فصلنامه سلامت و مراقبت
سال بیست و ششم شماره 3 (پاییز 1403)

  Since cancer patients struggle with psychological problems, this study aimed to compare the effectiveness of Islamic spiritual therapy and cognitive behavioral therapy based on immunization training against stress on emotional failure and anxiety sensitivity on patients with stomach cancer in Ardabil.

This was a quasi-experimental study with a pre-test and post-test with a control group design. The study population consisted of patients with stomach cancer who refered to Imam Khomeini hospital and Shafa Parto chemotherapy center in Ardabil in 1401 (from 21 March 2022 to 20 March 2023). A total of 60 patients were selected by convenience sampling and randomly divided into 3 groups (two experimental groups and one control group). Data were collected using the emotional dysfunction scale and the anxiety sensitivity questionnaire before the group intervention and at the end of the 10th session for all 3 groups. The intervention groups received the Islamic spiritual therapy, and the cognitive behavioral therapy based on immunization training against stress independently. The control group did not receive any psychological treatment. The collected data were analyzed using statistical tests of covariance and Bonferroni post-hoc tests using SPSS-23 software.

The result of the multi-purpose analysis of covariance showed that the two methods of Islamic spiritual therapy and cognitive behavioral therapy based on immunization training against stress were effective on emotional failure (f=11.058) and anxiety sensitivity (f=65.502). But the effect of Islamic spiritual therapy compared to cognitive behavioral therapy method based on immunization training against stress was higher in the study variables (p≤0.01).

According to the results, Islamic spiritual therapy and cognitive behavioral therapy based on immunization training against stress have a positive effect on emotional failure and anxiety sensitivity. While, comparing Islamic spiritual therapy to cognitive behavioral therapy method based on immunization training against stress, it is more effective on emotional failure and anxiety sensitivity. Therefore, applying this therapeutic method alongside other treatments and advices for patients with stomach cancer is recommend

Outsourcing refers to the transfer of services or functions that an organization traditionally performs to an external provider, controlled by a contract or cooperative management. This research aims to determine the effectiveness of the treatment services outsourcing policy on the development of human resources.

This was a mixed methods study with qualitative and quantitative phases responding to its purpose. In the qualitative phase, 10 senior managers of the Universities of Medical Sciences in the second major region (Ardabil, Tabriz, Urmia, Khalkhal, Sarab, Maragheh, and Khoy) were interviewed and the results were analyzed using the grounded theory method, and MAXQDA v3 software. In the quantitative phase, 380 employees and managers of the above-mentioned Universities were selected by stratified random sampling method and responded to the questionnaires on the outsourcing process of treatment service operations and human resource management. Quantitative data were analyzed using SPSS version 20 and Lisrel v10 software using structural equation testing.

The results showed that all the identified factors, including the mediating and contextual factors of the outsourcing of treatment service operations, have an impact on the development of human resources. Furthermore, based on the regression analysis, the impact of dimensions and indicators of treatment service outsourcing processes on the development of human resource management was 0.59.

The results confirmed the effectiveness of the outsourcing policy of treatment services on human resources development. Therefore, it seems that performing more outsourcing of treatment services can positively influence the development of human resources.

Childbearing is an important component of population science and the field of social issues. In recent years, there has been an increasing need for a deeper understanding of people's desire to have children. Also, it is necessary to identify the direct and indirect influencing factors of these conditions. This study aimed to explain the challenges related to childbearing from the perspective of married women aged 15-49.

The current qualitative study was conducted in 2023 using conventional content analysis. The research setting was where people lived and worked in Khalkhal city. A purposive sampling method was used, following the principles of maximum diversity. After obtaining informed consent, individual and semi-structured interviews were conducted and recorded with 24 women of reproductive age. Data collection continued until saturation was reached. The five-step method of Granheim and Lundman (2004) was used to analyze the data.

According to the analyzed interviews conducted with married women of reproductive age, four main categories in the field of childbearing were derived. These categories include economic challenges (financial problems and problems providing housing and life necessities), personal and family factors (maternal career challenges, parental mental and physical problems, individualism and avoidance of parental concerns, gender and desired number of children, and inadequate family support), social and cultural factors (unguaranteed future, adoption of social modeling, lack of child-rearing facilities and ineffective and inadequate childbearing policies) and labor phobia during childbirth (unpleasant experience and difficult childbirth and pregnancy experience). The most important challenge in childbearing was economic issues with the most recurring concept in the interviews.

The adoption of social modeling from society and the norm of low childbearing rate in society, economic and social issues on the one hand, and women's individualistic tendencies and avoiding child-rearing concerns on the other hand, lead families to low childbearing. This requires the adoption of policies and facilitating strategies to improve childbearing behavior. The results of this study can provide a small picture of the current state of willingness and unwillingness to have children in society and serve as a guide for officials in short-term, medium-term, and long-term planning to increase childbearing desire

One of the traumatic factors in the family structure is the issue of marital infidelity, which causes the most painful experiences related to marital life. Considering the value and status of the family institution, special attention should be paid to the damage caused by marital infidelity, especially in women. This study aimed to determine the effectiveness of compassion-based couple therapy (CBCT) on forgiveness and marital life quality of women affected by marital infidelity.

The research method was quasi-experimental with a pretest-posttest-follow-up design with a control group. The study population consisted of women affected by marital infidelity in Tabriz city who referred to the specialized counseling centers of this city in 1402. Among them, 30 people were selected using a purposeful sampling method and were randomly divided into two experimental and control groups (15 people each). Members of the experimental group received compassion-focused couple therapy for eight sessions 90 minutes each. While members of the control group received no treatment. Both groups responded to Rye, et al (2001) 15-question forgiveness and Zhang, et al (2013) 39-question marital life quality questionnaires before, after, and 4 months after the intervention. Data were analyzed using SPSS version 24 software using a chi-square test, t-test, and mixed analysis of variance with repeated measures.

The results revealed no significant difference between the scores of forgiveness and quality of marital life in the experimental group and the control group in the pre-test (p<0.05). The CBCT increased forgiveness and quality of marital life in women affected by marital infidelity in the post-test compared with the control group (p<0.001). The effects of CBCT on forgiveness and quality of marital life persisted until the follow-up phase (p<0.001).

Based on the results of this study, it can be concluded that compassion-based couple therapy can improve forgiveness and the quality of marital life in women affected by marital infidelity. Therefore, counselors and therapists can apply the above-mentioned treatment method to help families increase forgiveness and the quality of marital life in women

The life threat and encountering death in individuals who recovered from COVID-19 hospitalization resulted in ongoing psychological and emotional damage experienced after being fully recovered, even after several years. Therefore, this study aimed to investigate the prediction of death anxiety based on expressed emotion, intolerance of uncertainty, and experiential avoidance in patients recovered from COVID-19 hospitalization.

A descriptive correlational design was used in this study. All individuals in Khorramabad who have recovered from COVID-19-related hospitalization in the first half of 2024 constituted the study population. Among them, 190 people were selected using the snowball sampling method. The research tools were the Templer death anxiety questionnaire, the Cole and Kazarian expressed emotion questionnaire, the Freeston, et al. intolerance of uncertainty questionnaire, and the Bond, et al. experimental avoidance questionnaire. The data were analyzed using Pearson correlation coefficients and stepwise multiple regression using SPSS-24 software.

The regression analysis indicated that expressed emotions could negatively predict death anxiety in patients who recovered from COVID-19 hospitalization (p≤0.001). Conversely, the intolerance of uncertainty and experiential avoidance could positively predict death anxiety in the target group (p≤0.001).

This study highlights the role of emotional factors and dysfunctional cognitive patterns such as intolerance of uncertainty and experiential avoidance in the development of death anxiety in individuals who recovered from COVID-19-related hospitalization. Therefore, psychologists, counsellors, and psychiatrists may use techniques that promote adaptive emotional regulation strategies and cognitive strategies in the treatment of death anxiety in patients who recovered from COVID-19.

Granulomatous mastitis is a rare chronic inflammatory disease of the breast, which, in addition to chronic pain and physical problems, has brought patients many problems and challenges in the areas of marital satisfaction, sexual relations, and adaptation to the disease. Therefore, the aim of the study was to investigate the effectiveness of acceptance and commitment therapy on marital satisfaction, sexual desire and resilience of patients with granulomatous mastitis disease in Isfahan city.

The research method was quasi-experimental with a pre-test and post-test design with a control group. The study population consisted of patients with chronic granulomatous mastitis disease that referred to Al-Zahra, Zahra-ye Marzieh, Shariati, Sina, and Issa ben Maryam hospitals in Isfahan city in 2023. Based on medical records, 30 women with granulomatous mastitis disease were selected by convenience sampling method and randomly assigned to experimental and control groups (15 people in each group). Data was collected using the Enrich Marital Satisfaction Questionnaire (EMSS), the Halbert Sexual Desire Questionnaire (HISD), and the Connor and Davidson Resilience Questionnaire (RISC-CD), in two phases, pre-test and post-test, on the experimental and control groups. The acceptance and commitment therapy was held in nine sessions each lasting 90 minutes, once a week. Data were analyzed using SPSS 24 software using the analysis of covariance.

The results showed that the mean age of the participants in the experimental group was 31.48±2.82 and in the control group was 32.49±3.91 years. Furthermore, the results of the analysis of covariance showed that 64.8% of the variance in increased marital satisfaction, 71.2% in sexual desire, and 71.9% in resilience in the post-test phase was due to the effectiveness of the acceptance and commitment therapy (p<0.001).

Considering the effectiveness of acceptance and commitment therapy on marital satisfaction, sexual desire, and resilience in women with granulomatous mastitis, it is suggested that psychologists and counselors to use this intervention to improve marital satisfaction, resilience, and resolve marital problems in affected patients.

Alzheimer's disease, which affects memory and cognition, makes patients increasingly dependent on their caregivers. Informal caregivers feel socially rejected due to the presence of the patient in their family and this causes affiliated stigma towards them. This study aimed to investigate the affiliate stigma and its associated factors among family caregivers of older adults with Alzheimer's disease.

This cross-sectional study was conducted on 203 family caregivers of older adults with Alzheimer's disease in dementia and Alzheimer's association in Tehran, Iran. Data collection tools included the Demographic Information Sheet and Affiliate Stigma Scale (ASS). Data were analyzed using SPSS version 16 using descriptive statistics and Pearson correlation coefficient tests, independent t-tests, and analysis of variance.

 According to the results, the mean ages of the older adults with Alzheimer's disease and their caregivers was 76.62±7.87 and 55.59±13.66 years, respectively. The mean score of the affiliated stigma among the family caregivers of the older adults with Alzheimer's disease was 37.14±10.35. The affectional domain of ​​stigma with a score of 2.09±0.59 and the behavioral domain of ​​stigma with a score of 1.5±0.49 were the highest and the lowest rated dimensions, respectively. Additionally, affiliated stigma was significantly associated with caregivers’ demographic variables such as age, educational level, occupation, and relationship with the patient (p<0.05).

The results of this study showed that the affiliated stigma in family caregivers of patients with Alzheimer's disease is limited, but regardless of the level of stigma, it is considered a major problem and can affect many different aspects of caregivers and patients’ lives. Therefore, it is necessary to develop appropriate plans to provide effective services for family caregivers of the older adults with Alzheimer's disease and improve the quality of life of this vulnerable group.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women, affecting 4 to 20% of women worldwide. Pharmacological treatment and lifestyle modification are used to manage PCOS. This study aimed to investigate the relationship between animal and vegetable fat consumption and polycystic ovary syndrome.

This case-control study included 64 healthy women and 64 women with PCOS. Data were collected using a general information questionnaire, a 168-item food frequency questionnaire, a scale, and a stadiometer. The amount of fat intake was determined using Nutritionist 4 software. Data were analyzed using SPSS version 27 software. Chi-square test, comparison of means, and logistic regression test were used to analyze the data.

Participants showed no significant difference in employment status, marital status, age, body mass index, education level, height, and weight. Consumption of animal fat (P-value= 0.09) and vegetable fat (P-value= 0.001) was higher in the case group, but this difference was only significant for vegetable fat. Consumption of some animal fats, including butter (P-value>0.001), tallow (P-value>0.001), and cream (P-value=0.021), was significantly higher in the case group than in the control group. Logistic regression results showed that vegetable fats, butter, and tallow consumption was associated with a higher risk of PCOs.

According to the results of the present study, the consumption of vegetable fats and some animal fats was higher in the case group than in the control group, so a balanced fat consumption may be effective in improving the health status of women with PCOS.