ABSTRACT
BACKGROUND: In many countries, the consent of family members is required for organ donation from brain-dead patients who are potential candidates for organ donation. In this regard, knowing the factors affecting family members' decision for organ donation can help improve the conditions. This qualitative study aimed to identify the factors affecting family members' decision-making regarding donation of brain-dead patients' organs. MATERIALS AND METHODS: This research applied qualitative research by focusing on the content analysis approach. The study started from April 2021 in Al-Zahra Hospital in Isfahan and Ayatollah Kashani in Shahrekord and continued until data saturation was reached (September 1401). Participants were assigned to one of three groups: brain-dead patients' family members who consented to organ donation, brain-dead patients' family members who declined to consent to organ donation, and people involved in the organ donation process. The sample was selected using the purposive sampling method. The data were collected using unstructured interviews and the field survey method. In this study, a qualitative content analysis with a contractual approach was used to analyze the data. RESULTS: The analysis of the collected data using different methods yielded 11 main categories, including 1) unresponsive healthcare system, 2) inadequate support from government systems, 3) weakness of social work organizations, 4) fear of being stigmatized, 5) cultural values, 6) symbolization, 7) perpetuation and the society's attitude, 8) development of personality system and generalism, 9) human values, 10) spiritual maturity, and 11) belief-religious challenges, leading finally to three themes, including 1) structural and functional weakness of systems, 2) sociocultural factors, and 3) worldview. CONCLUSION: The findings of the present research were able to identify the roots and social factors affecting Iranian families' decisions regarding the consent or nonconsent of brain-dead patient members. Health system administrators and organ donation committees in medical sciences universities in Iran can try to solve the shortage of donated organs by using the specific social aspects introduced in this study. It is also recommended to design effective models for more satisfaction of family members for brain death patient organ donation in healthcare based on the underlying concepts of this study.
ABSTRACT
BACKGROUND: Dementia is a syndrome that reduces the cognitive and functional abilities of the brain increasing the need for care. The caregivers of these patients are mostly their family members. The great care burden causes devastating effects on the health of family caregivers and the grief experienced by these family caregivers is considerable. This study was conducted to investigate the effects of a compassion-based program on the grief experienced by caregivers of people suffering from dementia. METHOD: The present study was a randomized controlled clinical trial in which 70 family caregivers of people suffering from dementia were sampled through the block method and they were divided into experimental and control groups. The data collection tools included demographic information questionnaire and grief inventory that was completed before, a week and a month after the implementation of the compassion-based program in five sessions virtually by sending offline content to the experimental group. The obtained data were analyzed by SPSS 22 software using the repeated measures analysis of variance. RESULTS: The mean comparison of scores of the grief experienced in the experimental group between pretest and posttest and follow-up, unlike the control group, showed a significant difference (p < 0.001). The mean scores of the experimental and the control groups were significantly different in terms of experiencing mourning and all of its fields (p < 0.001). The mean comparison of post-test and follow-up showed that the effect of a compassion-based program at the follow-up stage has been mitigated. CONCLUSIONS: According to the study results, the compassion-based program reduced the grief experienced by the family caregivers of people suffering from dementia. Nevertheless, the effect of a compassion-based program has been reduced over time. This program can be a good guide for providing society-oriented services to the health team. TRIAL REGISTRATION: This study is registered by Iranian Registry of Clinical Trials with decree code: IRCT20190712044181N4 on 02/06/2020.
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BACKGROUND: Heart failure is one of the chronic heart diseases and a debilitating condition of increased prevalence in the elderly. One of the important and non-pharmacological strategies for improving clinical outcomes in these patients is promotion of the self-care. Background and social environment in which a patient is trying to control his disease is an important factor in the self-care. The aim of this study was to evaluate the effects of family support intervention on the self-care behaviors in patients with heart failure. MATERIALS AND METHODS: This study was a randomized clinical trial conducted in university hospitals in Isfahan, Iran, in 2012. A total of 62 patients with heart failure were randomly assigned to experimental (n = 32) and control (n = 32) groups. Supportive intervention including three educational sessions with the delivery of educational booklet and follow-up by telephone was performed for caregivers of patients in the experimental group. Data were collected using the questionnaire of self-care behaviors, which was completed before and 1 month after the intervention in both the groups, and the questionnaires were analyzed using descriptive statistics and independent and paired t-tests. RESULTS: The results indicate that after the intervention, self-care behavior scores in the experimental group and control group were 47.2 and 28.4, respectively, and independent t-test revealed that the difference was statistically significant. CONCLUSION: Family-focused supportive interventions can be used as an effective method for improving the self-care behaviors in patients with heart failure.
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BACKGROUND: Diabetes is a major health problem, which has a wide prevalence in the world. There is no sign of its stopping, but it is increasing. Diabetes in children is three to four times more common than other childhood diseases. Diagnosis of diabetes for children causes emotional responses in parents and family members. Interventions for children with diabetes involve the family, child, and professionals including physicians, nurses, and nutritionist. Self-care is difficult without direct parents' participation. According to studies, burden of diabetes for mothers is more than for fathers. This study aimed to explore mothers' experience of children with diabetes. MATERIALS AND METHODS: This is a qualitative content analysis. Study population was recruited through purposeful sampling. Eleven mothers who have a child with diabetes and referring to the "Glands and Metabolism Research Center" and "Al-Zahra Hospital" were selected. Participants were aged 28 to 42 years. Data gathering was done through deep interviews with participants in 2007 that was tape-recorded. Mean average of interviews was 45 minutes. Data analysis was done using conventional qualitative content analysis. RESULTS: Participants' experience was classified in the two main concepts including reaction at the time of diagnosis and disease consequences for mothers. CONCLUSION: Mothers of children with diabetes expressed some reactions at the time of diagnosis, which was mainly due to lack of information, and lack of attention to their needs at the time of diagnosis, especially it was due to the sudden diagnosis and lack of enough opportunities for mothers to accept the disease. The disease causes some consequences for mothers that affect their lives. Therefore, it is necessary to consider the needs of families of children with diabetes and to provide support and sufficient information about their child's illness for them.
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BACKGROUND: Breast cancer is one of the most frequent malignancies among Iranian women. These patients suffer from a wide range of physical and mental (depression, anxiety and stress) signs and symptoms during the diagnostic and therapeutic processes. Despite the improvement in survival rates due to advances in medical care, different types of psychosocial interventions are still growingly needed considering the increasing number of cancer patients with longer survival times. The objective of this study was to determine the effect of relaxation on depression, anxiety and stress in women who underwent mastectomy for breast cancer. MATERIALS AND METHODS: This clinical trial was conducted during about 4.5 months in a referral chemotherapy clinic of a teaching hospital in Isfahan, Iran. The participants consisted of 48 breast cancer patients who were selected by simple random sampling. They were randomly assigned into two groups of control and case. The control group was treated only by usual medical therapy, whereas the case group was treated by combined medical-relaxation therapy. Data collection tools were the validated Depression, Anxiety and Stress Scale (DASS42) and a demographic questionnaire. Data were analyzed by SPSS using descriptive statistics, repeated measures analysis of variance (ANOVA), chi-square test and paired t-test.. FINDINGS: The baseline mean scores of depression, anxiety and stress were not significantly different between the case and control groups. However, the scores in the case group improved significantly after the treatment (p < 0.05). On the contrary, such improvement was not seen in the control group. CONCLUSIONS: Relaxation therapy can be effective in the improvement of depression, anxiety and stress. Therefore, it can be recommended as an effective care program in patients with malignant disorders.
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BACKGROUND: Cardiovascular diseases have the highest death rates in human society. Coronary artery disease is among the most important of these diseases. No treatment of cardiovascular disease has as much impact on the quality of life of the patients as the heart surgery. The recovery from heart surgery is associated with symptoms of pain and psychological distress. In the early recovery period, the patients will face moderate symptoms of anxiety and depression. In this regard, various measures of nursing, as complementary therapy practices have been performed to help the patients for overcoming the physical and psychological needs. One of these methods, in recent years has been the use of complementary and alternative therapies, particularly massage therapy, after heart surgery. Thus, the aim of this study was to determine the effectiveness of massage therapy on the mood of patients after open-heart surgery in Isfahan Chamran Hospital during 2010-11. MATERIALS AND METHODS: In this study 72 patients, who underwent coronary artery bypass surgery, were selected. They were randomly assigned to the two case and control groups. The patients of the case group (n = 36) received Swedish massage for 20 minutes in 4 sessions in 4 consecutive days, 3 to 6 days after the open-heart surgery. The patients in the control group received only the routine care. The mood questionnaire (POMS) which was used in this study has been completed the day before the start of the study and intervention and again after the last day of the intervention. SPSS software version 12 and descriptive and inferential statistical methods were used for data analysis. FINDINGS: The comparison of study results showed that massage decreased the overall rating of the patients' mood after the surgery. CONCLUSIONS: The use of massage therapy as an effective nursing intervention can improve the patients' mood after open-heart surgery. Due to the low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative interventions used in these patients.
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BACKGROUND: Hypertension is one of the most crucial health problems and the most common chronic disease in developed and underdeveloped countries. It is called the silent killer which is usually diagnosed incidentally. Although hypertension is a preventable and treatable condition but without treatment it leads to serious and life threatening complications such as heart, kidney and brain disorders which in most cases result in patient's disability. Prevention, plays significant role in controlling this disease which is achieved by increasing the knowledge and awareness of the public and changing their attitude and practice. METHODS: A cross-sectional, correlation-descriptive study was conducted in one stage, by one group. Two hundred and thirty four patients were recruited by random sampling among hypertensive patients referring to public health care centers in Khoor & Biabanak in Isfahan province, IRAN. Data gathering was carried out with a questionnaire. RESULTS: Our findings indicate that there is significant relationship between awareness and knowledge; awareness and attitude; awareness and practice. There is no significant relationship between knowledge and attitude or knowledge and practice. In addition, there is a significant relationship between attitude and practice of the patients. CONCLUSIONS: Although patients relatively had high awareness, knowledge, attitude and practice about their disease but their hypertension was not still under control. Several barriers are associated with uncontrolled hypertension particularly treatment-related barriers. Findings suggest further studies to determine new effective strategies to solve this problem.
