نشریه سلامت اجتماعی
سال هفتم شماره 3 (تابستان 1399)

Crisis is a socio-psychological stress which breaks through the conventional notions of life and social reactions resulting in death, financial harms, threats, dangers and new needs. It can be managed based on careful observation and analysis of previous crises to reduce the negative consequences of the situation. The emergency management system includes three stages of:1- pre-occurrence measures as a prevention plan; 2- measures during occurrence as a countermeasure plan; and 3- post-occurrence measures as a recovery plan. Proper implementation of this system reduces deaths and financial/biological consequences while evolving a quick recovery of emergencies. After the crises, the main needs are transfer services as well as diagnosis and treatment, especially in hospitals. All hospital staff in general and hospital crisis staff in particular are highly responsible, especially in the early hours after the unwanted accidents. To play an effective and efficient role after the crisis, it is necessary to ensure the preparedness of the hospitals in terms of facilities, equipment, and staff. Due to the lack of sufficient resources in the provision of medical facilities, hospital managers generally pay the most attention to performing daily tasks. Hospital staff change over time making periodic maneuvers a necessity to become sure about their readiness to respond to accidents appropriately. Doing such maneuvers on preparedness for emergencies including fires, lifeguards, plane crashes, and boat sweating is a quite common strategy. As demand for medical services has always exceeded the capacity of hospitals and financial resources have become a constant limitation, implementation of the preparedness programs is often neglected. This editorial was written to especially draw the attention of the medical center managers and physicians involved in emergencies to the article entitled: " Plan Development and Experimental Implementation of It on Confronting with an Imaginary Chemical Attack in Loghman-Hakim Hospital in Tehran, Iran: Civil defense ”. It is expected to increase the sensitivity to the issue of preparedness for critical situations after unintended major accidents. Hospitals will not only improve staff readiness by conducting periodic maneuvers, but also will need to provide the necessary facilities and equipment.

Evidence from past wars of human history and the present century presents undeniable examples revealing the importance of civil defense. In Iran, there have been numerous attacks with a varietyof chemical gases during the eight years of the battle with Iraq. In addition, unintended accidents during earthquakes, hurricanes, and car accidents while transporting chemicals and chemical gases, although rare, are inevitable. For example, large-scale chlorine gas emissions have occurred. Because these events are rare, ED personnel are often not prepared enough to play an effective role in such situation, especially in the early golden hours after their happening. Due to lack of observation and repetition, preparedness of medical centers in terms of equipment and trained staff after the occurrence of attacks and accidents is a basic necessity. According to its inherent duties, Iranian civil defense organization is responsible for training and taking action to prepare hospital staff. This project, supported by this organization, aims to report how to confront with an accident or chemical attack in Loghman Hakim Hospital, a tertiary referral center for poisonings in Tehran, Iran, in 2019.

This project was performed as a maneuver with participation of 65 physicians, hospital personnel, and students at Loghman Hakim Hospital affiliated to Shahid Beheshti University of Medical Sciences. Initially, training workshops were held to raise theawareness and preparedness of the members of the crisis team and all active staff using existing texts and instructions. Then, a designed imaginary scenario was presented and acted as a maneuver on a non-holiday day between 9.30 AM and 4 PM.

Sixty-five physicians, hospital staff, and students attended the maneuver. The findings are reported in three levels of A: directorship and management level reaching almost 70% of its goals; B: operational level reaching about 70% of its goals, andC: termination of the maneuver and initiation of rehabilitation reaching almost 40% of its goals.

The maneuver was performed with almost 65% of the aims reached. Physicians and staff readiness was assessed to be moderate. Lack of equipment was undeniably obvious, especially in decontamination tools and protective clothing for employees. In general, our referral center of poisoning is not prepared enough to deal with any chemical accident or attack if it happens. More attention is needed to chemical accident/attack preparedness at least in all referral centers for clinical poisoning throughout the country.

Drug addiction is a chronic illness that can often be associated with another psychiatric illness, such as depression. The objective of this study was to compare the efficacy of existential group therapy and cognitive behavioral group therapy on depression among patients on Methadone Maintainance Therapy (MMT) in Qazvin Province.

The research method was quasi-experimental with pre-test, post-test, and control group. Participants included 90 male patients on MMT rehabilitation facilities of Qazvin in 2019, whowere purposefully selected and randomly divided into three groups: an experimental group under 10 weekly 120-minute existential group therapy, an experimental group under 10 weekly 120-minute cognitive-behavioral therapy, and a control group. All three groups completed Beck's Depression Questionnaire before the intervention, after the intervention and after 3 months. Data were analyzed using repeated measure test in SPSS software version 22.

In the group receiving cognitive-behavioral intervention, the mean (SD) score of depressionvaried from 44.5 (3.3) in the pre-test to 34.9 (3.1) in the post-test and 34.1 (3.5) in the follow-up, p<0.001. In the group receiving existential therapy intervention, the mean (SD) score of depression varied from 47.7 (3.2) in the pre-test, to 37.1 (5.5) in the post-test, and 35.9 (5.4) in the follow-up phase, p<0.001. In the control group, the mean (SD) score of depression did not vary significantly in pre-test, post-test and follow-up. The effect size of cognitive-behavioral therapy (Eta=0.53) was greater than the effect size of existential therapy (Eta=0.24) in reducing depression, which indicates a greater effictivenesss of cognitive-behavioral therapy compared to existential therapy in depression reduction.

It can be concluded that both cognitive-behavioral therapy and existential therapy are effective in reducing depression among patients under MMT, with cognitive-behavioral therapy being more effective in reducing depression than existential therapy.

Men’s views ongender equality, role and rights of men and women within the family may influence the tendency for violence against woman. The objective of this study was to determine the perception of men with a history of committing domestic violence on equality, role and rights of men and women in the family in Tehran.

This study was of qualitative design and participants were selected via convenience sampling method among those who were referred to family counselor in Tehran. Data were collectedusing semi-structured interview and demographic questionnaire in 11 interview sessions and then analyzed.

From participants’ point of view, sexual, mental and emotional needs of husband and children were the most important duties of wife and providing welfare, comfort and security of family besides meeting pecuniary, mental and sexual needs of wife are underlying duties of man. More than half of participants did not believe in gender equity and had no idea about woman rights in marital relationship. Most participants did not recognize any sort of legitimate of illegitimate sexual relationship outside the bonds of marriage for married men.

The results of this study indicated that more than half of male perpetrators did not believe in equal rights of man and woman in family and did not have enough information about the rights of woman.

Non-suicidal self-injury has become public health challenge in recent years. The prevalence of this phenomenon is higher among adolescents than other age groups. However, there are many ambiguities in conceptualizing non-suicidal self-injury. The objective of this study was to investigate the experiences of female high school students in Ardabil city who had committed non-suicidal self-injury.

This qualitative descriptive phenomenology study was conducted with participation of 17 female high school students in Ardabil city who were selected via targeted sampling method in 2018-2019. Data were collected via semi-structured interview sessions. Colaizzi’s seven-step analysis method was used for data analysis.

The findings of the study showed three main categories include predisposing factors of self-injury, function of self-injury, and consequences of self-injury. The main categories were subcategorized into cognitive emotional features, incompatible relations, teenage problems in the family, calming down, forgetting the problems, impressing others, proving greatness and strength, feelings of regret and scarring.

To better understand people involved with non-suicidal self-injury, it is essential to become more familiar with their experiences. From the participantspoint of view, this behavior has underlying causes, functions, purposes and also the implications that should be addressed for prevention programs as well as proper evaluation and treatment.

Children with coping disobedience are generally incompatible and have more insidious behaviors than peers. The objective of this study was to determine the effectiveness of interactive behavior analysis training on the control of anger and anxiety among mothers with non-oppressive children in Isfahan.

This study was of quasi-experimental design with pre-test, post-test, and two experimental and control groups. The statistical population of this study included all mothers of children with oppositional defiant disorder in Isfahan in 2017. The sampling method was multi-stage cluster sampling, among whom 60 mothers were randomly selected and divided into two groups of 30. Subsequently, the experimental group underwent eight weekly 90-minute group training sessions on interpersonal analysis, but the control group did not receive any interventions. Beck anger and anxiety inventory was used for data collection. The data wereanalyzed using single-variable covariance analysis and SPSS software version 22.

The mean (SD) anger score in the experimental group was 36.1 (1.7), which decreased to 27.9 (1.7) in the post-test (P<0.01), but the mean (SD) of the control group was 35.8 (6.3) in the pre-test, which reached 35.6 (0.6) in post-test, which was not statistically significant. The mean (SD) anger score in the experimental group was 25.5 (4.5) in the pre-test, which decreased to 18.1 (3.9) in the post-test (P<0.01), but the mean (SD) score of the experimental group in the pre-test was 26.8 (5.1), which was 25.2 (4.1) in the post-test, which was not statistically significant. The mean (SD) score of lack of anger control in the experimental group was 87.1 (8.3) in pre-test,which decreased to 69.6 (6.3) in post-test (P<0.01), but the mean (SD) score of the group in the pre-test was 87.5 (8.5), which was 87.9 (8.6) in post-test, which was not statistically significant. The mean (SD) anxoety score of the experimental group in the pre-test was 52.4 (4.6), which decreased to 34.5 (4.7) in the post-test (P<0.01), but the mean (SD) of the control group in the pre-test was 51.4 (6.5) which was 51.9 (6.6) in the post-test, which was not statistically significant.

The study showed that group interactive behavior analysis training led to reduction of anger, state of anger, lack of anger control and also anxiety reduction among mothers with non-oppressive children in Isfahan.

Divorce disrupts the psychological well-being of children, relatives and friends of the couple. The objective of this study was to investigate the effectiveness of premarital education based on Relationship Education Program on difficulties in spouse-selection decision and attitudes toward marriage of children of divorce among the staff of the Ministry of Defense.

This research was of expanded quasi-experimental design with pretest-posttest and follow-up with control group. The statistical population of this study was all divorced children who were referred to a counseling center in Tehran, among whom 60 were selected using convenience sampling method and were randomly divided into two groups of 30. Premarital education was conducted based on the communication training program for the experimental group. Before the intervention and the final session, pre-test and post-test were taken and follow-up was performed 45 days after the post-test. The data were analyzed using the decision-making scales for choosing a spouse and the attitude toward marriage and analyzed using one-way covariance analysis via SPSS software version 22.

The mean (SD) decision-making problem score in choosing the spouse of the experimental group decreased from 231.2 (10.6) in the pre-test to 163.4 (10.1) in the post-test and 163.9 (15.8) in follow-up (P<0.001), but the mean (SD) of the control group did not differ in pre-test, post-test and follow-up. The mean (SD) score of the attitudes toward the marriage of the experimental group increased from 51.6 (4.9) in the pre-test to 82.4 (3.9) in the post-test and 83.1 (2.4) in follow-up (P<0.001), but the mean (SD) score of the control group did not differ in pre-test, post-test and follow-up.

The study showed that the relationship education program led to a reduction in decision-making problems in choosing a spouse and an increase in the positive attitudes toward marriage among children of divorce.

Attitudes towards marital infidelity and unfaithfulness could be considered among the most complex and painful emotional problems among couples. The objective of this study was to compare of personality characteristics and sexual satisfaction among couples with marital infidelity and normal couples.

This study was of descriptive design with a causal-comparative method. The statistical population of the study included all couples who had come to a counseling clinic in District 3 of Tehran from May to November 2018 due to marital infidelity. Convenience sampling method was used and 120 participants, 30 couples, were selected: 30 couples with a history of marital infidelity and 30 couples in the control group. Data were collected using Neo Five personality traits and sexual satisfaction questionnaire. Data were analyzed using multivariate analysis of variance via SPSS software version 22.

The mean (SD) score of marital satisfaction in the group with a history of marital infidelity was 56.9 (10.5) which was lower than the control group: (14.4) 72.8, P<0.001. In the groupwith a history of marital infidelity, the scores of components of personality traits including neurosis 37.1 (4.6), extraversion 36.7 (4.3), openness to experience 39.3 (4.1) were higher than neurosis 32.7 (4.6), extraversion 33.7 (4.3), and openness to experience 35.1 (4.1) in the control group, P<0.001. The components of consensus 36.6 (5.1) and conscientiousness 37.6 (5.7) 37.6 in the normal group were higher than consensus 32.1 (5.1) and conscientiousness 33.6 (6.3) in the group with history of maritalinfidelity, P<0.001.

The study showed that sexual satisfaction was lower among couples who had a history of marital infidelity, while prevalence of personality traits including neurosis, extraversion and openness to experience was higher than normal couples

Female prisoners are a vulnerable group who are negatively affected by the imprisonment in various ways. Reality therapy is a major treatment approach, whose effectiveness has been proven in solving many problems. The purpose of this study was to determine the effectiveness of reality therapy on the consistent strategies for cognitive management of female prisoners.

This semi-experimental study was of pretest-posttest design with control group. Participants included 30 female prisoners in Rasht in 2017, who were selected via convenience sampling method and were randomly assigned to two experimental and control groups. Both groups completed emotional cognitive regulation questionnaire before the intervention. The experimental group received vertigo intervention in eight 90-minute sessions, but the control group received no intervention. Data were analyzed using descriptive statistics and multivariate analysis of covariance analysis by SPSS software version 18.

Among components of cognitive emotion regulation, the mean (SD) score of underplay was 6.0 (1.5) in the pre-test and 13.9 (2.0) in post-test, P<0.01;re-evaluation was 5.6 (1.6) in pre-test and 14.8(1.8) in the post test, p<0.01; re-scheduling was 5.6 (1.5) in pre-test and 14.8 (1.9) in post-test, P<0.01; and focus was 5.6 (1.4) in pre-test and 15.2 (1.5) in post-test, P<0.01. The test scores in the control group did not differ in pre-test and post-test.

The study showed that reality therapy could improve components ofadaptive cognitive emotion regulation strategies including underplay, re-evaluation, re-scheduling, and focus amon female prisoners.

Children as a vulnerable age group are subject to a variety of psychological and behavioral problems requiring psychological intervention. The purpose of this study was to determine the effectiveness of anger management training on the educational problems among 10-12-year-old students.

The present study was of quasi-experimental design with pre-test/post-test and a control group. The statistical population of the study included 10-12 year-old elementary school students in the city of Gonbad-e-Kavus in the academic year 2017-2018. A multi-stage randomized sampling method was used in which 60 students were randomly assigned into two groups of 30, experimental and control group. The experimental group participated in eight anger management sessions, while the control group did not receive any training at that time. Behavioral questionnaire (teacher form) was used for data collection. The results of this study were analyzed using one-way ANOVA via SPSS software version 20.

The mean (SD) age in the experimental group was 10.1 (1.4) for male students and 10.7 (1.2) female students. The mean (SD) age in the control group was 10.7 (1.6) for male students and 10.2 (1.5) for female students. The mean (SD) score of behavioral problems in the experimental group was 10.1 (12.8) in the pre-test, which decreased to 5.6 (6.1) in the post-test (P <0.01); however, the mean (SD) score of behavioral problems in the control group was 10.7 (13.1) in pre-test and varied to 10.6 (12.9) in the post-test, which was not statistically significant (P>0.05).

The study showed that anger management training led to reduction of students' behavioral problems

A healthy lifestyle consisting of physical activity, stress management, healthy diet, and avoiding smoking and alcohol, has a significant impact on mental health. However, these components and their impact may vary among men and women. The aim of this study was to determine the ability of healthy lifestyle components in predicting women’s and men’s mental health.

The present study is descriptive-analytical. The statistical population included all 20 to 60-year-olds living in Kerman in 1398, 600 of whom, including 300 women and 300 men, were selected based on the sampling method of quotas from four regions of Kerman. The research data were collected through a global health scale of 12 questions and a healthy lifestyle questionnaire and analyzed with SPSS-23 statistical software and t-test and linear and multiple regression.

The mean (SD) age was 39 (9.6) among women and 40.5 (10.1) among men. The mean (SD) of women’s healthy lifestyle score was significantly higher than men: 55.7 (6.6) vs. 17.6 (7.9), P<0.001. The mean (SD) score of women’s stress management was 12.6 (3.7) significantly higher than men’s 11.7 (4.2), P<0.001. The rate of avoidance of tobacco and alcohol consumption among women was significantly higher than men: 19.4 (1.3) vs. 11.11 (4.2), P<0.001. The mean (SD) score of physical activity among women was significantly lower than men: 7.6 (3.0) vs. 8.2 (2.7), P<0.001. The mean (SD) score of healthy diet among women was significantly higher than men: 16.1 (2.8) vs. 15.3 (2.2), P<0.001. Predictive components for health Women’s Psychiatry Stress Management was 0.42 units, exercise and physical activity were 0.18 units, smoking cessation and alcohol consumption were 0.12 units, and the predictive components for men’s mental health were stress management 0.30 units and a healthy diet 0.16 were units.

The study found that stress management, smoking cessation, and a healthy diet were better among women. However, they had lower physical activity than men. Women’s mental health was positively associated with increased stress management, more exercise, less smoking, alcohol, and employment. Men’s mental health positively associated with increasing stress management and diet improvement. Among the components of a healthy lifestyle, stress management was the most effective predictor of mental health in both sexes.

Hypertension is one of the major causes for morbidity and mortality in Iran and the world. This study is a brief report of the blood pressure measurements during the National Hypertension Campaign in Iran in 2019 at Tehran Heart Center.

In this cross-sectional study, performed during the national Blood pressure screening campaign between 5 June and 5 July 2019, data of all the participants who referred to the blood pressure station at Tehran Heart Center were gathered and analyzed. Finally, the frequencies of various types of hypertension based on the current hypertension guideline of the American Heart Association were reported.

In this study, the blood pressure of 3031 individuals wasmeasured. 54.7% of participans was womenandthe mean (SD) agewas 52.3(13.8)years. The frequency of hypertension of any type, considering the normal upper limit of 130/80 mmHg was 42.7%. Overall, 47 (1.5%) patients had a blood pressure above 170 mmHg who were referred to the emergency department for treatment.

The studyshowedthe high prevalence of hypertension in our society and therefore we suggest developing preventive and screening programmes to reduce the burden of hypertension.