فهرست مطالب

Jundishapur Journal of Chronic Disease Care
Volume:13 Issue: 3, Jun 2024

  • تاریخ انتشار: 1402/12/24
  • تعداد عناوین: 10
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  • Maryam Khalafi, Hamzeh Rostami, Naghmeh Malekpour, Forouzan Behrouzian, Hatam Boostani * Page 1
    Background

     Recent evidence suggests the potential efficacy of modafinil in addressing specific symptom domains associated with schizophrenia, particularly negative and cognitive symptoms. However, it's important to note that findings in this area have been inconsistent.

    Objectives

     This study was done to assess the impact of modafinil on improving negative symptoms in schizophrenia patients.

    Methods

     In this clinical trial, 40 individuals diagnosed with schizophrenia and referred to Golestan Hospital were selected. Patients received a daily dose of 100 to 200 mg of modafinil in addition to their ongoing antipsychotic treatment with either Risperidone or Olanzapine. In the control group, patients received a placebo along with their prescribed antipsychotic therapy. The duration of the follow-up was 4 weeks. Both the evaluator and the patients were blinded to the administered medication. The Scale for the Assessment of Negative Symptoms (SANS) was utilized to measure negative symptoms before the intervention, and at 2 and 4 weeks following the intervention.

    Results

     The mean age of participants in the intervention and control groups was 34.00 ± 6.60 and 36.90 ± 6.88 years, respectively. 2 weeks after the intervention, the average SANS score was lower in the intervention group compared to the placebo group (99.70 ± 10.24 vs. 111.24 ± 7.08, P = 0.04). At 4 weeks post-intervention, the average SANS score in the intervention group was significantly reduced compared to the placebo group (84.39 ± 3.54 vs. 113.79 ± 3.75, P = 0.002).

    Conclusions

     This study suggests that modafinil may be an effective adjunctive therapy for schizophrenia, particularly for treating anhedonia symptoms.

    Keywords: Schizophrenic, Modafinil, Negative Symptoms
  • Sara Shirdelzade, Monir Ramezani, Peyman Eshraghi, Abbas Heydari * Page 2
    Background

     Inborn errors of metabolism (IEMs) are a group of congenital and chronic diseases that cause many difficulties for children and their parents.

    Objectives

     This review aims to identify the needs that they are faced in caring.

    Methods

     This is an integrative review using the method of Whittemore and Knafl (2005). The databases of PubMed, Web of Science (ISI), SID, and Google Scholar were searched in English and Persian without any time and methodology restrictions in October and November 2022.

    Results

     After screening the documents, 19 articles, consisting of 9 quantitative, 7 qualitative, and 3 review studies, were retrieved. Three categories of needs, including children, parents, and the healthcare system, were identified. The most reported needs were related to diet, psychological, social, and financial support dimensions and the necessity of implementing a multidisciplinary and coordinated care approach.

    Conclusions

     Children with IEMs and their parents have many needs that can be satisfied through a multidisciplinary, patient-centered, and coordinated care approach.

    Keywords: Care, Need, Inborn errors of metabolism, Child, Parent
  • Shohreh Dashtpayma, Parvin Abedi *, Poorandokht Afshari, Shahin Norouzi, Maryam Dastoorpour Page 3
    Background

     There is evidence that maternal near miss (MNM) may adversely affect sexual function later in life.

    Objectives

     This study aimed to evaluate the effect of cognitive-behavioral therapy (CBT) on the sexual function of women with MNM.

    Methods

     Forty-eight women with MNM were randomly assigned to 2 groups: CBT (n = 24) and control (n = 24). Women in the CBT group received 8 counseling sessions based on CBT. Data were collected using a demographic questionnaire and the Female Sexual Function Index (FSFI). Women were requested to complete the FSFI questionnaire before and after the 8-session intervention. A total score of > 26 was considered normal sexual function. The intervention started in June and was completed in October 2021. The Shapiro-Wilk test, independent t-test, Chi-square test, and Mann-Whitney test were used to analyze the data.

    Results

     The scores of all components of sexual function improved in the CBT group compared to the control group as follows: Sexual desire (3.77 ± .64 vs. 2.25 ± .53, P < 0.001), sexual arousal (3.72 ± .45 vs. 2.40 ± .48, P < 0.001), lubrication (3.13 ± .35 vs. 2.60 ± .36, P < 0.001), orgasm (3.11 ± .45 vs. 1.0 ± .42, P < 0.001), sexual satisfaction (4.25 ± .52 vs. 2.83 ± .81, P < 0.001), pain (2.36 ± .80 vs. 4.21 ± .54, P < 0.001), total score of sexual function (20.37 ± 1.44 vs. 15.3 ± 1.40, P < 0.001).

    Conclusions

     While CBT significantly improved the sexual function of women with MNM, their sexual performance score still did not fall within the normal range. Our results indicate that women with a near miss may require additional counseling sessions or alternative interventions.

  • Seyyed Abolfazl Vagharseyyedin, Zahra Ghorbanimoghadam, Shahnaz Tabiee * Page 4
    Background

     Ischemic heart disease stands as the foremost cause of death among cardiovascular conditions. The most commonly employed revascularization method for treating ischemic heart disease is percutaneous coronary intervention (PCI). An improvement in the patient's quality of life frequently serves as the primary measure of PCI's success.

    Objectives

     The purpose of this study was to assess the impact of an educational program grounded in the information-motivation-behavioral skills (IMB) model on the quality of life of patients who have undergone PCI.

    Methods

     This quasi-experimental study involved 84 patients selected from those referred to the Cardiovascular Clinic of Razi Hospital in Birjand city, located in eastern Khorasan. Participants were required to fill out a demographics form and the Short Form of the Quality-of-Life Questionnaire (SF-12). They were then divided into an intervention group (n = 42) and a control group (n = 42) through the use of the permuted block method. Those in the intervention group participated in a 6-week educational program (meeting once weekly) designed around the IMB model. The control group received the standard care available at the Cardiovascular Clinic. Both groups were asked to return to the Cardiology Clinic 6 weeks after the initial test to complete the SF-12 (posttest). All participants were surveyed again one month after the second questionnaire completion (follow-up).

    Results

     The intervention group showed a significant increase in the mean score of physical health immediately and one month after the intervention, compared to the pretest scores (P = 0.001 and P = 0.004, respectively). Furthermore, the mean posttest score for psychological health in the intervention group significantly improved compared to the pretest (P < 0.001), and their follow-up score improved significantly compared to the posttest score (P = 0.02). There were no significant changes in the mean scores for physical and psychological health in the control group over time (P > 0.05).

    Conclusions

     This study indicates that the quality of life for patients post-PCI can be significantly improved through participation in an educational program based on the IMB model. This research provides a foundation for the development of interventions with more enduring effects on post-PCI patient outcomes.

    Keywords: Information-Motivation-Behavioral Skills Model, Percutaneous Coronary Intervention, Quality of Life
  • Mehrnoosh Zakerkish, Poorandokht Afshari *, Parvin Abedi, Maryam Beheshtinasab, Elham Maraghi, Hossein Meghdadi Page 5
    Background

     There is a paucity of research investigating the changes in thyroid hormones in individuals affected by coronavirus disease 2019 (COVID-19).

    Objectives

     This study aimed to evaluate the levels of thyroid hormones in individuals affected by COVID-19 infection in Ahvaz, Iran.

    Methods

     This was a comparative cross-sectional study on 78 patients with COVID-19 infection and 80 individuals without infection. Thyroid-stimulating hormone (TSH), triiodothyronine (TT3), and tetraiodothyronine (TT4) were measured in hospitalized patients at baseline and one month after recovery and in participants without infection. The data were analyzed using a paired t-test, the Chi-square test, the Wilcoxon test, and the analysis of covariance (ANCOVA).

    Results

     The level of TSH at baseline in the hospitalized patients was significantly lower than that in the control group (1.24 ± 1.08 vs. 2.05 ± 1.02 mlU/L, respectively, P < 0.0001). The mean level of TT3 was 1.20 ± 0.24 and 1.28 ± 1.25 ng/dL in the case and control groups, respectively (P = 0.188). The level of TT4 in the case group was high at baseline in comparison to the control group (8.48 ± 2.27 vs. 7.76 ± 1.43 ng/dL, P = 0.076), which was reduced in the follow-up period. Thirty-five (44.8%) patients had severe disease and were admitted to the intensive care unit (ICU). The level of TSH was non-significantly lower in patients with severe disease than those with moderate disease.

    Conclusions

     Patients with COVID-19 infection showed abnormalities in thyroid hormones, such as decreased levels of TSH and TT3. Patients with severe COVID-19 showed lower levels of TSH and unchanged levels of TT3 and TT4 in comparison to the patients with moderate disease. Further investigation into thyroid function in patients with COVID-19 is recommended.

    Keywords: COVID-19, Triiodothyronine, Thyroid Hormone, Thyroxine
  • Pouriya Darabiyan, Hadis Nazari, Kourosh Zarea *, Saeed Ghanbari, Zeinab Raiesifar, Morteza Abdullatif Khafaie Page 6
    Background

     Since the beginning of mobile phone addiction, alexithymia, depression, anxiety, and stress have been mentioned as complications of Internet addiction in various studies; however, the relationship between these variables has not been well investigated.

    Objectives

     This study was conducted to investigate the relationship between alexithymia and mobile phone addiction, emphasizing the mediating role of anxiety, stress, and depression.

    Methods

     In this descriptive-analytical study, 412 students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, were included using an available sampling method in 2019. Data collection tools were the demographic questionnaire, Toronto Alexithymia Scale (TAS-20), Depression, Anxiety, Stress Scale (DASS-21), and Mobile Phone Addiction Index (MPAI). Statistical analysis was carried out using SPSS software (version 22) and Amos software (version 16). A significance level of less than 0.05 was considered.

    Results

     Alexithymia was a predictive factor for mobile phone addiction. Additionally, it had a direct and significant effect on depression (β = 0.540, P < 0.001), anxiety (β = 0.500, P < 0.001), and stress (β = 0.53, P < 0.001). Depression (β = 0.452, P < 0.001), anxiety (β = 0.408, P < 0.001), and stress (β = 0.460, P < 0.001) had a positive and significant effect on cell phone addiction.

    Conclusions

     In this study, alexithymia was a predictive factor for mobile phone addiction. Moreover, the variables of depression, anxiety, and stress play the role of a relative mediating variable between alexithymia and mobile addiction.

    Keywords: Alexithymia, Mobile Phone Addiction, Depression, Anxiety, Stress, Student
  • Samira Beiranvand, Sakineh Akbari *, Amin Sattari Page 7
  • Maryam Alsadat Kardaani *, Majid Ebrahimpur Page 8
    Background

     Comprehension and visual-motor integration skills are still widely used in the psychological assessments of children. Recent evidence suggests that children with autism spectrum disorder (ASD) might have a general impairment in visual motion perception.

    Objectives

     This study aimed to evaluate the effects of motion imagery on visual motor perception in children with ASD.

    Methods

     In a before and after clinical trial study, 30 children with ASD were divided into two groups of 15 subjects, test and control. The intervention group received 3 sessions of 60 minutes per week for 15 weeks with movement visualization exercises. Before and after the intervention and after the follow-up period, visual motor perception and motor imagery questionnaires were completed and implemented. The data were analyzed using SPSS22 software (P ≤ 0.05). The Kolmogorov-Smirnov test was used to determine the normality of the data, and variance analysis was used to compare the averages of the two groups before and after the intervention and follow-up.

    Results

     The results obtained in all subscales of motor imagery with P = 0.001 indicated that there was a statistically significant difference between the two groups in the pre-test and post-test scores. Additionally, the results obtained concerning visual motor perception showed that in all the subscales with P < 0.001, statistically significant differences could be observed after the intervention and in the 3 months of follow-up.

    Conclusions

     Motion visualization is an easy and accessible method that has positive and effective effects on visual-motor perception skills. Treatment practitioners can use this method to improve ASD children.

    Keywords: Motion Imagery, Visual Motor Perception, ASD, Children
  • Fariba Abdollahi, Eman Ariyan, Fardin Rastegar, Rana Rezai Sepasi, Seyedeh Ameneh Motalebi * Page 9
    Background

     Patients with Multiple Sclerosis (MS) often experience varying levels of social stigma, which can impact their health.

    Objectives

     This study aimed to explore the relationship between perceived stigma and coping strategies among MS patients.

    Methods

     Conducted from December 2019 to June 2020, this cross-sectional and correlational study involved 100 MS patients. Participants were recruited from a neurologic clinic in Qazvin, Iran, using convenience sampling. Data collection employed the Lazarus Coping Strategies Questionnaire and the Korean version of the Stigma Scale for Chronic Illness 8-item (SSCI-8). Patients completed these questionnaires at the clinic. Data analysis utilized Pearson’s and Spearman’s correlation coefficients.

    Results

     The average age of participants was 35.93 ± 7.20 years. Mean scores for internal and external stigmas were 6.47 ± 2.03 and 8.73 ± 3.48, respectively. Problem-focused strategies were most commonly used by MS patients. Pearson correlations revealed a significant positive relationship between internal stigma and escape-avoidance (r = 0.391, P < 0.000), seeking social support (r = 0.215, P = 0.031), confronting (r = 0.240, P = 0.016), and self-controlling strategies (r = 0.222, P = 0.026). Significant associations were also noted between external stigma and escape avoidance (r = 0.322, P = 0.001) and confronting strategies (r = 0.240, P = 0.016). Inverse correlations were found between educational level and internal stigma (r = -0.273, P = 0.006) and between MS duration and external stigma (r = -0.296, P = 0.003).

    Conclusions

     Multiple sclerosis (MS) patients experiencing higher levels of stigma tended to use more negative coping strategies. Implementing programs to reduce stigma and promote effective coping strategies may enhance the physical and psychological well-being of these patients.

    Keywords: Social Stigma, Coping Strategies, Multiple Sclerosis, Social Support
  • Naser Mohamadkhani *, Mohammad Hadian Page 10

    Context:

     Due to the chronic nature of cancer, screening programs were a set of sequential decisions taken over time. Markov decision process (MDP) and partially observable Markov decision process (POMDP) models were the mathematical tools applied in studies, including sequential decision-making such as screening protocols for medical decision-making.

    Objectives

     The main goal of this study was to investigate optimal policy for cancer screening using MDP and POMDP models.

    Methods

     We performed a review of articles published within July 2000 to November 2022 in PubMed, Web of Science, and Scopus databases. The stopping age, the type of optimal strategy, the benefits of the optimal policy, and the relationship between age and risk threshold were extracted. Studies that did not use MDPs and POMDPs as the mathematical maximization models in cancer screening, review articles, editorials or commentaries, non-English articles, and those that did not focus on optimization were excluded.

    Results

     From 532 articles, 6 studies met the study criteria. All studies suggested that the optimal policy was control-limit, and the cancer risk threshold was a non-decreasing function of age. Three studies specified a stopping age for cancer screening. In five studies, the optimal policies outperformed the guidelines or no screening strategy.

    Conclusions

     Two essential factors in screening decisions were cancer risk and age, which were individual variables. The control-limit policy included these factors in decision-making for cancer screening. These policies highlighted personalized screening and showed that this type of screening could outperform cancer screening guidelines regarding economic and clinical benefits.

    Keywords: Markov Decision Process, Partially Observable Markov Decision Process, Cancer Screening, Diagnosis, Early Detection