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Development and psychometric evaluation of the Motivation to Use CPAP Scale (MUC-S) using factorial structure and Rasch analysis among patients with obstructive sleep apnea before CPAP treatment is initiated
Get PDFBackground Continuous positive airway treatment (CPAP) is first-line treatment for obstructive sleep apnea (OSA), but adherence
tends to be low. A clinical tool focusing on motivation to use CPAP is missing. The purpose was to develop a brief
questionnaire to assess motivation to use CPAP that is psychometrically robust and suitable for use in clinical practice.
Methods A convenience sample including 193 treatment naive patients with OSA (67% men; mean age = 59.7 years, SD 11.5)
from two CPAP clinics was used. Clinical assessments and full night polygraphy were performed. Questionnaires administered
before CPAP treatment included the newly developed Motivation to Use CPAP Scale (MUC-S), Minimal Insomnia Symptoms
Scale (MISS), Epworth Sleepiness Scale (ESS), and Attitude towards CPAP treatment Inventory (ACTI). The validity and
reliability of the MUC-S were investigated using Rasch and exploratory factor analysis models. Measurement invariance,
dimensionality and differential item functioning (i.e., across gender groups, excessive daytime sleepiness (ESS), insomnia
(MISS) and attitude towards CPAP (ACTI) groups) were assessed.
Results The results supported a two-factor solution (autonomous motivation, 6 items, factor loadings between 0.61 and 0.85 and
controlled motivation, 3 items, factor loadings between 0.79 and 0.88) explaining 60% of the total variance. The internal
consistency was good with Cronbach’s alpha of 0.88 and 0.86 for the two factors. No differential item functioning was found.
A latent class analysis yielded three profiles of patients with high (n = 111), moderate (n = 60) and low (n = 22) motivation.
Patients with high motivation were older, had higher daytime sleepiness scores, more insomnia symptoms and a more positive
attitude towards CPAP.
Conclusions The MUC-S seems to be a valid tool with robust psychometric properties suitable for use at CPAP clinics. Future
studies should focus on how motivation changes over time and if MUC-S can predict objective long-term CPAP adherence
Predictors of breastfeeding self-efficacy during the covid-19 pandemic
Get PDFBackground: Breastfeeding self-efficacy (BSE) is a strong predictor of the duration of breastfeeding. The aim of
this study is to determine the predictors of BSE in breastfeeding mothers during the Covid-19 pandemic.
Methods: A cross-sectional study was conducted with 300 breastfeeding mothers who breastfed during the Covid-
19 pandemic. Convenience sampling was used to recruit participants. A battery of online questionnaires
measured sociodemographic and obstetric characteristics, breastfeeding self-efficacy, spouse postpartum social
support, perceived social support, anxiety and depression, and fear of Covid-19. Data were analyzed using
Pearson correlation coefficients, one-way ANOVA, and multivariable linear regression via stepwise method. The
significance level in this study was α = 0.05.
Results: The mean BSE score among participants was 58.19 ± 10.48 (out of 70). Spouse postpartum social support
(β = 0.732, p = 0.04), intention to breastfeed (β = 0.17, p = 0.001), use of formula while breastfeeding (β
Effect of melatonin on postpartum hemorrhage in vaginal delivery: a prospective randomized double-blind study
Get PDFBSTRACT
Background. The similarities between the melatonin and oxytocin signaling could promote myometrium contractility. We conducted this study to determine the effect of melatonin on the bleeding during and after vaginal delivery.
Methods. The current double-blind randomized clinical trial was conducted on 140 pregnant women at term with labor pain. Subjects in the melatonin group received three sublingual doses of melatonin from labor room staff as follows: 6 mg in 7 cm dilatation, 3 mg after delivery of the fetus and 3 mg one hour after the delivery. The same schedule was conducted for the subjects in the placebo group by giving the placebo. The hemoglobin levels before and 24 hours after vaginal delivery, the hemodynamic variables were recorded.
Results. There was a significant difference between the groups regarding the mean of hematocrit changes in the melatonin (3.59 ± 2.89) and placebo (5.29 ± 3.19) groups (P = 0.001). The mean variation of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) show a significant difference among two groups of the study (P = 0.021, P = .020 and 0.001, respectively).
Conclusions. The sublingual of melatonin to pregnant women with labor pain could reduce the amount of blood loss after the vaginal delivery. Furthermore, melatonin could provide hemodynamic stability
مقايسه اثر دهانشويه هاي کلرهگزيدين)% 2.0 ( ، پرسیکا و ماتريکا بر شاخصهاي پريودنتال در کودکان تحت درمان ارتودنسي پیشگیرانه
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Frequency of Diabetic Ketoacidosis and Severe Hypoglycemia in Children with Type 1 Diabetes
Get PDFBackground and Objective: Diabetic ketoacidosis and severe hypoglycemia are common and recurrent acute complications of type 1 diabetes and are associated with high mortality and morbidity. The aim of this study was to determine the frequency of diabetic ketoacidosis and hypoglycemia in children with type 1 diabetes.
Methods: In this retrospective cross-sectional study, 480 patients with type 1 diabetes admitted to the Children Hospital in Qazvin were enrolled by census method. Demographic characteristics, season of referral, place of residence, existence of type 1 diabetes in the family, kin relationship of parents, cause of hospitalization (hyperglycemia, hypoglycemia and diabetic ketoacidosis) and length of hospital stay were extracted from the files and examined.
Findings: Most patients (62.9%) were female. 46%, 44.4% and 9.6% of patients were admitted with diabetic ketoacidosis, hyperglycemia and hypoglycemia, respectively. 47.96% of patients had severe diabetic ketoacidosis. 49.3% of patients had ketoacidosis with infection and 20% of known cases were hospitalized due to poor insulin compliance. Hospitalization days were significantly higher in patients with ketoacidosis (p=0.00).
Conclusion: According to the results of this study, the occurrence of infection and lack of adherence to insulin use were the main cause of hospitalization in patients with diabetes, which led to an increase in hospitalization days in these patients. Adequate training to regulate blood sugar reduces the rate of hospitalizations.
Keywords: Type 1 Diabetes Mellitus, Diabetic Ketoacidosis, Hypoglycemia, Insulin, Hyperglycemia
Evaluation of patients with phenylketonuria before and after screening in Qazvin Province, Iran
Get PDFBACKGROUND: Phenylketonuria (PKU) is a hereditary metabolic disorder and is inherited as autosomal recessive, so it is more likely to occur in consanguineous marriages. Early diagnosis is made by screening and timely treatment can prevent brain damage.
METHODS: This was a descriptive study including all children identified with PKU in Qazvin Province, Iran, up to march 2017. The required information was obtained through interviews with parents and reviewing of cases. Data were analyzed using SPSS software.
RESULTS: Of the 63 infected patients, 55.5% were residents of Qazvin City and the rest were residents of other cities in the province. Parents of 54.0% of the patients were related. 20.6% of patients had at least one patient with PKU in their family. The mean age that patients were diagnosed before screening was 34 months, and the statistical difference between the two groups was significant (P < 0.001). 52.4% of the patients were girls. The most common reason of referring of the patients before screening was a developmental delay. The prevalence of hyperactivity, seizures, and delay in walking and language were significantly different between the two groups (P <0.001).
CONCLUSION: Early diagnosis and treatment of children with inherited metabolic diseases can prevent brain damage and retardation in them and reduce the financial and psychological burden of treating these children by maintaining their intelligence quotient (IQ).
KEYWORDS: Diagnosis; Phenylketonuria; Developmental Disabilitie
