Aim. This study was aimed to assess the effect of self-care educational program on quality of life in patients with hypertension.

Background. Hypertension is a major health problem due to complications and high mortality rate. It causes problems in the ability of patients for self-care and affect their quality of life.

Method. This clinical trial study with control group was conducted in Mahmud-Abad Hospital affiliated to Mazandaran University of Medical Sciences. In this study, 70 patients who met the inclusion criteria were selected through convenience sampling and to prevent information contamination, they were allocated to groups according to whether they refer to hospital even or odd days. Before and three months after intervention, data were collected by quality of life questionnaire SF-36 in both groups. Patients in control group received routine education. Patients in intervention group participated in three face to face self-care education sessions (each session lasted 20 minutes) and received educational package including instruction booklet and CD. Data were analyzed by using Independent t-test, Paired t test, Chi-square test, and Fisher’s exact test through SPSS version 21.

Findings. The results showed that before intervention, there was not a statistically significant difference between two groups regarding quality of life, but after 3 months there was a statistically significant difference (P<0.0001). Also, in the intervention group, there were statistically significant differences regarding the total score of quality of life and all related dimensions, before and three months after education (P<0.0001).

Conclusion. Self-care education can improve quality of life among patients with hypertension. It is recommended that health care providers, particularly nurses, implement these educational programs for improving the quality of life of patients with hypertension.

Abstract

Aim. The aim of this paper is to review studies related to sodium restriction and adherence to this restriction in patients with heart failure.

Background. In the last decade, there has been a dramatic increase in the prevalence and incidence of chronic heart failure. Non-pharmacological and non-surgical therapies in the management of chronic heart failure play an important role, and low sodium intake, by reducing fluid retention, improves symptoms and prevents worsening of the disease, but adherence to nutritional regimes is often less than adherence to medications.

Method. We reviewed studies published over the recent 15 years regarding sodium restriction in patients with heart failure. These were searched out through scientific databases, including PubMed and Science Direct by the keywords adherence, chronic  heart failure, low-sodium diet, sodium restriction, low salt diet and their Persian equivalents.

Findings. In the reviewed studies, sodium intake assay and patient's adherence to sodium restriction were different. Although sodium restriction is known as the basic management of heart failure, butthere are not consensus about its usefulness. It was also found that there is no specific guidelines for sodium restriction in heart failure, and that a small percentage of patients follow sodium restriction. Few studies have been conducted regarding related factors of adherence to the sodium restriction diet in patients with heart failure. Also, non-pharmacological methods including education and counseling have not been successful in improving patients’ adherence.

Conclusion. Further research with higher methodological quality, larger sample size and the use of appropriate and accurate approach to measure sodium intake is needed. To achieve a sodium restriction diet is possible, but difficult. Although, there is no consensus on the exact amount of the reduction of daily sodium intake, but seems that reduction in sodium intake can improve symptoms and quality of life in patients with heart failure. Theory-based and family-based interventions may be able to help improving patients’ adherence to sodium restriction diet, although more studies are essential to be conducted.

Abstract

 Aim. The aim of this paper is to review studies related to fatigue in patients with heart failure.

 Background. Fatigue is a subjective feeling and a multifactorial phenomenon in patients with heart failure. Fatigue is an important symptom of heart failure; however, lack of information exist regarding this phenomenon. Also, fatigue is considered as a challenge by health care providers and clinical guidelines have paid less attention to fatigue in these patients. 

 Method. This article reviewed studies published regarding fatigue in patients with heart failure. The studies were searched out through scientific databases, including PubMed and Science Direct by the keywords fatigue, predictors, related factors, heart failure and their Persian equivalents.

 Findings. The literature review revealed that the prevalence of fatigue in patients with heart failure is high and different findings have been reported regarding its severity in these patients. Fatigue and its increasing trend during the disease progress is related to unsatisfactory quality of life and clinical outcome. In various studies, multiple factors including the nature of the illness and psychological factors particularly depression have been reported as predictors of fatigue and its severity in patients with heart failure. Few studies were conducted with the aim of evaluating the effect of non-pharmacological intervention on management of fatigue in these patients.

 Conclusion. According to the high prevalence of fatigue in patients with heart failure, it is essential to consider timely interventions by health care providers, particularly nurses, for reducing it and improving patients’ well-being. Regarding the limitation of studies and importance of reducing fatigue, it is necessary to conduct further research to evaluate the effect of non-pharmacological interventions on symptom management (especially fatigue) in these patients.