Photovoice: Method of data collection in qualitative research

Background & Aim: The role of the Nurse Practitioner (NP) is gaining importance worldwide. Many countries in the West and Europe have embraced the role within their health care system. NPs require training to carry out their roles and responsibilities effectively. A one year hospital based certification program was developed for NPs at one University teaching hospital in Pakistan. 
Case Report:  Using a work based model base model approach, competencies were developed in eight major areas. This allowed the NP’s to study and work at the same time. The program was delivered using Blended Learning pedagogies. The development of the NP program from conceptualization to implementation will be discussed in this paper.
Conclusion: Drawing on the experiences of the authors this paper will provide valuable insights into the challenges encountered in setting up similar programs locally and regionally for NPs.

Background & Aim: insulin injection to the patients suffered from diabetes mellitus need to consider the dose, route, time and injection spot since it will affect to postprandial blood sugar.  This study aimed to determine the effectiverness of insulin injection site and interval timing administration to the control of postprandial glucose in diabetes mellitus patients type 2.
Methods & Materials: The study was an experimental with Randomized Complete Block Design (RCBD). The population were patients with diabetes mellitus type 2 in dr. Moewardi Hospital Solo, Indonesia, consisted of 60 respondents taken from simple random sampling (allocate by inverse transform random variate generator and with Microsoft Excel), the respondents were divided into 4 blocks or groups (15 respondents/blocks). Injection used was Rapid-acting insulin with the dosage prescribed by the doctor. Injection was done in four (4) locations; abdomen, deltoid, thigh and gluteus. The administration were 0 minutes (along with meals), 10 minutes before meal, 20 minutes before meal and 30 minutes before meal. Two hour postprandial glucose levels were measured using a Glucometer. Data were then analyzed by SPSS 18 with Two-Way ANOVA and Tukey HSD.
Result: 55% of the respondents was male and 45% was female. All respondents were ≥ 40 years old, most of the respondents were in normal body weight and they have suffered the illness >10 years. There were differences in postprandial glucose levels in people with diabetes who obtained insulin injection at the site of the abdominal, deltoid, thigh and gluteus (P <0.05). There were differences in postprandial glucose levels in people with diabetes who obtained insulin injections at 0, 10, 20 and 30 minutes before meal (P <0.05). The location and the most effective time for insulin injection was in the abdomen at time 0 minute before meal (P <0.05).
Conclusion:Injection of insulin made in the abdomen by the time of meals effectively controlled postprandial glucose levels in patients with diabetes mellitus type 2.

Background: Considering the increased life expectancy of patients with colorectal cancer, concerns about the quality of life of these patients have increased. Regarding the importance of spirituality in lingered surgeries such as intestinal stomatitis, and the necessity of providing cares for these patients to give them hope for continuing living and accepting the treatment, the present study was conducted to evaluate the relation between spiritual attitude and quality of life among ostomy patients.
Methods: The present study was a descriptive analytical cross-sectional study that was conducted on 82 ostomy patients who referred to public and private wound centers of Isfahan and were selected through convenience sampling. Data gathering tool was a three-part questionnaire (demographic characteristics, spiritual attitude, and quality of life in ostomy patients). Data were analyzed using descriptive and inferential statistics with the help of SPSS software version 18.
Results: According to the results, the relation of income and the duration of ostomy with the quality of life of the patients and also between the type of ostomy and the total score of quality of life and patients’ spiritual attitude were statistically significant (p < 0.05). Also a significant direct relation existed between the total score of spiritual attitude and its dimensions with the total score of quality of life and its dimensions (p < 0.001).
Conclusions: According to the results of the present study, nurses, as a professional group, by providing nursing supports and fulfilling spiritual needs of the patients during the hospitalization, besides enhancing the spiritual health of the patients, could improve their quality of life too.

Background &Aim: Sexual self-concept is providing recognition of sexual aspects of each person, which is derived from previous experiences, points out the recent experience and guides the sexual behaviors. The aim of the present study was to evaluate the relation between sexual self-concept and attachment styles in married women who referred to the health centers of Tehran in 2014.
Methods & Materials: This descriptive analytical cross-sectional study was conducted on 365 women of reproductive age (15 to 44 years old) who referred to the health centers affiliated with Tehran University of Medical Sciences. Data gathering tools were demographic characteristics questionnaire, the standard questionnaire for sexual self-concept and the standard questionnaire for attachment. Data were analyzed by SPSS version 16 using descriptive statistics and Pearson correlation coefficient with a significant level of α = 0.05.
Results: Results showed a direct correlation between negative sexual self-concept and anxious attachment (p < 0.0001) and avoidant attachment (p < 0.0001) and a reverse correlation between negative sexual self-concept and secure attachment (p < 0.0001). In contrary, positive sexual self-concept had a reverse correlation with anxious attachment (p = 0.006) and avoidant attachment (p = 0.114) and a direct correlation with secure attachment (p = 0.006).
Conclusions: Considering the direct correlation between positive sexual self-concept and secure attachment and also between negative sexual self-concept and non-secure attachment (anxious and avoidant), it is predicted that by appropriate planning for secure attachment, health sexual behaviors could be reached.

Background & Aim: The quality of life (QOL) in patients with psoriasis is low. little evidence was available for the effect of self-management intervention in patients with psoriasis.
Aim: This study aimed to investigate the effect of the self-management education on the QOL and the severity of the disease in patients with psoriasis.
Methods & Materials: This non-randomized clinical trial was conducted with 99 patients hospitalized in a dermatology ward in a hospital in an urban area of Iran in 2015. They were selected using a convenient sampling method and randomly assigned into the intervention (n=50) and control groups (n=49). While the patients in the control group received routine care and education, those in the intervention group received self-management education consisting of three sessions of group education lasting between 20 and 30 minutes, discussions, educational booklet and telephone follow up one, two and three months after discharge from the hospital. Data was collected using the demographic data form, the dermatology life quality index, and psoriasis area and severity index.
Findings: The means of the QOL after education in the control and intervention groups were 7.69 (SD= 6.49) and 6.46 (SD= 6.04), respectively. There were significant differences between the intervention and control groups in terms of changes in the severity of psoriasis (P value=0.025, effect size= -0.46, 95% CI= -0.86, -0.059) and QOL (P value= 0.035, effect size=-0.43, 95% CI= -0.83, -0.03) before and 3 months after the self-management education. Accordingly, the reduction of the severity of psoriasis and improvement of QOL after the self-management education was higher than the control group.
Conclusion: Healthcare providers can use the self-management program as a low-cost approach along with the routine care for improving the QOL in patients with psoriasis.

Background & Aim: Juvenile or type 1 diabetes mellitus is the most common metabolic and endocrine disorder in childhood and adolescence that affects quality of life. On the other hand, self-care agency could be considered as a significant factor in improving the quality of life. This study aimed to investigate the self-care agency and quality of life among Iranian adolescents with diabetes mellitus type 1 referring to the Diabetes Center at Sina Hospital in Tabriz, Iran.
Materials and Methods: In a descriptive correlation study, 120 diabetic adolescents were selected from a pool of referrals to the Diabetes Center at Sina Hospital affiliated to the Tabriz University of Medical Sciences, using the convenience sampling process. Adolescents completed a demographic and clinical characteristics questionnaire, the Diabetes-Specific Quality Of Life Brief Clinical Inventory (DQOL-BCI), as well as the Self-Care Appraisal Scale. Statistical analysis included Pearson correlation coefficient, independent samples t-test, one-way ANOVA and linear regression. Data was analyzed by SPSS ver.16.
Results: The mean score of quality of life and self-care agency was 32.14 (8.17) and 30.24 (8.64), respectively. There was a significant relationship between the quality of life and self-care agency (P<0.05). Furthermore, a significant correlation with some of the demographic and clinical characteristics was revealed (P<0.05).
Conclusion: Based on the association between the quality of life and self-care agency in diabetic adolescents, researchers emphasize the need for planning diabetes education programs based on self-care training to improve the quality of life.