Journal of Hayat

Using commercial marketing approach to deliver health and prevention: helping to promote self-care

Elham Shakibazadeh

Self-care is a series of learned actions and goal-directed activities done by individuals in order to provide, maintain, and promote health. Self-care activities involve health promotion, disease prevention, treatment of diseases and injuries, and treatment of chronic diseases. Although the impact of the self-care on improvement of health outcomes and reduction of costs are proven in numerous studies, implementation of self-care programs requires systematic educational and supportive interventions provided by health care providers including nurses to overcome health problems.
Many health professionals in Iran emphasize on negative aspects of unhealthy behaviors to persuade people to do preventive and healthy behaviors. For example, in drug abuse preventive programs, disadvantages of drug abuse as well as the increasing rate of drug abuse and other addictive behaviors, and the economic costs resulting from drug abuse are presented to youth.
Although the emphasis on negative aspects and side effects of unhealthy behaviors is worthy, especially when negotiating the budget with the competent organizations and key supplier, it is not always the best way of proposing behavior change to individuals. For example, showing the pictures of amputated parts of body, and/or blindness to patients with diabetes who are mostly depressed and seek treatment in the diabetes clinics does not seem to be an appropriate approach. Is not there any other positive ways to announce messages to people?
To answer this question, let's take a look at the concept of commercial marketing. Do successful companies highlight negative content of their products and services? The answer is: not often. In commercial marketing, products are presented in a positive way. In fact, everything from cars to clothing, from food products to furniture is offered positively in the market. Car reminds success, health and welfare; cloths helps people to seem younger and more fit; food products help people to feel refreshed, healthy and happy; even furniture is for a modern and convenient life. In commercial marketing, foot blisters of a walking individual are never shown to make people to buy cars.

Relationship between Perceived Stress with Spiritual Health among Older Adults with Diabetes Registered to the Association of Diabetes Prevention and Control in Babol, 2013

Asghar Pourmohammadi

Background & Aim: Demographic transition and aging are global conditions result in increased risk of disability and chronic diseases such as diabetes. Considering stress as having mutual interaction with different aspects of health is vital in treatment of common disorders among older adults with diabetes. This study aimed to assess the relationship between the perceived stress with spiritual health among older adults with diabetes registered to the Association of Diabetes Prevention and Control in Babol .

Methods & Materials: In this cross-sectional (descriptive- analytical) study, 194 older adults aged 60-75 years old were selected using convenience sampling from the Association of Diabetes Prevention and Control in Babol. Data were collected using the demographic form as well as the Perceived Stress Scale (PSS) and the Spiritual Well-being Questionnaire (SWB). The validity and reliability of the scales were confirmed previously. Data were analyzed using descriptive and inferential statistics including ANOVA, Chi-Squared tests, t-test and Pearson correlation coefficient in the SPSS-21 .

Results: The study findings showed that perceived stress was low in a substantial percentage of the elderly (74.2%) with the mean ± SD of 22.52±8.06. Also, the levels of spiritual health were medium to high among most participants (97.72 ± 11.51). Interestingly, there was a significant negative relationship between the perceived stress and spiritual health (r=-0.48, P<0.001) .

Conclusion: This study elaborated the relationship between the perceived stress with spiritual health of elderly patients with diabetes. Considering the results, enhancing spiritual health as one of the health dimensions seems necessary .

Living With Implantable Cardioverter Defibrillator: A phenomenological Study

Reza Negarandeh

Background & Aim: Implantable Cardioverter Defibrillator is the most effective treatment for cardiac dysrhythmias. Having such life-saving device is the unique experience with important changes in the patient’ life. Understanding of these experiences can lead to success in treatment and follow- up.This study aimed to understand the experiences of patients with Implantable Cardioverter Defibrillator .

Methods & Materials: A qualitative study using interpretative phenomenological approach was used. Thirteen participants were selected purposefully from heart clinics of Imam Khomeini hospital (Tehran). Each semi-structured interview was conducted in the period 30 to 45 minutes. Data analysis was performed using the six steps of van Manen .

Results: The main theme of ‘Start Living Again’ was extracted from patients with implantable defibrillator.This theme consist of ‘a sense of security’, ‘living with angel’, ‘attachment to the device’ and ‘attempt to maintain power’ .

Conclusion: The participants with an Implantable Cardioverter Defibrillator have a life again with a sense of security and peace of mind. They try to keep this life-saving device.Therefore, health care providers, especially nurses can help this patients and their families by providing appropriate self care education .

Relationship between Nurses' Job Satisfaction and Burnout with Patients Satisfaction in Shiraz, 2012

Hojjat Habibi

Background & Aim: Patients often build their perceptions about the quality of health services on the care provided for them in hospitals by nurses. The present study aimed to assess the relationship between the job satisfaction and burnout among nurses with patients' satisfaction in Shiraz hospitals in 2012 .

Methods & Materials: In this cross-sectional study, participants were selected through a multi-stage sampling . A total of 280 nurses and 560 patients were recruited to the study. Data were collected using the Spector's job satisfaction and the Maslach Burnout questionnaire s. The structural equation modeling and the confirmatory factor analysis were used to analyze the data in the SPSS and AMOS .

Results: There were significant relationships between the nurses' job satisfaction and burnout with the patients' satisfaction. Also , there was a negative and significant relationship between the job satisfaction with burnout among nurses (P<0.001) .

Conclusion: T he factors affecting job satisfaction and burnout among nurses should be considered in promoting health care provided by nurses .

Role of Social Interactions on Health-Seeking Behavior among Iranian Women with Breast Cancer Symptoms: a Qualitative Study

Ali Taghipour

Background & Aim: Breast cancer is the most common cancer diagnosed in women in both developed and developing countries. Long-term prognosis of breast cancer strongly depends on the stage of disease at diagnosis. More than three months after detecting breast symptoms by Iranian women, they go to visit a doctor. The understanding of life-threatening symptoms and the subsequent responses are differently affected by social interaction networks as well as cultural and social contexts. This study aimed to explore the role of social interactions on health-seeking behaviors among Iranian women with breast cancer symptoms .

Methods & Materials: A qualitative study was conducted using purposive sampling method. Twenty Iranian w omen who attended the Cancer Institute in Imam Khomeini hospital at Tehran University of Medical Sciences and complained of symptoms of breast cancer were recruited to the study du ring 2012-2013. Data were collected through semi-structured and in-depth interviews. Interviews were transcribed and analyzed using conventional content analysis in the MAXqda .

Results: The results revealed three themes including: 1) effectiveness of social learning 2) seeking social support and 3) feedback with a supportive approach which included seven categories of informative social learning, reliable social learning, selective disclosure, seeking information, seeking emotional support , giving reassurance and social support for decision making .

Conclusion: E ffective social learning and supportive interactions have influential role on health seeking behavior. Thus it is necessary to improve public awareness and correct clients' social beliefs about breast cancer to shorten the patients' delay .

Quality of Reporting of Nursing and Midwifery Cohort Studies According to the STROBE Statement

Abdolghader Assarroudi

Background & Aim: Transparent and appropriate reporting of studies facilitates critical appraisal, application and combination of findings. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, is a relatively new statement in order to improve the quality of reporting of observational studies. The present study aimed to assess the quality of reporting nursing and midwifery cohort studies according to the STROBE statement published in the Iranian electronic databases .

Methods & Materials: In this cross-sectional study, we conducted a literature search in the SID, Magiran, Irandoc, Iranmedex databases and Google Scholar using the "cohort" keyword. It produced 1951 articles. After excluding duplicates and irrelevant articles, 241 papers were remained. We included: papers that were published after publishing of the STROBE statement, papers with cohort designs, and papers which their first author or corresponding author were nurse or midwife. Finally, we included 33 papers in our study. We evaluated the papers with the extended STROBE statement. Data were analyzed using the Kruskal Wallis, Mann Whitney and Spearman tests .

Results: About half (48.5%) of the papers had a prospective design others were historical cohort. The compliance with the STROBE statement was 56%. The title, abstract and introductions had generally good quality. The missing data, loss to follow-up and sensitivity analyses had poor quality. There were no associations between the papers' reporting quality with the year of publications, authors' specialty, design of the study, and the time of reviewing process .

Conclusion: The quality of reporting in nursing and midwifery cohort studies was moderate. Reporting the essential elements of cohort studies according to the STROBE statement is recommended .

The Assessment Effect of Kangaroo Care on Maternal Stress of Premature infants Hospitalized in Neonatal Intensive Care Units

Maryam Dehghan

Background & Aim: Mothers often feel anxious about giving care to their premature babies. This maternal stress is associated with negative attitudes and behaviors towards babies. The aim of this study was to assess the effect of Kangaroo mother care on stress among mothers with premature babies .

Methods & Materials: This quasi-experimental study was carried out on 46 pairs of mothers and their premature babies hospitalized in the ICUs of Shahid Sadooghi and Tamin Ejtemaee hospitals. The participants were selected using convenience sampling method and were assigned into two intervention and control groups. In the intervention group, the Kangaroo mother care was provided to the babies after breastfeeding for about 30 minutes once a day for four weeks. Maternal stress was measured using the Parental Stress Scale before and immediately after the intervention. Data were analyzed using the Chi-squared test, t-test, and Mann-Whitney test .

Results: The mean of stress score in mothers of the intervention and control groups were 102.0 ± 17.02 and 174.52 ± 18.25, respectively (P<0.001). The stress score was significantly different before and after the intervention among mothers of the intervention group (P<0.001) .

Conclusion: The Kangaroo mother care decreased stress score among mothers who had premature babies. The Kangaroo mother care is strongly recommended to be used by mothers with premature babies .

Effect of a Cognitive-Behavioral Intervention on Medication Adherence in Patients’ Undergoing Hemodialysis

Mitra Zolfaghari

Background & Aim: Medication usage is the bases of disease management in patients who undergo hemodialysis. Non-adherence to medication regimen increases the incidence of complications among the patients . The aim of this study was to investigate the effect of a cognitive-behavioral intervention on medication adherence in patients undergoing hemodialysis .

Methods & Materials: In this clinical trial, 70 patients were selected from Imam Reza and Valiasr hospitals. Patients were assigned into two intervention (n=35) and control (n=35) groups. The intervention group received a cognitive-behavioral intervention including six steps: 1) Identifying the problem 2) Creating confidence and commitment 3) Increasing awareness of behavior 4) Developing and implementing the action plan 5) Evaluating the plan and 6) Maintaining the desired behavior. Adherence to medication regimen was assessed using a self-report questionnaire before and immediately after the intervention. Data were analyzed using the independent t-test .

Results: At baseline, there was no significant difference in adherence to medicine regimen between the intervention (20.77 ± 4.56) and control (22.34 ± 3.65) groups (P=0.1). After the intervention, significant difference was observed between the two groups in adherence to medication regimen (P<0.001) .

Conclusion: Cognitive–behavioral intervention could improve medication adherence in patients undergoing hemodialysis. It is recommended for nurses to use this approach to improve medical care among the patients .