فصلنامه سلامت و مراقبت
سال بیست و سوم شماره 4 (زمستان 1400)

Treatment adherence is one of the main factors in achieving maximum clinical efficacy. It seems that self-compassion and coping strategies of patients, can be effective on improving treatment adherence. The aim of this study was to investigate the mediating role of coping strategies in the relationship between self-compassion with treatment adherence in cardiovascular patients.

This research was correlational research using structural equation method. The number of 234 cardiovascular patients referred to the center of the heart of Shahid Madani in 2021 was selected as available samples. Data were collected using Raes's Self-Compassion Scale and coping with the stressful situations of Endler & Parker and Modanloo's Adherence questionnaire and then analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation and path analysis) in SPSS-24 and AMOS-24 software.

The results showed that self-compassion and Problem-Focused coping strategy had a direct, positive and significant effect on treatment adherence (p<0.001), while Emotion-Focused and avoidance strategies had a direct, negative, and significant effect on treatment adherence (p<0.001). Self-compassion also had a direct, positive, and significant effect on Problem-Focused strategy (p<0.001) and a direct, negative, and significant effect on Emotion-Focused and avoidance strategies (p<0.001). The results of Sobel test showed that self-compassion through coping strategies (Problem-Focused Strategy, β=0.19; Emotion-Focused Strategy, β=0.08; Avoidance Strategy, β=0.11) had an indirect, positive and significant effect on treatment adherence (p<0.001).

The results confirmed that self-compassion through coping strategies increased treatment adherence through coping strategies. According to the findings, it is possible to prepare educational programs that affect self-compassion and the using of adaptive coping strategies of patients.

Problem-based learning, as a relatively new educational approach, has found a high status in higher-educational institutions. The present study aimed to investigate the effect of problem-based learning on nursing students' communication skills.

This is a quasi-experimental study, in which a total of 78 fourth-year nursing students were recruited and allocated into two groups of intervention (n=43) and control (n=35). Participants in the intervention group received eight 60-minute sessions of problem-based learning and a post-test was conducted one month after the intervention. Data were collected using a demographic questionnaire and the verbal and non-verbal communication skills questionnaire. Data were first entered into the SPSS statistics, version 16. 0 (SPSS Inc., Chicago, Ill., USA) and then analyzed using independent-samples t-test, paired-samples t-test, and chi-squared test.

There was a statistically significant difference between the mean scores of baseline and the post-intervention verbal communication skills in the control and intervention groups (p<0.05). The results of independent-samples t-test showed that the difference in the mean scores of verbal communication skills was statistically significant between the two groups (p=0.002). Moreover, the difference between the baseline and the post-intervention mean scores of non-verbal communication skills was found to be statistically significant in the control and intervention groups (p<0.05) The results of independent-samples t-test also indicated that the difference in the mean scores of non-verbal communication skills was statistically significant between the two groups (p=0.004).

  Problem-based learning has shown to be effective in improving students' verbal and non-verbal communication skills. Therefore, it is recommended to develop students' communication skills by using effective methods of nursing education, especially problem-based learning. Accordingly, students would be able to act more efficiently in the clinical setting and make better clinical decisions.

Depression is the most common psychopathological disorder among hemodialysis patients. This disorder can reduce the quality of life of patients. adequacy of dialysis and demographic characteristic can be effective factors in the prevalence of depression disorder. The aim of this study was to determine the relationship between depression and dialysis adequacy and demographic characteristic in hemodialysis patients.

The present cross-sectional study was conducted on 102 hemodialysis patients referred to Tohid hospital in Sanandaj, Participants were selected by convenience sampling method. Demographic characteristics form and Beck depression questionnaire are used to data collecting. Dialysis adequacy was measured with KT /V standard. The data were analyzed using the SPSS-21. Descriptive statistical methods (mean and standard deviation) and multiple regressions were used.

Results showed that 76% of patients had depression. There were no significant differences between depression and dialysis adequacy (p=0.06).

The results showed that there was no significant relationship between the adequacy of dialysis and depression in these patients. Therefore, due to the high prevalence of depression in these patients, it is necessary to pay more attention to this problem. Also in order to clarify the issue, more study is needed.

One of the important areas of midwifery services is safe satisfying delivery with the least amount of pain. The moral and professional commitment of health professionals and caregivers is the most important aspect of labor pain management. So, the purpose of the study was to assess the relationship between observance codes of professional ethics by the birthing team with the perception of labor pain as the parturient viewpoint in Yasuj city.

This was a descriptive correlational study involving 200 parturient women who were referred to a labor center affiliated to Yasuj university of medical sciences for vaginal birth. The sampling method was convenient sampling method. For collecting data, three questionnaires, comprising demographic information, perception of labor pain questionnaire, and a questionnaire about women's attitudes toward medical ethics in the childbirth process were completed by parturient women during 24 and 48 hours after delivery. The data were loaded into SPSS-22 and analyzed using the Pearson correlation coefficient and multiple linear regression analysis in p<0.05 significance level.

The results of multiple regression analysis showed that among the four principles of professional ethics, the first (autonomy), second and third principles of medical ethics (as beneficence and non-maleficence) predicted the perception of labor pain (p<0.05). Among the components of these principles, mother’s privacy related to first principle (B=-0.28, p=0.003), mother’s health (B=-0.23, p=0.017) and mother’s need for pain reductions (B=-0.18, p=0.014) related to second and third principles were negative predictors of labor pain perception score.

According to the findings of this study, the birthing team can make a pleasant experience for mothers by considering autonomy, benefice, and non-malfeasance principles to parturient and improvement of communication skills in the delivery room. As a result, it would be taken a step in the improvement of maternal and child health and the prevention of further irreversible mental damage.

Adherence to ethical standards is an effective factor in improving the performance of nurses in providing quality care. Nursing ethics and ethical care is one of the main goals of the health care system in the world. The aim of this study was to investigate the level of professional ethics and factors related to facilitate its observance in nurses working in Ardabil and Khalkhal teaching hospitals.

The present study is a descriptive-correlation study that was conducted in 2020 on 435 nurses working in Ardabil and Khalkhal universities of medical sciences. Samples were selected by random sampling method and completed the questionnaires for ethical standards and the factors that facilitate the observance of ethical standards. Data were analyzed using SPSS 22 software by pair T test.

The findings of the study showed that 59.8% of nurses had good moral performance. Also, 42.41% of nurses in dimension of responsibility, 69% in dimension of improving the quality of care and 55.9% in dimension of patient respect had good performances. Adequate scientific knowledge and awareness about nursing care with 62.8% was the most important factor facilitating ethics in nurses. The results of paired t-test showed that there was a statistically significant relationship between compliance with ethical criteria and its facilitators (P <0.05).

The findings of the present study showed that the moral performance of nurses was good and adequate scientific knowledge and awareness about nursing care was the most important factor facilitating the observance of ethical principles in nurses. Survey the current situation and identifying the causes and factors affecting the observance of professional ethics can be considered by nursing managers in eliminating the ethical and professional shortcomings of nursing.

Bulimia nervosa, as a common psychological disorder, negatively affects the lives of people with this disorder and reduces their quality of life. This study aimed to compare the effectiveness of cognitive-behavioral therapy and self-healing on quality of life in women with bulimia nervosa.

This study was pretest-posttest quasi-experimental research with the control group. The statistical population of the study included all women with bulimia nervosa who had been referred to specialists and medical centers in Isfahan in 1398. 45 women were selected by purposive sampling and randomly placed in experimental and control groups. Data were collected via WHO Quality of Life questionnaire. Each of the experimental groups underwent 12 sessions of cognitive-behavioral group therapy, and self-healing group therapy, but the control group did not receive any training. Analysis of Mancova in SPSS-24 software was used to analyze the data.

Based on the chi-square test, no significant difference was observed in terms of age, education, and disease duration between the three groups (p<0.05). The results showed that the cognitive-behavioral and self-healing experimental groups were significantly different from the control group in all variables of quality of life (p<0.001). Also, self-healing therapy increased the psychological, physical, and environmental dimensions of quality of life more than cognitive-behavioral therapy (p<0.05).

According to this study, cognitive-behavioral therapy and self-healing can be used to increase the quality of life of women with bulimia nervosa. However, self-healing treatment seems to be more effective than cognitive-behavioral therapy in this case.

Stress in any physical illness makes its symptoms worse. Hypertension is a common illness that psychological factors such as stress can worsen its symptoms and complications; the present study aimed to evaluate the effectiveness of Roy's adaptation model on alexithymia and diet adherence in people with hypertension comorbid with stress.

This was a quasi-experimental study with a pretest-posttest design and a control group. Using the convenience sampling method, 40 patients with hypertension comorbid with stress    (21 females and 19 males) who were referred to Aligudarz city medical centers in 2021, were selected by convenience sampling method and randomly assigned to the experimental (n=20) and control (n=20) groups. The experimental group received a Roy's adaptation model intervention for 8 sessions of 60 minutes, but the control group did not receive any intervention. The data were collected by the stress, anxiety and depression questionnaire, Toronto emotional dysfunction scale, diet information record form and a form for assessing Roy’s adaptation model.

The results of covariance analysis showed that Roy's adaptation model was significantly effective in reducing alexithymia (F=235.24, p<0.01) and increasing diet adherence (F=540.87, p<0.01) in hypertension patients comorbid with stress.

 The results of this study suggest that Roy's adaptation model significantly decreased the alexithymia and increased diet adherence, therefore using Roy's adaptation model in hypertension patients comorbid with stress is recommended.