ED and quality of life in CABG patients: an intervention study using PRECEDE-PROCEED educational program

Effect of oral health education on improving knowledge, attitude, practice, and oral health status of patients with liver cancer: A quasi-experimental study

PURPOSE

To evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in helping patients with liver cancer be aware of their knowledge, skills, and abilities in self-oral health behaviors and improve their oral health status.

METHODS

This is a quasi-experimental study of 90 patients with liver cancer assigned to an oral health education or a control group. The intervention group was educated with the PRECEDE-PROCEED model. A brief oral scale and the knowledge, attitude, and practice oral health questionnaire were employed to measure the oral health status and cognitive behavioral ability to seek oral health in patients.

RESULTS

Among 102 eligible patients, 90 (88.23%) agreed to participate in the present study and were divided to intervention (n = 45) or control (n = 45) groups. After the intervention and one month after discharge, the oral health scores of patients in the Intervention group were lower than those of the control group (P < 0.05). In addition, after the intervention and one month after discharge, the patients in the test group had higher scores on knowledge, beliefs, and behaviors of oral health than the control group (P < 0.05). One month after discharge, the mean knowledge and skills scores were significantly higher in the intervention group than in the control group.

CONCLUSIONS

Our findings suggest that oral health education may be a useful health intervention for patients with liver cancer. It may also improve the knowledge and beliefs of liver cancer patients seeking oral health. Larger long-term investigations are necessary to provide more support for these preliminary conclusions.

Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis

Background

Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.

Aim

To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.

Methods

This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis.

Outcomes

The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function.

Results

A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity (I 2 = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue.

Clinical Translation

CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group.

Strengths and Limitations

The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment.

Conclusion

The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).

Effects of a PRECEDE-PROCEED Model-Based Intervention on Fatigue in Patients With Coronary Heart Disease: A Randomized Controlled Trial

OBJECTIVE

This research aimed to determine how a 12-week PRECEDE-PROCEED model-based intervention affected fatigue in patients with coronary heart disease.

METHODS

This cluster randomized controlled trial recruited participants diagnosed with coronary heart disease at 2 community health centers in China. Participants in the control group (n = 36) received routine health education, whereas those in the intervention group (n = 38) were given a 12-week PRECEDE-PROCEED model-based intervention and routine health education. The intervention consisted of 6 training sessions on coronary heart disease, fatigue, fatigue management, self-management skills and social support. A primary outcome (fatigue) and 4 secondary outcomes (knowledge of fatigue, self-management, quality of life and body mass index) were assessed using the Fatigue Scale-14, Fatigue Cognitive Questionnaire for Patients with Coronary Heart Disease, Coronary Artery Disease Self-Management Scale, Chinese Cardiovascular Questionnaire of Quality of Life, and electronic weighing scale, respectively. Data were collected 3 times over 12 weeks.

RESULTS

Compared with the control group, the intervention group showed a statistically significant improvement in the level of fatigue (8.72 vs 7.06, P < .001), knowledge of fatigue (P < .001), self-management skills (P < .001), and quality of life (P < .001). However, there was no significant difference in body mass index between the 2 groups (P = .504).

CONCLUSIONS

The findings suggest that a well-designed intervention based on the PRECEDE-PROCEED model could alleviate fatigue symptoms and increase knowledge of fatigue, self-management skills and quality of life in patients with coronary heart disease.

Development and evaluation of a theory-based health promotion programme aimed at improving retirees' psychological well-being and quality of life: a protocol for a mixed-method study

INTRODUCTION

The changes that retirees experience during their retirement years will challenge their ability to cope, potentially endangering their health and quality of life. This study aims to design and evaluate a theory-based health promotion programme to improve retirees' psychological well-being and quality of life.

METHODS AND ANALYSIS

This mixed-method, non-blinded study uses an embedded design. The purposive sampling method will be employed for the qualitative aspect of the study. Qualitative data will be collected at baseline, focusing on retirement adjustment, through semistructured, in-depth individual interviews and focus group discussions. The data will be analysed using Graneheim and Lundman's qualitative content analysis method. A pre-post test controlled group design will be conducted for the quantitative part of the study. A sample size of 80 is estimated for both the intervention and control groups. Systematic sampling and the block randomisation method will be employed for sampling. The training programme in the intervention group will consist of eight 60 min sessions and environmental support, implemented after assessing the research environment and obtaining approval from the relevant officials. A brief training programme unrelated to the intervention group's focus (home safety) will be implemented for the control group. Quantitative measures will be collected in both groups at baseline, 3 months and 6 months after the intervention. These measures will include self-administered questionnaires covering demographic variables, retirement adjustment, retirement resources, quality of life, coping methods, spiritual well-being and psychological well-being. Analytical statistics will be performed using the generalised linear model, with p values≤0.05 considered significant.

ETHICS AND DISSEMINATION

This protocol has received approval from the ethics committee of Shiraz University of Medical Sciences. The research findings will be disseminated through peer-reviewed manuscripts, presentation in abstracts at National and International Scientific Conferences, and data sharing among researchers.

TRIAL REGISTRATION NUMBER

IRCT20180516039690N2.

Effect of the PRECEDE-PROCEED model on health programs: a systematic review and meta-analysis

BACKGROUND

The predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation policy, regulatory, and organizational constructs in educational and environmental development (PRECEDE-PROCEED) model has been used as a theoretical framework to guide health promotion strategies to prevent chronic diseases and improve the quality of life. However, there is a lack of evidence as to whether applying the PRECEDE-PROCEED model effectively improves health outcomes. This study aimed to systematically review intervention studies that applied the PRECEDE-PROCEED model and examine its effectiveness.  METHODS: In December 2020, seven databases were systematically searched. The quality of studies was assessed using the Mixed Methods Appraisal Tool. The outcome of interest for the meta-analysis was knowledge.

RESULTS

In total, 26 studies were systematically reviewed. Most studies provided educational programs as the main intervention for various population groups. Symptom or disease management and health-related behavior promotion were the most common topics, and education was the most frequently used intervention method. The PRECEDE-PROCEED model was applied in the planning, implementation, and evaluation of the intervention programs. Eleven studies were included in the meta-analysis, which showed that interventions using the PRECEDE-PROCEED model significantly improved knowledge.

CONCLUSIONS

This study indicated that individuals are more likely to engage in health-related behaviors with better knowledge. Thus, the PRECEDE-PROCEED model can be used as the theoretical framework for health promotion interventions across population groups, and these interventions are particularly effective with regard to knowledge improvement.

Impact of minimally invasive mitral valve surgery on sexual dysfunction in male patients

Background

Sexual dysfunction after cardiac surgery can seriously affect patients’ quality of life, but the impact of cardiac surgery on sexual function has long been neglected. Compared with conventional cardiac surgery, minimally invasive cardiac surgery has the advantages of aesthetic appearance and no disruption of the sternal structure, which can greatly improve the patient's quality of life. However, studies focusing on the effects of minimally invasive mitral valve surgery (MIMVS) on sexual function have not been reported. The objective of this research was to investigate the effects of totally endoscopic mitral valve surgery on health-related quality of life and sexual function in male patients and to provide possible recommendations.

Methods

Patients who underwent median sternotomy or totally endoscopic mitral valve surgery at our institution from January 2019 to December 2020 were selected using an electronic medical record system. Data were collected by questionnaires, including the MOS 36-item short-form health survey and the International Erectile Function Questionnaire.

Results

There were 156 male patients who participated in our study. Of these, 112 patients completed all questionnaires. Forty-five patients (40.18%) developed postoperative sexual dysfunction, including 15 patients (29.41%) in the MIMVS group and 30 patients (49.18%) in the conventional MVS group, indicating that the incidence of sexual dysfunction could be reduced by MIMVS and that the MIMVS group scored better on the International Erectile Function Questionnaire (P < 0.05). On the evaluation of health-related quality of life, the MIMVS group scored better than the MVS group on the mental health and bodily pain subscales of the MOS 36-item short-form health survey. In addition, our study showed that postoperative sexual dysfunction was associated with physical functioning and mental health.

Conclusions

In our study, totally endoscopic mitral valve surgery had less adverse effects on sexual function in male patients than conventional mitral valve surgery. In terms of health-related quality of life, totally endoscopic mitral valve surgery was superior to conventional surgery. Patients who opt for totally endoscopic mitral valve surgery may have a more satisfying and healthier sexual life than those who undergo conventional mitral valve surgery.

Efficacy of Date Palm Pollen in the Male Sexual Dysfunction after Coronary Artery Bypass Graft: A Randomized, Double-Blind, Clinical Trial

Background

Bypass graft surgery of the coronary artery has a significant effect on the creation and development of sexual dysfunction among male patients. The previous studies have demonstrated that date palm pollen (DPP) increases the count and quality of sperm. Additionally, it has been shown that DPP has a protective effect against myocardial infarction and cardiac remodeling. Therefore, this is the first study investigating the impact of DPP (Phoenix dactylifera L.) on managing male sexual dysfunction after coronary artery bypass graft.

Methods

This randomized, double-blind, placebo-controlled clinical trial was conducted on 60 patients (DPP group n = 30, control group n = 30) of Iranian men after coronary artery bypass graft. Two parallel groups were randomly generated from the study participants. The intervention group was prescribed 3 grams of the powder of DPP twice a day (9 AM and 9 PM) for two months, while the control group received the same prescription of the placebo powder.

Results

The DPP consumption significantly increased the International Index of Erectile Function (IIEF) (from 23.21 to 46.57) and the Hurlbert Index of Sexual Desire (HISD) (from 59.39 to 64.45) scores over time in the intervention group. However, there were no significant changes in the control group.

Conclusion

Daily intake of 6 g DPP for two months exhibited beneficial effects on the symptoms of male sexual dysfunction in patients who have undergone coronary artery bypass graft (CABG).

Relationship between self-efficacy and sexual function after open heart surgery

AIMS

The high level of self-efficacy that facilitates the adaptation of patients to their new lives and accelerates the healing process after open heart surgery has a positive effect on sexual function. The aims of the study are to examine the self-efficacy and sexual function of patients undergoing open heart surgery and factors affecting it.

METHODS AND RESULTS

This descriptive cross-sectional study was conducted with 76 patients (44 females, 32 males). The data were collected with an information form, Barnason Efficacy Expectation Scales (BEES): Cardiac Surgical Version, Beck Depression Inventory (BDI), International Index of Erectile Dysfunction (IIEF), and Female Sexual Function Index (FSFI). The mean age of the patients was 63.12 ± 7.91. It was found that 30.3% of the patients (73.9% female and 26.1% male) were sexually inactive, and they did not receive information about sexual function. The mean BEES: Cardiac Surgical Version score was 43.96 ± 6.07. The mean IIEF score was 19.07 ± 26.0, and the mean FSFI score was 15.67 ± 9.12. There was a positive correlation between BEES: Cardiac Surgical Version and IIEF (r = 0.34; P = 0.00), and there was a negative correlation between BEES: Cardiac Surgical Version and FSFI (r = -0.27; P = 0.01).

CONCLUSION

It was determined that patients did not have sufficient information about sexual life after open heart surgery. The patients had sexual problems after surgery. It was found that sexual function increased with increasing self-efficacy in men, while sexual function decreased with increasing self-efficacy in women.

Sexual Activity After Myocardial Revascularization Surgery

After a cardiovascular event, patients and their families often face numerous changes in their lives. Poorly addressing physical and psychological challenges can lead to an impaired quality of life. Sexuality is an important quality of life aspect to many patients and couples who can be negatively affected by a cardiovascular event. Sexual health requires a positive and respectful approach to sexuality and sexual relationships. Time to resume sexual activity after myocardial revascularization surgery is a gap in cardiologic practice. We know from literature that coronary patients have decreased sexual activity. There are barriers from the medical environment such as lack of knowledge, confidence and training, and many others that arise from the patient's perspective, which do not allow generating a space to address sexual problems. This review aims to familiarize and update cardiologists, providing knowledge and resources to face the impact of myocardial revascularization surgery on the quality of sexual life, promoting multidisciplinary management among doctors and other health professionals.

Sexual Activity After Myocardial Revascularization Surgery

After a cardiovascular event, patients and their families often face numerous changes in their lives. Poorly addressing physical and psychological challenges can lead to an impaired quality of life. Sexuality is an aspect of quality of life that is important to many patients and couples who can be negatively affected by a cardiovascular event. Sexual health requires a positive and respectful approach to sexuality and sexual relationships. The timing of return to sexual activity after myocardial revascularization surgery is a gap in cardiology practice. We know from the literature that coronary patients have a decrease in sexual activity. There are barriers from the medical environment such as lack of knowledge, confidence, and training, and many others that arise from the patient's perspective, which do not allow generating a space to address sexual problems. This review aims to familiarize and update the cardiologist, bringing knowledge and resources closer to the impact of myocardial revascularization surgery on the quality of sexual life of patients, always encouraging multidisciplinary management among doctors and other professionals in health.

The effect of a structured patient education intervention on the quality of life for coronary artery bypass grafting patients: A prospective randomised controlled study

This study aimed to determine the effectiveness of structured patient education on the quality of life for coronary artery bypass grafting patients. The research included 80 patients (40 control, 40 experimental) who underwent coronary artery bypass graft surgery at the cardiovascular surgery ward of a university hospital in Western Turkey and met the criteria to be included in the sample. The following documents were used to collect data: Patient Information Form, Knowledge Level Form and SF36 Quality of Life Scale. It was determined that the structured planned patient education for coronary artery bypass grafting patients effectively improved the patients' knowledge level and quality of life.

Malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, south of Iran: interventional design based on PRECEDE model

Suburban areas suffer from unfavorable conditions as a result of poor health standards, low income, illness, and slight levels of education. One of the most important components in malaria elimination programs is health education. Bandar-Abbas is a malaria endemic city. Therefore, this study aimed to promote malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, Iran, through a PRECEDE model-based intervention program. This quasi-experimental study was carried out on 172 housewives under the coverage of four healthcare centers in Bandar-Abbas in 2016. The participants were randomly divided into two experimental and control groups, based on the inclusion criteria. The data collection tools included ademographic questionnaire, aresearcher-made questionnaire based on the educational phase of the PRECEDE model and achecklist for assessing malaria preventive behaviors. After the pre-test, the educational intervention was implemented on the intervention group at the first stage and the same questionnaire was administered as the post-test for both groups two months after the intervention. In this study, after implementing the intervention using the PRECEDE educational program, asignificant difference was found between the intervention and control groups in the mean scores for predisposing factors (knowledge and attitude) (P< 0.001), enabling factors (P< 0.001) and reinforcing factors (P< 0.001), which contributed to the improvement of preventive behaviors (P< 0.001). The PRECEDE model-based health education was effective in increasing knowledge and attitude, enabling and reinforcing factors, and promoting malaria preventive behaviors in the studied endemic areas.

An initial study on the effect of functional electrical stimulation in erectile dysfunction: a randomized controlled trial

Erectile dysfunction (ED) affects approximately 150 million men worldwide. Functional electrical stimulation (FES) therapy has shown a high regenerative capacity for smooth muscle cells and, therefore, is being increasingly adopted. FES can be a beneficial treatment option when the cause of ED is related to degeneration of cavernous smooth muscle. To evaluate the impact of FES on erectile function in men with erectile dysfunction. Twenty-two patients with ED participated in this randomized clinical trial. Participants were randomly assigned to two groups: intervention (IG) or control (CG). IG participants underwent FES therapy (50 Hz/500 µs) for a total of 4 weeks, divided into two weekly sessions lasting 15 min each, with intensity lower than the motor threshold. CG participants were treated with placebo FES and followed the same routine as the IG. Erectile function was assessed by the validated International Index of Erectile Function (IIEF-5) and Erection Hardness Score (EHS), applied before and after treatment, and quality of life, by the WHOQOL questionnaire. Statistically significant differences in IIEF-5 and EHS were found between the IG and CG after treatment (p <  0.05), as well as a within-group difference in the IG when comparing the post-treatment periods (p < 0.0001) The WHOQOL revealed a significant difference between CG and IG after treatment (p < 0.05), as well as a within-group difference in the IG after treatment (p < 0.0001), except in the Environment domain, in which there was no difference between the pre- and post-treatment periods (50.9 ± 2.8 pre vs. 52.3 ± 3.1 post). This trial showed that FES therapy may improve erectile function and quality of life in men with ED.