Pain experience in hemophilia patients: a hermeneutic phenomenological study

Background: pain, as a crucial subsequence of joint hemorrhages in hemophilia patients, is chronic, debilitating, and distracting. This study aimed to describe and interpret pain experiences of hemophilia patients in their lives

Methods: this qualitative study with hermeneutic phenomenological approach was conducted on fourteen hemophilia patients who had been referred to a hemophilia center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The study question was "what is the meaning of pain in hemophilia patients' lives? The data were collected through semi-structured interviews and field notes through purposeful sampling. Then, thematic analysis with van Manen's six-step methodological framework was used. MAX.QDA qualitative software package, 2010, was used to analyze the data

Results: the three main themes that emerged in this study were "alteration in physical health", "engagement in psychological problems", and "impairment in social relationships". Alteration in physical health consisted of three subthemes, namely "impairment of physical function", "change in body physics", and "disturbance in sleep quality". In addition, two subthemes including "nostalgia of pain in adults with hemophilia" and "psychological distress" emerged from engagement in psychological problems. Finally, "loss of social activity" and "change in relationships" were related to impairment in social relationships

Conclusion: the present study highlighted alteration in physical health, engagement in psychological problems, and impairment in social relationship as a result of pain in hemophilia patients. Thus, healthcare providers and family members have to pay special attention to these problems. Besides, providing complementary therapy interventions is suggested for reducing these issues

Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial

Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention [n=30] and control groups [n=30] through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3 +/- 1129.74 and 6366.7 +/- 922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months [t=-3.05, P=0.03]. Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting, producing "Agha" sound, and taking objects by hand [P<0.05] during six months of age. The results showed that the home visit program was effective in preterm infants' weight gain and some development indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health

quality of life of children with hemophilia in Shiraz, Iran

Hemophilia might impact the quality of life [QOL] in children and adolescent. This study aimed to assess the quality of life in children with hemophilia and identify the factors that predict their QOL. It was a cross-sectional study. A consensus sample of twenty-seven male children aged 8-16 years old with hemophilia participated in this study during 2011. The Haemo-QoL questionnaire version age group II [8-12 years old] or age group III [13-16 years] was used to measure the quality of life in children with hemophilia. Data were analyzed in SPSS using Spearman's rho, Pearson correlation coefficients, and multiple regression analysis. The total mean score on the Haemo-QoL was 54.1 +/- 7.3. Haemo-QoL correlated with the number of bleeding event and school absence, family income, mothers' education level, severity of hemophilia, person who performs his/her infusions, insight to health status and insight to suffering from hemophilia [P0.05]. QOL was predicated by family income [fiN-0.69; explained 73% of variance] and infusion of the clotting factor replacement by parents [P=-0.33; explained 81% of variance]. The QOL of a sample of male children with hemophilia was impaired. Moreover, number of bleeding event, number of school absences, mother s' education level, severity of hemophilia, insight to health status and insight to suffering from hemophilia were associated with Haemo- QOL. In addition, family income and parent- administration of the product were the factors which predict the QOL in children with hemophilia