Jundishapur Journal of Chronic Disease Care
Volume:11 Issue: 4, Oct 2022

Elderly people can be exposed to a number of psychological disorders, including death anxiety, due to the many changes they experience during the aging process, which affects their quality of life.

The present study aimed to determine death anxiety and associated factors in the hospitalized and non-hospitalized elderly in Ahvaz in 2019.

This descriptive cross-section study enrolled a convenience sample of 195 hospitalized and non-hospitalized elderlies in Ahwaz. Data collection tools included the demographic characteristics form and death anxiety questionnaire. Independent t-test, chi-square, and ANOVA analyzed data in SPSS v.16 software. Data collection was instituted after approval of the research ethics committee, and all ethical considerations such as informed consent were met.

This study was undertaken on 195 elderlies with a mean age of 66.06 ± 5.59 years (60 to 88 years), most of whom were male (61%). The mean death anxiety score was 111.98 ± 19.27 for hospitalized elderlies and 100.002 ± 25.12 for non-hospitalized ones. Statistical tests revealed that the two groups significantly differed in the total score of death anxiety and all its subscales except for the death of acquaintances (P < 0.05). Death anxiety had a statistically significant relationship with education level, gender, and marital status.

The hospitalized, female, and low-educated elderly and those living alone had more death anxiety. Thus, it is imperative to offer social support to this vulnerable elderly group, perform periodical psychiatric evaluations, and utilize psychological interventions to improve the elderly's quality of life.

Coronavirus disease 2019 (COVID-19) severity and mortality have been found to be directly associated with age, chronic diseases, and immune system deficiency. Therefore, older adults suffering from chronic diseases are at a higher risk of the serious complications of COVID-19 and receive less social support, compared to younger age groups, which usually results from complicated treatment regimens. Moreover, the increase in age is accompanied by changes in the quality of psychological well-being. Considering this group’s higher vulnerability, it is essential to identify the factors related to their psychological well-being, such as happiness and hope.

Therefore, the present study aimed to determine the relationships between happiness and hope with adherence to the treatment regimen among older adults with chronic diseases during the COVID-19 pandemic in 2020.

This descriptive-analytical study was conducted on 216 older adults over 55 years of age who suffered from chronic diseases in comprehensive centers for the elderly. The data were collected using validated instruments, such as the Morisky Medication Adherence Scale, Oxford Happiness Questionnaire, and Herth Hope Index. Then, the data were entered into SPSS software (version 24) and were analyzed using descriptive statistics, dispersion indices, and regression.

The mean age of the study participants was 70.64 ± 10.56 years. The mean scores of adherence to treatment, hope, and happiness were 65.72 ± 7.1, 73.91 ± 29.3, and 47.74 ± 34.10, respectively. Based on the results, good adherence to treatment was observed in 128 (59.3%) participants. The results revealed no significant relationship between the mean scores of hope and adherence to the treatment regimen (b = 0.037, P = 0.222). However, a significant relationship was observed between the mean scores of happiness and adherence to the treatment regimen (b = 0.036, P = 0.001).

Interventions aiming at increasing such patients’ happiness levels might be effective in their health-related behaviors, including adherence to treatment regimens, improvement of the disease process, and enhancement of quality of life.

 Distress tolerance has increasingly been used as an important construct to develop a novel insight into the onset and persistence of psychological traumas as well as prevention and treatment.

 The present study investigated the relationship between social support and distress tolerance with death anxiety using artificial neural networks (ANN) in human immunodeficiency virus (HIV)-positive cases.

 The research method was descriptive-correlational. The statistical population included all the HIV-positive cases of Ahvaz in 2021. The convenience sampling method was employed to select 91 participants as the research sample. The research instruments included the Death Anxiety Scale (DAS), the Social Support Survey (SSS), and the Distress Tolerance Scale (DTS). The Pearson correlation coefficient, simultaneous regression, and ANN were used for data analysis.

 The mean and standard deviation (SD) of death anxiety, social support, and distress tolerance were 9.07 ± 2.76, 63.78 ± 18.05, and 37.49 ± 12.91, respectively. The results showed a negative correlation between death anxiety, social support, and distress tolerance. Also, there was a significant negative relationship between social support and death anxiety (β = -0.31, P < 0.001). There was also a significant negative relationship between distress tolerance and death anxiety in HIV-positive cases (β = -0.53, P < 0.001).

 It is now more necessary than ever before to consider the effects of social support and distress tolerance on death anxiety in HIV-positive cases. Apparently, their death anxiety is affected by other factors and their interactive effects.

Epilepsy is a worldwide common neurological disorder characterized by an enduring predisposition to epileptic seizures. Protective elements are circumstances that help an individual cope with stressful events more effectively. Resilience may act as a protective factor against the subjective experience of hardship, especially when receiving a probable negative medical diagnosis.

The purpose of this study was to explore resilience among patients with epilepsy.

This descriptive-analytical study was performed in 2021 on 250 patients with epilepsy referred to selected medical centers in Isfahan, who were selected by the simple random sampling method. Data collection tools included a demographic information questionnaire and Connor- Davidson Resilience Scale (CD-RISC). Data were analyzed in SPSS software version 26 using descriptive statistics such as the mean and standard deviation for quantitative variables and frequency and percentage for qualitative variables. Stepwise regression tests were used to examine the relationship between independent variables and dependent variables while controlling contextual and confounding variables.

In this study, the mean (standard deviation) of the resilience score in epileptic patients was 60.34 ± 19.86. The socioeconomic status and the level of education, but not martial status and gender, were found to correlate significantly with resilience (P = 0.445 and P = 0.396, respectively). Duration of epilepsy, age, and job status inversely correlated with resilience (P = -0.269, P = -0.131, P = -0.155, respectively).

According to the results of this study, increasing knowledge and understanding of the relationship between epilepsy and resilience may help obviate this problem in patients with epilepsy.

Considering the problems, multiple diseases, disabilities, and the increased likelihood of suicidal ideation aroused by mental disorders among the elderly, the present study aimed to study the effects of reminiscence on depression in elderly people with suicidal ideation living in a nursing home.

This is a clinical trial study. Considering the inclusion criteria, 30 elderly persons were selected regarding the inclusion criteria and then assigned to two intervention (n = 15) and control (n = 15) groups using the simple random method. An educational program on reminiscence protocol was held in eight sessions. The participants were asked to complete the suicidal ideation, depression, and mental status questionnaires before, immediately after, and one month after the intervention. chi-squared, Mann-Whitney, and Friedman tests were used to analyze the data with SPSS software version 25.

The experimental and control groups were homogenous in terms of marital status, age, gender, psychological status, suicidal ideation, and level of education (P > 0.05). Comparison of the mean scores of depression showed a significant difference between the experimental and control groups immediately after (P = 0.037) and one month after the intervention (P = 0.030). However, before the intervention, no significant difference was observed between the two groups (P = 0.899)

According to the findings of this study, reminiscence as a nursing intervention can improve depression in the elderly with suicidal ideation. Accordingly, holding group reminiscing sessions in places such as nursing homes can be effective in reducing depression symptoms and preventing suicidal ideation in the elderly.

 Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in school-aged children.

 This study assessed the effectiveness of metacognitive therapy in behavioral-emotional problems, cognitive-emotional regulation strategies, and mind wandering in children with ADHD.

 This quasi-experimental study utilized a pretest-posttest design with a control group. The statistical population comprised all students referred to the West Health Center of Ahvaz in 2019. A sample of 45 patients was selected and randomly divided into intervention (MCT, n = 15) and control (n = 15) groups. The experimental group underwent eight sessions (90-minute sessions per week) of MCT, and the control group did not receive any intervention. The research instruments included the Cognitive-Emotional Regulation Questionnaire-children form (CERQ-K-P), Rutter Children Behavior Questionnaire (RCBQ), and Mind Wandering Questionnaire (MWQ). Multivariate analysis of covariance was used to analyze the data.

 The participants included 30 children aged 10.92 ± 2.02 years. In the experimental group, the average score of behavioral-emotional disorder changed from 30.78 to 24.14, cognitive-emotional regulation strategies from 58.34 to 69.43, and mental wandering from 78.18 to 85.14. In the control group, the average score of RCBQ changed from 29.17 to 30.58, CERQ-K-P from 54.5 to 52.34, and MWQ from 19.77 to 19.87. The MCT effectively reduced behavior-emotional problems and mind wandering and improved cognitive-emotional regulation strategies in children with ADHD (P < 0.05).

 Metacognitive therapy improved behavioral-emotional problems, cognitive-emotional regulation strategies, and mind wandering in ADHD children. Therefore, metacognitive and psychiatric treatments are recommended for these patients.

Families of children with thalassemia may become exhausted due to the frequent hospitalizations of the child for blood injections and because of spending a great deal of time learning about and managing this disease.

The aim of this research was to explain supportive systems for parents of children with thalassemia.

This study was done at Hajar hospital in Shahrekord in 2017. Content analysis was used. Ten samples consisting of 5 mothers, one grandmother, two fathers, and two nurses were selected purposely in this study. A semi-structured, face-to-face interview was used.

Based on data analysis, three categories of the need for supporters, lack of consultative services, and economic problems were obtained.

Since thalassemia is a chronic disease, the parents of these children need support and consultative services throughout their life. It is necessary for authorities and healthcare planners to take measures in order to support parents of children with thalassemia (the forgotten part of the health system). The consultant-trained nurse has an important role in supporting these families.

Low back pain (LBP) is the leading cause of disability in the world. This study aimed to evaluate the effect of acupressure on LBP intensity and depression among chronic nonspecific LBP patients.

This sham-controlled randomized clinical trial was performed on 84 patients with chronic nonspecific LBP. The data were collected using a demographic information questionnaire, the Visual Analogue Scale (VAS), and the Beck Depression Inventory-II (BDI-II). The participants were randomly assigned to acupressure (n = 42) and sham (n = 42) groups. The acupressure group was trained on how to apply pressure on Yin tang, Feng Chi, and Shu Fu acupoints; nevertheless, the sham group was trained on how to apply pressure on Chen Jiang, Huang Shu, and Ji ache acupoints. The participants in both groups applied acupressure once a day for 4 weeks. Both groups completed the VAS and the BDI-II again one day after the intervention.

No significant differences in LBP intensity (P = 0.45) and depression (P = 0.26) were observed between the two groups before the intervention. By controlling the baseline scores of LBP and depression, analysis of covariance revealed that the LBP and depression of the acupressure group significantly improved after the intervention, compared to the sham group (P < 0.05).

Applying pressure on Shu Fu, Yin Tang, and Feng Chi points is effective in reducing LBP and depression among chronic nonspecific LBP patients. The findings of this study can be used in designing and evaluating more robust protocols.

Royal jelly is a supplement with various vitamins and active ingredients, which can create good physiological adaptations in the body along with training.

This study aimed to examine the effect of high-intensity interval training (HIIT) with royal jelly on serum glucose, insulin, and insulin resistance index of overweight and obese middle-aged men.

In this quasi-experimental study, 60 men were randomly assigned to four groups: (1) Control, (2) training, (3) royal jelly, and (4) training + royal jelly. The training and training + royal jelly groups implemented the exercise program. The HIIT protocol included eight weeks of high intensity (85 - 95% of the maximum heart rate) and active rest periods (60 - 70% of the maximal heart rate). The royal jelly group used one 1000 mg capsule daily. Extra-group data analysis was conducted by one-way ANOVA and Tukey post hoc test, and in-group analysis was carried out by dependent t test using SPSS version 22 software. A P value < 0.05 was considered statistically significant.

A significant increase was observed in weight from the pretest to posttest in the groups of royal supplement (P = 0.001), training (P = 0.001), and training + royal supplement (P = 0.0001). However, blood glucose, insulin, and insulin resistance index showed a significant decrease between posttests as well as pretest and posttest groups (P ≤ 0.05).

High-intensity interval training (HIIT) combined with royal jelly supplementation could improve blood glucose and insulin levels in obese or overweight people prone to cardiovascular disease and diabetes.