Investigating the Effect of Education on Self-Care among Chronic Heart Failure Patients Admitted to Shahid Mostafa Khomeini Hospital of Ilam

<p><strong>BACKGROUND:</strong> Congestive heart failure is a common cause of hospitalization. If patients can adhere to self-care behaviors, the progression of the disease can be prevented. The aim of this study is to evaluate the effect of education on self-care in chronic heart failure patients admitted to Shahid Mostafa Khomeini Hospital of Ilam in 2016.</p><p><strong>METHODS:</strong> This study is of intervention typeand 40 patient’s sufferingfrom heart failure were selected. Research tools include a standard indicator questionnaire for measuring self-care by patients. The questionnaire contains 22 questions about their certainty ofself-care. Four point Likert scale was used for scoring and SPSS V.19 was used for data analysis.</p><p><strong>RESULTS:</strong> The sample consisted of 16 men (40%) and 24 women (60%) most of which were married (75%). The statistical correlation between the total score of self-care behavior before and after education was significant (P VALUE = 0.003), which shows that the education conducted on the patients was effective and caused more scores in all areas.</p><p><strong>CONCLUSION:</strong> Self-care behavior can be attained and spread through education. It is recommended that the patients suffering are given enough information about their diet and activities after their discharge from hospital.</p>

Development and Validation of a Questionnaire to Measure Iranian Nurses' Knowledge, Attitude and Practice Regarding Disaster Preparedness

INTRODUCTION

Despite the key role of Iranian nurses throughout disaster management, there is no instrument available to examine nurses' current disaster preparation levels.

AIM

The aim of this study was to develop and analyse the reliability and validity of a questionnaire on the nurses' knowledge, attitude and practice of disaster preparedness.

MATERIALS AND METHODS

The scale was developed based on a comprehensive literature review and applied to 112 nurses in three public educational center affiliated to Ilam University of Medical Sciences, Ilam, Iran. Relibility was obtained using the test-retest method. Cronbach's alpha was used to verify internal consistency. Exploratory factor analysis was used to assess the validity of the questionnaire.

RESULTS

Explanatory factor analysis using varimax rotation revealed seven main factors associated with the nurses' knowledge, attitude and practice regarding disaster preparedness. The questionnaire overall internal consistency using Cronbach's alpha was 0.785, showing acceptable internal consistency. The intraclass correlation coefficient using Test-retest method was 0.82. Total variance was 67.57%.

CONCLUSION

The instrument has satisfactory reliability and validity indices and can be used to measure nurses' knowledge, attitude and practice regarding disaster preparedness.

Investigation the relationship between self-care and readmission in patients with chronic heart failure

BACKGROUND

Chronic heart failure (CHF) is associated with unpredictably increased prevalence of hospital admissions. Self-care is one of the most important aspects of management for patients with CHF. Self-care adequacy has led to increased satisfaction, independence in daily activities, reduced stress, and morbidity.

OBJECTIVES

We aimed to assess the relationship between self-care behavior and readmission rate in patients with heart failure.

PATIENTS AND METHODS

A total of 287 patients with a diagnosis of systolic CHF with a left ventricular ejection fraction less than 35% admitted for acute heart failure were enrolled. The self-care behavior was assessed using SCHFI questionnaires that have three domains (self-care maintenance, self-care management, and self-care confidence). An acquired score greater than 70 was considered as proper self-care index. The study population was followed over three months after discharge for readmission.

RESULTS

This study showed that self-care behavior was improper in our study population. More than 75% of patients had a score less than 70 in the different domains for self-care. The multivariable regression analyses showed a significant relationship between self-care management (ß = 1.6, P = 0.006, OR (CI) = 2.66 (1.37-5.1) and self-care confidence (ß = 0.9, P = 0.02, OR (CI) = 2.01 (1.1-3.68) and readmission rate.

CONCLUSIONS

We concluded that a good administration program such as education and a surveillance plan for the improvement of self-care behaviors would reduce hospital readmissions in patients with heart failure.

A comparative study on the effectiveness of positive psychotherapy and group cognitive-behavioral therapy for the patients suffering from major depressive disorder

OBJECTIVE

Aim of this experimental study is evaluating the effectiveness of two different approaches towards the treatment of major depressive disorder (MDD): Positive-oriented psychotherapy and group cognitive-behavior therapy.

METHODS

Eighteen out-patients suffering from major depression were randomly divided into two groups to be treated according to either of these two approaches. Both groups undertook the treatments for 12 weeks. All the subjects were tested by Beck Depression Inventory, Subjective Wellbeing Scale, Oxford test of Happiness, and the scale of Subjective Units of Distress before and after the treatments.

RESULTS

The results show significant differences between the two groups in terms of the variables of happiness and mental distress, suggesting that effectiveness of positive psychotherapy is more than cognitive-behavioral therapy in increasing happiness. These two approaches were significantly different in neither decreasing the acuteness of depression symptoms nor increasing subjective wellbeing.

CONCLUSION

As a whole, the results of this comparative study indicate that positive psychotherapy is more effective in increasing happiness among MDD patients.