فصلنامه سلامت و مراقبت
سال بیست و دوم شماره 3 (پاییز 1399)

Practical exams are frequently used in the training and evaluation of medical students. One of these exams is Objective structured clinical examination (OSCE). The present study aimed to explaining the factors affecting the success of the nursing students in OSCE exam.

This research was designed to pursue a qualitative approach following content Analysis. 11 undergraduate nursing students participated in this study with mean age of 24±3.5 years. Elo & Kyngas (2008) method was used to analyze the data. To help the data analysis, the MAXQDA 10 software was used.

Data analysis led to the extraction of two main categories and 8 general categories: facilitators of success in the exam with general categories (previous experiences, peer learning, personal characteristics and managerial readiness) and barriers to success in the exam with general categories (uncertainty in running exam, test giant, clinical training method and Inattention and lack of motivation).

The present study is one of the first studies to explain the factors affecting the success of nursing studentschr('39') in OSCE exam. According to the results of this study, many factors, including individual, group and educational conditions in the faculty and hospital are effective in the success in OSCE exam. According to the results of the study, the officials of nursing schools should try to minimize the obstacles to the success in OSCE exam in the next years, and on the other hand, strengthen the facilitators, so that the students and colleges benefit the most from OSCE exam.

Nowadays, the prevalence of chronic low back pain is increasing in the world and vitamin D deficiency is associated with impaired neuromuscular function and chronic musculoskeletal pain. In addition, exercise therapy and selection of core stabilization exercise interventions have main roles in rehabilitation of these patients. The aim of this study was to investigate the effect of 8 weeks of core stabilization exercises and vitamin D intake on the pain and functional disability levels in women with chronic non-specific low back pain.

This clinical trial study was performed by pre-test and post-test design. Initially, 48 women with chronic non-specific low back pain were selected by available sampling method and then randomly divided into control, exercise, vitamin D and exercise+vitamin D (combined) groups (12 subjects in each group). The exercise and combined groups performed 8 weeks of core stabilizing exercises. The vitamin D and combined groups received 50,000 IU vitamin D/week for 8 weeks. The severity of the pain and functional disability, before and after the interventions, were determined by visual analog scale of pain and Oswestry questionnaire, respectively. Data analysis was performed using Paired T-Test and ANOVA with the significance level of less than 0.05.

Eight weeks of core stabilizing exercises, vitamin D intake and the combined intervention were associated with a significant reduction (p<0.001) in pain (20.15%, 18.60% and 34.20%, respectively) and functional disability (48.35%, 44.26% and 51.81%, respectively) in women with chronic non-specific low back pain. In addition, combined intervention induced more reduction in the pain compared with two other interventions (p<0.001)

It seems that core stabilizing exercises, vitamin D intake, and the combination intervention can reduce the pain and improve the physical function in patients with chronic low back who have low levels of vitamin D. But combined intervention is associated with greater effectiveness in reducing the pain.

Leadership in medical sciences and nursing education, especially in relation to clinical learning, is very important, and can significantly predict the effectiveness of clinical education. The aim of this study was to design an optimal model for educational leadership competency in clinical departments of medical universities.

This research was conducted by a mixed qualitative (qualitative-quantitative) method. To conduct the research, a semi-structured interview was conducted with 15 deputies and group managers in some universities in the northwest of the country. It was evaluated by content analysis method and, in the qualitative stage, approved by fuzzy Delphi method and application of structural equations.

The competency variable of educational leaders from the perspective of educational administrators and deputies in the qualitative stage and category analysis included 50 competencies in five categories of leadership competencies in clinical education, self-assessment and evaluation of educational performance, development of student clinical skills and individual competence, human resources. The designed model was evaluated in a quantitative step with the structural equation technique.

Considering the importance of educational organizations as well as the competencies of managers in medical sciences for clinical success, this model can be used by decision makers and consultants in order to select clinical education leaders in universities and to guide managers.

Spirituality therapy means using the religious and cultural beliefs of individuals in the process of psychotherapy and considering the transcendent dimension of the clients that leads them to the transcendent source. The present study was conducted to compare the effect of spirituality therapy in improving the symptoms of internet addiction and quality of life among students.

This study was a quasi-experimental study (multi-group with pretest-posttest). The statistical population of the study included all students with internet addiction, studying in the faculties of Ardabil University of Medical Sciences in academic year of 1997-98. Samples were selected by available sampling (30 people) and assigned to experimental and control groups. Data were collected from groups using Internet Addiction and Quality of Life Scale in pre-test and post-test and analyzed by covariance statistical method in SPSS-21 software.

The results of one-way analysis of covariance (ANKOVA) showed that there was a significant difference between internet addiction and quality of life between pre-test and post-test (p<0.001). Mankova analysis (with control of pre-test scores) showed that the spirituality therapy program was significant on variable means of quality of life and internet addiction.

Based on the results, it seems that spiritualty therapy is significantly effective in reducing the symptoms of internet addiction and increasing the quality of life in students. Therefore, it is suggested that psychotherapists use this treatment throughout the country to increase resilience and consequently, to control the symptoms of internet addiction and improve the quality of life of clients.

Social capital plays an effective role in promoting the health and quality of life of the elderly by providing emotional and psychological support. Therefore, this study investigated the relationship between social capital and quality of life of inactive elderly.

This descriptive correlational study was performed on 200 inactive elderly in Lahijan, in 1399. Data collection tools were Onyx and Bolen Social Capital Questionnaire and WHO Quality of Life Questionnaire. Data were analyzed using K-S, Spearman correlation, Watson camera and multivariate regression using SPSS23 software.

According to the results, the intensity of the correlation between the relationship dimension with quality of life (0.531), structural dimension with quality of life (0.569), cognitive dimension with quality of life (0.512) and social capital with quality of life (0.5377) and statistical results showed that there is a significant relationship (0.001) between social capital and quality of life of inactive elderly.

It is concluded that the dimensions of social capital can be effective in predicting the quality of life of inactive elderly and attention to each dimension of social capital can play an effective role in their quality of life.

Human immunodeficiency virus (HIV) is one of the biggest challenges in human life that requires a variety of psychological support. The aim of this research was to compare the effect of acceptance and commitment therapy (ACT) and compassion focused therapy (CFT) on psychological well-being and quality of life in individuals diagnosed with HIV.

This research was a quasi-experimental study with pretest-posttest design with two experimental groups and one control group. The statistical population included all HIV positive patients referred to Tehran center of behavioral disorders between October and February 2018, among which 45 patients were selected by convenience sampling method and randomly assigned into three groups (two experimental groups and one control group, n=15). One of the experimental groups underwent ACT for 8 session of 120 minutes and another received CFT for 8 sessions of 120 minutes. The control group receivedno intervention. To collect data, Ryff Psychological well-being (1989) and Ware & Sherbourne (1992) quality of life scales were used. Data analysis was performed using descriptive and inferential statistics (analysis of covariance).

The results showed that both acceptance and commitment therapyand compassion focused therapyhad effects on psychological well-being and quality of life in patients with HIV (p<0.05), however, the effect of compassion focused therapy was more noticeable on the psychological dimension of quality of life (p<0.05). Regarding other variables, no significant difference was found between two treatments.

Both acceptance and commitment therapy models and compassion-focused therapy can increase the psychological well-being and quality of life of people with HIV. Therefore, it is recommended to behavioral disease centers to use this protocol to increase the psychological well-being and quality of life of patients with HIV.

Quality of life of patients with type 2 diabetes is one of the most important indicators of physical and mental health in these people. The aim of this study was to determine the structural pattern of health-related quality of life in patients with type 2 diabetes based on health-related literacy and self-efficacy by considering the mediating role of self-care activity.

The present study was a correlational study using path analysis method performed on 300 patients with type 2 diabetes referred to public and private medical centers in Tehran and Mashhad. Samples were selected using available sampling method and questionnaires of Quality of Life (SF-36), Health Literacy (HLS), Diabetes-Related Self-Efficacy (DMSES) and Diabetes Self-Care Activities (SDSCA) were completed by them. Data were analyzed using descriptive statistics (central and dispersion indices) and inferential (Pearson correlation) using SPSS-25 and LISREL 8.80 software.

The results of Pearson correlation test indicated that health literacy, diabetes- related self-efficacy, and self-care activities were significantly (p≤ 0.05) correlated to health-related quality of life. Furthermore, the results of path analysis revealed that diabetes-related health literacy and self-efficacy had no direct effects on health-related quality of life, but had a significant indirect effect on the quality of health-related life of type 2 diabetes patients through self-care activities.

The results showed that the quality of life of patients with type 2 diabetes can be predicted based on health literacy and self-efficacy and also self-care exerts its effect through a mediating role. Health literacy and self-efficacy can play an effective role in improving and also predicting the quality of life of patients with type 2 diabetes. Also, self-care activities are important factors in patients with type 2 diabetes. In addition, engaging in self-care activities can help reduce the psychological symptoms of diabetes in patients with diabetes, which can ultimately improve the quality of life of patients with diabetes. Physicians and psychotherapists can improve the health literacy and self-efficacy of patients with diabetes to increase their quality of life.

Anxiety before invasive procedures such as colonoscopy is one of the most common psychological problems in patients. Nowadays, providing education using different methods before invasive procedures to control patientschr('39') anxiety and pain has received a lot of attention. The aim of this study was to compare the effect of face-to-face training and educational videos on anxiety and physiological parameters of patients undergoing colonoscopy.

In this quasi-experimental study, 105 candidates for colonoscopy referred to Shahid Beheshti Hospital of Hamadan were selected by available sampling method from February 2019 to September 2020 and assigned to two groups of face to face (n=52) and educational videos (n=53). Face-to-face training was performed for 15 minutes the night before the colonoscopy. The training video was broadcast to patients for 15 minutes the night before the colonoscopy. Patientschr('39') anxiety before and after training was measured by Spielberger Anxiety Questionnaire. Physiological indices were recorded by physiological index table, 5 minutes before, during and 5 minutes after colonoscopy. Data were analyzedby chi-square tests, T-test, Paired t-testand analysis of variance with repeated measuresin SPSS 16 software.

In both groups of face-to-face training and educational video, the mean score of overt and covert anxiety after the intervention was significantly lower (p<0.001). There was no statistically significant difference between the mean scores of overt and covert anxieties in two groups before the intervention. However, after the intervention the mean score of anxiety in the educational film group was significantly lower than the face-to-face training group (p<0.05). From physiological indicators, only systolic blood pressure was statistically different between two groups at all times of measurement (p<0.05).

The results of the study showed that training through educational videos has a greater effect on controlling anxiety in patients undergoing colonoscopy than face-to-face training. Therefore, according to the patientchr('39')s condition, this method can be used instead of the usual method of face-to-face training to better train and control patientschr('39') anxiety.