The psychometric properties of the Persian version of the Multiple Sclerosis Self-Management Scale-Revised: A cross-sectional methodological study.

Backgrounds and Aims: Patients with multiple sclerosis (pwMS) need self-management (SM) skills to manage their symptoms and problems. An essential step to SM improvement is accurate SM assessment using valid and reliable instruments. The aim of this study was to evaluate the psychometric properties of the Persian version of the Multiple Sclerosis Self-Management Scale-Revised (MSSMS-R). Methods: This cross-sectional methodological study was conducted from December 2021 to June 2022. The face, content, and construct validity of MSSMS-R were evaluated. Construct validity was evaluated through confirmatory factor analysis (CFA) and evaluating convergent and discriminant validity using the data obtained from 210 randomly selected MS patients. The reliability of the scale was also evaluated through the test-retest stability and the internal consistency evaluation methods. Results: The face validity was confirmed and the content validity ratio and index values of all items were more than 0.62 and 0.79, respectively. CFA revealed the acceptable construct validity of the scale after omitting items 21 and 22. In convergent and discriminant validity evaluation, the total score of MSSMS-R had significant positive correlation with the total mean scores of the Multiple Sclerosis Self-Efficacy Scale (r = 0.36; p < 0.001) and the physical health composite (r = 0.31; p < 0.001) and the mental health composite (r = 0.39; p < 0.001) dimensions of the 54-item Multiple Sclerosis Quality of Life scale and significant inverse correlation with the total mean score of the Beck Depression Inventory (r = -0.28; p < 0.001). The Cronbach's alpha values of the scale and its subscales were 0.86 and 0.65-0.90 and their test-retest intraclass correlation coefficients were 0.97 and 0.95-0.99, respectively. Conclusion: The Persian MSSMS-R is a valid and reliable scale and can be used in future studies for SM assessment among pwMS.

The effect of tablet containing Boswellia serrata and Melisa officinalis extract on older adults' memory: A randomized controlled trial.

BACKGROUND: Memory deficits and age-related memory loss are currently two significant concerns in older adults. In Iranian herbal medicine, there are some prescriptions for memory improvement. OBJECTIVE: This study was designed to investigate the effect of tablet containing Boswellia serrata (BS) extract and Mellisa officinalis (MO) extract on memory of the older adults. METHOD: This is a randomized, parallel, double-blind, placebo-controlled clinical trial that performed among 70 older adults who referred to healthcare centers of Kashan University of Medical Sciences, Iran. Subjects were randomly assigned to receive either tablets (n = 35) or placebo (n = 35) for a month (n = 30). Data were collected using a demographic questionnaire and the Wechsler Memory Scale-Revised (WMS-R). Data were analyzed using Chi-square, independent-samples t-tests, paired t-test, repeated measure ANOVA, and ANCOVA using SPSS v13. RESULT: Participants' baseline characteristics were similar in the two groups. The study was completed by 53 participants. However, as the analysis was based on an intention-to treat approach, all 70 older adults were included in the final analysis. Comparison of the two groups with showed that the total scores of the WMS-R and the subscales, including auditory immediate, immediate memory, visual immediate and working memory, were increased after consumption of the containing BS and MO tablets (p < 0.0001). CONCLUSION: The BS and MO tablet in older adults can be beneficial on improvement of memory. This is still necessary to investigate effects and durability of the tablets on older adults with memory impairments in future studies.

The Quality of Pre-hospital Circulatory Management in Patients With Multiple Trauma Referred to the Trauma Center of Shahid Beheshti Hospital in Kashan, Iran, in the First Six Months of 2013.

BACKGROUND: Circulatory management is a critical issue in pre-hospital transportation phase of multiple trauma patients. However, the quality of this important care did not receive enough attention. OBJECTIVES: The aim of this study was to investigate the quality of pre-hospital circulatory management in patients with multiple trauma. PATIENTS AND METHODS: This was a cross-sectional study conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services (EMS) to the central trauma department in Kashan Shahid Beheshti medical center, Kashan, Iran. We recruited a convenience sample of 400 patients with multiple trauma. Data were collected using the circulatory assessment questionnaire and controlling hemorrhage (CAQCH) that were designed by the researchers and were described by using frequency tabulations, central tendency measures, and variability indices. The chi-square test was used to analyze the data. RESULTS: The study sample consisted of 263 males (75.2%); 57.75% had lower levels of education and 28.75% were workers. The most common mechanism of trauma was traffic accident (85.4%). We found that the quality of circulatory management was unfavorable in 61% of the cases. A significant relationship was observed between the quality of circulatory management and type of trauma and staff's employment status. CONCLUSIONS: The quality of pre-hospital circulatory management provided to patients with multiple trauma was unfavorable. Therefore, establishment of in-service training programs on circulatory management is recommended.

Quality of working life of nurses and its related factors.

BACKGROUND: Nurses as the largest group of health care providers should enjoy a satisfactory quality of working life to be able to provide quality care to their patients. Therefore, attention should be paid to the nurses' working life. OBJECTIVES: This study aimed to investigate the quality of nurses' working life in Kashans' hospitals during 2012. MATERIALS AND METHODS: This cross-sectional study was conducted on 200 nurses during 2012. The data-gathering instrument consisted of two parts. The first part consisted of questions on demographic information and the second part was the Walton's quality of work life questionnaire. Data were analyzed using the SPSS software. For statistical analysis T test and one way ANOVA were used. RESULTS: The results of the study showed that 60% of nurses reported that they had moderate level of quality of working life while 37.1% and 2% had undesirable and good quality of working life, respectively. Nurses with associate degrees reported a better quality of working life than others. A significant relationship was found between variables such as education level, work experience, and type of hospital with quality of working life score (P < 0.05). No significant differences were observed between quality of working life score of nurses with employment status (P = 0.061), salary (P = 0.052), age, gender and marital status (P > 0.05). CONCLUSIONS: Nurses' quality of work life was at the moderate level. As quality of work life has an important impact on attracting and retaining employees, it is necessary to pay more attention to the nurses' quality of work life and its affecting factors.

Efficacy of prehospital spine and limb immobilization in multiple trauma patients.

BACKGROUND: Injuries are a major cause of mortality and disability worldwide and are estimated to become the third leading cause of death by 2020. Most traffic deaths occur during the prehospital phase; consequently, prehospital trauma care has received considerable attention during the past decade. However, there is no study on the prehospital immobilization of spine and limbs in patients with multiple trauma in Iran. OBJECTIVES: This study aimed to investigate the epidemiology of trauma and the quality of limb and spine immobilization in patients with multiple trauma transferred to Shahid Beheshti Medical Center via emergency medical services (EMS). PATIENTS AND METHODS: This cross-sectional study was conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by EMS to the Central Trauma Department of the Shahid Beheshti Medical Center, Kashan, Iran. The study used a checklist and we recruited a convenience sample of 400 patients with multiple trauma. Data were described by using frequency tables, central tendency measures, and variability indices. Moreover, we analyzed data using SPSS. RESULTS: The study sample consisted of 301 (75.2%) males and 99 (24.8%) females. The most common mechanism of trauma was traffic injuries (87.25%). Motorcyclists constituted 52.25% of the road traffic injuries victims. Overall, the quality of immobilization was at an undesirable level in 95.8% of patients with spine and limbs injuries. A significant association was observed between the quality of spine and limbs immobilization and the EMS workers' education level (P = 0.005). CONCLUSIONS: The quality of spine and limb immobilizations was undesirable in more than 90% of cases. Due to the importance of good spine and limb immobilization in patients with multiple trauma, prehospital EMS technicians should be retrained for proper immobilization in patients suspected of spine or limb injuries. Developing evidence-based protocols and strengthening the regulatory and supervisory system to improve quality of prehospital emergency care in patients with multiple trauma is recommended.

Epidemiology of patients with multiple trauma and the quality of their prehospital respiration management in kashan, iran: six months assessment.

BACKGROUND: Respiration management is an important and critical issue in prehospital transportation phase of multiple trauma patients. However, the quality of this important care has not been assessed in Iran Emergency Medical Services' (EMS). OBJECTIVES: This study was conducted to investigate the quality of prehospital respiration management in patients with multiple trauma, referred to the Shahid Beheshti Trauma Center, Kashan, Iran. PATIENTS AND METHODS: This cross-sectional study was conducted in the first six months of 2013. All the 400 patients with multiple trauma, transferred by EMS to the Shahid Beheshti Medical Center, were recruited. The study instrument was a checklist, which was completed through observation. Descriptive statistics were presented. RESULTS: Out of all included individuals, 301 were males (75.2%) and 99 were females (24.8%). The most common mechanism of trauma was traffic accident (87.25%). Furthermore, 71.7% of the patients were injured in head and neck and chest areas. The quality of consciousness monitoring and airway management was desirable in 95% of the cases. However, the quality of monitoring patients' respiration was only desirable in 42% of the cases. Only 18.6% of the patients received oxygen therapy during prehospital transportation. CONCLUSIONS: The quality of monitoring patients' respiration and oxygen therapy was undesirable in most patients with multiple trauma. Therefore, the EMS workers should be retrained to apply proper respiration management in patients with multiple trauma.

The quality of pre-hospital oxygen therapy in patients with multiple trauma: a cross-sectional study.

BACKGROUND: Trauma is a major healthcare challenge worldwide. In developing countries, most road deaths happen during the pre-hospital phase; consequently, pre-hospital trauma care has received considerable attention during the past decades. OBJECTIVES: The aim of this study was to investigate the quality of pre-hospital oxygen therapy in patients with multiple trauma. PATIENTS AND METHODS: This cross-sectional study was conducted in the year 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services to the central trauma department in Shahid Beheshti Medical Center, Kashan, Iran. The data collection instrument had three parts including demographic, a trauma assessment, and an oxygen therapy quality assessment questionnaires that were designed by the researchers. In total, 350 patients with multiple trauma were recruited from March through July 2013. Data were described by using frequency tables, central tendency measures, and variability indices. Moreover, we analyzed data by using the Chi-square test, Mann-Whitney U test, and the logistic regression analysis. RESULTS: The study sample consisted of 263 (75.1%) male and 87 (24.9%) female patients. Overall, 211 patients needed oxygen therapy during the pre-hospital phase; however, only 35 (16.60%) patients had received oxygen. The quality of oxygen therapy was undesirable in 92.42% of cases. In addition, 83.4% of patients, whose pre-hospital records indicated the administration of oxygen, reported that they had not received oxygen therapy. Logistic regression analysis revealed that the place of accident and the level of patients' education were significant predictors for administration of oxygen during the pre-hospital phase (P < 0.001). CONCLUSIONS: The quality of pre-hospital oxygen therapy had been provided for the patients with multiple trauma was poor while these patients, particularly patients with chest traumas and head injuries, were in urgent need of oxygen therapy. Consequently, developing and implementing standard evidence-based oxygen therapy protocols and administrating continuous education programs are recommended.

The role of continuous care in reducing readmission for patients with heart failure.

INTRODUCTION: About 20-50% of patients with heart failure are readmitted to hospitals in 14 day to 6 months of hospital discharge. Several supportive programs are developed to reduce post discharge hospital readmissions. The present study was performed to review the clinical trials conducted to determine the effect of post-discharge follow-up on readmission of patients with heart failure (HF).  METHODS: Internet search was conducted to identify clinical trial studies that have been conducted on post-discharge follow-up care for patients with HF. Databases of Science direct, Pubmed, Iranmedex, SID and also the Google's search engine were searched for studies that have been published between the years 1995 and 2013. Keywords used in searching Persian databases were included readmission, heart failure, continuous care, and follow-up. Keywords used in searching English databases were included of heart failure, readmission, follow-up and home monitoring. RESULTS: 21 clinical trials were reviewed. 16 studies have shown that continuous care through patient education before discharge, home visits, and telephone follow up could significantly reduce the rate of post discharge readmissions of patients with HF. However, five studies did not show significant reductions in post-discharge readmissions. CONCLUSION: Patient education and continuous post-discharge follow up interventions conducted by nurses could significantly reduce the rates of readmissions to the hospital or to the physicians' office. Considering limited health care resources, using one or a combination of follow-up methods, can reduce the number of readmissions of patients with HF.