Jundishapur Journal of Chronic Disease Care
Volume:2 Issue: 4, Oct 2013

Family caregivers are often responsible for providing significant support to relatives who require care at home. However, evidence suggests that family caregivers have limited information, resources or support to prepare them for such a role. Furthermore, family caregiving can be associated with negative physical and psychosocial outcomes. This study examines the short-term impact of psychoeducational interventions on genera health of family caregivers of patients with spinal cord injury. In this randomized controlled trial 62 caregivers, who had a primary role, participated in this study; these candidates were randomly categorized into intervention (n=33) and control (n=29) groups. Caregivers of the intervention group took part in the training sections, which were held once a week for four successive weeks (each session lasting 90 minutes), while control group received no training. Both groups completed the general health questionnaire (GHQ-28) before the intervention and 2 and 6 weeks after the intervention. A Chi-square test, independent t-tests, fisher exact test and Repeated Measures Analysis of Variance were used with the SPSS program for data analysis. The results have revealed that all the participants had mental health disorders, in both groups. After the intervention a significant difference was found between the two study groups regarding the mean score of mental health 2 and 6 weeks after the intervention (p= 0.001). Similar results were also obtained regarding the domains of mental health (p<0.05). The results revealed the effectiveness of psycho-educational interventions in improving general health among caregivers of patients with spinal cord injury. Designing continual programs along with consultation is essential and beneficial in promoting general health of family caregivers of spinal cord injury patients.

Urogenital atrophy is a common problem after menopause, and results from declining estradiol levels and may causes symptoms that can significantly affect quality of life. The aim of this study was to determine the effect of the vaginal suppository of vitamin E in the treatment of atrophic vaginities. This randomized, double-blind controlled trail study was carried out on 42 postmenopausal women with of vaginal atrophy symptoms. The women were randomized in two groups to take vaginal suppository containing 1 mg vitamin E (n=20) or placebo (n=22) for 8 weeks. The symptoms of vaginal atrophy, vaginal pH and maturation value were measured and compared in both groups before and after treatment. Data were analyzed using t-test and Chi square in SPSS version 16. The results showed that the symptoms of atrophy were relieved significantly in recipient vitamin E group (p<0.001). A significant decrease in vaginal pH was detected in recipient vitamin E group compared to placebo group (p<0.001). In addition, the mean maturation index was significantly higher in vitamin E group compared with placebo group (p<0.002). The results showed that vitamin E relieves symptoms of vaginal atrophy. Therefore, the use of vitamin E vaginal suppositories is recommended for the women with vaginal atrophy who do not want or cannot receive a topical estrogen treatment.

Minerals and trace elements like zinc have a significant effect on the growth and development of the fetus and newborn. The purpose of this study was to determine the relationship between zinc deficiency during pregnancy and neonatal anthropometric indicators. This study is a cross-sectional study and done on the women admitted for delivery in Ahvaz Imam Khomeini hospital. Sampling was available.120 women who had all Characteristics of the study were enrolled. The data was collected by Questionnaires and information lists, spectrophotometer, centrifuge, balance and centimeter. The collected data was analyzed with statistic T absolute, Squire and SPSS 17 software. The mean serum zinc level in mothers was 76.57 mg/dl. Average weight, length and head circumference at birth in infants of mothers with normal serum zinc level respectively: 3229 g, 50.32 cm, 34.73 cm and in the group with abnormal serum zinc level: 3092.17 g, 50.10 cm, 34.48 cm. The results of this study showed that only birth weight has been associated with serum zinc level in maternal (p=00.7).

People suffering from psychiatric illness experience stigma as an unpleasant social construct. Stigma has many damaging effects on the individuals, work, home-managing and social communications in these people. The main objective of this grounded theory study was to develop the perspectives of sufferers, their families, and healthcare team members about stigma in people with psychiatric problems. Data analysis in the grounded theory method was conducted. Sixteen participants were selected based on purposeful sampling and then subjected to semi-structured interviews until reaching data saturation. Four categories emerged: stigma initiating factors, instigation of stigmatization (facilitators), mental challenges and emotional reactions of the individual when facing with stigma, avoidance strategy against stigmatization. “Social identity” was the fifth and the core category. The stigma is a multifactor long-term psychiatric problem, as serious threat for social identity of the psychiatric problems individuals. Therefore, control of social identity is considered as a mental-social process in these people when dealing with the stigma.

Phenylketonuria (PKU) is a congenital metabolic disorder of Phenylalanine, If which, the diet is not to be followed exactly, it can lead to progressive mental retardation. The purpose of this study was to investigate the effect of face to face and non-face to face trainings by parental on controlling serum phenylalanine levels in the children with Phenylketonuria. In the clinical trial, 45 patients (aged 1-18 years) with Phenylketonuria, having the inclusion criteria, along with their parents, were divided into three groups of 15 subjects randomly; intervention 1: face to face training, intervention 2: non-face to face training using booklets and pamphlets and 3:a control group. The knowledge of parents was assessed and recorded by a questionnaire; and phenylalanine levels in children were examined by a venous blood samples before and after intervention in all households. The paired t-test, Chi-square and ANOVA and Tukey tests were used for analyzing data. There was no significant difference for parents'' knowledge prior to the intervention in the groups, but after the intervention, there was a significant difference in the intervention group compared to the control group (p =0.006). The educational intervention (face to face and non-face to face trainings) enhanced the knowledge of the family. This increase was seen in the control group (p = 0.086). For serum phenylalanine, although both educational methods led to reduce, but this reduction was significant only in the non-face to face method (p =0.015). This study showed positive effects of both educational methods on the amount of parental awareness; however, the non-face to face educational effectiveness of parents on phenylalanine levels of children was showed more outcomes. Therefore, the regular non-face to face education parameter should be included to follow-up of these patients.

Nephrotic syndrome is a common glomerular injury that appears in primary shape of children. Parents'' knowledge quantity is important to prevent complications from the disease, so this study aimed to determination the knowledge quantity of parents about recurrence of disease. In this descriptive study based on a designed questionnaire that 66 parents of children with nephrotic syndrome were randomly selected. The validity of questionnaire was confirmed by teachers of the AJUMS. Cronbach''s alpha showed that with α=0.82 the questionnaire has good validity. Collected data were analyzed using Chi-square test. Only 18.2 % had good knowledge about their child''s recurrence of symptoms. Furthermore there is a significant relationship between of literacy of caring fathers and their education level (p = 0.01). It was found that most parents had n''t good knowledge about the recurrence of symptoms, so recommended further studies.

In recent decades Cardiovascular disease (CVD) is the important leading cause of death in the world. One of its most insidious forms is coronary heart disease (CHD). There are a number of factors that may contribute to incidence of CHD and physical and psychological side effects of it. But previous research indicates that Type D personality, emotional intelligence, stress, coping styles and Quality of life may be interrelated with CHD patients'' Psychopathology. The present survey, studies the prevalence of Psychopathology and the role of psychological factors on it in CHD patients'' at imam Reza hospital in Mashhad. Through convenience sampling method, 180 CHD patients based on G.Power software were selected and filled in SCl-25, Type D personality, Coping Style Questionnaire, The Perceived Stress Scale, the Emotional Intelligence Scale and Whoqol. Prevalence of psychopathology and conceptualized model of psychopathology were evaluated through path analysis by lisrel software. In the 1 and 2 levels upper average, interpersonal hostility and paranoid believes and Emotional Intelligence was significantly related to perceived stress, coping styles and quality of life. Respectively high and low prevalent psychopathology in coronary heart disease patients. Also the conceptual casual model showed direct and indirect effects of psychopathology in CHD patients. Quality of life, Type D personality and emotional intelligence directly and with mediating role of stress and coping styles could affect significantly of psychopathology of patients. Educating the appropriate personality characters, stress management, positive coping style and EQ could lead to decrease of psychopathology in CHD patients and in result reduce somatic and psychic side effects of it and promoting improvement of patients. Then attention to mental health factors in these patients could prominent help to heart specialist in treatment of heart disease patients.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic disorder with many systematic complications and one of the most important reasons for patients to require mechanical ventilation, admission in intensive care unit and prolonged mechanical ventilation. Although the first attempt in separation of mechanical ventilation is failed in half of chronic obstructive pulmonary disease (COPD) patients, but delaying in the weaning process in these patients also cause ventilator dependence. PaCO2 = 35- 60 mm/Hg is one of the most important indexes for predicting a successful extubation. Case report: A 49-year-old man and known case of COPD who was supported by mechanical ventilation following to bronchopneumonia and severe respiratory infection. After 9 days, followed by gradual reduction of ventilatory support, the patient was placed on Spontaneous Mode with 15 cm/H2o pressure support. Due to satisfactory consciousness and stable hemodynamic status, in spite of high PaCO2 (PaCO2> 115), weaning was done on the 11th day of hospitalization. Patient was discharged from ICU with satisfactory breathing and clinical status one week after the extubation. Regarding the results of this report, it could be stated that because of the compatibility generated in COPD patients in the endurance of the high levels of PaCO2, in case satisfactory consciousness and stable hemodynamic condition of patients, the option of successful weaning could be considered. Additionally, it is suggested that clinician experience and his clinical judgment in addition to predictor indexes for successful weaning be utilized.