نشریه سلامت اجتماعی
سال هشتم شماره 2 (بهار 1400)

 Emotional divorce occurs when the relationship of husband and wife is impaired, and their interpersonal emotional capital has become passive. The aim of this study was to compare the effectiveness of treatment based on acceptance and commitment therapy with resilience training on sense of coherence and emotional divorce among women.

 The research method was semi-experimental with pre-test, post-test, follow-up, and a control group. Participants included 90 women aged 25-45 years seeking a divorce in Tehran who had been referred to Shahid Bahonar Family Court in Tehran between January 2018 and May 2019, who were selected by convenience sampling method and were randomly assigned to two experimental and one control group (each group containing 30 participants). The resilience training program was performed in 11 weekly 120-minute sessions, and acceptance and commitment treatment protocol was performed in 10 weekly 120-minute sessions. The control group did not receive any intervention. All three groups responded to an individual sense of coherence and emotional divorce questionnaires in the pre-test, post-test, and follow-up. Data were analyzed using univariate analysis of covariance using SPSS software version 22.

 In the resilience training group, the mean (SD) sense of individual cohesion increased from 65.5 (8.9) in the pre-test to 79.6 (11.5) and 79.5 (11.3) in follow-up (P<0.001). In the acceptance and commitment group, the mean (SD) sense of individual cohesion increased from 64.4 (9.6) in the pre-test to 78.1 (12.1) and 77.8 (12.1) in follow-up (P<0.001). In the control group, the mean (SD) sense of individual cohesion increased from 64.1 (10.6) in the pre-test to 65.6 (9.4) and 65.4 (9.2) in follow-up, which was not significant. In the resilience training group, the mean (SD) of emotional divorce decreased from 18.2 (3.8) in the pre-test to 12.6 (3.7) and 12.4 (3.4) in follow-up (P<0.001). In the acceptance and commitment group, the mean (SD) of emotional divorce decreased from 18.5 (3.8) in the pre-test to 14.8 (3.7) and 14.6 (3.5) in follow-up (P<0.001). In the control group, the mean (SD) of emotional divorce increased from 18.7 (4.7) in the pre-test to 17.9 (4.4) and 17.7 (4.3) in follow-up, which was not significant.

 Acceptance and commitment therapy and resilience training are effective in increasing the sense of individual cohesion and reducing emotional divorce of women seeking a divorce, and resilience training were more effective on emotional divorce in women.

Infertile women often use laboratory fertilization (IVF-ET), a stressful process, to fulfill their desire for childbearing. The aim of this study was to determine the effect of mindfulness-based cognitive therapy training on state anxiety in infertile women undergoing IVF treatment.

This quasi-experimental study was conducted with participation of 60 women with a history of infertility who were referred to an infertility treatment center in Mashhad and were selected via convenience sampling method and then randomly assigned to two experimental and control groups. The experimental group received eight sessions of 2-hour mindfulness training weekly, while the control group did not receive any psychological services. The two groups completed the questionnaires before and after the intervention. Three months later, the test group completed the questionnaire again to track the effects of the educational intervention.Spielberger's state anxiety questionnaire was used to measure anxiety. Data analysis was performed using single-variable covariance via SPSS software version 21.

The mean (SD) age of the experimental group was 31.1 (4.9), and the control group 31.2 (5.1). The mean (SD) score of state anxiety in the experimental group decreased from 44.1 (12.8) in the pre-test to 41.4 (11.1) in the post-test and 40.8 (11.1) in the follow-up stage (P<0.001). However, the mean (SD) score of state anxiety in the control group decreased from 47.1 (12.3) in the pre-test to 46.5 (12.1) in the post-test and 46.2 (12.1) in the follow-up stage, which was not statistically significant.

The study showed that mindfulness-based cognitive therapy training reduced state anxiety among infertile women undergoing IVF treatment

Infertile women often use laboratory fertilization (IVF-ET), a stressful process, to fulfill their desire for childbearing. The aim of this study was to determine the effect of mindfulness-based cognitive therapy training on state anxiety in infertile women undergoing IVF treatment.

This quasi-experimental study was conducted with participation of 60 women with a history of infertility who were referred to an infertility treatment center in Mashhad and were selected via convenience sampling method and then randomly assigned to two experimental and control groups. The experimental group received eight sessions of 2-hour mindfulness training weekly, while the control group did not receive any psychological services. The two groups completed thequestionnaires before and after the intervention. Three months later, the test group completed the questionnaire again to track the effects of the educational intervention. Spielberger's state anxiety questionnaire was used to measure anxiety. Data analysis was performed using single-variable covariance via SPSS software version 21.

The mean (SD) age of the experimental group was 31.1 (4.9), and the control group 31.2 (5.1). The mean (SD) score of state anxiety in the experimental group decreased from 44.1 (12.8) in the pre-test to 41.4 (11.1) in the post-test and 40.8 (11.1) in the follow-up stage (P<0.001). However, the mean (SD) score of state anxiety in the control group decreased from 47.1 (12.3) in the pre-test to 46.5 (12.1) in the post-testand 46.2 (12.1) in the follow-up stage, which was not statistically significant.

The study showed that mindfulness-based cognitive therapy training reduced state anxiety among infertile women undergoing IVF treatment.

The spread of spirituality could be considered the main approach to achieve physical and mental health among younger generation. Positive attitudes and commitment to saying one’s prayer is among the best examples for spirituality. The aim of this study was to determine the attitudes towards and commitment to prayer and their determinants among the students of Ferdowsi University of Mashhad.

This descriptive-analytical study was conducted in 2017-2018 with participation of 308 students in Ferdowsi University of Mashhad who were selected via stratified random sampling. Data were collected via commitment to prayer questionnaire, which included four subscales, and religious practice among peers questionnaire. Data were presented in mean, standard deviation, minimum and maximum scores, and were analyzed via linear regression analysis, Pearson correlation, and t-test.

There was a direct relationship between attitudes and commitment to prayer and parental religious performance (correlation coefficient=0.58), religious performance among peers (correlation coefficient=0.45), and religious performance at university (correlation coefficient=0.36), P<0.001. Higher scores of religious performance among parents, peers, and that at university were positively correlated with the score of attitude and commitment to prayer among students. No significant differences were found between female and male students and those who were single and married in terms of the score of attitudes and commitment to prayer.

The study showed that the level of commitment to prayer among students was higher than medium and religious performance among family, peers and at university werepositively correlated with students' tendency to pray. Therefore, the family peers, and the university could play a significant role in the emergence of religious beliefs and commitment to religious rituals among university students.

Diabetes is an incurable disease among the elderly. Itis estimated that it affects the quality of life, and non-pharmacological and psychological therapies can help reduce the problems of the elderly with diabetes. The objective of this study was to compare the effectiveness of laughter therapy and solution-based therapy on hopefulness, meaningfulness, self-compassion, and hemoglobin A1C elderly patients with type 2 diabetes.

The present study was quasi-experimental with pretest-posttest, follow-up, and control group. The statistical population of the study included elderly patients 60-75 years old with type 2 diabetes referred to the Iranian Diabetes Association in Tehran. Among them, 54 were randomly selected and replaced in three groups: laughter therapy, solution therapy, and controlgroup. Data were obtained by self-compassion questionnaire, hopefulness scale, meaningfulness questionnaire, and glycated hemoglobin test. Before the beginning of the sessions, the pretest was administered for all three groups. After two months, the posttest was administered. In the first experimental group, laughter therapy, in the second experimental solution-centered intervention, and in the control group, no intervention was done. Glycated hemoglobin test was completed again two months after the end of the training in order to follow up and evaluate the sustainability of treatment effects. Data were analyzed by repeated measure ANOVA and SPSS software.

The mean (SD) of self-compassion in the laughter group increased from 67.5 (5.2) at pretest to 85.8 (6.2) at posttest and 86.2 (6.1) at the end of the follow-up period (P<0.001) and increased in solution-based therapy group from 69.2 (4.7) in pretest to 81.3 (8.3) in posttest and 81.7 (8.4) at the end of the follow-up period (P<0.001). The mean (SD) of meaningfulness in the laughter group increased from 43.9 (6.2) at pretest to 50.3 (6.8) at posttest and 50.7 (6.5) at the end of the follow-up period (P<0.001). It increased in the solution-based therapy group, from 44.8 (6.7) at pretest to 49.5 (7.9) at posttest and 49.8 (7.7) at the end of the follow-up period (P <0.001). The mean (SD) of hopefulness in the laughter group increased from 40.3 (8.1) at pretest to 45.6 (8.1) at posttest and 46.1 (7.7) at the end of the follow-up period (P<0.001) and increased in solution-based therapy from 40.2 (7.9) at pretest to 43.7 (8.1) at posttest and 43.7 (7.7) at the end of the follow-up period (P<0.001). The mean (SD) of hemoglobin A1C in the laughter group decreased from 7.3 (1.6) at pretest to 6.4 (1.1) at posttest and 6.3 (0.9) at the end of the follow-up period. (P<0.001). Moreover, it decreased in the solution-based therapy, from 7.2 (1.1) at pretest to 6.6 (1.1) at posttest and 6.6 (1.1) at the end of the follow-up period (P<0.001). In the control group,there was no significant difference in mean (SD) self-compassion, hopefulness, meaningfulness, and A1C hemoglobin levels in pretest, posttest, and follow up. A comparison of two treatments showed that laughter therapy was more effective in self-compassionand meaningfulness in the posttest period than solution-based therapy (P<0.001).

The study showed that both laughter therapy and solution-based therapy led to increased hopefulness, self-compassion, and reduced hyperglycemia. Laughter therapy was more effective than solution-based therapy in enhancing self-compassion and meaningfulness in patients with diabetes. However, there was no difference between hope and hyperglycemia in two therapy methods.

Irritable bowel syndrome is a gastrointestinal disorder that is diagnosed from a clinical point of view with symptoms such as changing bowel movements, pain, and feelings of abdominal dilation, and in addition to arbitration therapy, it requires psychological interventions. The aim of this study was to determine the effectiveness of short-term dynamic psychotherapy on the severity of symptoms and the perception of disease among patients with irritable bowel syndrome.

The research design was applied and quasi-experimental with pretest, posttest, and a three-month follow-up with a control group. Participants included 30 patients with irritable bowel syndrome in Tehran in 2020, who were selected via convenience sampling method and were randomly assigned to one experimental group and one control group, each consisting of 15 people. Before the intervention, a pretest was held, and then the experimental group received 12 90-minute short-term dynamic psychotherapy, while the control group did not receive any intervention. Then, the posttest was performed, and after three months of posttest, a follow-up was included. Data were collected via the Severity of Symptoms of Irritable Bowel Syndrome and theShortened Illness Perception Scale. Data were analyzed by SPSS software via univariate analysis of covariance.

In the experimental group, the mean (SD) severity of symptoms decreased from 150.0 (22.3) in the pretest to 124.4 (17.0) in the posttest, and 120.5 (0.2) in the follow-up (P<0.001). Illness perception increased from 40.4 (3.5) in the pretest to 48.4 (3.5) in the posttest, and 48.7 (3.3) in the follow-up (P<0.001).

Short-term dynamic psychotherapy reduced the severity of symptoms and increased disease perception among patients with irritable bowel syndrome.

Having a stable marriage depends on effective communication skills, empathy, and social skills among couples. Narrative therapy with emphasis on life stories can help develop and enhance these skills.The main purpose of this study was to investigate the effect of narrative therapy model on communication skills, emotional expression and empathy among girls and boys whointended to get married in the city of Kashan.

This study was a quasi-experimental study with pre-test, post-test, and control group. The statistical population consisted of all girls and boys who intended to get married in Kashan city and were referred to Vesta Psychology Clinic in Kashan in 2019. Sixty individuals were selected by simple random sampling method and were randomly assigned into two groups (30 in narrative intervention and 30 in control group). The experimental group participated in 11 sessions of group narrative therapy. The control group did not receive any intervention. The research tools were King and Emmons Emotion Expressions Scale, Matson Communication Skills and Mehrabian and Epstein Empathy questionnaire. Multivariate analysis of covariance was used to test the research hypotheses. The data were analyzed by SPSS software version 22.

Narrative therapy was effective in increasing communication skills scores from mean (SD) 46.7 (2.8) in pre-test to 69.1 (6.2) in post-test, P<0.001. In addition, Narrative therapy had increased emotional expression scores from mean (SD) 27.4 (3.3) in pre-test to 56.1 (6.1) in post-test, P<0.001. At last, Narrative therapy had an effect on empathy scores for boys and girls from 70.5 (20.2) in pre-test to 103 (27.2) in post-test, P<0.001). There were no significant differences between pre and post-tests scores in the control group.

The narrative therapy approach increased the communication skills, social expressing and empathy skills among couples who intended to get married

Natural disasters such as earthquakes might result in long term psychological outcomes. The aim of the current study was to test the causal model of post-traumatic growth among earthquake-stricken persons based on social support, mindfulness, and rumination with the mediating role of acceptance and action.

The method of this study was descriptive-correlational. Participants included 120 adults who experienced the earthquake of November 2017 in SarpolZahab city, Kermanshah, Iran, who were selected by cluster sampling. Data were collected using the Post-Traumatic Growth Inventory, Social Support Scale, Kentucky Inventory of Mindfulness Skills, Ruminative Response Scale, and Acceptance and Action Questionnaire II. Data analysis was performed using structural equation modeling via SPSS software version 22 and Lisrel software version 8.8.

The mean (SD) age of participants was 21.2 (5.9). With the increase in rumination with a mean (SD) 43.7 (12.7), post-traumatic growth with a mean (SD) 54.8 (14.2) decreased. With the increase in mindfulness with a mean (SD) 62.8 (15.1), social support with a mean (SD) 53.1 (12.5) and acceptance and action with a mean (SD) 53.8 (17.6) post-traumatic growth increased (P<0.01). Post-traumatic growth increased with an increase in acceptance and action. Acceptance and action are also modulated in the relations of rumination, mindfulness, and social support with post-traumatic growth.

The acceptance and action and post-traumatic growth decreased with increasing rumination and increased with increasing Mindfulness and social support. Furthermore, increasing acceptance and action increased post-traumatic growth. Mindfulness and social support increase post-traumatic growth indirectly with increasing acceptance and action. Rumination led to decreased post-traumatic growth via decreasing acceptance and action.

Obesity, as a predisposing factor for various diseases, has become the focus of the health systems worldwide. Social, psychological, and economic consequences associated with obesity have become a global threat. The purpose of this study was to investigate the predictors of quality of life, based on coping strategies and spiritualhealth among pregnant women with obesity.

This cross-sectional study was conducted with participation of 200 pregnant women with obesity, who were referred to health centers in Arak in 2019, and were selected via convenience sampling method. Data were collected via World Health Organization Quality of Life, Billings and Moose Coping Strategies, and Spiritual Health of Pullotzin and Ellison Questionnaires. Data were analyzed via SPSS software version 24.

The mean (SD) ageof participants was 29.1 (4.4) years. Increased mean (SD) problem-solving score 14.1 (4.1) (P<0.001), and decreased mean (SD) emotion-focused coping score 33.3 (9.5) (P=0.004) were associated with increased mean (SD) score of quality of life 92.2 (13.5). With the increase in physical health with the mean (SD) of 45.5 (5.3), the score of quality of life increased: 92.2 (13.5), P=0.002. Coping strategies and spiritual health dimensions explain 22% of the variance of quality of life among pregnant women with obesity.

It can be concluded that the variables of coping strategies and spiritual health could explain the quality of life among pregnant women with obesity.

Diagnosis of cancer following long treatments is usually a stressful experience. The aim of this study was to investigate the effectiveness of spirituality therapy training on distress tolerance and death anxiety among patients with leukemia in Valiasr hospital of Khorramshahr in 2019.

The research method was quasi-experimental with pre-test, post-test, and follow-up design with a control group. Participants included 98 people with leukemia referred to Valiasr hospital in Khorramshahr in 2019, selected by purposeful sampling method and randomly assigned to experimental and control groups, each group consisting of 15 people. Data were collected via distress tolerance and death anxiety questionnaires. Before the intervention, a pre-test was held, and then the experimental group received twelve 90-minute spirituality therapy training sessions, but the control group did not receive any intervention. Then, the post-test was performed, and after one month of post-test, the follow-up period was performed. Data were analyzed using covariance analysis using SPSS software version 22.

The mean (SD) age of participants was 32.9 (4.6) in the experimental group and 34.3 (5.1) in the control group. In the experimental group, the mean (SD) of death anxiety score decreased from 12.4 (1.4) in the pre-test to 7.9 (1.3) in the post-test and 7.7 (1.2) in the follow-up (P<0.001). However, in the control group, the mean (SD) of death anxiety score increased from 12.6 (1.8) in the pre-test to 11.5 (1.6) in the post-test, and 11.4 (1.3) in the follow-up, which was not significantly significant. In the experimental group, the mean (SD) distress tolerance score increased from 24.6 (2.8) in the pre-test to 0.57 (4.3) in the post-test and 54.8 (4.2) in the follow-up (P<0.001). However, in the control group, the mean (SD) of distress tolerance score increased from 31.8 (5.7) in thepre-test to 30.5 (6.9) in the post-test and 32.6 (10.6) in follow-up, which was not significantly significant.

It can be concluded that spiritual therapy reduces death anxiety and increases distress tolerance in leukemia patients.

Multiple sclerosis is an unpredictable life-altering disease gradually leading to disability. Improved quality of life could prevent the onset of disease attacks and progressive disability associatedwith physical illness. The objective of this study was to investigate the effectiveness of positive therapy on psychological capital and emotion expression styles among women with multiple sclerosis.

This study was of quasi-experimental design with pre-test, post-test, a 2-month follow-up, and a control group. Participants included 24 women with multiple sclerosis who were members of the MS Association of Tehran in 2019, selected via convenience sampling method and randomly assigned to two groups. The experimental group received eight 90-minute positive therapy sessions. In three steps, participants filled-out the Luthans Psychological Capital Questionnaire and the Amuns & King Ambiguity Questionnaire. The obtained data were analyzed using repeated-measures analysis of variance.

The mean (SD) resiliency and hope of the experimental group increased from 18.7 (3.5) and 20.0 (5.1) in the pre-test to 21.5 (2.6) and 22.5 (4.4) in the post-test, and 21.8 (4.0) and 22.7 (4.2) in the follow-up (P<0.05). The mean (SD) score of the control group did not differ in the pre-test, post-test and follow-up. The mean (SD) efficacy and optimism of the experimental group varied from 22.8 (6.9) and 22.9 (3.1) in the pre-test to 22.0 (5.9) and 22.3(3.6) in the post-test, and 22.0 (5.5) and 22.5 (3.9) in the follow-up (P<0.05); however, the difference was not statistically significant. The mean (SD) scores of the ambivalence of positive and negative emotion and expressing intimacy of the experimental group changed from 20.1 (3.0), 8.0 (1.6), and 16.5 (2.0) in the pre-test to 24.9 (4.2), 6.7 (1.4), and 19.9 (2.1) in the post-test, and 24.4 (3.8), 5.4 (1.8), and 21.0 (2.0) in the follow-up (P<0.001). The mean (SD) scores of the control group did not differ in the pre-test, post-test and follow-up.

Positive therapy increased the components of resilience and hope, but no significant change was observed in the components of self-efficacy and optimism among women with multiple sclerosis. Positive therapy increased ambivalence in expressing positive emotion and intimacy and decreased expression of negative emotion among women with multiple sclerosis

Paying attention to married life and increasing the components related to married life has been growing because a healthy society cannot be imagined without a healthy family. Accordingly, the aim of this study was to determine the effectiveness of Enrichment training for couples based on the Enrichmodel on optimism, and attitudes toward infidelity amongcouples with infidelity.

The present study was quasi-experimental with pretest, posttest design, and a control group. Participants included 30 couples referred by the judiciary to pre-divorce counseling centers in Sabzevar during 2018-2019, who were selected via purposeful sampling method. The experimental group received couple Enrichment based on the Enrichmodel for six sessions of 90 minutes per week. Before and after the intervention, the Betrayal Attitude Questionnaire and Optimism Questionnaire were administered in both groups. Data were analyzed by analysis of covariance using SPSS software version 22.

The mean (SD) score of attitudes toward marital infidelity in the couples' relationship Enrichment training group in the pretest was 22.7 (4.3), which decreased to 14.2 (2.8) in the posttest (P<0.001). The mean (SD) score of attitudes to marital infidelity in the conflict resolution styles group in the pretest was 22.2 (6.3), which decreased to 17.1 (4.2) in the posttest (P<0.001). In the control group, the scores of pretest and posttest were not different. Also, the mean (SD) of optimism in the couples' relationship Enrichment training group in the pretest was 7.3 (2.2), which increased to 15.4 (3.8) in the posttest (P<0.001). The mean (SD) of optimism in the conflict resolution styles group in the pretest 7.9 (1.6), which increased to 12.8 (1.9) in the posttest (P<0.001). In the control group, the scores of pretest and posttest were not different.

The study showed that couple Enrichment training based on the Enrichmodel and teaching conflict resolution styles increased optimism and decreased the negligent attitude to infidelity in couples. Couple relationship Enrichment training based on Enrichmodel of couples had more effect on reducing marital infidelity and increasing optimism than conflict resolution style training.