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Background. Family-centered intervention can be used as a therapeutic intervention to improve the quality of life (QOL) in clients with ostomy. This study aimed to determine the effects of family-centered intervention on the QOL in ostomy clients. Methods. A quasi-experimental study was carried out with participation of 70 clients with colostomy and 70 caregivers (family members). The participants were selected through convenient sampling and randomly allocated into the experimental and control groups. The experimental group received family-centered education. The education program included four sessions, 50–60 min each, that were implemented in two weeks at hospital wards or clients’ houses for the clients’ companions. Afterwards, the caregivers implemented the care at home for one month. The subjects in the control group received routine care before being discharged. The QOL of the clients in both groups was measured using the city of hope-QOL-ostomy questionnaire before and one month after the intervention. Results. The mean scores of the QOL after family-centered intervention in the experimental and control groups increased from 197.97 to 207.49 and from 195.2 to 199.03, respectively. The paired t-test showed a significant change in the experimental and control groups after the intervention at a confidence level of 95% ( p = 0.0001 ; p = 0.002 ). In addition, after the intervention, however, there was a significant difference between the two groups in all these areas except for social aspects ( p = 0.007 ). Conclusion. Family-centered intervention can be used as a therapeutic intervention to improve the QOL in clients with ostomy. The intervention was effective in the physical, spiritual, psychological, and social health of these clients.

Context: Effective implementation of self-care programs can reduce the treatment costs and the risk of severe complications of heart failure (HF). However, people with low health literacy (HL) fail to properly conduct the complex care techniques. The control of chronic, progressive, and complex diseases largely depends on self-efficacy, adherence to treatment, and health-related quality of life (HRQoL). The purpose of this systematic review is to study research literature to explore the impact of self-efficacy and HL on medication adherence and HRQoL in patients with HF. Evidence Acquisition: Considering the PRISMA guideline, this systematic review study the articles published between 1999 and 2022. The articles written in the English language were recruited from PubMed, Scopus and Web of Science, CINAHL Plus, Embase, Cochrane, PsycINFO and google scholar databases. The quality of the studies was assessed by the organization Agency for Healthcare Research and Quality (AHRQ) and then the data was collected based on the designed checklists. Results: A total of 27 articles met the inclusion and exclusion criteria. The studies were conducted on range of 44 to 705 patients with HF. Inadequate HL was observed to have a high prevalence in HF patients. Health literacy had a direct impact on quality of life and treatment adherence in all studies. Several studies have shown that interventions to increase patient self-efficacy led to greater adherence to treatment, higher quality of life, and lower hospitalization rates in the HF population. Low self-efficacy in patients was linked to high rates of comorbidity. Conclusions: Self-efficacy and HL have a positive effect on the quality of life, adherence to treatment, and reduction of mortality in patients with HF. Therefore, the implementation of training programs to improve these areas should be formulated by the health systems.

Variations in loadings of rolling contact components lead to a change in contact forces between surfaces. These forces are the main cause of rolling contact damages such as fatigue. Residual stresses are a major issue in railway wheel structures and it is appropriate to reduce such stresses.The aim of this paper is to estimate residual stresses in railway wheel due to hub to rim and axle to hub fitting process. a nonlinear three-dimensional model of stress is applied for analyzing stress field during press fitting process. An elastic-plastic finite element model is developed to model variable thermal loading in railway wheel. Finally, results of three dimensional finite element analysis showed a good agreement to field observations.