Journal of Multidisciplinary Care
Volume:10 Issue: 1, Winter 2021

Schizophrenia is one of the most complicated psychiatric disorders. Some afflicted patients show resistance to routine treatments. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique with the potential to reduce symptoms among patients with schizophrenia. The aim of this study was to evaluate the effects of high-frequency rTMS on auditory hallucinations and working memory among patients with schizophrenia.

This experimental study was conducted using a pretest-posttest controlled design. The statistical population of the study consisted of all patients with schizophrenia and auditory hallucinations who referred to the outpatient psychiatric emergency department of Imam Hossein hospital, Tehran, Iran, in 2019. In total, twelve eligible patients were recruited through convenience sampling and randomly allocated to a control and an intervention group. Participants in the intervention group individually received rTMS in ten sessions, while their counterparts in the control group received no intervention during the study. Data were collected using the diagnostic interview, the screening questionnaire for rTMS, the Positive and Negative Syndrome Scale for schizophrenia, the Varieties of Inner Speech Questionnaire, and the Working Memory Measure. Data analysis was performed using univariate and multivariate analyses of covariance.

The posttest mean score of auditory hallucination in the intervention group was significantly less than the control group, while the posttest mean score of working memory in the intervention group was significantly greater than the control group (P < 0.05).

This study suggests the effectiveness of rTMS in significantly reducing auditory hallucinations and improving working memory among patients with schizophrenia.

Coronary artery bypass graft (CABG) surgery is associated with high levels of stress for patients’ family members. Information delivery to family members is a strategy with potential positive effects on their stress. The aim of the present study was to compare the effects of intraoperative information delivery via electronic patient tracking system (EPTS) and mobile-based communication (MBC) on stress and coping ability among the family members of patients under CABG surgery.

This clinical trial was conducted on 80 family members of patients under CABG surgery. Participants were randomly allocated to an EPTS and an MBC group. Intraoperative information delivery to family members in the EPTS and the MBC groups was performed using EPTS and hourly mobile phone contacts, respectively. Data were collected before and after the intervention using the Perceived Stress Scale and the Coping Response Inventory. The SPSS software (v. 22.0) was used for data analysis through the Fisher’s exact, Chi-square, independent-sample t, and paired-sample t tests.

There were no significant differences between the groups in terms of the pretest and the posttest mean scores of stress and coping ability (P > 0.05). The mean scores of stress and coping ability did not significantly change in the EPTS group (P > 0.05). Moreover, the mean score of coping ability did not significantly change in the MBC group (P = 0.429), while the mean score of stress significantly decreased in this group (P = 0.009).

Intraoperative information delivery to family members through mobile phone contacts is effective in significantly reducing stress among the family members of patients under CABG. Healthcare providers can use the findings of the present study to provide quality care to patients’ family members.

Decreased physical functioning and increased risk of fall are among the most common age-related problems among elderly people. This study aimed at assessing the effects of tai chi exercise on gait speed (GS) and fall rate among a group of elderly women in Iran.

This randomized controlled trial was conducted in 2018. Participants were sixty elderly women purposefully selected from comprehensive healthcare centers in Lahijan, Iran, and randomly assigned to an intervention and a control group. Study intervention was Yang-style tai chi exercise implemented in two group sessions per week for twelve consecutive weeks. GS was assessed before and after the intervention using the short physical performance battery and fall rate was assessed using a researcher-made self-report fall assessment checklist. The SPSS program for Windows (v. 18.0) was employed for data analysis at a significance level of less than 0.05.

Between-group differences respecting the pretest and the posttest GS were not statistically significant (P > 0.05). Moreover, posttest fall rate in the intervention group was less than the control group.

Tai chi exercise is effective in increasing GS and reducing fall rate among elderly women and is recommended for elderly people.

Communication is a key component of professional nursing care. This study aimed at evaluating the effects of empathetic techniques education for nurses on resilience and spiritual well-being (SWB) among mothers with preterm neonates in neonatal intensive care unit (NICU).

This cluster randomized controlled trial was conducted in 2018 using a two-group pretest-posttest design. Main participants were 68 mothers of preterm neonates in the NICUs of Montazeri and Amin hospitals in Isfahan, Iran. Nurses in the intervention hospital (i.e. Montazeri hospital) were provided with empathy techniques education in five weekly sessions in one month. After that, mothers in both groups completed the Connor-Davidson Resilience Scale and the SWB Scale both at the time of their neonates’ NICU admission and at the time of their neonates’ NICU discharge. Data were analyzed using the SPSS software (v. 22.0).

The pretest mean scores of resilience and SWB were respectively 79.74 ± 12.78 and 175.6 ± 11.95 in the control group and 78.0 ± 16.9 and 176.67 ± 16.0 in the intervention group. At posttest, these values were 78.32 ± 12.12, 176.53 ± 11.40, 92.0 ± 13.77, and 186.0 ± 12.5, respectively. Although the between- group differences respecting the pretest mean scores of resilience and SWB were not statistically significant (P > 0.05), the posttest mean scores of resilience and SWB in the intervention group were significantly greater than the control group (P < 0.05).

Empathy techniques education is effective in significantly improving resilience and SWB among the mothers of preterm neonates in NICU. Therefore, this intervention is recommended for nurses in NICU.

The family members of patients in intensive care unit (ICU) experience high levels of anxiety and stress. This study sought to assess the effects of written emotional disclosure (WED) on anxiety and perceived stress among the family members of patients in ICU.

This clinical trial was conducted in 2019 on seventy family members of patients hospitalized in the ICUs of Kashani hospital, Shahrekord, Iran. Family members were conveniently recruited and randomly assigned to a 35-person control and a 35-person intervention group. Participants in the intervention group were trained to write for twenty minutes every other day for two consecutive weeks about their negative emotional feelings, negative thoughts, concerns, and fears associated with their patient hospitalization in ICU. The Spielberger State-Trait Anxiety Inventory and the Cohen Perceived Stress Scale were used for anxiety and stress assessment before, two weeks after, and one month after the study intervention. The data were analyzed using the SPSS software (v. 18.0) at a significance level of less than 0.05.

The mean of participants’ age was 38.91 ± 9.01 years in the control group and 33.83 ± 10.22 years in the intervention group. Around 37.1% of participants in the control group and 54.3% of participants in the intervention group were male. There were no significant differences between the groups respecting participants’ age and gender (P > 0.05). One month after the intervention, the mean scores of state and trait anxiety were respectively 57.83 ± 11.58 and 51.11 ± 10.49 in the control group and 46.94 ± 11.07 and 43.71 ± 8.76 in the intervention group. Between-group differences were significant (P < 0.05). The mean score of perceived stress at one month after the intervention was 29.00 ± 7.21 in the control group and 26.51 ± 6.15 in the intervention group and the between-group difference was not significant (P > 0.05).

WED is effective in significantly reducing anxiety and slightly reducing perceived stress among the family members of patients in ICU. Therefore, WED can be used as a simple, cost-free, and complication- free strategy to reduce anxiety and stress among the family members of patients in hospital settings, particularly in ICU.

Prediabetic individuals are more at risk for developing diabetes mellitus (DM). Physical activity (PA) is a significant factor contributing to health maintenance and promotion. This study aimed to assess the factors affecting PA among prediabetic women based on the Theory of Planned Behavior (TPB).

This cross-sectional study was conducted in 2019 on 100 prediabetic women selected from comprehensive healthcare centers in Arak, Iran. A demographic questionnaire, a TPB-based questionnaire, and Godin-Shephard Leisure-Time Physical Activity Questionnaire were used for data collection. Data were analyzed through the Spearman’s correlation analysis and the linear regression analysis with the backward method.

The mean score of PA was 0.56 ± 0.8 (in the possible range of 0–2). Around 61% of participants had limited PA, 16% of them had moderate PA, 19% of them had adequate PA and 4% no response. Perceived behavioral control explained 5.5% of the variance of the PA behavior.

Given the significant effects of perceived behavioral control on PA, TPB-based educations may be helpful in promoting PA among prediabetic women.

Stress and anxiety during coronary angiography (CA) can lead to serious complications such as cardiac dysrhythmias, coronary artery spasm, and coronary artery rupture. This study aimed to evaluating the effects of clinical simulation on stress, anxiety, and hemodynamic parameters among the candidates for CA.

This clinical trial was conducted on eighty candidates for CA. Participants were conveniently recruited from Tehran Heart Center, Tehran, Iran, and randomly allocated to a control and an intervention group through block randomization with a block size of 2. The Beck Anxiety Inventory, the Cohen Perceived Stress Scale, and a datasheet for hemodynamic parameters were used to assess participants’ anxiety, stress, and hemodynamic parameters before and after the study intervention. Participants in the intervention group received routine care services and a clinical simulation intervention, while participants in the control group solely received routine care services. Data were analyzed using the chi-square, independent-sample t, and paired-sample t tests.

The mean scores of stress and anxiety and the mean values of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) significantly decreased in the intervention group (P < 0.05), but did not significantly change in the control group (P > 0.05). The pretest posttest differences in the means of stress, anxiety, SBP, DBP, and HR in the intervention group were significantly greater than the control group (P < 0.05).

Clinical simulation is effective in significantly reducing stress, anxiety, and hemodynamic parameters among the candidates for CA. Therefore, clinical simulation is recommended before CA.

Family caregivers have significant role in managing psychiatric emergencies in the time interval between their request for emergency medical services (EMS) and ambulance arrival at the emergency scene. This study aimed at assessing the effects of educational short message service (SMS) messages about emergency scene management (ESM) on perceived stress and satisfaction among the family caregivers of patients with mental disorders who requested EMS.

This randomized controlled trial was conducted in 2019–2020 using a two-group posttest-only design. Participants were sixty family caregivers of patients with mental disorders in Mashhad, Iran, who called the EMS center and requested EMS. They were continuously recruited and randomly allocated to an intervention or a control group. Participants in the control group received routine educations, while participants in the intervention group received routine educations and SMS-based educations about ESM. Data were collected using a demographic questionnaire, a researcher-made caregiver satisfaction questionnaire, and the Cohen’s Perceived Stress Scale. Data analysis was performed via the SPSS software (v. 25.0).

Most participants were female (53.3%) and their mean age was 44.30 ± 13.03 years. The mean score of perceived stress in the intervention group was significantly less than the control group (P = 0.001), while the mean score of caregiver satisfaction in the intervention group was significantly more than the control group (P = 0.001).

SMS-based education about ESM is effective in significantly reducing perceived stress and enhancing satisfaction among the family caregivers of patients with mental disorders.