The Effect of Continuous Care on the Lifestyle of Patients with Multiple Sclerosis: A Randomized Clinical Trial

The effect of education of self-care behaviors on the quality of life and resilience of multiple sclerosis patients

BACKGROUND

Multiple sclerosis (MS) is one of the most common causes of non-traumatic disability in young adults. Typically, doctors diagnose MS between the ages of 20 and 50. This study aims to determine the effect of educational intervention on self-care behaviors on MS patients' quality of life and resilience in Shiraz, Iran.

METHODS

This interventional study included 90 individuals, aged 15 to 50, who were members of the support association for MS patients in Shiraz city, Iran. The study employed a convenient sampling method. Patients were randomly assigned to two experimental and control groups, and the self-care educational program was conducted during six educational sessions. The quality of life and resilience of the patients were measured before and after the study. Information was collected by completing the questionnaires before and three months after the intervention. To analyze the data, SPSS 23 was used. To describe the data, frequency, percentage, mean, and standard deviation indicators were used, and for analysis, independent t-tests and paired t-tests were used.

RESULTS

This study examined a total of 90 MS patients. 50.4% of the people in the study were married, 40% of them had a high school diploma, and 78.5% were unemployed. The results of the t-test showed that there was a significant difference between all the components of self-care, quality of life, and resilience before and after the intervention (P < 0.05).

CONCLUSION

By accepting the responsibility of self-care, patients would improve the inadequacies and disabilities resulting from the disease, use the power of self-care to solve problems, and improve their quality of life and resilience.

Prevention and Treatment of COVID-19 Using Traditional and Folk Medicine: A Content Analysis Study

Background

Coronavirus 2019 (COVID-19) is a respiratory disease with no specific and definitive drug treatment. With the COVID-19 outbreak, traditional and folk methods were used for its treatment. This study was conducted to explore people's experiences of using traditional and folk medicine for the prevention and treatment of COVID-19 in Iran.

Methods

This qualitative study was conducted on 37 people in Arak (Iran) from May to November 2020 using a conventional content analysis approach. The participants were selected using cluster sampling and interviewed using semistructured telephone interviews. After transcribing the interviews, they were analyzed using content analysis. Accordingly, semantic units were identified, related codes were extracted and placed in subcategories and categories based on similarities, and themes were formed. The interviews continued until data saturation.

Results

After analyzing the collected data, 116 different codes were extracted and classified into two subcategories of pharmacological and non-pharmacological methods. Then, each of the subcategories was classified into two categories: conventional medicine and traditional medicine. Finally, two main themes were obtained, including prevention methods and self-treatment methods for COVID-19.

Conclusion

People use various traditional and folk methods for COVID-19 prevention and treatment. Such methods can be either useful or lack the necessary effectiveness and have side effects. Thus, necessary training should be provided to the public about using these methods and avoiding unapproved treatments.

Effect of Health Belief Model-Based Education on Infection Control Standard Precautions in Prehospital Emergency Staff: A Clinical Trial Study

BACKGROUND

Standard precautions are a basic strategy to prevent occupational exposure in prehospital emergency staff. The Health Belief Model (HBM)-based education can be used to promote and educate health behavior. The aim of this study was to investigate the effect of the HBM-based education on infection control standard precautions in prehospital emergency technicians.

MATERIALS AND METHODS

This clinical trial study was conducted on 84 prehospital emergency staff of Hamadan who were randomly assigned to two groups: Experimental (n: 42) and control (n: 42) using a cluster method. The data were collected by a researcher-developed questionnaire. Before education, the questionnaires were completed by both groups, and then three educational sessions were held for the experimental group within one month. Two months after the intervention, the two groups completed the questionnaire and the data were analyzed by SPSS 21 software.

RESULTS

Before education, there was no significant difference in the mean scores on HBM constructs and performance between the two groups (p > 0.05). The results of the Analysis of Covariance (ANCOVA) after educational intervention showed there was a significant difference in the mean scores of all constructs and performance between the two groups (p < 0.05).

CONCLUSIONS

HBM-based educational intervention could affect the scores of the model's constructs and improve the use of standard precautions in emergency medical technicians. In-service training is recommended to be developed for the staff based on HBM.

Effect of continuous nursing on negative emotion and quality of life in patients with leukemia under chemotherapy

OBJECTIVE

To investigate the effect of continuous nursing on negative emotion and quality of life in patients with leukemia under chemotherapy.

METHODS

Ninety-two patients with leukemia who received chemotherapy in our department were divided into observation group (n=46) and control group (n=46) according to the random number table. The patients in the control group were treated with routine nursing. The patients in the observation group were treated with continuous nursing on the basis of routine nursing. The scores of Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Quality of Life Index Scale (Spitzer) of patients on admission and one month after discharge in both groups were compared.

RESULTS

There was no significant difference in HAMD, HAMA and Spitzer scores of patients on admission between the two groups (P>0.05). After one month of discharge, the HAMD and HAMA scores of patients in both groups were decreased, while the Spitzer scores of patients in both groups were increased (all P<0.05). In addition, compared with the control group, the HAMD and HAMA scores in the observation group were lower, while the Spitzer scores and nursing satisfaction in the observation group were higher (all P<0.001). The incidence of chemotherapy-related adverse reactions in the observation group was lower than that in the control group (P<0.01).

CONCLUSION

Continuous nursing can improve the negative emotion, quality of life and nursing satisfaction in patients with leukemia under chemotherapy.

The Multiple Sclerosis Self-Management Scale-Revised (MSSM-R): Persian Version and Psychometric Analysis

Background

Self-management is the most important component in the treatment of chronic diseases, including multiple sclerosis (MS). The Bishop and Frain Multiple Sclerosis Self-Management Scale-Revised (MSSM-R) is one of the valid tools available for self-management assessment. The purpose of this study was to evaluate the psychometric properties of the MSSM-R in Iranian people with MS.

Methods

This cross-sectional study was conducted in 2018 in the 1600 people with MS in Guilan Province, Iran. In this study, 250 people were selected by convenience sampling. The reliability of the Persian version of this scale was examined by internal consistency and test-retest methods, and validity evidence was evaluated using confirmatory factor analysis.

Results

The MSSM-R had acceptable face and content validity. Confirmatory factor analysis results showed that 24 items on this scale have factor loadings in five subscales. Other results showed the internal consistency, as measured by Cronbach α and test-retest reliability, for the MSSM-R overall (α = 0.85, r = 0.77) and for the following subscales: Healthcare Provider Relationship and Communication (α = 0.83, r = 0.70), Treatment Adherence/Barriers (α = 0.70, r = 0.71), Social/Family Support (α = 0.79, r = 0.85), MS Knowledge and Information (α = 0.89, r = 0.72), and Health Maintenance Behavior (α = 0.77, r = 0.75).

Conclusions

This study provides evidence of the validity and reliability of the MSSM-R. To further ensure its psychometric properties, additional studies with this scale are suggested.

How have researchers defined and used the concept of 'continuity of care' for chronic conditions in the context of resource-constrained settings? A scoping review of existing literature and a proposed conceptual framework

Background

Within the context of the growing burden of non-communicable diseases (NCDs) globally, there is limited evidence on how researchers have explored the response to chronic health needs in the context of health policy and systems in low- and middle-income countries. Continuity of care (CoC) is one concept that represents several elements of a long-term model of care. This scoping review aims to map and describe the state of knowledge regarding how researchers in resource-constrained settings have defined and used the concept of CoC for chronic conditions in primary healthcare.

Methods

This scoping review adopted the modified framework for interpretive scoping literature reviews. A systematic literature search in PubMed was performed, followed by a study selection process and data extraction, analysis and synthesis. Extracted data regarding the context of using CoC and the definition of CoC were analysed inductively to identify similar patterns; based on this, articles were divided into groups. MaxQDA was then used to re-code each article with themes according to the CoC definition to perform a cross-case synthesis under each identified group.

Results

A total of 55 peer-reviewed articles, comprising reviews or commentaries and qualitative or quantitative studies, were included. The number of articles has increased over the years. Five groups were identified as those (1) reflecting a change across stages or systems of care, (2) mentioning continuity or lack of continuity without a detailed definition, (3) researching CoC in HIV/AIDS programmes and its scaling up to support management of NCDs, (4) researching CoC in NCD management, and (5) measuring CoC with validated questionnaires.

Conclusion

Research or policy documents need to provide an explicit definition of CoC when this terminology is used. A framework for CoC is suggested, acknowledging three components for CoC (i.e. longitudinal care, the nature of the patient–provider relationship and coordinated care) while considering relevant contextual factors, particularly access and quality.

Electronic supplementary material

The online version of this article (10.1186/s12961-019-0426-1) contains supplementary material, which is available to authorized users.

The Effect of Collaborative Care Model-Based Intervention on Hope in Caregivers and Patients with Multiple Sclerosis: A Randomized Controlled Clinical Trial

BACKGROUND

Multiple Sclerosis can affect the patients' and their families' life. In this regard, the collaborative care model could be useful. This study aimed to investigate the effect of the collaborative care model on hope in patients with Multiple Sclerosis (MS) and their family caregivers.

METHODS

This randomized controlled clinical trial was conducted in May to September 2015 on 60 patients with MS referring to the MS Society of Khuzestan province and 60 family caregivers. After block randomization, the intervention groups (patients and caregivers) received 8 intervention sessions based on collaborative care model over 12 weeks. The data were collected using Snyder's adult hope scale and a demographic questionnaire at baseline and 12 weeks after the beginning of the intervention. Data analysis was conducted through SPSS, version 19, using frequency, mean, Chi-square, independent, paired t-tests and Fisher's exact test (P˂0.05).

RESULTS

The results of independent t-test before the intervention showed no significant differences between the patients in the intervention (42.76±8.75) and control groups (43.13±7.20) (P=0.86) and caregivers in the intervention (50.26±5.79) and control groups (49.23±6.71) (P=0.52), regarding the score of hope. However, a significant difference was found in this regard 12 weeks after the beginning of the intervention, between the patients in the control (43.63±6.97) and intervention groups (47.96±8.72) (P=0.03), and caregivers in the control (50.66±5.79) and intervention groups (53.80±4.71) (P=0.02).

CONCLUSION

The collaborative care model promoted hope in patients with MS and their family caregivers. Hence, this model can be used by healthcare personnel for promoting hope among patients and caregivers. Trial Registration Number: IRCT2015051121474N2.