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Introduction: A variety of maladies, sometimes disabling, beset many ovulatory women in a recurrent manner during the luteal phase of each ovarian cycle. These problems can deteriorate interpersonal relationships and/or interfere with normal activities of life. Present research was performed to evaluate effects of hypericum perforatum for treatment of physical symptoms of premenstrual syndrome.

Materials and Methods: This study was a randomized, double-blind, placebo-controlled, parallel group compassion study performed over two menstrual cycles on student of Tehran University of Medical Sciences and Tehran University. Volunteers underwent a preliminary screening interview, completed Beck questionnaire as a screening test for depression and attended a medical screening visit before being diagnosed as having premenstrual syndrome. Participants administrated hypericum or placebo, 30 drops BD, for two complete cycles. Premenstrual symptoms were evaluated by a daily symptom report form. Data analysis performed by Chi square, Fisher exact, Wilcoxon and t tests.

Results: Premenstrual daily hypericum caused a significant improvement in mean daily score of severity of premenstrual problems compared to placebo (p<0.05). Premenstrual administration of hypericum, 30 drop BD, showed significant advantage over placebo for physical disorders (%49, p=000).

Conclusion: Daily premenstrual administration of hypericum perforatum treats physical symptoms of premenstrual syndrome. It seems that hypericum perforatum can improve symptoms of premenstrual syndrome.

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Background & Aim: Dysmenorrhea is a common problem in young women. Although dysmenorrhea is not life threatening, it can have adverse effects on quality of life. Various treatments are offered for dysmenorrhea including vitamin E supplements. This study investigated the effect of vitamin E on primary dysmenorrhea.

Methods & Materials: In this before-after clinical trial, 200 female students who suffered from primary dysmenorrhea were recruited to the study at Mashhad University of Medical Sciences. First, they filled a questionnaire including demographic characteristics and the pain measurement chart (duration and severity). Then, they were divided into three groups: low, moderate and severe dysmenorrhea groups. Vitamin E (200 mg) tablets were administered to them and they were requested to have them once/day for five days (two days before and three days after the beginning of the menstruation). They filled the pain measurement chart (duration and severity) after two treatment periods. Data were analyzed using t-student, chi-square, and variance analysis tests in SPSS software.

Results: The age of the students ranged 19-26 years old. The severity of dysmenorrhea was mild, moderate, and severe respectively in 28%, 60%, and 14% of the students. The mean of painful menstrual days was 2.05 in the first month, and 2.08 in the second month before using vitamin E. After using vitamin E, painful menstrual days were 1.63 in the first month and 1.64 in the second month. Regarding duration of painful days, all of the participants felt pain in the first day of menstruation. After using vitamin E, about one sixth of the participants in the first month and one fifth of them in the second month had no pain at first day. The severity of pain was 5.18 before using vitamin E that decreased to 3.40 after the intervention.

Conclusion: Vitamin E administration in women, who suffer from primary dysmenorrhea, significantly reduces the severity and duration of pain. It can be used as an alternative treatment method in affected women.

 

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Background & Aim: Concerns over limited equipment and resources particularly in the intensive care units have raised the issues of medical futility, futile treatment, and futile care. Considering that there is no consensus in the definition of the concept of futile care, this study aimed to explore the concept of futile care, especially in terms of clarifying it with the concept of futile treatment.
Methods & Materials: This is a qualitative study conducted using the conventional content analysis approach. In this study, 22 nurses, eight medical specialists, four medical ethics specialists, and one sharia specialist, were purposively recruited with the consideration of maximum variation. Data were collected using individual, in-depth, semi-structured interviews.
Results: The main theme of the study was “care is never futile: care as goal”. This theme is consisted of four main categories including: 1. care as an indispensable service; 2. care as an ongoing process focused on human existence; 3. care as a sacred and essential process in Islam; 4. the necessity for differentiating between care and cure: futile treatment instead of futile care.
Conclusion: Although, in some cases, and depending on the circumstances, medical interventions may be futile, care is never futile. According to the findings of this study, the terms medical futility and futile care cannot be used interchangeably because interchangeable use of these terms can devalue the nature of care. Thus, it is necessary to use the term of “futile treatment” instead of “futile care”.
 

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Background & Aim: Patients with heart failure experience some outcomes such as poor self-management, poor adherence to treatment and low quality of life. The aim of the current study was to evaluate the effect of self-management based discharge planning on treatment adherence in patients with heart failure.
Methods & Materials: In this quasi-experimental research, 80 patients with heart failure hospitalized in teaching hospitals in Zahedan in 2019-2020, were selected by convenience sampling and were randomly allocated into either intervention or control groups. The self-management-based discharge plan consisted of four educational sessions in hospital for the intervention group. In order to follow up, the first call was made 2-3 days after discharge. Then, the patients or their family caregivers were contacted weekly in the first month and twice a month in the second and third month. Data were collected by the treatment adherence questionnaire and were analyzed using independent sample t-test, Fisher exact test, Chi-square and repeated measures ANOVA by the SPSS software version 16.
Results: The two-way repeated measures analysis of variance showed a significant difference in the mean scores of treatment adherence over time (P<0.001) and in the intervention and control groups (P<0.001).
Conclusion: According to the findings, it is recommended that self-management-based discharge plan be employed in an integrated manner for patients with heart failure in medical wards.
 

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Background & Aim: The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.
Methods & Materials: In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.
Results: Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).
Conclusion: The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.
Clinical trial registry: IRCT20201006048953N

 

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Background & Aim: Considering that a decline in sexual satisfaction after assisted reproductive treatment failure can cause a decrease in the overall quality and satisfaction of life, the present study was conducted to compare the effect of sexual counseling based on EX-PLISSIT and BETTER models on the sexual satisfaction of infertile women following the failure of assisted reproductive technologies.
Methods & Materials: This randomized clinical trial, conducted in 2022, involved 66 infertile women who had experienced unsuccessful assisted reproductive treatments and were referred to the Milad Infertility Center of Imam Reza (AS) Hospital in Mashhad, Iran. The participants were divided into two intervention groups – EX-PLISSIT and BETTER – and received individual sexual counseling across four weekly sessions, comprising two face-to-face and two virtual sessions. Data were collected using the Sexual Satisfaction Scale for Women (SSSW) and subsequently analyzed using SPSS software version 25, through chi-square, independent t-tests, Mann-Whitney, and Wilcoxon tests.
Results: After the intervention, there were no statistically significant differences in the total scores of sexual satisfaction and its components between the two groups (P>0.05), with the exception of relational anxiety (P=0.021). Intra-group comparisons revealed a significant increase in the total scores of sexual satisfaction and its components within each group after the intervention, as compared to before the intervention (P<0.05).
Conclusion: Sexual counseling utilizing the EX-PLISSIT and BETTER models was found to be an effective, affordable, and side-effect-free method in enhancing sexual satisfaction among infertile women after the failure of assisted reproductive methods, particularly by addressing relational anxiety.
Clinical trial registry: IRCT20210211050324N1

 

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Background & Aim: Medication non-adherence remains a significant problem in managing the global epidemic of hypertension. This study aimed to explore the factors affecting medication non-adherence from the perspectives of both patients with hypertension and healthcare providers in Mahan health centers, located in Kerman province.
Methods & Materials: This qualitative study utilized a conventional content analysis method within healthcare centers in Mahan city in 2022. A total of 29 participants were included in the study, selected through purposive sampling. Data were collected through in-depth semi-structured interviews, with all interviews being recorded, transcribed verbatim, and utilized as the primary data for analysis. The trustworthiness of data was evaluated in accordance with the criteria established by Guba and Lincoln criteria.
Results: Three categories of factors contributing to medication non-adherence among patients with hypertension were identified: ""nature of the disease and treatment," "individual and family factors," and "organizational factors." Factors related to the "nature of the disease and treatment" included the asymptomatic and chronic nature of hypertension as well as fatigue stemming from continuous drug use. "Individual and family factors" encompassed fear and internal doubts, a desire for non-pharmacological treatments, and inadequate family support. "Organizational factors" comprised high treatment costs and access to specialized services, insufficient support from treatment and care teams, and inadequate disease monitoring.
Conclusion: Various factors across a spectrum of influences contribute to medication non-adherence in patients with hypertension. It is crucial for healthcare providers to engage in consistent patient education regarding the nature of the condition and the importance of medication adherence to enhance compliance among patients.

 

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Background & Aim: Hypertension is a common, often asymptomatic chronic disease that can lead to severe complications if not properly controlled. Patient education plays a vital role in improving blood pressure management and preventing related complications. This study aimed to compare the effects of mobile health (mHealth) and face-to-face education on treatment adherence among patients with hypertension.
Methods & Materials: This quasi-experimental study was conducted on 110 patients with hypertension referred to teaching hospitals in Zahedan, Iran. Participants were selected using convenience sampling and randomly assigned to two groups. Data were collected using a demographic questionnaire and the Hypertension Treatment Adherence Questionnaire. In the mHealth group, patients received educational content via the Eitaa messaging application, and the adherence questionnaire was completed six weeks after the final message. In the face-to-face group, educational sessions were held once a week for three consecutive weeks, and the same questionnaire was administered six weeks after the last session. Data were analyzed using SPSS version 26 with independent and paired t-tests, chi-square test, Fisher’s exact test, and analysis of covariance (ANCOVA). A P-value<0.05 was considered statistically significant.
Results: Before the intervention, there were no significant differences between the two groups in total adherence scores and most of its subdimensions (except for dietary adherence). After the intervention, however, the difference between the two groups became statistically significant (P=0.001).
Conclusion: Both mHealth-based and face-to-face education effectively improved treatment adherence among patients with hypertension. However, mHealth-based education provides the additional advantage of flexible and continuous access to educational materials anytime and anywhere, making it a practical alternative for patient education.