Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home.

BACKGROUND: Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients. METHODS: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020-2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4-0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. RESULTS: Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. CONCLUSIONS: The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.

Validation of the Persian version of the Compassionate Care Assessment Tool.

OBJECTIVES: The present study aimed to translate and determine the psychometric properties of the Persian version of the Compassionate Care Assessment Tool (CCAT) ©. METHODS: The study was carried out to translate and validate of the CCAT©. After securing permission from the designer of the tool and translating it, the psychometric properties were determined through examining face validity, construct validity, internal consistency, and test/retest reliability. With regard to construct validity, confirmatory factor analysis was used so that 300 patients in internal and surgery wards were selected by a simple random sampling method from three hospitals. Data were analyzed using SPSS (v.24.0) and LISREL statistical software version 8.8. RESULTS: The results of the confirmatory factor analysis supported the validity and reliability of the Persian version of the CCAT© and its four factors. The reliability of the tool and internal consistency were confirmed through test/retest method with two weeks' interval. At the two areas of importance and provision of compassionate care, Cronbach's α coefficient equaled to 0.918 and 0.933 and intraclass consistency equaled to 0.848 and 0.907 respectively. CONCLUSION: The results showed that the Persian version of the CCAT© was adequately valid and reliable for Iranian patients. Given the acceptable psychometric parameters of the tool, using it in future studies to measure importance and provision of compassionate nursing care to Iranian patients at internal and surgery wards is recommended.

The Importance and Extent of Providing Compassionate Nursing Care from The Viewpoint of Patients Hospitalized in Educational Hospitals in Kermanshah - Iran 2017.

AIM: This study is an attempt to determine the importance and extent of providing compassionate nursing care from the hospitalised patients' viewpoint in educational hospitals in Kermanshah-Iran 2017. METHODS: The study was carried out as a descriptive, analytical work in the hospitals affiliated to Kermanshah University of Medical Sciences on 300 patients in 2017. The patients were selected through convenient sampling, and Burnell Compassionate Care Scale was filled by the participants. The collected data was analysed in SPSS (v.20) using descriptive and inferential statistics. RESULTS: The results showed that the mean and standard deviation score of importance and extent of compassionate care were 3.27 ± 0.526 and 2.80 ± 0.647 respectively. There was a significant difference between these two scores (p < 0.001). About all the factors in compassionate nursing care, there was a significant difference between the importance and extent of compassionate nursing care. The mean score of the importance of compassionate nursing care from female patients' viewpoint was higher than that of men (p = 0.032). The observers with college educations perceived the extent of compassionate nursing care less than the other groups of participants (p = 0.008). CONCLUSIONS: There was a significant difference between the importance and extent of compassionate nursing care from the patients' point of view. This highlights negligence by the nurses of this critical aspect of care. It is recommended, therefore, to add compassionate nursing care to nursing programs and commission more research works on other groups of health care personnel.

The Effect of 2 Different Exercise Programs on Pain Intensity and Muscle Dimensions in Patients With Chronic Low Back Pain: A Randomized Controlled Trial.

OBJECTIVES: The purpose of this study was to compare the effect of 2 exercise programs combined with electrotherapy on pain intensity and lumbar stabilizer muscles dimensions in patients with nonspecific chronic low back pain. METHODS: A randomized controlled clinical trial was performed with 41 patients with chronic LBP. Participants were randomly allocated into 2 groups: an experimental group (n = 20) received stabilization exercises plus electrotherapy, and a control group (n = 21) received routine exercises plus electrotherapy. Pain intensity, using a visual analog scale, and muscle dimensions of both right and left transverse abdominis and lumbar multifidus muscles, using rehabilitative ultrasonography, were assessed before and immediately after 4 weeks of intervention. RESULTS: Significant improvement was identified after interventions on pain intensity and muscle size measurements in both groups (P < .01 in all instances). The only exception was the right-side lumbar multifidus cross-sectional area of the control group, which was not statistically significant (P = .081). No significant differences were found between the 2 exercise groups on pain intensity and muscle dimensions (P > .05 in all instances). CONCLUSIONS: The results of this study suggest that a combination of electrotherapy with either routine or stabilization exercise programs may improve pain intensity and muscle dimensions in patients with nonspecific chronic low back pain.

Effects of adult day care services on disability in older persons: Evaluation of a designed service package in Iran.

OBJECTIVE: To assess the effects of a rehabilitation service package designed by the State Welfare Organization of Iran for adult day care centres on the disability of older clients. METHODS: A case-control study, with 46 older participants in the case group and 46 participants, matched for level of disability, in a control group. The World Health Organization Disability Assessment Schedule 2 was used to collect data at 4 time-points: baseline and 2, 4, and 6 months later. Data were analysed using repeated-measures analysis of variation. RESULTS: The rehabilitation service package had significant effects on the disability scores of older users of day care services. The disability scores significantly changed within the subjects (p = 0.010) and between the 2 groups (p < 0.001). Within-subjects effects in all 6 domains ("understanding and communication" (p = 0.002), "getting around" (p = 0.046), "self-care" (p < 0.001), "getting along with people" (p < 0.001), "life activity" (p < 0.001) and "participation" (p < 0.001)) and between-subjects effects, in all except the "self-care" domain, showed significant differences during the 6-month study period (p = 0.003, p < 0.001, p <0.001, p < 0.001, and p < 0.001, respectively). CONCLUSION: The adult day care service package may have a positive role in decreasing measures of disability among older persons over a 6-month period.

Community-based relapse prevention for opiate dependents: a randomized community controlled trial.

Relapse prevention (RP) programs mainly focus on patients and their families; however a patient's community can also play a significant role in RP. A randomized-controlled-trial was conducted among opiate-dependents discharging from residential abstinence-based treatment programs to assess the effect of a community-based relapse prevention program (CBRP) on the RP. Seventy-one participants were consented and randomized into CBPR (n = 35) or treatment-as-usual arms. Developing and implementing CBRP, social-workers and peer-group counselors facilitated and advocated thirty-six RP projects across 7 communities during a three-month follow-up period. Negative-drug-tests, 45 and 90 days after discharge from residential programs were considered as the main outcome. Abstinence rates were significantly greater for patients who received CBRP in comparison to the subjects in the treatment-as-usual arm at 45 days (27 and 20, P < 0.004) and 90 days (27 and 21, P < 0.007) after discharge. CBRP was an effective method for RP among opiate-dependents after being discharged from the residential programs.

Brain areas impaired in oral and verbal apraxic patients.

BACKGROUND: As both oral and verbal apraxia are related to vocal orofacial musculature, this study aimed at identifying brain regions impaired in cases with oral and verbal apraxia. METHODS: In this non-experimental study, 46 left brain damaged subjects (17 females) aged 23-84 years, were examined by oral and verbal apraxia tasks. Impaired and spared Broca's area, insula, and middle frontal gyrus in the left hemisphere were checked from magnetic resonance imaging and computed tomography scans utilizing Talairach Atlas. Data were analyzed using chi-square test. RESULTS: Insula was significantly impaired in both forms of oral and verbal apraxia and different severities and prominent forms of both apraxias (P < 0.05). Broca's area was slightly less involved than insula in two forms of apraxia. CONCLUSION: As the damage of insula was more prominent in both forms of apraxias, it seems that oral and verbal apraxia may have commonalities regarding their underlying brain lesions.

Fatigue, depression, and physical impairment in multiple sclerosis.

BACKGROUND: Fatigue, depression, and physical impairment are common among multiple sclerosis (MS) patients. The aim of this study was to determine the relationship between depression, physical impairment, and fatigue in an Iranian MS cohort. METHODS: Fifty consecutive relapsing-remitting MS patients and 50 age- and sex-matched healthy controls (HCs) were recruited from Sina Rehabilitation Clinic, Tehran, Iran. The depression substance of Hospital Anxiety and Depression Scale (HADS), Expended Disability Status Scale, and Fatigue Severity Scale questionnaires were used to assess depression, physical impairment, and fatigue, respectively. RESULTS: This study included 38 (76%) females and 12 (24%) males in both patients and HC groups. The depression substance of the HADS in MS and HCs showed a mean value of 1.92 ± 0.80 and 1.17 ± 0.38, respectively (P < 0.001). Pearson's correlation analyses showed that in the MS group depression was associated with fatigue (r = 0.54, P = 0.01), but not with physical impairment (r = 0.16, p = 0.01), while fatigue was associated with both depression (r = 0.54, P = 0.01) and physical impairment (r = 0.36, P = 0.01). Depression in HCs group was also associated with fatigue (r -0.64, P = 0.01). CONCLUSION: Fatigue is associated with both depression and physical impairment, and an intervention in one of these conditions might improve others.

Triage effect on wait time of receiving treatment services and patients satisfaction in the emergency department: Example from Iran.

BACKGROUND: Long wait time interval in emergency department (ED) of hospitals, from the patients' point of view in ED is a major problem causing patients' dissatisfaction and may result increasing in patient morbidity and indirectly nurses dissatisfaction. Evaluation of wait time intervals in ED and giving nursing feedback may improve the quality of services, as well as patient satisfaction. The present study was designed to investigate the effect of nursing triage on receiving treatment of wait time interval and satisfaction of the patients referring to ED in Shahid Rajaee hospital. MATERIALS AND METHODS: This study was conducted on patients those referring to Shahid Rajaee hospital in Karaj, Iran employing quasi experimental design d ividing in two experiment and control groups during 2009. This is a quasi-experimental study of which the data were collected by standard questionnaire covering patient satisfaction and measuring wait time. T-test, Mann-Whitney and frequency analysis were used to evaluate the effect of triage on wait time from receiving treatment services and patients' satisfaction. RESULTS: The findings showed that there was a significant difference between experiment and control groups regarding wait time from receiving treatment services and patients' satisfaction. CONCLUSIONS: Triage could significantly reduce the wait time interval between patients' entrance to ED to receive treatment services and enhance patients' satisfaction. It may help nursing in emergency ward to have better performance and indirectly their satisfaction.