فهرست مطالب neda mahdavifar

One of the main complications of diabetes is psychological problems, such as reduced stamina and psychological well-being. The use of muscle relaxation is a simple, safe, and non-pharmacological method. Therefore, the present study was designed to investigate the effect of Jacobson's muscle relaxation technique on psychological well-being and resilience in patients with type 2 diabetes.

The current study is a two-group randomized clinical trial with a pre-test and post-test design conducted on 40 patients with type 2 diabetes at the Khayyam Diabetes Clinic in 2021. Eligibility criteria included minimum literacy, acceptable hearing, and speaking ability, age between 25 and 65 years, no history of relaxation training, type 2 diabetes for at least 6 months, no smoking and no alcohol, ability to use a computer, poor psychological well-being and resilience (psychological well-being score equal to or less than 63, resilience score equal to or less than 50), and no definite psychiatric disorders. Exclusion criteria included: special medical conditions (such as hospitalization or medical inability to continue treatment), withdrawal from the research, death, unwillingness to cooperate, incomplete completion of questionnaires by members, and failure to perform sedation for more than 4 sessions. The samples were selected using the available methods and then randomly allocated with permutation blocks to two intervention and two control groups. The relaxation technique was then practiced at home by the intervention group once a day for 8 weeks. Rif's psychological well-being questionnaire and Connor's resilience questionnaire were completed by the intervention and control groups at the beginning and end of the intervention. Data were analyzed using the Shapiro-Wilk test for normality, Fisher's exact test, chi-square, and analysis of covariance using SPSS 25 software.

The results of the research showed that the two groups were homogeneous in terms of gender, marriage, age, education, history of chronic diseases, history of neuro medications, insulin history, exercise history, peer history, dietary compliance, income, and occupation and there was a statistically significant difference. There was no difference in these variables between the two groups (P>0.05). The results of the covariance test show that the means of the experimental and control groups are the same in terms of patient resilience (P=0.49, eta=0.02). Therefore, it can be concluded that there is no significant difference between the experimental and control groups in terms of patient endurance, controlling for the effect of pre-test means. Also, the means of the experimental and control groups differ in psychological well-being (P=0.00, eta=0.44). Therefore, It can be concluded that there were statistically significant differences between the groups. More specifically, there was a significant difference between the experimental and control groups in terms of psychological well-being, controlling for the effect of pre-test means.

 Results of the study showed that muscle relaxation training was an effective, practical, and inexpensive method of improving and preventing psychological problems in people with diabetes in the intervention group compared with the control group.

Chronic kidney disease is one of the public health issues in the world. Imbalances in the gut microbiome contribute to the progression of multiple diseases, including chronic kidney disease. The consumption of probiotics and synbiotics in treating various diseases has progressed significantly. 

The present study investigates the effects of synbiotic supplements on the intestinal microbiome, resulting in improving fatigue and sleep quality of end-stage renal disease patients undergoing hemodialysis.

The study was a double-blind, randomized, placebo-controlled clinical trial. A total of 52 patients with end-stage renal disease undergoing hemodialysis were included in the research and, through permuted block randomization, assigned to the synbiotic group (28 patients) and the placebo group (24 patients). The intervention group received 500 mg of synbiotic (Lactocore) twice a day for eight weeks, and the control group received a placebo for the same period. The patients were evaluated with the Chalder fatigue and Pittsburgh sleep quality questionnaires at the beginning, the fourth week of the study, and at the end of the study. Demographic variables were analyzed using the chi-square test, Fisher exact test, or independent sample t-test, as appropriate. The repeated measures test was used because the outcome variable has been measured three times in each group.

The samples, consisting of 26 males (50%) and 26 females (50%), were randomly allocated to the placebo (n=24, 46.16%), 12 males and 12 females, and the synbiotic supplement (n=28, 53.84%), 14 males and 14 females, groups. The result showed regular use of a synbiotic supplement for 8 weeks did not show a change in the amount of fatigue and sleep quality reported in patients receiving the synbiotic supplement considering the effect of time and group compared to the placebo group.

In general, the 8-week consumption of synbiotic supplements in the intervention group compared to the control group did not significantly affect the fatigue and sleep quality of patients undergoing hemodialysis treatment. However, further studies with larger sample sizes and longer duration are suggested.

Sleep disorder is common in women with mastectomy. Previous studies have shown that relaxation technique improves sleep quality. However, the effects of these interventions on the sleep quality of breast cancer patients who underwent mastectomy surgery is still unclear. This study aimed to determine the effect of the Benson relaxation technique (BRT) on sleep quality in women with breast cancer after mastectomy.

This randomized clinical trial study was performed on 72 eligible patients who were referred to the screening and chemotherapy center of Shahid Modares Hospital of Kashmar City from April to July 2021. The patients were selected through convenient sampling and randomly allocated to intervention (n = 36) and control (n = 36) groups. In the intervention group, in addition to the routine treatments, BRT was performed once in the morning and once in the evening for 2 months, each time for 20 minutes. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the score of sleep quality at the beginning of the study and 2 months later. Data were analyzed using the paired t test and independent t test at 95% CI.

The mean score of sleep quality before the intervention in the intervention and control groups was 9.25 ± 2.50 and 8.47 ± 2.13, respectively. After the intervention, the mean score of sleep quality in the intervention and control groups was 6.63 ± 1.92 and 8.41 ± 2.15, respectively, and the difference was significant between the 2 groups (P = 0.001)

The Benson relaxation technique improves sleep quality in women with breast cancer after mastectomy. Therefore, it can be considered an adjunct therapy to improve the sleep quality in these people.

Informal caregivers provide long-term support and care for cancer patients and they do not receive enough support from the family and the health system; as a result, they suffer from a lot of caregiver burden.

In the current study, we investigated the effect of the Benson relaxation technique on caregiver burden in informal caregivers of cancer patients.

This randomized clinical trial with a control group was conducted on 113 caregivers, who scored X  48 from the Novak and Guest caregiver burden inventory. They were randomly divided into intervention group (n = 57) and control group (n = 56). The intervention group performed Benson relaxation twice a day for 20 minutes each time for 1 month. The control group did not receive any intervention. Then, after 1 month, Novak and Guest caregiver burden questionnaire was completed by both groups. The conceptual framework for this study was based on the general system theory modified by Ludwig Von Bertalanffy.

The mean score of the total caregiver burden before the intervention in the intervention and control groups was 71.16 ± 14.42 and 74.47 ± 15.16, respectively. After the intervention, the mean score of the total care burden in the intervention and control groups changed to 57.21 ± 14.66 and 75.47 ± 13.94, respectively. Data analysis shows a significant decrease in the intervention group (P = 0.000).

The results showed that the Benson relaxation technique as a cheap and non-pharmacological method effectively reduces the caregiver burden in informal caregivers of cancer patients.

As the core of a health‑care team, nurses play a key role in promoting community health, and their job involves witnessing human suffering and pain in health‑care settings. The present study aimed to evaluate the correlations between resilience coping strategies, and the underlying factors in the nurses working in COVID‑19 hospitals.

This descriptive, cross‑sectional study was conducted on 320 nurses working in COVID‑19 wards for a minimum of 6 months in 2021. The participants were selected via multistage sampling. Data were collected using demographic, resilience, and coping strategy instruments. Data analysis was performed in SPSS version 20.

The mean resilience score was 76.94 ± 11.33. The mean scores of emotion‑focused and problem‑focused strategies were 59.65 ± 4.40 and 96.08 ± 5.38, respectively. The assessment of the correlation between resilience with the emotion‑focused and problem‑focused strategies showed a positive significant correlation (r = 0.25; P < 0.001 and r = 0.33; P < 0.001, respectively).

According to the results, the nurses working in COVID‑19 wards mostly adopted problem‑focused strategies in difficult work conditions depending on the required care provision. Both coping strategies significantly affected the subscales of resilience in the nurses. Therefore, it is recommended that special attention be paid to teaching strategies to cope with anxiety and resilience and develop problem‑solving skills in nursing personnel during the emergence and outbreak of new diseases in order to reduce their anxiety.

The outbreak of coronavirus disease 2019 (COVID-19) in early 2020 has affected reperfusion time in patients with ST-segment elevation myocardial infarction (STEMI) across the globe.

The present study aimed to assess the effect of the COVID-19 pandemic on the treatment management of STEMI.

This quantitative cross-sectional descriptive-analytical study investigated medical records of all patients (n=279) with STEMI who were consecutively admitted to Heshmatieh Hospital in Sabzevar city and underwent Primary Percutaneous Coronary Intervention (PPCI) in the last 9 months of 2019 (from April to December) as "Pre-pandemic group" (n=161) and the same period in 2020 as "post-pandemic group" (n=118). The data collection tools were a demographic information form and a checklist for recording treatment information.

The average times from the symptom onset to first medical contact (FMC) and from FMC to the commencement of PPCI were significantly increased in the post-pandemic group, compared to those in the pre-pandemic group (870.50±1397.48 versus 348.80±399.20 min and 73.23±91.87 versus 52.68±27.46 min, respectively). The mean length of stay was reduced after the intervention in the post-pandemic group. Despite the reduction in the number of STEMI patients’ referrals in the post-COVID-19 pandemic period, the comparison of the referral of patients by month showed no significant difference between the two study groups before and after the COVID-19 pandemic.Implications for Practice: The COVID-19 pandemic caused treatment delay and reduced hospital stay among STEMI patients. The results of this study can be used to inform the community and better manage time-dependent diseases, such as STEMI, in the future.

Limited use of episiotomy and performing selective episiotomy versus conventional episiotomy has been recommended in various studies. But according to the statistics from developing countries, episiotomy is still the most common obstetric incision. The most common cause of episiotomy in low-risk mothers is maternal concern about severe perineal injuries. This study was performed with aim to compare perineal injuries in normal delivery of primiparous mothers with and without episiotomy.

This descriptive-analytical study was performed by reviewing 3602 files of primiparous pregnant women who had a normal delivery in Sabzevar Obstetrics and Gynecology Hospital during 2017 and 2019. Data collection tool was a researcher-made checklist. The maternal demographic variables, active phase length, neonatal weight, neonatal head circumference, labor mobility, induction or non-induction with oxytocin, and exposure to analgesia, neonatal hospitalization in neonatal intensive care unit (NICU), neonatal death and the degree of perineal damage including grade 1, 2, 3 and 4 laceration. Data were analyzed by SPSS software (version 21) and Chi-square and regression tests. P<0.05 was considered statistically significant.

In the delivery group without episiotomy, 317 mothers (37.8%) had healthy perineum, 324 (38.5%) grade 1 laceration and 56 (6.6%) grade 2 laceration, but in the delivery group with episiotomy, 1302 (99.3%) had grade 2laceration. Chi-square test showed a significant difference between the two groups in terms of perineal injuries (P= 0.0001). The rate of severe perineal injuries was not significantly different in the delivery group with and without episiotomy (p> 0.05). The NICU admission was not significantly different between the two groups (p> 0.05).
 

Delivery without episiotomy in primiparous mothers who don't have risk factors for maternal diabetes, instrumental delivery and infant weight > 4000 g, does not increase severe perineal injuries.

Nurseschr('39') attitudes affect their preference for working with the elderly as well as the quality of care. The aim of this study was to investigate the factors related to nurseschr('39') attitudes toward caring of elders and the predictive role of altruism, moral intelligence, life satisfaction and general health in Sabzevar hospitals in 2019..

This cross-sectional descriptive-analytical study was performed on 265 randomly selected nurses in Sabzevar hospitals in 2019. Data were collected using demographic information questionnaire, Kogan Attitudes Toward Old People Scale , lennick and kiel moral intelligence questionnaire, Carlochr('39')s altruism questionnaire, Dinerchr('39')s Satisfaction With Life Scale , and General Health Questionnaire-28 (GHQ-28). Data were analyzed via descriptive statistics (mean, standard deviation and frequency) and inferential statistics (correlation coefficient, linear regression, and independent t-test) using SPSS software version 16. A significance level of 0.05 was considered.

The mean age of participants was 33.10±7.17. Nurses had a positive attitude toward the care of the elderlies. The mean score of nurseschr('39') attitudes was 155.39 ± 17.74. There was no significant relationship between nurseschr('39') attitudes and variables such as age, sex, marital status, education, work experience, place of work, and general health of nurses (P Value> 0/05). The results of multivariate regression model showed that the factors of moral intelligence (P = 0.01), altruism (P = 0.008) and life satisfaction (P = 0.03) had a significant relationship with nurseschr('39') attitudes toward caring for the elderly.

Since the attitude of nurses to elders care is predictable with moral intelligence, altruism and life satisfaction. It seems that the evaluation of these characteristics in nurses who provide services to the elderly can positively affect to their attitudes and prevent phenomena such as age discrimination.

Quarantine is medically very effective in protecting the public from disease. Given the significant role of women in forming the health behavior of the family, this study was performed with aim to investigate the level of knowledge, attitude, and practice of women in Sabzevar concerning home quarantine for prevention of the new coronavirus disease.

This cross-sectional study was performed on 605 women of Sabzevar in 2019. The study tool was a researcher-made questionnaire whose validity and reliability were approved. The range of scores in each dimension of the questionnaire was between 0 and 100. Data were collected by available and non-probabilistic sampling methods as virtual dissemination. Data were analyzed by SPSS software (version 16) and t-test, analysis of variance, Pearson correlation test, and linear regression test. P<0.05 was considered statistically significant.

The highest mean score of practice concerning the home quarantine program were observed in the age group upper 55years (82.58±22.31) and College education (70.77±21.95). The mean scores of women's knowledge, attitude, and practice concerning the home quarantine program were 73.45 ± 13.73, 80.74 ± 7.27, and 69.71 ± 22.14, respectively. Age (P =0.004, B =2.6), education level (P = 0.03, B = 4.45), and attitude (P = 0.03; B =0.27) had an increasing impact on women’s practice.

The level of knowledge, attitude, and practice about the implementation of home quarantine to prevent coronavirus disease was satisfied. However, despite the positive attitude of women about the implementation of home quarantine, their practice was not satisfied. This shows that given the role of women in improving the health behavior of the family, enhancing their skills and capabilities is essential.

Prevention is the best way to break the transmission chain of COVID-19. The aim of this study was to determine the knowledge, attitude and practice of people regarding home quarantine to prevent COVID-19 in Sabzevar city, Iran.

In the present cross-sectional study in 2020, 836 people from Sabzevar participated. Data were collected by the virtual questionnaire and released in social media by nonprobability methods (Convenience and Snowball). The study questionnaire was researcher-made. The questions included demographics, knowledge, attitude and practice. The validity and reliability of the questionnaire were confirmed. 

The variables of gender, attitude and job on practice, variables of gender, education, job and attitude on knowledge and variables of knowledge, age, gender and underlying disease on attitude toward home quarantine have a significant impact (P˂0.05).

Peoplechr('39')s practice regarding home quarantine to prevent COVID-19 depends on a number of factors. Paying attention to the gender, attitude and occupation of individuals in policy making regarding home quarantine can improve the performance of the public.

Personality is associated with health behaviors, such as smoking and substance abuse, yet there is little information about the relationship between optimism and tobacco smoking or substance abuse among high school students. The aim of the present study was to determine the association between optimism or pessimism in predicting tobacco smoking and substance abuse among high school students in southeast of Iran. In this study, 1094 students of high schools in Zahedan city, southeast of Iran, were selected using proportionally multi-stage sampling. Cigarette and hookah smoking status, substance abuse, optimism, and other potential confounders were measured using a self-administered questionnaire. The data were analyzed using chi-square, analysis of variance (ANOVA) tests and ordinal logistic regression in Stata.14 software. According to the results of present study, the prevalence of cigarette smoking and ever hookah smoking was 32.7% and 36.1%, respectively. About 11.2% of students had used at least one illicit drug. After controlling potential confounders, optimism score was negatively related to cigarette smoking stages (OR = 0.90, 95% CI: 0.79 to 0.97) and illicit drugs use (OR = 0.91, 95% CI: 0.70 to 0.96) yet was not associated with hookah smoking (OR = 0.98, 95% CI: 0.82 to 1.31). Optimism and pessimism have an important role in tendency of students to tobacco smoking and substance abuse. On the other hand, the co-occurrence of smoking and substance abuse is high among students with low optimism scores. Therefore, educating and consulting students regarding positivism and promising could prevent from smoking and substance abuse and probably transition to higher stages.

Leukemia is the most common childhood cancer. This cancer, considering its unknown cause(s), is considered as one of the most important health problems amongst children worldwide. The present study was aimed to determine the relationship between breastfeeding and leukemia in Sistan and Baluchestan province, southeast of Iran.
This case-control study was implemented on 120 children between 11 months and 17 years old with leukemia as the case group, and 240 children hospitalized due to other non-leukemia-related diseases in the study area (the mean age of children in both groups was about 8 years). The children were categorized according to age and gender. To determine the relationship between variables and the risk of leukemia morbidity, the odds ratio (OR) with 95% confidence intervals was estimated through conditional logistic regression using Chi-square and Fisher's exact test and utilizing SPSS-16.
Out the 120 children with leukemia, about 60% were male and the age group of 5-9 years old was the most frequent age group (45%). The results of the study showed that breastfeeding was significantly associated with leukemia in children, P-value = 0.02(OR = 0.24, CI: 95%, 0.71-0.71).
Regarding the protective role of breastfeeding, the necessary measures for training to maintain and promote breastfeeding and its continuity up to 2 years are required to be taken.