شراره ضیغمی محمدی

Predicting the role of early maladaptive schemas in students' social anxiety helps to identify students at risk, the possibility of early interventions to prevent the development and exacerbation of social anxiety, and improve the quality of life, mental health, and academic and social performance of students. Therefore, the research was conducted to predict social anxiety based on early maladaptive schemas in university students.

Methods :

This was a descriptive-correlational study. The statistical population included all students at the Islamic Azad University, Karaj Branch, during the first semester of the 2023-2024 academic year. A total of 200 students was selected for the study using a convenience sampling method based on predefined inclusion criteria. Data were collected using a demographic profile form, the Social Anxiety Questionnaire (Connor et al., 2000), and the Young Schema Questionnaire (Young et al., 2006). The data was analyzed using the SPSS version 23 software, linear regression tests, and Pearson's correlation coefficient at a significance level of P < 0.5.

The results indicated that early maladaptive schemas explained 25% of the variance in social anxiety. Specifically, the domain of Disconnection and Rejection had a standardized regression coefficient of 0.29, and the domain of Impaired Autonomy had a standardized regression coefficient of 0.22, both contributing significantly to the explanation of the variance in social anxiety.

The findings showed that social anxiety can be predicted based on early maladaptive schemas. Therefore, it is suggested to develop educational programs and workshops in student counseling centers to identify and adjust maladaptive schemas, as well as to teach effective coping skills against students' social anxiety.

One of the problems of people undergoing hemodialysis is the reduction of the tolerance threshold and the reduction of resilience against psychological problems. The present study was conducted with the aim of comparing the effectiveness of "Acceptance and Commitment Therapy" and "Metacognitive Therapy" on the resilience of women undergoing hemodialysis.

The current research was semi-experimental using a pre-test, post-test and follow-up design with 3 months later. In this study, 54 hemodialysis patients referred to Imam Ali (AS) and Shahid Rajaei Hospital in Karaj in 2019 were selected by convenience sampling method and included in the study by random and lottery method. Demographic questionnaire and "Connor-Davidson Resilience Scale" were used to collect data. The content validity of the instrument was satisfied by previous studies, and the reliability was calculated by the internal consistency method by calculating the Cronbach's alpha coefficient and by the test-retest method. For the "Acceptance and Commitment Therapy" group (18 people), 8 sessions of 90 minutes "Metacognitive Therapy" group (18 people), 8 sessions of 60 minutes, were held in the dialysis department of the hospital. Data were analyzed with SPSS. 23 with a significance level of less than 0.05.

The results of the multivariate covariance analysis showed significant differences between the intervention and control groups in the post-test and follow-up stages (P≤0.001). The effect size of the intra-group and interaction sources of change for the resilience variable was 0.800 and 0.775 percent, respectively. 

Both therapy methods have had an effect on improving the endurance of patients undergoing hemodialysis treatment. It is suggested to use therapeutic interventions to increase resilience in hemodialysis patients.

 Considering the role of interpersonal interactions in the clinical environment in the formation of professional self-concept, this study was conducted to investigate the correlation between feedback in clinical education and professional self-concept among nursing students.

 This descriptive correlational study was performed on 167 nursing students in the 7th and 8th semesters in the School of Nursing and Midwifery of Karaj Islamic Azad University in Iran in the academic years 2020-2021. Sampling was done through the census sample method. Data collection tools were demographic information form, the Cowin's 36-item Nursing Professional Self-Concept questionnaire, and feedback in clinical education questionnaire, completed by the self-report method. Data were analyzed through descriptive tests of mean, standard deviation, frequency, and percentage, inferential tests such as Spearman correlation coefficient and Chi-square.

 The mean and standard deviation of the total score of the nursing professional self-concept was 176.65±23.53 and 82% had a high professional self-concept. The mean score of feedback in clinical education was 82.76±10.15 and 77.8% had received moderate feedback in clinical education. The Spearman correlation coefficient test showed a weak and significant positive correlation between the total score of feedback in clinical education and the total score of the nursing professional self-concept (r = 0.222 p = 0.004).

 There was a weak correlation between feedback in clinical education and the professional self-concept of nursing students.

 Receiving feedback from students about the distance learning environment is necessity to improve distance education. The present study aims to investigate the perceptions of the distance learning environment in nursing students of Islamic Azad University, Karaj Branch, Iran during the coronavirus disease 2019 (COVID-19) pandemic.

 This is a descriptive cross-sectional study that was conducted on 194 undergraduate nursing and midwifery students in Islamic Azad University, Karaj Branch in 2020-2021. The data collection tools were a demographic from and the distance education learning environment survey (DELES) that were prepared in Google forms. Data were analyzed in SPSS software, version 22 using descriptive statistics, t-test, one-way ANOVA, and Pearson correlation test.

 The mean total score of DELES was 100.1±23.8, and 59.3% of students perceived their distance learning environment as good.

 More than half of the nursing students of Islamic Azad University, Karaj Branch perceive their distance learning environment as good. To achieve maximum student satisfaction, attention to different areas of the distance learning environment survey should be paid by teachers, managers, and curriculum and distance education planners as well as to the empowerment of teachers for distance education in the School of Nursing & Midwifery.

With the sudden shift of face-to-face education to e-learning during the COVID-19 pandemic, awareness of learnerschr('39') readiness for online learning and its impact on studentschr('39') psychological distress related to e-learning is important for teachers, counselors, and educational planners. Therefore, the present study was conducted to investigate the correlation between online learner readiness and psychological distress related to e-learning in nursing and midwifery students during the COVID-19 pandemic in 2021.

The present study was a descriptive -correlational study that was conducted on 194 undergraduate nursing and midwifery students of the Islamic Azad University, Karaj Branch in the second semester of 2020-2021. The sampling method in this study was convenience sampling. Data were collected by demographic data form, Online Learner Readiness scale, and psychological distress related to e-learning questionnaire. Data was analyzed by SPSS software version 22 and using descriptive statistics, t-test, ANOVA, and coefficient Pearson correlation.

Findings showed that the mean score of psychological distress related to e-learning was 65.34± 14.42 and 61.7 students had moderate psychological distress related to e-learning. Also, the mean score of readiness for online learning was 64.05 ±10.29 and 56.1% of students had moderate readiness for online learning. There was an inverse, moderate and significant correlation between the total score of readiness for online learning and the total score of psychological distress related to e-learning in students (r=-0.369, p<0.001).

The present study showed that students who were less ready for online learning had more psychological distress related to e-learning. This finding highlights the need to empower students to online learning, screening for psychological disorders, and providing support and counseling resources to promote studentschr('39') mental health are emphasized.

Psychological factors play an important role in the outcome and adaptability of the patient with chronic heart failure, but they are often ignored in the treatment process. This study aimed to determine the correlation between hopelessness, resiliency, and type D personality in patients with chronic heart failure. The study was descriptive-correlational. The researchers, using purposive sampling method, selected One hundred patients with chronic heart failure who referred to the Farhangian clinic located in the second district of Tehran. The researchers completed patients’ demographic form, the index of severity of illness, beck hopelessness scale (BHS), short version of Connor–Davidson Resilience Scale (CD-RISC), and type D personality questionnaire by interviewing the participants. SPSS software version 19 analyzed data. The findings showed that most heart failure patients had moderate hopelessness (86%) and resiliency (85%) and 67% had type D personality. Pearson correlation coefficient showed a moderate, inverse, and significant correlation between type D personality and resiliency (r = -0.479, p <0.001) and a weak but positive and significant correlation between type D personality and hopelessness(r = 0.198, p = 0.048). There was no significant correlation between hopelessness and resiliency (P >0.05). Type D personality in patients with heart failure is accompanied by a reduction in resilience and an increase in hopelessness. These findings can be used for health policymakers in designing and planning of multidisciplinary team care and holistic care of patients with heart failure. Considering the high frequency of hopelessness, reduction of resiliency, and type D personality in patients with heart failure, screening, identification, and referral of patients requiring psychological support is essential for facilitating adjustment and improvement of the quality of life. The identification and psychological support of patients with type D personality can help increase the hope and resilience of heart failure patients.

Labor pain is one of the most severe pains. Given the importance of reducing labor pain and prioritizing natural delivery, this study was performed with the objective of investigating the effect of local heat therapy on pain, delivery outcomes, and rate of satisfaction in primiparous women.
This clinical trial study was conducted on 80 primiparous women in Karaj city. The samples were selected using easy sampling and assigned to two groups, then, pain severity, delivery outcomes, and rate of satisfaction, were recorded in the two groups,. Data were analyzed using independent and dependent t-tests at the significance level of p In this study, there was a significant difference between the two groups in variables of severity of pain, mean duration of first and second stages of the labor, frequency distribution of satisfaction of the studied subjects in terms of the type of intervention, satisfaction from the delivery process, first experience of breastfeeding, and mothers’ satisfaction from embracing their newborn babies (p Based on the results of this study, it seems that control of pain and making satisfaction using noninvasive methods of local heat therapy without affecting adverse maternal and fetal outcomes, promote progression and encourage mothers for normal delivery.

Pressure ulcers are serious health problems, common but preventable and defined as care quality indicator for health care provider services. Pressure ulcers had negative consequences for patients and healthcare systems. The aim of this study was to determine mortality and length of hospital stay in elderly people with hospital acquired pressure ulcers in Alborz Hospital of Karaj 2012.
132 records belong to elderly people with hospital acquired pressure ulcers of Alborz Hospital in Karaj 1391, through convenience sampling were studied retrospectively. Include criteria was age >65 years, minimum 2-day stay in hospital and hospital acquired pressure ulcers. Data were analysis by descriptive statistics, t-test, ANOVA and chi-square tests.
The findings indicated that 15.2% of elderly patients with hospital acquired pressure ulcers was died. Mortality significantly was associated with hospitalized in intensive wards (p Focus on strategies for the prevention of ulcers, particularly in older adults hospitalized in intensive wards, neurological problems and prevent progression of ulcers can help to reduce length of hospital stay and mortality in these patients.

Adherence to low-sodium diet is an important aspect of self-care behaviors, which plays a role in improving the quality of life, and in reducing readmission rate, mortality, and healthcare costs. This study aimed to investigate the correlation between type D personality and adherence to low-sodium diet in patients with systolic heart failure.
This descriptive-correlational study was conducted on 100 patients with heart failure with at least one year history and ejection fraction below 40% hospitalized in the internal ward of Alborz Social Security Hospitals of Karaj and Shahriar in 2013, who were selected by convenience sampling. Demographic characteristics form, type-D personality questionnaire, and adherence to low-sodium diet, were completed by interview. The data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient.
In this study, there was a poor significant positive correlation between adherence to low-sodium diet and dimensions of depression/anxiety (p=0.032), social inhibition (p=0.008), and total score of type D personality (p=0.023).
The results of this study showed that heart failure patients with type D personality had lower adherence to low-sodium diet. Hence, screening and evaluation of heart failure patients in terms of type D personality, referring patients for consultation, and use of appropriate therapies, can help to improve adherence to low-sodium diet and quality of life in heart failure patients.

Marital satisfaction, one of the most important determinants of healthy family functioning. Therefore dealing with components that can be useful is very important. Spiritual health is one of them. This study aimed to investigate the relationship between spiritual health and marital satisfaction.
The research was cross-sectional and correlational study, 122 married women referred to health centers in Karaj using a convenience sampling participated in the study. Enrich marital satisfaction questionnaire and Palutzian Ellison spiritual health questionnaire were used. To analyze the data was used SPSS version 16. Descriptive statistics, Pearson correlation coefficient, regression, t-test and ANOVA was used to achieve the goals and answer research questions.
The results showed there were significant correlation between marital satisfaction and spiritual well being in married women ( (P According to the results of this study to improve the quality of life of women and men and marital satisfaction, spiritual health should be considered.

Obstructive sleep apnea (OSA) is an important risk factor for cardiovascular disorders. The aim of this study was to determine the frequency of OSA in myocardial infarction patients in the CCU of Karaj Hospitals, 2009. This cross-sectional study was conducted, via convenience sampling, on 140 acute myocardial infarction patients in two cardiac care units of Shariati and Rajaei hospital in Karaj, 2009. We assessed demographic data, history of cardiovascular risk factors, STOP-Bang questionnaire through interview, information related to the type of myocardial infarction and laboratory parameters from medical records, and also we measured anthropometric indices with balance scale and meter tap. Mean score of STOP-BANG questionnaire was 4.9 ± 1.2 in the range of 2 to 8 points and in 64% of the participants was higher than 4 points. The Score of STOP-BANG questionnaire was statistically significant considering age, smoking, hypertension, dyslipidemia, extensive infarction, BMI, waist-to-height ratio, Waist to Hip Ratio, Waist Circumference, neck circumference, cholesterol and left ventricular ejection fraction (P=0.001), sex (P=0.044), Diabetes(P=0.019), inferior infarction (P=0.006), anterior wall (P=0.048) and triglyceride levels (P=0.031). OSA is common among patients with myocardial infarction and is associated with anthropometric indices, cardiovascular risk factors, the location of infarction and left ventricular ejection fraction. Thus, Screening, evaluating the symptoms of OSA and referring for counseling and treatment is neces.

Physiologic and hormonal changes during pregnancy increase risk of occurrence and severity of sleep breathing disorders in pregnant women. This study was performed with the aim to determine the frequency of sleep breathing disorders and some related factors in pregnant women referred to delivery ward of Alborz social security hospital of Karaj. This cross-sectional، descriptive study was performed on 200 pregnant women referred to the delivery ward of Alborz social security hospital of Karaj in 2009. Background information and Stop Bang questionnaire (for sleep breathing disorders screening) were evaluated through interviews، and information related to neonatal weight and Apgar score were evaluatedfrom medical records، and anthropometric indices of pregnant women were measured with balance scale and tap meter. The data was analyzed by SPSS software (version 18) and Chi-square and Fisher''s Exact tests. P< 0. 05 was considered significant. 91 cases (54. 5%) of pregnant women had habitual snoring، 114 (57%) daily sleepiness and fatigue، 43 (21. 5%) sleep apnea، 14 (7%) hypertension، 6 (3%) body mass index > 35 kg/m²، and 20 (10%) neck circumference > 40 cm. 29 cases (14. 5%) were at high risk for sleep breathing disorders. Statistical significant relationship was found between sleep breathing disorders in pregnant women and increased neck circumference، systolic and diastolic blood pressure، increased BMI and higher Apgar score and increased birth weight (P<0. 001). Pregnant women are at risk for sleep breathing disorders and sleep breathing disorders are more common in pregnant women with central and general obesity، and higher blood pressure.

Lack of facilities, experienced teachers and choosing appropriate teaching method have always been among the challenges of holding CPR courses. The aim of this study was determining “the effect of multi- media educational software on learning basic principles of Cardio-Pulmonary Resuscitation (CPR) in nursing students”. This is a quasi- experimental study which was conducted in 2013. The study population included 70 nursing students in fifth and sixth semester of Islamic Azad University of Karaj. The samples were divided into two lecture and practical training (35) and multi-media education and practical training (35) groups through blocked random method. Theoretical education of CPR basic principles was done by lecturing in the first group and by multi-media educational software in the second group. Practical training was done similarly in both groups through 2 sessions working on mannequins. After a week, written exam was taken from the both groups by using basic life support skills questionnaire and after two weeks, practical test was taken based on the standard checklist and also Objective Station Clinical Evaluation (OSCE). Data was analyzed in SPSS 18 software by using independent t-test, chi- square and Mann-Whitney U. The knowledge mean score in the intervention group (16.20±2.02) was significantly higher than the control group (12.57±2.60) (p<0.001). In the scope of practice, there was no significant statistical difference between the two groups in the practical areas of patient’s assessment (p=0.056), opening the airway and respiration (p=0.13) and cardiac massage (p=0.36). The results of the present study indicated that providing content in the form of multimedia software can improve nursing student's knowledge more than lecturing and simulation, but it is not effective in improving student's psychomotor performance. Therefore, using objective methods and clinical education are recommended for improving CPR psychomotor skills.

Bakground and Chronic illness and its treatment have negative impact on physical, psychological, and social aspects of quality of life. The purpose of this study was to determine the relationship between spiritual well-being with quality of life and mental health in young adults with beta- thalassemia major. This is a descriptive-correlational study in which ninety six young thalassemics were selected by convenience sampling method from centers for special diseases and Adult Thalassemia Center of Zafar in Tehran. The data werer collected by self-report. The instruments used included the demographic data form, the short form of WHO quality of life (WHOQOL-BREF), the 28- item general health questionnaire (GHQ-28), and the spiritual health questionnaire. The data were analyzed by SPSS version 18 using descriptive statistics, t- test, ANOVA, and pearson coefficient correlation. The findings indicated that 74% had moderate spiritual well-being, 72.9% moderate quality of life, and 62.5% mental health disorder. There was a positive correlation between the score of spiritual well-being and the total score of quality of life (r= 0.347 p= 0.001) and a negative correlation with the score of mental health (r = -0.525 p < 0.001). The increase in the spiritual well being of thalassemia patients is associated with a better quality of life and mental health. It is recommended that the spiritual dimension along with physical, mental, and social dimensions of patients be considered for the holistic nursing care to be properly exerted.

Nowadays, using of internet for academic and non-academic activities is an integral part of student's life. Studies show that overuse of electronic media has negative impacts on physical and mental health. This study was conducted to determine the relationship between internet addictions and sleep problems in students of Islamic Azad University of Karaj. This descriptive-analytical study was done over 500 students, which were selected by convenience sampling from Karaj Islamic Azad University in 2010. Data were collected by self-report method. Data collection instruments used for this study were: Internet Addiction Questionnaire, Epworth Sleepiness Scale, Sleep Disorder Index and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by SPSS v.18 and using descriptive statistics, t- test, ANOVA, and linear regression. The mean PSQI score was 5.04 ±2.93. 132 people (26.4%) had worse sleep quality. Mean sleep disturbances score was 5.50 ±3.96 and insomnia was the most common sleep disturbance. Mean daytime sleepiness score was 6.19 ±3.35 and 219 people (43.8 %) had mild daytime sleepiness. Mean score of internet addiction was 31.95 ±9.10 and 26 people (5.2 %) were at risk for internet addiction. There were significant relation between internet addiction with sleep quality (p=0.005) and daytime sleepiness (p=0.005). Excessive use of the internet was related to high daytime sleepiness and low quality of sleep. Choosing correct pattern in use of the internet helps to reduce sleep problems in students.

Few studies have assessed physical and emotional distressing symptoms in patients with chronic renal failure undergoing hemodialysis. The aim of this study was to investigate distressing symptoms and its relationship with the quality of life of the patients، suffering from chronic renal failure undergoing hemodialysis. In this cross sectional study، two hundred patients with chronic renal failure undergoing hemodialysis at four dialysis units in Karaj، in 2011 were interviewed and also their medical records were investigated. Sampling method was census sampling. The used instruments included; demographic data form، dialysis symptom index and World Health Organization quality of life (WHOQOL-BREF) questionnaire. Data were analyzed by SPSS software and using descriptive statistics، t-test، ANOVA and Pearson coefficient correlation. Findings showed that، the most common distressing symptoms was related to decreased interest in sex (87%)، difficulty of becoming sexually aroused (81%)، fatigue (68. 5%) and bone or joint pain (57%). 77% had mild and 20. 5% had moderate distressing symptoms severity. There were significant positive correlation between frequency score of distressing symptoms with age (p<0. 0001) and negative and significant correlation with physical health (p<0. 0001) social relationships (p<-0. 011)، mental health (p<0. 0001)، environmental health (p<0. 0001) and total score of quality of life (p<0. 0001). Distressing symptoms severity had significant positive correlation with age (p=-0. 006) and negative correlation with physical health (p<0. 0001) social relationships (p<0. 0001)، mental health (p<0. 0001)، environmental health (p<0. 0001) and total score of quality of life (p<0. 0001). Hemodialysis patients experience many distressing symptoms that negatively affect their quality of life. Teaching self-care behaviors in order to reduce and control distressing symptoms can help to improve the quality of life in hemodialysis patients.

The aim of this study was to investigate anthropometric indices in acute myocardial infarction patients and their relationship with some coronary heart disease risk factors. Several studies showed that not only the quantity, but also the distribution of the fat mass is important, because increased visceral fat tissue deposition is a risk factor for cardio-metabolic diseases. In this cross-sectional study with a descriptive correlational design, 140 patients with acute myocardial infarction were selected from cardiac care unit of Shariati and Rajaei hospital in Karaj, 2009. The sampling method was convenience. Demographic data and history of cardiovascular risk factors were collected through interview, and some medical information were reviewed from medical records, anthropometric indices were measured by balance scale and meter tape. Data were analyzed using SPSS software and using descriptive statistics, t-test, ANOVA and Pearson coefficient correlation. Neck circumference of 46.6% of men was over 40cm and 33.3% of women more than 37cm. Also, 53.9% of men and 74.1% of women had a waist circumference above 95 cm. Waist-to-hip ratio of 66.4% of men over 0.95 and 66.7% of women over 0.90. Waist-to-height ratio of 61.9%% of men over 0.55 and 66.7% of women over 0.62. Also, 13.3% of males and 29.6% of women had a BMI above 30 kg/m².There were significant positive correlation between triglyceride levels with neck circumference (p=0.006), waist circumference (p<0.001), waist-to-height ratio (p<0.001) and BMI (p<0.001), between cholesterol with neck circumference (p=0.009), waist circumference (p=0.001), waist-to-height ratio (p=0.003) and BMI (p<0.001), between LDL with waist circumference (P=0.005), waist-to-height ratio (p=0.014) and between glucose with waist-to-height (p=0.038). HDL had negative correlation with Waist-to-hip ratio (p<0.001) and waist-to-height ratio (p=0.001). More than half of myocardial infarction patients had central obesity. Central obesity is associated with cardiovascular risk factors. It Seems that lifestyle change and weight loss are to be considered during cardiac rehabilitation programs for myocardial infarction patients with overweight and obesity for reduces cardiovascular risk factors.

Sexual dysfunction is a common problem in women and has negative effects on their quality of life. Several factors affect sexual function. The aim of this study was to determine the relationship between depression and sexual function index among married women. This is a descriptive- analytical study that was conducted on 200 womenreferred to the health clinic of Hazrat Ali hospital in Karaj on 2009. Samples were selected based on simple randomized method. Data was collected by interview. The used instruments included demographic data form، depression scale of the Center for Epidemiologic Studies (CES-D) and Female Sexual Function Index (FSFI). Data was analyzed by SPSS software، using descriptive statistics، t-test، ANOVA and logistic regression. The findings indicated that the mean score of female Sexual Function Index was 20. 59±5. 10 (1. 2-36 range) and their mean score of depression was17. 61 ±11. 63 (0-60 range). Among the studied women 31. 5% had mild to moderate depression and 98. 5% had sexual dysfunction. The most common sexual problems were sexual arousal disorder 36%، sexual dissatisfaction 20% and orgasm disorder 16. 5%. There were found significant associations between depression and sexual desire (OR 1. 4، 95% CI 1. 6-16. 07) and depression and orgasm (OR 1. 96، 95% CI 0. 02-0. 72). Sexual function is associated with one''s mental status، so paying attention to sexual problems in depressed patients and also assessing and treating depression in patients with sexual disorders are recommended.

Delegation is one of the most required skills for managers in order to give authority to their efficient subordinates to carry out different tasks and take responsibility in their absence. The aim of the present study was to find out the attitude of nursing managers about delegation in Karaj social security clinics and hospitals in 2010. In this descriptive and cross-sectional study done in 2010 fifty-four nursing managers were selected through convenience sampling, from three hospitals and four clinics of social security of Karaj, in 2010. Necessary data was collected from self-report. Instruments used included: a demographic questionnaire and an attitude one about delegation. The obtained data was analyzed by means of SPSS statistical software (version 14) using descriptive statistics, t- test, and Pearson's coefficient correlation at the significant level of P<0.05. It was found that 74.1% of nursing managers had a neutral attitude about delegation. There was a significant statistical difference between the degree of attitude about delegation, regarding acquaintance with delegation presented in management subjects during the educational curriculum (P=0.031) and the case's participation in in-service educational programs on management (P=0.005). Most of nursing managers had a neutral attitude about delegation and their a wareness of leadership skills and management principles, including delegation, was related to the nursing managers ' attitude about delegation.

One of the important aspects of life quality is sexual function. Chronic renal failure and its treatments have effect on sexual function. The aim of this study was to investigate sexual function of women with chronic renal failure undergoing hemodialysis and factors related to it. In this cross sectional study, one hundred women with chronic renal failure undergoing hemodialysis at four dialysis units in Karaj were interviewed in 2011 and also their medical records were investigated. Sampling method was census sampling. The instruments used included: demographic data form, the (CES-D) center of epidemiologic studies of depression scale and Female Sexual Function Index (FSFI) and World Health Organization life quality (WHOQOL- BREF) questionnaire. Data was analyzed by SPSS software and using descriptive statistics, t-test, ANOVA and coefficient Pearson correlation. The findings indicated that mean score of female sexual function index was 13.22 ± 8.58 (1.2-36 range) and 100% of women had score of female sexual function index lower than 28. Sexual desire decrease, 62% sexual arousal decrease, 52% vaginal lubrication decrease, 60% failure to orgasm, 33% sexual dissatisfaction and 54% dyspareunia were experienced. There were significant inverse correlation between score of female sexual function index undergoing hemodialysis with creatinine level (p=0.016), depression (p=0.016) and positive correlation with hemoglobin level (p=0.001) and total score of life quality (p=0.006). The presence of diabetes showed significant relationship with score of female sexual function (p=0.049). with regard to sexual dysfunction prevalence among women with chronic renal failure undergoing hemodialysis and negative impact on life quality, it seems that in order to provide holistic nursing care, assessment and planning for treating it, is necessary.

Sleep problems negatively impact on quality of life. In this study, sleep quality, sleep disorders, daytime sleepiness and their associated factors were evaluated in systolic heart failure patients. This cross-sectional study was conducted on 100 male patients with systolic heart failure. Simple sampling method was used for data collection. Data were collected using Epworth sleepiness scale questionnaire, sleep disorder index, and the Pittsburgh sleep quality index (PSQI). Data were analyzed by descriptive statistics, t-test, one-way ANOVA, and Pearson correlation coefficient using SPSS software, significance level was considered as p<0.05. In this study, the mean PSQI score was 13.24 ±3.14 and 100% of patients had PSQI score>6. 53% had mild daytime sleepiness. The most common sleep problems were insomnia and sleep apnea. There were statistically significant relationships between sleep quality and age (p=0.030), education (p=0.004), smoking (p=0.048) and between sleep disorders and income (p=0.012), body mass index (p=0.028), education (p=0.019), smoking (p=0.050), chronic obstructive pulmonary disease (p=0.035), consumption of angiotensin converting enzyme inhibitors (p=0.009), and angiotensin receptor blockers (p=0.016). The results of this study showed that sleep problems are common in heart failure patients. Weight loss, smoking cessation, control and treatment of chronic diseases, and control of drugs side effects could help to decrease sleep problems in heart failure patients.

Introduction & Women are at risk of domestic violence at all stages of their lives، especially during pregnancy. Domestic violence increases risk of complications of pregnancy. The aim of this study was to determine frequency of domestic violence in women with adverse pregnancy outcomes. This descriptive cross sectional study was conducted on 168 pregnant women with adverse pregnancy outcomes referred to medical centers of Karaj in six months (2007-2008). Participants were selected by convenience sampling and data was collected through interview. The instruments of data gathering were demographic data form،Domestic Violence against pregnant women questionnaireand adverse pregnancy outcomes questionnaire. Data was analyzed by SPSS software using t-test، ANOVA and Pearson’s correlation coefficient. Adverse pregnancy outcomes included low birth weight25. 8%، premature labour 24. 9%، premature rupture of membranes15. 5%، small for gestational age births11. 5%، placenta decolman9. 3 %، abortion6. 7%، prenatal death6. 3%. Mild، moderate and sever domestic violence had been experienced respectively by 95. 8%، 3. 6% and 0. 6% of the participants during their pregnancy. The frequency of psychological -Verbal violence was 50%، sexual violence 45. 2% and physical violence 16. 7%. There were statistically significant differences between mean total score of domestic (p=0. 034)، sexual (p=0. 048) and physical violence (p=0. 010) and the women’s education level، total domestic (p=0. 002)، verbal-psychological (p=0. 003)، sexual (p=0. 018) and physical violence (p=0. 022) and the women’s job، total domestic (p<0. 001)، verbal-psychological (p<0. 001)، sexual (p<0. 001) and physical violence (p=0. 040) and the husbands’ addiction، physical violence and prenatal care (p=0. 024) and verbal-psychological violence and neonates'' low birth weight (p=0. 046). Screening and prevention programs of domestic violence in pregnant women may help to improve pregnant women’s health and pregnancy outcomes

Depression associate with increase severity of illness، length of hospitalization and mortality in heart failure patient''s. The aim of this study was to investigate the frequency and related factors of depression in male systolic heart failure patients. This is a cross sectional study that was conducted on 100 male patients with systolic heart failure in Alborz of Karaj and Shahriar Social Security Hospitals in 2010. Sampling method in this study was Convenience sampling. Data collected by demographic data form، MLHFQ (Minnesota Living with Heart Failure Questionnaire)، (CES-D) Center for Epidemiologic Studies Depression Scale. Data was analyzed by SPSS software version 18 and using descriptive statistics، t-test، ANOVA and coefficient Pearson correlation. The findings indicated that mean score of depression was 20. 3±12. 47% had severe and 16% had mild to moderate depression. Depression significant associated with age (p=0. 002)، education (p<0. 001)، economic status (p=0. 002)، smoking (p=0. 034)، hemoglobin level (p=0. 004)، left ventricular ejection fraction (p=0. 012)، use of digoxin (p=0. 019)، angiotensin receptor blocker (ARB) (p=0. 005)، aldacton (p=0. 005) and quality of life (p<0. 001). Depression was common among men with systolic heart failure and had negative impact on quality of life. Nurses by screening and assessment symptoms of depression and refer patients for counseling and treatment can help to improve quality of life in heart failure patient.

Domestic violence against pregnant women is an important health problem. Pregnant women who experience domestic violence are at risk of pregnancy complications. The aim of this study was to determine the effect of domestic violence on pregnancy outcomes in pregnant women referring to Karaj medical centers. This descriptive analytical study was conducted on 335 pregnant women during six months (2007-2008). Participants were recruited using convenience sampling method. Pregnant women with adverse pregnancy outcomes (n=168) were considered as cases and pregnant women with desirable pregnancy outcomes (n=167) were considered as controls. Data were collected through interviews with the participants using demographic data form، the domestic violence against pregnant women questionnaire، and adverse outcomes in pregnancy questionnaire. Data were analyzed in the SPSS using t-test، Chi-square and logistic regression. The prevalence of domestic violence in the case group was 30. 1%، including verbal-psychological (25. 1%)، sexual (22. 7%)، and physical (8. 4%) violences. The prevalence was 21. 8% in the control group، including verbal-psychological (14. 9%)، sexual (14. 6%)، and physical (3. 3%) violences. There were statistically significant differences between the total domestic violence rate (p=0. 002)، verbal-psychological (p > 0. 001)، sexual (p=0. 002)، and physical (p=0. 003) violences in the two groups. There was a significant relationship between verbal-psychological violence with low birth weight (OR= 3. 3; 95% CI: 1. 328-8. 593)، sexual violence with premature rupture of membranes (OR= 2. 67; 95% CI: 1-7. 09)، and physical violence with abortion after 12 week gestation (OR= 3. 56; 95% CI: 1. 15-11. 03). Regarding the results of this study، it seems that domestic violence against pregnant women increases adverse pregnancy outcomes. Therefore، screening and prevention programs focusing domestic violence in pregnancy may help to improve desirable pregnancy outcomes.

Obesity is a major health concern that is prevalent in women. Obesity and overweight affect physical and psychological well-being. The aim of the present study was to determine correlation between body mass index, body image, and depression among women referring to health clinic of Hazrat-e-Ali hospital in Karaj in 2009. This was a descriptive- correlational study conducted on 200 women referring to the health clinic of Hazrat-e-Ali hospital in Karaj in 2009, who were selected through convenience sampling, and then, assessed. Necessary information was collected by means of demographic data form, a multi - dimensional body self -image questionnaire evaluation (MBSRQ-AE), body shape questionnaire and (CES-D) center for epidemiologic studies depression scale. The obtained data was analyzed by SPSS software using descriptive statistics, t-test, ANOVA, and coefficient Pearson's correlation at the significant level P<0.05. The findings indicated that mean body mass index was 25.6 ± 3.8, mean score of body image was 118.2 ± 12.5, body dissatisfaction 72.9 ± 33.1 and mean depression was 17.6 ± 11.6. Overweight was diagnosed in 45.5% of women, moderate body image was observed in 32.5%, 29% of the women expressed mild body dissatisfaction and 31.5% suffered mild to moderate depression. There was a significant negative correlation between body mass index with score of body image (P=0.002) and a positive correlation with body dissatisfaction (P<0.001) and score of depression (P=0.002). There was a negative correlation between score of depression and body image (P=0.038) and a positive correlation with body dissatisfaction (P=0.002). The present study showed that overweight and obesity in women leads to a negative body image and increases body dissatisfaction and depression.