Evidence Based Care
Volume:11 Issue: 1, Spring 2021

Most children undergoing hemodialysis (HD) are burdened with some deficits to practice self-care, causing poor quality of life (QoL). Orem’s Self-Care Theory (SCT) is known as one of the nursing models involving patients in care and putting much more emphasis on self-care.

This study aimed to investigate the effectiveness of a support-training program developed based on Orem’s SCT on QoL among Iranian children undergoing HD.

This quasi-experimental study with a pretest-posttest research design was conducted using the census method on a total number of 27 children aged 8-15 undergoing HD at Dr. Sheikh Hospital, Mashhad, Iran, in 2019. For this purpose, the Self-Care Measurement Scale (Shintani, 2009) and the KIDSCREEN-52 quality of life questionnaires were completed before the inclusion of the study participants, and then, universal self-care and health-deviation self-care needs were identified. The data were further analyzed in the SPSS Statistics software (version 16).

The total mean scores of QoL were obtained at 24.9±0.118 and 27.3±0.177 before and immediately after the intervention program, respectively. The results of the Bonferroni posthoc test showed a significant difference between the total mean scores of the pretest-posttest stages (P˂0.001). Moreover, the difference between the total mean scores was significant 2 and 6 weeks after the implementation of the given program and immediately after it (P˂0.001).

Since, in this study, the self-care support-training program practiced was developed based on Orem’s SCDT, the study findings can be utilized in planning to improve the QoL of children undergoing HD.

Postpartum weight retention is known as a public health challenge that causes obesity in women in the long term.

The present study aimed to determine the effect of nutrition education and physical activity interventions on weight changes and anthropometric indices among postpartum women.

This quasi-experimental randomized controlled trial (RCT) was conducted as a two-group pre/posttest research design in Bandar Abbas, Hormozgan, Iran, in 2020. A total of 64 women were randomly selected in their postpartum period. Multi-stage sampling was conveniently performed. The training sessions were held for the intervention groups of 5-7 participants in four sessions of 45-60 minutes and once a week by using a pedometer. The control group received routine postpartum care. Maternal weight and anthropometric indices were measured by the end of weeks four and eight.

The study findings showed no significant difference in the mean weight of the two groups before the intervention (p=0.47). However, comparing the results of the fourth and eighth weeks after the intervention with the pre-intervention stage revealed that the mean weight in the intervention group had respectively reduced by -3.28±5.57 and -3.75±0.65 which was statistically significant (p˂0.001). The mean waist and hip circumferences also decreased significantly before and after the intervention in both study groups, but such a reduction in the intervention group was significantly higher than that in the controls .(p˂0.05).  

Using a pedometer in nutrition and physical education is simple, low-cost, and uncomplicated. Promoting nutritional behaviors and physical activity in postpartum women is recommended by extensively implementing this intervention program which moderates their weight and improves their anthropometric indices.

Families play a peculiar role in adherence to treatment in diabetic patients; therefore, it seems that interference in motivational, psychological, and self-issued characteristics based on the family-centered empowerment model (FCEM) affects this adherence.

The present study aimed to determine the effect of FCEM on eating habits, weight, hemoglobin A1C, and blood glucose control in Iranian patients with type 2 diabetes.

This semi-experimental study was conducted on 70 participants with type 2 diabetes in a diabetes clinic in Birjand, Iran, in 2018. The participants were selected via purposive sampling and randomly assigned to two groups of control (n=35) and intervention (n=35) using block randomization. The intervention group received family-centered empowerment training for four weekly-held 90-min sessions. Data were collected using demographic and disease characteristics form and Azartel et al.’s Dietary Behaviors Questionnaire and analyzed in SPSS software (version 19).

The mean age scores of participants in the intervention and control groups were 49.66±6.37and 49.46±5.98 years, respectively. The intervention group showed an increasing trend through time, where the mean scores for eating habits and blood glucose had insignificant improvement one month (P>0.05) and three months (p <0.05) after the intervention. Hemoglobin A1C level reduced significantly in the intervention group three months after the intervention (p <0.05), as compared to that in the control group (P>0.05).

The FCEM can improve nutritional behaviors, hemoglobin A1C, and blood glucose in type 2 diabetic patients. This intervention can guide health care providers on how to improve the eating habits of diabetic patients through family empowerment training.

Depression and anxiety as the most common psychological disorders reduce the quality of life in women during menopause.

Given the potential therapeutic properties of Rosa damascena, the present study aimed to investigate the effect of Rosa damascena on the severity of depression and anxiety in postmenopausal women.

This clinical trial was conducted on 110 postmenopausal women in Tehran, Iran, during 2020. The participants in the intervention group received 500 mg dried Rosa damascena capsules, and the control group received placebo capsules three times a day (once every 8 hours) for 40 days. The data were collected using a demographic characteristics form, Beck's Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and adverse effects questionnaire. Subsequently, the data were analyzed in SPSS software (version 19) through the independent t-test, chi-square, Mann-Whitney, and repeated measures tests.

There was no difference in the mean score of depression before and 20 days after the intervention in the intervention group; however, this difference was significant 40 days after the intervention (p <0.05). The severity of anxiety differed significantly in the intervention group on days 20 and 40 post-intervention (p <0.001); however, these changes were not significant in the placebo group. The mean score of anxiety 20 and 40 days and depression 40 days after the intervention showed a significant difference between the two groups (p <0.001).

It seems that R. damascena has effects on postmenopausal depression and anxiety. Accordingly, menopausal women are recommended to use R. damascena as an efficient non-pharmacological intervention.

The emergence of this coronavirus disease 2019 (COVID-19) is now a public health crisis that leads to various challenges. There is a significant scientific gap in this field, including the necessity of updating the definitions and information about this disease. This disease causes a lot of physical and psychological problems and leads to changes in and reduced quality of life. However, one of the definitive pieces of data about this disease is human-to-human transmission and its very high prevalence, which itself carries certain social and psychological risks.

This study aimed to explore patients' experiences of living with COVID-19.

The present qualitative study was conducted based on a conventional content analysis method. The statistical population of this study (n=17) consisted of recovered patients from COVID-19 with a history of admission to the intensive care unit of Afzalipour Hospital in Kerman, Iran, selected using a purposive sampling method. The data were collected through semi-structured interviews and analyzed using the qualitative content analysis method proposed by Graneheim and Lundman.

Data collection and analysis led to the determination of 1 theme, 4 categories, and 18 subcategories. The theme was identified as "Coronavirus as a prison of time" and the categories were "behavioral challenges", "human flourishing", negative emotions", and "psychological distress in quarantine".

Study participants had both positive and negative experiences. The results of this study can help healthcare providers to identify the needs of these patients and design a care model for these patients

The role of family caregivers in the promotion of safety for hospitalized children is an important issue in the area of safety improvement. However, there are limited studies related to innovative programs.

This study aimed to investigate the effects of a multi-component program on family caregiver’s knowledge and engagement in promoting safety.

A quasi-experimental study was performed on 160 female family caregivers in two pediatric wards of two public hospitals in Thailand, in 2019. Participants were assigned into two groups of intervention (n=80) and control (n=80) through consecutive sampling. The program was developed based on the standardized guidelines of child patient safety. Participants were educated and trained. The participants’ knowledge and engagement were measured using validated questionnaires. An analysis of covariance (ANCOVA), controlling for some possible confounders, was performed to examine the effect of intervention.

Family caregivers gained more knowledge after the implementation of the Multi-Component Program. They noticed if something was wrong and checked the administration of medication by nurses after the intervention. Engagement in promoting safety was enhanced in each domain. Mean±SD scores of three dimensions of Multi-Component Program including advocate to ask, report and response, and dimension monitoring were obtained at 4.61±0.26, 4.48±0.19, and 4.76±0.25, respectively. Moreover, the groups’ post-test scores of knowledge and engagement were significantly different (P<0.001) after adjusting the length of stay.

Implications for Practice: 

The Leaflet, Poster, Talking, Video, and SMS program can enhance a family caregiver’s ability to take responsibility for children. The findings indicated the possible range of safety behaviors that family caregivers can perform during the childcare process. Healthcare providers should adopt this program as a part of child safety promotion in hospital settings.

Postpartum hemorrhage is one of the most common causes of maternal mortality worldwide.

The present systematic review and meta-analysis aimed to evaluate the effectiveness of herbal medicines on a postpartum hemorrhage.

The largest proportion of articles with funding information was found from 2000 to 2020 were included using PubMed, Scopus, ISI Web of Science, Cochrane, Magiran, SID, and Google Scholar databases. The relevant English keywords, "postpartum hemorrhage، PPH control, PPH prevention, phytotherapy, herbal medicine, complementary medicine, traditional medicine” were used to search for the eligible studies. Data were analyzed using STATA software (version 11).

The results indicate heterogeneity in the studies (I2=0.87). Standardized mean difference was (SMD= -1.08, 95% CI: (-1.31, -0.85), P<0.001), (SMD= -0.80, 95% CI: (-1.03, -0.58), P<0.001), (SMD= -1.13, 95% CI: (-1.36, -0.90), P<0.001) in the first, second and third hour after delivery, respectively. The bleeding rate was statistically lower in the intervention group than that of the control group.

This meta-analysis indicated the positive role of herbal medicines in reducing postpartum hemorrhage. Therefore, herbal medicines might be a proper substitute for chemical medicines and could be used in combination with pharmaceutical drugs such as oxytocin to reduce early postpartum hemorrhage.

Fear of falling (FOF) acts as an inhibitory factor for the activities of daily living and causes disability and dependence in the elderly suffering from heart failure (HF). This study aimed to determine FOF among the elderly with HF and its related factors. This cross-sectional study was performed on 445 elderly patients with heart failure who were referred to the HF clinic of Tehran Heart Center affiliated with Tehran University of Medical Sciences, Tehran, Iran, from March to July 2018. Participants in this study were selected randomly. Data collection was conducted using demographic characteristics form and Falls Efficacy Scale-International questionnaires. Data were analyzed using STATA software (Version 14). The mean FOF among participants was 36.7 out of 64 scores (ST=0.27 and CI: 95%). The level of FOF was moderate in 61% of the participants. Based on the obtained results, FOF had no statistically significant correlation with gender, education, smoking, and marital status (P>0.05); however, it had a statistically significant correlation with age, HF class, residence, medications, and the history of falls (P<0.05). It is recommended that health caregivers should develop a comprehensive care program that takes into account such factors as age, HF class, residence, medications, and history of falls to prevent and reduce the FOF. Therefore, given the importance of the issue of FOF in older adults with HF, a comprehensive care program and educational, counseling, and welfare interventions should be developed in a way to prevent and reduce FOF.