Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran

Since quality of life [QoL] is subjective, self-reported QoL is the main source of assessment; however, in some situations the patient cannot evaluate his/her own status. In this cross-sectional study, 148 patients with breast cancer referred to the Cancer Institute of the Islamic Republic of Iran and their caregivers were selected through the consecutive sampling method. Five oncologists from this centre also evaluated the QoL of these patients. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was completed by these 3 groups and the results compared. The patient-caregiver intra-class correlation coefficient [ICC] for all 15 QLQ.C30 domains was moderate to good [ICC = 0.41-0.76]. Agreements between QoL scores of patients and those of oncologists were moderate to good, except in the 4 domains. In the patient-caregiver comparison there was 55% exact agreement, and for the patient-physician comparison agreement was 45%. The findings can be used in the patients' decision-making process and care planning when patients with breast cancer are unable to self-report the QoL

Seat-belt use among drivers and front passengers: an observational study from the Islamic Republic of Iran

Although seat-belts are the most effective means of preventing severe injuries and deaths from road accidents, drivers and passengers in many developing countries neglect to wear them. This study aimed to measure the rate of use of seat-belts and factors affecting their use in Tehran, Islamic Republic of Iran. In direct observations of 7718 vehicles at randomly selected sites in Tehran, 77.9% of drivers and 43.7% of front passenger had seat-belts fastened. More women used seat-belts than did men while driving but fewer as front-seat passengers. Rates of seat-belt wearing among both drivers and front passengers of vans and pick-up vehicles was low. In a separate interview study of 666 citizens, 62.4% stated that they always wore seat-belts while driving. The most frequently reported reasons for using seat-belts were avoiding fines, fear of injuries and respecting the law. To improve seatbelt use, it is recommended that law enforcement accompanied by public education should be a priority

Quality of life of Iranian beta-thalassaemia major patients living on the southern coast of the Caspian Sea

In the present study, the aim was to explore the quality of life of thalassaemia major [TM] patients according to age, sex, school performance, severity and complications of the disease. A cross-sectional descriptive study was conducted. Quality of life was evaluated by 4 questionnaires; demographic characteristics, the short form 36 health survey [SF-36], Persian version of symptoms checklist-90-revised [SCL-90-R] and life satisfaction index [LSI]. 687 [41.08%] of the eligible patients with TM completed the questionnaires. With the SF-36 questionnaire, 329 [47.9%] participants had an excellent level of physical functioning. With the SCL-90-R questionnaire, 446 [64.9%] participants had a global severity index of > 0.7, considered psychiatric patients, 141 [20.5%] patients had GSI between 0.4 and 0.7, considered suspected psychiatric patients and 100 [14.6%] participants had GSI of < 0.4, considered non-psychiatric patients. The mean score of LSI questionnaire was 20.50 [SD 5.95], range 2-37. Beta-TM patients are at risk of psychiatric symptoms and need appropriate psychiatric counseling

[ effect of constraint -induced movement therapy [CIMT] on quality of life, function and range of motion of upper extremity of patients with stroke]

Constraint-induce movement therapy is one of the treatment methods to treat those who have stroke disorders. The aim of this study was to determine the effect of constraint-induced movement therapy [CIMT] on quality of life, function and range of motion of upper extremity of patients with stroke. This study was conducted in 15 patients in accordance to random clinical trial during the treatment operation, the patients were asked to restrict their upper extremity movement with orthopedics sling for 3 days per week and each day for 8 hours. They were asked to practice on affected upper extremity for 2 hours while their hands were restricted. Additionally, the present study was conducted for 6 weeks. The statistical analysis illustrated that quality of life was significantly changed which measured by SF36 test [p=0.008]. Furthermore, the upper extremity function which was assessed by Box and Black test was statistically analyzed by t-coupled; in this regard, it showed a significant change when the treatment ended up [p=0.009]. However, active range of motions in wrist extension and elbow extension did not significantly changed [p=0.227]. Based on the results, it can be implied that constraint-induce movement therapy is an effective method for improvement of life quality and the upper extremity function .Three mechanisms are discussed: involvement of non used affected limbs, neural plasticity in CNS, and amelioration of mental and physical health of patients can be resulted in life quality and patients' hand improvement

[Association between health-related quality of life and glycemic control in type 2 diabetics]

Although several studies indicate that the quality of life of diabetic individuals decreases compared with non-diabetics, fewer studies have evaluated the association between quality of life and glycemic control in these people. The present study was conducted to assess the association between health-related quality of life and glycemic control in people with type 2 diabetes. This cross-sectional study was conducted on 125 type 2 diabetic individuals. Indices of glycemic control [serum concentrations of glucose, fructosamine and insulin, insulin resistance and HbA1c percent] were measured after 12-14 hours of fasting. Health-related quality of life was examined by a 36-item short-form health survey questionnaire [SF-36]. Using logistic regression and considering the confounding variables, the relationship between quality of life scales and glycemic control were evaluated.An inverse significant relationship between fructosamine concentration [p=0.04] and glucose concentration [p=0.04] with the general health scale score was observed. There was also a reverse significant relationship between serum glucose concentration and role limitations due to the physical problems scale score [p=0.02] and between insulin concentration and the physical functioning scale score [p=0.04]. There was a significant relationship between some quality of life scales and glycemic indices, indicating that better glycemic control in diabetic individuals enhances their quality of life

Knowledge, attitudes and practices towards HIV/AIDS among Iranian prisoners in Mazandaran province in the south-coast area of the Caspian Sea

HIV infection in the Islamic Republic of Iran is concentrated primarily among intravenous drug users. This study investigated the knowledge, attitudes and practices towards HIV/AIDS prevention of a random sample of prisoners in 5 prisons in Mazandaran province. Of 1760 individuals aged 18-65 years old completing the questionnaire, the mean age was 30.1 [SD 8.1] years [range 18 to 59 years]; 95.8% were male. Respondents had an average to fairly good knowledge about HIV/AIDS, with the percentages answering correctly ranging from 11.9%to 85.9%. However many had the misconception that [HIV/AIDS does not influence Iran] and [I will not be infected with HIV/AIDS under any conditions] and 63.6% agreed that lack of religious and moral commitment could spread AIDS infection. HIV/AIDS prevention efforts are needed for prisoners in Mazandaran province

[Using the social marketing model to reduce risky driving behaviors among taxi drivers in Tehran]

In social marketing, the common techniques of commercial marketing are used to increase the chances of acceptability of an idea or action by the target group. In this study, we determined the impact of an intervention based on social marketing to reduce risky driving behaviors among taxi drivers in Tehran. This was a quasi-experimental study, consisting of a quantitative and a qualitative part, on taxi-drivers in 2 regions [an intervention and a control groups] in the City of Tehran. Based on a formative research approach, the components of social marketing, namely, the product [reminder message for concentrating on avoidance of two target behaviors, tailgating and not driving between lines], price, place and promotion were determined. An 8-week educational program was implemented, the components being installation of stickers before the driver's eyes, distributing a pamphlet, and transferring messages through taxi route supervisors as opinion leaders. After six weeks, risky driving behaviors were assessed by checklists and compared. The intervention resulted in statistically significant reductions in the two target behaviors in the intervention group as compared with the control group. Furthermore, logistic regression showed that the odds ratio for avoiding both behaviors increased significantly in the intervention group. Determining specific target groups, designing interventions based on actual needs and wants of the target group, and focusing on the factors influencing the behavior market are the basic elements of social marketing. Due consideration of these elements when designing behavioral interventions would lead to reductions in risky driving behaviors

[Relationship between quality of life and musculoskeletal disorders in car manufacturing workers]

Work-related musculoskeletal disorders are considered as major occupational health problems and undesirable posture during work is one of the most important causes of such problems. Therefore describing the effect of different levels of musculoskeletal system on healthrelated quality of life and work absence is essential for preventive strategy. In this study the health- related quality of life in personnel of an assembly line of a car manufacturing company who suffered musculoskeletal disorders was investigated and later compared with healthy subjects. A case control study was performed on workers of Saipa car manufacturing company who were exposed to musculoskeletal disorders. A total of 165 workers with musculoskeletal disorders and 165 controls were randomly selected. Musculoskeletal disorders were determined using valid and reliable Nordic and SF-36 questionnaires. Data were analyzed using, Chi Square, Odds Ratio, 95% Confidence Interval, and Logistic Regression. Comparison of physical indicators of quality of life such as physical pain, general health, physical function, and role limitation due to physical problems with indicators of musculoskeletal disorders showed a significant difference between two groups [P<0/001]. Musculoskeletal disorders were higher in those with lower quality of life [P<0.001, CI: 95% [0.32-0.82], OR=0.51]] There was a relationship between the indicator of quality of life and musculoskeletal disorders. Physical conditions and quality of life among workers of assembly line of the car manufacturing company affected the risk of chronic musculoskeletal disorders. Improving and optimizing such conditions play an important role in health- related quality of life

[Exploring the experiences of Iranian women with breast cancer: a qualitative study]

The experience of patients with breast cancer may vary in different cultures. The aim of this qualitative study was to explore the experiences of women with breast cancer in Iran. Fifty one participants were recruited from a university-affiliated breast clinic in Tehran. In-depth interviews each lasting approximately one hour per participant were scheduled and conducted in a private room. The interviews intended to motivate the participants to reflect on their life experiences since the cancer diagnosis. The interviews were tape-recorded and were transcribed to elucidate the major themes encountered in the interviews. The mean age of patients was 48.8 years [SD = 10.5], 44 were married, one was single, and six were widowed or divorced. Forty-eight participants underwent radical mastectomy and 13 patients received breast-conserving surgery. Thirty-five [69%] patients received chemotherapy. Overall eight major themes emerged from the analysis. These were: importance of God and spiritual beliefs, importance of family support especially husbands and children during the diagnosis and treatment, difficult times during receiving mammography results, experiencing an ambiguous condition while losing their breasts, fear of recurrence, concerns about children, and chemotherapy as the worst experience during the course of treatment

Stress, coping strategies and related factors in a sample of Iranian adolescents

Since the stress and coping are the most reported problems by adolescents, this study aims to apprise the stressors, coping strategies and influential factors among male adolescents. The effect of stressors, coping strategies and some demographics variables were studied in 402 male adolescents in Tehran, Iran. A self-administered questionnaire was used to collect the data. A multiple regression was performed to assess factors related to perceived stress. The mean age of adolescents was 15.44 [SD=0.68] years. The mean value of perceived stress for the whole sample was 17.99 [SD=6.02]. Cognitive/emotional coping was the most frequent coping style. The findings revealed that there was a significant correlation between perceived and accumulative stress. In multiple regression analysis, the accumulative stress, social resources, parent's education and grade point average were found to be significant predictors of perceived stress. The findings suggest that increased level of perceived stress is associated with accumulative stress, social resources and parent's education that are modifiable factors. Stress management education might be a solution to overcome increased perceived stress

Anxiety, depression and health-related quality of life in those injured by landmines, Ilam, Islamic Republic of Iran

We assessed depression, anxiety and health-related quality of life [HRQOL] in 137 cases of landmine I injury in Ham province, using the Hospital Anxiety and Depression Scale [HADS] and the Short Form Health Survey [SF36] questionnaires. We also compared their scores with an uninjured control group [n - 360]. Most of the injured were male [93.4%] and illiterate [54.7%] with some irreversible sequelae [86.9%]. Overall, 69.3% of the injured participants scored high for both anxiety and depression. The level of anxiety and depression was significantly higher in older cases, those not completely recovered compared with recovered cases and those with amputation compared with those without amputation. The injured also had significantly lower mean scores in all HRQOL components than the control group. Landmine injured should be monitored for early identification and treatment of depression and anxiety

[Reasons for using withdrawal contraception: a qualitative study]

To identify reasons why married women use withdrawal when they do not desire pregnancy. This was a qualitative study. We performed 50 interviews with women who were using withdrawal contraception. Theory of Planned Behavior used as framework for elicitation salient believes about contraception methods. Participants were married women who were not currently pregnant, not desire to have a child, using withdrawal contraception. Women gave many reasons for using withdrawal contraception. Three major categories emerged: behavioral believes, normative believes and control believes. The results suggest that multidimensional interventions may be needed to effectively reduce withdrawal contraception and unwanted pregnancy

[High risk behaviors among Iranian motorcyclists: a qualitative study]

To explore risk behaviors among Iranian motorcyclists. This was a qualitative study based on grounded theory to identify factors influencing Iranian motorcyclists' risk behaviors. In all, 22 participants took part in the study. To collect data, two focus groups and 13 in-depth interviews with key informants were conducted in Tehran, Iran. Moreover, thirty two observations regarding motorcyclists' behaviors were assessed to increase trustworthiness of the collected data. All interviews and discussions were transcribed and analyzed. A total of 22 participants with an average age of 26.4 years shared their experience regarding motorcyclists' risk behaviors factors while riding. Among all participants, 16 participants were riders or pillions and family members of riders and 2 participants were policemen. Of all, 4 participants were female and 41.7% were single. The findings of this study revealed that personal characteristics, environmental factors, vehicle related factors and abuse of safe equipments could cause risky behaviors while riding. The findings of this study indicated that different factors might influence risky behaviors. Thus a multidimensional and comprehensive approach should be designed to prevent risky behaviors

[Modification of reasoned action theory and comparison with the original version by path analysis for substance abuse prevention among adolescents]

Objective of present study was assessing the competence of self efficacy to development of theory of Reasoned Action [TRA] and comparison with original version by path analysis for substance abuse prevention among adolescents. In this analytic study, 433 randomly selected adolescents [range of age 15-19] from Tehran participated in study. The study design was based on the theory of Reasoned Action and other self efficacy methods. Validity and reliability of the study questionnaire was assessed. Then the collected data were analyzed by using path analysis method The results indicated that the reasoned action developed by self efficacy, has a better fitness [RMSEA=0.043-df / chi[2]=1.77-P-value=0.1829] compare to the original [RMSEA=0.128-df / chi[2]=7.96-P-value=0.00479] in path analysis. In this study self efficacy become effective construct for fitness of model and powerful predictors for intention [beta=0.35] and behavior [beta=0.20]. The model covered 36% of intention variance and 28% of behavior variance. The reasoned action was developed by self efficacy and increased its prediction

Prevalence and quality of life in Qashqai migrating nomads with irritable bowel syndrome in southern Iran

Irritable Bowel Syndrome [IBS] is an important public health problem, owing both to its high prevalence and its impact on the quality of life. The purpose of this study was to investigate the prevalence and risk factors of IBS and its relationship to life style in Qashqai migrating nomads with a different lifestyle in Fars province, southern Iran. In summer 2006, 748 Qashqai migrating nomads aged 25 years or more were enrolled, using a multiple-stage stratified cluster random sampling method. A questionnaire consisting of demographic data and IBS symptoms was completed for each subject. For about 50% of them, SF 36 questionnaire was also completed. The prevalence rate of IBS was 11.8% and there was a close relationship between IBS and the life quality. The prevalence of IBS in Qashqai migrating nomads was higher than the urban population in the area with a close relationship to the life quality

[Effects of topiramate in the prevention of drug resistant migraine headache]

Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate [TPM] in the prevention of drug-resistant migraine headache. This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compare with the placebo group for 3 months. Collected data were analyzed using analysis of variance [ANOVA], Newman-Keuls and Spearman's Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. 66 of 70 patients completed the study. The mean age of the patients was 30.33 +/- 7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months [P<0.0001] for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group [64.6%, P<0.0001] in the 3 rd month of the treatment side effects of treatment were transient and well tolerated. Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine

Is quality of life data predictive of the survival in cancer patients? a rapid and systematic review of the literature

To review literature on relationship between quality of life data and the length of survival in cancer patients. A literature search was carried out using MEDLINE to assess existing knowledge on relationship between quality of life data as a prognostic factor and survival in cancer patients. The intention was to review all full publications in English language biomedical journals. The search strategy included the combination of keywords 'cancer', 'prognostic', 'predictor', 'predictive', 'quality of life' and 'survival' in titles of publications. The literature was also examined to ensure that the study used multivariate analyses. Pure psychological studies were excluded. The initial search was carried out twice in December 2008 and twice for a final check in early and late January 2009. A manual search also was performed for including possible additional papers. In all 146 citations were identified and reviewed. Of these, 88 citations on relationship between quality of life and survival were found relevant and examined in this rapid and systematic review of the literature. The findings are summarized under different headings including studies on heterogeneous sample of cancer patients, lung cancer, breast cancer, gastro-oesophageal cancers, colorectal cancer and other cancers. Except a few exceptions most studies found that quality of life data or some aspects of quality of life measures were significant independent predictors of survival duration. Global quality of life, functioning domains and symptom scores such as appetite loss, fatigue and pain individually or in combined were the most important factors that predicted the length of survival in cancer patients after adjusting for one or more demographic and known clinical prognostic factors.Studies reported in this review provide evidence for a positive relationship between quality of life data or some aspects of quality of life measures and the length of survival in cancer patients. Pre-treatment quality of life data are appeared to be most reliable information that could help clinicians to establish prognostic criteria for treatment of their cancer patients. Indeed, conducting studies using valid instruments, applying sound methodological approaches and adequate but not sophisticated multivariate statistical analyses adjusted for demographic characteristics and known clinical prognostic factors are recommended in order to yield more specific quality of life related prognostic variables for specific cancers

World AIDS day campaign in Iran: a population-based study

This was a population-based study to examine whether the campaign for World AIDS Day 2005 in Iran was successful. A random sample of the general population was asked whether they had seen the campaign and knew the message. They were also asked whether it was attractive; there was anything offensive, whether the campaign could raise awareness, and how they rated the campaign. In all 1215 individuals were approached and 1014 agreed to take part in the study. Only 43% [n= 435] said that they had seen the campaign. Of those who had seen the campaign 79% knew the subject and 24% acknowledged the main message correctly. Only 27% said it was very attention getting or eye-catching, 64% said the campaign could raise awareness but 75% said the message was unclear, and confusing. A few respondents [23%] rated that the campaign overall looked good or very good. The findings suggest that if the World AIDS Day is an opportunity to give visibility to the problem, then there is an urgent need to think seriously to choose other approaches for raising global awareness on the state of the epidemic in Iran and elsewhere

[Quality of life in war related spinal cord injured women]

To assess health-related quality of life [HRQOL] in women who had suffered spinal cord injuries in the Iran-Iraq war [1980-1988]. A total of 35 female patients who had suffered spinal cord injury [SCI] in the war were entered into the study. Patients who gave their consent to participate in the study were asked to complete The Short Form of Health Survey questionnaire [SF-36]. The study achieved a response rate of 60% [21/35]. The mean age of participants was 41.95 [SD=12.9] years [ranging from 17 to 62 years]: 57.7% of the subjects were single and 28.6% were married. Compared to the normal population, quality of life was significantly lower in all subscales [p<0.05] studies except for Vitality [VI] and Role Functioning [RP]. The study showed that spinal cord injury was associated with a significant decline in quality of life

[Self poisoning with suicidal intent- Part I]

Self poisoning is one of the most common forms of suicide- especially in adolescents- and constitutes a major reason for hospitalization and referral to emergency wards. The high frequency of repeated attempts together with the shortage of reliable epidemiologic data makes it difficult to plan effective preventive measures. The present article is the first section of a two-part paper on the epidemiology of self-poisoning in Iran. This was a cross-sectional study conducted in Tehran, Mashad, Tabriz, Isfahan, Shiraz and Kermanshah [5 major provinces of Iran]. Data were collected using a structured questionnaire and were analyzed in a descriptive fashion. In all, 723 cases were studied. There were 550 cases [%71] of self poisoning with suicidal intent. The mean age of those who had attempted suicide was [25.42 +/- 10.26] years; sixty percent [n=330] were female and the remaining 40% [n=220] were male. Eighty percent of attempted suicides involved the use of drugs; other suicide modalities included poisons, psychotropic substances and other chemicals. Thirty-one percent of the cases reported previous suicidal gestures. The mean number of past suicidal attempts was 2.08 [SD = 2.28]. The findings show that the frequency of attempted suicide is relatively high. To deal with the current situation, issues of mental heath have to be addressed more attentively and hospital emergency wards must be provided with adequate equipment and trained manpower [psychologists, psychiatrists, toxicologists, etc]