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 (

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 (

Comparing the Pattern of Primary Dysmenorrhea Before and After Childbirth

Background & aim: Dysmenorrhea also known as menstrual cramp or painful period is one of the most prevalent health issues among women. There are contradictory evidence regarding the impact of childbirth on the occurrence of dysmenorrhea. Also, only pain severity has been examined, as one of the clinical features of dysmenorrea in most related literature and the other characteristics of pain including duration, quality, location, as well as the associated symptoms have been overlooked. Therefore, the present study aimed to compare the patterns of primary dysmenorrhea before and after childbirth in primiparous women. Methods: In this cross-sectional study, 124 primiparous women with only one delivery were examined. The multistage sampling method was used to select the subjects who referred to the healthcare centers of Mashhad, Iran in 2010. The research tools included a demographic questionnaire, a form to record menstrual pattern, and verbal multidimensional scoring system for assessment of severity of dysmenorrhea. Data were analyzed by Wilcoxon signed-rank test and Cohen’s kappa coefficient using SPSS. Results: The findings showed statistical significant differences in all pain characteristics before and three cycles after childbirth including pain severity (P

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

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 (

The Relationship between Psychological Hardiness and Coping Strategies during Pregnancy

Background & aim: Although pregnancy seems to be a pleasant experience in a women’s life, the accompanied physical and psychological changes lead to high levels of stress in mothers. Prenatal stress widely affects the physical and mental health of mothers and infants; therefore, adopting appropriate coping strategies are highly required. Considering the importance of coping strategies in psychological hardiness, we aimed to determine the relationship between psychological hardiness and prenatal coping strategies. Methods:This correlational study was conducted on 500 pregnant women, referring to the healthcare centers of Mashhad, Iran in 2014. The study subjects were selected via convenience sampling. Data collection tools included Kobasa Hardiness Scale, the Revised Prenatal Coping Inventory and Perceived Stress Scale. For data analysis, Spearman correlation coefficient and regression analysis were performed, using SPSS version 16. The significance level was considered to be 0.05. Results: Psychological hardiness had a significant positive correlation with planning/ preparation (r=0.70,

The Effect of Intravenous Fentanyl on Pain and Duration of the Active Phase of First Stage Labor

Objectives: Opioids are most widely used for pain relief during childbirth. An alternative opioid, fentanyl, has been shown to be a good option for pain management and has fewer side-effects on both mother and fetus. Therefore, the purpose of this study is to determine the effect of fentanyl on pain as well as the duration of the active phase of labor.Methods: This clinical trial was conducted on 70 multiparous parturients having labor from May to July 2006 at Tamin Ejtemai Hospital. They were selected by convenience sampling at the beginning of the active phase of labor. The samples were then randomly divided into the case and control groups. The case group received fentanyl 50 micrograms in two doses, one hour apart after being diluted (0 and 60 mins). Vital signs were recorded pre-administration and 5, 15, 30, 45, 60 minutes post-administration. Pain intensity was estimated by visual pain scale (0-10) four times (before and 1, 2, 3 hours after the intervention). Data analysis was done using the student t-test, repeated measure ANOVA and chi-square tests via SPSS 11.5 software.Results: The results showed a significant reduction in pain (p=0.002) and HR (p=0.001) in the case group. The mean pain score also decreased from 8±1 to 5±1. There was a significant difference in terms of the duration of the active phase between the two groups (p=0.001). However, there were no significant differences in terms of systolic blood pressure and diastolic blood pressure between the two groups.Conclusion: Fentanyl provides good analgesic effect for pain management during labor by considerably reducing the duration of the active phase, and can therefore be used as an acceptable analgesic agent during labor

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

Comparing the Effects of Training Based on Continuous Care Model and Telehealth on Quality of Sleep in Pregnant Women

Background: Quality of sleep disorder is a common problem during pregnancy. Training based on continuous care model and telehealth has improved the quality of health care and may also ameliorate quality of sleep. Aim: The present study was conducted to compare the effects of training on the quality of sleep in pregnant women on the basis of continuous care model and telehealth. Method: This three-group clinical trial was performed in 2017 on 91 pregnant women visiting health centers in Mashhad, Iran. Orientation, sensitization, control and evaluation were carried out in the continuous care group, and four DVDs were watched by mothers in the telehealth group over the course of four weeks along with eight weeks of follow-up, and the routine care of health centers was administered for the control group. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was completed at the end of weeks 8 and 12 after the start of the study. Data were analyzed in SPSS version 24 using Kruskal-Wallis statistical test. Results: The three groups were homogeneous in terms of demographic variables (

Developing Basic Educational Standards for Evaluation and Accreditation of Master of Sciences Course in Neonatal Intensive Care Nursing: A Report of a Delphi Study

Background & Objective: Despite the importance of local educational standards for the correct implementation and evaluation of higher education programs, studies show such standards do not exist for the master’s degree in neonatal intensive care nursing. Therefore, the purpose of the present study was to develop basic educational standards for program evaluation and accreditation of the master of sciences course in neonatal intensive care nursing. Methods: This study was a descriptive survey conducted using the Delphi survey method in 2014. A total of 20 experts, including infants and medical education specialists, administrators of the department of education, faculty members of the department of pediatrics, nursing administrators of neonatal intensive care units, and students and graduates of the neonatal intensive care nursing course were selected through purposive sampling. First, items related to basic educational standards were extracted through an extensive review of databases. Subsequently, 3 sessions in 2 rounds were held with the experts and basic educational standards for the evaluation of the master of sciences course in neonatal intensive care nursing were developed on the basis of consensus. Results: This study led to the proposal of 20 items as basic educational standards for the evaluation of the master of sciences course in neonatal intensive care nursing. In the first round, 25 items, of the total 41 items, were agreed upon by experts. Statistical results showed the content validity index in clear expression, importance, and availability in the second round was 0.94, 0.92, 0.87, respectively. Conclusion: Considering that the checklist of basic educational standards was developed by experts, it is hoped it will gain high acceptability and be an efficient model for the evaluation of the master’s program in neonatal intensive care nursing. ------------------------------------------------------------------------