Jundishapur Journal of Chronic Disease Care
Volume:1 Issue: 3, Jul 2012

Poor sleep quality affects many hemodialysis patients and can leave a significant negative impact on their quality of life and health status. The purpose of the present study was to evaluate the effect of a collaborative care model on sleep quality of hemodialysis patients. A total of 52 patients with maintenance hemodialysis in this clinical trial study, were selected and randomly divided into two equal groups; intervention and control (26 patients per each group). Demographic Data Questionnaire and Pittsburgh Sleep Quality Index (PSQI) questionnaire were applied as instruments. Collecting data in the pre-test stage, a collaborative care model was developed for patients undergoing maintenance hemodialysis according to their four steps (motivation, readiness, involvement and evaluation) for the intervention group over three months. the average score of sleep quality for one month after the intervention were compared against previous intervention. Data were analyzed using SPSS v. 19 and chi-square tests, t-independent, repeated values, Man-Whitney and Wilcox on. Repeated measures showed a significant difference between the means of Pediatrics PSQI dimensions in all aspects, except sleep disorders and hypnotic drug use (p≤0.009). Moreover, the paired t-test showed a significant difference in the Pediatrics Pittsburgh Sleep Quality Index dimensions of the intervention group before and after the intervention (p<0.001). Overall, the findings revealed that the collaborative care model was effective on the increasing sleep quality in patients with undergoing maintenance hemodialysis.

Heart transplantation is an important option for patients with heart failure who are at the final phases and have not responded to other treatments. The process complexity for heart transplantation may strict and severe patients who enjoy inadequate support system and their lifestyle is below the standard after transplantation. This research intended to study the experience of the heart transplant recipients of supportive sources. This study applied a qualitative approach using a descriptive phenomenology method. The purposive sampling was conducted with 9 participants and collected data was analyzed through Colaizzi method. Four concepts were extracted from data including lack of social support, role of spouse, medical staff support and peers support. The findings of this study on part of the heart transplant recipients’ experience can help to develop the care of these patients and the supportive sources and ultimately provide appropriate area to improve the life and life style of patients.

Diabetes mellitus is the most prevalent cause for non- traumatic amputations, which starts with an ulcer in the lower limb. About 15% of patients with diabetes suffer from this ulcer. By controlling blood sugar, we can highly prevent the ulcer. The study was aimed to survey the barriers to control blood sugar in the patients with diabetic foot ulcer in three fields of interpersonal factors, extra-personal factors, and barriers related to the health system. A descriptive study was conducted on 56 patients with diabetic foot ulcer admitted Ahvaz Razi Hospital. The Study population was selected applying a convenience sampling. Collected data through researcher- made questionnaire were analyzed using statistical descriptive elements (mean and standard deviation, frequency and percentage). The analytical statistical methods of Mann-Whitney and Kruscal-Wallis tests were also applied analyzing data using SPSS version 19. Extracted findings showed intrapersonal barriers are the most important factors for blood sugar control failures in diabetic foot ulcer patients. The total mean score for intrapersonal barriers, extra personal barriers, and barriers related to the health system were 38.30±7.8, 33.91±8.03 and 32.66±7.15, respectively. No significant relation existed between the mean score of intrapersonal barriers with the sex, age, and education. However, a significant relation existed between the mean score of intrapersonal barriers and the Arabian ethnicity (p<0.05). Intrapersonal barriers had the most importance in blood sugar controlling for patients with diabetic foot ulcer compared to extra personal and health system barriers with a significant correlation in Arabian ethnicity.

Oral and dental health is an important public health indicator and general health is more depends on the oral and dental health and if not dealt with in childhood and adolescence ages the future health of the community will be compromised. The purpose of this study was to assess DMFT (Decay, Missing, Filled, Teeth) index and dental carries for 12-14 years old students.. A descriptive-cross sectional research was conducted to assess DMFT index and dental carries. The research units included 1000 boys aged between 12-14 years old, from first to third grade, which were selected randomly from secondary schools, based on multistage sampling. The data collection tools were a questionnaire and an observation record sheet. Using descriptive and inferential methods collected data was analized by SPSS ver. 15 statistical software. Results extracted from this study showed that the mean of decay, missed and filled permanent teeth in all the age groups of 12-14 years, were 2.37, 0.61 and 0.32 respectively, and mean of DMFT was 1.1. Also, 76 percent of the DMFT score was related to decayed teeth and mann-whitney test shows that there is no significant relationship between DMFT index and brushing teeth. Considering the high percentage of dental caries in this study, it is necessary that students, especially in this growth ages have paid attention from the education authorities and must be done basic measures to reduce or eliminate this problem in health planning for these ages.

Changes in body composition after menopause are including; decreased muscle mass, increased fat mass and central obesity with central fat accumulation, which can increase the risk of cardiovascular diseases and metabolic syndrome (1). Body composition and its changes in postmenopausal women associate with osteoporosis and metabolic syndrome. Metabolic syndrome is the key factor for cardiovascular disease that is become a major health problem in many countries. We performed this study to recognize the relationship of reproductive period and menopause age with body composition among non-obese post menopausal women. Methods and In this cross sectional research, we selected 140 healthy non-obese postmenopausal women who had a BMI less than30 Kg/m2, in 2010 in Iran. Data were obtained through interview that included demographic information (age, age at menarche, age at menopause, date of last menstrual period, parity), measured height and weight, skin folds (tricepse,superiliac,thigh), BMI and WHR. We used the Pearson correlation and multiple regression analysis by SPSS 15 software for statistical purposes. In this study a significant correlation was found between reproductive period and fat mass (r=0.22,P=0. 007) and weight (r=0.16, P=0. 04). A significant relationship was observed between menopausal age and fat mass (r=0.26, P=0. 002) weight (r=0.24, P=0. 004) and BMI(r=0.19,P=0. 02), but menopausal age with WHR and fat-free mass was not significantly associated. The increasing of reproductive period and menopausal age is associated with increased body weight and fat mass and increasing of menopausal age is associated with higher BMI.

Hemodialysis treatment process in patients with chronic renal failure affects the patient from clinical, psychosocial and economic aspects. Today, life quality is considered as the main indicator to assess the health status. The purpose of this study was to determine the correlation between life quality and health status in hemodialysis patients with end-stage renal disease. A descriptive correlational study on 122 was conducted for hemodialysis patients using simple random sampling. The instrument used is a questionnaire consisting of three-parts of demographic information, quality of life (SF-36) and health status. Data were analyzed by pearson correlation coefficient and paired t-test with SPSS, ver 17. The lowest mean for scores obtained from the aspects of health status belongs to the physical aspect. The majority (53.4%) received a poor score for health status. In addition, the mean score of life quality in patients was 46.85. Life quality had a significant relationship with the physical, psychological and social aspects of health status however, it did not show any significant relationship with the medical and economic aspects. Furthermore, its correlation with the physical and psychological aspects is more than other aspects. Life quality (r=0.76) and general health status (P<0.01) showed also a strong correlation. Life quality and health status correlation demonstrated that patients’ attitudes towards themselves are affected by the health. Having a useful life, that is, in addition to the physical impairments caused by chronic renal failure and hemodialysis, the patient''s psychological structure and social environment can affect their motivation and life expectancy.

Depression is the most common mental disorder in patients with multiple sclerosis which is along with disability, disease recurrence and enormous economic burden. Hence, this study was designed to examine rates of depression in multiple sclerosis patients and relationship between depression and associated factors. A descriptive study was carried out on a total of 110 multiple sclerosis patients from Iran MS Society applying selected convenient method. Data collection was conducted applying a questionnaire with both individual and disease characteristics related questions as well as the beck depression scale (BDI). The SPSS 16 software version and descriptive inferential statistics were used analyzing data. The data showed that 6% of multiple sclerosis patients had no depression, and the rest had suffered depression, ranged from mild (46%), moderate (26%) and severe (22%). Examination of the applied variables showed a significant difference for depression associated with education level, frequent disease recurrence and family economic status (p <0.05). This study showed a high rate depression in multiple sclerosis patients which could jeopardize patients health. Hence, a timely diagnosis is recommended for depression treatment through psychiatric periodically examinations.

Dyspnea is described as a sensation of difficulty awareness in breathing and it is a common complaint of patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the related factors of exersional dyspnea and determine the predictors of it. Across-sectional study was developed on 37 patients with chronic obstructive pulmonary disease referred to Specialized Pulmonary Clinic of Aria Hospital in Ahvaz in 2011. Purposive sampling method was used gathering the samples. The 6Minute Walk Test (6MWT) was performed at the end of the test based on American Thorax Society’s protocol exersional dyspnea was measured by Borg scale. Also the health related quality of life was assessed by the St George’s Respiratory Questionnaire (SGRQ). The data was analyzed using Pearson’s linear correlation coefficient, Spearman’s correlation coefficient and Multivariate linear regression. The finding revealed that there was a negative significant relation between dyspnea and exercise tolerance(r=-0.33, p<0.05).A positive correlation was observed between dyspnea and quality of life (r=0.60, p<0.001).Moreover, no statistically significant correlation was found between dyspnea and blood pressure, respiratory rate, heart rate and O2sat before 6MWT. Multiple regression analysis indicated that the O2sat and respiratory rate after exercise and forced expiratory flow the middle 50% of the FVC (FEF25-75) was identified as independent predictor of the exersional dyspnea(p<0.05). The result showed that the patients with more dyspnea had a lower exercise tolerance and quality of life. Tree factors consist of the O2sat and respiratory rate after exercise and FEF25-75 maybe were the predictors of exersional dyspnea.