Palliative care is the science of promoting the patient's quality of life. It can improve the quality of life of a patient, which is effective not only in patient's late-life but also useful in dealing with a chronic illness over many years. In this regard, nurses, as the largest providers of health care services, play an important role in palliative care.Objective: This study aimed to investigate the palliative care knowledge of nurses and its contributing factors.
Materials and Methods:This cross-sectional study was conducted on 280 nurses working in different departments of hospitals affiliated to Guilan University of Medical Sciences (GUMS). They were recruited using the stratified random sampling technique. Their data were collected by a demographic form and the Palliative Care Quiz for Nursing (PCQN) instrument. The collected data were analyzed by Kruskal-Wallis and Mann-Whitney U tests.
Results:The Mean±SD score of palliative care knowledge of study nurses was reported as 7.86±2.16 indicating their imperfect knowledge. Among studied factors, only the personal study about palliative care had a significant association with the nurses' knowledge (P=0.038).
Conclusion:Nurses had poor knowledge of palliative care and its subscales that is one of the main obstacles in providing optimal palliative care. So, increasing their quality of palliative care services by improving their knowledge through in-service education and on the job retraining could promote the quality of palliative care services for the patients.
Objective:The purpose of this study was to evaluate the disability in patients with spondylolisthesis who assigned either to posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF) and to compare it between two groups.Methods:In a prospective observational study, 102 surgical candidates with low-grade degenerative and isthmic spondylolisthesis enrolled from 2012 to 2014, and randomly assigned into two groups: PLF and PLIF. Evaluation of disability has been done by a questionnaire using Oswestry Disability Index (ODI). The questionnaire was completed by all patients before the surgery, the day after surgery, after 6 months and after 1-year.Results:There were no statistically significant differences in terms of age and sex distribution and pre-operation ODI between groups (P > 0.05). Comparison of the mean ODI scores of two groups over the whole study period showed no significant statistical difference (P = 0.074). ODIs also showed no significant differences between two groups the day after surgery, 6th months and 1-year after surgery (P = 0.385, P = 0.093, P = 0.122 and P = 433) respectively. Analyzing the course of ODI over the study period, showed a significant descending pattern for either of groups (P < 0.0001).Conclusion:Both surgical fusion techniques (PLF and PLIF) were efficient to lessen the disability of patients with spondylolisthesis, and none of the fusion techniques were related to a better outcome in terms of disability.
Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is associated with functional and cognitive outcomes of stroke and plays a key role in preventing neuronal death. This study aimed to answer the following question: does BDNF Val66Met polymorphism prognosticate survival status and risk of post-stroke dementia (PSD)? In a retrospective cohort study, 206 patients with ischemic stroke (IS) entered the study. They were consecutively being admitted to the neurology clinic in Poursina Hospital (northern Iran) from 2012 to 2014. The diagnosis of PSD was based on DSM-5 criteria. The current and the premorbid cognitive statuses of the patients were respectively assessed through the third edition of Addenbrooke's Cognitive Examination and the Informant Questionnaire on Cognitive Decline in the Elderly. BDNF Val66Met gene polymorphism was determined by PCR-RFLP. On average, 48 patients (23.3 %) developed PSD 6 months after IS. Log-rank test showed that the survival rate of at least one Val-allele carriers was significantly lower than that of Met/Met homozygotes (P = 0.0005), and the former developed PSD sooner than the latter (375, 492 days, respectively). Cox model showed that heterozygous carriers of Val/Met were at greater risk of PSD over time (HR 2.280, 95 % CI 1.566-4.106, P = 0.006). However, the risk ratio of patients with PSD among different BDNF genotypes decreased after adjusting demographic, clinical, and vascular risk factors, and was no longer statistically significant (AHR 2.434, 95 % CI 0.597-9.926, P = 0.215). Val-allele carriers or Val/Met genotypes were more quickly diagnosed as having dementia after IS. However, this genetic vulnerability became more destructive when it was added to demographic, clinical, and vascular risk factors.
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