فهرست مطالب zahra dalir

Excessive interdialytic weight gain (IDWG) in hemodialysis (HD) patients has serious effects. Therefore patients should follow a fluid-restriction diet. Non-adherence to fluid restriction can lead to excessive IDWG. The aim of this study was to determine the effect of ice chips on thirst, xerostomia and IDWG in HD patients.

This one- group pretest- posttest study included 49 HD patients and had three stages. In the first week (baseline stage) the patients received instructions for three sessions. In the second week (liquid stage) patients consumed fluid for one week and in the third week (ice chip stage) patients consumed fluid and ice intermittently for one week. Weights of the patients were measured before and after every dialysis session. Thirst and dry mouth were evaluated only before the dialysis session. Using SPSS version 16, data were analyzed by t-test and Wilcoxon tests.

The average IDWG (p=0.001) and xerostomia scores (p=0.041) in the two stages of fluid and ice chips were significantly different. Comparison of the thirst scores (p=0.127) between the two stages of fluids and ice chips showed no significant difference.

Consumption of ice chips led to reduction in IDWG which was indicative of less fluid consumption by the patients. This is one of the most important goals of care in HD patients, and can be used as an educational recommendation for them

It is unclear how health literacy is associated with health-related quality of life. The aim of this study was to examine the mediating role of treatment regimen adherence between health literacy and health-related quality of life (HRQoL) in older adults with type 2 diabetes mellitus (T2DM).

In this cross-sectional study, a multi-stage cluster sampling method was used to recruit 300 diabetic patients aged 60 years and over with diabetes. The abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and the Swedish Health-related Quality of Life (SWED-QUAL) instrument were used to measure health literacy and HRQoL, respectively. In addition, the Morisky Medication Adherence Scale (MMAS), the diet and exercise adherence questionnaire, were used to assess treatment regimen adherence. The four steps of Baron and Kenny’s procedure were implemented to test the mediation hypotheses.

The mean age of the respondents was 64.92 years. In addition, the mean of the respondents’ health literacy score was 52.82. The prevalence rates of the inadequate, marginal, and adequate health literacy of the respondents were 70%, 14.7%, and 15.3%, respectively. Two items of treatment regimen adherence (medication adherence and diet and exercise adherence) had a partial mediating role between health literacy and quality of life in elderly diabetes patients. The result of Baron and Kenny’s procedure and Sobel’s test showed a significant mediation role in medication adherence (p = 0.00, Sobel’s Z = 2.77) and diet and exercise adherence (p = 0.00, Sobel’s Z = 6.26) between health literacy and HRQoL.

Medication adherence, diet adherence, and exercise adherence are mediating factors in relationship between health literacy and HRQoL that increase the health literacy and quality of life in older adults with T2DM.

The families of children with Congenital Heart Disease (CHD) experience challenges in taking care of their child, which may affect the whole family. Therefore, the families need to manage and organize the caregiving process for the child. In order to help families provide optimized and quality care for their child, it is important to understand how they manage caregiving challenges. This study was conducted with the aim to explore the strategies used by families for managing family caregiving for their child.

This qualitative study was conducted on families of children with CHD referred to hospitals in Mashhad, Iran. The participants were selected using a purposive sampling method. The data were collected from among 40 eligible participants using in‑depth and semi‑structured interviews from November 2017 to December 2018. Conventional content analysis was used for data analysis and MAXQDA software for managing the coding process.

According to the results, effort to manage caregiving emerged as the main theme, which included the 4 categories of “monitoring the child’s health conditions,” “organizing family life,” “optimizing family life,” and “establishing interaction.”

The families used various strategies to manage caregiving including monitoring of the child’s health conditions, organization, and optimization of family life, and effective interaction based on their knowledge, experiences, beliefs, and available sources. The results of the present study can help healthcare professionals and nurses to develop family‑centered empowerment programs in order to promote families’ abilities to manage family caregiving for a child with CHD.

The families of children with congenital heart disease experience significant stress as to the care of the child and need to cope with stress. Accordingly, understanding of how families cope and use coping strategies is more important to help them better cope with stressful situations caused by caregiving. This study aimed to explore coping strategies used by families in the face of caregiving stress. This qualitative study was conducted on 40 eligible participants from the families of children with congenital heart disease. They were recruited through a purposive sampling method from those referred to hospitals in Mashhad, Iran. In-depth and semi-structured interviews were used for data collection from November 2017 to December 2018. The data were analyzed using conventional content analysis, and MAXQDA software (Ver.2010) was used to manage the data encoding process. According to the results, effort to maintain well-being emerged as the main theme which included five categories: “spirituality in caregiving”, “acceptance and adjustment”, “optimism and hopefulness”, “self-control and patience”, and “ management of psychological needs”. Families used various coping strategies including spirituality, acceptance, optimism, patience, and management of psychological needs based on their beliefs, attitudes, abilities, and available resources for coping with caregiving stress. The results can help the nurses and health care professionals to develop appropriate educational, supportive, and psychological interventions based on the family’s needs to cope effectively with caregiving stress.

Background and Heart failure is one of the most common chronic diseases with high mortality rate. Self-care training is effective in reducing the number of hospitalizations and improves the quality of life in these patients. However, the influence of such training was not found to be viable in previous interventions. This study was conducted to determine the effect of training based on teach back method on self-care in patients with heart failure.
In this clinical trial, 62 hospitalized patients with heart failure in Imam Reza and Ghaem hospitals in Mashhad (2014-2015) were randomly allocated into experimental and control groups. Subjects in the experimental group received individual self-care training for 3-4 days based on teach back method and the control group received usual self-care training. Self-care was measured using the European Heart Failure Self-Care Behaviour Scale (EHFScB Scale) before and one month after discharge. Data was analyzed using independent-samples t-test and paired t-test.
Before the intervention no significant difference was seen in the mean score for self-care between the two groups, but after intervention, it significantly increased in the experimental group (P Training based on teach back method was found to be more effective than usual training in promoting self-care among patients with heart failure. Therefore, it is recommended in care planning for these patients.

Hemorrhage، infection and hypertension during pregnancy are the most important causes of maternal mortality. Folic acid affects on development، angiogenesis، DNA synthesis and proliferation and hemocystein metabolism. The aim of this study was comparing plasma folate concentration in pregnant women with and without pre-eclampsia. This descriptive and analytical study was conducted on 60 pregnant women who referred to Ghaem hospital، Mashhad، Iran in 2008. Women were divided into in two groups of 30 pregnant women with pre-eclampsia by detection of obstetrician and 30 pregnant women without pre-eclampsia that had normal blood pressure. Both groups answered demographic and pregnancy characteristics questionnaires. Blood test was done to measure serum folate concentration. Data were analyzed using statistical tests such as Chi-square، t-student and ANOVA. P value less than 0. 05 was considered significant. There were significant differences between folate concentration in two group (p<0. 001). The mean of serum folate in pre-eclampsia group was 0. 87±0. 67 ng/L and without pre-eclampsia 1. 42±0. 57 ng/L. There was significant relationship in confidence level of 90% between usage of folic acid in pregnancy and folate concentration (p<0. 09). Pregnant women with pre-eclampsia had lower folate concentration than pregnant women without pre-eclampsia، but the difference is significant in confidence level of 90%.

Background and Discharge is one of the most important and unique parts of nursing profession. Since patients in burn units need care and rehabilitation services after discharge، it seems that having a fundamental plan for the discharge of these patients is essential. This research is conducted to determine the nurses’ viewpoints toward the existing problems and barriers in implementing the burn unit discharge planning. For this descriptive research، 90 nurses among those working in Ïmam Reza Hospital in Mashhad، and Zare Hospital in Sari were selected through simple non-probabilistic sampling. To collect data، the participants filled in a questionnaire including demographic data، and questions in Likert scale about the existing problems and barriers in discharge planning implementation in the burn units. Ït was found that the most crucial barriers for implementing the discharge planning included nurses’ heavy workload due to difficult conditions in their workplace، shortage of time، not having enough knowledge about discharge planning، lack of financial and mental support systems for the patients in the society، lack of instructional packages and standard discharge planning. Çonclusion: Based on the findings of this research، it is recommended to hold continuous education for nurses، provide instructional packages and standard programs for the patients’ discharge، and increase the number of the nursing personnel based on the world standards so that suitable conditions for the implementation of discharge planning can be provided.