masoume rambod

Limited evidence is available regarding the effect of reflexology on Acute Myocardial Infarction (AMI). The present study evaluated the effect of foot reflexology on fatigue, sleep quality, physiological indices, and electrocardiogram changes in AMI.

This clinical trial was conducted on 80 subjects with AMI. They were divided into an intervention (received reflexology for 3 consecutive days) and a control (received the routine care) group. The Multidimensional Fatigue Inventory, the Pittsburgh Sleep Quality Index, a pain numeric analog scale, a daily physiological indices form, and daily electrocardiogram were used to collect data. The collected data were analyzed in SPSS software. The study was conducted based on CONSORT criteria.

After controlling the covariates, a significant difference was found between the intervention and control groups with regard to the mean scores of fatigue (F5,80 = 16.33; p < 0.001), sleep quality (F5,80 = 16.56; p < 0.001), and chest pain intensity (F5,80 = 6.86; p = 0.010); means of systolic blood pressure (F5,80 = 22.20; p < 0.001), heart rate (F5,80 = 5.86; p = 0.010), respiration (F5,80 = 9.37; p = 0.003), and temperature (F5,80= ‑4.23; p < 0.001); and incidence of ST‑segment (χ21,80 = 5.00; p = 0.020) and T‑wave changes (χ21,80 = 6.05, p = 0.010) on the fourth day of the intervention.

Given the effectiveness of foot reflexology in different aspects of AMI patients, the implementation of this intervention is recommended for these patients in coronary care units.

Resilience is a psychological trait and a protective factor that plays a vital role in coping with Chronic Pain (CP). Despite its importance, research has yet to fully clarify the concept and components of resilience in patients with CP. Accordingly, the present study aims to explain the components of resilience in patients with CP.

The current qualitative study used a conventional content analysis methodology. The research population included all patients with CP who were referred to clinics affiliated with Shiraz University of Medical Sciences (south of Iran) from August 2021 to August 2022. Participants were selected using the purposive sampling method. In‑depth semi‑structured interviews were conducted with 20 participants to collect information. Data analysis was conducted using MAXQDA 2020 software in conjunction with data collection efforts.

Generally, in the current study, 30 sub‑sub‑categories, 11 sub‑categories, and five main categories were extracted as components of resilience in patients with CP. The main categories of resilience against CP included the following: 1. emotional self‑regulation, 2. psychological flexibility, 3. self‑care, 4. appeal to religion–spirituality, and 5. internal resources and individual competencies.

The present study highlights the different physical, mental, and religious‑spiritual strategies that may contribute to resilience against pain. The resilience components identified in this study provide a foundation for healthcare professionals, particularly nurses, to design and implement diverse pain management strategies that enhance adjustment to CP conditions.

Preoperative anxiety can lead to various challenges. Aromatherapy using lemon essence may alleviate certain complications. This study aimed to determine the effect of lemon essence aromatherapy on anxiety levels and physiological indices (systolic and diastolic blood pressure, pulse rate, respiration rate, and SPO2) in patients who are candidates for lower extremity fracture surgery.

Methods & Materials: 

This randomized clinical trial employed convenience sampling to recruit 90 patients referred to SUMS, who were subsequently randomized into control (n=45) and intervention (n=45) groups in 2021. The aromatherapy intervention commenced on the morning of the surgical procedure and extended through the operating and recovery rooms, continuing for 16 hours post-surgery. Almond essential oil was administered to the control group. Data collection involved the Spielberger Inventory for anxiety assessment and a checklist of physiological indices. Data were analyzed using two-way repeated measures ANOVA.

The study findings showed a significantly greater reduction in state anxiety levels in the intervention group compared to the control group (P<0.001). Moreover, the physiological indices of the intervention group exhibited greater stability in comparison to the control group (P<0.05). However, the intervention did not have a significant impact on the diastolic blood pressure and respiratory rate of the patients (P>0.05).

The utilization of aromatherapy with lemon essential oil resulted in a decrease in the state anxiety and an improvement in some physiological indices of the patients who underwent surgery for lower extremity fractures. Therefore, this complementary approach is recommended in conjunction with routine treatments.

The multitude of responsibilities faced by faculty members, both before and after the COVID-19 pandemic, may potentially lead to musculoskeletal pain. This study aimed to determine the prevalence and compare musculoskeletal pain among faculty members of medical universities before and after the COVID-19 pandemic. A cross-sectional study was conducted on 300 professors from April 2021 to April 2022. Data were collected using a numerical scale and a checklist of musculoskeletal pain before and after the COVID-19 pandemic. The study results showed that before the COVID-19 pandemic, 7.84% of the professors experienced musculoskeletal pain in at least one part of their bodies, and before the pandemic, 6.59% and 5.6% of individuals had experienced pain in two or three regions of the musculoskeletal areas, respectively. However, a noteworthy point was that after the pandemic, individuals had more pain in four regions. The findings indicated a significant increase in the intensity of lower back pain, hip pain, and pain in the neck, shoulder, and nose and its blade, as well as the frequency of wrist, knee, and jaw pain after the pandemic (P<0.001). The study results indicate an increase in the intensity and frequency of musculoskeletal pain when comparing before and after the COVID-19 pandemic among professors in medical universities nationwide.

The COVID-19 pandemic led to changes in the medical education process. The aim of this study was to explain the process of virtual medical education during the COVID-19 pandemic.

The present qualitative study with a grounded theory approach was conducted on 40 medical students of Shiraz University of Medical Sciences. Data were collected using in-depth semi-structured interviews and focus groups. Purposeful and theoretical sampling methods were used. Data analysis was conducted by Strauss and Corbin’s approach in 2015. 

The findings showed that at the beginning of the COVID-19 pandemic, medical students were faced with insufficient virtual education infrastructure. The challenges of poor time management and lack of management of resources and facilities were reported in the virtual medical education process. During the COVID-19 pandemic, no need for physical presence inthe academic environment, and always educational content was virtual medical education opportunities. During the virtual medical education process, students used strategies such as developing self-directed virtual learning, effective virtual student-teacher communication, teaching management, and e-learning development. Finally, e-learning was associated with consequences such as physical and mental complications and effects, familiarity with new methods of e-learning, efficient and effective learning of theoretical courses, the gap between theory and practice, and change in the type of interaction. 

Medical students in the virtual education process were faced with insufficient educational infrastructure, the challenge of poor time management, and a lack of resources and facilities management. Medical students using opportunities and strategies such as the development of e-learning and education management tried to increase their learning.

Psycho‑educational interventions might play a crucial role in the management of diseases. This study was conducted to determine the effect of psycho‑educational interventions via social networks on self‑efficacy and anxiety among Coronavirus Disease 2019 (COVID‑19) patients in home quarantine.

This randomized clinical trial was conducted on 72 COVID‑19 patients, in Shiraz, Iran, in 2020. The patients were randomly assigned to an intervention and control group. Patients in the intervention group underwent psycho‑educational interventions daily for 14 days. The data were collected using the Strategies Used by People to Promote Health (SUPPH) questionnaire and the State‑Trait Anxiety Inventory (STAI ) before and 2 weeks after the intervention.

After the intervention, the mean score of SUPPH was mean = 120.75 (16.56) and mean(SD) 111.27 (14.40) in the intervention and control groups, respectively. Moreover, after the intervention, the mean score of state and trait anxiety were 34.69 (10.75) and 38.31 (8.44) in the intervention group, and mean(SD) 45.75 (13.01) and 43.50 (8.44) in the control group, respectively. After the intervention, a difference was observed between the groups concerning the mean score of SUPPH (t70 = 2.58; p </em>= 0.01), state anxiety (F1 = 16.52; p </em>< 0.001), and trait anxiety (t70 = −2.49; p </em>= 0.01).

Considering the effectiveness of psycho‑educational interventions in self‑efficacy and anxiety, healthcare providers are recommended to use these interventions in COVID‑19 patients.

Patients with chronic renal failure face many challenges. They try to use spiritual approaches to deal with these challenges. This study aimed to explore spirituality in the lives of Muslim patients with renal failure.

This was a qualitative study on patients with chronic renal failure. Samples were selected through Purposive sampling and semi-structured interviews were used to collect data. Data were analyzed using a content analysis approach.

The findings of this study showed that patients with chronic renal failure had supernatural beliefs, enjoyed spiritual support, and were connected to transcendental powers. They connected with God, reciting and listening to the Qur'an, reading prayers, and visiting the shrines. Patients also relied on God and dedicated themselves to God.

The results of this study indicated that patients with chronic renal failure had supernatural beliefs and were connected with the transcendent powers.

Implantable cardioverter defibrillator (ICD) plays a life-saving role via controlling malignant dysrhythmias. However, it may result in the incidence of psychological tensions in patients’ lives, eventually leading to changes in their quality of life (QoL). To date, this association has remained unclear among Iranian population. Therefore, the present study aimed to determine the association between QoL and psychological issues in patients with ICD.

Using convenience sampling method, this cross-sectional study was conducted on 96 patients referred to the pacemaker clinic of Shahid Faghihi hospital and Kowsar heart hospital affiliated to Shiraz University of Medical Sciences, Iran from September 2016 to January 2017. The data were collected using Depression, Anxiety, Stress Scale (DASS-21) and the Short Form36 (SF-36) questionnaire, and analyzed in SPSS software version 13 using independent t-test, Pearson’s correlation test, and ANOVA.

The mean (SD) score of patients’ QoL was found to be 1672.02 (43.43). Moreover, the mean (SD) scores of depression, anxiety, and stress were 4.69 (0.46), 5.6 (0.47), and 7.51 (0.05), respectively indicating moderate depression, anxiety, and stress levels among the patients. A significant association was found between the patients’ QoL and depression, anxiety, and stress.

As an association was observed between the patients’ QoL and depression, anxiety, and stress, performing some interventions to reduce the patients’ psychological issues might improve their QoL.

 Along with increasing population of the elderly in various countries, the incidence of falls and respective damages has also increased.

 Given the numerous disagreements regarding the effectiveness of different interventions mentioned in various sources, the present study aimed to examine the effectiveness of the Stepping-On fall preventive program on the quality of life, fear of fall, and fall-preventive behaviors among community-dwelling older adults in Shiraz, Iran.

 This study is a single-blinded randomized interventional or clinical trial study conducted on 90 elderly people under the coverage of two large health centers during 2019 - 2020 in Shiraz, Iran. Multi-stage randomized sampling was used to select the participants who were randomly allocated to either of the intervention (n = 45) or control groups (n = 45). Data collection tools were the fall efficiency scale, fall prevention behaviors, and Lipad quality of life questionnaires. The intervention group participated in a 7-session Stepping-On program, while the control group received the same routine care. Collected data were analyzed with SPSS software version 22.

 The findings indicated that the Stepping-On program was effective on the fear of falling scores (P = 0.008) and the quality of life of the elderly under study (P = 0.019) at follow-up time. However, there was no significant difference immediately after the intervention (P > 0.05). However, the mean score of fall-preventing behaviors increased during the course of the study and reached a significant level immediately after the study was conducted (P = 0.046) and the other two months later (P = 0.028).

 The Stepping-On program may apparently affect the study variables. Therefore, further research is suggested to confirm the effectiveness of this program so that it can be used across all healthcare centers for the elderly.

Most hemophilia patients experience pain in their lives. Some complementary interventions might affect pain belief. This study aimed to determine the effect of Benson’s relaxation technique on pain intensity, pain belief and perception, and pain acceptance in hemophilia patients.
In this clinical trial study, 80 hemophilia patients were divided into an intervention (relaxation technique) and a control (routine care) group based on block randomization. This study was conducted in the hemophilia center of Shahid Dastgheib hospital affiliated to Shiraz University of Medical Sciences from October to December 2018. The intervention group listened to a voice containing relaxation technique twice a day for eight weeks. Numeric rating scale, pain belief and perception inventory, and chronic pain acceptance questionnaires were completed at the beginning and eight weeks after the intervention. Data were analyzed by SPSS 21 using independent t-test, Paired-t-test, Chi-square, Mann-Whitney U test, and ANCOVA. P-value <0.05 was considered as significant.
After the intervention, the mean scores of pain intensity, pain belief and perception inventory, and pain acceptance in the intervention group were 4.26±2.17, -13.35±1.50, and 67.24±9.49 and in the control groups were 5.85±2.61, -2±1.70, and 56.57±11.04, respectively. After the intervention, a difference was found between the groups regarding the mean score of pain intensity (P=0.007), pain belief and perception inventory (P<0.001) and its subscales (P<0.05) as well as total pain acceptance (P<0.001).
This study showed relaxation technique can be applied to reduce these patients’ pain intensity, improve their pain belief and perception, and enhance their pain acceptance.

Debate still exists regarding physical and cognitive factors associated with Body MassIndex (BMI) in the elderly population. This study aimed to determine the association between BMIand comorbidity, Quality of Life (QOL), and cognitive function in the elderly population. This cross-sectional study was conducted from October 2017 to January 2018. Theparticipants included 246 old people who referred to Imam Reza elderly clinic, Shiraz, Iran. Thedata were collected using Leipad Quality of Life Questionnaire and Mini-Mental State Examination(MMSE). Indeed, weight and height were measured to assess the BMI. The data were entered intoSPSS, version 21, and analyzed using ANOVA, Chi-square test, Pearson correlation coefficient, andmultiple regression analysis. This study showed that 104 (47%) of the participants were overweight and obese. Themean±SD score of QOL was 46.14±12.01. Additionally, 93 (37.8%) of the participants had cognitiveimpairment. The results showed a significant difference among normal weight, overweight, and obesegroups regarding the mean scores of QOL (P<0.001) and cognitive function (P<0.001). Moreover,29% of the changes in BMI was explained by QOL, cognitive function, and having hypertensionand cancer. Among these variables, the associations between BMI and QOL (r=–0.52, P<0.001) andcognitive function (r=–0.28, P<0.001) were significant. The results showed that half of the old people suffered from overweight and obesity.Moreover, roughly one-third had cognitive impairment. In addition, BMI was associated with QOLand cognitive function in the elderly. Therefore, healthcare workers might use these findings to design prevention and treatment programs targeting the elderly population.

This study aimed to determine the impact of the preceptorship program on self‑efficacy and learning outcomes and the association between self‑efficacy and learning outcomes in nursing students. This quasi‑experimental study was conducted on 112 nursing students in 2012–2013. The subjects were selected through convenience sampling from the School of Nursing and Midwifery of Shiraz University of Medical Sciences, Iran. The general self‑efficacy scale and the perception of overall learning outcomes scale were used to measure the students’ perception of self‑efficacy and achievement of learning outcomes. The data were analyzed using Pearson’s correlation coefficient and linear regression analysis. The students’ mean [standard deviation (SD)] scores of self‑efficacy and learning outcomes were 30.69 (5.88) and 4.10 (0.82), respectively, after taking part in the preceptorship program. The results showed a significant association between the mean scores of self‑efficacy and learning outcomes (r = 0.30, p = 0.002). In addition, self‑efficacy was predicted by gender ( = −0.19, p = 0.030) and the components of “understand ethical aspects of patient care” ( = 0.31, p = 0.010), “work more systematically” ( = −0.44, p = 0.005), and “use of nursing research” ( = 0.34, p = 0.020). Although the nursing students who participated in the preceptorship program demonstrated high mean scores of self‑efficacy and learning outcomes, the lack of control group led to the conclusion about the effectiveness of the program to be made in caution. However, this program is suggested to be retained in nursing students’ curriculum.  

Diabetes patients are at risk of psychosocial problems. Some interventions might decrease these problems. This study aimed to evaluate the effect of coping skills training on depression, anxiety, stress, and self-efficacy of adolescents with type I diabetes.
This randomized controlled trial with pre- and post-test design was performed in the diabetes clinic in Shiraz from June to November 2015. This study was conducted on 100 adolescents with type 1 diabetes who were randomly divided into an intervention (receiving coping skills training in groups for eight sessions) and a control group (usual care). Depression, Anxiety, and Stress Scales (42-items, scores=0-42) and General Self-Efficacy questionnaire (17-items, scores=17-85) were used. The variables were measured at baseline and two months after starting the intervention. Data were analyzed using SPSS, version 16 through Chi-square test, independent t–test, and paired t-test. P After the intervention, the mean scores of depression, anxiety and stress in the intervention group were 5.41±4.58, 6.44±7.01, and 7.46±7.01, and in the control groups they were 19.73±11.80, 18.28±10.51, 21.10±10.94, respectively. Moreover, after the intervention, the mean scores of self-efficacy were 70.82±10.84, and 50.13±15.42 in the intervention and control groups, respectively. The results showed differences between the two groups regarding depression, anxiety, stress, and self-efficacy after starting the intervention (P As coping skills training reduced depression, anxiety, and stress and improved the patients’ self-efficacy, the use of this intervention could be a part of community-based nursing practice for adolescents with diabetes and more research for improving evidence-based practice in this regard are warranted.

Parents of insulin-dependent children and adolescents need resilience to continue their lives. The aim of this study was to determine the psychological predictors of resilience in parents of insulin-dependent children and adolescents.
This was a descriptive correlational study performed in 2016. One hundred and thirteen parents of children and adolescents with diabetes who referred to a diabetes clinic in Shiraz participated in this study. Convenience sampling was used. Depression Anxiety Stress Scales (DASS-21) and Connor-Davidson Resilience Scale (CD-RISC) (25 items) were also used. The data were analyzed by SPSS software version 20 using t-test, ANOVA, Pearson correlation coefficients, and linear regression analysis. P The findings showed that the mean±SD score of resilience was 65.33±23.81 in parents of children and adolescents with diabetes. Indeed, 45.1% of the parents had mild to extremely severe levels of stress. Besides, 58.4% and 71.4% of them reported mild to extremely severe depression and anxiety, respectively. The lowest mean±SD scores of resilience were reported in parents with extremely severe levels of depression (37.57±16.26), anxiety (44.89±23.53), and stress (37.84±17.90). Moreover, 49% of changes in resilience was explained by such factors as stress, anxiety, depression, and life and health satisfaction. Among these variables, the association between resilience and depression (t=-6.97, P Since nearly half of the parents experienced stress, depression, and anxiety, and there was an association between resilience and these psychological variables, parents’ psychological problems, especially depression, might be reduced by improving their resilience.

Pain, as a crucial subsequence of joint hemorrhages in hemophilia patients, is chronic, debilitating, and distracting. This study aimed to describe and interpret pain experiences of hemophilia patients in their lives.
This qualitative study with hermeneutic phenomenological approach was conducted on fourteen hemophilia patients who had been referred to a hemophilia center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The study question was “what is the meaning of pain in hemophilia patients’ lives? The data were collected through semi-structured interviews and field notes through purposeful sampling. Then, thematic analysis with van Manen’s six-step methodological framework was used. MAX.QDA qualitative software package, 2010, was used to analyze the data.
The three main themes that emerged in this study were “alteration in physical health”, “engagement in psychological problems”, and “impairment in social relationships”. Alteration in physical health consisted of three subthemes, namely “impairment of physical function”, “change in body physics”, and “disturbance in sleep quality”. In addition, two subthemes including “nostalgia of pain in adults with hemophilia” and “psychological distress” emerged from engagement in psychological problems. Finally, “loss of social activity” and “change in relationships” were related to impairment in social relationships.
The present study highlighted alteration in physical health, engagement in psychological problems, and impairment in social relationship as a result of pain in hemophilia patients. Thus, healthcare providers and family members have to pay special attention to these problems. Besides, providing complementary therapy interventions is suggested for reducing these issues.

In nursing, self-efficacy is quite critical for skill performance. Some factors might influence and predict self-efficacy in nurses. Thus, the present study aimed to investigate self-efficacy and the factors predicting nurses’ self-efficacy in clinical setting. In this cross-sectional study, 264 nurses were selected from five hospitals affiliated to Shiraz University of Medical Sciences by stratified random sampling. General Self-efficacy Scale (GSE) was used to assess a general sense of perceived self-efficacy. The data were analyzed using one-way analysis of variance (ANOVA) and multiple regression analysis. The mean of self-efficacy in all the nurses was 29.78 [Standard Deviation (SD) = 5.82]. Moreover, the self-efficacy of the nurses with diploma, bachelor’s, and master’s degrees was 32.22 (SD = 6.21), 29.33 (SD = 5.68), and 32.00 (SD = 6.00), respectively. In addition, a significant difference was found between the nurses with bachelor’s and diploma degrees regarding their self-efficacy (P = 0.01). Also, a significant relationship was found between self-efficacy and willingness to work in the nursing unit (F = 3.31, P = 0.01) and interest in the nursing field (F = 2.43, P = 0.04). The nurses who had more than 16 years of working experience in the field of nursing reported a better self-efficacy score. Overall, self-efficacy was predicted by the years of experience in the field of nursing (β =0.25, P = 0.009) and the interest in the nursing field (β = −0.15, P = 0.02). This study indicated that the nurses with diploma degrees gained higher self-efficacy scores compared to those with bachelor’s degrees. Changing the nursing curriculum and increasing the motivation in the nursing context might enhance the interest in the nursing field as well as the nurses’ self-efficacy. Of course, other studies are recommended to be conducted to improve the nurses’ self-efficacy.

Home visit program can be effective in infants’ growth and development. The present study aimed to investigate the effect of home visit program on preterm infants’ growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital’s routine care. Then, the infants’ growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants’ mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting, producing “Agha” sound, and taking objects by hand (P<0.05) during six months of age. The results showed that the home visit program was effective in preterm infants’ weight gain and some development indexes at the sixth month. Considering the importance of infants’ growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants’ health.

Due to the higher risk of pain in preterm infants, pain management is important for such infants. The present study aimed to determine the effectiveness of kangaroo care on the severity of pain and physiological parameters after heel-stick in preterm infants. This was a prospective and randomized controlled cross-over study. Twenty preterm infants allocated into an intervention (30 minutes of kangaroo care before and throughout heel-stick) and a control condition (standard incubator care during heel-stick). The severity of pain and the physiological parameters (heart rate and oxygen saturation) were collected after the heel-stick procedure. The pain mean scores in the intervention and control conditions were respectively 4.9 (SD=2.91) and 11.00 (SD=4.21) and a significant difference was found between the two conditions regarding the pain score 30 seconds after the heel-stick [t=5.33, p<0.001]. Moreover, a significant difference between the two conditions concerning the infants'' heart rate (F=3.73, p<0.0001) and oxygen saturation (F=1.84, p<0.0001) was demonstrated during the three study periods. In order to relieve the preterm infants'' pain and prevent quick acceleration and deceleration of heart rate and oxygen saturation in the intervention condition, the intervention is recommended to be done in a nursery.

Phyto therapy or herbal therapy is one of the major branches of CAM that has been common in many countries, including Iran, since a long time ago. It was used as a rich source of pharmaceutical ingredients in various diseases. This study aimed to investigate the use of herbal medicines in the newborns referring to neonatal emergency department.

The present descriptive, cross-sectional study was conducted on 30 parents of the infants admitted to the neonatal emergency department. A questionnaire was used to collect the information about the newborns and their parents, using herbal medicines, type of herbal drugs used for the infants, existence or absence of complications, and the person recommending the use of herbal medicines. The data were analyzed using the SPSS statistical software and descriptive statistics.

The results showed that 24 parents (80%) had used or were using herbal therapies for their infants. These drugs included Jujube, Purgative manna, Manna of hedysarum, Fumitory, Chicory, Castor oil, Ghee butter, Torbak lips, Frankincense and Rock sugar, Sisymbrium irio, Plantago major, Violet flower, Citrus limetta, Thymus vulgaris, Adiantum capillus-veneris, Cassia, and Garden morus and the highest rate was related to Jujube, Purgative manna, and Manna of hedysarum. Besides, 70% and 30% of these drugs were recommended by grandmothers and medicinal herbs sellers, respectively. According to the results, 95.2% of the parents believed that these drugs had no complications, while 4.8% had observed toxicity. In addition, 83.3% of the parents had also used these drugs for their previous children and reported their positive impact.

Considering the fact that 80% of the parents had used herbal medicines for their infants, herbal medicines are recommended to be used under a physician's supervision and recorded in the patient's medical records.

Hemophilia might impact the quality of life (QOL) in children and adolescent. This study aimed to assess the quality of life in children with hemophilia and identify the factors that predict their QOL. It was a cross-sectional study. A consensus sample of twenty-seven male children aged 8-16 years old with hemophilia participated in this study during 2011. The Haemo-QoL questionnaire version age group II (8–12 years old) or age group III (13–16 years) was used to measure the quality of life in children with hemophilia. Data were analyzed in SPSS using Spearman’s rho, Pearson correlation coefficients, and multiple regression analysis. The total mean score on the Haemo-QoL was 54.1±7.3. Haemo-QoL correlated with the number of bleeding event and school absence, family income, mother s’ education level, severity of hemophilia, person who performs his/her infusions, insight to health status and insight to suffering from hemophilia (P<0.05). QOL was predicated by family income (β=-0.69; explained 73% of variance) and infusion of the clotting factor replacement by parents (β=-0.33; explained 81% of variance). The QOL of a sample of male children with hemophilia was impaired. Moreover, number of bleeding event, number of school absences, mother s’ education level, severity of hemophilia, insight to health status and insight to suffering from hemophilia were associated with Haemo-QOL. In addition, family income and parent- administration of the product were the factors which predict the QOL in children with hemophilia.