Journal of Multidisciplinary Care
Volume:8 Issue: 2, 2019

Premenstrual syndrome (PMS) is defined as a set of physical and psychological symptoms occurring during the luteal phase of the menstrual cycle. This study aimed to compare the effectiveness of group cognitive behavioral therapy and group cognitive hypnotism on decreased depression among female students with PMS.

This clinical trial was conducted on female students of Rasht, Iran in 2017. In total, 30 students with PMS were selected by random sampling and randomly divided into three groups, including two experimental groups and one control group. While eight sessions of cognitive behavioral therapy and hypnosis cognitive therapy were held for the first and second groups, respectively, the third group received no treatment. Data were collected using an eight-item researcher-made PMS questionnaire and Beck Depression Inventory in two pretest and posttest stages. In addition, data analysis was carried out using the covariance analysis and Lamtriks post hoc.

In this study, both therapy methods were effective in reducing depression among women with PMS (P<0/001). However, hypnosis had a greater impact on PMS, compared to the other method, showing a significant difference in this regard (P=0.002).

According to the results of the study, the psychological therapies affected PMS among the subjects. It is recommended that these methods be applied more than pharmaceutical methods due to their fewer complications.

Midwifery care has a dramatic effect on reducing maternal and infant mortality, as women's increased access to quality midwifery services has become a global effort. Considering that the health and progress of each society are largely based on women's health, the aim of this study was to determine the quality of midwifery care from the viewpoint of service recipients using the SERVQUAL model in Sanandaj comprehensive health centers in 2017.

In this descriptive-analytical study, 1920 women who were referred to comprehensive health centers in Sanandaj were studied for midwifery care. The sampling method was multi-stage. For data collection, the SERVQUAL questionnaire was used. Data were analyzed by SPSS-23 software using descriptive statistics, paired and independent t tests and ANOVA.

In all aspects of the quality of service provided there was a negative gap. The highest gap in the reliability dimension(69/1-) and the lowest gap in the responsiveness dimension  (58/1-) were obtained. There was also a significant relationship between quality gap and age (P=0/001), education level (P=0/001)  and occupation (P=0/003).
Conclusio: In all aspects of quality, the level of customer expectations was higher than their perceptions. It is recommended to pay attention to the comments and complaints of clients, while providing access to staff in case of need, to provide services at all office hours, and to use modern equipment .

The effects of general anesthesia and seizure caused by electroconvulsive therapy increase the risk of cardiovascular changes. This study aimed to evaluate the effect of reflexology on physiological indices after electroconvulsive therapy.

This clinical trial was performed on 56 patients with depression, who were selected by stratified random sampling after an electroconvulsive therapy and randomly allocated to the intervention and control groups. Data were collected using a demographic characteristics questionnaire and a vital sign record form and its tools. In the intervention group, vital signs were recorded after electroconvulsive therapy and patients’ vigilance, followed by performing a 20-minute reflexology session at reflex points. The vital signs were measured 10 minutes after the intervention and compared to vital signs immediately after vigilance and with the control group one hour later. In addition, data analysis was performed in SPSS version 24 using the Mann-Whitney U and Wilcoxon test.

In this study, the mean and standard deviation of blood pressure in the control and intervention groups were estimated at 111.60 ±11.47 and 114.92±10.54, respectively. Moreover, the results of Mann-Whitney and Wilcoxon test were indicative of a significant intra and intergroup difference between the control and intervention groups in terms of the mean and standard deviation of patients’ blood pressure. After the intervention, the mean and standard deviation of pulse in the control and intervention groups were reported to be 83.35±4.83 and 78.64±5.07, respectively. According to the results, there was an intra and intergroup difference between the control and intervention groups in terms of the mean and standard deviation of patients’ blood pressure.

According to the results of the study, reflexology affected the rapid improvement of physiological indices after ECT in depressed patients and caused relaxation and balance of physiological indices in these patients. Therefore, nurses can use this method as a branch of complementary medicine to be effective in balancing the physiological indices of patients.
Keywords: Depression, Electrotherapy, Physiological Indices, Reflexology

Developing countries such as Iran experience a growing phenomenon of aging, and the elderlies are at a risk of longer hospital stay. The increasing number of elderly patients necessitates the establishment of age-friendly hospitals. This study aimed to determine the factors affecting the development of age-friendly hospitals in Iran using factor analysis.

This descriptive, analytic and cross-sectional study was performed during three months in 2018. The statistical population included physicians, nurses, and paramedical staff  of hospitals from across the country. In total, 408 subject were selected by cluster sampling. Data were collected using a demographic characteristics questionnaire (seven items) and the researcher-made age-friendly hospital questionnaire (57 items). In addition, data analysis was performed in SPSS version 22, and the exploratory factor analysis was confirmed by AMOS.

The exploratory analysis identified seven main components, including ethics in care (eight variables and variance 8.84%), physical environment (nine variables and variance 7.75%), care process (six variables and variance 7.69%), emotional and behavioral environment (six variables and variance 7.38%), organizational support (six variables and variance 7.33%), healthcare systems (six variables and variance 5.99), and policy-making (six variables and variance 5.56%). All the seven factors explained 50.56% of total variance.

According to the results of the study, attention to factors including ethics in care, physical environment, care process, emotional and behavioral environment, organizational support, healthcare systems, and policy-making factors can lead to the development of age-friendly hospitals in Iran.

Managers are always learning to make critical decisions, and learning organizations emphasize continuous learning to survive in the current competitive environment. This study aimed to evaluate the relationship between assertiveness and decision making styles and organizational learning of health managers of Shahrekord University of Medical Sciences.

This descriptive, analytical, and correlational study was performed on 200 health managers of Shahrekord University of Medical Sciences selected by census sampling. Data were collected using three standard questionnaires of Scott and Bruce decision making style (1995), Gambler and Richie's standard assertiveness questionnaire (1957), and Niefe's standard learning questionnaire (2001). Data analysis was performed on SPSS version 16 using descriptive statistics, the Pearson’s correlation coefficient, independent t-test, Kolmogorov-Smirnov test, one-way ANOVA and regression analysis.

The mean score of assertiveness (88.24±14.5), decision making style (45.70±9.6), and learning (43.51±7.53) were at an average level. There was a relationship between the mean score of assertiveness with decision making styles and organizational learning (P<0.05). Morevoer, there is an association between the mean score of decision-making styles and organizational decision making, and decision-making styles could predict organizational learning (P<0.05). Furthremore, a relationship was observed between the mean score of assertiveness and organizational learning, and assertiveness could predict organizational learning (P<0.05). Finally, the results were indicative of a relationship between the mean score of assertiveness, decision making styles and organizational learning with some demographic variables (age, gender, type of contract, level of education, and occupational status) (P<0.05).

According to the results of the study, the level of organizational learning of health managers at Shahrekord University of Medical Sciences was related to their assertiveness. Therefore, effective steps could be taken toward the improvement of organizational decisios by familiarizing managers with different decision making styles

Feeling of low self-efficacy in management of pain and fear of disease progression are some of the problems that necessitates the need for psychological services for people with migraine headaches. Therefore, this study aimed to determine the effect of metacognitive therapy on the self-efficacy of pain and fear of disease progression in nurses with migraine headaches.

This quasi-experimental research had a pretest-posttest design and a control group and was carried out all nurses with migraine in Tabriz, Iran during 2018-2019. In total, 30 individuals who were diagnosed with the disease based on ICHD-3 criteria and by receiving a score higher than standard deviation in the migraine headache symptom questionnaire were selected by purposive sampling and randomly assigned to experimental and control groups of 15 participants. The groups completed the pain self-efficacy questionnaire by Nicholas (1989) and fear of progression questionnaire by Herschbach (2011) as a pre-test and post-test. Group metacognitive therapy was performed in 10 sessions of 60 minutes (two sessions weekly for five weeks) in the experimental group while the control group received no intervention. Data analysis was performed in SPSS version 23 using multivariate and univariate covariance analysis.

According to the results of covariance analysis, the metacognitive therapy had a significant effect on the increase of self-efficacy of pain and reduce of fear of disease progression in nurses with migraine headaches.

Considering that metacognitive therapy was effective in increasing the self-efficacy of pain and reducing the fear of progression in nurses with migraine headache, it is recommended that this therapeutic approach be considered as an effective interventional method at the hospital level.

The mastectomy increases the chance of body dysmorphic concern and depression among women, which can impair their functioning. This study aimed to compare the effect of narrative therapy and rational emotive behavior therapy on the body dysmorphic concern and depression in women with breast surgery experience.

This quasi-experimental study had a pretest-posttest design and a follow-up. The statistical population included mastectomized women in Tabriz, Iran undergoing radiotherapy, who were selected by available sampling and randomly divided into three experimental and control groups in 2018. Data collection tools were body image concern inventory and Beck’s depression inventory. Members of both experimental groups received treatment in eight sessions of 1.5 hours. Data analysis was performed in SPSS version 24 using repeated measures ANOVA and Bonferroni post hoc test.

The posttest results showed that the score of body dysmorphic concern decreased in the narrative therapy and emotional behavior therapy groups, compared to the control group, and the depression score decreased in the mentioned groups, compared to the control group. In the follow-up, the effect of narrative therapy on the body dysmorphic concern (23.50) and depression (16.60) and the effect of emotional behavior therapy on body dysmorphic concern (49.50) and depression (16.90) was sustainable. However, narrative therapy had a higher impact on body dysmorphic concern, compared to raitonal emotional behavior therapy, in the posttest stage.

Narrative therapy and rational emotive behavior therapy resulted in release from metanarratives and change of irrational beliefs, which led to decreased body dysmorphic concern and depression in women with breast surgery. Therefore, these methods could be used as effective clinical interventions for these patients.

Heart failure is a major growing problem that affects patients, their families, and the social network. The higher the level of social support provided by families, the lower the risk of heart failure progression in individuals. This study aimed to determine the relationship between family social support and disease-related concerns of patients with heart failure.

This descriptive-analytical study was performed on 150 patients selected by census method. A questionnaire containing information of demographic characteristics, family social support, and disease-related concerns of patients was applied to collect the data. In addition, data analysis was carried out in SPSS version 19 after collecting and coding the data.

The mean total score of family social support and disease-related concerns was 228.62±39.34 and 78.32±26.44, respectively. Data analysis showed that all aspects of family social support had a positive and significant relationship with the disease-related concern (P<0.05(. Moreover, the total score of the family social support had a positive and significant correlation with the total score of the disease-related concerns in patients.

The results confirmed the role of family support in improvement of mental health of patients. Therefore, it is suggested that a family-centered and cooperative nursing intervention be designed to involve family members in the care process of patients with heart failure.