Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients

BACKGROUND

Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF.

METHODS

A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests.

RESULTS

The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03-0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03-0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016).

CONCLUSIONS

Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient's condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.

The Meaning of Life Related to Heart Disease and Its Relationship to Quality of Life After Repeat Coronary Artery Angioplasty

PURPOSE

Following angioplasty for coronary artery disease, patients may search for a new meaning of life. The purpose of this study was to determine patients' meaning of life related to heart disease and its relationship to quality of life after repeat coronary artery angioplasty.

METHODS

The current descriptive-correlation study recruited 144 patients with coronary artery disease admitted to hospitals in Karaj, Iran. Data were collected using a demographics questionnaire, the Meaning in Heart Disease (MHD) instrument, and the Iranian version of the Short Form Health Survey (SF-12), and were analyzed with descriptive statistics and the Pearson correlation.

FINDINGS

There was a significant relationship between the meaning of life related to heart disease (creating illusions, changing goals, reattribution, and meaning congruence) and quality of life scores (p <.05).

CONCLUSION

The majority of the patients undergoing repeat angioplasty used the creation of illusions to support a positive attitude toward their heart disease. Nursing interventions based on the individual patient's meaning of life can promote health and life quality.

Perceived Barriers to Mammography Adoption among Women in Iran: A Qualitative Study

Background

Breast cancer is the most commonly diagnosed tumorous cancer and the second leading cause of cancer-related deaths among women worldwide. This study aimed to qualitatively explore the barriers to mammography adoption among Iranian women.

Methods

This study is a qualitative component of a large research project on exploratory sequential mixed method design, utilizing conventional content analysis. In total, 24 participants were selected from among women who had participated in the first phase of the study. Data were collected through in-depth, semi-structured interviews.

Results

Five main themes were extracted, consisting of unawareness of mammography, fear control, priority of mammography needs, inadequate competency of mammography centers, and a sense of losing family support.

Conclusion

Different perceived barriers within various levels (individual, intrapersonal, health systems, and community) play influential roles in women’s decisions to participate in breast cancer screening program, which indicates the cultural aspect of perceived barriers in different communities and countries. The study provides the basis for intervention planning in this regard.

Assessing the mediating role of breast conflict on cognitive factors associated with adopting mammography

Breast conflict may represent a woman's unpleasant feelings toward her breasts, which may adversely affect her decision to undertake the procedures for an early detection of breast cancer. The purpose of the present study was to examine the mediating role of breast conflict in cognitive factors, as suggested by the Health Belief Model (HBM), for adopting mammography. In this explanatory cross-sectional study, multistage cluster sampling was employed to recruit 738 women in the age range of 40 to 69 years in Iran. Champion's revised HBM Scale for mammography adoption and the Women's Breast Conflict Scale were used to measure the variables of interest. Generalized structural equation modeling and hierarchical logistic regression were used for data analysis. Breast conflict was negatively associated with perceived barriers of mammography. Perceived barriers were inversely related to self-efficacy, which was positively related to mammography, suggesting the mediating role of perceived barriers and self-efficacy, connecting breast conflict to mammography indirectly. The mediating role of breast conflict in perceived barriers and self-efficacy suggests an indirect link between breast conflict and mammography. Clinicians and public health-care providers must pay attention to women's feelings in formulating and delivering appropriate interventions and consultations.

Prevalence of low back pain and its related factors among pre-hospital emergency personnel in Iran

Objective: Low back pain is one of the most important job injuries among emergency medical personnel. This study was carried out to investigate the prevalence of low back pain as well as its physical, mental and managerial predisposing factors among emergency medical personnel in Iran. Methods: In this analytical cross-sectional study we recruited 298 pre-hospital emergency medical personnel based on census sampling. Data were gathered using Nordic and a research-made questionnaire related to physical, mental and managerial back pain factors. Data were analyzed using SPSS version 20. Descriptive and analytical tests including chisquare test were used appropriately. P value less than 0.05 was considered as the level of significance. Results: Findings showed that 46.3% of pre- hospital emergency technicians had a history of low back pain with different intensities. We observed a significant relationship between age, work experience, occupational-physical factors with low back pain (P>0.001). However, there was no significant relationship between occupational-managerial factors and mental-occupational factors with low back pain (P>0.05). Conclusion: Results show that the prevalence of back pain among emergency medical personnel is high. Identifying the factors associated with back pain can help the managers as well as the personnel to control the problem of back pain and increase employees’ productivity.

The effect of two educational methods on knowledge and adherence to treatment in hemodialysis patients: clinical trial

INTRODUCTION

Patients with chronic renal disease (CRD) deal with many potential problems with hemodialysis for all their life. Regarding the importance of preventing dialysis adverse effects, which are in close connection with lack of knowledge and report on how to train the patients? This study aims at comparing the impact of two methods of face to face training and training pamphlet on complying and informing of hemodialysis treatments.

METHODS

This clinical trial study was conducted on 58 hemodialysis patients who visited Shahid Rahnemun Teaching hospital, Yazd, Iran, and had required conditions of the research. Data were collected through a questionnaire including personal-social information, several questions to assess the level of compliance and to inform the treatment method. The quantitative analysis of this study used the Statistical Package for Social Sciences SPSS version 13 and descriptive (frequency, mean, standard deviation) and inferential (Chi-square, paired t-test, ANOVA, ANCOVA) statistics were employed.

RESULTS

The mean scores for informing both groups (face to face and training pamphlet) were significantly increased. The mean score for adherence to treatments was also significant.

CONCLUSION

In this research, face to face training was found to be more effective than training pamphlet. It seemed to have more strong effect on increasing the level of information and adherence to treatment. To train these people, face to face training should be, thus, preferred.

Comparison of pectoral angina misconception among Iranian nurses, nursing students and patients

Background and objective: previous studies revealed some angina misconception among patients and health care providers. The aim of this study was to assess the misconceptions about angina held by nurses, nursing students and patients. Materials and methods: In this cross sectional study, 120 nurses, 120 nursing students, and 120 patients with angina pectoris in Iran participated. Data were gathered by using the York angina belief Questionnaire version 1. The mean of angina misconception were compared by using ANOVA analysis of variance. The correlations between the questionnaire and the variables were calculated by regression. α < 0.05 was considered significant. Results: Nursing students had a significantly lower misconception than patients and nurses (39.03 ± 6.35 vs. 43.70 ± 7.22 in nurses and 43.78 ± 5.77 in patients, P = 0.001). However, the differences between nurses and patients with angina, regarding the misconception score, were not significant: 43.70 ± 7.22 vs. 43.78 ± 5.77, P = 0.9, and no statically significant association was made between age, sex, education, training and number of misconception in patients, nurses and nursing students. Conclusion: Nurses have the most pregnant relationship with patients at different stages of their treatment and can play an important role in assessing their misconceptions and intervention to dispel them. It seems that the nursing students and the nurses' continual professional educations should be emphasized to use the scientific knowledge to dispel the misconceptions in patients.

The effect of folic Acid on menopausal hot flashes: a randomized clinical trial

INTRODUCTION

The use of alternative therapies for the treatment of menopausal hot flashes has increased due to the serious risk of hormone therapy. Most alternative therapies have not been accepted by women. Therefore, conducting a study to find effective treatment, which has a low rate of complications and is more acceptable, is necessary. The aim of this study was to assess the effects of folic acid on menopausal hot flashes.

METHODS

In the present study 70 menopausal women were placed into two groups of 35 with random allocation, and were treated with folic acid 1 mg tablets and placebo tablets once a day during four weeks. Information was gathered by questionnaire, interviews, and hot flash diary during five stages. Comparisons of within-group RESULTS were performed by ANOVA and between-group results were performed using ANCOVA. Data were analyzed by SPSS for Windows.

RESULTS

There was a significant difference between mean severity, duration, and frequency of hot flashes before and after treatment within both groups. In comparing the results between the groups, mean hot flash severity in second, third, and fourth weeks were significantly different. The mean hot flash frequency was significantly different in third and fourth weeks, and the mean hot flash duration was significantly different in the fourth week.

CONCLUSION

The results of the present study indicated that folic acid was effective in reducing the severity, duration, and frequency of hot flashes during menopause. Therefore, it can be recommended as an affordable and accessible method for treating menopausal hot flash for women.

The effects of intravenous fluids temperature on perioperative hemodynamic situation, post-operative shivering, and recovery in orthopaedic surgery

BACKGROUND

Perioperative hypothermia is physiologically stressful because it elevates blood pressure, heart rate and plasma catecholamine concentration that may increase the risk of cardiac complications, bleeding, wound infection, and post-anaesthesia care unit stay. This study was designed to evaluate the effects of warming intravenous fluids on perioperative hemodynamic situation, post-operative shivering and recovery in orthopaedic surgery patients.

METHODS

Perioperative pulse rate, blood pressure, intraoperative esophageal and skin temperature were measured in sixty patients undergoing orthopaedic surgery that were randomly divided into two groups according to intraoperative IV fluids management. In 30 patients (hypothermia group) all IV fluids infused were at room temperature. In the other 30 patients (normothermia group) all IV fluids were warmed using a dry IV fluid warmer.

RESULTS

The core and skin temperatures of the hypothermia and normothermia groups decreased significantly between the induction of anesthesia and the end of surgery, but the drop was greater in the hypothermia group (P < 0.005). Postoperative mean arterial blood pressure (non-invasive) increased significantly more in the hypothermia group versus normothermia group (p < 0.005). Shivering was observed in 21 of 30 in the hypothermia group and 11 of 30 in the normothermia group (p < 0.005) and recovery time was significantly lower in the normothermia group (36 +/- 5 vs. 26 +/- 3 min, p < 0.005).

CONCLUSION

Intraoperative IV fluid warming reduces perioperative changes to the hemodynamic situation, post-operative shivering, and recovery time.