BackgroundManaging type 2 diabetes (T2D) is assumed to be heavily dependent on patients’ active participation in their own self-care behaviors including prescribed diets.ObjectivesThe purpose of the present study was to investigate the effectiveness of educational intervention based on psychological factors on nutritional behaviors as well as levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) in patients with T2D referring to diabetes clinics and healthcare centers in the city of Izeh, Iran.MethodsA total number of 145 patients were recruited in this clinical trial and then randomly assigned to two groups of intervention (n = 73 individuals) and control (n = 72 individuals). After that, a researcher-made multi-part questionnaire including a demographic characteristics information form, a nutritional perceptions and beliefs questionnaire; a scale measuring fears, concerns, and discomforts associated with diabetic diet, as well as the valid and reliable Perceived Dietary Adherence Questionnaire were used to collect the required data before and 3 months after the completion of the educational intervention. To this end, the patients in the intervention group attended an educational program for eight sessions but the individuals in the control group only received routine services. Data analysis was also conducted using the SPSS Statistics (Version 18) and via descriptive and inferential statistics.ResultsThe findings revealed that the mean scores of the sub-groups of nutritional perceptions and beliefs (but not exaggerated ones) in the patients assigned to the intervention group were significantly higher than those in the control group after 3 months (p = 0.001). As well, the mean scores of the sub-groups of fears, concerns, and discomforts in patients as well as exaggerated beliefs witnessed a significant decrease in the intervention group compared to those in the control group (p = 0.001) 3 months after the educational intervention. Furthermore, the mean scores of adherence to a healthy diet in the intervention group had significantly increased compared to those in the control group. There was correspondingly a significant descending trend in the average levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) in the intervention group compared to those obtained in the control group (p = 0.001).ConclusionThe results of this study shed light on the importance of the effectiveness of psychological factors on achieving health outcomes in patients with type 2 diabetes (T2D). Moreover, a new combination of diet-related psychological factors in patients with diabetes was introduced in the present study.Trial registration IRCT. IRCT20180308039008N1. Registered 15 April 2018, http://www.irct.ir
Type II diabetes (T2D) is a major global health problem (Banerjee, Nema, Dhas, & Mishra, 2017), and its prevalence is rapidly increasing throughout the world (Hu et al., 2015). According to an International Diabetes Federation (IDF) report, 382 million adults in the world had diabetes in 2013 (Han, Kim, Kim, Lee, & Cho, 2017) and this figure is expected to reach 592 million by 2035 (Guariguata et al., 2014). The mentioned statistic also suggests that most of the diabetes patients will have T2D (Han et al., 2017). Currently, more than 4 million people have diabetes in Iran and this figure triples every 15 years (Esteghamati et al., 2014; Zendehtalab, Vaghei, & Emamimoghadam, 2013). According to the experts' unofficial predictions, the diabetes population of Iran will reach nine million by 2020 (Rohani et al., 2016). However, the prevalence of T2D is estimated to be 8.6% in Iran (Nosratabadi, Halvaiepour, Yousefi, & Karimi, 2016). The increasing prevalence of diabetes leads to extensive treatment costs. In this regard, in the United States, the total cost of DM amounts to $2108/patient per year (Leon & Maddox, 2015), because diabetes is associated with an increased risk of cardiac, renal and neurological diseases, visual impairment and early mortality (Baraz,
Background The adherence of diabetic patients to their medication regimen is associated with many psychosocial factors that are still unknown. Therefore, the present study aims to identify the psychosocial barriers to medication adherence of patients with type2 diabetes (T2D). Methodology This descriptive qualitative study was done in Isfahan, Iran by conducting in-depth unstructured interviews with 23 purposively selected patients with T2D and 10 healthcare providers (HCPs). The participants were interviewed face-to-face between November 2017 and June 2018 at the patient’s home, a Health Care Center, or at the diabetes clinic. Data analysis was performed using MAXQDA-10 software and the conventional content analysis. Results The analysis of the data led to six categories of perceived psychosocial barriers: 1) fear, concern and distress, 2) exhaustion and burnout, 3) the children’s issues being the priority, 4) poor financial support, 5) communication challenges, and 6) poor work conditions. Conclusions This study identified some of the psychosocial barriers to medication adherence of patients with T2D, which will be of great help to researchers and HCPs in designing and implementing effective interventions to overcome these barriers and change patient self-care behaviors and increase their medication adherence.
Background It is necessary to evaluate COVID-19 data on Knowledge, Attitudes and Practices (KAP) to confirm effective protective practice and to reduce risk in society. Hence, the study was carried out to determine KAP towards COVID-19 and the factors associated with knowledge and practices among patients with type 2 diabetes (T2D). Methods In this cross-sectional (descriptive-analytical) study, 357 patients with diabetes in Izeh participated in the study. The sampling method used was convenience sampling method. Data collection tool was a researcher-made questionnaire of demographic information and KAP of patients with T2D in relation to the new coronavirus. The validity and reliability of the research tool was confirmed using the content validity and test–retest. Data analysis was done in Stata.14.2 and Smartpls 3.2.8 using descriptive and analytical statistical tests. Results The mean score of participants' KAP towards Covid-19 was 74.22 (16.30), 72.88 (14.87), and 70.51 (19.70), respectively. The lowest and the highest score of the patients' knowledge was in the field of transmission (56.60 (20.96)) and care and prevention of the COVID-19 (88.58 (21.88)), respectively. Residence was the most important factor predicting the practice of diabetic patients with an explanatory coefficient ([SMD 1.08 (95% CI 0.85 to 1.30), P < 0.001] and R2 = 0.87%). Conclusion Despite the good level of KAP of people towards the COVID-19 disease, there were answers showing poor knowledge, incorrect beliefs and attitudes, and insufficient practice regarding different aspects of the COVID-19 in some cases in our study. Residence was a strong predictor of type 2 diabetes mellitus (T2DM) patients’ practice in terms of protective behaviors against Covid-19. Hence, educational needs evaluation based on residence is recommended, especially in rural T2DM patients.
Background Non-adherence of patients with vulvovaginal candidiasis (VVC) to treatment recommendations leads to treatment failure and recurrence of infection. Therefore, this qualitative study was conducted to identify barriers and facilitators of observance of treatment among women afflicted with vulvovaginal candidiasis. Methods This qualitative study was conducted through 26 in-depth unstructured interviews with 24 patients and 2 gynecologists using purposeful sampling with maximum variation in Ahvaz, southwest Iran. Interviews were conducted in person at health centers and the gynecologist’s offices. MAXQDA 10 software and conventional content analysis were used for data analysis. Results The findings showed barriers and facilitator factors of adherence to treatment in women with VVC. Some of these factors lead to an increase in adherence to treatment, and others play the role of hindering factors. These factors were classified into two main categories: patients’ beliefs and patients’ fears and concerns. Conclusion The results of this study showed that many of the behaviors of patients from the acceptance of the diagnosis process to treatment are rooted in the patient's beliefs and fears. Therefore, it seems necessary to design and carry out interventions based on the findings of this study, which can be used in the development of appropriate solutions, treatment guidelines, and adopting a policy for treatment adherence.
Toxic air pollutants are one of the main factors that have the effect of synergism to increase the incidence of multiple sclerosis (MS). This review aims to investigate the effects of toxic air pollutants on the occurrence of multiple sclerosis (MS). A narrative review of the literature was done from 2000 to 2022 based on various databases such as Google Scholar, Web of Science, Springer, PubMed, and Science Direct. In this study, according to the databases, three hundred and sixty articles were retrieved. Of these, 28 studies were screened after review and 14 full-text articles entered into the analysis process. Finally, 9 articles were selected in this study. According to the finding of this study, toxic air pollutants including polycyclic aromatic hydrocarbons (PAHs), heavy metals (HM), volatile organic compounds (VOCs), particulate matter (PM), and gases are the main agents that cause the development and spread of chronic diseases such as respiratory and cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and multiple sclerosis. The result of this study showed that the main sources of emission of toxic air pollutants include industries, cars, power plants, and the excessive consumption of fossil fuels. In general, the inhalation of high concentration of toxic air pollutants can increase the risk of chronic diseases and multiple sclerosis.
Background: Type 2 diabetes is a global problem, and most of people suffering from it are faced with problems caused by it. The use of medicinal plants is increasing among type 2 diabetic patients. Reasons and factors leading to the use of these plants have not yet been fully known. Thus, the present study aims to identify experiences of patients who use medicinal plants to discover factors determining the use of them.The present qualitative study was conducted using a content analysis approach.Methods: This qualitative study was conducted from April 2020 to May 2020 in Yazd City located in Central Iran. The data were collected by conducting in-depth unstructured interviews with 16 type 2 diabetic patients. Convenience sampling was used for selecting participants. In addition, data collection and analysis were conducted simultaneously. To extract categories and themes, the thematic analysis method was employed using MAXQDA 10. The COREQ (consolidated criteria for reporting qualitative research) checklist was employed to ensure the method of conducting the study.Results: Data analysis showed that factors determining the use of medicinal plants fell into six categories. These categories included beliefs about medicinal plants, psychological factors, accessibility and economic barriers, patients' knowledge and awareness, pressure imposed by the society, and the role of family culture.Conclusion: It is essential to promote patients’ information and skills of the proper use of medicinal plants. For this purpose, it is recommended to provide proper counselling and referrals to specialists. Moreover, strengthening pharmaceutical infrastructures of drug storage and distribution in deprived areas could play a significant role in facilitating patient access to common drugs and preventing the use of medicinal plants.
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