مجله علوم پزشکی صدرا
سال سیزدهم شماره 1 (زمستان 1403)

Peace is a multidimensional concept influenced by various factors. This study aimed to explain the process of peace formation in comprehensive health services.

Material: 

This qualitative study was conducted using a grounded theory approach to answer the question: “How is peace formed in comprehensive health networks?”. Semi-structured interviews were conducted with 25 patients and staff members of comprehensive health networks. Purposeful sampling was used initially, followed by theoretical sampling. Data were analyzed using the Strauss and Corbin approach (1998).

The peace formation process in a comprehensive health network included 5 main categories and 8 sub-categories. The main categories were threats, opportunities, barriers to organizational productivity, strategies, and consequences. Threats included subcategories of poor performance management and organizational challenges. Opportunities included teamwork, cooperation, organizational freedom, inner peace, trust, and authority. Barriers to organizational productivity included deviant behaviors and negative emotions within the organization. Strategies included effective management and adherence to professional ethics. The consequence included two subcategories, social capital and organizational development.

Comprehensive health networks encounter organizational challenges and poor performance management in establishing peace, as well as barriers to organizational productivity. Therefore, policymakers and managers should implement effective measures and strategies to address these challenges.

The appointment of managers is one of the most critical decisions in any organization, and it should be based on the competencies of the managers. Managerial competencies at different levels in hospitals offer numerous benefits, including gaining a competitive advantage, strengthening teamwork behavior, and improving financial performance. This study aimed to investigate the role of managerial competencies in enhancing the financial performance of public hospitals in Yazd Province.

This study was applied-developmental in terms of purpose and deductive in terms of approach. In terms of strategy, it was a descriptive-analytical study of the exploratory type, situated within the positivist paradigm. Data were collected using a questionnaire, and the study population comprised managers and supervisors of public hospitals in Yazd Province. Given the limited number of participants, the questionnaire was distributed to all members of the population. Out of 180 distributed questionnaires, 152 valid responses were collected. Data analysis was conducted using Smart PLS3 and SPSS 25 software.

The results indicated that managerial competencies, specifically in the individual, technical, and interactive dimensions, had a direct and significant effect on the financial performance of hospitals.

Selecting competent managers for decision-making related to resource allocation, control, and the efficient utilization of resources can enhance the financial performance of hospitals. Furthermore, it could improve managerial accountability in performance evaluation and help achieve objectives in line with the accreditation standards of public hospitals in Yazd Province.

Employee retention is a critical issue in the context of skilled labor shortages, high turnover intentions, and economic growth, as high turnover rates negatively impact organizations. Hospital employees, due to their challenging working conditions, require particular attention in this regard. This study aimed to investigate the effect of procedural justice on affective commitment, with the mediating role of organization-based self-esteem, among employees of Sari hospitals. This study was applied in purpose, quantitative in nature, and descriptive with a survey strategy. Data were collected through both library and field methods, using a stratified random sampling method. The field data collection tool was a standard questionnaire, the reliability of which was confirmed using Cronbach’s alpha coefficient. The study population consisted of 500 employees from Sari hospitals, with a sample size of 217 determined using Morgan’s table. Data were analyzed using structural equation modeling with the partial least squares method, implemented in SPSS 22 software and PLS software. Hypothesis testing revealed that procedural justice significantly affected organization-based self-esteem and affective commitment, with path coefficients of 0.743 and 0.295, respectively. Additionally, the mediating role of organization-based self-esteem was confirmed using the Sobel test. The results showed that organization-based self-esteem is a significant variable for employees. It could be enhanced through employees’ perception of procedural justice, thereby increasing affective organizational commitment. Therefore, formal procedures should be developed to establish standards for consistent organizational decisions, address the concerns of all stakeholders affected by decisions, and allow requests for additional information regarding decisions.

This study aimed to investigate the mediating role of organizational participation in the relationship between talent management and its components with organizational growth in public hospitals. This descriptive-correlational study included all employees of public hospitals in Bushehr in 2021. Based on Morgan’s table, a sample size of 384 participants was estimated, and stratified random sampling was used to select participants proportionally to the size of each department. Talent management was measured using Bani Asadi’s questionnaire, organizational participation was assessed using Hosseini Noh’s questionnaire, and organizational growth was evaluated using a researcher-made questionnaire. The face and content validity were checked and confirmed by 30 experts, and reliability was assessed using Cronbach’s alpha coefficient. Data were analyzed using SPSS software (version 23). The results indicated that organizational participation played a mediating role in the relationship between talent management and its components, including human resource recruitment, talent identification, and talent pool creation, with organizational growth in public hospitals (P<0.05). However, no significant relationship was found between talent retention, employee engagement, and talent development and improvement (P>0.05). Organizational growth was a critical factor in the success of organizations. Without growth, organizations risk falling behind in competition and becoming isolated. Therefore, identifying factors influencing organizational growth is essential.

Numerous studies reported a strong relationship between inflammation and reduced quality of life. This study aimed to investigate the relationship between body cell mass index (BCMI), phase angle, and hematological indices indicating inflammation with quality of life among personnel of Shiraz University of Medical Sciences (SUMS). This cross-sectional study was based on the health cohort study of SUMS employees, in which 1195 people were included in 2017. Body composition, including BCMI and phase angle, was measured using In Body device. Hematological indices were extracted from blood test results, and quality of life was assessed using the World Health Organization's Quality of Life questionnaire. Data were analyzed using SPSS (version 21). The study included 1195 participants with a mean age of 42±6.99 years, mean weight of 72±13 Kg, and mean height of 1.65±0.9 m. BCMI, cell mass index, and phase angle showed a significant direct relationship with the physical and psychological domains of quality of life and an inverse relationship with the environmental domain (P<0.05). Besides, the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) showed a significant and direct relationship with the environmental domain of quality of life (P=0.010 and P=0.035, respectively). There was a direct relationship between certain body composition indicators and specific aspects of quality of life. Hematological indices also had a direct relationship with the environmental domain of quality of life.

Aging is a natural phenomenon accompanied by reduced physical activity and the onset of sarcopenia. Accordingly, this study aimed to investigate the effect of resistance-endurance training on the expression of IGF-1, Akt, and p70s6k pathway genes in the gastrocnemius muscle of aged rats. In this experimental study, 14 male Wistar rats aged 22 to 24 months were randomly divided into control and resistance-endurance training groups. The training program was conducted for 10 weeks, with three sessions per week. Gene expression levels of IGF-1, Akt, and p70s6k pathway in skeletal muscle were measured using quantitative real-time PCR, and the data were analyzed using an independent t-test. The results showed that, compared to the control group, the resistance-endurance training group exhibited a significant increase in the expression of the IGF-1 gene (P=0.003), Akt (P=0.019), and p70s6k (P=0.004) genes after 10 weeks of training. The findings suggested that resistance-endurance training probably increased the expression of IGF-1, Akt, and p70s6k pathway genes in aged rats. The activation of the Akt /p70s6k signaling pathway was partially induced by autocrine/paracrine response mediated by IGF-1, ultimately leading to muscle hypertrophy. These effects might also apply to humans. Therefore, further research on human samples is recommended.

Supportive and preventive interventions can potentially influence the resilience of cancer patients. This study aimed to compare the effect of spiritual therapy and the Spiritual Emotional Freedom Technique (SEFT) on resilience and hope in patients with colorectal cancer. This semi-experimental study evaluated 66 patients with colorectal cancer, divided into two groups of 33 people (spiritual therapy and SEFT). Data were collected using a demographic information form, Herth’s Hope Index, and Connor–Davidson Resilience Scale (CD-RISC). Data analysis was performed using SPSS software (version 24). Both spiritual therapy and SEFT had a positive effect on resilience and hope in patients with colorectal cancer. Life expectancy was significantly increased in both the SEFT and the spiritual therapy groups. However, the increase in the SEFT group was higher than the spiritual therapy group. SEFT training resulted in a 32.63-point increase in life expectancy and a 21.09-point in resilience, while spiritual therapy was associated with an increase of 22.06-point increase in life expectancy and 8.51-point in resilience (P=0.01). Both spiritual therapy and SEFT were effective in improving life expectancy and resilience in patients; however, SEFT was more effective than spiritual therapy. Since cancer affects individuals’ resilience, spiritual therapy could indirectly affect patients’ psychological adaptation by providing support resources.

Cancer and the fear of its recurrence significantly impact individual performance and quality of life. This study aimed to compare the effectiveness of cognitive-behavioral therapy and mindfulness-based therapy on fear of recurrence, body image, and disease perception in women with breast cancer. This quasi-experimental study examined the effect of cognitive-behavioral therapy and mindfulness-based therapy using a pre-test and post-test design with three groups of 15 participants each. The study included women with breast cancer referred to Karaj psychiatric treatment centers in Karaj during the first 6 months of 2022. The data were collected using the Bradbett Disease Perception questionnaire, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and the Fear of Cancer Recurrence Scale. Data analysis was performed using SPSS software version 22.  The results indicated that the mean scores for fear of recurrence, body image, and disease perception were higher in the pre-test than in the post-test stages across the cognitive-behavioral therapy group, the mindfulness-based therapy group, and the control group. The mean difference between the cognitive-behavioral therapy group and the control group was 39.31 for fear of recurrence and 56.06 for body image, showing a significant difference (P=0.01). Mindfulness-based cognitive therapy led to reduced dissatisfaction decreased body-related concerns, and lower fear of negative evaluation in the experimental group than in the control group. Mindfulness-based cognitive therapy could modify body image and reduce the fear of negative evaluation, thereby improving the quality of life for women with breast cancer.

The present study aimed to investigate the effect of Namaste care on the Quality of Life (QoL) of elderly individuals with Alzheimer’s disease (AD). This quasi-experimental pre-post intervention study was conducted on 25 elderly individuals with AD who were receiving care at a nursing care center. The QoL in the Last Stage of Dementia (QUALID) questionnaire was used to evaluate QoL before the intervention. This questionnaire had 11 items across various domains and was scored on a 5-point Likert scale. All participants received Namaste care for 4 months, 7 days a week, by trained caregivers. At the end of the study, QoL was reassessed using the QUALID questionnaire. The findings revealed that the mean QoL scores before and after the intervention were 45.24±6.26 and 23.72±6.55, respectively. Namaste care significantly improved the QoL of elderly individuals with AD (P<0.001). All variables related to QoL showed improvement after the provision of Namaste care. The care for individuals with AD extended beyond medical and nursing protocols and encompassed psychological and social dimensions. Namaste care could enhance the quality of care for elderly individuals with AD.

Students are considered valuable assets and key members of society, playing a pivotal role in shaping the future of the country. Given the prevalence of emotional fluctuations, anxiety, and worry among students, this study aimed to investigate the effectiveness of cognitive-behavioral training on meta-worry and social adjustment of University students. This study employed a quasi-experimental design with pre-test, post-test, and control group. The statistical population included all undergraduate students enrolled in 2022 at the Islamic Azad University, Kerman Branch. A total of 72 students were selected through a multi-stage cluster sampling method and randomly assigned to two groups of 36. The intervention group received cognitive-behavioral training in nine sessions, each lasting 60 to 90 minutes. The research instruments included Wells’ Meta-Worry Questionnaire and Bell’s Adjustment Inventory. Data were analyzed using multivariate analysis of covariance (MANCOVA). The results indicated a significant difference between the mean scores of meta-worry and social adjustment in the experimental and control groups during the post-test phase, with a 95% confidence level (P<0.05). Cognitive behavioral training led to a 13.06% reduction in meta-worry scores and a 19.87% increase in social adjustment scores in the experimental group. Cognitive behavioral training could be effectively utilized to reduce psychological issues among students and enhance their social adjustment.

This study aimed to compare the effectiveness of Emotion-Focused Couples Therapy (EFCT) based on the Attachment Injury Model and Acceptance and Commitment Therapy (ACT) on distress tolerance among healthcare workers in Lorestan Province who experienced marital infidelity during the COVID-19 pandemic.

The study population included all female healthcare workers in Lorestan Province who sought counseling services due to marital infidelity during the COVID-19 pandemic. Using non-random convenience sampling, 30 participants were selected and assigned to two intervention groups (EFCT and ACT) and a control group. Additionally, 15 women without a history of marital infidelity were selected as the control group. The study employed a pretest-posttest design, and data were collected using Simmons and Gaher’s (2005) Distress Tolerance Questionnaire. Data analysis was performed using SPSS software (version 24).

Most participants were under 30 years old, with a small proportion over 40 years old, and the majority held a Bachelor’s degree. The mean distress tolerance scores were 3.480±0.661 for the EFCT group, 5.121±0.565 for the ACT group, and 3.813±0.631 for the control group. ACT had a greater impact on distress tolerance than EFCT, with an effect size of 0.772.

The results indicated that, compared to EFCT, ACT significantly improved distress tolerance among participants. ACT, as a therapeutic approach, influenced individuals’ internal motivation, thought patterns, and perceived control, fostering hope and goal-directed behavior. This approach was effective in enhancing distress tolerance among healthcare workers, who were affected by marital infidelity during the COVID-19 pandemic.

Social anxiety disorder is a debilitating psychiatric condition characterized by persistent fear in social situations. Individuals with this disorder fear negative evaluation by others and experience significant worry. This study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and paradoxical timetable therapy (PTT) on worry in individuals with social anxiety disorder. This applied study employed a single-case experimental design with an ABA framework. The statistical population included undergraduate psychology students with social anxiety disorder symptoms at Islamic Azad University, Khorramabad Branch during the 2022-2023 academic year. Six participants were selected through purposive sampling and randomly assigned to two intervention groups (PTC, ACT) and one control group. The experimental groups received ACT and PTT in 12 weekly 90-minute sessions over 12 weeks. The follow-up assessments were conducted at one month and two months post-intervention. The Penn State Worry Questionnaire (PSWQ) and Social Anxiety Questionnaire (SAQ) were used for data collection. Data were analyzed using single-subject analysis, including visual analysis of charts, trend indices, stability, percentage of non-overlapping data (PND), percentage of overlapping data, and recovery percentage. The percentage of non-comprehensive data (PND) was used for statistical significance. The results showed that there was a significant difference between the effect of ACT and PTT on worry levels in individuals with social anxiety disorder (P<0.001). ACT was more effective than PTT in reducing worry, and its effects remained stable during the follow-up period. It can be concluded that ACT, utilizing six core processes—psychological acceptance, cognitive defusion, self-as-context, present-moment awareness, values clarification, and committed action—can be prioritized as a therapeutic approach for individuals with social anxiety disorder.

The analysis of patients’ opinions is considered a valuable indicator for assessing the quality of healthcare services. The increasing volume of textual reviews about healthcare has made these reviews a critical factor in other patients’ decision-making processes when selecting medical services. Consequently, researchers aimed to extract valuable insights, classify sentiments, and identify patient needs and behavioral patterns through sentiment analysis, thereby developing appropriate strategies to enhance patient satisfaction. However, patient reviews often contain a significant amount of specialized terminology, and existing sentiment analysis tools are typically trained on general-domain data. Therefore, to analyze these reviews accurately, it is essential to employ models and their combinations in a way that ensures reliable and valid results. To improve the efficiency and accuracy of sentiment analysis for Persian healthcare reviews, this study utilized the FastText-BERT hybrid embedding model for semantic relation extraction and the CNN-BiLSTM model for sentence-level sentiment classification. The proposed framework achieved an accuracy of 86% and an F1-score of 84.99%. The results demonstrated that combining embedding models leverages the strengths of both approaches, enabling the identification of specialized and out-of-domain expressions and the extraction of semantic relationships between them. This combination significantly enhances the efficiency and accuracy of sentiment analysis.

Investigating students’ academic performance is one of the critical factors in enhancing the quality of school education. The purpose of the present study was to examine the structural relationship model predicting students' academic performance based on problem-solving skills and intelligence beliefs, with the mediating role of academic challenge. This study was applied in terms of purpose and descriptive in terms of nature and method. The study population included all second-grade high school students enrolled in public schools in Ardabil in 2023. A total of 170 students were selected through a multi-stage cluster random sampling method. They completed questionnaires on academic performance, problem-solving skills, intelligence beliefs, and academic challenges in a group setting at their school. The collected data were analyzed using SmartPLS 4 software. The results of the structural equation model indicated that intelligence beliefs and problem-solving skills had a direct and positive effect on academic performance. Additionally, the indirect effect of intelligence beliefs and problem-solving skills on academic performance was confirmed through the mediation of academic challenge (P<0.001). The model demonstrated a good fit based on the goodness-of-fit indices. In light of the findings and the reciprocal relationships between academic performance, problem-solving skills, intelligence beliefs, and academic challenges, it is recommended that educational practitioners and teachers strengthen students’ problem-solving skills, intelligence beliefs, and academic challenges. This approach is expected to contribute to the improvement of student’s academic performance.

Based on the evidence, participation in congregational prayers positively impacts mental and spiritual health, fostering spiritual guidance. In this regard, the present study aimed to identify the factors contributing to students’ non-attendance in congregational prayers at Shiraz University of Medical Sciences and propose solutions to enhance participation in this divine obligation. This descriptive cross-sectional study included 436 students selected through a stratified random sampling method, from a total population of 9471 students at Shiraz University of Medical Sciences in 2023. The data were collected using a questionnaire including demographic information and factors affecting participation in congregational prayers. The validity and reliability of the questionnaire were confirmed. Data analysis was performed using SPSS  software (version 23). Independent t-tests, ANOVA, and correlation coefficients were used to examine the effects of demographic factors on the total questionnaire score. The results of the statistical tests showed that demographic variables, field and level of education, marital status, and age significantly affected the total score of the questionnaire (P<0.05). Married individuals (P=0.014) and professional doctoral students (P=0.034) had higher questionnaire scores. Besides, the scores increased with age (P=0.001). Physical factors, the role of the prayer leader, social influences, and personal inclinations significantly influenced attendance (P≤0.001), while extracurricular activities and the presence of a counselor had no significant effect (P=0.924). The findings suggested that better-equipping prayer halls, organizing extracurricular activities, the effective role of prayer leaders and religious advisors, and the presence of university officials and professors in congregational prayers could encourage students to participate in this divine obligation. University authorities can facilitate maximum participation through better planning and programming.

This study aimed to review the scientific literature on the effect of repeated rotations on the lumbar spine in professional tennis players and to provide a comprehensive summary of previous research.

A literature review was conducted using the following databases and motor searches: Google Scholar, Web of Science, PubMed, Scopus, SID, Iranmedex, and Magiran. The search terms included “spinal curvature”, “lumbar rotation”, and “tennis”. The search was limited to studies published between 2000 and January 2024.

Out of 2,500 studies initially identified, 95 abstracts were selected for review, and 12 studies were ultimately included in this research. These studies investigated the effects of repeated rotations on the lumbar spine in professional tennis players. The findings indicated that various tennis techniques increased the intensity of lumbar rotation over time, predisposing players to low back pain and other lumbar spine injuries.

Repeated rotations of the lumbar spine over time could lead to low back pain in professional tennis players. This was likely due to the gradual increase in flexibility of the lumbopelvic segments relative to the stiffness of the hip joint segments, resulting in excessive premature movement in the lumbopelvic region. Therefore, interventions focusing on controlled physical activity, core muscle strengthening, proprioceptive improvement, and the correction of repetitive movement patterns in tennis players might effectively reduce the incidence of low back pain.

“Mithridatium” is one of the most renowned antidotes in history, traditionally attributed to the king of Asia Minor. This study aimed to identify and report the historical and medical background of this remedy. Using a qualitative, documentary research method, this study reviewed information from medical and historical texts to define the true identity of Mithridatium The findings revealed that, despite its historical background, lexical and semantic transformations, and the Hellenic origins of its creator, Mithridatium was invented by Mithridates VI (134 to 63 B.C.), the king of the ancient Anatolian Kingdom of Pontus who was of mixed Persian and Greek ancestry in the Black Sea region. Regardless of its genealogy, the Greek form of Mithridates’ antidote, known as Mithridatium, permeated Persian medicine (PM) and became firmly established. What is clear is that Mithridatium had an Iranian origin, with semantic transformation in PM.