Archives of Rehabilitation (Journal of Rehabilitation)
Year:2019 | Volume:20 | Issue:3 |Papers Count:12

Objective Plantar fasciitis is a plantar fascia inflammation and one of the most common causes of heel pain, causing pain in the inner side of the heel bone. The purpose of this investigation was to analyze the effect of different foot orthoses on the distribution of foot pressure in patients with plantar fasciitis. Materials & Methods The systematic search of PubMed, Science Direct and Web of Knowledge databases was conducted using keywords such as plantar pressure, plantar fasciitis, heel pain, foot orthoses, and orthotic insoles to identify published articles in this field. The statistical population was all studies that examined heel and foot pressure in patients with plantar fasciitis. In addition, studies on different perspectives were identified in plantar fasciitis. From 1999 to 2018, thirteen articles were evaluated in Persian and English, nine of which directly evaluated the effect of foot orthoses on heel and foot pressure, and were selected based on entry criteria for the final examination. Results Nine articles were selected for inclusion in the study. These articles examined types of foot orthoses include, custom insole, prefabricated insole, foam insole, silicone heel cup, foam heel pad, viscoelastic heel pad, and tape and then measured heel and foot pressure using various devices. The results show that the insoles can be effective in reducing the maximum pressure and also reducing the average pressure. In one study, the maximum total pressure before using the insoles was 12 and decreased using custom insoles and prefabricated insoles respectively 7/7 and 8/7. Some studies have found little difference between these two insoles in reducing the heel and foot pressure. In one study, both insoles reduced the maximum pressure at the inside of heel to a value of 13%. Compared to the prefabricated insole with foam heel pad and silicone heel cup and heel lift, decrease pressure in prefabricated insoles was higher than other groups (P<0. 001). Silicone insoles also reduce the pressure of the heel, but this is insignificant (P=1). Also, according to studies cups and pads also contribute to decreasing foot pressure (P<0. 05). Conclusion Although all types of foot orthotics are effective in reducing the heel and foot pressure, the effect of custom-made and prefabricated insoles in reducing foot pressure was greater than heel orthoses. Also, in most studies, custom-made insoles were more effective than different prefabricated insoles, however, the slight difference in reducing the amount of pressure by the prefabricated and custom-made insoles makes it impossible to come to a definite conclusion regarding the superiority of the insoles.

Objective Teamwork is a fundamental part of medical rehabilitation. The purpose of rehabilitation teamwork programs aims to enhance the functional and mental capabilities of disabled people to improve their quality of life. One of the problems of providing rehabilitation services in Iran is teamwork. In fact, teamwork is a missing link in rehabilitation services, and teamwork between physicians and therapists in different areas of rehabilitation helps to provide quality rehabilitation services. Therefore, this study aimed to identify barriers to teamwork in providing rehabilitation services. Materials & Methods This study was conducted in a qualitative approach to identify the barriers of teamwork using conventional content analysis based on Graneheim method (2004) in Shiraz and Tehran in 2017. 32 participants were selected based on purposive sampling with maximum diversity and sampling until data saturation. Data were collected through semi-structured interviews. Before the interview, the purpose of the study was explained and informed consent was obtained from the participants. Interviews lasted between 20 and 60 minutes and MAXQDA 10 software was used for data analysis. In this study, four criteria of acceptability, reliability, transferability and verification capability of Guba and Lincoln were used to evaluate and validate the data. Results After conducting interviews and analyzing of data, 846 primary codes extracted by removing similar codes. The classes were identified from the indirect open coding process by reading the text several times and assigning related codes to them by continually comparing the codes with each other and ensuring the accuracy of the coding. The findings of this study showed that the barriers to teamwork in providing rehabilitation services included a core theme of "trustworthy of a missing link to rehabilitation teamwork", and six main categories including: "disorderly planning and planning", "poor communication and coordination", " Lack of financial resources, "inadequate education system", "false cultural beliefs", "inadequate knowledge and experience", as well as 20 subcategories. . Conclusion According to the findings, efficient rehabilitation teamwork requires a comprehensive understanding, considering the long-term in addressing the barriers. Identifying the barriers for providing rehabilitation teamwork can be the first action in the formation and advancement of teamwork at hospitals and rehabilitation centers. The "trustworthy of a missing link to rehabilitation teamwork" was the main barrier to teamwork. The results of this study can provide insights and extensive knowledge about teamwork to policy-makers, managers, providers, and rehabilitation staff for removing these barriers to order promotion of rehabilitation services. Therefore, it is vital for health policy-makers and managers to change their vision and focus on teamwork as a key part of health plans. Further research is suggested.

Objective Methamphetamine use in patients treated with methadone is a health problem in Iran that reduces the benefits of this treatment. This has been more reported by women than by men. Short-term psychological interventions are one of the major methods of rehabilitation to solve this problem. The current study aimed to explore the reasons for methadone patients for using these interventions to quit daily MA use while in treatment. Materials & Methods In this qualitative-descriptive study, 64 women undergoing maintenance treatment from three methadone clinics in Tehran, Iran, were selected through a simple and accessible method and were interviewed. in 2016. All women met the Diagnostic and Statistical Manual, Edition Five (DSM-V) criteria for regular MA use in the past 12 months while in methadone treatment. A researcher-made questionnaire was devised to interview with the patients. Quantitative-descriptive data were analyzed by PPSS software V. 22 and qualitative data were analyzed by content analysis method. Results The mean age of the women was 37. 8 years (age range: 18-56 years). Overall, 50% of the participants reported living with their families. The average duration of undergoing methadone treatment was 18 months. Overall, 84. 3% of participants consumed MA by smoking. The main reasons women expressed as self-reporting to use short-term psychological interventions were as follows: learning short-sighted cognitive skills is easy and affordable to quit smoking (79%): routine counseling and training on methadone treatment does not have a significant effect on stopping the use of MA, as it requires cognitive-behavioral skills and techniques (76%); with continued consumption, there is a possibility of increased divorce and separation from the family and consequently, lack of financial support (71%), which caused lack of paying for methadone treatment charges; therefore, learning cognitive-behavioral skills was necessary; regular MA use is against the religious and traditional values of family and society (66%); likelihood of homelessness was high due to continued MA use (53%); the stigma and social labeling and discrimination against consumption for women are higher than men (51%); positive feedback of methadone-therapy has been greatly reduced due to consuming MA and therefore the probability of expulsion from methadone-therapy is high P(43%). Problems related to work (38%) and risk of losing the right to foster care (31%) were also other reasons. Conclusion A combination of individual, familial, social and therapeutic reasons were described by MA dependent women as their needs for having short-term psychological treatments while experiencing methadone treatment. More studies should be conducted to investigate the effects of short-term psychological treatments in reducing regular MA use among women in methadone treatment services. Family therapy needs to be provided to reduce the likelihood of divorce, separation, homelessness, and lack of financial support among these women. Mass media should provide educational programs to reduced stigma and discrimination against women with regular MA use.

Objective As a universal problem, cancer is the third cause of deaths in Iran. Recent advances in the treatment of this disease have been led to the prolonged life of these patients and increased the importance of paying attention to their psychological adaptation to the disease. Since the disease is a threat to individual life, perceiving the diagnosis of this disease can cause post-traumatic symptoms and intensify the psychological reactivity of the individual. This study conducted in order to investigate the effectiveness of Narrative Exposure Therapy (NET) on reducing the post-traumatic symptoms and interpersonal reactivity in patients with cancer. Materials & Methods This research is a pilot experimental study with pretest-posttest design with a control group. The statistical population of this study included all female cancer patients with Post-Traumatic Stress Disorder (PTSD), admitted to the Blood and Oncology Department of Motahari Hospital of Foulad Shahr of Isfahan from July to September of 2016, and had completed complementary and maintenance chemotherapy and radiology treatments. To select the subjects, the list of all patients with cancer diagnosis was obtained and after referring them to the site of the section and explaining the goals of this research, the scale of PTSD and the interpersonal reactivity were conducted to the all 63 hospitalizations and after collecting data, 30 of these people who had a score higher than 65 in the scale of Mississippi PTSD, and had malignant diagnosis were selected. In the next stage, structured clinical interviews, on the basis of DSM-5 criteria for the diagnosis of PTSD symptoms, and after confirmation of diagnosis, subjects were assigned to experimental group (n=15) and control group (n=15). The experimental group received 6 sessions of 90 minutes of NET, but the control group received no treatment. Collected data were analyzed by MANCOVA and ANCOVA tests using SPSS 18 software. Results According to the results, after controlling for the pre-test effects, there was a significant difference between the mean scores of the two groups in the total score of the PTSD scale and the components of malicious memories, interpersonal communication, emotion control, depression, and two interactive reactivity components, namely, empathy and personal discomfort exist (P<0. 05) indicating that NET has been effective in reducing symptoms of traumatic stress disorder and empathy and improving personal empathy and discomfort in cancer patients. But according to the results in the fantasy subscales, having a broad vision and overall stress response score did not find a significant difference between the two groups. Conclusion The results of this study revealed that NET can be an appropriate therapeutic program for reducing post-traumatic symptoms in patients with cancer because this intervention is based on the expression and retrieval of the traumatic event's details in a safe environment of therapy, but this intervention has less effect on interpersonal reactivity. Based on these results, it can be recommended using this intervention as an effective method for improvement of psychological problems related to diagnosing cancer along with biological treatments in patients with cancer.

Objective Paying more attention to human factors is undoubtedly one of the most important organizational principles. Job Satisfaction is one of the most important issues related to human resources in organizations and job dissatisfaction can decrease the productivity of the employees. In this regard, their occupational health is regarded as the science of workforce health in any organization. The purpose of this study was to investigate the status of Occupational Health Management and job satisfaction and the relationship between these two factors in the staff of rehabilitation centers in Tehran. Materials & Methods This descriptive correlation study was conducted on 1403 employees of 28 rehabilitation centers in Tehran during the second half of 2017. Sampling was done through the census. Research data were collected using a questionnaire consisting of two researcher-made questionnaires of occupational safety and health status and standard job satisfaction questionnaire. At first, the instrument used to assess occupational safety and health status for rehabilitation centers was developed and then, with the opinion of academic experts, the validity of the instrument was confirmed using the formal credibility and content validity index and the necessary corrections were made. In addition, 5-10 staff working in rehabilitation centers were asked about the content, clarity, and simplicity of the questionnaire terms. Content Validity Index (CVI) and Content Validity Coefficient (CVC) were 0. 68, 0. 83, 0. 69, and 0. 83, respectively, for Occupational Health Management and job satisfaction. Instrument reliability was also assessed using the Cronbach's alpha coefficient, which was 0. 872. Finally, after verifying the validity and reliability of the instrument, a questionnaire was used to collect the research data. Shapiro-Wilk, Wilcoxon, and Spearman correlation tests were used to analyze the findings. Data analysis using Version 22. 0. Armonk; NY: IBM Corp; SPSS V. 20. Results The participants in this study included 657(46. 8%) male and 746(53. 2%) women. The results showed that the average score of Occupational Health Management variables and its sub-scales was higher than the mean Likert scale. Job satisfaction variables and its subscales, other than the pay-asyou-go variable, were higher than the mean Likert score. The variables in "Occupational Health Management", "Public Safety", "Fire Extinguishment and Crisis", and "Ergonomics and Psychological Factors" were 0. 65, 0. 57, 0. 60, and 0. 79, respectively. Job satisfaction variables for job satisfaction, job, supervisor, coworker, and employee promotion were respectively 0. 09%, 0. 4%, 0. 25%, 0. 6%, and 0. 83% of the obtained variable. The regression coefficient between the two variables of Occupational Health Management and job satisfaction was 0. 267. Conclusion According to the evaluation of the prepared and completed questionnaires, the results of this study showed that the level of job satisfaction and occupational health management in the studied centers is relatively favorable. Also, the results of this study confirmed that there was a significant positive correlation between the Occupational Health Management and the staff’ s job satisfaction working in rehabilitation centers (P<0. 001). It was argued that implementation of programs the extent to which occupational safety and health management system such as HSE in rehabilitation centers can affect the employee’ s job satisfaction. Therefore, it is necessary to provide more job satisfaction to the personnel of the centers by planning and following the necessary improvements to improve the level of health and safety of the occupational health centers. This will be important in the quality of the provided services.

Objective One way to examine a child's ability to think about language is by word definition. Word definition is a meta-linguistic skill representing the aspect of the lexical knowledge of a person about the nature and function of language. The success of a person in defining the word is indicative of the fact that he is aware of the use of language as a symbolic system and a tool for transferring information about the world around him and his own inner states, ideas, and purposes. The studies about word definition skill consider two content and form aspects within the development of vocabulary skill. ‘ Content’ is the expression of the semantic features of a word that is expressed in a definition, and ‘ Form’ is the syntactic structure of a definition and how it is formulated to transfer the best information which exists about a word in mind. Considering the importance of hearing sense on learning and use of language and meta-linguistic skill, the delay or problem in obtaining word definition skills in children with hearing loss is predictable, however, this question may arise that how is the quality of word definition skills in children with hearing impairment. The study aimed to compare the skill of noun definition in terms of content and form in children with Cochlear Implant (CI) and Typically Developing (TD) children. Materials & Methods In this descriptive-analytic study, samples included 16 students (8 girls and 8 boys) with CI in the third grade of primary school (8-9 years old) by available sampling from Tehran Cochlear Implants based on inclusion criteria including education in regular schools, 100 Cochlear Implant training sessions, resolution Intermediate Speech was selected according to the Speech and Language Pathologist's viewpoint, not having a mental disability, passing a pre-school entrance examination, and failing a passing grade in previous years. All children before the age of 3 received Cochlear Implants and had hearing aid in their other ear and, according to their parents' statements, used hearing aids as prescribed by experts after their hearing loss was identified. Thirty normal children (15 girls and 15 boys) were randomly selected based on the following criteria: no hearing, speech, and language problems (being normal), no failing score in previous years, no psychological problems, and no lack of mental disability. Exclusion criteria in this study were the child or parental unwillingness to continue the test during the study. In this study, Mohammadi’ s Noun Definition Test, which was designed and validated for Persian-speakings, was used. This test evaluates the skill of word definition of students in seven categories including animals, occupations, fruits, places, body organs, foods and transport items. The validity of Name Definition Test was estimated in the content aspect (r=81%) and in the form aspect (r=91%) estimated by correlating the scores of two independent evaluators. Data were analyzed using SPSS-24 software by Shapiro-Wilk and Mann-Whitney tests. All comparisons were considered significant at α =0. 05 level. Results The findings indicated that the mean scores of content and form aspects of Noun Definition Test were significantly lower in children with CI than their TD peers (P<0. 001). The children with CI used significantly more concrete and functional responses in the content aspect, and had significantly less transitional and Aristotelian forms in the form aspect in comparison with their TD peers (P<0. 001), while hearing children used significantly more Combination I and II responses in the content aspect, and had significantly more Clause, Transitional and Partial Aristotelian forms in the form aspect. Conclusion The significance of the means obtained in comparing the content and structural aspects of noun definitions indicates that children with CI have lower performance in both content and structure of the nouns than hearing children. It seems that the content and structural growth pattern of the definition of CI in children is almost similar to that of younger hearing-children. According to the results of this research, developing a coherent program to teach the noun definition skills in cochlear implant children with CI seems necessary.

Objective Responsiveness is a process that all organizations, such as hospitals and rehabilitation centers, need to implement it in order to legitimize their activities; and on the other hand, the recipients of rehabilitation services as a citizen of the community have a special place. Therefore, the main purpose of this study was to determine and compare the response status of rehabilitation service providers from the perspective of People With Disabilities (PWD) and their families in Tehran in 2016. Materials & Methods The study is descriptive-analytical and cross-sectional. The statistical population of the study consisted of all people with disabilities and their families who received rehabilitation services (Red Crescent, Wellbeing, Private Sector) in 2017. Samples were collected from rehabilitation centers of 5 districts of Tehran, using available sampling. The questionnaire was distributed based on the Response Questionnaire (World Health Organization, 2000) and 357 samples were collected. Adults with physical and motor disabilities and families with children with physical disabilities were included in the study, as well as those with mental disabilities and those who did not wish to participate in the study, as well as incomplete and unread questionnaires. The questionnaire has eight domains and included 25 questions. The questionnaire was distributed among 11 rehabilitation specialists with CVI=0. 91 and the reliability of the questionnaire was confirmed by 30 questionnaires in four centers in two weeks with a correlation coefficient of 0. 83 and Cronbach's alpha of 0. 77. Data were analyzed through descriptive statistics (mean and standard deviation) and inferential statistics (Mann-Whitney and Kruskal-Wallis) by using SPSS V. 22. Results The results showed that the age of the majority of patients (49. 6%) was in the group of 30-39 years. Depending on the type of center, the mean age included 49. 5% in private centers, 49. 5% in the welfare centers, and 50% in Red Crescent. The highest responsiveness was related to the dimensions of the right to choose and environmental quality (2. 6 and 2. 41 out of 5, respectively) in private centers, environmental quality (2. 1 out of 5) in welfare centers, and then, right to choose had the highest score. The lowest accountability was reported for dignity (2. 18 out of 5). The mean scores of social support dimensions in the three types of center were statistically different (P=0. 001), as well as the mean scores of immediate attention (P=0. 002), participation in decision-making (P=0. 009), confidentiality (P=0. 010), and total responsiveness (P=0. 04) there was a statistically significant difference between the two groups of referral type and mean scores of immediate attention dimensions in the two sex groups (P=0. 022). However, the mean scores of total responsiveness dimensions in marital status (P=0. 446) and type of insurance (P=0. 535) were not statistically significant. Conclusion The findings of this study displayed that responsibility as a criterion of quality of rehabilitation services, in fact, provides a clear picture of the clients’ performance. Responsibility of welfare centers was better than private and Red Crescent Centers. In this study, rehabilitation centers had the lowest performance in areas of transparent communication, dignity, and social support which may result in lower dignity which may indicate less attention to the dignity of the recipient of the service and the deficiency of insufficient insurance coverage to support rehabilitation services. While these dimensions of responsiveness are important for services recipients. Therefore, it is necessary to respond to the rehabilitation system in these areas (transparent communication, dignity and social protection). Also, it is recommended further studies in the area of responsiveness of rehabilitation system.

Suicide and suicidal behavior (suicidal ideation, suicidal plan, and suicidal act) as one of the major problems in the social and psychological health system is an important and significant issue around the world. In addition to personal and family damage, this phenomenon is also a social loss. Suicide is also a psychological and social problem which is one of the social traumas that requires immediate attention from relevant centers. Preventing suicide requires a comprehensive approach that includes physical, mental, social, and spiritual interventions, and the implementation of a wide range of psychosocial and social actions from social support and life skills training to counseling, follow-up, and treatment for mental disorders. It is possible to consider the action to reduce suicidal ideation using different approaches as part of preventive approaches to deal with this harm. Social workers as one of the specialized groups are closely associated with this problem. Their approach to have the more impact on reducing suicidal ideation is the problem-solving, which focuses on the individual and his decision-making problem, which is opposed to stigmatizing and instead emphasizes on abilities, promotion, and empowerment. The purpose of this study was to determine the effectiveness of group Social Work intervention with a problem-solving approach to reducing suicidal ideation in females referring to psychology and Social Work clinics. Materials & Methods In this study, quasi-experimental design with a randomized control group was used. The statistical population included all cases referring to Social Work clinics and counseling centers and clinics in Qorveh in 2017. Considering the importance of access to research samples and with the collaboration of psychiatric centers, 30 individuals willing to participate in the study and with suicidal ideation identified through a psychiatric interview, was divided into two experiment and control groups after giving written consent and using Block randomization method. A number of samples were dropped due to non-compliance with the intervention, of which 12 were in the experiment group and 11 were in the control group until the end of the intervention. The research tool was Beck Scale for Suicidal Ideation (BSSI) Questionnaire. In the experiment group, Social Work intervention with problem-solving approach and in the control group, training package of coping strategies was performed. All analyses were performed using SPSS software and covariance analysis was used to analyze the data. Results The findings of the study showed that group Social Work intervention with a problemsolving approach statistically had a significant difference with the control group and could reduce the total score of suicidal ideation significantly, compared to the control group (P<0. 05). The findings of different analyzes in two groups showed that Social Work with problem-solving approach was more effective than the training package of coping strategies in reducing the suicidal ideation of women referring to clinics. The results of various analyzes in the two groups showed that the group work intervention had a significant effect on the four subscales: a desire for death, preparing for suicide, suicidal tendency, and the inhibitory factors or self-control (P<0. 001). Also, the power of a test (Cohen effect size), there are four major dimensions of suicidal ideation in the Social Work intervention compared to the training package of coping strategies. Conclusion A comprehensive look at the social factors affecting suicide, especially group Social Work interventions that take a multilateral approach to a social problem, can reduce suicidal ideation and provide the basis for improving the quality of life of different groups of society. Regarding the nature of group Social Work with a problem-solving approach, it is very effective and promising and can also open a door to expanding Social Worker interventions in intervening in a suicidal crisis.