Jundishapur Journal of Chronic Disease Care
Volume:6 Issue: 3, Jul 2017

When controlling diabetes in children, families suffer from burden of care imposed by the disease. The aim of this study was to investigate the effect of family psychoeducation on the burden of care imposed on families of adolescents with type 1 diabetes referring to Golestan diabetes clinic in Ahvaz city.
The present study was a clinical trial with before-after design. The study population included families with adolescents with type 1 diabetes aged 12 - 19 years. A total of 40 families of sick children and one parent who was more in touch with the patient were selected and randomly divided into experimental (20 families) and control groups (20 families). To measure family burden of care, burden of care Questionnaire (DFI-S) was used. Family psychoeducation was carried out for the experimental group twice a week for 8 sessions of 90 minutes. Independent and paired t-test and Mann-Whitney test were used to compare the mean score of family burden of care in both groups while Chi-square test was used to compare qualitative variables between the two groups. SPSS v. 20 was used for statistical analysis.
The most frequent age range of diabetic children was 12 - 14 years (55%) and 15 - 19 years in the experimental and control groups (65%), respectively. Most fathers and mothers were self-employed (60%) and homemakers (85%), respectively. The mean score of burden of care imposed on families before the intervention in the experimental and control groups was 26.6 and 30.15, respectively, that reduced to 21.6 and 30.35 three months after the intervention, respectively, showing no change.
Family psychoeducation can reduce family burden of care imposed by adolescents suffering from type I diabetes and increase the period for families facing the disease. It also reduces medical treatment costs and length of stay in health centers and increases quality of home care.

Multiple sclerosis is one of the most prevalent chronic diseases of the central nervous system, which has a disabling nature. This study aimed at investigating the relationship of body image with emotion regulation, stress, and aggression and to compare them between males and females with multiple sclerosis (MS).
The current study was correlational with a casual-comparative design. The statistical population of this study included all MS patients referred to the MS society of Zahedan from November 2016 to January 2017. Among these individuals, 60 patients (30 males and 30 females) were selected using a convenience sampling method and were asked to fill out four questionnaires including the Cash, Winstead, and Janda body image questionnaire, Abell index of stress, self-regulation inventory (SRI-25), and buss and perry aggression questionnaire.
The obtained data was analyzed using the Pearson correlation coefficient, stepwise regression analysis, multiple analysis of variance (MANOVA), and t-test. Results of the correlation test indicated that body image was significantly and negatively correlated with stress (r = -0.259, P 0.05). Results of the regression analysis demonstrated that body image was a predictor of stress and among its 6 subscales, appearance evaluation, body area satisfaction, and fitness orientation were able to determine 0.27 of variances in stress. Moreover, aggression was a predictor of body image, such that among its six subscales, fitness evaluation and body area satisfaction explained a total of 0.23 of variances in aggression. Results of the MANOVA and t-test revealed that considering body image, stress, emotion regulation, and aggression, there were significant differences between males and females with MS (P Given the obtained results, through training skills aimed at improving body image among MS patients, these patients could be aided to decrease their stress in the face of stressful events and, consequently, control their aggressive behaviors.

Chronic renal disease is a threatening condition for the health, economic, and social status of the affected person and his/her family. Patients undergoing hemodialysis encounter mental and health problems; the current study aimed at predicting resilience via social support and illness perceptions among patients undergoing hemodialysis.
The current descriptive-correlational study had a statistical population including 308 patients undergoing hemodialysis in Kerman, Iran, in 2017. Based on the Krejcie-Morgan table, the minimum required sample size was 169. The sample was selected using a convenience sampling method. Data collection tools were the Connor-Davidson resilience scale, the medical outcome study (MOS) social support survey developed by Sherbourne and Stewart, and the brief illness perception questionnaire developed by Broadbent et al. Data were analyzed using a Pearson correlation coefficient and a stepwise regression analysis via SPSS version 19.
Results indicated that resilience was significantly and positively related to social support (r = 0.318, P The obtained results demonstrated that resilience was significantly and positively related to social support and illness perceptions. Additionally, the subscales of social support and illness perceptions could predict resilience among the patients undergoing hemodialysis.

Caesarean section (CS) is one of the most commonly undertaken operations worldwide with numerous potential complications such as subsequent infertility. Thus, the aim of this study was to evaluate subsequent infertility after CS.
This retrospective epidemiological study was conducted in Obstetrics and Gynecology of Ahvaz Imam Hospital from 2011 to 2015. During the five years, 2047 patient records were collected representing that only 218 patients had secondary infertility after CS or vaginal delivery (including 114 (52.29%) after CS and 104 (47.7%) after vaginal delivery). Then, information of all patients was extracted from infertility clinic records.
The results showed that there was no significant difference between the groups in terms of demographic features and sign and symptoms such as dysmenorrhea (P = 0.386), dyspareunia (P = 0.357), hirsutism (P = 0.622), and galactorrhea (P = 0.352). Moreover, associated disorders including Men disorders (P = 0.577), Uterine disorders (P = 0.286), Fallopian tube disorders (P = 0.394), and Ovulation disorders (P = 0.21) did not have any significant differences between the groups.
The results of this study suggest that CS did not increase the risk of subsequent infertility when compared to vaginal delivery. Therefore, in patients who have infertility problems after the first CS, we should evaluate other reasons in order to treat it.

Psoriasis is a chronic inflammatory disease with frequent recurrence. The associated complications cause disturbance in patients’ quality of life. In addition to treatment procedures, use of self-care behaviors can be considered a cost-effective and applicable method in improving the patients’ symptoms. Therefore, the present study aimed to investigate the effectiveness of a self-care program in promoting self-care behaviors of patients with psoriasis.
The present study aimed to investigate the effectiveness of a self-care program in promoting self-care behaviors among patients with psoriasis.
This quasi experimental, before-after study was carried out on 32 patients. The educational program was implemented face-to-face and in groups (in areas such as medicine, bathing, and clothing). The samples were examined once every 2 weeks for 3 months. Two questionnaires and 1 self-report checklist with a correlation coefficient of 92.5% were used in this study. The validity of the questionnaires was determined using content validity. Data were analyzed using repeated measures ANOVA in SPSS.
The patients’ demographics were as follows: mean age, 42.37%; males, 16 (55.2%) and females, 13 (44.8%); married, 21 (72.4%), single, 6 (20.7%), and widowed, 2 (6.9%); secondary school education, 13 (44.8%); average disease period, 9.03%; most self-employed and housewives (9, 31%); history of disease, 7 (24.1%); and physician-diagnosed disease, 29 (100%). The results showed that the mean medication adherence rate increased from 7% to 9.72% after the intervention, and comparison of self-care behaviors before and after the intervention showed that the frequency of most behaviors significantly increased.
The results showed that training could improve self-care behaviors. Use of simple, low-cost, and available programs for self-care behaviors is effective in reducing the patients’ symptoms and improving their conditions.

Despite the remarkable development of medical sciences, cancer has yet remained one of the most important diseases of the current century and the second cause of death following cardiovascular diseases. Although we witnessed considerable development in treating cancer and increased number of survivors, cancer is a unique disease that makes the patients deeply feel helplessness and fear.
A qualitative content analysis research was done. The present study investigated patients’ experience and behaviors after hearing about their cancer. Purposeful sampling was carried out and continued until data saturation. We used qualitative validation methods to verify the results.
Study participants consisted of 14 patients. 10 main components emerged from the data including: 1) getting shocked, 2) fear, 3) anxiety and stress, 4) guilt, 5) hopelessness, 6) depression, 7) isolation, 8) lack of affection and dependency on family members, 9) getting prepared to die and, 10) reviving spiritual relationship with God.
There is a necessity to understand the mental feelings of cancer patients, and program suitable clinical interventions based on patients’ mental needs. As the number of cancer patients is increasing, the results of the present study can be useful for patients’ families and clinical personnel especially physicians and nurses in dealing with cancer patients.

Kidney chronic failure and its replaced remedies make the patient exposed to a wide range of physical, mental, economic, and social problems and as the life quality is affected by them, the life quality would be changed. Therefore, evaluation of the life quality by specific evaluation tools and based on demographic information help the patients’ problems to be dealt with principally. In this study, we examine the life quality of hemodialysis patients and kidney transplant recipients in Ahvaz.
This study is a cross sectional study to compare the life quality of patients who had kidney transplantation or underwent hemodialysis treatment. Sampling was conducted based on purposeful method and the life quality of 70 patients and 70 kidney transplant recipients referring to medical center and the people who had the criterion for entering the study were examined by a questionnaire of kidney diseases’ life quality (KDQOL-SF36); then, after collecting data, they were compared by applying statistical tests including T-test and Chi-square test.
The mean total scores of the life quality did not show a statistically significant difference in two groups (P = 0.344), but the kidney transplantation group with a significant mean difference obtained better scores in the dimensions of general health (P = 0.002), physical health (P = 0.000), sleep (P = 0.028), limitation in playing a role (P = 0.000), and physical limitation (0.002) in comparison with hemodialysis group. The two groups did not show any significant difference in dimensions of disorder in social natural function and social relations, physical pain, limitation because of pain, vivacity, coping with disease, inner emotion related to disease, self-knowledge, emotional issues, and sexual activities.
Although kidney transplantation could increase the patients’ life quality in some dimensions, in the kidney transplantation group the people still encounter their previous problems and are in need of receiving more care to keep their transplant kidney. Based on results, therefore, educational - medical centers must predict and implement necessary arrangements to increase the life quality in both groups.

Spinal-Z is a methanolic mixture of dried seed powder of Peganum harmala Linn. and leaf of Dracocephalum kotschyi Boiss. It is available as oral capsules and has been used to treat various cancers. The aim of this study was to evaluate the effects of Spinal-Z capsules (containing herbal extracts) on blood parameters and gastrointestinal symptoms of patients with metastatic gastric adenocarcinoma and to determine its potential side effects.
A total of 76 patients were randomly assigned into 2 groups. The intervention group received 6 Spinal-Z capsules per day (2 after breakfast, 2 after lunch, and 2 after dinner). The control group received placebo capsules in the same manner. The patients were followed-up for 24 weeks.
The distribution of demographic and clinical characteristics was homogeneous in the intervention and control groups. Spinal-Z treatment had no significant effects on cardiovascular parameters, such as systolic blood pressure, diastolic blood pressure, or heart rate, compared to the control group. No significant changes were observed over time, although a significant reduction in fasting blood sugar was observed in the intervention group, compared to the controls. Based on the findings, treatment could significantly reduce dysphagia and stomachache in the follow-up, while it had no significant effects on symptoms, such as itching, nausea, or vomiting neither temporarily nor in the long run (follow-up; P > 0.05).
Spinal-Z does not have any adverse effects on cardiovascular, renal, and hematopoietic systems or blood glucose level. On the other hand, it could improve gastrointestinal complications. Overall, Spinal-Z, as an accessible and affordable medication with very few side effects, may be a suitable option for treating complications in patients with metastatic gastroesophageal adenocarcinoma, as it can decrease fasting blood sugar and erythrocyte sedimentation rate.

Elderly’s quality of life involves many factors, among which chronic diseases are of the most important. On the other hand, elderly residing in nursing homes are a group of elderly, who need special attention.
the present study was conducted to investigate the relationship between chronic diseases and quality of life for elderly residing at nursing homes across Guilan province, Iran.
This descriptive-correlational study was conducted on elderly residing in nursing homes across Guilan province, during year 2016. Through a stratified random sampling approach, 180 elderly, aged 60 and older were selected from nursing homes. The data gathering tool was SF36 quality of life questionnaire, demographic information checklist and records of engaging with chronic diseases attained via face-to-face interviews. In order to analyze the gathered data, SPSS 16 Software, Pearson correlation, analysis of variance (ANOVA), and t test were utilized. Significance level was set at P Mean and standard deviation of the quality of life scores for the elderly residing in nursing homes was 62.6 (± 25.30). In all sub-scales, mean quality of life was significantly different from chronical diseases (P The present research showed that an increase in the number of chronic diseases results in a reduction in the elderly’s quality of life. As such, it is necessary to undertake training programs in communities and modify lifestyle to maintain and even enhance elderly’s quality of life.

Fibroadenoma is the most common benign tumor of the breast. It may be associated with proliferative epithelial changes, fibrocystic changes, and very rarely, insitu and invasive cancer. This report describes malignant transformation of a bilateral fibroadenoma. The histopathological characteristics and clinical course of a rare case of invasive bilateral lobular carcinoma arising within fibroadenoma in a young female are discussed.