مجله علوم مراقبتی نظامی
سال نهم شماره 2 (تابستان 1401)

In military environments, due to the particular sensitivity and existing risks, stress and mental pressure are more prevalent, and therefore, the employed personnel is at risk of mental disorders, such as depression. Mental disorders of military personnel increase psychological stress in their spouses, which require the use of appropriate interventions to be controlled.

This study aimed to investigate the effect of Jacobson's progressive muscle relaxation technique on the caregiving burden of military personnel's spouses with depressive disorders.

This clinical trial study was performed with the participation of 69 military personnel's spouses of depressed patients hospitalized in 3 selected AJA hospitals in Tehran, Iran, in 2019. The subjects were selected through the convenience sampling method and randomly allocated into two groups of experimental (receiving Jacobson progressive muscle relaxation technique) and control (receiving no intervention). Before the intervention, individual characteristics and caregiver burden status of both groups were assessed using a demographic information form and the Guest and Novak caregiving questionnaire. The experimental group underwent daily Jacobson’s progressive muscle relaxation technique for 4 weeks. Data analysis was performed in SPSS software (version 18).

There was no significant difference between the two groups in terms of individual characteristics (P˃0.05). In the pre-intervention phase, the mean scores of caregiver burden scores in the experimental and control groups were obtained at 51.94±8.79 and 52.32±8.74, respectively, with no significant difference (P=0.861). However, the mean scores of caregiver burden scores were 48.60±7.44 in the experimental group and 52.21±8.81 in the control group, which had a statistically significant difference (P=0.020).

The Jacobson muscle relaxation technique can be used as a simple and inexpensive method along with other interventions to reduce the pressure of the caregiver burden, especially in spouses of military personnel suffering from depression.

 Despite the great importance of bone health in military training course, there is a dearth of research in this regard.

 The present study was conducted to investigate the effect of vitamin D supplementation on increasing bone osteoblastic activity in conscript soldiers during the military training course in one of the army training barracks of the IRI Army in 1400.

 This quasi-experimental before-and-after study was conducted on 60 soldiers who were randomly divided into two groups of 30, including the intervention and control groups. At the beginning of the training course, the soldiers of the intervention group were given a single dose oral supplement of 50,000 units of vitamin D. Soldiers were followed up for 40 days. Serum levels of vitamin D, calcium, phosphorus, bone alkaline phosphatase, and osteocalcin were measured before and after the training course.

 Before the training course, there was no significant difference between the two groups in terms of calcium (P=0.839), phosphorus (P=0.681), vitamin D (P=0.256), bone ALP (P=0.481), and osteocalcin (P=0.455). However, after the end of the course, the amount of vitamin D (P=0.034) and osteocalcin (P=0.003) was significantly higher in the intervention group, compared to the control group. In addition, the level of vitamin D (P=0.003) increased significantly in the intervention group at the end of the study.

 At the end of this course, the level of osteocalcin in both groups increased, compared to the time before the treatment. This indicates that the physical activities in this training course do not have a destructive effect on the bones. This increase was higher in the group that received vitamin D supplements, showing the importance of proper nutrition and the use of supplements.

Diabetes is one of the most common chronic diseases in the world that occurs at the time of disasters and its complications are aggravated. Therefore, developing a comprehensive plan seems necessary to care for diabetic patients in disasters.

This study aimed to develop the elements of a curriculum for nurses regarding diabetic patients’ care in disasters.

This was a multi-stage quantitative study in which 380 nurses working in the Armed Forces hospitals in Tehran, Iran, in 1399 participated, who were selected through convenience sampling. The study units reported their educational needs to provide services to diabetic patients in disasters in a valid and reliable researcher-made questionnaire with 72 items using the self-assessment method. According to the needs assessment results, the curriculum elements were presented based on a six-step process. The Delphi method was utilized in two rounds to determine the desirability of the program. The statistical sample at this stage was 10 expert professors selected through snowball sampling. Finally, the developed curriculum was reviewed, revised, and approved in an expert roundtable session. Data were analyzed using the SPSS software (version 22).

The results of the educational needs assessment of nurses regarding diabetic patients’ care in disasters were identified in the form of 9 tasks, 19 sub-tasks, and 72 minor tasks. According to the needs assessment and international experience, the elements of the disaster care curriculum were developed, and their desirability was approved by experts in two rounds using the Delphi method.

The developed program can be effective in guiding nurses to provide care to diabetic patients in disasters. It is suggested that the program developed in this study be presented at regular intervals in the form of in-service retraining programs for nurses.

With the onset of the Covid-19 pandemic, psychological disorders, such as depression, increased in nurses, highlighting the necessity of timely and effective interventions to prevent their negative consequences.

The present study aimed to determine the effect of progressive muscle relaxation training using the demonstration method on depression among nurses who are in close contact with Covid-19.

This randomized clinical trial was conducted in 2020-2021. The statistical population consisted of nurses working in Aja hospitals in Tehran, Iran. A total of 46 nurses were selected by convenience sampling method and randomly assigned to intervention and control groups. The nurses in the intervention group were trained on the progressive muscle relaxation technique by practical demonstration method; thereafter, they were encouraged to perform it, while no intervention was performed for the control group. Data were collected by demographic characteristics questionnaires and the depression section of the Depression, Anxiety, and Stress Scale- 21 Items (DASS-21). Data were analyzed using SPSS statistical software (version 21) using Fisher's exact test, Chi-square, independent t-test, and paired t-test.

There was no significant difference between the intervention and control groups in terms of demographic characteristics (P>0.05). Depression scores in nurses in the intervention and control groups were 13.65±3.19 and 14.08±2.69 before the intervention, respectively (P=0.621), while after the intervention, they reached 9.95±2.36 and 13.95±2.73 (P<0.001). In the post-test phase, the nurses' depression significantly reduced in the intervention group (P <0.001); nonetheless, no significant change was observed in the control group (P=0.479).

The results of this study pointed to the effectiveness of progressive muscle relaxation training using demonstration in the reduction of depression among nurses working in Covid-19 wards. Therefore, it is suggested that nurses be trained on the use of this method and encouraged to put it into practice.

Cardiac surgery is an unpleasant and unfamiliar experience for patients that can affect hemodynamic parameters by psychological factors. Lecture and multimedia training can reduce the impact of these factors on the indicators.

This study aimed to determine and compare the effect of multimedia education and lecture on hemodynamic indices of patients candidates for open heart surgery.

This interventional randomized controlled trial study was conducted on 72 patients who were candidates for heart surgery in the selected military hospital in Isfahan, Iran, in 2020. The intervention, which was about all stages of heart surgery, was performed by the researcher in the multimedia training group by playing an educational video and in the other group by a lecture in a half-hour session on the day of hospitalization. In the control group, only routine training was given to patients. Hemodynamic symptoms were completed after entering the ward and one hour before entering the operating room. The collected data were entered into Spss24 software and analyzed using Chi-square or Fisher's exact tests, one-way ANOVA, paired t-test, and Scheffe's follow-up. The significant level was considered less than 0.05.

There was no significant difference in respiration rate, heart rate, and diastolic and systolic blood pressure before the intervention. After the intervention in multimedia and lecture groups, except for the respiratory factor (P=0.02), a significant decrease was observed in the other variables (P<0.05), and vice versa, a significant increase was observed in the control group (P<0.01).

Pre-surgery training can reduce the hemodynamic disturbance of coronary heart patients who are candidates for cardiac surgery. Research with larger sample size is recommended.

Anxiety is one of the most common complications after heart surgery and has a negative effect on patients’ quality of life.

This study aimed to investigate the effectiveness of evidence-based heart care training on patients’ anxiety after coronary artery bypass graft surgery.

This experimental study was conducted in 2016 on 67 patients who underwent coronary artery bypass graft surgery and were admitted to the heart ward of a selected military hospital in Tehran, Iran. The patients were selected using the convenience sampling method and randomly assigned to experimental (n=34) and control (n=33) groups. The intervention included face-to-face training and the presentation of an evidence-based heart care training booklet to the experimental group. The training booklet had been designed by the researchers based on the Stetler model. The control group received only routine care. The anxiety level of patients in both groups was measured twice using Spielberger’s seven-item anxiety questionnaire. The collected data were then analyzed using SPSS software (version 21) through paired and independent t-tests.

The mean±SD age of patients was 60.37±10.202 years, and all were male and married. Patients in the two study groups were homogeneous in terms of individual characteristics. There was no statistically significant difference between the two study groups in terms of anxiety scores before intervention. However, the level of anxiety in the experimental group decreased significantly after the intervention compared to the control group (P<0.05).

Based on the obtained results, evidence-based heart care training using booklets and face-to-face training can be effective in reducing patients’ anxiety following coronary artery bypass graft surgery.

Postoperative nursing care is critical in open heart surgery patients and can be effective in patient satisfaction. Therefore, it is of utmost importance to have a codified nursing care management program in the intensive care unit (ICU) after open heart surgery.

The aim of this study was to determine the effect of the implementation of the designed nursing care management program on patients' satisfaction in open heart surgery ICU.

In this study, 53 patients were randomly assigned to two groups: control and experimental. In the experimental group, nursing care was designed as managed and performed for two and a half months. In the control group, nursing care was performed routinely after open heart surgery. To collect information, a patient satisfaction questionnaire was used before and after the intervention in both groups. Data were analyzed in SPSS software (version 22) using descriptive and inferential statistics of analysis of variance, independent t-test, Mann-Whitney, and Chi-square.

In the experimental group, the majority of patients were satisfied with all aspects of care, while in the control group, most patients had low levels of satisfaction. Satisfaction scores were obtained at 180.07±13.02 and 117.60±11.54 in experimental and control groups, respectively, demonstrating a significant difference between the two groups (P<0.05).

The nursing care management program led to an increase in the satisfaction of patients admitted to open heart surgery ICU. It is suggested that the training of the above program be included in in-service training courses for nurses.

The importance of blood and its role in the medical system is undeniable; however, the excessive demand for blood and blood products in teaching hospitals is a major concern.

This study aimed to evaluate the demand and consumption of blood products and their causes in teaching and medical hospitals of Urmia, Iran, in 2017.

This descriptive cross-sectional study was conducted in teaching hospitals of Urmia using the census method in 2017. It included 15,489 needs of patients, which equaled 40,695 units of various blood products. The data was collected using a checklist including factors such as age, gender, hospital name, department, blood group, reasons for requesting blood, type of the requested product, and the purpose of requesting blood. All of these variables were in order of frequency and the number of units requested, received, and injected. After collecting the data, it was entered into the SPSS software (version 18) and analyzed using descriptive statistics (such as frequency and percentage).

The results showed that most requests were from males (21,653 units), patients aged between 65-71 years (5,422 units), and Imam Khomeini Hospital (27,026 units). Additionally, in the special care department, the majority of applicants were from the O-positive blood group, with 10,493 and 15,470 units. Chronic anemia was one of the main request reasons with 8,642 units, dense red blood cell was the most requested product with 15,809 units, and bleeding was one of the primary request purposes with 10,431 units. Most requests and deliveries of blood products were performed in the morning shift, and the majority of injections were performed in the evening shift.

The demand for blood products is very high, which requires a review of how to request blood and establishing a monitoring system for managing blood bank and ward communication.

Exercise and physical activity are among the factors that have a positive effect on people's quality of life. On the other hand, smoking is one of the health threatening factors that can affect people's quality of life.

The present study aimed to evaluate the effectiveness of physical activity in tobacco consumers’ quality of life.

The study was conducted based on a descriptive causal-comparative design. The statistical population of the present study consisted of male tobacco consumers in Shiraz, among whom, 350 cases were selected via available sampling method as a statistical sample. Based on the amount of physical activity per week, they were assigned to two groups: physically active (n=170) and physically inactive (n=180). The Quality of Life Questionnaire (SF12) was used to assess sleep quality. The data were analyzed in SPSS software (version 16) using U-Whitney test.

The results pointed to a significant difference between active and inactive subjects in the overall score of quality of life (P= 0.01), vitality and energy (P=0.01), general perception of life (P=0.001), physical health (0.001), and physical function (P=0.008). The active participants had a better situation than inactive people; nonetheless, there was no significant difference in other scales.

The results of this study demonstrated that physical activity and exercise improve the quality of life in tobacco consumers. As evidenced by the obtained results, in order to improve the quality of life among tobacco consumers, sports activities can be included as a part of their daily activities.

Coronavirus is a serious threat to the well-being of families and their children due to challenges related to social disorders (e.g., financial problems, care burdens, and stress caused by quarantine).

This study aimed to investigate the causal modeling of the role of family functioning in predicting Corona anxiety mediated by academic procrastination in high school students.

This descriptive-correlation research is of structural equation types. The statistical population of the study included all high school students in Ardabil, Iran, in 2021. A total of 250 of these individuals were selected by the available sampling method from the above-said population and participated in the study. The family functioning questionnaire, academic procrastination, and Corona anxiety questionnaire were used to collect data. To analyze the collected data, Pearson correlation coefficient tests and structural equation modeling were measured with the help of SPSS (version 25) and Lisrel (version 8.8) software.

The correlation coefficient results showed that Corona anxiety has a negative relationship with family functioning and a positive and significant relationship with academic procrastination and academic procrastination has a negative and significant relationship with family functioning (P<0.001). Model fit indices also confirmed family functioning on Corona anxiety mediated by academic procrastination.

Considering the role of family functioning and academic procrastination in predicting Corona anxiety, counselors and psychologists are advised to hold social skills and problem-solving workshops for families and teach students learning strategies during the Coronavirus pandemic.