Comparison of quality of life between hemophilic children receiving prophylaxis and on demand therapy in Tehran

Improving quality of life in a chronic disease such as hemophilia is a major goal of treatment. Hemophilic patients can be treated either prophylactically or on demand. Since haemophilia quality of life may be affected by the disease and treatment outcomes, comparison of these regimens in respect to quality of life outcomes provides useful information. The purpose of this study is to compare the quality of life between hemophilic children receiving prophylactic and on demand therapy in Tehran, Iran. A descriptive -comparative design was used. The sample of the study consisted of 60 hemophilic children which were recruited from haemophilia treatment centres in Tehran. Of these children 30 were receiving prophylactic therapy and 30 of them were treated on-demand .Data was collected by haemophilia-specific QoL questionnaire [HAEMO-QoL]. The questionnaire consists of 8 dimensions: physical health, feeling, view of yourself, family, friends, others, sport and dealing with haemophilia.The questionnaire consists of 18 items using a5-point scale.The Higher scores represent a poorer quality of life and lower scores represent better quality of life. Data were analyzed by SPSS 15 statistical software. The mean age of children was 5.3 +/- 1.2 and 6 +/- 1 in prophylactic and on demand therapy respectively. The mean total score of quality of life was 40 +/- 9.8 and 58 +/- 10.9 for children in prophylactic therapy and on-demand treatment respectively. There was a significant difference between the quality of life scores in two groups. Analysis of subscale scores showed a lower quality of life score for family domain in prophylactic therapy group, while the scores for family and physical health subscsles in on-demand group showed a poor quality of life. Results of the study suggest that quality-of-life may be better for haemophilia children treated prophylactically

Violence toward nurses at emergency rooms [ERs] of hospitals of Medical Universities in Tehran

ER nurses are at risk of violence due to the nature of their job and confrontation with a variety of patients as well as heavy workload. This can, in turn, leads to decreased quality of care. This descriptive study was conducted to identify prevalence and causes of violence toward nurses at ERs of hospitals affiliated with Medical Universities in Tehran. 100 nurses with at least 1 year continuous experience at ER were included in the study. Data were collected by a questionnaire. The questionnaire contained items including demographics, frequency and characteristics of violence at work [physical, verbal, nonverbal] and the factors involved. Content and test-retest as well as internal consistency [Cronbach's a] methods were used for Validity and reliability of the questionnaire respectively. Data were analyzed by version 16 of SPSS package. The most frequent type of violence was verbal [87%]. The frequencies of nonverbal and physical violence were 70% and 28% respectively. The most common type of verbal violence was yelling [84%] and, in physical violence, it was throwing objects [33%]. In nonverbal violence, insulting and threatening look [64%] and hitting on the table were very common. Verbal [48.2%] and nonverbal [65.8%] violence was committed mostly over the past month of the study and at nights. The subjects [38%] experienced verbal violence up to 5 times. The most frequent cause of violence [77%] was the lack of control over entrance of patients' relatives, chi test showed a significant relationship between physical violence and night shifts [P<0.001] and between female sex of nurses and physical violence [P<0.005]. ER nurses usually face with violence in a week and the most frequent types are verbal, nonverbal and physical, leading to decreased speed in delivering efficient care to patients and decreased quality of health care resulted from it

[Incidence of intradialytic complications and their risk factors in patients undergoing hemodialysis in hospitals affiliated to medical university of Hamadan Iran]

Hemodialysis is one the most common renal replacement therapies in end stage renal disease. Despite progress in dialysis technology, intradialytic complications occur frequently. The aim of this study was to determine the rate of intradialytic complications and their risk factors in patients undergoing hemodialysis in hospitals affiliated to Medical University of Hamedan Iran in 2009. 192 patients undergoing hemodialysis participated in this descriptive correlational study. These patients were included in the study using census method. Data were collected by1- a questionnaire which consisted of 3 sections [demographic information, person - related factors and therapy- related factors], 2-a check list and clinical examination [blood pressure and weight measurement]. Content validity of the questionnaire was assessed by 10 nursing experts, 5 staff of hemodialysis wards and 2 nephrologists. Reliability of check list was measured using inter-rater reliability [r=0.98]. Data were collected by the second author. Data were analyzed by SPSS 15. Findings showed that the most frequent complications include: hypotension [%15.1], muscle cramp[%11.5], nausea[%9.4], headache[%7.8], angina[%2.6], vomiting [%2.1] and itching[%1.6] respectively. Logistic regression analysis, showed a significant correlation between age and cramp [person - related causes] and a significant correlation between hypotension, cramp with vomiting and headache. Moreover, findings showed a significant correlation between nausea with eating during dialysis [patient- related causes]; and between hypotension with dialysis solution [therapy- related causes]. Based on the results of this study, most of intradialytic complications can be prevented. Use of these findings can improve the process of dialysis

[Focus group, a data gathering method]

Using focus group to collect data is a valuable method for qualitative researchers. This method is being used increasingly in nursing research. It can provide rich information about a special topic through group dynamics. This article aims to provide a comprehensive review on characteristics of and implementing focus group as a data collection method. A focus group is a semi-structured group session which is moderated by a group leader and held in an informal setting to collect information about a designated topic. The main characteristic of a focus group is the presentation of information and knowledge through interaction between the moderator and the group, as well as group members. Open-ended questions result in extended, in-depth and rich information. Also, participants' non-verbal responses can complete their verbal responses. Focus groups are used to study several qualitative subjects in the fields of politics, consumers' satisfaction, health subjects, quality of care evaluation, designing instruments and so on. Main components of a focus group include skilled moderator, proper participants, appropriate place and time, and correct implementation of the process. The moderator is responsible not only for guiding the participants through the discussion, but also for looking after the group dynamics to ensure that all participants dominate the discussion. Ideally, two people will be needed to conduct each focus group, one as the moderator and the other as note-taker. Using a discussion guide can help in effective data collection and the researcher can also use probing questions to reach in-depth information. Selecting proper participants is necessary, and sampling is usually purposive in which individuals with common experience about the phenomena under investigation, are selected. Time and the place of performing a group discussion must be proportionate to the subject and participants' condition. Tape recording and verbatim transcription along with field notes are usual methods of documenting data in focus groups. Focus group is a carefully planned series of discussions, designed to obtain perceptions on a defined area of interest in a permissive, non-threatening environment. A well-organized and guided group discussion results in rich and in-depth information about the phenomena at interest. However, this method has its own strengths and weaknesses which must be considered

[Sleep disturbances and sleep hygiene in hemodialysis patients at hospitals affiliated to Shaheed Beheshti medical university]

Sleep is one of the most important needs of a person. In addition to restoring physical and mental well-being, it decreases stress and anxiety and improves the ability of coping and concentrating on activities of daily living. Sleep disturbances are very common in hemodialysis patients and can be observed in more than %50 of them, which can be reduced by applying hygienic recommendations as well as decreasing disturbing factors. The aim of this descriptive study was to assess sleep disturbances and hygiene in hemodialysis patients at hospitals affiliated to Shaheed Beheshti Medical University. 171 hemodialysis patients were randomly selected. Data were collected by interview via a questionnaire in the form of Likert scale with three parts including demographic and affective variables, sleep problems, and sleep hygiene. Content validity was used to validate it and its reliability was achieved by test-retest method. Results showed that 34.5, 57.9, and 7.6 percent of the patients had low, moderate and high sleep disturbances respectively. Sleeping disturbances included delayed sleeping [%42.1], frequent awakening [%63.2], early rising [%17.6], excessive sleepiness [%25.1] and restless legs [%22.3]. Only %6.4 of patients had proper sleep hygiene. %72.5 and %21.1 of the subjects had moderate and weak sleep hygiene respectively. There was a significant correlation between sleep disturbances and sleep hygiene [p<0.01]. Moreover, the patients reported such problems as bone pain, dyspnea, cramp, pruritus, coughing, and dry mouth with a significant correlation with sleep disturbances. Sleep disturbances significantly correlated with sleep hygiene. In other words, those who don't observe sleep hygiene, take sleeping drugs, or suffer from bone pain, dyspnea, cramp, pruritus, coughing, and dry mouth reported more sleep disturbances. Nurses can apply the above to assess, diagnose, prevent and control sleep disturbances and their side effects