جستجوی مقالات مرتبط با کلیدواژه « شدت » در نشریات گروه « پزشکی »

Abnormal fear of childbirth (FOC) can leave many complications. Examining the factors that worsen the FOC is helpful in eliminating or modulating the fear. In this regard, we aim to investigate the relationship between psychological factors and the increase of the FOC.

This scoping review study was conducted in 2023 by searching for related studies in databases Scopus, Cochrane Library, ScienceDirect, Web of Science, IranDoc, MagIran, SID, and Google Scholar using related keywords. After screening the titles, abstracts, and full texts, 10 eligible descriptive-analytical studies were selected. Evaluation of their quality was done by the AXIS checklist.

The findings from 10 studies were divided into three groups based on the answer to the main research question. Four studies showed the relationship between FOC and depression. Six studies showed the relationship between FOC and anxiety, and three studies showed the relationship between FOC and self-esteem. In all students, the relationships were statistically significant (P<0.05).

Psychological factors of depression, anxiety, and low self-esteem are related to the increased FOC in women. In this regard, by designing intervention programs to eliminate related psychological factors, it is possible to prevent the increase of the FOC in women.

 Due to COVID-19 pandemic and high rate of its mortality, grief and bereavement are one of the psychological problems experienced by the people. There is a need to examine the efficacy of grief counseling protocols in providing good services during the COVID-19 pandemic. The aim of the study was to compare the effect of spiritually multidimensional Psychotherapy on grief experience and grief intensity.

 This is a quasi-experimental study with a pre-test post-test design with a control group and follow-up. The population consisted of all people who had lost a member of their family due to COVID-19. Thirty-four individuals were selected through purposive sampling based on their acceptance to participate in the study and having inclusion criteria and were randomly assigned to experimental and control groups (17 in each group). In the three stages of pre-test, post-test and follow-up, data were collected by the Grief Intensity Scale and Grief Experience Questionnaire. In the present study, all ethical considerations were observed and the authors reported no conflict of interests.

Results:

 The results showed that spiritually multidimensional psychotherapy was effective in alleviating grief experience and reducing grief intensity (P<0.05).

 The results of this study strongly support the effectiveness of spiritually multidimensional psychotherapy in alleviating grief experience and reducing grief intensity. Also, the results showed that religious background of individuals should be attended to in theory and practice of psychotherapy.

Whole-Body Vibration (WBV) exercise seems to be an effective alternative to improve physical performance in the elderly. This study aims to compare the effects of eight weeks of WBV exercise combined with rope skipping at two different intensities on physical performance of older men.

Methods & Materials:

 This is a randomized single-blind clinical trial. Participants were 30 older men (Mean±SD age= 65.83±4.16 years; Mean±SD height= 169.26±3.90 cm; Mean±SD weight= 77.04±4.62 kg; Body Mass Index= 26.86±0.69 kg/m2) living in Mashhad, Iran in 2019, who were selected by purposive and convenience sampling methods and randomly divided into three groups: high intensity (HI; n=12), low intensity (LI; n=12) and control (n=10). The WBV exercise was performed at a frequency of 25-40 Hz and amplitude of 3 mm. Rope skipping was performed based on the Borg scale at 13-14 level intensities with 30-35 jumps per minute. Physical performance indicators, body mass index, and fat percentage were measured before and after eight weeks of intervention. Repeated measures analysis of variance was used for data analysis in SPSS v. 20 software. The significance level was set at P≤0.05.

In HI and LI groups, body fat percentage (-4.50%, -5.99%), lower body flexibility (105%, 102%), upper limb muscle strength (42.43%, 42.93%), handgrip strength (43.38%, 39.45%), dynamic leg strength (36.47%, 26.43%), lower limb muscular endurance (27.20%, 26.10%), cardiorespiratory function (10.27%, 10.90%), and dynamic balance (-32.60%, -24.10%) showed a significant improvement compared to the control group (P<0.05). There was no significant difference in body mass index between exercise and control groups (P>0.05), and no significant difference between the two exercise groups in any of the study variables (P>0.05)

It seems that low intensities of the WBV exercise + rope skipping is effective in improving body composition and physical performance in older men. The selection of intensity level depends on the physical condition of the elderly.

Irritable bowel syndrome is one of the most common gastrointestinal disorders that significantly affects the quality of life of patients. One of the salient features of this disease is that most of the patients are young adults who, in addition to gastrointestinal symptoms, are involved with various physical symptoms and suffer from extensive extra intestinal symptoms. The chronic nature of the disease is such that it disrupts a person's lifestyle and causes degrees of psychiatric disorder by interfering with underlying health. Several studies have shown a high prevalence of concomitant mental disorders among people with irritable bowel syndrome. It is worth mentioning that this disease has been introduced as a stress-related disorder and psychological factors play a very important role in its control and prognosis. The results of studies show that the more severe the symptoms of IBS, the greater the contribution of psychological variables in these conditions, and in moderate to severe cases of the disease, especially in patients with psychosocial problems, it is better in addition to drug treatment, psychotherapy should also be used. Written emotional expression is a non-pharmacological intervention that has been studied in several studies on its effect on physical and mental health and the prognosis of chronic diseases. The results of some studies suggest that there is a link between emotional repression and emotional inhibition with IBS. Psychological inhibition, which means the inability to express thoughts, feelings, and behaviors related to an experience, occurs when people think they cannot easily talk about their experience with others. Patients with irritable bowel syndrome are more likely than healthy people to hide their negative emotions. Embarrassment about the symptoms of the disease may lead to secrecy and reluctance to discuss the emotional problems associated with the disorder. Accordingly, encouraging patients to express emotions and change behaviors associated with emotional suppression can be valuable in IBS treatments. Doing so may improve the quality of life of sufferers, as suppressing emotions brings more psychological burden and, by increasing anxiety, exacerbates symptoms and worsens the disease. Expressing emotions in the form of writing, in addition to the effect it has on improving a person's emotional state, can be easily taught and practiced, and it is done spontaneously, without face-to-face and continuous referrals, and with less interference from the intervener. Considering the benefits of written expression and considering the importance of the role of psychological variables in aggravating the symptoms of this syndrome and the educational-supportive role of nurses, this study aimed to determine the effect of written emotional expression on severity of gastrointestinal symptoms in patients with Irritable bowel syndrome.

This clinical trial study was conducted in 2019, on 71 patients with Irritable bowel syndrome who were referred to the gastrointestinal clinics of Firoozgar and Hazrat Rasoul Akram hospitals in Tehran. Patients were selected using a continuous sampling method. Participants were randomly (permuted block randomization) assigned to two groups: the control group (n=35) and the intervention group (n=36). The sampling process started in November 2019 and continued for 8 months until the completion of the sample size until May 2020. Inclusion criteria include: IBS according to the doctor's diagnosis, at least 3 months have passed since the diagnosis, having symptoms based on the severity of symptoms of irritable bowel syndrome (SI-IBS) in the mild, moderate or severe range, having Literacy, having sufficient physical and mental ability to write, age 18 to 65 years, no acute mental disorders based on physician diagnosis and record, no use of anti-anxiety drugs during the last 3 months according to patient reports and no infection At the same time, participants had other functional or structural gastrointestinal disorders based on patient reports. Exclusion criteria also include: diagnosis of any disease during the study by the treating physician who has symptoms similar to the symptoms of irritable bowel syndrome, the patient does not have the necessary cooperation or unwillingness to continue cooperation, the patient does not attend pre-test or post-test evaluations , Not writing in the booklet more than 2 times or 4 sessions in total and hospitalization of the patient due to exacerbation of gastrointestinal symptoms during the study. After obtaining permission from the ethics committee, the researcher referred to the research environments, selected people with IBS who met the inclusion criteria, and after explaining the objectives of the research to these people and if they wish to participate in the research, the informed consent form Completed by them. A questionnaire on demographic characteristics and symptom severity index (IBS-SI) were answered by participants in both groups. The Symptom Severity Index Questionnaire was designed in 1977 by Francis et al. The Persian version of this questionnaire was translated into Persian in the study of Afshar et al by the standard method of linguistic validation. The internal correlation coefficient of this scale is 0.86 and Cronbach's alpha is 0.69. In the intervention group, in addition to routine care, a white booklet with a special format was given to each participant to express their emotions in writing. A weekly written expression of the patient's feelings for a period of 15 to 30 minutes, based on the topics in the booklet, was done at home for one month. During the intervention, the process of writing patients was followed by a researcher by phone at the end of each week. At the end of the intervention, by phone call and at the invitation of the researcher, the research samples were referred to medical centers again and after the presence of test subjects in the clinic training class, patients' notes were collected by the researcher. After the researcher viewed the booklet in terms of the patient's written expression each week, the booklet was returned to them. Also, all subjects in the experimental group answered the symptom severity index questionnaire again and in the same session. The control group received only routine care by clinic staff after the pre-test. In this group, telephone follow-ups were performed every week, in which the researcher answered the questions of the sample people regarding their health status and the training they received from health care providers. In this group, after one month, the subjects returned to the medical centers on the dates agreed by the researcher and completed the IBS-SI tool. Finally, in order to observe the ethical points, a written guide to the written emotional expression was provided to this group. Questionnaire data were extracted and analyzed using SPSS software version 16 and descriptive statistical methods, independent t-test and analysis of variance with repeated measures.

The two groups were homogeneous in terms of demographic characteristics. Before performing the written expression, the mean score of symptom severity in the experimental group was 262.36 with a standard deviation of 104.74 and the mean in the control group was 263.48 with a standard deviation of 11.874. The results of independent t-test showed that before the intervention, the experimental and control groups were not statistically significant in terms of symptom severity and were homogeneous (p = 0.966). One month after the written expression, the mean score of symptom severity in the experimental group was 218.75 with a standard deviation of 116.11 and the mean in the control group was 239.51 with a standard deviation of 107.67. After the intervention, there was no statistically significant difference in the severity of symptoms in the control group (p = 0.134). The severity of gastrointestinal symptoms in the experimental group decreased significantly compared to before the intervention (p = 0.016). However, there was no statistically significant difference between the mean scores of gastrointestinal symptoms in the experimental and control groups 1 month after the intervention (p = 0.438).

Execution of written emotional expression in this study, although did not cause a statistically significant difference in the score of gastrointestinal symptoms in patients with irritable bowel syndrome, but was associated with a decrease in the severity of gastrointestinal symptoms in patients in the experimental group, so that significant improvement in gastrointestinal symptoms. Patients with severe symptoms and mild to moderate symptoms were observed. This non-pharmacological intervention can be considered as a practical and easy method along with pharmacological treatments for patients with irritable bowel syndrome.

The aim of this study was to determine the predictors of disease severity and death in patients hospitalized with coronavirus disease 2019 (COVID-19) in the Infectious Diseases Center of Qazvin University of Medical Sciences, Qazvin, Iran.

A total of 228 patients with COVID-19 were included in this cross-sectional study. Of these, 114 patients were alive and 114 patients were dead, who were selected using the available sampling method. The logistic regression analysis method (Inter model) was used to predict the effective factors of severity of disease and mortality of patients and control of confounders.

Multivariate logistic regression analysis showed that increase in C-reactive protein (CRP), blood urea nitrogen (BUN), and potassium (K), and decrease in the mean time from onset of symptoms to hospitalization could be predictors of death in patients with COVID-19. Moreover, the deceased patients were older than the surviving group. There was also a significant difference between the two groups of deceased and survivors in terms of the presence of underlying diseases of hypothyroidism and chronic kidney insufficiency (P < 0.001).

According to the results of this study, measuring electrolytes at the beginning of hospitalization, and then serially, is recommended to take corrective measures in the field of disease control.

The Persian Diagnostic Aphasia Battery (P-DAB-1) is one of the tests available for screening and determining the severity of aphasia. The test classifies the patients in seven major diagnostic classes based on the extent of the impairment in different linguistic modalities. The present study aimed to describe the pattern of linguistic impairment in four aphasic patients according to the P-DAB-1 and compare that with the classical view of aphasia.

The study was done in four Persian-speaking aphasic patients who were selected by convenience sampling. Inclusion criteria were being fluent in Persian and right-handed. Patients with severe untreated visual or hearing impairments and neurological diseases affecting cognition were excluded from the study. The P-DAB-1 test was used to determine the severity and type of aphasia.

In this research, the participants had moderate aphasia quotient, of whom three had transcortical motor aphasia and one had conduction aphasia. The patients did not show some symptoms of a specific category according to the classical view.

This study proves the efficiency of P-DAB-1 test and also provides evidence for the deficiencies of the classical view in determining the types of aphasia.

Knee osteoarthritis (KOA) is one of the most common age related joint diseases. Various grades of KOA lead to change in gait pattern by different compensatory mechanisms. The aim of current study was to determine how KOA severities will affect spatiotemporal parameters of gait.

Forty subjects, in three groups of mild, moderate and severe KOA and a group of people without KOA were recruited in this study according to the K–L scale. The subjects walked with a self‐selected speed along the walking path to collect five successful trials. The spatiotemporal parameters of gait i. e. stride length, speed, cadence, stance percentage, stride time and stance time were analyzed

The ANOVA results and post hoc analysis shown «stride length» and normalized stride length are the only parameters that are significantly different in healthy groups with moderate and severe OA subjects (P=0. 004, P=0. 001 for stride length and P=0. 014, P=0. 001 for normalized stride length respectively). Severe KOA was significantly different from mild KOA and control group (P<0. 05) for all studied variables. In addition, stride time in moderate OA participants was significantly less than severe KOA patients (P=0. 038).

It seems that spatiotemporal parameters of gait are valuable parameters for distinguishing KOA severities and differentiating it from healthy joint. Among them, stride length may be a good parameter for identifying healthy subjects and those suffering from different OA severities.