Journal of Caring Sciences
Volume:7 Issue: 2, Jun 2018

Caring for stroke survivors may be burdensome with adverse consequences on caregivers’ physical health. This study examined the prevalence of musculoskeletal symptoms and associated factors among family caregivers of stroke survivors in Nigeria.
A hospital-based cross-sectional study involving 90 stroke caregiver and stroke survivor dyads was conducted. Data on the participants’ demographics and post-stroke duration were obtained. Seven-day prevalence of musculoskeletal symptoms among the caregivers and level of stroke survivors’ disability were respectively assessed using the Nordic Musculoskeletal Questionnaire and Modified Rankin Scale. Prevalence of musculoskeletal symptoms was presented as percentages while participants’ characteristics associated with prevalence of musculoskeletal symptoms were examined using inferential statistics.
Mean (SD) age of caregivers and stroke survivors was 33.2 (10.7) years and 58.9 (9.7) years respectively. Majority of the caregivers were females (61.1%), and children of the stroke survivors (58.9%). Prevalence of musculoskeletal symptoms was 82.2%. The low back was the most affected body region (72.2%) followed by the upper back (40%) while musculoskeletal symptoms in the wrist was least prevalent (3.3%). Female caregivers, caregivers of female stroke survivors and spousal caregivers had significantly higher prevalence of musculoskeletal symptoms compared to other categories of caregivers. Only 5 (5.6%) caregivers had however received any training on safe care giving methods while only 21 (28.4%) caregivers with musculoskeletal symptoms had received treatment.
With the high prevalence of musculoskeletal symptoms among family caregivers of stroke survivors, effective preventive strategies including training and education as well as timely access to treatment would be required.

As well as its negative effect on the subcutaneous tissues, lipohypertrophy has negative effects on clinical data. The purpose of this study was to examine the frequency of lipohypertrophy, risk factors and perceived barriers preventing rotation in individuals with type 2 diabetes.
This descriptive cross-sectional study was conducted at Diabetes Education Center and Endocrine and Metabolism Clinic of a university hospital and Diabetes Education and Monitoring Center in a private hospital in Turkey between June 2016- April 2017. The inclusion criteria were as follows; undergoing at least one year of insulin therapy, injecting insulin pens or syringes themselves, being over 18 years of age, making regular injection of insulin and being a patient with type 2 diabetes. Introductory information form was used to collect the data. The data were analyzed using descriptive statistics and chi-square analysis with SPSS version 16.0.
Factors influencing lipohypertrophy development were determined as follows; healthcare personnel who provide insulin education, duration of diabetes, the number of injection administered daily, needle length, the number of injection sites, insulin types, injection site rotation and intra-site rotation and needle exchange frequency. In addition, the prevalence of lipohypertrophy was found to be higher in patients with hypoglycemia, unexplained hypoglycemia, and those with high BMI and A1C.
It is recommended that diabetes education should be provided by the diabetes specialist nurses who have diabetes-specific certifications and / or education and who can provide full-time education. Randomized controlled interventional studies investigating how to prevent the lipohypertrophy development are also needed.

Physical restraint may seem to be a useful and simple procedure to help the treatment but is a complex practice including physical, psychological, judicial, ethical and moral issues. Research was made on description basis in order to determine the knowledge, attitude and application levels of nurses working in critical care units about physical restraint applied on patients.
The study was performed as a descriptive and correlation study. Working in ICUs, 158 nurses constituted the sampling. "Levels of Knowledge, Attitudes and Practices of Staff Regarding Physical Restraints Questionnaire" was used to collect data.
For information, attitude and practice scores, participants’ scores were 7.1(1.7), 31.8 (4.6) and 36.6 (3.2), respectively. No association was found between information subscale, and age, professional years, working time in ICUs and weekly working hours. However, for attitude subscale, a negative and weak association was found between age (r=-0.229) and professional years (r=-0.174), and increasing these variables decreased attitude score. No association was found between attitude score, and working time in ICUs and weekly working hours. While there was no association between practice score, and age, professional years and working time in ICUs, the increase in weekly working hours (r=-0.243) was found to decrease practice score, and this association was found weak.
In conclusion, we consider nurses’ level of information is sufficient, but attitudes and practice were not at a positive level. It is recommendable that out of such conditions, novel approaches should be developed to decrease the use of physical restraint.

Sexual dysfunction is one of the commonest causes of family breakdown. In recent years, various approaches have been proposed to resolve this conflict. Given the negative effects of sexual dysfunction on women and its complications, the present study was carried out in order to examine the effect of cognitive-behavioral consultation on sexual function among women who had referred to health centers in Hamadan.
The present study was a randomized clinical trial including two groups, a pretest, and a posttest. It focused on 198 qualified women who had referred to selected health centers of Hamadan in 2016. The intervention group received four 2-hour sessions of cognitive-behavioral group consultation. The required data were collected using a questionnaire of demographic characteristics and Female Sexual Function Index (FSFI). To analyze the collected data, SPSS 21.0 was employed; t-test was used for independent samples. ANCOVA was also utilized. Significance level was set at 0.05.
The results of the present study showed that the two groups were not significantly different in terms of mean pretest scores in all domain, except for sexual satisfaction and total sexual function .However, after cognitive-behavioral consultation sessions, the intervention group experienced a significant increase in all behavioral domains and total sexual function compared to the control group (pCognitive-behavioral consultation among women can play a positive and effective role in improving sexual relationships. Therefore, the effectiveness of this type of consultation can be confirmed with more certainty.

Stroke is the most common debilitating neurological disease in adults. Therefore, rehabilitation is a major consideration to reduce costs and relief disabilities. Biofeedback, a newly recommended method is claimed to be able to improve the consequences following stroke by enhancing the understanding of the psychological functions of the body. The purpose of this study was to investigate the effects of biofeedback on the motor– muscular situation in balance and ability to walk, muscle stiffness (spasticity), hand muscles strength of stroke patients.
The present study was a randomized clinical trial done in 2016. The participants were randomly divided into 2 groups (case and control group). In the intervention group, biofeedback was performed. The check list of main variables, including balance and ability to walk, muscle stiffness (spasticity) and hand muscles strength was completed by a physician before the intervention and at the end of the intervention (16th session). The statistical analysis was conducted, using SPSS version 13.
The mean score of balance in intervention group versus control group showed significant differences. The results showed that by eliminating the effects of muscular strength before the intervention, this variable had made improvements and significant differences in both intervention and control groups after the intervention. Comparison of the average spasticity showed that spasticity evaluation score before and after the intervention revealed no significant difference between the two groups.
Biofeedback therapy is a promising treatment modality for improving the motor–muscular situation of patients after stroke.

The quality of life of patients undergoing hemodialysis is lower; to improve their living conditions, patients need further training. This study conducted to compare the effectiveness of two methods of text messaging and face to face education on knowledge and quality of life of patients under hemodialysis.
In a semi-experimental study, 60 patients undergoing hemodialysis in Sina-teaching hospital of Tabriz, Iran were selected by convenience sampling and randomly allocated into three groups: two intervention groups: text massaging (p=20), face to face group (n=20) and one control group (n=20). Their knowledge and quality of life were assessed and compared by Chronic Hemodialysis Knowledge Survey (CHeKS) and Kidney Disease Quality of Life-short form (KDQOL-SF) questionnaires. Data were analyzed by SPSS version 13.
After intervention, the knowledge of text messaging and face to face groups was significantly more than the control group (p Text messaging and face to face was effective on improving knowledge of patients undergoing hemodialysis. However, the effectiveness of these methods on quality of life needs further evaluations in different setting for longer times in hemodialysis patients.

Maternal mental health during pregnancy has a major impact on fetal growth and consequently, child health. The objective of this study was to assess the effect of "Cooperative-Supportive" Intervention Program on Pregnancy.
The present before and after interventional research was conducted on 114 pregnant women referring to Khoy health centers in 2014. Pregnant women were randomly divided into intervention (n=57) and control groups (n=57). The data collection tool in this research was the researcher-made questionnaire based on the Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model which assessed the participants’ predisposing, enabling, and reinforcing factors. The educational interventions for enhancing pregnant women’s stress controlling skills were conducted and also practical pacifying lessons were held for the intervention group during five weeks with relaxation exercises. In order to assess health status among pregnant women, knowledge, attitude, depression, anxiety and self-efficacy were investigated by applying different scales and questioners. The questionnaires were completed before and after the interventional program. The data were analyzed, using suitable statistical tests.
After the intervention, the mean score of PRECEDE major components significantly increased and the total anxiety and depression scores decreased in the intervention group in comparison to those of the control group.
The present study showed the positive impact of educational intervention programs based on PRECEED model and major components on reducing anxiety and depression, and finally mental health promotion in the studied population.

Many physical, psychological, social and economic complications have been reported after discharge, which have a negative impact on the quality of life of burn patients. The present research examines the effect of pre-discharge training program on the life quality of patients with burns.
This is a pre and post-experimental study with control group that was conducted in 2015 in teaching hospital Sina. The control group received the typical instructions upon being discharged from hospital while the experimental group received in-person training in the form of question-answer, pamphlets and a researcher-made instruction booklet. The patients’ life quality was evaluated when they were being discharged, a month and then three months after they were discharged.
The result showed that the quality of life has a significant statistical difference across the three time points. And these differences are compared using Bonferroni’s adjustment multiple comparisons indicating that pre-discharge training affects the quality of life scores and this effect continues over time.
The results show that the pre-discharge training has significantly improved the life quality among the burns patients. The improvement of life quality is also correlated with the quantitative variable of total body surface area percent (TBSA %). Thus, planning and designing in-discharge training programs based on the existing context, combined with training packages focusing on the patients’ needs could be a very significant step in more successful implementation of the follow-up programs on the burn patients and improving their quality of life.

Oncology nurses should create a balance in their personal and professional life to provide holistic care to patients. The more the awareness of spirituality in oncology nurses develops, the more obviously it manifests itself in their attitudes toward spiritual care. This study aimed to assess the relationship between oncology nurse's spiritual wellbeing, and their attitudes toward spiritual care based on Neumann’s Systems Model.
This descriptive correlational study tested the relationships of Neuman system-based model constructs, named oncology nurses antecedents, their spiritual wellbeing, and attitudes to spiritual care by using a causal model and path analysis. 130 oncology nurses from 12 Tehran hospitals completed the study questionnaires, having completed written informed consents. The study administration permission was approved by Urmia University of medical sciences ethical committee. The collected data were coded and entered to computer to be analyzed by SPSS 13. We used path analysis and multiple regressions for assessing the relationships among the variables of the hypothesized study model.
The model testing revealed, from four antecedents’ predictors’ variables, only age and spiritual wellbeing had a direct and meaningful relationship with oncology nurses’ attitudes towards spiritual care. The nurses’ antecedent and mediator variable, and spiritual wellbeing explained 32.5% of the variance in their attitudes towards spiritual care. Moreover, the nurses’ spiritual wellbeing was found to have a positive relationship with their attitude to spiritual care (β= 0.450).
However, the study model and its constructs proved to be quite efficient in indicating oncology nurses’ attitudes to spiritual care-related factors, but it is not a comprehensive model and other studies are required for its empirical testing.