فصلنامه سلامت و مراقبت
سال بیست و چهارم شماره 3 (پاییز 1401)

Addiction is a chronic relapsing mental disorder defined by physical and psychological dependence on substances. The present study was conducted with the aim of modeling the structural relationships between dysfunctional personality beliefs and the dependence intensity in substance dependent people with the mediation of difficulty in emotion regulation.

The intended research was applied in terms of purpose and among correlational research. The statistical population included all drug addicts who referred to addiction treatment camps in Ardabil in 2021. Two hundred addicted people completed the questionnaires of dependency intensity, emotion dysregulation, and dysfunctional personality beliefs using available sampling method. Pearson correlation coefficient and structural equation modeling were used to analyze the data.

The results of the correlation coefficients showed that the severity of substance dependence has a positive and significant relationship with ineffective personality beliefs (r=0.44, p=0.001) and difficulty in regulating emotions (r=0.49, p=0.001). Also, difficulty in regulating emotions has a positive and significant relationship with dysfunctional personality beliefs (r=0.25, p=0.001). The model had a good fit based on the goodness of fit indices. Dysfunctional personality beliefs had an effect on dependency severity both directly and indirectly through the mediation of difficulty in emotion regulation.

From a practical point of view, it is necessary to provide regular training programs for substance dependent people using the principles of cognitive-behavioral therapy to determine the patients’ dysfunctional beliefs about addiction, and ultimately helping the patients to create more effective beliefs and behaviors, and cadaptive emotion regulation strategies.

Pregnancy causes several physical and psychological changes. Therefore, pregnant women may face with numerous issues and problems including stress and marital dissatisfaction. This study was conducted to compare the effectiveness of two cognitive-behavioral and emotion-oriented couple therapy training methods on perceived stress and marital satisfaction in primiparous women.

In a semi-experimental design using a pre-test and post-test with the control group plan, 60 pregnant women were chosen by considering the inclusion criteria, and then they randomly divided into three 20-subject groups (two experimental groups and one control group). The Experimental groups were trained on cognitive-behavioral and emotionally focused in 8 sessions of 90 minutes, while the control group did not receive any training during this time. The tools which are used to collect data were the Perceived Stress Scale of Cohen and Enrich Marital Satisfaction questionnaire. Data were analyzed by using mean, multivariate analysis of covariance in SPSS software version 23 at a significance level of 0.05.

Findings showed that both cognitive-behavioral and emotionally focused approaches are practical on perceived stress, marital satisfaction (and its subscales) (p<0.05). Cognitive-behavioral couple therapy (17.6±2.99) was more effective than emotionally focused therapy (24.8±4.74) on perceived stress (p<0.05). On the other hand, emotionally focused couple therapy (158.7±6.64) was more effective than cognitive-behavioral therapy (144.9±4.9) on marital satisfaction and some of its components including personality issues and marital relationship.

Due to the greater effectiveness of cognitive-behavioral couple therapy on perceived stress and also the greater effectiveness of emotionally focused couple therapy on marital satisfaction, they reduce stress and improve marital satisfaction and then can be used as effective methods during pregnancy

 Women’s sexual function and satisfaction is often ignored by health professionals in the postpartum and breastfeeding periods. The aim of this study was to determine the status of sexual function and satisfaction in lactating women in Ardabil in 2019.

 An analytical, cross-sectional study was conducted on 371 lactating women attended in health care centers of Ardabil city in 2019 (from July 5 to the end of December). Health centers were selected by cluster-stratified sampling method. Then, convenience sampling approach was used to recruit the eligible lactating women from fourth week to 6 months after delivery. Data collection scales were three questionnaires (demographic, Rosen's sexual function and Hudson's sexual satisfaction) which were completed by a trained health expert or midwife in the center. Data analysis was performed in SPSS version 23 at significance level of p<0.05.

 The mean total score of sexual function was 21.73±3.99. Pain (1.87±93) and satisfaction (4.99±1.13) dimensions had the lowest and highest scores, respectively. There was a direct and significant correlation (r=0.000, p=0.613) between women’s sexual function and satisfaction. There was a statistically significant relationship between the variables of women's age (p=0.022), women's education (p=0.006) and husband’s income (p=0.011) with women's sexual function and between the variables of woman's age (p=0.000), husband's age (p=0.021), husband's income (p=0.000), number of births (p=0.011) and having a private room (p=0.027) with sexual satisfaction of lactating women in 4 weeks to 6 months after birth.

 Besides sexual satisfaction, the majority of lactating women were suspected to have sexual dysfunction. It seems that more attention should be given to sexual health in the lactating women by health providers and physicians.

The COVID-19 outbreak is a main challenge for clinical education which has faced nursing students and their tutors with problems in clinical settings. The purpose of this study was to determine the quality of clinical education from perspective of nursing students during the outbreak of COVID-19 in Ardabil University of Medical Sciences

The present study was a descriptive and cross-sectional design in which 234 nursing students from Ardabil University of Medical Sciences participated by convenience sampling method. Data collection tools were demographic questionnaire and a questionnaire for assessing effective factors on the quality of clinical education. Data were analyzed by SPSS version 22 using descriptive (mean and standard deviation) and analytical statistical tests (Independent-sample t test, One-Way ANOVA and Pearson correlation coefficient).

The mean score of quality of clinical education in nursing students was 41.91 ± 13.56. The highest mean quality score of clinical education belonged to the domain of dealing with students (1.41±0.67) and the lowest mean score possessed by the domain of monitoring and evaluation (1.09±0.77). There was a significant relationship between students’ academic years and the level of quality of clinical education (p<0.001).

The quality of clinical education from the perspective of nursing students was moderate. From the students’ perspective, the dimension of dealing with students was reported as the most effective domain and the domain of assessment or evaluation was graded as minimum importance. Educational interventions are recommended to be carried out during the COVID-19 outbreaks including improvement of the educational goals in the clinical environment, improving clinical performance of the instructors, improving communication between medical staff and nursing students, revision of evaluation process of nursing students, and the enhancing the qualities of welfare facilities in medical centers

Thinking to death is one of the main concerns of patients with diabetes and is associated with anxiety or stress. In addition, limitations imposed by long-term treatment can also cause stress in this group of patients. Therefore, the present study aimed to examine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy on death anxiety and perceived stress in patients with type 2 diabetes.

This quasi-experimental research was a pretest-posttest design with follow-up and the statistical population included all patients with type 2 diabetes referred to the Charity Association for Diabetic Patients in Tehran, Iran, 2022. The statistical sample size was 40 patients (20 in the experimental group and 20 in the control group) from the statistical population who were selected by purposeful sampling method and randomly assigned to control and experimental groups. In experimental group, eight 90-minute sessions of EMDR therapy were performed and no treatment received by control group. Death Anxiety Scale Timpler (1970) and Perceived Stress Scale (Cohen and el, 1983) were used to collect data. The collected data were analyzed using the analysis of variance test with repeated measurements.

The average scores of death anxiety in the stages before and after the intervention were 9.15 and 6.10 in the experimental group and 9.10 and 8.90 in the control group, respectively. Also, the average scores of perceived stresses in the stages before and after the intervention in the experimental group were 27.65 and 19.65, respectively, and in the control group, 26.45 and 26.05, respectively. Repeated-measure test showed that the post-intervention scores of mean death anxiety score and perceived stress score in the experimental group had significantly difference with scores from control group, and this effect has also continued in the follow-up stage (p<0.01).

According to the results of this study, it can be concluded that EMDR therapy can decrease death anxiety and perceived stress in patients with type 2 diabetes. Therefore, this intervention is suggested for the psychological rehabilitation of patients with type 2 diabetes.

 The rapid spread of the COVID-19 disease has led to fear and anxiety in pregnant women. While extreme fear and anxiety in pregnant women leads to negative consequences in mothers and fetuses. This study was conducted to determine the status of fear of COVID-19 and its related factors among pregnant women in the city of Bam.

 This descriptive and cross-sectional study was conducted on 161 pregnant women referring to women's clinics of Bam University of Medical Sciences in 2021. The participants were selected by convenience sampling method. Demographic information form and women's fear of COVID-19 questionnaire were used to collect data. The data was analyzed by SPSS software version 22 and with descriptive (mean, standard deviation, frequency and percentage) and inferential (independent t-test, one-way ANOVA and linear regression) tests at a significance level of p<0.05.

 In this study, 161 pregnant women between the ages of 21 and 25 participated, most of them were housewives (95%), had less than diploma education (49.7%) and were in the third trimester of pregnancy (72.7%). The average score of fear from COVID-19 was 23.39±5.20 (out of 35 scores). There was a significant relationship between the fear of COVID-19 with the level of education and the history of the disease (p<0.05).

 The findings showed that the fear of COVID-19 in pregnant women was moderate to high. Furthermore, the level of fear was related with factors such as level of education, economic status, and history of illness, which requires interventions according to these conditions. Therefore, due to the harmful consequences of fear and anxiety on the health status of the mothers and fetuses, it seems necessary to hold training courses to effectively deal with fear in this group

Due to the prevalence of type 1 diabetes in children and the importance of this developmental period, self-management plays a very important role in disease management. This study was designed to determine the relationship between self-monitoring of blood sugar (SMBG) and self-management behaviors in children with type 1 diabetes.

The present study was a correlational-descriptive study which carried out in Besat’s Teaching University hospital in the city of Hamadan, 2021. Through simple random sampling, 92 children with type 1 diabetes, aged between 9 to 12 were included to the study. Subjects completed the demographic, self-monitoring and diabetes self-management questionnaires validated by Cheraghi et al. (2013). Data analysis was done by independent t-test and Pearson correlation in SPSS-20.

The average scores of self-management dimensions were obtained, including blood sugar measurement range (14.63±3.50), compliance with insulin therapy (39.39±8.49), compliance with diet (41.84±10.36) and physical activity (19.60±4.69). There was a direct and significant relationship between total self-management behavior score and self-management dimensions’ score with blood sugar self-monitoring (p<0.001).

There was a significant relationship between self-monitoring of blood sugar and self-management behaviors in children with type 1 diabetes. Therefore, it is recommended that self-monitoring of blood sugar by children with type 1 diabetes should be done more carefully and regularly so that the children with type 1 diabetes can have better self-management upon this disease.

 Delirium is a prevalent disorder that frequently appears in inpatients and is followed by undesirable consequences and complications. Considering the role of nurses in determining and preventing delirium, investigating nurses’ understanding of the care of patients with delirium is crucial. The present study was conducted in order to explain the experiences of nurses caring for patients with delirium.

 The research population consisted of nurses who work in Shahid Beheshti hospital. Eleven nurses were selected by purposive sampling method. The selection criteria of participants included consent to participate in the study, having at least a Bachelor’s degree, and working experience of more than 5 years. For data collection, a semi-structured focus group discussion method was used. The time, place, and duration of the sessions were coordinated based on the participants’ preferences. Every Focus Group Discussion session lasted about 60 minutes. Data were analyzed by conventional content analysis method with an inductive approach.

 The result of the study showed that nurses differently understood delirium, considering their experiences and based on this, they stated variable factors in its occurrence. According to this study, individual factors, family neglect, ineffective communication, fear of the unknown and unstable environment were identified as the roots of delirium. The three main categories of the findings of the present study were ‘lost in time and space’, ‘unbridled behaviors’, and ‘the underlying cause of delirium’.

 As reported by nurses, delirium is characterized by some features including loss of time and space and unbridled behaviors. Also, they listed other factors such as individual underlying factors, fear of the uncertainty, ineffective communication, and unstable environment as effective roots in the occurrence of delirium. Based on the results of the present study and considering the role of nurses in the prevention and control of delirium, compiling delirium prevention guidelines and programs in accordance with international guidelines is recommended to be used by nurses.