Jundishapur Journal of Chronic Disease Care
Volume:13 Issue: 2, Apr 2024

 Open-heart surgery is associated with life-threatening complications, and providing nonstandard nursing care without any plan for patients undergoing this type of surgery in the intensive care unit (ICU) can deteriorate their conditions.

 This study investigated the effect of providing nursing care based on Gordon's functional health patterns model on the clinical outcomes of patients undergoing coronary artery bypass surgery in the cardiac surgery ICU.

 This was a quasi-experimental study involving 58 patients undergoing coronary artery bypass surgery admitted to the cardiac surgery ICU of Ahvaz Golestan Hospital in 2021. The patients were selected using convenience sampling and based on the inclusion criteria, and they were divided into intervention and control groups. First, the information related to the outcomes of the patients in the control group was collected using a checklist. Then, all the ICU nurses working at the study site were trained in Gordon's model and how to perform nursing care based on this model. They provided the necessary nursing care based on this model for the patients in the intervention group under the supervision of the researcher. The data of the patients in the intervention group were collected after completion of the intervention using the same checklist used for the control group. Finally, the data were analyzed using SPSS version 25.

 There was a statistically significant difference between the intervention and control groups in the length of stay at the ICU (P = 0.007), length of ventilation (P = 0.001), and successful weaning from the ventilator (P = 0.026). However, there was no significant difference between the 2 groups in terms of patient mortality (P = 0.16) or re-admission to the ICU (P = 0.16).

 According to the results, Gordon's functional health patterns model of the nursing process can be easily used to improve the care and treatment outcomes of patients admitted to the cardiac surgery ICU.

 Cystic fibrosis (CF) stands as the most common chronic multisystem and fatal inherited disease.

 The present study aimed to assess the clinical presentation and laboratory findings in children with CF.

 This retrospective cross-sectional study reviewed the records of CF patients over a 2-year period beginning in 2018. The diagnosis of CF was confirmed based on clinical manifestations, sweat chloride tests, or genetic studies. Children aged ≥ 2 years were included; nevertheless, patients without sweat chloride tests or genetic studies were excluded. This study recorded demographic features, gastrointestinal manifestations, vitamin D levels, and the number of hospital admissions. A pediatric gastroenterologist conducted fecal elastase and stool fat analyses to evaluate pancreatic insufficiency. Vitamin D levels < 30 ng/mL were considered vitamin D insufficiency; however, levels < 20 ng/mL indicated a vitamin D deficiency. A P-value < 0.05 was considered statistically significant.

 This study included 59 children (37 male and 22 female) in the study. Low weight, height, and body mass index (BMI) percentiles (< 5) were most frequently observed. Approximately 86.4% of the patients had consanguineous parents, and 40.7% had affected siblings. Failure to thrive (FTT) (49.2%) and recurrent respiratory infections (45.8%) were the most common clinical presentations. A majority (57.7%) of the patients were diagnosed before the age of 1 year. The mean number of admissions in the past 2 years was 3, and 58% of the cases reported gastrointestinal symptoms. A significant correlation was observed between vitamin D levels and the number of hospital admissions (Pearson coefficient = 0.298, P = 0.042).

 In this study, there was a high prevalence of vitamin D insufficiency and FTT in children with CF. Additionally, there was a significant correlation between vitamin D levels and the number of hospital admissions over a 2-year period.

 Knee osteoarthritis is a prevalent chronic musculoskeletal problem among older people, leading to pain, muscle weakness, and a decline in the quality of life.

 This study aimed to investigate the impact of proprioceptive neuromuscular facilitation techniques on the muscle strength of patients with knee osteoarthritis.

 This quasi-experimental study was conducted on all patients with knee osteoarthritis who visited orthopedic offices in Darab City in 2021. A non-probability sampling method was used to select 50 eligible patients, who were then divided into 2 groups: an experimental group and a control group. The allocation of participants into these groups was done by a block randomization method. The experimental group underwent proprioceptive neuromuscular facilitation techniques for eight weeks, with two sessions per week lasting 30 - 45 minutes. In contrast, the control group received only routine care. Muscle strength in both groups was evaluated using the manual muscle test scale before, four weeks, and immediately after the intervention. The collected data were analyzed using SPSS 21, descriptive statistics (such as central tendency and dispersion indices), independent t, chi-square, Fisher’s exact, Mann-Whitney U, Kolmogorov-Smirnov, Wilcoxon, and repeated measures ANOVA tests. A significance level of 0.05 was considered.

 Fifty patients (24% male and 76% female) with a mean age of 53.6 ± 10 completed this study. There was no statistically significant difference by mean scores of muscle strength parameters, including degree (2.8 ± 0.4 vs. 2.8 ± 0.3), the percentage of normality (45 ± 10 vs. 44 ± 12), and scale (2.8 ± 0.4 vs. 2.8 ± 0.3) between the intervention group and the control group on the before of intervention, respectively. However, a significant difference was observed by degree (3.6 ± 0.6 vs. 2.8 ± 0.3; P = 0.001), the percentage of normality (65 ± 14 vs. 45 ± 9; P = 0.001), and scale (3.5 ± 0.6 vs 2.8 ± 0.3; P = 0.001) between the intervention group and the control group, respectively, at the end of the intervention.

 The proprioceptive neuromuscular facilitation techniques could improve the muscle strength of patients with knee osteoarthritis. If this finding is confirmed in other studies, healthcare workers should use these techniques for the benefit of these patients.

Patients with type 2 diabetes suffer from fatigue and disease complications. Exercise is one of the non-medicinal methods, which is also affordable and can be done at any time and place.

This study aimed to determine the effects of modified stretching exercise on fatigue intensity in patients with type 2 diabetes.

In the present clinical trial study, the research population consisted of all patients with type 2 diabetes in the internal clinic of Shahid Fayaz-Bakhsh Hospital, Tehran, in 2021. A total number of 50 eligible patients with type 2 diabetes were selected by non-randomized sampling method. The selected participants were randomly divided into two groups: Experiment (25 people) and control (25 people). In the experimental group, training was held in 12 sessions. A demographic checklist and the Multidimensional Fatigue Inventory (MFI) were used to collect data before and after the intervention. The collected data were analyzed through descriptive statistics and paired t-test, chi-square, and independent t-test.

Before the intervention, there was no statistically significant difference in the overall scores of fatigue and its dimensions between the experimental and control groups (P > 0.05). After completing the interventions, a statistically significant difference was observed in the mean scores of fatigue and its dimensions between the experimental and control groups (P < 0.001).

Modified stretching exercises can improve the severity of fatigue in patients with type 2 diabetes. We suggest that healthcare providers use this stretching exercise to improve fatigue in diabetic patients.

Context: 

The recent growth of research and the vast amount of knowledge available highlight the necessity for synthesizing existing research in a reliable and high-quality manner. The substantial body of qualitative meta-synthesis studies on chronic diseases indicates the need for a deeper understanding of this methodology. Therefore, the purpose of this paper was to explain the process of meta-synthesis in qualitative research.

 This was a narrative review with predefined inclusion and exclusion criteria, followed by a web search using relevant keywords. Initially, 980 relevant articles were selected. Subsequently, the titles, abstracts, and full texts were assessed for eligibility using the Critical Appraisal Skills Program checklist. Finally, 21 articles were included in this study.

 Various approaches have been adopted to address the meta-synthesis of qualitative studies. Common types of qualitative meta-synthesis include meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis, and ecological triangulation. However, concerning chronic diseases, the most commonly used methods were ethnography and Sandelowski and Barroso’s method.

 Meta-synthesis is a method for integrating the results of studies, re-understanding the findings, and ultimately interpreting them to generate new insights beyond what is obtained from individual studies. Given the extensive body of qualitative research on chronic diseases, it is recommended to conduct this type of research to develop new knowledge based on the findings of previous studies.

Deafness and hearing loss can pose adverse developmental consequences in communicative, cognitive, and socioemotional areas for both the child and parents.

The present study aimed to investigate the mediating role of maternal chronic fatigue in the relationship between the reactive aggression of deaf and hard-of-hearing children and attitudes toward having a disabled child.

This study employed a descriptive correlational research design. The statistical population of this study consisted of mothers of all deaf and hard-of-hearing elementary students in special centers for such children in Ahvaz, Iran, of whom 202 mothers were selected as the sample through convenience sampling. Data collection was performed using the Reactive-Proactive Aggression Scale, Attitudes of Parents with Special Needs Children toward Their Children Scale, and Chalder Fatigue Scale. The proposedmodelwasexaminedusing structural equationmodeling(SEM),andindirect relationshipsbetweenthe research variables were tested by bootstrapping.

The mean and standard deviation (SD) of reactive aggression, attitudes toward having a disabled child, and maternal chronic fatigue were 20.37 ± 4.84, 73.16 ± 14.66, and 21.47 ± 6.12, respectively. The results showed a significant relationship between attitudes toward having a disabled child and maternal chronic fatigue and between maternal chronic fatigue and reactive aggression in children (P < 0.001). Nevertheless, no significant relationship was observed between attitudes toward having a disabled child and reactive aggression in children. The results also indicated that maternal chronic fatigue mediated the indirect relationship between attitudes toward having a disabled child and reactive aggression in deaf and hard-of-hearing children (P < 0.001).

The study findings suggested that the finalized model was well fitted to the data; therefore, it can be used to identify the maternal factors causing reactive aggression in deaf and hard-of-hearing children.

Patients undergoing hemodialysis often experience a low quality of life, which can significantly impact their lifestyle. Despite various proposed solutions, these patients continue to face ongoing challenges.

This research aimed to investigate the effects of continuous nursing care, based on the Information, Knowledge, Attitude, and Practice (IKAP) theory, on the quality of life and lifestyle of patients undergoing hemodialysis.

Sixty-eight patients receiving hemodialysis treatment at 2 university hospitals in Ahvaz met the inclusion criteria for this experimental research. With the simple random method, the participants were divided into 2 equal groups: the experimental group and the control group. In addition to routine care, the experimental group received 20 to 30 minutes of continuous nursing care based on the IKAP theory every 2 weeks, while the control group received only routine care. Three questionnaires were administered: A Demographic Information Questionnaire, a Health Promoting Lifestyle Profile, and a Kidney Disease Quality of Life Questionnaire-Short Form (KDQOL-SF), which were completed before the intervention, 1 month after, and 3 months after by both groups. Data analysis employed independent samples t-tests, chi-square tests, and repeated measures analysis of variance (ANOVA).

The nursing intervention based on the IKAP model had a significant impact on the quality of life and lifestyle of patients undergoing hemodialysis. In the experimental group, the mean score for overall quality of life before and after the intervention showed a statistically significant difference (P < 0.001), while in the control group, this difference was not significant (P = 0.807). Similarly, the mean score for lifestyle in the experimental group before and after the intervention was statistically significant (P < 0.001), whereas there was no significant difference in the control group (P = 0.991).

Nursing intervention based on the IKAP model has a positive effect on improving the quality of life and lifestyle of patients undergoing hemodialysis. Therefore, it is important to inform health care providers and policymakers about this model, which can serve as a reference for health education in hospitals and other health care centers.

Asthma is a chronic disease in children that significantly impacts their quality of life.

This study aimed to investigate the effect of yoga breathing exercises on the quality of life of children with asthma.

In this quasi-experimental study, 84 children with asthma aged 5 - 11 years old were selected and nonrandomly divided into the control group (n = 42) and the intervention group (n = 42). Both groups completed the Pediatric Quality of Life Inventory 3.0 (the PedsQL 3.0) Asthma Module. Then, the intervention group performed yoga breathing exercises twice a day for 2 months in addition to receiving medical treatment at home, while the control group only received medical treatment. After 2 months, both groups completed the PedsQL 3.0 Asthma Module for the second time.

The mean score and standard deviation for the quality of life before the intervention were 69 ± 13.6 in the intervention group and 72 ± 12.2 in the control group (P = 0.29). After the intervention, the mean score and standard deviation for quality of life were 79.4 ± 9.1 in the intervention group and 72.7 ± 11.1 in the control group (P < 0.003).

Yoga breathing exercises improved the quality of life in children with asthma. Therefore, these exercises are recommended as a complementary therapy for pediatric asthma.

Down syndrome (DS) is a complex genetic disease that is caused by having three copies of chromosome 21. A possible association between polymorphisms in maternal folate metabolism genes and DS has been evaluated.

It was aimed to first investigate the influence of C677T and A1298C polymorphisms in the methylenetetrahydrofolate reductase gene (MTHFR) and plasma homocysteine (Hcy) on the maternal risk for DS in the southwest of Iran.

The MTHFR C677T and A1298C polymorphisms were genotyped using restriction fragment length polymorphism and Sanger sequencing, respectively. Allele and genotype frequencies and the dominant model of the MTHFR C677T and A1298C polymorphisms were evaluated in 80 mothers of children with DS and 80 control mothers. Eventually, the ELISA test was used to compare the concentration of plasma Hcy in both groups.

A significant association was observed in the 677T and 1298C alleles between the mothers of DS and control groups (P = 0.00077 and P = 0.01248, respectively). Further, the median concentrations of Hcy were significantly higher in mothers with DS babies compared to the control group (P < 0.05).

There was an association between MTHFR C677T, A1298C, and plasma Hcy concentrations as the maternal risk of mothers with DS children.

Sleep plays a crucial role in children's motor, mental, and cognitive development. Due to the significant prevalence of sleep problems in children with autism and the side effects of pharmacological therapy, complementary interventions should be considered.

This study aimed to investigate the effect of foot reflexology massage on sleep habits in children with autistic spectrum disorder.

This randomized clinical trial was conducted on 60 children with autistic spectrum disorder in Mashhad, Iran. The control group received routine care from the family. In the intervention group, in addition to the routine family care, a foot reflexology massage was performed for 15 min by parents for 30 nights before bedtime for children. The standard Children's Sleep Habits Questionnaire (CSHQ) was completed 3 times in both groups. In the control group, the questionnaire was completed at the beginning of the study, on the 15th day, and on the 30th day after entering the study. In the intervention group, the questionnaire was completed before the intervention, on the 15th day after the intervention, and on the 30th day after the intervention. Data were analyzed using SPSS version 16 by the independent t-test, Mann-Whitney test, and repeated measures analysis of variance (ANOVA).

Among the children included in the study, 78.3% were male, and their mean age was 8.56 ± 2.4 years. The mean total score of children's sleep habits before the intervention was not significantly different between the control and intervention groups (P = 0.71). After the intervention, the mean total score of children's sleep habits was significantly different between the control and intervention groups (P = 0.001). The foot reflexology massage, with a score reduction of 8.13 ± 3.95 points, had a significant impact on the score of sleep habits in the intervention group (P = 0.002).

Foot reflexology massage improves the quality of sleep in children with autism and can be recommended as a safe intervention for parents of children with autism. 

It is widely acknowledged that family caregivers of patients with chronic mental disorders face numerous challenges that can jeopardize their mental well-being. Therefore, the adoption of effective coping strategies can equip them to navigate the difficult and stressful situations encountered in their daily lives.

The primary objective of this study was to assess the coping strategies employed by family caregivers of patients with chronic mental disorders who were receiving care at psychiatric centers in Isfahan, Iran.

This descriptive-analytical study involved 188 family caregivers of individuals with mental disorders selected through convenience sampling. Data were collected using a demographic characteristics form and the Endler and Parker Coping Inventory for Stressful Situations – Short Form (CISS-SF). The relationship between demographic variables and coping strategy scores was analyzed using independent t-tests, one-way analysis of variance (ANOVA), and Pearson and Spearman correlation tests in SPSS v. 20.

The results revealed that 55.1% of family caregivers utilized emotion-oriented coping strategies, 30.3% employed problem-solving coping strategies, and 14.6% adopted avoidance coping strategies. Furthermore, there was no significant relationship between the types of coping strategies and any of the demographic variables (P > 0.05).

Given the findings of this study, which suggest that family caregivers tend to use ineffective coping strategies, it is imperative to implement preventive and psychological interventions aimed at enhancing the utilization of problem-oriented coping strategies within this group. 

Internet addiction is recognized as a global public health issue, with high prevalence among medical students. The identification of risk factors related to Internet addiction is crucial for reducing its prevalence and severity.

This study aimed to assess the epidemiology and related factors to Internet addiction, emphasizing the role of feeling loneliness and interpersonal problems.

A cross-sectional correlational study was conducted in 2022, involving 414 students from the Nursing and Midwifery Faculty, Jundishapur University of Medical Sciences, Ahvaz, Iran. Young’s Internet addiction questionnaire, along with the assessments of interpersonal problems and loneliness, was used. Descriptive and inferential statistics (including correlation coefficients and hierarchical regression) were applied using SPSS software (version 22), with a significance level set at P < 0.05.

All students had internet addiction; nevertheless, the majority (82.4%) of them were in the range of mild addiction, and none of them had severe Internet addiction. The average score of Internet addiction was 51.59 (4.77), which shows moderate Internet addiction among students. Internet addiction had a positive and significant relationship with students’ lodging (dormitory), feelings of loneliness, and interpersonal problems; however, there was no correlation with age, gender, marital status, major, and academic year.

The prevalence of Internet addiction was significantly higher in the present study than in previous studies, serving as a critical warning for health practitioners and planners. Notably, the highest level of addiction observed was at a mild level, necessitating early intervention to prevent further escalation. Considering the correlation between Internet addiction and students’ lodging (dormitory), feelings of loneliness, and interpersonal problems, it is imperative to explore alternative activities within dormitories and provide regular psychological counseling for the early detection of these issues.

Diabetes is a chronic and costly disease that is very common in adolescents. Improving self-care behaviors will be a motivation to continue treatment. On the other hand, peer support and education have been used as an effective method in reducing behavioral and attitudinal disorders caused by chronic diseases.

Determining the effect of peer group support educational intervention on the HgA1C level and self-care behaviors of adolescents with type 1 diabetes.

This quasi-experimental research was conducted on adolescents aged 11-18 years with type 1 diabetes who were referred to the Diabetes Clinic in Zahedan city, Iran, in 2019. A total of 189 samples were included in the study using the convenience sampling method and were randomly assigned to two intervention groups and one control group (63 people in each group). The researcher used two methods of educational intervention, including peer support intervention and individual training by the researcher. Individuals in the intervention groups were subjected to separate educational interventions during 4 sessions of 60 minutes, one session every week. The control group received routine care. Demographic information, self-care behaviors, and HbA1c questionnaires were completed and recorded before, immediately, and 2 months after the end of the intervention. The data were analyzed using the Shapiro-Wilk test, Chi-square test, repeated measures analysis of variance, one-way analysis of variance, and Bonferroni post hoc test using the SPSS version 26 software. The significance level of the tests was considered 0.05.

Peer support training significantly improved self-care behavior (P < 0.001) and decreased HbA1c level (P < 0.001) in the intervention group compared to the control group. Moreover, in the intervention group, the self-care score and HbA1c level were significantly different between the pre-test, post-test, and follow-up stages (P < 0.001). The permanence of the effect of peer education in the follow-up phase was not confirmed for the variables self-care (P < 0.001) and HbA1c (P < 0.001).

Our findings showed that using peer groups and the experiences of similar people as educators can improve self-care behaviors and also record lower average glycosylated hemoglobin in type 1 diabetic patients. Therefore, it is recommended that peer support training be used as an effective method in diabetes and other chronic diseases.