Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients.

BACKGROUND: Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF. METHODS: A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests. RESULTS: The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03-0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03-0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016). CONCLUSIONS: Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient's condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.

The Meaning of Life Related to Heart Disease and Its Relationship to Quality of Life After Repeat Coronary Artery Angioplasty.

PURPOSE: Following angioplasty for coronary artery disease, patients may search for a new meaning of life. The purpose of this study was to determine patients' meaning of life related to heart disease and its relationship to quality of life after repeat coronary artery angioplasty. METHODS: The current descriptive-correlation study recruited 144 patients with coronary artery disease admitted to hospitals in Karaj, Iran. Data were collected using a demographics questionnaire, the Meaning in Heart Disease (MHD) instrument, and the Iranian version of the Short Form Health Survey (SF-12), and were analyzed with descriptive statistics and the Pearson correlation. FINDINGS: There was a significant relationship between the meaning of life related to heart disease (creating illusions, changing goals, reattribution, and meaning congruence) and quality of life scores (p <.05). CONCLUSION: The majority of the patients undergoing repeat angioplasty used the creation of illusions to support a positive attitude toward their heart disease. Nursing interventions based on the individual patient's meaning of life can promote health and life quality.

Perceived Barriers to Mammography Adoption among Women in Iran: A Qualitative Study.

BACKGROUND: Breast cancer is the most commonly diagnosed tumorous cancer and the second leading cause of cancer-related deaths among women worldwide. This study aimed to qualitatively explore the barriers to mammography adoption among Iranian women. METHODS: This study is a qualitative component of a large research project on exploratory sequential mixed method design, utilizing conventional content analysis. In total, 24 participants were selected from among women who had participated in the first phase of the study. Data were collected through in-depth, semi-structured interviews. RESULTS: Five main themes were extracted, consisting of unawareness of mammography, fear control, priority of mammography needs, inadequate competency of mammography centers, and a sense of losing family support. CONCLUSION: Different perceived barriers within various levels (individual, intrapersonal, health systems, and community) play influential roles in women's decisions to participate in breast cancer screening program, which indicates the cultural aspect of perceived barriers in different communities and countries. The study provides the basis for intervention planning in this regard.

Assessing the mediating role of breast conflict on cognitive factors associated with adopting mammography.

Breast conflict may represent a woman's unpleasant feelings toward her breasts, which may adversely affect her decision to undertake the procedures for an early detection of breast cancer. The purpose of the present study was to examine the mediating role of breast conflict in cognitive factors, as suggested by the Health Belief Model (HBM), for adopting mammography. In this explanatory cross-sectional study, multistage cluster sampling was employed to recruit 738 women in the age range of 40 to 69 years in Iran. Champion's revised HBM Scale for mammography adoption and the Women's Breast Conflict Scale were used to measure the variables of interest. Generalized structural equation modeling and hierarchical logistic regression were used for data analysis. Breast conflict was negatively associated with perceived barriers of mammography. Perceived barriers were inversely related to self-efficacy, which was positively related to mammography, suggesting the mediating role of perceived barriers and self-efficacy, connecting breast conflict to mammography indirectly. The mediating role of breast conflict in perceived barriers and self-efficacy suggests an indirect link between breast conflict and mammography. Clinicians and public health-care providers must pay attention to women's feelings in formulating and delivering appropriate interventions and consultations.

Psychological Needs, Satisfaction and Intention to Migrate in Iranian Nurses: A Qualitative Content Analysis.

BACKGROUND: The shortage of nurses is a global health problem and one of the main challenges for healthcare systems throughout the world including Iran. One of factors that affect the migration trends is psychological needs satisfaction. This study aimed at identifying the psychological factors which persuade Iranian nurses to migrate and suggesting necessary measures in this regard. METHODS: This qualitative study was conducted through a traditional content analysis approach on 20 working Iranian nurses who are migrating to other countries between 2015 and 2017. Data were collected through interviews and observation in different wards of hospitals in Iran. Data were written and analyzed after reduction, naming them, obtaining analytical codes, and identifying the categories and subcategories using traditional method. RESULTS: Three main categories in relation to satisfaction of the psychological needs and reasons for migration were obtained after data analysis. The first category was "authority" with two subcategories of independent decision-making power and being unconsidered, the second category was "social support" with three subcategories of communication with health team members, communication with nurse colleagues, and communication with nurse managers, and the third category was "job promotion" with four subcategories of addressing the routines, nurse role, job promotion opportunities, and teaching organizational environment. CONCLUSION: Identifying problems and obstacles to achieve the goal is the first step to solve the problem. This study provided further and clearer understanding of psychological causes regarding decision of nurses to migrate to developed countries, and nurses noted that the decision to migrate is in the search to meet their psychological needs.

Dealing with Chronic Illness: Experiences of Iranian Families of Persons with Multiple Sclerosis-A Qualitative Study.

BACKGROUND: Today family members are providing care and support to each other during illness. In particular, in chronic illness, such as multiple sclerosis, the families are more involved in caring for and supporting their patients, so they use several strategies to cope with this situation. The purpose of this study was to explore the coping strategies in family caregivers of persons with multiple sclerosis in Iran. METHODS: This is a qualitative study that was conducted through 18 family caregivers of persons with multiple sclerosis. A purposeful sampling method was used. Data were collected through semistructured and in-depth interviews conducted in Multiple Sclerosis Society and hospitals of Tabriz in Iran. The collected data was analyzed according to qualitative content analysis. RESULTS: Five main categories were elicited from interviews: "using spirituality," "living with hope," "experiencing persistence and stability," "seeking support," and "seeking alternative treatments." Conclusion. The study findings can help to inform the support given to families to help them cope with the effects of caring for someone with multiple sclerosis. Health system managers and professionals by using these results are able to support patients and their families appropriately in order to improve their quality of life and alleviate the complications of disease.

The effect of two educational methods on knowledge and adherence to treatment in hemodialysis patients: clinical trial.

INTRODUCTION: Patients with chronic renal disease (CRD) deal with many potential problems with hemodialysis for all their life. Regarding the importance of preventing dialysis adverse effects, which are in close connection with lack of knowledge and report on how to train the patients? This study aims at comparing the impact of two methods of face to face training and training pamphlet on complying and informing of hemodialysis treatments. METHODS: This clinical trial study was conducted on 58 hemodialysis patients who visited Shahid Rahnemun Teaching hospital, Yazd, Iran, and had required conditions of the research. Data were collected through a questionnaire including personal-social information, several questions to assess the level of compliance and to inform the treatment method. The quantitative analysis of this study used the Statistical Package for Social Sciences SPSS version 13 and descriptive (frequency, mean, standard deviation) and inferential (Chi-square, paired t-test, ANOVA, ANCOVA) statistics were employed. RESULTS: The mean scores for informing both groups (face to face and training pamphlet) were significantly increased. The mean score for adherence to treatments was also significant. CONCLUSION: In this research, face to face training was found to be more effective than training pamphlet. It seemed to have more strong effect on increasing the level of information and adherence to treatment. To train these people, face to face training should be, thus, preferred.

The lived experiences of patients post coronary angioplasty: a qualitative study.

Few qualitative studies have focused on the experiences of patients post angioplasty. A deep understanding of patient experiences of care and the way a treatment can affect their everyday life is particularly important in chronic disease management. The aim of this study was to explore experiences that patients undergo after angioplasty. Using a phenomenological study design, 15 patients participated in individual, face-to-face, semistructured interviews. Data were analyzed using qualitative content analysis. The following core themes emerged from the analysis, which reflect the experiences of patients post angioplasty: (a) Angioplasty is a milestone in the patient's life, (b) living with a mended heart, and (c) psychological distress as an integral part of the patient's life. Participants after angioplasty went through both positive and negative changes in their life. Understanding these experiences is essential to modifying high-risk behaviors while supporting patients through their rehabilitation.

The effect of folic Acid on menopausal hot flashes: a randomized clinical trial.

INTRODUCTION: The use of alternative therapies for the treatment of menopausal hot flashes has increased due to the serious risk of hormone therapy. Most alternative therapies have not been accepted by women. Therefore, conducting a study to find effective treatment, which has a low rate of complications and is more acceptable, is necessary. The aim of this study was to assess the effects of folic acid on menopausal hot flashes. METHODS: In the present study 70 menopausal women were placed into two groups of 35 with random allocation, and were treated with folic acid 1 mg tablets and placebo tablets once a day during four weeks. Information was gathered by questionnaire, interviews, and hot flash diary during five stages. Comparisons of within-group RESULTS were performed by ANOVA and between-group results were performed using ANCOVA. Data were analyzed by SPSS for Windows. RESULTS: There was a significant difference between mean severity, duration, and frequency of hot flashes before and after treatment within both groups. In comparing the results between the groups, mean hot flash severity in second, third, and fourth weeks were significantly different. The mean hot flash frequency was significantly different in third and fourth weeks, and the mean hot flash duration was significantly different in the fourth week. CONCLUSION: The results of the present study indicated that folic acid was effective in reducing the severity, duration, and frequency of hot flashes during menopause. Therefore, it can be recommended as an affordable and accessible method for treating menopausal hot flash for women.