The effects of family-centered empowerment model on depression, anxiety, and stress of the family caregivers of patients with COVID-19: a randomized clinical trial

BACKGROUND: Taking care of patients with Covid-19 is regarded as a challenging task for family caregivers. Hence, a Family-Centered Empowerment Model (FCEM) should help them achieve greater psychological strength throughout the home healthcare process. METHODS: This study is a randomized clinical trial with two groups; besides, pre-test and post-test designs were conducted based on the CONSORT checklist from April to July 2020, in Iran. Seventy family caregivers were randomly assigned to FCEM (n = 35) and control (n = 35) groups. Then, four stages of FCEM in four online sessions were provided to the participants of the intervention group via WhatsApp messenger. The procedure started at the patient's discharge and continued for two weeks. The demographic information questionnaire and Depression Anxiety Stress Scale (DASS-21) were employed before and five days after the FCEM sessions to gather the required data. RESULTS: The sample was made up of 55.8% women and 44.2% men caregivers, with a mean age of 42.5 years. The results demonstrated a substantial difference in the average score of stress (p = 0.023), anxiety (p = 0.003), and depression (p = 0.012). CONCLUSIONS: The combination of a face-to-face orientation session and online methods of FCEM is likely to lower stress, anxiety, and depression in family caregivers, which can be contributed to the practicability, simplicity, and effectiveness of this home health intervention. TRIAL REGISTRATION: This study (no. IRCT20180429039463N2) was registered in the Iranian Registry of Clinical Trials on 10/04/2020. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-022-01795-8

Comparing the Effects of Aquatic and Land-based Exercises on the Bio-motor Abilities of Elderly Men

Background: Physical activity, whether in water or on land, can improve motor disorders in the elderly. However, the more effective type of exercise remains inconspicuous. Aim: To compare the effects of aquatic and land-based exercises on the bio-motor abilities of elderly men. Method: This clinical trial was performed on 60 elderly men visiting Imamat and Daneshamuz health centers in Mashhad, Iran, in 2016. The eligible volunteers were randomly assigned to two groups (n=30 each). In one group, the subjects attended aquatic exercise sessions for six weeks, while the other group participated a land-based exercise program. Bio-motor abilities of the subjects including motor ability, flexibility, and general endurance were evaluated before and immediately after the intervention and recorded in a researcher-made checklist. Data were analyzed in SPSS, version 16, using the independent t-test, paired t-test, Chi-square test, Fisher’s exact test, and exact Chi-square test. Results: The mean ages of the aquatic exercise and land-based exercise groups were respectively 69.9±5.1 and 68.0±5.0 years. Post-intervention, the aquatic exercise group showed significantly higher motor ability (P=0.01) and general endurance (P=0.02) than did the other group. However, the difference in final flexibility of the groups was not significant (P=0.252). Paired t-test showed a significant improvement in bio-motor abilities of both groups post-intervention (

Self-administered Medications in Cardiovascular Ward: A study on Patients' Self-efficacy, knowledge and Satisfaction

Background: Self-efficacy of medication use and pharmaceutical knowledge are important factors for medical treatment completion. Aim: This study aimed to determine the effect of self-administration of medication program on pharmaceutical knowledge and satisfaction of patients with cardiovascular diseases. Methods: This randomized clinical trial was conducted on 60 patients with cardiovascular diseases (CVD) in Imam Reza hospital in Mashhad during 2018. Self-efficacy was examined using the standard scale of self-efficacy for appropriate medication use. Moreover, pharmaceutical knowledge was examined using the standard scale for the measurement of patients’ knowledge level before and after the intervention. Patients’ satisfaction with the medication use manner was also evaluated at the time of discharge from the hospital. Data were analyzed in SPSS software (Version 20). Results: According to the results, the mean ages of patients in the intervention and control groups were 40.9±8.6 and 44.4±8.5, respectively. In the pre-test, the self-efficacy and pharmaceutical knowledge scores obtained from independent t-tests and Mann-Whitney U test were homogeneous. However, self-efficacy scores in the post-test were 32.0±3.3 and 24.7±3.1 in the intervention and control groups, respectively. The mean satisfaction of patients with medication use manner was significantly higher in the intervention than that in the control group (

Effect of Flourishing Promotion Program on Social Health in the Elderly

Background: Social health is considered of utmost importance as a social necessity. Thus, the Flourishing Promotion Program (FPP) can be effective in promoting social health. Aim: To determine the effect of the FPP on social health in the elderly. Method: A randomized controlled clinical trial of 60 elderly individuals residing in Toos Nursing Home and Salamati Nursing Home, Mashhad, Iran, was performed in 2017. The participants were assigned to intervention and control groups. The intervention group enrolled in the FPP for eight 90-minute sessions, and the control group only performed the routine activities. Keyes’ Social Well-Being Scale was completed before, as well as immediately and one month after the intervention. To analyze the data, Mann-Whitney U test and Friedman test were run in SPSS, version 21. Results: The mean ages of the control and intervention groups were 74.9±11.4 and 78.1±7.0, respectively. According to the Mann-Whitney U test, the mean score of social health in the intervention (57.1±6.3) and control (50.4±9.0) groups were significantly different before the intervention (P=0.001). Given the findings of the analysis of covariance, the mean score of social health in the intervention (67.9±5.5) and control (50.4±9.0) groups immediately post-intervention were also significantly different (P=0.001). Such a significant difference was also observed between the intervention (66.8±5.5) and control (49.3±8.7) groups one month post-intervention (P=0.001). Implications for Practice: The FPP could effectively enhance mental and social health and functioning in the elderly through providing a sense of belonging, positive excitement, and better interactions

Evaluating the Effect of Painting Therapy on Happiness in the Elderly

Background: Reduced happiness is one of the consequences of aging. Happiness is a component of mental health that leads to life satisfaction and physical well-being. Aim: This study aimed to evaluate the effect of painting therapy on the happiness of the elderly. Method: This randomized clinical trial was conducted on 60 elderlies in 2017. The subjects were selected from two elderly care centers in Mashhad, Iran, through the convenience sampling method and randomly divided into two groups of intervention (N=30) and control (N=30). The data collection tools included a demographic characteristics form, research unit selection questionnaire, Cognitive Short Questionnaire, and Oxford Happiness Questionnaire. In addition, 12 sessions of painting therapy (three 50-60-minute sessions per week) were performed. At the end of the intervention, the Oxford Happiness Questionnaire was completed again by the subjects of both groups. In addition, data analysis was performed in SPSS, version 21. Results: In this study, the groups were homogenous in terms of demographic variables. In terms of mean happiness score before the intervention, no significant difference was observed between the intervention and control groups (55.6±2.1 vs. 57.6±5.0; P=0.06). However, after the intervention, the mean score of happiness was significantly higher in all its dimensions in the intervention group compared to the control group (

Effect of an Educational Program based on Health Belief Model on Medication Adherence in Elderly Patients with Hypertension

Background: Aging population growth is accompanied by the risk of cardiovascular diseases and hypertension. Medication nonadherence is one of the problems affecting patients, especially elderly individuals with high blood pressure. Aim: The present study aimed to determine the effect of an educational program based on the Health Belief Model (HBM) on medication adherence in older adults suffering from hypertension. Methods: This randomized controlled clinical trial was conducted on 60-year-old elderly people referring to health centers in Mashhad, Iran, during 2017. To this end, the intervention group received education on medication adherence while the control group was only subjected to typical routine services. The data were analyzed in SPSS Software (Version 20) through the independent t-test, Chi-square test, and Fisher’s exact test. Results: The mean ages of the participants in the intervention and control groups were 69.1±8.3 and 63.9±6.7 years, respectively. The post-test mean score of medication adherence obtained by the intervention group was 6.7±0.5 that was significantly higher than that of the control group (3.7±1.0) (P˂0.001). Moreover, the mean score of medication adherence in the intervention group had significantly increased in the post-test phase (P˂0.001) based on the within-group results of the paired t-test. Implications for Practice: The HBM might improve medication adherence in elderly individuals with hypertension by changing their beliefs. Therefore, it was recommended to use this model for teaching self-care to older adults suffering from chronic illnesses and also in other senior healthcare centers

COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries

BACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : an analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2.5 originating from ambient and household air pollution.Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2.5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2.5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2.5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure, with an estimated 3.78 (95% uncertainty interval 2.68-4.83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13.4% (9.49-17.5) of deaths and 13.6% (9.73-17.9) of DALYs due to type 2 diabetes were contributed by ambient PM2.5, and 6.50% (4.22-9.53) of deaths and 5.92% (3.81-8.64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2.5.Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2.5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : An analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes