Iranian Journal Of Medical - Surgical Nursing
Volume:9 Issue: 1, Feb 2020

Chronic obstructive pulmonary disease (COPD) is a debilitating condition. Those with COPD often complain about fatigue, which can negatively affect activities of daily living, and consequently, the quality of life (QoL).

This study aimed at determining the effect of pulmonary rehabilitation on fatigue and QoL in patients with COPD.

This quasi-experimental study was performed on 40 eligible patients with COPD admitted to two teaching hospitals in Zahedan in 2018 - 2019. The subjects were randomized into the experimental (n = 20) and control (n = 20) groups based on convenience sampling. Data collection tools included a demographic questionnaire, St George’s Respiratory questionnaire (SGRQ), and the Multidimensional Fatigue inventory (MFI). The QoL and fatigue in both groups were initially measured through interviews. For three consecutive days, patients in the experimental group received three 30-45-min face-to-face training sessions. The pulmonary rehabilitation program was conducted on patients’ bedsides and included theoretical and practical dimensions. Additionally, after necessary coordination with the patients and their families, a summary session was held at patients’ homes. The control group received no training, except for routine care. At the end of the eighth week, the researchers made telephone contact with the two groups (patients or their families) and visited them at their home to complete the SGRQ and MFI. Data were analyzed using SPSS and descriptive and analytical tests (independent t-test, paired t-test, and chi-squared test) at the significance level of less than 0.05.

The mean score of changes in QoL was 21.75 ± 7.06 in the experimental group and -1.93 ± 4.70 in the control group. The results of the paired t-test indicated that the mean score of QoL in the experimental group in the post-test was significantly different compared with the baseline (P = 0.001). Moreover, the mean score of changes in fatigue was 35.65 ± 7.12 in the experimental group and 3.25 ± 144 in the control group. In this regard, the paired t-test results showed that the mean fatigue score of patients in the experimental group in the post-test was significantly different compared with the baseline (P = 0.001).

Pulmonary rehabilitation program reduced fatigue and improved QoL in patients with COPD. Therefore, it is suggested to consider this program in the care plan of these people.

Improving lifestyle, increasing lifespan and life expectancy have led to the phenomenon of aging in societies. The increasing population of older adults is one of the most important economic, social, and health challenges in the current century.

This study was conducted to measure the mental health of older adults in Qom City and its relationship with socioeconomic factors.

This is a cross-sectional descriptive-analytical study on 400 older adults over 60 years in the urban areas of Qom in 2018. A multi-stage sampling method was used for this study. The research tools were a demographic questionnaire, the Kessler Psychological Distress scale (K6), and a standard psychological well-being scale. Data were analyzed by Stata 12 software using the t-test. The significance level was considered less than 0.05.

Considering the mental health status, based on the K6, 55% of the elderly showed signs of low depression anxiety, 34% moderate, and 11% showed severe anxiety symptoms. Regarding the status of well-being, 49.50% were in good condition (11.3 ± 3.3), 27.75% were in moderate condition (13.8 ± 2.9), and 22.75% were in poor condition (7.3 ± 2.6). Anxiety and depression had significant relationships with gender, having an illness, marital status, having a caregiver, and income.

The results showed that about half of the elderly in Qom had moderate anxiety and depression disorders, as well as moderate mental well-being, which indicates the moderate level of anxiety and mental disorders in the elderly in Qom.

Death anxiety is one of the concerns of the elderly population in the late stages of life. In this context, recalling memories is one of the favorite characteristics of these people that can affect different aspects of their mental and social health.

This study aimed to determine the effect of reminiscence therapy on the death anxiety of men retried from the Islamic Republic of Iran Army living in Zahedan.

A quasi-experimental study was performed on 90 retired men over 60 years of age. The subjects were recruited through convenience sampling at the Army Retirement Center in Zahedan in winter 2019. The participants were randomly divided into the intervention (n = 45) and control (n = 45) groups. In the intervention group, reminiscence therapy was carried out based on major life events twice a week for six sessions. Data were gathered again two months after the intervention. The control group did not take part in any program. Data collection tools included a demographic form and the Death Anxiety scale (Templer, 1970). The results were analyzed by SPSS-21 using descriptive and inferential statistics. The P values < 0.05 were considered statistically significant.

The mean scores of death anxiety were 25.37 ± 1.89 and 25.17 ± 1.61 in the intervention and control groups, respectively. After the experiment, this score was 9.09 ± 1.79 in the intervention group and 25.04 ± 1.62 in the control group. Thus, while reminiscence therapy significantly relieved death anxiety in the intervention group (P < 0.0001), the control group showed no significant difference in this respect at the end of the study (P = 0.63).

Group reminiscence therapy can reduce the death anxiety of older adults. Since the elderly are fond of expressing their memories, and such storytelling is an attractive, simple, and inexpensive intervention, it could be used to help these people mitigate their death anxiety.

Considering recent economic challenges, the short-term hospitalization of cancer patients for routine chemotherapy, and the lack of routine home visits for cancer patients in Iran, the quality of life of these patients after discharge can be a source of concern.

This study aimed to determine the effect of a planned discharge program on the quality of life of gastrointestinal cancer patients undergoing chemotherapy in hospitals of Zahedan University of Medical Sciences.

This clinical trial was conducted in 2018 on gastrointestinal cancer patients undergoing chemotherapy in hospitals affiliated to the Zahedan University of Medical Sciences. The sample was selected by convenience sampling, and the participants were randomly assigned into two groups of intervention (n = 45) and control (n = 45). The intervention was performed in three 45 to 60-minute sessions and sending text messages, which were based on the patients’ identified problems and needs for the intervention group. Data collection tools included the QLQ-C30 questionnaire and a demographic characteristics form. Data were analyzed by SPSS V. 21 software using descriptive and analytical statistical tests.

The mean scores of the patients’ quality of life increased on most of the functional subscales and global health/quality of life in the intervention group. In the control group (routine care), however, no significant difference was observed in most functional subscales of quality of life. There was a significant change in the mean severity of symptoms in the intervention group so that the severity of symptoms decreased after the intervention. In the control group, there was a significant difference in the mean severity of symptoms before and after the intervention so that the severity of symptoms increased in most cases.

Home visits of cancer patients are not in routine care after discharge in Iran, and they are not covered by insurance companies. Thus, home visits are expensive. However, in areas where the economic index is low, and patients have little access to smartphones, the designed discharge program can be a suitable method to increase the quality of life of cancer patients.

Mothers of children with thalassemia major encounter numerous problems associated with treatment and care that often stem from the disease and lead to inappropriate coping behaviors, which impose an onerous burden on the caregiver. Thus, maintaining and promoting the mental health of these mothers and alleviating their care burden should be a health priority.

This study aimed at investigating the impact of group education on adaptive behaviors and care burden in mothers of children with thalassemia major.

In this clinical trial, 70 mothers of children with thalassemia major were selected through convenience sampling and randomized into the intervention and control groups. The data collection tools included a demographic questionnaire, the coping health inventory for parent (CHIP), and the Caregiver Burden scale (CBS). The subjects in the intervention group received four 120-min sessions of group education over four weeks and were followed up for a month. The obtained data were analyzed using SPSS 22 and descriptive statistics, paired t-test, independent t-test, and chi-square test. All results below 0.05 were considered statistically significant.

A total of 70 subjects completed the study. The two groups were not significantly different in terms of demographic variables (gender, child’s age, ethnicity, mother’s age, mother’s education, economic status, number of children, and parents’ occupation). The mean score of adaptive behaviors in the intervention and control groups at baseline was 55.57 ± 18.75 and 58.57 ± 21.04, respectively. At the end of the study, this score changed to 83.68 ± 10.45 in the intervention group and 52.80 ± 17.46 in the control group, indicating the significant positive impact of group education (P < 0.001). On the other hand, the mean score of mothers’ care burden in the intervention and control groups was 54.60 ± 12.05 and 59.25 ± 13.34 at baseline, respectively; which changed to 41.28 ± 7.01 in the intervention group and 60.02 ± 13.19 in the control group after the experiment, suggesting the positive impact of group education on mitigating caregiver burden (P < 0.001).

Group training focused on mothers’ involvement can improve their adaptive behaviors and reduce the burden resulting from caring for the patient. Nurses are recommended to employ this educational method to promote family involvement in health care.

Anxiety is one of the most common psychological problems after myocardial infarction and can lead to many problems in acute coronary syndrome (ACS). Two possible ways to reduce anxiety are to listen to music and to recite the Holy Quran, the effects of which have never been compared to date.

The aim of this study was to compare the effect of listening to instrumental music and listening to Quran recitation on the anxiety level of patients with acute coronary syndrome.

This semi-experimental study was conducted among 96 patients with ACS referred to Hajar Hospital, Shahrekord, Iran, from 3/10/2019 to 4/30/2019. The patients were entered into the study using the convenience sampling method and then randomly assigned to the three groups of Quran recitation, instrumental music, and control. In this study, the patients’ anxiety level was measured using Spielberger’s state-trait anxiety inventory (STAI) before and after listening to Quran recitation and instrumental music. Data were analyzed by SPSS version 16 using descriptive and analytical tests, including paired samples t-test, Chi-square, and one-way ANOVA.

Anxiety level decreased from 43.1 ± 6.15 to 38.5 ± 3.82 in Quran recitation group (P < 0.001) and from 44.2 ± 1.21 to 39.1 ± 4.17 in the instrumental music group (P = 0.035), and from 46.3 ± 3.84 to 44.7 ± 6.21 in the control group (P < 0.001). There was no significant difference between the three groups before the program. However, the mean score of anxiety level showed a significant difference, indicating that listening to Quran recitation had a greater effect than listening to instrumental music in reducing the patients’ anxiety (P = 0.02).

Both interventions can be useful in decreasing the anxiety level of patients with ACS; however, the Holy Quran recitation had a greater effect in this regard.

Continuous follow-up is one of the most essential factors in patient participation, self-care, continuity of care, and ultimately improved quality of care.

This study aimed to compare the effect of three methods of follow-up through telephone, educational booklet, and SMS on the self-care ability of patients with acute coronary syndrome (ACS).

A quasi-experimental study was performed on 120 patients with ACS admitted to the CCU and PCCU of two teaching hospitals affiliated to the Zahedan University of Medical Sciences. The subjects were chosen via convenience sampling and randomized into three intervention groups, including educational booklet, SMS (daily), and telephone (twice a week, 15 - 20minutes per session). Data collection tools included a demographic questionnaire and the Kearney and Fleischer Self-Care scale. The interventions were sustained for four weeks after discharge. Six weeks after the program, the questionnaires were completed again. Data were analyzed in SPSS 21 using the chi-square test, paired t-test, and ANOVA at a significance level of below 0.05.

A total of 120 patients completed the study. The results showed a significant difference in the self-care scores after the intervention between all of the three groups (P = 0.0001). There was a significant difference between the booklet and SMS groups (P = 0.0001) and between the booklet and telephone groups (P = 0.0001) after the intervention. However, self-care scores were not significantly different between the SMS and telephone groups after the intervention (P = 0.19).

The use of SMS was associated with the highest score of self-care in patients with ACS, and it is proposed as the best follow-up method. Therefore, health care providers can enhance patients’ self-care ability through this simple technique and thus, help patients recover sooner and show reduced disease complications.

Celiac disease (CD) is a chronic, systemic immune disorder that can affect one’s quality of life.

The aim of this study was to explore the key performance indicators (KPIs) related to the quality of life of patients with CD admitted to the Celiac Association of Bouali Hospital in Zahedan.

This descriptive-analytical study was performed on 60 patients with CD who referred to the Celiac Association of Bouali Hospital in Zahedan in 2018. Data collection tools included a demographic questionnaire (age, gender, marital status, duration of illness, education, ethnicity, economic status, occupation, breastfeeding history, family history of CD, as well as vitamin D and iron supplementation) and the Quality of Life Questionnaire for patients with CD. Data were analyzed in SPSS 21 using descriptive statistics. All values less than 0.05 were considered statistically significant.

Sixty participants completed the study, 66.7% of whom were female, 76.7% weremarried, and 85.3% reported a family history of CD. The total score of patients’ quality of life was 81.66± 18.33, and the lowest score of quality of life was associated with patients’ concerns (51.81 ± 3.85). The findings also showed that, among various KPIs, vitamin D had a particularly significant relationship with patients’ quality of life.

There was a significant relationship between the quality of life and vitamin D supplementation in the participants. Besides, considering the effect of physical health on improving the quality of life and the chronic nature of CD, it is necessary to enhance the quality of life of these individuals by raising their awareness aboutmicronutrient intakes while respecting their dietary restrictions.