The effect of an educational app on hemodialysis patients' self-efficacy and self-care: A quasi-experimental longitudinal study.

OBJECTIVE: Adequate self-care and exploring ways to improve it is imperative for patients with hemodialysis in order to meet the challenges arising from hemodialysis. This study aimed to determine the effect of an educational app on patients with hemodialysis' self-efficacy and self-care. METHODS: The present study is a quasi-experimental longitudinal single-group study, carried out from October 2020 to March 2021 with the participation of 60 Patients with hemodialysis. Simple random sampling was used to sample patients. The intervention included an educational application, and participants completed questionnaires on self-efficacy and self-care performance at four points including baseline and at one, three, and six-month intervals post- intervention. Two-way ANOVA with repeated measures was used to examine the impact of the intervention. Bonferroni's posthoc test was also used for in-class calculation and comparison of changes over various periods. RESULTS: The results of this study showed that the self-care performance of patients at different times was statistically significant (P <0.001). Also, the results showed that the mean total score of self-efficacy in the second period compared to the first was significantly improved (P <0.001). But the trend of changes in the third period compared to the second and the fourth to the third was not significant (p = 0.1 and p = .82). Also, a significant change was observed in the fourth period compared to the first (p = .029). CONCLUSIONS: The study showed that education through a mobile app can result in significant improvements in these patients' self-care behaviors and self-efficacy over time. The educational intervention should be provided to patients with hemodialysis over a several-month period to allow for proper integration of the learning.

Evaluating the Effect of Preoperative Provision of Information on Salivary Cortisol in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Study.

PURPOSE: Surgery is considered to be an anxious experience and most patients experience preoperative anxiety. Preoperative awareness has long been one of the most effective ways to reduce fear and anxiety caused by surgery. The aim of this study was to determine the effect of preoperative provision of information on salivary cortisol in candidates for breast cancer surgery. DESIGN: This randomized clinical trial was conducted on 80 patients (divided into control group and intervention group; 40 patients in each group) admitted to the surgery department of the Cancer Institute of Imam Khomeini hospital in Iran. Samples were selected using random allocation method with a block size of four. Data were collected on participants' demographic characteristics and salivary cortisol. METHODS: The educational intervention for patients in the control group was routine training and for patients in the intervention group was based on the training booklet approved by cancer specialists. Findings were analyzed using SPSS software version 21. FINDINGS: The mean age of participants in the intervention and control groups was 44.00 ± 11.45 and 42.62 ± 12.83 years, respectively . The mean score of anxiety in the intervention group was 18.85± 6.19 before intervention, and decreased to 7.40± 3.68 after intervention . The mean score of anxiety in the control group was 19.75 ± 7.26 and significantly decreased to 14.25 ± 5.73 at the end of the study. CONCLUSIONS: The results showed that preoperative anxiety significantly decreased in both groups, but was lower overall in the intervention group. In fact, using an educational booklet to raise awareness about patients' health, surgery knowledge and postoperative care as well as how to adapt to postsurgery physical changes and to promote psychological support can reduce patients' anxiety. Hence, providing education to patients may be integrated as a complementary method in patients' routine education.