A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study.

BACKGROUND: There is slight evidence on the effectiveness of relaxation techniques to improve quality of life of the old people, and no comparative studies have particularly investigated this population. Hence, the present study was conducted to examine the effect of Mitchell relaxation versus Benson relaxation technique to improve quality of life of the old people. METHODS: In the present quasi-experimental study, 96 eligible old people in a nursing home were selected by available sampling method. Afterwards, they were assigned to three groups: Mitchell's Relaxation Technique, Benson Relaxation Technique, and control (each of 32 participants) using the random block sampling method. The intervention groups received relaxation for 8 weeks and 3 sessions of 20 min each week. However, the control group did not receive any relaxation. Data was gathered by questionnaires (SF-36) and (CASP-19) before (week 0) and after the intervention (week 8) and were analyzed using the SPSS software version 26. RESULTS: The results indicated that both Benson and Mitchell relaxation had improved the quality of life (SF-36) and (CASP-19) and their sub-scales in the participants compare to the control group (P < 0.001). Accordingly, the median (quartile 25, 75) of the specific quality of life of the participants before the intervention was 21 (18.25, 25.75) in the Benson group, 20.5 (16, 24) in the Michel group, and 21 (16.25, 24) in the control group. However, after the intervention they reached 35(26.25, 38.75), 34.5(26.75, 42.25), and 17 (14, 21) respectively. There was no statistically significant difference between the Benson and Michel relaxation groups. CONCLUSIONS: Based on the results, Benson and Mitchell relaxation techniques improve the quality of life of the old people. If the results be confirmed in other studies, the education of each of them, especially for the old people living in nursing homes and their caregivers, is suggested as routine care.

The Effect of Family-Centered Intervention on Key Indicators of Diabetes Management and Control in Patients with Type-2 Diabetes.

Background: This study is to determine the effect of the family-centered intervention (FCIS) on the key indicators of diabetes management and Control control in patients with type-2 diabetes. Method: The present study is a quiz- experimental study with a randomized control group. Participants were 64 patients with type-2 diabetes visiting Ali Asghar Hospital of Isfahan in 2018. The eligible patients were assigned to either the intervention group or the control group (i.e., patient-center care) through block randomization. FCIS were implemented in 4 two-hour sessions as home visits while the patients and their caregivers were present. Data were collected twice-i.e. before the intervention and 12 weeks after it- and were analyzed, by running a t-test (α = 0.05), using SPSS-21. Results: The mean ± SD age of participants was 50.4 ± 8.5. There was no significant difference between the two groups in the mean weight, serum levels of FBS and A1C, physical activity, energy intake, and BMI before intervention. But, a significant improvement in the mean values of these variables in the intervention group after the intervention, compared with the control group was indicated (P < 0.05). Conclusions: This study suggests that FCIS are more effective than patient-center care in the management and control of type-2 diabetes. Therefore, it is recommended that the family be considered in educational interventions.

Effect of chamomile aromatherapy with and without oxygen on pain of women in post cesarean section with spinal anesthesia: A randomized clinical trial.

Background: Pain is the most common side effect in cesarean section with spinal anesthesia. It seems that oxygen therapy and chamomile aromatherapy may diminish pain. The present study was conducted to examine and compare the effect of chamomile aromatherapy with and without oxygen on the severity of pain of women following cesarean section surgery with spinal anesthesia. Methods: The present randomized clinical trial study was carried out on 136 women undergoing cesarean section surgery with spinal anesthesia at Imam Sajad Hospital, Yasuj, Iran in 2020. The eligible women were assigned into four 34-member groups including oxygen therapy plus aromatherapy, oxygen therapy, aromatherapy, and control via block randomization. Each of these interventions were performed 6, 6.30 and 7 h post operation. In the first intervention group, one drop of chamomile essential oil with distilled water was poured into a small nebulizer using a simple mask connected to 6 L of oxygen. The second intervention group received oxygen without chamomile aromatherapy at similar times, and the third intervention group received chamomile aromatherapy without oxygen. The control group received only routine interventions. The instrument used in the research was visual analog scale which was completed by the researcher 6, 12, 18 h after cesarean section. The data were analyzed by the SPSS software version 20. Results: There was a significant difference in the intensity of pain of patients between the various groups of study following the interventions (P < 0.001). Pain intensity reduced significantly in the group receiving combined intervention of chamomile aromatherapy plus oxygen compared to the other three groups. Moreover, the pain intensity diminished more in the groups undergoing each of these interventions alone as compared to the control group (P < 0.05). Conclusions: The combined intervention of chamomile aromatherapy with oxygen was more effective than each of the chamomile aromatherapy and oxygen interventions alone in reducing the pain of cesarean section patients though each intervention alone was still effective in lowering pain post-operation.

Effect of Leventhal's self-regulatory intervention on the hypertensive patients' illness perception and lifestyle: a randomized controlled trial.

BACKGROUND: The perception of illness may lead to improving the hypertensive patients' lifestyle, but no study was found in this regard. Therefore, this study was conducted to determine the effect of intervention based on Leventhal's self-regulatory model on the illness perception and lifestyle of patients with hypertension. METHODS: In the present randomized controlled trial study, ninety eligible patients with primary hypertension were randomly assigned to one of the two groups of intervention and control. Patients in the intervention group received five sessions of Leventhal's self-regulatory intervention, each of 60 min and weekly. However the control group received routine care. The outcomes were illness perception and lifestyle of the patients with hypertension. The Revised Illness Perception Questionnaire and the Lifestyle Questionnaire were administered to assess illness perception and lifestyle before the treatment to establish a baseline and subsequently 12 weeks after the intervention. The collected data were analyzed using statistical IMB SPSS software, version 21. Qualitative data were analyzed using Chi-Square test or Fisher's Exact test, and the Independent Sample t- test and Paired Sample t- test were used for analyzing quantitative data. RESULTS: Leventhal's self-regulatory intervention improved subscales of illness perception (p < 0.05) except for emotional representations and consequences. The global mean scores of the hypertensive patients ̓ lifestyle in the intervention group significantly increased from 102.8 ± 2.3 at the baseline to 112.1 ± 3 post-intervention. CONCLUSIONS: Interventions based on Leventhal's self-regulatory model could improve the illness perception and lifestyle of patients with hypertension. Trial registration The present randomized controlled trial study was registered on the Iranian Registry of Clinical Trials Website (IRCT); ID: IRCT20141222020401N6 on 8/5/2019.

Comparing the effects of self- care education by lecture and smartphone application on self-efficacy of patients with thalassemia.

BACKGROUND: Patients with the thalassemia have a basic requirement for self-efficacy regarding their treatment procedure. The present study aimed to compare the effect of self-care education via a smartphone application and lectures on the self-efficacy of patients with thalassemia. METHODS: In the present quasi-experimental study, 99 patients with thalassemia at Shahid Beheshti Hospital in Yasuj, Iran, in 2019 who were eligible to enter the study, were selected. The block randomization was done with the block sizes of 3, 6, and 9, and participants were randomly assigned to 3 groups: smartphone application (A), lecture intervention (B), and control (c). Smartphone application and lecture interventions were performed for intervention groups A and B, respectively, during 8 weeks. Scherer's self-efficacy measure was used to collect the data at baseline and eight weeks after the intervention. Data were analyzed by SPSS-version 25 software using Paired t-test, Wilcoxon and Kruskal-Wallis tests. RESULTS: Ninety-nine patients with thalassemia with a mean (SD) age of 25 (6) and 58 females (58.59%) participated in the present study. The results indicated a significant difference in self-efficacy among 3 groups after intervention (P = 0.001). However, self-care education with smartphone application revealed a significant increase in the mean (SD) of self-efficacy of the patients with thalassemia 68.36(8.45) compared to the lecture method 62.55 (7.3) (P = 0.003) and control 62.09 (6.7) (P = 0.001). There were no significant differences among the self-efficacy scores of the patients in lecture intervention and control groups. CONCLUSIONS: The results revealed that smartphone application was a suitable educational software to promote self-efficacy in patients with thalassemia. It is recommended to use smartphone application methods to improve the self-efficacy levels of patients with thalassemia.

Effect of Acupressure on Health-Related Quality of Life in Patients with Polycystic Ovarian Syndrome: A Randomized Clinical Trial.

The present study was conducted to determine the effect of acupressure on health-related quality of life in patients with polycystic ovary syndrome. This study was a double-blind, randomized clinical trial with a control group. Ninety-six patients with polycystic ovary syndrome from Mofateh gynecological clinic in Yasuj in Iran were enrolled according to the inclusion criteria. Patients were randomly assigned to intervention and control groups. In the intervention group, pressure on the points, Ren3, Ren4, Liv3, Sp6, and Sp10 and in the control group, pressure on sham points were performed for 6 weeks (2 sessions per week). The primary outcome was health-related quality of life, measured by the modified polycystic ovary syndrome health-related quality of life questionnaire (MPCOSQ). The secondary outcomes were total testosterone levels and clinical symptoms in patients with polycystic ovary syndrome. The outcome variables were measured before the intervention at week 0 (baseline) and after the intervention at week 18 (12 weeks after the end of intervention). The results indicated that at week 18, the score of clinical symptoms and the total testosterone level of the intervention group were lower than those of the control group. The health-related quality of life score in the intervention group was higher than that in the control group, which was statistically significant (P < 0/05). Therefore, acupressure in these points is recommended as a practical and effective method of treating polycystic ovarian syndrome.

Randomized Controlled Trial Study of the Impact of a Spiritual Intervention on Hope and Spiritual Well-Being of Persons with Cancer.

OBJECTIVES: To determine the impact of spiritual intervention on hope and spiritual well-being of persons with cancer. METHODS: Randomized controlled trial in which 74 patients with cancer referring to a chemotherapy ward of Shahid Rajaie Hospital in Yasuj city, Iran, were participated. The eligible patients were randomly assigned to either intervention or control group. Spiritual-based intervention was performed based on the protocol in four main fields namely; religious, existence, emotional and social over 5 sessions before chemotherapy. The participants in the control group had received usual cares. Data were collected using Snyder's Hope Scale and Ellison's Scale Spiritual Well-Being Scale on a week before and after intervention. RESULTS: The total mean scores of the scales of hope and spiritual well-being in both groups did not present statistical differences in the pre-intervention assessment. In contrast, at the post assessment, significant differences (p<0.001) were found in the mean scores between the intervention and control groups on the hope scale (60.9 versus 39.8) and on the spiritual well-being scale (94.3 versus 71.6). CONCLUSIONS: Spiritual intervention could promote hope and spiritual well-being of persons with cancer.

A Randomized Controlled Trial Study of the Impact of a Spiritual Intervention on Hope and Spiritual Well-Being of Persons with Cancer / Ensayo controlado aleatorio sobre el impacto de una intervención espiritual en la esperanza y el bienestar espiritual de los personas con cáncer / Ensaio controlado aleatório sobre o impacto de uma intervenção espiritual na esperança e no bem-estar espiritual de pessoas com câncer

Objective. To determine the impact of spiritual intervention on hope and spiritual well-being of persons with cancer. Methods. Randomized controlled trial in which 74 patients with cancer referring to a chemotherapy ward of Shahid Rajaie Hospital in Yasuj city, Iran, were participated. The eligible patients were randomly assigned to either intervention or control group. Spiritual-based intervention was performed based on the protocol in four main fields namely; religious, existence, emotional and social over 5 sessions before chemotherapy. The participants in the control group had received usual cares. Data were collected using Snyder's Hope Scale and Ellison's Scale Spiritual Well-Being Scale on a week before and after intervention. Results. The total mean scores of the scales of hope and spiritual well-being in both groups did not present statistical differences in the pre-intervention assessment. In contrast, at the post assessment, significant differences (p<0.001) were found in the mean scores between the intervention and control groups on the hope scale (60.9 versus 39.8) and on the spiritual well-being scale (94.3 versus 71.6). Conclusion. Spiritual intervention could promote hope and spiritual well-being of persons with cancer.

Objetivo. Determinar el impacto de una intervención espiritual en la esperanza y el bienestar espiritual de las personas con cáncer. Métodos. Ensayo controlado aleatorio en el que participaron 74 pacientes con cáncer que acudieron a una sala de quimioterapia del Hospital Shahid Rajaie de la ciudad de Yasuj (Irán). Los pacientes elegibles se asignaron aleatoriamente al grupo de intervención o al de control. Durante 5 sesiones, y antes de la quimioterapia, se llevó a cabo una intervención espiritual basada en un protocolo con cuatro campos principales: religioso, existencia, emocional y social. Los participantes en el grupo control recibieron el cuidado usual. Los datos se recogieron mediante la aplicación de la escala de esperanza de Snyder, una semana antes y una semana después de la intervención, y de la escala de bienestar espiritual de Ellison. Resultados. Las puntuaciones medias de las escalas de esperanza y bienestar espiritual en ambos grupos no presentaron diferencias estadísticas en la evaluación pre-intervención. En cambio, en la evaluación posterior, se encontraron diferencias significativas (p<0.001) en las puntaciones medias entre los grupos de intervención y de control en la escala de esperanza (60.9 frente a 39.8) y en la escala de bienestar espiritual (94.3 frente a 71.6). Conclusión. La intervención espiritual podría promover la esperanza y el bienestar espiritual de las personas con cáncer.

Objetivo. Determinar o impacto de uma intervenção espiritual na esperança e no bem-estar espiritual das pessoas com câncer. Métodos. Ensaio controlado aleatório envolvendo 74 pacientes com câncer que frequentaram uma sala de quimioterapia no Hospital Shahid Rajaie na cidade de Yasuj (Irã). Os pacientes elegíveis foram aleatoriamente designados para o grupo de intervenção ou controle. Durante 5 sessões, e antes da quimioterapia, foi realizada uma intervenção espiritual baseada em um protocolo com quatro campos principais: religioso, existencial, emocional e social. Os participantes do grupo controle receberam os cuidados habituais. Os dados foram coletados por meio da aplicação da Escala de Esperança de Snyder e da Escala de Bem-Estar Espiritual de Ellison uma semana antes e uma semana após a intervenção. Resultados. Os escores médios das escalas de esperança e bem-estar espiritual em ambos os grupos não apresentaram diferenças estatísticas na avaliação pré-intervenção. Por outro lado, na avaliação subsequente, foram encontradas diferenças significativas (p <0.001) nas pontuações médias entre os grupos intervenção e controle na escala de esperança (60,9 vs. 39.8) e na escala de bem-estar espiritual (94.3 vs. 71.6). Conclusão. A intervenção espiritual pode promover esperança e bem-estar espiritual para pessoas com câncer.

The effect of Fennel seed powder on estradiol levels, menopausal symptoms, and sexual desire in postmenopausal women.

OBJECTIVES: The present study was designed to determine the effect of Fennel seed powder on menopausal symptoms, sexual desire, and serum estradiol levels in postmenopausal women. METHODS: The present study was conducted on 80 eligible women (45-60 y) who were referred to the Mofatteh Gynecology Clinic in Yasuj, Iran. Participants were randomized into equal intervention and control (control) groups. The intervention and control groups received four capsules of Fennel seed powder (2 gr) and starch-containing capsules (2 gr) daily over 8 weeks, respectively. Menopausal symptoms and sexual desire of the participants were evaluated using both the menopausal Kupperman index and Hurlbert index of sexual desire. The questionnaires were completed at baseline, week 4 and week 8 of the study by the participants. The serum estradiol levels were measured at baseline and also at the end of the study. The Chi-square test, independent t test, and repeated-measures analysis of variance were used to analyze the data. RESULTS: Menopausal symptoms score significantly decreased from 30.8 ±â€Š6 to 19 ±â€Š5.5 in the intervention group and also from 31.2 ±â€Š6.5 to 26.4 ±â€Š6.2 in the control group (P < 0.05). Treatment with Fennel seed did not significantly enhance the participants sexual desire (P > 0.05). The estradiol levels declined in the intervention (from 60.4 ±â€Š43.4 to 52.6 ±â€Š25.7) and control groups (from 55.1 ±â€Š22.4 to 39.9 ±â€Š26.9). However, this decrease was lower in the intervention group than in the control group. The intergroup differences were not statistically significant (P > 0.05). CONCLUSIONS: The results of the present study indicated that daily use of Fennel seed significantly improved menopausal symptoms in postmenopausal women over 8 weeks, though its effect on estradiol levels and sexual desire was not significant. Further studies with a larger sample size and longer duration are needed to verify these findings.

Psychometrics properties of the Iranian version of fertility quality of life tool: A cross- sectional study.

BACKGROUND: Clinical measurement of quality of life (QoL) for assessing reproductive problems should be considered as a standard investigation at the initial and continuing medical consultations with infertile people. OBJECTIVE: The purpose of this study was comprehensive testing the psychometric properties of the Iranian version of fertility quality of life (FertiQoL). MATERIALS AND METHODS: This cross-sectional study was conducted on300 women referred to infertility clinic. After linguistic validation, a semi-structured interview was conducted to assess face validity. Consequently exploratory factor analysis was performed to indicate the scale constructs. Discriminate validity was assessed using the known groups comparison. Convergent validity was evaluated by assessing the correlation between similar content on the 12-Item Short Form Health Survey (SF12), Hospital Anxiety and Depression Scale and FertiQol. In addition, reliability analysis was carried out with internal consistency. RESULTS: The reliability of the Iranian version of the FertiQoL was satisfactory in all dimensions (0.77-0.83). Six factors (emotional, mind/body, relational, social, environmental, and tolerability) were extracted from the results of exploratory factor analysis. Discrimination validity showed that FertiQoL can differentiate between female patients with differing duration of infertility and number of children. Moreover, the results of convergent validity showed a favorable correlation between the related dimensions of SF12 (0.43-0.68), Hospital Anxiety and Depression Scale (0.47-0.52) and FertiQoL. CONCLUSION: The Iranian version of FertiQoL is valid and reliable for assessing infertility problems and the effects of treatment on QoL of infertile patients referred for diagnosis and treatment at infertility clinic.

A randomized controlled clinical trial evaluating quality of life when using a simple acupressure protocol in women with primary dysmenorrhea.

OBJECTIVE: To evaluate a simple acupressure protocol in LIV3 and LI4 acupoints in women with primary dysmenorrhea. METHODS: This paper reports a randomized, single blinded clinical trial. 90 young women with dysmenorrhea were recruited to three groups to receive 20min acupressure every day in either LIV3 or LI4, or placebo points. Acupressure was timed five days before menstruation for three successive menstrual cycles. On menstruation, each participant completed the Wong Baker faces pain scale, and the quality of life short form -12 (QOL SF-12). RESULTS: Intensity and duration of pain between the three groups in the second and third cycles during the intervention (p<0.05) differed significantly. Significant differences were seen in all domains of QOL except for mental health (p=0.4), general health (p=0.7) and mental subscale component (p=0.12) in the second cycle, and mental health (p=0.9), and mental subscale component (p=0.14) in the third cycle. CONCLUSION: Performing the simple acupressure protocol is an effective method to decrease the intensity and duration of dysmenorrhea, and improve the QOL. Registration ID in IRCT: IRCT2016052428038N1.

Facilitating and inhibiting factors related to treatment adherence in women with polycystic ovary syndrome: A qualitative study.

BACKGROUND: Adherence issues in polycystic ovary syndrome (PCOS) patients have not been examined thoroughly. Patients report prolonged periods of treatment and side effects of the drug as the most common reason for withdrawal from treatment. To improve the effective management of PCOS patients, it is fundamental to understand facilitating and inhibiting factors to treatment adherence. OBJECTIVE: To explore facilitating/inhibiting factors related to treatment adherence among PCOS patients. MATERIALS AND METHODS: This was a qualitative study with a purposive sample of women with confirmed diagnosis of PCOS. The data were collected via 20 in-depth semi-structured interviews with women aged between 21-34 yr. A qualitative content analysis was used to analyze the data. RESULTS: Five themes were identified which described different types of facilitating/ inhibiting factors to treatment adherence. Inhibiting factors included financial issues, patient-related, disease-related, and health care provider-related factors; while social factors were found to be both facilitating and inhibiting. CONCLUSION: The findings suggest that successful adherence to PCOS treatment is highly dependent on patients recognizing and adapting to financial, social, and health care related inhibiting factors. It is also crucial for clinicians and policy makers to recognize these key inhibiting factors in order to improve treatment outcomes.

Determining the disease management process for epileptic patients: A qualitative study.

BACKGROUND: Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease management process in patients with epilepsy in Iran. MATERIALS AND METHODS: This qualitative approach and grounded theory study was conducted from January 2009 to February 2012 in Isfahan city (Iran). Thirty-two participants were recruited by the goal-oriented, and snowball sample selection and theoretical sampling methods. After conducting a total of 43 in-depth interviews with the participants, the researchers reached data saturation. Data were analyzed using Strauss and Corbin method. RESULTS: With a focus on disease management process, researchers found three main themes and seven sub-themes as a psychosocial process (PSP). The main themes were: perception of threat to self-identity, effort to preserve self-identity, and burn out. The psychosocial aspect of the disease generated one main variable "the perception of identity loss" and one central variable "searching for self-identity." CONCLUSIONS: Participants attributed threat to self-identity and burn out to the way their disease was managed requiring efforts to preserve their identity. Recommendations consist of support programs and strategies to improve the public perception of epilepsy in Iran, help patients accept their condition and preserve self-identity, and most importantly, enhance medical management of epilepsy.

Effect of motivational interviewing on quality of life in patients with epilepsy.

OBJECTIVE: In this study, the effect of motivational interviewing on quality of life was evaluated in patients with epilepsy. METHODS: Fifty-six patients with epilepsy in a clinical trial were randomly assigned to intervention and control groups. Motivational interviewing during 5 sessions was applied for the intervention group, and the control group received health-care services. Quality-of-life questionnaire in epilepsy (QOLIE-89) was applied as pre- and posttest for both groups. Before and two months after intervention, both groups were assessed. Data were analyzed by independent t-test, Chi-square test, and paired t-test. RESULTS: The data analysis showed that mean score of the QOLIE-89 was 38.94±8.55 and 70.90±7.99 in the intervention group before and after the intervention, respectfully, and 44.59±12.27 and 36.52±7.16 in the control group sequentially. The intervention group showed a significant score increase in their quality of life (p<0.001), whereas the control group had a score decrease (p<0.001). CONCLUSION: Motivational interviewing approach could be used as an effective intervention method for improving patients' quality of life.

Application of the PRECEDE model to improve sexual function among women with hysterectomy.

OBJECTIVE: To determine the effect of an educational program based on the PRECEDE model to improve sexual function among women with hysterectomy. METHODS: The present randomized trial, conducted in Iran during 2014, included 48 women with hysterectomy who were selected through convenience sampling and randomly divided into two equal groups. Women in the experimental group received an educational program based on constructs of the PRECEDE model. The control group received only routine interventions. Before the interventions, the women completed two questionnaires: one that measured the PRECEDE model constructs and the Rosen Female Sexual Function Index. The questionnaires were repeated 4 weeks after the intervention and the results were compared within and between groups. RESULTS: In each group, a significant improvement in sexual function was demonstrated after the intervention (P<0.001). The mean sexual function score increased to a greater extent in the experimental group (difference 16.95±6.33) than in the control group (difference 4.35±1.94; P<0.001). CONCLUSION: The findings confirm the effectiveness of an educational program based on the PRECEDE model in terms of improving sexual function among women with hysterectomy. Iranian Registry of Clinical Trials: IRCT2014122220401N1.

Health-related quality of life in Iranian women with polycystic ovary syndrome: a qualitative study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with a range of challenging symptoms which impact patient's lives. Iranian women with PCOS are likely to face a number of unique difficulties given particular societal and cultural norms for women. Understanding health-related quality of life (HRQoL) from a patients'perspective is critical to developing the appropriate support interventions. The present study aimed to generate an in-depthunderstanding of HRQoL Iranian women with PCOS. METHODS: Twenty Iranian women were interviewed and data was subjected to thematic analysis. RESULTS: Women reported substantial effects of PCOS on their quality of life, Themes generated from the data related to sexual - physical problems (An unsexualised self: loss, change and pain; and Being pained and painful); exposure and nvasion: the rejecting and invading social world (Concealing and Avoiding and Public property: public scrutiny), diminished self and diminished life (Infertile as inferior and Exhausted mind andbody) respectively. CONCLUSION: PCOS is a physical - sexual, psychological and social syndrome; therefore, it is necessary to taking a more holistic approach to patient care beyond treating physical symptoms.

Patients' perception of epilepsy and threat to self-identity: a qualitative approach.

INTRODUCTION: A clinical diagnosis of epilepsy often carries a silent social stigma and is associated with metaphysical forces. This qualitative study aimed to explore the Iranian patients' perception of epilepsy where clinical aspects are more benign than the social implications with long-term psychological consequences. Historically, epilepsy has been known as a form of insanity, madness, sorcery, and possession by evil spirits. METHOD: Thirty participants consisting of 21 patients with epilepsy, 5 family members, and 4 medical staff were selected from urban and rural medical and health care centers, hospitals, physician offices, outpatient clinics, and the Iranian Epilepsy Association. Unstructured and semistructured interviews were applied to obtain data. Transcribed interviews and field notes were analyzed using qualitative content analysis method. FINDINGS: Categories and subcategories emerged from the participants' perceptions of epilepsy and its disruptive effects on their self-identity. The main categories derived from data were 1) a different perspective about epilepsy, 2) self-debasement, and 3) being a burden. The major theme found in this study was "identity loss". CONCLUSION: Our study results highlight the importance of public awareness among community members and healthcare professionals on how patients with epilepsy experience their disease with psychosocial implications. Understanding patients' perspectives can be essential to developing a comprehensive and holistic care plan for patients with epilepsy and addressing their multidimensional needs.

Evaluation of Female Youth Educational Needs about Reproductive Health in Non-Medical Students in the City of Qom.

OBJECTIVE: To evaluate reproductive health education which is essential to the prevention of sexual risk behavior and its associated adverse outcomes of unwanted pregnancy, AIDS and other sexually transmitted disease in adolescents. Little is known about youth educational needs about reproductive health in Iran. The aim of this study is evaluation of female youth educational needs about reproductive health in non-medical universities in the city of Qom, north central of Iran. MATERIALS AND METHODS: The study was descriptive-analytical type conducted in nine non-medical universities (400 students). A questionnaire was constructed to meet the purpose of the study based on similar studies of knowledge and attitude in different countries, yet it was modified according to Iranian culture and social norms. RESULTS: The findings showed that a majority of participants have moderate knowledge about all components of reproductive health. Approximately, one - third of the participants reported difficulties to discuss about sexual health with mothers. The most of the participants believed insufficient female youth reproductive health services and low knowledge about reproductive health were the main barriers for female youth reproductive health aims. CONCLUSION: The participants in this study are representatives of an important subgroup in Iran in order to evaluate female youth reproductive health educational needs. The study identified many misconception and negative attitude that need to be addressed. A health education program through parents, peers, mass media campaign and more comprehensive family planning curriculum in universities are recommended to overcome misconception and spread awareness.

Striving for balance: coping with epilepsy in Iranian patients.

Patients with epilepsy are subject to a wide range of distinctive psychosocial consequences, which can be more harmful than the seizures themselves and other medical difficulties accompanying them. This qualitative study was aimed at identifying coping strategies employed by 21 Iranian adults with epilepsy. The study participants were chosen by purposeful sampling from hospitals, neurologists' clinics, rural health care facilities, and epilepsy associations. Data were collected through semistructured interviews. A qualitative content analysis method was used to analyze the gathered data. The analysis resulted in the emergence of six themes and seven subthemes: confronting the disease using religious sentiment, seeking support, fighting the disease, defending oneself against the disease, concealing the disease, and expressing emotions. The findings showed that the participants used an emotion-focused approach more often than a problem-focused approach as a coping strategy. The results will improve health care professionals' knowledge of how Iranian patients cope with epilepsy and help them to design nursing care models to promote successful coping strategies for patients.