Effective Strategies for Physical Activity Adherence in Heart Failure Patients: An Umbrella Review.

Background: Despite the importance of physical activity in heart failure treatment, physical activity adherence in heart failure patients is low. The purpose of this umbrella review was to obtain the best strategies for enhancing physical activity adherence among HF patients. Methods: Databases were investigated from 2010 to Jan 2022. The full text of the papers was investigated in terms of inclusion and exclusion criteria. Eventually, out of 74 relevant papers, 7-review study with 20977 patients were eligible and included in the study. Results: Five key effective approaches were identified in two subsets for enhancing physical activity adherence as follows: 1) exercise-based approaches including 1.1) Exergames, whereby the extent of adherence to exergames was between 84 and 98%. 1.2) Tele-rehabilitation with 70%-100% adherence the intervention groups 1.3) Tai chi and Qigong practices (TQPs), whereby the exercise adherence in TQP groups was 67-100%, 2. Theoretical-behavioral approaches 2.1) approaches based on behavioral and psychological theories, which were a combination of an exercise program alongside a behavior modification intervention, 2.2) Self-efficacy. Conclusion: Approaches that are based on exercise alongside behavioral and theoretical interventions could enhance physical activity adherence among HF patients. It is suggested to evaluate mix methods of exercise-based approaches and theoretical-behavioral approaches mentioned in this study in future clinical trial studies. Use of capacity of TR programs improve to physical activity adherence should receive more attention.

Experiences of what influences physical activity adherence in Iranian patients with heart failure: A qualitative study.

BACKGROUND: Heart failure (HF) is becoming one of the important health care problems around the world. Physical activity as the foundation of the cardiac rehabilitation program is poorly adhered by patients with HF. This study aimed to understand the experiences of patients with HF in terms of adherence to physical activity. MATERIALS AND METHODS: This study was conducted using conventional qualitative content analysis. Data were collected by semistructured telephone interviews with 25 patients with HF through open-ended questions. Data were collected from patients with HF in Birjand and Mashhad hospitals and heart departments from December 2021 to March 2022. Data were analyzed using Max-QDA10 and data analysis was continuous, comparative, and simultaneous with data collection. RESULTS: After data analysis, three main categories were identified: (1) patient-related barriers and facilitators, (2) support system-related barriers and facilitators, and (3) environmental barriers and facilitators. These categories were subdivided into two main themes: (1) threatening disease and (2) challenging disease. CONCLUSION: The results showed that beyond patient-related, support system-related, and environmental categories, perceiving the disease as a challenge or a threat is crucial in the activity of patients with HF. Nurses and other health care providers can train problem-solving behaviors to patients with HF to improve their physical and mental well-being. It is suggested that theoretical-behavioral approaches can be used in future clinical trials to improve adherence to physical activity.

Predictors of preventive behavior of nosocomial infections in nursing staff: a structural equation model based on the social cognitive theory.

BACKGROUND: The occurrence of nosocomial infections remains a health threat to patients and hospital staff. This study applied social-cognitive theory for predicting determinants of nosocomial infections control behaviors in hospital nursing Staff. METHODS: In this cross-sectional study, 280 nurses and assistant nurses were selected by random sampling from intensive care wards including CCU, ICU, NICU, dialysis of educational hospitals in Mashhad, Iran in 2020. Data were collected using a 5-point Likert scale structural questionnaire based on social cognitive theory constructs. Using the structural equation modeling method, direct and indirect relationships of social cognitive factors on preventive behaviors of nosocomial infections were analyzed via AMOS 23.0. RESULTS: Our results showed that self-regulation, outcome expectations, and barrier constructs had a direct effect on behavior and the highest effect was related to self-regulation structure (p < 0.001). The constructs of social support, modeling, perceived environment and Task self-efficacy had an indirect effect on behavior and the most impact was related to the constructs of perceived environment (p < 0.05). CONCLUSION: Considering that self-regulation, outcome expectation and barriers have a significant effect on following the preventive behaviors of nosocomial infections in nursing staff. It is suggested that policymakers and planners try to reduce barriers, strengthen behavioral motivation, and empower nursing staff by teaching self-regulatory strategies.

The Effect of Peer Support with Telecommunication on Subjective Well-being in Colorectal Patients: A Randomized Controlled Clinical Trial.

BACKGROUND: Colorectal cancer has a widespread impact on the psychological and physical dimensions of patients and threatens their subjective well-being. Peer support is an effective strategy to increase subjective well-being in cancer patients. This study aims to evaluate the impact of peer support through telecommunications on the subjective well-being of colorectal cancer patients. MATERIALS: This randomized clinical trial was conducted on 60 patients with colorectal cancer in Mashhad, Iran from November 2018 to April 2019. Two educational hospitals were selected through random sampling from four educational hospitals. Then, participants were randomly selected from the list of patients in each group using a block randomization method. The intervention group received the peer support program by using telephone and virtual social networks for a month. The data were collected by the Warwick-Edinburgh Subjective Well-being Scale before and after the intervention and were then analyzed through independent t-test, paired t-test, and chi-squared test using SPSS version 16. The level of significant was set at P<0.05. RESULTS: Before the intervention, the mean subjective well-being score of the patients did not show significant difference in the intervention and control groups, respectively (27.8±5.4 vs. 27.6±6.3, P=0.619). However, after the intervention, the mean subjective well-being score of the intervention group showed a significant increase compared to the control group (49.16±3.3 vs. 26.6±6.1, P<0.001). CONCLUSION: This randomized controlled trial shows that peer support interventions through telecommunication can improve the subjective well-being of patients with colorectal cancer. Therefore, this method can be used as an effective palliative approach to promote patients' subjective well-being. Trail Registration Number IRCT20190123042480N1.

The Effect of Simultaneous Sand-Ice Bag Application on Hemorrhage and Hematoma after Percutaneous Coronary Intervention: A Randomized Clinical Trial.

Introduction: Angioplasty is widely used as a selective treatment for acute coronary syndromes. The complications of this procedure often lead to an increase in the length of the patients' stay and hospital costs. Therefore, this study aimed to determine the effect of using sand and ice bags on hematoma and hemorrhage after percutaneous coronary intervention (PCI). Methods: In this randomized clinical trial, study was completed with participation of 60 patients with femoral angioplasty candidate, referring to Imam Reza hospital in Mashhad, were randomly divided into control and intervention groups. In the control group, a sand bag was placed on the location for up to 4 hours. In the intervention group, the ice bag and the sand bag were used simultaneously for 15 minutes, and then for 45 minutes, with the pressure of the sand bag only. This cycle was repeated four times. Hemorrhage (volume and weight) and hematoma (area and lump) were checked four times. The data were analyzed using SPSS software version 22. Results: The rate of hemorrhage after intervention was significantly reduced in the intervention group compared to the control group. Although the incidence of hematoma in the intervention group decreased from control to 20% to 6.7%, but the statistical test was not significant. Conclusion: According to the results of the present study, the simultaneous sand-ice bag application can reduce post-PCI' hemorrhage (and hematoma rate, though insignificantly) through compression and vasoconstriction.

Effect of health education program on promoting physical activity among diabetic women in Mashhad, Iran: applying social cognitive theory.

BACKGROUND: Physical activity regularly is one of the important aspects of healthy lifestyle, which has an essential role in reducing the burden of disease and death. Diabetes is a typical general health problem. The aim of this study to determine the effect of education based on social cognitive theory on promoting physical activity among women with diabetes II in Iran. METHODS: In this randomized control study, 82 diabetic females were randomly selected then were assigned into two groups: intervention (n=41) and control (n=41). Educational intervention was planned then performed during 7 sessions of 60-min in accordance with social-cognitive theory (SCT). The participants were asked to fill in the questionnaires in educational evaluation before and immediately after intervention and the follow up (10 weeks later). The data were analyzed through Repeated Measures ANOVA, Friedman, independence t and Mann-Whitney tests. RESULTS: The mean age among the participants was 48.37±5.67 yr also the body mass index was 28.69±3.95. In the intervention group, light physical activity and sedentary behavior reduced from 56.1% (23 individuals) to 14.6% (6 individuals) in the following up stage. There was significant improvement across time in the mean of minute's physical activity (P=0.042). There were significant differences in the mean's constructs of the Social-cognitive theory (SCT) (P<0.05). DISCUSSION: Design and execution of training program based on social cognitive theory can lead to promote physical activity among women with diabetes II through changes in the theoretical constructs.