Journal of Health And Care
Year:2024 | Volume:26 | Issue:2|Papers Count:8

Background: Chronic pain results from a complex interaction of biological, psychological and social factors that causes the experience of pain. The purpose of this research was to identify the structural model of chronic pain based on mindfulness, social support and life events with the mediating role of psychological distress and pain catastrophizing. Methods: This was a descriptive-correlational study with structural equation modeling. The study population included all patients suffering from chronic pain with musculoskeletal and rheumatoid arthritis related pain, which had referred to Tehran medical centers for follow-up in 2023. A total of 496 people were selected using the convenience sampling method. They completed the McGill Pain Questionnaire (1957), the Bauer Five Factor Mindfulness Questionnaire (2006), the Perceived Social Support of Zimmet et al. (1988), the Pickel's Stressful Life Events (1971), the Leviband's Depression, Anxiety and Stress Questionnaire (1995) and the Pain Catastrophizing Scale of Sullivan et al. (1995). Research data were analyzed using SPSS-26 and AMOS-23 softwares using Pearson correlation coefficient and structural equation modeling. Results: The results of the structural equation model indicated that this model fits the experimental data well. The direct effects of the standard pathway mindfulness coefficient and the amount of stressors on chronic pain were significant (p<0.01) and the direct effects of social support and the number of stressors for chronic pain was insignificant. Additionally, the effects of standard indirect path coefficients for mindfulness, social support and the number and the amount of stressors with the mediating role of psychological distress and pain catastrophizing on chronic pain was significant (p<0.01). Conclusion: Mindfulness, social support and life events play an important role in explaining chronic pain through the mediation of psychological distress and pain catastrophizing. Therefore, the findings of this study can be used in more detailed planning of psychotherpeutic interventions for patients with chronic pain.

Background: Forgotten nursing care is one of the consequences of the Covid-19 pandemic. Also, moral courage is one of the important factors affecting the quality of nursing care. The present study was conducted to investigate the relationship between forgotten nursing care and moral courage of nurses during the COVID-19 pandemic. Methods: This descriptive correlational study was conducted on 380 nurses working at educational hospitals affiliated with Hamadan University of Medical Sciences. Sampling was performed through a stratified random method. Data collection tools included Sekarka's Moral Courage and Kalisch and Williams' Forgotten Nursing Care Questionnaires. Data were analyzed using Stata-16 software using Pearson correlation coefficient and linear regression. The significance level of statistical tests was considered to be less than 0. 05. Results: The mean score of forgotten nursing care and moral courage of nurses were 85. 51±10. 73 and 78. 30±14. 44 respectively. The results showed that there was a negative and significant correlation between forgotten nursing care and moral courage (r=-0. 27, p<0. 001). Conclusion: Based on the results, there was a significant negative relationship between forgotten nursing care and moral courage during the COVID-19 pandemic. It is suggested that organizing training courses to improve the moral courage of nurses can reduce forgotten nursing care.

Background: The problem of mental health in children and adolescents is one of the concerns of modern societies and is of interest to many researchers. Many different factors play a role in its formation and manifestation, one of them is the occupational issues of the parents. Job burnout and job insecurity are two examples of employment issues that have psychological and physical consequences for difficult jobs, including nursing, which can negatively affect aspects of their lives, including their children’s mental health. Therefore, this study was conducted to investigate the role of nurses' job burnout and job insecurity in predicting the emotional-behavioral problems of their children. Methods: The present study was descriptive and correlational. A total of 200 nurses working in hospitals of Sari in 2022 and 2023 with 4 to 12-year-old children were studied using convenience sampling method. The data collection tools were Maslach's job burnout questionnaire (1981), Nisi et al. 's job security questionnaire (1379), and Goodman's strengths and difficulties questionnaire (1997). The obtained data were analyzed using Pearson's correlation coefficient and regression analysis using the SPSS-22 software. Results: Pearson correlation results showed that nurses’ job burnout (r=0. 354) and job insecurity (r=0. 412) were positively related to their children's emotional and behavioral problems (p<0. 05). Based on the results of stepwise multivariate regression analysis, lack of personal accomplishment =β) 0. 37) and emotional exhaustion =β) 0. 31) as the components of job burnout,and lack of job satisfaction=β) 0. 28) and not having a suitable job =β) 0. 21) as the components of job insecurity were instrumental in predicting emotional and behavioral problems in nurses' children. Conclusion: According to the results, ensuring job security and adjusting job burden for nurses can be an effective measure to reduce work-related problems for nurses and improve the mental health of their children. It is also proposed to improve the mental health of nurses and their families through the provision of psychological services and life skills training

Background: The healthcare systems, in addition to focusing on improving patient health during hospitalization, should pay attention to the outcomes followed by discharge. Therefore, it is crucial to identify factors associated with post-discharge outcomes. Hence, this study aimed to investigate the relationship between patients' discharge readiness from the nurses’ perspective and post-discharge outcomes. Methods: The present descriptive-analytical study was conducted in 2022. The study population included adult patients hospitalized in the general wards of two selected educational medical centers in Sanandaj City and the discharge nurses of each patient. A total of 360 people were selected through convenience sampling. Data collection tools included demographic information forms, a questionnaire on discharge readiness from the nurses' perspective, and a 6-item checklist on post-discharge outcomes. Data were analyzed using SPSS 21 software with a significance level of 0. 05, using descriptive statistics and independent t-test, chi-square test, and multiple regression analysis. Results: The total score of patients' discharge readiness was 7. 82±1. 19 considered moderate. The lowest score was in the knowledge dimension (7. 61±1. 60). One month after discharge recovery was reported by 93. 4% of patients. Patients who died within one month after discharge had significantly lower discharge readiness scores from the nurses' perspective (P<0. 001). Conclusion: These results indicated that although the overall discharge readiness score was in an appropriate range, the score in the knowledge dimension needs more attention. On the other hand, to reduce negative outcomes after discharge, evaluating the nurses' assessment of the patient's condition at the time of discharge and considering it in the discharge decision-making process should be taken into account, as patients who died had significantly lower discharge readiness from the nurses' perspective

Background: Irritable bowel syndrome is a chronic functional disorder of the gastrointestinal system. Besides physical problems, it can also affect the patient’s cognitive, emotional, and psychological processes. The study aimed to compare the effectiveness of cognitive-behavioral therapy and schema therapy on health anxiety and psychological flexibility in patients with irritable bowel syndrome. Methods: The study method was quasi-experimental with a pre-test and post-test design and a 2-month follow-up period with a control group. The study population included all patients with irritable bowel syndrome referred to Velayat and Shahid Rajaei hospitals in Qazvin City in 2022. Based on specialist diagnosis and clinical interviews, 48 patients with irritable bowel syndrome who scored higher than 35 on the health anxiety questionnaire were selected through purposive sampling. They were also divided into three groups based on a table of random numbers, including schema therapy, cognitive behavioral therapy, and control groups (16 people in each group). The research instruments were the Health Anxiety Questionnaire by Salko-Sakis and Warwick (2002) and the Psychological Flexibility Questionnaire by Dennis and Vanderwaal (2010). The experimental groups received Yang's schema therapy and Leahy's cognitive behavioral therapy in nine 90-minute sessions once a week, and the control group received no intervention. Data were analyzed using repeated measures analysis of variance (ANOVA) using SPSS-23 software. Results: The results showed that schema therapy and cognitive behavioral therapy were effective in reducing health anxiety and increasing psychological flexibility in patients with irritable bowel syndrome (P<0.001). Furthermore, comparing the two treatment methods, no significant differences were found between the mean scores of the variables studied at post-test and follow-up. Conclusion: According to the results, schema therapy and cognitive behavioral therapy can be used as an effective treatment for health anxiety and psychological flexibility of patients with irritable bowel syndrome.

Background: The outbreak of COVID-19 disease has been considered one of the crucial public health issues in Iran and worldwide, placing one of the most important conditions on healthcare services. In addition to the resulting challenges, concepts such as human empathy and voluntary activities in confronting the crisis became more colorful. The presence of volunteers during the COVID-19 crisis and their role in controlling the crisis has been effective. Therefore, this study was conducted to explain the motivation for the voluntary participation clergies in the care of patients with COVID-19 in educational and medical centers in Ardabil. Methods: The present qualitative study was conducted using conventional content analysis method. Therefore, 6 clergies who volunteered to serve and care for patients in hospitals and convalescent centers related to COVID-19 were included in the study through purposive sampling. Semi-structured in-depth interviews were used to collect data. Data were analyzed based on the method proposed by Elo and Kyngäs using MAXQDA-10 software. Results: The results of conventional content analysis led to the formation of 4 main categories as the main causes motivating the volunteer activities of clergies, including responding to the call for sacrifice, meeting the desire to expectations and needs of society, and concerning and obedience to administrative values and religious beliefs. Conclusion: The results showed that both the internal factors and motivations and the expectations and values ​​governing the society have been effective in volunteering to participate in controlling the COVID-19 crisis among the clergies. On the one hand, social values ​​are the foundation of voluntary activities, and on the other hand, volunteers’ responsibility towards society leads to the development of social values. On this basis, paying attention to these motivational factors, expanding a volunteering culture based on a sense of altruism, and creating a social platform for volunteer participation can bring potential possibilities to deal with similar crises

Background: Mothers of attention deficit/hyperactive children have many psychological problems in interacting with their children. Therefore, their psychological problems should be taken into account and resolved. The aim of this study was to determine the effectiveness of parental management training (PMT) on perceived stress and life satisfaction in mothers of children with attention deficit/hyperactive. Methods: The method of this study was semi-experimental with pre-test, post-test and follow-up with a control group design. The study population included all mothers of children with attention deficit/hyperactive in girls' primary schools in Tabriz during the 2022-2023. A total of 30 people were selected through convenience sampling and randomly divided into two groups, experimental and control (15 people each). The experimental group received 9 specific training sessions of 1.5 hours each. However, the control group did not receive any training. The measurement tools included Cohen's (1983) perceived stress and Diener (1985) life satisfaction questionnaires. Data were analyzed using the analysis of variance with repeated measures and using the SPSS-24 statistical software. Results: In the pretest, the mean and standard deviation of the experimental and control groups for perceived stress were (26.47±2.61) and (27.13±2.06), and for life satisfaction were (134.20±3.24) and (133.73±3.94), respectively (p>0.05). Compared with the control group, in the post-test, PMT resulted in a decrease in perceived stress and an increase in life satisfaction (p<0.001). In the follow-up phase, the effect of PMT on perceived stress and life satisfaction were long-lasting (p<0.001). Conclusion: It appears that parental management training could reduce perceived stress and increase life satisfaction in mothers of attention deficit/hyperactive children. Therefore, it may probably be a useful training strategy to improve the psychological state of these mothers

Background: Stigma, along with physical limitations due to respiratory symptoms of chronic obstructive pulmonary disease (COPD), can lead to social isolation and loneliness, poor self-management, and reduced engagement with health care providers. This study was conducted to determine the relationship between stigma and medication adherence in patients with COPD. Methods: This correlational study was conducted on 140 patients with COPD hospitalized in Razi Hospital in Rasht city in 2023. Convenience sampling method was performed based on the inclusion criteria. Data collection tools were the demographic and clinical information form, Morisky Medication Adherence Questionnaire, and Stigma Scale for Chronic Diseases. The Data were analyzed using the Pearson correlation coefficient and multivariate regression model in SPSS-27 software. Results: The mean of stigma score was 73.38±24.29 and the mean of medication adherence score was 2.67­±2.61. Pearson correlation coefficient showed a negative and statistically significant relationship between medication adherence and stigma scores in COPD patients (p=-0.591, p<0.001). In addition, based on the results of multivariate linear regression analysis, stigma, and use of drug and inhaler can predict the medication adherence score. Conclusion: Based on the results of this study, the stigma in COPD patients was moderate and medication adherence was poor. Furthermore, a significant inverse relationship was observed between medication adherence and stigma scores in these patients. Therefore, it is necessary to plan interventions to prevent stigma and control stigma-related factors, such as medication non-adherence, in COPD patients.