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Background and purpose: Diabetes type 1 is a chronic disease in children during their childhood, which may have unfavorable effects on children, family and society. By enhancing self- care in children having diabetes type 1, we can reduce these effects. Self- care in children also can be affected by factors such as family reaction. The purpose of this research is to determine the relationship between self-care in diabetic children and their family’s reaction.
Materials and methods: This research is a non- experimental and correlative study which determines and specifies the relationship between diabetic self- care in children, who are affected by diabetes and their family’s reaction. 133 children between the ages of seven to fourteen suffering from diabetes type 1 were chosen with above continuous method for two months from selected centers. Collecting information, observation and questionnaire forms were used.
Results: The results obtained from this study, showed there is a meaningful relationship between child's self- care and reaction of their family (p=0.000). Variants such as age, sex, rank of birth and length of disease period are not considered as an interfering element in relation between self caring and family reaction.
Conclusion: The results from this research reveal that the self caring of children in an average level has a direct influence and relationship with family reaction and at the same time, the direct and strong correlation with the diabetic child’s knowledge regarding their functions and performances. We suggest that educational programs should be provided for these children and their families, in order to promote self caring of children and their family’s reaction. We also propose conducting similar research, by using case- control method, to identify other factors in this regard.

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Background and purpose: The most important underlying cause of death in diabetic patients is the lack of self-care. One way to assess self-care skills in diabetic patients is the measurement of glycated hemoglobin (HbA1c). Different training programs are implemented to improve self-care behavior, however, the role of nurses in such trainings and counseling is neglected. The aim of this study was to compare the effect of group education versus group counseling for self-care on HbA1c in patients with diabetes type II. Materials and methods: In a clinical trial, 112 patients with type II diabetes mellitus attending Mashhad Parsian Diabetes Clinic in 2014 who were selected by convenience sampling. They were randomly allocated into three groups, counseling (n= 37), education (n = 37) and control (n= 38). Group counseling and group education were held for five sessions (1.5 hours each) every three days, in groups consisting of 8 to 10 patients. HbA1c test was performed before and two months after the intervention. Data was analyzed in SPSS V. 11.5 applying Paired sample T Test and ANOVA. Results: The groups did not show any significant differences in HbA1c levels before the intervention (P=0.133). But after the intervention, the HbA1c levels decreased significantly in patients who had group counseling (8.3±0.9) and group education (8.5±1.1) compared to the control group (9.1±1.4) (P=0.016). Conclusion: This study showed that group education and group counseling improved self-care behaviors in patients with diabetes, therefore, they could be highly beneficial when integrated into an educational program.

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Background and purpose: Diabetes is the most common metabolic disease in the world. The most important factor in controlling the disease is self-care. The purpose of this study was to evaluate the effect of some variables on self-care behaviors such as duration of disease, central obesity and diabetes knowledge. Materials and methods: In a cross-sectional study 500 diabetic patients were selected in 2014 using stratified random sampling. The subjects were chosen from 752 patients registered as diabetic in Abyek health centers. Data was collected through questionnaires about demographic information, self-care and diabetes knowledge. χ2, independent T test and ANOVA were used to examine the relationship between demographic characteristics and self-care. Also, the multiple-linear-regression was used to predict the affecting factors on self-care. Results: A total of 464 patients participated in the study resulting in the response rate of 92.8%. The mean for self-care behavior score in patients with diabetes was 3.77±1.15. There was a significant association between self-care and different parameters including duration of diabetes (P= 0.013), type of treatment (P= 0.035), and central obesity (P= 0.046). The strongest predictors of self-care behavior were duration of disease (B= 0.170) and diabetes knowledge (B=-0.123). Conclusion: Despite the role of demographic factors that influence self-care behaviors, knowledge is also of great importance. Therefore, health workers and doctors should focus more on promoting diabetes knowledge.

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Background and purpose: Heart failure is one of the most common chronic diseases with high mortality rate. Self-care training is effective in reducing the number of hospitalizations and improves the quality of life in these patients. However, the influence of such training was not found to be viable in previous interventions. This study was conducted to determine the effect of training based on teach back method on self-care in patients with heart failure.

Materials and methods: In this clinical trial, 62 hospitalized patients with heart failure in Imam Reza and Ghaem hospitals in Mashhad (2014-2015) were randomly allocated into experimental and control groups. Subjects in the experimental group received individual self-care training for 3-4 days based on teach back method and the control group received usual self-care training. Self-care was measured using the European Heart Failure Self-Care Behaviour Scale (EHFScB Scale) before and one month after discharge. Data was analyzed using independent-samples t-test and paired t-test.

Results: Before the intervention no significant difference was seen in the mean score for self-care between the two groups, but after intervention, it significantly increased in the experimental group (P<0.001). This increase was also significant compared to that of the experimental group before the intervention (P<0.001); but in the control group this difference was not significant (P = 0.138).

Conclusion: Training based on teach back method was found to be more effective than usual training in promoting self-care among patients with heart failure. Therefore, it is recommended in care planning for these patients.

(Clinical Trials Registry Number: IRCT2015070423053N1)

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Background and purpose: Diabetes is the most prevalent metabolic disease and a network of environmental and genetic risk factors. Control and prevention of diabetes are based on self-care and patients education. "The Method of Islamic Care" is a common and successful method of behavior modification in Islamic ethics and mysticism. The aim of this study was to evaluate the effect of Islamic Care Method on nutritional self-care, anthropometric indices and blood pressure in diabetic patients.

Materials and methods: In a randomized clinical trial, 110 middle-aged patients with type two diabetes were randomly assigned to either the experimental or control group. Nutritional self-care behaviors were determined using a questionnaire. Weight, height and blood pressure were measured. The same education about diabetic diet was presented in both groups. In the intervention group Islamic teachings and Islamic Nutritional Care Method were taught with the intention of satisfying Allah. Two months later, the variables were measured again in 98 patients. Data analysis was performed in SPSS V.22, using Paired and Independent- samples T- Tests, Chi-square, and Analysis of covariance.  

Results: After adjustment for confounding variables, the intervention group had a significant increase in nutritional self-care (P>0.002) and significant decrease in weight (P>0.05) compared with those in the control group. The results indicated significant improvements in most of the indices in both groups at post-intervention (P>0.001).

Conclusion: Islamic Care Method demonstrated its efficacy in promoting nutritional self-care behaviors and reducing weight indicator. This method is recommended for controlling chronic diseases influenced by behavioral factors.

(Clinical Trials Registry Number: IRCT2016010325826N1)

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Background and purpose: Self-care activities can be effective in empowering patients with posttraumatic stress disorder (PTSD) in their recovery and health. There are limited information on self-care practices undertaken by veterans with chronic PTSD, so, this study aimed at exploring these strategies in this population.
Materials and methods: The present study is the part of grounded theory that was carried out during 2015-2017. Data were collected via semistructured in-depth interviews and field notes. Twelve veterans with chronic PTSD and 13 caregivers participated. They were selected via purposive sampling from Baqiyatallah-Azam Hospital, Sadr Psychiatric Clinic, and West Tehran Consulting Center. Data were analyzed by Corbin and Strauss approach.
Results: The loss of existential integrity was identified as the main concern of veterans with chronic PTSD. Effective and intervening factors in performing self-care activities included spirituality, personal knowledge, family supports, social supports, and institutional facilities, while the dimensions and outcomes of the disease, personality traits, the nature and dimensions of treatments, and inadequate organizational supports were the barriers to self-care. Self-care strategies included incompatible coping (escape or avoidance, isolation, repression and impulsive behavior) and compatible coping (adherence to treatment, seeking social supports, spiritual holding, and attempts to gain and maintain independence).
Conclusion: Self-care strategies of combat veterans with chronic PTSD could be different based on contextual-structural factors. Supportive sources (family, society, and organization) could help in facilitating the use of consistent and effective coping strategies to reconstruct existential integrity.
 

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Background and purpose: Mental health problems can negatively affect one’s ability to take precautionary measures. The aim of this study was to evaluate the effects of perceived stress and self-care behaviors on precautionary measures against COVID-19 among staff and students in shahid Beheshti Dental School.
Materials and methods: This cross-sectional study was conducted after reopening of the school. Information was collected from 830 people (academic members, students, and staff) within two weeks in spring 2020. A questionnaire was designed consisting of items on demographic characteristics, perceived stress, self-care behaviors, and precautionary measures. To calculate the coefficients of the effects of stress and self-care behaviors on precautionary measures, path model analysis was applied.
Results: There was a significant relationship between perceived stress and precautionary measures in dental students. In this group, stress had a significant direct effect on preventive social behaviors (P<0.001). On the other hand, the negative effects of perceived stress on both individual and social preventive measures were mediated via self-care measures. In academic members, perceived stress was not found to significantly affect precautionary measures (P=.28). In staff, self-care behaviors had significant positive effects on both individual and social preventive measures (P<.001).
Conclusion: Perceived stress as an exogenous variable had both direct and indirect effects on social preventive behaviors. It also affected individual preventive behaviors via self-care measures as an endogenous variable.

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 Background and purpose: Patient education is an important part of treatment process. Educational models such as Health Belief Model (HBM) emphasize on people's motivation. The aim of this study was to investigate the effect of this educational method on self-care performance and metabolic indicators in patients with type 2 diabetes.
Materials and methods: In this clinical trial, type 2 diabetic patients were randomly assigned into an intervention group (n=40) and a control group (n=40) (routine care). In intervention group, diabetes knowledge and health beliefs about diabetes, lifestyle, and self-care were taught through lectures and question/answer forum based on health belief model for 90-minute in four sessions. In all samples, fasting blood sugar, HBA1C, lipoproteins, and blood pressure were measured before and four months after the intervention. Also, health belief model constructs and self-care behavior scale were completed. Data were analyzed in SPSS V23 using Analysis of Covariance (ANCOVA).
Results: Compared to the control group, in intervention group, the scores for knowledge (P=0.01), performance (P= 0.01), and self-efficacy (P= 0.04) increased significantly and the score for perceived barriers decreased significantly (P= 0.02). Changes in FBS, LDL, and blood pressure were similar between the two groups, but a significant difference was seen in changes in HbA1C (P= 0.04).
Conclusion: Education based on health belief model seems to be effective in promoting self-care behaviors and control of metabolic complications in diabetic patients, so the model is suggested to be applied also in larger populations and long term studies in other patients such as those with hypertension and cardiovascular disease. 
 
(Clinical Trials Registry Number: IRCT20171230038142N5)

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Background and purpose: The health Locus of control (HLC) as a psychological variable has an effective role in predicting self-care behaviors in type 2 diabetic patients, health education programs focusing on strengthening HLC improve the effectiveness of interventions. The aim of the study was to determine the effectiveness of educational intervention based on HLC on self-efficacy, self-care and metabolic indicators of T2D patients.
Materials and methods: In an experimental study, 84 T2D patients reffered to health care centers of Qazvin city were assigned to experimental and control groups using multi-stage random sampling. The theory based education regarding HLC included 2 individual counseling sessions and three 45-minute group training sessions. Data collection tools included demographic items, summery of Diabetes self-care activity questionnaire (Toobert et al., 2000), and self-efficacy scale (Rohani et al., 2018), multidemnsion health locus of control scale (Moshki et al., 2006), and FBS and HbA1c measurements. Data were analyzed with SPSS 25.0 software and chi-square tests, independent t test, analysis of covariance.
Results: The mean of self-efficacy, dimensions of health locus of control, the total score of self-care along with its dimensions have improved significantly in the experimental group after controlling the effect of the pre-test (P<0.05). Moreover, the mean of HbA1c (from 7.46±1.82 to 6.14±1.23) and FBS (from 154.8±56.63 to 115.5±40.19) was significantly reduced in the experimental group after controlling the effect of the pre-test (P<0.001).
Conclusion: Designing educational interventions focusing on strengthening the HLC can lead to improvement of self-efficacy, self-care behaviors and blood glocuse reduction in T2D patients.

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Background and purpose: Considering the global spread of COVID-19, it seems that correct information obtained from reliable sources and training based on the need for self-care behaviors are useful solutions to reduce the harm caused by the disease. This study aimed at assessing the educational needs of people in Mazandaran province about COVID-19.
Materials and methods: In a cross-sectional study, 1220 people were recruited via convenience sampling in 2020. A researcher-made questionnaire was administered and information such as demographic characteristics, disease condition, and educational needs for COVID-19 were recorded. Data were analyzed using descriptive statistics and parametric tests, correlation, analysis of variance, and t-test.
Results: The mean age of the participants was 39.34 ± 8.74. Educational level included diploma (42.5%) and university education (38.9%). About 73.3% of the participants were women. According to findings the main sources of information about COVID-19 were social networks (68.4%), satellite programs (20.9%), Ministry of Health notices (8.1%), national media (1.6%), other sources (0.6%), and family members (0.4%). Online methods were the most desirable educational methods (94.6%) reported by the people living in Mazandaran province. The overall mean score for educational needs was 3.89±0.96. The educational need for the disease (3.76±0.84) and self-care needs (4.03±1.07) indicated high needs for educational trainings and significant differences between these areas (P=001).
Conclusion: In this study, social networks and media were the primary sources of information about COVID-19. Designing and implementing self-management and self-care training programs could improve the health of people in Mazandaran province and prevent the spread of COVID-19.

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 Background and purpose: Today, development of telemedicine technology has led to wide use of smartphone to connect patients and health care teams to improve patient care. The aim of this study was to determine the effect of a self-care application on pain and mobility rehabilitation in patients following total knee arthroplasty surgery.
Materials and methods: A randomized controlled clinical trial was carried out in 100 patients who were candidates for knee arthroplasty surgery at Tehran Baqiyatullah (Aj) Hospital. In this study, the experimental group was provided with a self-care application and the control group received routine hospital care. At days 7 and 14 after the surgery, the two groups were evaluated for pain and mobility rehabilitation using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Von Korff Pain Intensity and Disability Score.
Results: Out of 100 people, 30 were men and 70 were women with an average age of 48.66±15.62. Findings showed significant differences between the two groups, at day 14 after the surgery, in mobility rehabilitation (P= 0.004) and pain (P= 0.001) at 95% confidence interval.
Conclusion: According to this study, the self-care application improved pain and motor recovery after total knee arthroplasty surgery.

(Clinical Trials Registry Number: IRCT20210724051973N1)
 

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Background and purpose: Many patients fail to reach the expected results, even with the very considerable strides forward in the treatment of hypertension (HTN). They undergo serious complications after this condition remains uncontrolled. Patients' perceptions regarding the importance of Islamic self-care may be the occasion for managing chronic diseases. The present study aimed to investigate the effectiveness of the Islamic self-care model on blood pressure (BP) and medication adherence (MA) among older adults living with HTN.
Materials and methods: Utilizing a randomized controlled trial in 2019 in Amol City of Iran, 60 elderly patients suffering from high blood pressure were assigned to two intervention and control groups in the form of random block allocation. Then, their BP and MA were measured using a dial sphygmomanometer and Morisky questionnaire, respectively.  Designed for four weeks, the intervention group participated in an HTN-management education program, putting much emphasis on proper nutrition within the framework of the Islamic self-care model and gaining divine satisfaction. Simultaneously, the control group received a similar scientific HTN management and medication adherence education program. Following the re-measurement of BP and MA in both groups, the data were analyzed using descriptive statistical tests, Chi-square, Fisher, independent-samples t-test, and analysis of covariance.
Results: In the pre-intervention phase, there was no significant difference between the two groups in the mean BP indices and MA. At the post-intervention, results revealed a significant reduction in the average systolic blood pressure (133.125±8.95) and diastolic (78.33±61.4) of the Islamic self-care group compared to systolic blood pressure (141.33±10.16) and diastolic (82.0±4.27) in the control group (P>0.001). Also, there was a significant improvement in the MA score in the Islamic self-care group (1.07±1.01) compared to the control group (2.43±1.38) (P<0.001).
Conclusion: The Islamic self-care model was found to be effective in managing the average BP and MA of patients.
(Clinical Trials Registry Number: IRCT20200118046170N2)

 

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Background and purpose: Self-care is recognized as a fundamental approach in the field of providing, maintaining, and promoting health in individuals, families, and society. Providing essential training in the field of self-care is one of the important tasks of primary health service systems to the community, including household health ambassadors. On the other hand, determining the educational needs of self-care in each society should be based on the educational needs assessment in the same society. Therefore, the present study was conducted to determine the educational priorities of self-care using the educational needs assessment of health ambassadors.
Materials and methods: The current study is a cross-sectional study (descriptive-analytical). The research community included household health ambassadors living in the Golestan and Mazandaran provinces. Entry criteria included being family health ambassadors, being between the ages of 20 and 60, and volunteering to enter the program. Also, the exclusion criteria included the health ambassador's unwillingness to participate in the evaluation. The study tools included a demographic questionnaire and a researcher-made questionnaire on "self-care educational needs" for health ambassadors. The health ambassadors' needs assessment questionnaire was the result of self-care educational priorities based on a general survey of the community, which was scored by the health ambassadors. Data analysis was done using SPSS version 20 software. U-Mann-Whitney and Kruskal-Wallis tests were used to analyze the data.
Results: Results showed that the average age of health ambassadors participating in the study was 38.11±9.64 years. 987 people (57.8 percent) of them were health ambassadors of Golestan province and 721 people (42.2 percent) of them were health ambassadors of Mazandaran province. Also, concerning the participants' gender, 1439 people (84.3%) were women and 269(15.7%) were men. The educational needs assessment showed the top 10 priorities among self-care education topics determined by household health ambassadors, including stress and anxiety, healthy eating, life skills, parenting skills, water hygiene, inactivity, depression, skeletal problems, and lack of vitamins. , and oral and dental health. It was also shown that there is a statistically significant difference between different subgroups of participants such as gender, place of residence, education level, occupation, and ethnicity with self-care educational priorities in household health ambassadors (P<0.05).
Conclusion: The findings of the study showed that mental health issues such as stress, anxiety, and depression, as well as issues related to people's lifestyles, such as healthy eating, inactivity, and skeletal problems, were determined among the needs-based priorities for community education. Due to the limitation in financial and human resources, it is necessary to conduct self-care training based on the needs assessment of the society, because, on the one hand, an important part of the health needs of the society will be answered. On the other hand, the educational subjects that have priority will be the target of educational programs.

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Background and purpose: In 2023, the incidence of tuberculosis (TB) in Golestan Province was reported to be 26.1 cases per 100,000 people, which is three times higher than the national average in Iran. The contagious nature of tuberculosis has economic repercussions and indirect effects on the quality of life of affected individuals. The stigma associated with tuberculosis often leads to social isolation, which can hinder TB control efforts. On the other hand, social support from family, friends, healthcare workers, and community leaders improves quality of life, promotes self-care behaviors, and enhances patient adherence to medication regimens. This study aimed to determine the correlation between stigma, social support, and self-care behaviors in patients with tuberculosis.
Materials and methods: This cross-sectional (descriptive-analytical) study was conducted in 2023, surveying 325 tuberculosis patients undergoing treatment in Golestan Province. Data were collected using a demographic information questionnaire, a 12-question stigma questionnaire (patients' perceptions of tuberculosis), the Sherborn and Stewart Perceived Social Support Questionnaire, and the self-care behaviors questionnaire for tuberculosis patients by Herandi et al. The data were analyzed using SPSS version 24 software. To investigate the relationship between perceived stigma and social support with the dimensions of self-care behaviors in tuberculosis patients, Spearman and chi-square tests were used. Logistic regression was employed to predict factors affecting self-care in the studied patients.
Results: The average age of the participants was 51.97±17.33 years, with an age range of 19 to 84 years. The overall scores for the stigma questionnaire, perceived social support questionnaire, and self-care behaviors questionnaire were 29.03 ± 5.30, 71.14 ± 14.53, and 84.78 ± 10.17, respectively. Based on the univariate logistic regression model, the variables of race, number of family members, addiction, and age were analyzed for their effects on self-care behaviors. Additionally, the effects of marital status and age on stigma were examined. Significant effects of family size, income, and marital status on social support were observed. Spearman correlation tests showed an inverse and significant correlation between stigma and social support (r= -0.19, P= 0.001), stigma and self-care (r= -0.21, P<0.001), and a direct and significant correlation between social support and self-care (r= 0.55, P<0.001).
Conclusion: As stigma increases, levels of social support and self-care behaviors decrease. Stigma has a significant impact on tuberculosis treatment, while higher levels of social support enhance self-care and accelerate the recovery process. To control tuberculosis effectively, comprehensive support from community leaders, the Ministry of Health, welfare organizations, relief committees, municipalities, and other organizations, as well as from patients' families and surrounding communities, is essential. Additionally, health and medical intervention programs aimed at increasing self-care behaviors, raising awareness among patients, and reducing stigma and misconceptions among families, friends, healthcare workers, and society at large are recommended.

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Background and purpose: Individuals undergoing chronic hemodialysis face various daily challenges due to their unique lifestyle, which significantly reduces their quality of life. Self-care plays a crucial role in improving health behaviors and delaying the progression to the final stages of the disease. Since self-care is comprehensive, learnable, and improvable, this study aimed to investigate the relationship between loneliness and self- care in elderly patients undergoing hemodialysis.
Materials and methods: This cross-sectional study involved 138 elderly patients undergoing hemodialysis at the Citizen Dialysis Center in Sari, selected through a census method. Data collection tools included a socio-demographic questionnaire, the Standardized Elderly Self-Care Scale, and the Russell Loneliness Scale. Data were analyzed using SPSS version 22, employing both descriptive and inferential statistics. The significance level was set at P≤ 0.05.
Results: The average age of the participants was 68.67±6.28 years, and the majority (51.4%) were female. Pearson correlation analysis revealed no significant association between total self-care scores and loneliness (r=0.14,P=0.108), physical self-care scores and loneliness (r=-0.03,p=0.694), or illness-related self-care scores and loneliness (r=0.11,P=0.218). However, a significant negative correlation was observed between spiritual self-care scores and loneliness (r=-0.33,P=0.001) and between social self-care scores and loneliness (r=-0.20,P=0.018). As loneliness scores increased, spiritual and social self-care scores declined.
Conclusion: The findings underscore the importance of addressing the emotional and social needs of elderly hemodialysis patients along with their physical health needs to enhance their overall quality of life. Healthcare providers and policymakers should implement self-care interventions, particularly those emphasizing spiritual and social aspects, into care plans for elderly hemodialysis patients to reduce the negative impact of loneliness and promote their well-being.