Journal of Hayat

Effect of telephone education on medication adherence in patients with epilepsy

Seyed Kazem Mousavi

Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy.
Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisher's exact test, independent t-test and paired t-test).
Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P<0.05); But two months after the intervention, a statistically significant difference was observed in the mean score of medication adherence between the two control and experimental groups so that the patients in the experimental group had higher scores of medication adherence (P<0.001).
Conclusion: The results of this study showed the usefulness of using the telephone education method in improving the medication adherence of patients with epilepsy. Therefore, it is recommended that this method be used in the training program for these patients. In addition, further studies are needed on the comparison of the effectiveness of telephone education with other methods of telemedicine such as cyberspace and online education.

Factors related to spiritual coping in adolescents with cancer based on the "Reed self-transcendence theory"

Azam Shirinabadi Farahani

Background & Aim: Being diagnosed with cancer during adolescence can cause disabilities and disrupt the achievement of important tasks during this period. Given the complex spiritual issues that adolescents face, emphasizing them can provide a unique framework for understanding and coping with illness. The purpose of this study was to determine factors related to spiritual coping in adolescents with cancer based on the "Reed self-transcendence theory".
Methods & Materials: In this descriptive, correlational study, 270 adolescents with cancer referred to hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran in 2018-19 were selected using the convenience sampling method. Data was collected using the demographic and clinical characteristics questionnaire, the “Adolescents Spiritual Coping Scale”, “Adolescents Hope Scale”, “Self-transcendence Scale: Adolescent version and “Adolescent Coping Scale”. Data was analyzed using the SPSS software version 19 through descriptive statistical methods, Kruskal–Wallis test, Kolmogorov-Smirnov test, the Spearman's correlation test and Path analysis.
Results: Based on the Spearman correlation coefficient, the relationship of hope (r_s=0.440, P<0.001), coping (r_s=0.149, P=0.015) and self-transcendence (r_s=0.143, P=0.019) was positive and significant with the spiritual coping. Also, the results of path analysis of the Reed self-transcendence model showed that hope and self-transcendence had direct effects on spiritual coping and coping had an indirect effect on spiritual coping in adolescents through the intermediate variable of self-transcendence.
Conclusion: The variables hope, coping and self-transcendence are the factors related to spiritual coping in adolescents with cancer, and the model of self-transcendence in Iranian adolescents with cancer is appropriate. Therefore, nurses as the first providers of care can enhance spiritual coping in adolescents by focusing on this model and manipulating its various variables.

Effect of applying the specific situation theory on the quality of life in patients with heart failure

Sakineh Sabzevari

Background & Aim: Self-care education is one of the effective ways to improve the quality of life and health in patients with heart failure. The purpose of this study was to determine the effect of applying the specific situation theory on the quality of life in patients with heart failure.
Methods & Materials: In a clinical trial study, 80 patients with class 2 or 3 heart failure, referred to 12 Farvardin hospital in Kahnooj in 2018 were included. Data collection tool included a three-part questionnaire: demographic variables, Left Ventricular Dysfunction Scale to assess patients' quality of life, and Self-care Heart Failure Index. The questionnaires were completed at the first visit and three months after follow-up. Data was analyzed using independent and paired t-test, ANOVA, Pearson correlation through the SPSS software version 20.
Results: Before the intervention, there was no significant difference in the scores of quality of life and self-care between the two groups. After the intervention, the mean score of quality of life and self-care dimensions increased (P<0.001). Regarding self-care after the intervention, the highest score was related to self-care confidence with mean and standard deviation of 21.43 and 3.30 respectively, and the lowest score was related to self-care management with mean and standard deviation of 17.45 and 5.5 (P<0.001).
Conclusion: Paying attention to the dimensions of self-care based on a specific situation theory can lead to a better understanding of these patients’ problems and appropriate planning, and in turn improvement of the quality of life. Since in this study, most of the participants were illiterate, using visual teaching aids, adjusting the schedule according to the patient's conditions and readiness, and if necessary, family involvement can have positive results. It appears necessary to consider the underlying factors in the implementation of self-care programs, especially in people with lower levels of education and income.
Clinical trial registry: IRCT20141109019862N6

Comparison of the effect of thought distraction by music therapy and the presence of caregiver on anxiety level of patients undergoing endoscopy

Aref Faghih

Background & Aim: Stress and anxiety are one of the major problems in patients undergoing semi-invasive and invasive procedures such as endoscopy. Different methods to reduce anxiety do not have the same effects. The aim of this study is to compare the effect of thought distraction by music therapy and the presence of caregiver on anxiety level of patients undergoing endoscopy.
Methods & Materials: In this randomized clinical trial, 105 patients referred to endoscopy ward of Shahid Mohammadi hospital and Persian Gulf Bandar Abbas hospital in 2018 were selected by the convenience sampling method and assigned into three groups of music therapy, presence of caregiver and control using the random allocation (35 in each group). The demographic information form and the Spielberger anxiety questionnaire (STAL) were completed before and after the intervention. In the music therapy group, patients received natural sounds through headphones. In the caregiver’s presence group, endoscopy was performed with the presence of caregiver, and the control group only received routine pre-endoscopic care. Data were analyzed using descriptive and inferential statistics through the SPSS software version 24 at a significance level of 0.05.
Results: The result of analysis of variance showed that there was no significant difference in the anxiety mean score between the three groups before the intervention (P=0.77), but a significant difference was observed after the intervention (P<0.005). The decrease in scores in the music therapy group was significant (P=0.044), but in the caregiver’s presence group (P=0.571) and the control group (P=0.663), no significant change was observed before and after endoscopy.
Conclusion: The results of this study showed that distraction with music therapy is an effective way to help patients undergoing endoscopy, and the use of this method can help the procedure to be performed better and enhance patient satisfaction.
Clinical trial registry: IRCT20190715044215N1

Relationship between resilience and self-efficacy with professional quality of life in EMS personnel

Maryam Aghabarary

Background & Aim: Pre-hospital emergency staff, as the first responder group at the scene of emergencies and disasters, should be able to cope with, and maintain their physical and mental health. The aim of this study was to investigate the relationship between resilience and self-efficacy of pre-hospital emergency staff with their professional quality of life.
Methods & Materials: The present study is a cross-sectional, descriptive study that was conducted in 2019. A total of 200 pre-hospital emergency operational staff from Alborz province participated in the study using proportional and convenience sampling. Data collection tools were a demographic form and three standardized questionnaires including the emergency medical services resilience scale, the Schwartz and Jerusalem self-efficacy scale, and the Stamm professional quality of life scale. Data were analyzed through the SPSS software version 20 using descriptive statistics (mean and standard deviation) and analytical statistics (Spearman correlation, one-way ANOVA and linear regression) at the significance level of P less than 0.05.
Results: The mean and standard deviation of self-efficacy (29.67±5.82), resilience (123.14±17.07), compassion satisfaction (39.81±8.09), burnout (12.06±4.76), and secondary traumatic stress (23.61±7.27). There was a significant correlation between self-efficacy and three components of professional quality of life (P<0.05). Self-efficacy was positively related to compassion satisfaction and negatively related to burnout and secondary traumatic stress. Self-efficacy and resilience were also predictors of compassion satisfaction and burnout (P<0.05). The effect of self-efficacy and resilience on compassion satisfaction was positive. The results of stepwise multiple linear regression analysis showed that five components of resilience including self-management, stress outcomes, communication challenges, maintaining peace of mind and job motivation had an effect on compassion satisfaction (P<0.05). The effect of all resilience components on compassion satisfaction was positive.
Conclusion: Alborz pre-hospital emergency operational staff were at an acceptable level in terms of resilience, self-efficacy and professional quality of life.

Factors influencing COVID-19 vaccine acceptance based on the behavioral change wheel model in Bushehr province in 2021: A web-based study

Azita Noroozi

Background & Aim: Considering the importance of COVID-19 vaccine acceptance to end the corona disease pandemic, the study was conducted to determine the factors affecting the vaccine acceptance based on the behavioral change wheel mode and its components (capability, opportunity, and motivation).
Methods & Materials: In this cross-sectional study, 1102 adults aged 18 years and older living in Bushehr province were selected by multi-stage sampling method from February 16 to 28, 2021. To collect the data, a questionnaire including demographic characteristics, questions on the constructs related to the behavioral change wheel model components and questions on the COVID-19 vaccine acceptance was completed on WhatsApp platform. Data was analyzed using the SPSS software version 22.
Results: The results of the study showed that most participants tended to receive the Iranian vaccine (726 people or 65.9%). Among the demographic factors, only gender was associated with vaccination, and men were more likely to accept to be vaccinated (P=0.022). Among the model constructs, the most predictive construct was related to social support in the opportunity component (P<0.001, β=0.55 and B=0.183). In the motivation component, social role (P<0.001 and β=0.118 and B=0.162) and in the capability component, behavioral regulation (P<0.001 and β=0.152 and B=0.155) had the highest predictor of vaccine acceptance. In general, constructs of opportunity component had the greatest impact on vaccine acceptance.
Conclusion: In order to increase the acceptance of COVID-19 vaccination, opportunities should be provided through social support, vaccination should be introduced as a social role, and behavioral regulation, in other words, understanding of the ability to vaccinate to prevent the disease and break the disease transmission chain should be promoted.

Elderly people's perceptions of the facilitators of abuse: A thematic analysis

Maryam Esmaeili

Background & Aim: With the increasing phenomenon of elder abuse in today's societies, understanding the facilitating and inhibiting factors related to abuse seems necessary. The purpose of this study was to explain the facilitators of elder abuse in Iranian society.
Methods & Materials: This is a qualitative study that used a thematic analysis approach to collect and analyze data in order to explain the elderly’s perceptions of the facilitators of abuse. In this study, 20 elderly people in the community were selected by purposeful sampling. The data were collected by in-depth, semi-structured and face-to-face individual interviews. The Braun and Clark’s thematic analysis was used to analyze the data.
Results: The results of data analysis led to the identification of three themes including role modeling, evacuation of failures, and cultural-familial context of the society. The third theme had three sub-themes intergenerational gap, parenting style and society’s indifference.
Conclusion: Abuse is the result of a combination of causes and factors. The elderly’ experiences suggest that abuse goes beyond a personal matter and is rooted in cultural, social, and economic practices. Today, it is not acceptance of each other and disregard for the expectations of the other party that gives rise many contradictions and abuses at the family and community level.

Frequency of predisposing factors for the entry of foreign bodies into the ear, ingestion and aspiration in children under five years in Tabriz, 2019

Leila Valizadeh

Background & Aim: Structured description of pediatric medical emergencies requires the assessment and classification of underlying factors. The aim of study was to investigate frequency of predisposing factors for the entry of foreign bodies (FB) in the ear, ingestion and aspiration in children under five years in Tabriz.
Methods & Materials: This is a descriptive, cross-sectional study conducted through convenience sampling (n=245) in the ENT and emergency departments and the clinic of children's hospital in Tabriz, from March 2019 to June 2019. A researcher-made tool including the demographic characteristics form and questionnaire on predisposing factors was used to collect the data. Data was analyzed using the SPSS software version 21 through descriptive statistics.
Results: There were 137 (55.9%) cases of FB aspiration into the airways (upper and lower), and the highest was related to nose. FB in ear was 19.6% and in stomach was 19.2%. Clinical manifestations were pain (50.2%), no clinical signs (29.4%), and the rest were bleeding with pain, cough, shortness of breath, suffocation, wheezing, nausea, and vomiting. The place of event was at home (in living room) and in the evening and night time. FB types included objects, food stuff/snacks/nuts, beans and fruit cores, and toy pieces, and it is most likely to be seed, toy pieces, nuts, shirt buttons, and rosary beads.
Conclusion: Parental, child-related, and environmental predisposing factors were reported. Therefore, future studies are suggested to evaluate the contribution of each of three factors and to implement necessary educational, notification, and interventional measures.