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Ability to read and comprehend, interacting with health personnel, and interacting with peers as an antecedents and improved self-care, health promotion, medication adherence, and decreased use of health care services to be the consequences of these attributes were found. Conclusion The findings can add knowledge about the concept of health literacy in MS patients. Also, health care professionals can use a deeper understanding of the concept of health literacy in providing care plan for MS patients.Background Maternal near-miss (MNM) is defined as "a woman who almost died but survived a serious maternal complication during pregnancy, childbirth, or within 42 days of completion of pregnancy". Despite the long-term physical and psychological burden of this event on the mother's life, the meaning of MNM is not clear. In addition, the mother's role complicates the understanding of this phenomenon. Therefore, this study aimed to understand lived experience of Iranian "near-miss" mothers in the postpartum period. Methods In this Heideggerian phenomenological study, we used Souza and colleagues' theoretical framework to understand the meaning of the lived experience of near-miss mothers in-depth. The participants had experienced MNM at least one year ago by World Health Organization (WHO)approach in multicenter, academic, tertiary care hospitals in Mashhad, Iran. Taking into account reflexivity and after obtaining ethical approval, participants were purposively sampled using semi-structured interviews, and data analysis was conducted by Diekelmann and colleagues up to data saturation. Data collection and analysis has been argued by Lincoln and Guba. Discussion Our findings resulted in updating the existing knowledge about the meaning of MNM and its implication. Given the different needs and challenges of near-miss mothers, it is necessary to design a supportive program of primary care for them. Policymakers and managers should consider the lived experience of these mothers when planning and taking decisions.Introduction Attachment is a stable connection or emotional knot between two individuals as one of the parties tries to maintain this connection. Delivery time as a turning point between two stages of attachment is very important. Methods In a descriptive-analytical study based on specific inclusion criteria, 262 pregnant women were selected in the age range of 15-45 years old and the gestational age of 37 to 42 weeks who were candidates for physiological or non-physiological delivery. After obtaining written consent forms, the demographic information questionnaire was given to the participants. One hour after delivery, the attachment questionnaire was completed by the researcher in the postpartum ward. Also, the Spielberg anxiety inventory was completed up to 1 hour after delivery. Independent sample t test was used to compare the results between the two groups. Data were analyzed by SPSS software version 21. Results The participants in the physiological delivery group showed more positive attachment behaviors in comparison with the other group. In all three dimensions of attachment (emotional, contiguous, and caring behavior), physiological delivery showed higher scores than the other group. Also in non-physiological delivery group, the participants had experienced higher levels of anxiety and the differences between the groups were not significant. Conclusion Results of the current study indicated that mothers engaged in physiological delivery had higher scores in mother to child attachment behaviors. It means they are more successful than the non-physiological delivery group in getting attached to their babies.Introduction Cardiovascular diseases (CVDs) are one of the most common chronic illnesses and the leading cause of mortality worldwide. This study aimed to design and assess the psychometric properties of questionnaire to examine the care needs of patients with coronary artery disease (CAD) in phase 1 of cardiac rehabilitation (CR). Methods This sequential exploratory study used a mixed method with two phases. In the first phase, qualitative study was performed by analyzing the concept of Schwartz-Barcott-Kim hybrid model; and in the second phase, quantitative data were obtained and analyzed for the psychometric parameters of the designed tool. Results The questionnaire for care needs was based on the indicators of measurement, which was identified in the qualitative phase of the study, as a tool with 40 items. After conducting face validity qualitatively, all tool items were considered important and were retained for the next steps. After completing the steps for determining the content validity ratio (CVR) and content validity index (CVI) of 40 items, they were preserved for decision making at a later stage. The results of exploratory factor analysis revealed four factors; the factor analysis of three items was eliminated and the final version of the questionnaire CNCR-Q (Care Needs Cardiac Rehabilitation-Questionnaire) with 37 items remained. Conclusion The findings indicated that the questionnaire with properties, such as simple scoring, reliability and validity, is an appropriate tool for assessing care needs in Iranian patients with CAD. Moreover, the CNCR-Q is an effective instrument for assessing patient needs before discharge.Introduction Developing new training methods for improving the health of diabetic patients has always been a concern for nurses. The present study aims to investigate the effects of empowerment-based interventions with or without telenursing on self-efficacy and HbA1c level in diabetic patients. Methods In this randomized clinical trial, 156 patients with type-2 diabetes were randomly assigned into two intervention groups (empowerment with/without telenursing) and one control group. All subjects in the intervention groups participated in two sessions of the empowerment program. However, only the group of empowerment with telenursing received telephone counseling for 12 weeks. The patients in the control group did not receive any intervention programs. Self-efficacy was measured by diabetes-specific self-efficacy scale. The HbA1c level was measured using Bionic kit. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, Ill., USA). Results After 14 weeks, while the changes in self-efficacy scores of the control group were not statistically significant, they were significant in the two intervention groups. Comparison of the two intervention groups showed that self-efficacy was higher in the group of empowerment with telenursing. It was only in the empowerment with telenursing group that the reduction of HbA1 c was significant. Conclusion Training based on empowerment models and emphasis on the strengths of clients in solving their own problems can play a major role in increasing self-efficacy and reduction of HbA1c level. In addition, a continuous training program, along with telephone follow-ups can result in higher self-efficacy and lower HbA1c level.Introduction Electroconvulsive therapy (ECT) is the oldest procedure among the early biological treatments introduced in psychiatry. However, the most debated and treatment-limiting adverse effect of ECT is amnesia. Therefore, due to the restriction of the use of drugs to manage amnesia in patients undergoing ECT, the present study investigated the effect of reflexology on amnesia. Methods In this randomized controlled trial, 68 patients who met the inclusion criteria were randomly allocated to intervention and control groups. The intervention group received foot reflexology with olive oil 20 minutes a day for 3 days, while the control group was given a gentle foot rub with olive oil 20 minutes a day for 3 days. The amnesia rate of all patients was measured by the Galveston Orientation and Amnesia Test (GOAT) 30 minutes after the end of ECT. The data were analyzed using SPSS software version 11.5 and t-test, chi-squared test, and repeated measures ANOVA. Results The results showed that reflexology significantly increased recalling scores in the intervention group compared to the control group. Foot reflexology seems to be effective in managing amnesia in patients after ECT. Conclusion Foot reflexology, as a relatively simple, inexpensive, and non-invasive technique with few side effects, can be used to manage amnesia in patients after ECT.Introduction Hospitalization is a stressful event for both patients and relatives. The aim of the study was to explorefactors affecting state and trait anxiety of relatives of hospitalized patients. Methods In this cross-sectional study, was enrolled a convenience sample of 222 relatives of hospitalized patients in a public hospital in Athens, Greece. Data were collected by the completion of State-Trait Anxiety Inventory (STAI) which also included participants' characteristics. Data were analyzed using SPSS version 25, while the statistical significance level was P less then 0.05. Results Of the 222 relatives, 72 were men and 150 women. The average state and trait anxiety score was 45.6 and 42, respectively, within the possible range of scores (20-80) thus indicating moderate levels of anxiety. Moreover, state and trait anxiety was statistically significantly associated with gender, degree of information of patient's health, whether they had readjusted family responsibilities, whether they had financial worries, whether they experienced uncertainty about future and finally whether they were anxious about their ability to respond to patients care. Conclusion Factors associated with relatives' anxiety were gender, information regarding patient's health, family responsibilities, financial worries, uncertainty and anxiety to respond to patients' care. These factors need to be evaluated when planning psychological intervention to alleviate this emotional burden.Introduction There is a growing concern regarding self-care and chemotherapy side effects. The present study aimed to assess the effectiveness of self-care measures on knowledge, self-efficacy, and performance status among cancer patients undergoing chemotherapy. Methods A quasi-experimental study was conducted in Dr. Kamatchi Memorial Hospital, India. Using purposive sampling technique, 200 cancer patients were selected. Patients were interviewed using semi-structured knowledge questionnaires, Modified Stanford Patient Education Research Center Self-efficacy scale, deliberate self-efficacy with rating scale under four subheadings, and ECOG Performance Status Scale with 5-point grading scale i.e., dead to fully active. Results There was adequate knowledge (95%) on self-care measures after the intervention. The mean score was significant, i.e., 21.33 (2.25), which had difference between post-knowledge score in experimental and control was statistically significant at P less then 0.001 level. The majority of patients reported a high self-efficacy level (t = 198.60, P less then 0.001). In addition, despite self-efficacy and knowledge the performance status observed at each cycle, i.e., 4 cycles had mean score of t = 32.13, P less then 0.001, showed high level of performance status. Conclusion The study revealed that the self-care measures during each cycle had improved the selfefficacy and performance status to high level, which in turn reduced the side effects of chemotherapy to the certain level.

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