[Comparison of quality of life in adolescences with thalassemia and their families]

Introduction: The impact of thalassemia major and thalassemia intermedia and their associated complications on quality of life is largely unknown. Determining the degree of health impairment as perceived by the patient is essential information needed to recommend suitable therapy. The impact of thalassemia and its complications on the quality of life of these patients and families perspective has been little studied. The aim of this study was to Comparison of quality of life in adolescence with thalassemia and their families

Method: In this descriptive-analytical study, the quality of life of 90 adolescences upper than 18 years with thalassemia who returned to Shafa hospital of Ahwaz in 2007-2008 was studied using a demographic and quality of life questionnaire [SF36]. The participants were chosen based on a non-randomized sampling. The data was analyzed using descriptive analysis and t-test

Results: The mean quality of life in patients was 70.25 +/- 17.17 and in their parents was 67.44 +/- 16.59. Significant difference has shown between social activities of two groups [P<0.012]. There was no difference between other points of views

Conclusion: Presented data suggest that thalassemia patients and family members in social functioning, which were most affected, will be the special focus in the interventions

[Examination with two types of semmes Weinstein monofilaments as screening tools for diabetic peripheral neuropathy]

Diabetic neuropathy is one of the more common complications plaguing individuals with type 2 diabetes. The development and progression of such complications are responsible for much of the morbidity and mortality related to this disease. This investigation evaluated accuracy of lily and Semmes-Weinstein monofilaments examination for diabetic peripheral neuropathy screening. Our study population consisted of 150 patients treated for diabetes mellitus at the Diabetes Clinic of the Ahvaz Jundishapur University of Medical Sciences. The samples were chosen on the basis of a non-randomized sampling. All patients were tested for sensory neuropathy using two types of monofilament [Semmes Weinstein monofilament examination 8, and 10-grams]. In the next phase EMG-NCV were examined. Sensitivity and specificity two types of monofilaments were analyzed. The 10-g monofilaments had a sensitivity ranging from 38.5% to 51.3% at sites 1-4, and specificity between 73 to 87.4 the sensitivity and specificity of the 8-g monofilament were 41 to 51.3% and 72.1 to 86.5% respectively. Two types of monofilaments at with 51.3 and 74.8% sensitivity and specificity respectively sites 1 and 4 was the most useful diagnostic test for DPN. These data suggest that the monofilaments may be the optimum methodology for identifying individuals at risk of diabetic peripheral neuropathy. Hence, we recommend screening of patients for neuropathy as soon as they are diagnosed with diabetes

[Assessing barriers of Nurse-patient's effective communication in educational hospitals of Ahwaz]

Establishing an effective communication with patients is an essential aspect of nursing care. However, most of studies described the nurse-patient relationship as weak. Recognition of barriers in nurse-patient's effective communication from their point of view could facilitate the actions need to be taken for removing such barriers. The study aimed at assessing barriers of nurse-patient's effective communication from nurses and patients' viewpoints and to compare them. This descriptive - analytic study was undertaken in 2008, with a sample of 80 nurses and 80 patients drawn from three educational hospitals in Ahvaz city. They were selected by convenience sampling. Data were gathered through a questionnaire with 30 questions for nurses and 15 questions for patients on a 5-points Likert rating scale. It was found that [nursing works overload] [77.5%], [hardship of nursing tasks][73.75%], [deficiency of welfare facilities for nurses][67.5%], [physical and emotional fatigue] [66.25%] and [not appreciating nurses] [62.5%] were reported by nurses as the main barriers of effective communication. Patients considered [nurses' unfamiliarity with local language] [40%] [Nurses' bad temper] [33.75%], [sex difference with nurses] [32.5%], [Patients' transmitted diseases] [28.75%] and [lack of therapeutic and welfare facilities for patients] [25%] main barriers of effective communication. The study revealed there are some congruency and discrepancy between nurse's and patient's viewpoints in ranking barriers. Thus health manager should put their attempts on eliminating or modifying the most important barriers announced by nurses and patients, especially on factors which both groups reported

[Effect of Orem self care model on elderies' quality of life in health care centers of Masjed solaiman in 2007-2008]

The most important determinant factor in elder's quality of life is healthy. Since health can be declined by aging, in health promotion consider an effective model of care can by very important. We surveyed the effect of Orem Self Care Model on quality of life [QQL] of elderly in Masjed Solaiman. This is a pre and post quasi-experimental study was carried out on 349 elderly clients which were selected from 11 health care centers in Masjed Solaiman in 2007-2008. Orem Self Care program was performed during a 3 months in days that the clients came to health care centers. Data were gathered by a short form questionnaire [SF 36] before and after the intervention and was analyzed by descriptive statistics and paired t-test. Results showed a significant increase in mean scores of different dominations of QOL including; health, physical performance, physical role- performance, emotional role- performance, social performance, body pain, power and energy, general health perception, and overall mean of QOL. Paired t-test showed a significant difference [P<0.001] between all of dominations of the quality of life. Performing Orem Self Care educational program had a positive influence on improving QOL of elderly

[Correlation of quality of sleep or quality of life and some of blood factors in hemodialysis patients]

Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis [HD]. However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life of patients on dialysis is not known in Iran. Therefore, this study was aimed to investigate correlation between quality of sleep and quality of life [HRQoL] and some of blood factors in hemodialysis patients. This descriptive and analytical study was accomplished on 85 of hemodialysis patients in 1383-84. The samples were chosen on the basis of a non-randomized sampling selected from the educational hospitals of Iran and Tehran medical science universities. Quality of sleep was measured using the Pittsburgh Sleep Quality Index [PSQI] and HRQoL was measured using the Medical Outcomes Study 36-item Short Form [SF-36]. Data were analyzed using X[2], two-tailed Fisher's exact, Mann-Whitney, and Spearman correlation coefficient tests. Sixty-three [71%] of the patients were 'poor sleepers' [global PSQI>5]. The SF-36 mental component summary [MCS] and physical component summary [PCS] correlated inversely with the global PSQI score [P<0.05]. The PCS score also correlated with age [P<0.05], hemoglobin [P<0.05]. Global PSQI score correlated inversely with hemoglobin, serum albumin, mental component summary [MCS] and physical component summary [PCS] [P<0.05]. Subjects with global PSQI>5 had a lower hemoglobin and lower HRQoL in all SF-36 domains [P<0.05]. Poor sleep is one of the common problems in these patients and causes low HRQoL. Low level of hemoglobin and albumin result in decreasing of quality of life and quality of sleep. Regulation of hemoglobin, albumin, and other blood factors in patients can lead to better sleep and thus increasing of quality of life in them

effect of dietary regimen education on the laboratory variables and interdialytic weight gain in hemodialytic patients

Nutrition is an important factor in patients with chronic kidney disease. An inadequate nutritional regimen decreases the life quality and leads to high mortality and morbidilty in these patients. Therefore, this study was performed to determine the effect of dietary regimen education on the laboratory variables and interdialytic weight gain in hemodialytic patients. This quasi-experimental study was carried out on a group of 32 hemodialytic patients [pretest-posttest] in the educational hospitals of Iran and Tehran medical science universities in 2003-2004. The patients were assessed by a questionnaire about their educational needs before starting dialysis. The laboratory variables were analyzed by two-month average before the education and interdialytic weight gain was measured at four stages with a time interval of two weeks. Then, an educational program on the basis of Orem theory, existing problems, characteristics of the patients and the required education was presented in four sessions, [each session lasted 20 minutes]. At the end of the educational period, the laboratory variables [average two months] and interdialytic weight gain were studied at four stages with a time interval of two weeks [third and fifth weeks]. Data was analyzed, using t test. The findings showed that there were significant decreases in serum levels of urea [p<0.001], uric acid [p<0.01], phosphorous [p<0.01] and K [p<0.005]. Interdialytic weight gain, between two sessions of hemodialysis, was also decreased [p<0.001]. However, there were no statistically significant differences in serum levels of Na, Ca, Cr and albumin. Performing of the educational program for nutrition may have positive influence on decreasing the problems of hemodialytic patients

[ comparative study on the effect of two methods of self-care education [direct and indirect] on quality of life and physical problems of hemodialysis patients]

The main goal of treatment and care of chronic patients including those suffering from end stage chronic renal failure is to promote their health and their quality of life [QOL]. Various researches have shown that health level, performance status and QOL, especially for hemodialysis patients are often less than expected. So, an attempt to find effective and cost benefit education methods in this area seems to be necessary. This study is done to compare the effects of two educational methods of direct and indirect [multimedia educational package] self-care program on QOL and physical problems of hemodialysis patients. This quasi experimental research was carried out on two groups of hemodialysis patients. Sixty three patients were selected from three main dialysis centers in Tehran and allocated randomly into two groups [group one 32 and group two 31 patients]. The first group used the direct educational program and the second group used the indirect educational package [multimedia]. Patients were assessed before education using QOL questionnaire [short form SF-36], need assessment questionnaire and checklists. After determining educational needs and status of the patients, a self care educational program was designed based on self care model and the principles of patients education and also through counseling with nephrologists and nutritionists. The educational program was implemented directly on group one [direct education]. Also it was recorded and indirectly used for the second group as a multimedia educational package once a week within one month during dialysis. After implementation of the self care educational program, both groups were assessed and measured again by same questionnaires and checklists. Data was analysed using student T, Wilcoxon and Mc Nemar tests. Findings showed that most of studied variable including laboratory tests, blood pressure, weight gain between two dialysis, skin itching, edema and some vascular complications are decreased significantly in each group before and after education. QOL was also significantly improved in each group. But there was no significant difference between the two groups. Since, there was no significant difference between the two groups in terms of efficiency of two methods of direct and indirect [multimedia] educational self care programs and also due to the problems and higher costs of the direct educational program comparing to the indirect method, the indirect method is recommended as an effective, cost benefit, simple and patient-friendly method for hemodialysis patients

[The effect of self - care educational program on decreasing the problems and improving the quality of life of dialysis patients]

In patients who have a chronic disease such as end stage renal disease for which cure is not a realistic goal, maximizing functioning and well-being should be a primary objective of care. However, functioning status in the dialysis patients is often lower than normal. This study is aiming to determine the effect of self-care educational programs on decreasing problems and improving quality of life of dialysis patients. This study was a quasi-experimental research in one group [pretest-posttest] accomplished in the educational hospitals of Iran and Tehran medical sciences universities from 2003 to 2004. A total of 32 patients were chosen on the basis of a non-randomized sampling. Each patient was assessed in two sessions before starting the dialysis treatment by questionnaires about educational requirements and quality of life and a checklist of common problems in dialysis patients. In order to validate the results, the laboratory variables were analyzed as a two months average prior to the education. The authors designed an educational program on the basis of existing problems and then determined the characteristics of each person under study and the required education was presented in two sessions. After the educational period was ended, the laboratory variables [average two months] and quality of life two months after education were analyzed and also the checklist were studied in two stages with a time interval of two weeks [third and fifth weeks]. There was a significant decrease in serum urea, uric acid, serum creatinine, K, weight gain, systolic blood pressure, edema, skin itching and local vascular problems. Also, there was a significant improvement in the patients' quality of life. Self-care educational programs have a positive influence on decreasing the problems and improving the quality of life of dialysis patient