مجله دانشگاه علوم پزشکی سبزوار
سال سی‌ام شماره 5 (پیاپی 130، آذر و دی 1402)

Operating room is a stressful workplace. Therefore, the present study aimed to examine the structural model of the relationship between psychological well-being and critical thinking with strategies to deal with stressful situations in operating room personnel, considering the mediating role of family process and content. The present research is a descriptive and correlational study. The statistical population included all operating room personnel in Mashhad, Iran as of 2023 winter; 200 operating room personnel were selected as the study sample. To measure the variables, the Family Process and Content Questionnaires, Psychological Well-Being Scale, Critical Thinking Questionnaire and Index Questionnaire for Dealing with Stressful Situations were adminsitered. Data analysis was done using structural equation modeling with Amos22 and SPSS 22 software. The results of the structural equation model showed that the family process played a mediating role in the relationship between critical thinking and problem-oriented and avoidance-oriented strategies. Also, family content played a mediating role in the relationship between critical thinking and avoidance coping strategy (p <0.05). Finally, the results showed that the content of the family and the family process did not play a mediating role in the relationship between psychological well-being and strategies for coping with stressful situations (p >0.05). According to the results obtained from the research, it is suggested to use family therapy workshops for operating room personnel.

Preparation for a crisis is necessary. The experiences of nursing and midwifery professors and students involved in the Covid-19 pandemic have helped us clarify and better prepare for future crises, particularly for biological crises. Therefore, the present research aimed to explore the views and experiences of nursing and midwifery  instructors and students regarding in-hospital crisis management during the Covid-19 pandemic. In this qualitative study, data collection was done using semi-structured interviews with 14 nursing and midwifery instructors and students with experience in caring for coronavirus patients during the covid-19 pandemic; data analysis was conducted according to the conventional content analysis approach. The analysis of the interviews was accompanied by 425 inference codes, which finally ended in 9 categories and 3 main categories after merging the repeated cases (integrated management, professional ethics and development of specialized knowledge). In order to prepare for biological crises such as the Covid-19 pandemic, the cooperation of various organizations is necessary for a more proper management of the situation. It is also necessary for health managers to recruit workers after assessing the severity of the crisis, and to help them develop their knowledge and skills with evidence-based training, while sticking to the principles of professional ethics, and paying special attention to maintaining and improving the mental health of the workers.

Autism spectrum disorder is one of the neurodevelopmental disorders that has been associated with persistent deficits in communication and social interactions in several different fields.  This study aimed to examine the effectiveness of reality therapy on psychological capital, emotional self-regulation and anxiety sensitivity in mothers of children with autism spectrum disorder. The research method is a quasi-experimental method and its design is pre-test and post-test with a control group. This study was carrie out on mothers of children with autism spectrum disorder in Rasht, Iran. The instruments included the 16-question anxiety sensitivity questionnaire of Deacon and Wallen (2002), the 24-question psychological capital questionnaire of Luthans (2007) and the 63-question self-regulation questionnaire of Miller and Brown (1999).The data were analyzed using SPSS23 software and Mankova's multivariate analysis of covariance test. The results of the research showed that reality therapy had a significant effect on psychological capital, emotional self-regulation and anxiety sensitivity in mothers of children with autism spectrum disorder. Reality therapy also had a significant effect on anxiety sensitivity and psychological capital. It also had a significant effect on emotional self-regulation. The average scores of psychological capital, emotional self-regulation in the intervention group under reality therapy in the post-test stage significantly increased compared to the pre-test and the control group. Also, the average scores of anxiety sensitivity in the intervention group under reality therapy in the post-test phase decreased compared to the pre-test and the control group.

The illness of a family member affects the whole family and changes their lifestyle. The purpose of this research was to compare the effectiveness of self-determination skills training and Islamic quality of life training on resilience and psychological well-being of primary caregivers of chronic mental patients in Borujen city. The present study is a semi-experimental which was selected from the community of primary caregivers of chronic mental patients in Borujen city in Chaharmahal and Bakhtiari province using available sampling method. Research tools included resilience questionnaires (Connor and Davidson, 2003) and psychological well-being (Reif, 1989). The results showed that the effectiveness of self-determination skills training and Islamic quality of life group training on increasing resilience was significant (P<0.05) and the effectiveness of Islamic quality of life group training was more than training self-determination skills. Also, the effectiveness of self-determination skills training and Islamic quality training on increasing psychological well-being was significant (P<0.05) and the effectiveness of Islamic life quality training was more than self-determination skills training. Therefore, it can be said that teaching self-determination skills and teaching the quality of Islamic life can improve the resilience and psychological well-being of the main caregivers of chronic mental patients.

Covid-19 has become one of the most important challenges to health care systems, causing various complications and death in severe cases. Therefore, the present study was conducted with the aim of investigating the complications of the Covid-19 disease in patients admitted to 16-hour centers in Sabzevar, Iran. The current research is descriptive-analytical, which investigated 220 patients selected by random sampling from among those admitted to the 16-hour centers for Covid-19 in 2022. After recording the patients’ information, verbal consent was obtained from them to join the study. Four weeks after the PCR test, they were asked some questions over the phone by a trained researcher and the questionnaires were instantly completed. The results of the study showed that the remaining symptoms after recovery in the participants are physical fatigue (27.3%), weakness (14.1%), cough (23.6%), diarrhea (2.7%), mental fatigue (9.1%), anxiety (5%) and others. There was a statistically significant relationship between gender and residual complications from the Covid-19 disease. But there was no significant relationship between the recovery rate and anxiety symptoms such as restlessness and heart palpitation. Also, 40.5% of the patients had full recovery, 51.8% had moderate recovery and 0.9% had poor recovery. Patients with Covid-19 disease may recover from the disease but will face clinical manifestations and psychological disorders. Remote follow-up based on a telephone call program can be very useful in the management of recovered patients by establishing simple communication between patients and therapists.

Pregnant women and their fetuses are likely to represent a high‐risk population during the coronavirus disease 2019 (COVID‐19) pandemic. The present study was designed aiming to evaluate the maternal and fetal outcomes in pregnant women diagnosed with COVID-19 with D-dimer levels. In this descriptive analysis, blood samples were collected from patients with laboratory-confirmed COVID‐19 for evaluating D-dimer levels. The descriptive statistics are used to give more information using SPSS software. The flowing mean scores were obtained: age (30.99±5.66 y), gravidity (1.89±0.92 %), parity (1.38±0.63 %), and gestational age (24.39±10.6 w). Of 106 eligible pregnant women, 28.3% were receptive in the first trimester, 28.3% in the second trimester, and 43.39% in the third trimester. Our study showed RT-PCR test and HRCT chest scan to be positive in 91.5% and 63.2% of cases, receptively, with clinical suspicion and symptoms. The most common maternal and fetal outcomes included cesarean section, abortion, preterm labor, meconium, pulmonary embolism, prelabor rupture of membranes, and hypertension. The mean level of D-dimer in patients was 852.14±915.08 mg/L. Reference ranges for D-dimers level increased in the trimester order. In pregnant COVID-19 patients, about 79.25% of cases were out of the conventional normal threshold of D-dimer values. The majority of complications were observed in the positive D-dimer levels. D-dimer level elevation continues to be a sign of poor prognosis in pregnant patients with COVID-19.

Kidney stones are one of the most common urological diseases. Renal colic is a medical emergency due to severe pain, and the repetition of its periods greatly impacts the patient's life quality. Providing different treatments while increasing the patient's life expectancy causes changes in their lifestyle, health status, and life quality. This study aimed to evaluate the life quality of patients with kidney stones in Mashhad in 2019 with a review of Persian medicine.

The present descriptive-analytical study was performed on 96 patients. Data were collected by SF-36 quality of life questionnaire, researcher-made demographic questionnaire, and the Salmannejad temperament determination questionnaire. Data analysis was performed using SPSS-16 software.

The mean age of patients was 45.6 years; the mean number of stones was 18.1± 84.1 and the mean size of stones was 12.32 ± 8.53 mm. The mean and standard deviation of patients' life quality was 369.26±98.32. The highest mean was related to the physical function dimension (82.68 ± 21.8) and the lowest mean was related to the pain dimension (52.23 ± 25.47). There was a statistically significant relationship between some dimensions of life quality with blood pressure and temperament (Mizaj) variables (p <0.05).

Several factors improve the life quality of patients with kidney stones. Paying special attention to the characteristics of patients with kidney stones and modifying the type of nutrition based on their temperament can prevent the recurrence and re-formation of kidney stones.

The emergency department is often associated with congestion and high workload. Emergency nurses usually experience situations that lead to moral challenges, and one of its consequences is moral distress, defined as the most important hidden job challenge among emergency nurses. This study was conducted with the aim of determining nurses’ level of moral distress and factors affecting it in the accidents and emergency department. This cross-sectional study was conducted on 200 nurses working in the emergency department of hospitals in Semnan and Sabzevar, Iran. They were asked to complete the moral distress and demographic questionnaires by self-reporting. The data was analyzed with SPSS 22 using independent t-test and analysis of variance. The mean age of the participants was 32.20 ± 7.2 years. The overall score of moral distress was 54.61 ± 10.1, which shows a low level of moral distress in these public hospitals. The lowest level of moral distress was related to high job satisfaction while the highest score of moral distress was related to unfavorable relationship between nurses and doctors. Considering the negative effects caused by moral distress on the quality of nursing care, it is necessary for managers of organizations to take necessary measures to identify the symptoms of moral distress in nurses and take a positive step towards reducing it by interventions and, as a result, increase the quality of services provided to patients.

Pregnancy is an important part of a woman's life that requires psychological adjustment. This research was conducted aiming to investigate the effectiveness of acceptance and commitment therapy on pregnancy anxiety and physiological parameters of newborns. In this pre-test-post-test pilot study in which there was an experimental and a control group, single-blind method was used since the evaluation of research participants was based on self-reporting. The statistical population of the research consisted of primiparous women who presented to Bahar Hospital, Shahrood in 2022. Overall 60 women were included in the study via convenience sampling method. They were then randomly divided into experimental and control groups (n=30). The experimental group received eight one-hour therapy sessions based on acceptance and commitment, but the control group did not receive any intervention. Research tools were Vandenberg Pregnancy Anxiety Questionnaire (1989) and Measurement of physiological parameters of newborns. The research data was analyzed by using univariate covariance analysis in the SPSS version 24 software. The findings showed that the treatment based on acceptance and commitment is effective on pregnancy anxiety and physiological parameters of newborns (p<0.05). The results indicate that treatment based on acceptance and commitment by reducing experiential avoidance and increasing acceptance leads to a decrease in anxiety during pregnancy and improvement of the physiological parameters of newborns.

The second victim phenomenon is an incident that occurs after an adverse medical event; while the patient is the first victim of the incident, the nurses and healthcare personnel become the second victims because they feel ashamed after that. The present research aimed to investigate various dimensions of the second victim phenomenon among nurses in South Khorasan Province, Iran. The current research was a descriptive study. The sample selection method was multi-stage cluster randomization, including 200 nurses working in South Khorasan Province, Iran. The data was collected using a demographic questionnaire and the second victim experience and support tool (SVEST) and analyzed using SPSS version 21. The scores of incidence of psychological distress (14.60), professional self-efficacy (9.42), supervisor support (15.97), institutional support (10.71), turnover intentions and absenteeism (13.35), non-work-related support (expected sources of support) (25.25) and the total score of second victim phenomenon (114.55) were higher than the expected average; but other scores including colleague support (8.56), family support (5.41), and physical distress (11.31) were significantly lower than the expected average (p<0.05). Medical errors cause negative emotional reactions and psychological distress among healthcare provideres turning them to the second victims of those errors. Timely and effective support from their institutions and other  sources should be supplied in order to reduce the incidence of second victim phenomenon.