فصلنامه حیات
سال بیست و ششم شماره 2 (پیاپی 86، تابستان 1399)

Self-care plays an important role in the management of care for patients with chronic renal failure. In order to provide effective education, it is necessary to identify problems, concerns and challenges in this group of patients. The aim of this study was to explore the challenges of self-care in the patients undergoing hemodialysis.

This study is part of a research project on adherence to treatment regimen in hemodialysis patients referred to hospitals affiliated to Tehran University of Medical Sciences in 2019. Patients with the highest and lowest mean (SD) scores of self-care were selected by the purposeful sampling method and finally, 22 in-depth semi-structured interviews were performed with 18 interviewees. All data were recorded, transcribed and analyzed using the conventional content analysis approach proposed by Graneheim and Lundman.

Findings from the data analysis included four categories: "the mismatch between the view of patient and the view of nurse", "missing loop training", "culture: a double sword ", and "dual role of religious beliefs".

The results of the present study showed that patients undergoing hemodialysis faced many challenges in self-care. They had difficulty in understanding the meaning of self-care and its implications. There is a need to plan for educating these patients and also changing their religious and cultural beliefs.

Optimal weight gain during pregnancy, as an important indicator of maternal and fetal health, is affected by many adjustable variables. The present study was conducted to evaluate the gestational age-specific weight gain based on the indices of the American Institute of Medicine and to determine its related factors.

In this descriptive study, 250 pregnant women referred to the health centers of Torbat Heydarieh were assessed in 2018. The gestational age-specific weight gain was calculated for each woman, and based on the amount of deviation from the IOM indices, the subjects were divided into three groups including weight gain less than optimal, optimal and over than optimal. Data collection tools were demographic questionnaire and Multidimensional Body Relationship Questionnaire. Data were analyzed by chi-square, ANOVA, Kruskal-Wallis tests and ordinal regression using the SPSS software version 16.

In this study, 22% of the subjects gained weight less than optimal, 46.4% gained weight normally and 31.6% had excessive weight gain. Weight gain in most women with normal and low body mass index was in a normal range (55.4%) and in most overweight and obese women was higher than an optimal range (43.2% and 35.7%, respectively). Weight gain was related to age, education, parity, abortion history, feelings of women and their partners toward pregnancy and wanting the pregnancy from the viewpoint of the partner (P<0.05). After entering the significant variables into the ordinal regression model, only nulliparity was able to predict pregnancy weight gain status (P=0.017).

Optimal weight gain in most pregnant women of this study may reflect the proper nutrition and effectiveness of prenatal care in this city. Identifying factors related to weight gain out-of-range increases the effectiveness of interventions on weight gain.

Cesarean section (CS) rate was 56% in 2012 in Iran, which was considerably higher than the WHO recommended rate (10-15%). Thus, the Normal Delivery Promotion (NDP) program as a part of Iran’s Health Transformation Plan (HTP) was implemented in 2014 to reduce unnecessary cesarean deliveries and promote maternal and neonatal health. The aim of the study was to evaluate the effect of the NDP plan on the CS rates.

This quasi-experimental and longitudinal study analyzed the immediate and long- term effects of the NDP program on the CS trend in Iran using an interrupted time series analysis. Monthly CS rates in the hospitals of the country were extracted from April 2013 to September 2018.

Overall CS rate in Iran decreased by 6% immediately after the implementation of the NDP program and then remained at the same level. The NDP program reduced the CS rate in teaching (9.5%), non-teaching (11.7%), private (18.1%), and charity (27.1%) hospitals. But the CS rate increased in social security (7%) and other hospitals (15.7%). The CS rate would have reached 58.5% by September 2018 if the NDP program had not been implemented.

The NDP program was somewhat effective in reducing the CS rate in Iran. Promoting this program by formulating a strategic plan and comprehensive action plans addressing various underlying causes of CS at meta (ministry of health), macro (universities of medical sciences), meso (hospitals) and micro (obstetricians, midwives, and mothers) levels and considering effective solutions in the areas of governance and leadership, financing, human resources, equipment, information and service delivery is critical to achieve the determined national goals.

Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts.

 This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance.

After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P<0.01). There were no significant differences in these variables between the two groups before the intervention.

Counseling based on quality of life therapy in this study had a positive and significant effect on reducing the severity of psychological reactions in family caregivers of addicts. Therefore, health care providers are recommended to use this counseling approach along with addiction treatment programs to increase the welfare and psychological well-being of family caregivers.

Proper recording of the nursing report indicates the nurse’s optimal clinical performance and compliance with the standards. Nanda Nursing Diagnosis is one of the most important and widely used international standard terms for recording nursing care. The aim of this study was to determine the degree of compliance and frequency of nursing diagnoses registered in the pediatric oncology department with the statements of nursing diagnoses of the Nanda classification system.

In this descriptive study, the nursing reports recorded in the files of children hospitalized in the pediatric oncology wards of two hospitals affiliated to Shahid Beheshti University of Medical Sciences in the first quarter of 2016, were reviewed. Sampling was done by the census method for 3 consecutive months. Overall, 86 files and 3701 nursing reports were reviewed. Nurseschr('39') documentation was analyzed through the manifest content analysis. The obtained expressions were adapted to the nursing diagnoses of the Nanda classification system and the degree of adaptation and frequency of nursing diagnoses were determined.

The overall compliance between the diagnoses extracted from the nursing reports and the Nanda nursing diagnoses was 14.7%. The most frequent nursing diagnoses were diagnoses related to safety/protection classification with a frequency of 47.95%, followed by diagnoses related to nutrition classification with a frequency of 24.42% and finally a frequency of 12.8% for nursing diagnoses related to comfort classification.

The findings of the present study indicated the low levels of compliance with the Nanda nursing diagnoses and nursing process in the nursing reports. Therefore, practical training is suggested to increase nurseschr('39') knowledge and motivation to apply Nanda nursing diagnoses.

Frustration is one of the important psychological consequences for the elderly in the nursing home. Spiritual care is a unique aspect of nursing care that can be a strong response to the dealing with frustration. The aim of this study was to determine the effect of spiritual care education on hope in the elderly residents of nursing homes.

 The present study was a before-and-after semi-experimental study, conducted in 2018 on 35 elderly residents of nursing homes in Hamadan, assigned into two groups of intervention (35 people) and control (35 people). At the beginning of the study, both groups completed the Schneider hope scale. For the intervention group, the intervention based on spiritual care was performed in three sessions. The post-test was performed for both groups after one month. Spearman correlation and Kruskal-Wallis tests were used to analyze the data through the SPSS software version 16.

There was no significant difference in overall hope score between the groups of intervention (22.94±9.80) and control (25.94±3.86) before the intervention (P=0.085); but after the intervention, there was a significant difference between the intervention (42.94±6.04) and control (23.80±4.09) groups (P<0.001).

Considering the positive effect of spiritual care on hope in the elderly in this research, planning for spiritual education is essential in this group of people.

The healthy nutrition education is one of the most important priorities in all life periods, especially in childhood. The teaching method is also considered one of the important factors for the effectiveness of education. Therefore, the aim of this study was to compare the effect of lecture and role-playing methods on awareness of healthy nutrition in school-age children.

This quasi-experimental study was conducted on 60 primary school students in Gonabad city in 2017. Participants were selected by multistage random sampling and allocated into two groups of role-playing and lecture. Studentschr('39') awareness was measured by a self-structured questionnaire before, immediately and one month after education. Data were analyzed using the SPSS software version 16 by descriptive and inferential statistics. A P-value less than 0.05 was considered significant.

The mean score of awareness for the role-playing group before, immediately and one month after the intervention respectively was 10.77±2.55, 14.1±55.15 and 14.50±1.10 and for the lecture group respectively was 11.07±1.85, 13.72±1.43 and 11.47±2.84 (the score range: 0-16). There was a significant difference in the mean score of awareness before, immediately and one month after the intervention between the two groups (P<0.001), and in the role-playing group, the increase in awareness score was more than in the lecture group.

Considering the greater effect of role-playing method than lecture on healthy nutrition education in school-age children, it is suggested that more attractive, dynamic and effective methods such as role-playing, in accordance with educational behavioral goals, be used in school nutrition education programs. In addition to enhancing educational efficiency, this will make the effects of education and learning more sustainable for students.

Self-control is the capacity to organize cognitive and emotional responses in order to provide continuous and adaptive behavior with ideal standards for long-term goals. Due to the high levels of care burden of patients with chronic disease, this study aims to explain the concept of self-control in the family caregivers of patients with chronic disease based on the family-centered empowerment model.

 Data were collected through in-depth, semi-structured interviews with 26 participants (19 caregivers, four nurses and three patients with chronic disease) from June 2016 to August 2017 in southwestern of Iran. Data were analyzed using the directed content analysis approach. The documents recording, accurate description of details, member checking, peer checking, and maximum variation of participants, were considered for ensuring the trustworthiness of the data.

“Transcendental self-control” of family caregiver was explained by four conceptual categories: “caregiver insight", "value prioritization in care", "acceptance of care responsibilities" and "committed care". By predicting the potential risks of playing the care role and deeply understanding the conditions of care while paying attention to the value prioritization outcome-centered and virtue-based care, the family caregiver accepts the care burden through positive thinking and expediency and modestly offers "committed care" while having competent care experiences.

The explanation of self-control concept based on family-centered empowerment model in the real field creates a clear understanding of this concept and leads to "commitment care" by family caregivers of patients with chronic diseases and in turn provides a basis for reducing workload in the clinical setting.