320 research outputs found
Impact of preconception health education on health locus of control and self-efficacy in women Impact de l'éducation sanitaire avant la conception sur le lieu de contrôle de la santé et l'auto-efficacité chez les femmes
The preconception period is an ideal opportunity to optimize women's health. This study of women attending premarital clinics in the Islamic Republic of Iran aimed to evaluate the impact of a health education workshop on their health locus of control and self-efficacy in physical activity. The design was a randomized controlled trial with a questionnaire before and after the intervention. At post-intervention, there were significant increases in scores of internal health locus of control and self-efficacy in the experimental group (n = 109) compared to the control group (n = 101). It was concluded that a short-term health education may empower women to adopt healthy lifestyles
Social support and relationship with hope among mothers of a child with leukemia
زمینه و هدف: امروزه، بیماری لوسمی(leukemia) شایعترین نئوپلاسم دوران کودکی از یک بیماری کشنده به یک بیماری مزمن تبدیل شده است. لذا تمرکز بر مشکلات ناشی از درمان طولانیمدت در خانواده بخصوص مادران که مراقب اصلی کودک هستند، افزایش یافته است. حمایت اجتماعی و امید در توانایی مادران جهت اداره و مواجهه با تجربه بیماری و سازگاری با تنش موجود نقش مهمی را بازی میکنند. هدف از پژوهش حاضر بررسی ارتباط حمایت اجتماعی و امید در مادران کودکان مبتلا به لوسمی میباشد. روش بررسی: در این مطالعه توصیفی، تحلیلی 150 نفر بطور مستمر از میان مادران مراجعهکننده به مرکز خون مرکز آموزشی درمانی حضرت علی اصغر (ع) تهران، در مدت 3 ماه انتخاب شدند. ابزار گردآوری دادهها پرسشنامههای حمایت اجتماعی نورتوس (Northouse) و امید میلر (Miller hope scale) بود. برای تجزیه و تحلیل دادهها از آزمون کای اسکوئر، تی مستقل و آنالیز واریانس یک طرفه استفاده شد. یافتهها:میانگیر سنی مادران شرکت کننده 36/33 سال و 3/97آنان متأهل بودند. حدود 7/50 مادران مورد مطالعه از حمایت اجتماعی بالا و 3/45 آنها از امید بالا برخوردار بودند و بین میزان حمایت اجتماعی دریافت شده و میزان امید، همبستگی مثبت معنیدار (05/0P< و 443=r) وجود داشت. نتیجهگیری: بر مبنای یافتههای پژوهش و ارتباط حمایت اجتماعی با امید و با توجه به اهمیت این متغیرها در مادران، بعنوان مهمترین گروه مراقبتدهنده به کودک مبتلا به لوسمی، برنامهریزی در جهت آموزش و افزایش میزان حمایت اجتماعی و امید در این زنان ضروری بوده که نهایتاً می تواند بر کیفیت مراقبت از کودکان مبتلا به لوسمی موثر واقع شود
The effect of educational- counseling program on general health of women as caregivers of patient, with Alzheimerdisease
زمینه و هدف: ارائه مراقبت طولانی مدت به بیماران مبتلا به آلزایمر، با افزایش خطرات ابتلا به بیماری جسمی و روانی برای مراقبین همراه است و فقدان تعلیمات لازم نیز مشکلات سلامتی آنها را دو چندان نموده است. این مطالعه با هدف تعیین تاثیر برنامه آموزشی- مشاوره ای بر سلامت عمومی زنان مراقبت کننده از سالمندان مبتلا به آلزایمر انجام شده است. روش بررسی: در این پژوهش تجربی، 150 زن 18 تا 60 ساله که از وابستگان درجه یک سالمندان مبتلا به آلزایمر بوده و مراقبت مستقیم از آنها را به مدت حداقل 6 ماه به عهده داشتند، با روش نمونه گیری آسان انتخاب شدند و پس از انجام پیش آزمون شامل پرسشنامه اطلاعات دموگرافیک و سلامت عمومی گلدبرگ، با روش تصادفی بلوکه شده، به شکل تصادفی در دو گروه آزمون و کنترل قرار گرفتند. گروه آزمون در یک برنامه آموزشی – مشاوره ای شامل یک جلسه بحث گروهی، دریافت یک پمفلت آموزشی و دو مشاوره تلفنی شرکت نمودند. 6 هفته پس از مداخله، پس آزمون برای هر دو گروه انجام گرفت. برای مقایسه متغیرها از آزمون های آماری t زوجی، t مستقل، کای اسکوئر و آنالیز واریانس یک طرفه استفاده شد. یافته ها: نتایج نشان داد که قبل از برنامه آموزشی- مشاوره ای 3/17 از نمونه های مورد پژوهش سلامت عمومی نامطلوب داشتند. پس از انجام برنامه آموزشی- مشاوره ای میانگین سلامت عمومی در گروه آزمون از 3/15±68/39 به 03/10±09/19 تقلیل یافت (001/0
Effect of aromatherapy with Damask Rose (Rosa damascena Mill.) on anxiety in the elderly: Open-labeled quasi-experimental placebo-controlled trial
Background: Anxiety in orthopedic surgeries, especially knee replacement, is one of the most common complaints of the elderly. Aromatherapy with Damask Rose (Rosa damascena Mill.) can be one of the non-pharmacological methods in complementary medicine to control anxiety. Objectives: The present study aimed to determine the effect of aromatherapy with R. damascena on elderly anxiety after knee replacement surgery. Methods: In this quasi-experimental study, 80 elderly patients (60 to 90 years old) undergoing knee replacement surgery according to inclusion criteria were selected by convenience sampling method randomly from Moheb Mehr and Shafa Yahyaian hospitals of Tehran, Iran, and were divided into two groups of case and control. The case group was exposed to aromatherapy intervention at four intervals of 30 minutes. The instrument for measuring anxiety was the Visual Analogue scale for anxiety (VAS-A). Results: The results showed that the study elderly were homogeneous in terms of demographic variables in both case and control groups, except for two variables of education level and consumption of analgesics, which were also determined by two-way ANOVA. These parameters (education level, P = 0.54, and consumption of analgesics, P = 0.661) were not confounding variables. Significant differences were observed in the anxiety of the case group before and after the intervention (P < 0.001), while this difference was not significant in the control group (P = 0.304). Moreover, the difference in anxiety scores was significantly decreased after the intervention compared to before intervention in both case and control groups (P < 0.001). Probably Damask Rose aroma molecules produce and secrete neurotransmitters such as endorphins and encephalin, thereby reducing pain and anxiety. Conclusions: According to the findings of the study, the aromatherapy with R. damascena seems to be effective in reducing postoperative anxiety in these elderly patients. Copyright © 2020, Author(s)
Influence of B cells in liver fibrosis associated with hepatitis B virus harboring basal core promoter mutations
The development of the liver disease in chronic hepatitis B with common viral variants can be determined through the interaction between the virus and the host immune response. B cells constitute half of the intrahepatic lymphocyte population with an impact on fibrosis. A proliferation-inducing ligand (APRIL) has been shown to have a co-stimulatory activity on B cells. For this study HBV DNA was amplified and then sequenced to show the presence of the basal core promoter (BCP) mutations in the serum from 57 patients with chronic hepatitis B. The range of IgD-positive B cells was detected by immunohistochemistry in liver biopsies; and patients serum was assayed for APRIL levels by enzyme immunoassay. Twenty-seven patients (47.4) harbored the A1762T-G1764A BCP mutations. Coefficients of logistic regression showed that the effect of increasing IgD-positive B cells in rising odds of the liver disease is the same in the patients with BCP mutation A1762T-G1764A and in the patients without mutation, nevertheless the effect of APRIL is not similar in these two groups of patients. Logistic regression in patients with BCP A1762T-G1764A mutations demonstrated that increasing one score of APRIL decreased the odds of fibrosis stage about 8. These results suggest that in infection with viral variants of hepatitis B virus, the population of IgD-positive B cells may play a decisive role in later stages of the liver disease which is reduced by APRIL in chronic hepatitis patients with BCP mutations. J. Med. Virol. 84:18891896, 2012. (c) 2012 Wiley Periodicals, Inc
Family caregivers burden and its related factors among iranian elderly psychiatric patients' caregivers
Background: Providing care for an old person with a psychiatric disorder is a long-term and stressful process exerting negative outcomes on the caregivers' physical, psychological, and social health. Objectives: The aim of the study was to determine the burden among family caregivers of psychiatric elderly and its related factors. Methods: This descriptive study was conducted on 200 elderly psychiatric patients via convenient sampling, referring to the zare teaching psychiatric hospital of Sari, Iran. The sampling lasted from June tomid-November, 2015. Twoquestionnaires of demographics (the elderly and caregivers) and Zarit Burden Interview were used to collect the data. The data was analyzed using descriptive and inferential statistics, such as independent t-test, Analysis of Variance (ANOVA) and Scheffe Post Hoc test. Results: The results indicated that the mean of the caregivers' age was 51.24 ± 12.16. Ninety-four percent of the caregivers were married, and 49 had higher diploma education. Sixty-seven percent reported average economic status. The findings showed 68 of caregivers came up with mild to severe burden. According to the demographics, the hours of care per week (P = 0.001) and having other psychiatric patients in the family (P = 0.006) were related to the burden. Conclusions: Significantly high caregivers' burden can overshadow the risk of low quality of care the psychiatric elderly patients and expose their caregivers' psychological health to danger. Thus, it seems that community-oriented interventions are required to reduce the burden and boost long-term quality of care by informal caregivers, such as patients' families. ©2018, Iranian Journal of Psychiatry and Behavioral Sciences
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The balanced scorecard as a strategic management tool in hospital pharmacies: an experimental study
Purpose: A balanced scorecard (BSC) is an applied tool for implementing strategic management in various organizations. Implementing strategic management using the BSC approach has not received much attention in pharmacy departments. This study aims to provide a model for the strategic management of pharmacy departments using the BSC framework.
Design/methodology/approach: This experimental study was conducted from 2015 to 2018 in a 300-bed hospital and regional healthcare centers affiliated with the Petroleum Industry Health Organization in Tehran province, Iran. After carefully reviewing the organization's mission and vision, the strategic objectives were determined via the internal matrix and the external matrix (IE matrix), and the strengths–weaknesses–opportunities–threats matrix (SWOT matrix) were examined. Then, six BSC measures and interventions were identified, and each was examined from the perspectives of finance, patient satisfaction, internal processes and learning/growth. Finally, the proposed strategy was evaluated.
Findings: Results showed significant increases in patient satisfaction and gross profit. The observed increase range, from 0.09 to 0.29, indicates more effective operational management for optimal resource utilization. In addition, the pharmacy department was able to save US 442,899 during the two years of our strategic management plan by implementing the standard mechanism for returning unused medications to the pharmacy department after patients were discharged from various treatment units.
Originality/value: This study is among the first studies to demonstrate the simultaneous development, implementation and evaluation of the proposed strategy using the BSC in a pharmacy department in a public healthcare center. The BSC application improved the optimal use of resources and reduced costs while increasing patient satisfaction. It appears that the application of such an intervention may be as valuable to public pharmacies as it is to other private centers
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Cost-effectiveness of approaches to cervical cancer screening in Malawi: comparison of frequencies, lesion treatment techniques, and risk-stratified approaches
BackgroundRecently-updated global guidelines for cervical cancer screening incorporated new technologies-most significantly, the inclusion of HPV DNA detection as a primary screening test-but leave many implementation decisions at countries' discretion. We sought to develop recommendations for Malawi as a test case since it has the second-highest cervical cancer burden globally and high HIV prevalence. We incorporated updated epidemiologic data, the full range of ablation methods recommended, and a more nuanced representation of how HIV status intersects with cervical cancer risk and exposure to screening to model outcomes of different approaches to screening.MethodsUsing a Markov model, we estimate the relative health outcomes and costs of different approaches to cervical cancer screening among Malawian women. The model was parameterized using published data, and focused on comparing "triage" approaches-i.e., lesion treatment (cryotherapy or thermocoagulation) at differing frequencies and varying by HIV status. Health outcomes were quality-adjusted life years (QALYs) and deaths averted. The model was built using TreeAge Pro software.ResultsThermocoagulation was more cost-effective than cryotherapy at all screening frequencies. Screening women once per decade would avert substantially more deaths than screening only once per lifetime, at relatively little additional cost. Moreover, at this frequency, it would be advisable to ensure that all women who screen positive receive treatment (rather than investing in further increases in screening frequency): for a similar gain in QALYs, it would cost more than four times as much to implement once-per-5 years screening with only 50% of women treated versus once-per-decade screening with 100% of women treated. Stratified screening schedules by HIV status was found to be an optimal approach.ConclusionsThese results add new evidence about cost-effective approaches to cervical cancer screening in low-income countries. At relatively infrequent screening intervals, if resources are limited, it would be more cost-effective to invest in scaling up thermocoagulation for treatment before increasing the recommended screening frequency. In Malawi or countries in a similar stage of the HIV epidemic, a stratified approach that prioritizes more frequent screening for women living with HIV may be more cost-effective than population-wide recommendations that are HIV status neutral
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