Family Caregivers' Experiences of Living with Hemodialysis Patients: A Descriptive Phenomenology.

Background: Several challenges are experienced by caregivers of patients with chronic kidney disease undergoing hemodialysis treatment. These difficulties pertain to the patients, their hemodialysis treatment, and other caregiving responsibilities and concerns. Given the adverse effects of caring for individuals with such conditions on the lives of caregivers, this study aims to investigate the experiences of hemodialysis patients' family caregivers. Materials and Methods: A qualitative study with a descriptive, phenomenological approach was conducted in the hemodialysis department of a teaching hospital in Birjand, Iran, in 2022. Fourteen participants were selected through purposive sampling. The data were collected through semistructured interviews and analyzed using Colaizzi's method. Results: The participants were caregivers of dialysis patients who had a 6-month history of caring for patients and were first-degree relatives of the patient. A total of 278 initial codes emerged, which were categorized into three overarching themes and eight subthemes based on the research purpose and question. The overarching themes comprised caregiver time and cost strain, social challenges faced by the caregiver, and life challenges faced by the caregiver. Conclusions: Caregivers of patients with chronic kidney disease face problems in multiple dimensions and are susceptible to developing new problems. The majority of caregivers in this study were extremely vulnerable women; if they experience difficulties, the family's foundation will be weakened. Therefore, caregivers should be included in patients' treatment plans. The expression of caregivers' experiences can help solve the problems they are facing and also helps hospital managers and health planners better plan to solve problems.

Comparison of the effect of Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BiPAP) on hemodynamic parameters in Covid-19 patients: A clinical trial.

BACKGROUND: The most prevalent clinical sign for COVID-19 patients are respiratory diseases such that the criteria for clinical screening and care of the patients in most countries, including Iran, are based on the three primary symptoms, i.e., fever, cough, shortness of breath, or difficulty breathing. The purpose of the current study was to compare the effect of continuous positive airway pressure and bi-level positive airway pressure on hemodynamic parameters in COVID-19 patients. MATERIALS AND METHODS: It was a clinical trial conducted on 46 COVID-19 patients admitted to Imam Hassan Hospital in Bojnourd in 2022. This study included patients selected through convenient sampling and then through Permuted block randomization, who were assigned to continuous positive airway pressure (CPAP), and Bi-Level Positive Airway Pressure (BiPAP) groups. Patients were compared in terms of the severity of their COVID-19 disease in both groups and were divided equally in each disease severity. After determining their type of respiratory aid use, the patient's hemodynamic status (systolic blood pressure, diastolic blood pressure, pulse, arterial oxygen saturation, and temperature) was examined beforehand, immediately after 1 hour, 6 hours, and then daily up to 3 days of CPAP/BiPAP at a specific time. Data collection tools were demographic data questionnaires and information on patients' diseases. A checklist was also used to record the main variables of the research. The collected data were put into SPSS software version 19. To analyze the data, the Kolmogorov-Smirnov normality test was used to evaluate the normality of quantitative variables. As a result, it was found that the data had a normal distribution. Repeated measures of ANOVA and independent t-tests were employed to compare quantitative variables in the two groups at different times. In this study, a significance level of 0.05 was considered. RESULTS: There was a significant difference in terms of systolic blood pressure, diastolic blood pressure, respiration rate, pulse rate, oxygen saturation, and temperature in the two groups of patients at 1 day, 2 days, and 3 days after use (P < 0.05). CONCLUSION: The results displayed better performance of CPAP than BiPAP in the parameters of systolic blood pressure, diastolic blood pressure, respiration rate, pulse rate, oxygen saturation, and temperature in COVID-19 patients. Therefore, in necessary cases, it is recommended to use a CPAP mask.

Effect of educational- counseling program based on precede-proceed model during Pregnancy on postpartum depression.

AIM: To explore the effects of an educational- counselling programme based on the precede-proceed model during pregnancy on preventing post-partum depression. DESIGN: A randomized clinical trial (RCT) study. METHOD: 130 pregnant women were selected and randomly assigned to intervention and control groups. Data collection was carried out using questionnaires of predisposing, reinforcing and enabling factors, GHQ and Edinburgh Postnatal Depression Scale (EPDS). The Education programme was designed and performed in each group in a given weekday through four 60-minute sessions. The whole intervention lasted for one month in all groups. The participants in the control group were given routine pregnancy care. Data were gathered before and after the intervention in both groups. RESULTS: Independent t test showed a significant difference between the two groups in terms of the mean score of predisposing, reinforcing, enabling factors and post-partum depression (p < .05). Regression tests indicated predisposing, reinforcing, enabling factors and general health as the most important factors associated with post-partum depression (p < .05). The results supported the effectiveness of the educational intervention on reducing post-partum depression and showed that implementing these training during pregnancy leads to a reduced level of post-partum depression.

The prediction of postpartum depression: The role of the PRECEDE model and health locus of control.

BACKGROUND: The main purpose of this study was to investigate the effect of the PRECEDE model and health locus of control (HLC) on postpartum depression. This study used the path analysis to test the pattern of causal relations through the correlation coefficients. MATERIALS AND METHOD: The participants included 230 pregnant women in the north-east of Iran who were selected by convenience sampling. To analyze data, Pearson correlation and path analysis were applied to examine the relationships between variables using SPSS 20 and LISREL 8.50software. RESULTS: The result of path analysis showed that a positive correlation exists between predisposing (knowledge, internal HLC, powerful others HLC, chance HLC) enabling and reinforcing factors with postpartum depression by GHQ score (GFI = 1, RSMEA = 000). CONCLUSION: The current study supported the application of the PRECEDE model and HLC in understanding the promoting behaviors in mental health and demonstrated their relationships with postpartum depression.