Patient Care
Zahra Noori; Parvaneh Khorasani; Habibollah Hosseini
Abstract
Introduction: The purpose of this study was to assess the status of diabetes management among elderly people living in Isfahan nursing homes using the Donabedian framework in three parts: structure, process, and outcome.Methods: In 2018, the current descriptive-cross-sectional approach was used in 13 ...
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Introduction: The purpose of this study was to assess the status of diabetes management among elderly people living in Isfahan nursing homes using the Donabedian framework in three parts: structure, process, and outcome.Methods: In 2018, the current descriptive-cross-sectional approach was used in 13 nursing homes in Isfahan. Data was collected using a dependable and valid research-created checklist that evaluated diabetes management through three components: organizational structure (8 dimensions and 33 items), processes (3 dimensions and 23 items), and outcomes (2 dimensions and 7 items). Data was collected by observing the equipment and human resources, interviewing key informants and nurses, reviewing documents, and collecting blood and urine samples under standard conditions.Results: Structure, process, and outcome mean scores were 34.5±2.6, 38.5±5.9, and 65.6±13.9, respectively. The highest and lowest structure scores were associated with "referral system" and "trained personnel," respectively; process scores were associated with "counseling and risk factor reduction" and "immunization," and outcome scores with "physical examination and history taking" and "documentation of laboratory results." The mean score of structure was found to have a direct relationship with process and outcome (p < 0.05). There was also a direct relationship (p <0.05) between the mean process and outcome scores. Linear regression analysis revealed that structure was a significant predictor of outcome (p = 0.01).Conclusions: The findings revealed some issues with the structure, process, and outcome of providing appropriate diabetes management care in nursing homes. To achieve positive results in this area, it is necessary to focus on the human resources, facilities, and equipment required to manage diabetes in nursing homes.
Patient Care
Fatemeh Ghapanvari; Seyedehzahra Hosseinigolafshani
Abstract
Background: Recent studies on hemodialysis patients have focused more on the suffering caused by physical and psychological problems in them, and they have paid less attention to their caregivers. Since the caregivers of these patients are intensively affected by the physical and psychological problems ...
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Background: Recent studies on hemodialysis patients have focused more on the suffering caused by physical and psychological problems in them, and they have paid less attention to their caregivers. Since the caregivers of these patients are intensively affected by the physical and psychological problems caused by this method of treatment, it is necessary to pay more attention to the challenges as well as the problems that exist among them. This study aimed to describe the lived experiences of caregivers in caring for hemodialysis patients. Methods: The present study is a qualitative study with a phenomenological design. Sampling was first done through a purposive sampling method, and the snowball sampling method was then applied in order to select 21 caregivers for the hemodialysis patients from three hemodialysis centers in Qazvin, Iran. An audio recorder were used to collect the data of in-depth face-to-face semi-structured interviews. The interviews were analyzed using Colaizzi's approach. The criteria of Lincoln and Guba was followed for trustworthiness. Results: Analysis of the interviews in response to the main question revealed 108 initial codes, 18 subcategories, and 3 main themes, including 1. Care: Growth experience, 2. Care: Living in solitary confinement, and 3. In silence: Seeking help. Conclusion: In situations where the caregivers of hemodialysis patients felt they did not have sufficient material and spiritual support from those around them, they reported two different and conflicted experiences. Some people experienced progress and excellence, while others felt stuck and had to make ideal sacrifices. More in-depth research is required to discover the factors that influence such diverse insights.
Patient Care
Razieh Akbari; Shayesteh Salehi; Nasrollah Alimohammadi
Abstract
Background: Most survivors of traumatic head injury, due to functional disorders, are dependent on their family members. In fact, these families are at the forefront of many challenges and stresses. The aim of the present study was to investigate the effectiveness of a family-centered empowerment program ...
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Background: Most survivors of traumatic head injury, due to functional disorders, are dependent on their family members. In fact, these families are at the forefront of many challenges and stresses. The aim of the present study was to investigate the effectiveness of a family-centered empowerment program on the care needs of the families of patients with traumatic head injuries discharged from Al-Zahra Hospital in Isfahan in 2019.Methods: The present study was a clinical trial conducted among 56 family members of patients with traumatic head injury. The samples were randomly allocated to two groups: experiment and control. The experimental group received an empowerment program based on the "family-centered empowerment model" through 3-5 sessions of 45-60 minutes, while the control group received routine education during discharge. Data was collected using a checklist for demographic information as well as the standardized Family Need Questionnaire (FNQ).Results: Based on the findings of the present study, the level that the care needs have been met regarding health information, emotional support, instrumental support, and professional support was statistically significant higher in the experimental group compared to the control group (p < 0.001). The average care needs related to health information, emotional care, and instrumental support were statistically significant lower in the experimental group compared to the control group (p < 0.05). While considering community support network, the average care needs were statistically significant lower in the control group compared to the experimental group (p < 0.05); however, about involvement in care, no statistically significant difference was found between the two groups of experiment and control (p > 0.05).Conclusion: To meet the care needs of the families of patients with traumatic head injuries discharged from medical centers, implementation of the family-centered empowerment program is effective, and it results in improvement and continuous providing of services at home and meeting families’ care needs. Therefore, the application of such programs is recommended for healthcare planners.