Journal of Education and Health Promotion最新文献

Preoperative anxiety (POA) is a concern for children undergoing surgery, especially with general anesthesia. POA can result in many postoperative problems, such as physical, psychological, and financial problems. Nonpharmacological treatments have been investigated for reducing POA as they are more pleasant and have fewer adverse effects compared to pharmacological treatments. Audiovisual technology treatment is one of the nonpharmacological treatments developed lately. This study aims to evaluate the efficacy of an audiovisual technology intervention for reducing POA in children undergoing general anesthesia. This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline 2020. Google Scholar, PubMed, ProQuest, and Cochrane databases were used for searching English articles published between January 2015 and June 2023. Cochrane Review Manager 5.4 was used for the meta-analysis and the Risk of Bias Tool 2.0 was used to measure the risk of bias. The studies included were randomized controlled trials (RCTs) that compared the audiovisual technology intervention with a control population. The modified Yale Preoperative Anxiety Scale was the outcome of interest. We found 627 articles in four databases using the search term. After screening with the eligibility criteria, three studies from Iran, Denmark, and China were included in the meta-analysis. A random effect model was applied. The meta-analysis resulted in a significant result as a lower modified Yale Preoperative Anxiety Scale score was found in the audiovisual technology intervention group compared with the control group (mean difference -10.75 [-16.48 to -5.03]; 95% confidence interval; P = .0002.) The presence of audiovisual technology interventions such as video games, cartoons or animation videos, and smartphone applications could significantly lower POA in children undergoing general anesthesia.

Background: Millions of people lost their loved ones due to the COVID-19 pandemic; this dire situation had an impact on almost every aspect of the daily life of every person. However, most of the individuals adapted to their losses nearly 2-10% of the population experienced dysfunctional grief in which adolescents were also affected. Aims and Objectives: Prime objective of the study was to assess dysfunctional grief due to loss from COVID-19 Pandemic among adolescents and to find out the coping strategies used by them to overcome this grief.

Materials and methods: The study was conducted among school-going adolescents of District Dehradun. A pre-designed, pre-tested, self-administered, semi-structured questionnaire including socio-demographic details, COVID-19-related questions and Pandemic Grief Scale (Cronbach alpha-0.77) was used in the offline survey.

Results: Out of 690 study participants, a total of 151 (21.8%) adolescents lost their loved ones due to the COVID-19 pandemic. Of these, 9.93% were facing dysfunctional grief due to their loss. To overcome this grief, coping strategies used by study participants were mainly phone and internet usage (78%) followed by watching TV (73.8%) and sleeping (68.1%).

Conclusion: Adolescents who experienced loss and were grieved are more at high risk of developing psychological disorders, particularly depression, anxiety, and physical illness, that might affect their education and overall development. Though to tackle the mental health crisis in the country Tele-Mental Health Assistance and Networking Across States (Tele-MANAS) has been initiated, still there is a lack of clarity regarding the structure and range of services provided by Tele-MANAS centers set up under the National Tele-Mental Health Program (NTMHP). Timely intervention and research to take solid steps to diminish the potential adverse effects of bereavement on adolescents' mental health is necessary.

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disease that is usually seen in women of reproductive age and causes complications such as body image dissatisfaction, anxiety, and depression. This study was done with the aim of comparing the effectiveness of emotion-focused therapy (EFT) and cognitive-behavioral therapy (CBT) on body image, anxiety, and depression in women with PCOS.

Materials and methods: This research was semi-experimental with a pre-test-post-test design with control and follow-up groups. The statistical population included all women with PCOS who were referred to the infertility clinic of Afzalipur Hospital in Kerman in 2022. A total of 45 patients were selected as a sample using the convenience sampling method and then they were randomly assigned to two experimental groups (15 people each) and a control group (15 people). After the pre-test, the experimental groups were subjected to the interventions of EFT and CBT, and afterward the post-test was performed. Cash et al., body image questionnaire, and Beck anxiety and depression questionnaires were used. Data were analyzed using PSS21 software and analysis of variance.

Results: The findings revealed that the effectiveness of EFT and CBT on body image, anxiety, and depression is significant (P < 0.05). The comparison of the two therapy showed that the effect of CBT on body image, anxiety, and depression is more than EFT. Moreover, there was no statistically significant difference between the post-test and follow-up scores (P > 0.05).

Conclusion: According to the results, CBT can reduce dissatisfaction with body image, anxiety, and depression in women with PCOS, therefore it is recommended to use this therapy.

Background: The announcement of a cancer diagnosis represents a real turning point, significantly and pessimistically changing the patient's vision of his future. The task of the healthcare professional in communicating bad news is complex. It requires careful use of words, establishing a relationship of trust, a patient approach, and encouraging the person affected by cancer to express their emotions. This is a sociological study of a series of cancer patient cases designed to reveal the different perceptions and experiences of cancer patients with regard to the announcement of the diagnosis of cancer by healthcare professionals.

Materials and methods: This descriptive qualitative study was done in 2022. The participants were selected from cancer patients cases treated in the Fès-Meknès Region. Participants in this study were 35 patients selected using a purposeful sampling method. Data were collected using in-depth semi-structured interviews. The qualitative content analysis approach was used to analyze the data using Atlas.ti software.

Result: A double suffering has been observed among cancer patients with regard to the announcement of their cancer diagnosis. In addition to the intensification of negative feelings and distress at the time of the announcement, dissatisfaction has been observed with the way in which the cancer diagnosis is communicated. The announcement does not address the holistic needs of the cancer patient, particularly with respect to health literacy. This finding is justified by limitations in relation to the basic training of the medical and nursing cops with regard to the announcement of the diagnosis.

Conclusion: This event represents a critical moment, requiring a multidisciplinary approach and involving various professionals involved in cancer management. Health professionals need to develop the skills necessary to accurately but smoothly announce a cancer diagnosis in order to maintain hope regardless of prognosis. Thus, an indispensable aspect to take into account in diagnostic communication is the cancer patient's level of literacy.

Background: Type-1 diabetes mellitus (T1DM) is one of the most dreaded chronic diseases, especially in children or youth. To help patients and their families effectively manage their disease, structured therapeutic patient education (TPE) is essential.

Materials and method: The purpose of this non-randomized before and after controlled study was to assess TPE program effects. In total, 200 T1DM children and adolescents, aged 8-18 years, selected from two pediatric departments, were equally assigned to the intervention and control groups. The primary endpoints were differences between groups at 3 months follow-up in measured HbA1c and health-related quality of life (QoL) assessed by a validated questionnaire.

Results: At 3 months follow-up of a TPE intervention for T1DM children and adolescents, although there was no significant change in HbA1c for both groups, a significant improvement was observed in the maximum pre- and postprandial blood glucose levels (r: ~0.3; variation rates: -10,47% and -3,85%, respectively) in the intervention group, whereas there was a significant increase in the maximum and minimum of preprandial blood glucose levels in the control group (r: ~0.3, variation rates: 14.29% and 25%, respectively). Global and dimensional QoL mean scores variation rates showed a significant difference between groups, with an improvement in the intervention group (r ≥ 0.7, Cohen's > 0.8) and a decrease in the control group (r ≥ 0.7).

Conclusion: These results support the hypotheses of difference between the study groups in favor of better glycemic control and QoL for the intervention group.

Background: Chronic kidney disease (CKD) can be complicated by malnutrition, which has adverse implications on patients' health outcomes and quality of life. CKD patients from different sociocultural contexts may have varying perceptions of knowledge, attitudes, and practices of malnutrition. However, information on the perception of malnutrition in patients with CKD is limited. This study aimed to explore and describe the knowledge, attitude, and practice of patients with CKD disease regarding malnutrition.

Materials and methods: A qualitative-descriptive design was used. Thirteen participants were selected through a purposive sampling technique among malnourished CKD patients from a hospital in Xi'an Provincial Hospital of Traditional Chinese Medicine between November 2022 and January 2023. Data were collected through face-to-face semistructured interviews until data saturation. All participants were informed about the study. Data obtained were analyzed by content analysis.

Results: Three main categories and seven subcategories were extracted from the data analysis: 1) knowledge (basic knowledge acquisition and understanding, knowledge misconceptions, and confusion, nutrition knowledge, and culture collision); 2) attitude (negative attitudes and adverse situations, positive attitude and self-awareness); 3) practice (disadvantageous and passive practice, favorable practice).

Conclusion: This study provided insight into the knowledge, attitude, and practice of malnutrition in patients with CKD. Our findings can serve as important baseline data for the development of future interventions that can help reduce the risk of malnutrition, slow disease progression, and improve the quality of life in patients with CKD.

Background: Narratives can provide a framework to teach the concepts of patient-centered care to the students. This article describes the experiences of midwifery students from employing of purposive storytelling as a teaching strategy in the education program.

Material and methods: This qualitative study used an in-depth interview method to collect the experiences of midwifery students engaged in a narrative medicine training program. The narrative-based teaching activities focused on three patients to teach four themes (clinical manifestations, treatment options, prevention strategies, and ethics), and related to MMR (maternal mortality rate) concept offered to students from Guilan University of Medical Sciences in 2022-2023. At the end of the course, all students were invited to provide experiences regarding the teaching method. Conventional content analysis was performed simultaneously with data collection. Four-dimension criteria (Lincoln and Guba) were used to evaluate the rigor of the findings.

Results: Data analysis led to the extraction of three main categories and eight sub-categories: effective learning (extended learning, a safe learning environment, and boosted motivation for midwifery role), challenges on the way of learning (contagious sadness, shattered cohesion, and executive monopoly), and challenges on the way of performance improvement (the necessity of interdisciplinary education and the inevitability of a strong foundation).

Conclusions: Narrative-based teaching may improve the learning experience of students, but it is not possible to train all the course content by this method, and it should ideally be a supplement to other educational methods, such as lecturing.

Background: Irritable bowel syndrome (IBS) is a lifestyle disease associated with significant morbidity and healthcare expenses. Although the pathophysiology of this disease remains obscure till date, there are many possible predisposing factors that have been described. Medical education is extremely demanding and taxing, with students facing multiple stressors throughout their course. Stress and mental illnesses being one of the main risk factors for IBS, these students are possibly at a much higher risk of suffering from this disease.

Objective: The objective of this article is to study the frequency of IBS among a sample of students in a medical college in India and try to determine the determinants associated with this disease.

Materials and methods: This is a cross-sectional study conducted among students studying in Kasturba Medical College, Mangalore. A self-administered World Gastroenterology Organization (WGO) questionnaire was filled by the participants. The responses were analyzed for identifying those likely to be suffering from IBS based on a scoring system and to assess the association between risk categories and IBS.

Results: Prevalence of IBS among 397 participants was found to be 16.9%. About 20.8% of females suffered from IBS as against 11.4% of males. It was also found that the proportion of medical undergraduates likely to be suffering from IBS was more in those belonging to the NRI category (28.6%), those who consumed a diet which was predominantly vegetarian (19.1%) and less in those staying at home (14.5%).

Conclusion: The proportion of students suffering from IBS was observed to be 16.9% of the sample population with a significant female gender preponderance.

Burnout is recognized as a negative contributor to well-being within healthcare. The purpose of this study was to evaluate whether participation in the Peace Education Program (PEP), a 10-week wellness course, promoted durable improvement of burnout and wellness in a large academic medical center. We deployed PEP virtually through a series of free, interactive, online wellness sessions focusing on 10 domains: peace, appreciation, inner strength, self-awareness, clarity, understanding, dignity, choice, hope, and contentment. Two weeks before and six months following the sessions, we distributed de-identified surveys based upon the validated Schwartz Outcome Scale-10 (SOS-10) with Likert scale scores 0-6 to assess participant wellness. The Mann-Whitney U test was used to analyze statistical differences between post- and pre-course data. Sixty-nine faculty, trainees, and staff registered to participate, 21 participants completed the pre-course survey and 10 completed the post-course survey. The pre-course mean + standard error (SE) SOS-10 score was 43.2 ± 0.8, which improved to 51.0 ± 0.7 post-course (P < 0.001). Overall, all 10 domains demonstrated improved mean scores over time, with the five domains of "inner strength" (P = 0.008), "understanding" (P = 0.030), "peace" (P = 0.048), "choice" (P = 0.026), and "hope" (P = 0.020) demonstrating statistically significant score improvements six months after course completion. Participants completing ≥7 sessions benefited more than their counterparts and achieved statistically significant improvement in SOS-10 wellness scores (8.77 points) six months after course completion. Our findings demonstrate improved wellness in participants following peace education course completion. This free, interactive, online course may be utilized at other medical centers to improve wellness.

Background: The recent spike in the incidence of type 2 diabetes is most likely caused by the obvious rise in the prevalence of overweight and obesity. The risk of developing noncommunicable illnesses can be prevented and reduced with even modest weight loss. This study was conducted with the aim of evaluating the effectiveness of a nurse-led intervention (NLI) strategy on weight reduction among adults in urban Puducherry.

Materials and methods: A two-arm, parallel-group, randomized controlled study with an open label was conducted with obese adults in urban areas of Puducherry, namely Nesavalar colony and Govindanpet, from November 2022 to February 2023. Totally, 88 obese adults were randomized using a simple random sampling method to either the NLI arm or the general care (GC) arm. WHO STEPS (version 3.2) questionnaire was adopted to gather baseline and end line data. NLI arm participants received NLI and GC arm participants received GC from urban primary health center. In statistical analysis, the proportion was used to summarize categorical variables. The parametric and nonparametric tests were applied based on the variable type and normality of the data. Multiple linear regressions were used with outcome changes in weight in the NLI arm.

Results: At 16 weeks, the NLI arm lost a mean weight of - 2.58 kg and the GC arm gained 0.38 kg with a mean difference in weight of 2.96 between arms. A significant reduction was found (P < 0.001) in weight, waist circumference, body mass index, and also found significant improvement in cholesterol profile and thyroid stimulating hormone.

Conclusion: This community-based NLI study is effective for weight reduction in urban Puducherry and it lowers the risk of developing noncommunicable diseases among adults. Due to the larger size of the geographical area and the more number of clusters, a stringent follow-up plan and extra manpower must be created for the main study.