International Journal of Community Based Nursing and Midwifery
Volume:7 Issue: 3, Jul 2019

This study aimed to analyze the effect of the Orientation Program based on Activitiesof Daily Living on depression, anxiety, and stress in the elderly. This is an experimental study on 65 elderly individuals living in 5 nursing homes inTehran in 2017 for 6 months (May to October). Samples were selected using non-random availablesampling methods and randomly assigned to intervention and control groups. Demographicinformation questionnaire and 21-item version of the Depression Anxiety Stress Scale (DASS- 21)were used. The elderly in the intervention group were subjected to the Orientation Program based onActivities of Daily Living for 6 one-hour sessions for 1 month. DASS- 21 was measured before theintervention, one month and two months after the intervention. Data were analyzed using SPSS V.24 and Independent T-test, Mann-Whitney, Chi-Square and repeated measure ANOVA tests with asignificance level of P<0.05. The results showed differences between the two groups regarding depression, anxiety, andstress one month after the intervention (P=0.003, P=0.005 and P<001, respectively). One month afterthe intervention, the mean scores of depression, anxiety, and stress in the intervention group decreasedto 8±4.54, 4.5±3.09 and 7.53±5.42, respectively, and two months after the intervention, they decreasedto 8.25±4.44, 4.71±3.05 and 8.21±5.71, respectively. According to the results, the Orientation Program based on Activities of Daily Living iseffective on depression, anxiety, and stress in the elderly. Considering the instability of the interventionon the depression variable, further studies and long-term interventions are recommended.

The postpartum health care program in Iran is limited to the first six weeks of deliveryand only focuses on women’s physical problems. It seems that the issue of emotional recovery isunderestimated in postnatal women with prenatal injuries. This study was designed to explore women’sexperiences of emotional recovery from childbirth-related perineal trauma. This qualitative content analysis was performed on 22 postnatal women with perineal traumaduring labor at Omol-banin Hospital from the 20th of April to 25th of December in Mashhad, Iran in2016. The participants were purposively selected between 10 days to one year after childbirth. Datawere collected through semi-structured interviews and saturated after 26 interviews. The analysisof data was concurrently carried out using conventional content analysis adopted by Elo and Kyngas(2008). The MAXQDA software (Ver.10) was used for data organization. Emotional recovery after birth trauma is defined as going on a journey from negative emotionsto subjective well-being. Two super-ordinate generic categories emerged from the analysis: 1) feelingtrapped in multifaceted issues, and 2) regaining possession of life. The participants encounterednumerous concerns initially and with the help of family and community support, they regained theability to dominate life and develop a pleasant mood. Improving physical functions had an essentialrole in regaining emotional well-being and enjoying daily life. The results of this study promoted our understanding of the emotional recovery in womenwith childbirth-related perineal trauma. This helps the caregivers to understand woman’s emotionalconcerns and needs in order to offer appropriate counseling services.

Migraine headache is classified as acute or chronic. In recent years, efforts have beenmade to identify the factors that might predispose individuals to develop the chronic-type headache.The present study aimed to draw a comparison between patients with acute and chronic migraine interms of demographic, pain-related, and psychological variables. In addition, we also investigatedfactors affecting headache chronicity in such patients. The present cross-sectional study was conducted during 2017-2018. The target sampleconsisted of 250 patients with acute or chronic migraine who referred to various clinics affiliatedto Shiraz University of Medical Sciences (SUMS), Shiraz, Iran, recruited by convenience sampling.All the participants filled in the questionnaires related to demographic characteristics, pain intensity,disability, depression, emotional intelligence, and anger. The data were analyzed using SPSS software(version 22.0) with t test, Chi-square test, and logistic regression analysis. Pstatistically significant. Patients suffering from chronic migraine experienced higher levels of disability, depression,anger, and had lower levels of emotional intelligence compared to those with acute migraine. Basedon the logistic regression analysis, variables that had a significant effect on headache chronicity werefemale gender (OR=5.81), married status (OR=3.77), patients with lower level of education (OR=0.26),headache duration (OR=1.53), disability (OR=0.28), depression (OR=3.66), and anger (OR=5.04). Variables such as disability, depression, and lack of anger control were among the keyfactors associated with headache chronicity in migraine patients.

Multiple sclerosis (MS) is a chronic nervous system disease with a wide range ofsymptoms that affect the self-care ability of patients in daily activities of life; the patients afflictedwith this disease face with many challenges. This study was conducted to explore the activities of dailyliving (ADL) challenges of these patients. In this conventional content analysis study, fourteen MS patients who were selectedpurposively from Iran MS Society in Jahrom (Iran) participated in 2018. Data were gathered usingsemi-structured and in-depth interviews. A total of 14 interviews were conducted. These data wereanalyzed using MAXQDA 10 Software and the Graneheim and Lundman method. Analysis of data led to extraction of the main theme “fear of ambiguous future of diseases”as the most important daily living challenge in MS patients. This challenges were categorized in fourmain categories: 1) confrontation to physical, emotional, psychological and behavioral changes, 2) fearof becoming crippled, 3) tolerance of financial burden of the disease, and 4) confrontation to culturalsocial wrong beliefs. The results of this study showed that people with MS face a number of ADL challenges.Fear of an ambiguous future leads to problems in ADL of patients. Therefore, considering the ADLchallenges, health care personnel especially nurses, family members and social organizations canimprove ADL and compromise patients with the disease as much as possible by providing conditionsfor application of the self-care activities and their implementation by patients.

In view of the effect of self-efficacy on empowerment of patients and the role of resiliencein the psychological adjustment and physical health of patients, the present study was conducted toexamine the effect of resilience training on the self-efficacy of patients with type 2 diabetes. This double-blinded controlled clinical trial was carried out on 143 diabetic patients inthe diabetes clinic in Shiraz between June 2016 and January 2017. Patients were selected using asimple sampling method and randomly divided into control (n=71) and intervention (n=72) groups.The intervention group received 6 sessions of training workshops on resilience skills. The controlgroup received the routine educational pamphlets. The subjects completed diabetes self-efficacyquestionnaire before, immediately after, and one month after completion of the intervention. Datawere analyzed using SPSS version 16.0. Repeated measure ANOVA, t-test, and Chi-Square tests wereused.  Based on the results of the repeated measures ANOVAs, the overall score of self-efficacywas found to be significantly increased in the intervention group. Compared with the control group,the intervention group reported significantly higher levels of self-efficacy immediately after theintervention (P<0.001) and one month later (P<0.001). Training programs in resilience skills improves the self-efficacy of patients with type2 diabetes. The results of this study support the use of resilience training in diabetics; it providesthe health professionals and policymakers with an increased understanding of how to recognize theresilience skills for the improvement of self-efficacy.

Health literacy (HL) has important implications for health outcomes in heart failure(HF) patients. Studying health literacy requires culturally appropriate and valid instruments. The aimof the study was validation of the Persian version of the heart failure-specific health literacy scale(HF-Specific HL Scale). One hundred patients with heart failure were selected in Qom, Iran in 2017. The ‘forwardbackward’ procedure was applied to translate the questionnaire from English into Persian. Contentvalidity, face validity, construct validity have been employed to validate the prepared scale. Cronbach’salpha coefficients and the test-retest were used to assess the scale reliability. Data were analyzed usingSPSS, version 16, and Smart PLS 3.0 software. Confirmatory factor analysis completely supported the three-factor model of the HL scales.Convergent validity was satisfied in that all factor loadings and the average variance extractedexceeded 0.5. The divergent validity was verified using Fornel and Larcker method. R-square andpath coefficient were higher than 0.43 and 0.65 respectively, indicating the good structural model.Composite reliability and Cronbach’s α coefficient for all of the constructs were over the recommendedthreshold of 0.70, ensuring adequate internal consistency of the scale. The test-retest reliability rangedfrom 0.78-0.90, which indicated a good level of stability. The findings indicated that the Persian HF-specific HL scale is reliable and valid formeasuring health literacy among heart failure patients. Further research is required to measure thesensitivity and specificity of the scale.

Infertility can affect the physical, mental and emotional aspects of a person’s life. Thisstudy aimed to investigate the effect of sexual counseling via social networks on Smartphone in sexualself-concept of infertile women. In a randomized controlled trial, 80 eligible infertile women referred to the fertility centersof Alborz University of Medical Sciences from April to July 2018. They were randomly assignedinto intervention) sexual counseling with routine infertility counseling) and control groups )routineinfertility counseling). Eight counseling sessions via social networks were held for both groups.The Snell’s sexual self-concept questionnaire was completed by participants before and after theintervention. The data were analyzed using SPSS 19 with a significance level of P<0.05. The mean age of women was 30.76±0.72 years and the most infertility duration was morethan 36 months. The results of a repeated measure showed that there were significant differencesin positive self-concept domain between the two groups during the time by comparing the means(120.4±17.9 versus 105.1±16.8). We also found an increasing trend of the scores in positive sexual selfconcept domain (110.6±18.42, 120.1±18.7, 120.4±17.9) (P<0.001) and a decrease in negative sexual selfconcept domain (24.3±7.87, 20.2±7.77, 19.65±6.97) (P<0.001) in intervention group. In the situationalself-concept, there were no difference between the two groups during the time )P=0.06) The results obtained in the present study showed that counseling through social networkswas effective in improving the sexual self-concept in infertile women, thus ameliorating the couples’sexual relations.

The present cross-sectional study aimed to evaluate Attention-deficit hyperactivity disorder (ADHD)symptoms in terms of gender and age. Based on convenience sampling, the data records of 1,184children and adolescents with ADHD were gathered from various Child and Adolescent PsychiatryClinics affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). During 2010-2015, thepatients had been interviewed face-to-face for ADHD diagnosis in accordance with the Diagnosticand Statistical Manual of Mental Disorders 4th Edition (DSM-IV) diagnostic criteria. The collecteddata were re-analyzed using parent-reported ADHD symptoms measured with the DSM-IV clinicalsymptoms checklist. Statistical analysis was performed using SPSS software with the Pearsoncorrelation test, Chi-square test, and t test. PThe mean age of the participants was 9.29±2.55 years, 904 (76.40%) of whom were boys. The mean total score of hyperactivity-impulsivity in girls and boys was 2.63±2.77 and 3.19±8.17, respectively. The mean total score of inattention in girls and boys was 3.40±1.97 and 3.28±2.00, respectively. Ageand gender were not associated with the symptoms of inattentive ADHD. The symptoms associatedwith hyperactivity-impulsivity had a significant association with age (P<0.05). The symptoms with astatistically significant association with gender were frigidity (P=0.001), often running about (P=0.03),and often difficulties with playing or leisure activities (P=0.005). The most common symptoms ofinattentive ADHD in both boys and girls were “inattention to details or making careless mistakes”(47.6% and 54.3%, respectively) and “fails to finish work” (43.0% and 40.1%, respectively).In contrast with the hyperactivity-impulsivity, the severity of inattention was not associated withage. The results of the present study indicated that while the ADHD screening questions for inattentioncould be the same for both genders, they should be different for hyperactivity-impulsivity.