فصلنامه سلامت و مراقبت
سال بیست و چهارم شماره 2 (تابستان 1401)

 The high quality of nursing care for cancer patients is a shared priority for health policymakers. Two important influencing variables on the quality of nursing care are the ethics climate governing hospitals and missed nursing care. This study aimed to determine the relationship between ethical climates and missed nursing care in centers providing services to cancer patients in Rasht and Zanjan.

This cross-sectional study was conducted in 2019. The participants were 360 patients with cancer and 84 nurses working in the oncology wards of Rasht and Zanjan, who were included in the study using the Poisson distribution sampling method. The data collection tools were two standard scales; the Miss Care survey and Ethical Climate Questionnaire, and two demographic forms specific to patients and nurses. SPSS version 16 statistical software and independent t-tests, and Pearson's correlation were used to analyze the data.

The results showed that the dominant ethical climate in the mentioned care units was professional and law-oriented, and the independent ethical climate was at the bottom. The mean score of missed nursing care is 1.95±0.40 out of 5. According to the Pearson correlation test, there was a significant negative relationship between ethical climate and missed nursing care in cancer care units (r=-0.422, p<0.001).

A negative and significant relationship between the ethical climate and missed nursing care showed that nurses' correct perception of the ethical climate reduces missed nursing care. It seems that the nursing care quality can be improved by preparing and setting up care guidelines, rules and clear care instructions.

Mindfulness-based interventions are considered as one of the cognitive-behavioral therapies that reduce the psychological stress resulting from diseases such as high blood pressure in patients. Therefore, the present study was conducted with the aim of the effectiveness of mindfulness-based stress reduction training on tolerating helplessness, failure and anger control in women with high blood pressure.

This study was quasi-experimental with pre-test design, post-test with control group. 30 women with hypertension were selected and randomly divided into a experimental group and a control (15 in the experimental group and 15 in the control group). The experimental group received 8 sessions of 120 minutes of mindfulness-based stress reduction training, but the control group did not receive any intervention. The Simmons and Gaher (2005) Helplessness Tolerance, the Harrington Failure Tolerance (2005), the Spielberger Anger Control (1996-1999) questionnaires were used to collect data. Data were analyzed using multivariate analysis of covariance via SPSS-28 software.

The results showed that mindfulness-based stress reduction methods were able to increase the rate of helplessness tolerance, failure tolerance and anger control in women with high blood pressure (p<0.05).

In overall, the results showed that mindfulness-based stress reduction methods can be used as a treatment to reduce the problems of patients with hypertension, especially women in counseling centers and hospitals.

Sexual schemas are the central beliefs of a person's sexual dimensions that affect sexual and non-sexual performance. The present study was conducted with the aim of determining the effectiveness of two methods of cognitive behavioral therapy and therapy based on acceptance and commitment on the sexual schema of postmenopausal women.

This was a semi-experimental study with a pre-test, post-test and follow up design with control group, which was conducted in 2019-2020. Among the menopausal women who visited health centers in Zanjan to receive services, 45 people who scored less than 28 (out of 36) in the "Women's Sexual Performance Index" test were purposefully selected and they were divided into three groups of 15 people by random allocation method (2 intervention groups and one control group). In the first group, cognitive behavioral therapy (CBT) and in the second group, acceptance and commitment-based therapy (ACT), were implemented for 8 sessions of 2 hours each. The data was collected from the intervention and control groups in the pre-test, post-test and follow-up stages with the "female sexual self-schema scale" which had 50 traits with a 7-point Likert scale. The data obtained from the research was analyzed through analysis of variance with repeated measures and using SPSS-24 software.

The results showed that cognitive behavioral therapy improved the sexual schema of postmenopausal women (F=4.355, p=0.021), while acceptance and commitment therapy did not have a significant effect on their sexual schema (F=0.232, p=0.633). In comparing the effects of two intervention groups on sexual schema (F=0.226 and p=0.638), no statistically significant difference was observed.

Based on the findings, cognitive behavioral therapy improves sexual schemas in postmenopausal women. Therefore, it is suggested to use this treatment method to improve the sexual schemas of postmenopausal women in health care centers.

One of the basic problems of children with autism spectrum disorder is the disruption in daily life functions. Therefore, the present study was conducted with the aim of determining the impact of social-communicative empowerment with the Tich and Pex approach on the daily functions of children with autism spectrum disorder.

The quasi-experimental research design was pretest-posttest and follow-up with the control group. The statistical population of this study included all boys with autism spectrum disorder aged 6 to 12 years in Tehran in the academic year 2021 from the special school for autism, by available sampling method, 40 autistic individuals were selected using the Gilliam Autism Diagnosis Scale (Gilliam, 1995) and were randomly divided into experimental (20) and control (20) groups. For the experimental group, 7 sessions of 45 minutes of communication-social empowerment program was implemented with the TEACCH and PECS approach. The research instruments included the Gilliam Autism Rating Scale (1995) and the Waisman- Activity of Daily Living Scale (W-ADL). The collected data were analyzed using the analysis of variance test with repeated measurements.

The average scores of daily functions in the pre-test, post-test and follow-up phases were 17.650, 21.250 and 21.450 respectively in the experimental group and 17.550, 17.400 and 17.650 respectively in the control group. The results of variance analysis with repeated measurements showed that social-communication enhancement package based on TEACCH and PECS approach had a significant effect on improving daily functions in the post-test and follow-up stages (p<0.01).

The social-communication enhancement package based on TEACCH and PECS approach has been effective on the daily functions of children with autism spectrum disorder. Therefore, it is recommended that this educational program be considered as an effective intervention by the relevant centers and organizations to empower children with developmental disabilities, especially children with autism spectrum.

Positive interventions are clinical approaches using the principles of positive psychology that help people live a quality, enjoyable and meaningful life. The present study was conducted with the aim of determining the effectiveness of positive psychology on the quality of life of patients with diabetes in Shahriar city.

This research was a semi-experimental study based on a pre-test and post-test design with a control group. The statistical population included all patients with diabetes who referred to comprehensive health service centers of Shahriar city in 1400, from which 30 people were randomly selected and placed in two experimental (15 people) and control (15 people) groups. Then, the principles of positive psychological skills were presented to the participants in the experimental group in 8 two-hour sessions over a period of 2 months, while the control group did not receive these trainings. Both groups completed the World Health Quality of Life Questionnaire (WHO-QOL-BREF) once before the intervention and once after the intervention. The data were analyzed using variance analysis with repeated measures and SPSS version 28 software.

The average scores of the intervention group were 42.33 in the pre-test, 78.33 in the post-test, and 77.87 in the follow-up.The result showed that positive psychological education had a significant effect on the components of quality of life, including physical health, mental health, the health of social relationships, and environmental in patients with diabetes (p<0.005).

Positive psychological education can help diabetic patients to improve their potential capabilities through having positive emotions, nobility, control and goal seeking, and in this way, their quality of life in the areas of physical, mental, social and environmental relations.

Sleep quality, alexithymia, and non-medication adherence are among the factors that contribute to the risk of developing or worsening coronary artery disease. Therefore, the aim of this study was to determine the effectiveness of cognitive emotion regulation on sleep quality, alexithymia and medication adherence of coronary artery patients.

The quasi-experimental research design was pretest-posttest and follow-up with the control group. The statistical population of this study included all patients with coronary heart disease who referred to the specialized heart hospital in Urmia in 2022 who had referred to this center for medical services. The sample size consisted of 40 people from the mentioned community who were selected by available sampling method and randomly placed in two experimental and control groups. For the experimental group, cognitive emotion regulation intervention was implemented in 8 sessions of 50 minutes during four weeks, while the control group did not receive any training. The research instruments included the Pittsburgh Sleep Quality Inventory (1989), The Toronto Alexithymia Scale (1994) and the Morisky Medication Adherence Scale-8 (2008). The collected data were analyzed using the analysis of variance test with repeated measurements.

The results of the analysis of variance with repeated measurements showed that the intervention of cognitive regulation of emotion significantly improved sleep quality (F=76.551, p<0.01), difficulty in recognizing emotions (F=44.102, p<0.01), difficulty in describing feelings (F=30.514, p<0.01), externally oriented thinking (F=31.981, p<0.01) and non-medication adherence (F=43.136, p<0.01) in the sample It has been effective in cardiovascular patients.

The results showed that the above emotional cognitive intervention has significantly improved the quality of sleep, ataxia, and adherence to treatment in the studied subjects, so the use of this intervention is suggested for cardiovascular patients.

Background &

Lumbar segmental instability is one of the consequences of non-specific chronic low back pain, which is defined as excessive intervertebral transmission and rotational movements and causes functional disabilities. The aim of this study was to determine the effect of progressive stability exercises with and without breathing exercises on plantar pressure variables in patients with lumbar segmental instability.

The present study was a single-blind randomized clinical trial with a pre-test-post-test design. The population of the present study was male employees of Hamedan city suffering from back instability who were selected as available. . In order to select the research samples, the ability to stand on one leg for 30 seconds and back instability tests were used (three out of five tests were positive). Subjects were randomly selected in two experimental groups (combined core stability-respiratory exercises (CCSRE) and core stability exercises (CSE)) and a control group. The variables of plantar pressure distribution were investigated using a foot scan device. Data were analyzed by ANOVA with repeated measurement         (p≤ 0.05).

The results showed changes in the vertical ground reaction force in the CCSRE group (p=0.016), the center of pressure (anterior-posterior) in the CSE group (p=0.001) and the CCSRE group (p=0.001), the center of pressure (internal-external) in the CSE group (p=0.007) and the CCSRE group (p=0.033) and the travel distance in the CSE group (p=0.014), was significant from pre-test to post-test. Also, the inter-group results (interaction between group and time) showed a statistically significant difference in the variables of vertical ground reaction force, center of pressure (internal-external) and (anterior-posterior) and travel distance (p<0.05).

According to the results, it is recommended to use the combination of breathing exercises and core stability in the rehabilitation and treatment of patients with lumbar instability.