فهرست مطالب مهدیه پودینه مقدم

Education is fundamental to diabetes treatment. Various educational methods do not have the same effects, so this study aimed to compare the effects of peer education and self-learning modules on glycosylated hemoglobin in patients with type II diabetes.

In this clinical trial, 60 patients with type 2 diabetes referred to the Zabol diabetes clinic were enrolled. Patients were randomly divided into two groups using coin flips. Patients in the peer group participated in 6 sessions of 30-45 minutes each, conducted over a month (2 sessions per week). In the module group, self-learning packages were provided to patients. The patients in the module group studied at the same time as the peer group sessions. To ensure compliance with the module study, the researcher established telephone contact with patients. Telephone follow-ups were conducted for both peer training and module groups. The self-care scores of patients were assessed before and 12 weeks after the intervention.

The level of glycosylated hemoglobin significantly decreased in patients after participating in peer training (P = 0.032), while the level of glycosylated hemoglobin did not show a significant change before and after participation in the self-learning module group (P = 0.385). There was no significant difference in the levels of glycosylated hemoglobin between the peer training and self-learning module groups after the intervention (P = 0.199).

This study showed that peer education could lead to a reduction in glycosylated hemoglobin levels in patients with type 2 diabetes. Therefore, peer education is an effective method to help control diabetes and can be beneficial in reducing complications in diabetic patients.

Diabetes is a health challenge worldwide. Self-care activities are one of the effective ways to control this disease and its complications. In this study, the effect of the peer method and self-learning module on patients' self-care was investigated.

In this semi-experimental study, 60 patients with type 2 diabetes who were referred to a diabetes clinic in Zabol, Iran, were included. Patients were randomly divided into two groups by tossing a coin. Patients in the peer group participated in 6 sessions of 30-45 min long. This intervention was implemented for the peer group in one month (2 sessions per week). Self-learning packages were also provided to the patients in the module group. In the module group, at the same time as the peer group training sessions, the corresponding module (the module related to the same topic as the peer group training session) was provided to the patients to study it. To ensure the validity of the study, the researcher made telephone calls to the patients. In addition, the researcher conducted telephone follow-ups to remind the treatment plan to both peer education and self-learning module groups. The self-care score of the patients was checked before and 12 weeks after the intervention.

The self-care score of patients in the peer group (P<0.001) and self-learning module group (P<0.001) increased significantly. The patients in the peer group had a significantly higher self-care score than the patients in the self-learning module group (P=0.019).

The present study showed that the two self-learning methods, peer and module, effectively improved patients' self-care. This effect was higher in the peer group since, in the peer-oriented education method, patients learn from the experiences of their peers with the same conditions and diseases. Consequently, this can lead to an improvement in the adaptation of patients to their disease conditions, ultimately leading to disease control and the reduction of its complications.

Diabetes is one of the most common chronic metabolic diseases. The crisis provoked by this disease leads to seeking moral support as a coping mechanism. Spiritual well-being is one of the basic concepts associated with handling the problems and tension caused by the disease. Based on former studies, type II diabetes has a negative impact on quality of life. Accordingly, the present study aimed to investigate the relationship between spiritual health and quality of life in patients with type 2 diabetes.
This descriptive-analytical study was performed on 100 patients referring to diabetes clinic of Zabol, Iran, who met the inclusion criteria. Spiritual well-being (SWB) and quality of life (WHOQOL-BREF) questionnaires were employed for data collection. After completing the questionnaires, the collected data was analyzed using descriptive and inferential statistics in SPSS, version 20.
According to the obtained results, the mean score of spiritual well-being was 91.69±10.26, indicating the favorable condition of the patients in this regard. Mean score of quality of life (232.21±43.65) also demonstrated that the participants were in a relatively good state. Furthermore, we found a positive association between quality of life and its subscales and spiritual health and its subscales (P To improve quality of life, developing plans and approaches to promote spiritual well-being of diabetic patients can be beneficial.

Diabetes is a chronic heterogeneous disease, one of the characteristics of which is hyperglycemia that can cause fatal complications. One of the criteria for diagnosis and management of diabetes is fasting blood glucose measurement. Given the few side effects, the use of traditional herbs to control blood sugar has gained popularity during the recent years. Herein, we aimed to investigate the effect of dill (Anethum graveolens) tablet on the level of fasting blood sugar in patients with type II diabetes.
This controlled clinical trial was carried out on 60 patients who met the inclusion criteria. The participants were selected through purposive sampling and randomly divided into intervention and control groups. Initially, fasting blood glucose was measured, and then the experimental group received dill tablet for six weeks. The obtained information was analyzed by independent and paired t-test in SPSS, version 21.
The mean blood glucose level was not significantly different between the intervention and control groups; moreover, the control group was not significantly different before and after the intervention in this respect (P>0.05). However, after the intervention, the mean blood glucose level significantly diminished in the intervention group compared to the control group (P Given the significant reduction in fasting blood sugar in the intervention group, dill tablets can be recommended to diabetic patients to reduce the side effects of this disease.

Nursing education aims at training efficient, educated people who can recognize the needs of the patients in an ever changing social environment and in clinics and through using the best scientific evidences, perform the most suitable care. The aim of this study was to evaluate the impact of evidence-based education on nursing students’ critical thinking. This quasi-experimental study was conducted on all the 43 senior and junior undergraduate nursing students of the Zabol University of Medical Science, Zabol, Iran using before/after design, who were selected using the census in 2014. The data collection tool was a 34-question critical thinking California questionnaire (B form). Evidence-based nursing education program was performed for the students in two workshops. After 45 days of the training program critical thinking questionnaire was completed again, data were analyzed using SPSS 17 software and descriptive statistics and inferential statistics by a significance level of p< 0.05. According to the results, the average total score of students’ critical thinking was promoted from 10.30±3.82 before intervention to 12.4±3.00 after intervention, which was significant according to the results of paired-T statistical test (p= 0.001). Evaluating the dimensions of critical thinking separately showed an increase in the score of the evaluating, analyzing, deduction and deductive reasoning items after intervention, which was significant only in evaluating (p=0.003) and deductive reasoning (p= 0.001) components. The findings of the research confirmed that the use of evidence-based education method in nurses’ education could lead to the development of critical thinking skills. Since the learner has an active role in her learning in the evidence-based method, thinking is promoted at high levels of learning.

Complications resulting from diabetes have a large impact on patients’ quality of life and their families and impose significant costs on both the patients and social economy. Marital relationship is affected by chronic diseases. Therefore, affliction with diabetes may also affect family relationships. In this study, we aimed to review the family problems of patients with type II diabetes. Scientific databases including PubMed, Google Scholar, SID and Iran Medex were searched in order to identify articles published during 1992-2014, using the following keywords: “diabetes patients” and “family problems”. Finally, 40 articles were examined, among which only 22 articles were considered relevant to the purpose of the present study. According to the results of this study, family support is effective in controlling the disease in diabetic patients. Also, it helps patients accept the consequences of their condition. This can have positive impacts on family conditions of diabetic patients. According to the findings, diabetes is the main cause of reduced family satisfaction in affected couples. In total, family plays an important supporting role in determining the quality of life in these patients.

Complications associated with atherosclerosis are the most common cause of human mortality. Hyperlipidemia is an important risk factor for atherosclerosis. In fact, a decline in cholesterol concentration decreases the incidence of coronary artery diseases by approximately 50%. Considering the use of herbal medicine as one of the earliest modes of treatment, this study aimed to determine the effect of ginger on reducing lipid level in humans. In this study, 90 patients with hyperlipidemia were randomly allocated to 3 groups of 30 subjects. The first group only received anti-hyperlipidemic medications, the second group was given anti-hyperlipidemic and placebo medications, and the third group received ginger in addition to anti-hyperlipidemic medications for 7 weeks. Fasting blood sugar (FBS), blood pressure, and serum lipid were evaluated before and after the intervention. FBS, triglyceride, cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels were not significantly different among the three groups before the intervention. However, after the intervention, FBS was different between the first and third groups. Moreover, triglyceride level in the third group was significantly different from those reported in the first and second groups. Also, HDL in the third group was significantly different from those of the first and second groups. Given the significant effects of ginger on blood sugar and serum lipid profile, we recommend ginger for controlling hyperlipidemia, hyperglycemia, and hypertension.

Chronic renal failure and hemodialysis can lead to numerous self-care deficits in patients. Promotion of psychological self-care behaviors can help patients maintain their mental health and well-being. The present study was performed to determine the impact of a self-care program, based on Orem’s Self Care Model, on psychological self-care deficits in hemodialysis patients.

In this quasi-experimental study, carried out in 2013, thirty-six hemodialysis patients were selected via convenience sampling from the hemodialysis ward of Vali-e-Asr Hospital in Birjand, Iran. Data were collected, using a self-care deficit questionnaire, which was designed based on Orem’s Self-Care Model. After confirming its validity and reliability, the questionnaire was completed during interviews. By considering the subjects’ self-care deficits, the program was carried out via face-to-face interviews. One month after the intervention, the questionnaire was filled out again. Descriptive and inferential statistics were calculated by SPSS version 17. P-value ≤ 0.05 was considered statistically significant.

As the findings showed, psychological self-care deficits included knowledge deficit related to effective relaxation techniques and anger management via problem-solving, inability to use relaxation techniques and anger management via problem-solving, deficit in using positive sentences, deficit in expressing emotions toward family and friends, social isolation, grief, and despair. Before the intervention, the majority of patients (n=33, 91.7%) had knowledge deficit related to effective relaxation techniques, deficits in anger management via problem-solving, and inabilities to use relaxation techniques. However, after the intervention, the number of patients with knowledge deficit reduced to 13 (36.1%) (P< 0.001), and the number of subjects with deficits in using relaxation techniques decreased to 18 individuals (50%) (P=0.001), according to McNemar’s test.

The present study showed that a self-care program, based on Orem’s Self-Care Model, can significantly reduce psychological self-care deficits in hemodialysis patients. Therefore, nurses can apply self-care programs based on Orem’s Self-Care Model to improve patients’ mental health.

Diabetes is among the most important metabolic diseases, affecting 171 million people, worldwide. The number of people affected by diabetes is estimated to reach up to 366 million until 2030. Magnesium (Mg) is a co-factor for many enzyme reactions in the body and contributes to the oxidation and metabolism of carbohydrates and insulin activation. The current study aimed to evaluate serum Mg level in patients with type 2 diabetes and identify the contributing factors. In this descriptive, analytical (cross-sectional) study, 60 patients with type 2 diabetes, referring to the diabetic clinic and internal ward of Amir-al-Momenin Hospital of Zabol, were evaluated. The subjects were selected via accessible sampling, and written informed consents were obtained. Data were gathered, using interviews and a researcher-made checklist. Blood samples were taken for evaluating Mg and glycosylated hemoglobin (HbA1c). Descriptive and inferential statistics were applied, using SPSS software. P-value < 0.05 was considered statistically significant (confidence interval=95%). The mean Mg level in patients with type 2 diabetes was 1.76±0.43 (mg/dl), and the mean HbA1c was 8.51±1.60 %. There was a significant relationship between Mg level and HbA1c (P=0.01). More over, Mg level was significantly correlated with patients’ gender. However, no statistical relation was observed between Mg level and other variables such as age, educational level, body mass index, economic status, blood pressure, or systolic and diastolic blood pressure. As the results indicated, the mean Mg concentration in diabetic patients was lower than the normal level (1.8–2.5 mg/dl). Considering the statistical relation between Mg concentration and HbA1c, more attention should be paid to integrating Mg in the diet of diabetic patients, and the patients should be informed about magnesium-rich sources.

Diabetes mellitus is a global public health issue that has a prevalence of between 5-8% in different parts of Iran. One of the most serious complications of diabetic foot ulcer and chronic complications of diabetes mellitus is one of the leading causes of Morbidity and amputation in patients with diabetes. On the other hand, amputations in patients with diabetes are three-year survival rate is only 50 percent. Hyperbaric oxygen a treat medical that the patient is in a closed chamber exposed to oxygen at 100 percent pure at a pressure higher than the pressure at sea (4/1 atm or higher) are placed. Patient can breathe pure oxygen that tissue levels and further increases healing. The purpose of this study, an overview of the use of hyperbaric oxygen in the treatment of Diabetic foot. Present study was done to review the literature in search of Persian databases such as (Iranmedex, SID, Magiran) and English databases such as (EBSCO, Pub med, ProQuest, Google Scholars) With Hyperbaric Oxygen Therapy and diabetic foot keywords related to the years 1987 to 2012. Hyperbaric oxygen is beneficial for diabetic ulcers and Increases the oxygen level in tissue and healing mechanisms by angiogenesis, collagen synthesis, increase the response of fibroblasts, blood vessels and increases the antibacterial activity of leukocytes also has some side effects such as toxicity with oxygen in the brain and lungs, barotraumas of the middle ear, Myopia and seizures that for reduce the side effects is recommended that patients monitored by doctors and nurses who do Hyperbaric Oxygen Therapy. Results showed that hyperbaric oxygen may reduce the risk of major amputation and accelerates healing rate after one year but further studies should be treated in the clinical trials done to ensure greater accuracy as the standard treatment for hyper oxygen therapy in the treatment of diabetic foot ulcers utilized.

Chronic renal failure and hemodialysis affect patients'' ability due to its debilitating nature. It can cause numerous self-care deficits for patients. Promoting self-care behaviors can help patients to maintain their health and well-being. The present study was performed to determine the effect of educational plan based on Teach Back method on hemodialysis patients'' self-care deficits. In this quasi-experimental study carried out in 2012، thirty-six hemodialysis patients were selected through convenience sampling method from the hemodialysis ward of Birjand Vali-e -asr hospital. Necessary data was collected using self-care deficits questionnaire whose validity had been approved. The questionnaire was filled out through live interview، and an educational plan was carried out using teach-back method considering the deficits diagnosed. One month، after intervention، the questionnaire was filled out again. The obtained data was analysed by means of SPSS software (V: 17) using Wilcoxon test at the significant level P<0. 05. The findings showed that mean of patients'' self-care deficits in seven domains before the intervention were 4. 05 ± 1. 85، 2. 19 ± 1. 89، 3 ± 2. 17، 1. 11 ± 1. 23، 2. 97 ± 1. 34، 2. 52 ± 2. 41، and 2. 80 ± 2. 68 in nutrition، skin care، activity and rest، elimination، fluid and electrolytes، drug taking، and mental health; respectively. But، after the intervention mean self-care deficits in the seven domains changed to 1. 97 ± 1. 69 (P<0/001)، 0. 97 ± 1. 59 (P<0/001)، 1. 58 ± 1. 71 (P<0. 001)، 0. 30 ± 0. 66 (P<0. 001)، 0. 91 ± 1. 50 (P<0. 001)، 2. 52 ± 2. 41 (P<0. 001)، and 2. 80 ± 2. 68 (P<0. 001); respectively. The results revealed that the educational plan had been positively effective in patients'' self-care deficits. The present study showed that an educational plan based on Teach-Back method can significantly reduce hemodialysis patients'' physical and psychological self-care deficits. Therefore، nurses can apply this educational strategy to improve their health.

The most important and vital property of health centers is efficient manpower. Since nursing interns are effective members of the patient care team in educational institutions and their efficacy has an important role in the effectiveness of nursing care of patients, it is not clear how clinical settings empower nursing students in an appropriate way. Therefore, the present study was performed to determine the empowering condition of the hospitals under the affiliation of BUMS from nursing interns 'point of views in the school of Nursing and Midwifery. In this descriptive cross-sectional study, 33 nursing interns in Nursing and Midwifery faculty of Birjand were studied in a census in the spring of 2012. Means of gathering data were the standard questionnaire, Scott & Jaffe workplace empowerment questionnaire consisting of 38 statements and 9 subscales, on Likert 4 scales. The obtained data was analysed by means of SPSS software (V:17), statistical tests, independent t and Pearson's correlation coefficient at the significant level P<0.05. Mean of total score was 2.26±0.34 and the value of subscales (objective clarity, fair behavior, understanding and appreciation, teamwork, cooperation, workplace health) was at a moderate level. Mean score of communication and education was low. Mean score of empowerment in communication significantly differed with native status (P=0.035). Mean score of fair behavior statistically had a significant difference with residence (P=0.046). Mean score of healthy workplace (P=0.039) and cooperation (P=0.033), too, had a statistically negative relationship with age and health significantly differed with age. The results showed that empowerment of university hospitals was average for students. It sounds that educational managers should make interns aware of the programs and objectives of the hospital and orientate them towards workplace; and make use of their views in group activities and treatment decisions.