The study of the correlation between medication adherence and quality of life of Rheumatoid Arthritis patients

Background and aims: Patient adherences with therapeutic regimens reduce the severity of desease negative complications and its non-adherence as a barrier to achieving the medical. The aim at this study was to determine the correlation between medication adherence and quality of life of Rheumatoid Arthritis patients in Shariati hospital in 2016. Methods: This study was descriptive-correlational that population consisted of all Arthritis patients in Shariati hospital in Tehran. 252 patients were recruited by convenience sampling. Three questionnaires were used to collect data including the demographic characteristics questionnaire, the medication adherence “CQR” and SF-36. The validity and reliability of SF-36 in similar studies and the validity and reliability of CQR by researcher was approved. Data were analyzed by SPSS. Results: The results showed the levels of medication adherence with an average of 65.86±5.85 and the quality of life of patients with an average of 51.96±9.73. Spearman correlation coefficient showed that no significant correlation between medication adherence and quality of life of patients (P=0.663, r=0.02). Medication adherence had a significant correlation between energy/fatigue subscales of quality of life (P=0.035, r=0.13). Conclusion: Due to the fact that medication adherence was not a predictor of quality of life in patients with rheumatoid arthritis Therefore, it cannot be poured programs for these patients to improve their quality of life due to medication adherence

The Impact of Individualized Music Therapy on the Behavior of Agitation in Elderly Patients with Alzheimer Living in Nursing Homes

Background and objective: Music therapy is a non- expensive, non- invasive and applicable nursing intervention that can be applied by nurses and family caregivers in different situations. The purpose of this study was to investigate the effect of selected music on agitation behaviors of elderlies who are suffering from Alzheimer disease and residing at selected nursing homes of Tehran city. Methods: The present study was performed in a Semi-experiential.  34 elderly individuals with Alzheimer who show agitation behaviors were selected and they were randomly divided to two groups: intervention group (n=17) and control group (n=17). The individualized music was collected on CDs based on the elderly peoples’ preferences or if they suffered from severe cognitive impairment, their families were asked to select the music. Subsequently the individualized music was played by headphone in three sessions per week, afternoon and each session lasted for 20-30 minutes during 1.5 month for intervention group. For control group, no intervention was taken and they only received routine daily care measures of nursing homes. Data was gathered in 4 times for groups: Pre Test, Post Test1 (after 9 sessions), Post Test 2(after 18 sessions) and follow up step (a month after intervention). The tools for collecting data include: demographic inventory, Cohen- Mansfield’s Agitation Inventory (1986) and Abbreviated mental test (1972). The data were analyzed by MANOVA/ANOVA test on p 0.05), while after execution of intervention, significant difference was observed in all three measurement stages (p < 0.05). Conclusion: This study supports the effect of individualized music on reduction of agitation behaviors of elderly people who are suffering from Alzheimer’s disease and reside in nursing homes. Paper Type: Research Article

A Comparison of the Effect of Virtual and Lecture-Based Patient Safety Education on Patient Safety Culture among Nurses

Background and Objectives: Patient safety is crucial for promotion of healthcare quality and is monitored as an important parameter by all healthcare provider organizations worldwide. Nurses play a major role in maintaining and promoting patient safety due to the nature of their work. The purpose of this study was to compare the effect of patient safety education program on patient safety culture among nurses working in Ilam education-treatment centers. Methods: In this experimental study, 40 nurses were selected from Ilam educational-treatment centers and randomly allocated to two groups of virtual patient safety education and lecture-based education. Hospital Survey on Patient Safety Culture questionnaire was completed by nurses of the two groups before and after patient safety education program. Statistical analysis was performed using Kolmogorov-Smirnov, independent t-, and paired t-tests. The significance level was considered less that 0.05. Results: Patient safety culture was significantly improved in both virtual and lecture groups after educational intervention (p<0.01). In the virtual education group, the mean score of patient safety culture was higher than lecture group, and this difference was significant (p<0.01). Conclusion: The findings of this study indicated that educational programs could be used by administrators of health service providers to improve patient safety culture among nurses. Also, providing patient safety educations as virtual or lecture both will be helpful. &nbsp

Barriers to end-of-life care delivery to home-dwelling terminally-ill older patients: A qualitative content analysis

Background: In the last days of life, home-dwelling terminally-ill older patients have complex care needs. End-of-life (EOL) care for these patients is usually delivered at home. However, there is limited information about the barriers to EOL care delivery to home-dwelling terminally-ill older patients. Objectives: This study is aimed to explore the barriers to EOL care delivery to home-dwelling terminally-ill older patients. Methods: This qualitative study was conducted in 2017-2018. Ten family caregivers and ten health-care providers were purposively selected. The main inclusion criterion was the experience of EOL care delivery to home-dwelling terminally-ill older patients. Data were collected through semi-structured interviews and were analyzed through conventional content analysis. In total, 23 interviews were held with twenty participants. Results: The barriers to EOL care delivery to home-dwelling terminally-ill older patients were categorized into the following three main categories and ten subcategories: inappropriate community-based healthcare context (subcategories: lack of public home care services, lack of palliative/hospice care services, legal/ethical dilemmas, and wrong cultural beliefs leading to wrong EOL care), unsupportive healthcare providers (subcategories: limited preparation for EOL care delivery, negligence towards appropriate home care delivery, and indifference to patients' and their families' rights), and inappropriate family conditions (subcategories: families' lack of care-related knowledge and skills, families' poor financial status, and tension in families). Conclusion: There are different familial, financial, professional, organizational, and social barriers to EOL care delivery to home-dwelling terminally-ill older patients. Culturally-appropriate policies and strategies are needed for operationalizing EOL care, integrating it into the public health-care system, and preparing healthcare providers and family caregivers for its delivery

Challenges of Female Nurses in Disasters: A Qualitative Study

Background: Awareness of nurses&rsquo; experiences is helpful to identify current problems in providing services during disasters. In this regard, better planning and preparation may reduce the problems of this large group of health care providers. This study aimed to investigate the experiences of female nurses in providing services during disasters. Materials and Methods: This is a qualitative study with content analysis approach. The participants comprised 15 nurses with experience in providing healthcare services during disasters. Samples were recruited by purposive sampling method and sampling was continued until data saturation. Data were collected through semi-structured interviews, then analyzed by manifest content analysis. Results: Based on experiences and perceptions of nurses, three main categories found out of analyses of the obtained data were as follows: &ldquo;the importance of paying attention to the specific needs of female nurses,&rdquo; &ldquo;places for female nurses during disastrous period,&rdquo; and &ldquo;the importance of the presence of female nurses in providing services.&rdquo; Conclusion: Many factors affect the services delivered by female nurses. The results of this study showed that the specific needs of female nurses, who are the main body of Iranian nurses, could maximize their performance and minimize their psychological and emotional damages

The Effect of Pet Therapy on Depression of Elderly Resident in Nursing Homes

Objectives: In old age depression is common problem. Its rate at elderly residing at nursing homes is 30-50%. Several types of medications are used to treat depression. However because elderly use many drugs due to their numerous problems, non pharmacological methods such as pet therapy can be considered. So the present study intended to assess the effectiveness of pet therapy on elderly depression.&nbsp; Methods & Materials: A quasi-experimental study was conducted with 60 elderly living at nursing homes. The elderly were randomly placed at two groups: intervention group (N:29) and control group (N:31). In both groups Geriatric Depression Scale (GDS) and a questionnaire for demographic characteristics were used to collect data. Then research intervention including animal care program over a six-week period was performed. And the control group did not receive this intervention. Both groups were assessed by The Geriatric Depression Scale after the intervention period. Pretest score and posttest score were compared. To analyze the collected data Chi-square and independent t-test were used and the dependant t-test was applied to analyze the variables. Results: Findings of this study showed that depression of elderly of intervention group decreased from 8/55 before intervention to 4.79 after intervention (P<0.001). But no significant difference was observed in the control group. The comparison of depression scores mean in both groups before intervention shows no significant statistical difference (P=0.531) while the mean after the intervention in control group was significantly higher (P=0.001).&nbsp; Conclusion: Considering the results of this study, it can be suggested that pet therapy has positive effects on reduction of elderly depression. Therefore, non-invasion interventions such as keeping pet by nurses can improve elderly depression and can cause their active participation. It is strongly recommended to use this intervention widely at nursing homes. In addition, this study provided a new field for research and nursing services

انگ اختلالات مصرف مواد: تحلیل مفهوم

زمینه و هدف: اختلالات مصرف مواد، یکی از نگرانی‌های اصلی در دنیای امروز است که باعث ایجاد اثرات عاطفی و جسمی بر مصرف‌کنندگان مواد می‌شود. بخش قابل ‌توجهی از این عوارض ناشی از انگ و برچسب‌زدن اطرافیان به این بیماران است. تحلیل مفهوم انگ در زمینه اختلالات مصرف مواد با هدف یکپارچگی معنایی، کاهش ابهامات و افزایش ثبات در کاربرد این مفهوم انجام شد. روش: این پژوهش با هدف تبیین و تحلیل مفهوم انگ اختلالات مصرف مواد و تعیین ابعاد و ویژگی‌های آن با استفاده از رویکرد تحلیل مفهومی واکر و آوانت در سال 1401 انجام شد. ملاحظات اخلاقی: در پژوهش حاضر جنبه‌های اخلاقی مطالعه مروری شامل اصالت متون، صداقت و امانتداری رعایت شده است. یافته‌ها: بعد از تجزیه و تحلیل مطالعات، ویژگی‌های فرایند روان‌شناختی اجتماعی چندبعدی، فراگیری در عرصه‌های مختلف زندگی، نفوذ پرشتاب در جامعه، مبتنی بر زمینه اجتماعی ـ فرهنگی، مبتنی بر نوع و میزان مصرف مواد و قائل‌بودن به سیر ازمان به دست آمد. نتیجه‌گیری: در این مطالعه مفهوم‌پردازی، تعریف جامعی از انگ اختلالات مصرف مواد با پیشایندها، مشخصه‌ها و پیامدها از طریق فرآیند تحلیل مفهوم پدیدار شد. یافته‌ها مورد بررسی قرار گرفت و در نهایت به موارد مدل، مرزی و مخالف منجر شد. تعریف ارائه‌شده و حمایت‌شده توسط متون، ادعا می‌کند که انگ اختلالات مصرف مواد، فرآیند روان‌شناختی اجتماعی چند‌بعدی مزمن، با فراگیری در عرصه‌های مختلف زندگی فرد مبتلا و نفوذ پرشتاب در جامعه که مبتنی بر زمینه اجتماعی ـ فرهنگی و نیز نوع و میزان مصرف مواد بوده که عملکردهای ناعادلانه و جرم‌انگارانه سازمان‌های بهداشتی و غیر بهداشتی، باورهای اجتماعی مبتنی بر هویت نامطلوب فرد مبتلا، ناآگاهی مردم، عدم تجربه شخصی اطرافیان در برخورد با فرد معتاد، فاصله قدرت اجتماعی اقتصادی بین انگ زننده و فرد مبتلا و ویژگی‌های جمعیت‌شناختی تسهیل‌کننده انگ‌زنی، آتش‌زنه آن است که منجر به آسیب‌پذیری همه‌جانبه اعتبار و سلامت فردی، عملکردی، خانوادگی، اجتماعی، فرهنگی، اقتصادی و سیاسی فرد مورد انگ می‌شود. این تعریف و همچنین پیشایندها، پیامدها و مراجع تجربی آن می‌تواند مبنایی برای درک جامع‌تر و همچنین مطالعات کاربردی آینده باشد.Background and Aim: Substance abuse disorders are a major concern in today's world, which have both emotional and physical impacts on substance abusers. A significant part of these complications is caused by marking these patients with stigma and labeling them. The analysis of the concept of stigma regarding substance abuse disorders was carried out with the aim of reaching semantic integration, reducing ambiguities and increasing stability in the application of this concept. Methods: This study was conducted with the aim of clarifying and analyzing the concept of the stigma of substance abuse disorders and determining its dimensions and characteristics, using the concept analysis approach of Walker and Avant in 2022. Ethical Considerations: In the current research, the ethical aspects of the review study, including the originality of the texts, honesty and trustworthiness, have been observed. Results: After analyzing the studies, the characteristics of the multi-dimensional psycho-social process were obtained: Pervasiveness in different areas of life, rapid spread in the society, being based on the socio-cultural context, dependence on the type and the quantity of substance consumption and being chronic. Conclusion: In this conceptual study, a comprehensive definition of the stigma of substance abuse disorders, along with antecedents, characteristics and consequences, was achieved through the process of conceptual analysis. The investigation of the findings eventually led to model, borderline and contrary cases. The presented definition, which is also supported by the literature, claims that the stigma of substance abuse disorders is a chronic, multidimensional psycho-social process, which is pervasive in different areas of the affected individual's life, along with rapid spread in the society. Moreover, it is based on the socio-cultural context and depends on the type and the quantity of substance consumption. The unfair and criminalizing practices of healthcare and non-healthcare organizations, the social beliefs regarding the undesirable identity of the affected individual, people's ignorance, the relatives’ lack of personal experience in dealing with the substance abuser, the socioeconomic power gap between the stigmatizer and the affected individual and demographic characteristics trigger stigmatization. Stigmatization leads to comprehensive vulnerability of the stigmatized individual’s credibility and health in different aspects: personal, functional, family, social, cultural, economic and political. This definition as well as its antecedents, consequences and empirical references can be a basis for a more comprehensive perception and future applied studies. Please cite this article as: Moghaddam F, Mohammadi Shahboulaghi F, Khankeh HR, Norouzi Tabrizi K. The Stigma of Substance Use Disorders: A Concept Analysis. Faṣlnāmah-i akhlāq-i pizishkī, i.e., Quarterly Journal of Medical Ethics. 2022; 16(47): e18.زمینه و هدف: اختلالات مصرف مواد، یکی از نگرانی‌های اصلی در دنیای امروز است که باعث ایجاد اثرات عاطفی و جسمی بر مصرف‌کنندگان مواد می‌شود. بخش قابل ‌توجهی از این عوارض ناشی از انگ و برچسب‌زدن اطرافیان به این بیماران است. تحلیل مفهوم انگ در زمینه اختلالات مصرف مواد با هدف یکپارچگی معنایی، کاهش ابهامات و افزایش ثبات در کاربرد این مفهوم انجام شد. روش: این پژوهش با هدف تبیین و تحلیل مفهوم انگ اختلالات مصرف مواد و تعیین ابعاد و ویژگی‌های آن با استفاده از رویکرد تحلیل مفهومی واکر و آوانت در سال 1401 انجام شد. ملاحظات اخلاقی: در پژوهش حاضر جنبه‌های اخلاقی مطالعه مروری شامل اصالت متون، صداقت و امانتداری رعایت شده است. یافته‌ها: بعد از تجزیه و تحلیل مطالعات، ویژگی‌های فرایند روان‌شناختی اجتماعی چندبعدی، فراگیری در عرصه‌های مختلف زندگی، نفوذ پرشتاب در جامعه، مبتنی بر زمینه اجتماعی ـ فرهنگی، مبتنی بر نوع و میزان مصرف مواد و قائل‌بودن به سیر ازمان به دست آمد. نتیجه‌گیری: در این مطالعه مفهوم‌پردازی، تعریف جامعی از انگ اختلالات مصرف مواد با پیشایندها، مشخصه‌ها و پیامدها از طریق فرآیند تحلیل مفهوم پدیدار شد. یافته‌ها مورد بررسی قرار گرفت و در نهایت به موارد مدل، مرزی و مخالف منجر شد. تعریف ارائه‌شده و حمایت‌شده توسط متون، ادعا می‌کند که انگ اختلالات مصرف مواد، فرآیند روان‌شناختی اجتماعی چند‌بعدی مزمن، با فراگیری در عرصه‌های مختلف زندگی فرد مبتلا و نفوذ پرشتاب در جامعه که مبتنی بر زمینه اجتماعی ـ فرهنگی و نیز نوع و میزان مصرف مواد بوده که عملکردهای ناعادلانه و جرم‌انگارانه سازمان‌های بهداشتی و غیر بهداشتی، باورهای اجتماعی مبتنی بر هویت نامطلوب فرد مبتلا، ناآگاهی مردم، عدم تجربه شخصی اطرافیان در برخورد با فرد معتاد، فاصله قدرت اجتماعی اقتصادی بین انگ زننده و فرد مبتلا و ویژگی‌های جمعیت‌شناختی تسهیل‌کننده انگ‌زنی، آتش‌زنه آن است که منجر به آسیب‌پذیری همه‌جانبه اعتبار و سلامت فردی، عملکردی، خانوادگی، اجتماعی، فرهنگی، اقتصادی و سیاسی فرد مورد انگ می‌شود. این تعریف و همچنین پیشایندها، پیامدها و مراجع تجربی آن می‌تواند مبنایی برای درک جامع‌تر و همچنین مطالعات کاربردی آینده باشد

فاصله گذاری اجتماعی: تحلیل مفهوم

Background and Aim: With the beginning of the pandemic caused by the COVID-19 virus, the concept of social distancing received a lot of attention and was used in many public health announcements. However, this concept is vague and inexpressive and in the scientific literature, there is no consensus about what is called social distancing. Considering the multi-dimensional view and the ambiguity in different dimensions of social distancing, the need for further development and efforts to achieve a deep perception of this concept is felt. Therefore, this study was conducted with the aim of analyzing the concept of social distancing and determining its dimensions and characteristics. Methods: The analysis of the concept of social distancing, based on Walker and Avant's approach, was done in eight steps: Choosing a concept; determining the purpose of analysis; identifying the uses of the concept; defining attributes, antecedents and consequences; identifying model, borderline and contrary cases and finally, empirical referents. The articles within the time span of 2019-22 were searched in electronic databases PubMed, ProQuest, CINAHL, Irandoc, SID and Google Scholar search engine, using the keywords social distancing and social distance. Ethical Considerations: In the current research, the ethical aspects of the review study have been observed, including the originality of the texts, honesty and trustworthiness. Results: The result of the search was 480 articles, which were screened according to the research criteria and finally, 23 articles that had repeatedly been used to define or describe the antecedents, characteristics and consequences of the desired concept were analyzed. After analyzing the studies, the concept of social distancing was found to have certain qualities: Preventing the transmission of infectious diseases, recommending staying at home and being quarantined, being culture-oriented and the passage of time. Conclusion: In this study, a definition of social distancing was obtained, which is also supported by the literature. According to this definition, social distancing is a health protection and preventive measure, which prevents or reduces the transmission of contagious diseases through recommending keeping physical distance from others, staying at home and being quarantined during the outbreak of infectious diseases. Future studies can use this definition in designing preventive interventions related to the adverse consequences of this concept. Furthermore, this definition can be the basis for better teaching this phenomenon to students. Since concepts such as social distancing are always associated with issues like changing social relations and ethical challenges, the need for more reflection on the application of this concept is felt, due to the lack of respect for individuals’ independence.زمینه و هدف: مفهوم فاصله‌گذاری اجتماعی، با شروع همه‌گیری جهانی ناشی از ویروس کووید-19 مورد توجه زیادی واقع شد و در بسیاری از اطلاعیه‌های سلامت عمومی مورد استفاده قرار گرفت، اما این مفهوم مبهم و نارسا است و در ادبیات علمی اتفاق نظری درباره آنچه فاصله‌گذاری اجتماعی نامیده می‌شود، وجود ندارد. با توجه به دیدگاه چندبعدی و ابهام در ابعاد مختلف این مفهوم، نیاز به توسعه بیشتر و تلاش برای دستیابی به درک عمیقی از آن احساس می‌شود، لذا این پژوهش با هدف تحلیل مفهوم فاصله‌گذاری اجتماعی و تعیین ابعاد و ویژگی‌های آن انجام شد. روش: آنالیز مفهوم فاصله‌گذاری اجتماعی، بر اساس رویکرد Walker &amp; Avant، در هشت گام: انتخاب مفهوم، اهداف تحلیل، شناسایی کاربردهای مفهوم، پیشایندها، ویژگی‌ها و پیامدهای مفهوم، معرفی موارد مدل، مخالف و مرزی و در نهایت ارجاعات تجربی مفهوم انجام شد. جستجوی مقالات در پایگاه‌های اطلاعاتی PubMed، ProQuest، CINAHL، Irandoc، SID و موتور جستجوگر Google Scholer با واژگان کلیدی فاصله‌گذاری اجتماعی، فاصله اجتماعی و Social Distancing &amp; Social Distance در محدوده زمانی 2019 تا سال 2022 صورت گرفت. ملاحظات اخلاقی: در پژوهش حاضر جنبه‌های اخلاقی مطالعات مروری مانند اصالت متون، صداقت و امانتداری رعایت شده است. یافته‌ها: نتیجه جستجو 480 مقاله بود كه با توجه به معیارهای پژوهش مورد غربالگری قرار گرفتند و در نهایت 23 مقاله که به طور مکرر برای تعریف یا توصیف پیشایندها، ویژگی‌ها و پیامدهای مفهوم مورد نظر استفاده شده بود، تحلیل شدند. بعد از تجزیه و تحلیل مطالعات، ویژگی‌های ممانعت از انتقال بیماری مسری، توصیه به در خانه‌ماندن و قرنطینه‌شدن، فرهنگ‌مداری و گذشت زمان برای مفهوم فاصله‌گذاری اجتماعی به دست آمد. نتیجه‌گیری: در این مطالعه، تعریفی از فاصله‌گذاری اجتماعی که توسط متون نیز حمایت شده است، به دست آمد. فاصله‌گذاری اجتماعی: یک اقدام محافظتی بهداشتی و پیشگیرانه است که در زمان شیوع بیماری‌های واگیردار با توصیه به رعایت‌کردن فاصله فیزیکی از دیگران، در خانه‌ماندن و قرنطینه‌شدن، باعث ممانعت یا کاهش انتقال بیماری‌های مسری می‌شود. مطالعات آتی می‌توانند از این تعریف، در طراحی مداخلات پیشگیرانه در ارتباط با پیامدهای نامطلوب این مفهوم استفاده نمایند. همچنین این تعریف می‌تواند مبنای آموزش بهتر این پدیده به دانشجویان باشد. از آنجایی که مفاهیمی مانند فاصله‌گذاری اجتماعی همواره با مسائلی نظیر تغییر مناسبات اجتماعی و چالش‌های اخلاقی همراه است، نیاز به تأمل بیشتری در کاربرد این مفهوم با توجه به عدم احترام به استقلال افراد احساس می‌شود