مجله علوم پزشکی صدرا
سال نهم شماره 3 (تابستان 1400)

Nowadays, the issue of the COVID-19 disease has created a wave of worry and fear among the general public, especially nurses. Nurses include a large group of treatment staff who will not be able to act an optimal care if they do not possess an appropriate mental and physical health. The present research was planned to determine the rate of anxiety and its effective factors among nurses caring for COVD-19 patients at hospitals affiliated with Universities of Medical Sciences of Shiraz and Yazd. This descriptive study was carried out in the year 2020 using multi-stage stratified random sampling method. Data were collected and analyzed using demographic and Spielberger standard questionnaire. The mean score of overt and covert anxiety among nurses of Shiraz was 51.71±10.59 and 44.28±8.88, and among Yazdi nurses, it was 47.47±12.43 and 44.28±10.70, respectively. According to the results of the linear regression model, the effective factors on overt anxiety consisted of the place of service, marriage status, age, and nurses’ contact with the COVID-19 patients for a period of minimum 15 days. The effective factors on covert anxiety consisted of marriage status and nurses’ contact with the COVID-19 patients for a period of minimum 15 days. Considering the results of the present study and the importance of nursing profession in such created crisis, it is necessary to develop some programs in order to increase the mental health of such personnel.

The prevalence of autism spectrum disorder is increasing recently, leading to a decline in individual performance and many problems in the family. The cause of the disease is still unknown. This study aimed to investigate the epidemiological factors in autism disorder in patients referred to psychiatric clinics of Shiraz University of Medical Sciences in 1397 in Shiraz.

This is a descriptive study. A total of 114 children were selected through convenience sampling. Data were collected through questionnaires including maternal information during pregnancy and data related to father and child.

The results showed that 54.3% of mothers who were giving birth were in the range of 20-29 years old and 32.1% of fathers were between 30 and 34 years old. 96.4% of parents did not smoke or drink during pregnancy. 66.5% of children were born by cesarean section and 70.8% of infants’ weight were in the range of 2500 to 3999 grams. 75% of mothers did not report pregnancy complications and 51.8% of the mothers had 38-37 weeks gestation.

The present study showed that the epidemiological factors in these children were in the normal range and more studies are needed to obtain the causes of this disease.

Face burn has several psychosomatic effects on patients. Good management leads to a decrease in adverse effects and consequently leads to quick and effective healing. This study aims to compare the results of dry dressing with oxygen therapy vs wet dressing on face burn wound healing.

86 patients with deep second-degree face burn were investigated. 50 patients received dry-dressing with oxygen therapy and 36 patients received wet dressing. The researchers compared these two groups in regard to the healing of deep second-degree face burn.

The age of the group that received dry dressing with oxygen therapy was 29.6 years in average, while it was 34.5 years (p-value=0.03) in the group that received wet dressing. The burn percent was 31.5% in average in the first group while it was 32.5% in the second group (p-value =0.74). The average healing day (Re-epithelialization) was 13 days in the first group and 13.2 days in the second group (p-value =0.74).

The results did not show any significant difference in the average days of wound healing in deep second-degree face burn in the group that received dry dressing with oxygen therapy vs the group that received wet dressing (p-value =0.74) although it was shorter in the group that received dry dressing with oxygen therap. Therefore two methods are useful in the management of deep second-degree face burn.

The Nursing Services Tariff Setting and Adjustment of Nursing Fees Act and Productivity Improvement Act for Clinical Staff have not been adequately implemented after more than ten years of approval. However, various pressures that put the health system in a difficult situation should be considered carefully. This study aims to make a multilateral analysis of nursing services tariff setting, its policy, and executive dimensions. Scenarios confronting the nursing services tariff setting are explained and evaluated.

The study followed a qualitative approach using library studies. The authors selected the participants using purposive sampling, while they collected data through semi-structured and in-depth interviews. Library data were analyzed and implicated using the stakeholder analysis method. The "policy analysis triangle" model has also been used to take a comprehensive and coherent approach to data collection, analysis, and presentation.

The research findings were categorized into four dimensions of this model, namely policy content, context, process, and actors, which clarified the required scientific and theoretical foundations, the existing documents in the field of pricing, the history and components of pricing, and the views of the main stakeholders on this issue.

In conclusion, possible scenarios have been evaluated to ensure both nurses' satisfaction and motivation while maintaining the quality of health services. Also, some suggestions have been made for short-term and medium-term actions that can provide the opportunity for fundamental reforms by reducing the current crisis severity.

Personality disorders are a group of mental disorders characterized by maladaptive patterns of behavior, cognition, and stable internal experience. The present study aimed to investigate the mediating role of anxiety tolerance and cognitive emotion regulation concerning childhood injuries and dependent personality disorders symptoms in nurses working in hospitals in Shiraz in 1399.

In this descriptive-correlational cross-sectional study, 291 nurses selected by simple cluster sampling at Shiraz University of Medical Sciences participated in the survey in 1398. The instruments used in the present study included the Childhood Injury Questionnaire, the Cognitive Emotion Regulation Questionnaire (CERQ), the Millon-3 Clinical Multi-Axis Questionnaire (MCMI-III), and the DTS Distress Tolerance Questionnaire. To analyze the statistical data, the authors used the Pearson Product Moment correlation coefficient by SPSS software version 16. They also used the structural equation model in AMOS-22 software to determine the fit of the studied model to analyze the path of observable variables.

The results showed that general injuries and childhood physical and sexual abuse could indirectly affect obsessive-compulsive personality disorder (p <0.05) and emotional abuse during childhood.

The present study results showed that abused nurses during childhood are more likely to show obsessive-compulsive personality disorder symptoms in adulthood.

Vitamin D deficiency or insufficiency is prevalent in patients with low back pain, while vitamin D deficiency links to chronic musculoskeletal pain and dyslipidemia. This study aimed to investigate the effectiveness of vitamin D with core stabilization exercise on lipid status in patients with chronic low back pain.

This quasi-experimental study was conducted in women with chronic low back pain. First, 48 patients were selected using the availability sampling method, and then they were randomly divided into four groups: control, exercise, vitamin D, and exercise + vitamin D (combined). Exercise and combination groups performed eight weeks of core stabilization exercises with different levels of Vitamin D, and combined groups received 50,000 IU vitamin D per week. Serum markers of triglycerides, total cholesterol, LDL-cholesterol, and cholesterol-HDL were measured before and after the intervention. Data were analyzed by paired t-test, ANOVA, and Kruskal Wallis tests with a significant level of less than 0.05.

The results showed that 74.26% and 25.64% of the patients had deficiency and insufficient vitamin D, respectively. Also, eight weeks of research interventions were associated with a significant reduction in triglyceride levels, total cholesterol, LDL cholesterol, and increased HDL cholesterol. In addition, the effect of the combined intervention was more significant in reducing triglycerides and cholesterol than exercise intervention and in lowering LDL cholesterol and increasing HDL cholesterol compared to the other two interventions (p < 0.05).

It seems exercise training, vitamin D intake, and a combination of these non-pharmacological interventions can improve lipid status in patients with chronic low back pain, but combination therapy is more effective.

Due to the high number of road traffic accidents in Iran and the significant rate of death and adverse complications caused by these accidents, it seems necessary to investigate the related factors. The aim of this study was to investigate the epidemiological characteristics of traffic accidents and the factors affecting the death of hospitalized patients due to accidents.

In this study, injured patients due to traffic accidents referring to the trauma hospital in Shiraz were randomly entered into the study for 6 months. The factors affecting the occurrence of an accident including the risk factors before the accident, during the incident, and at the time of hospitalization were investigated in the patient's mortality rate. A multivariable logistic regression was used to investigate the effect of factors on the patients’ chances of death.

In this study, 563 injured patients from traumatic accidents admitted to the recovery unit for a period of 6 months were investigated. Injuries and death in the first eight hours of admission are significantly higher than other hours. The results show that damage to the age group of 15-39 years, Glasgow coma score, injury severity score, trauma injury severity score, revised trauma score, head and neck injury score, and the history of having a surgery significantly increase the chance of death.   Among the areas of injury, having head and neck injuries as well as abdomen injury makes the chance of death 3.36 and 6.62 fold, respectively.

It is necessary to observe safety rules for drivers and passengers of the car more than before.  Also, patients   referring to trauma centers should be prioritized and treated based on the existing classification criteria and the risk assessment of death according to prognostic factors.

Diabetes is a chronic and common disease of the endocrine glands that puts patients at risk for emotional disorders, so given the negative effects of these two structures on the process of controlling and treating diabetes, psychological interventions seem necessary. Therefore, the authors conducted the present study to evaluate the effectiveness of Moritz-based metacognitive training on fasting blood sugar levels and the difficulty of regulating the excitement of patients with type 2 diabetes.

The research method was pre-test-post-test with a control group. Of the women with type 2 diabetes, 50 women with type 2 diabetes were assigned to two experimental (25) and control (25) groups based on convenience sampling. Research instruments included difficulty scaling (2004, DERS) and blood tests. After conducting the pre-test, the Moritz-based metacognitive training sessions group received eight 90-minute weekly sessions, and the control group was placed on the waiting list. Data were analyzed by repeated measurement of variance and Bonferroni follow-up test.

By adjusting the pre-test scores, there was a significant difference (p<0.001) between the experimental and control groups in the fasting blood sugar variable, and emotion regulation strategies including not accepting emotional responses, difficulty in conducting purposeful behavior, limited access to emotional regulation strategies, and lack of emotional clarity in the post-test stage.

Moritz-based metacognitive training can be used to reduce fasting blood sugar levels and the difficulty of regulating the excitement of people with diabetes.

Mental health is considered one of the most important health indicators of societies, which is specifically followed by psychiatrists, psychologists, and other behavioral and social scientists. Women comprise half of the world's population and have a direct role in nurturing the other half. Women are always at risk of mental problems due to their multi-dimensional role in society. Although women live longer than men, they are more vulnerable to mental disorders including depression, anxiety, and Alzheimer. This policy brief is achieved through evaluating presentations at the 8th International Conference on Women's Health with a special focus on women's Mental Health held on Nov 4&5, 2019 in Tehran, Iran. The topics of the conference included measures taken to promote women's mental health, the role of policy-making in women's mental health promotion, analysis of Iranian women's mental health status, family consolidation, vulnerable women, and tlerance. Based on the findings from presentations and expert panels, women's mental health status in Iran is not desirable. So, it implies the importance of preventive interventions and improving mental health services. Other strategies could be following recommendations provided to promote women's mental health in Iran including improving primary health care by mental health services, assigning a specified authority to enhance the intra-sectoral governance and inter-sectoral leadership.