مجله طب نظامی
سال بیست و چهارم شماره 4 (پیاپی 113، تیر 1401)

 Military personnel are prone to depression due to their job’s nature and requirements. Therefore, the use of accurate and efficient screening tools to diagnose depression is essential. The aim of this study is to investigate the psychometric properties of the Iranian version of the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) in the military community.

 The present study is a descriptive-correlational and validation study. In this regard, a sample of 410 volunteers was chosen from the 505th specialized military psychiatric hospital of the Islamic Republic of Iran. In addition to the demographic questionnaire, participants also completed the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) and the Beck Depression Inventory II (BDI-II). Then the face and content validity, internal consistency, test-retest validity, cut-off point, and sensitivity and specificity of the inventory were analyzed by using qualitative method, Cronbach's alpha, Pearson correlation coefficient, independent means comparison test, and receiver operating curve analysis which were all done via the SPSS-26 software.

 The results showed that this inventory has good content and face validity. The internal consistency of 0.91 and the reliability coefficient of the test-retest indicates the stability of the scores in the interval of 3 days. The independent t-test showed that this inventory can differentiate between depressed and non-depressed people. The sensitivity of the inventory was 0.87 and its specificity was 0.73. Therefore, according to the most appropriate sensitivity and specificity, the cut-off point of the quick inventory of depressive symptomatology was 17.

 The findings indicated that the list of quick inventory of depressive symptomatology has good validity and reliability among the Iranian military population and can be used in research and clinical situations.

 Job burnout is one of the major unavoidable consequences of job stress. Nurses experience the most occupational stress due to job problems and difficult working conditions and are exposed to high job burnout. Therefore, the purpose of this study was to compare stress and job burnout in nurses in the wards of patients with COVID-19 and non-COVID-19 patients.

 This research is a cross-sectional (descriptive-analytical) study that was conducted in 1400. Its statistical population included caring nurses in the wards of patients with COVID-19 and non- COVID-19 patients in Aja affiliated hospitals in Tehran. A total of 96 nurses were selected as the research sample. The data were collected using the demographic information form and HSE (Health and Safety Executive) occupational stress and burnout questionnaires of Copenhagen and were analyzed using the SPSS.v25 software, descriptive and inferential statistics, and independent t-test.

 The results of the independent t-test showed that there is a significant difference between the burnout dimensions of the two groups of nurses, and in nurses, the wards of patients with COVID-19 were higher than the wards of non-COVID-19 patients (P=0.03). The results of the independent t-test did not show any significant difference between the work-stress dimensions of the two groups. The results of Pearson's correlation test in non-COVID-19 patient’s departments, between nurses' burnout with role dimension (r=0.03) and demand dimension (r=0.02) and between burnout with patients and control dimension (r=0.004) and the demand dimension (r=0.007) was significant. In the wards of patients with COVID-19, the Pearson test results showed a significant difference between personal burnout and the demand dimension (r=0.01).

 Considering the importance of work environment tensions and their effect on nurses' burnout, it is suggested that the authorities should plan appropriately to reduce the factors of nurses' burnout via psychotherapy consultations, holding programs Fun and morale-giving, reducing consecutive shifts, improving work-rest cycles, and providing motivational items.

 Hospital preparedness in disasters is an important role in maintaining and promoting community health. Hospital disaster risk management accreditation standards have been developed since 2016. This study was conducted to investigate the implementation of these standards in the country's hospitals to identify the strengths and weaknesses of hospitals and provide practical solutions.

 This descriptive cross-sectional study was performed in hospitals throughout the country. The results of the evaluation of the third round of accreditation in 2017 were used. Hospitals were evaluated by national accreditation surveyors of the Ministry of Health using a checklist related to accreditation standards and measures based on disaster risk management (seven standards and 37 criteria) and registered in the country's accreditation system. Descriptive statistics were used to analyze the data.

 The average score of the country's hospitals in the field of disaster risk management was 48.82. Zanjan (58.27) and Qazvin (56.44) provinces have the highest score and Ilam (25.36) and Lorestan (38.39) provinces have the lowest score. The highest score was in the first standard (disaster risk assessment and prioritization) with an average of 67.78 and the second standard (fire prevention and control) with an average of 67.05. The lowest scores were related to the fifth standard (reporting accidents and dangerous situations) (29.38) and the seventh standard (activating response systems) (32.33). More than 75% of the country's border provinces (Ilam, Kermanshah, Khuzestan, Kurdistan, Khorasan Razavi, North Khorasan, Sistan and Baluchestan, East and West Azerbaijan) have scored less than 50%.

 The results of this study showed that the average scores of the country's hospitals in disaster risk management was low and the country's hospitals, especially hospitals in border provinces, are not adequately prepared to deal with disasters. The biggest weaknesses of hospitals in the scientific formulation of preparedness and response programs are the lack of knowledge about the national instructions of preparedness and response, lack of education and training, non-structural vulnerability, and infrastructure of hospitals. Strengthening the safety and resilience of hospitals, improving the level of knowledge and skills of managers and staff, and improving the quality and continuous review of standards based on the challenges of the hospital, are among the strategies for developing and improving hospital preparedness for disasters.

Posttraumatic Stress Disorder (PTSD) is the fourth most prevalent psychological disease that not only disrupts the different live domains of the affected individuals but also negatively influences their spouses and children. The present study investigates the effect of Acceptance and Commitment Therapy (ACT) on emotional irritability and numbness in the children of veterans suffering from war-induced PSTD.

The design of the present study is a randomized controlled clinical trial with pretest and posttest. Participants were selected by simple random sampling from the children of veterans with war-induced PTSD. According to the inclusion criteria, 70 girls and boys with an age range of 15-19 years were selected and randomly assigned into two 35-person groups, including the experimental group (Acceptance and commitment therapy, ACT) and the control group (training life skills for adolescents). Before and after the intervention, the participants filled out the questionnaire of Crick et al. and the emotional numbness subscale of the post-traumatic stress disorder checklist (PCL). The experimental group received ACT for 8, 60-90-minute sessions, and the control group was provided with 7, 60-90-minute sessions on life skill protocols for adolescents. Finally, the obtained data were analyzed by the SPSS 22 software.

The results showed that the irritability averages of both groups were significantly different in the posttest (P<0.01). Furthermore, the ANCOVA results revealed that the posttest scores of both groups were not significantly different in the emotional numbness variable (P>0.05).

The findings of this study displayed that ACT reduced irritability in the children of veterans suffering from PTSD. Thus, this therapeutic method can be employed in mental health and counseling centers for improving the symptoms of these children.

 Metabolic syndrome is considered as an important public health problem and there are few reports of this disease in the military, therefore, this study was performed to determine the prevalence of metabolic syndrome and its risk factors among the personnel of a military population.

 This descriptive cross-sectional study was conducted in 2021. In this study, 368 law enforcement personnel referred to the annual health monitoring plan, values of age, height, weight, body mass index (BMI), abdominal circumference, pelvic circumference, systolic pressure, diastolic pressure, fasting blood sugar, cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and alanine aminotransferase (ALT) were measured. Metabolic syndrome was calculated by two criteria, Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF).

 The mean age, weight, and BMI of the participants in this study were 39.50 years, 83.74 kg, and 27.16 kg/m2, respectively. Abnormal levels of blood pressure, fasting blood sugar, triglycerides, cholesterol, HDL, LDL and ALT in individuals were 9.2%, 16.6%, 50.5%, 4.9%, 66.6%, 1.9% and 22.6%, respectively. A high value of body mass index was observed in 83.1% of people. The waist calculated values according to ATP III and IDF criteria were 7.1% and 35.9%, respectively. The prevalence of metabolic syndrome according to the ATP III and IDF criteria were 17.7% and 20.7%, respectively in the total population. There were positive corrections between metabolic syndrome with BMI and age. The prevalence of metabolic syndrome according to the ATP III and IDF criteria were 17.7% and 19.7% in the operational military unit, and 17.6% and 21.8% in the headquarters military unit, respectively.

 The results of the present study show that approximately one fifth of the studied military personnel have metabolic syndrome. Although this amount is less than the average of the society, considering the lifestyle and job of the military, and to achieve the high goals specified for this organization, the same amount needs attention. Therefore, the use of various educational methods to control weight and diet, as well as increase physical activity is recommended.

Iranian veterans have suffered spinal cord, chemical, psychological, and amputation injuries due to the eight-year war in Iraq, which has necessitated long-term care. Most caregivers are their spouses. In this study, the overall quality of life score of the wives of Iranian veterans has been estimated.

In this systematic review and meta-analysis, the databases of Scientific Information Database (SID), MagIran, PubMed, ISI, and Scopus were searched with the keywords war veteran, quality of life, Iran, and their combinations without time limit. Data were analyzed using meta-analysis and random-effects model. Heterogeneity between studies was assessed by I2 test. Meta-regression was used to investigate the relationship between quality of life score with the year of publication and sample size of articles.

Fourteen studies with a sample size of 2905 people were analyzed. The pooled score of quality of life of veterans’ wives was 59.86% (95% CI: 48.20-71.51) in the physical dimension and 57.67% (95% CI: 46.81-68.53) in the psychological dimension. The highest and lowest scores of quality of life of veterans’ spouses in the physical dimension were related to the subscales of physical function (58.72%, 95% CI: 42.74-50.94)) and pain (43.55, 95% CI: 34.69-52.42), respectively; and in the psychological dimension were related to the subscales of social performance (53.56%, 95% CI: 42.43-64.70) and psychological role limitation (41.52%, 95% CI: 36.52-46.29).

Veterans' wives have a relatively low quality of life due to intensive and long-term care of veterans, and it seems necessary to pay more attention to this group.

 Coronavirus disease 2019 (COVID-19) pandemic has caused a great deal of conflict and tension between couples and their families. Meanwhile, less attention has been paid to potential tensions and conflicts in families exposed to high stress, such as military families. Therefore, this study was conducted to investigate the effect of cognitive-behavioral therapy on changing the conflict resolution styles in military personnel and their spouses during the COVID-19 pandemic.

 In this quasi-experimental study, 66 military personnel and their spouses were included. They were then assigned to the case (n=32) and the control (n=34) groups using block randomization method. Data were collected by using a demographic information form and Rahim Organizational Conflict Inventory-II. The later form was completed before, immediately after, and one month after the intervention. Cognitive-behavioral therapy was presented to the case group during 9 sessions. Each session lasted 90 minutes. The Control group underwent no intervention. Independent t-test, Chi-square, and Fisher's exact test were used to analyze the data by SPPSS software (version 22).

 The results showed that the use of non-constructive conflict resolution style was significantly reduced in the case group compared to the control group (P<0.001) after the implementation of cognitive-behavioral therapy. In addition, it was found that the use of constructive conflict resolution style increased significantly in the case group compared to the control group (P<0.001).

 Our findings suggested that cognitive-behavioral therapy reduced the use of non-constructive conflict resolution style but increased the use of constructive conflict resolution style among military personnel and their spouses.