Showing papers by "Mohsen Saffari published in 2019"

The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes

Abstract: Type 2 diabetes is a major public health issue particularly in the elderly. Religion may affect the Health Related Quality of Life (HRQoL) in such patients, mediated by factors such as religious coping and social support. This study aimed to investigate the impact of religiosity on medication adherence and HRQoL. 793 adults (> 65 years old, 45% females) were recruited from 4 diabetes care centers and followed for 1 year. Duke University Religion Index, Spiritual Coping Strategies, Multidimensional Perceived Social Support, Medication Adherence Report Scale, WHOQOL-BREF and Diabetes-specific Quality of Life Questionnaire Module were used for assessment, as well as HbA1c and fasting blood glucose level. Using structural equation modeling, the potential paths were tested between religiosity, medication adherence and HRQoL; social support, religious coping and medication adherence served as the mediators. Religious coping and social support were recognized as the significant mediators between religiosity and medication adherence (CFI = 0.983, TLI = 0.985, and RMSEA = 0.021). The relationships between religiosity and HRQoL were considerably mediated by social support, religious coping and medication adherence and these variables explained 12% and 33% of variances of generic and specific HRQoL, respectively. There was no significant direct effect of religiosity on HRQoL. HbA1c and fasting blood glucose level were successfully loaded on the latent construct of medication adherence (factor loading = 0.51 and 0.44, respectively). The impact of religiosity on medication adherence and HRQoL occurs through the mediators such as religious coping and social support. Therefore, to improve the adherence to treatment and quality of life, interventions may be designed based on these mediators.

A Persian version of the Affiliate Stigma Scale in caregivers of people with dementia.

Abstract: Background: Dementia is prevalent among older adults and frequently causes dependence on family caregivers. Caregivers may experience a form of stigmatization called affiliate stigma that negatively affects their mental health. The current study sought to establish the psychometric properties of a tool to measure affiliate stigma among Iranian caregivers. Methods: Overall, 541 caregivers of older people with dementia were included in this cross sectional study. Several measures were used to assess the psychometric properties of the Affiliate Stigma Scale (ASS) including the Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS), Short Form 12 (SF-12), Rosenberg Self-Esteem Scale (RSES), and Multidimensional Scale of Perceived Social Support (MSPSS). Convergent and discriminate validity were examined.Exploratory and confirmatory factor analyses were utilized to assess the factor structure of the Ass and a Rasch model was used to evaluate the measurement functioning of the scale. Results: Factor loadings ranged from 0.69 to 0.83 and test-retest reliability from 0.72 to 0.89.Item difficulty ranged widely from -0.66 to 0.89. No considerable differential item functioning (DIF) was found across gender. Confirmatory factor analysis confirmed the three cognitive,effective, and behavioral dimensions of the scale (comparative fit index [CFI]=0.931 to 0.995,root mean square error of approximation [RMSEA]=0.046 to 0.068). Internal consistency was acceptable (Cronbach's α: 0.88 to 0.94). Significant and positive relationships were found between affiliate stigma and depression, anxiety, and care giving burden (β =0.35 to 0.46). Conclusion: The ASS is a psychometrically valid measure for assessing affiliate stigma in Iranian caregivers of people with dementia. Application of this tool among other caregivers, language sand cultures deserves further study.

A Comparison Between Impact of a Health Education Program Using In-situ Training and Text-Messaging on Lifestyle and Blood Pressure in Military Personnel at Risk of Hypertension

Abstract: Article Information DOI: Received: Accepted: Available Online: Corresponding Author: Article History: IJHEHP 2019; 7(1):74-83 Use your device to scan and read the article onlin Mohsen Saffari Associate Professor, Health Research Center, Life style Institute, Baqiyatallah University of Medical Sciences,

Psychometric properties of Persian Diabetes-Mellitus Specific Quality of Life (DMQoL) questionnaire in a population-based sample of Iranians

Abstract: Health-related quality of life (HRQoL) among patients with diabetes mellitus is often poorer than in those with other chronic medical conditions. Appropriate disease specific measures are needed to measure HRQoL in these patients. This study sought to validate a culturally adapted version of the Diabetes-Mellitus Specific Quality of Life (DMQoL) questionnaire module in Persian. Concurrent validity of the scale was assessed by the Diabetes Quality of Life (DQOL) questionnaire. Convergent and discriminative validity of the DMQoL was determined using a brief version of World Health Organization’s Quality of Life Scale Brief version (WHOQOL-BREF), Hospital Anxiety and Depression Scales (HADS), and Medication Adherence Report Scale (MARS). Construct validity was examined using confirmatory factor analysis. Rasch analysis was also performed to examine the unidimensionality of the DMQoL. Known-group method was used to examine the ability of the scale to differentiate between different categories of patients. A sample of 824 patients (512 females) with diabetes mellitus was recruited from diabetic care centers located in Qazvin, Iran. The mean age of participants was 54.1 (SD 6.3) and 27% were smokers. All items loaded on a single factor (factor loadings ≥ 0.6) and internal consistency of the scale was acceptable (α = 0.89). Significant associations were found between the scale and DQOL, indicating concurrent validity (p < 0.001). The DMQoL was able to differentiate subgroups of patients with hypertension, HbA1c, cholesterol, and diabetic diet. All items were appropriate with regard to difficulty level and confirmatory factor analysis verified the scale’s single dimension (CFI = 0.927; RMSEA = 0.067). Persian DMQoL is a reliable and valid measure of HRQoL in a Persian-speaking population with type II diabetes. Further assessment is needed to confirm the psychometric properties of the scale in other cultures and languages. Future studies are needed to determine the sensitivity of the scale to change over time in response to treatment.

The effect of a psycho-educational intervention on weight management in obese military personnel

Abstract: Obesity is a serious health problem for many population groups, including military personnel. Model-based health education programs have been shown to be effective in reducing weight. This study assessed the efficacy of an educational intervention based on a trans-theoretical model (TTM) targeting weight loss among active duty military. A single group experimental study using a before-after design was conducted in 49 military personnel with obesity. Constructs such as self-efficacy, decisional balance, stages of change, and processes of change as well as anthropometric measures including weight, waist circumference, and body mass index (BMI) were assessed at three times (baseline, 2 months after the intervention, and 4 months later). The intervention consisted of 10 educational sessions developed based on TTM constructs. At baseline, 30 (61%) and 19 (39%) persons were in the pre-action and action stages, respectively. By 2 months after the intervention, only 24 persons (49%) were in pre-action sta...

Mediating effect of spiritual coping strategies on caregiving burden and mental health in caregivers of Iranian patients with dementia

Abstract: Introduction: Dementia is a common cognitive disorder among elderly people requiring special care. Family carers of people with dementia (PWD) may experience mental health issues. This study examined whether spiritual coping is a mediator between the physical function of the patients and mental health status or caregiving burden in their carers. Methods: The caregivers of the PWD (n = 513) were assessed by the Instrumental Activities of Daily Living (IADL) and Spiritual Coping Strategies (SCS) questionnaires at baseline and Zarit Burden Interview, Short Form-12 (SF-12), and Hospital Anxiety and Depression Scale questionnaires at 6 months. The proposed model to assess the mediating effect of SCS was: SCS subscales as mediators, PWD's IADL as an independent variable, and mental health components as dependent variables. Using PROCESS SPSS Macro, the indirect effects of patients' IADL score on mental health-related variables in the caregivers were examined. Results: There were significantly negative associations between IADL score and mental health components (r > 0.3). SCS scores were negatively correlated with depression, anxiety, and caregiving burden (P

The effect of educational program based on theory of planned behavior on health promotion and childbearing of minor thalassemia couples.

Abstract: INTRODUCTION It is essential to provide key information and support to every woman regarding pregnancy and childbirth to enable all women to make a fully informed decision regarding their choice of reproduction. The study aimed to find the impact of an educational program based on the Theory of Planned Behavior (TPB) on health promotion and childbearing of minor thalassemia couples. SUBJECTS AND METHODS This study was quasi-experimental. A total of 70 women with minor thalassemia held in Minudasht health center were classified into two groups: study and control. The study group received the educational program based on TPB, and the control group only received the routine program. The data were collected using the TPB-based questionnaire at baseline and 3 months after the intervention. They were analyzed by Chi-square, Student's t-test, Wilcoxon test, and regression analysis through SPSS version 16. RESULTS The mean (standard deviation) ages of the participants in the control and study group were 30.69 (6.20) and 31.08 (6.66), respectively. There were significant differences between the two groups (study vs. control) in terms of perceived behavioral control, intention, attitude, or childbearing behavior (P < 0.001). The change in fertility behaviors had a significant increase in the study group (62.8%) compared to the control group (2.9%) (P < 0.001). CONCLUSION Based on the results, the TPB is an effective model to explain fertility intentions and behaviors in Iranian women with minor thalassemia; however, further researches are needed to generalize our findings to other people including healthy women.

Childbearing through the Lens of Women with Minor Thalassemia: A Qualitative Study.

Abstract: Background It is essential to provide key information and support to every woman regarding pregnancy and childbirth to enable all women to make a fully informed decision regarding their choice to reproduce. Of particular importance; however, is that women who suffer from a specific condition that increases risks associated with reproduction, to receive specific information regarding such risks and health complications regarding pregnancy and childbirth. This study aims to explore the feelings, experiences, and needs of women with minor thalassemia in relation to childbearing. Materials and Methods This sample comprised of 12 Iranian women with minor thalassemia who attended to local health centers in Minudasht, Golestan province, from October 2017 to January 2018. The purposeful sampling technique was employed. The data were collected through deep semi-structured interviews, analyzed using conventional content analysis and processed by using the Graneheim and Lundman method. Results The findings were based on the participants' experiences of pregnancy and fertility. Three major themes emerged; 'Emotional and Physical Experience,' 'Satisfaction' and 'Social and Cultural Issues.' The most common problem identified was the impact of emotional problems and difficulties regarding the negative implications of thalassemia on reproduction as well as the views and perceptions of family members and those within the community. Conclusion From the findings, it is evident that thalassemia imposes a heavy psychosocial burden on those women who suffer from the condition. Local health centers in areas most affected by thalassemia would be considered the most suitable venues to introduce key health educational interventions.

An Education-Based Text Messaging Program to Improve Nurses' Knowledge, Attitude, and Practice Related to Nosocomial Infections in Intensive Care Settings

Abstract: BACKGROUND Nosocomial infection (NI) is common in health care settings. Educational strategies such as mobile teaching methods for health care providers may help to resolve this problem. This pilot study assessed the influence of a text messaging program to improve intensive care unit nurses' knowledge, attitude, and practice related to NI prevention. METHOD In this single-group experimental study, 32 nurses received an educational intervention via short text messages on their cell phones. Information on knowledge, attitude, and practice regarding NI prevention was collected using a standard scale. Preventive messages about NI were prepared and sent to participants during a 2-month trial. Results were assessed 2 weeks after the intervention, and data were analyzed by paired t test. RESULTS Knowledge, attitude, and practice of participants increased by 17%, 3%, and 9%, respectively, from baseline to follow up. The average score on the knowledge dimension was lower than for other components. Knowledge components such as hand hygiene, work safety, and protective equipment increased to a lesser degree from pre- to posttest, compared with other aspects (p < .05 versus p < .001). CONCLUSION An education-based program operating through short text messages may be a useful in-service training strategy for intensive care unit nurses. [J Contin Educ Nurs. 2019;50(5):211-217.].

The 10-Year Incidence Trend of Common Cancers at a Referral Hospital in Tehran, Iran From 2007 to 2016

Abstract: Background: Common cancers such as colon, breast, and lung cancer are increasing in developing countries. Objective: This study was conducted to determine 10-year trends and changes in common cancers in patients from a referral hospital in Tehran, Iran. Methods: This cross-sectional study investigated a study population comprising colon, stomach, lung, prostate, and breast cancer patients registered at the cancer center of a referral hospital in Tehran, Iran from April 1, 2007 to the end of March, 2016 (n=4472). Inclusion criteria were a definitive diagnosis of cancer and an age between 15 and 75 years. Data was entered into SPSS (version 18) software and analyzed using the Time Series analysis and Scatter IO graph. Results: Significant correlations (P value <0.001) were seen between age increases in patients and the increasing number of patients in any type of cancer. With almost all of the five studied cancers, incidence increased with aging (P value <0.001). The incremental linear trend in the age of patients with lung (P value = 0.008) and colon (P value = 0.004) cancers and the decreasing trend in the age of prostate cancer patients (P value = 0.001) were statistically significant. Conclusion: The incidence of cancer has increased over the past 10 years in both genders and ages. It is suggested that future studies should address the causes and factors behind the increasing incidence of common cancers.