نشریه پژوهش توانبخشی در پرستاری
سال ششم شماره 2 (پیاپی 22، زمستان 1398)

Cardiac rehabilitation programs refer to interventions aimed at stopping the recurrence of coronary artery disease in patients. The purpose of this study was to determine the effect of rehabilitation-education program on risk factors in patients with coronary artery disease.

In this clinical trial study 70 CAD patients who were admitted to coronary care units of Ali-Ebne Abitaleb Hospital, Zahedan were selected using convenience sampling according to the inclusion criteria. Then, they were randomly allocated to the intervention and control groups by using coin flipping. The intervention consisted of a twelve-week training and exercise program. The exercise program included walking sessions at home at least three times a week. Data were collected through using a demographic questionnaire, measuring blood pressure, fasting blood sugar, low-density lipoprotein and high- density lipoprotein. Data were analyzed in SPSS version 21 using independent t-test, paired t-test, and Chi-square test.

The results showed the significant difference between the two groups after the intervention in terms of risk factors. High- density lipoprotein increased and other risk factors such as systolic and diastolic blood pressure, fasting blood sugar and low-density lipoprotein decreased after the intervention.

The cardiac rehabilitation program reduced the systolic and diastolic blood pressure, fasting blood glucose and low density lipoprotein in the intervention group. On the other hand, it increased high density lipoprotein. Therefore, the adjustment of risk factors is evident in patients who received a cardiac rehabilitation program. It is recommended that healthcare providers deploy such interventions and rehabilitation programs which adjust the risk factors, alleviate disease complications, and reduce individual and social costs associated with cardiovascular diseases.

The family is the first and most important social system. It is the first place where each person’s sexual identity is based on which the individual accepts self as a man or a woman in family. The mother is the main core of the family and the first person to whom the communication with her child, and effects of their children issues. Due to key role of the mother and her interaction with the transsexual’s child, she faces numerous psychological challenges. Therefore, the present study was conducted to investigate the psychological challenges in mothers with transsexual’s child.

The method of research was a qualitative type based on phenomenological descriptive study. The information of study gathering by a deep and semi-structured interview type. The participants of this study consisted of all mother with transsexual’s child in some city in Iran by 2018.17 of them were selected purposefully for this interview the sampling by target and was based on snowball. Analysis of interviews was done through content analysis using a seven-step Colaizzi’s method.

The results of the research showed that the psychological challenges of the participating five main contents, including: negative and painful reactions of mothers, mother’s concerns about his child future’s, negative and biased reactions of family members and relatives, social stigma, lack of government and professional Advocacy.

According to the results, the lack of awareness of the issue of transsexual has led to reactions such as fear, shame, and confusion in these mothers. The awareness of cusecs’ and the effects of the mental and physical problems could be helping the mental health professionals and the health system to dealing with this issue.

Exercise training along with the use of herbs is the most effective methods for improving liver function in obese people. The purpose of this study was to investigate the effect of 8 weeks of circuit resistance elastic band training with green coffee supplement on fatty liver function indices (fatty liver index (FLI) and lipid accumulation product (LAP) in middle-aged obese women.

In this randomized clinical trial, 60 obese women (33.58±2.96) and middle aged (42.99 ± 3.08) were selected as subjects and randomly divided into four supplement (15), exercise + supplement (15), exercise+placebo (15) and placebo (15) groups. The training groups received 8 weeks of circuit resistance elastic band training at 3 sessions per week and 60 minutes each session. Also, supplement groups received a daily 400 mg capsule of green coffee extract. Blood samples were taken 24 hours before the first session and 48 hours after the last training session after 12 hours. The t-test was used to compare the intra-group and the two-way ANOVA and post-hoc bonferroni test were used for comparison between groups.

There was a significant difference between the groups after 8 weeks of intervention in the FLI index (P = 0.025) and the non-significant difference in LAP (P=0.288) between the 4 groups. The results of the bonferroni post-hoc test for FLI showed a significant reduction in this indicator in the exercise + placebo group compared to placebo group (P = 0.008).

The results of the present study show that green coffee does not have a possible potential to improve liver function indices. In general, improvement in liver function indices in obese women may require longer periods of resistance training and supplementation of green coffee.

Diabetes is one of the major health issues. This disease is one of the most chronic diseases and threatening the community. The aim of this study was to compare the strategies of cognitive emotion regulation, behavioral brain systems and quality of life in people with diabetes.

The present study was a post-event (comparative study). the statistical population consisted of two groups of diabetic patients referring to a specialized clinic in Tehran and normal people in 1397. The sample of patients (40 diabetes patients) were matched with 40 normal subjects on gender, education, and marital status using the placement method. The research instruments included cognitive emotion regulation, quality of life and inhibition / behavioral activation systems. Data were analyzed by multivariate analysis of variance analysis.

The results showed that between two groups in adaptive emotional cognitive (P <0.001), maladaptive cognitive-emotional regulation strategies (P <0.001), quality of life (P <0.001), and Brain-behavioral systems (P <0.001) difference is significant.

Using some of the negative and improper strategies of emotional cognitive regulation, such as rumination and catastrophic thinking, as well as the large activity of the inhibition system that triggers emotional state of anxiety and experiences of negative emotions and low quality of life It can reduce the psychological health of people with diabetes. So, to improve the psychological well-being of diabetic patients, you can use excitement training, awareness of behavioral brain behavior and quality of life.

Population aging and advancing longevity is one of the achievements of the present century. Life satisfaction is considered as a typical sign of a successful adaptation to changes in various life situations, among these factors are forgiveness and endurance distress. The purpose of this study was the role of forgiveness and endurance distress on life satisfaction in elderly people in Qazvin.

The research method was descriptive correlational. The statistical population consisted of 150 elderly people living in nursing homes of Qazvin who were selected by simple random sampling and 108 items using Morgan table. Data were analyzed by using Simons & Gaher Distress Tolerance Questionnaire (2005), Forgive Thompson et al. (2005) and Life satisfaction (1985) using SPSS software version 22 and Pearson correlation coefficient and multiple regression analysis.

The results showed that correlation coefficient between distress tolerance and life satisfaction (r = 0.680, P <0.001) and forgiveness with life satisfaction (r = 0.616, P <0.001) were significant. Also, components of tolerance of distress 46/46 are positive and predictors of forgiveness of 1/38 positively predict life satisfaction (P <0.001).

The results of the research show the importance of forgiveness and tolerance of distress on the life satisfaction of the elderly. It is suggested that treatment modalities for the treatment of forgiveness and tolerance of distress should be considered in order to improve the life satisfaction of the elderly.

Most of the functional disorders in the foot are created by changes in the arch of the foot. The motion control shoes are designed to control the excessive rear foot motions. The aim of this study was to evaluate the effect of long-term use of motion control shoe on the ground reaction force components in individuals with functional pronated feet during running.

The present study was a semi-experimental and laboratory type. The statistical society of the present study includes runners with pronated feet in Ardabil city. The available sampling sample was used in the present study. 30 male runners with pronated feet were randomized into experimental and control groups. The Bertec Force plate was used to record ground reaction forces. Control group used control shoes (Supernova control, Adidas) and experimental group used the motion control shoes (Supernovacushion, Adidas) during 5 months in their training sessions. Two-way ANOVA with a significance level of P>0.05 was used for statistical analysis.

The findings of the experimental group demonstrated significant increase in peak medio-lateral ground reaction force during push off phase (P=0.022; d=0.86) and the time to peak of vertical ground reaction force during heel contact phase (P = 0.013; d=1.05) in post-test compared with pre-test. Also, the vertical loading rate showed a significant reduction in post-test than that in the pre-test (P=0.109; d=0.43). Other ground reaction force components in three directions, their time to peak, center of presser and the free moment showed no significant difference during the post-test compared to the pre-test (P>0.05).

Because of reduction in loading rate after long term use of motion control shoe, it could be said that this shoe is beneficial in reduction of lower limb injury risk factors such as stress fracture.

The present study aimed to investigate brain-behavioral systems, early maladaptive schemas and premenstrual syndrome as predictors of postpartum blues.

The present study was a descriptive correlational research. Study population included all referred females who diagnosed as mothers with postpartum depression in health centers of Mashahd city during 2018. A total sample of 200 mothers with postpartum depression selected with Multi-stage cluster sampling method. The participants completed brain behavioral systems scale, early maladaptive schema scale, Edinburgh postpartum depression scale, and premenstrual syndrome scale. Collected data were analyzed by a stepwise regression model.

The results showed that inhibition and activation behavioral systems, premenstrual syndrome, impaired autonomy and performance schemas and impaired limits schemas were all related to postpartum blues. The behavioral inhibition system, impaired autonomy and performance schemas, impaired limits schemas and premenstrual syndrome positively predicted postpartum blues and the behavioral activation system negatively predicted postpartum blues.

Postpartum depression disorder in mothers were related in terms of brain behavioral systems, early maladaptive schema and premenstrual syndrome. Hence evaluation, diagnostic and therapeutic consideration based on these correlations for postpartum depression disorder seems necessary.

Today breast cancer is as a one of the most important diseases, the most common cancer and the second cause of death among women, and breast evacuation is a one of the its primary treatment methods. As a result, present research aimed to determine the effect of hope therapy on sleep quality, subjective well-being and health hardiness among cancer patients with breast evacuation.

Present study was a quasi-experimental with a pre-test and post-test design with an experimental and control groups. The research population was cancer patients with complete breast evacuation referred to the health and care centers of Zahedan city in 2018 year. The sample research was 38 women which selected by available sampling method and randomly with using lottery assigned into two equal groups. The experimental group trained eight 90-minutes session by hope therapy and the control group doesn’t received training. The research instruments were the Pittsburgh sleep quality index, subjective well-being questionnaire and revised health hardiness inventory. Data were analyzed by multivariate analysis of covariance method with using SPSS-23 software.

The findings showed that there was a significant difference between the experimental and control groups in terms of sleep quality, subjective well-being and health hardiness. In the other words, hope therapy led to increase desirable sleep quality, subjective well-being and health hardiness among cancer patients with breast evacuation (P<0/01).

The findings indicated the effect of hope therapy on promoting the desirable sleep quality, subjective well-being and health hardiness among cancer patients with breast evacuation. Therefore, it is suggested that counselors, clinical psychologists and therapists used from hope therapy method to psychological interventions, especially for improve the sleep quality, subjective well-being and health hardiness.

Stress urinary incontinence (SUI) is a common health problem in women which is not revealed to the family most of the times. One of the ways for promoting the health level is taking into account the individuals’ level of self-care behaviors which was examined in this study. SO in this study, the impact of family-centered empowerment model on quality of life in women with stress urinary incontinence is discussed.

This study is a randomised clinical trial. Sampling was done through convenience sampling method, the subjects (N=64) were divided into intervention and control groups, using the blocked random method. For the intervention group, the interventions based on family-centered empowerment model which included four stages (perception of threat, problem solving, educational participation and evaluation) were performed using group discussion, representation, and training participation. Research tools included questionnaires of demographic and disease information, and researcher-made questionnaire of self-care behaviors for women with urinary incontinence.

The total score of self-care behaviors after intervention was 55.90 in the intervention group and 42.75 in the control group. The independent t-test showed a significant difference after intervention between the two groups (P = 0.001).

The results of the study indicated that the intervention based on the family-centered empowerment model has been effective in the promotion of the self-care behaviors of the women suffering from the stress urinary incontinence. Therefore, it is suggested that the health team uses this model as an appropriate solution so as to support the non-hospitalized women living in the society and enhance their adjustment with the available conditions.

Spinal cord injury is one of the problems of human societies, which causes many physical and emotional problems for a person and will have consequences for personal, family and social problems. The purpose of this study was to investigate the phenomenological factors affecting post-traumatic growth in patients with spinal cord injury.

The qualitative research project was based on the phenomenological approach. The statistical population of the study included people with spinal cord injury in Isfahan in 2018. Among them, 16 individuals were selected based on the criteria for entering and leaving the research, semi-structured interviews, and data saturation. Then, the interviews were analyzed using a colaizzi method.

As a result of the main themes, their sub-themes and semantic units supporting the theme in five main themes and 25 sub-themes include the underlying factors (severity and nature of injury, cause of injury, marital status and education), positive psychological characteristics (internal motivation, optimism and hope for recovery, personality abilities and acceptance of injury), social factors (participation in support groups for spinal cord injury, job creation, financial emotional support of family and others), medical care and Psychosocial education (work therapy and physiotherapy, rehabilitation of doing personal tasks, learning job  skills, received individual and group psychological education) and spirituality (Helping people with similar problems, meaning, Belief in God's wisdom, Cultural beliefs and values). Each of the above themes has several semantic units supporting.

The discovered topics with the phenomenological method, based on the experience of living, provide new information on the factors affecting post-traumatic growth after spinal cord injury, which requires the elaboration of the life experiences of these individuals by caregivers, psychologists and experts.

Psychological problems of chronic patients, especially M.S, that often are ignored, need special attention to proper treatment. The aim of this study was to determine the effectiveness of cognitive therapy based on mind-awareness on depression and emotional adjustment strategies in patients with M.S.

The research was semi-experimental with a pre-posttest and control group. The statistical population included all male and female patients with M.S who referred to Emamreza Dental Hospital in Kermanshah in 2016. A sample of 40 people was selected and randomly assigned into two groups of experimental and control. The research instruments included anxiety-depression questionnaire and cognitive-emotional regulation questionnaire. Data were analyzed using SPSS-22 and descriptive statistics and multivariate analysis of covariance (MANCOVA).

The results of this study showed that cognitive therapy based on mind-awareness could reduce the mean depression scores of the experimental group compared to the control group (Eta = 0.698, P = 0.002, F = 24.47). Also, the results showed that Mindfulness-Based Cognitive Therapy significantly decreased the mean scores of maladaptive strategies of self-blame (P = 0.001, F = 13.43), others-blame (P = 0.004, F = 17.31), catastrophizing (P = 0.005, F = 14.13), and rumination (P = 0.012, F = 11.10), as well as an increase in the average scores of adaptive strategies of acceptance (P = 0.001, F= 14.00), positive refocusing (P = 0.012, F = 11.10), refocus on planning (P = 0.001, F = 12.97), positive reappraisal (P = 0.008, F = 13.88), and putting into perspective (P = 0.002, F = 16.58) in the experimental group is associated with the control group (P < 0.05).

The results of this study suggested that using counseling centers, health clinics, and M.S. associations throughout the country to increase the emotion regulation and reduce depression of patients with multiple sclerosis using mindfulness-based cognitive therapy.

Providing patient safety is considered as one of the most important goals of the health sector, and health organizations have placed it as one of the main focus on improving the quality of services provided to patients. This study aimed to determine if the effect of inter-professional communication skills training on patient safety culture among Emergency department staff in Bahman hospital of Tehran in 2018.

This study is a Semi-experimental study that in that Pretest-posttest plan with a control group was used. All of the Emergency Department staff of Bahman hospital in the second six months of 2018 was our statistical research community. 50 personnel 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. The intervention group received three sessions of one and a half hours by lecture and question and answer methodology, along with providing a booklet on inter-professional communication with the SBAR model. Samples filled the standard patient safety culture questionnaire before and after the intervention. SPSS statistical software SPSS19 data using chi-square, Fisher's exact test, and independent t-test and paired T was performed.

Results showed no difference between two groups of intervention and control about demographic characteristics (P > 0.05). The mean patient safety culture Score was 102.96 ± 9.27 in the intervention group, and 105.52 ± 6.35 in the control group before the intervention, which respectively reached to 115.44 ± 9.19 and 107.12 ± 6.78 after implementation of the intervention and this difference was significant in intervention group (P < 0.001).

According to the results, we can say that interprofessional communication skills training is effective in improving patient safety culture among Emergency department staff. So it can be an applied method of this study as a pure, non-invasive, low-cost, and effective in improving r patient safety culture in Emergency department staff.

Cancer is considered as a chronic disease in human society, suffering from which is a horrific diagnosis leading to death anxiety among the patients. The study was conducted to determine the effectiveness of logotherapy on death anxiety in cancer patients at 5 Azar Hospital of Gorgan.

The study was experimental with a simple random sampling method where the population was all cancer patients admitted to 5 Azar Hospital. Forty subjects were selected from this population using convenience sampling and randomly assigned to experimental (20 subjects) and control (20 subjects) groups. In group experimental, logotherapy training, eight sessions of 60-90 minutes were performed in 4 groups of 5. Data collection tools were Templer's Death Anxiety Scale (DAS), where the data were analyzed in SPSS16 after collection using descriptive statistics (Tables, mean and standard deviation) and inferential statistics (paired t and independent t-tests).

Paired t-test before and after the intervention did not show a significant difference in the control group (P = 0.67), but this test in the experimental group showed a significant difference before and after the intervention (P < 0.01). Also, the ANCOVA test showed a significant difference between the two groups (Eta = 0.27 P < 0.01).

Given the impact of logotherapy on reducing death anxiety in cancer patients, it is recommended that relevant authorities try to change the perspective of cancer patients on life and meaning in life through counseling and psychotherapy sessions.

Cancer as one of the most common illnesses in the world is associated with mental, physical, social, and financial problems, which affects not only the patients but also the family caregivers and creates a Burden of care. Few studies have investigated relationship spiritual well-being and Burden of care in family caregivers of cancer patients.

This cross-sectional correlational study was conducted on 130 caregivers of cancer patients referred to Tohid hospital of Sanandaj in 2018 using the convenience sampling method. Demographic form, the spirituality well-being, and the caregiver burden inventory questionnaires were used to collect the data. Data were analyzed using the SPSS-21 software, descriptive statistics, Pearson and Spearman correlation coefficients, independent T-test, and ANOVA at a significance level of 0.05.

The results showed that the mean and standard deviation of the spiritual well-being score and Burden of care was 72.70 ± 8.51and 58.097 ± 10.42, respectively. There was a significant relationship between mental well-being (and its components, including spiritual prosperity and existential well-being) and Burden of care (r = - 0.377, P = 0.01).

Family caregivers experience the Burden of care during caring for cancer patients, which is related to their spiritual well-being. Therefore, paying attention to the mental well-being of these caregivers is emphasized.

One of the most critical issues in occupational health is nurses' work fatigue, and one of the factors associated with it is conflict management strategy styles. Therefore present research aimed to investigate the relationship of conflict management strategy styles with work fatigue in nurses.

This study was cross-sectional from the type of correlation. The research population was nurses of a selected hospital in Tehran city in the 2018 year with 500 people. Based on Morgan's table, 218 persons were chosen as a sample using a simple random sampling method. The research tools were the research-made questionnaires of conflict management strategy styles and work fatigue. Data in SPSS version of 21were analyzed with methods of Pearson correlation coefficients and multiple regression with entering the model.

The findings showed that there was a positive and significant relationship between conflict management styles of competition and compromise with nurses' job fatigue (P < 0.05). Also, no significant relationship between conflict management styles of cooperative, accommodation, and avoidance with their job fatigue recorded (P > 0.05). Furthermore, conflict management strategy styles significantly could explain 7.4 percent of variance of nurses' job fatigue (P < 0.01).

The results indicated the relationship between conflict management strategy styles of competition and compromise with nurses' work fatigue. As a result, to reduce their work fatigue can be reduced the rate of competition and commitment in nurses through training sessions.

Chronic kidney failure causes many limitations for patients. Despite the effectiveness of hemodialysis, this method causes mental problems and frustration in patients. The purpose of this study was to evaluate the mental health and hope status of dialysis patients referred to teaching hospitals of Isfahan University of Medical Sciences in 2017.

This is a descriptive cross-sectional study conducted at Nour and Hazrat Ali Asghar, al-Zahra, Amin, and Farabi hospitals. One hundred thirty-five dialysis patients were selected based on inclusion criteria. Demographic, mental health (SCL 90-R), and Snyder Hope Scale (SHS) questionnaires were used. Data analysis was performed using SPSS-v22 software.

The mean of mental health was 162.35, and the mean of hopefulness was 39.04. Based on the results of one-way ANOVA and Tukey's post hoc test, the mental health status of patients who undergo dialysis 1 times a week and those who had less history of dialysis were significantly better than others (P < 0.05). Also, the mean hope of single patients was significantly higher than other patients (P < 0.05).

The findings of the study indicate an unacceptable level of mental health and hope among hemodialysis patients. The importance of these components in terms of quality of life and the degree of compliance of patients with the therapeutic orders makes it necessary to design and implement effective interventions in this regard.

Obsessive-compulsive disorder is one type of anxiety disorder, which patients often have guilt feelings and obsessive-compulsive disorder. Acceptance and commitment therapy method is one effective method in improving anxiety disorders. Therefore this research aimed to investigate the effectiveness of acceptance and commitment therapy on symptoms of obsessive-compulsive disorder and guilt feeling in patients with obsessive-compulsive disorder.

The design of the present study was semi-experimental from the type of pre-test, post-test, and follow-up with a control group. The research population was including all patients with obsessive-compulsive disorder referred to Sina psychiatric services clinic of Dezful city in the 2018 year. The research sample was 30 patients who were selected by purposeful sampling method and randomly replaced into two equal groups. The experimental group treated with acceptance and commitment for eight sessions of 60-minute by therapy, and the control group received no training. The research tools were the Padua obsessive-compulsive disorder and guilt feeling questionnaire. Data were analyzed by the repeated-measures method in SPSS-21 software.

Based on the findings of present research there was no significant difference between the experimental and control groups in the pre-test stage in terms of symptoms of obsessive-compulsive disorder and guilt feeling (P > 0.05), but there was a significant difference in the post-test and follow-up stages in terms of both variables (P < 0.001). In other words, acceptance and commitment therapy method in the post-test step led to decrease symptoms of obsessive-compulsive disorder, and guilt feeling in patients with obsessive-compulsive disorder and treatment results were maintained in the follow-up stage (P < 0.001).

The results of this study showed that acceptance and commitment therapy method is effective in reducing symptoms of obsessive-compulsive disorder and guilt feelings. Based on these results, it is recommended that in health improvement interventions along with other therapies used from acceptance and commitment therapy for reducing symptoms of obsessive-compulsive disorder and guilt feelings.

Nurses employed in military hospitals are exposed to the stresses of the military environment and high levels of job burnout. The model of follow-up care is a way to reduce job burnout. The purpose of this study has performed the effectiveness of the Continuing Education Program on job burnout of nurses.

This quasi-experimental study was performed on 94 nurses working in the selected Military hospital of Tehran. Initially, the Validated Goldard questionnaire was filled by nurses, and then 70 nurses with inclusion criteria were randomly divided into case and control groups. A two-hour group session was held on strategies for reducing job burnout and presenting educational booklets to the case group. The short message service (SMS) was sent to the experimental group three times each week for three months. Finally, both groups completed the burnout questionnaire. The data were analyzed using inferential and descriptive statistics with the help of SPSS-17.

Findings showed that there was no significant difference in a burnout before intervention between the case and control groups. Also, there was no significant difference between the two groups before and after the intervention. There was a significant difference in burnout in the case group before and after the intervention (P=0.001).

Based on the results of using continuous training programs by telephone, the internet and SMS to reduce burnout of nurses is recommended. These treatment recommendations should be brief, useful, and applicable.