manoochehr azkhosh

Grief is a human, universal, personal and multidimensional experience. Although studies have been conducted to describe grief, there is no consensus among scholars about its theoretical or empirical definition in older adults. This study aims to analyze the concept of grief in old age.

This is a review study that was conducted in eight steps using Walker and Avant’s concept analysis method. To find studies related to grief in the elderly, a search in online databases including ScienceDirect, Scopus, PsychInfo, PubMed, Web of Science, and EMBASE using keywords: Grief, mourn, bereavement, old, geriatric, aging, age, later life, seniors, nonagenarian, octogenarian and centenarian. Also, articles were examined without considering the time limit published until January 30, 2023. The search strategy, screening, and data reporting were done based the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement.

Of 5963 articles, 34 were included. According to the findings, grief had five features, “a unique phenomenon”, “negative emotional experience”, “physiological irritation”, “experience of loneliness”, and “loss of previous meanings”. Three antecedents of grief included: Loss of loved ones, loss of pets, spouse divorce, and loss of health. Four consequences of grief included health consequences, social consequences, financial consequences, and resiliency.

The provided definition of grief in older adults can help the health team understand the concept better and carry out investigations, interventions, and evaluations to improve the health of the elderly.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes abnormal communication, repetitive and limiting interests, and social dysfunction. This study aimed to identify the experiences of parents in raising children with ADS in Iran.

A total of 18 parents of children with ASD were selected by purposive and convenient sampling method to participate in the study. To collect data, in-depth semi-structured interviews were conducted. The text of the interviews was analyzed using interpretative phenomenological analysis.

Two main themes of positive and negative experiences were identified in the analysis. In the positive experiences two sub-themes of “continuing education and acquiring spirituality” and “increasing life skills” and in the negative experiences five sub-themes of “reduction of communication and lack of social support,” “improper treatment with the child with ASD,” “feeling ashamed,” “lack of adaptability,” and “being judged by others” were identified. 

These findings can provide a deep understanding of the experiences of caring parents of children with ASD in Iran. In addition, the results of this study can provide valuable information to researchers, clinicians, etc. to indicate the specific needs of families who care for children with ASD.

 Oculocutaneous albinism (OCA) is a genetic disease that causes the impaired conversion of melanin, thus leading to the development of vision impairment and skin/hair-related complications. This disease can also cause extensive psychosocial consequences for patients with this disease.

 This research aimed to provide a deep understanding of the lived experience of people with albinism (PWA) in Iran.

 this research has been conducted using a qualitative approach. The sampling was done as purposive and continued until reaching data saturation. The data were collected through deep semi-structured interviews, and then analyzed via thematic analysis, after transcribing the interviews and removing the similar codes, 1077 initial codes were extracted. The categories were coded using open coding indirect process alongside several times of reading the text and allocating relevant codes through constant comparison of codes with each other.

 The results obtained from data analysis led to extraction of three main themes including: (1) Challenges; (2) perceived sources of support; and (3) psychological mechanisms of coping with challenges.

 based on the findings of this research, the main challenges of PWA were categorized into two major groups: body-based challenges and psychosocial challenges. The perceived support sources of these people against these challenges were social supports and access to facilitator tools. The psychological mechanisms were divided into adaptive and maladaptive sub-categories. The findings of this research can provide a deeper understanding of the needs of these people for providing optimal care and ultimately promote their psychosocial well-being and also can be employed in developing interpretive theories about the biopsychosocial conditions of PWA.

Context: 

Existential guilt is an important concept in cancer patients. However, the literature shows that the components of this concept are not well defined and specified. Hence, this study aimed at enhancing understanding of the characteristics of existential guilt and its differentiation from other similar concepts in the field of cancer.

Evidence Acquisition: 

Focusing on cancer patients, Walker & Avant's approach was followed to clarify and analyze the concept of existential guilt. So, Web of Sciences (ISI), PubMed, ProQuest, Scopus, PsycINFO databases, and Google Scholar were searched, using 'existential guilt', 'guilt', and 'cancer' keywords to identify relevant studies with no time limitation. After screening and evaluation, 58 articles were identified, of which 26 were analyzed.

 Initially, definitions, characteristics, antecedents, and consequences of the existential guilt concept were introduced. Then, a case model was explained to create a more clarified understanding of the concept and, eventually, some implications for the approach to cancer patients were proposed.

 The existence of different definitions and separate research pathways about the concept of existential guilt may indicate a sense of scatteredness. However, as shown in this study, one can come to a widely accepted understanding as well as a differential understanding of this concept; this clarification can, in turn, result in efficient and comprehensive psychological attention to cancer patients. Indeed, this concept analysis can pave the way for clinical interventions, operationalization, and research on this topic and population

Context: 

Multiple sclerosis (MS) is a neurological disease in which the myelin lining the central nervous system is damaged and often occurs between the ages of 20 and 40. In addition to loss of motor, sensory, and cognitive function, patients with MS also experience related symptoms such as depression, anxiety, stress, fatigue, and pain.

 The aim of this study was to systematically and meta-analyze the effectiveness of cognitive-behavioral, mindfulness and acceptance and commitment (CMAC) therapies to improving the psychological symptoms of patients with multiple sclerosis in Iran.

 The study was conducted using preferred reporting items for systematic reviews and meta-analysis. This study examined articles published from the beginning until November 20, 2021 in Persian and English on cognitive and behavioral interventions performed in Iran, in order to influence psychological symptoms for people with multiple sclerosis. Articles relevant to research were screened in external (Google Scholar, PubMed, Scopus, Science Direct, Web of Science) and internal databases (Sid, Magiran, Ganj, Irandoc, Civilica). The quality of the included RCTs was assessed using the Cochrane guideline risk of bias tool. The results were expressed in terms of mean difference (MD) and the corresponding 95% confidence interval. Data analyses were performed by RevMan5.4.

 In the first stage of the search, 792 articles were obtained. After reviewing the titles of the articles, 701 articles were discarded due to irrelevance and duplication and 91 articles remained. Finally, 21 studies were selected by reviewing the abstracts and considering the inclusion criteria. Compared with the control group, the standardized mean difference (SMD) estimate depression was 1.60 (2.27, 0.93), for anxiety 0.49 (0.80, 0.19), for stress 0.97 (1.70, 0.23) and for fatigue 0.19 (2.75, 1.25) had a positive effect; But no significant effect on pain reduction equal to 0.49 (2.21, 1.23) was not found.

 The meta-analysis in the posttest showed that the effects of CMAC were considerable on reducing depression, anxiety, stress, and fatigue, but the effects were not notable for pain mitigation. Future high quality studies with follow-up evaluations are needed to support the effects of CMAC on reducing symptoms in people with multiple sclerosis and to evaluate the interventional features that enhance and maintain the effects.

The circumstances and needs of children with autism spectrum disorder (ASD) affect children and their families.

This study aimed to explore the challenges and needs of parents caring for children with ASD.

An exploratory qualitative method and the conventional content analysis method were employed in the present study. Participants were 18 parents with children with ASD in Tehran who were recruited by the accessible sampling method. To collect data, semi-structured, face-to-face, and in-depth interviews were used. The interviews were audio-recorded and transcribed verbatim into Microsoft Word software. Qualitative analysis was performed using the content analysis approach.

Parents had three main needs in caring for their children: (1) first, issues and problems related to diagnosis, treatment, and rehabilitation, including three categories (issues and problems of diagnosis and treatment, issues and problems of rehabilitation, and inadequate therapeutic support); (2) second, issues and problems related to parents, including four categories (parents’ lack of knowledge and awareness about ASD, lack of life skills, daily problems of parenting, and familial & marital issues); and (3) third, financial, cultural, and social issues, including two categories (financial problems and social & cultural problems).

The needs and challenges mentioned by the parents of children with ASD highlighted the need for medical, educational, and counseling services and emotional and material support from the community and the government. Planning and implementing support programs enable parents to face problems strategically, which ultimately improves their quality of life.

 There is ample evidence indicating that the parents of children with cerebral palsy report the experience of hope, despite all problems to which they are exposed.

 This study aimed to explain the factors facilitating hope regarding the experiences of parents having children suffering from cerebral palsy.

 This qualitative study was carried out using the content analysis method. The experiments of 17 parents (11 females and 6 males) having children with cerebral palsy were collected in in-depth unstructured interviews in 2019, and then content analysis was performed using Strauss and Corbin’s approach. The purposive sampling method was used as long as data saturation was reached. After that, the collected data were analyzed using the content analysis method.

 In this study, several factors were extracted as facilitators of hope in parents of children with cerebral palsy. These effective facilitating factors were classified into four main categories: promising treatment, positive beliefs, motivational drivers, and support networks.

 Various factors can be effective in promoting hope in parents of children with cerebral palsy, the detection of which would help developing educational and counseling programs and providing support for such parents.
 

Cognitive emotion regulation refers to the ability to manage personal emotional reactions through cognitive strategies that occur after an unfortunate event. Emotional dysfunction is thought to be common among the elderly due to their certain limitations. Cognitive-behavioral Music therapy (CBMT) seems to be capable to act as a bridge to new insights and behaviors. Hence, the aim of the current study was to determine the effectiveness of CBMT on cognitive regulation of emotion in the elderly. The present study was a quasi-experimental study with the pretest-posttest and a control group design. The statistical population consisted of all the elderly registered in the day care centers in Babol, Iran in 2019 among which one was selected using convenience sampling method. Out of 53 people eligible to participate in the study according to the inclusion and exclusion criteria, 30 were randomly assigned in two groups of experiment and control (each group with 15 people). Experimental group underwent six sessions of cognitive-behavioral music therapy, while no intervention was performed for the control group. The research tool was Garnefskis’s cognitive emotion regulation questionnaire. Data were analyzed using univariate analysis of covariance in SPSS-22 software. Findings indicated that CBMT resulted in cognitive regulation of elderly emotions (P<0.05). Based on the findings, CBMT can be applied as an effective model in counseling and psychotherapy centers for cognitive regulation of emotion in the elderly. This treatment method contributes to the cognitive control and the alteration of negative and self-defeating thoughts.

The present review study aimed at investigating the vocational rehabilitation of individuals with drug dependence disorders. Based on the research method, a comprehensive search was conducted in the following databases: PubMed, Scopus, Web of Science, Science Direct, EBSCO, ProQuest and Google Scholar. All keywords synonymous with vocational rehabilitation and substance abuse were considered in search. Then related studies with vocation rehabilitation were selected and included in the study. Job is a protective and major factor in effective treatment, and ignoring vocational counseling and rehabilitation leads to a significant defect in addiction treatment. Individuals receiving vocational services along with drug abuse treatment would experience reduced drug abuse and a more productive life.

Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran.
This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz. Sixty individuals were evaluated according to inclusion/ exclusion criteria and were divided into three equal groups randomly (20 participants per group). One group received acceptance and commitment group therapy (Twelve 90-minute sessions) and the other group was provided with the 12-steps Narcotics Anonymous program and the control group received the usual methadone maintenance treatment. During the treatment process, seven participants dropped out. Data were collected using the psychological well-being questionnaire and AAQ questionnaire in the three groups at pre-test, post-test and follow-up visits. Data were analyzed using repeated measure analysis of variance.
Repeated measure analysis of variance revealed that the mean difference between the three groups was significant (P The results of this study revealed that acceptance and commitment therapy can be helpful in enhancing positive emotions and increasing psychological well-being of addicts who seek treatment.

The awareness of sexual experiences could be an effective factor in preventing high-risk sexual behavior pertaining to relapse during the recovery period of substances. This research explored the role of sexual behaviors among Iranian methamphetamine (MA) users in relapse process.
The study was conducted with a qualitative approach using content analysis method. 28 participants were selected through purposeful and theoretical sampling. Data were collected based on face-to-face, in-depth, semi-structured interviews based on open-ended questions. Interviews continued until the data saturation had occurred. All interviews were examined in four stages of codes, sub-categories, categories and themes according to the content analysis of explanations and descriptions of sexual behaviors.
Findings: Two main themes were emerged from the analysis of interviews, including extreme pleasure seeking (including the main categories of sexual tunnel vision and sexual totalitarianism) and comprehended threat (including the main categories of internal conflict and external disorganization) as well as 10 subcategories.
The results indicated that sexual behaviors played an important role in relapse process among Iranian MA users and needed to be considered and managed properly in the planning of prevention, treatment, and rehabilitation.

Chronic pain is one of the important health problems that affect stress and anxiety. The aim of this study is to determine the relationship between mindfulness and coping strategies in patients with chronic pain and compare it with non-patient individuals. In order to do so, in a descriptive correlational study, 140 patients with chronic pain and 144 non-patient individuals were selected through availability sampling method and evaluated for mindfulness and coping strategies via Five Facet Mindfulness Questionnaire (FFMQ), and Lazaros & Folkman Coping Strategy Questionnaire (CSQ). The resulted data analyzed by Pierson correlation revealed that the relation between mindfulness and emotion focused coping strategies is negative and significant in patient with chronic pain group; while this relation is not significant in non-patient group. Furthermore, there is a positive and significant relation between mindfulness and problem focused coping strategies in both groups. Z Fisher test results did not show any significant difference between two groups in problem focused coping strategies. These results demonstrated that people using higher levels of mindfulness, both in patients and non-patients groups, use the problem focused coping strategies more often. It could be concluded that developing mindfulness from an early age can be used as a preventative approach in order to promote employing problem focused coping strategies compare to emotional focused coping strategies; an issue that could predict individuals’ mental health and overall well being.

Elderly people experience the many resentments that Inability to forgive of this resentments resources may be associated with depressive symptoms. Hence present study Examined the relationships between forgiveness of self, others and Uncontrollable situations with Depression in Late Life. present research is a cross- section & correlation study. The populations of the study were all elderly of Jahandidegan homes in Tehran City. Participants were 96 of elder people, which were selected via convenient sampling & completed Heartland Forgiveness Scale (HFS) & Geriatric Depression Scale (GDS). Data were analyzed using Pearson correlation & multivariate regression through stepwise method. the results revealed that there is a negative and meaningful relationship between forgiveness of self (r=-.32, p<0/01), forgiveness of others (r=-.25, p<0/05) & forgiveness of uncontrollable situations (r= -.38, p<0/01) with depression in elderly. Also forgiveness of uncontrollable situations (β= -.33) & forgiveness of self (β= -.26) have more determinant role to covering predicted variable (p<0/01). Inability to forgive is associated with psychological vulnerability among the elderly and recommended that therapeutic models of enhancing forgiveness be considered for the emotional problems of elderly people.

The main objective of this study was to determine the effectiveness of narrative therapy and group counseling on depression and loneliness among elderly women. This is a quasi experimental research method using post-test design with a control group. 24 women were selected from all the elderly women referring to Iranian Alzheimer’s Association in 2012 through randomized sampling method and have been assigned to experiment and control groups. The tools for assessing depression and loneliness were the Geriatric Depression Scale and the Loneliness questionnaire. The experiment group had eight 90 -minute sessions of group counseling narrative therapy which took place once a week. The collected data have been statically analyzed using independent t -test in SSPS-19. The findings showed that there is a significant difference between the mean scores of the experiment and control group and it can be argued that employing narrative therapy group counseling was influential in reducing depression and loneliness (P<0.01). The effect of group counseling narrative therapy on reducing depression and loneliness of elderly women has been confirmed by the results of this study. Based on the findings, conducting narrative therapy group counseling is strongly recommended in health care organizations for the elderly people.

Since problem solving group training is a comprehensive, active program and based-on cognitive behavioral approach, the aim of present study was to determine the effectiveness of problem solving therapy on depression and coping style in patients with type 2 diabetes mellitus. In an experimental design the study was done with pretest-posttest with control group. Totally 30 female clients who had inclusion criteria with score of 20-28 in Beck Depression Inventory was selected from Prophet Mohammad hospital in Tehran and divided to two groups. Then coping skills questionnaire was completed by experimental and control group. The experimental group participated in seven sessions on problem solving therapy, while the control group received no intervention. T-test analysis and variance analysis with repeated measures on one variable were used for data analysis. The results of variance analysis show that teaching problem solving therapy on Zurilla and Goldfried model lead to significant reducing emotion focused coping skills and significant increasing problem focused coping skills among patients with type 2 diabetes on the experimental group. The results also indicated significant reducing depression between this individual in experimental groups. The results of this study indicated that problem solving therapy could be effective way for improvement coping skill and reducing depression in patients with type 2 diabetes mellitus.

The aim of this study was to examine the effectiveness of psychotherapy based on acceptance and commitment therapy (ACT) on the subscales of marital satisfaction; overall satisfaction, religious orientation, relations with children, sex, occasional conflicts, interpersonal conflicts and arrogance, by single case study in the spouses of veterans with spinal cord injuries. Participants completed Enrich marital satisfaction questionnaire at baseline (3 to 6 weeks), during six session’s psychotherapy and the two-month follow-up. Analysis method of charting and visual analysis of the results showed that the (ACT) is an effective therapeutic approach to 4 marital satisfaction subscales but second and third participant didn’t show any improvement.. Considering the above, (ACT) is an effective therapeutic approach to overall satisfaction, occasional conflicts, relations with children and interpersonal conflicts.

Nowadays، with advances in medical sciences، possibility of fertility has been provided for many couples، but according to characteristics of this methods and challenges facing these therapies، their acceptance will depend on several factors. The aim of this study was determining the relationship between demographic characteristics of infertile cases with their attitudes toward modern assisted reproductive techniques. This descriptive-correlational study was carried out on 250 infertile men and women who referred to infertility research center of Yazd، Iran، 2012. Cases were selected randomly. Data were collected by two-part questionnaire containing demographic information and attitudinal statements and analyzed using SPSS software version 18، independent t-test، ANOVA and Spearman correlation coefficient tests. P value less than 0. 05 was considered significant. The differences between duration of marriage (p=0. 01)، duration of infertility (p=0. 000)، age (p=0. 04) and income (p=0. 004) were statistically significant with attitudes toward assisted reproductive techniques. But، no significant differences were found between attitudes scores toward assisted reproductive techniques and gender، education level and type of accommodation (p>0. 05). The increase in duration of marriage، duration of infertility، age and adequate income will affect infertile attitudes toward assisted reproductive techniques.

The main goal of the present study was to determine the effectiveness of an interventional program called “social life skills group training” to improve daily life skills of male patients with schizophrenia attending Razzi psychiatric center (Tehran-Iran). To examine the effectiveness of the intervention, a quasi-experimental study including pre-test, post test, and control group was designed. 24 schizophrenic patients were randomly assigned either to experimental (n = 12) or control (n = 12) groups. A check list of daily living skills (ADL) (Karbalaei Ismail, 1996) and a demographic questionnaire were used for data collection. All of data of interest were statistically analyzed by SPSS software version 16. The significance level was set at P = 0/05. The findings indicated enhanced communal life skills in experimental group as compared to the control group after the intervention (P < 0/05). Also, there was a significant difference between these two groups regarding daily life skills (P < 0/05). Study results revealed that a communal skills training program might improve daily life skills in schizophrenic patients. Besides, it is worthy to point out that training social and life skills can enhance communication skills. In conclusion, patients who receive these kinds of treatments are better able to handle problems they may face in the real life than those who do not.