Factors Associated with Self-Management in Adolescents with Type 1 Diabetes

AbstractIntroduction: Diabetes is one of the most common chronic diseases that is also highlyprevalent among adolescents. The present study was conducted to determine therelationship between demographic characteristics and self-management in adolescentswith type 1 diabetes.Methods: This descriptive-analytical study was conducted on 426 adolescents withtype 1 diabetes aged 13 to 18, and diagnosed for at least one year. The research toolsincluded a demographic information form covering the patients’ personal, family,and health details, and the Self-Management of type 1 Diabetes in Adolescence(SMOD-A) with five subscales of collaboration with parents, diabetes care activities,diabetes problem-solving, diabetes communication, and diabetes goals. The contentvalidity of the measure was then evaluated by a group of experts and found to beacceptable (SCVI = 98%). In the assessment of the measure›s reliability, the intraclasscorrelation showed an overall Cronbach’s alpha of 0.88. The test-retest showed aconsistency of 0.73 for the measure.Results: The results obtained showed that the presence of another diabetic memberin the family leads to higher levels of self-management in some dimensions, includingproblem-solving, communication, and goals, yet to lower levels in some others,including collaboration with parents and diabetes care activities. A direct relationshipwas observed between the duration of time since the diagnosis and the scores obtainedby the adolescents. An inverse relationship was observed between the type of physicianin charge and the scores obtained in the subscales of collaboration with parents,problem-solving, communication, and goals. The scores obtained were directly relatedto having a school health record and having access to diabetic care tools at school.Family income was found to be directly related to diabetes care activities and inverselyto problem-solving, communication and goals. P of ≤ 0.05 was considered significantfor all relationships.Conclusions: Self-management was found to be moderate to good among Iranianadolescents with type 1 diabetes; however, it could be further improved with thesupport of both families and medical teams involved

Barriers to Support for Parents of Children with Cerebral Palsy: A Qualitative Study

Introduction: Parents who have children with cerebral palsy are exposed to the complicated care procedures of the afflicted child. Thus, they need support in order to decrease problems in this respect. However, their needs are not sufficiently met. Therefore, this study was conducted to explore barriers to support for parents of children with cerebral palsy. Method: This qualitative study was conducted in 2011-2012 using content analysis. Purposeful sampling was used to select the participants and continued until data saturation was reached. As a result, 31 participants from among parents of children with cerebral palsy referred to the rehabilitation centers in Tehran, Iran, and experts were sel categories of organizational barriers (poor institutional coordination and communication, and lack of supportive laws with administrative support), professional barriers (poor teamwork, and lack of professional competency), and family barriers. Conclusion: Through understanding parents' needs and complementing supportive laws for parents with afflicted children, coordination among supportive organizations, and planning for comprehensive care along with supportive services packages, policy makers and health services managers can help eliminate parents' problems with regard to caring for their children with cerebral palsy. Keywords: Parents, Cerebral palsy in children, Support, Barriers, Qualitative study

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

Challenges nurses experienced in caring for patients with COVID-19 admitted to the Intensive Care Units: A Qualitative Study

Background: Nurses working in intensive care units (ICU) have experienced numerous challenges while caring for patients with COVID-19.Objectives: The aim of this study was to explore ICU nurses’ experiences of caring for patients with COVID-19.Methods: This research presents part of a qualitative study conducted using a grounded theory approach. Participants consisted of nurses and physicians from the selected hospitals in Sabzevar, Neishabour, and Mashhad, Iran. Data collection was performed using semi-structured in-depth interviews. Participants were enrolled via purposive sampling during 2022–2023. A total of 21 participants were interviewed. The method of Corbin and Strauss (2015) was used to analyze the data. We used Guba and Lincoln’s four criteria of credibility, dependability, transferability, and confirmability to ensure data trustworthiness.Results: Four main categories emerged from the data that collectively reflect the experiences of Iranian ICU nurses in caring for COVID-19 patients. These categories included ward overcrowding, changing patterns, complexity of care, and feeling exhausted. All of these categories show that Iranian ICU nurses were under intense pressure during the COVID-19 pandemic.Conclusion: This study showed that taking care of patients was very exhausting for nurses during the COVID-19 pandemic. Hospital authorities and nursing administrators have a responsibility to support nurses and provide them facilities to feel less stress and uncertainty, while caring for patients with COVID-19

Respecting the privacy of hospitalized patients:an integrative review

Background: Privacy is a complicated and obscure concept, which has special meanings in the healthcare environment; therefore, it is essential for healthcare providers to fully understand this concept. However, there is no universally accepted definition for this concept in the texts, and it has been interpreted differently, based on its application. Aim: To analyze and provide a clear and scientific definition for respect of privacy of hospitalized patients and identify the common aspects of this concept. Research design: This study was conducted using the Whittemore and Knafl’s modified framework as a conceptual analysis method. Ethical consideration: This study was approved by the Research Council of the University of Social Welfare and Rehabilitation Sciences. We have respected the ethical requirements required regarding the sources and authorship. Research context and data sources: Using integrative review, a search was performed using national and international databases, including CINAHL, Scopus, Medline, Web of Science, and ISI (with no date restriction). The keywords employed during the search process were “privacy of patients,” “confidentiality,” “and patients’ rights.” In total, 1345 articles were retrieved from the databases. After the elimination of repetitive studies and with regard to the study objectives, 124 articles, 3 books, and 4 theses were entered into the study. The data were analyzed using the conventional content analysis approach. Findings: The results were extracted in the form of four, seven, and two themes related to attributes such as physical, informational, social, and psychological and the antecedents and consequences of respecting patient privacy, respectively. Conclusion: Respect for hospitalized patient privacy contains multiple dimensions. Factors affecting the achievement of this concept include individual backgrounds, nature of the disease, and rule of paternalism. The fulfillment of patient privacy leads to such consequences as protection and improvement of human dignity as well as improved communication between the patient and the health team. </jats:sec

Leisure Activities and Mental Health among Aging People in Tehran, Iran

Introduction: Leisure activities are common among the elderly, however the effect of such activities on their mental health is poorly defined and not underpinned by strong evidence. This study aims to determine the prevalence of leisure activities and its relation to mental health in the elderly. Methods: A cross- sectional study was conducted and 400 community dwelling older adults 60 years and more with appropriate cognitive function (Abbreviated Mental Test score 7 and more), were recruited through multi-stage stratified cluster sampling in Tehran, Iran . Data was gathered by demographic questionnaire and General Health Questionnaire (GHQ). The primary outcomes to measure were the prevalence of leisure activities, and GHQ score in subgroups. Data were analyzed by Kolmogorov-Smirnov test, ANOVA, independent t-test and multiple linear regressions. Results: Of participants 62% were in their 7th decade (60-74 years), 56% (224) were female with mean age of 66.98±8.22 , and 44% (176) male with mean age of 66.98±8.22. GHQ scores showed 65% of participants had good mental health (0-23) and 35% had mental health problems(24 and more).Mean of GHQ score in participants (n=377) was 21.8± 11.37 (0-28). watching TV(77%), reading books( 40.3%), walking (31.5%) and taking trip(36%) were more interesting leisure activities among older adults .Women, single, unemployed, alone and illiterate older adults had statistically significant(P&le0.05) upper  GHQ scores. Participating in active leisure activities such as taking trip and cultural classes, participating in NGO activities, going to parks and gym and walking had significant relationships with good mental health (P&le0.05).  Conclusion: Encouraging older adults to participation in active leisure activities would be an effective intervention in mental health improvement. On the other hand understanding of relationship between type of leisure activities and mental health, provides evidence for policy makers and health care planners to offer and facilitate a context in which older adults can improve participation  in active leisure activities

A Critical Review of Studies on Health Needs Assessment of Elderly in the World

Introduction: Health improvement, control of communicable diseases and increase in life expectancy among the elderly of developed and developing countries has greatly increased. Since the health care and social needs of older adults differ from that of other adults, it is necessary to identify the needs of the elderly in order to make proper plans that will promote their health. The aim of this paper is to critically review these researches. Methods: A comprehensive literature review on the needs assessment of elderly health was applied searching English and Persian databases in Pub Med, Science Direct, ProQuest, Elsevier, Magiran, ISC and using key words including, Health need, Assessment, Elderly, Aging, Older adults, Aged and Health care needs. Results: Initial search yielded 745 references, considering the inclusion criteria, 21 papers were reviewed. Results revealed that in conducting needs assessment, various methods and procedures in various health dimensions including physical health, mental health, emotional, care, social, cultural, economic, nutritional, service, security, legal and educational needs have been utilized. Some of the dimensions had been more explored and some rarely. Conclusion: Most of the conducted studies had mainly focused on the elderly physical health needs and had neglected to take in to account other needs such as social and health care needs. In order to comprehensively recognize the health needs of the elderly, identifying their health care and care services is also important. Furthermore, in addition to quantitative studies, discovering the older adults&rsquo; perceptions of their own health needs is also necessary. It seems that the challenge ahead of managers, experts and researchers on elderly health is trying to design comprehensive mechanisms of health need assessment and considering it as a reference for any future planning

Eeffect of “Tai Chi Chuan” on Anxiety among elderly women

Background & Aim: Anxiety is a common psychological disorder among the elderly, which could deteriorate social and cognitive functions and lead to disabilities and low quality of life in this population. Physical exercise is an important, inexpensive therapeutic approach to improving geriatric psychological disorders. The present study aimed to investigate the effects of tai chi chuan on the level of anxiety in elderly women. Materials & Methods: This clinical trial was conducted with a pretest-posttest design on 60 elderly women in the intervention and control groups in 2014. The subjects were the retired members of Tehran Petroleum Industry. The subjects were selected via stratified random sampling and allocated to two groups of intervention (n=29) and control (n=31). The intervention involved 24 sessions of tai chi chuan exercises for eight weeks (three times per week). Data were collected using demographic questionnaires and Spielberger&rsquo; state-trait anxiety inventory (STAI). Results: Mean score of anxiety before the intervention was 41.79 in the intervention group and 39.54 in the control group, which indicated no significant difference (P=0.368). After the intervention, the mean score of anxiety in the intervention and control groups was 29.41 and 39.38, respectively. According to the results of ANCOVA, the intervention could significantly reduce anxiety in elderly women (P=0.001). Conclusion: According to the results, tai chi chuan exercises could decrease the level of anxiety in elderly women. Therefore, the implementation of this safe and economical method seems essential to enhancing the psychological health of the elderly