نشریه پژوهش توانبخشی در پرستاری
سال ششم شماره 4 (پیاپی 24، تابستان 1399)

Chronic diseases around the world are rapidly increasing. One of these chronic diseases is stroke. Given the multiplicity of problems in this disease, it needs to be managed and provided with appropriate education and support services to the patient and family to achieve self-management ability to maximize functions, feel good, reduce care burden, and improve quality of life. The purpose of this study was to investigate the effect of a self-management program based on the 5A Model on caregiver burden of family caregivers of stroke patients.

This quasi-experimental study was performed on 64 family caregivers of patients with stroke in Kashan Shahid Beheshti Hospital. Sampling was done by convenience sampling based on inclusion criteria. Data collection tools included demographic characteristics of the patient questionnaire and the primary caregiver and The Zarit Burden questionnaire. The data were analyzed using descriptive and inferential statistics and SPSS-19 software.

Findings showed that the mean age of patients was 69.28±15.57 and the mean age of caregivers was 44.10±10.80. Most of the patients’ main caregivers (62.5%) were their children. There was no statistically significant difference in the mean of caregiver burden between the intervention and control groups in the pre-test (P-value=0.109), while the caregiving burden was significantly decreased in the intervention group and increased in the control group in the post-test (P-value=0.001).

Implementation of a self-management program based on the 5A Model is helpful in reducing the caregiver burden for family caregivers of patients with stroke and can be used as one of the effective methods for empowering them.

Having a disabled child can negative effect on health and quality of life of parents, especially mothers. Therefore, present research aimed to comparison of coping styles, distress tolerance and religious adherence in mothers of children with physical-motor disabled and normal.

In a causal-comparative study among mothers of children with physical-motor disabled and normal of Tehran city in 2018 year, number of 70 people (35 in each group) were selected by available sampling method. The groups responded to the questionnaires of coping styles, distress tolerance and religious adherence. Data were analyzed by multivariate analysis of variance method with using SPSS version 19 software.

The findings showed that there was a significant difference between the groups in terms of coping styles and distress tolerance, but there wasn’t significant difference in terms of religious adherence. In the other words, the rate of distress tolerance and coping styles including problem solving, physical control, attracting social support, emotional control and cognitive evaluation in mothers with physical-motor disabled children was lower that mothers with normal children (P<0.05).

The findings indicated there were lower types of coping styles and distress tolerance in mothers of physical-motor disabled children in compared with mothers of normal children. Therefore, specialists and authorities should design and implement programs to improve the coping styles and distress tolerance of mothers with physical-motor disabled children.

Psychological therapies can play an important role in the improvement of anxiety, depression and stress in patients with asthma. The purpose of this study was to investigate the effectiveness of cognitive-behavioral stress management group therapy in group therapy on anxiety, depression, stress and readmission in asthmatic patients.

In this quasi-experimental study, 38 patients with asthma were selected and randomly assigned to intervention and control groups. DASS-21 questionnaire was used for data collection which was completed at pre-test, post-test and follow-up. Cognitive-behavioral stress management therapy was administered to the intervention group on 10 sessions but no intervention conducted for the control group. Data were analyzed using ANCOVA, one-way ANOVA, t-test, and repeated measures.

The results showed that there was a significant difference between the mean score of depression in the intervention group before (6.42±7.9) and after the intervention (5.05±5.55) (p=0.00). There was also a significant difference between the mean score of depression between the intervention (5.05±5.55) and control groups (13.47±9.49) in first month (p=0.017). There was a significant difference between the mean scores of stress before (10.5±74.97) and after (9.05±5.22) the intervention in the intervention group (p = 0.00). The mean score of anxiety variable after the intervention was significant different between the intervention group (4.53±5.37) and control groups (10.95±7.90) (p=0.01). There was no significant difference in re-admission in the intervention and control groups before and after the intervention.

The results of the present study indicate the effectiveness of cognitive-behavioral stress management therapy in improving anxiety, depression and stress in patients with asthma. Given the high level of anxiety, depression and stress in patients with asthma and the effectiveness of cognitive-behavioral stress management training intervention and the need for serious attention to psychological therapies in this group of patients.

Total-Body Resistance Training (TRX) is a new method for increasing muscle strength and decreasing muscle atrophy and improving balance in the elderly. The purpose of this study was to investigate the effect of 12 weeks of TRX training on static and dynamic balance in elderly men.
 

In this quasi experimental study, 16 elderly men, with age range of (62.06 ± 1.53 years) were selected as sample by availability sampling method; and were randomly placed in two TRX and control groups; each group n=8. Experimental group practiced in a TRX exercise program for 12 weeks; each week 3 sessions with duration of 60 minutes. The collected data were analyzed by paired t-test and analysis of covariance (ANCOVA) at a significant level of P<0.05.
 

The results of paired t-test showed that there is significant difference between pre-test and post-test for static (t= -22.40, p=0.0001) and dynamic (t=13.8, p=0.0001) balance in TRX group. Also the results of ANCOVA test showed that there was significant difference between TRX and control groups in static (F=495.45, P =0.0001) and dynamic balance (F=74.94, P= 0.0001).

It seems that TRX exercises can increase static balance time and decrease dynamic balance time in older men. Probably by using this exercise method, negative physical consequences and consequently treatment costs can be reduced. This method can be useful in the field of elderly nursing.

One of the most common complaints in patients during the pin is removed from the metacarpal bone fracture is pain. Topical warm and cold therapy have effects on the skin, so that it can relieve pain. On the other hand, according to traditional Chinese medicine, the Hoku point is the most important pain point in the body. The aim of this study was to compare the effect of cold and warm stimulation of Hoku point on pain Caused by Removal of External Fixators pin in patients with hand fractures.

This randomized clinical trial study was performed on 109 patients with metacarpal finger fracture with external pin referring to emergency department of Shahid Beheshti Hospital in Kashan at 2019. Patients were divided into three groups through block randomization: Huko point massage with ice, Huko point massage with warm compress and routine care. The Hoku point massage was done for 10 minutes before the pin was removed. Patients' pain severity was measured by McGill pain questionnaire immediately after remove of pin in all three groups. Data were analyzed using Chi-square test and one-way ANOVA.

The mean total pain score in the Huko point stimulation group with warm compress, ice, and routine care was 65/33±1/50, 31/21±5/21 and 42/30±4/93, respectively. The results of one-way ANOVA showed a significant difference in terms of overall pain between the three groups (p<0.001).Post hoc test showed that the mean score of all pain and its dimensions were significantly lower in the cold-stimulated Hoku point group than in the other two groups and in the Hoku-stimulated point-warm group significantly lower than the control group ( p<0.001).

Cold-stimulated Hoku point stimulation significantly attenuated pain due to external pin removal in patients with fractures compared to Hoku-stimulated point-warm or routine care. Therefore, considering the cheapness, applicability and safety of this method, it is recommended to plan nurses' training in applying alternative medicine approaches including stimulation of Hoku point.

Breast cancer is one of the most common malignant tumors in women which their most common treatment is mastectomy. Mastectomized women have a many psychological problems. Regarded to effectiveness of psycho-social rehabilitation, present research aimed to determine the effect of psycho-social rehabilitation on psychological well-being, mental health and body image concern in mastectomized women.

The method of present study was quasi-experimental with pretest and posttest design with control group. The research population was mastectomized women in Pastorno hospital of Mashhad city in 2018 year. From the members of population, 50 people after reviewing the inclusion criteria were selected by available sampling method and randomly replaced into two equal groups. The experimental group trained 8 sessions of 90-minutes as a group psycho-social rehabilitation program and the control group didn’t receive any training. Data collected by form of demographic information and the questionnaires of psychological well-being, mental health and body image concern and analyzed with using statistical tests of Chi-square, t-test and multivariate analysis of covariance.

The findings showed that there was no significant difference between the experimental and control groups in terms of age, education and duration of mastectomy in mastectomized women (P>0.05). Also, in the pretest stage there was no significant difference between the experimental and control groups in terms of psychological well-being, mental health and body image concern (P>0.05), but in the posttest stage there was significant difference in terms of all three variables (P<0.05). In the other words, psycho-social rehabilitation program led to significant improve of psychological well-being and mental health and significant decrease of body image concern in mastectomized women (P<0.05).

Based on the results, use from psycho-social rehabilitation approach along with other educational and therapeutic approaches by therapists and health professionals can be effective to improve different psychological characteristics especially improve psychological well-being and mental health and decrease of body image concern of vulnerable groups including mastectomized women.

after reconstructing the anterior cruciate ligament, in order to prevent re-injury of the ligament, evaluation of neuromuscular function is of clinical importance in coordinating the onset time and time to peak of lower limb's muscles activity.

Therefore the purpose of this study was to compare the timing of muscles activity in the stance phase of running between athletes with reconstructed anterior cruciate ligament and healthy subjects.

This study was a semi-experimental and applied type. 10 athletes with reconstructed anterior cruciate ligament who at least one year had passed since their surgery, as experimental group and 10 healthy subjects as control group of Hamedan city were volunteered to participate in the study. The control group in terms of age, height and weight were homological with experimental group. surface electromyography system was used to quantify the onset time and time to peak of lower limb's muscles activity. multivariate MANOVA with a significance level of P< 0.05 was used for statistical analysis.

In experimental group, the onset of the activity in tibialis anterior, medial gastrocnemius, vastus medialis, vastus lateralis, gluteus medius (P= 0.001) as well as the time to peak in tibialis anterior, vastus lateralis, vastus medialis, gluteus medius, semitendinosus (P= 0.001) and biceps femoris (P= 0.045) were delayed.

During the stance phase of running, experimental group displayed a delay on the activation onset, and a longer time to peak in the lower limb's muscles. It is not clear if these changes are due to a neuromuscular adaptation or proprioception related damage. A more comprehensive study is recommended to clarify this aspect. It is recommended to assess the possible link between this delay with reoccurrence of anterior cruciate ligament rupture.

The aim of this study was to Developing an integrated psychotherapy model of people with generalized anxiety disorder comorbid with emotional disorders.

The research method was deductive content analysis. Purposive sampling was used and written sources were used to study etiology and treatment of generalized anxiety disorder. Then the content of the books and articles were analyzed in terms of the components involved in the etiology and treatment of generalized anxiety disorder. In this study, therapeutic components were first extracted, then classified into main theme, main component and sub-component. Finally, the validity and reliability of the above mentioned model were examined.

The integrated treatment model of generalized anxiety disorder contains 8 main themes: psychoeducation, motivational processes, behavioral strategies, cognitive strategies, meta-cognitive strategies, emotional efficacy, interpersonal effectiveness, and personal development and sprituality training. As a result of these 8 themes, 34 main and 71 sub-component were obtained.

The integrated therapeutic model of generalized anxiety disorder developed in this study can be used along with other interventions to formulate intervention for treatment of generalized anxiety disorder.