فهرست مطالب

International Journal of Community Based Nursing and Midwifery
Volume:7 Issue: 4, Oct 2019

  • تاریخ انتشار: 1398/08/01
  • تعداد عناوین: 8
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  • Ella Danielson, Christina Melin Johansson, Mahnaz Modanloo* Pages 248-257
    Background

    Adherence to treatment is a process that begins with alertness about the disease and has to end with staying in treatment. It is a concern to all health care disciplines. The aim of this study was to explore the experience of adherence to treatment patients with chronic diseases.

    Methods

    This qualitative study was conducted during a period of 6 months in Golestan province in Iran in 2017. In-depth semi-structured interviews were done with a purposive sample of 15 patients with chronic disease (i.e. Chronic renal failure (CRF), Hypertension (HTN), Multiple sclerosis (MS) and Diabetes). Data were analyzed using qualitative content analysis in MAXQDA Software.

    Results

    The analysis of the data in this study led to the development of ten subthemes and four themes emerged as follows: motivation, cohesion, commitment and empowerment which are necessary components for adherence to treatment in patients. “Moving from alertness to persistence” emerged as the main theme.

    Conclusion

    The findings of the study offer helpful insights into the concept of adherence to treatment and its components for health care providers, which can be used to develop the best possible care plan and may help health care providers to support the patients to have an active role for following treatment rather than just doing it.

    Keywords: Chronic disease, Qualitative research, Treatment adherence
  • Mohsen Adib Hajbaghery*, Bahareh Ahmadi Pages 258-269
    Background

    Few studies have been conducted on the burden of care in caregivers of children with chronic illnesses. This study investigated the burden of care and associated factors in first-degree caregivers of children and adolescents with chronic conditions.

    Methods

    A cross-sectional study was conducted from June to September 2017 on 385 first-degree caregivers of children and adolescents with chronic disorders. Data were collected using the Zarit burden inventory which assesses the caregiver burden in physical, psychological, economic, and relational areas and has a total score from 0 to 88. Scores 61-88, 41–60, 20–40, and <20 indicate severe, moderate, mild, and no burden. Data were analyzed using descriptive statistics and Chi-Square, Fisher’s exact tests, t-test, analysis of variance, and multiple regression analysis.

    Results

    The mean age of the caregivers and children were 38.20±8.04 and 8.90±4.90 years, respectively. Also, 33 (8.5%), 135 (35.1%), and 181 (47%) of the caregivers suffered from severe, moderate, and mild burden, and only 9.4% perceived no burden. The mean caregiver burden scores were significantly different in terms of their education (P<0.001), job status (P=0.04), financial status (P<0.001), family size (P<0.001), numbers of children (P<0.001), numbers of children with chronic illnesses (P<0.01), type of supportive resources (P=0.004), and children’s education (P<0.01), type of disease (P<0.001), numbers of diseases (P<0.001), and interval of medical visits (P<0.001).

    Conclusion

    Caregivers of children and adolescents with chronic disease are under pressure. Our study showed a number of factors influencing caregiver burden. Health care providers should plan familycentered care plans to decrease the burden of care in caregivers of children with chronic conditions.

    Keywords: Caregivers, Child, Chronic disease, Parents, Pressur
  • Mamat Lukman, Kusman Ibrahim, Desy Indra Yani, Sheizi PristaSari, Neti Juniarti* Pages 270-278
    Background

    Community health volunteers contributed to the total Tuberculosis (TB) case findings; however, the attrition rate of these volunteers was high which reduces their optimal performance. Hence, sustainability of efforts should be explored to retain the community health volunteers in the TB program. Improvement of community health volunteers to perform community-based health education and prevent TB has not been examined consistently around the globe, including Indonesia. This study aimed to explore the strategies to improve performance of community health volunteers for TB care and prevention to reduce the incidence and stop the spread of TB in the community.

    Methods

    A qualitative design was adopted and we used two focus group discussions in 2017 to collect the data. The participants included village health workers as volunteers in two regencies of Bandung City, West Java Indonesia. A thematic analysis was used to analyze the data.

    Results

    Four major themes should be considered in developing a community-based TB health education program: (1) informing community health volunteers about the benefits and difficulties of being a TB volunteer; (2) recognizing the activities and feelings of volunteers; (3) emphasizing the Willingness to Help Others; and (4) having access to TB training.

    Conclusion

    To develop a community-based health education program for TB care and prevention, community nurses need to listen to the opinions of community health volunteers, and TB patients and their family members to ensure that the health education program is tailored to meet community needs.

    Keywords: Community health education, Tuberculosis, Village health workers
  • Mahnaz Rakhshan*, Mitra Rahimi, Ladan Zarshenas Pages 279-287
    Background

    This study aimed to examine the effects of an education program based on illness perceptions on the lifestyle of patients with metabolic syndrome.

    Methods

    This is a randomized controlled clinical trial on 80 patients with metabolic syndrome referred to diabetic clinic affiliated to Shiraz University of Medical Sciences from August to November 2016. The patients were assigned to two control and intervention groups using a simple randomization method. The intervention group received education based on illness perceptions, using face-to-face and telephone follow up sessions in five weeks. The lifestyle questionnaire, brief illness perception questionnaire and demographic information questionnaire were used for data collection. The patients’ lifestyle was examined before and at the end of the eighth week from the beginning of the intervention. Descriptive and inferential statistics were used for data analysis.

    Results

    After the intervention, the total lifestyle score in the intervention group significantly increased, as compared to the control group (14.60±6.85 vs 6.15±5.80) (P<0.001). Of all the lifestyle dimensions, only stress management after the intervention showed no significant changes (P>0.001).

    Conclusion

    Education based on illness perceptions affected the lifestyle of patients with metabolic syndrome. Therefore, nurses and healthcare providers can use this program for improving the lifestyle of patients with metabolic syndrome.

    Keywords: Illness perception, Lifestyle, Metabolic syndrome
  • Alireza Nikbakht Nasrabadi, Hooman Shahsavari, Mohammad Almasian, Heshmatolah Heydari*, Abdolrahim Hazini Pages 288-299
    Background

    Considering the position of home health care in the current world, the objective of this study was to design an applied model of providing home care services in Iran.

    Methods

    The mixed methods approach was employed in three stages in Iran from Feb 2015 to Sep 2016. During the first phase, the qualitative method of content analysis was used. Data were collected by conducting 26 individual interviews and holding one focus group session involving 7 people. Data analysis was based on Graneheim and Lundman’s approach to content analysis. In the second phase of the study, a literature review was carried out and at the end of this stage, a preliminary model was designed. The model was standardized in the third phase using the Delphi method with 23 participants in two rounds.

    Results

    In the first and second stages of the study, various categories emerged including patient referral, agreement, determination of the needed level of care, care plans designing, provision of comprehensive services, documentation, service monitoring, inter-professional cooperation, issuance of death certificates at home, ethical considerations, and the evaluation of services. Then, in the Delphi phase, 20 (95.2%) of the experts confirmed the structure and content of the model and its applicability.

    Conclusion

    The designed model can be helpful in organizing the provision of integrated and comprehensive health services to clients at home, which can be effective in improving the clients’ health and enhancing their self-care and autonomy.

    Keywords: Home care services, Iran, Process modelling, Qualitative study
  • Mozhgan Mohammadzadeh Nimekari, Marzieh Saei Ghare Naz, Yaghoub Ashouri Taziani, Malihe Nasiri, Mohammad Reza Evazi, Amin Shafizad, Giti Ozgoli* Pages 300-308
    Background

    Breast Cancer is highly prevalent among women. The supportive care needs of such patients not only affect their quality of life (QoL) but also that of their family caregivers. The present study aimed to assess the correlation between the supportive care needs of women with breast cancer and the QoL of their family caregivers.

    Methods

    The present cross-sectional study was conducted from September 2017 to June 2018. The target populations were breast cancer patients (N=150) and their primary family caregivers (N=150) who attended the Omid Chemotherapy and Radiotherapy Center affiliated with Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Data collection tools included a demographic information form, the Supportive Care Needs Survey-Short Form 34, and the Caregiver Quality of Life Index-Cancer Scale. The data were analyzed using SPSS software (version 22.0) with descriptive statistics and Pearson’s correlation coefficient. P<0.05 was considered statistically significant.

    Results

    The mean age of the patients was 45.76±10.44 years. Of the family caregivers, 99 (66%) were the patients ’spouses. Of the different dimensions of the supportive care needs, the score for the physical needs (40.60±23.50) was the highest. In terms of the QoL of the family caregivers, mental and emotional burden scored the highest (20.19±7.38). There was a significant correlation between the caregivers’ mental and emotional burden and the physical needs of the patients (r=0.19, P=0.02).

    Conclusion

    The result of the present study showed that physical needs were the most common supportive care needs of patients with breast cancer. Such needs also significantly undermined the QoL of the caregivers in terms of emotional burden and financial concerns.

    Keywords: Breast cancer, Caregivers, Needs Assessment, Quality of life
  • Mohtasham Ghaffari, Mohammad Ali Morowatisharifabad, Yadolah Mehrabi, Samad Zare, Jafar Askari, Somayeh Alizadeh* Pages 309-318
    Background

    Nowadays, the prevalence of chronic diseases, such as chronic renal failure, is rising. These patients need hemodialysis to continue their treatment, which is a stressful process. This research was conducted with the purpose of explaining coping styles in hemodialysis patients regarding stress factors based on the Lazarus and Folkman’s transactional model.

    Methods

    This qualitative study was conducted as a content analysis. The data collection method was semi-structured interview with 22 patients from dialysis centers in Tehran. The data were collected from October to January 2017. Sampling was purposive and continued until data saturation. Data were analyzed using the directed content analysis method. The process of data analysis proposed by Hsieh and Shannon’s was followed.

    Results

    106 codes and 24 sub subcategories were obtained through this research and classified into 8 sub-categories of transactional stress model including: problem management, emotional regulation, social support, dispositional coping styles, positive reappraisal, revised goals, spiritual beliefs and positive events; and 3 categories of coping structures that included coping efforts, meaning-based coping and moderators.

    Conclusion

    Dialysis patients are making efforts to cope with their stress in order to reduce their stress; in some cases, these efforts lead to reduction in stress, and in some cases, due to using unsound coping style, they are ineffective or even harmful. Therefore, the necessity of planning and proper interventions is felt by health care providers to control stress in dialysis patients.

    Keywords: Coping, Hemodialysis, Qualitative research, Stress
  • Razieh Nouzari, Seyed Saeed Najafi, Marzieh Momennasab* Pages 319-328
    Background

    Cancer not only is a traumatic experience for the patients, but also can affect the family caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by people as a result of a struggle in dealing with traumatic events in life. Both the patients and their caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and both the social support (SS) and hope.

    Methods

    The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed using the SPSS software (version 23.0). P<0.05 was considered statistically significant.

    Results

    The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84, respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59) and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62) compared to SS (ẞ=0.27).

    Conclusion

    The results showed a good level of PTG among the caregivers and the experience of stressful situations positively affected their psychological condition. The positive change was associated with the perceived SS and hope.

    Keywords: Cancer, Caregivers, Hope, Post-traumatic growth, Social support