BackgroundHemodialysis patients face numerous physical and psychological stresses that result in reduced health. The aim of this study is to determine the impact of an empowerment program on self-efficacy, quality of life, clinical indicators of blood pressure and interdialytic weight gain, and laboratory results in these patients.MethodsThis randomized, controlled trial was conducted at Boo Ali Sina Dialysis Center, Shiraz, Iran. A total of 48 hemodialysis patients participated in this study. After acquisition of informed consent, eligible patients were randomly divided into two groups, control and experimental. Pre-test data were obtained by using a demographic data form and two questionnaires for self-efficacy and quality of life. Blood pressure and interdialytic weight gain were measured. We extracted laboratory data from patients’ charts. A six-week empowerment intervention that included four individual and two group counselling sessions was performed for the experimental group. Six weeks after intervention, post-test data were obtained from both groups in the same manner as the pre-test. Data were analyzed by ANCOVA using SPSS v11.5.ResultsThere were no statistically significant differences in demographic variables between the groups. Pre-test mean scores for self-efficacy, quality of life, blood pressure, interdialytic weight gain and laboratory results did not differ between the groups. There was a significant difference between the experimental and control groups in terms of pre-to post-intervention changes in overall self-efficacy scores, stress reduction, and decision making, in addition to overall quality of life and all dimensions included within quality of life based on this questionnaire. Additionally, the pre- to post-intervention changes in systolic/diastolic blood pressures, interdialytic weight gain, hemoglobin and hematocrit levels significantly differed between the groups.ConclusionOur study demonstrates that a combination of individual and group empowerment counselling sessions improves self-efficacy, quality of life, clinical signs, and hemoglobin and hematocrit levels in hemodialysis patients. Empowerment of hemodialysis patients should be considered in hemodialysis centers to assist patients with the management of their health-related problems.Trial registrationIrct ID: IRCT138901172621N4

BackgroundSeveral lines of evidence suggest that early sensory stimulation and regular family visiting programs are potential nursing interventions to improve the outcomes of head injured comatose patients. However, little is known about the impacts of family involvement in providing sensory stimulation.ObjectivesTo determine the effects of a sensory stimulation program conducted by nurses and families on the consciousness, level of cognitive function, and basic cognitive sensory recovery of head injury comatose patients.Patients and MethodsThis was a randomized clinical trial performed at the Shiraz level I trauma center including 60 head injured comatose patients with an initial Glasgow coma score (GCS) of less than 8. Patients were randomly assigned to receive sensory stimulation by a qualified nurse (nurse group; n = 20), by the family (family group; n = 20), or usual care (control group; n = 20). The sensory stimulation program involving the nurses and patients’ families was conducted, twice daily, in the morning and evening for 7 days. The level of consciousness, level of cognitive function, and basic cognitive sensory recovery of the patients were evaluated and monitored using the GCS, Rancho Los Amigos (RLA), and Western Neuro-Sensory stimulation profile (WNSSP). Data were analyzed by chi square, Kruskal-Wallis, and repeated-measures tests using SPSS.ResultsAll the patients were comparable regarding their baseline characteristics, level of consciousness, level of cognitive function, and basic cognitive sensory recovery determined by GCS, RLA, and WNSSP. Although the two intervention groups of the study improved, those who received the sensory stimulation program from their families had significantly higher GCS (P = 0.001), RLA (P = 0.001), and WNSSP (P = 0.001) scores after 7 days when compared to the two other groups.ConclusionsThe application of sensory stimulation by families led to significant increases in the consciousness, level of cognitive function, and basic cognitive sensory recovery of comatose patients with severe injuries.

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Background and aimSome physical, emotional and social changes arise in mothers during the postpartum periods which can affect the quality of life (QOL) of the mother and family. Given the importance of the quality of life in the postpartum period and its influencing factors such as method of delivery, the present study aimed at investigating the relationship between the quality of life and methods of delivery in the world, using a systematic review and meta-analysis method.MethodsThe present study is a systematic review and meta-analysis on the relationship between aspects of quality of life and method of delivery in the world conducted in Persian and English language articles published by the end of 2015. For this purpose, the databases of Medlib, SID, Scopus, ISI Web of Science, PubMed, Google scholar, Irandoc, Magiran and Iranmedex were searched using key words and their compounds. The results of studies were combined using the random effects model in the meta-analysis. Heterogeneity of studies was assessed using I2 index and Cochran test and data were analyzed using STATA Version 11.1 and SPSS Version 16.ResultsBased on the results of the meta-analysis of studies, the aspect of physical functioning had the highest quality of life mean score in women with vaginal delivery: 74.37 (95% CI: 67.7–81) and mental health had the highest QOL mean score in women with cesarean delivery: 65.8 (95% CI: 62.7–69). Also, based on the time elapsed since delivery, mental health had the highest mean score in less than 1 month, 2 months and 4 months’ postpartum. Physical pain had the highest mean score 6 months after giving birth, and mental functioning in 8 months after giving birth.ConclusionsThe results of the present meta-analysis showed that the mean scores for most dimensions of quality of life in women with vaginal delivery were higher than in women with cesarean delivery.

Background: Premature birth is the main cause of neonatal mortality and long-term complications, which imposes heavy financial and psychological burdens on the family and society; therefore, it is important to recognize the factors affecting it. Objective: The aim of this study was to determine the relationship between socioeconomic status, psychosocial factors, and food insecurity with preterm delivery. Materials and Methods: This longitudinal study was conducted on 674 pregnant women at 24-28 wk of gestation who met the inclusion criteria. The subjects were selected using cluster sampling. The pregnant women filled out total questionnaires of study and they followed up until delivery and the data about the newborn was collected after delivery. The data collection tools included questionnaires for evaluating socioeconomic status, psychosocial factors, and food insecurity. Results: The prevalence of preterm delivery was 7.7%, and socioeconomic factors were not associated with preterm labor. Among the intermediary factors, social health, food insecurity, stress, and prenatal care had a significant relationship with preterm labor. The prevalence rates of preterm delivery in cases with food insecurity, stress, and inadequate prenatal care were 2, 9.1 and 13.2 times higher than those who had food security, did not experience stress, and received adequate care during pregnancy. Conclusion: Preterm labor is a relatively common problem in which intermediary social determinants of health can play an important role. Considering the limited studies on this issue, the results of this study can lay the foundation for future studies.