorable physical activity. There was statistically significant correlation between quality of life and variables such as duration of disease (P<0.05), intensity of pain (P<0.05), decline or loss of job function, and the degree of fatigue (P<0.05), but there was no statistically significant relationship between quality of life and other demographics as age, gender, marital status, economic status and occupational status. Conclusion: Because fatigue and pain have some relationship with quality of life in patient with myocardial infarction, health care personnel, spatially nurses should pay attention to dimensions of quality of life when planning care for these patients. Failure to do so may leads to quality of life of patients to be neglected

A comparison of life style with body mass index (BMI) of loss and more than 25 in individuals between 20-65 years in Shahrekord city

Background and aim: The present study aimed to compare the habits and features of obese (BMI>25) and normal (BM25 kg/m2 then it was designated in the case group (obese). Samples with BMI between 20-25 kg/m2 were assigned into the control (normal) group. The Miller-Smith life style questionnaires were used for both groups. Data were analyzed using Chi-square and t-tests. Results: No significant differences were found between the two groups tested in terms of the mean age, gender, level of education, marital status insurance, the length of sleep during 24 h, cigarette smoking and losing job or spouse. However, a significant relation was found in using vegetables, sausage, fried potatoes, enriched breads, low fat milk, low salt, candies and chocolates (P<0.05). Conclusion: The present study suggests that one way to control obesity and prevent diseases is to ameliorate the life styles with education to people

Nurses\\\' Performance in Prevention of Ventilator associated Pneumonia

Background & Aim: The ventilator associated pneumonia is a common problem in critical care units. It is associated with increased mortality, cost and length of stay. Nurses have great role in preventing the ventilator associated pneumonia. The aim of this study was to assess nurses' performance in prevention of ventilator associated pneumonia .   Methods & Materials: In this descriptive study, 110 nurses working in selected hospitals affiliated to Tehran University of Medical Sciences were selected using convenience sampling method. A 32-item observational checklist was provided based on the ventilator associated pneumonia prevention guideline. The nurses' performance was observed three times. Data were analyzed using descriptive statistics in the SPSS-16 .   Results: This study showed that the mean score of the nurses' prevention was 46.8±5.79. Most of the nurses (66.4%) had poor performance; and 36.6% had relatively good performance. There were no nurses with favorable performance in the prevention of ventilator associated pneumonia. The highest score was in contact precaution (72±9.67) and the lowest score was in mouth hygiene (18.78 ± 17.4) .   Conclusion: The majority of nurses had poor performance in prevention of ventilator associated pneumonia. More attention should be paid for planning appropriate training programs for nurses and giving adequate facilities to improve health care quality

Effect of Application of Critical-Care Pain Observation Tool in Patients with Decreased Level of Consciousness on Performance of Nurses in Documentation and Reassessment of Pain

Background & Aim: The presence of pain is a common phenomenon among patients in critical care units. Critically ill patients are often unable to communicate because of illness or sedation; so, recognition and assessment of their pain is difficult. In these patients, observational behavioral indices can be used to evaluate pain. The aim of this study was to investigate the effect of application of critical-care pain observation tool in patients with decreased level of consciousness on performance of nurses in documentation and reassessment of pain after palliative intervention. Methods & Materials: In this before and after quasi-experimental study, 106 nurses working in general intensive care units in selected hospitals affiliated to Tehran University of Medical Sciences were selected. First, we examined the nurses' performance three times in relation to documentation and reassessment of pain after palliative intervention, position change and suction procedure in patients with decreased level of consciousness using a researcher-made check list. Then, we taught nurses individually, how to use this tool to investigate the pain of patient in a session lasting an hour. A week after the training, the researcher reevaluated performance of trained nurses in relation to documentation and reassessment of pain after palliative intervention in patients with decreased level of consciousness. Finally, those data collected before and after the training of the CPOT to nurses were compared using the Wilcoxon test. Results: Findings showed that the CPOT could not lead to improved nurses' function in relation to documentation of pain in the patients records (P=0.209) and recording palliative measures related to pain (P=0.117). However, there were significant statistical differences between nurses' function in relation to reassessment of pain after palliative intervention, before and after the training and application of the CPOT. Comparing the mean function scores before and after the intervention, demonstrated that the performance of nurses in this area has been improved after the intervention. Conclusion: The critical-care pain observation tool can increase nurses' sensitivity to pain in patients with decreased level of consciousness. It forces the nurses to reassess the pain after palliative intervention. This tool does not motivate in nurses to document pain palliative process. So it is recommended that future studies investigate the impact of this tool on other aspects of pain management, such as diagnosis of pain and using of drugs and non-drug measures

Modification of Environmental Factors on Quality of Sleep among Patients Admitted to CCU

Background & Aim: Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU.Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v.18.Results: Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group (P<0.001). There were no statistically significant changes in the sleep quality before and after hospitalization in the intervention group (P=0.053).Conclusion: Using environmental factors mitigation strategies can improve sleep quality of patients admitted to CCUs

Nurses Use of Critical Care Pain Observational Tool in Patients with Low Consciousness

Objectives: The diagnosis of pain in patients with low consciousness is a major challenge in the intensive care unit (ICU). Therefore, the use of behavioral tools for pain assessment could be an effective tool to manage pain in this group of patients. The aim of this study was to determine the effects on pain management by nurses using a critical care pain observational tool in patients with a decreased level of consciousness. Methods: Our research used a before and after design to evaluate the ability of nurses to manage pain in patients with low consciousness. A total of 106 ICU nurses were included in the study. The study was divided into three phases: pre-implementation, implementation, and post-implementation. The researchers first observed the nurses management of pain in their patients; this was done three times using a checklist following tracheal suctioning and position change procedures. The nurses were then taught how to apply the critical-care pain observational tool (CPOT). Post-implementation of the tool, the researchers re-evaluated trained the nurses’ pain management. Results: Performance scores after training improved with relation to the nurses diagnosis of pain, pharmacological and nonpharmacological actions, reassessment of pain, and re-relieving of any pain. However, use of the tool did not improve the recording of the patient’s pain and the relief measures used. Conclusion: Use of the CPOT can increase nurse’s sensitivity to pain in non-conscious patients and drive them to track and perform pain management