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Background & Aim: Empowerment is a dynamic, positive, interactive and social process, leading to the improvement of quality of life (QOL) in patients with chronic disease. The purpose of this systematic review and meta-analysis was to determine the effect of family-centered empowerment model (FCEM) on QOL in adults with chronic diseases.
Methods & Materials: By searching FCEM in Persian databases including SID, MagIran, IranMedex, IranDoc, and googlescholar, Scopus, Pubmed, Web-of-science, Proquest, and Sciencedirect, all relevant studies were extracted. The methodological quality of the papers was examined using Cochrane-risk-of-bias. Data analysis was carried out through the random effects model and heterogeneity by I² index. The data were analyzed using the STATA software version 11.0.
Results: Of the 647 initial studies, only 8 studies examined the effect of FCEM on the QOL in adult patients using SF-36. The pooled standardized mean difference of the 8-dimensions of QOL included: social-functioning (1.781), Physical role limitation (1.416), bodily pain (0.987), general health (1.352), social functioning (1.010), general health (1.122), emotional role limitation (0.656), and vitality (1.361).
Conclusion: The implementation of FCEM had a significant effect on the 8-dimensions of QOL based on the SF-36 questionnaire. The implementation of FCEM is recommended in order to improve the QOL of adult patients with chronic disease.
 

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Background & Aim: Stoma in children causes physiological and psychological changes and reduces self-esteem and quality of life. The aim of study is to determine the effectiveness of self-care skills training on self-esteem and quality of life in 8-12 year old children with stoma.
Methods & Materials: This study is a non-randomized clinical trial with pretest and posttest design, performed in selected hospitals (Mofid, Hazrat Ali Asghar and Medical Center) in Tehran in 2016-17. A total of 36 children aged 12-8 years with stoma, were selected using the convenience sampling method and divided into two groups of intervention (n=18) and control (n=18). Self-care skills training was performed in six sessions of 45 minutes for the intervention group. The control group received routine care. The Cooper Smith questionnaire and the Kindle quality of life questionnaire were used in this study. Data were analyzed by descriptive and inferential statistics using the SPSS software version 16.
Results: The repeated measures analysis of variance showed a significant difference in the quality of life score means over time (P<0.005) and between the two groups of intervention and control (P<0.015). Also, there was a significant difference in the self-esteem score means over time (P=0.004) and between the intervention and control groups (P=0.004).
Conclusion: Self-care skills training for 8-12 year-old children with stoma, has increased their self-esteem and quality of life. Therefore, nurses can use self-care skills training for similar patients.
Clinical trial registry: IRCT20160802029166N2
 

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Background & Aim: Nowadays, home-based cardiac rehabilitation (HBCR) program is one of the major methods that can improve the quality of life of patients following coronary artery bypass graft surgery. The present study aimed to investigate the effect of a HBCR on the quality of life of patients following CABG.
Methods & Materials: In this clinical trial, 104 inpatients at Golestan and Imam Khomeini hospitals in Ahvaz in 2017, based on permuted-block randomization were assigned to an intervention or a control group. The intervention group received four training sessions for four days at the hospital and then six sessions of home-based cardiac rehabilitation (at 2-week intervals for three months). The Mac-New quality of life questionnaire was completed by the intervention and control groups before the surgery and three months after CABG surgery. Data were analyzed using the SPSS software version 22.
Results: The postoperative mean scores for quality of life subscales and for overall quality of life in the intervention group were greater compared to the control group (P<0.001). The obtained effect sizes were 1.17 for the emotional, 1.42 for the physical, and 1.91 for the social subscales and 1.67 for the overall quality of life. The Eta-squared value (0.408) indicated that the effect of the home-based cardiac rehabilitation program on the quality of life was significant (P<0.0001).
Conclusion: The study findings suggest that the home-based cardiac rehabilitation program has positive effects on the various subscales of quality of life. HBCR is recommended as a cost-effective care model for all patients attending heart surgery centers.
Clinical trial registry: IRCT20171114037468N1
 
 

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Background & Aim: Substance use as a crisis and a long-term chronic disorder can lead to psychological burden and reduce the quality of life of family caregivers. The aim of this study was to determine the effect of the quality of life therapy intervention on the burden of the family caregivers of addicts.
Methods & Materials: This is a clinical trial. The research population included all the family caregivers of the recovering addicts, admitted to Baharan psychiatric hospital in Zahedan in 2018. The samples were 80 people who were randomly divided into either intervention or control group. Caregivers in the intervention group received eight sessions of group counseling based on the quality of life therapy and on the basis of the determined content, every other day. Before the intervention and eight weeks after the intervention, the data were collected using the Zarit burden questionnaire and were analyzed by statistical tests through the SPSS software version 21.
Results: Before the intervention, there was no significant difference in the mean score of burden between the two groups (P=0.25). After the intervention, the mean score of family caregiver burden in the intervention group (40.10±12.92) was significantly lower than in the control group (46.80±13.58) (P<0.01).
Conclusion: The quality of life therapy intervention in this study had a positive and significant effect on reducing the burden of family caregivers of addicts. Therefore, it is recommended that healthcare providers use this counseling approach along with addiction treatment programs to improve the psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 

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Background & Aim: Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts.
Methods & Materials: This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance.
Results: After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P<0.01). There were no significant differences in these variables between the two groups before the intervention.
Conclusion: Counseling based on quality of life therapy in this study had a positive and significant effect on reducing the severity of psychological reactions in family caregivers of addicts. Therefore, health care providers are recommended to use this counseling approach along with addiction treatment programs to increase the welfare and psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 
 

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Background & Aim: Fatigue and sleep disorders are the most common physical complaints in hemodialysis patients. It seems necessary to find effective, low-complication and cost-effective treatments to alleviate these problems. The aim of this study was to examine the effect of slow-stroke back massage on the level of fatigue and sleep quality in hemodialysis patients.
Methods & Materials: In this randomized controlled trial, 82 hemodialysis patients hospitalized in Shahid Beheshti hospital in Abadan in 2018, were selected based on the inclusion criteria and were allocated to either the intervention or control group using permuted block randomization (4 blocks). The intervention group underwent massage therapy for 12 sessions. The numerical rating scale for measuring fatigue and the Pittsburgh Sleep Quality Questionnaire were completed 14 times and three times respectively, by both groups. Data were analyzed through the SPSS software version 22 using descriptive statistical tests, independent t-test and repeated measures analysis of variance.
Results: The results showed that before the intervention, there was no statistically significant difference in demographic variables between the intervention and control groups (P>0.05). Significance of group and time interactions for fatigue score showed that the trend of changes in mean fatigue scores was different in the two groups and over the study time period (P<0.001). Also, there was a statistically significant difference between the two groups in the total score of sleep quality and all sleep components except two components (mental quality of sleep and sleep disorders) (P<0.05).
Conclusion: This study showed that slow-stroke back massage improves fatigue and sleep quality in hemodialysis patients. Therefore, it is recommended as an inexpensive, effective and uncomplicated method in hemodialysis patients.
Clinical trial registry: IRCT20181119041702N1
 

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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
 

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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.
 

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Background & Aim: Caring for children with congenital heart disease is very challenging for their parents, and the mothers of these children have a low quality of life. The aim of this study was to evaluate the effect of discharge planning on quality of life among mothers of children with congenital heart disease undergoing surgery.
Methods & Materials: In this quasi-experimental study, 72 mothers of children with congenital heart disease referred to Shahid Rajaie Cardiovascular center in Tehran in 2019 were included in the study using the continuous sampling method and non-randomly allocated to experimental or control groups (36 in each group). Data collection tool included demographic questions and the SF-36 questionnaire, which was completed before and two months after the intervention. The intervention was performed in six thirty-minute training sessions at the time of admission, during hospitalization and discharge. The training follow-up continued for two months after discharge. Data was analyzed by the SPSS software version 20 using Chi-Square test, independent t-test and Fisher's exact test.
Results: The mean score of quality of life before the intervention was 58.93±19.35 in the experimental group and 64.93±16.78 in the control group, and there was no significant difference between groups (P=0.165). Two months after the intervention, the mean score of quality of life was 73.44±17.81 in the experimental group and 73.67±16.49 in the control group, and there was no statistically significant difference between groups (P=0.956).
Conclusion: The discharge planning did not improve the mothers’ quality of life. It is suggested that in addition to educating about proper care of the child, psychological support be provided for mothers while implementing discharge planning.
Clinical trial registry: IRCT20180501039489N3
 

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Background & Aim: Self-care and self-management, as two effective strategies play an effective role in controlling pain and quality of life. Therefore, considering the characteristics and dimensions of these two concepts, this study aimed to compare the effect of self-care education and pain self-management on the nature of pain and quality of life in patients with sickle cell disease.
Methods & Materials: In this clinical trial study, 75 patients with sickle cell disease, referred to the thalassemia clinic of Baqaei hospital 2 in Ahvaz and Shahid Beheshti hospital in Abadan, were selected and randomly divided into three groups of 25 people (self-care, pain self-management and control groups). The two intervention groups (self-care and pain self-management) were divided into groups of five people, and received specific training during four sessions for three months. The nature of pain and quality of life of patients were assessed four times (before the intervention, one month, two months and three months after the intervention) using the McGill Pain Questionnaire and Quality of Life Questionnaire. The SPSS software version 22 was used to analyze the data.
Results: The results showed that pain self-management and self-care programs were effective in improving the quality of life and pain of patients with sickle cell. However, there was no statistically significant difference between the two intervention groups in the nature of pain and quality of life.
Conclusion: Self-care and pain self-management have similar effects on reducing patients’ pain and improving their quality of life.
Clinical trial registry: IRCT20160726029086N5
 

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Background & Aim: Reduced quality of life and self-efficacy are among problems of mothers of children with chronic diseases. This study aimed to determine the effect of empowerment based on the Gibson model on self-efficacy and quality of life in the mothers of children with thalassemia.
Methods & Materials: In this quasi-experimental study, the study population were the mothers of children with thalassemia referred to rare disease clinics in Rafsanjan and Kerman in 2020. The sample size was 25. Mothers were selected by the convenience sampling method and divided into two groups. In the intervention group, mothers participated in five training sessions based on the Gibson model, and in the control group, mothers received routine care. Data collection tools included the Zhang’s self-efficacy questionnaire and the SF-36 which were completed before the intervention and six weeks after the intervention. Data were analyzed using chi-square test, independent and paired t-test via the SPSS software version 18.
Results: Before the intervention, the mean score of self-efficacy (P=0.31) and quality of life (P=0.47) were not statistically significant between the groups, but after the intervention, the mean score of self-efficacy in the intervention group (68.81±9.36) was significantly higher than that of in the control group (44.69±6.87) (P<0.001). But there was no significant difference in the mean score of quality of life between the intervention (60.64±10.08) and control (56.19±11.41) groups after the intervention (P=0.19).
Conclusion: According to the results, empowerment based on the Gibson model is an appropriate method for improving self-efficacy in the mothers of children with thalassemia. However, further studies are recommended about its effect on quality of life.

 

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Background & Aim: Decreased sleep quality is one of the most common complications of radiotherapy in cancer patients. Although soaking feet in warm water and foot reflexology are two easy, inexpensive, and accessible ways to improve sleep quality, which one is more effective, has not been evaluated in existing studies. The purpose of this study was to compare the effect of soaking feet in warm water and foot reflexology on sleep quality in patients undergoing radiotherapy.
Methods & Materials: This two-group randomized clinical trial was conducted on 62 cancer patients undergoing radiotherapy at Reza (AS) Medical Center in Mashhad in 2020. Patients were randomly allocated into two groups of soaking feet in warm water and reflexology. In the group of soaking feet in warm water, patients soaked their feet in 41 °C water for 20 minutes every night from the seventh day after starting radiotherapy for two weeks. In the foot reflexology group, the intervention was performed from the seventh day after starting radiotherapy for two weeks every night for 10 minutes for each foot in three areas including solar plexus, pituitary gland and pineal gland. Sleep quality score was assessed using the Petersburg Sleep Quality Questionnaire on the seventh day of radiotherapy (pre-test) and then 7, 14 and 28 days later. Data were analyzed by the SPSS software version 20 using descriptive/inferential statistics.
Results: The results showed the total score of sleep quality in the two groups decreased significantly over time (P<0.001), and this reduction was from 13.81±1.33 on the pre-test day to 4.86±1.73 on the day 28 for the reflexology group, and from 13.55±1.23 to 7.92±1.97 for the group of soaking feet in warm water. It should be noted that a decrease in the score of Petersburg questionnaire means an improvement in sleep quality.
Conclusion: Foot reflexology and soaking feet in warm water improve sleep quality in patients undergoing radiotherapy but foot reflexology is more effective in improving sleep quality. Therefore, using this method is recommended.
Clinical trial registry: IRCT20190625044009N1

 

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Background & Aim: Identifying the factors affecting the quality of life in postmenopausal women will help to design and implement the quality of life-improving interventions tailored to these women’s needs. This study aimed to determine the relationship between the educational phase of the PRECEDE model and the quality of life among postmenopausal women.
Methods & Materials: The present cross-sectional study was conducted on 240 postmenopausal women in Asadabad in 2021. The data collection tool included demographic information, the menopause-specific quality of Life questionnaire (MENQOL), and a questionnaire based on educational phase constructs of the PRECEDE model about menopause and behaviors related to the control of menopause complications. Data were analyzed using the SPSS software version 16.
Results: The mean score of quality of life in the women was 72.72±23.15. Perceived self-efficacy (β=-0.367, P<0.001) and attitude (β=-0.155, P=0.009) were significant predictors of quality of life. The educational phase constructs of the PRECEDE model explained about 33.6% of the variance of quality of life among the postmenopausal women in Asadabad.
Conclusion: Educational phase constructs of the PRECEDE model are useful for identifying the factors affecting the quality of life in postmenopausal women, and designing educational interventions in this area. It is recommended promoting self-efficacy (to perform behaviors related to the control of menopause complications) and improving attitude toward menopause to be integrated into all educational interventions designed and implemented to improve the quality of life in postmenopausal women.

 

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Background & Aim: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort and altered bowel habits and can significantly impair quality of life (QOL). Personality has an important effect on health-related quality of life. However, its effect on the quality of life of patients with irritable bowel syndrome is yet unknown. The present study was conducted with the aim of determining the relationship of quality of life with neuroticism, extroversion, conscientiousness, and their subcomponents in patients with irritable bowel syndrome.
Methods & Materials: This is a descriptive-correlational study. The studied population was IBS patients referred to a private gastrointestinal clinic in Tehran in 2021.The sample size was 223, and subjects were selected through the consecutive sampling method. The data were collected using NEO Five-Factor Inventory (NEO-FFI) and the Irritable Bowel Syndrome Quality Of Life (IBS-QOL) questionnaire. To analyze the data, descriptive statistics and regression analysis were used at the confidence level of 95% through the SPSS software version 24.
Results: The mean score of IBS-QOL was 57.68±20.55. Regression analysis suggested that personality subcomponents such as self-reproach (β=-0.376, P<0.001) and positive affect (β=0.160, P=0.020) were the most important predictors of the score of IBS-QOL. The scores of self-reproach and positive affect explained 22.6% of the variance score of IBS-QOL.
Conclusion: The results of current study suggested that the scores of some personality subcomponents including self-reproach and positive affect significantly predict the score of IBS-QOL. Hence, it seems that in addition to common pharmaceutical treatments for IBS patients, considering personality subcomponents (particularly self-reproach and positive affect) is effective in improving these patients’ quality of life.

 

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Background & Aim: Chest pain is one of the main symptoms of acute coronary syndrome, and sleep disorders are among common problems in these patients. The aim of this study was to determine the effect of Curcuma Longa on chest pain and sleep quality in patients with acute coronary syndrome.
Methods & Materials: This triple-blind clinical trial was conducted on 270 patients in the Coronary Care Unit of Kowsar Hospital in Semnan, with random allocation to three groups (intervention, placebo and control) in 2020-2021. The intervention group received 500 mg of Curcuma Longa tablets and the placebo group received 500 mg of starch, Oisel and lactose tablets at 9 a.m. after breakfast once a day for 3 days. The control group received daily interventions. Chest pain was assessed using the pain assessment tool before the intervention and half an hour after the intervention for 3 consecutive days. Sleep quality was evaluated by the standardized sleep quality questionnaire of Saint Mary's Hospital in the morning of the first day before the intervention and in the morning of the second and third days after the intervention.
Results: There was no significant difference in the average reduction of chest pain intensity from the first to the third day between the groups (P>0.05). But there was a significant difference in the chest pain intensity within the intervention, placebo and control groups (P<0.001), and the average chest pain intensity on the second day compared to the first day of hospitalization decreased in three groups (P<0.001). However, the decrease in chest pain intensity on the third day compared to the second day of hospitalization was not significant in the three groups (P>0.05). The average score of sleep quality before the intervention in the intervention group was higher than that of in the placebo group (P=0.021), but on the second and third days of the intervention, it was lower in the intervention group compared to the placebo (P<0.001) and control groups (P<0.001).
Conclusion: The results showed that Curcuma Longa did not have a significant effect on chest pain in the patients with acute coronary syndrome, but it improved the quality of sleep. Therefore, Curcuma Longa can be used to improve the sleep quality of these patients.
Clinical trial registry: IRCT20110427006318N14

 

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Background & Aim: The COVID-19 survivors are prone to psychological distress due to their experience of illness and severe conditions. Diseases can also affect patients’ quality of life. The aim of this study was to determine the relationship between mental health and quality of life among the COVID-19 survivors one year after the infection.
Methods & Materials: This is a descriptive, correlational, cross-sectional study that was conducted from February, 2020 to July 2020. A total of 276 patients who survived from COVID-19 were included to the study through the convenience sampling method. Data were collected using a demographic and clinical information form, the 12-item general health questionnaire (GHQ-12) and the 36 item short form survey (SF-36). Data analysis was performed through the SPSS software version 16 using independent t-test, Pearson correlation coefficient, analysis of variance (ANOVA) and linear regression.
Results: The mean score of mental health and total score of quality of life were 6.26±2.75 and 59.2±18.30, respectively. There is a significant relationship between the score of mental health and the score of quality of life (P<0.001), so that with the increase of the mental health score, which indicated the worsening of the mental health status of the participants, their quality of life score decreased.
Conclusion: Paying attention to the mental health and quality of life of the survivors of COVID-19, as well as adopting supportive strategies for them are recommended. Providing psychological and psychiatric services can improve their mental health and quality of life.

 

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Background & Aim: Many factors affect the hypertensive patients’ quality of life. Identifying the factors related to the quality of life can help to promote the quality of life in hypertensive patients. This study aimed to determine the predictive role of illness acceptance and social, individual factors in the hypertensive patients’ quality of life.
Methods & Materials: This correlational, cross-section study was conducted in 2020-2021 on 245 hypertensive patients referred to a hypertension clinic in Lahijan selected by the convenience sampling method. Data were collected by a questionnaire, including demographic information, Acceptance of Illness Scale and the WHO's Quality of Life-Brief questionnaire. Data were analyzed by multiple linear regression at a 95% confidence level using the SPSS software version 23.
Results: The mean score for the quality of life was 65.32±12.18 (0-100) and for the acceptance of illness was 31.83±4.98 (8-40). Age, sex, employment status, marital status, monthly income, family arrangement and the acceptance of illness were identified as the predictors of quality of life in hypertensive patients (P<0.001). According to the coefficient of determination (R²=0.401), the variables of the final regression model explained about 40% of the quality-of-life changes among hypertensive patients.
Conclusion: Given that the acceptance of illness and some social, individual factors can affect the hypertensive patients’ quality of life, focus on the strategies to promote the acceptance of illness and paying attention to social, individual factors can help improve the quality of life among hypertensive patients.

 

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Background & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19.
Methods & Materials: In this descriptive-cross-sectional conducted in 2021-22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis.
Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001).
Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units.

 

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Background & Aim: Given the importance of the emergency department in providing prompt and high-quality services, the emphasis on lean management has increased to minimize non-value-added and wasteful activities within a process. The aim of the study was to determine the process of patient flow and identify opportunities for its improvement using the Six Sigma method as one of the most important subsystems of lean management, in the emergency department of the selected teaching hospital in Kerman.
Methods & Materials: The current research is a sequential mixed-method study conducted in 2022 within the cardiovascular and neurological emergency department in Kerman. The Six Sigma method, specifically the DMAIC approach consisting of four steps, was employed in conjunction with spaghetti charts to implement lean management principles. The research population included 180 patients referred to the cardiovascular and neurological emergency department. The data were collected using researcher-developed forms, and Excel software version 2013 was used to analyze the data.
Results: By examining the processes and using the spaghetti chart, the main problems contributing to prolonged patient admission time in the cardiology and neurology emergency department were identified. The implementation of a strategy involving the presence of admission staff during triage for level 1 to 3 patients will eliminate the additional distance and time required for patient admission.
Conclusion: The use of lean thinking principles in the emergency department with the implementation of Lean Six Sigma and Spaghetti Chart by streamlining the service process, will result in improving patient flow, providing timely quality services, reducing service delivery time, and ultimately increasing patient satisfaction.

 

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Background & Aim: The misuse of opioids is one of the most important problems in today's world, directly affecting the quality sleep for individuals. This study sought to explore the effect of a nursing care program, based on Roy's adaptation model, on the sleep quality of patients undergoing methadone maintenance treatment.
Methods & Materials: This randomized, single-blind clinical trial was conducted between December 2022 and March 2023, involving 60 opioid abuse patients undergoing methadone maintenance treatment at the Addiction Reduction Center in Isfahan. Convenience sampling was employed, with participants allocated randomly using random sequence generation software into the intervention group (n=30) and the control group (n=30). Data was collected using the Pittsburgh Sleep Quality Questionnaire. The intervention comprised a three-month nursing care program based on Roy's adaptation model, while the control group received routine treatments. Data analysis was performed using SPSS version 26 software, utilizing descriptive and inferential statistics.
Results: The results showed a significant decrease in the total average score of sleep quality in the intervention group after the intervention, indicating an improvement in sleep quality (P<0.001). Before the intervention, there was no statistically significant difference in the total average score of sleep quality between the intervention and control groups (P>0.05); however, a significant difference was observed after the intervention (P<0.001).
Conclusion: The findings indicate that the nursing care program based on Roy's adaptation model is effective in improving the sleep quality of patients undergoing methadone maintenance treatment. Therefore, this model can provide a promising framework for delivering care to such patients.
Clinical trial registry: IRCT20141127020108N6