فهرست مطالب masoumeh bagheri-nesami

One of the response areas of Iran's health system in dealing with the COVID-19 pandemic is the area of health and prevention. In many countries of the world, the primary strategy against COVID-19 is prevention and health, and this issue was considered before treatment. Considering that the COVID-19 pandemic was a new event and a new experience for health systems around the world, there is a need to investigate the different effects of this emerging phenomenon in different populations. Therefore, this study was conducted to explain the experiences of the health management of the COVID-19 pandemic in Mazandaran University of Medical Sciences.

This applied research was conducted in terms of the qualitative paradigm and by the method of summative content analysis. In this study, semi-structured interviews and existing documents of university vice-chancellors during the COVID-19 pandemic were used. In this study, interviews were conducted with 16 officials of Mazandaran University of Medical Sciences (The president of the university, vice president of health, health managers, doctors, experts of health centers, and also experts who worked in the university headquarters in the department of health vice) and a three-hour focus group of 15 people. The participants were selected based on the goal of maximum diversity. For the validity and strength of the study, the criteria proposed by Goba and Lincoln were used. The researcher tried to increase the credibility of the research with long-term involvement and sufficient interaction with the participants, collecting valid information and confirming the information by the participants. The researcher tried to increase the reliability of the data by repeating step by step and collecting and analyzing the data, taking advantage of the review by the experts. To increase the data Confirmability criteria, the approval of the associate professors of the project and their supplementary comments were used. To be able to transfer the data of the study, the researcher tried to provide a rich description of the research report to evaluate and applicability of the research in other fields so that other researchers can also be able to understand the data and achieve the same, as well as the participation quotes. The participants were presented in the same way as said. In this study, MAXQDA software was used for data analysis.

From the data analysis, two main layers (health challenges, preventive and coping strategies) and eight sub-layers (challenge of lack/delay in receiving health-treatment services, epidemiological challenge, health management challenge, vaccination challenge, strategies Receive health-treatment services on time to promote community health, epidemiological strategies, strategies for implementation of health guidelines, strategies for implementation of COVID-19 vaccination) and twenty-six sub-categories were extracted.

Mazandaran University of Medical Sciences faced many challenges during the COVID-19 pandemic, by holding decision-making meetings and coordinating various health units, in line with the policies of the ministry, providing suitable solutions for prevention and countermeasures. The results of this study can be used to teach other university officials to deal with other emerging diseases and the future planning of health policymakers. It is suggested to conduct a study comparing the rate of acceptance of the COVID-19 vaccine in normal people and medical staff and related factors at Mazandaran University of Medical Sciences.

The prevalence of metabolic syndrome in societies is increasing. Metabolic syndrome is a cluster of medical conditions that include obesity, hypertension, dyslipidemia, and insulin resistance. Poor dental care is linked to numerous systemic disorders. Scientific research supports the presence of a relationship between oral hygiene and metabolic syndrome. Therefore, the present study was conducted to determine the relationship between oral hygiene based on DMFT (decayed, missing, filled teeth) and metabolic syndrome in the registration phase data of the Tabari cohort population.

This study was cross-sectional and analytical and included participants from the Tabari cohort population who had performed oral health and metabolic syndrome assessments during the registration phase. Throughout the registration period of the Tabari cohort study (TCS), data was gathered from 10255 individuals ranging from 35 to 70 years old. This data was obtained from both urban and mountainous parts of Sari, Mazandaran, Iran, during the years 2015 and 2017. Data regarding education level, occupation status, residential location, socio-economic status, marital status, mental health history, smoking or hookah habits, daily physical activity, dental hygiene practices (such as tooth brushing and flossing frequency), denture usage and care, mouthwash usage, and DMFT index were gathered during the implementation of TCS through interviews and oral examinations. Metabolic syndrome was diagnosed based on the criteria of the third adult treatment panel (ATP III). Ultimately, SPSS version 27 software was utilized to describe the data using mean, standard deviation, and percentage. The qualitative variables were compared with the metabolic syndrome using the chi-square test, while the quantitative variables were compared using the independent t-test in univariate analysis. Furthermore, the process of adjusting for confounding variables was carried out through the utilization of multivariate logistic regression.

9,939 people were included in the final analysis. Independent T-test result showed that there was no significant relationship between metabolic syndrome and DMFT (P=0.156, T=4.59), so the average DMFT in the group with metabolic syndrome was 17.66±9.07, whereas in the non-affected group, it was 16.81±8.99. Based on chi-square test results, significant relationships with metabolic syndrome were found for the use of dentures (P<0.001), use of dental floss (P<0.001), age (P<0.001), gender (P<0.001), marital status (P=0.05), occupation (P<0.001), place of residence (P<0.001), psychiatric disorders (P<0.001), socio-economic status (P=0.005), smoking (P<0.001), BMI (P<0.001), MET (P<0.001), and education level (P<0.001). Upon adjustment of confounders in the multivariable logistic regression model, only the number of flossing twice a day was significantly associated with metabolic syndrome (OR 1.493 [95% CI 1.008–2.213], P=0.046).

The findings of this study showed that there is no significant relationship between oral and dental hygiene measured by the DMFT index and the presence of metabolic syndrome in the population registration stage data of the Tabari cohort. There was a significant relationship identified alone between flossing twice daily and metabolic syndrome. Further studies are necessary to explore other potential factors that may contribute to the development of metabolic syndrome in this population.

Due to the importance of sleep for the quality of life of cardiac patients, there is a need to find effective methods to improve their sleep quality. One of these methods is the foot reflexology (FR). This study aims to investigate the FR effects on the sleep conditions of cardiac patients.

This is a systematic review study that was conducted in 2023. After searching in the national and international databases for studies published from 1980 to 2023, 162 studies were assessed according to the inclusion and exclusion criteria, of which 147 were excluded. Finally, three randomized clinical trials that used FR were included, two were for patients with coronary artery bypass graft surgery (CABG) and one for patients with acute myocardial infarction (MI).

The time of FR for each foot was in the range of 15-20 minutes and its duration ranged 2-4 days. The results of one study indicated that FR had a significant effect on sleep quality and quantity. However, other studies reported that FR was not significantly effective in improving sleep quality and quantity.

FR may improve the cardiac patients’ sleep quality and quantity. It seems that 15-minute FR at night is effective for improving the sleep conditions of CABG patients. However, further research is required on MI patients.

Fatigue is a significant factor that affects nurses and the quality of care they provide. This study aimed to compare the effects of foot reflexology (FR) and foot massage (FM) on fatigue and its impacts in female nurses. A randomized controlled trial was conducted with 60 nurses who were randomly assigned to two groups of 30 to receive either FR or FM, in Buali Hospital (Sari-Iran), from January 2022 to July 2023. Nurses received FR or FM for 10 minutes once a day for three consecutive days. Fatigue and its impacts were assessed before, immediately after, and one week following the intervention. Data were collected using the General Health Questionnaire (GHQ-12), the Chalder Fatigue Scale (CFS), and the Fatigue Impact Scale (FIS). The mean baseline fatigue scores in the FR and FM groups were 23.33±9.69 and 22.07±6.51, respectively (P=0.65). Both groups showed a significant decrease in fatigue scores immediately and one-week post-intervention, with the FM group exhibiting a significantly smaller decrease (P<0.05). There was no significant difference in the mean baseline FIS scores between the two groups (P=0.91), but both groups showed a significant decrease in FIS scores over time. The GEE model indicated a significant reduction in CFS and FIS scores over time in both groups (P<0.001). Foot reflexology and foot massage were effective in reducing fatigue and its impacts in nurses. Nurses can choose either of these methods based on their preferences and conditions to alleviate fatigue and its effects.

Generation gap, as one of the most common concepts of social phenomenon, is a concept that refers to  differences between younger and older generations. It takes into account the clear psychological, social and cultural differences and the difference in awareness, beliefs, perceptions, expectations, value orientations and behavioral patterns of two generations in a society at the same time. In the Oxford Dictionary, this concept is defined as" the difference in attitude or behaviour between young and older people that causes a lack of understanding". In the Merriam-Webster Dictionary, it is defined as “the differences in opinions, values, etc., between younger people and older people”.

Hemodialysis patients often face various psychological challenges that can significantly affect their overall health. Alexithymia is a construct that refers to the inability to distinguish between emotions and bodily reactions, difficulty describing emotions to others, and a cognitive style that is driven by reality and concrete situations. Various studies have shown that alexithymia is significantly and positively correlated with many psychiatric disorders. Moreover, as a factor, it hurts mental health (especially anxiety) and the quality of life of hemodialysis patients. Therefore, this research aimed to determine the mediating role of alexithymia in the relationship between social support and death anxiety in hemodialysis patients.

This cross-sectional and analytical study was conducted on 235 patients at Sari Shahrvand dialysis center, Iran 2023. Patients were included in the study by convenient sampling method. Data collection was done using demographic information questionnaires, Templer's Death Anxiety Scale (DAS-15), Zimmet's Multidimensional Scale of Perceived Social Support (MSPSS), and Toronto Alexithymia Scale (TAS-20). Demographic information included gender, place of residence, level of education, duration of hemodialysis treatment, number of visits per week, history of underlying diseases, and history of hemodialysis. Templer's death anxiety scale includes 15 questions in the form of a 5-point Likert scale regarding thoughts of death, fear of death, talking about death, fear, and thinking about incurable diseases. Zimmet's multidimensional scale of perceived social support is a 12-question instrument in the form of a 7-point Likert scale, which was used to evaluate perceived social support from three subscales of friends, family, and significant others. The Toronto Alexithymia Scale was a 20-question questionnaire with a five-point Likert scale, with three subscales: difficulty in recognizing emotions, difficulty in describing emotions, and objective thinking (Externally oriented), which was used to evaluate alexithymia. Finally, the data was analyzed by descriptive statistics and structural equation modeling with the bootstrap method, utilizing SPSS 26 and AMOS 22.

The study revealed that most participants were male, comprising 58.3% of the statistical population. The average scores for death anxiety, perceived social support, and alexithymia were 38.97±10.31, 4.88±1.26, and 55.72±9.76, respectively. The results suggest that there is no statistically significant relationship between social support scores and death anxiety (B=-0.13 (-0.30, 0.04), P=0.153), nor between social support and alexithymia (B=-0.12 (-0.28, 0.09), P=0.256). However, there is a significant and direct relationship between alexithymia and death anxiety (B=0.66 (0.46, 0.82), P=0.016).

Considering the significant and direct relationship between alexithymia and death anxiety, it is recommended that managers and healthcare planners regularly evaluate the presence of death anxiety and alexithymia among individuals and formulate targeted interventions to alleviate these conditions.

Flaxseed powder seems to improve bowel movements in these patients. Therefore, this study compares the effects of flaxseed powder and magnesium hydroxide on bowel movements of acute myocardial infarction patients hospitalized in ICU.

The population of the present parallel randomized controlled clinical trial included 70 acute myocardial infarction patients hospitalized in ICU who had no history of chronic constipation. The patients in the intervention group were given three sachets of flaxseed powder (each sachet was 3 g) twice a day for four days. The patients in the control group were given 20 cc of magnesium hydroxide syrup each morning. The Bristol scale was used to describe stool consistency.

The mean and standard deviation of the number of bowel movements within five days after intervention are 1.86 ± 1.08 and 1.6 ± 0.65 in the intervention and the control groups, respectively. The frequency of normal stool consistency of the first bowel movement is 94.3% for the intervention group and 85.7% for the control group, which shows no significant differences between the two groups in terms of stool consistency and bowel movement frequency (P=0.510). The bowel movements started on average after 35.2±97.97 hours in the flaxseed group and 24.771±2.677 hours in the magnesium hydroxide group (P=0.023).

The results showed that flaxseed powder increases bowel movement frequency and improves the patients’ stool consistency, but the differences between the two groups are insignificant. Finally, the time to the first defecation was shorter in the magnesium hydroxide group.

Pruritus is a troublesome symptom in patients with chronic kidney failure (CKF). Topical treatment is the first choice for many skin conditions including pruritus. This study examined the effect of topical lipogel containing Ziziphus jujube and Echium amoenum extracts on pruritus in hemodialysis (HD) patients. A double-blind crossover trial was conducted with 50 HD patients. A demographic and medical information form and the 12-item Pruritus Severity Scale were used to collect data. Participants were randomly assigned into a placebo group and an intervention group. The intervention was carried out for four weeks. The groups were then switched after a 2-week washout period and followed for the next four weeks. The severity of pruritus was measured before and once a week after the intervention for 4 weeks. The independent samples t-test, the Mann-Whitney U test, the chi-square test, and repeat measures analysis of variance (RMANOVA) were used to analyze the data. The mean baseline pruritus scores were 15.14±2.59 and 14.34±2.6 in the intervention and placebo groups, respectively (P=0.581). The mean pruritus score decreased by three points in the intervention group and one point in the placebo group at the end of the intervention. The results of the RMANOVA also showed that over time, the herbal lipogel significantly reduced the mean pruritus scores in the intervention group (P<0.0001), while it remained relatively unchanged in the placebo group. The use of a topical lipogel containing extracts of Ziziphus jujube and Echium amoenum can effectively reduce pruritus in HD patients. Therefore, this lipogel may safely be used to relieve pruritus in patients receiving HD.

Several studies have investigated the effects of acupressure in patients with known diabetes. However, no studies have investigated the effects of acupressure on women with prediabetes. The present study aimed to investigate the effects of self-administered acupressure on fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and anxiety levels in prediabetic women. This randomized controlled trial was carried out on 50 women with prediabetes who referred to the Diabetes Clinic of Mazandaran University of Medical Sciences, Sari, Iran, from September 4, 2021, to February 20, 2023. Participants were randomly assigned to two groups of 25 to receive either metformin and self-administered acupressure or metformin and sham point pressure. FBS, HbA1c, and anxiety levels were measured in both groups before and 12 weeks after the intervention. All patients also received routine training. Data were analyzed using chi-square test and Fisher's exact test, independent samples t-test and analysis of covariance (ANCOVA). The two groups did not differ significantly in their mean baseline FBS and HbA1c values. However, the mean baseline anxiety was significantly higher in the control group (P=0.009). After the intervention, the mean FBS, HbA1c, and anxiety were significantly lower in the intervention group (P<0.001). After controlling for the effect of baseline anxiety scores using ANCOVA, we found that the intervention was effective in reducing mean anxiety (P<0.001). Self-administered acupressure reduced FBS, HbA1c, and anxiety levels in prediabetic women. Therefore, it is recommended that nurses and physicians train prediabetic patients to use self-administered acupressure to manage their anxiety and prediabetic symptoms.

The nursing process is a framework in which nurses determine the abilities and problems of patients and develop methods for evaluating and planning nursing care programs. One of the challenges of nursing education is the use of methods to promote learning and creative thinking skills in learners. Therefore, this study was compiled to compare two methods of flipped classroom and conceptual map and flipped classroom and traditional method for the topic of nursing process on the variables of self-regulation learning strategies and satisfaction of nursing students.

This is an interventional study. The statistical population includes all nursing students of the first semester of Mehr (teaching using traditional and flipped classroom methods) and Bahman (teaching using flipped classroom method and conceptual map) of the year 2022 of Nasibah Sari School of Nursing and Midwifery. The study tool was a two-part questionnaire (demographic information, and learning strategies questionnaire). Visual Analog Scale (VAS: Visual Analog Scale) teaching method was used to check the level of students' satisfaction. In this study, the topic of the nursing process was selected from the nursing principles and skills course, the self-regulated learning strategies questionnaire was completed by the students once before and 4 weeks after teaching. Data entry and analysis were done using SPSS version 24 software.

There was no significant difference between students' satisfaction with the flipped classroom teaching method and the traditional method (8.54±1.38) with the flipped classroom teaching method and conceptual map (7.98±1.84) (P=0.124). The t-test showed that there was no significant difference in the average of self-regulated learning strategies after implementing the two teaching methods (P=0.258). The paired t-test showed that the comparison before and after the mean of self-regulation learning strategies in the flipped class group and the traditional method showed a significant difference (P=0.013).

The findings showed that despite the lack of statistical difference, students' satisfaction with the flipped classroom teaching method and the traditional method was higher. The average of self-regulation learning strategies in the flipped classroom and traditional method group was higher than the flipped classroom and conceptual map method group, and the previous comparison and then the mean of self-regulation learning strategies in the flipped class group and the traditional method showed a significant difference. It is suggested to conduct research with a larger sample size and in higher semesters

 Respiratory complications are prevalent in coronary artery bypass graft (CABG) surgery. Breathing exercises are efficient and cost-effective techniques to eliminate this problem.

 This study investigated the effect of simultaneous breathing exercises on patients' respiratory condition after CABG surgery.

 In a randomized controlled clinical trial, 52 CABG candidates were allocated to two intervention and control groups. The control group received routine breathing exercises (incentive spirometry and vibration). Besides routine exercises, the intervention group performed exercises such as pursed-lip breathing, diaphragmatic breathing, incentive spirometry, and effective coughing for three days after the surgery. The incidence of atelectasis, oxygen saturation, lung auscultation, and the patients' satisfaction with the respiratory function was measured and recorded before and after the surgery in both groups. The collected data were analyzed in SPSS v. 22 at a significance level of < 0.05.

 The patients' mean age was 60.9 ± 9.5 years, and 26 (51%) were male. There was no significant difference between the patients in underlying parameters. None of the patients in the two groups had atelectasis before the surgery. However, four days after the surgery, 40% of the patients in the control group and 23% of those in the intervention group suffered from atelectasis complications. The visual analog scale (VAS) score increased after surgery in the intervention group, although the difference was insignificant. Moreover, the arterial oxygen saturation percentage and breathing rate increased in the intervention group. No significant difference was observed between the two groups regarding crackles at different hours after surgery, although they were relatively less in the intervention group.

 Breathing exercises, especially combined breathing exercises, improve respiratory function after open heart surgery.

Coronary artery bypass graft (CABG) is associated with death anxiety and endangers the feeling of well-being.

This study was designed to examine the impact of foot reflexology massage on well-being and death anxiety in patients undergoing CABG surgery.

This randomized controlled clinical trial was conducted on 66 patients undergoing CABG hospitalized in Fatemeh Zahra Hospital in Sari, Iran, in 2021. The patients were assigned to control (receiving routine care) and intervention (receiving reflexology massage of the foot sole) groups by permuted-block randomization. Massage therapy was conducted after the surgery for half an hour for each foot during 3 sequential days (from the second to the fourth day after surgery) for patients of the intervention group. A sociodemographic and medical information questionnaire, Templer Death Anxiety Scale, SubjectiveWell-being Scale, and Hospital Anxiety and Depression Scale were completed for the patients. The data were analyzed by descriptive and analytical statistics, including the Mann-Whitney U test, chi-square test, Fisher’s exact test, Friedman’s test, and generalized estimating equations (GEE).

The study results revealed a significant difference in the level of death anxiety of the intervention group (before: 52.57 ± 3.97, second day: 50.07 ± 3.38, 4th day: 36.61 ± 5.25) compared to the control group (before: 51.25 ± 3.06, second day: 49.57 ± 3.83, fourth day: 47.71 ± 3.01) (P < 0.001). Additionally, comparing the well-being mean of the group undergoing reflexology massage of the foot sole (before: 52.57 ± 3.97, second day: 50.07 ± 3.38, fourth day: 36.61 ± 5.25) and the control group (before: 52.57 ± 3.97, second day: 50.07 ± 3.38, fourth day: 36.61 ±5 .25) during the 3 days by GEE showed a significant difference between the two groups (P = 0.001).

According to the findings, reflexology foot massage reduced death anxiety and increased feeling of well-being. Due to low costs, no complications, and ease of performance, this method is recommended to reduce death anxiety and promote wellbeing in patients after CABG.

Background and

Despite so many advances in the treatment of heart failure, the rate of readmission is still relatively high which imposes additional costs on patients and hospitals. Therefore, this study was designed and implemented to determine the causes of rehospitalization of heart failure patients admitted to Fatemeh Zahra Heart Center in Sari during 2022.

In this descriptive study, 309 patients with heart failure, who were admitted at Fatemeh Zahra Heart center for the second time, were selected by available sampling method during 2022. The data collection tool was a questionnaire which included demographic information as well as factors associated with readmission of heart failure patients. The qualitative content validity of the questionnaire was checked and confirmed by five cardiologists. The samples were analyzed using SPSS V21 applying descriptive statistics of relative frequency, absolute frequency, mean, and standard deviation.

Dyspnea was reported in 88% of the patients, and according to the NYHA Class evaluation criteria, the highest level of severity was 2 (in 44% of cases). An increase in chest pain before rehospitalization was also reported in 30% of the patients, and according to the CCS Class evaluation criteria, the highest level of severity was 2 (in 54% of cases) Failure to comply with the rehabilitation program was observed among 74% of patients who had a rehabilitation program. The other main reasons for readmission of heart failure patients in order of priority were failure to comply with medication regimen (28% of patients), palpitation (28%), stressful event (22%), heavy activity (21%), non-adherence to food diet (21%), smoking (7%), infectious disease (4%), discontinuation of medication (4%), and alcohol use (3%).
Conclusion.: Considering that dyspnea was the main reason for rehospitalization of heart failure patients, and non-compliance with the rehabilitation program, non-observance of the drug, and food diet regimen accounted for a high percentage of readmission, it is recommended to emphasize compliance with the rehabilitation program due to its great impact on improving the respiratory condition. Furthermore, it is beneficial to educate patients on adhereing to their diet and medication, using consultations, and following the doctors' recommendations after discharge. This can be effective in preventing rehospitalization of patients and improving the quality of their life.

The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs.

A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention.

There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets.

The findings of the present investigation demonstrate that acupressure has a greater impact on patients’ sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.

Background and

Anxiety and depression are prevalent problems associated with  chronic diseases, such as hemodialysis. It is possible to reduce the psychological problems of hemodialysis patients by detecting the needs of these patients. The present study aimed to determine the relationship between spiritual needs and the levels of anxiety and depression in hemodialysis patients. 

The present study was conducted using descriptive correlational method. The statistical population of this study was comprised of 164 hemodialysis patients who referred to Shahrvand Kidney Diseases Center in Sari. They were included in the study by a convenience sampling method. Data collection tools included demographic information questionnaire, hospital anxiety and depression questionnaire (1983), and Büssing et al. emotional needs questionnaire (2010). Data were analyzed using SPSS V25 applying descriptive statistics of mean and standard deviation. Spearman's correlation coefficient and regression were performed to examine the relationship between variables.

A total of 164 people participated in this study. The mean score of spiritual needs of hemodialysis patients was 27.62±10.85. The results revealed a significant positive relationship between spiritual needs and all its subscales, and anxiety and depression (P<0.05, r=0.721 for anxiety, and r=0.645 for depression). Also, religious and emotional subscales were the best predictive variables for anxiety; and religious and existential subscales were the best predictors of depression.

Based on the observed relationship between spiritual needs, and anxiety and depression in hemodialysis patients, more attention should be paid to these needs and the factors exacerbating the conditions of hemodialysis patients. Also, more studies are required to gain a better understanding of their needs and to find ways to improve their conditions.

This study aimed to determine the effects ofacupressure on the intestinal function of patients undergoing Coronary Artery Bypass Graft (CABG) surgery.

Studies indicated that cardiovascular patients are prone to constipation. Acupressure is one of the therapeutic and palliative approaches that can be used by doctors, nurses, and even patients themselves.

The present three-group randomized clinical trial study was conducted on 90 patientsundergoing CABG surgery. In the intervention group, 48 hours after surgery the patients received acupressure points LI4 and ST25 twice a day (10 am and 6 pm) for three sequential days. In the sham group, the patients received acupressure at a 1.5 cm distance from the LI4-ST25 points, and the patients in the control group received only the usual care. This research used a demographic and medical information questionnaire, Rome IV scale, Bristol stool scale, symptom registration checklist, and daily excretion assessment checklist. The intestinal function indices were completed 24 hours after surgery (before intervention), 48, 72, 96, and 120 hours after surgery.

All three intervention, sham, and control groups were without defecation in 24 hours (before intervention) and 48 hours aftersurgery. There was a significant difference between the three intervention, sham, and control groups in the number of stools after 72 hours, 96 hours, and 120 hours after the intervention (p<0.001). Also, a significant difference was observed among the three groups in terms of stool consistency 96 hours after the start of the intervention (p=0.032) and 120 hours after the start of the intervention (p<0.001).

The results showed that patients had a significant improvement in the number of bowel movements and stool consistency in the intervention group.In acute conditions, acupressure on LI4-ST25 points can positively affect intestinal function when patients are hospitalized in the intensive care unit.

The diagnosis and treatment of cancer is stressful and perceived stress and concerns during the treatment period can add to this stress and affect the recovery of patients with gastrointestinal cancer. The aim of this study was to investigate the relationship between illness perception and coping styles, and perceived stress in patients with gastrointestinal cancer.

The present cross-sectional correlational study was conducted in 110 patients with gastrointestinal cancer in Sari Imam Khomeini Hospital, Iran 2022, selected by convenience sampling. Data were collected using a demographic questionnaire, The Brief Illness Perception Questionnaire (Brief IPQ), Billings and Moos Coping Styles Questionnaire, and Perceived Stress Scale (PSS). Finally, the data were analyzed applying descriptive statistics and Chi-square, independent t-test, Pearson's coefficient correlation, and ANOVA.

Most of the participants were females (50.9%), with a medium income level (59.1%), living in the city (91.8%), suffering from colon cancer (40.9%), and undergoing treatment (90.0%). Findings showed that most of the patients had a high level of perceived stress (57.3%), moderate levels of illness perception (71.8%), and moderate coping styles (71.8%). We observed an inverse relationship between perceived stress and illness perception (P<0.001, r=-0.604), but there were no significant relationships between perceived stress and coping styles (P=0.064, r=-0.177) and other demographic variables.

Considering the inverse relationship between illness perception and perceived stress, healthcare managers are suggested to take measures to improve the illness perception of patients with gastrointestinal cancer.

 A patient experiences high pain and anxiety during laceration healing. One of the non-pharmacological methods of pain and anxiety relief is using music.

 This study was outlined to examine the impact of music therapy on the pain and anxiety levels of patients experiencing wound healing by suturing in the emergency wards.

 The study population for this randomized controlled clinical trial was all patients aged 18 - 65 years who were referred to the Emergency Ward of Imam Khomeini and Buali Sina hospitals, Sari, Iran, to suture the hand or foot. Thirty people were included from each group in the study. In the intervention group, traditional Iranian wordless music (Peyk Sahar track) was played with headphones from when the patient was placed on the bed for suturing to the end, and the duration was recorded. In the control group, sutures were made according to the usual procedure. The pain level was measured by a visual analog scale in two stages before washing and immediately after the anesthetic injection. Moreover, the anxiety level was assessed in three steps, before washing the wound, after the end of the anesthetic injection, and immediately after suturing. Data were analyzed by the SPSS software version 22. Descriptive statistics, including mean and standard deviation, and inferential statistics, such as Exact Fisher’s test, Mann-Whitney test, and Wilcoxon, were used to describe and analyze the variables.

 The mean pain before washing the wound (before music therapy) and after the end of the anesthetic injection was not significantly different between the intervention group (5.38 ± 1.31 and 3.71 ± 1.98, respectively) and the control group (5.31 ± 1.69 and 4.60 ± 2.31, respectively) (P = 0.27 and 0.057, respectively). The mean anxiety before washing the wound, after the end of anesthesia injection, and immediately after finishing the suture was 3.37 ± 0.89, 2.73 ± 1.23, and 1.27 ± 0.52in the intervention group, and 3.50 ± 0.97, 3.07 ± 1.33, and 2.07 ± 1.14 in the control group, respectively. The mean anxiety at all three times was significantly different between the two groups (P < 0.001).

 The study results indicated that music therapy lowered pain without a statistically significant difference. However, music therapy significantly reduced anxiety. Therefore, it is recommended to use music therapy to reduce pain and anxiety in patients.

Distraction is a technique that has had positive effects on reducing children’s pain in painful interventions, such as venipuncture, and replacing the burn dressing. Based on the available data, very few articles exist about the application of this technique when suturing children. 

This study was designed to determine the effect of distraction by watching cartoons on the level of pain during preparation before suturing children in the emergency ward.

This study is a randomized controlled trial. The research population included all children aged 3-12 years who were referred to the emergency ward of Bu Ali Sina Hospital in Sari City, Iran. Forty-three subjects were selected from each group. In the intervention group, playing cartoons on the tablet was initiated from the time of placing the child on the bed for suturing, and continued until the end of the anesthetic injection, and this time was recorded. In the control group, the suturing was performed conventionally. The behavioral reactions of both groups were measured twice based on the pain behavioral reactions scale. The first time was when the child was placed on the bed and before cleaning for the anesthetic agent, while the second time was observed and recorded by the researcher immediately after injecting the anesthetic agent.

The comparison of mean pain before injecting the anesthetic agent (after playing the cartoon) showed a significant difference between the intervention and control groups based on Mann-Whitney test (P=0.0001). The comparison of mean pain immediately after termination of anesthetic injection also showed a significant difference in both the intervention and control groups based on the Mann-Whitney test (P=0.0001). Based on the results of the present research, the pain in the intervention group was less before the anesthetic injection and less in the control group immediately after the injection.

The results suggested that distraction from watching cartoons has a positive effect on reducing the pain of preparation before suturing children. Therefore, this technique can be used in emergency departments.

Cardiac patients are prone to experiencing constipation. The main purpose of the present study was to assess the effect of acupressure on preventing constipation in patients with acute myocardial infarction (AMI) under primary percutaneous coronary intervention.

The present randomized clinical trial was conducted on 90 patients with AMI (30 patients in each group) who were randomly allocated based on inclusion criteria. The intervention was carried out among the patients with AMI on the acupressure points SJ6, LI4, ST25, and SP6 two times a day (10 am and 6 pm) for three sequential days.

On the first and second days of the study, all of the patients had no defecation, and the first defecation occurred on the third day of the study. In the intervention, sham, and control groups, 93.3%, 46.7%, and 50.0% had normal defecation on the third day of the study, respectively. The results of the Chi-square test revealed significant differences among the three groups (P < 0.001).

The results of the present study showed that patients with AMI in the intervention group had significant improvement in terms of stool consistency based on the Bristol stool scale. So, acupressure can be used as a nursing intervention in critical care units.

Learners prefer to use a system for learning that improves their interaction; therefore, self-regulated learning is important. The present study aimed to determine online self-regulated learning (OSRL) and its related factors among medical science students during the COVID-19 pandemic, 2021.

This cross-sectional study was conducted on 249 students affiliated with Mazandaran University of Medical Sciences, Mazandaran, Iran, using a non-randomized quota sampling method. The required data were collected using a demographic form, an Online Self-Regulated Learning Questionnaire, and a researcher-made questionnaire of related factors of OSRL based on a literature review. The data were analyzed using descriptive and inferential statistical methods, such as ANOVA, t-test, Pearson, and multivariate linear regression using the Enter method.

The mean of the total score of self-regulated learning was 80.2±15.5 and in a good range. Among the related factors, students' gender (β=-0.239), marital status (β=-0.210), age (β=0.195), and time management (β=-0.125) explored 16.5% of the variance OSRL. The other variables had no significant relationship with OSRL.

In the present study, marital status, gender, age, and time management significantly correlated with the variance of OSRL. Different studies are necessary to investigate the variables that explore OSRL so that educational managers can provide a better virtual learning environment for students by considering these variables.

Complaints of low back pain and fatigue caused by prolonged lying on the back are complications of angioplasty. The aim of this study was to evaluate the effect of acupressure on severity of low back pain and fatigue in patients after coronary artery angioplasty through femoral artery.

A simple randomized controlled clinical trial was carried out in three groups of patients (n= 75); experimental group, pseudo-intervention group, and control group. The study was performed in Sari Fatemeh Al-Zahra Hospital affiliated with Mazandaran University Medical Sciences, 2021. In experimental group, acupressure was applied to four points, including ST36, GV26, SI3, and BL60, each for two minutes, at two, four, six, and eight hours after angioplasty. In pseudo-intervention group, all measures performed in the experimental group were done without putting pressure. The control group received no intervention. The severity of low back pain was measured using Visual Analogue Scale and the severity of fatigue was measured using Visual Analog Fatigue Scale before and after the intervention. Data were analyzed applying descriptive and inferential statistics.

Severity of back pain significantly decreased in experimental group after four hours (P=0.001), six hours (P<0.001), and eight hours (P=0.01) following angioplasty compared with other groups. Also, in this group, severity of fatigue significantly decreased after four hours (P<0.001) and six hours (P<0.001) following angioplasty when compared to other two groups.

Acupressure was effective in reducing the severity of low back pain and fatigue in patients undergoing angioplasty. Therefore, this method can be introduced as an easy, non-invasive and helpful method in reducing the severity of low back pain and fatigue in these patients.

Context:

 Self-regulated learning is a process by which learners choose goals for themselves and then try to regulate, control and manage their cognition, motivation, and behavior. The COVID-19 pandemic faced students to numerous educational challenges. Rapid transition of the traditional classroom to the virtual environment affected E-learning acceptance of the students in the age of the COVID-19 pandemic.

The present study aimed to determine the relationship between online self-regulated learning and E-learning acceptance among Mazandaran University of medical sciences during the COVID-19 pandemic.

Settings and Design: 

This descriptive-analytical study was conducted on 234 Mazandaran University of medical sciences students.

The nonprobability quota sampling method was used for data collection. Inclusion criterion was experience E-learning at least one semester in the age of COVID-19 pandemic. Internship medical sciences students were excluded. The online questionnaire consisted of three parts: Sociodemographic questionnaire, online self-regulated learning and E-learning acceptance. Statistical Analysis Used: Descriptive statistics, one-way ANOVA, Pearson test, and univariate and multivariate linear regression model were utilized.

According to the univariate linear regression model, E-learning acceptance explored 19.8% variance of the online self-regulated learning. The multivariate linear regression showed age, gender, marital status, medical students, another job and E-learning acceptance explored 47.1% variance of the online self-regulated learning.

The results showed that E-learning acceptance was correlated with online self-regulated learning. The faculty members and university managers can use strategies to enhance the E-learning acceptance to improve online self-regulated learning and facilitate barriers in the age of mandatory online learning