Clinical Outcome Comparison between Staged -Bilateral Versus Simultaneous Bilateral Total Knee Replacements.

BACKGROUND: This retrospective study aimed to compare the clinical outcomes of patients with staged and simultaneous bilateral total knee arthroplasty (TKA). METHODS: The present study included 100 patients with a mean age of 62±3.72 years from 2014 to 2017. Among them, 51 and 49 patients underwent simultaneous and staged bilateral TKA, respectively. The two groups were compared regarding the range of motion (ROM), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) improvement, and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores. The mean follow-up duration was 24 months (range: 12-36 months). RESULTS: According to the results obtained from the SF-36 questionnaire (possessing eight different factors of quality of life), there was no significant difference between the two groups. Furthermore, the OKSs were 39.98±1.52 and 38.68±2.55 in the simultaneous and staged groups, respectively. Moreover, the WOMAC improvement scores were obtained at 84.15±2.2 and 83.26±2.6 in the simultaneous and staged groups, respectively. The final knee ROM was acceptable without a significant difference between the two groups. CONCLUSION: Substantial controversy about the complications, functional, and clinical outcomes has negatively affected the decision of the surgeons on conducting bilateral sequential TKA. This clinical assessment revealed that all determinants, including OKS, WOMAC, SF-36, ROM, postoperative bleeding, and hospitalization duration exhibited almost the same improvement in both groups. According to this study, no statistically significant difference exists in both procedures.

Animal-assisted therapy on happiness and life quality of chronic psychiatric patients living in psychiatric residential care homes: a randomized controlled study.

BACKGROUND: Psychiatric patients who live in psychiatric residential care homes may often feel a loss of autonomy, decision making, and participation in social activities. They usually have few or no visitors and also do not have any purpose for living. Animals may increase the happiness and quality of life of psychiatric patients. This study aimed to evaluate the effects of Animal-Assisted Therapy (AAT) on happiness and quality of life of chronic psychiatric patients living in psychiatric residential care homes in Tehran, Iran. METHODS: This randomized controlled trial was conducted with 70 males with a chronic psychiatric disorder who were living in psychiatric residential care homes in Tehran, Iran, in 2016. The patients were randomly selected and divided into animal therapy intervention group and control group. Patients in the intervention group received animal-therapy with a bird for eight weeks. Patients in the control group received no intervention. The Oxford Happiness Inventory evaluated all patients pre and post-intervention. To evaluate life quality, the Wisconsin Quality of Life Index was used. Data were statically analyzed using SPSS Ver.19.0. ANCOVA with pretest statistical control. The significance level was set as p < 0.05. RESULTS: The mean age in both control and intervention groups were 47.12 and 45.82 years, and the mean age of illness onset for both control and intervention groups was 18.94 and 16.83 years, respectively. The result of this study showed that happiness in the intervention group had significantly increased (p < 0.001). The results also showed that the quality of life in four sub-domains increased significantly. CONCLUSION: To bring happiness to chronic psychiatric patients living in psychiatric residential care homes is essential and may result in returning them to society and healthy life. The results of this study showed that AAT was helpful for chronic psychiatric patients living in psychiatric residential care homes and not only made them happy but also increased their quality of life. TRIAL REGISTRATION: This was registered in Iranian Registry of Clinical Trials (IRCT) (clinical trial code: IRCT20101013004922N4. Registered 2018-08-19. Retrospectively registered, https://www.irct.ir/trial/32390.

The effect of emotion regulation training on family relationships of hyperactive children.

INTRODUCTION: One of the psychiatric disorders related to childhood is attention deficit hyperactivity disorder that can negatively affect the family interactions of these children. Parents of these children, especially the mother as the main caregiver, need comprehensive training to make a positive difference in their attitudes and behaviors with these children. The purpose of this study was to investigate the effect of emotion regulation training on family relationships in hyperactive children. METHODS: This was a randomized clinical trial study with a control group performed on eighty mothers of hyperactive children who were selected randomly. The intervention group members attended emotion regulation skills training sessions for one session of 90 min each week for 8 weeks. During the training course in the intervention group, the control group did not receive any training. Data collection tools included demographic information questionnaires, Mother-Child Relationship Evaluation, and Rahim Organizational Conflict Inventory-II. Data analysis was performed by descriptive statistics and the analysis of covariance. RESULTS: The mean scores of the mother-child relationship in the intervention group showed a significant improvement in the subscales of acceptance, overprotection, facilitation, and rejection (P < 0.0001). The results of this research also showed improvements in all the five communication styles of integrating, avoiding, compromising, obliging (P < 0.0001), and dominating (P < 0.012) between spouses. CONCLUSION: It seems that the emotion regulation training approach in mothers with hyperactive children improved both the mother-child relationship and the interactive spousal styles and can be considered by the managers of treatment and rehabilitation field as an adjunctive therapy for the families of these children.

Data for the level of women׳s self-esteem and couples' sexual satisfaction before and after mammoplasty.

Nowadays, one of the existing problems in the societies is the increase in the rate of plastic surgeries such as mammaplasty, especially among the women in Iran. The present study was conducted on the positive and negative effects of this surgery on Iranian women׳s self-esteem and couples' sexual satisfaction before and after mammaplasty. The analysis is based on data of a pretest -posttest design with only one group conducted on 100 couples. Three questionnaires of demographic characteristics, Rosenberg׳s self-esteem, and women׳s and men׳s sexual satisfaction were adopted. The questionnaires were completed before surgery and two months after by the couples. Among 100 studied participants, mean self-esteem before and after mammaplasty were 18.77 and 17.96 respectively. Mean women׳s sexual satisfaction before and after surgery were 30.80 and 39.80 respectively. In conclusion, mammaplasty is effective on increase of women׳s sexual satisfaction, but it has no effect on increase of their self-esteem and their husbands' sexual satisfaction.

Relationship between Health Literacy and Sexual Function and Sexual Satisfaction in Infertile Couples Referred to The Royan Institute.

BACKGROUND: Health science and technology today is a rapidly growing field. Health is a multifaceted concept influenced by several factors, and health literacy is essential to deal properly with the current situation. In this study, the association between health literacy and sexual function and sexual satisfaction were investigated in 2016. MATERIALS AND METHODS: This descriptive and correlational study was conducted on 193 couples in the Royan Institute, Tehran. Data collection instruments were three standard questionnaires which included the Test of Functional Health Literacy, the Female Sexual Function Index (FSFI) and the International Index of Erectile Function, and the Iranian version of the Sexual Satisfaction Scale. The data were analyzed using SPSS-v23 software at a significance level of 0.05. RESULTS: Marginal health literacy, 49.7% among men and 44.1% among women, was more common than adequate or inadequate health literacy. Erectile function for the majority of men was appropriate (53.3%), compared to 16.6% who had perfect function and 30.1% for whom function was less than appropriate. The majority of women (57.0%) had sexual dysfunction. One hundred and three (53.3%) men had appropriate sexual function and 57% of women had normal sexual function. The greater proportion of men (50.8%) and women (46.1%) had good, rather than very good or less than good, sexual satisfaction. The results of chi-square tests indicated that greater health literacy was associated with higher levels of sexual function and sexual satisfaction among men and women. However, application of the Cramer's V test indicates that the strength of these associations is moderate to weak. CONCLUSION: Health literacy was marginal among most couples and its adverse impacts on sexual function and sexual satisfaction were confirmed. Accordingly, it is recommended that plans be developed to promote health literacy among infertile couples.

An investigation on the level of awareness, attitude, and interest among medicine, dentistry, and pharmacy students toward their majors on entering university: The case of Islamic Azad University, Tehran medical sciences branch.

INTRODUCTION: Having awareness, interest, and positive attitude toward one's fields of study leads to the development of a compatibility between demands and expectations on the one hand and future career on the other hand. This study was carried out to determine the level of awareness, attitude, and interest of medicine, dentistry, and pharmacy students of Islamic Azad University, Tehran Medical Sciences Branch toward their own field of study on entering university. MATERIALS AND METHODS: This research is a basic descriptive study conducted on 273 students who had just entered university. This study was performed using census. Data collection instrument was a four-part questionnaire which included demographic information, and questions measuring students' awareness, attitude, and interest. RESULTS: With regard to their field of study, there was no statistically significant difference in the average of students' awareness (P = 0.731). The attitude of medicine students was significantly more positive than pharmacy and dentistry students (P < 0.001), and the attitude of dentistry students was significantly more positive than that of pharmacy students (P = 0.460). Medical students' interest level was significantly higher than that of pharmacy and dentistry students (P < 0.05), and the interest level of dentistry students was significantly greater than the interest level of pharmacy students (P = 024/0). There was a statistically significant positive relationship between awareness and attitude and between awareness and interest in all of the study subjects (P < 0.001). CONCLUSION: The study results indicated that having a high level of awareness toward one's major led students studying in medicine, dentistry, and pharmacy to experience a more positive attitude and a higher level of interest. Thus, before entering the university, academic counseling will be beneficial for acquiring a better understanding of most majors, a goal which could be provided through school, social media, and family.

Effects of a Continuous Care Model on Patients' Knowledge and Health-Related Quality of Life in Systemic Lupus Erythematosus.

PURPOSE: The purpose of this study was to evaluate the effects of applying the continuous care model (CCM) on the knowledge level and health-related quality of life (HRQoL) of systemic lupus erythematosus (SLE) patients and their perceptions of family awareness about the disease. DESIGN: The Continuous Care Model (CCM) was implemented for 3 months on 34 SLE patients, in a pretest-posttest quasiexperimental design. METHODS: Two sets of questionnaires were designed for knowledge assessment. HRQoL was assessed by SF-36 questionnaires. Analysis was by paired t test and one-way ANOVA. FINDINGS: The continuous care model significantly improved patients' knowledge level and their perceptions of their family members' awareness of their disease. HRQoL status in SLE patients was poorer than the general population in six of eight SF-36 scales (p < .05), except for Bodily Pain and Mental Health. Postintervention scores showed improvement in six SF-36 scales (p < .001), except for Bodily Pain and Social Functioning. CONCLUSIONS: Our results underlined the advantages of applying the CCM as a comprehensive method of self-care in SLE. CLINICAL RELEVANCE: Despite many improvements in SLE care, the patients' quality of life is still much affected by SLE. Implementation of the CCM could lead to improvement in the knowledge and HRQoL of SLE patients.

Efficacy of neurolinguistic programming training on mental health in nursing and midwifery students.

BACKGROUND: Neurolinguistic programming (NLP) refers to the science and art of reaching success and perfection. It is a collection of the skills based on human beings' psychological characteristics through which the individuals obtain the ability to use their personal capabilities as much as possible. This study aimed to investigate the efficacy of NLP training on mental health in nursing and midwifery students in Islamic Azad University Tehran Medical Sciences branch. MATERIALS AND METHODS: In this quasi-experimental study, the study population comprised all nursing and midwifery students in Islamic Azad University, Tehran Medical branch, of whom 52 were selected and assigned to two groups through random sampling. Data collection tool was Goldberg General Health Questionnaire (28-item version). After primary evaluation, NLP training was given in five 120-min sessions and the groups were re-evaluated. The obtained data were analyzed. RESULTS: In the nursing group, paired t-test showed a significant difference in the scores of mental health (with 39 points decrease), physical signs (with 7.96 scores decrease), anxiety (with 10.75 scores decrease), social function (with 7.05 scores decrease) and depression (with 9.38 scores decrease). In the midwifery group, it showed a significant difference in mental health (with 22.63 scores decrease), physical signs (with 6.54 scores decrease), anxiety (with nine scores decrease), and depression (with 8.38 scores decrease). CONCLUSIONS: This study showed that NLP strategies are effective in the improvement of general health and its various dimensions. Therefore, it is essential to conduct structured and executive programs concerning NLP among the students.

A study of patient safety management in the framework of clinical governance according to the nurses working in the ICU of the hospitals in the East of Tehran.

BACKGROUND: The improvement of patient safety conditions in the framework of clinical service governance is one of the most important concerns worldwide. The importance of this issue and its effects on the health of patients encouraged the researcher to conduct this study to evaluate patient safety management in the framework of clinical governance according to the nurses working in the intensive care units (ICUs) of the hospitals of the east of Tehran, Iran in 2012. MATERIALS AND METHODS: This descriptive study, which was based on census method, was conducted on 250 nurses sampled from the hospitals located in the east of Tehran. For the collection of data, a researcher-made questionnaire in five categories, including culture, leadership, training, environment, and technology, as well as on safety items was used. To test the validity of the questionnaire, content validity test was conducted, and the reliability of the questionnaire was assessed by retest method, in which the value of alpha was equal to 91%. RESULTS: The results showed that safety culture was at a high level in 55% of cases, safety leadership was at a high level in 40% cases and at a low level in 2.04% cases, safety training was at a high level in 64.8% cases and at a low level in 4% cases, safety of environment and technology was at a high level in 56.8% cases and at a low level in 1.6% cases, and safety items of the patients in their reports were at a high level in approximately 44% cases and at a low level in 6.5% cases. The results of Student's t-test (P < 0.001) showed that the average score of all safety categories of the patients was significantly higher than the average points. CONCLUSIONS: Diligence of the management and personnel of the hospital is necessary for the improvement of safety management. For this purpose, the management of hospitals can show interest in safety, develop an events reporting system, enhance teamwork, and implement clinical governance plans.

The relationship between spiritual intelligence with psychological well-being and purpose in life of nurses.

BACKGROUND: Spiritual intelligence is defined as the human capacity to ask questions about the ultimate meaning of life and the integrated relationship between us and the world in which we live. It results in an increase in psychological well-being of individuals as well as having a goal in their life. This study was conducted to investigate the relationship between spiritual intelligence with purpose in life and psychological well-being among the nurses. MATERIALS AND METHODS: The study was a descriptive correlation study. In this study, 270 nurses were selected from some hospitals of Tehran University through convenient sampling. Data were collected through a four-section questionnaire including demographic characteristics, a 24-item questionnaire of spiritual intelligence and its four components, psychological well-being questionnaire with six subscales and 84 questions, and the questionnaire of purpose in life with 20 questions. The data obtained from the questionnaires were analyzed through SPSS software. RESULTS: The results showed that there was a significant relationship between spiritual intelligence with psychological well-being and having a purpose in life. Furthermore, there was a significant association between the components of spiritual intelligence including conscious state expansion, personal meaning production, transcendental awareness, and critical existential thinking with psychological well-being. CONCLUSION: High level of spiritual intelligence in nurses helps them to improve their psychological well-being and have a purpose in life, which can lead to the health provision of them and their patients.

The effects of self-care training on quality of life in patients with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system with debilitating symptoms and complications. Therefore, education and appropriate interventions, including self-care education, are necessary to increase the quality of life in these patients. The purpose of this study was to determine the influence of self-care education on quality of life in MS patients affiliated to Iranian MS Association. MATERIALS AND METHODS: This quasi-experimental study assessed a single group of MS patients before and after training. Totally, 50 MS patients were selected non-randomly from the patients referring to Iranian MS Association. A two-part questionnaire was used to collect data. The first part included demographic information and the second part consisted of a quality of life questionnaire (MSQOL-54) including 54 items in 3 sections and 14 subgroups. The scores ranges from zero to a hundred in each subgroup. The reliability of the questionnaire has been confirmed (Cronbach's alpha = 0.96). The questionnaires were filled out by the patients before training. After at least six 50-minute training sessions during three months, the same questionnaire was again completed by the participants. Statistical analyses, including absolute and relative frequency tables and mean and standard deviation for descriptive analysis, and t-test and Pearson correlation for descriptive analysis, were performed by SPSS. FINDINGS: The mean values of quality of life in physical health, pain, fatigue, health conception, changes in health status, sexual activities, as well as overall quality of life scores differed significantly after training. Moreover, except for cognitive activity, there were significant differences in values of mental health before and after training. CONCLUSIONS: Designing and applying the self-care programs based on the educational needs of MS patients has a positive effect on physical and psychological aspects of their quality of life.

Efficacy of life skills training on general health in students.

BACKGROUND: With regard to the importance of life skills, the present study deals with the effect of life skills training on general health of the students. MATERIALS AND METHODS: This was a one-group, pre-test, post-test, quasi-experimental research. Forty students were selected through purposive sampling method. The data collection tool was Goldberg General Health Questionnaire. RESULTS: Paired t-test showed a 22 score significant decrease in general health after education compared to before education (P < 0.01). CONCLUSION: This study showed that life skills education increases general health level of the students.

The efficacy of self-care education on rehabilitation of stroke patients.

OBJECTIVE: To determine the efficacy of self-care education on rehabilitation of hemiplegic stroke patients discharged from hospital. METHODS: For this experimental study, 80 patients were randomly assigned to 2 groups at Urmia University of Medical Sciences Hospitals, Iran, in 2008. First, we recorded the demographic data, and ability performance of both groups, then self-care education was given for the experiment group. Finally, both groups were retested 45 days following the last self-care education section of the experiment group. RESULTS: The results of the study showed a significant difference between the mean acquired distinctions in different performance fields before and after education for the study group (p=0.0001). In addition, the findings showed a significant difference between the 2 groups post-test (p=0.0001). We statistically concluded by independent t test that the level of performance in the experimental group was higher than the controls (t=19.83; p=0.0001). CONCLUSION: Self-care education of stroke survivors can improve patient's performance, and change them from a dependent to an independent person.