Effect of educational intervention based on PRECEDE model on lifestyle modification, self-management behaviors, and hypertension in diabetic patients.

BACKGROUND: Inappropriate lifestyle and poor self-management in diabetic patients lead to many complications including hypertension and increased disease burden. Because of insufficient studies on Effect of educational interventions on lifestyle, self-management and hypertension in diabetic patients, the present study aimed to evaluate the Effect of educational intervention based on PRECEDE model on lifestyle, self-management, and hypertension of diabetic patients. METHODS: This clinical trial was conducted on 300 diabetic patients with hypertension. The patients were selected using simple random sampling and divided into 2 groups of intervention (150 people) and control (150 people). The intervention group was trained through ten 50-55 min sessions on lifestyle skills, self-management, and hypertension control based on the PRECEDE model. Before and after the intervention, lifestyle skills, self-management, and PRECED model constructs were evaluated using a standard questionnaire. Data were analyzed by SPSS 20 software using t-test, Kolmogorov-Smirnov, and Chi-Square tests (P < 0.05). RESULTS: In the intervention group, the mean score of different dimensions of lifestyle and self-management significantly increased from 110.45 ± 18.78 to 172.58 ± 186.66 and 64.33 ± 15.24 to 144.32 ± 15.82, respectively (P = 0.001). Mean systolic and diastolic blood pressure also decreased from 148.5 ± 5.39 to 123.54 ± 5.32 and 95.41 ± 3.12 to 72.24 ± 3.06 (P < 0.001). Moreover, the mean score of all the PRECEDE model constructs significantly increased after the intervention. In the control group, the mean score of the PRECEDE model constructs, the dimensions of lifestyle, self-management, and systolic and diastolic blood pressure did not change significantly before and after the intervention (P > 0.05). CONCLUSION: | Based on the study's results, the PRECEDE model was found to be a non-invasive, non-pharmacological, cost-effective method without any complication and as a complementary action along with other methods in the treatment of diabetic patients.

Effect of Educational intervention based on Health Belief Model on promoting preventive behaviours of urinary tract infections in mothers with children under 6-Years of age.

BACKGROUND: Children are one of the most vulnerable social groups to infectious diseases, and prevention of urinary tract infections in children is very important; therefore, the present study aimed to investigate the effect of education based on health belief model (HBM) on promoting preventive behaviours of urinary tract infection in mothers with children under 6-years of age. METHODS: This quasi-experimental study was conducted on 150 women with children under 6 years of age referred to health centers in Fasa city, Iran in 2021. Subjects were selected using simple sampling method and were randomly divided into intervention (n = 75) and control (n = 75) groups. The educational intervention for the experimental group consisted of 6 virtual training sessions of 40-50 min using lecture, question and answer, group discussion and video clips. Two virtual follow-up sessions were also held one month and two months after the educational intervention. Three months after the educational intervention, both experimental and control groups completed the questionnaire. Data were analysed by using SPSS 22 through Chi-square, independent t-test, and paired t-test (p > 0.05). RESULTS: Before the intervention, based on independent t-test and paired t-test, the mean score of HBM constructs were not significantly different between the control and intervention groups (P > 0.05). However, while perceived barriers significantly decreased (P < 0.05) after the intervention, the mean score of knowledge, | perceived sensitivity and severity, perceived benefits, | self-efficacy, cues to action, and performance significantly increased (P < 0.05) after the intervention. CONCLUSION: Considering the effect of training preventive behaviours of urinary tract infection based on HBM, application of the model as an effective and cost-effective method along with other methods is recommended for educational programs of mothers with children under 6 years of age.

Comparison of the outcomes of EMS vs. Non-EMS transport of patients with ST-segment elevation myocardial infarction (STEMI) in Southern Iran: a population-based study.

BACKGROUND: In the medical management of acute myocardial infarction, the transport of patients and primary care provided by emergency medical technicians (EMTs) and paramedics are effective in reducing the mortality and disabilities. Therefore, the present study aimed to compare the outcomes of emergency medical services (EMS) vs. non-EMS transport of patients with ST-segment elevation myocardial infarction (STEMI) in southern Iran. METHODS: This is an analytical, cross-sectional study. The study population consisted of the individuals registered in Fasa Registry on Acute Myocardial Infarction (FaRMI) in the south of Iran. 2244 patients with STEMI were included in the study. Statistical analyses were performed using Chi-Square test and independent t-test at a significance level of P < 0.05 in SPSS 22. RESULTS: Out of the 2244 patients with STEMI, 1552 (69.16%) were male and 672 patients (29.94%) were female. 934(41.62%) patients used EMS transport to the hospital, while 1310 (58.37%) patients used non-EMS transport to the hospital. A total of 169 patients with STEMI (7.26%) expired (out-of-hospital cardiac arrest); of them, 113 (66.86%) patients did not use EMS transport to the hospital. Successful cardiopulmonary resuscitation (CPR) was performed on 52 patients who used EMS transport. 27 patients also received an effective DC shock due to ventricular fibrillation (VF). Of the total number of patients, 49 had a stroke; among them, 37(75.51%) patients did not use EMS transport. CONCLUSION: In the present study, the death rate in patients with acute myocardial infarction who used EMS transport was lower than those who used non-EMS transport. The health system managers and policymakers in the healthcare systems are recommended to take the necessary measures to increase public health awareness and knowledge about the use of EMS and consequently reduce the death rate and complications of acute myocardial infarction.

The Effect of Educational Intervention Based on PRECEDE Model on Health Promotion Behaviors, Hope Enhancement, and Mental Health in Cancer Patients.

In this experimental study, 200 cancer patients (100 subject in experimental group and 100 subjects in control group) referred to Amir Oncology Hospital in Shiraz were investigated. Educational intervention for experimental group consisted of 12 educational sessions for 50 to 55 minutes. A questionnaire including demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure health promotion behaviors, patients' hope, and mental health before and 6 months after intervention. Six months after intervention, experimental group showed significant increase in knowledge, attitude, self-efficacy, enabling factors, social supports, health promotion behaviors, patients' hope, and mental health compared to the control group. This study showed the effectiveness of intervention based on PRECEDE constructs in mentioned factors 6 months after intervention. Hence, this model can act as a framework for designing and implementing educational intervention for health promotion behaviors of cancer patients.

Effect of positive thinking training on stress, anxiety, depression, and quality of life among hemodialysis patients: A randomized controlled clinical trial.

BACKGROUND: Given the relationship between positivity interventions and psychological problems, this study aimed to investigate the effect of positive thinking training on stress, anxiety, depression, and quality of life of hemodialysis patients. MATERIALS AND METHODS: This is a quasi-experimental and interventional study conducted on 70 hemodialysis patients referred to Fasa hemodialysis centers, Iran, between April 2019 and October 2019. Patients were selected using a simple sampling method and randomly divided into control (n = 35) and intervention (n = 35) groups. The intervention group was trained on positive thinking skills in eight sessions of a workshop. Before and after the intervention, stress, anxiety, depression, and quality of life in both the groups were measured using the Depression, Anxiety, and Stress Scale-21 and Short Form-36 Questionnaire. Data were analyzed using paired t-test, independent t-test, Kolmogorov-Smirnov, and Chi-square tests. RESULTS: There was no significant difference in the mean scores of stress, anxiety, depression, and quality of life in the two groups before the intervention.(P > 0.05), and in the control group, there was no statistically significant difference before and after the intervention (P = 0.092, P = 0.228, 0.280, respectively). In the intervention group, the mean score of stress and anxiety decreased from 23.65 ± 4.12 to 16.68 ± 4.41 (P < 0.001) and from 17.77 ± 5.15 to 14.57 ± 4.18 (P = 0.002), respectively, and that of the patients' quality of life also increased from 35.19 ± 10.07 to 55.98 ± 11.71 (P < 0.001). However, the mean score of depression did not change significantly after the intervention (P = 0.689). CONCLUSION: According to the results of this study, the use of positive thinking intervention programs with other methods for hemodialysis patients' care and treatment is recommended as a nonpharmacological, cost-effective, and uncomplicated method.

Factors associated with suicidal ideation in drug addicts based on the theory of planned behavior.

BACKGROUND: Several studies have attempted to understand the link among drug addicts and suicidal ideation. The purpose of this study was to investigate the factors associated with suicidal ideation in drug addicts based on the Theory of Planned Behavior (TPB). METHOD: This cross-sectional study was conducted with 2160 of drug addicts in private and public clinics for quitting addiction through methadone treatment in Shiraz city, Fars province, Iran from October 2018 to June 2019. Data gathering tools were a questionnaire on demographic characteristics, the Beck Scale for Suicidal Ideation and a questionnaire based on constructs of TPB. Data were analysed by SPSS 22 using descriptive statistics (mean, standard deviation, and frequency) and statistical tests (independent t-test, Pearson correlation coefficient, and linear regression). The significance level was considered 0.05. RESULTS: The mean age of the participants was 39.24 ± 11.92; 80.28% of them had a history of quit and 43.19% of them had a history of arrest and imprisonment. According to the results, 19.63% of the participants had suicidal ideation and 10.97% had a history of suicide attempt during their lifetime. The constructs of attitude, subjective norms, perceived behavioral control, and intent predicted suicidal ideation in the subjects. Intent and perceived behavioral control constructs were the strongest predictors of suicidal ideation, respectively. In general, the studied variables predicted 54.8% of suicidal ideation. CONCLUSION: The structures of attitude, subjective norms and perceived behavioral control and intent predicted suicidal ideation in the drug addicts, so the theory of planned behavior will be a good framework for educational interventions to reduce suicide in them.

Moving Into Action: The Master Key to Patient Education.

BACKGROUND: Illness and hospitalization are situations that increase the need for assistance and education. Poor education is currently the most common source of patient complaints in the health sector in Iran. PURPOSE: The aim of this study was to explore the perspectives and recommendations of nurses to improve patient education. METHODS: This research followed a qualitative exploratory design with a qualitative content analysis approach. The study participants, including eight head nurses and 16 staff nurses, were selected through purposive sampling. The data were collected through semistructured interviews, focus group sessions, and observations during 2016. RESULTS: Coding and analysis of the data generated one main theme, two subthemes, and four categories. The subthemes were "strengthen total commitment" and "reconstructing the infrastructure," and the categories were "developing motivational factors," "facilitating change by every impetus," "systematizing activities," and "contextual promotion." CONCLUSIONS: Study findings provide a complete picture of patient education and challenge managers to develop new strategies to plan and implement appropriate changes.

Effect of Acupressure on Preoperative Cesarean Section Anxiety.

Anxiety is a common preoperative problem in cesarean section candidates. Nonpharmacologic anxiety control has been demonstrated to be more suitable in pregnant women. The current study was a randomized, single-blind clinical trial which evaluated the effect of acupressure on preoperative C-section anxiety. In this study, 60 patients facing surgery were randomly divided into two groups of 30 patients each. Those patients in the intervention group received simultaneous acupressure at the Yintang and HE-7 acupoints for 5 minutes before surgery, and patients in the control group received intervention at a sham acupoint. The anxiety level of patients was preoperatively assessed twice using the Spielberger's State-Trait Anxiety Inventory. The mean anxiety scores of the two groups were shown to be insignificantly different before the intervention (p = 0.859), whereas a significant difference between the mean anxiety scores of the two groups was observed after the intervention (p = 0.001), suggesting that acupressure reduced the anxiety of patients before surgery.

The Barriers and Challenges of Applying New Strategies in the Clinical Evaluation of Nursing Students from the Viewpoints of Clinical Teachers.

BACKGROUND: Numerous studies have emphasized the use of new approaches in clinical evaluation. However, there are some challenges and barriers to applying these new approaches. The aim of the present study was to investigate the barriers and challenges of applying new strategies in the clinical evaluation of nursing students from the viewpoints of clinical teachers. MATERIALS AND METHODS: This cross-sectional study was conducted among 151 clinical teachers. A researcher-made questionnaire was used to collect data. The questionnaire was validated using library references and a variety of texts, as well as thorough consulting with 15 clinical teachers. The questionnaire's reliability was approved with a Cronbach's alpha of 78%. Data analysis was conducted using Pearson's correlation coefficient, one-way analysis of variance (ANOVA), and descriptive statistics in SPSS software. RESULTS: The highest score was related to the "students and clinical environment" domain [24.05 (8.10)], and the lowest to the "facilities" domain [13.31 (1.50)]. One-way ANOVA results showed a significant relationship between the mean scores of academic degree and the two domains of "tests" (F = 9.66, p < 0.001) and "facilities" (F = 8.26, p < 0.001). CONCLUSIONS: The implementation of a new approach for evaluating clinical training requires infrastructure and overcoming executive obstacles. Educating students and clinical teachers on new evaluation methods requires their familiarity with the implementation process as well as encouragement and support by their educational institution and administrators.