فهرست مطالب masoumeh namadian

Diabetes is a chronic and progressive metabolic disease with profound effects on mental health.

This study aimed to determine diabetic distress status and its relationship with some demographic characteristics and clinical outcomes in patients with type 2 diabetes.

This study was part of a larger study on psychological adjustment and diabetic distress. Data were collected using a demographic questionnaire and a standard 17-item tool for measuring diabetic distress and were analyzed using descriptive and analytical statistics, including mean (standard deviation), independent t-test, analysis of variance, and Pearson correlation coefficient, in SPSS version 22 software.

The mean (SD) of distress score in patients with type 2 diabetes was 2.12 (0.75). The prevalence of distress worthy of clinical attention was 11.4%. Regarding distress dimensions, the highest mean distress score was related to the emotional burden dimension 2.82 (1.06), and the lowest mean score was obtained in the dimension of interpersonal distress 1.48 (0.84). The overall distress score was significantly associated with hospitalization history (P ≤0.001) and history of diabetes-related problems (P=0.001). Also, the total distress score was significantly related to physical complications of diabetes (P=0.001), type of treatment (P=0.001), and occupation (P=0.018). The overall distress score significantly correlated with monthly income (r=-0.171, P=0.001), disease duration (r=0.268, P=0.001), and HbA1c level (r=0.115, P=0.032).

Since the level of distress shows interindividual variations and is influenced by demographic, clinical, and social features, it is recommended that those in charge of providing care to diabetic patients consider individualized distress coping training for patients with diabetes.

Cancer can affect the quality of life of patients. Family support is essential in this disease.

This study aimed to determine the relationship between family functioning and quality of life in patients with gastric cancer.

This cross-sectional study was performed on patients with gastric cancer at the Valiasr Medical Center in Zanjan, Iran, in 2018 using the census method. A specific standard questionnaire for the quality of life of cancer patients and a McMaster family assessment device were used to collect information. The descriptive analysis and Pearson’s correlation coefficient were used to analyze data by SPSS software version16.

In total, 108 patients were assessed. The family functioning of the patients was assessed in the normal range and was partially good in all dimensions. The mean of general function (2.97 of 4) and affective responsiveness dimensions (2.31 of 4) was the weakest and the best, respectively. The overall quality of life, symptoms, and function [42.20 (2.65), 69.77 (7.23), 43.43 (7.38)] were at an unfavorable level. There was a significant inverse relationship (P<0.001) between the overall quality of life and the dimensions of family functioning: problem solving (r=-0.623), communication (r=-0.74), roles (r=-0.588), and behavior control (r=-0.718). A significant inverse relationship was also found between the overall quality of life and general family function (r=-0.577) (P<0.001).

The study showed the association between quality of life and family function in patients with cancer. Improving family function in these patients using different methods is recommended.

The use of analgesics and sedatives to provide sedation for Patients in Intensive Care Unit (ICU) is inevitable. The present study aimed to determine the effect of sedation protocol using the Richmond Agitation‑ Sedation Scale on sedation level and amount of pharmacological and non‑pharmacological interventions on patients under mechanical ventilation.

This randomized clinical trial was conducted on 79 patients under mechanical ventilation in Zanjan. The patients were recruited using the blocking randomized sampling method. In the experiment group, the sedation was provided hourly, using the Richmond sedation Protocol, during the mechanical ventilation period. The level of sedation and pharmacological and nonpharmacological interventions were compared in the two groups using Fisher exact test.

Totally, 40 patients in the experiment and 39 patients in the control groups were evaluated. No significant difference was found between the two groups in terms of confounding variables (age, sex, level of consciousness, Acute Physiologic and Chronic Health Evaluation (APACHE) II criterion, underlying disease, and cause of hospitalization). The level of sedation in the experiment group was significantly closer to the ideal score of the Richmond Scale compared to the control group (p </em>< 0.001). The experimental group received significantly more non‑pharmacological interventions and fewer pharmacological interventions compared to the control group (P </em>< 0.001).

Using a sedation protocol could provide better sedation levels in patients under mechanical ventilation, and reduce the use of sedative medications, and consequently, the cost of hospitalization. Further research is suggested.

Diabetes is one of the major health issues worldwide and a challenge for health care providers.

The aim of this study was to determine the status of psychological adjustment and associated factors in patients with type 2 diabetes in Zanjan University of Medical Sciences.

This descriptive cross-sectional study was carried out on 350 patients with type 2 diabetes referred to Vally-e-Asr Medical Center in Zanjan and Special Endocrinology Clinic in 2019. These patients were included in the study by the Poisson distribution method. Demographic and clinical factors questionnaires and valid Diabetes Adjustment Assessment Scale (DAAS) were used in this study. Data analysis was conducted using SPSS22 software. Also, Pearson correlation coefficient, independent t-tests, and analysis of variance were applied.

The mean of total adjustment in this study was 162.79± 18.06. The highest mean of adjustment was related to advanced self-management (4.15± 0.84) and the lowest mean of adjustment was about the initial imaging of illness (3.23± 0.67). Patientschr('39') adjustment had a statistically significant relationship with hospitalization history, family history of diabetes, HbA1C level, history of physical, psychological, and social problems caused by diabetes, place of residence, marital status, education, occupation, age, duration of illness, and income.

In this study, patients had an acceptable adjustment. Because adjustment varies among individuals and is influenced by demographic, clinical, and social factors, it is recommended that diabetic caregivers include individual-oriented diabetes education and promotion of adjustment to the disease in their program.

Social well-being is one of the main health dimensions that needs to be assessed.

As there are few studies on the social well-being dimensions, the current study aimed to determine the social well-being of women of reproductive age and the related factors in Zanjan, Iran.

This cross-sectional study was conducted on 382 women of reproductive age (10-49 years), referred to the Health Centers of Zanjan, Iran. Samples were selected using the stratified cluster sampling method, according to the socioeconomic status. Data were collected, using the Keyes social well-being questionnaire as a tool with good validity and reliability. Data were analyzed through SPSS software using descriptive and analytical tests (Kruskal-Wallis, Pearson Correlation, and Multiple regressions). The statistical significance level was considered as p<0.05.

In total, 382 women were assessed, and their social well-being total mean score was 64.7±6.5. The domains of Social contribution (16.8) and Social integration (10.8) had the highest and the lowest mean score, respectively. Those women and their husbands’ who had a higher educational level (p<0.001, P=0.03) and were employed (P=0.003, p=0,004) were more likely to have better social well-being. A significant association was found between the social well-being and socio-economic level (P<0.001). No significant association was found among age groups and marital status with social well-being. The educational level and sufficient income were found significant as independent variables associated with social well-being in the multiple linear Regression models.

The majority of women had a moderate level of social well-being. When planning for improving social well-being, education and income should be considered. Further research to improve the dimensions of social well-being in women in reproductive age is recommended.

 Dietary patterns and the consumption of some macronutrients could influence hypertension as a public health problem. This study was conducted to identify dietary patterns and compare the intake of some micronutrients, as well as food groups, according to the Dietary Approach to Stop Hypertension (DASH) guidelines.

 This cross-sectional study assessed the dietary patterns of 101 people with mild to moderate hypertension who were randomly selected among outpatients attending hospital clinics and health centres at Zanjan. Food intake data were collected using the food frequency questionnaire (FFQ) and three-day food diaries. Factor analyses and binary logistic regression were used to identify dietary styles and the associations between types of dietary patterns and hypertension, adjusted for covariates.

 Two main dietary patterns were identified, including the DASH-style dietary pattern and the modern dietary pattern which contains high intakes of fast foods, junk foods, animal fat, organ meat, chicken, tea, and coffee. A greater odds ratio for hypertension (odds ratio: 3.95; 95% CI: 0.91-17.2) was found at the first quartile of the modern pattern compared to the last one, adjusted for confounding variables. Also, patients at the last quartile of the DASH-style pattern received significantly more sodium (P=0.02). Hypertensive patients consumed more sodium and less potassium, calcium, and magnesium than given in the DASH recommendations for both identified dietary patterns.

 Two main dietary patterns were found in hypertensive patients. Considering both dietary patterns and micronutrient intake in prevention programs for hypertensive patients is suggested. Future research is recommended

Providing for patients’ comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU). The current study was conducted to determine the effect of a protocol using a Richmond Agitation-Sedation Scale (RASS) on some clinical outcomes of patients under mechanical ventilation (MV) in 2017.

This single-blind clinical trial was conducted on 79 traumatic patients in the ICU who were randomly allocated into the intervention (N=40) and the control groups (N=39). The sedation was achieved, using a sedation protocol in the intervention group and the routine care in the control group. The clinical outcomes of the patients (duration of MV, length of staying in ICU, final outcome) were measured. As the participants had different lengths of MV and staying in ICU, the data were restructured, and were analyzed, using proper statistical methods.

The patients’ level of sedation in the intervention group was significantly closer to the ideal score of RASS (-1 to +1). The duration of MV was significantly reduced in the intervention group, and the length of stay in the ICU was also significantly shorter. There was no difference in terms of final outcome. The ICU cost in the control group was twice as high as the cost in of the intervention group.

The applied sedation protocol in this study would provide better sedation and could consequently lead to significantly better clinical outcomes, and the cost of caring as a result.

Women's lifestyle affects their health and having a healthy lifestyle reduces the risk of developing non-communicable diseases. Evidence suggests that disadvantaged women are more subject to the risk of non- communicable diseases such as type 2 diabetes.

This study aimed to investigate the lifestyle of disadvantaged women at the risk of type 2 diabetes under the support of social welfare center of Zanjan city in 2018.

This cross-sectional study was performed on 287 women aged 65-35 and under the support of social welfare centers of Zanjan who were selected by Poisson random sampling. Data collection tools included a three-part questionnaire including demographic and background characteristics, an international physical activity questionnaire (IPAQ), and a Mini Nutrition Assessment questionnaire (MNA), filled out by a researcher at the social welfare center. Data were analyzed using descriptive-analytic statistical tests (mean index, standard deviation and one-factor analysis of variance, Kolmogorov-Smirnov) by applying SPSS software version 24.

The minimum and maximum age of women were 35 and 61 years, respectively, with a mean of 41.6(±9). The minimum and maximum body mass indexes were 16.2 and 42, respectively, with a mean of 26.1±4.3. In terms of education, the majority of women (42%) had Quranic-elementary education and concerning the income, 76% had insufficient income. As to the marital status, the majority of participants (69%) were widowed or divorced. According to the quantitative criterion of physical activity questionnaire (IPAQ), more than half of the women (60%) had low to moderate physical activity and according to the quality criterion of WHO physical activity, 89% of women had unfavorable physical activity. In terms of nutritional status, more than half of the women (50.5%) had poor nutrition.

The findings of the study indicated that the majority of women were undesirable in terms of physical activity and healthy nutrition. Therefore, interventional research is needed to find appropriate educational models to improve diabetes preventive behaviors in this population group.

The HIV/AIDS is spreading rapidly in the middle east and Iran. The health belief model is one of an appropriate model to assess the preventive behaviors. In this way, this study was conducted to design and evaluate the validity and reliability of a cultural-based psychometric instrument of AIDS in teachers and parents of Iranian students. A scale including 58 items relevant to preventive behaviors in AIDS/HIV was developed by reviewing literature.  Then, content and construct validity were evaluated using qualitative and quantitative methods, through the involvement of the participants and expert panel. The internal consistency was evaluated and approved using Cranach's alpha index, and test-retest analysis. The face and content validity of the primary developed scale was confirmed by item impacts of 1.5, CVR 0.49 and CVI 0.79, and the number of items decreased to 46. Considerably, the exploratory factor analysis approved the construct validity by factor loading of more than 0.40 in six factors (perceived susceptibility, perceived severity, perceived benefit, perceived barrier and perceived self-efficacy), including 35 items that jointly accounted for 59.49 % until 67.20% of the observed variance. The internal validity of the scale was approved by Cronbach’s alpha coefficient for the subscales ranged from .80 to .86 for each group, and the intra-class correlation coefficient ranged from 86 to .96. The results presented that the developed scale underpinning of the constructs of HBM in preventive behaviors of HIV/AIDs among students, teachers and parents had an appropriate validity; and an acceptable reliabliability.