The components of diabetes educator's competence in diabetes self-management education in Iran: A qualitative study.

BACKGROUND: Limited research has been conducted in the field of diabetes educator's competency. However, no comprehensive and integrated explanations of educator's competence requirements in treatment centers exist in Iran. The aim of this study is to explain the components of diabetes educator's competence in diabetes self-management education in Iran. MATERIALS AND METHODS: This was a qualitative descriptive-exploratory study. The data were collected through semi-structured and in-depth interviews and using purposeful sampling method in Isfahan University of medical science from April to October 2018. Sampling continued until data saturation. Participants included 20 people who were selected by purposive and snowball sampling method. The interviews were analyzed using content analysis method of Graneheim, Lundman. RESULTS: Data analysis resulted in the emergence of three main categories including (1) Patient and family centered education, (2) process-based education, and (3) continuous progress in profession and also seven subcategories (patient and family activation, empower), facilitating educational process, comprehensive education assessment, development, implementation and evaluation of educational plans, developing educators' educational knowledge and skills, development of creativity and innovation, promote inter-professional cooperation in education. CONCLUSION: The evaluation of facilitation factors for participation and empowerment patient and family along with creativity and interprofessional collaboration for comprehensive evaluation of patients in designing, implementation of educational programs were mentioned as important competencies of diabetes educators, which can have a significant impact on patients' recovery, treatment, and the promotion of society's health.

Challenges and Strategies of Needs Assessment Implementing in Diabetes Self-management Education in Iran: A Qualitative Study.

BACKGROUND: Many diabetes educators in Iran do not have the necessary skills and competence for performing a needs assessment, and thus, cannot provide Diabetes Self-Management Education (DSME) to suit individual educational needs and conditions. The purpose of the present study was to explore and analyze needs assessment implementation in DSME and evaluate the barriers and the appropriate strategies from educators' viewpoints. MATERIALS AND METHODS: The present qualitative study was conducted using a conventional content analysis approach with semi-structured and in-depth interviews and using a purposeful sampling method on 20 nurses, physicians, and endocrinologists. The data of this study were collected from April to October 2018. The interviews were analyzed using the content analysis method of Graneheim and Lundman. RESULTS: Qualitative data analysis resulted in the emergence of two main categories of educational challenges of needs assessment and managerial challenges of needs assessment and four subcategories (lack of structured educational planning, lack of needs assessment practical patterns, managers' insufficient support and supervision, and managers' insufficient attention to motivational factors). CONCLUSIONS: Educational strategic planning, managers' obligation and support in designing practical patterns, and supervision tools to evaluate educators' performance in the needs assessment domain can result in the promotion of DSME needs assessment, the efficiency of plans, and the promotion of society's health.

Experimental and statistical analysis on a nanostructured sensor for determination of p-hydroxybenzoic acid in cosmetics.

In this research, differential pulse voltammetry (DPV) coupled with experimental design, was used for determination of p-hydroxybenzoic acid (PHB) in cosmetics. Optimization of effecting parameters was carried out based on rotatable central composite design (RCCD) and response surface methodology (RSM) at the surface of a nanostructured electrode for achieving the best sensitivity. Sol-gel process was used for synthesize of nickel titanate (NiTiO3) nanoceramics. The structural and morphological characterization of the nanoparticles was studied by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM). Then the NiTiO3 nanopowders were used for surface modification of a carbon paste modified electrode (CPE). Surface characterization of the electrode was accomplished using SEM, electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) techniques. Under the optimized conditions, the voltammograms exhibited two linear dynamic ranges of 0.7-80.0 µM and 80.0-1000.0 µM for PHB with the detection limit of 62.0 nM (S/N = 3). Finally the NiTiO3 nanoceramics modified carbon paste electrode (NiTiO3/CPE) could be employed for the determination of PHB in real samples with satisfactory results.

A carbon paste electrode modified with a nickel titanate nanoceramic for simultaneous voltammetric determination of ortho- and para-hydroxybenzoic acids.

An electrochemical sensor is described for the simultaneous determination of ortho-hydroxybenzoic acid (OHB) and para-hydroxybenzoic acid (PHB). The sensor consists of a carbon paste electrode modified with nickel titanate nanoceramics (NiTiO3/CPE). The NiTiO3 nanoceramics and the nanostructured modified CPE were characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, electrochemical impedance spectroscopy and cyclic voltammetry. Differential pulse voltammetry indicates that the response to OHB (best measured at 0.90 V vs. Ag/AgCl) and PHB (measured at 0.80 V vs. Ag/AgCl) is significantly improved at the modified CPE compared to a bare CPE. The limits of detection (at S/N = 3) are 0.38 and 0.10 µM for OHB and PHB, respectively. The method was applied to the determination of the two isomers in peeling skin lotion and during the Kolbe-Schmitt reaction. Graphical abstract Nickel titanate nanoceramics (NiTiO3) were synthesized by a sol-gel method. Then, a carbon paste electrode modified with NiTiO3 (NiTiO3/CPE) was constructed. The modified electrode was applied to the interference-free and simultaneous determination of ortho-hydroxybenzoic acid (OHB) and para-hydroxybenzoic acid (PHB).

Spiritual experiences of family members to cope with the challenges of childhood disability: A Qualitative study in Iran.

BACKGROUND: If we take the family as a circle, the disabled child is in the center of the circle and weights on all communications in the family. Therefore, in this research, the experiences of all family members are studied. The knowledge about families' experiences helps the caregivers to have a deep recognition of family status and individual and social relations. MATERIALS AND METHODS: This was a phenomenological study. Participants were Iranian families with disabled child and were selected by a goal-oriented sampling. Data collection was done through an unstructured interview. Interviews were transcript based. Data analysis was done by Colaizzi's method. Codes were extracted from the interviews and then the main concepts were formed by organizing the formulated meanings into clusters of themes. RESULTS: Data were being compiled from the 18-h interview tapes and the verbatim transcription of the interviews with the 12 study participants. Then, the researchers formulated the meanings of each significant statement into 65 codes and organized the formulated meanings into following four clusters of themes: 1 - protective structure, 2 - adjustment, 3 - social isolation, 4 - psychological tension. CONCLUSION: The existence of a disabled child may lead to psychological and spiritual distress and vast changes in every aspect of each member of the family.

Quality of Life and Related Factors Among People With Spinal Cord Injuries in Tehran, Iran.

BACKGROUND: Spinal Cord Injury (SCI) is one of the biggest health problems. Disabilities resulting from injuries such as spinal disability requires special attention because of their potential reduced to cause adverse effects in different systems of the body. Today, improving the Quality of Life (QOL) in patients with SCIs is an important goal of treatment. OBJECTIVES: The purpose of this study was to determine the QOL and related factors among people with SCIs. PATIENTS AND METHODS: In this cross-sectional descriptive study, 106 patients with SCI were selected through sampling based on census. Data were collected using a demographic questionnaire and a Short-Form 36 (SF-36) health survey questionnaire for measuring the QOL among patients. Data were analyzed using SPSS 14 software and descriptive and inferential statistics. P < 0.05 was considered statistically significant. RESULTS: The mean QOL in these patients was 37.1 ± 1.7 years (21 - 65 years) and mean disease duration was 7.3±6 years. The most common injury was paraplegia. Most of the patients have moderate QOL (54.7 %). The results showed a significant relationship between QOL and marital status and employment status (P < 0.05). Also, results showed a significant relationship between QOL and education levels (P = 0.002), age (P = 0.001), and duration of illness (P = 0.001).The highest and lowest scores were 64 ± 7.1 and 36 ± 5.3 for understanding General Health (GH) and role physical, respectively. CONCLUSIONS: The results show that patients with SCI have a moderate health-related QOL Determining the QOL is needed to focus on the strengths and weaknesses of patients with spinal cord injuries. Planning principles is recommended in order to reform the disability.

Effect of stress inoculation training on the levels of stress, anxiety, and depression in cancer patients.

BACKGROUND: Cancer is a broad group (over 270 types) of diseases. This disease, like other chronic diseases, occurs in all ages and ethnic groups, and is considered as a major health problem. Stress is one of the most important psychological factors influencing the occurrence of physical diseases, and can lead to severe anxiety, depression, and negative effects on health. It can also make individuals vulnerable to physical diseases, and in the long term, leads to death. This study was conducted to determine the effect of inoculation training on stress, anxiety, and depression in cancer patients. MATERIALS AND METHODS: This study was conducted in 2013 as a clinical trial with convenient random sampling of patients from the chemotherapy clinic of Seyed Al-Shohada hospital of Isfahan. Forty patients with cancer who were eligible for the study were randomly assigned to either case or control group. The case and control groups had the same treatment plans, and the only difference was stress inoculation training administered in the case group, which was composed of eight 90-min sessions over 8 weeks. Data were collected using Depression, Anxiety, Stress Scales 42 (DASS-42) questionnaire and demographic questionnaire, and analyzed by analysis of covariance (ANCOVA) and t-test in SPSS. RESULTS: The results showed that there was a significant difference between case and control groups in terms of stress, anxiety, and depression (P < 0.001). Stress inoculation training reduced stress, anxiety, and depression in cancer patients. CONCLUSIONS: Stress inoculation training significantly reduced stress, anxiety, and depression. Therefore, teaching this skill and the strategies of coping with stress is recommended for these patients, in addition to medicational treatment.

The effect of massage therapy on the quality of sleep in breast cancer patients.

BACKGROUND: Annually, about 6000 new cases are diagnosed with breast cancer in Iran. In Iran, more women are affected with breast cancer than a decade earlier in comparison with other countries, and 70% of them are diagnosed at an advanced phase. Insomnia is the most common disorder following breast cancer, and interference in sleep quality and rest causes changes in physiological functions and reduces the body's daily performance. The objective of this study was to determine the effect of massage therapy on the quality of sleep in patients with breast cancer. MATERIALS AND METHODS: This clinical trial was conducted for about 1 month in a referral chemotherapy clinic of a teaching hospital in Isfahan, Iran. The participants consisted of 57 women with breast cancer who were selected by simple random sampling. They were randomly assigned to two groups of control and experimental. The control group was treated only by usual medical therapy, whereas the case group was treated by combined medical-massage therapy. Data collection tools were the validated Pittsburgh Sleep Quality Index and a demographic questionnaire. Data were analyzed by SPSS using descriptive statistics, Chi-square test, paired t-test, and Student's t-test. RESULTS: The results showed significant differences in the mean scores of quality of sleep before and after the intervention in the case group, while no significant differences were observed in the mean scores of quality of sleep before and after the intervention in the control group. In addition, no significant differences were observed in the mean scores of quality of sleep before the intervention between case and control groups. However, significant differences were observed in the mean scores of quality of sleep after the intervention between case and control groups. CONCLUSION: According to the results of this study, learning and applying massage techniques by medical staff causes health promotion and improves the quality of sleep in cancer patients. Furthermore, massage therapy is suggested as a non-pharmacologic method to improve sleep quality in these patients.

The effects of relaxation on reducing depression, anxiety and stress in women who underwent mastectomy for breast cancer.

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.