Publications by authors named "Ali Mohammadpour"

24 Publications

  • Page 1 of 1

Association between prostate-specific antigen change over time and prostate cancer recurrence risk: A joint model.

Caspian J Intern Med 2020 May;11(3):324-328

Department of Urology, Babol University of Medical Sciences, Babol, Iran.

Background: Prostate specific antigen (PSA) is an important biomarker to monitor patients after treated with radiation therapy (RT). The aim of this study is to evaluate the relationship between the PSA data and prostate cancer recurrence using the joint modeling.

Methods: This historical cohort study was performed on 422 prostate cancer patients. Inclusion criteria included: patients with localized prostate cancer referring to Cancer Institute in Tehran (Iran) from 2007 to 2012, and under radiation therapy. Joint model has two components or sub-models. We showed the results by parameter estimating the longitudinal sub-model and survival sub-model. EM algorithm, Newton-Gauss and Gauss-Hermit law were used for final model parameters. R software version 3.2 was used for statistical analysis.

Results: In this study, considering the inclusion and exclusion criteria, out of 422 patients, the data on 314 cases were selected for analysis and the main result of joint model was obtained. PSA directly and significantly was associated with recurrence risk, therefore increasing 2.6 ml/lit PSA (one unit in transformed PSA) increases 39% recurrence risk (95% CI for RR: 1.09-1.77). Also, slope of PSA trend has significant association with prostate cancer recurrence risk (95% CI for RR: 1.05-1.41).

Conclusion: This study showed a significant relationship between PSA, and its slope with the recurrence risk by joint model, with regard to the pathological, demographic and clinical features in the Iranian population.
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http://dx.doi.org/10.22088/cjim.11.3.324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442453PMC
May 2020

Use of Health Information Technology in Patients Care Management: a Mixed Methods Study in Iran.

Acta Inform Med 2019 Dec;27(5):311-317

Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran.

Introduction: New technologies, including health information technologies, play an important role in effectiveness of management and nursing care services.

Aim: This study was aimed to determining the use of health information technology in patient care management in a case study in Iran.

Methods: This Mixed method study was conducted in 2018 in Kowsar Hospital of Semnan, Iran. Data gathered by an observational checklist and one questionnaire included two main parts, one demographic and another assessment of information technology use in care management of inpatients. The researcher prepared the questionnaire and its validity was verified. The data were organized and analyzed in the form of a descriptive analytic report. In the process of data collection, 10 participants including nurses, head nurses, physicians, radiology experts and Information Technology (IT) managers were interviewed and data analyzed using Directed Content Analysis.

Results: Nurses were satisfied with the computerized system and believed it can facilitate the affair. From the nurse's viewpoint, the most common use of the Health Information Technology (HIT) were access (observation) of patients admit and discharge information (100%), providing medicine and equipment, transfer of patients (92.3%). The least of them were retrieve of evidence in the care process (0 %) and judgment and analysis of radiological diagnostic procedures (0%). The potential of electronic record is not still applicable.

Conclusion: Use of modern information and communication technology in hospitals facilitates access and transfer of information, and also accelerates patient's admission and discharge process, relation between hospital units, providing medical equipment supporting affairs' process and diagnostic procedures. However, modifying organizational policies, improve the infrastructure and enhancing nurses' motivation in documenting nursing reports can be effective in increasing the impact of information technology in care management processes especially in electronic record and nurse's clinical judgment and evidence-based care.
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http://dx.doi.org/10.5455/aim.2019.27.311-317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085310PMC
December 2019

The role of psychosocial determinants in predicting adherence to treatment in patient with hypertension.

Interv Med Appl Sci 2019 Mar;11(1):8-16

Jahadieh Health Center, Semnan University of Medical Sciences, Semnan, Iran.

Introduction: Non-adherence in patients with hypertension directly exacerbates clinical outcomes. The purpose of the present research is to study the recognition of the relationships between the perceived social support and self-efficacy and the satisfaction of health care agents and the interaction of the patient with therapeutic personnel and access to health care and the behaviors of adherence to treatment in the patients who suffer hypertension.

Materials And Methods: This descriptive cross-sectional correlation study recruited 250 patients from a specialized hypertension clinic in Semnan, who completed the following questionnaires: Multidimensional Scale of Perceived Social Support, self-efficacy, adherence to treatment, access to and satisfaction with health care, and the patient's interaction with treatment personnel.

Results: An overall statistical description of the sample consists of 89 (35.6%) men and 161 (64.4%) women (SD = 10.41, range = 51.98). Regression coefficient of previous variables (three steps) shows that self-efficacy share, consent form civil services, and job could demonstrate with 99% certainty in the changes of treatment conformity in a meaningful way.

Conclusions: High self-efficacy, satisfaction with health care, and a favorable job have a high direct effect on adherence to treatment in patients with hypertension and controlling hypertension. Social support and education do not have a significant impact on adherence to treatment.
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http://dx.doi.org/10.1556/1646.10.2018.43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044565PMC
March 2019

Iranian physicians' expectations of telemedicine development and implementation infrastructures in teaching hospitals.

AIMS Public Health 2019 22;6(4):514-522. Epub 2019 Nov 22.

Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.

Introduction: In spite of the fact that telemedicine has various advantages; similarly as in some other data systems, it is essential to investigate clients' perspective of technology. Besides, the clients' awareness and satisfaction of the telemedicine are significant issues that ought to be considered before starting a telemedicine program. The present examination in this way looks to assess Iranian doctors' demeanor and recognition toward the infrastructures of telemedicine development and implementation.

Methods: The participants of this examination included doctors working in health care organizations subsidiary to Semnan University of Medical Sciences during 2019 in Iran. A valid and reliable questionnaire was used in order to evaluate the subjects' attitudes.

Results: The mean score of physicians' attitudes towards human factors was 3.43 ± 0.59, towards educational factors was 3.68 ± 0.94 and towards security factors was 3.50 ± 0.52. Regression analysis showed that there were significant relationships between physicians' knowledge and their attitudes towards human (P < 0.001), educational (P < 0.001) and security (P = 0.046) infrastructures.

Conclusion: the findings of this study show that there are several obstacles that can be reduced through teaching, change-management methods and personal patient-to-provider communication. These techniques can improve acceptance and continuous usage of telemedicine among Iranian physicians.
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http://dx.doi.org/10.3934/publichealth.2019.4.514DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940578PMC
November 2019

Serum levels of interleukin-23 and 35 in patients with and without type 2 diabetes mellitus and chronic periodontitis.

Caspian J Intern Med 2019 ;10(3):295-302

New Iberia Research Center, University of Louisiana at Lafayette, New Iberia, Lousiana, USA.

Background: Type 2 diabetes mellitus (DM) and chronic periodontitis (CP) show common pathophysiological features. We investigated the serum levels of IL-23 and IL-35 in people with type 2 DM and CP.

Methods: In a cross-sectional study, 72 patients were divided into four equal groups: group A, participants without type 2 DM and CP; group B, patients with type 2 DM without CP; group C, patients with CP and without type 2 DM; and group D, patients with type 2 DM and CP. Demographic data were obtained and periodontal conditions including clinical attachment loss, bleeding on probing, plaque index, gingival index, and probing depth was evaluated on all existing teeth. Fasting blood sugar (FBS) levels, hemoglobin (Hb) A1c, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In addition, serum levels of IL-23 and 35 were measured using enzyme-linked immunosorbent assay.

Results: The serum levels of IL-23 and 35 showed no significant differences between all groups (P>0.05). A significant positive correlation between the serum concentration of IL-23 and clinical attachment loss in the control group (r: 0.548, P=0.019) was detected. A significant negative correlation between IL-35 and the plaque index in group B (r: -0.578, P=0.012), plus significant negative correlations between IL-23 with ESR (r: -0.487, P=0.040) and CRP (r: -0.498, P=0.035) in groups C and D were also detected.

Conclusion: Despite significant associations of serum concentration of IL-23 and 35 with certain periodontal and inflammatory indices, neither type 2 DM nor CP differentially affects serum levels of these two cytokines.
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http://dx.doi.org/10.22088/cjim.10.3.295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729149PMC
January 2019

Effects of Minocycline on Neurological Outcomes In Patients With Acute Traumatic Brain Injury: A Pilot Study.

Iran J Pharm Res 2019 ;18(2):1086-1096

Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.

Traumatic brain injury (TBI) is a public health problem worldwide. Secondary damage of brain injury begins within a few minutes after the trauma and can last a long time. It can be reversible, unlike primary injury. Therefore, therapeutic intervention can be used. The aims of this study were to assess the effects of minocycline on neurological function and serum S100B protein and neuron-specific enolase (NSE) levels in patients with moderate to severe TBI. Patients with acute onset of TBI and surgical evacuation of hematoma were randomized to receive either minocycline 100 mg orally twice daily or placebo for 7 days. The primary outcomes included changes in level of S100B and NSE at different time points during the trial. Additionally, changes in Glasgow coma scale (GCS) score were evaluated. The Glasgow Outcome Scale-Extended (GOS-E) score at 6 months after injury was assessed in discharge patients. Thirty four patients were randomized into the placebo (n = 20) and treatment (n = 14) groups. There was a marginal statistically significant differences in the normalized value of S100B between groups ( < 0.1). The reduction in serum NSE level from baseline to day 5 was statistically significant ( = 0.01) in minocycline group while it was not significantly decrease in placebo group ( = 0.2). Also, GCS improvement over time within the minocycline group was significant ( = 0.04) while was not significant in placebo group ( = 0.11). The GOS-E scores were not significantly different between minocycline and placebo group. Based on this study, it seems that the use of minocycline may be effective in acute TBI.
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http://dx.doi.org/10.22037/ijpr.2019.1100677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706715PMC
January 2019

Melanoma: Where we are and where we go.

J Cell Physiol 2019 04 26;234(4):3307-3320. Epub 2018 Oct 26.

Department of Radiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Melanoma is known as an aggressive tumor which shows an increasing incidence and poor prognosis in the metastatic phase. Hence, it seems that diagnosis and effective management (including early diagnosis, choosing of the effective therapeutic platform, caring, and training of patients for early detection) are major aspects of melanoma therapy. Early detection of melanoma is a key point for melanoma therapy. There are various diagnosis options such as assessing of biopsy, imaging techniques, and biomarkers (i.e., several proteins, polymorphism, and liquid biopsy). Among the various biomarkers, assessing circulating tumor cells, cell-free DNAs, cell-free RNAs, and microRNAs (miRNAs) have emerged as powerful diagnosis tools for melanoma patients. Deregulations of these molecules are associated with melanoma pathogenesis. After detection of melanoma, choosing of effective therapeutic regimen is a key step for recovery of melanoma patients. Several studies indicated that various therapeutic approaches including surgery, immunotherapy, systematic therapy, radiation therapy and antibodies therapy could be used as potential therapeutic candidates for melanoma therapy. Caring for melanoma patients is one of the important components of melanoma therapy. Caring and training for melanoma patients could contribute to better monitoring of patients in response to various therapeutic options. Here, we summarized various diagnosis approaches such as assessing biopsy, imaging techniques, and utilization of various biomarkers (i.e., proteins, CTCs, cfDNAs, and miRNAs) as a diagnostic biomarker for detection and monitoring patients with melanoma. Moreover, we highlighted various therapeutic options and caring aspects in patients with melanoma.
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http://dx.doi.org/10.1002/jcp.27286DOI Listing
April 2019

Hospital Information Systems: The status and approaches in selected countries of the Middle East.

Electron Physician 2018 May 5;10(5):6829-6835. Epub 2018 May 5.

Ph.D. in English Language, Assistant Professor, Department of English Language, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran.

Background And Aim: Since hospital information systems (HISs) are among the most important information systems in the health sector, the present study aimed to shed light upon the situation of HISs in selected countries of the Persian Gulf region to reflect national strategies and activities in the case of HISs.

Methods: In this descriptive cross-sectional study, the information about HISs status of the selected countries of the Persian Gulf region were obtained through approaches including review of national and international resources. Then, according to aspects included in HIS status, content analysis was performed. Information obtained from content analysis after several stages of reading, was categorized and then findings, presented.

Results: The findings revealed that the surveyed countries have widely used HISs since the 1980s. HIS use and development vary to a certain extent. Since the middle of the first decade of the 21st century, Ministry of Health officials of the studied countries have considered the importance of HIS's integration and creating Electronic Health Record where, Oman, Bahrain and UAE are among the leading countries.

Conclusion: Since the emergence of HISs in healthcare centers, these countries have employed various approaches. In any case, in order to avoid wasting important resources, including financial and human ones, the use of successful experiences of other countries along with the formulation of a comprehensive plan is highly recommended while considering all HIS aspects, including national and international standards.
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http://dx.doi.org/10.19082/6829DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033126PMC
May 2018

Investigating the role of perception of aging and associated factors in death anxiety among the elderly.

Clin Interv Aging 2018 15;13:405-410. Epub 2018 Mar 15.

Social Development and Health Promotion Research Centre, Gonabad University of Medical Sciences, Gonabad, Iran.

Background And Objectives: The world's growing elderly population highlights the necessity for further attention to the psychological problems of the elderly, such as death anxiety. Analysis of the elderly's perception of aging and associated factors can contribute to prediction of their future physical and mental health. The purpose of this study was to determine the relationship of perception of aging, and a group of demographic factors, with death anxiety in the elderly living in Gonabad, Iran.

Subjects And Methods: This analytical descriptive study was conducted on 330 elderly residents of Gonabad, who were selected by stratified random sampling. Research tools were a standard demographic questionnaire, Barker's Brief Aging Perceptions Questionnaire, and Collett-Lester Fear of Death Scale. Data were collected by interview of respondents at their home. Data analysis was carried out in SPSS 16 using descriptive statistics, analysis of variance, Pearson's test, independent -test, and linear regression.

Results: Respondents had a mean age of 73.97±7.68 years, 42.4% of respondents were men and 57.6% were women. The total Barker's Brief Aging Perceptions Questionnaire score was 63.18±8.75, with the highest score (17.10±4.70) associated with negative consequences and control. The total Collett-Lester Fear of Death Scale score was 128±14.80, with the highest score (35.13±4.06) pertaining to the subscale fear of other people's death. Regression results indicated that the death anxiety score was predictable according to the age and all dimensions of perception of aging, except for the consequences and negative control dimension.

Conclusion: Age and the perception of aging are good predictors of death anxiety. The authors recommend further research on the determinants of death anxiety in the elderly and the development of a comprehensive care plan to reduce this anxiety among Iranian elderly.
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http://dx.doi.org/10.2147/CIA.S150697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858545PMC
August 2018

Periodontitis in rheumatoid arthritis patients, abundance and association with disease activity.

Med J Islam Repub Iran 2017;31:44. Epub 2017 Aug 10.

Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

There are some discrepancy in association between activity of rheumatoid arthritis (RA) and periodontitis. The aim of this study was to evaluate the periodontal status of outpatients with RA. The study was conducted in 2013-14 in a rheumatology clinic in Sari, north of Iran on 74 patients with RA. Evaluation of RA disease activity was according to disease activity score 28 (DAS28). Periodontitis was evaluated by probing depth (PD), gingival index (GI), clinical attachment level (CAL index), plaque index (PI), and panoramic X-ray. Statistical analysis included independent ttest and Mann-Whitney U test for quantitative, and chi square and OR for qualitative variables and evaluation of RA activity and periodontitis severity. The mean±SD of age and disease duration were 47.01±8.1 and 8.93±8.6 years, respectively and the mean±SD number of teeth was 20.70±6.8. Twenty-seven (36.5%) patients had moderate to severe disease. Forty-seven cases (63.5%) were found with periodontitis and 14 (12.2%) were identified to have moderate to severe periodontitis, unrelated to disease activity (p=0.22). For active/inactive periodontitis OR =1.33 (95% CI: 0.46 - 3.87) was computed. There was no association between RA disease activity and number of teeth, CAL, PI, PD, and GI, (p>0.05). About 60% of RA patients suffered from periodontitis, but there was not any significant relation between RA disease activity and severity of periodontitis. Periodontitis may interfere with management and follow up of RA, so periodic periodontal examination is suggested in these patients.
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http://dx.doi.org/10.14196/mjiri.31.44DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804465PMC
August 2017

The therapeutic potential of human adipose-derived mesenchymal stem cells producing CXCL10 in a mouse melanoma lung metastasis model.

Cancer Lett 2018 04 10;419:30-39. Epub 2018 Jan 10.

Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Interferon γ-induced protein 10 kDa (IP-10) is a potent chemoattractant and has been suggested to enhance antitumor activity and mediate tumor regression through multiple mechanisms of action. Multiple lines of evidence have indicated that genetically-modified adult stem cells represent a potential source for cell-based cancer therapy. In the current study, we assessed therapeutic potential of human adipose derived mesenchymal stem cells (hADSC) genetically-modified to express IP-10 for the treatment of lung metastasis in an immunocompetent mouse model of metastatic melanoma. A Piggybac vector encoding IP-10 was employed to transfect hADSC ex vivo. Expression and bioactivity of the transgenic protein from hADSCs expressing IP-10 were confirmed prior to in vivo studies. Our results indicated that hADSCs expressing IP-10 could inhibit the growth of B16F10 melanoma cells and significantly prolonged survival. Immunohistochemistry analysis, TUNEL assay and western blot analysis indicated that hADSCs expressing IP-10 inhibited tumor cell growth, hindered tumor infiltration of Tregs, restricted angiogenesis and significantly prolonged survival. In conclusion, our results demonstrated that targeting metastatic tumor sites by hADSC expressing IP-10 could reduce melanoma tumor growth and lung metastasis.
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http://dx.doi.org/10.1016/j.canlet.2018.01.029DOI Listing
April 2018

Evaluation, prediction and optimization the ultrasound-assisted extraction method using response surface methodology: antioxidant and biological properties of Stachys parviflora L.

Iran J Basic Med Sci 2016 May;19(5):529-41

Medical Surgical Nursing, Social Determinant of Health Center, Gonabad University of Medical Sciences, Gonabad, Iran.

Objectives: To optimize the extraction method using response surface methodology, extract the phenolic compounds, and identify the antioxidant and biological properties of Stachys parviflora L. extracts.

Materials And Methods: Maceration and ultrasound-assisted extraction (UAE) (4, 7, 10 min treatment time, 40, 70, 100 % high-intensity and 60, 80, 100 % (v v-1) methanol purity) were applied to obtain the extracts. SEM was conducted to provide the microstructure of the extracted plant. MICs (colorimetric assay), MFCs (colony diameter), total phenolic content, total flavonoid content, radical scavenging capacity and extraction efficiency were determined. HPLC analysis was applied to measure the existent phenolic compounds.

Results: A quadratic model (4 min treatment time, 74.5 % high-intensity and 74.2 % solvent purity) was suggested as the best (TPC: 20.89 mg GAE g-1 d.m., TFC: 6.22 mg QEs g-1 d.m., DPPH IC50: 21.86 µg ml-1 and EE: 113.65 mg g-1 d.m.) UAE extraction model. The optimized UAE extract was generally more effective against Gram-positive microorganisms (MIC: 10-20; MBC: 10-40 (mg ml-1)) than Gram-negative ones (MIC: 40; MBC: >40 (mg ml-1)). Moreover, it (MGI: 2.32-100 %) revealed more anti-mold activity than maceration (MGI: <28.77 %). Explosive disruption of the cell walls, therefore, enhanced extraction yield by acoustic cavitation, was elucidated using SEM. Caffeic acid, tannic acid, quercetin, trans ferulic acid and rosmarinic acid were determined as the phenolic compounds in the optimized extract.

Conclusion: RSM optimization was successfully applied for UAE from S. parviflora. The considerable antioxidant and biological properties were attributed to the phenolic compounds.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923474PMC
May 2016

Surveillance of Antibiotic Consumption Point Prevalence Survey 2014: Antimicrobial Prescribing in Pediatrics Wards of 16 Iranian Hospitals.

Arch Iran Med 2016 Mar;19(3):204-9

Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran.

Background: Antibiotics are among the most commonly prescribed drugs in pediatrics. Due to lack of uniformity in pediatric antimicrobial prescribing and the emergence of antibiotic resistance, appropriate drug utilization studies have been found to be crucial to evaluate whether these drugs are properly used.

Methods: Data were collected between January 2014 and February 2014 in 16 Iranian pediatric hospitals using a standardized method. The point prevalence survey included all inpatient beds.

Results: Of 858 children, 571 (66.6%) received one or more antimicrobials. The indications were therapeutic in 60.6%. The parenteral route was used in 92.5% of therapeutic indications. Ceftriaxone was the most prescribed antimicrobials for therapeutic indications (32.4%) and combination-therapy was the most type of therapy in pediatric intelligent care unit (PICU).

Conclusion: According to results of this study, antibiotics' prescribing in pediatrics wards of Iranian hospitals is empirical. Therefore, for quality improvement of antimicrobial use in children continuous audit process and antibiotic prescriptions require further investigation.
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http://dx.doi.org/0161903/AIM.009DOI Listing
March 2016

A New Horizon in Life: Experiences of Patients Receiving Chemotherapy.

Glob J Health Sci 2015 Jul 31;8(4):102-8. Epub 2015 Jul 31.

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Introduction: The treatment quality of diseases can affect the patient's experience. Due to its different complications among cancer patients, the experience of chemotherapy is unique. The present study was conducted to explore the lived experience among cancer patients who had received chemotherapy.

Methods: The study was conducted by a qualitative approach and a phenomenological method. In so doing, 12 cancer patients who had received chemotherapy were purposefully selected were interviewed using an in-depth method. After the required data were collected, they were analyzed by Tanner, Allen, Diekelmann method.

Results: Analysis of the collected data indicated that the experience of chemotherapy appeared as "a new horizon in life" for the patients. Secondary themes of the new horizon in life included rebirth, understanding of life values, dependence, and need.

Conclusion: According to the results of the study, it was concluded that in addition to taking into providing mental-spiritual support and reducing the complications of the treatment, nurses in chemotherapy wards should pay attention to the experiences of the patients receiving chemotherapy and enhance hope and positive attitude among them.
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http://dx.doi.org/10.5539/gjhs.v8n4p102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873593PMC
July 2015

The effect of a supportive educational intervention developed based on the Orem's self-care theory on the self-care ability of patients with myocardial infarction: a randomised controlled trial.

J Clin Nurs 2015 Jun 16;24(11-12):1686-92. Epub 2015 Apr 16.

Mashhad University of Medical Sciences, Mashhad, Iran.

Aims And Objectives: The aim of this study was to assess the effect of a supportive educational intervention developed based on the Orem's self-care theory on the self-care ability of patients with myocardial infarction.

Background: Patients with cardiovascular disease suffer from the lack of knowledge about the disease and consequently are not able to fulfil their own self-care needs.

Design: This was a randomised controlled trial conducted in 2012.

Methods: We recruited a random sample of 66 patients with myocardial infarction who had been recently discharged from coronary care unit. The study setting was two university hospitals located in Khorasan, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received education, support, and counselling while patients in the control group received no intervention. We employed a demographic questionnaire and the Myocardial Infarction Self-Care Ability Questionnaire for data collection and spss version 16.00 for data analysis.

Findings: After the study, patients in the experimental group had higher levels of self-care knowledge, motivation and skills compared to the prestudy readings and the control group.

Conclusion: The supportive educational intervention developed based on the Orem's self-care theory can improve nonhospitalised patients' self-care ability and positively affect public health outcomes. Consequently, using the developed programme for providing follow-up care to nonhospitalised patients is recommended.

Relevance To Clinical Practice: Having the ability to develop caring systems based on the nursing theories is a prerequisite to standard nursing practice. Identifying patients' educational needs is a fundamental prerequisite to patient education. Our findings revealed that the supportive educational intervention developed based on the Orem's self-care theory can help health care providers identify and fulfil patients' self-care needs.
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http://dx.doi.org/10.1111/jocn.12775DOI Listing
June 2015

Comparing the effect of open and closed endotracheal suctioning on pain and oxygenation in post CABG patients under mechanical ventilation.

Iran J Nurs Midwifery Res 2015 Mar-Apr;20(2):195-9

School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.

Background: The aim of this study was to compare changes in pain, oxygenation, and ventilation following endotracheal suctioning with open and closed suctioning systems in post coronary artery bypass grafting (CABG) patients.

Materials And Methods: 130 post CABG mechanically ventilated patients were randomly allocated to undergo either open (n = 75) or closed (n = 55) endotracheal suctioning for 15 s. The patients received 100% oxygen for 1 min before and after suctioning. Pain score using critical-care pain objective tool (CPOT) was compared during suctioning between the two groups. Arterial oxygen pressure (PaO2), PaO2 to fraction of inspired oxygen (FiO2) (PF) ratio, and arterial carbon dioxide pressure (PaCO2) were compared at baseline and 5 min after suctioning. Peripheral oxygen saturation (SpO2) was compared at baseline, during suctioning, and at 1 min interval after suctioning for 5 min between the two groups.

Results: The patients were the same with regard to CPOT scores, i.e. 3.21 (1.89) and 2.94 (1.56) in the open and closed suctioning systems, respectively. SpO2 did not change significantly between the two groups. Changes in PaO2 and PF ratio was more significant in the open than in the closed system (P = 0.007). Patients in the open group had a higher PaCO2 than those in the closed group, i.e. 40.54 (6.56) versus 38.02 (6.10), and the P value was 0.027.

Conclusions: Our study revealed that patients' pain and SpO2 changes are similar following endotracheal suctioning in both suctioning systems. However, oxygenation and ventilation are better preserved with closed suctioning system.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387642PMC
April 2015

The Relationship between Cognitive Appraisal and Adherence to Medical Regimens in Type 2 Diabetic Patients.

J Caring Sci 2014 Dec 1;3(4):277-85. Epub 2014 Dec 1.

Departemant of Psychology, Payamnoor University, Tehran, Iran.

Introduction: Non-adherence to medical regimen has remained a challenge to the medical profession as well as to social sciences. To achieve positive results, the factors negatively impacting patient adherence to medical regimens (i.e., diet, drug and exercise regimen) must be scrutinized in detail. The objective of this research was to explore the relationship between cognitive appraisal and adherence to medical regimens in type 2 diabetic patients.

Methods: In this correlational study, 218 type 2 diabetes patients receiving treatment at the Diabetes Clinic affiliated with Gonabad University of Medical Sciences were selected through non-probability (convenience) sampling from April 2012 to May 2013. Two valid and reliable questionnaires of cognitive appraisal and adherence to medical regimens were completed by each patient. The data were analyzed using SPSS ver 13.

Results: A relationship was observed between perceived cognitive and adherence to some aspects of medical regimen. Also direct relationship was observedbetween perceived cognitive in form challenge and adherence of diet in patients with diabetes. There was no statistically significant relationship between aspects of cognitive appraisal and adherence to the drug regimen.

Conclusion: The results suggest that interventions undertaken to improve adherence to medical regimen, particularly to drug regimen in patients with type 2 diabetes, should be focused on enriching cognitive appraisal. Nurses need to help patients perceive diabetes as less of a threat and in fact should empower them, so as to look upon it as more of a challenge.
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http://dx.doi.org/10.5681/jcs.2014.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334179PMC
December 2014

Iranian nursing students' perspectives of educational equity.

Acta Med Iran 2014 ;52(12):935-42

Research Center for Nursing and Midwifery Care in Family Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. AND Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Around the world there is a growing consensus that students' rights must be protected, regardless of race, creed, color, sex, religion, and socioeconomic status. One of these rights is the educational equity. However, little is known about these phenomena in nursing education. The aim of this study was to explore the educational equity from the perspective of nursing students. A qualitative study was conducted. Thus, we purposefully recruited for in-depth interviews 13 nursing students (8 female and 5 male). All interviews were transcribed verbatim and analyzed by thematic analysis approach to identify categories and themes. Four main themes emerged from the data: Fair Educational Opportunity, fair evaluation, attempts to combat discrimination, and employing qualified teachers.  It is argued that educational equity should be developed in higher education. Principles of equity and students' rights may form the most basic rationale for all formal and informal efforts to extend the right of equal access to education.
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March 2016

The effects of topical heat therapy on chest pain in patients with acute coronary syndrome: a randomised double-blind placebo-controlled clinical trial.

J Clin Nurs 2014 Dec 3;23(23-24):3460-7. Epub 2014 Apr 3.

Social Determinates of Health Research Center, Department of Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Science, Gonabad, Iran.

Aims And Objectives: To investigate the effects of local heat therapy on chest pain in patients with acute coronary syndrome.

Background: Chest pain is a very common complaint in patients with acute coronary syndrome. It is managed both pharmacologically and nonpharmacologically. Pharmacological pain management is associated with different side effects.

Design: This was a randomised double-blind placebo-controlled clinical trial conducted in 2013.

Methods: A convenience sample of 66 patients with acute coronary syndrome was selected from a coronary care unit of a local teaching hospital affiliated to Gonabad University of Medical Sciences, Gonabad, Iran. Patients were randomly assigned to either the experimental or the placebo group. Patients in the experimental and the placebo groups received local heat therapy using a hot pack warmed to 50 and 37 °C, respectively. We assessed chest pain intensity, duration and frequency as well as the need for opioid analgesic therapy both before and after the study. The study instrument consisted of a demographic questionnaire, the McGill Pain Questionnaire, and a data sheet for documenting pain frequency and duration as well as the need for analgesic therapy.

Findings: The placebo heat therapy did not significantly decrease the intensity, the duration and the frequency of pain episodes. However, pain intensity, duration and frequency in the experimental group decreased significantly after the study. Moreover, the groups differed significantly in terms of the need for opioid analgesic therapy neither before nor after the intervention.

Conclusion: Local heat therapy is an effective intervention for preventing and relieving chest pain in patients with acute coronary syndrome.

Relevance To Clinical Practice: Effective pain management using local heat therapy could help nurses play an important role in providing effective care to patients with acute coronary syndrome and in minimising adverse effects associated with pain medications.
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http://dx.doi.org/10.1111/jocn.12595DOI Listing
December 2014

The effects of topical heat therapy on chest pain in patients with acute coronary syndrome: a randomised double-blind placebo-controlled clinical trial.

J Clin Nurs 2014 Dec 3;23(23-24):3460-7. Epub 2014 Apr 3.

Social Determinates of Health Research Center, Department of Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Science, Gonabad, Iran.

Aims And Objectives: To investigate the effects of local heat therapy on chest pain in patients with acute coronary syndrome.

Background: Chest pain is a very common complaint in patients with acute coronary syndrome. It is managed both pharmacologically and nonpharmacologically. Pharmacological pain management is associated with different side effects.

Design: This was a randomised double-blind placebo-controlled clinical trial conducted in 2013.

Methods: A convenience sample of 66 patients with acute coronary syndrome was selected from a coronary care unit of a local teaching hospital affiliated to Gonabad University of Medical Sciences, Gonabad, Iran. Patients were randomly assigned to either the experimental or the placebo group. Patients in the experimental and the placebo groups received local heat therapy using a hot pack warmed to 50 and 37 °C, respectively. We assessed chest pain intensity, duration and frequency as well as the need for opioid analgesic therapy both before and after the study. The study instrument consisted of a demographic questionnaire, the McGill Pain Questionnaire, and a data sheet for documenting pain frequency and duration as well as the need for analgesic therapy.

Findings: The placebo heat therapy did not significantly decrease the intensity, the duration and the frequency of pain episodes. However, pain intensity, duration and frequency in the experimental group decreased significantly after the study. Moreover, the groups differed significantly in terms of the need for opioid analgesic therapy neither before nor after the intervention.

Conclusion: Local heat therapy is an effective intervention for preventing and relieving chest pain in patients with acute coronary syndrome.

Relevance To Clinical Practice: Effective pain management using local heat therapy could help nurses play an important role in providing effective care to patients with acute coronary syndrome and in minimising adverse effects associated with pain medications.
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http://dx.doi.org/10.1111/jocn.12595DOI Listing
December 2014

Facing the challenges and building solutions in clinical psychiatric nursing in Iran: a qualitative study.

Issues Ment Health Nurs 2012 Oct;33(10):697-706

Ahvaz Jundishapur University of Medical Sciences, School of Nursing and Midwifery, Ahvaz, Islamic Republic of Iran. [corrected].

Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program.
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http://dx.doi.org/10.3109/01612840.2012.698371DOI Listing
October 2012

HIV-infected patients' adherence to highly active antiretroviral therapy: a phenomenological study.

Nurs Health Sci 2010 Dec 17;12(4):464-9. Epub 2010 Nov 17.

Department of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran.

Adherence to the treatment regimen is essential to the success of highly active antiretroviral therapy for patients who are infected with HIV. The evidence suggests that poor adherence to antiretroviral drug therapy is a major problem that has the potential to diminish effective viral suppression, promote viral resistance, and place patients at risk for hospitalization, opportunistic infections, and an increased risk of HIV transmission. The primary aim of this study was to understand patients' experiences regarding their adherence to antiretroviral drug therapy. Thus, 19 participants were recruited for in-depth interviews regarding their adherence to drug regimens. All the interviews were transcribed verbatim and analyzed by using Benner's phenomenological analysis approach. Four main themes emerged from the data: (i) choosing to live and the decision to start taking medications; (ii) strategies for adhering to the regimen and managing the side-effects; (iii) relationships with healthcare providers; and (iv) advantages of the medications as a motivator to continue one's adherence to the regimen. Studying and understanding the experiences of patients can provide new insights and strategies in order to enhance patients' adherence to highly active antiretroviral therapy.
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http://dx.doi.org/10.1111/j.1442-2018.2010.00560.xDOI Listing
December 2010

Transient thermal and stress analysis of maxillary second premolar tooth using an exact three-dimensional model.

Indian J Dent Res 2010 Apr-Jun;21(2):158-64

Kerman Oral and Dental Diseases Research Center, Iran.

Aim: In this paper, the temperature and stress distributions in an exact 3D-model of a restored maxillary second premolar tooth are obtained with finite element approach.

Objective: The carious teeth need to restore with appropriate restorative materials. There are too many restorative materials which can be used instead of tooth structures; since tooth structures are being replaced, the restorative materials should be similar to original structure as could as possible.

Materials And Methods: In the present study, a Mesial Occlusal Distal (MOD) type of restoration is chosen and applied to a sound tooth model. Four cases of restoration are investigated: two cases in which base are used under restorative materials and two cases in which base is deleted. The restorative materials are amalgam and composite and glass-inomer is used as a base material. Modeling is done in the solid works ambient by means of an exact measuring of a typical human tooth dimensions. Tooth behavior under thermal load due to consuming hot liquids is analyzed by means of a three dimensional finite element method using ANSYS software. The highest values of tensile and compressive stresses are compared with tensile and compressive strength of the tooth and restorative materials and the value of shear stress on the tooth and restoration junctions is compared with the bond strength. Also, sound tooth under the same thermal load is analyzed and the results are compared with those obtained for restored models.

Results: Temperature and stress distributions in the tooth are calculated for each case, with a special consideration in the vicinity of pulp and restoration region. Numerical results show that in two cases with amalgam, using the base material (Glass-ionomer) under the restorative material causes to decrease the maximum temperature in the restorative teeth. In the stress analysis, it is seen that the principal stress has its maximum values in composite restorations.

Conclusion: The maximum temperatures are found in the restoration case of amalgam without base. Besides, it is found that restoration has not any influence on the stress values at DEJ, such that for all cases, these values are close to sound tooth results.
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http://dx.doi.org/10.4103/0970-9290.66624DOI Listing
November 2010

Coming to terms with a diagnosis of HIV in Iran: a phenomenological study.

J Assoc Nurses AIDS Care 2009 Jul-Aug;20(4):249-59

Tehran University of Medical Sciences, School of Nursingand Midwifery, Tehran, Iran.

The number of people living with HIV (PLWH) has increased in all Asian regions, including Iran. Discovering that one has any serious illness can be a traumatic experience, but coming to terms with an HIV diagnosis is made more difficult by social constructs and negative reactions to the infection. This interpretative phenomenological study was carried out to understand and describe the lived experience of HIV-infected Iranians during the period immediately following an HIV diagnosis. Audiotaped in-depth semistructured interviews with 13 participants were used to collect data, which were analyzed with critical hermeneutics. Two main themes emerged: (a) doubt and delay in coming to terms with the diagnosis and (b) testing and its associated impacts. Nine subthemes were also found. Many challenges face people who need to determine their HIV status, and these are compounded by the sociocultural context found in Iran. Iran needs more education, counseling, testing facilities, and support programs to encourage people to get tested for HIV and to help them deal with a positive test result.
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http://dx.doi.org/10.1016/j.jana.2009.03.003DOI Listing
September 2009