Background Responsibility for diabetes management tasks must shift from caregivers to adolescents as adolescents grow older. Also, family-centered care is a way to provide efficient care for them at home. This study aimed to identify the effect of family-centered care on management of blood glucose levels in adolescents with type 1 diabetes mellitus (T1DM). Methods This is a Pre-experimental study with a pre- and post-test design. The participants consisted of forty adolescents with T1DM, aged between 10-14 years, with their caregivers who were selected through simple random sampling from Hamadan Diabetes Research Center in Iran in 2013. The sample was divided into four similar groups. Educational sessions were conducted for each group for 30 to 40 minutes. Data collection tools were “Supervisory Behaviors of Caregiver” (SBC), “Management Behaviors of adolescents” (MBA) questionnaires, and the “Blood Glucose Levels Record Sheet”. Data were analyzed using SPSS 19 and based on descriptive statistics, Kolmogorov-Smirnov, paired t-test and Pearson coefficient. Results There was a significant difference between the subjects’ MBA and SBC mean scores before (110.17±26.6) and after (134.6±1.28) intervention in four domains: “blood glucose testing”, “insulin therapy”, “meal plan” and “physical activity” (P<0.001). There were significant differences between the mean levels of recorded blood glucose during a week before and after intervention and between the mean levels of Glycated Hemoglobin level (HbA1c) before (8.4±1.12) and three months after (7.78±1.2) it (P<0.001). Pearson coefficient showed a positive relationship between the supervisory behaviors of caregivers with management behaviors of adolescents before and after the intervention (P<0.001). Conclusion Empowering adolescents with T1DM and their caregivers in home-centered care could improve diabetic adolescents’ management of blood glucose levels and reduce their HbA1Clevels. Therefore, Family-centered care could provide for better regime adherence at home.
Introduction Emergency medical services (EMS) providers are at continuous exposure to occupational stressors which negatively affect their health and professional practice. This study explored perceived occupational stressors among EMS providers. Methods This qualitative study was conducted from December 2019 to April 2020 using conventional content analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured interviews (with length of 45–60 min) were held for data collection. Data were analyzed through Graneheim and Lundman’s conventional content analysis approach. Findings Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and personal and professional conflicts. The six categories of these two themes were complexity of patients’ clinical conditions, interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts. Conclusion Besides the stress associated with emergency patient care, EMS providers face many different occupational stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress among EMS providers and thereby, improve their health and care quality.
Objective:To assess the efficacy of pharmacotherapy (citalopram) and cognitive therapy, alone or in combination for the treatment of major depressive disorder.Methods:This study was a randomised controlled clinical trial. We randomly assigned 120 adults with a major depressive disorder to 8-week treatment with either citalopram, cognitive therapy, or both. Major depressive disorder was diagnosed using DSM-IV criteria. Patients were assessed with the Beck Depression Inventory before and after treatment.Results:Statistical analysis showed that cognitive therapy, pharmacotherapy, and combined therapy were effective in the treatment of depression. There was no significant difference between medication and cognitive therapy. Treatment with the cognitive therapy intervention and citalopram combined yielded better responses than treatment with citalopram or cognitive therapy alone.
Purpose: Suicide is a complex phenomenon that needs to be studied with a variety of approaches. The purpose of this study is to explore the lived experience of attempted suicide with the phenomenology approach. Method: An interpretive phenomenological approach was used to analyse semi-structured, in-depth interviews with 16 participants (ages 19-57) who were recruited by means of purposive sampling from October to November 2017 at the Farshchian Psychiatric Hospital in Hamadan/Iran. Data analysis was conducted according to van Manen's phenomenological method. Results: Identified three themes and eight subthemes: Mental pain (subthemes: living through grief, internal conflict, the world is better without me), Social challenges (lack of social connection, financial problems, social support services) and Need for love and belonging (feeling understood, need of empathy). Conclusions: Outcomes and key implications of the study related primarily to improving the treatment experiences of suicide attempt survivors and other at-risk population, and also advancing suicide prevention efforts and to provide support for suicide attempt survivors.
Background and Objective: Parents' attitude play important role in children's behavior and child abuse. The aim of current study was to assess the impact of parent role training on the mothers' attitudes with children aged 1-5 years toward child abuse in Malayer. Methods: In the current semi-experimental study with pre and post-tests, 122 mothers with children 1-5 years old were selected through cluster sampling from kindergartens of Malayer in 2016. Then, mothers were randomly selected and divided into two groups of experimental and control (61 in the experimental group and 61 in the control group). "Adult Adolescent Parenting Inventory" questionnaire was used as data collection. Training Group of parental role was held in four sessions for two weeks. Before training and one month after it, questionnaires were completed by both groups. The data were analyzed using SPSS 16. Descriptive statistics, independent and paired t-tests, were applied for data analysis with a confidence level of 0.95. Results: The mean and standard deviation of the attitude scores for the experimental group before and after training were 69.60±7.28 and 86.8 ±14.79, respectively, and this difference was significant (P<0.01). Moreover, the comparison of the mean scores of attitude and its components (its compass) between experimental and control groups revealed a significant difference after the intervention (P<0.01). Conclusion: Parent role training has changed mothers' attitudes about child abuse and improved their attitude toward correct nurture (proper pedagogical) behavior. Therefore, systematic and group training of parental role, by reducing misuse of toddlers and young children, is an important step in their physical and mental health.
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