نشریه روان پرستاری
سال دوازدهم شماره 6 (پیاپی 66، بهمن و اسفند 1403)

Marital intimacy is a concept in positive psychology and has a special place in interpersonal relationships of couples and family mental health. This research aimed to test the marital intimacy model based on the couple's communication pattern and the original family health with mediation of self-differentiation in female students with chronic pain of Shahid Chamran University of Ahvaz.

The current research method was descriptive path analysis. The statistical population included all female students with chronic pain of Shahid Chamran University of Ahvaz. 220 people were selected via purposive sampling. To collect data, the Intimacy Questionnaire (Walker & Thompson, 1983), Couple Communication Patterns (Christensen & Salawi, 1984), Original Family Health (Haustadt et al., 1985), and Self-Differentiation (Skuron & Friedlander, 1998) was used. For data analysis, the Pearson correlation method and path analysis were used.

Results showed that the communication pattern of mutual avoidance(β=-0.215,P<0.005), original family health (β=0.217,P<0.003)and self-differentiation(β=0.293,P<0.001)on marital intimacy as well as the constructive communication (β=0.179,P<0.02), expectant/avoidant communication (β=-0.243,P<0.008),mutual avoidance communication (β=-0.219,P<0.004) patterns and original family health (β=0.186,P<0.008)have significant relationship on self-differentiation. There was no significant relationship between the constructive communication and expectant/avoidant communication (β=0.022&β=0.10,P>0.05) patterns on marital intimacy. Also, there was significant relationship between constructive communication (β= 0.052,P<0.006), expectant/avoidant communication (β= -0.071,P<0.003), mutual avoidance communication (β= -0.064,P<0.005) patterns ,the original family health (β= 0.054,P<0.012) with marital intimacy through mediation of self-differentiation in female students with chronic pain.

The results of the analysis showed that the proposed model fit the data. Psychotherapists' awareness of these results can be helpful in finding factors related to improving marital intimacy and solving couples' interpersonal problems.

Childhood trauma can lead to extensive psychological problems in adulthood due to various structures, so exploration and intervention in these structures can be of vital importance in treating the problems of people with childhood trauma. In this regard, the present study was conducted with the aim of investigating the effectiveness of mentalization-based treatment on epistemic trust, emotional dysregulation, and impulsivity in adults with childhood trauma.

The current study was a semi-experimental type with a pre-test-post-test design with a control group. Among the people who experienced childhood trauma and referred to clinics and counseling centers in Tehran, 30 people were selected using convenience sampling method and randomly replaced in two experimental groups and a control group (15 people). The experimental group received 20 sessions of mentalization-based therapy, but the control group received no specific intervention. The research tools were: Childhood Trauma Questionnaire, Epistemic Trust, Mistrust, and Credulity Questionnaire, Difficulties in Emotion Regulation Scale, and Barratt Impulsiveness Scale. Data were analyzed using multivariate analysis of covariance test.

The results of the research showed that the treatment based on mentalization is effective in optimally increasing epistemic trust and reducing emotional dysregulation and impulsivity in adults with childhood trauma (P<0.05).

Considering the confirmation of the effectiveness of mentalization-based therapy on the treatment of adults with childhood trauma, it is suggested that therapists consider this therapy to optimally increase epistemic trust and reduce emotional dysregulation and impulsivity in adults with childhood trauma.

Non-suicidal self-injury (NSSI) is associated with a wide range of psychiatric disorders. Mentalization-based therapy (MBT) is a therapeutic approach that can possibly target the mechanisms involved in NSSI. The purpose of this study was to investigate the effect of mentalization-based therapy on dissociative experiences, alexithymia and impulsivity in people with non-suicidal self-injury.

The current research was a semi-experimental type of research with a pre-test-post-test design. Among the people who referred to the clinics and counseling centers of Tehran in 2023, 30 people who had obtained the highest score in the non-suicidal self-injury (NSSI) questionnaire were selected by convenience sampling method and randomly divided into two experimental groups and The control group (15 people) was replaced. The experimental group received 20 sessions of mentalization-based therapy, but the control group did not receive any specific intervention. The research tools were: non-suicidal self-injury questionnaire, Dissociative Experiences Scale, Toronto Alexithymia Scale and Barratt Impulsiveness Scale. Data were analyzed using multivariate analysis of covariance test.

The results showed that there is a difference between the average scores of dissociative experiences, alexithymia and impulsivity in the experimental and control groups, so that the mentalization-based treatment reduces dissociative experiences, alexithymia and impulsivity in people with non-suicidal self-injury (P<0.05).

Mentalization-based therapy is an appropriate treatment method for improving dissociative experiences, alexithymia, and impulsivity in people with non-suicidal self-injury, and it can be used as an effective intervention method in the treatment of non-suicidal self-injury.

With the growing number of opioid users, as well as with the non-compliance with methadone maintenance protocol principles in terms of dosage and occasional impulsive increases in dosage due to lack of effective emotional regulation, The present study was conducted with the aim of investigating the structural relationships of childhood trauma experience with emotional dysregulation in methadone treated individuals with the mediating role of mentalization.

The statistical population in this study included all drug-dependent patients treated with methadone who referred to addiction treatment centers in Qazvin city in 2023, of which 220 people were selected using the available sampling method. In order to collect data, Childhood Trauma Questionnaire, reflective functioning questionnaire, and difficulties in emotion regulation scale were used. For data analysis, Pearson correlation, structural equation modeling and SPSS-18 and AMOS-24 software were used.

The findings indicate the fit of the assumed model. The present research is a descriptive-correlation type of structural equations. The direct effect of childhood trauma (T=2.11, β=0.43) and mentalization (uncertainty component) (T=5.65, β=0.41) on meaningful and positive on emotional dysregulation and the direct effect of mentalization (uncertainty component) (T = -3.32, β = -0.47) on emotional dysregulation was significant and negative. Also, the analysis of research findings indicated the mediating role of mentalization in the relationship between childhood trauma experience and emotional dysregulation. The results also showed that the research variables explained a total of 56% of the variance of emotional dysregulation. The results also showed that the research variables explained a total of 56% of the variance of emotional dysregulation.

Early traumatic experiences, especially with caregivers, create an environment that invalidates the child's emotions and feelings, and in this unsafe environment, the child uses incompatible strategies such as suppressing or avoiding negative emotions. It may lead to substance abuse problems in adulthood, On the other hand, in spite of traumatic experiences, if people acquire a high psychological capacity and understanding and insight into their mental processes (mentalization capacity), they will not resort to drugs in order to regulate their impulses and emotions. Therefore, it is suggested to pay special attention to the treatments based on mentalization and the treatments based on emotion regulation in people treated with methadone.

Surgery has always been accompanied by significant stress and anxiety for patients, particularly those undergoing brain tumor surgery who possess specific physical and psychological conditions. Therefore, this study aimed to identify and elucidate the stressors in patients undergoing brain tumor surgery.

This qualitative study utilized a conventional content analysis approach. Purposeful sampling was conducted, and participants were selected based on inclusion and exclusion criteria. Data were collected through semi-structured interviews. Data analysis was performed using the Graneheim and Lundman method.

12 patients undergoing brain tumor surgery participated in this study. Based on data analysis, 4 main themes and 16 sub-themes were identified, including care-treatment, health-related, individual, and social stressors.

The results of this study indicated that multiple stressors exist that can impact patients undergoing brain tumor surgery, leading to negative outcomes and serious complications for them. Therefore, surgical centers should pay attention to these stressors and take action to reduce them by providing counseling and education to patients and healthcare staff, especially nurses and surgical personnel, as well as implementing other supportive programs.

Cancer, as a chronic physical-psychological condition, challenges the regular and continuous process of life and has numerous behavioral consequences for the child. Based on this, the present study was conducted to investigate the effect of mentalization therapy on behavioral problems in children with cancer. In this way, the subjects' baseline was determined. In the next step, mentalization therapy for children was carried out for 12 sessions of 45 minutes individually and in parallel for the child and the mother.

The method of this research was semi-experimental with a single case structure and A-B-A design. The statistical population of the research was all children aged 9 to 12 with cancer in Seyed al-Shohda Hospital in Isfahan city in 1402, from among them, four children were selected by available sampling method. Before the intervention, the performance of the subjects was evaluated for three sessions, using the child behavior list of Achenbach et al. and during this period, no intervention was provided to improve the performance of the subjects. In this way, the subjects' baseline was determined. In the next step, mentalization-based therapy for children was carried out for 12 sessions of 45 minutes individually and in parallel for the child and the mother, and at the end of the sessions, their performance was measured using research tools. After the completion of the intervention sessions, the performance of the subjects was examined again in three separate times. Visual analysis of graphs and trend index, stability index, percentage of non-overlapping data, and percentage of overlapping data were used for data analysis utilizing SPSS and Excel software version 24.

The result of the data analysis indicated the positive effect of this intervention on behavioral problems, including internalized and externalized behavioral problems in children with cancer; So, the scores of behavioral problems of the participants in the intervention phase were reduced compared to the baseline phase. The percentage of non-overlapping data was also reported as 75 to 12.5 percent and the percentage of overlapping data from 87.5 to 25 percent. Also, the effect size for these children varied from 0.09 to 1.43, which is considered a favorable effect size.

Based on the findings of the research, mentallization-based therapy for children was effective in reducing the behavioral problems in children with cancer. Therefore, it is suggested that psychologists and counselors use this new method of psychotherapy as a useful and effective tool to reduce the behavioral problems in children with cancer.

The developmental process of brain changes during adolescence makes people vulnerable to wrong decisions, including self-harm. Identifying predictors of self-injury in adolescents with borderline personality disorder is of particular importance; therefore, the present study was conducted to investigate the causal model of self-injury in adolescent girls with borderline personality traits based on shame, guilt, and sensitivity to rejection with the mediator of family functioning.

  Regarding the data collection method, the current research method is a descriptive correlation type implemented with the structural equation model technique. The statistical population of this research included all adolescent girls between the ages of 14 and 18 in Hamadan province in 1400-1401, and 350 people were selected from among the mentioned statistical population using the available sampling method. The tools used in this research are the Schizotypal Trait Questionnaire-B form, Self-Harm Inventory, Guilt and Shame Proneness Scale, Rejection Sensitivity Questionnaire Rejection Sensitivity Questionnaire (RSQ), and Family Assessment Device. Finally, after collecting the data, the correlational research and structural equation model method were used using SPSS26 and AMOS24 software.

The findings of the present study showed that the coefficient of feeling shame, guilt, and sensitivity to rejection has a positive and direct effect on self-injurious behavior in adolescent girls with borderline personality traits (P<0.001). The coefficient of the path of family functioning had a negative and direct effect on self-injury behavior in adolescents (P<0.001). Also, guilt has an indirect effect on self-injury behavior through family functioning (P<0.001); However, the mediating role of family functioning in the relationship between feelings of shame and sensitivity to rejection with self-injurious behavior of adolescents was not confirmed (P<0.001).

It seems that the feeling of shame and sensitivity to rejection in adolescents, along with inappropriate functioning in the family, aggravates the occurrence of self-injurious behaviors in adolescents. Therefore, paying attention to protective factors such as proper functioning of the family, lack of rejection in the family, and reducing teenagers' sensitivity to shame and guilt can be effective in reducing and controlling teenagers' self-injurious behaviors.

The quality of nursing care faces significant challenges worldwide. Evaluating quality of care and its influencing factors is important for identifying limitations and improving service delivery. This study aimed to examine the relationship between quality of nursing care, professional identity, and resilience among nurses.

This descriptive-correlational study included 118 nurses from medical centers affiliated with the University of Social Welfare and Rehabilitation Sciences in 2024. Data were collected using a demographic questionnaire, the Nursing Care Quality Scale, Hao et al.'s Professional Identity Questionnaire, and the Connor-Davidson Resilience Scale. Statistical analysis was conducted using SPSS version 25. Parametric tests included independent t-tests, one-way ANOVA, Pearson correlation, and multiple linear regression.

The mean nursing care quality score was 172.46 ± 20.68, reflecting a high level of care quality. Resilience and professional identity scores were 61.61 ± 14.26 and 56.02 ± 11.72, respectively, indicating moderate levels. Professional identity (r= 0.398) and resilience (r= 0.201) exhibited significant positive correlations with nursing care quality (p<0.05).

Professional identity and self-perception as a nurse are important for fulfilling duties and significantly influence all aspects of nursing performance, including the quality of care provided. Resilience is also important for nurses' professional success and delivering high-quality patient care. Enhancing resilience, professional identity, and implementing relatively stable work schedules can contribute to improving nursing care quality.

Bulimia nervosa has negative effects on the quality of life of individuals undergoing gastric sleeve/bypass surgery. The aim of the present study was to determine the effectiveness of group schema therapy on psychological capital in patients with bulimia nervosa.

The study was a quasi-experimental study with a pre-test and post-test design with a control group. The statistical population was all patients with bulimia nervosa undergoing gastric sleeve/bypass surgery who were referred to medical centers in Tehran province in 2023. Patients were assessed with the Eating Disorders Questionnaire by Stick et al. (2001). A sample of 30 individuals with bulimia nervosa was selected and 15 were randomly assigned to each group. In the experimental group, individual and group therapy sessions (during 3 months) were implemented based on the Simpson and Smith (2020) group schema therapy protocol for eating disorders. Data were collected from the Luthans Psychological Capital Questionnaire (2007); Their analysis was performed using multivariate analysis of covariance and SPSS-26 software.

The mean post-test scores of the experimental group and the control group in the components of self-efficacy increased from 32.33 to 27.92, hopefulness from 30 to 21.83, resilience from 23.92 to 20, and optimism from 26.33 to 19.92, respectively. Also, the group schema therapy intervention significantly improved the psychological capital of patients with bulimia nervosa (p<0.05).

Group schema therapy can be used as an effective component in treatment programs for bulimia nervosa.

 Intensive care unit nurses are exposed to numerous psychological disorders, including alexithymia and death anxiety, due to their continuous exposure to complex and stressful conditions. Therefore, the present study was conducted to compare the effectiveness of emotion-focused therapy and schema therapy on alexithymia and death anxiety of intensive care unit nurses.

 The method of the present study was a semi-experimental pre-test-post-test with a control group. The statistical population of the present study was the nurses of Imam Hossein Hospital in Shahrood City working in the intensive care unit in 1403. Of these, 45 nurses were selected by convenience sampling and randomly assigned to three schema therapy, emotion-focused, and control groups. The intervention groups received treatment in eight sessions weekly, and the control group did not receive any intervention. The Toronto Alexithymia Scale (TAS) and Templer Death Anxiety Scale (DAS) were used to collect data. Data analysis from this study was performed using SPSS-27 software and univariate and multivariate analysis of covariance.

 The data showed that alexithymia significantly decreased in emotion-focused therapy (F = 0.01, p < 17.91) and schema therapy (F = 0.01, p < 0.08). Death anxiety also significantly improved in emotion-focused therapy (F = 0.01, p < 128.42) and schema therapy (F = 0.01, p < 34.70). From the comparison of the two treatment methods, it can be concluded that emotion-focused therapy was more effective than schema therapy in reducing alexithymia in intensive care unit nurses (P<0.001), and no significant difference was observed between the two groups regarding death anxiety (P<0.001).

 Considering the effectiveness of emotion-focused therapy compared to schema therapy, it can be concluded that emotion-focused therapy can be used as a more effective treatment in the treatment of alexithymia in intensive care unit nurses.