فهرست مطالب

Jundishapur Journal of Chronic Disease Care - Volume:11 Issue: 1, Jan 2022

Jundishapur Journal of Chronic Disease Care
Volume:11 Issue: 1, Jan 2022

  • تاریخ انتشار: 1400/11/12
  • تعداد عناوین: 10
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  • Farzin Bagheri Sheykhangafshe*, Hojjatollah Farahani, Parviz Azadfallah Page 1
    Context

    Fibromyalgia is a debilitating syndrome characterized by scattered and multifaceted musculoskeletal pain, the presence of multiple and unstable points sensitive to pain, sleep disturbance, fatigue, and muscle inflexibility, which were damaged during mental health by the COVID-19 pandemic. In this regard, the present review study was conducted to investigate the psychological consequences of the COVID-19 pandemic in patients with fibromyalgia.

    Data Sources

    In this review study, published articles on the psychological consequences of the COVID-19 pandemic in fibromyalgia patients in 2020 (February) and 2021 (July) were reviewed. To access relevant scientific documents, the keywords COVID-19, Chronic Pain, Fibromyalgia, Mental Health, Chronic Illness, and Psychological Anxiety in the titles and abstracts of articles published in reputable international scientific databases, such as Google Scholar, PubMed, Science Direct, Scopus, EMBASE, and PsycINFO, were searched and all related English-language articles were listed.

    Results

    The studies showed that patients with fibromyalgia had high levels of depression, anxiety, stress, and fear during the COVID19 pandemic. Variables such as age, gender, low level of education, sleep quality, marital status, financial status, and loneliness were associated with psychological distress and the exacerbation of symptoms in fibromyalgia patients. In contrast, social support and the use of effective coping strategies led to improved quality of life and mental health of patients.

    Conclusions

    According to the results of studies, patients with chronic pain, including fibromyalgia patients during the COVID-19 pandemic, experienced problems in mental health, quality of life, social relationships, and sleep quality, which caused recurrence of the disease and increased anxiety and depression in them.

    Keywords: COVID-19, Psychological Consequences, Fibromyalgia, Systematic Review Study
  • Maryam Chamani, Saeid Shahrabi, Ali Malmir, Fereshteh Hassanzadeh* Page 2
    Background

    Preeclampsia (PE) is a disease characterized by abnormalities in the placenta and endothelial cells. The pathogenesis is not fully understood; however, aspirin prescription can be effective to treat the disease and prevent fetal developmental disorders.

    Methods

    This study was performed as a clinical trial in Shahid Akbrabadi Hospital in Tehran city. Eighty patients participated in two groups (n = 40). The first group of patients received the dose of 80mg, and the second group received the dose of 160mg aspirin. Then, the fetal-maternal and treatment process complications were examined in the patients.

    Results

    The results showed that the incidence of fetal-maternal complications, including intrauterine growth restriction (IUGR) and intrauterine fetal death (IUFD) was lower in patients treated with 160 mg aspirin than in the other group, but this difference was not statistically significant (P-value > 0.05). Aspirin complications such as bleeding were more in the second group than in the first one (P-value < 0.05).

    Conclusions

    Although the increasing dose of aspirin reduces fetal-maternal complications in PE patients, the problems such as aspirin-induced bleeding should be considered.

    Keywords: Aspirin, Preeclampsia, Fetus, Mother, Complication
  • Ahmadreza Assareh, Bijan Helli, Hoda Mombeini, Marzie Zilaiee, Mahshad Shokuhi Nasab, Asad Khosravi* Page 3
    Background

    The awareness of the risk factors of atherosclerosis and attempts to correct and control them can effectively reduce the risk of complications.

    Objectives

    This study was performed to evaluate the risk factors for routine atherosclerosis in patients with symptoms of heart disease in the Arab race, compared to those of Lor patients.

    Methods

    This descriptive-analytical study was conducted on 200 patients with symptoms of heart disease. A food frequency questionnaire was used for data collection.

    Results

    Out of 200 patients, 101 (51.5%) and 99 (48.5%) participants were Lor and Arab, respectively. Significant differences were observed between the two races for cholesterol and fasting blood sugar levels (P < 0.05). Additionally, no significant difference was observed between different quarters of following dietary patterns and lipid-glucose factors (P > 0.05).

    Conclusions

    Risk factors for cardiovascular diseases, such as atherosclerosis, are multifactorial. Various factors can effectively affect the prevalence of this disease in each region, which necessitates the identification of risk factors to take steps to correct risk factors and improve the quality of patients’ life.

    Keywords: Atherosclerosis, Risk Factors, Dietary Patterns
  • Mehrnoosh Zakerkish*, Abolghasem Assarzadeh, Seyed Saeed Seyedian, Alireza Jahanshahi Page 4
    Objectives

    This study was designed to investigate the prevalence of metabolic syndrome in patients diagnosed with non-alcoholic fatty liver disease (NAFLD) referring to the gastrointestinal and endocrinology clinics of Golestan and Imam Khomeini Hospitals, Ahvaz.

    Methods

    The current cross-sectional study was performed on patients with NAFLD referring to the gastroenterology and endocrinology clinics of Golestan and Emam Khomeini hospitals, Ahvaz in the second half of 2020. Demographic information included age, gender, lumbar posture (while standing and the waist be in the upper edge of the iliac crest at the end of a normal exhalation using a non-elastic meter), grading fatty liver evidenced by ultrasound, and blood pressure and laboratory parameters, including triglyceride (TG), fasting blood sugar (FBS), and high-density lipoprotein (HDL) was recorded in the checklist. Data analysis was performed using SPSS 26.0 software.

    Results

    This study was performed on 130 patients with an average age of 46.22 ± 14.27 years. Patients comprised 42 men (32.8%) and 88 women (67.2/%). Also, 63.84% of the patients with NAFLD had metabolic syndrome, and 56.2, 69.6, and 81.8% with grades 1, 2, and 3 of fatty liver, respectively had metabolic syndrome. There was a significant difference in terms of mean height and weight in both gender. There was a significant relationship between age and FBS, so that the levels of FBS increased statistically significantly with age (P < 0.05). Gender had a statistically significant relationship with HDL and waist circumference (P = 0.038). There was no statistically significant relationship between blood pressure, TG, HDL, FBS, and waist circumference, and different grades of fatty liver (P > 0.05).

    Conclusions

    The current study showed a significant number of patients with NAFLD had metabolic syndrome, so that the most common symptom of metabolic syndrome was low HDL levels, followed by high FBS levels, blood pressure, and TG levels and waist circumference size. Nevertheless, it was not probable to assess whether NAFLD precedes the progress of metabolic syndrome.

    Keywords: Non-alcoholic Fatty Liver Disease, Metabolic Syndrome, Waist Circumference, Hyperglycemia
  • Azadeh Rezaei, Abdolali Shariati *, Shahram Molavynejad, Saeed Ghanbari Chah Anjiri Page 5
    Background

    One of the effective nursing measures for enhancing the quality of life (QOL) and adaptation of patients undergoing coronary artery bypass graft (CABG) is the use of Roy’s adaptation model (RAM).

    Objectives

    This study aimed to determine the effect of a training program based on Roy’s adaptation model on the adaptation of patients undergoing CABG.

    Methods

    This quasi-experimental study was performed on 60 patients admitted to the intensive care units (ICUs) of Imam Khomeini Hospital and Golestan Hospital in Ahvaz, southwest of Iran, in 2020. Patients were selected based on inclusion criteria and randomly assigned into intervention and control groups. A four-session training program based on RAM was held for the intervention group. Data were analyzed using SPSS ver. 22.

    Results

    The mean scores of physiological, self-concept, role function, and independence and interdependence dimensions in the experimental group before the intervention were 48.76 (6.36), 23.76 (4.10), 19.60 (2.93), and 25.60 (3.54), respectively. After the intervention, the mean scores in the mentioned dimensions were 101.26 (5.23), 50.80 (3.82), 39.10 (4.15), and 25.47 (3.99), respectively, indicating an upward trend (P < 0.05). Also, the mean score of total adaptation before the intervention was 117.73 (12.00), which rose to 216.63 (7.88) after the intervention (P < 0.05).

    Conclusions

    The results showed that RAM plays an important role in the adaptation of patients undergoing CABG surgery. Thus, this model can provide a suitable framework for examining and providing care for patients undergoing CABG in ICUs.

    Keywords: Roy’s Adaptation Model, Adaptation, CABG
  • Mina Karami, Zohreh Rafezi, Maryam Sadat Motavalli, Nader Ayadi* Page 6
    Background

    Pain is a pervasive and disabling barrier for the injured athlete threatening his/her ability to participate in sporting events and professional goals. However, psychological factors in the treatment process of chronic diseases are an important factor in involving the patient in treatment and making treatment decisions.

    Objectives

    This research aimed to investigate the relationship between emotion regulation and pain self-efficacy with psychosocial adjustment in athletes with chronic pain, considering the mediating role of mental fatigue.

    Methods

    The statistical population of this descriptive correlational study was all athletes with chronic pain referred to the Iranian Sports Medicine Federation. Using the convenience sampling method, a total of 200 injured athletes were selected as the sample size. For data collection, Psychosocial Adjustment to Illness Scale (PAIS), Pain Self-Efficacy Questionnaire (PSEQ), Pain Fatigue Scale (PFS), and Cognitive Emotion Regulation Questionnaire (CERQ-short) were used. Descriptive statistics, correlation matrix, and path analysis (structural model) were used to analyze data. Also, SPSS (v21) and AMOS (v23) software were used to analyze the data.

    Results

    According to the results, pain self-efficacy (β = 0.18), adaptive emotion regulation (β = 0.27), and mental fatigue (β = -0.19) had a direct positive and significant impact on psychosocial adjustment. Also, the direct effect of pain self-efficacy (β = -0.19), maladaptive emotion regulation (β = 0.17), and adaptive emotion regulation (β = -0.12) on mental fatigue was significant. In addition, the indirect effect of pain self-efficacy and maladaptive emotions on psychosocial adjustment via mental fatigue was significant.

    Conclusions

    Mental fatigue plays a good mediating role between pain self-efficacy and emotion regulation with psychosocial adjustment of athletes with chronic pain.

    Keywords: Emotion Regulation, Adaptation, Psychological, Mental Fatigue, Athletes, Chronic Pain
  • Fatemeh Ahmadi, Roohangiz Nashibi, Mehrak Tavakoli Garoosi, Davood Kashipazha*, Narges Keshtkar Page 7
    Background

    Neurological disorders such as the peripheral nervous system (PNS) involvement are common complications associated with human immunodeficiency virus (HIV) infection, occurring in both asymptomatic and symptomatic individuals.

    Objectives

    This study evaluates the frequency of different types of PNS involvement among HIV-seropositive patients.

    Methods

    In this analytical study, 59 HIV-seropositive patients visiting an HIV referral center in Ahvaz, Iran, between April 2018 and April 2019 were studied. Data regarding age, sex, history of neuropathy, education, time of diagnosis and treatment, history of tuberculosis (TB), drug history (ART and others), and history of smoking were documented. Also, data associated with other causes of peripheral neuropathy, such as diabetes mellitus (DM), chromium (Cr) level, and alcohol consumption, were recorded. The relationship between these variables and PNS was determined.

    Results

    Out of 59 patients, 30 and 29 patients were male and female, respectively, with a mean age of 37.88 years. Thirteen (13/59, 22%) patients had PNS involvement. Data analysis demonstrated no significant relationship between PNS involvement and gender (P-value = 0.8), height (P-value = 0.898), smoking (P-value = 0.312), education (P-value = 0.111), CD4 count (P-value = 0.073), viral load count (P-value = 0.57), and the mean duration of diagnosis (P-value = 0.913). The analysis also showed a significant relationship between age and the prevalence of PNS involvement (P-value < 0.05)

    Conclusions

    Peripheral neuropathy is relatively common in HIV-seropositive patients, the prevalence of which increases with advancing age. Older age significantly elevates the risk of neuropathy. There was no significant relationship between PNS involvement and gender, height, smoking, education CD4 count, viral load count, and the mean duration of diagnosis in the present study. Further studies with larger cohorts of patients are recommended.

    Keywords: Carpal Tunnel, HIV Seropositivity, Neurological Disorders, Peripheral Nervous System Diseases
  • Marjan Faramarzi, Javad Khalatbari *, Shohreh Ghorban Shiroudi, Khadijeh Abolmaali Page 8
    Background

    It is essential to understand and support hepatitis B patients to minimize their challenges and limitations and provide them with appropriate treatment. Therefore, it is essential to incorporate training and consulting programs to prepare for and identify various aspects of the disease.

    Objectives

    The present study aimed to investigate the effectiveness of mindfulness-integrated cognitive-behavioral group therapy (MiCBT) in the motivational structure of hepatitis B patients in Tehran, Iran.

    Methods

    This quasi-experimental study utilized a pretest-posttest design with a control group. The study sample consisted of 28 hepatitis B patients selected from all patients visiting specialist clinics in Tehran in 2020. Following the interviews and completion of the Personal Concerns Inventory, 14 patients were selected per group using simple random sampling and were randomly divided into intervention and control groups. A posttest was conducted after 12 sessions of MiCBT (one 90-min group session weekly for three months). Data were analyzed using the multivariate analysis of covariance in SPSS software.

    Results

    The results revealed a significant increase in adaptive motivational structure (P < 0.001) and a significant decrease in maladaptive motivational structure (P = 0.012) in hepatitis B patients following the therapeutic intervention.

    Conclusions

    The study indicated the MiCBT effectiveness in increasing adaptive motivational structure and decreasing maladaptive motivational structure in hepatitis B patients. As a therapeutic approach, MiCBT can make the motivational structure of hepatitis B patients more adaptive.

    Keywords: Cognitive-Behavioral Therapy, Mindfulness, Motivation, Hepatitis B
  • Fatemeh Akbari, Shahram Molavynejad *, Dariush Rokhafroz, Hamid Sharif Nia Page 10
    Background

    Diabetes has debilitating and dangerous effects on any of the vital organs in the body. Its impact on quality of life, as well as the variables that impact it, is of great importance.

    Objectives

    This study was conducted to design a structural equation model of the effect of diabetes distress and self-care activities on the quality of life of type 2 diabetes mellitus (T2DM) patients.

    Methods

    This descriptive cross-sectional study included 398 patients with T2DM referred to medical centers affiliated with Ahvaz Jundishapur University of Medical Sciences in 2020; they were selected by convenience sampling method. Data collection tools included the Problem Areas in Diabetes Scale (PAID) used to identify depression and emotional stress associated with diabetes, Audit of Diabetes-Dependent Quality of Life 19 (ADDQoL-19) used to assess the physical, mental, and social status of patients, and Summary of Diabetes Self-care Activities used to evaluate the self-care behaviors of diabetic patients. Data were analyzed using SPSS version 26, Hayes PROCESS macro version 3.5, and path analysis regression.

    Results

    The mean scores of diabetes distress, self-care activities, and quality of life were 3.69±12.39, 65.57±12.11, and 56.94±18.62, respectively. Path analysis regression showed that for every 1-unit increase in the score of diabetes distress, quality of life decreased by 0.249, and for every 1-unit increase in the score of self-care activities, quality of life increased by 0.183 (P < 0.001). Also, for every 1-unit increase in the score of self-care activities, diabetes distress increased by 0.138 (P < 0.006).

    Conclusions

    This study showed that T2DM patients who engaged in more diabetes self-care activities had a higher health-related quality of life. Also, patients with higher levels of diabetes-specific emotional distress have a lower health-related quality of life. Training on identifying and reducing the factors affecting distress and those promoting self-care behaviors in diabetic patients is highly recommended.

    Keywords: Diabetes, Structural Equation Model, Model, Self-care, Quality of Life