Investigating the effectiveness of self-management program based on 5A model on fatigue and dyspnea in patients with heart failure.

BACKGROUND: Some symptoms such as fatigue and dyspnea decrease the quality of life in patients with heart failure. The effectiveness of self-management programs on management of chronic conditions was discussed. So, this study aimed to investigate the effectiveness of self-management program based on 5A model on fatigue and dyspnea in patients with heart failure. METHODS: In this clinical trial study, 60 patients with heart failure were included. The intervention group underwent self-management program based on 5A model and the control group received routine care. All the enrolled patients were evaluated once at baseline and once after 3 months using fatigue severity and Borg dyspnea scales. The obtained data were analyzed using SPSS software version 16 by descriptive statistics and independent t-test, covariance test, and paired sample t- test. The significance level was set at 0.05. RESULTS: There was no significant difference in the mean scores of fatigue and dyspnea at the beginning of the study between control and intervention groups (p > 0.05), but 3 months after intervention a significant difference was found in mean scores of fatigue and dyspnea between two groups, (p < 0.05). The difference between pre- and post-intervention scores in terms of the dyspnea and fatigue variables was significant based on the result of paired sample t-test (p < 0.05). CONCLUSION: According to the results of this study, self-management program based on 5A Model can be used to reduce the severity of fatigue and dyspnea as well as improve the quality of life in patients with heart failure (Tab. 4, Fig. 1, Ref. 33).

Trends and projection of incidence, mortality, and disability-adjusted life years of HIV in the Middle East and North Africa (1990-2030).

Evidence shows a growing trend of the HIV epidemic in the Middle East and North Africa (MENA). We aimed to project the incidence, mortality, and disability-adjusted life years (DALY) in the region from 1990 to 2019 and assess its trend by 2025, and 2030. We extracted the HIV incidence, mortality, and DALY data from the Global Burden of Disease (GBD) and UNAIDS databases. The joinpoint regression model was used to examine changes in HIV trends. The trend changes were estimated by average annual percent change (AAPC). In most countries, an increasing trend was observed in HIV incidence, mortality, and DALY. Specifically, the highest growth in the annual incidence rate was related to Egypt (AAPC = 14.4, GBD) and Iran (AAPC = 9.6, UNAIDS). Notably, Qatar (AAPC = - 5.6, GBD), Bahrain (AAPC = - 3.3, GBD), and Somalia (AAPC = - 4.2, UNAIDS) demonstrated a significant reduction in incidence. Regarding mortality rates, Djibouti (AAPC = 24.2, GBD) and Iran (AAPC = 16.2, UNAIDS) exhibited a significant increasing pattern. Furthermore, the estimated increase in incidence by 2030 was most marked in Djibouti (985%) and Iran (174%). Iran (422%) and Egypt (339%) showed a prominent rise in mortality rates. GBD data showed 16 countries had an increasing pattern in DALY in both genders. According to age and period effects, there was a significant upward trend in incidence, mortality rates, and DALY. Findings highlighted the urgent need for improved prevention and treatment services, including expanding access to HIV testing, promoting safe practices, increasing antiretroviral therapy coverage, and supporting targeted interventions for high-risk populations.

The effect of family-centered empowerment model on burden of care in parents and blood glucose level of children with type I diabetes family empowerment on burden of care and HbA1C.

BACKGROUND: Parents play a critical role in caring for their children with diabetes and bear a significant burden of care. Health education has increasingly focused on empowering parents through new strategic methods. The present study aims to investigate the impact of a family-centered empowerment model on the burden of care in parents and blood glucose levels of children with type I diabetes. METHODS: An interventional study was conducted in Kerman, Iran, where 100 children with type I diabetes and their parents were randomly selected as participants. The study aimed to implement a family-centered empowerment model in the intervention group, which consisted of four stages (educational phase, increasing self-efficacy, improving self-confidence, and evaluation) over a period of one month. The control group received routine training. The Zarit Caregiver Burden questionnaire and HbA1c log sheet were utilized to evaluate the effectiveness of the intervention. Questionnaires were administered before, after, and two months post-intervention, and data were analyzed using SPSS 15. Non-parametric tests were employed, and statistical significance was set at p < 0.05. RESULTS: Before the study, no significant differences in demographic variables, level of burden of care, or HbA1C levels were observed between the two groups (p < 0.05). After the intervention, the burden of care score in the intervention group was significantly lower than that in the control group, both immediately post-intervention and two months later (P < 0.0001). Additionally, the median HbA1C levels in the intervention group were significantly lower than those in the control group after two months (6.5 in the intervention group and 9 in the control group) (P < 0.0001). CONCLUSION: The findings of this study suggest that the implementation of a family-centered empowerment model is an effective strategy for reducing the burden of care on parents of children with type 1 diabetes and for controlling the HbA1C levels of these children. Based on these results, it is recommended that healthcare professionals consider incorporating this approach into their educational interventions.

Investigating the access barriers to oral and dental health services for children from the perspective of parents attending the health centers of Kerman.

Background: Oral health plays a key role in people's overall health. Dental caries is the most important problem in children's oral health. Despite significant advances made in the area of oral health around the world, there is inequality in access to oral health within Iran and abroad, and this is considered a public health challenge. This study was conducted to investigate the access barriers to children's oral health services from the perspective of parents attending the health centers of Kerman, Iran. Materials and Methods: The present descriptive-analytical study was carried out, as a cross-sectional survey, on 410 parents of children living in Kerman, Iran. The data were collected by access barriers questionnaire, and then were analyzed by SPSS software using descriptive statistical methods and the multiple linear regression test. Confidence interval (CI) in this study was 95% (95% CI). Results: The most common access barrier to children's oral health was the high treatment cost. The access barriers to children's oral health services were significantly associated with parental education (P = 0.00), maternal employment (P = 0.04), supplementary insurance (P = 0.00), and family income (P = 0.01). Parental satisfaction was also significantly correlated to the child's sex (P = 0.04), supplementary insurance (P = 0.04), and number of filled teeth (P = 0.04). The mean score of parental satisfaction was 1.83 ± 0.34; within the range of 1-3 from satisfied to dissatisfied. Conclusion: The cost of dental treatment services high and there are many barriers to accessing children's oral health.

The role of e-health on the public knowledge and behavior in preventing COVID-19.

Background: Electronic health (e-health) technologies play an important role in improving public knowledge and behavior to control the COVID-19 pandemic. The present study aimed to investigate the role of e-health on the public knowledge and behavior in preventing COVID-19 in Kerman, a city in Iran. Methods: The present descriptive cross-sectional study used an online survey in Kerman in November 2021. The research instrument was a tripartite questionnaire that included demographic information, the level of respondents' knowledge about COVID-19, the extent of change in respondents' behavior influenced by e-health. Negative binomial regression analysis was run to test the relationship between individual characteristics and the research variables with knowledge and behavior. Spearman correlation test was used to measure the correlation between the two main parts of the survey. Results: As the negative binomial regression analysis results showed, the relationship between no demographic variable and the public knowledge and behavior was statistically significant (p < 0.001). The mean knowledge and behavior scores were 5.84 ± 2.55 and 11.95 ± 5.09, respectively, showing that people who used e-health had a high level of knowledge, and taking preventive measures was at a high level. The Spearman correlation coefficient test results showed a positive association between knowledge and behavior (r = 0.71). Conclusion: E-health played a decisive role in increasing knowledge and improving behavior in preventing COVID-19. The results of our research can encourage the use of e-health to improve the public knowledge and behavior in pandemics such as COVID-19.

Assessing parents' awareness about children's "first thousand days of life": a descriptive and analytical study.

BACKGROUND: Many adulthood illnesses are rooted in childhood, especially in the "first thousand days of life". Despite parents' role in children's development, no study has examined parental awareness concerning this period. This study aimed to examine the awareness of parents concerning the "first thousand days of life" and the relationship between parents' demographics and their awareness. METHODS: This study was conducted on 135 parents in Kerman, Iran, using a valid and reliable questionnaire developed by researchers based on the opinion of experts and relevant references. The relationship between participants' demographics and their awareness was examined by multiple regression. The relationship between homogeneity of couples' education degree and awareness was analyzed using ANOVA. Chi-square was used to examine the relationship between information sources and parents' familiarity and to compare parents' preferred sources. RESULTS: The average parental awareness was 41.96 ± 11.90. Eighty-three percent of the parents have not heard about the "first thousand days of life". The source of information for 57% of the parents was friends and relatives (p < 0.0001). Overall, 87% of the parents desired to know about this period, and 47% liked using mobile applications for information (p < 0.0001). CONCLUSIONS: Parents' awareness about the "first thousand days of life" is lower than the average. Since the source of information concerning this period for most parents is friends and relatives and most parents are very interested in obtaining information, it is recommended that policy-makers use the capacity of other sources to increase parents' awareness. Given the greater tendency of parents to obtain information through mobile applications, we suggest investing more in this source.

The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial.

BACKGROUND: Individuals with unwanted pregnancies often experience high levels of anxiety, stress and depression that associated with maternal-neonatal outcomes. Mindfulness training is a safe and acceptable strategy to support mental health before parturition. PURPOSE: The main objective of present study was to evaluate the influence of eight-week application of mindfulness-based stress reduction on stress, anxiety and depression caused by unplanned pregnancy. METHOD: In this study, 60 women with unwanted pregnancy before 32 weeks of gestational age were selected and randomly divided into two groups. Intervention group received MBSR sessions, practice at home and the recorded sound. Mental health was evaluated before intervention and at the end of the eight sessions by standard stress, anxiety and depression DASS-21 questionnaire. Data were analyzed using Chi-square, Mann-Whitney U and Wilcoxon tests. FINDINGS: In order to compare pre-test and post-test scores in each group, the Wilcoxon Test was used. The results revealed that the participants in the intervention group reported a significant decrease in mean scores of stress, anxiety and depression compared to baseline (P = 0.0). Whereas no significant decrease in mean stress, anxiety and depression score were found in control group. P-value was estimated to be 0.346, 0.212 and 0.343 respectively. CONCLUSIONS: The mindfulness program has effectively reduced stress, anxiety and depression. Further research is needed to investigate the mechanisms and effects of mindfulness on maternal-neonatal outcomes.

Comparison of Effects of Local Anesthesia and Two-Point Acupressure on the Severity of Venipuncture Pain Among Hospitalized 6-12-Year-Old Children.

The aim of the present study was to compare the effects of topical anesthesia and acupressure at the Yintang (Extra 1) and the Laogong (P-8) points on the severity of venipuncture pain among hospitalized 6-12-year-old children. A sample (n = 120) of 6-12-year-old hospitalized children was recruited from two teaching hospitals located in Rafsanjan, Iran. The children were allocated to the topical anesthesia, acupressure, and control groups. For children in the topical anesthesia and the acupressure groups, eutectic mixture of local anesthetic (EMLA) cream and two-point acupressure were used, respectively, prior to performing venipuncture, whereas children in the control group only received routine prevenipuncture care. The severity of venipuncture pain was evaluated 5 minutes after performing venipuncture by using the Face, Leg, Activity, Cry, and Consolability behavioral pain assessment scale. The findings revealed that pain severity in both experimental groups was significantly lower than that in the control group, whereas there was no significant difference between the experimental groups regarding pain severity. Although acupressure was as effective as topical anesthesia cream in alleviating children's venipuncture pain, nurses are recommending to use acupressure instead of pharmacological pain management agents because of its greater safety, cost-effectiveness, and applicability.