Jundishapur Journal of Chronic Disease Care
Volume:3 Issue: 3, Jul 2014

Patients with sickle cell disease suffer from various complications during their lifetime. In order to cope with the disease, they must adapt themselves to a complex set of behaviors that promote self-management and prevent complications associated with the disease. Chronic disease self-management programs are a combination of strategies that increase self-efficacy and promote self-management behaviors.. This study aimed to determine the effectiveness of self-management programs on self-efficacy in patients with sickle cell disease..Patients and In this quasi-experimental study, 69 patients with sickle cell disease who were referred to the Thalassemia Clinic of Ahvaz Shafa Hospital were entered into the study through the census method. Then, the self-management program was implemented using the 5A method for 12 weeks. The Levels of pre and post intervention self-efficacy were assessed using the sickle cell self-efficacy scale (SCSES), while descriptive statistics, paired t-test and Wilcoxon test were used to analyze the data.. Before the intervention, the majority of subjects (50.7%) had moderate self-efficacy, whereas after the intervention, the majority of patients (81.2%) showed high self-efficacy. The overall scores and scores of the post-intervention self-efficacy sub-groups were significantly increased (P < 0.001).. The results of this study showed that self-management interventions are effective in promoting self-efficacy in patients with sickle cell disease. Thus, the use of self-management programs is advisable to change behaviors and promote self-efficacy in such patients..

Because of the nature of their disease, patients with mental disorder are more at risk and usually fail to recognize their natural rights in comparison to other patients.. The present study aims to determine the relationship between nurses'' awareness of the rights of patients with mental disorder and the respect for the rights from nurses'' perspective..Patients and This research is a cross-sectional study whose participants were 43 nurses working in psychiatric wards of hospitals in Ahvaz. We used questionnaires to collect data that was analyzed using descriptive statistics and Pearson correlation coefficient test.. Awareness of the majority of nurses about the rights of the patients with mental disorder and respect for their rights from their perspective were at a good level. Using Pearson correlation coefficient test, a statistically significant correlation was found between the level of awareness of and the respect for their rights from the perspective of nurses (P ≤ 0.002).. This study clearly showed a significant correlation between awareness of and respect for the rights of patients with mental disorder from the nurses'' perspective. Also, considering the specific condition of these patients and psychiatric wards, relevant authorities should take further measures to increase awareness of the healthcare staff regarding the rights of these and subsequently increase its compliance so that we witness the practical and real respect for patients'' rights by medical staff..

Cardio vascular diseases (CVDs) are the main cause of death around the world and coronary artery bypass grafting (CABG) has proven to be the most effective treatment for ischemic coronary heart diseases when other treatments are ineffective. Despite the perceived improvement in the health of patients undergoing CABG, there are problems that result from operations after they are discharged from hospital. Provision of information is an integral part of most psychological interventions. Having a clearer understanding of patients’ experiences will be helpful to healthcare workers with respect to patients’ care and education planning. Caring science places more attention on the patient''s everyday life from his/her perspective. Most of the studies conducted in Iran used a quantitative method or measured care needs according to pre-defined criteria.. The aim of this study was to explore the lived experiences of patients who have undergone cardiac surgery, in order to obtain a deeper understanding of what they experienced and what those who provide care for these patients experienced..Patients and A qualitative design, using a content analysis approach, was adapted to collect the data and analyze the experiences of 18 patients after cardiac surgery through a purposive sampling strategy. After the selection of the participants, semi structured interviews were held in order to collect the data. Scientific accuracy, and rigor of the data and research ethics were respected.. The data analysis revealed three main themes and 11 subthemes, categorized as conceptual and abstract, based on their nature: concern of going out therapeutic framework (Fear of the recurrence of heart attack, Fear of performing more activities than permitted, Fear of taking journeys, Fear of mass communication)/Tired of living within the confines of the therapeutic framework (Need to take various medications, Dietary restrictions, Limitations in function, Family fatigue)/Living between boundaries (Feeling caught between wanting to accept or reject treatment, Feeling caught between the sadness of having the disease and the joy of it not getting worse, Feeling caught between knowing and not knowing).. Patients’ experiences after cardiac surgery indicated the need for the consideration of holistic care and supportive intervention programs after surgery to promote recovery and a better quality of life following cardiac surgery..

Most people do not appreciate the aging period because of lack of knowledge or unknown backgrounds; therefore, they get affected by chronic mental disorders. Depression is one of the most predominant chronic mental disorders.. In this study, we aimed to examine the relationship between quality of life (QOL) and spiritual well-being among geriatric retired employees of the oil industry in Khuzestan, Iran, who had chronic depression..Patients and This was a cross-sectional study on 200 retired employees of the oil industry in Khuzestan, Iran, selected using simple random sampling technique. The variables were measured by three different standard questionnaires, including the QOL questionnaire (SF12), spiritual well-being scale (SWB), and depression scale (GDS).. The mean age of the study group was 65 ± 4 years. Most of the patients had elementary or middle school level of education (44%). Hypertension was the predominant chronic disease associated with depression (37%). The mean QOL, spiritual well-being, and depression scores were 27.9 ± 6.4, 105 ± 13.8, and 4.2 ± 4.35, respectively. Spiritual well-being had a significant negative correlation with depression (P = 0.0001), indicating that the prevalence of chronic diseases such as depression decreased as spiritual well-being increased. There was also a significant negative correlation between the QOL and depression (P = 0.0001).. The results of our study showed that chronic depression disorder was significantly correlated with QOL and spiritual well-being of the elderly. To have healthy, independent, and happy geriatrics, it is important to consider such problems..

The key factor in the management of diabetes mellitus (DM) is promoting self-care behavior, which may help to control patients’ blood glucose appropriately. The first step in DM management is to identify the patients’ self-care needs.. The present study aimed to determine and compare self-care performance between children and adolescents with type 1 DM (DM-1)..Patients and This descriptive-analytical research was conducted on 99 children and adolescents with DM-1 who were referred to the Endocrinology and Metabolism Research Institute of Isfahan in the first half of 2012. The participants were recruited using convenience sampling procedure. The data were collected using researcher-made questionnaire; the reliability and validity of this questionnaire were examined and approved before administration to the subjects. The data were analyzed using SPSS.. The items were quantified on a five-point Likert scale. With regard to nutrition, 36.4% of children and 40.9% of adolescents had moderate performance. Moreover, 56.3% of children and 47% of adolescents showed moderate performance regarding DM management and 37.9% of adolescents had moderate performance in exercise training. The subjects had good and very good self-care performance scores. The results showed no significant difference in the mean scores of overall self-care performance between children and adolescents; however, there was a significant difference in the mean scores of exercise training and glucose self-monitoring between males and females, which indicated females’ weaker performance in comparison to that of males regarding these two factors (P = 0.02).. Identifying the needs of children and adolescents with DM-1 in terms of self-care and education may help them to have better performance in management, control, and prevention of DM complications..

Context: Migraine is a kind of primary headache that affects 10% to 20% of people worldwide. Recent studies have shown that migraines can be involved in strokes incidences, especially ischemic strokes.Hence, the current study aimed to review evidence in relation to migraine and risk of stroke.. Evidence Acquisition: A literature search was done for related articles dated between 1993 and 2013 on PubMed, Science Direct, Embase, Web of Science and Scopus for both English and non-English language articles by entering “migraine”, “migraine with aura”, “headache” and “ischemic and hemorrhagic stroke” as keywords.. In most evaluated studies, there was a positive association between migraine with aura (MA) and strokes incidences, especially ischemic strokes. Moreover, patients with high frequency of migraine attacks had greater odds of having a stroke compared with those who had low frequency of migraine attacks. Also, the association between migraine and stroke was more significant in subjects under 45 years old. Some migraine symptoms such as vomiting and nausea had a protective role in the development of ischemic strokes.. Migraine, especially MA, is a risk factor for incidences of strokes, especially ischemic strokes. However, due to conflicting results on the association between different types of migraine and stroke, more studies are needed in this field..

Chronic obstructive pulmonary disease (COPD) is a progressive process leading to major clinical problems in patients. There is no highly effective treatment for these patients and therapists only try to relieve the symptoms.. The present study was performed to investigate the effects of self-management program on exercise tolerance and dyspnea in patients with COPD..Patients and In this clinical trial, 50 patients with moderate and severe grade COPD who met the inclusion criteria were randomly assigned to control and intervention groups. The control group received usual care and the intervention group received usual care plus a self-management program based on the 5A model. Patients were assessed by six-minute walking test and the Borg scale for exercise tolerance and dyspnea at base line and after 12 weeks. SPSS software version 17, independent t-test, and chi-square test were used for data analysis.. There was no significant difference between the groups in exercise tolerance at base line; but, they were significantly different at the end of 12 weeks (P = 0.007). In addition, a significant reduction was found in patients'' dyspnea in the intervention group, compared with the control group after 12 weeks (P < 0.0001).. In short term, using the self-management program can lead to increased exercise tolerance and decreased dyspnea in patients with COPD; thus, this program is recommended as an effective way to improve the functional statuses of these patients..

Anxiety is a one of the psychological aftereffect of cardiac surgery, which affects the outcome of treatment. One of the most effective ways to reduce anxiety is to train and establish a targeted relationship based on a functional model.. The present study aimed to determine the effect of Peplau''s therapeutic relationship model on anxiety of patients who were candidate for coronary artery bypass graft surgery (CABG)..Patients and In this clinical trial, 74 patients were enrolled according to eligibility criteria and were randomly allocated to intervention and control groups of 37 people. We evaluated anxiety of the patients using the Beck anxiety inventory before, immediately after, and two and four months after intervention. Based on Peplau''s therapeutic relationship model, therapeutic communication sessions were conducted in four phases during seven sessions. Data analysis was performed with the statistical test of covariance analysis using SPSS version 16.. The results of our study showed that after therapeutic communication, the mean score of anxiety decreased from 30.35 to 25.38 in the intervention group (P < 0.001), while the scores decreased from 33.22 to 31.46 in the control group. Furthermore, the mean score of anxiety in the intervention group decreased at two and four months after the intervention.. The findings showed a positive effect of therapeutic relationship based on Peplau''s model on reducing anxiety of patients undergoing CABG. Therefore, health care teams, including nurses, should take advantage of appropriate communication with patients in their care procedures. In that regard, Peplau''s communication model is recommended as a simple, low-cost, and efficient method..