Evaluating the Effect of Family-Centered Intervention Program on Care Burden and Self-Efficacy of Hemodialysis Patient Caregivers Based on Social Cognitive Theory: A Randomized Clinical Trial Study / 가정의학회지

Background@#Caregivers of hemodialysis patients spend a large amount of time providing care to these patients while tolerating fatigue and stress. This study evaluated a family-centered empowerment program on the care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory. @*Methods@#In this randomized clinical trial, 70 family caregivers of hemodialysis patients in Isfahan, Iran, were selected and randomly allocated to intervention and control groups, in 2015–2016. Two questionnaires were used to collect the family caregivers’ characteristics, care burden, and self-efficacy, and patients’ negative and positive outcomes expectancies. Data were analyzed using SPSS before, immediately after, and 2 months after the intervention. @*Results@#There was no significant difference in the mean scores of care burden, positive outcomes expectancies, negative outcomes expectancies, and self-efficacy between the two groups before the intervention. However, there were significant differences in the post-test and follow-up data analyses (P<0.05). @*Conclusion@#Given the degenerative nature of chronic kidney disease, it can be considered as a source of long-term and chronic stress for caregivers. Therefore, by implementing an empowerment program, caregiving behaviors can be improved, positive outcomes expectancies can be increased, and negative outcomes expectancies can be reduced.

Experience of nursing students about the barriers to patient education: a qualitative study in Iran / 한국의학교육

PURPOSE: Patient education is a dynamic and continuous process that should be implemented during the entire time of hospital stay and even afterward. Studies have shown the typically poor quality of patient education in Iran and its failure to convey the required knowledge and skills to patients. The purpose of this study was to survey the experience of nursing students in regard to the challenges of patient education in hospitals. METHODS: This qualitative study was conducted using the conventional qualitative content analysis approach on a sample of 21 undergraduate nursing students (4th semester and beyond), which was drawn from the Qom Nursing and Midwifery School through purposive sampling with maximum variation. Data were collected through semi-structured interviews conducted over a period of 45 to 75 minutes, and were analyzed using the conventional qualitative content analysis. RESULTS: Results were derived from the experiences of 21 nursing students (nine males, 12 females) about the research subject. The primary themes identified in the study were the student-related, patient-related, instructor-related, education environment-related, and curriculum-related barriers to patient educations. CONCLUSION: Participants believed that patient education in Iranian hospitals is faced with many challenges. Nursing instructors and curriculum planners should ensure more emphasis on patient education at the initial semesters of nursing education curriculum and make sure that it is included in the evaluation of students. Hospital officials should provide a dedicated education environment with suitable facilities, tools, and atmosphere for patient education. Also, special education programs need to be developed for less educated patients.

[Factors influencing quality of life in patients with myocardial infraction]

Myocardial infarction is a common and dangerous life threatening disease with an impact on quality of life. The present descriptive-analytical study aims to determine quality of life in patients with myocardial infarction referring to Hadjar hospital affiliated to the Shahre-kord University of Medical Sciences. This was as descriptive- analytical study in which 150 patients admitted to cardiac care unit of Hadja hospital within 8 weeks post infarction were selected by non random sampling method. Data were collected through interview, patients' medical records and patients self report. The tool for collecting data regarding quality of life was SF36 questionnaire. Data were analyzed by descriptive and inferential statistics. Findings showed that the mean value of age was 55.7 +/- 10.5 and that quality of life in majority of subjects [%53] was fairly favorable. Regarding aspects of quality of life, most patients had fairly favorable general status [physical and psychological health] [%62] and social function [%65]. Also, sleep pattern of majority of subjects [%61] was favorable and most of them [62%] had unfavorable physical activity. There was statistically significant correlation between quality of life and variables such as duration of disease [P<0.05], intensity of pain [P<0.05], decline or loss of job function, and the degree of fatigue [P<0.05], but there was no statistically significant relationship between quality of life and other demographics as age, gender, marital status, economic status and occupational status. Because fatigue and pain have some relationship with quality of life in patient with myocardial infarction, health care personnel, spatially nurses should pay attention to dimensions of quality of life when planning care for these patients. Failure to do so may leads to quality of life of patients to be neglected

Assessment of dioxin-like compounds released from Iranian industries and municipalities

In the past 10-15 years, the world has encountered a new type of organic dioxin-like pollutant from products of combustion and byproducts of industrial processes and activities of the municipality. Dioxins are very toxic substances. According to various studies, it is believed that these compounds have devastating impacts on the environment and public health. Since these pollutants are persistent and can remain in the environment for several decades, they may have global implications. Estimation of the amount of dioxin-like compounds has been done in 15 industrialized countries according to United Nations Environment Programme[UNEP]. In this study, the amount of dioxin-like pollutants in Iran was estimated to be 1282gr TEQ/year compared with 100 to 4000gr TEQ/year in European countries, the USA and Japan. Iranian sources of dioxins are considerable comparing to that of industrialized countries. Therefore, a higher incidence of adverse health effects such as carcinogenesis and changes in liver function, thyroid hormone levels, immune cell levels, and decreased performance in learning and intelligence tests may be anticipated in polluted areas. The result of this study necessitates a sound national strategy for monitoring the release of these pollutants in Iran. Further studies are recommended on Dioxin-like compounds in polluted areas