Jundishapur Journal of Chronic Disease Care
Volume:8 Issue: 1, Jan 2019

Previous studies confirm that thyroid cancer, as the most common endocrine cancer, accounts for about 1% of new malignant diseases all over the world. As thyroid cancer incidence in Iran has changed rapidly over the past years, therefore this study was designed to investigate period prevalence (PP) and incidence rate (Irs.) of thyroid cancer in Isfahan Province, Iran. Recorded data of thyroid cancer were obtained from the Isfahan Cancer Registry at the Deputy of Health. Continuous variables were reported as means ± SD and categorical variables as frequencies and percentages. In order to examine the relationship of PP with age and gender, the t-test and chi-squared test were used, respectively. The PP was defined as the proportion of the total cases over the study years to the population at risk during the same period ×100000. 1545 patients were diagnosed with thyroid cancer, among which 3% were related to death events. The mean (± SD) age of the study subjects was 41.9 ± 15.4 years. For the total population, the PP was calculated as 31.0, accounting for 49.3 versus 13.3 per 100000 for females versus males (P < 0.001). The study of Irs. data showed an increasing trend (P < 0.001) in the number of patients from 2011 to 2015. With a minimum age of three-years-old, in 84% of the patients, the age ranged from 20 to 60 years old. In this study, not only was the period prevalence 3.7 times higher in females than in males but also there was an increase (61.9%) in the incidence of thyroid cancer from the year 2011 to 2015. Based on the findings, however, detection methods of thyroid cancer have improved recently all over of the world, but a well-established classification of the disorder, pharmacotherapy, and surgical plan in the Iranian population can improve the clinical outcome. Further study in these contexts seem to be useful in Isfahan, Iran.

Sleep is one of the most basic and physiologic needs, which has impressive effects on the humans’ physical and mental health. According to the need for permanent presence of the nurses in the hospitals, they often suffer from shift work effects such as sleep disorders. Considering the high sensitivity of nursing jobs, the aim of this study was to evaluate the prevalence and consequence of sleep disorders in shift work nurses. This cross-sectional study was conducted on all of the nurses employed in hospitals of Larestan city in south of Iran in 2017. After screening based on inclusion criteria, 100 nurses were selected. to evaluate the prevalence and consequence of sleep disorders in the nurses, the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleep Quality Index (ESQI) and Insomnia Severity Index (ISI) were used. Data were analyzed using SPSS software version16. Descriptive and analytical statistical tests, including One-way ANOVA, paired t-test, independent t-test, Kruskal-Wallis, chi-square, and Pearson correlation coefficient were used to analyze the data. A P ≤ 0.05 was considered statistically significant. The results showed the mean score of sleep quality index was 6.52 ± 4.23 and according to this index, 56% of the studied nurses are in hazardous situations. In all of the nurses, sings of insomnia were observed during routine works; consequently, 78.5% were sleepy, 16.5% were very sleepy, and 5% were severe sleepy. By the increased rate of night shift work per week, the severity of insomnia was also increased in the nurses (R2 = 0.78). Sleep disorders in the nurses working in the surgical section were higher than the nurses in other sections of the hospitals (P < 0.05). A high percentage of the nurses employed in different sections of the hospitals have poor sleep quality and increased rate of night shift work per week plays a major role in decreasing their sleep quality. Regarding the adverse effects of poor sleep quality on the health status of the nurses and their quality of job performance, it is necessary to carry out proper planning to improve the sleep quality of night shift work nurses employed in different sections of the hospitals.

The prevalence of skin manifestations in hemodialysis patients is increasing. The aim of this study was to evaluate skin manifestations in patients with end-stage renal disease (ESRD) undergoing hemodialysis. In this descriptive-analytical study, 100 patients undergoing hemodialysis from among 120 patients referring to Shahid Beheshti Hospital of Abadan and Vali-e-Asr Hospital of Khorramshahr were assessed. A demographic questionnaire and a checklist about skin disorders were used for data collection. The data were analyzed by SPSS version 16 software using descriptive and analytical statistics. The most common skin findings were pale skin (87%), dry skin (71%), hyperpigmentation (46%), and purpura (35%). Among nail manifestations, the most common finding was a half-and-half nail (50%) and the rarest symptom was dystrophy (1%). The results of this study indicated that ESRD was associated with multiple skin symptoms, the most prevalent of which were pale skin and dry skin symptoms. Therefore, early diagnosis of these problems is a major step in improving the quality of life of these patients.

Coronary artery disease (CAD) is the most common chronic disease with marked effects on different health aspects, which can affect the quality of life (QOL) of patients. Today, open heart surgery is one of the most common treatments for patients with CAD. This study was conducted to determine the QOL of patients before coronary artery bypass graft (CABG). This descriptive-analytical study was conducted in 2017 - 2018 on 104 candidates for CABG in the Golestan and Imam Khomeini hospitals, affiliated to Jundishapur University of Medical Sciences in Ahvaz. The subjects were selected using the convenience sampling technique. Data collection instruments included a demographic questionnaire and the MacNew quality of life questionnaire. Data was collected on the day before surgery and evaluated with mean, percentage, and frequency in SPSS 22. Findings showed that the overall QOL score was 87.3 ± 0.76. The score mean in the emotional dimension, physical dimension, and social dimension were respectively; 4.01 ± 0.72, 3.25 ± 0.78, and 3.45 ± 0.80. Regarding the effect of CAD on QOL of patients, healthcare providers should plan to improve their QOL.

Living with hemodialysis is a permanent challenge due to the need for adaptation to the treatment plan, related complications, and dietary constraints. Therefore, the quality of life in such patients is influenced by physical and psychological stressors posed by these challenges. The aim of this study was to investigate the relationship between stressors and coping strategies in hemodialysis patients, Qazvin, Iran. A descriptive cross-sectional correlational design was used to investigate the relationship between physiological and psychosocial stressors and coping strategies among Iranian patients undergoing hemodialysis in 2018. Samples consisted of 140 patients recruited through the simple random sampling method from a large referral hemodialysis center affiliated to Qazvin University of Medical Sciences, Iran. A demographic variables form, hemodialysis stressors scale (HSS,) and Ways of Coping Scale- revised (WOCS-R) were employed for data collection. SPSS version 24 was used for data analysis. The majority of the patients (49.2%) had moderate and 3.6% of them had severe physiological stressors. With regard to psychosocial stressors, 51.4% had moderate and 3.6% of the participants had severe stressors. The majority of the participants used “distancing” strategies. Pearson’s correlation showed that strategies of escape avoidance and physiological stressors had a significant positive correlation (r = 0.2, P = 0.004), and strategies of problem solving (r = 0.2, P = 0.01), escape avoidance (r = 0.3, P = 0.000), and self-control (r = 0.1, P = 0.03) had a significant positive correlation with psychosocial stressors. The majority of the hemodialysis patients had moderate to severe stress in physiological and psychosocial dimensions. They often used negative strategies for coping with stressors. The above-mentioned challenges are considered as risks to patients’ well-being and require the attention of policy-makers and managers to provide comprehensive and high-quality services.

Rheumatoid arthritis (RA) is a chronic and multi-systemic disease with an unknown origin that is associated with inflammation and impairment of the immune system. Cardiovascular disease is the most common cause of death in patients with rheumatoid arthritis. This study was conducted to evaluate cardiovascular parameters in patients with rheumatoid arthritis. In this descriptive study, 112 patients with rheumatoid arthritis, who had been diagnosed for at least six months, were studied. A questionnaire containing demographic data by the researcher using the interview was completed and measuring the cardiovascular parameters was done. Data were analyzed using SPSS software and appropriate statistical tests. Based on the body mass index mean (27.98), the patients under study were overweight; in addition, serum levels of glucose 107.55 ± 38.47, total cholesterol 209.90 ± 37.90, LDL 129.28 ± 30.60 and systolic 145.75 ± 16.23, and diastolic 78.46 ± 11.91, blood pressure in these patients did not have normal distribution. The risk of cardiovascular disorders in patients with rheumatoid arthritis is considerable due to the increase in body mass index, glucose, total cholesterol, LDL, and blood pressure; therefore, screening of at-risk people is recommended.

Non-communicable diseases such as cardiovascular diseases (CVDs) are the main cause of death worldwide. Besides, major risk factors such as age, gender, race, and modifiable or psychological risk factors have a significant role in the incidence of CVDs. This study established an integrated intervention program based on psychological risk factors for Iranian cardiovascular patients, and tried to validate its effectiveness in improving quality of life and personality type. Therefore, the aim of this study was to evaluate the efficiency of integrated intervention program in type D personality and quality of life among the cardiovascular patients. In an experimental randomized controlled trial, a total of 60 patients (29 - 42 years old, 67% males and 33% females, and all married) were assigned randomly either to the experimental (30 patients) or the control group (30 patients). The patients in the experimental group participated in the intervention program for one month. The content of the integrated intervention program included understanding the role of psychological factors on cardiovascular diseases, understanding personality types, understanding hardiness and resiliency, healthy heart lifestyle, thoughts and behavior, understanding coping styles and emotion regulation, understanding spirituality and personal growth, understanding social support, and learning relaxation techniques. Quality of life and personality type in two groups were measured through WHOQOL and type D personality questionnaire before and after the intervention. All analyses were conducted using SPSS version 20. The patients in the experimental group had significantly more quality of life (P < 0.001) and less type D personality traits (P < 0.001), which support the effectiveness of the cardiac integrated intervention program.</p><p> The results from meta-analyses indicated the role of psychological risk factors in the development of CVDs. The findings of the current study suggested that cardiac integrated intervention program increases the quality of life and reduces the type D personality traits in cardiovascular patients. Furthermore, it is recommended that cardiac care professionals use this effective treatment to improve the recovery of cardiac patients.

The present study was conducted to examine the relationship between the perceived behavioral risk factors of cardiovascular diseases (CVDs) and health-promoting lifestyle in men under methadone therapy. In this cross-sectional study, 68 patients who referred to methadone-maintenance treatment (MMT) centers in Kermanshah city were assessed during September 2017. Perceived heart risk factors scale (PHRFS) and health promoting lifestyle profile (HPLP-II) were used for data collection. The data were analyzed using multivariate linear regression analysis. The mean age of the patients was 39.4 ± 13.3 years. The results of correlation and regression analysis showed that there was a significant direct relationship between perceived behavioral risk factors and all subscales of HPLP-II (P < 0.001). The model generally could explain the variance of 14.9% to 35.8% related to healthy lifestyle components. It can be concluded that understanding harmful heart behavior patterns by drug addicts under methadone therapy may lead to adopting a comprehensive healthy lifestyle. Training must be focused on improved knowledge and perception of the drug addicts about behavioral risk factors of CVDs.