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Self - injury or self mutilation is one of the destructive behaviours in which theindividual generally hurts his own body and his attempts to injure himself leadto physical pain and suffer.In the existence of self - injury behaviours some different reasons should betaken into consideraticn . Perhaps the mostimportantausesofthisbehaviousare the disability to express the feelings, anger and aggression, reduction oftolerance while facing the stresses and tensions and finally fear and feeling ofbeing sinful.Self - injury should be recognized as a symptom of different types of mentaldisorders and some organic disarders . Such as encephalilis and Adison' sdisease.In order toachieve a successful treatment, the patients should be trained toreduce their tension and anger by means of comforting techniques ,considering the individual health and physical demands and elevating the levelof his skills to solve the problems.Having Knowledge about disease and awareness of the causes of self - injurybehaviours, it can be helpful to the patients in prevention of such behaviours.Index of Terms:

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Children are the biggest national investment that a society can make. With increased child population so too have their problems increased, amongst which are the increased incidence of street children, which as a result has endangered their health. This research is a descriptive and cross sectional study towards determining the effective factors on the self-concept of street children aged 6-12 years who were referred to the Khajouye Kermani culture house of Tehran in 1380. In this regard, 140 street children between the ages of 6-12 were chosen. The method was a 4-part questionnaire which included personal, family and societal information and questions related to the self- concept of the children. The data was collected by interviews with the children. In accordance with the average and the deviation criteria achieved, the level of self-concept was divided into four groups, extremely negative, negative, positive and extremely positive. The results showed that half of the subjects (50%) had very negative concepts of themselves and only 2.2% of them had a very positive self- concept levels. Therefore the street children had a very low self- concept level. Also as concerns the factors affecting self- concept was also a meaningful relationship between self- concept and some factors such as gender, education, level of income, duration of work, level of happiness within the family, counseling, reaction to the child's mistakes, having necessities for the home, adequate nutrition and clothing, having street friends before work (P<0.05). Therefore street children are at risk as regards their mental and physical development because they suffer from low self- concept levels and require special attention. Because of the vast responsibilities nurses can play an important role to improve of the health of these children.

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Introduction: Self-burning is a cruel method of suicide and prevention is the most effective way to decrease its morbidity and mortality.

Material and Methods: This investigation is a descriptive prospective study performed at Shahid Motahari Burn Center, Tehran, Iran from December 2001 to December 2002. Inclusion criteria included being female, married, having no history of medical and mental disorders and admission of self-burning. Data were collected by a questionnaire and interviews and were analyzed with descriptive statistics methods and chi-square test.            

Results: A total of 35 cases entered our study. The mean age of patients was 24.573.94 years and 48.6% of cases were in the 21-25 year age group, 80% had primary school education, 97.1% were housekeeper and 68.8% had low economical status. There were statistically significant differences in all of these variables. In 42.9% self-burning had happened at 12-18 hour period and in 45.7% it had occurred at yard. Kerosene had been used by 91.4% of the women as the burning agent 94.3% of the women had experienced husband’s violence (verbal and physical), 60% of the women stated that their husbands were guilty in their action and 91.4% of the women didn’t know any supportive sources in the society. The mortality rate was 100%.

Conclusion: This research showed that family violence and marital problems are the most important causes of self-burning in the married women. Because of close relationship to families, community health nurses can prevent self-burning in married women by detecting and eliminating these risk factors.

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Introduction: In patients who have a chronic disease such as end stage renal disease for which cure is not a realistic goal, maximizing functioning and well-being should be a primary objective of care. However, functioning status in the dialysis patients is often lower than normal.

Materials and Methods: This study is aiming to determine the effect of self–care educational programs on decreasing problems and improving quality of life of dialysis patients. This study was a quasi-experimental research in one group (pretest-posttest) accomplished in the educational hospitals of Iran and Tehran medical sciences universities from 2003 to 2004. A total of 32 patients were chosen on the basis of a non-randomized sampling. Each patient was assessed in two sessions before starting the dialysis treatment by questionnaires about educational requirements and quality of life and a checklist of common problems in dialysis patients. In order to validate the results, the laboratory variables were analyzed as a two months average prior to the education. The authors designed an educational program on the basis of existing problems and then determined the characteristics of each person under study and the required education was presented in two sessions. After the educational period was ended, the laboratory variables (average two months) and quality of life two months after education were analyzed and also the checklist were studied in two stages with a time interval of two weeks (third and fifth weeks).

Results: There was a significant decrease in serum urea, uric acid, serum creatinine, K, weight gain, systolic blood pressure, edema, skin itching and local vascular problems. Also, there was a significant improvement in the patients’ quality of life.

Conclusion: Self-care educational programs have a positive influence on decreasing the problems and improving the quality of life of dialysis patients.

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Background & Aim: Family history of one member suffering from hepatitis B of family is one of the most important ways of illness transmission in Iran. Thus attention to quality of self care of patients of hepatitis B family has vital role in prevention and control in family and society.

Methods & Materials: This research is descriptive study. Samples of this research included 250 patients which 160 persons belonged to simplex hepatitis B families and 90 persons belonged to multiplex hepatitis B families. Patients refer to the center of blood transfusion organization from all of area of Gillan province. In this study data has collected by patens’ questionnaire include: demographic qualifications that were designed in two parts 1- individual qualifications and illness qualifications and questions were about quality self care of drug regimen meal regimen, addictions, precautions standard, fallow up disease and diagnostic quality self care in these groups has been analyzed in SPSS statistical soft ware by statistical tests such as 2 test and fisher test. (p<0.005).

Results: Our results show that (%64) patients of simplex family and (85.6%) patients of family multiplex have not suitable quality self care. In response to hypothesises (there is relationship between quality of self care of patiens members in family and increasing of HBSAg cases) findings show that exists meaningful relation between self care about hepatitis B and increasing cases HBSAg in families (p<0.05).

Discussion: Regarding to dimensions of quality selfcare about hepatitis B disease has important role in preventing from increasing cases HBSAg in families. Particularly regarding to results of research which indicate unsuitable quality self care of patients about drug regime “diet or therapy” “addictions” follow up disease. Therefore in order to control the hepatitis B in family according to the results of this study it is suggested further efforts should be down. The results of this study can be used for other patients infectious such as hepatitis c and Aids.

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Background & Aim: Chronic illnesses, such as cancer, can cause changing in self-esteem. This study has been perform to compare the self-esteem between male and female cancer patients.

Methods & Materials: In this research 101 patients (51 women and 50 men) with different types of cancer (solid tumors and leukemia) have selected by simple sampling method. The tool for gathering data was a questionnaire, with three parts: demographic characteristics, disease characteristics, and Cooper smith self-esteem inventory. Data collection was done through interview, patient’s charts and patients self-report. The descriptive and analytic statistics have been used and the exams were “chi-2” and “Fisher”, through SPSS software.

Results: This study showed that the majority of cancer patients in male and female group have moderate level of self-esteem. There is no significant difference in self-esteem of men and women with cancer and the majority of them (84.3% women) and (%76 men) have moderate self-esteem, but noticeable difference between men and women is connected to the variables that are related to self-esteem, whereas, men’s self-esteem has not any significant meaningful relationship with demographic variables, meanwhile, variables of being under support of somebody (p=0.005) and having caregivers at home (p=0.039) have a meaningful relationship with women’s’ self-esteem. Among the diseases’ characters change or decrease in function of different parts of body has a meaningful relationship with men’s (p=0.014) and women’s (p=0.005) self-esteem. Constipation is the only other variable related to men’s’ self-esteem (p=0.071), but about women there are some variables related to the self-esteem of them consist of duration of amputation (p=0.018), anorexia (p=0.001), alopecia (p=0.027) and fatigue (p=0.021).

Conclusion: It seems that, in comparison between tow genders with cancer although the women’s self- esteem is related to more variables than men, but, recognition and specify these variables can help nurses to design an effective care-plan to meet the gender-specific needs.

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Background & Aim: Breastfeeding is the most cost-effective, health-promoting, and disease-preventing activity that new mothers can perform. Many researches have focused on identifying factors that influence breastfeeding initiation and duration. An important and modifiable factor is the perceived self-efficacy of mothers for breast feedings. It refers to a mother&aposs perceived ability to breastfeed her newborn and is a dominant variable in the duration of breastfeeding. The purpose of this study was to assess the relationship between self-efficacy and breastfeeding.

Methods & Materials: A descriptive, longitudinal, analytic approach was used in this study. The three-part questionnaire was administered to the eligible pregnant women (437 pregnant women) who were at least in 37 weeks of gestation and intended to breastfeed. They were then contacted again at one and four months postpartum to determine their infants&apos feeding level and method. The questionnaire was re-administered to the participants at that time.

Results: The results showed that 80.4 percent of participants had exclusive breastfeeding during one month. There was no significant relationship between antenatal breastfeeding self-efficacy and the breastfeeding. The self-efficacy was significantly related to breastfeeding outcomes at one month. Mothers with high self-efficacy were significantly more likely to breastfed their babies exclusively at one and four months postpartum than the mothers with low self-efficacy.

Conclusion: Maternal breastfeeding self-efficacy is significantly related to breastfeeding duration and level. Measuring breastfeeding self-efficacy not only identifies high risk mothers, but also provides important information to health care providers in providing support to new mothers.

 

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Background & Aim: Self-care activity is a key factor in managing Rheumatoid Arthritis (RA) in order to reduce disability caused by the disease. Predisposing factors including knowledge, attitude, and self-efficacy are introduced as determinants of self-care behaviors in the forth phase of PRECEDE model, i.e., ecological and educational assessment. This study aimed to assess the relationship between the predisposing factors and self-care behaviors in patients with RA in Yazd, Iran.

Methods & Materials: In this cross-sectional study, a convenience sampling was used to recruit 181 outpatients with RA referred to a rheumatology clinic in Yazd, Iran. Data were collected by conducting interviews with the participants using a survey questionnaire included knowledge, attitude, and self-efficacy, as predisposing factors and self-care behaviors items. Reliability and validity of the instruments were examined and approved. The statistical tests included bivariate correlations, Mann-Whitney U test, and linear regression.

Results: Knowledge, attitude, and self-efficacy scores were 71.7%, 66.9%, and 47.5%, respectively. The total predisposing factors score was 62.3%. There was a significant positive correlation between the self-care behaviors with attitude and self-efficacy. However, there was no significant correlation between the patients&apos knowledge and self-care behaviors. Totally, the measures explained 39.3% of total self-care behaviors variance within which the self-efficacy was the strongest predictor (β=0.41).

Conclusion: Regarding the high power of predisposing factors, especially self-efficacy, in predicting self-care behaviors and the low scores of self-efficacy, health promotion planners should pay more attention to predisposing factors of self-care behaviors especially the self-efficacy in designing health promotion programs.

 

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Background & Aim: Regarding the importance of determining the determinants of diabetes self-care, this study aimed to examine two major determinants of self-care activities, i.e. perceived barriers, and perceived self-efficacy among type two diabetic patients in Tehran, Iran.
Methods & Materials: In this cross-sectional study, 128 patients were recruited to the study using convenience sampling. The validated diabetes instruments were completed by the patients. The included participants aged older than 18 years. Data were analyzed using bivariate correlation and path analysis.
Results: The mean score of the perceived barriers and perceived self-efficacy were 3.05 and 2.18, respectively. The maximum score of self-care was 4.18. There was a positive correlation between self-efficacy and the self-care (r=0.22 P<0.01). Positive correlations were also found between education with self-efficacy and self-care (r=0.28 P<0.05), (r=0.29 P<0.05). There was a negative correlation between perceived barriers and self-care behaviors (r=-0.68 P<0.000). Using serial multiple regressions and path analysis, we had a final model (RMSEA=0.05 GFI=0.95 CFI=0.98 P=0.44 and Chi-Square=26.5). This model showed that perceived barriers were the strongest predictor for self-care behaviors. Perceived barriers mediated the effect of self-efficacy on the self-care behaviors.
Conclusion: The intervention efforts that address the studied determinants related to self-care behavior could potentially impact type two diabetic patients&apos self-care activities. These determinants should be mentioned in the program developing.

 

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Background & Aim: Gestational diabetes is a major concern during pregnancy. Psychological factors such as self-efficacy play important role in adherence of the treatment, control of blood glucose, and the outcomes of the pregnancy. The main purpose of this study was to determine correlations of self-efficacy in women with gestational diabetes attending to educational medical centers of Iran University of Medical Sciences in Tehran.

Methods & Materials: In this descriptive correlational study, we recruited 100 women aged 15-49 years old with gestational diabetes and singleton pregnancies using consecutive sampling method. Data were collected using Diabetic Self-Efficacy scale.

Results: The mean age of the women was 31 years. The majority of the women (66%) had moderate economic status and more than half (60%) had no higher education. Sixty eight percent of the study participants were obese or overweight. About 33% of the participants were nullipara and 69% had wanted pregnancies. The results showed that 43% of the women had low self-efficacy. The self-efficacy scores were significantly correlated with education (P=0.005) and occupation (P=0.016).

Conclusion: Self-efficacy is an important determinant of self-management and self-control in gestational diabetes. Regarding low self-efficacy among the women, it seems that implementing educational-counseling strategies to enhance self-efficacy can be helpful to promote optimum self-care among women with gestational diabetes

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Background & Aim: Patients adherence to medical recommendations requires new and effective strategies. Promoting self-efficacy is considered as an important measurement to help patients to participate in their own treatment protocol. This study was conducted to determine the effect of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases in a public hospital in Urmia.

Methods & Materials: In this single group before/after study, 81 patients with at least two cardiovascular adjustable risk factors were recruited. The self-efficacy intervention was presented to the patients and one of their family members. The self-efficacy was scored before, immediately and one month after the intervention. The Cardiovascular risk factors were measured before and one year after the intervention. Descriptive statistics, ANOVA with repeated measures, paired t-tests, and McNemar test were used to analyze data.

Results: Overall self-efficacy scores and its sub-groups were significantly improved after one month. There were significant differences in the mean BMI, HDL, LDL, systolic and diastolic blood pressures, and weight before and one year after the intervention. The number of smokers and patients with hyperlipidemia were significantly decreased one year after the intervention. However, there were not significant differences in the number of overweight patients and patients with hypertension before and after the intervention.

Conclusion: Results showed that our intervention to improve self-efficacy had positive effect on the overall self-efficacy score and the scores of its subgroups. Our intervention was also effective in controlling cardiovascular risk factors and in reducing the frequency of smokers and patients with hyperlipidemia. It seems that combination of medical orders with self-efficacy improving interventions on patients and their families are influential in controlling cardiovascular risk factors.

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Background & Aim: Early diagnosis of breast lumps through breast self-examination (BSE) is important for early detection of breast cancer. The aim of this study was to evaluate factors predict the BSE behavior using Health Belief Model constructs in women referred to health centers in Bandar abbas, Iran.

Methods & Materials: In this cross-sectional study, 240 eligible women were randomly selected from eight health centers. Data were collected using a self-administered questionnaire including demographic characteristics and Champion&aposs Health Belief Model Scale (CHBMS). The CHBMS measures the HBM concepts of susceptibility (3 items), seriousness (6 items), benefits (4 items), barriers (8 items) and self-efficacy (10 items). All items were ranged in a Likert scale ranging from ‘‘strongly disagree (score: one)&apos&apos to ‘‘strongly agree (score: five)&apos&apos.

Results: A total of 240 women took part in the study. The mean age of participants was 37.2 (SD=6.1). Of all, 32.5% had high school education and 95.8% were married. The results showed that 31.7% of the women had performed the BSE however, only 7.1% had performed it regularly. Perceived BSE benefits, perceived BSE barriers and perceived BSE self-efficacy of the participants who performed the BSE were significantly higher than those who did not (P<0.03). The results from regression analysis indicated that the perceived BSE self-efficacy and perceived BSE barriers predicted breast self-examination behavior (P<0.001).

Conclusion: The findings of this study indicated that perceived BSE barriers and perceived BSE self-efficacy were influencing factors in predicting the BSE behavior. Therefore, in order to improve self-efficacy and decrease the barriers, BSE training programs are strongly recommended.

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Background & Aim: Caregivers of elderly with Alzheimer&aposs disease, particularly females, encounter challenges. Their different roles in giving care to the patients could result in physical and mental disorders. The self-efficacy seems to be an essential factor in empowering individuals coping with stressful situations and challenging tasks. The aim of this study was to investigate general self-efficacy among women as family caregivers of elderly with Alzheimer&aposs disease.

Methods & Materials: In this cross-sectional descriptive study, 112 women reffered to the Iran Alzheimer Association, Tehran were selected through convenience sampling method. The General Self-Efficacy Scale (GSE-10) was used to collect data. Data were entered into the SPSS-16 and then processed using descriptive statistics and independent t-test, ANOVA and Scheffe.

Results: The mean score of the general self-efficacy was 28.24±6.34 indicating that considerable percentage of the participants had unsatisfactory level of self-efficacy (65.2%). In addition, there were significant relationships between the women&aposs general self-efficacy with educational and economic statuses (P<0.05). There were no significant relationships between general self-efficacy with age, marital status, occupational status and duration of caring.

Conclusion: According to the findings, a considerable percentage of the participants had unsatisfactory level of self-efficacy. Therefore, it is essential to promote the caregivers self-efficacy in order to give them the ability of better adaptation with the life&aposs challenges. In particular, the self-efficacy promotive programs should be implemented among caregivers with lower educational and economic status.

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Background & Aim: Asthma is one of the most prevalent chronic diseases worldwide. About 6.5 million people suffer from asthma in Iran. The Effective strategy to control asthma is related to education. The self-management has a major role in the standard education program. This study aimed to assess the effect of education on using peak flow meter and follow up via SMS on asthma self management.

Methods & Materials: This study was a quasi-experimental controlled clinical trial. The samples included 98 patients, suffering from asthma referred to the pulmonary clinic in Imam Khomeini and Shariati hospitals. Patients were selected using convenient sampling method and were randomly assigned into the experiment (n=47) and control (n=51) groups through blocking method. Two educational sessions were held in the experiment group about how-to-use peak flow meter. Accordingly, the patients in the experiment group sent their peak flow rates via SMS to the researcher within 12 weeks. The researchers provided feedback to the patients about their asthma control via phone, weekly. Patients in the control group did not receive any education. Data were collected using the Asthma Control Test before and three months after the intervention. Data were analyzed using the statistical tests of Chi-square, Mann-Whitney, Independent t-test and Kolmogorov-Smirnov.

Results: There was a significant statistical difference between the two groups of experiment and control in terms of asthma control (P=0.002).

Conclusion: The education using peak flow meter and following up via SMS promotes asthma self-management. With regard to the significant role of nurses in patient education, educating patients with asthma by nurses is recommended at the Iranian Society of Asthma and Allergies clinics and medical centers.

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  Background & Aim: Although breast self-examination (BSE) is no longer recommended for screening of breast cancer, its training and practicing is a gateway to health promotion and provides women with knowledge and attitudes that set the stage for clinical breast examination and mammography screening later in life. The aim of this study was to recognize predicting factors of the BSE based on the Health Belief Model (HBM) and the locus of control model among women aged 20-50 years old.

  Methods & Materials : Inthis cross-sectional study,400 women were selected through theconvenience sampling method from health centers. Data were collected using four questionnaires including the Champion’s Scale, health locus of control, and demographic and functional questionnaires. Data were analyzed in the SPSS using independent T-test, Chi-squared test, logistic and linear regression models.

  Results: The results showed that 10.9% of the participants reported performing BSE regularly. Perceived self-efficacy was the strongest positive predictor in the BSE performance (Exp (B) =1.863). Awareness had direct and indirect effects on the BSE. The locus of control did not predict the BSE (p=0.05).

  Conclusion : Improving self-efficacy, especially in young women, and increasing awareness about cancer among women is necessary to increase the rate of the BSE.

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  Background & Aim: Several studies have shown that the self-care activity of patients with implantable cardioverter defibrillator is inadequate. This study was conducted to assess the effect of an educational program based on the Orem’s self-care model in self-care ability of the patients .

  Methods & Materials: This clinical trial was conducted among 66 patients with implantable cardioverter defibrillator. Four educational sessions were held based on the patient's needs and Orem’s self-care model. Data was collected using a self-report questionnaire at baseline and one month after the intervention. Data were analyzed using statistical tests (x², t-test, paired t-test) in the SPSS-18 . 

  Results: There were no significant differences in the self-care awareness, tendency to self-care, self-care skills, and self-care ability between the control and intervention groups. After the intervention, the self-care awareness score remained 22.06 ± 3.26 in the control group and increased (28.69 ± 1.51) in the intervention group (P<0.000). There was also significant difference in the tendency to self-care between the control (25 ± 3.31) and intervention (28.9 ± 1.33) groups (P<0.000). The self-care skills differed significantly between the control (14.9±3.06) and intervention (29.03±1.15) groups after the intervention (P<0.000). After the intervention, the self-care ability was also significantly different among the control (61.96±8.06) and intervention (86.63±2.93) groups (P<0.000) .

  Conclusion: The results of this study showed that implementing educational programs based on the Orem’s self-care model can improve self-care ability in patients with implantable cardioverter defibrillator. Applying this method is recommended in nursing interventions to promote health status of the patients .

  

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  Background & Aim: Insertion of chest tubes is a necessary measurement in chest trauma. The trauma patients need specific skills for self-care. This study aimed to determine the effect of using supportive-educative system on self-care skills in trauma patients with chest drainage system .

  Methods & Materials: In this quasi-experimental study, 62 trauma patients with chest-tube were selected from three surgery wards of Besat hospital in Hamadan from December 2012 to May 2013. Two wards were randomly allocated into the experiment group (n=31) and one ward was allocated into the control group (n=31). Participants were selected using convenience sampling. The supportive-educative system was designed based on the patients’ needs and was implemented to the experimental group in three consecutive days. The study instruments included self-care needs assessment form and self-care skills checklist. Measurements were completed once the patients were admitted to the wards and three days later by an external observer. Data were analyzed using t-test, Chi-squared test, Mann-Whitney and Wilcoxon tests with a 95% confidence level in the SPSS-16 . 

  Results: There were no significant differences between the two groups in the study variables at baseline (P>0.05). Although self-care skills in both control (P<0.01) and experiment (P<0.001) groups were improved, using educative-supportive system led to better self-care skills in the intervention group in compare to the control group (P<0.001) .

  Conclusion: In general, self-care skills of patients with chest drainage system could be improved by supportive-educative system. The improvement in the control group can be attributed to self-care trainings conducted routinely by doctors and nurses .

  

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  Background & Aim: Exacerbation of the symptoms among patients with chronic obstructive pulmonary disease is a part of the disease's cycle . Despite having medical treatments, most patients experience severe degrees of dyspnea. Self-management programs can help relieving the symptoms. T his study aimed to assess the effect of a self-management program on dyspnea and fatigue severity in patients with chronic obstructive pulmonary disease (COPD) .

  Methods & Materials: In this randomized clinical trial, 50 patients with COPD referred to Apadana clinic in Ahvaz were recruited into the study. Patients were randomly allocated to control and intervention groups. The intervention group received a self-management program designed based on the 5A model the control group did not receive any intervention. Patients were assessed using the Fatigue Severity Scale and the Borg Dyspnea Scale at baseline and three month later. The Chi-squared test and t-test were used to analyze the data . 

  Results: There was no significant difference between the two groups in fatigue severity at baseline. At the end of the three months, the fatigue severity score differed significantly between the two groups (P=0.004). There was also significant reduction in the patients' dyspnea in the intervention group than the control group after 12 weeks (P<0.001) .

  Conclusion: Our program was effective in reducing the COPD symptoms among patients. This simple and non-expensive program can be applied as a beneficial intervention to decline major difficulties of the disease among patients with COPD .

  

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  Background & Aim: The ultimate goal of self-care behavior is patients' empowerment. There are limited studies on perspectives of patients with Parkinson's disease on self-care. This study aimed to explore for the process of self-care in patients with Parkinson’s disease during 2011 to 2013 .

  Methods & Materials: This exploratory qualitative study was carried out using grounded theory method. Data were collected via semi-structured in-depth interviews and field notes. We interviewed with 12 patients with Parkinson 's disease and four family caregivers . Participants were selected from two neurology clinics. Interviews were conducted at participants' homes or nursing homes. Data were analyzed using the Corbin and Strauss (2008) approach . 

  Results: Concepts of study were identified using a micro and general analysis. The 'fear of becoming crippled' was identified as a main concern. Strategies used in response to context included 'independency', 'spiritual care', 'informed self-care' and ‘seeking treatment’. 'Striving for taking independent self-care' was the most important process. Demographic, familial and social factors had important roles in self-care processes of patients with Parkinson's disease .

  Conclusion: The process of self-care in patients with Parkinson’s disease depends on the context and severity of the signs and symptoms. Health care providers especially nurses can support patients with Parkinson's disease in achieving maintain independence in self-care. In addition, attention to self-care behaviors with focus on person as self-care agent can considerably increase control and management of life .

  

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  Background & Aim: Psychological and social factors such as attachment styles may influence chronic diseases through self-care behaviors. This study was conducted to determine the relationship between attachment styles and self-care behaviors in patients with heart failure .

  Methods & Materials: In this correlational study, 180 patients with heart failure hospitalized in CCUs and Post CCUs of educational hospitals in Zahedan in 2014 were selected through convenience sampling. Data collection tools included the Experiences in Close Relationships-Revised (ECR-R) questionnaire and Self-Care of Heart Failure Index (SCHFIV6.2). Data were analyzed in the SPSS-20 using the descriptive statistics, independent T-Test, Pearson's correlation and regression analysis . 

  Results: The mean and standard deviation of self-care behaviors score of the group with secure attachment style (62.89 ± 12.66) was significantly higher than the group with insecure attachment style (40.43 ± 16.11) (P<0.05). Also, the regression model showed that the score of anxiety, attachment avoidance and age were as predictors of the self care scores in patients .

  Conclusion: Regarding the relationship between attachment styles and self-care behaviors and the low level of self-care in patients with insecure attachment style, psychological interventions should be considered through long-term treatment of chronic heart failure .