مجله سلامت جامعه
سال سیزدهم شماره 4 (زمستان 1398)

Elderly women with cardiovascular disease have major problems in psychological health. One of the intervention methods for reducing psychological issues is acceptance and commitment therapy. As a result, the present research aimed to determine the effect of acceptance and commitment-based group therapy on existential anxiety, distress tolerance, and meta-worry in elderly women with cardiovascular disease.

This study was a semi-experimental pre-test/post-test design with a control group. From the elderly women with cardiovascular disease referred to Mehr hospital of Ahvaz city in 2018, 40 people were selected by the available method and then randomly divided into two groups. The experimental group was trained 10 sessions of 60 minutes with group therapy based on acceptance and commitment method. Data were collected by questionnaires of existential anxiety, distress tolerance, and meta-worry; then, they were analyzed by t-tests and multivariate analysis of covariance.

In the pre-test, there was no significant difference in existential anxiety, distress tolerance, and meta-worry (p>0/05); however, in the post-test, there was a significant difference in the three variables (p<0/001). In other words, the group therapy based on acceptance and commitment method led to decrease existential anxiety plus meta-worry and increase distress tolerance in elderly women with cardiovascular disease (p<0/001).

The results indicated that acceptance and commitment-based group therapy decreased existential anxiety plus meta-worry and increased distress tolerance. Therefore, clinical psychologists and therapists perhaps can use this treatment along with other therapeutic methods for intervention in existential anxiety, distress tolerance, and meta-worry.

Women are more likely to develop anxiety than men, and this strongly affects family functioning. Humor training has been applied to educational and clinical cases and has been found to be effective. However, there is litter research on the use of humor training to improve family functioning in women.Therefore, this study aimed to determine the effectiveness of humor training on anxiety and family functioning in married women.

This study was performed in the form of an educational trial with pre-test, post-test, and the control group. The researchpopulation included all married women referring to health centers in Tehran in 2019. Using simple random sampling, 50 womenwere selected and divided into experimental (25 persons) and control (25 persons) groups and completed the Family Functioning Scale (Bloom, 1985) and the Anxiety Scale (Cattell, 1973). In the experimental group, sense of humor training was performed in 8 sessions, 1 session per week and each session for 1 hour. At the end of the training, the post-test was taken from the participants in the two groups. The data collected from the pre-test and post-testwere analyzed using independent samples t-test, paired samples t-test, and multivariate analysis of covariance (MANCOVA).

The results showed that the training of sense of humor had a positive and significant effect on reducing total anxiety and its dimensions including morbid anxiety and hidden anxiety in the experimental group (p<0.05). Also, the training of sense of humor increased the mean scores of family functioning in the intervention group in the post-test phase (p<0.05).

Overall, the findings showed that training a sense of humor is effective in reducing anxiety and improving the family functioning of married women. Therefore, it seems necessary to consider the training of sense of humor in the planning of the prevention of mental health problems and the improvement of the family functioning.

Because MS affects both the body and mind, people with MS need to be treated by both pharmacological and psychological interventions. Psychological interventions involve using a variety of counseling and psychotherapy approaches, including mindfulness-based therapy and short-term solution-focused therapy. The purpose of this study was to compare the efficacy of mindfulness-based therapy and short-term solution-focused therapy on sense of coherence in MS patients.

This study used a quasi-experimental method with pre-test, post-test, follow up, and the control group. The population under study consisted of all women with MS in Tabriz who were members of MS Society in Tabriz in 2019. In total, 30 women were selected by purposive sampling as the participants and randomly divided into three groups; the mindfulness-based therapy, short-term solution-focused therapy, and control the group. The participants in the three groups were tested by Flensberg Sense of Coherence Questionnaire before, after, and four months after the treatment. The members of both experimental groups received their own treatment respectively in 8 and 7 sessions each lasting 1.5 hours. The collected data were analyzed by repeated measures ANOVA and Bonferroni post hoc test.

The mean scores of sense of coherence for the mindfulness-based treatment group, the short-term solution-focused treatment group, and the control group on the posttest were 50.10±3.72, 49.60±3.66, and 49.20±3.36, respectively. The results showed that the mindfulness-based therapy (55.20±3.52) and short-term solution-focused therapy (55.50±2.98) compared to the control group (48.80±3.58) increased the sense of coherence in MS patients on the posttest (p=0.001). Besides, the effect of mindfulness-based therapy (50.40±3.40) and short-term solution-focused therapy (55.10±3.10) on the sense of coherence (16.90±3.77) persisted in the follow-up phase (p <0.001). It was also shown that the mindfulness-based therapy and short-term solution-based therapy did not show any significant differences in terms of their effects on the feeling of cohesion at posttest and follow-up phases (p <0.05).

It was found that the mindfulness-based therapy, and the slow discovery of exceptions in the life of the MS patients in short-term solution-focused therapy reduced the patients' stress and thus enabling them to better cope with their illness, This in turn increased the sense of coherence in patients with MS. Based on the findings of this study, it can be concluded that mindfulness-based therapy and short-term solution-focused therapy increased the sense of coherence of MS patients.

  Diabetes is one of the most common diseases in the world. On the other hand, stress, anxiety, and depression are exacerbated by diabetes. Given psychological complications of diabetes, together with the education importance concerning the tactics to cope with, the present study aims to determine the effect of psychological training with progressive muscle relaxation on stress, anxiety, and depression in Diabetes Type 2 patients.   In this study, the educational trial control group included 60 patients with Diabetes Type 2 who were affiliated with the Diabetes Clinic of Rafsanjan University of Medical Sciences. They were selected based on systematic random sampling from the records in the clinic and then divided randomly into two groups of intervention and control (30 in each). For the former, 12 sessions of psychological training with a progressive muscle relaxation technique were held, two sessions each weeks, and no intervention was performed for the latter. Data were collected using demographic (disease information) and DASS21 questionnaires. Data were analysed using Chi-square, Fisher's, Independent t-test, and Two-way ANOVA with Repeated Measurements before, immediately after, and three months follow-up. Results showed that there was a significant difference between the mean scores of stress, anxiety, and depression before, immediately after, and three months follow-up in the experimental group (p<0.050); however, no significant difference was found in the control group (p>0.050).   Psychological training intervention with a progressive muscle relaxation technique can improve depression, anxiety, and stress. Thus, the results of the study provide empirical support for the treatment in order to improve anxiety, depression, and stress.

Failure to resolve children's problems in restructured families can dramatically increase anxiety disorders in these children and have a lasting impact on the child's life. The present study aims to investigate the effectiveness of cognitive-behavioral therapy on children’s anxiety in restructured families.

This research was of a quasi-experimental (pre-test, post-test, and follow-up with the control group). The sample size consisted of 20 children in Shahreza city in 2019, who were selected using purposeful sampling among eligible children; they were randomly assigned into two groups of experimental (10 children) and control (10 children). The children in the experimental group received cognitive-behavioral therapy for children of 7 to 14 years old according to the instruction of Seiler (2008), which was held in 10 sessions of 45 to 60 minutes. The Achenbach questionnaire (parental form) was used to collect data. The data were reported in two descriptive and inferential sections. Mean and standard deviation were used in the descriptive part, and repeated measures analysis of variance was used in the inferential section.

The results showed that the mean score of anxiety in children in the experimental group was significantly different from the control, and the cognitive-behavioral intervention was effective (p=0/001).

Based on the results of this study, cognitive-behavioral therapy can be used to reduce children's anxiety in restructured families. Therefore, therapists are advised to use it in the treatment of anxiety disorders among children in structured families.

Ventilator-associated pneumonia (VAP) is considered a severe infectious disease in Intensive Care Units (ICUs). It seems that the teaching of nurses staff may improve the quality of care and reduce the VAP rate. This study is performed to determine the effect of education on VAP and nurses' performance in Rafsanjan ICUs.

The semi-experimental study was conducted on 62 intensive care nurses, who were selected through convenience sampling and inclusion criteria. VAP rate and nurses' performance were measured three months prior to intervention. Then, the necessary education about the methods of preventing such VAP took place. After three months, nurses' performance and VAP rates were measured again. Data were analyzed by SPSS software (V.18).

The results showed that the VAP rate changes before(97.8%) and after the intervention (89.2%)were not statistically significant(p=1.000).Nurses' performance on hand washing, suctioning, patient position change, scrubs wearing, mouthwash, and intubation improved after training and had a statistically significant difference  (p<0/05).

The study indicated that nurses' education on the prevention of infection and VAP could be effective although this intervention had only clinical impact.

The early years of life are important for the multi-dimensional transformation of children and the foundation shaping of life. There are many tactics to reduce impulsive behaviors and increase self-efficacy in students. Child-centered play therapy is one of the most effective approaches in this context. The present study aims to determine the effectiveness of child-centered play therapy on impulsive behaviors and self-efficacy of third-grade female students.

 A quasi-experimental design, with a pre-test and post-test with the control group, was used in this applied research. The statistical population of the study included all 9-years-old female students of Ramsar elementary schools in the academic year of 2017-2018. 24 persons were selected by convenience sampling method from two schools in Ramsar city, according to conditions of the study; then, they were randomly divided into experimental and control groups (12 persons in each group). The groups completed Wheeler & Ladd Children Self-Efficacy Scale (1982) and Hirschfield Impulsivity Scale (1965)in pre-test and post-test stages. During8 sessions of 45minutes, child-centered play therapy was performed for the experimental group individually, while the control group did not receive any intervention. MANCOVA was used to analyze the data.

 The results of MANCOVA showed that child-centered play therapy increased self-efficacy in subscales with conflict, without conflict, and total scale (F=165.60,p=0.001,Eta=0.865). Furthermore, the effectiveness of child-centered play therapy on reducing impulsive behaviors was confirmed (F=1380.15, p=0.001,Eta=0.891).

 Based on the results, child-centered play therapy as an effective treatment to decrease impulsive behaviors and increase self-efficacy in third-grade female students is recommended.

 The World Health Organization (WHO) has selected reducing the prevalence of sedentary behavior as its top priority by 2025. One of the holistic models of lifestyle modification is Pender's Health Promotion Model. The purpose of this study is to determine the effective components to perform and maintain physical activity in middle-aged women.

 This was a cross-sectional study of the variance-covariance matrix. The data were collected from health centers in the west of Ahvaz on different days in 2018 based on a structural equation modeling approach. This data included demographic characteristics, commitment to do and maintain physical activity, social support, perceived barriers, self-efficacy, and perceived enjoyment. The average variance extracted index (AVE) and Fornell-Larker criterion were used to assess convergent and divergent validity, and Cronbach's alpha coefficients and composite reliability were used to assess internal consistency. 

 The mean and standard deviation of the age was 38/22 ± 6/72 years. Controllable barriers had the highest (0.265) and uncontrollable barriers the least (0.152) effect on the commitment to do and maintain physical activity. Also, composite reliability coefficients of controllable (0.75) and uncontrollable (0.79) barriers were found to be favorable.

 The proposed model had a sufficient fit to determine the main components' commitment to do and maintain physical activity in middle-aged women. It is recommended to pay particular attention to the role of controllable and uncontrollable barriers along with the perceived pleasure in commitment to do and maintain physical activity in middle-aged women.