Efficacy of Dry Cupping versus Counselling with Mindfulness-based Cognitive Therapy Approach on Fertility Quality of Life and Conception Success in Infertile Women due to Polycystic Ovary Syndrome: A Pilot Randomized Clinical Trial

Background

Physical and psychological interventions could affect the quality of life (QoL) of women with infertility. The purpose of this study was to compare the effectiveness of dry cupping and counselling with the mindfulness-based cognitive therapy (MBCT) approach on fertility QoL and conception success in infertile women due to polycystic ovary syndrome (PCOS).

Methods

This was a two-arm pilot randomized clinical trial from first January 2021 to the end of November 2022. In this regard, 19 women with infertility who were referred to the health centers affiliated with Shiraz University of Medical Sciences and met the inclusion criteria were enrolled in the study. Participants were randomly divided into two groups (10 in the virtual MBCT group and 9 in the cupping group). All participants completed the fertility quality of life (FertiQol) tool before the intervention and three months after the end of the intervention. In addition, after the end of the intervention, a human chorionic gonadotropin test was performed monthly for three months, too. We used ANOVA/ANCOVA and its related effect sizes, including mean difference (MD) and standard mean difference (SMD: Hedges's g), and chi-square tests to compare the study group outcomes in Stata 14.2. P-values equal to or less than 0.10 were considered significant.

Results

The intervention resulted in significant differences in the mean overall scores of FertiQol between the counseling and cupping groups (61.76±14.28 and 50.65±12.53, respectively) [P=0.091, MD=11.11 (90% CI: 0.33 to 21.89), SMD=1.07 (90% CI: 0.279 to 1.84)]. No significant difference was found in conception rates between the groups after the intervention.

Conclusion

This pilot study found that MBCT improved the fertility QoL in PCOS-related infertility patients better than cupping therapy.

Trial registration

IRCT201706110334452N1.

Factors influencing health-related quality of life in older adult women with sarcopenia: analysis of the Korean National Health and Nutrition Examination Survey 2019

PURPOSE

This study aimed to identify factors influencing the health-related quality of life (HRQoL) of older adult women with sarcopenia.

METHODS

The study was secondary data analysis using data from the 2019 Korea National Health and Nutrition Examination Survey. The final sample consisted of 142 women aged 60 years and older with sarcopenia and were selected from 8,110 women. The participants was analyzed using complex descriptive statistics, independent t-test, and regression.

RESULTS

In terms of HRQoL, three general characteristics were found to be influential, with an explanatory power of 56.0%: difficulty climbing stairs, difficulty working, and perceived health status. Having no or mild difficulty when climbing stairs (B=.20, p=.001; B=.21, p<.001) and no or mild difficulty when working (B=.25, p=. 002; B=.208, p=.013) had a significant effect on HRQoL compared to severe difficulty. Having good or ordinary perceived health status had a significant effect on the HRQoL (B=.11, p<.001; B=.09, p<.001).

CONCLUSION

Based on study findings that the HRQoL of older adult women with sarcopenia were influenced by difficulty climbing stairs and working, as well as good perceived health status, healthcare providers should assist elderly women to maintain physical activities in their daily lives.

An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model

PURPOSE

This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model.

METHODS

This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment).

RESULTS

The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=-.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=-. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=-.56 p=.023) indirectly affected QoL.

CONCLUSION

It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.

The Added-on of Ziziphus jujube Syrup in the Treatment of Chronic Spontaneous Urticaria Resistant to Standard-Dose of Secondary-generation H1 Antihistamine: A Double-Blind Randomized Clinical Trial

Background

Although antihistamines are the first-line treatment for chronic spontaneous urticaria (CSU), 50% of patients don't respond to standard doses. In this study, the effectiveness of Ziziphus jujube fruit syrup in combination with antihistamines was assessed in patients with CSU.

Methods

This double-blind randomized clinical trial was conducted in Shiraz between December 2019 and December 2020. 64 patients with CSU who had experienced hives for at least six weeks and did not respond to the usual treatments were enrolled in the study. They were randomly assigned to intervention and control groups using permuted block random allocation. For four weeks, the intervention group received 7.5 mL Ziziphus jujube syrup twice a day, while the control group received 7.5 mL simple jujube syrup twice a day. Both groups received cetirizine 10 mg every night. Urticaria activity score (UAS) and CU-Q2oL questionnaires were used to assess urticaria state and sleep quality before and after each week for four consecutive weeks. Data were analyzed using SPSS software version 18, and P<0.05 was considered statistically significant.

Results

Before the intervention, there was no statistically significant difference between the two groups' mean of UAS (P=0.490) and sleep quality (P=0.423). During the follow-up, UAS in the intervention group was significantly lower (P=0.001). Moreover, this difference was significant on the day 28 (P=0.046). During the follow-up, the quality of sleep in both groups improved significantly, and this improvement was more significant in the intervention group.

Conclusion

Ziziphus jujube syrup could be an effective adjuvant treatment for CSU.Trial Registration Number: IRCT20190304042916N1.

Effects of anxiety, depression, social support, and physical health status on the health-related quality of life of pregnant women in post-pandemic Korea: a cross-sectional study

PURPOSE

This study aimed to examine the effects of anxiety, depression, social support, and physical health status on the health-related quality of life of Korean pregnant women using Spilker's quality of life model.

METHODS

This was a cross-sectional study with a correlational design. The participants included 166 pregnant women who were recruited via convenience sampling at two healthcare centers in South Korea. Questionnaires were collected from April 22 to May 29, 2023, in two cities in South Korea. The EuroQol-5D-3L, General Anxiety Disorder-7, Patient Health Questionnaire-2, Perceived Social Support through Others Scale-8, and EuroQol visual analog scale were used to assess the study variables. The t-test, Pearson correlation coefficients, and multiple regression tests were conducted using IBM SPSS ver. 26.0.

RESULTS

Statistically significant correlations were identified between the health-related quality of life of pregnant women and anxiety (r=.29, p<.001), depression (r=.31, p<.001), social support (r=-.34, p<.001), and physical health status (r=-.44, p<. 001). Physical health status (β=-.31, p<.001) and social support (β=-.21, p=.003) had the greatest effect on health-related quality of life (F=15.50, p<.001), with an explanatory power of 26.0%.

CONCLUSION

The health-related quality of life of pregnant women was affected by social support and physical health status. This study demonstrated that physical health and social support promotion can improve the health-related quality of life of pregnant women. Healthcare providers should consider integrating physical health into social support interventions for pregnant women in the post-pandemic era.

Impact of onychomycosis on the quality of life of patients

Background and Purpose

Onychomycosis is a very common cosmopolitan onychopathy. It affects the fingers and toes, which are important organs of function and socialization. They can cause physical and psychological discomfort. In this regard, the present study aimed to assess the impact of onychomycosis on the quality of life of patients.

Materials and Methods

This prospective, cross-sectional, observational study was carried out in the parasitology-mycology laboratory of the Avicenne Military Hospital in Marrakesh, Morocco, over 5 months between June and October 2022. The study population was all the patients referred to the laboratory for mycological examination of a nail lesion suspected of onychomycosis of the hands and/or feet.

Results

Onychomycosis was confirmed in 50 patients. Pain, nail thickening, and dyschromia were the most commonly reported symptoms (56%). Onychomycosis had an impact on at least one of the socio-economic, emotional, or functional aspects of the lives of affected patients. More than half (56%) of participants felt embarrassed by the appearance of their nails, 40% hid them, and 28% had a complex about them. The functional aspect was the most bothersome and the time spent on nail care concerned the patients (56%), as well as the discomfort reported when wearing shoes (40%). Women were more worried about the need to hide their nails. A duration of onychomycosis evolution of over 5 years was associated with the highest response rate to the questionnaire (66%).

Conclusion

Although onychomycosis is not a fatal pathology, it significantly reduces the quality of life of affected patients. There is a need to raise the level of awareness of the general population and, above all, of the medical professionals to ensure comprehensive management of onychomycosis.

The Effect of Internet-delivered Mindfulness Stress Reduction Combined with Acceptance and Commitment Therapy on Health Anxiety and Quality of Life of Caregiver of Patients Infected by COVID-19: A Randomized Clinical Trial

Background

Coronavirus disease-19 (COVID-19) is a widespread disease all over the world that has caused many psychological complications such as health anxiety (HA) and low quality of life (QOL). Mindfulness-based approaches could improve these complications. Therefore, this study aimed to investigate the effect of Internet-delivered mindfulness stress reduction combined with acceptance and commitment therapy (IMSR-ACT) on QOL and HA of caregivers of patients infected by COVID-19.

Methods

In this randomized clinical trial, 72 people from Golpayegan city, Iran, who had a patient with COVID-19 in their family were selected from March to June 2020. A caregiver with a score above 27 on the Health Anxiety inventory (HAI-18) was selected using simple random sampling. Participants were assigned in the intervention or control group by permuted block random allocation. The intervention group was trained by MSR and ACT techniques for 9 weeks accomplished via WhatsApp. All participants completed the QOLQuestionnaire-12 (SF-12) items and HAI-18 before and after completing IMSR-ACT sessions. The data were analyzed through SPSS-23 software, using Chi square, independent and paired t-test, and analysis of covariance, and P-value<0.05 was considered as significant.

Results

The results showed that the intervention group compared to the control group had a significant decrease in all subscales of HAI after the intervention including worry about consequences (5.78±2.66 vs. 7.37±1.34, P=0.004) and awareness of bodily sensation or changes (8.90±2.77 vs. 11.75±2.30, P=0.001), worry about health (10.94±2.38 vs. 13.09±1.92, P=0.001), and total score of HAI (25.62±4.93 vs. 32.25±3.93, P=0.001). Also, the intervention group compared to the control group had better QOL after the intervention in general health perceptions (3.03±0.96 vs. 2.43±0.95, P=0.01), mental health (7.12±2.25 vs. 6.34±1.85 and P=0.01) and mental component summary) 16.78±3.75 vs. 15.43±3.05, P=0.01), physical component summary (16.06±2.66 vs. 15.19±2.25, P=0.01), and total score of SF-12 (32.84±5.39 vs. 30.62±4.34, P=0.004).

Conclusion

Internet-delivered MSR combined with ACT could improve the HA and QOL of caregivers with patients infected by COVID-19. Thus, it can used in other similar situations for now and future. Also, it seems to be a useful approach for caregivers of the other illnesses. Trial Registration Number: IRCT20180909040974N.

The impact of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life among gynecological cancer patients undergoing chemotherapy: a cross-sectional survey

PURPOSE

This study investigated the effects of peripheral neuropathy symptoms, self-care ability,and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy.

METHODS

The participants included 144 patients with gynecological cancer undergoing anticancerchemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28,2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed.

RESULTS

Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), andthe most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89)was greater than the midpoint. The regression model analyzing the patients' QoL was statisticallysignificant (F=15.38, p&lt;.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p&lt;.001),disturbances to daily life (β=-.38, p&lt;.001), the duration of peripheral neuropathy symptoms(β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL.

CONCLUSION

Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their dailylife can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care abilityof patients and alleviating their limitations in daily life may improve QoL.

Factors associated with levels of health-related quality of life in elderly women: secondary data analysis of the Korea National Health and Nutrition Examination Survey 2019

PURPOSE

The purpose of this study was to investigate factors related to the levels of health-related quality of life (HRQoL) in elderly women based on Wilson and Cleary's HRQoL model.

METHODS

This study analyzed data from the eighth Korea National Health and Nutrition Examination Survey 2019 on 868 women over the age of 65 years. Based on the HRQoL model, parameters were categorized as personal, environmental, and physiological characteristics; symptom status; functional status; and perception of health status. The data were analyzed by quantile regression.

RESULTS

The overall level of HRQoL was 0.87. Factors related to HRQoL in the 10% quantile were higher education level, higher economic status, economic activity, more walking days, fewer diseases, lower stress, less activity limitation, and higher perceived health status. Factors related to the 25% quantile of HRQoL were more walking days, fewer diseases, less activity limitation, and higher perceived health status. Factors related to the 50% quantile were age, economic activity, more walking days, fewer disease, lower stress, less activity limitation, and higher perceived health status. Factors related to the 75% quantile of HRQoL were smoking, more walking days, fewer diseases, lower stress, less activity limitation, and higher perceived health status.

CONCLUSION

While differing parameters were identified according to the level of HRQoL of elderly women in Korea, there were five common factors. Interventions that focus on increasing walking, mitigating diseases, stress, and activity limitations, and improving perceived health status can improve HRQoL.

A menopausal transition model based on transition theory

PURPOSE

The purpose of this study was to construct a hypothetical model based on Meleis and colleagues' Transition Theory and a literature review to explain women's menopausal transition, constructing a modified model considering previous studies and model fit and testing the effects between variables.

METHODS

With a correlational survey design, middle-aged Korean women aged 40 to 64 years who had experienced menopausal symptoms were recruited and filled out a self-administered study questionnaire. Measures included menopausal symptoms, resilience, social support, menopause management, menopause adaptation, and quality of life. The data were analyzed using SPSS 24.0 and AMOS 24.0.

RESULTS

The model fit indices were considered acceptable: χ2 /degree of freedom=2.93, standardized root mean residual=.07, comparative fit index=.90, and parsimonious normed fit index=.73. All eight direct-effect paths-from menopausal symptoms to support and adaptation, from support to adaptation and resilience, from resilience to adaptation and management, from management to quality of life, and from adaptation to quality of life-were significant. The explanatory power of the menopause transition model was 63.6%.

CONCLUSION

Women who experience menopausal symptoms may be able to maintain and improve their quality of life if menopause management and menopause adaptation are successful through resilience and social support. Future research is needed to confirm whether strengthening facilitation as a nursing intervention strategy may promote healthy response patterns.

Quality of Life and Its Determinants in Liver Transplantation Candidates: A Missed Link in Liver Care Program during the Waiting Time for Liver Transplantation

Background

The health-related quality of life (HRQOL) in the before liver transplantation (LT) stage has not been studied as much as that after the LT stage. We aimed to assess HRQOL and its determinants before the LT stage.

Methods

As a cross-sectional study, HRQOL of all adult patients (n=632) referred to the LT center of Shiraz, Iran in 2018-2019 were assessed. Demographic, socioeconomic, medical, and paraclinical data were requested. Physical (PCS) and mental (MCS) aspects of HRQOL were assessed using the SF36 questionnaire. Univariable, multivariable (linear regression), and confirmatory factor analysis were performed utilizing SPSS 20 and Mplus 6.1 software. P<0.05 was considered to be significant.

Results

The mean age of the patients was 47.6±12.3 years, while 414 (65.6%) were men, and the mean, score of the model for end-stage liver disease (MELD) was 18.36±5.58. The mean score of QOL, PCS, and MCS was 50.01±21.73, 46.23±23.23, and 53.78±23.91 (out of 100), respectively. Vitality had the most association with HRQOL, while role limitations had the lowest. The multivariable analysis revealed that unemployment (P<0.001), anemia (P=0.005), weight loss (P=0.005), diabetes mellitus (DM) (P=0.009), low MELD score (P=0.027), and drug use (P=0.03) were the significant determinants of HRQOL, respectively.

Conclusion

The present study showed that HRQOL in the LT candidates was at the intermediate level, while their PCS and MCS are at the low and moderate levels, respectively. Furthermore, physical performance, job status, anemia, weight loss, MELD score, DM, and drug use should be considered as the significant determinants of HRQOL in the LT candidates.

The Effect of Self-care Education Based on Self-efficacy Theory, Individual Empowerment Model, and Their Integration on Quality of Life among Menopausal Women

BACKGROUND

Menopause has adverse physical and emotional effects on the quality of life. The aim of this study was to determine the effect of self-care education based on self-efficacy theory, individual empowerment model, and their integration on the quality of life among menopausal women.

METHODS

In this quasi-experimental study, 186 menopausal women, aged 45-60 years at Kashan health centers entered the study using cluster sampling for health centers and simple random sampling inside each center from the list of the population from December 2019 to March 2020. The intervention was performed in 3 groups, using empowerment training, self-efficacy training, and their integration for 4 sessions each lasting 1-1.5 hours of weekly training. Three study groups were selected from different centers to minimize information exchange. Menopausal women's quality-of-life questionnaire was used to assess the quality of life. Questionnaires were completed pre-intervention and one and three months after completing the intervention. SPSS16 software and ANOVA, Chi-square, and repeated measure tests were used.

RESULTS

The mean±SD score of quality of life in pre-intervention measurement was 32.96±10.62 in empowerment, 31.93±12.54 in self-efficacy, and 34.07±11.7 in integrated groups. The intervention was effective in improving the quality of life of all three groups (P values were<0.001 for time, 0.92 for group, and 0.38 for time*group interaction).

CONCLUSION

This study showed that empowerment and enhancing self-efficacy could improve menopausal women's quality of life. This can help health professionals to better educate postmenopausal women about self-care in menopausal complications.

Prevalence of menopausal hot flashes in Lebanon: A cross-sectional study

Background

Menopausal hot flashes or vasomotor symptoms are prevalent and could be debilitating in postmenopausal women. There is controversy regarding the risk factors for hot flashes, some of which may vary from one country or culture to another.

Objective

To shed light on this matter by assessing the prevalence of hot flashes, their effect on quality of life, and their association with certain factors such as physical exercise, caffeine, spicy food consumption, dietary intake, smoking, alcohol, etc.

Materials and Methods

A large cross-sectional study was conducted among 627 Lebanese women, aged 45-67 yr using a well-developed and comprehensive questionnaire, in order to better assess the prevalence of hot flashes, focusing on their characteristics, association with various factors, severity, and effect on the women's quality of life.

Results

62.5% of participants experienced hot flashes. A statistically significant difference was noted between women who experience hot flashes and their counterparts with respect to smoking, body mass index, spicy food consumption, education level, age, menstrual status, and parity. An association was not found with physical activity or other dietary factors.

Conclusion

As an alternative for hormone therapy, clinicians should consider lifestyle changes to help manage hot flashes, which impose a tremendous physical and social toll on the women experiencing them.

Effectiveness of a Spousal Support Program in Improving the Quality of Life of Male Patients Undergoing Infertility Treatment: A Pilot Study

Background:

There are various causes of male infertility. Infertile men usually have a low quality of life (QoL) and a high level of stress compared with men without infertility problems. The present study aimed to examine the effects of a spousal support program to enhance the QoL of male patients undergoing infertility treatment

Methods:

The present quasi-experimental study (pretest-posttest) was conducted among 38 infertile couples in Tokyo (Japan) during April-August 2018. The levels of QoL, distress, and spousal support were measured using self-administered valid and reliable questionnaires. The paired t test was used to analyze pre- and post-intervention data with SPSS software (version 23.0). P<0.05 was considered statistically significant

Results:

There were significant differences between the pre-test and post-test scores for the relational and emotional sub-scales of QoL. The paired t test results showed that the post-test emotional sub-scale (66.9±16.9) was significantly higher than the pre-test emotional sub-scale (58.5±13.5; t (30)=2.2, P=0.04). Similarly, the post-test relational sub-scale (71.2±21.6) was significantly higher than its pre-test score (60.8±13.7; t (30)=2.3, P=0.03). The majority of the participants 23 (74.2%) expressed satisfaction with the program.

Conclusion:

The spousal support program was well-received and significantly improved part of the QoL of men who were infertile due to various causes

Comparison of Functional Outcomes between Functional Jejunal Interposition and Conventional Roux-en-Y Esophagojejunostomy after Total Gastrectomy for Gastric Cancer

BACKGROUND

The reconstruction of digestive tract after total gastrectomy is associated with various postoperative complications. We aimed to investigate the differences in functional outcomes of 2 reconstruction techniques following total gastrectomy: functional jejunal interposition (FJI) versus Roux-en-Y esophagojejunostomy.

METHODS

Sixty patients were enrolled and divided into FJI and Roux-en-Y groups. Nutritional parameters and incidences of reconstruction-related symptoms were evaluated. Oral glucose tolerance test and endoscopy examination were carried out.

RESULTS

The postoperative prognostic nutritional index scores and postoperative/preoperative body weight, meal intake, serum albumin level ratio were significantly higher in the FJI group than in the Roux-en-Y group. At 3, 6, and 12 months postoperatively, the elevations of plasma glucose level after glucose intake were more significant in the FJI group than in the Roux-en-Y group. The incidence of postoperative stasis symptoms in the Roux-en-Y group was significantly higher than in the FJI group, but no obvious difference was observed regarding dumping and reflux symptoms. The incidence rates of severe esophageal mucosa injury and severe anastomotic stricture were also similar between the 2 groups.

CONCLUSION

FJI reconstruction might accelerate the recovery of nutritional status and reduce the occurrence of stasis symptoms postoperatively as compared with Roux-en-Y esophagojejunostomy, which may have an advantage over FJI in stabilizing body glycometabolism after surgery. These 2 types of reconstruction may have a similar anti-reflux function to prevent severe reflux esophagitis and anastomotic stenosis.

Exploration of the Quality of Life in Iranian Morbid Obese People: A Qualitative Study

Background:

Morbid obesity (body mass index≥40 kg/m² or >35 kg/m² with co-morbidity) is an important factor in reducing the quality of life which is influenced by the characteristics of the individual, his social, cultural, and environmental conditions; also, each disease has unique effects on it. Although most of the studies have been conducted on obesity (25>BMI>40), how to prevent it and improve life quality, there is lack of knowledge about what morbid obese people really experience about their life quality. Thus, this qualitative study aimed to explore the viewpoints of morbid obese people about life quality.

Methods:

In this conventional content analysis, data were collected using semi-structured interviews with 20 morbid obese patients who were referred to nutrition and obesity clinics of Shiraz and Ahvaz Jundishapur University of Medical Sciences. Purposeful sampling was processed from May 2016 to January 2017. The sampling continued until data saturation. Each interview was recorded by audio recorder and typed in the MAXQDA10 software. Data were analyzed after each interview. The meaning units were encoded and the codes were categorized. This trend continued until the main and sub-categories emerged.

Results:

Data analysis indicated 1835 codes, 76 sub-subcategories, 26 subcategories and 6 main categories including physical changes, psychological experiences, socio-personal dysfunction, negative body image, financial pressure, and change in the spirituality.

Conclusion:

Final results indicated that life quality had a special definition in morbid obesity and includes very different dimensions. This study can promote health care providers’ knowledge (nurses) for supporting obese people and improving their quality of life by community-based care approaches.

A Systematic Review and Meta-Analysis of Applicability of Web-Based Interventions for Individuals with Depression and Quality of Life Impairment

OBJECTIVE

The purpose of this meta-analysis was to determine the applicability of web-based treatment programs for individuals with depression and quality of life impairments.

METHODS

We conducted database and manual searches using imprecise search-term strategy and inclusion criteria. Research published from 2005 to December 2015 was included in this study. Upon review, a total of 12 published papers on web-based intervention for individuals with depression were assessed eligible for this meta-analysis. Effect sizes were estimated for depression and quality of life.

RESULTS

The mean effect size of web-based treatment on depressive symptoms was 0.72. However, unlike the result showing medium to large effect size, the analysis on the quality of life did not yield adequate effects of web-based interventions.

CONCLUSION

Our results suggest robust benefits of employing web-based treatments for depressive symptoms. However, the adequacy of these relatively new intervention tools for individuals who suffer severe impairments of quality of life was found insufficient. The current study demonstrates the need to further develop web-based intervention techniques to improve overall functioning, as well as the clinical symptoms of patients with mental disorders.

Effects of the Problem Solving Technique in Type 2 Diabetic Patients with Cognitive Impairment: A Randomized Clinical Trial

BACKGROUND

Diabetes mellitus is a common metabolic disorder, one of the lesser known of whose consequences is cognitive disorder. This study aimed to evaluate the effects of problem-solving technique in type 2 diabetic patients with cognitive impairment.

METHODS

This randomized clinical trial was conducted in the south of Iran between December 2014 and April 2015. 96 type 2 diabetic patients with cognitive impairment were randomly divided into two groups. The patients in the intervention group attended classes on problem-solving skills, while the patients in the control group attended the usual classes in the clinic. The quality of life, self-management profile, metabolic indexes of the patients in both groups were measured before and three months after the experiment. Data were analyzed using SPSS version 16.0. Paired t-test, independent t-test, Wilcoxon, Mann-Whitney and Chi-Square tests were used.

RESULTS

The differences between the groups' levels of HbA1c (P=0.02) and HDL (P=0.02) were significant, but the differences between their FBS, cholesterol, triglycerides and LDL were not significant (P>0.05). The mean difference of the changes in the quality of life (P<0.001) between the intervention and control groups was significant. The differences between the two groups in the area of self-management were as follows: patient's anxiety management (P<0.001), patient's capability in using medicine (P<0.001), healthy eating (P<0.001), weight management (P=0.02), and confidence in one's ability to manage his/her diabetes (P<0.001).

CONCLUSION

Applying problem-solving technique significantly enhanced self-management, quality of life and metabolic indexes in type 2 diabetic patients with cognitive impairment. Trial Registration Number: IRCT2014041517283N1.

Effectiveness of Life Review Therapy on Quality of Life in the Late Life at Day Care Centers of Shiraz, Iran: A Randomized Controlled Trial

BACKGROUND

Life review therapy, used as part of a comprehensive therapy plan for increasing the quality of life of the elderly, helps them to resolve their past conflicts, reconstruct their life stories, and accept their present conditions. The present study aimed to explore the effectiveness of life review therapy on the quality of life of the elderly.

METHODS

The present study was a randomized controlled trial with a pre-posttest design during April to Aug 2014. The study was conducted on 35 members of the elderly day care centers in Shiraz, Iran, that were randomly assigned to two groups (experimental and control). The subjects in the experimental group attended 8 two-hour sessions of life review therapy. The quality of life of the elderly participants was evaluated before, immediately, one month, and three months after the intervention using the quality of life questionnaire (WHOQOL_BREF). Data analysis was conducted through SPSS version 22, using statistical tests including Chi-square, repeated measures test and T-test, with the significance level of 0.05.

RESULTS

The results of the study showed that life review therapy interventions significantly improved the quality of life of the elderly (P<0.05). Moreover, group interaction with passage of time was also significant, which indicates that the pattern of changes has been different between the two groups.

CONCLUSION

The findings of the study confirm the research hypotheses, showing that the application of life review is effective and viable. It is recommended that all nursing homes and even the families of the elderly should employ this convenient, inexpensive, quick, and practical method. Trial Registration Number: IRCT2015021621106N1.

Health Related Quality of Life in Iranian Elderly Citizens: A Systematic Review and Meta-Analysis

BACKGROUND

The ever-growing elderly population of Iran and their physical and mental consequences put emphasis on the necessity of determining the quality of life (QoL) in this social group. This systematic review and meta-analysis aimed to estimate the mean score of QoL in Iranian elderly citizens.

METHODS

Twenty-one articles that were indexed in Iranian (MagIran and Iran Medex) and international (Scientific Information Database, Google Scholars, Science Direct, PubMed, ProQuest, Scopus) databases were selected. The articles have used the Short Form Health Survey (SF-36) to measure QoL in Iranian elderly. The collected data were analyzed using a random effects model, while heterogeneity of the studies was measured by I2 index. The data analysis was performed by STATA.

RESULTS

The sample size of the 21 articles was 5318 and the mean score of QoL in the healthy and sick elderly citizens was 53.8 (CI 95%: 49.4-58.2) and 50.6 (CI 95%: 38.4-62.9) respectively. In addition, there was no significant relationship between the score of QoL and the year of publication of the articles. (P=0.748).

CONCLUSION

Given that QoL of the studied elderly was almost at an average level, there is a need to codify and implement comprehensive programs through effective training programs toward improving QoL of the elderly.

Effects of Collaboration Care Model on the Quality of Life in Patients after Coronary Angioplasty: A Randomized Controlled Clinical Trial

BACKGROUND

Coronary artery diseases and therapies such as coronary angioplasty would lead to changes in the quality of life in patients. The aim of this study was to determine the effects of collaborative care model on the quality of life in patients after coronary angioplasty.

METHODS

This randomized controlled clinical trial was conducted in Isfahan, Iran during 2015. In this study, 50 samples were selected by simple sampling and randomly allocated into two equal groups of intervention and control. Collaborative care model was performed in the intervention group for 3 months. Data were collected using quality of life (SF-36) questionnaire which includes 36 questions on physical and psychological dimensions and was completed before and one month after the intervention in both groups. Data were analyzed using descriptive and analytical statistics and by independent t- test, paired t test, Chi square and Mann-Whitney tests through SPSS 18.

RESULTS

After the intervention, the mean score of quality of life in the intervention group was significantly higher than the control group (P<0.05). The results of independent t-test showed a significant difference between both groups regarding the mean of changes in the score of quality of life and its dimensions in patients undergoing coronary angioplasty 3 months after the intervention (P<0.001).

CONCLUSION

Results revealed that patients who had been cared based on collaborative care model had better scores of quality of life in all the physical, mental and social dimensions than the control group. Therefore, using this model for taking care of patients after coronary angioplasty is recommended. Trial Registration Number: IRCT2015120120912N4.