Adherence to Treatment in Patients with Chronic Diseases: From Alertness to Persistence
Ella
Danielson
Department of Health Sciences, Mid Sweden University, Östersund, Sweden
author
Christina
Melin-Johansson
Department of Health Sciences, Mid Sweden University, Östersund, Sweden
author
Mahnaz
Modanloo
Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran
author
text
article
2019
eng
Background: Adherence to treatment is a process that begins with alertness about the disease and has to end with staying in treatment. It is a concern to all health care disciplines. The aim of this study was to explore the experience of adherence to treatment patients with chronic diseases.
Methods: This qualitative study was conducted during a period of 6 months in Golestan province in Iran in 2017. In-depth semi-structured interviews were done with a purposive sample of 15 patients with chronic disease (i.e. Chronic renal failure (CRF), Hypertension (HTN), Multiple sclerosis (MS) and Diabetes). Data were analyzed using qualitative content analysis in MAXQDA Software.
Results: The analysis of the data in this study led to the development of ten subthemes and four themes emerged as follows: motivation, cohesion, commitment and empowerment which are necessary components for adherence to treatment in patients. “Moving from alertness to persistence” emerged as the main theme.
Conclusion: The findings of the study offer helpful insights into the concept of adherence to treatment and its components for health care providers, which can be used to develop the best possible care plan and may help health care providers to support the patients to have an active role for following treatment rather than just doing it.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
248
257
https://ijcbnm.sums.ac.ir/article_45559_2bc4eb281e8427a64b16d52ab28f63e7.pdf
dx.doi.org/10.30476/ijcbnm.2019.81303.0
Caregiver burden and its predictive factors in caregivers of children with chronic conditions
Mohsen
Adib-Hajbaghery
Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
author
Bahareh
Ahmadi
Department of Nursing, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences,
Isfahan, Iran
author
text
article
2019
eng
Background: Few studies have been conducted on the burden of care in caregivers of children with chronic illnesses. This study investigated the burden of care and associated factors in first-degree caregivers of children and adolescents with chronic conditions.
Methods: A cross-sectional study was conducted from June to September 2017 on 385 first-degree caregivers of children and adolescents with chronic disorders. Data were collected using the Zarit burden inventory which assesses the caregiver burden in physical, psychological, economic, and relational areas and has a total score from 0 to 88. Scores 61-88, 41–60, 20–40, and <20 indicate severe, moderate, mild, and no burden. Data were analyzed using descriptive statistics and Chi-Square, Fisher’s exact tests, t-test, analysis of variance, and multiple regression analysis.
Results: The mean age of the caregivers and children were 38.20±8.04 and 8.90±4.90 years, respectively. Also, 33 (8.5%), 135 (35.1%), and 181 (47%) of the caregivers suffered from severe, moderate, and mild burden, and only 9.4% perceived no burden. The mean caregiver burden scores were significantly different in terms of their education (P<0.001), job status (P=0.04), financial status (P<0.001), family size (P<0.001), numbers of children (P<0.001), numbers of children with chronic illnesses (P<0.01), type of supportive resources (P=0.004), and children’s education (P<0.01), type of disease (P<0.001), numbers of diseases (P<0.001), and interval of medical visits (P<0.001).
Conclusion: Caregivers of children and adolescents with chronic disease are under pressure. Our study showed a number of factors influencing caregiver burden. Health care providers should plan family-centered care plans to decrease the burden of care in caregivers of children with chronic conditions.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
258
269
https://ijcbnm.sums.ac.ir/article_45557_f31ea24db76bdb0f001bd6183c6bdd94.pdf
dx.doi.org/10.30476/ijcbnm.2019.73893.0
Strategies to Improve the Performance of Community Health Volunteers for Tuberculosis Care and Prevention: A Qualitative Study
Mamat
Lukman
Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung,
Indonesia
author
Kusman
Ibrahim
Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
author
Desy Indra
Yani
Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung,
Indonesia
author
Sheizi
Prista Sari
Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung,
Indonesia
author
Neti
Juniarti
Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung,
Indonesia
author
text
article
2019
eng
Background: Community health volunteers contributed to the total Tuberculosis (TB) case findings; however, the attrition rate of these volunteers was high which reduces their optimal performance. Hence, sustainability of efforts should be explored to retain the community health volunteers in the TB program.Improvement of community health volunteers to perform community-based health education and prevent TB has not been examined consistently around the globe, including Indonesia. This study aimed to explore the strategies to improve performance of community health volunteers for TB care and prevention to reduce the incidence and stop the spread of TB in the community.
Methods: A qualitative design was adopted and we used two focus group discussions in 2017 to collect the data. The participants included village health workers as volunteers in two regencies of Bandung City, West Java Indonesia. A thematic analysis was used to analyze the data.
Results: Four major themes should be considered in developing a community-based TB health education program: (1) informing community health volunteers about the benefits and difficulties of being a TB volunteer; (2) recognizing the activities and feelings of volunteers; (3) emphasizing the Willingness to Help Others; and (4) having access to TB training.
Conclusion: To develop a community-based health education program for TB care and prevention, community nurses need to listen to the opinions of community health volunteers, and TB patients and their family members to ensure that the health education program is tailored to meet community needs.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
270
278
https://ijcbnm.sums.ac.ir/article_45558_bb869d9660329060a496d81b9d2b5e9e.pdf
dx.doi.org/10.30476/ijcbnm.2019.81353.0
The Effect of an Education Program Based on Illness Perception on the Lifestyle of Patients with Metabolic Syndrome: A Randomized Controlled Clinical Trial
Mahnaz
Rakhshan
Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
author
Mitra
Rahimi
Student at Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
author
Ladan
Zarshenas
Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz,
Iran
author
text
article
2019
eng
Background: This study aimed to examine the effects of an education program based on illness perceptions on the lifestyle of patients with metabolic syndrome.
Methods: This is a randomized controlled clinical trial on 80 patients with metabolic syndrome referred to diabetic clinic affiliated to Shiraz University of Medical Sciences from August to November 2016. The patients were assigned to two control and intervention groups using a simple randomization method. The intervention group received education based on illness perceptions, using face-to-face and telephone follow up sessions in five weeks. The lifestyle questionnaire, brief illness perception questionnaire and demographic information questionnaire were used for data collection. The patients’ lifestyle was examined before and at the end of the eighth week from the beginning of the intervention. Descriptive and inferential statistics were used for data analysis.
Results: After the intervention, the total lifestyle score in the intervention group significantly increased, as compared to the control group (14.60±6.85 vs 6.15±5.80) (P<0.001). Of all the lifestyle dimensions, only stress management after the intervention showed no significant changes (P>0.001).
Conclusion: Education based on illness perceptions affected the lifestyle of patients with metabolic syndrome. Therefore, nurses and healthcare providers can use this program for improving the lifestyle of patients with metabolic syndrome.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
279
287
https://ijcbnm.sums.ac.ir/article_45564_c95e4c33b94f5d7d3a4ae4133ef6e30e.pdf
dx.doi.org/10.30476/ijcbnm.2019.81658.0
Designing a Process Model of Home Care Service Delivery in Iran: A Mixed Methods Study
Alireza
Nikbakht Nasrabadi
Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
author
Hooman
Shahsavari
Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
author
Mohammad
Almasian
Department of English Language, School of Medicine, Lorestan University of Medical Sciences,
Khorramabad, Iran
author
Heshmatolah
Heydari
Social Determinants of Health Research Center, Lorestan University of Medical Science, Khorramabad, Iran
author
Abdolrahim
Hazini
Department of Home-Based Palliative Care, ALA Cancer Prevention and Control of Charity Center
(MACSA), Charity Foundation, Tehran, Iran
author
text
article
2019
eng
Background: Considering the position of home health care in the current world, the objective of this study was to design an applied model of providing home care services in Iran.
Methods: The mixed methods approach was employed in three stages in Iran from Feb 2015 to Sep 2016. During the first phase, the qualitative method of content analysis was used. Data were collected by conducting 26 individual interviews and holding one focus group session involving 7 people. Data analysis was based on Graneheim and Lundman’s approach to content analysis.
In the second phase of the study, a literature review was carried out and at the end of this stage, a preliminary model was designed. The model was standardized in the third phase using the Delphi method with 23 participants in two rounds.
Results: Inthe first and second stages of the study, various categories emerged including patient referral, agreement, determination of the needed level of care, care plans designing, provision of comprehensive services, documentation, service monitoring,inter-professional cooperation, issuance of death certificates at home, ethical considerations, and the evaluation of services. Then, in the Delphi phase, 20 (95.2%) of the experts confirmed the structure and content of the model and its applicability.
Conclusion: The designed model can be helpful in organizing the provision of integrated and comprehensive health services to clients at home, which can be effective in improving the clients’ health and enhancing their self-care and autonomy.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
288
299
https://ijcbnm.sums.ac.ir/article_45562_aa2f28cde2d238795794bd090a6d220d.pdf
dx.doi.org/10.30476/ijcbnm.2019.73934.0
Correlation between Supportive Care Needs of Women with Breast Cancer and Quality of Life of their Family Caregivers
Mozhgan
Mohammadzadeh Nimekari
Student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Marzieh
Saei Ghare Naz
Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
author
Yaghoub
Ashouri Taziani
Department of Radiation Oncology, Shahid Mohammadi Hospital, Hormozgan University of Medical
Science, Bandar Abbas, Iran
author
Maliheh
Nasiri
Department of Biostatistics, Faculty of Paramedics, Shahid Beheshti University of Medical Science, Tehran, Iran
author
Mohammad Reza
Evazi
Department of Hematologist and Medical Oncologist, Hormozgan University of Medical Science, Iran
author
Amin
Shafizad
Department of Radiation Oncology, Shahid Mohammadi Hospital, Hormozgan University of Medical
Science, Bandar Abbas, Iran
author
Giti
Ozgoli
Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research
Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
text
article
2019
eng
Background: Breast Cancer is highly prevalent among women. The supportive care needs of such patients not only affect their quality of life (QoL) but also that of their family caregivers. The present study aimed to assess the correlation between the supportive care needs of women with breast cancer and the QoL of their family caregivers.
Methods: The present cross-sectional study was conducted from September 2017 to June 2018. The target populations were breast cancer patients (N=150) and their primary family caregivers (N=150) who attended the Omid Chemotherapy and Radiotherapy Center affiliated with Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Data collection tools included a demographic information form, the Supportive Care Needs Survey-Short Form 34, and the Caregiver Quality of Life Index-Cancer Scale. The data were analyzed using SPSS software (version 22.0) with descriptive statistics and Pearson’s correlation coefficient. P<0.05 was considered statistically significant.
Results: The mean age of the patients was 45.76±10.44 years. Of the family caregivers, 99 (66%) were the patients’ spouses. Of the different dimensions of the supportive care needs, the score for the physical needs (40.60±23.50) was the highest. In terms of the QoL of the family caregivers, mental and emotional burden scored the highest (20.19±7.38). There was a significant correlation between the caregivers’ mental and emotional burden and the physical needs of the patients (r=0.19, P=0.02).
Conclusion: The result of the present study showed that physical needs were the most common supportive care needs of patients with breast cancer. Such needs also significantly undermined the QoL of the caregivers in terms of emotional burden and financial concerns.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
300
308
https://ijcbnm.sums.ac.ir/article_45563_d1d3fb35e9544f9aa1a840519289c6ad.pdf
dx.doi.org/10.30476/ijcbnm.2019.73892.0
What Are the Hemodialysis Patients’ Style in Coping with Stress? A Directed Content Analysis
Mohtasham
Ghaffari
Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Mohammad Ali
Morowatisharifabad
Department of Aging Health, School of Public Health, Yazd Shahid Sadoughi University of Medical
Sciences, Yazd, Iran;
author
Yadollah
Mehrabi
Department of Epidemiology, School of health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
author
Samad
Zare
Department of Medical, School of Urology. Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Jafar
Askari
Department of Medical, School of Psychology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
author
Somayeh
Alizadeh
Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of
Medical Sciences, Yazd, Iran
author
text
article
2019
eng
Background: Nowadays, the prevalence of chronic diseases, such as chronic renal failure, is rising. These patients need hemodialysis to continue their treatment, which is a stressful process. This research was conducted with the purpose of explaining coping styles in hemodialysis patients regarding stress factors based on the Lazarus and Folkman’s transactional model.
Methods: This qualitative study was conducted as a content analysis. The data collection method was semi-structured interview with 22 patients from dialysis centers in Tehran. The data were collected from October to January 2017. Sampling was purposive and continued until data saturation. Data were analyzed using the directed content analysis method. The process of data analysis proposed by Hsieh and Shannon’s was followed.
Results: 106 codes and 24 sub subcategories were obtained through this research and classified into 8 sub-categories of transactional stress model including: problem management, emotional regulation, social support, dispositional coping styles, positive reappraisal, revised goals, spiritual beliefs and positive events; and 3 categories of coping structures that included coping efforts, meaning-based coping and moderators.
Conclusion: Dialysis patients are making efforts to cope with their stress in order to reduce their stress; in some cases, these efforts lead to reduction in stress, and in some cases, due to using unsound coping style, they are ineffective or even harmful.Therefore, the necessity of planning and proper interventions is felt by health care providers to control stress in dialysis patients.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
309
318
https://ijcbnm.sums.ac.ir/article_45561_cffe195af4528d41bf4d0da6977b0665.pdf
dx.doi.org/10.30476/ijcbnm.2019.81324.0
Post-Traumatic Growth among Family Caregivers of Cancer Patients and Its Association with Social Support and Hope
Razieh
Nouzari
Student research committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
author
Seyed Saeed
Najafi
Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
author
Marzieh
Momennasab
Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
author
text
article
2019
eng
Background: Cancer not only is a traumatic experience for the patients, but also can affect the family caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by people as a result of a struggle in dealing with traumatic events in life. Both the patients and their caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and both the social support (SS) and hope.
Methods: The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed using the SPSS software (version 23.0). P<0.05 was considered statistically significant.
Results: The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84, respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59) and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62) compared to SS (ẞ=0.27).
Conclusion: The results showed a good level of PTG among the caregivers and the experience of stressful situations positively affected their psychological condition. The positive change was associated with the perceived SS and hope.
International Journal of Community Based Nursing & Midwifery
Shiraz University of Medical Sciences, Shiraz, Iran
2322-2476
7
v.
4
no.
2019
319
328
https://ijcbnm.sums.ac.ir/article_45560_2b37db2472a4285ea2c503e0f1e597e9.pdf
dx.doi.org/10.30476/ijcbnm.2019.73959.0