نشریه پرستاری و مامایی ارومیه
سال بیست و یکم شماره 9 (پیاپی 170، آذر 1402)

Dear Editor, Art therapy is a useful method for integrating conflicting emotions like anxiety and promoting healthy functioning in various diseases and situations (1). One of the techniques used in art therapy is mandala coloring, which has received much attention from researchers today. In most of the studies, there is no mention of the exact way of coloring the mandala and its steps, and since there is not enough information, it can cause situational anxiety; Therefore, it is suggested that in future studies, a written intervention program should be used to perform mandala coloring. Same as what was used in Kari et al. 'S research. In their study, they investigated the effectiveness of different types of artistic activities, including mandala therapy, in reducing students' anxiety, and for this purpose, they used a written intervention program that included familiarizing the participants with the goals and process of coloring, raising the level situational anxiety is coloring and reducing anxiety and ending the meeting and getting feedback (2). Cone cells and cylinder cells are both light-sensitive cells in the human retina. Cone cells are also responsible for color vision in the retina, just as they are responsible for other visual tasks (3). In addition, the cone cells of the eye, which are responsible for color vision, are usually more active in bright light (4). Staining in the morning or under adequate artificial light is better than staining in the evening, at night, and/or under weak light. It is suggested in future studies to stain at the beginning of the morning. The color contrast mechanism states that in conditions with high contrast, the color of the central region depends on the intensity and spatial frequency of the surrounding colors (5). Also based on the nature of colors and paying attention to the fact that warm colors tend to expand and radiate outwards and cold colors tend to contract and radiate inwards (6). Therefore, in coloring mandalas, it is suggested that the participants use warm colors (such as red) more in the center of the mandala schemes and use cold colors (like blue) around it to establish a balance and achieve a balanced self-concept and reduce anxiety, as well as a better understanding of the colors used by creating a better contrast between the colors. Given the impact of this method on reducing anxiety and psychological factors in various studies, and the ease, availability, and practicality of this method, it is recommended that future studies improve the effectiveness of mandala coloring. It is important to carefully consider the application method, time, and method.

Foot ulcers in diabetic patients are one of the common complications of diabetes mellitus that can lead to death and amputation. Managing these ulcers is one of the significant challenges for patients and their families. In this case study, according to the patient's physical and financial condition, a resistant diabetic foot ulcer was treated using maggot therapy.

This report relates to a 72-year-old man with a 5-year history of uncontrolled type 2 diabetes. The patient had a 1 × 1 cm gangrenous diabetic foot ulcer on his left heel that was resistant to antibiotic treatment. Despite regular care, the diabetic foot ulcer did not heal. The patient was referred to our wound management team, and the diabetic foot ulcer was treated using surgical debridement and larval therapy. Ten sessions of maggot therapy were conducted (one therapeutic session every 48 hours). After three months, the patient's diabetic foot ulcer improved, and was discharged in a better condition.

Infectious diabetic foot ulcers cause activity impairment and decrease the quality of life of the patient due to resistance to treatment and poor healing. Therefore, effective treatment approaches are necessary for managing diabetic foot ulcers. This case report demonstrated that surgical debridement and maggot therapy are safe and effective approaches to healing diabetic foot ulcers.

Although pregnancy is the most critical and cheerful experience in women's lives, hormone changes affect their physical and mental health. Meanwhile, the psychological distress of pregnant women is an expression of emotional suffering that is explained by the symptoms of depression and anxiety, and mindfulness in the sense of an open, non-judgmental attitude and paying full attention to the present moment can help a person adapt to difficult conditions. So, the challenging nature of these problems would be considered a crucial public health concern. Therefore, this research aimed to determine the effectiveness of web-based acceptance and commitment therapy on psychological distress and mindfulness in pregnant women.

This research clinical trial with a pre-test, post-test, and follow-up with a control group was conducted from February to March 2023. Fifty pregnant women referred to Urmia's health centers were selected by available sampling and randomly allocated to two groups (25 control and 25 intervention). The intervention group received eight online individual psychotherapy sessions from March to June 2023 and was followed up again in July 2023. Kessler's standard psychological distress, Brown and Bryan's mindfulness questionnaires, and demographic data were used to collect data. The data was analyzed using a statistical variance analysis method with repeated measurements and SPSS version 22 software.

The results indicate that the intervention group's mean psychological distress and mindfulness at the beginning of the study was 25.84 and 51.60, and it changed to 23.76 and 61.16 at the end of the study. At the same time, there was no significant change in the control group. So, web-based acceptance and commitment therapy was effective in the psychological distress and mindfulness of patients (P<0.05).

Web-based acceptance and commitment therapy increases psychological flexibility in people and creates an atmosphere for them to let the challenges go to control their unpleasant thoughts, feelings, bodily sensations, and emotions. They chose to take a step to achieve their goals and values for life. Therefore, Web-based acceptance and commitment therapy led to a decrease in psychological distress and an increase in mindfulness in pregnant women.

Cardiovascular diseases are considered one of the most common diseases of today's societies, so that in Iran, over a million adults are suffering from this disease. The irreparable effects of this disease on the functional ability and quality of life of patients have been proven. To manage anxiety and depression caused by the disease, more effective treatments focused on the participation of the patient seem necessary. Since one of the effective ways to reduce the anxiety and depression of these patients is to teach them about the strategies to deal with their disease, the present study was conducted to determine the effect of self-care training on the level of anxiety and depression in heart failure patients.

This semi-experimental study was conducted on heart failure patients at Seyyed al-Shohdai Hospital in Urmia in 1400. The patients who were referred to the cardiac unit and CCU with the diagnosis of heart failure were selected using convenience sampling and were randomly divided into two control and intervention groups. The data was analyzed using SPSS version 22 software and statistical tests, t-test, chi-square, and analysis of covariance.

The mean anxiety score was different between the control and intervention groups after the intervention, and it was statistically significant (P=0.001). In addition, there was a significant difference in mean depression scores between the control and intervention groups after intervention.

The results showed that the patient's anxiety and depression were improved in the intervention group compared to the control group after the intervention. It seems that self-care education in easy language through educational books and face-to-face teaching methods can help in controlling the psychological consequences of heart failure.

The communication skills of nursing managers play a crucial role in influencing nurses’ job satisfaction and anxiety levels. Therefore, it is of the utmost importance to thoroughly investigate and understand the extent and nature of the relationship between nursing managers' communication skills and nurses' job satisfaction and anxiety. This study aimed to examine the communication skills of nursing managers and their associations with nurses' job satisfaction and anxiety.

This descriptive correlational study was conducted on 200 nurses at the Academic Medical Centers of Urmia University of Medical Sciences in 2023. Participants were selected using a proportional stratified random sampling. The inclusion criteria were willingness to participate in the study, a minimum of six months of clinical work experience, and no history of psychiatric disorders. Data were collected using a 4-part questionnaire, which included (a) demographic characteristics, (b) nursing managers' communication skills scale, (c) the Minnesota Satisfaction Questionnaire, and (d) the Spielberger State-Trait Anxiety Inventory. The collected data were analyzed using the IBM SPSS software V.22.0.

The nurses’ job satisfaction score was average (M = 52.30, SD = 6.09). Participants exhibited scores below the average level for personality anxiety (M = 38.1, SD = 5.41), situational anxiety (M = 38.43, SD = 7.02), and total anxiety (M = 76.53, SD = 10). Similarly, the mean scores for nursing managers' nonverbal communication skills (M = 42.06, SD = 6.56), verbal communication skills (M = 37.24, SD = 4.08), and total communication skills (M = 125.37, SD = 11.96) indicated an average level of proficiency. The Pearson correlation test revealed a statistically significant relationship between nursing managers' communication skills and nurses' job satisfaction (r = 0.001, P < 0.638) and anxiety (r = 0.001, P < 0.532).

The higher the nursing managers' communication skills, the greater the nurses' job satisfaction and the lower their anxiety levels. Therefore, healthcare system officials should emphasize empowering nursing managers in terms of communication skills and consider these skills as one of the most crucial criteria for the employment, appointment, and evaluation of nursing managers.

Cardiovascular diseases are considered one of the most common causes of death worldwide. Given the increasing trend of heart diseases, one of the most common diagnostic and therapeutic methods that aid in the diagnosis and treatment of heart diseases is coronary angiography. Patients undergoing coronary angiography report significant anxiety, and various pharmacological and non-pharmacological methods are employed to cope with this anxiety. Non-pharmacological methods have gained popularity due to the numerous side effects of pharmacological interventions. This study aims to compare the effects of Acupressure and Benson relaxation on the level of anxiety in patients undergoing coronary angiography at the Seyed Al-Shohada Teaching and Treatment Center in Urmia in 2022.

This study is a quasi-experimental study conducted on 90 patients who were candidates for coronary angiography in Urmia. The samples were selected using convenience sampling, and the participants were randomly assigned to one of three groups: control, Benson relaxation, and Acupressure. This study used a demographic questionnaire and the Spielberger anxiety questionnaire to collect data. Finally, the data were analyzed using SPSS ver.22 statistical software.

The results showed a statistically significant difference in the mean anxiety scores after the intervention compared to before the intervention in both the Acupressure and Benson relaxation groups(p<0.05). However, in the control group, no statistically significant difference was observed in anxiety scores before and after the intervention (p>0.05), and after the intervention, the mean anxiety score in the two intervention groups had decreased compared to the control group.

The present study demonstrated that both Acupressure and Benson relaxation interventions can be effective in reducing the level of anxiety in candidates for angiography. Therefore, considering the positive effects of Acupressure and Benson relaxation interventions, they are recommended as methods for alleviating anxiety.

There is a close relationship between maternal and fetal thyroid function. Considering the effect of complications caused by thyroid disorders on pregnancy, the present study was conducted to determining the prevalence of thyroid disorders in pregnant women referring to health centers in Bojnurd.

In this descriptive study, 968 pregnant women under 20 weeks who visited Bojnord health centers for routine pregnancy care were included in the study as a census and were examined regarding serum thyroid stimulating hormone (TSH) Levels. TSH levels higher than 3.9 and lower than 0.2 milliunits per liter were considered hypothyroidism and hyperthyroidism, respectively. The results were analyzed using descriptive and chi-square tests.

In this study, 15.7% of pregnant women had hypothyroidism and 1.5% had hyperthyroidism. The prevalence of hypothyroidism was higher in multiparous women than in primiparous women. Having a family history of thyroid disorders was related to serum TSH levels, but this relationship was not significant (P = 0.07). The chi-square test results showed no significant statistical difference between the studied variables in terms of suffering from thyroid disorders.

Considering the relatively high prevalence, complications, and risks of thyroid disorders in the mother and fetus, it is recommended to conduct studies in the future to identify the causes and factors affecting the prevalence of thyroid disorders, including environmental or nutritional factors in different regions.

In today's era, when the country is involved with the coronavirus disease and the recent incidents and events have increased the number of people visiting hospitals, and according to the results of the studies, nurses experience more work pressure and stress. Due to the nature of their work, they are more exposed to psychological harm, so it is necessary to examine their post-traumatic growth and by knowing this, we can promote the strengthening factors of nurses as much as possible. In this direction, we conducted a study regarding the assessment of post-traumatic growth in nurses caring for children with covid-19 disease.

This study was descriptive research. The research population was nurses working in children's departments of teaching hospitals affiliated with Iran University. The samples were selected using census sampling. The researcher attended the hospital in different shifts, introduced himself to the nurses, explained the research objectives, and asked if they were willing to participate in the study. The participants signed the consent form. The approximate duration of answering the questionnaires was 1 to 20 minutes. After collecting the data, it was analyzed using SPSS ver. 20.0 software. The significance level was considered 0.05.

In this study, 168 nurses, including 157 women and 11 men, were included. The mean score of the post-traumatic growth scale in nurses working in the children's department during the COVID-19 pandemic was 49±23.21, which is lower than the average of the tools used and shows that post-traumatic growth in nurses working in the pediatric department is low. Nurses received acceptable and lower scores in the dimensions of personal strength, spiritual change, and facilities, and they had the highest score in the dimension of valuing life. The results showed no statistically significant difference between the mean score of post-traumatic growth in different demographic variables; only the difference between the mean score of the component of spiritual change in the group of different ages and work histories was found to be statistically significant.

The present study's mean score is lower according to the distance between the post-traumatic growth score and the total score. This group is vulnerable and needs more comprehensive measures and investigations. Considering the continuity of contact with cases of illness, nursing managers must investigate and address this issue to promote and facilitate this phenomenon and develop counseling and psychological sessions to improve the mental health of nurses.