نشریه روان پرستاری
سال هفتم شماره 2 (پیاپی 32، خرداد و تیر 1398)

Postpartum depression is one of the most common postpartum mental disorders which usually associated with depression and irrational beliefs, so we should seek solutions to improve their psychological characteristics. The aim of research was comparison the effectiveness of dialectical behavior therapy, drug therapy and their combination methods on depression and irrational beliefs in women with postpartum depression. This study was a semi-experimental with a pre-test and post-test design. Research population was women with postpartum depression that referring to health and care centers of Mashhad city in 2018 year. 45 people selected by available sampling method and simple random method with lottery assigned to three groups of 15 people. The first group received 8 sessions of 90 minutes of dialectical behavior therapy, the second group received 200 mg Fluoxamine per day and the third group received a combination of both methods. Data collected with the questionnaires of depression and irrational beliefs and were analyzed by multivariate analysis of covariance and Bonferroni post hoc test methods. The findings showed that there was no significant difference between groups in depression and irrational beliefs (p>0/05), but there was significant difference in the post-test stage (p<0/05). The combined method in compared with the dialectical behavior therapy and drug therapy led to significant reduce the depression, but there was no significant difference between the dialectical behavior therapy and drug therapy in reducing depression. Also, dialectical behavior therapy and combined in compared with drug therapy led to significant reduce the irrational beliefs, but there was no significant difference between the dialectical behavior therapy and combined in reducing irrational beliefs (p<0/05). Regarded to results to reduce depression of women with postpartum depression used from combined method and to reduce their irrational beliefs used from dialectical behavior therapy method.

Vaginismus is a sexual dysfunction in which couples are not able to have a normal intercourse. This disorder is one of the causes of infertility in women. The aim of this study is to successfully treat vaginismus disorder using Cognitive-Behavioral Therapy (CBT). This cross-sectional study was conducted at a psychiatry clinic. Two patients diagnosed with vaginismus and long term infertility, one with 6 years and the other with 7 years infertility, were chosen. The treatment, which was performed in 8 sessions lasting 45 minutes each, consisted of anatomical and functional teaching of genital organs, correction of misconceptions about sexual activity, and teachings about relaxation and mental imaging of sexual activity. After the successful completion of training, both patients were able to have satisfactory intercourse. One of the patients became pregnant after 5 months and pregnancy occurred in the other one after 3 months. CBT is still an appropriate method to treat Vaginismus and can be employed as a helpful, cost-effective, and non-invasive interventional therapy.

Sexual health plays an important role in men's quality of life, and a relatively high prevalence of related disorders, causes problems in family life. The aim of the present study was to design a multidimensional Persian version of Sexual Health questionnaire and to assess its reliability and validity in the Iranian society. The present study was conducted within the framework of descriptive and correlation based psychometric design. The men's sexual health questionnaire was designed using questions from the Hensel and Fortenberry (2012) Women's Sexual Health Questionnaire. In order to that instead of 5 genital pain questions, was placed six questions related to erectile dysfunction. The participants included 202 men (the age range of 17 to 57) in Tehran who were selected by available sampling method. To determine the reliability of the questionnaire, the equivalence method was used and the validity was evaluated by confirmatory factor analysis. Also, for assessing the convergent and divergent validity, the correlation of the scale was evaluated with Rosen et al (2004) Sex Function Questionnaire. Cronbach’s alphas for the whole questionnaire (0/85) and for the Emotional, Physical, Mental/Attitudinal, Social domain (the range 0.65 to 0.96), suggested good inner consistency of the questionnaire and domains except for Sexual Autonomy. Confirmatory factor analysis supported the original pattern of questionnaire and all indicators except Sexual autonomy (10,11,12, questions). Also, factor loading was not significant for questions 19 (related to Fertility control) and 26 (related to Sexual anxiety). Therefore, Sexual autonomy variable and questions 19 and 26 excluded from the final version of the questionnaire. Except these 5 questions all paths was significant at P <0.01 level. The chi-square indices to degree of freedom, SRMR and CFI, were respectively 1.66, 0.062, and 0.95, which indicate good fit of the model. Finally, correlation patterns between dimensions of the questionnaire with Total sexual health questionnaire indicated good validity of the scale. The result of this study indicate that the "multidimensional Persian version of Sexual Health questionnaire" with 33 items, due to features such as proper reliability and validity, simple scoring and usability by therapists and researchers is an appropriate tool for multidimensional assessment of men sexual health.

pregnancy anxiety is associated with adverse health outcomes for the mother and the infant. Considering the importance of this issue, the present study aimed to predict pregnancy anxiety in pregnant women based on cognitive bias and emotion regulation. This study was a descriptive from correlational type. The statistical population of this study was all pregnant women referred to Ardabil health care centers in 2017 to receive prenatal care from the 1st to the 9th month of pregnancy. A total of 180 individuals were selected by stratified randomly sampling method. All of them completed the demographic questionnaire, pregnancy anxiety-short form questionnaire, cognitive bias scale and emotional regulation scale. Data were analyzed with using SPSS-22 and by Pearson correlation coefficient and multiple regression analysis. The findings showed that pregnancy anxiety has positive relationship with cognitive biases (P<0/01; r=0/68). Also, pregnancy anxiety has negative relationship with cognitive reappraisal (P<0/01; r= -0/75) and positive relationship with expressive suppression (P<0/01; r= 0/49) as a components of emotion regulation. The results of regression analysis also indicated that 50% of the total variance of pregnancy anxiety is explained by cognitive bias and 58% of it explained by emotion regulation. The results showed that cognitive biases and emotional regulation strategy are important predictors of pregnancy anxiety. Therefore counselors and therapists should pay attention to the symptoms of women with pregnancy anxiety and based on them, design and implement cognitive and emotional strategies in their curriculum to reduce pregnancy anxiety.

Multiple Sclerosis is a chronic and debilitating disorder of the central nervous system, but the factor that worsens the conditions for these patients is that they experience a lot of psychological symptoms after the first diagnosis. This study aimed to predict psychological symptoms in Multiple Sclerosis (MS) patients based on hope and self-actualization. The present study was a descriptive correlational study. The statistical population of this study included all MS patients referring to Sina Hospital and Razavi Specialized Hospital, and also MS patients referring to Parsian Medical Complex in 2018. The sample size was calculated based on Morgan's and Krejcie table estimates 217 people (93 males and 124 females), and were selected by available sampling method. The research instrument In addition to the demographic questionnaire and was including three questionnaires of Beliefs Questionnaire self-actualization, Snyder's hope scale (1991), and Symptom Chek List – 25- Revised (SCL-25). Data were analyzed using Pearson correlation test and regression analysis using SPSS software version 25. Findings showed that hope and self-efficacy variables could predict meaningful psychological symptoms and hope with beta -0.46 was stronger predictor than self-actualization with standard beta -0.28. The results of this study indicate that hope and self-actualization as general protective factors can be effective in reducing the psychological symptoms in MS patients. It is suggested that health professionals, especially counselors and psychologists in the field of behavioral and cognitive, help to reduce the psychological symptoms of MS patients through appropriate interventions in the field of hope and self-actualization.

People with hypertension, usually have high stress. For this reason, reduce their psychological wellbeing. According to emotional regulation strategies, differ the effect of stress on psychological wellbeing. Present study aimed to predict psychological wellbeing of women with hypertension based on Perceived stress with mediating role cognitive emotional regulation.

Methodology was correlation. Population was women with hypertension (equal or upper>140.90) referring to health center of Aran and Bidgol in Kashan in 2018. 120 participants selected by simple random sampling and completed questionnaires of Ryff, s (1980) psychological wellbeing, Cohen, s (1983) Perceived stress and Garenfeski, et al, s (2001) cognitive emotional regulation. Data were analyzed by tests of Pearson’s correlation and hierarchy regression.

There is a negative and significant relationship between Perceived stress, negative strategies of emotional regulation and psychological wellbeing and a positive and significant relationship between positive strategies of emotional regulation and psychological wellbeing (P<0.01). The results of hierarchy regression showed that positive and negative strategies of emotional regulation partially and significantly mediate on the relationship between Perceived stress and psychological wellbeing (P<0.01).

Positive and negative strategies of emotional regulation effect the role of Perceived stress on psychological wellbeing of women with hypertension, but this effect is not complete. In order to promote psychological wellbeing of women with hypertension, it may be useful to pay attention to Perceived stress and encourage women with hypertension to use positive strategies of emotional regulation.
 

The association between perceived stress and marital adjustment has received both theoretical and empirical support. However, less is known about the moderating mechanisms in this relationship. The aim of the present study was to explore the moderating effect self- differentiation in the relationship between perceived stress and marital adjustment in married nurses. In this descriptive – correlational study, from female married nurses’ population working in hospitals of Tehran, 150 people were selected via purposeful sampling method and were tested by Perceived Stress Scale (PSS), Dyadic Adjustment Scale (DAS) and Differentiation of Self Inventory (DSI). Then, collected data were analyzed using Pearson correlation and hierarchical linear modeling. Results showed that there is a negative significant relationship between perceived stress and marital adjustment (β= -0.69, P<0.001) and there is a positive significant relationship between self-differentiation and marital adjustment (β= 0.26, P<0.001). Also, result of hierarchical linear modeling confirmed the moderating role of self-differentiation in the relationship between perceived stress and marital adjustment (β= -0.18, P<0.001). The present study highlights the moderating role of self-differentiation as an underlying mechanism perceived stress and marital adjustment. Therefore; developing self-differentiation in married Nurses could be a good way to protect them in the face of adversity in marital life.

Elderly is a very important stage in life, and death anxiety is a common feature of the elderly, so it is important to identify the factors that affect death anxiety during this period. Therefore, purpose of this study was to investigate the role cognitive fusion, social support and perception of aging in prediction death anxiety in elderly. This is a cross-sectional study that statistical population consisted of all the elderly in Kermanshah in 2017. The total population of 199 people (75 women and 124 men) as sample size were selected. The collected data were analyzed using Pearson correlation coefficient, enter regression analysis, stepwise method and T test with SPSS22. Independent groups were analyzed. The results showed that there is a significant relationship between cognitive fusion, social support and perception of aging with death anxiety in elderly women and men was observed. The results of stepwise stepwise regression analysis showed that among female elderly, cognitive fusion and perceived aging variables were 38.9%, and among the elderly, cognitive fusion and perceived aging, 14% had anxiety before death they made it. But social support was not able to predict death anxiety. On the other hand, independent t-test showed that there is a significant difference between cognitive fusion and death anxiety in the elderly between men and women, as cognitive fusion (P < 0.05) and death anxiety (P < 0.01) among elderly women of man, but there was no significant difference in terms of social support and aging perception among them. Based on the results of this study and considering the high death rate anxiety in the elderly, which is one of the effective factors in the mental health of the elderly, using mental anxiety strategies, mental health can be increased in the elderly.

Many people with mental health problems do not seek professional help but their use of other sources of help is unclear. This study conducted to determine the referral pathways in mental patients in Gilan, Iran. In this cross sectional study, 308 mental patient's psychiatric patients who referred to the emergency department of Shafa educational – remedial Hospital located in Rasht, Iran (Only psychiatric hospital in Gilan province), were enrolled during the period January to March 2017. In the current study, as data collecting tools, a researcher-made questionnaire was employed. The questionnaire was completed during an interview. The questions were about socio-demographic characteristics of patients, psychiatric diagnosis, and the onset of the disease, age of onset of psychiatric patients, referral source, the first treatment method employed by the mentally ill, reasons for referring to non-medical staff. Collected data were analyzed using frequency tables as well Fisher's exact and Chi-square analyses.  All statistical analyses were conducted using the software package SPSS 20.0(SPSS Inc., Chicago, Illinois). The mean age of the respondents 38.4 years (SD±12/9 years; Min: 5, Max: 75 years). Seventy-five (24/4%) respondents were female. The main reported information sources on the help sought were family 264 (85/7%) and Jurisdictions 31 (10/1%). First therapeutic approach employed by respondents were avow (33/8%), followed by traditional and faith healer (39/2%) and only 26/9% of them was medical team. The main reasons for the treatment options employed were recommendations from friends and relatives (46.3%), belief in a physical cause for the psychiatric disorder (14.2%), and fear of stigma (14%).  Manner of the psychiatric disorder onset (gradually or sudden onset), age of patient, age at onset of psychiatric disorder, place of residence and income were significantly associated with the first employed approach (all P value were less than 0.05). But, others including gender, marital status, educational level, nationality and occupation status had not a significant effect on the first employed approach (all P value were more than 0/05). According to our results, a large number of psychiatric patients prefer to visit non-medical practitioners (e.g. traditional and faith healers) at first, especially in rural areas residence, lower- income and older age at onset as well those who experienced gradual onset of disease. Non-medical practitioners had more likely to be approached first because of locally availability, belief that mental illness are caused by supernatural powers and other prevalent cultural belief and the stigma attached to mental illness.

Due to the prevalence of psychological damage in cancer patients, some studies indicate the role of psychological structures in compromising cancer. The purpose of this study was to develop a model for the relationship between psychosocial factors and self-efficacy of pain by mediating optimism and psychological hardiness in patients with cancer in Urmia.

This study was carried out as structural equations. The sample consisted of 250 cancer patients in Urmia in 2018. These patients included Bauer Mindfulness Questionnaire (2006), Social Support for Zimt (1988), Parsian Spirituality and Donitigg (2009), Optimism by Shiyer and Carver (1994) , Psychological hardiness Kobasa et al. (1982) and self-efficacy of Nicholas's pain (1989). Then, using the LISREL software and their structural equations, their fitting proportions were calculated.

Mindfulness, social support and spirituality were positively predictive of the self-efficacy of pain; as well as the variables of mindfulness, social support and spirituality in a positive manner Able to predict optimism and psychological hardiness, and ultimately optimism and psychological hardiness, are able to predict positive self-efficacy of pain. The variables of mindfulness, social support and spirituality along with optimism and psychological hardiness simultaneously were able to explain 57.3 percent of the variance of self-efficacy in two. Also, the variables of mindfulness, social support and spirituality can simultaneously explain 32 percent of the variance of optimism and 21.9% of psychological hardiness changes.

According to the results of the theoretical model, the relationship between psychosocial factors and the self-efficacy of pain-induced pain is confirmed by the optimism and psychological hardiness of cancer patients.
 
 

Resilience is one of the most important factors that can lead to human success when it comes to severe tensions. It is very important to pay attention and to improve it in caregivers of mental patients. This study aimed to determine of Family psychological group training on Resilience of the families of schizophrenic patients referred to the Roozbeh hospital of Tehran in 2018. This study is Semi-experimental study that Pretest-posttest plan with control group was used. All of the families of schizophrenic patients, who referred to the Roozbeh hospital were our statistical research community. 100 patients were selected Based on inclusion criteria and purposive sampling method and randomly divided into two groups of experimental and control by using a table of random numbers. Experimental groups were performed intervention include Family psychological group training during six 90-120 minutes sessions, Weekly one day. Patient filled Conner and Davidson questionnaire (CD-RISC) before and 8 week after intervention. SPSS statistical software SPSS19 data using chi-square, Fisher's exact test, and independent t-test and paired T was performed. Results showed that no different between two groups of intervention and control about demographic characteristics. The mean resiliency Score was 38.8±9.92 in intervention group, and 38.06±6.47 in the control group before intervention, which respectively reached to 44.76±7.41 and 38.52±7.10 after implementation of the intervention and this difference was Significant in intervention group (P≤0.001). According to the results we can say that Family psychological group training is effective in improving resiliency in families of schizophrenic patients. So it can be applied method of this study as a simple, non-invasive, low-cost and effective in improving resiliency in families of schizophrenic patients in nurses suggests.