Self-efficacy and compliance with treatment regimen in tuberculosis patients in Kurdistan

Tuberculosis is a major public health problem in the world, affecting 30% of the world's population. Treatment of tuberculosis is the most effective strategy to stop the spread of the disease. However, non-adherence remains an important cause of treatment failure. It is believed self-efficacy may affect patient's compliance to treatment regimen. The purpose of this study is to determine the correlation between self-efficiency and treatment compliance in tuberculosis patients attending to medical centers of Kurdistan University of medical sciences Kudistan, Iran. A descriptive-correlational design was used. The sample of the study consisted of 161 tuberculosis patients attending to health centers in Kurdistan province .Data were collected using a self efficacy questionnaire and the review of patients' medical records, he validity of the questionnaires were determined by 12 experts through the content validity and formal validity methods. The minimum index of content validity for self-efficiency questionnaire was calculated to be 75.5 percent and that of compliance was 83.5 percent. The reliability of the questionnaires was determined using the Krunbach's Alpha-Test. The coefficient of reliability for self-efficiency questionnaire and compliance questionnaire were 0.94 and 0.97 respectively. Data were analyzed using the SPSS 16 software. The average age for patients was 58 +/- 12 years old. 61.5 percent of studied samples were male and the rest were female. The amount of compliance by patients was moderate [average scores of 30.23] and correlated to age, marital status, job, income level, education and place of living but, its relation to gender was not statistically significant. The amount of self-efficiency of the majority of patients was moderate [41.6 percent] and it was also related to age, marital status, job, income level, education and place of living but its relation to gender was not statistically significant. There was a direct and strong correlation between self-efficiency and compliance [P<0.001, r=0.90]. The reason why the compliance level in this study has been higher with respect to the previous similar studies could be due to the implementation of direct supervision and control system over treatment. In this study there was a significant correlation between compliance and self-efficiency which was in consistency with most studies in this field while in Hamilton [2000] no significant correlation between the two variables was reported. Given that the correlation coefficient of Pearson in this study is positive and close to 1 [P < 0.001, r = 0.90], it indicates a direct and strong correlation between the two variables of self-efficiency and compliance

[ effect of reflexotherapy on chemotherapy-induced vomiting of patients]

Vomiting as a side effect of chemotherapy causes to refuse or delay in treatment by most cases. Nowadays, for controlling these side effects researchers attempt to use noninvasive-, safe- and low cost methods, instead of expensive drugs with various side effects. This study aimed to assess effect of reflexotherapy on vomiting reduction among patients under chemotherapy, in oncology-hematology ward of Zahedan's Ali Ebn Abitaleb Hospital in 2010. This study was a before and after clinical trial [pre-test and post-test] with a group of 37 patients. The participants were selected using purposeful sampling method and based on the results of a pilot study. They were also considered once in the control group [receiving anti-vomiting drug Granisetron] and after 15 to 20 days in the interventional group [receiving reflexotherapy in a period of 10 minutes for each leg]. The Summary of Morrow Questionnaire and CTCv[2.0] [Common Toxicity Criteria Version 2] of National Cancer Institute of America were used for making a questionnaire to data collection. Face and content validity of questionnaire and its reliability [Chronbach alpha Coefficient =0.73] was confirmed beforehand. Data was analyzed using central and dispersion indexes as well as Wilcoxon and Mann-Whitney tests and Marginal modeling [generalized estimating equations GEE]. The mean age of samples was 44.73 +/- 13.38 [years]. Majority of participants were married and women. Patients were in their second to 15th cycle of chemotherapy; receiving Cisplatin-Gemzar or Adriamycincyclophosphamide and were from breast cancer cases. Assessment of severity of vomiting during first 24 hours showed more sever vomiting in the first 4 hours among control group than interventional group [p<0.001], but it was more severe in interventional gropup than control group in third 4 hours [p<0.001] and the second 12 hours [p=0.006]. During the second 4 hours, severity of vomiting was not significantly different between the two Groups [p=0.313]. Finnally, the results showed no significant difference between two treatment methods respecting their effect on severity [p=0.153] and the number of vomiting [p=0.239] during the 24 hours after treatment. Although reflexotherapy was not shown to have positive effect on chemotherapy induced vomiting of patients but it caused to reduce severity and number of vomiting in the first 4 hours after chemotherapy among patients with moderate and sever vomiting. Therefore, experimental study using reflexotherapy is recommended in multiple sessions.

[Physiologic indices of patients before, during and after visit in coronary care unit at Imam Khomeini hospital in Ardebil]

Visit is an essential issue in hospitals and of patients' basic needs in coronary care units [CCUs]. However, there is no evidence regarding its physiologic effects on them. The aim of this was to determine the physiologic indexes of patients before, during and after visit at CCU of Imam Khomeini Hospital in Ardebil. In this descriptive study, 50 patients with acute myocardial infarction were selected through convenience sampling method. A questionnaire and a cardiac monitoring device were used for data collection. Content method and calibration the device were used for validity and reliability of the tools respectively. ANOVA with repeated measurements was used for data analysis. 72% of patients was male and 28% was female. Their mean age was 59.8. Significant differences were found between systolic, diastolic and mean arterial pressures; heart as well as respiratory rates; temperature; and oxygen saturation before, during and after the visits. Accordingly, the indexes increased significantly by the start of visits and turned back to the previous state after them with no significant difference in before-after amounts. It seems that the physiologic indices of patients change in normal range during visits and return to their primary state after 30 minutes from the end of visits with no clinical importance

[Effects of bladder irrigation with chlorhexidine and normal saline on prevention of bacteriuria in patient with foley catheter]

Urinary tract infection [UTI] is the most common infection acquired in both hospitals and nursing homes and is usually associated with catheterization. The aim of this study was to compare the effects chlorhexidine 0.2% with saline for bladder irrigation on preventing bacteriuria in patients with foley catheter. In this randomized clinical trial, 60 neurologic patients 50 years old and over in need of foley catheter for at least 14 days with no UTI at the beginning of the study were enrolled, catheterized by one of the researchers and randomly divided into two groups of chlorhexidine 0.2% and saline. Bladder irrigation was performed on days 3 and 10 following catheterization. A questionnaire and urine analysis as well as culture were used for data collection, each of which was validated and made reliable. Different statistical tests including T-student and Chi square as well as logistic regression were used for data analysis. With respect to negative culture results in both groups on days 1 and 2, a significant difference was found between chlorhexidine [30%] and saline [77.3%] groups [P<0.001]. All subjects contracted infection after 17 days. The relative risk for urinary tract infection in saline group was 2.4 times greater than the other group. During the first 9 days, bladder irrigation with chlorhexidine 0.2% may lead to decreased rate of infection due to catheterization