Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

INTRODUCTION: The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. METHODS: This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. RESULTS: The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). CONCLUSION: The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Pregnancy Concerns as Predictors of Sleep Quality in Primigravid Women: A Cross-Sectional Study.

Introduction Poor sleep quality may be a risk factor for adverse pregnancy outcomes. Identifying the predictors of sleep disorders can help design effective interventions. The present study aimed to evaluate the impact of pregnancy concerns on the sleep quality of primigravid women. Methods This cross-sectional study was conducted on 220 primigravid women referred to health centers in Hamadan, Iran. In addition to completing the demographic characteristics questionnaire, the Parkinson's Disease Questionnaire (PDQ) questionnaire was completed to determine the level of pregnancy concerns, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire was completed to determine the quality of sleep by pregnant women. Data were analyzed using descriptive statistics, the Pearson correlation coefficient, independent t-test, and univariate and multivariate logistic regression models with a backward method at a 95% confidence level. Results Pregnant women's total PSQI score was 13.8 ± 3.08, and with a PSQI ≥ 5 as a cut-off point, 76.3% of the study's participants had poor sleep quality. There was a significant direct correlation between the total score of PDQ and its subscales with the total PSQI score (P < 0.05). The adjusted regression logistic model showed a significant relationship between the PDQ scores, women's educational level (adjusted odds ratio (AOR) 1.19; confidence interval (CI) 95%: 0.19-2.18), and their spouse's educational level (AOR 1.03; CI 95%: 0.02-2.03) with sleep quality scores. Conclusion Pregnancy concerns, including concerns about birth and the baby, concerns about physical symptoms and body image, and concerns about emotions and relationships, can reduce the sleep quality of primigravid women. Designing and implementing effective interventions to reduce or modify these common concerns can improve the sleep quality of pregnant women and prevent the adverse effects of poor sleep quality on pregnancy outcomes.

Relationship between nurses' cultural competence and observance of ethical codes.

BACKGROUND: Cultural competence is considered as one of the main skills of nurses enabling them to provide nursing care for those with different cultures. One of the cases related to nurses' cultural competence is observance of ethical codes, but it has not been investigated sufficiently in studies. AIM: This study has been conducted to determine the relationship between nurses' cultural competence and observance of ethical codes in practice. RESEARCH DESIGN: This descriptive-correlational study was conducted in 2020. Sampling was done at several stages. The data were collected using questionnaires of demographic information, cultural competence, and observance of ethical codes as self-report. The questionnaires were provided to the subjects by the corresponding researcher and the data were analyzed using Pearson correlation test. PARTICIPANTS AND RESEARCH CONTEXT: This study was done with participation of 267 nurses working in four training hospitals located in northwestern Iran and 16 head nurses of selected wards. ETHICAL CONSIDERATIONS: The study was approved by Human Ethics Committee of Hamadan University of Medical Sciences. Participation was voluntary. Consent was obtained and confidentiality kept. FINDINGS: The results of Pearson correlation coefficient test showed a positive and statistically significant relationship between cultural competence and observance of ethical codes (r = 0.524, p = 0.001). In addition, cultural competence and observance of ethical codes by most nurses were at a moderate level. CONCLUSIONS: The results of the present study showed a significant relationship between nurses' cultural competence and observance of ethical codes. Therefore, it can be concluded that by strengthening the level of nurses, the level of observing ethical codes by them can be increased. Cultural competency and observance of ethical codes are important components of nursing care, and their development can improve nursing care delivery to clients through academic training, hidden curriculum and in-service education.

The comparison of two professional prophylaxis systems in plaque removal and debonding of orthodontic brackets.

INTRODUCTION: During orthodontic treatment, patients are expected to undergo consistent periodic prophylaxis as a result of complexities in oral hygiene. The aim of this study was to investigate, analyze, and compare the effectiveness of two professional prophylaxis systems of rubber cup polishing (RCP) and air-powder polishing (APP) in patients undergoing orthodontic treatment based on different levels of plaque and pigment on teeth and the extent of attachment of brackets after prophylaxis. MATERIALS AND METHODS: A total of 50 patients were selected for this clinical trial study. A couple of months after the orthodontic treatment, the patients were placed on professional prophylaxis in terms of the plaque index. Randomized cross-arch prophylaxis (right maxilla with left mandible), RCP (left maxilla with right mandible), and APP were carried out on the patients. The main indexes in the study (number of plaque removal and debonding), the work time duration per second, and convenience of patients using visual analog scale in each of the methods were evaluated as minor factors. Data were recorded in a special checklist. RESULTS: The mean of the plaque index and the time spent on RCP were observed to be higher than APP. The average satisfaction rate of patients with RCP was higher than APP. The debonding of the bracket and the tooth was not observed in any of the methods. CONCLUSION: APP is more efficient than RCP for performing professional prophylaxis of orthodontic patients.