| 1. |
- Nakhaei, Maryam, et al.
(författare)
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Impact of disaster on women in Iran and implication for emergency nurses volunteering to provide urgent humanitarian aid relief : A qualitative study
- 2015
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Ingår i: Australasian emergency nursing journal : AENJ. - : Elsevier. - 1574-6267 .- 1839-2776. ; 18:3, s. 165-172
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Men and women are equally affected by disasters, but they experience disaster in different ways. To provide new knowledge and promote women's involvement in all phases of the disaster management, we decided to capture the perspectives and experiences of the women themselves; and to explore the conditions affecting Iranian women after recent earthquake disasters.METHODS: The study was designed as a qualitative content analysis. Twenty individuals were selected by purposeful sampling and data collected by in-depth, semi-structured interviews analysed qualitatively.RESULTS: Three main themes were evident reflecting women's status after disaster: individual impacts of disaster, women and family, and women in the community. Participants experienced the emotional impact of loss, disorganisation of livelihood and challenges due to physical injuries. Women experienced changes in family function due to separation and conflicts which created challenges and needed to be managed after the disaster. Their most urgent request was to be settled in their own permanent home. This motivated the women to help reconstruction efforts.CONCLUSIONS: Clarification of women's need after a disaster can help to mainstream gender-sensitive approaches in planning response and recovery efforts.
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| 2. |
- Begum, Afroza
(författare)
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Social Determinants of Suicidal Ideation among Adolescents in Rural Bangladesh
- 2021
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and Objective: Suicide is a leading cause of death and a critical public health problem among adolescents worldwide. However, adolescent suicidal behaviour is a neglected public health issue, especially in low- and middle-income countries, such as Bangladesh. There is evidence from developed countries showing that suicidal ideation (SI) among adolescents is related to social indicators as well as individual risk factors. Scarce evidence from studies inlow- and middle-income countries suggests that social factors may influence adolescent SI. In Bangladesh, only a few studies have focused on the social determinants of suicide, and the present study is the first to examine the prevalence and social determinants of suicidal ideation among adolescents in rural Bangladesh. Therefore, the present thesis assessed the effects of socioeconomic status (SES) on adolescent SI.Methods: The present thesis is based on two studies, which used data from a cross-sectional survey conducted in 2013 among 2,476 adolescents aged 14-19 years selected randomly in arural community in Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district, an area surveyed within the Injury Prevention Program of the Centre for Injury Prevention and Research, Bangladesh (CIPRB). Study I estimated the prevalence of suicidal ideation among adolescents and investigated what factors were associated with suicidal ideation. Study II examined the relationship between parental socio-economic factors and suicidal thoughts among adolescents.Results: Study I showed that life time prevalence of suicidal ideation was 5% among adolescents. The majority of adolescents with suicidal ideation were female (67, 5.3%), unmarried (106, 5.5%) and students (86, 6.2%). Suicidal ideation was significantly associated with age, education, occupation and living with parents or others. Respondents aged 18-19 years, had a Secondary school certificate (SSC) and Higher Secondary school certificate (HSC) or higher, were day labourers, living without parent had odds ratios of 2.31 (CI 1.46-3.65), 2.38(CI 1.51-3.77), 4.15 (CI 2.41-7.14), .28 (CI 0.13-0.60) and 1.80 (CI 1.07-3.03), respectively.In study 2, results demonstrated that suicidal ideation was more common among adolescents with parents from the low-income group (5.5%). In addition, adolescent SI was found to be significantly associated with parental education, marital status and house ownership. Adolescents whose parents received an SSC or higher had an SI odds ratio of 2.10 (CI 1.21-3.64) and 1.92 (CI 1.15-3.23) for mothers and fathers respectively. Suicidal ideation among adolescents with single parents was higher with an odds ratio of 3.00 (CI 1.75-5.19) in comparison to adolescents who had both parents. Adolescents whose parents owned a house had an odds ratio of 0.14 (0.05, 0.35).Conclusion: The thesis found that the prevalence of lifetime suicidal ideation among adolescents is moderately high in a rural community of Bangladesh. Furthermore, it was observed that personal characteristics such as parental marital status, education and homeownership were statistically significantly associated with suicidal ideation among adolescentseven after adjusting for potential confounders.
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| 3. |
- Dalvandi, Asghar, et al.
(författare)
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Lack of continuity of rehabilitation care for stroke survivors : Iranian family caregivers' experience
- 2011
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Ingår i: Middle East Journal of Age and Aging. - 1449-8677. ; 8:4, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objective: Stroke is a common disabling disorder that requires the involvement of family caregivers to successfully encourage the patient's rehabilitation. This is especially true in Iran, where the family members commonly have the main responsibility of care of disabled persons. The aim of this study was to explore the Iranian family caregivers' experience of providing rehabilitation care at home. Method: A grounded theory approach and the main tenets of constant comparative method were used. Twelve participants were interviewed using semi-structured in-depth interviews. Findings: The core concept was identified as "lack of continuity of rehabilitation care". Seven main categories were identified. Three of them were related to the problems family caregivers faced, including inadequate knowledge and skills, inappropriate accessibility to rehabilitative services, and inadequate social insurance. Four categories were about the strategies that family caregivers used to deal with the major concerns; modifying home environment, managing coexisting medical conditions, improving nurses' roles and, relying on family unity. Conclusion: Family caregivers need continuity of rehabilitative care besides their family engagement, to enable access to care. They also need support from adequate social insurance and increased access to rehabilitation care. Undergoing rehabilitation at home gives people the advantage of practicing skills and developing compensatory strategies in the context of their own living environment by training and helping family caregivers and stroke survivors in terms of modifying home environment and managing coexisting medical conditions. Here, nurses can have an important role by helping the family caregivers with education and training.
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| 4. |
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| 5. |
- Dalvandi, Asghar, et al.
(författare)
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Rehabilitation Experts' Experience of Community Rehabilitation Services for Stroke Survivors in Iran
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 19:5, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Successful stroke rehabilitation is a complex process involving teamwork by members of several professions. The aims of this study were to explore the experiences of Iranian rehabilitationexperts concerning community rehabilitation services for stroke survivors and obtain their opinions on how to further develop and improve these services. Method: A qualitative research method with grounded theory was used, including purposive and theoretical sampling. A constant comparative analysis was conducted. Data were gathered from 2 focus group discussions including 10 Iranian rehabilitation experts and 4 in-depth individual interviews. Results: Nonintegrated rehabilitation services emerged as the core concept of the study. The explored concepts were identified as deficiently allocated budget, inadequate public insurance, lack of availability of rehabilitative care, negative public opinion, lack of consistency in care, and split services and professional separation. Areas identified for potential improvement included need to change policymakers' attitudes, need to refine rehabilitation in the health care system, need to establish a registration system, need to provide information and skills, and need to see the family as a whole. Conclusion: Experts should participate in educational rehabilitation programs to become more aware of current rehabilitationservices within the community. Stroke survivors and their families should also participate in the rehabilitation programs as this would allow them to gain knowledge and skills for dealing withstroke management. This can help reduce problems, change public opinion, and eliminate mistrust between health care providers and families.
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| 6. |
- Eslami, Bahareh, et al.
(författare)
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Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country
- 2013
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Ingår i: Cardiology in the Young. - 1047-9511 .- 1467-1107. ; 23:02, s. 209-218
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Tidskriftsartikel (refereegranskat)abstract
- Background Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.Materials and methods The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.Results The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.Conclusion Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.
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| 7. |
- Eslami, Bahareh, et al.
(författare)
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Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country
- 2015
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 22:2, s. 169-179
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Tidskriftsartikel (refereegranskat)abstract
- Background Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.Design Cross-sectional case-control.Methods A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.Results The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.Conclusions The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.
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| 8. |
- Eslami, Bahareh, 1978-
(författare)
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The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and objectives:Adults with congenital heart disease (CHD) are a new group of patients with a prevalence of 4 per 1000. They have evolved as a result of significant improvements in medical management during the past decades. However, adults with CHD experience various medical and social challenges that may influence their psychosocial functioning. Providing appropriate medical, rehabilitation and social care for adults with CHD, and indeed improving their well-being require the evaluation of their current psychosocial situation. This thesis aims to increase the understanding of the mental health, somatic symptoms, social support, style of coping, quality of life and life satisfaction of adults with CHD and to examine the possible contributing factors in the context of a developing country; issues not addressed in the current literature.Methods:This thesis is based on four studies. Study I recruited 347 consecutive CHD patients (18-64 years) from two heart hospitals in Tehran, Iran. The study iscross-sectional and focused on sex differences in socio-economic status, lifestyle and medical characteristics of adults with CHD. Studies II, III and IV havea cross-sectional case-control design comparing the aforementioned CHD patients with 353 non-CHD participants, matched by sex and age. Outcome variables were anxiety, depressive and somatic symptoms (Study II), styles of coping (Study III), and life satisfaction/quality of life (Study IV). The data were analysed with bivariate and multivariate methods. Multivariate linear regression analyses were performed to scrutinize the association of demographic/socio-economic variables, social support, mental health, and medical variables with the aforementioned outcome variables among adults with CHD (Studies II, III, IV). Results:Study I showed that women with CHD were more often married and had children and were less often employed, but had healthier behaviour compared to men. Even though most of the patients received regular medical viiicare from different typesof medical professionals, half of them had no knowledge about the type of their cardiac defect. Study II showed that CHD patients experienced more anxiety and somatic symptoms than the healthy controls, whereas there were no differences in depressive symptoms. Perceived financial strain, lower social support and low annual income were positively associated with worse outcome in mental health and somatic symptoms. None of the medical variables were related to anxiety, depressive and somatic symptoms. Study III showed that the styles of coping of the CHD patients were comparable to those of the control group and CHD per se was not associated with a certain style of coping, except for palliative reaction pattern. Problem-focused styles of coping were associated with being never married, parenthood, higher level of anxiety and somatic symptoms, lower level of depressive symptoms and higher social support. Emotion-focused styles of coping were associated with annual income and higher level of anxiety. None of theadopted coping strategies were related to the heart disease variables. Study IV showed that adults with CHD had poorer quality of life and lower life satisfaction than the control group. However, CHD was associated only with decreased overall quality of life and its physical health domain, and life and health satisfaction. Among CHD patients, higher quality of life was associated with female sex, younger age, employment status, having less emotional distress and higher social support, while life satisfaction was associated with female sex, being employed, less emotional distress and higher social support. Conclusions:The results support the notion that psychosocial factors contribute to the well-being of adults with CHD.Socio-economic factors, emotional health and social support are significant determinants in nearly all outcomes of interest which need to be considered by health care providers and policy makers in their efforts to improve the health ofadults with CHD. However, longitudinal studies are warranted to establish causal linksand qualitative studies are recommended to deepen the understanding of coping and quality of life.
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