Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research

<b>Background</b> Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.<p></p> <b>Methods and findings</b> The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.<p></p> <b>Conclusions</b> Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems

Coping Styles of Stroke Survivors based on Patients’ Demographic Features

Abstract: Background & Aims: stroke is a stressful event associated with numerous physical, psychological, social and economical problems that can complicate the balance of different life aspects, but after a period of time, patients try to benefit from different coping styles to reduce their problems and retain to a normal life. The aims of this study were to investigate coping strategies used by stroke survivors, and to identify their distribution based on demographic factors. Methods: In this cross-sectional descriptive study, all stroke patients in Kerman city were considered as study population. Finally, ninety-five patients were selected by convenience sampling method and based on the study inclusion criteria. Data were gathered by demographic questionnaire and Folkman & Lazarus Coping Questionnaire. The severity of symptoms was measured by National Institutes of Health Stroke Scale (NIHSS). Data analysis was performed by using descriptive and referential statistics (t-test, ANOVA) and through SPSS 16 software package. Results: Maximal means were achieved for seeking social support and planned problem solving, while minimal means were achieved for escape-avoidance and self controlling. There were significant relationships between coping styles and some demographic features such as age, level of education and severity and duration of the disease (P<0.05). Gender did not have a role on use of coping styles. Conclusion: According, to the results of this study, stroke survivors use problem-focused coping strategies more than emotion- focused coping strategies. The results of this study in regard to the relationship of age and educational level with the adopted coping style and using emotion-focused coping strategies by patients with more severe disease should be considered in the patients; treatment planning and process. Keywords: Stroke, Psychological adaptation, Demograph

Time-aware VM-placement and routing with bandwidth guarantees in green cloud data centers

10.1109/CloudCom.2013.36Proceedings of the International Conference on Cloud Computing Technology and Science, CloudCom1212-21

Resilience of Patients With Chronic Physical Diseases: A Systematic Review and Meta-Analysis

Context: Resilience can be seen as an adaption to stress, such as that caused by health problems or disease, that attenuates the negative effects of stress. The present research performed a systematic review and meta-analysis to study resilience scores among adults diagnosed with chronic physical diseases. Evidence Acquisition: Electronic databases, including Persian language (scientific information database SID, IranMedex, Magiran, IranDoc, and Medlib) and English language (Google Scholar, Science Direct, PubMed, Pre-Quest, and Scopus), were searched. Fifteen articles were found using the keywords disease or chronic disease, resilience or resiliency, and illness, either alone or in combination, both in Persian and English languages. Data analysis was carried out through meta-analysis (random-effects model), and heterogeneity was investigated by subgroup and meta-regression analyses. The data were analyzed in STAT software (12.0). Results: The mean resilience score of the chronic disease patients (n = 3369) was 74.6 (95% CI: 51.8-97.4). In terms of diseases, the mean resilience score of cancer patients was 79.6 (95% CI: 48.3-111.1), whereas it was 79.6 for cardiovascular disease patients (95% CI: 45.8-113.3) and 64.6 for patients with other diseases (95% CI: 6.6-122.7). There was no relationship between the resilience of chronic disease patients and the year of the study (P = 0.711) and the sample size in the studies (P = 0.351). Conclusions: The mean resilience score of the patients was less than that of healthy individuals. As resilience can be acquired at any stage of life, irrespective of age and disease status, there is a need for training to improve resilience among patients through educational programs

The Relationship between family's lifestyle with sleep habits and BMI among children 6 to 11 years old in Qazvin city (2014)

Background: The family's lifestyle is a valuable factor for improving the quality of life and it has an impact on childrens' habits. Objective: The aim of this study is to evaluate the relationship between family's lifestyle and sleep habits and body mass index in children. Methods: This descriptive-analytical study was conducted in 2014 in primary school children of Qazvin (6-11 years old children) and those children were randomly selected. The data was collected by using standard questionnaires and children's sleep status. Findings: The total score for the studied lifestyles in families, physical and nutrition was moderate, the lowest and the highest respectively. Maximum average of sleep problems in children were related to the sleep behavior. The body mass index of children was moderate. There was a statistically significant relation between family's responsibility, diet, spiritual improvement and total score of the studied lifestyles with children waking up time (P0.05). Conclusion: According to a normal BMI and the presence of children in this study correlated variables lifestyle and sleep habits, improving sleep habits and lifestyle can be concluded as a strategy to prevent abnormal body mass index in children considered

Underreporting of needlestick injuries among healthcare providers in iran: A systematic review and meta-analysis

Background & Aim: Needlestick injuries (NSIs) are a serious occupational hazard for health care providers and nurses that are often not reported for various reasons. Several studies have reported a different rate of this great challenge. The aim of this systematic review and meta-analysis was to estimate the prevalence of under-reporting of NSIs in healthcare providers in Iran. Methods & Materials: By searching national and international databases including SID, Magiran, Google Scholar, IranMedex, Science Direct, PubMed and Scopus, 19 published articles were extracted. Data analysis was carried out through the random-effects model, and heterogeneity was investigated by I2 index. The data were analyzed using the Stata software version 12.0. Results: The rate of non-reporting of NSIs in 19 relevant articles in Iran with the sample size of 9274 was 59 (95 CI: 49-69). The rate of under-reporting of NSIs in the healthcare providers (64) was higher than in nurses (55). Based on the meta-regression results, there was no significant relationship between the prevalence of underreporting of NSIs and the year of publication (P=0.138), sample size (P=0.390) and age (P=0.918). Conclusion: The results of the study showed that more than half of health care providers did not report NSIs. Notifying health care providers about the risks of NSIs and properly dealing with the injured cases is necessary in order to increase the reporting of NSIs. © 2017, Tehran University of Medical Sciences (TUMS). All rights reserved

The Relationship Between Mental Health and Resilience: A Systematic Review and Meta-Analysis

Context: Considering the stressful conditions of life and social difficulties, an important question is why are some people can show positive adaptation and avoid mental health disorders, while others cannot? The present study aimed at reviewing the national studies on the correlation between resilience and mental health. Evidence Acquisition: In this systematic review, all national articles published in international and national databases were searched without restrictions, using the following keywords: "Resilience OR Resiliency" AND "Mental health" OR "General Health" and their combinations. The Persian equivalents of these words were also used in Persian language sites. Finally, based on PRISMA guidelines, 15 studies were selected. The results of these studies were combined using the random effects model of meta-analysis. Results: In the present research, 16 correlation studies were examined without time limits, and with a sample size of 3157. Overall, a positive correlation was found between resilience and mental health in the national studies (r = 0.48). The results showed that the correlation between resilience and mental health was lower in the population of school and university students than among other populations (r = 0.39, compared to r = 0.54). The analysis based on geographical division indicated that the highest correlation between resilience and mental health existed in the fifth area (r = 0.83), and the lowest correlation was found in the fourth area (r = 0.35). Conclusions: By providing cognitive, behavioral and emotional responses in stressful situations, resilience can maintain and improve mental health