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Showing 15 results for Adherence
Zahra Poshtchaman, Maryam Jadid Milani, Foroozan Atashzadeh Shoorideh, Alireza Akbarzadeh Bagheban, Volume 3, Issue 2 (9-2014)
Abstract
Abstract Background. One of the most important aspects of care and follow-up after coronary artery bypass graft surgery is treatment adherence program. As the long term success of the surgery depends on the treatment of adherence plan. Aim. The purpose of this study was to evaluate the efficacy of phone and SMS follow-up care on patients' treatment adherence after coronary artery bypass graft. Method. This clinical trial was performed on patients undergoing coronary artery bypass graft surgery in the heart surgery unit in Tehran hospitals in 2014. In this study, 90 patients were selected purposively and allocated into telephone follow-up group (n=30), SMS follow-up group (n=30) and control group (n=30). Demographic and treatment adherence questionnaire were completed twice (before intervention and two months after the intervention). The telephone follow-up and SMS follow-up groups were given training and booklet before discharge. In telephone follow-up intervention, three calls a week was made for two months and the SMS follow-up group received text messages daily for two months. To analyze the data, Chi-square test, Fisher exact test, t-test and ANOVA, ANCOVA, and Bonferroni test were used. Findings. There was no statistically significant difference between the telephone follow-up and SMS follow-up groups in terms of treatment adherence scores, before and after intervention. A statistically significant difference was seen between telephone follow-up and control groups (p<0.0001), and SMS follow-up and control groups (p<0.0001) in terms of treatment adherence scores, before and after the intervention. Conclusion. Both SMS and telephone follow-up are effective to improve treatment adherence in patients after coronary artery bypass graft. It is suggested to use these interventions for patient following coronary artery bypass graft.
Farhad Kamrani, Somayeh Nikkhah, Fariba Borhani, Mohammad Jalali, Sudeh Shahsavari, Kianoosh Nirumand-Zandi, Volume 4, Issue 3 (12-2015)
Abstract
Aim. The aim of this study was to determine the effect of patient education and nurse-led telephone follow-up (telenursing) on adherence to treatment in patients with acute coronary syndrome admitted to cardiac care units hospitals affiliated to Alborz University of Medical Sciences.
Background. Increasing adherence to treatment is essential in patients with acute coronary syndrome to reduce readmissions and improve the recovery, but only patient education does not guarantee the adherence to treatment and it is necessary to follow-up patients after discharge.
Method. This randomized clinical trial study was conducted on patients with acute coronary syndrome admitted to the selected hospitals of Karaj, Iran, in 2014. In this study, 90 patients were selected purposively and randomly allocated in three groups of education (n=30), education/ telephone follow-up (n=30), and control (n=30). Data collection instrument was questionnaire. Data were gathered at baseline and 12 weeks after the intervention. Patients in educational groups (education, and education/ telephone follow-up groups) were trained before discharge using educational pamphlets. Telephone follow-up were implemented for education/ telephone follow-up group for 3 months; twice a week in the first six weeks and weekly in the second six weeks. The data was analyzed by descriptive and inferential statistics in SPSS version16.
Results. After intervention, there was a statistically significant difference between the groups in terms of adherence to treatment (P=0.001). Participants in the education/ telephone follow-up group and education group experienced more improvement in adherence to treatment than the control group.
Conclusion. Both patient education and education/ telephone follow-up have effect on improvement of adherence to treatment, but education/ telephone follow-up results in more improvement in adherence in comparison to education. It is recommended to implement education/ telephone follow-up for patients with acute coronary syndrome.
Tahereh Najafi-Ghezeljeh, Kazem Akhondzadeh, Volume 4, Issue 4 (3-2016)
Abstract
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.
Mina Khanjari, Farhad Kamrani, Tahereh Nasr-Abadi, Volume 6, Issue 4 (3-2018)
Abstract
Abstract
Aim. This study aimed to investigate the effects of a Turkish, family-oriented multimedia application on adherence to therapeutic regimen in people with recent myocardial infarction.
Background. Using native language in education of people experiencing myocardial infarction may have an effect on their adherence to therapeutic regimen.
Method. This study is a clinical trial. The research was conducted in Post-CCU wards of Zanjan hospitals in 2016. In this study, 80 patient with myocardial infarction were randomly allocated to experimental (n=40) and control (n=40) group during a 6 month period. Data collection tools consisted of demographic form and a questionnaire measuring adherence to therapeutic regimen in domains diet, physical activity, and medication. Data were analyzed in SPSS V.20 by statistical tests (Chi-square, Mann-Whitney and T-Test.
Findings. Comparison of the groups indicated a statistical significant difference between the mean score change of adherence to medication regimen of experimental and control group (3.52±0.2 versus 2.79±0.73) (P≤0.0001), adherence to diet (3.91±0.3 versus 3.63±0.6) (P≤0.0001), and adherence to physical activity (3.57±0.4 versus 3.11±0.7) (P≤0.0001).
Conclusion. Family-centered family education through multimedia application (in Turkish) is effective on patients’ adherence to therapeutic regimen and in turn, may reduces the costs and complications.
Elnaz Yazdanparast, Malihe Davoudi, Marziye Safavinejad, Seyed Hasan Ghorbani, Sahar Nadimi, Bahare Rezvani Dehaghani, Volume 7, Issue 3 (12-2018)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of teach back learning strategy on illness perception, nutritional knowledge and dietary adherence in people with hypertension.
Background. Because of the chronicity of hypertension and the importance of nutrition in hypertension control, illness perception and nutritional knowledge play an important role in adherence to nutritional regimen and disease control.
Method. The present study is a quasi-experimental study control group and pretest-posttest design. Based on random sampling, two health care centers in Ferdows were selected as the place for experimental and control group. Using a simple randomized method, of patients with hypertension, 35 individuals were recruited for each group. These people entered the study based on inclusion criteria and after that they signed the consent form. Before and after the intervention, illness perception, nutritional knowledge and dietary adherence were measured by self-report questionnaire and compared between the groups.
Findings. After intervention, the mean score of nutritional knowledge in experimental and control group was 48.17±5.21 and 41.16±0.51, respectively, and a statically significant difference was found between groups in terms of nutritional knowledge (P≤0.0001; t=9.56). After intervention, the mean score of illness perception in experimental and control group was 9.75±1.81 and 7.72±1.60, respectively, and there was a statically significant difference between groups in terms of illness perception (P≤0.0001; t=4.15). But no statically significant difference was found between experimental and control group in terms of dietary adherence (17.55±4.17 against 16.88±3.62).
Conclusion. Given the positive effects of teach back method and the special role of nurses in patient education, attention to this teaching method seems necessary. The use of this method of training is suggested as part of care process to reduce patients' clinical problems.
Banafsheh Ghorbani, Fatemeh Bahramnezhad, Mohammad-Hossein Mandegar, Phd Zohrehsadat Mirmoghtadaie, Volume 8, Issue 1 (3-2019)
Abstract
Abstract
Aim. The purpose of this study was to review the importance of cardiac rehabilitation and physical activity training in the second phase of rehabilitation.
Background. Cardiac rehabilitation is defined as a comprehensive long-term program consisting of medical assessment, exercise program administration, correction of cardiovascular risk factors, training and counseling. Familiarizing nurses with the area of cardiac rehabilitation and providing necessary education to patients will have a significant effect on reducing complications and improving quality of life.
Method. This review study was carried out by library and internet searches in the years 2018-2019 using the keywords “coronary artery bypass graft surgery”, “adherence to treatment”, “cardiovascular disease”, “physical activity”, “exercises at home”, “cardiac rehabilitation” and their Persian equivalents. The search was carried out in databases, search engines PubMed, SID, MagIran, Web of Sciences, Cochrane Library, CINHAL, OVID, Google Scholar, Up-to-date, and Scopus without time limit. A total of 51 articles were found in relation to the subject under study, of which, 4 articles were excluded because of duplication and 10 articles were excluded because their full texts were not available. Finally, 37 articles were included in the study.
Findings. The role of the nurse in training cardiac patients for rehabilitation is of great importance. By educating patients about the principles of rehabilitation for prevention and management of complications, an important role can be played in improving the quality of life of patients and increasing their survival.
Conclusion. Nurses' acquaintance with the principles of cardiac rehabilitation is of particular importance. It is suggested that nurses consider rehabilitation education as one of the supportive therapeutic and preventive approaches and should always be familiar with the latest guidelines in this area.
Maryam Izanloo, Parisa Peyvandi, Ahmad Borjali, Mohammada Reza Sirafi, Yousef Mohsenzadeh, Volume 8, Issue 1 (3-2019)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of compassion-based therapy on adherence to treatment and components of type D personality in people with coronary heart disease in Alborz province, Iran.
Background. Coronary heart disease as a chronic disease is being considered as a psychosomatic disease that is affected by psychosocial factors as well as biological factors.
Method. The study method was quasi-experimental with pre-test post-test with control group and follow-up period. The statistical population of this study included people with coronary heart disease who referred to the cardiac ward of Rajaei hospital in Karaj, Iran, on an outpatient or inpatient basis in 2019. The sample consisted of 30 patients who were selected through convenience sampling and were randomly divided into experimental (N=15) and control (N=15) groups. The experimental group underwent compassion-focused therapy (CFT) weekly in 90-minute duration sessions for 8 weeks according to Gilbert's CFT protocol, and the control group was placed on a waiting list for training. Data were collected using questionnaires adherence to treatment and Denolt type D personality. Data were analyzed in SPSS software version 24 using mixed variance design.
Findings. After intervention, the mean score of adherence to treatment in experimental group (43.33±4.22) was statistically higher than that of the control group (34.60±4.33). After intervention, the mean score for type D personality in experimental group (26.73±4.94) was statistically lower than that of the control group (36.53±4.27). The main effect of time, the main effect of group, and group-by-time interaction for both adherence to treatment and type D personality was statistically significant, meaning that CFT influences these variables in people with coronary heart disease.
Conclusion. Programs that are performed in the form of psychological educational interventions along with medical interventions may decrease the severity of coronary heart disease, accelerate the healing process, and promote general health and long-term adaptation of these patients. Therapists and health professionals are advised to use compassion-focused therapy to improve the mental and physical health of people with coronary heart disease.
Bahareh Seraj, Fatemeh Alaee Alaee-Karahroudi, Tahereh Ashktorab, Maryam Moradian, Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. This study aimed to investigate the effect of telenursing on adherence to treatment in adolescents undergoing cardiac surgery.
Background. Congenital Heart Disease (CHD) has a significant global prevalence and a large number of patients undergo cardiac surgery every year. Adherence to treatment is essential to achieve the expected outcomes of surgery.
Method. This study was a quasi-experimental before-after study with control groups that was conducted in the year 2020. A total of 70 adolescents referred to a university cardiovascular medical and research center in Tehran, Iran, were recruited based on the inclusion criteria and then, randomly assigned to experimental (n=35) and control (n=35) group. The experimental group received a telenursing services via WhatsApp messenger for one month. Modanloo's questionnaire of adherence to treatment was used to collect the data. Data were analyzed in SPSS V-20 using descriptive and inferential statistics.
Findings. There was no statistically significant difference between the experimental and control groups in terms of demographic variables. Before intervention, the mean score of adherence to treatment in the experimental and control groups was 71.67±6.97 and 71.77±7.89, respectively, which were not statistically different. After intervention, the mean score of adherence to treatment in the experimental and control group changed by 15.17 and -2.49, respectively, and the difference between the groups was found to be highly significant (P≤0.0001).
Conclusion. According to the findings, telenursing improved adherence to the treatment. Therefore, it is recommended to provide the ground to take the benefits of this approach through increasing public information and awareness and empowering the nursing staff.
Yeganeh Pasebani, Mohammad Javad Alemzade Ansari, Mohammad Hassan Ghaffari Nejad, Shiva Khaleghparast, Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. The aim of this study was to review studies that investigate the factors affecting adherence to treatment in people with cardiovascular disease.
Background. Adherence to treatment is a comprehensive term that is used to convey acceptance of treatment process and following professional advice by the patient to increase the quality of life. Given the importance of adhering to treatment plans and being aware that many people do not follow treatment plans, understanding the factors that lead to patients' effective adherence to the treatment regimen can lead to the development of strategies to increase patients' adherence to the therapeutic regimen.
Method. Articles published between years 2010-2020 were searched out in databases Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc and Magiran using the keywords adherence to treatment, cardiovascular diseases and their Persian Equivalents. Research articles in Persian and English focusing on the factors affecting the adherence to treatment in cardiovascular patients were selected for the study. In total, 167 articles were found in primary search by reviewing the title and abstract and in some cases after studying the full text of the articles; out of them, 11 were selected that were in accordance with the research purpose of this study.
Findings. The most effective methods for improving adherence to treatment were tele-nursing and educating colleagues on how to follow up patients. Also, recognizing differences between personal and psychological aspects of patients and adopting an appropriate method for each person to pursue treatment and increase adherence to the treatment regimen are very important known factors in the care of cardiovascular patients.
Conclusion. In general, the care and training provided and continuous follow-up by the health care professionals have the greatest impact on increasing adherence to the treatment regimen among patients.
Mr Hosein Mahmoudi, Mrs Asma Shojaee, Volume 10, Issue 1 (3-2021)
Abstract
Abstract
Aim. The purpose of this study was to explore and clarify the concept of adherence to treatment in people with heart failure.
Background. The concept of adherence to treatment, which determines the consequences of heart failure, is widely used in the literature. But this concept is very complex and needs a clear definition.
Method. In this study, the evolutionary approach of Rogers concept analysis was used. The main criteria for entry were texts published in English between 2004 and 2019. The data sources were the PubMed, Scopus, and EMBASE. A total of 73 articles were found out of which 37 articles were selected after omitting duplications, and after screening the studies based on Prism Diagram, 35 articles were studied.
Findings. After reviewing the studies, 5 words, adherence to medication, medication adherence, non-medication adherence or self-care recommendations, adherence to therapeutic guidelines, and non- adherence treatment were recognized as alternative terms, and two concepts, compliance and self-care were identified as the most important and the most common concepts related to adherence to treatment. Seven concepts were found as the features of the adherence to treatment (adaptability, being multidimensional and complex, participatory, dependent on demographic variables and underlying diseases, being conscious and dependent on education, measurable and predictive, and continuous and follow-up). Outcomes of the concept of adherence to treatment were directly related to the consequences of the concept.
Conclusion. Adherence to treatment is a complex, multidimensional, participatory, conscious, and measurable concept that depends on demographic variables that must be constantly monitored by the health care team. Adherence to treatment is evolving over time, both semantically and conceptually.
Nahid Ramak, Kiana Ghasemnezhad, Elahe Ghasempour, Zeinab Sadeghkhani, Eshaqh Sam Khanian, Farshid Bibak, Alireza Sangani, Volume 10, Issue 1 (3-2021)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of functional analytical psychotherapy on treatment adherence and self-care behaviors in female patients with acute myocardial infarction.
Background. The severity of cardiovascular disease is affected by cognitive and behavioral function in people experiencing acute myocardial infarction. Therefore, with effective and modern treatments for this problem, effective results could be expected.
Method. The research method was quasi-experimental pre-test post-test and follow-up design with control group. A sample of 30 women with a history of acute myocardial infarction who had been admitted to Seyed Al-Shohada Heart Hospital in Urmia, Iran, in 2021, were selected based on inclusion and exclusion criteria and randomly assigned to experimental (N=15) and control (N=15) group. Tsai et al. (2010) Functional Analytical Psychotherapy Package was implemented for experimental group in 10 sessions of 45 minutes duration. Before and after the sessions, and also, 3 months after intervention, both members of experimental and control groups completed Treatment Adherence Questionnaire and Self-Care Behavior Questionnaire as pre-test, post-test and follow-up measurements. Data were analyzed using mixed model analysis of covariance in SPSS Version 18.
Findings. The results showed that there was a statistically significant difference between experimental and control groups in term of the means of treatment adherence and self-care behaviors in pre-test, post-test and follow-up. Functional analytical psychotherapy had a greater effect on improving self-care behaviors (0.912) than treatment adherence (0.897) in female patients with acute myocardial infarction (P≥0.0001).
Conclusion. These results emphasize the effect of functional analytical psychotherapy in cognitive and behavioral domains in the treatment of female patients with acute myocardial infarction.
Farzaneh Mehrvarz, Shiva Khaleghparast, Majid Maleki, Dr. Ali Zahedmehr, Saeideh Mazloomzadeh, Bahram Mohebbi, Volume 10, Issue 1 (3-2021)
Abstract
Abstract
Aim. This study aimed to examine the effect of education about anti-platelet drugs consumption through telephone follow-up on medication adherence in patients with coronary angioplasty.
Background. Regarding the necessity of proper use of antiplatelet drugs after coronary angioplasty, adherence to treatment is of great importance, and it is considered as one of the major concerns.
Method. This quasi-experimental study was conducted on 392 patients with percutaneous coronary intervention. The patients were divided into two experimental (telephone fallow-up) and control (without telephone fallow-up) group for one year. Adherence to treatment was assessed using the Morisky Medication Adherence Scale before and after percutaneous coronary intervention. Data were analyzed using t-test, chi-square and linear regression model in SPSS software.
Findings. The mean age of patients was 61.71±10.28 years in the experimental group and 60.72±11.14 years in the control group. Changes in the mean score of medication adherence was 53.09±1.37 in the experimental group and 18.09±1.30 in the control group, indicating a statistically significant increase in medication adherence in the experimental group compared with the control group (P=0.001). Non-use of anticoagulants in the experimental group increased until the end of the sixth month of telephone follow-up and then, decreased until the end of the twelfth month of follow-up.
Conclusion. Since changes in the mean score of adherence to medication in the experimental and control groups was significant, it is recommended that follow-up interventions in patients be continued continuously for at least one year.
Amir Tabatabaee, Esmaeil Mohammadnejad, Volume 10, Issue 1 (3-2021)
Abstract
Abstract
Aim. The purpose of this study is to review studies that have investigated the effect of family-centered self-care program on the activity of people with cardiovascular disease after hospital discharge.
Background. Adherence to medication, diet and physical activity in people with cardiovascular disease is very crucial to prevent readmission, independence in daily activities, and complications.
Method. In this review study, a comprehensive search of scientific databases and search engines such as Science Direct, Scopus, PubMed, Google Scholar, and Medline using the keywords cardiovascular disease, adherence to treatment regimen, and family-centered self-care program in both Persian and English languages was done to find articles published between 2000 and 2020.
Findings. Family-centered post-discharge self-care program can be a principled and effective method to increase adherence to medication, diet and physical activity in heart people with cardiovascular disease.
Conclusion. One of the most important factors in effectiveness of self-care is active family participation and family-centered self-care, which can be effective in three areas after the discharge of people with cardiovascular disease.
Fateme Izadi, Yasaman Khalili, Shiva Khaleghparast, Sepide Taghavi, Volume 11, Issue 1 (3-2022)
Abstract
Abstract
Aim. The aim of this study was to investigate the relationship of health literacy, knowledge of heart failure and social support with adherence to medical treatment in patients with heart failure.
Background. Despite significant advances in the treatment of heart failure, the prognosis in these patients is poor. Factors influencing the prognosis include comorbidities, disease severity, age and sex differences, inadequate health literacy, poor adherence to medication, poor knowledge, and poor social support.
Method. The present study was a cross-sectional descriptive correlational study that was performed on 300 patients referred to the clinic of Rajaie Cardiovascular Medical and Research Center. Sampling method was convenience. The study tools included questionnaires completed by the researcher or patient: demographic form (personal, economic and social information), Health Literacy Questionnaire, Dutch Heart Failure Knowledge Scale, Multidimensial Scale of Perceived Social Support and Morisky Medication Adherence Scale. Data were analyzed in SPSS software version 22 using descriptive and inferential statistics.
Findings. Median (interquartile range) age of the samples was 55 (41-65) years, and 172 (57.33%) were male and 128 (42.66%) were female. In this study, there was a statistically significant relationship of health literacy (P=0.029, r=0.13) and knowledge of heart failure (P=0.02, r=0.13) with adherence to medical treatment. But there was no significant correlation between social support and adherence to medical treatment.
Conclusion. The results of this study showed the relationship of health literacy and knowledge of heart failure with adherence to medical treatment. We can improve patient’s adherence to treatment by increasing the level of their knowledge related to heart failure and health literacy toward the disease
Niloofar Ahmadi, Masood Rezaei, Mohammadreza Zarei, Shima Haghani , Fatemeh Rashidi, Mohammad Abbasi, Volume 12, Issue 1 (3-2023)
Abstract
Abstract
Aim. This study aims to assess the impact of education based on the Pender’s health promotion model on quality of life and medication adherence in patients with implantable cardioverter defibrillator (ICD).
Background. Heart failure is a chronic condition in which the heart is unable to provide adequate circulation to meet the metabolic needs. One of the common complications of this disease is sudden cardiac death due to
arrhythmias. Implantable cardioverter defibrillators (ICDs) are recognized as an effective treatment for this issue, as they detect life-threatening arrhythmias and deliver electrical shocks to restore the heart's rhythm to a normal sinus rhythm. Despite the life-saving benefits of these devices, ICD shocks may have negative effects on patients' quality of life. Additionally, poor medication adherence remains a major challenge, leading to treatment failure, increased complications, and higher healthcare costs. Through the implementation of various educational models and health strategies, nurses can effectively influence patients' awareness, attitudes, and health behaviors. The Pender’s Health Promotion Model (HPM) is a framework that leverages individuals' experiences, emotions, perceptions, and
behaviors to improve health outcomes.
Method. This is a study protocol for a randomized clinical trial that will be conducted at Shahid Rajaei Cardiovascular Institute in Tehran. Patients with heart failure who undergo ICD implantation will be randomly assigned to the intervention and control group. Both groups will complete a demographic information form, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Morisky Medication Adherence Scale (MMAS-8). The intervention group, in addition to receiving the standard hospital educational program, will
participate in a 45-minute in-person session at discharge. This session will introduce the number and content of the educational sessions and emphasize the importance of continuous participation. Subsequently, five 30-minute virtual educational sessions will be conducted twice weekly, based on the Pender’s Health Promotion Model. Additionally,
weekly telephone follow-ups will be conducted for one month to monitor adherence to recommendations and address potential issues. The control group will receive only the standard hospital education program at discharge. At the end of the study, both groups will complete the MLHFQ and MMAS-8 questionnaires again to assess outcomes.
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