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Background Compliance to dietary recommendations by patients is the most difficult part of diabetes management. The nature of any educational method is to increase patients’ awareness. But the question is, what is the effect of each method and for this purpose a comparative method should be considered. Therefore, this study was conducted to compare the effects of in-person education versus video tele-education on dietary regimen compliance in patients with T2DM. Methods In this trial, 378 patients with type 2 diabetes mellitus (T2DM) were random allocated into video tele-education, in-person education and control groups. The patients’ weight and biochemical parameters were measured before educational programs and three-month later. Results The mean changes of patients’ weight, glycemic parameters, and Lipid profiles decreased more in the two educational groups than the control group in a three-month period. There were no significant differences in the all study variables between the in-person and video education groups in post interventions except Total Cholesterol (TC). The pre- and post-intervention changes in the weight, TC, hemoglobin A1c, Triglyceride, and Very Low-density Lipoprotein Cholesterol were significant in both in-person group and video group. None of the educational programs had a significant impact on the Fasting blood sugar, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol. Discussion Video tele-education was just as effective as in-person educational method on dietary regimen compliance among patients with T2DM in a three-month period. Therefore, it is recommended to use video tele-education in combination with or as an alternative to the in-person education method. This study provides support for diabetes educator. Trial registration This investigation was registered in the Iranian Registry of Clinical Trials Center ( IRCT20150302021307N4 ).

Introduction Various nursing models are usually employed to achieve self-management and improve the quality of life in chronic conditions. Given its person-based characteristics, the 5 A nursing model can improve the quality of life of hemodialysis patients. Purpose This study aimed to determine the role of a self-management program based on the 5 A nursing model in the quality of life of patients undergoing hemodialysis. Materials and methods This clinical trial was conducted on hemodialysis patients in Iran. Random sampling was adopted to assign 60 patients to intervention and control groups. After the participants completed a demographic questionnaire and the Kidney Disease Quality of Life–Short Form (KDQOL–SF) , routine measures were taken in the control group. However, the 5 A nursing model was implemented in the intervention group for three months. The self-care program was executed in face-to-face sessions or via phone calls and SMSs. After three months, the quality of life was measured again in both groups. Findings There were significant differences after the intervention between the intervention and control groups in specific dimensions of quality of life, such as cognitive functions, symptoms, sleep, dialysis, social support, and renal complications (P < 0.05). The two groups also had significant differences in the general scores of quality of life (P < 0.05). Conclusion The 5 A self-management intervention as a person-based model could improve self-care in hemodialysis patients. Nurses can implement this model to mitigate care costs, enhance interventions, and improve patients’ quality of life. Trial registration Iranian Registry of Clinical Trials (IRCT20211103052955N1; 19/11/2021).

Background Perception of the threatening disease leads to coping behaviors that can affect the treatment process. Social support can be one of the factors influencing the perception of the disease and coping strategies. Our study aimed to determine the perception of the disease, its relationship with coping strategies and social support in COVID-19 patients in Iran. Methods This cross-sectional study was conducted on 1014 patients who were hospitalized during October 2020 to May 2021 through multi-stage sampling method. The data-gathering instruments consisted a demographic information checklist, and standard questionnaires including disease perception, social support, and coping strategies. Correlation coefficient, multiple linear regression model, and simple linear regression model were used for data analysis. Results The mean age of the participants was 40.87 ± 12.42 and the majority of them were female (67.2%(, married (60.1%), and had relatives who had COVID-19 (82.6%). There was a significant inverse relationship between variables (identity, outcomes, emotional expressions etc.) and social support (> 0.01). Also there was a significant direct relationship between variables (self-control, therapeutic susceptibility etc.) and the coping behavior (p < 0.05). There was an inverse relationship between the variables (outcomes, self-blaming, sex, etc.) (P = 0.0001) and a direct one between the variables (education, disease phase, etc.) and perceived social support (P = 0.004). Conclusions These results show the importance of promoting positive coping strategies and social support in the face of large-scale health crises. The knowledge of nurses about the results of this study, who are responsible for the care and education of the patient, can be effective in the length of hospitalization and reducing costs.

In recent years, there has been increasing attention on the cluster approach to symptom management. Two significant challenges in the symptom cluster (SC) approach are identifying and predicting these clusters. This multiphase protocol aims to identify SCs in patients with advanced cancer as the primary objective, with the secondary objective of developing machine learning algorithms to predict SCs identified in the first phase. The 2-MIXIP study consists of two main phases. The first phase involves identifying SCs, and the second phase focuses on developing predictive algorithms for the identified SCs. The identification of SCs involves a parallel mixed-method design (quantitative and qualitative). Quantitative and qualitative methods are conducted simultaneously and given equal importance. The data are collected and analyzed independently before being integrated. The quantitative part is conducted using a descriptive-analytical method. The qualitative analysis is conducted using a content analysis approach. Then, the identified SCs from both parts are integrated to determine the final clusters and use them in the second phase. In the second phase, we employ a tree-based machine learning method to create predictive algorithms for SCs using key demographic and clinical patient characteristics. The findings of the 2-MIXIP study can help manage cancer patients' symptoms more effectively and enhance clinical decision-making by using SCs prediction. Furthermore, the results of this study can provide guidance for clinical trials aimed at managing symptoms.

Background Cancer-related fatigue (CRF) is still undertreated in most patients, as evidence for pharmacological treatments is limited and conflicting. Also, the efficacy of the pharmacological agents relative to each other is still unclear. Therefore, medications that may potentially contribute to improving CRF will be investigated in this head-to-head trial. Our main objective is to compare the efficacy of methylphenidate vs. bupropion vs. ginseng vs. amantadine vs. placebo in patients with advanced cancer. Methods The 5-EPIFAT study is a 5-arm, randomized, multi-blind, placebo-controlled, multicenter trial that will use a parallel-group design with an equal allocation ratio comparing the efficacy and safety of four medications (Methylphenidate vs. Bupropion vs. Ginseng vs. Amantadine) versus placebo for management of CRF. We will recruit 255 adult patients with advanced cancer who experience fatigue intensity ≥ 4 based on a 0–10 scale. The study period includes a 4-week intervention and a 4-week follow-up with repeated measurements over time. The primary outcome is the cancer-related fatigue level over time, which will be measured by the functional assessment of chronic illness therapy-fatigue (FACIT-F) scale. To evaluate safety, the secondary outcome is the symptomatic adverse events, which will be assessed using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events in cancer clinical trials (PRO-CTCAE). Also, a subgroup analysis based on a decision tree-based machine learning algorithm will be employed for the clinical prediction of different agents in homogeneous subgroups. Discussion The findings of the 5-EPIFAT trial could be helpful to guide clinical decision-making, personalization treatment approach, design of future trials, as well as the development of CRF management guidelines. Trial registration IRCT.ir IRCT20150302021307N6. Registered on 13 May 2023.

Objective: Although comorbidity of psychotic disorders and substance use can lead to increase in mortality, less is known about the outbreak and predictors. Psychotic patients tend to be overlooked during assessment; hence, the possibility of an undertreated or missed condition such as increasing substance use. This investigation aimed to measure the prevalence of substance use in psychotic patients and to survey the powerful predictors. Method: In a 1-year cross-sectional study, 311 psychotic patients were assessed using the Structured Interview Based on DSM-5 for diagnostic confirmation as well as questions surveying prevalence and possible predictors of substance use. Results: Prevalence of substance use among psychotic patients was 37.9%. Several variables were identified as factors associated with drug abuse among the psychotic patients. These included male gender, younger age, being currently homeless, a history of imprisonment, and having family history of drug use. The strongest predictors of substance use, however, were family history of drug use, male gender, and being currently homelessness. Conclusion: Policymakers should note the importance of substance use among psychotic patients. Developing active screening strategies and comprehensive preventive plans, especially in the high-risk population, is suggested.

To compare the effectiveness of Internet-based acceptance and commitment therapy (iACT) and bibliotherapy-based ACT (bACT) in reducing anxiety and depression among women with breast cancer. In this three-arm randomized controlled trial, 99 participants were recruited from three oncology centers in Iran and randomly assigned to iACT, bACT, or a control group (n=33 each). Interventions lasted 6weeks with a 4-week follow-up. The Beck Anxiety Inventory and Beck Depression Inventory-Short Form were used to assess outcomes at baseline, post-intervention, and follow-up. Data were analyzed using generalized estimating equations (GEE). The iACT group showed significantly greater reduction in depression and anxiety than the control group at post-intervention and follow-up (all p<0.001, except for post-intervention anxiety in iACT group was p=0.001). The bACT group showed delayed but significant improvement in anxiety at follow-up (p>0.001), but not in depression. Between-group comparisons revealed superior outcomes for iACT over bACT in both anxiety and depression post-intervention, though the difference in anxiety diminished by follow-up. Internet-based ACT was more effective than bACT or standard care in reducing anxiety and depression in breast cancer patients. These results support the broader use of guided Internet-based ACT interventions in oncology settings.

Despite advances in postoperative pain control, it is still a big challenge with high-prevalence for practitioners. Inadequate control of postoperative acute pain is common which can lead to serious complications for patient. Objectives: This study aimed to compare massage therapy and music therapy in the control of postoperative pain and amount of received opioid drug after abdominal surgery. Methods : in this randomized 3-group trial, 102 patients in the surgical wards of 3 military hospitals, Ahvaz, Iran, were randomly allocated to music group, massage group, and usual-care group. Participants in the massage and music groups received 10-minutes sessions of slow-stroke back massage and without lyrics music, respectively, 1, 6, and 12 hours after surgery. The pain intensity was measured by numeric rating scale 10 minutes after each intervention session. Also, the mean of received opioid drug during 12 hours was measured in each group. Results : the results indicated a decreasing trend of pain intensity in all the groups. However, the trend of pain intensity had a significantly more decrease in the massage group compared to the both music group (P = 0.001) and usual-care group (P = 0.001). Pain intensity at the baseline had no significant difference between the massage group and the music group (Mean ± SD: 7.13 ± 1.2 vs. 6.97 ± 1.3, P = 0.6); whereas, pain intensity 12 hours after surgery had a significant difference between the massage group and the music group (Mean ± SD: 2.26 ± 1.03 vs. 3.30 ± 1.5, P = 0.002). Also, the mean of received opioid drug was significantly lower in the massage group than both the music and the usual-care groups (P = 0.013 and P = 0.001, respectively). Also, the mean of received opioid drug was significantly lower in the music group than the usual-care group (P = 0.047). Conclusions: Massage therapy was more effective than music therapy in controlling postoperative acute pain after abdominal surgery. Hence, the use of non-drug methods (especially massage therapy) as safe, inexpensive, effective, and available methods are very helpful for controlling postoperative acute pain.