Barriers and reinforcing factors to self-management behaviour in rheumatoid arthritis patients: A qualitative study.

OBJECTIVE: The aim of the present study was to explore the view of rheumatoid arthritis (RA) patients about the barriers and reinforcing factors in practising self-management behaviour (SMB). METHODS: This was a qualitative study based on directed content analysis of in-depth semi-structured interviews with 30 patients. The participants were selected using a purposeful sampling approach. The interviews continued until data saturation was reached. The study was conducted over 6 months in 2014-2015 at the Rheumatology Clinic of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. RESULTS: Three main themes and 14 subthemes were extracted. The main themes included behavioural barriers, environmental barriers and reinforcing factors. The subthemes included lack of awareness; poor physician-patient relationship; lack of motivation; negative attitude and willingness; lack of time; cost; housing conditions and in-home equipment; negative social effects; social support; consequences of SMB; and comparing yourself with others. CONCLUSION: Behavioural and environmental barriers, as well as social support and outcomes of SMB were the most important barriers and reinforcing factors of SMB. Therefore, considering these factors in patients may help in designing programmes that attempt to reduce barriers and increase reinforcing factors, which ultimately result in higher levels of SMB and quality of life among patients.

Gender barriers to health promotion in middle-aged Iranian women.

This study explores the perceived socio-cultural factors that might be barriers to health-promoting behaviour in middle-aged women in the city of Yazd in Iran. The aim of this qualitative study was to explore the barriers to a healthy lifestyle in middle-aged women. Interviews with women aged 40-60 were audio-taped, transcribed and analysed using content analysis. The interviews focused on socio-cultural factors and five main themes emerged: (a) giving higher priority to non-health-related needs; (b) the dominance of the husband's will in the family; (c) preference of children's needs to own needs; (d) having to fulfil multiple responsibilities; and (e) low access to community resources for health promotion. The multiple responsibilities of family and work, patriarchal societal attitudes and lack of exercise facilities are barriers to health in middle-aged Iranian women.

Assessment of two emergency contraceptive regimens in Iran: levonorgestrel versus the Yuzpe.

OBJECTIVE: The purpose of this study was to compare the efficacy and tolerability of two emergency contraception (EC) methods, levonorgestrel versus the Yuzpe. METHODS: In a prospective, randomized, comparative study, we included 122 healthy volunteers who in the observed cycle had had only one act of unprotected intercourse within 72 h of treatment. They were randomly allocated in levonorgestrol group (n=62) and Yuzpe (n=60). The levonorgestrel regimen consisted of two pills: 0.75 mg levonorgestrel, taken twice in the 12-h interval within 72 h after unprotected intercourse. The Yuzpe method included two HD contraceptive pills taken as another regimen. Data were collected by questionnaire at first and 3 weeks later. The differences were compared with X2 & Fisher exact tests. RESULTS: There were no significant differences between two groups in any of the observed parameters. The levonorgestrel regimen was found superior to Yuzpe because it's more effectiveness (respectively 100% vs 91%, p=0.026) and fewer side effects. CONCLUSION: The study showed more effectiveness and safety of the levonorgestrel regimen as emergency contraception. Thus we recommend levonorgestrel as an alternative EC method instead of the Yuzpe regimen in Iran or other developing countries in order to decrease unwanted pregnancy.