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Introduction: The main goal of treatment and care of chronic patients including those suffering from end stage chronic renal failure is to promote their health and their quality of life (QOL). Various researches have shown that health level, performance status and QOL, especially for hemodialysis patients are often less than expected. So, an attempt to find effective and cost benefit education methods in this area seems to be necessary. This study is done to compare the effects of two educational methods of direct and indirect (multimedia educational package) self-care program on QOL and physical problems of hemodialysis patients. Materials and Methods: This quasi experimental research was carried out on two groups of hemodialysis patients. Sixty three patients were selected from three main dialysis centers in Tehran and allocated randomly into two groups (group one 32 and group two 31 patients). The first group used the direct educational program and the second group used the indirect educational package (multimedia). Patients were assessed before education using QOL questionnaire (short form SF-36), need assessment questionnaire and checklists. After determining educational needs and status of the patients, a self care educational program was designed based on self care model and the principles of patient education and also through counseling with nephrologists and nutritionists. The educational program was implemented directly on group one (direct education). Also it was recorded and indirectly used for the second group as a multimedia educational package once a week within one month during dialysis. After implementation of the self care educational program, both groups were assessed and measured again by same questionnaires and checklists. Data was analysed using student T, Wilcoxon and Mc Nemar tests. Results: Findings showed that most of studied variables including laboratory tests, blood pressure, weight gain between two dialysis, skin itching, edema and some vascular complications are decreased significantly in each group before and after education. QOL was also significantly improved in each group. But there was no significant difference between the two groups. Conclusion: Since, there was no significant difference between the two groups in terms of efficiency of two methods of direct and indirect (multimedia) educational self care programs and also due to the problems and higher costs of the direct educational program comparing to the indirect method, the indirect method is recommended as an effective, cost benefit, simple and patient-friendly method for hemodialysis patients.

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Introduction: Quality of life (QOL) has become an important concept in medical research. Some research has shown a curvilinear relationship between QOL and glycemic control, but some did not so. The aim of this study is to investigate different aspects of QOL and also assess the hypothesis in diabetic patients. Materials and Methods: In a cross-sectional study, a random sample of adult diabetic outpatients (n=110) were selected and completed the WHO-QOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Patients were divided in to 3 groups: 1-good control (HbA1c<7), 2-fair control (7≥HbA1c<9) and 3-poor control (HbA1c≥9). QOL was assessed by measuring physical, psychological, social and environmental domains. Data were analyzed with one way ANOVA (Tukey as post hoc), Chi2 and Mann-Whitney, and correlation tests. Results: A significant correlation was seen between BMI and glycemic control, physical and social aspects, physical and environmental aspects, psychological and environmental aspects, and social and psychological aspects. No significant difference was seen between mean score of different dimensions of QOL in relation to HbA1c changes. The mean score of each dimension in relation to glycemic control showed that, better score of psychological, environmental and social dimensions is seen in patients with fair glycemic control. But regarding the overall score of QOL this is completely reverse. The mean score of physical dimension is decreased with increasing HbA1c. There was no correlation between other domains of QOL and glycemic control. Conclusion: In this survey higher quality of life was seen in fair glycemic control in social, environmental and psychological dimensions, but physical dimension in patients was decreased when HbA1c was increased. Regarding the overall score of QOL it can be seen that the lowest score of QOL is in patients with fair glycemic control which is in contrast with curvilinear hypothesis.

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Background: The most important determinant factor in elder’s quality of life is healthy. Since health can be declined by aging, in health promotion consider an effective model of care can be vey important. We surveyed the effect of Orem Self Care Model on quality of life (QOL) of elderly in Masjed Solaiman. Methods and Materials: This is a pre and post quasi-experimental study was carried out on 349 elderly clients which were selected from 11 health care centers in Masjed Solaiman in 2007-2008. Orem Self Care program was performed during a 3 months in days that the clients came to health care centers. Data were gathered by a short form questionnaire (SF36) before and after the intervention and was analyzed by descriptive statistics and paired t-test. Results: Results showed a significant increase in mean scores of different dominations of QOL including health, physical performance, physical role- performance, emotional role- performance, social performance, body pain, power and energy, general health perception, and overall mean of QOL. Paired t-test showed a significant difference (p<0.001) between all of dominations of the quality of life. Conclusion: Performing Orem Self Care educational program had a positive influence on improving QOL of elderly.

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Background: Researches showed that there is a relationship among alopecia areata, psychological factors and prevalence of psychological disorders. In addition alopecia areata has a great effect on the quality of life of these patients. The purpose of this study is to investigate the effectiveness of cognitive-behavioral stress management therapy on female patients`s the quality of life with alopecia areata. Methods and Materials: This is a case-control study with pre and post-test exam which is carried out in Isfahan Skin Disease and Leishmaniasis Research Centre. The participants consisted of 20 alopecia areata patients diagnosed by specialists. The questionnaire was Skindex-16 which was completed by patients before and after the intervention. Cognitive-behavioral stress management therapy was done on the case group in eight sessions over a period of two months. Data was analyzed with covariance (ANOVA). Results: The mean of quality of life scores in experimental group in v.s control group significantly decreased (P<0.05). Conclusion: It seems, cognitive-behavioral stress management therapy couses in quality of life improvement in patients with alopecia areata.

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Abstract Background: Different studies have shown the inability of traditional lecture method to active teaching method in concept transmitting of higher learning domain. The aim of this study was comparing the effects of feedback lecture method and conventional lecture method on learning and quality of teaching. Materials and Methods: In quasi-experimental study, 27 Arak medical science midwifery students who were in fourth semester, randomly, were divided to two groups of “teaching by feedback lecture” and “teaching by conventional lecture”. Desired topic were presented by one teacher as a 90- minute lecture in control group and as two 35-minute lectures with 10-minute discussion after each part in case group. Informational form, and post test and student' opinion form were used respectively to identify the demographic characteristics, short tem and long term learning and quality of teaching form. Results: Demographic characteristics, quality of teaching form student’s opinion, total scores of pre and post test were similar in two groups. Results of teaching score in post test in knowledge and perception level were similar. But there was a significant difference between application and analysis level in two groups(p=0.011). Also, total and domain scores of post test after a month were not different in both groups. Conclusion: Results indicated that learning by feedback lecture can be more effective than conventional lecture method in application and analysis domain.

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Background: Diabetes Mellitus is a heterogeneous group of different metabolic disorders that are characterized by chronic increase of blood glucose and proteins, lipids and carbohydrates metabolism disorder. The aim of this study was to investigate the effect of 8 weeks of aerobic exercise on metabolic factors, quality of life and mental health of women with type II diabetes. Materials and Methods: In this semi-experimental investigation, 18 women with type П diabetes referring to Arak Petroleum Company Clinic were selected and divided into two groups: aerobic (10 participants) and control (8 participants). Aerobic group performed selected exercises in 8 weeks (three 30-50 min sessions per week). In this investigation, we used metabolic factors (such as total cholesterol, triglycerides, HDL, VLDL, LDL, FBS, HbA1c and Insulin serum) and SF-36 quality of life (QOL) and GHQ mental health (MH) questionnaires. The level of significance was considered to be 95% (P<0/05). Results: There were significant differences between the means of pre-test and post-test measures of FBS, HbA1C, Insulin serum, QOL and MH in aerobic group. There were no significant differences between the means of pre-test and post-test measures of TC, HDL, LDL, VLDL and triglycerides in aerobic group and all factors in the control group (P<0/05). Conclusion: Aerobic exercise affects metabolic factors, QOL and MH in type П diabetic patients and it results in their improvement.

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Background: This study was designed to investigate the quality of life in staff and hospital personnel of Arak University of Medical Sciences and to gain basic information for carrying out interventions for improving their quality of life. Materials and Methods: This cross-sectional study was done to determine quality of life of 300 staff and hospital personnel in Arak University of Medical Sciences. Data gathering tools were demographic and standard quality of life (SF-36) questionnaires. Results: Of the 275 participants who had completed the questionnaires, 127 (%46.2) were staff and 148 (%53.8) were hospital personnel. The means of age and years of experience were 36.797.02 and 12.297.39 years, respectively. The mean of different dimensions of quality of life in the staff was significantly much higher than that in the hospital personnel (p<0.05). In terms of physical performance, vitality, social performance, general health, physical and mental health domains, significant differences were found among personnel with different employment status. There was also a significant difference between men and women in terms of physical restriction factors, physical agony, vitality, sanity, mental and physical health. Conclusion: The mean of different dimensions of quality of life in hospital personnel was lower than the staff while this value was lower in women than men. Specific longitudinal studies are needed for investigating the causes of these differences.

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Background: Identifying the problems which exist in clinical education and setting to solve them will lead to the improvement of quality of medical care services. This study was conducted to fulfill this goal. Materials and Methods: In this descriptive–analytic research which was carried out in 2008, the views of the medical trainees and interns, who had at least gone through two major clinical courses at Arak University of Medical Sciences, about the obstacles of clinical education were evaluated. For achieving this purpose, a questionnaire containing 56 questions on 6 problem areas including clinical education spaces, educational facilities, cooperation of health and treatment personnel, clinical assessment and teaching methods, and clinical curriculum design methods was administered. Results: The quality of clinical education in the view of 41% of medical trainees and 48% of interns was seen to be at an average level. Assessment methods of clinical education, on the other hand, were rated as weak by 28.7% of trainees and 32% of interns. Also, 29.3% of trainees and 31.7% of interns evaluated the use of educational spaces to be at a weak level. Additionally, the quality of clinical teaching methods, educational facilities, cooperation of health and treatment personnel, and the design of clinical curriculum were seen at an average level. Conclusion: This study highlighted the importance of determining learning experiences, applying proper teaching methods, conducting continuous generative evaluations, using simulated environments and educational spaces congruent with graduates’ future employment opportunities, and enhancing students’ level of motivation, as effective strategies for the improvement of the quality of medical education.

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Background: Psychological interventions may improve the quality of life in females with temporal lobe epilepsy through affecting their bio-psycho-social dimensions. This aim of this study was to aim assess the efficacy of cognitive-behavioral stress management (CBSM) group education on improvement of quality of life in epileptic patients. Materials and Methods: This was a case-control study with pre-post-and follow-up tests. The sample population included 26 patients, already diagnosed with temporal lobe epilepsy by neurologist and through electro-encephalography, that were randomly selected and assigned to experimental and control groups. Data were collected through the Quality Of Life Questionnaire for Epileptic patients (QOLIE- 89) that was administered in the pre-test, post-test, and follow-up test. CBSM group education was given to the experimental group in ten sessions during two months. Results: The mean of QOLIE-89 score in the experimental group showed a significantly higher increase in comparison to that in the control group (p<0.05). Conclusion: The results demonstrated the effectiveness of CBSM group education on the improvement of quality of life in females with temporal lobe epilepsy.

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Background: In the last few decades, quality of life (QOL) has become known as an important concept in medical research. In this study, two standard QOL questionnaires were chosen for evaluation of patients’ personality characteristics: 1) World Health Organization Quality of Life (WHOQOL) and 2) Iranian Diabetics Quality of Life (IRDQOL). The main aim of this study was to compare two standard quality of life questionnaires for evaluation of the relationship between personality characteristics and glycemic control in diabetic patients. Materials and Methods: This cross-sectional study was carried out on 256 type 2 diabetic patients with a history of diabetes for more than one year. Validity and reliability measures were determined for the two questionnaires. HbA1c was measured through calorimetric method. Results: The mean of physical dimension scores on IRDQOL questionnaire was significantly lower than that on the WHOQOL questionnaire. No significant differences were observed between the other dimensions of the two questionnaires. Positive correlations were seen between different dimensions of each questionnaire. There was a high correlation between the different dimensions of each questionnaire and its related QOL. The two questionnaires did not indicate any correlations between glycemic control and different dimensions of QOL. Conclusion: The two questionnaires have reliability for the total QOL however, the distribution of questions in IRDQOL is not equal. The quality of the evaluation of patients’ personality characteristics by IRDQOL is less than that of WHOQOL. None of the questionnaires indicated any relationship between personal characteristics and glycemic control.

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Background: Cardiac rehabilitation is one of the essential components of caring in cardiac patients both in hospital and community. Therefore, this study was carried out to determine the effects of cardiac rehabilitation program on the quality of life in patients with myocardial infarction. Materials and Methods:This clinical trial was conducted on two groups (experimental and control). Thirty patients with myocardial infarction at Heart Center Hospital of Sari were randomly assigned to each group. The experimental group participated in the Home-based Cardiac Rehabilitation Program (3 visits at home in weeks 4, 8, and 12) however, the control group did not receive any intervention. Data were collected via demographic data and SF-36 quality of life questionnaires and patients’ home-based health behaviors checklist. Data analysis was done by Chi Square, ANOVA and Mann-Whitney tests using SPSS software version 16. Results: The two groups were homogenous in terms of demographic characteristics. The patients’ quality of life increased in the experimental group in physical and mental dimensions and in total before and after the intervention (P<0.001). In addition, the comparison of the quality of life showed a significant difference between experimental and control groups (P<0.001). Conclusion: Cardiac Rehabilitation Program at home can improve the quality of life in these patients therefore, its implementation is recommended.

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Background: Physiological studies suggest that sleep deprivation may influence bodyweight through affecting appetite (decreasing leptin and increasing ghrelin). The aim of this study was to evaluate the effects of 12 weeks of aerobic training on obesity indices, serum levels of ghrelin and leptin, and sleep quality in overweight and obese men. Materials and Methods: In this quasi-experimental study, 22 overweight and obese men with low sleep quality were randomly assigned to aerobic training (n=12) and control (n=10) groups. Aerobic training was performed (50-60 min/day, 3 day/week) for 12 weeks. Serum ghrelin and leptin and obesity and sleep quality indices were measured before and after the intervention. Changes in dependent variables resulting from the training intervention were assessed by dependant t-test using SPSS software. Results: After aerobic training, weight (p<0.03), body mass index (p<0.04), visceral fat (p<0.04), total abdominal fat (p<0.03), and sleep quality (p<0.001) significantly improved. However, ghrelin and leptin serum levels did not change in response to aerobic training (p<0.05) during the same period. Conclusion: Short-term aerobic training improved obesity indices and sleep quality in obese/overweight men, yet this improvement was not accompanied by changes in ghrelin and leptin serum levels.

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Background: Heavy menstrual bleeding is one of the leading causes of poor quality of life and iron deficiency anemia in women of reproductive age. This study was conducted to investigate the therapeutic effect of tranexamic acid (TA) on menorrhagia. Materials and Methods: In this before and after clinical trial, 46 women with menorrhagia were selected and, after a control cycle for evaluation of the volume and duration of primary bleeding, were subjected to tranexamic acid treatment (500mg every 6 hours from day 1 to 5 of bleeding) for 3 consecutive cycles. Data on the duration of bleeding, amount of bleeding (PBAC chart), quality of life (SF-36 and MQ questionnaires), and hemoglobin and ferritin values were checked and compared before and after treatment using SPSS software. Results: Tranexamic acid reduced mean PBAC score from 242.86 (160.47) in control cycle to 101.50 (72.67) after the third cycle (p<0.001). Hemoglobin increased from 11.85 (0.84) to 13.08 (0.97) g/dl and ferritin increased from 15.9 (20.39) to 22.13 (2.03) ng/dl (p<0.001). Duration of menstrual bleeding decreased from 7.6 (1.23) days to 6.86 (0.84) days (p=0.001). Tranexamic acid reduced mean MQ score from 70.26 (17.64) to 11.64 (6.49) (p<0.0001). Quality of life scores increased in all aspects (except for bodily pain scale) (p<0.001). Conclusion: TA due to its short course of prescription, fewer side effects, especially on the pattern of bleeding and menstrual cycle, and not having hormonal effects, seems to be an effective drug for menorrhagia in women of reproductive age.

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Background: Protein-energy malnutrition is regarded as one of the public health problems in developing countries as a result of poor feeding due to poverty. This study was conducted to compare protein quality of two samples of commercial weaning food, Cerelac (based on dry milk, wheat and banana containing probiotic Bifidobactriumlactis) and Ghoncheh (based on dry milk, wheat, and honey), in rats. Materials and Methods: This experimental study was conducted on 64 male rats aged 23 days in 8 groups under 8 diets, including 2 test diets (Cerelaccontaining probiotic Bifidobactriumlactis and Ghoncheh), 1 standard diet (casein), 1 basal diet (protein free) for true protein digestibility and apparent digestibility study, 2 test diets, 1 standard diet, and 1 basal diet for net protein ratio, protein efficiency ratio, and food efficiency ratio study. Results: The contents of true protein digestibility for casein, Cerelac, and Ghoncheh were 93.77, 84.23 and 89.82, respectively and the results were significant in all of the groups (p<0.001). The content of net protein ratio for casein, Cerelac, and Ghoncheh was 4.38, 4.1 and 3.17, respectively and the results were significantin all of the groups (p=0.009). The contents of protein efficiency ratio for casein, Cerelac, and Ghoncheh were 3.05, 2.59, and 2.01, respectively and the results were significant in all of the groups (p<0.001). Conclusion: The findings of this study indicated that the protein value of Cerelaccontaining Bifidobactriumlactis was higher than Ghoncheh.

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Background: Measurement of service quality is a basic prerequisite for improving quality. Studies show that consumers are in close contact with services quality better than any other group. This study was conducted with the aim of measuring service quality based on patients’ expectations and perceptions teaching hospitals in Arak, Iran. Materials and Methods: This cross-sectional study was done on 260 patients at under auspices of Arak University of Medical Sciences. For data collection SERVQUL questionnaire was employed to measure quality of services. The reliability and validity of this questionnaire had already been confirmed by studies both in Iran and other countries. Results: The results showed that there were significant differences between patients’ expectations and perceptions in all dimensions of quality. The accessibility dimension constituted the most serious problem at hospitals. Conclusion: The negative scores show that it is necessary to promote all quality services dimensions at hospitals. For reducing the qualitative gap among all dimensions, it is recommended that hospital managers take patients’ needs into account and provide desirable services for them.

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Background: In recent years, changes in the composition of Iranian population into aged population have increased the need for more information about the quality of life (QOL) of this group. Proper planning for this age group for increasing their quality of life depends on the identification of factors associated with QOL. The aim of the current study was to assess the quality of life and its relationship with the quality of diet in elderly people aged 60 years and more living in the urban areas of Markazi province. Materials and Methods: This cross-sectional study was carried out on 165 elderly people in the urban areas of Markazi Province in 2010. Data obtained via general and QOL (SF-36) questionnaires and three 24-hour recalls on food. The quality of diet was measured using Healthy Eating index. Results: The means of total SF-36, physical and mental components scores were 55.66, 51.32 and 57.30, respectively. Additionally, the average overall healthy eating index score was 82.83. The results showed that the total, physical, and mental components of SF-36 scores in the elderly were positively associated with the healthy eating index but not significantly (P=0.2). QOL and diet scores were significantly associated with age, sex, education, previous employment, income, leisure activities, exercise, insurance, smoking, present disease, and drug consumption (P<0.05). Conclusion: The results showed that the QOL in the elderly was not related to their quality of diet.

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Background: Nowadays, the elderly population is growing all over the world. Diseases and conditions resulting from this evolutionary process can severely affect the quality of life of the elderly. Therefore, the aim of this study was to determine the effect of educational programs of healthy lifestyle on the quality of life of the elderly in Arak city.

Materials and Methods: This quasi-experimental was carried out on 60 elderly subjects in Arak city. The subjects participated in classes on nutrition, exercise, sleep hygiene, and life skills for a month and they were followed for three months after intervention. Data were collected by the short form quality of life (SF-36) in elderly.

Results: The mean score of quality of life was 61.06±7.42. The highest mean was associated with social health (74.5±15) while the lowest mean was for physical health (46±17). In terms of quality of life indicators before educational intervention, four categories emerged: poor (13.3%), medium (30%), good (41.7%), and high (15%). After intervention, the majority of the samples fell in the good (38.3%) and high (45%) categories. There was a significant difference before and after the educational intervention (p<0.001).

Conclusion: Education to elderly about the healthy lifestyle practices can prevent a lot of problems and help them to improve their quality of life. Therefore, classroom education is fruitful for this group that is often neglected.

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Background: Breast cancer is the most common cancer among women. An important goal for cancer patients is to improve the quality of life (QOL) by maximizing functions affected by the disease and its therapy. This study examined the effects of massage therapy on quality of life in women with breast cancer after surgery.

Materials and Methods: The study was quasi-experimental. Among the 53 women with breast cancer surgery and oncology clinic of Arak, 30 were randomly allocated in two groups of massage therapy (n=15) and 5 weeks (30 min, 2 sessions per week) and control (15 cases). Cortisol levels and quality of life questionnaire (SF36) was redirected and mental health groups. Data analysis software SPSS version 16 using paired t-test and one-way analysis of variance and a confidence level of 95% (p<0.05) was performed.

Results: The results showed a significant increase in the experimental group improved after the massage, physical (p=0.001) and psycho-social (p=0.002) were compared with control subjects. Massage also improves quality of life and mental health in breast cancer patients after surgery was (p<0.05). However, serum cortisol levels between the experimental and control groups were not significant (p>0.05).

Conclusion: The overall results of this study showed that massage therapy can be an effective intervention to improve quality of life and mental health in patients with breast cancer during radiotherapy is used.

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Background: Today, the self-assessed health status is a standard part of epidemiologic and community based studies. The aim of this study is to assess and evaluate the health related quality of life in Qom city.

Materials and Methods: In this descriptive analytical study, population of 340 people over 18 years of Qom city entered the study by filling the questionnaires. A two-part questionnaire was used to collect data which the first part was related to demographic data including age, sex, marital status, education, occupation and place of residence. The second version of the SF-36 questionnaire was used to assess the quality of life.

Results: Generally, considering the all aspects of quality of life in this study, the mean (±SD) of scores was 67.69±14.78. This average was equal to 67.28±15.91 in men and 67.97±14.03 in women which showed a significant difference between them (p =0.030).

Conclusion: In this study the scores of women and single subjects were higher than other people. By the Persian version of 2nd version of SF-36 questionnaire, the quality of life people in different situations might be realized and impact of different demographic factors on quality of life could be measured.

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Background: The growing elderly population in Iran and the association of aging with the high prevalence of physical and mental disorders have increased the necessity of determining quality of life of this age group. The quality of life of elderly women is affected by several factors due to their vulnerability. Hence, this study was designed to investigate the quality of life of elderly women in Arak.

Materials and Methods: This cross-sectional study was carried out on 271 elderly women who lived in Arak in 2013 using classified sampling. Data were obtained via general QOL (SF-36) questionnaires and analyzed by SPSS software.

Results: The mean (±SD) age of the participants was 67.5±7.02 years. The mean (±SD) total scores of SF-36, mental health, and physical health dimensions were 50.22±18.39, 58.54±19.38, and 46.35±20.82, respectively. The mean (±SD) score of eight dimensions of QOL were: general health 45.52±10.79, social function 56.58±24.94, physical pain 47.60±28.27, physical function 51.46±27.05, physical limitation 38.10±42.67, emotional problems 46.22±42.11, vitality 50.16±19.09, and mental health 58.54±19.38. There were significant difference between QOL, marriage, and income (P<0.05).

Conclusion: The results showed that the quality of life in this study was average and some factors, such as education, income, marriage, and residential situation, have a direct influence on QOL.