Patient Health Engagement Model as the Predictor of Social Support, Self-efficacy, and Quality of Life in Breast Cancer Patients

Background: Patient health engagement (PHE) is a dynamic and evolutionary process that involves improving health; however, little information is available on the PHE model. This study aimed to investigate health engagement and its relationship with social support, self-efficacy, and the quality of life in women with breast cancer. Methods: This cross-sectional study was conducted on 129 breast cancer patients who were referred to a specialized medical clinic and met the inclusion criteria. Data were collected using the EORTC QLQ-br23 questionnaire, Communication and Attitudinal Self-efficacy Scale for Cancer (19-item), Perceived Social Support Scale, NCCN Distress Thermometer, and PHE Scale. The statistical methods used in this study were linear regression, ANOVA, CATREG (Categorical regression with optimal scaling using alternating least squares), and descriptive statistics. Results: The most commonly reported problem was tingling in hands and/or feet (43.3%). The median PHE score was 2. Additionally, 29.45% and 16.27% of the patients reported moderate and severe distress, respectively. The results of regression analysis showed that the PHE scale could predict social support, self-efficacy, quality of life and all of its dimensions (P<0.001). However, it is the strongest predictor of understanding and participating in care (P<0.001, r=0.485). Conclusion: Given that the model can predict factors effective in improving cancer and interventions based on this model have not been performed in Iran, it is recommended that health interventions based on this model should be designed and implemented.

High-risk behaviors and demographic features: a cross-sectional study among Iranian adolescents

BACKGROUND AND OBJECTIVES

High-risk behaviors are considered to be a serious threat among adolescents. This study aimed to investigate the frequency of unhealthy and high-risk behaviors and their relationship with demographic features in adolescents living in Shiraz, Iran.

MATERIALS AND METHODS

The present descriptive, cross-sectional study was conducted on 483 students in the 10th grade of high school. The data were collected using a demographic information form and a modified adolescents high-risk behaviors questionnaire. The reliability of the questionnaire was assessed using the test-retest method. Afterwards, the data were entered into the SPSS statistical software (IBM), version 22 and were analyzed using the chi-square (χ²) test, logistic regression analysis and one-way analysis of variance (ANOVA).

RESULTS

High-risk health behaviors were significantly correlated to adolescents' gender, parents' occupations and education levels, length of residency in Shiraz and talking about important things with one's parents (p < 0.03). Gender predicted 52% of variance of bullying behaviors at school [Exp(B) = 0.502, p < 0.03, 95% confidence interval (CI) = 0.261-0.996]. In fact, most high-risk behaviors were associated with gender (p < 0.001). Indeed, bullying was mostly reported in boys, while being hopeless or sad, suicide attempts and appropriate weight loss behaviors were mostly reported among girls. Additionally, the frequency of smoking cigarettes and using hookahs was higher among girls compared to boys (23.1% for smoking cigarettes and 39.6% for using hookahs). However, no significant correlation was observed between gender and smoking cigarettes and using hookahs (p > 0.704 for smoking cigarettes and p > 0.118 for using hookahs). The most prevalent high-risk behaviors were physical fighting (51.1%), being sad or hopeless (35.2%), alcohol abuse (26.7%), overweight (14.7%) and obesity (8.1%) in both genders. Based on the results, only 26.5% of the adolescents had sufficient physical activity. Besides, the adolescents' weight scores were significantly correlated to eating green salads (p < 0.01), which was seen more among overweight adolescents.

CONCLUSION

The findings indicated that adolescents' gender and their parents' roles should be taken into consideration in designing health promotion programs, such as mental health and its related skills. This would eventually result in the prevention and reduction of unhealthy habits.

Characteristics of care and caregivers of Alzheimer's patients in elderly care homes: a qualitative research

BACKGROUND

Due to the increase in the number of Alzheimer's patients in Iran and also the limitation of cultural knowledge about caring of these patients, this study was designed to explore the perceptions of Iranian caregivers about caring Alzheimer patients in the elderly care homes.

METHODS

A qualitative content analysis method was conducted on two elderly care homes of Shiraz/Iran, during 2009-2011. Fourteen key informants (10 women and 4 men, between 25-35 years of age), who had been working in elderly care homes caring for the elderly with Alzheimer disease for about 1-11 years (Mean=30 months) were selected by purposive sampling method. The caring experience and ability of transferring their experience to others were the main criteria for selection of the participants. They were participated in 2 focus groups and 4 interviews.

RESULTS

Nearly, 800 initial codes were extracted and categorized into 3 groups of "multidimensional care", "going along with the patients" and "need to be professional" and 12 subcategories. Although several aspects of care were mentioned by the participants but the main aspect was physical care. Infantilizing the patients was the main feature of care and caring personality was an important characteristic of caregivers.

CONCLUSION

An appropriate schedule of care considering main categories and subcategories of this research based on cultural context should be prepared. Moreover, consistent promotion of the schedule, employment of trained staff and plans for continued education for them can improve the quality of care and patient's life in elderly care homes.