Improving health-related quality of life and adherence to health-promoting behaviors among coronary artery bypass graft patients: a non-randomized controlled trial study

The relationship between health-related quality of life and academic success in nursing students: the mediating role of academic burnout and academic motivation

BACKGROUND

The identification of the key factors that affect academic success in nursing students, including health-related quality of life, academic burnout, and academic motivation, has been of the utmost importance to date. In this context, the present study sought to examine the relationship between health-related quality of life and academic success, with academic burnout and academic motivation mediating that relationship.

METHODS

This analytical cross-sectional study included 262 eligible nursing students selected through convenience sampling from the School of Nursing and Midwifery at Shahid Beheshti University of Medical Sciences, Tehran, Iran. To evaluate health-related quality of life, academic burnout, and academic motivation, the 12-item Short Form Health Survey, the Academic Motivation Scale, and Breso's Academic Burnout Scale were administered, respectively. The study achieved a 95% response rate. Academic success was assessed using the nursing program grade point average. Data analysis was conducted using SPSS Statistics (version 26) and Mplus (version 6.12) software, with a significance level set at 0.05.

RESULTS

The findings of the study indicated that although health-related quality of life did not directly affect academic success, it could potentially enhance academic success through the mediation of intrinsic motivation (B = 0.005, 95% CI = -0.01 to 0.005, p ≤ 0.05). Furthermore, health-related quality of life can increase academic success through the mediation of academic burnout and intrinsic motivation (B = 0.013, 95% CI = 0.005 to 0.02, p ≤ 0.01). This indicates that academic burnout and intrinsic motivation significantly mediate the path from the health-related quality of life to academic success.

CONCLUSIONS

The study findings indicate that nursing education planners and instructors should develop and implement appropriate measures to enhance academic success in nursing students. These measures should also promote their health-related quality of life, academic motivation, and reduce academic burnout.

Benefits of a family-based care transition program for older adults after hip fracture surgery

BACKGROUND

Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery.

METHODS

A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05.

RESULTS

The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support.

CONCLUSION

Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS.

A Theory-Based, Technology-Assisted Intervention in a Hybrid Cardiac Rehabilitation Program for Patients with Coronary Heart Disease: A Feasibility Study

PURPOSE

To assess the feasibility of a technology-assisted intervention in a hybrid cardiac rehabilitation program among patients with coronary heart disease.

METHODS

This study was a two-arm parallel randomized controlled trial. Twenty-eight patients with coronary heart disease were randomly assigned to either the intervention group, receiving a 12-week technology-assisted intervention (n = 14), or the control group (n = 14), receiving usual care. Guided by the Health Belief Model, the intervention group received three center-based, supervised exercise training sessions, a fitness watch that served as a cue to action, six educational videos, and a weekly video call. The Self-efficacy for Exercise, exercise capacity, and Health Promoting Lifestyle Profile II were assessed at baseline and immediately post-intervention (12-weeks).

RESULTS

Among the 28 patients who participated in this study, 85.7% completed the program, with a relatively low attrition rate (14.3%). The number of exercise training sessions accomplished by the participants in the intervention group was 51.27 ± 19.41 out of 60 sessions (85.5%) compared to 36.46 ± 23.05 (60.8%) in the control group. No cardiac adverse events or hospitalizations were reported throughout the study. Participants in the intervention group showed greater improvement in health-promoting behaviors when compared with the control group at 12 weeks. Within-group effects demonstrated improvement in exercise self-efficacy and exercise capacity among participants in the intervention group. A participant satisfaction survey conducted immediately post-intervention revealed that participants were "very satisfied" (23.1%) and "satisfied" (76.9%) with the technology-assisted intervention.

CONCLUSIONS

The findings demonstrated that technology-assisted intervention in a hybrid cardiac rehabilitation program was feasible and suggested to be beneficial in improving exercise self-efficacy, exercise capacity, and health promoting behavior among patients with coronary heart disease. A full-scale study is needed to determine its effectiveness in the long term.

TRIAL AND PROTOCOL REGISTRATION

ClinicalTrials.gov NCT04862351. https://clinicaltrials.gov/ct2/show/NCT04862351.

Relieving care burden and promoting health-related quality of life for family caregivers of elderly people with Alzheimer's disease via an empowerment program

BACKGROUND

Effective strategies should be adopted to reduce care burden (CB) and improve health-related quality of life (HRQoL) in family caregivers (FCGs) of elderly people with Alzheimer's disease (AD). Therefore, the purpose of this study was to determine the impact of empowerment program (EP) on CB and HRQoL of FCGs.

METHODS

The present two-group experimental study was conducted on 70 FCGs of the elderly with AD who were selected by convenience sampling and randomly assigned to the empowerment program group (EPG, n = 35) and control group (CG, n = 35). Data collection tools were 12-item Short Form Health Survey and Zarit Burden Interview. The EP was held for 5 weeks, one session of 20 to 30 min each week. Data were collected before, immediately and 3 months after EP and analyzed by SPSS version 25 software at a significance level of 0.05.

RESULTS

The results showed a significant decrease in the mean CB score in FCGs of elderly with AD in EPG before, immediately and 3 months after EP (p < 0.001). The result also revealed that there was a significant increase in the mean HRQoL score in EPG immediately and 3 months after EP (p < 0.001).

CONCLUSIONS

According to the results of this study, EP can reduce CB and increase HRQoL in FCGs of elderly with AD. Policymakers and planners active in the field of healthcare for the elderly can benefit from the results of our study to improve the health of FCGs of the elderly with AD.

Reducing care burden and improving adherence to health-promoting behaviors among family caregivers of patients with multiple sclerosis through a healthy lifestyle empowerment program

BACKGROUND AND AIM

The chronic, progressive nature of multiple sclerosis (MS) demands long-term family-centered care for patients. In view of that, inadequate education and support provided for the family caregivers (FCGs) of MS patients increase their care burden (CB) and affect their lifestyle. This study aimed to investigate the impact of a healthy lifestyle empowerment program (HLEP) on CB and adherence to health-promoting behaviors (HPBs) in the FCGs of patients suffering from MS.

METHODS

In this experimental study with parallel groups, conducted in Iran in 2020, a total of 60 FCGs of MS patients were recruited, and then randomized into intervention (n = 30) or control (n = 30) groups. The intervention program, the HLEP, was thus implemented virtually via WhatsApp in the intervention group upon coordinating with the MS Association in the city of Yasuj, Iran, and selecting the participants. The data were collected at three stages, including baseline, follow-up 1 (immediately after the HLEP), and follow-up 2 (three months after HLEP). The research tools were a 14-item demographic survey questionnaire, the 24-item Caregiver Burden Inventory, and the 52-item Health-Promoting Lifestyle Profile-II. Independent-samples t-test, repeated measures analysis of variance, and a linear mixed model were further used for statistical analyses, considering the significant level of 0.05.

RESULTS

The study results revealed a significant decrease in the CB scores from the baseline to the follow-up 2 (77.03 ± 15.76 to 42.33 ± 12.37), and a significant increase in the values of adherence to HPBs from the baseline to the follow-up 2 (123.53 ± 14.01 to 148.06 ± 15.04) were obtained in the intervention group (p < 0.001). The linear mixed model also showed that the significant absolute changes in the scores of CB and adherence to HPBs during the follow-ups in the intervention group, compared to those in the controls, were - 8.92 and 16.47 units, respectively (p < 0.001).

CONCLUSION

Health care managers, planners, and providers are highly recommended to start developing and implementing various HLEPs for reducing CB and improving adherence to HPBs among the FCGs of patients with MS.

Design and implementation of a follow-up and training program of health-promoting lifestyle after the coronary artery bypass graft

BACKGROUND

Coronary artery bypass graft (CABG) plays an important role in reducing coronary heart disease mortality, but patients are still at risk after surgery. Consequences can be avoided if threatening behaviors are soon detected and lifestyles are promoted. Therefore, the present study aimed to evaluate, follow-up, and promote a healthy lifestyle in the patients.

MATERIALS AND METHODS

The present research was a quasi-experimental pre- and postintervention single-group study on 35 patients under the CABG at two hospitals affiliated to the Baqiyatallah University of Medical Sciences in Tehran from August 2020 to April 2021. The samples were selected using the purposive sampling method and the educational content was determined by creating an expert panel. We utilized the Health-promoting Lifestyle Profile II to collect data, and SPSS 22 to analyze them.

RESULTS

There was a significant difference between mean total scores of health-promoting lifestyle before and after the intervention and they reached from 138.7 ± 20 to 157.2 ± 18 (P < 0.0001). There was also a statistically significant difference between mean scores of nutrition (P < 0.003), physical activity (P < 0.0001), health responsibility (P < 0.0001), and stress management (P < 0.0001) before and after the intervention, but there was no statistically significant difference between mean scores of interpersonal relationships, and spiritual growth before and after the intervention.

CONCLUSIONS

The program had a positive effect on the health-promoting lifestyle scores of patients after CABG. It is possible to increase scores of healthy lifestyles in the patients by combining face-to-face and virtual training methods as well as involving family members and relatives of patients in training and follow-up programs.