Design, development and evaluation of a mobile-based self-care application for patients with COVID-19 not requiring hospitalization; a study of Northwest of Iran.

BACKGROUND: Given the effective role of a mobile applications in disease management, disease monitoring, and self-care in patients with COVID-19 disease, we aimed to design, development and evaluation of a self-care Mobile app for COVID-19 patients not requiring hospitalization. METHODS: The design, development and evaluation the usability of the self-care and education mobile app for patients with COVID-19 disease were conducted in two main phases at 2021 in Northwest of IRAN; (1) Determine the features and capabilities and (2) Design, development and evaluation of self-care mobile App. JAVA programming languages and Android Operating System were used and selected to design and development of a mobile app. There were 25 participants who conducted evaluations of the mobile app's usability and impact using the mobile health app usability a Questionnaire of User Interface Satisfaction was administered to assess the usability of the developed application. The results were analyzed via Excel 2013. RESULTS: The model of developing a mobile app as an Information System was the Waterfall model. The smartphone application based on a set of capabilities and features was designed and consists of two main parts: the login screen for user registration, and the main home menu. The user interface includes three main pages or activities; (a) Main Menu for quick access to all of the pages, (b) Symptom management and monitoring to monitor the signs and symptoms during the illness, and (c) Set Reminders and Alarms to notify patients. The users' mean score of the application usability was calculated as 7.91 out of 9 indicating a good level of satisfaction. CONCLUSION: This app can be a guideline and a useful tools for managing and monitoring symptoms, reminding medications, and implementing self-care instructions in outpatients. The authors suggest evaluating the efficacy and functionality test of mobile-based applications for COVID-19 in clinical trial studies.

Reasons for not getting COVID-19 vaccine in Ardabil, a Northwestern province in Iran: Based on an ecological approach.

BACKGROUND: Understanding the reasons for not getting the COVID-19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated. METHODS AND MATERIAL: This study was conducted from October to December 2021 on 426 participants who had not received the COVID-19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy-making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment. RESULTS: A significant difference was found regarding gender between likely and not likely groups (P = 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738-0.942), P for trend = 0.003; model 1: OR = 0.820 (CI: 0.724-0.930), P for trend = 0.002; model 2: OR = 0.799 (CI: 0.703-0.909), P for trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783-0.948), P for trend = 0.002; model 1: OR = 0.864 (CI: 0.784-0.952, P for trend = 0.003; model 2:OR = 0.862 (CI: 0.781-0.951, P for trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy-making (P > 0.05). CONCLUSIONS: We found that a high score of "interpersonal" and "group and organization" factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.

Determinants of quality of life among elderly patients with type 2 diabetes in northwest of iran: based on problem areas in diabetes.

Background: Diabetes is a metabolic disease characterized by chronic hyperglycemia, leading to damage to various organs of the patients and a reduction of their life expectancy and quality of life (QOL). The aim of this study was to explore the determinants of the QOL based on the Problem Areas in Diabetes (PAID). Methods: This cross-sectional study was carried out in an Iranian diabetic clinic in Ardabil. The PAID, the short form health survey (SF-12), and the sociodemographic questionnaire were all employed. Using the census sample method, 266 elderly people with type 2 diabetes from the lone diabetic clinic at Ardabil took part in this study. One-way ANOVA, t-test, one-sample Kolmogorov-Smirnov test, and multiple regression were used to analyze the data. Results: Data analysis showed that there was a statistically negative significant relationship between the QOL dimensions and the triple domains of PAID (p < 0.01). In the final model of the predictors of the QOL, treatment barriers, psychological distress related to diabetes management, the type of treatment, age, and the duration of diabetes were statistically significant predictors of the QOL dimensions (p>0.05). Conclusion: Individual characteristics and factors connected to health services should be prioritized in any intervention program aimed at improving the QOL of elderly patients with diabetes. Psychological distress should be considered in addition to regular physician visits.

The impact of psychological factors on bereavement among frontline nurses fighting Covid-19.

The COVID-19 pandemic has considerably changed the workplace and social relationships of nurses. As potential factors, uncertainty, stigma, and exposure of nurses' families to risk have disturbed the process of providing healthcare services for patients infected by COVID-19. Accordingly, this study aimed at determining the impact of psychological factors on stigma among frontline nurses fighting COVID-19. The extant paper was carried out based on the descriptive-analytical method for April-June 2020. A total of 312 nurses working in educational-medical centers in Ardabil, Iran, were selected using the census method to participate in this research. To collect data, demographic features, stigma, mental health, perceived stress, and hardiness questionnaires were used. The collected data were analyzed using statistical correlation tests, multivariate regression, and descriptive tests through SPSS v.22 Software. The mean score of stigma in nurses equaled 28.36 ± 10.55. Results of the correlation coefficient showed a positive relationship between the mean score of stigma and stress (P ≤ 0.01) as well as the negative relationship between mental health and hardiness (P ≤ 0.01). Multivariate regression analysis indicated that mental health could be the predictor of stigma. Therefore, these factors should be identified and controlled to mitigate stigma under such critical circumstances.

Identifying the Predictors of Self-Management Behaviors in Patients with Diabetes Based on Ecological Approach: A Systematic Review.

BACKGROUND: Recognizing and promoting the factors that affect the self-management behaviors of diabetes lead to a reduction in the number of patients and an improvement in the quality of care. The ecological approach focuses on the nature of people's interactions with their physical and socio-cultural environments. OBJECTIVE: The purpose of this study was to identify the predictors of self-management behaviors with a comprehensive approach in these patients. METHODS: The keywords were investigated in the relevant national and international databases, including PubMed, Google Scholar, Science Direct, Scopus, and Scientific Information Database, Magiran, and Iran Medex, to obtain the articles published from 2009 to 2019. The search and article selection strategy was developed based on the Prisma checklist and was carried out in three steps. RESULTS: Most studies have shown that personal factors had the highest prediction power for the self-management of diabetes. The interpersonal factors, society and policy-making factors, and group and organization factors were then the most frequently reported predictors of self-management behaviors in diabetic patients. CONCLUSION: Self-management of diabetes is necessary for controlling it because 95% of care is done by the patient. When designing self-management interventions, factors are based on the individual level that is to increase self-management behaviors.

Transmission Modes of COVID-19: A Systematic Review.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) is a highly contagious viral infection that was initiated in Wuhan, China, and has spread around the world. The high prevalence and rapid transmission between individuals of COVID-19 have become an international challenge that requires careful consideration. We aimed to review the current evidence of COVID-19 transmission modes. METHODS: This study was a systematic review performed to identify current evidence of COVID-19 transmission modes. We searched selected keywords in six key databases to discover sources relevant to the main objective of the study. To identify studies meeting the inclusion criteria, the authors screened the titles and abstracts of the retrieved documents. The appropriate articles were then selected and their results were discussed to make the final inclusion. RESULTS: We identified five potential transmission modes of COVID-19, including airborne, droplet, contact with contaminated surfaces, oral and fecal secretions. Furthermore, some studies have pointed out other modes of virus transmission, such as person to person, and direct contact with animals. CONCLUSION: Droplet and contact with contaminated surfaces are the most frequent transmission modes of COVID-19. However, fecal excretion, environmental contamination, and fluid pollution may also contribute to viral transmission. The possibility of fecal transmission in COVID-19 has implications, especially in areas that are poorly hygienic. Environmental pollution can be caused by patients with SARS-CoV-2 through respiratory droplets and feces. Consequently, the human environment will become a potential medium of virus transmission.

Identifying features of a mobile-based application for self-care of people living with T2DM.

INTRODUCTION: Diabetes self-care requires support to empower patients to improve self-monitoring and maintain the necessary self-care behaviors. We aimed to identify features of a mobile-based application as a technology-based device for self-care of people living with T2DM. METHOD: This study was conducted in two main phases in 2020. In the first phase, a literature review study was performed to identify the data elements and technical features of the T2DM self-care application. In the second phase, using the information obtained from the review of similar articles, a questionnaire was designed to validate identified requirements. The statistical population of the present study consisted of 22 endocrinologists and metabolic specialists. RESULTS: Identification of 55 data elements and technical features for mobile-based self-care application for people with T2DM, and according to the statistical population, 15data elements for demographic requirements, 16 data elements for clinical requirements, and 17 features for the technical capability of this app were selected. CONCLUSION: Blood sugar monitoring, exercise, nutrition, weight monitoring, and educational capabilities were the most highlighted technical features of the T2DM self-care application. Software designers can use these requirements to design a self-care app for people with type-2 diabetes that can help manage and improve patients' health status.

Covid-19 effects on the workload of Iranian healthcare workers.

BACKGROUND: In this study, we aimed to evaluate the impact of the COVID-19 epidemic on the workload and mental health of Iranian medical staff using the General Health Questionnaire (GHQ-12) and NASA -Task Load Index (NASA-TLX) Questionnaire between March and April 2020, respectively. METHODS: The present cross-sectional study was conducted from March 5th to April 5th, 2020. To evaluate the workload and mental health of participants NASA-TLX and GHQ-12 online questionnaires were distributed. Data were entered into software SPSS (Version 23) and T-test, ANOVA, Regression methods were used for data analysis. RESULTS: Health workers who encountered COVID- 19 patients, were subjected to more task load compared to those who had no contact with COVID- 19 patients at the workplace (p <  0.001). In terms of the subscale score of NASA-TLX, nurses had more scores in mental pressure, physical pressure, time pressure (temporal), and frustration compared to the other jobs (p <  0.05). Moreover, nurses had significantly more workload compared to the other jobs. CONCLUSIONS: Type of job, the shift of work, educational level, and facing COVID-19 affected the score of NASA-TLX. NASA-TLX scores were higher in nursing compared to the scores of other health staff groups. The results of this study indicate that the scores of NASA-TLX and GHQ-12 among staff who had contact with COVID-19 patients were significantly higher than those who did not face COVID-19 patients. We suggested that a comprehensive assistance should be provided to support the well-being of healthcare workers especially nurses and healthcare workers who treated COVID-19 patients.

Successful recruitment and retention strategies for women health volunteers: viewpoints of the volunteers' supervisors and relevant researchers.

BACKGROUND: Women health volunteers (WHVs) are a link between people and healthcare workers. Despite their key role in promoting community health, strategies are rarely designed to keep them volunteering. The aim of this research was to find successful strategies to overcome barriers to recruitment and retention of the volunteers in assigned activities. SUBJECTS AND METHODS: A three-round online national Delphi technique was used to ask the opinions of Iranian health volunteers' supervisors and the relevant researchers. At the first round, the participants were asked ten open-ended questions across four barriers: inadequate capability of the volunteers and trainers, inadequate acceptance of the volunteers, restrictive social norms, and organizational problems. At the second round, with the questionnaire consisting of closed-ended questions, the experts were asked to rank the feasibility of each strategy using a seven-point Likert scale. Items along with the feedback received from the second round were included in the third-round questionnaire. Strategies with a median of 6 or higher and with an interquartile range ≤1 were regarded to be feasible. RESULTS: Consensus was obtained on 100 of the 133 strategies. A mixture of improving group work, implementing motivation tactics, assessing the needs of people/WHVs, reforming policy, monitoring and evaluation of WHVs/trainers, mobilizing the community, empowering WHVs/trainers, rationalizing WHVs/trainers/people, improving intersectional collaboration, implementing problem-based approaches, allocating proper resources, appropriate recruitment of WHVs, using social networks, and information dissemination were found to be the effective strategies to overcome the barriers to active participation. CONCLUSION: The highest consensuses among experts were on implementing motivation tactics and mobilizing the community. It seems that community mobilization, incentives, and logistical supplies such as providing prizes and transportation facilities for volunteers are mechanisms that can help retain WHVs and also overcome barriers to their active participation.