نشریه مراقبتهای بالینی
سال دوم شماره 2 (1393)

The Transtheoretical Model is one of themost widely usedmodelsfor the study offruit andvegetable consumption patterns. In this model behavioral changes can be seen in stages. This study aimed to determine the status of cognitive and behavioral processes across stages of change for fruit and vegetable consumption.
This cross-sectional study was conducted with the participation of 600 literate women from the city of Gilan-e Gharb who were selected by random sampling. Data gathering instruments included a questionnaire comprising questions on demographic data, stages of change, and the process of change and a 24-hour recall questionnaire for fruit and vegetables consumption. The validity of the questionnaires was examined by S-CVI and their reliability by test-retest and Alpha Cronbach’s Methods. The data was analyzed by SPSS 19 using the measure of central tendency, T-test, ANOVA, and Chi-Square.
The majority of subjects (89.5%) were in inactive stages of change (Precontemplation, Contemplation, and Preparation) for fruit and vegetable consumption and only 10.5 percent were located in active stages (Action and Maintenance). The average of daily consumption of fruits and vegetableswas 3.4 ± 0.96 servings, which was lowest in Precontemplators and trended upwards until the Maintenance stage (p Discussion and Differences of processes of change across stages of change decelerate the importance and impact of the processes for fruit and vegetables consumption patterns. We suggest educational programs to increase consumption of fruits and vegetables, specifically considering individuals’ current stages and processes of change.

Dairy products are one of valuable nutrition resources. Fats as one of main components of these products provide 15% to 25% of population total fat intake. Regarding dietary fats relation with health condition and specially their impact on chronic diseases, the objective of this study was to characterize amount of some dairy products fatty acids content. Seven products including sterilized and pasteurized milk, butter, ice cream, yogurt and cheese were selected. Three samples obtained randomly.Sample was 162 number. Folch method applied for fatty acids extraction and Gas Chromatography used for determination of fatty acids methylated with AOCS method. Highest percentage of saturated and unsaturated fatty acid in dairy products was palmitic acid and linoleic acid. Average percentage of saturated fatty acids 71.8% unsaturated fatty acids 22.1% . Highest mean percentage SFA was for Milk (98/5 ± 93/75), Animal butter (64/4 ± 8/75) and lowest was for margarine (6/3 ± 5/37). The highest and lowest levels of unsaturated fatty acids were reported for margarine (37/4 ± 9/60) and milk (6/6 ± 9/13). The highest proportion of unsaturated to saturated fatty acids was in margarine (51/5 ± 5/54) and the lowest proportion for milk (1/0 ± 1/10).
Discussion and In this study fatty acid had distance standards. All unsaturated fatty acids, except oleic acid, were lower than the standard range.

Background and Psychological factors affect the etiology and prognosis of coronary heart disease. Therefore, this study was conducted to comparatively investigate anger, anxiety, and depression among cardiac rehabilitation patients with and without marital stress. This study has a causal-comparison design. The study population included all cardiac rehabilitation patients in the Kermanshah Imam Ali (AS) hospital in the years 2010–2013; among them, 322 patients were selected and were divided into two groups (166 participants per group) with regard to their marital stress score as a form of matching. Data was collected using the Beck Anxiety Inventory (BAI), the Hudson Marital Stress Index, and the Buss–Perry Aggression Questionnaire. Finally, SPSS version 19 was used to analyze the data using methods of MANOVA, Bonferroni correction, Chi square test, and T test. The data showed significant differences between cardiac rehabilitation patients with and without marital stress in terms of anger, anxiety, and depression variables. That is, the levels of anger, anxiety, and depression are significantly higher in patients with marital stress as compared to patients without marital stress. Subsequently, marital stress likely has an effect on the worsening of psychological symptoms and therapeutic outcomes for patients in cardiac rehabilitation. Therefore, it is recommended that health psychologists pay special attention to the role of the marital stress variable in this group of patients.

Equity accessibility people are one of the services in family physician, and could provide people needs at health system. The present study aimed is to demonstrate stakeholder's views at educated knowledge of coordination with their professional duties list. This study was cross - sectional study. Population was student's midwifery in the third and final year, medical student's midwives and physicians and midwives in community health centers, public in Shahrood city. Questionnaire was two sectors, the first was regard participants demographic and the seconds was three segments in descriptive duties include professional scope, science learning, and skill during midwifery study. Based on five Likert measured after filling and gathering data, they were analyzed by software SPSS. Mean and standard deviation scores were computation. The majority of subjects (89.5%) were in inactive stages of change (Precontemplation, Contemplation, and Preparation) for fruit and vegetable consumption and only 10.5 percent were located in active stages (Action and Maintenance). The average of daily consumption of fruits and vegetableswas 3.4 ± 0.96 servings, which was lowest in Precontemplators and trended upwards until the Maintenance stage (p Discussion and The Midwifery and Physician students and their practitioners were agreeing at educated knowledge of coordination with their professional duties list at technical responsible issue, but no significant difference between them. All of the people at two groups were contrary or any point view at drug aid of district. The results revealed no significant difference at mean score of viewpoint's providers. It is needed to revise at Midwifery and Medicine courses as a family physician program in midwifery and medical course to with the best planning and policy-making be performed the highest efficiency of this important program.

The purpose of this study is to assess the impact of job stress and work locus of control on Tehran emergency first responders’ mental health. The sample in question included 160 members of Tehran emergency first responders who were selected through a multi-stage cluster sampling method. To collect data, three questionnaires were used including the following: the self-reported job stress questionnaire (Martinssuen, 2001), the Spector work locus of control questionnaire (1988), and the Goldberg general health questionnaire (1972). The results showed that there is a significant negative relationship between job stress and mental health. In addition, there are significant positive and negative correlation relationships between internal and external locus of control and mental health, respectively.Furthermore, stepwise multivariate regression analysis showed that the subscales of demands, colleagues, external locus of control, and supervisors could comprise an estimated 48% of variance in mental health.
Discussion and According to the findings of the present study, mental health can be estimated on the basis of the two effective factors of job stress and work locus of control.

Behavioral factors such as substance abuse are those that person has control over them, partly and modifies them to reduce the occurrence risk of coronary heart disease. Therefore, this study was conducted to review of the role of addict in cardiac rehabilitation patients on exacerbation of anxiety, depressive, and marital stress symptoms. This study has a causal-comparison design. The study population included all cardiac rehabilitation patients (male) in the Kermanshah Imam Ali (AS) hospital in the years 2010-2013, that among them were selected 234 patients (117 peoples per group); and were divided into two groups with regard to being positive or negative in drug test and the matching. The data collection was conducted using questionnaires of Beck anxiety and depression, and Hudson marital stress index. Finally, SPSS version 19 was used to analyze the data using method of analysis of variance. The data showed there are significant differences between addicted and non-addicted cardiac rehabilitation patients in terms of anxiety, depression, and marital stress variables. That is, the level of anxiety, depression, and marital stress are significantly higher in addicted patients then non-addicted patients.
Discussion and Addiction not only affects the patient's physiological recovery process, but it has a negative impact on the patient's psychological symptoms. Therefore, it is recommended to pay special attention to the role of addiction variable in this group of patients by health psychologists.

Background and óóAim: Dialysis is a stressful and invasive process which has numerous psychological and social problems that can lead to mental disorders in patients. This study was a quasi-experimental study. The population consisted of all hemodialysis patients admitted to hospital more than 15 years in Imam Reza, of which 42 were selected as sample. Measuring the hospital anxiety and depression scale before and after the intervention and control groups was carried out. The intervention included a progressive muscle relaxation technique. The analysis of demographic data showed that the average age was 53.2 in the experimental group and 53.1 in the control group and there was no significant difference between the two groups (p =0.978). In terms of other factors including gender (p =1), marital status (p =0.419) jobs (p =0,170) education (p =0.828), cause of failure (p =0.406), history (p =0.536), transplant (p =0.082), the list of transplant (p =0.082), the number of transplant (p =0.510), transplant period (p =0.989), number of dialysis per week (p =0.077). There was no significant difference between the two groups. There was significant differences between two groups in average of dialysis hours which was further in experimental group (p =0.002). There was significant difference between two groups in anxiety number average. (p =0.000), there was no significant difference between depression number average in two groups (p =0.474).
Discussion and Due to the positive effect of muscle relaxation techniques to reduce and control anxiety and depression in hemodialysis patients, teaching this techniques recommended in patients undergoing hemodialysis.