Introduction: Surgical site infection is a risky complication following coronary artery bypass graft (CABG) surgery that may increase mortality and morbidity. Hence, it seems that further investigation regarding this complication may be necessary, in order to improve prevention and treatment processes. Objective: The aim of this study was to determine the frequency of sternal wound infection and saphenous vein wound infection in patients undergoing CABG and its correlation with the determinants. Methods: This is a cross-sectional study that was undertaken from 2015 to 2019 on 2459 patients undergoing CABG surgery with off-pump and on-pump methods. Demographic and background information of our patients were recorded. After infection, secretions were sampled and cultured.Results: Results of the study showed that the frequency of sternal and saphenous harvesting site infection in patients was 3.7% (n=91), and these infections were often diagnosed two weeks after surgery (50 patients, 54.9%). Age and sex were identified as two significant risk factors of surgical site infection after CABG surgery (p=0.0001). Most patients came back with an infection two weeks after surgery (54.9%). Gram-positive bacteria had the greatest role in infection (35.2%) with Staphylococcus epidermidis acting as the predominant strain (n=13).Discussion and Conclusion: The results suggested that two factors with a crucial role in the incidence of infection, are female gender and age of 50-60 years old. Diabetes, previously identified in the literature as a risk factor for surgical site infection, did not have a significant effect in this study and further research is warranted.
Teddy bear hospital is a public health project for children with an easy to apply experiential method. We performed this project in Mashhad, Iran as a pilot study to compare the feeling of preschool children when facing doctors and hospitals before and after the project. Medical students took part in conducting this project in Razavi hospital that included different sections. Pre/post design test, using picture questionnaires’ was performed. Data analysis showed significant improvement in children feeling when facing hospital but not significant about doctors. Notably more children could recognize commonly used medical instruments: stethoscope and otoscope after the project.
Background: One of the important goals of the educational system is to provide the ground for all-round growth and training healthy.Objectives: Present study aimed to investigate the mediating role of academic self-efficacy in the relationships between academic engagement and achievement goals with social adjustment among high school students.Methods: The research method was descriptive-correlation with the path analysis-based design. The statistical population included all male high school students in Tehran in 2017-18 such that 546 students were randomly selected by multi-stage cluster sampling. For the data collection, Morgan-Jinks Student Efficacy Scale (MJSES), Zarang Educational Conflict Questionnaire, Sinha and Singh’s Adjustment Inventory and Elliott and Church’s Achievement Goal Questionnaire were used. Results: The results showed that the coefficient of academic engagement (0.50) and achievement goals (0.30) were significant in predicting self-efficacy. The self-efficacy coefficient in adjustment prediction was also significant (0.82). The direct effects of academic engagement (0.06) and achievement goals (-0.29) on predicting adjustment were insignificant and significant, respectively. Based on this data, academic self-efficacy mediates the relationship between academic engagement and adjustment. The role of academic self-efficacy is in the relationship between achievement goals and adjustment was partly.Conclusions: The implication of the findings is that educational approaches, while emphasizing students’ mastery of prerequisites and successful experiences, should consider academic self-efficacy as a fundamental principle and rely on persuasion and explanation in interactions.
Background and objective: In recent decades, emphasis on diet and thinness has been considered by all social and racial classes. This study aimed to compare the cognitive-behavioral approach's effectiveness and rational-emotional behavior therapy in reducing social anxiety in overweight adolescents. Methods: The research method was quasi-experimental with pre-test and post-test design with the control and two-month follow-up. The statistical population of this study consisted of male and female adolescents who had been referred to clinics in Tehran in 2019 with overweight and obesity problems, among whom 60 were selected by convenience sampling method. After selecting the subjects, they were randomly assigned to experimental and one control groups. Interventions in both groups were group therapy and consisted of eight sessions for 120 minutes. Data were obtained by social anxiety questionnaire and analyzed using repeated-measures ANOVA and SPSS.22 software. The significance level in this study was considered to be 0.05. Results: The results showed that cognitive-behavioral approaches and rational-emotional behavior therapy effectively reduced social anxiety in overweight adolescents (p <0.001). However, there was no significant difference between the effectiveness of cognitive-behavioral and rational emotional behavior therapy on social anxiety. Conclusion: It can be concluded that the cognitive-behavioral approach and rational-emotional behavior therapy can have positive effects on reducing social anxiety in adolescents.
Introduction: We undertook a systematic review of the literature to determine theefficacy and safety of Imatinib in the restriction of activity and effective treatment ofpatients with aggressive fibromatosis (AF) and pigmented villonodular synovitis (PVNS)and their recurrence.Method: We searched studies in the PubMed and Cochrane collaborative library at alllevels from 2010 to April 2019. Two independent reviewers evaluated the articlesaccording to the predefined criteria and extracted the related data. Primary outcomesassociated with tumor size shrinkage, relapse and overall survival along with secondaryoutcomes such as pain, quality of life, and side effects were investigated.Results: 112 studies were evaluated out of which only 6 studies that covered originalstudies and case reports were entered into this systematic review. A total of 79subjectshad participated in these six studies with an age range of 22 to 41 years old. In fivestudies, participants had a primary tumor and in one research they reported relapse. Therecommended dose was 400 mg/day, which was usually continued for 4 to 12 months.The tumor size shrinkage and low side effects of drugs have been reported.Conclusion: According to the results, no systemic treatment for PVNS and AF has beenapproved so far, but many studies have demonstrated the efficacy of Imatinib in thetreatment of these diseases. However, further studies are required for optimal treatmentand combined therapies.
Background and Objectives: Most deaths occur unpredictably and usually outside of health care facilities; while could be predicted by Cardiopulmonary Resuscitation (CPR). Whatever, the success rate of this procedure is affected by many factors and the aim of this study was to evaluate CPR outcomes and determine theassociated factors.Materials and Methods: This descriptive retrospective study was conducted in 2018 in a private hospital in Mashhad. Census method was used for sampling, and all the patients who underwent CPR were included in the study. Meanwhile, those who had signs of death and/ or those with incomplete medical records excluded from the study. Moreover, data were provided through the Statistics, Medical Records as well as Quality Improvement units.Results:In this study, 394 medical records were evaluated, out of which 224(56.9%) were male and 170(43.1%) were female. Totally, 96(24.4%) successful and 298(75.6%) unsuccessful CPR were recorded. There was a significant correlation between age of the patientand successful CPR (P=0.011).Conclusion:Results of the study showed that the success rate of CPR will be higher, if the patient is young, duration of CPR is short, and the patient has a non-cardiac underlying disease.
Background and Aim: Type 2 diabetes is a chronic and complex disease. This study aims to compare the effectiveness of stress management and acceptance and commitment therapy on psychological capital in patients with type 2 diabetes. Methods: The present study was a quasi-experimental study with pre-test, post-test, and follow-up design with a control group. The statistical population of the study consisted of all patients with type 2 diabetes referred to Milad Hospital in Tehran in 2019. In order to form three groups using the purposive sampling method, 90 patients were selected first by convenience sampling method, and then 30 patients were randomly grouped in the first experimental group and 30 in the second experimental group, and 30 in the control group. Follow-up phase was performed on all three groups three months after the post-test. The research instrument was The Lotans Psychological Capital Questionnaire (2007). Data were analyzed using a mixed analysis of variance by Spss.22. Results: The results showed that stress management and acceptance and commitment therapy had a significant effect on psychological capital components in patients with type 2 diabetes compared to the control group (p <0.00). Also, the mean scores of post-test and follow-up of hope component in the acceptance and commitment group increased more than the stress management group (p <0.00). Conclusion: It can be concluded that stress management and acceptance and commitment therapy were effective in psychological capital in patients with type 2 diabetes. Acceptance and commitment therapy was more effective than stress management on the hope component.
Introduction: Violence against women and girls is currently one of the most important and specific forms of violence against human rights.Objectives: The aim of this study was to determine the effectiveness of a cognitive-behavioral intervention based on psychological capital on experience avoidance and suicidal ideations in girls victims of domestic violence in Isfahan.Materials & Methods: The research design was quasi-experimental with a pretest-posttest design with a control group. The statistical population consisted of all girls’ victims of domestic violence in Isfahan who were referred to a Counseling Center in Isfahan in 2019. The sample consisted of 30 girls who were selected by purposive sampling method and randomly assigned to one experimental group (cognitive-behavioral intervention based on psychological capital) and a control group (each consisting of 15 people). The research tools included Beck Scale for Suicidal ideations (BSSI) and Acceptance and Action Questionnaire (AAQ-II). Data were analyzed by SPSS.22 software and univariate analysis of covariance. Results: The findings of this study showed that cognitive-behavioral intervention based on psychological capital was effective on experience avoidance (p <0.001) and suicidal ideation (p <0.001) in girls’ victims of domestic violence in Isfahan.Conclusion: It can be concluded that cognitive-behavioral therapy based on psychological capital is an effective treatment to reduce problems related to experience avoidance and suicidal thoughts of girls’ victims of domestic violence and can be used to improve psychological problems of girls’ victims of domestic violence.
Background: It is necessary to help pregnant women to solve pregnancy problems by identifying the factors affecting depression, anxiety, and stress. Objective: The aim of this study was to determine the effectiveness of acceptance and commitment therapy on depression, anxiety, and stress in nulliparous pregnant women.Methods: The research method was semi-experimental with a pretest-posttest design with a control group. The statistical population of this study included all pregnant women referred to hospitals in Tehran in 2019, among whom 34 eligible volunteers were selected by convenience sampling method and randomly assigned to two groups of acceptance and commitment and control group. The experimental group received acceptance and commitment therapy in 9 sessions of 120 minutes. Data were collected using a depression, anxiety, and stress questionnaire (Lovibond and Lovibond, 1995). Data were analyzed using repeated-measures ANOVA and SPSS.22 software. The significance level in this study was considered to be 0.05.Results: The results showed that acceptance and commitment therapy intervention significantly decreased depression (p <0.001), anxiety (p <0.001), and stress (p <0.001) in nulliparous pregnant women.Conclusion: It can be concluded that acceptance and commitment therapy was effective in reducing depression, anxiety, and stress in nulliparous pregnant women, and it can be used to improve the psychological problems of pregnant women.
Background and Aim: Cancer is one of the most common diseases in the world, and more than 30,000 Iranians die of cancer every year. This study aimed to predict the quality of life based on early maladaptive schemas and personality traits in women with breast cancer.Methods: The research method was descriptive-correlational. The statistical population of the study included all women with breast cancer, 240 women who were referred to Jam Hospital in Tehran in 2019, 144 people were selected by the available method. Data were obtained using the quality of life questionnaire, Young Schema Questionnaire (YSQ-SF), Personality Traits Questionnaire, and Early Ineffective Schema Questionnaire. Data were analyzed by Pearson correlation coefficient and linear regression using SPSS22 software.Results: The results showed that the quality of life has a predictive role based on early maladaptive schemas and personality traits in women with breast cancer (p <0.001). The results of the regression coefficient show that quality of life can predict agreeableness (Beta=0.38), social isolation/alienation (Beta=-0.26), distress (Beta=-0.22), pleasantness (Beta=0.26), and obedience (Beta=0.17).Conclusion: It can be concluded that the quality of life has a predictive role based on early maladaptive schemas and personality traits in women with breast cancer.
Background: Breast cancer is a disease that women with it are at risk of experiencing disease-related turmoil and pressures.Objective: This study aimed to compare the effectiveness of emotion-focused therapy and cognitive behavioral therapy on sexual self-efficacy in women with breast cancer. Methods: The present study was semi-experimental with pre-test, post-test, and follow-up with a control group. The statistical population of this study was all married women with breast cancer referred to Milad hospital in 2020. Forty-five patients who met the criteria for entering the study were selected as the final sample size by sampling method in non-random and available sampling and were placed in two experimental groups of one control group (each group 15 people). At this stage, all three groups responded to the sexual self-efficacy questionnaire as a pre-test, then the two experimental groups received cognitive-behavioral and emotion-focused therapy sessions and the control group waited. After completing the course, all three groups responded to the questionnaire listed as a post-test. After 4 months, the follow-up test was performed again. Data were analyzed by covariance analysis test and paired comparison of measurement stages by SPSS.22.Results: The results showed that both emotion-focused therapy and cognitive behavioral therapy were effective on sexual self-efficacy (p <0.001), but there was no difference between the two treatments on sexual self-efficacy. Conclusion: The results of this study showed the effect of emotion-focused approach therapy and cognitive behavioral therapy as supportive methods in increasing sexual self-efficacy in women with breast cancer.
Background and Purpose: After a childhood and following human beings to adolescence, changes have been achieved in him (or her), including the tendency of individuals to gain independence. The aim of this study was to investigate the relationship between metacognitive strategies and attachment styles with the sense of school belonging in high school students in Zahedan.Method: The present study was a correlational study; The statistical population of the present study was all high school students in Zahedan, and the sample consisted of 370 people who were selected by simple cluster-random sampling. The questionnaires that were considered to collect information from the sample group were: Barry et al.'s Feeling of Belonging Questionnaire (2004), O'Neill and Abedi Metacognitive State Questionnaire (1996), and Collins and Reid Attachment Questionnaire (1991). For the statistical analysis of data, the Pearson correlation coefficient and structural equation model (SEM) were used using Amos.22 and SPSS.22 software.Results: Results showed that metacognitive awareness (β=0.31, p <0.001), cognitive strategy (β=0.24, p=0.045), planning (β=0.23, p=0.003) and self-review (β=0.28, p <0.001) had positive effect on school belonging. Secure attachment style (β=0.17, p=0.021) has positive effect on school belonging. Avoidance attachment style (β=-0.27, p <0.001) and ambivalent attachment style (β=-0.23, p=0.003) had negative effect on school belonging.Conclusion: It can be concluded that metacognitive strategies components have a positive and direct effect on school belonging to school belonging. A secure attachment style has a positive effect on school belonging. Avoidance attachment style and ambivalent attachment style had a negative effect on school belonging.
Background: Diabetes mellitus is a metabolic disorder in the body whose prevalence is constantly increasing. Objectives: The aim of this study was to compare the effectiveness of metacognitive therapy and behavioral activation on executive functions of elderly people with type 2 diabetes.Methods: This study was a quasi-experimental study with pretest, posttest, and control group design, and a three-month follow-up. The statistical population included people with type 2 diabetes who were referred to five endocrine clinics located in area 11 and were at least 60 years old and 75 years old at most. Forty-five women and men participated in this study through a purposeful and voluntary sampling method. Wisconsin card was used for data collection. Data were analyzed using descriptive statistics such as mean and standard deviation and inferential statistics by analysis of covariance and repeated measure ANOVA with SPSS.25 software. Results: The results showed that show that there is no statistically significant difference between metacognitive and behavioral activation groups in the subscales of executive function, and the mean post-test of the groups is almost equal (p 0.05).Conclusion: It can be concluded that meta-cognitive therapy and behavioral activation increased effective executive functions.
Background: Multiple sclerosis (MS) is considered a chronic disease in which physical and mental disorders are common among these patients. This study aimed to evaluate the effectiveness of the Lazarus multimodal approach intervention on psychological distress, working memory, and anxiety in patients with MS. Methods: A quasi-experimental research method with pre-test, post-test, and follow-up and a control group was used in this study. The statistical population of the study included the patients who were members of the "MS Patient Support Society" in Tehran who had been referred to this center during January and March 2017. The sample consisted of 32 people selected by the convenience sampling method from the members of the MS community. The data were obtained through the Kessler psychological distress scale (K10), the Wechsler’s Working Memory Index, and the Beck Anxiety Inventory. The experimental group underwent the Lazarus multimodal approach in ten 90-minute sessions of two sessions per week for one and a half months. The control group received no intervention. The follow-up was performed three months after the post-test. The repeated measurement method and SPSS 22 were used to analyze the data. Results: The findings showed that the Lazarus multimodal approach had a significant effect on decreasing anxiety (P<0.001), psychological distress (P<0.001), and increasing working memory (P<0.001). Conclusion: It can be concluded that Lazarus’ multimodal approach was effective on anxiety, psychological distress, and working memory and can be employed to reduce psychological problems in patients with MS.
Background: Distress tolerance has been observed as an important structure in creating new insights against the onset and persistence of psychological trauma and prevention and treatment.Objective: This study aimed to investigate the role of commitment in the relationship between early maladaptive schemas and distress tolerance in conflicted couples. Method: The method of this study was descriptive-correlational. The study population consisted of married men and women residing in Kerman. The sampling method was cluster sampling method, through which 400 participants (200 females and 200 males) were selected. Data collection tools included Simmons Distress Tolerance Questionnaire (2005), Adams and Jones Marital Commitment Questionnaire (1997), and Young's Early Maladaptive Schemas Questionnaire (1990). Data were analyzed using correlation and structural equation analysis by spss.22 and Amos.22. Results: The results indicated the moderating role of marital commitment variable in the inverse relationship between maladaptive schemas of three areas of cuts/exclusion, impaired performance, and emotional inhibition with distress tolerance (p <0.01). Conclusion: It can be concluded that although the areas of early maladaptive schemas reduce distress tolerance and commitment of women, the high level of communication commitment among couples can increase distress tolerance in them.
Background: This study aimed at comparing the efficacy of dialectical behavioral therapy and compassionate focused therapy on blood cortisol and serotonin levels among drug abusers. Materials: It was a quasi-experimental study with pretest-posttest design and control group. The statistical population consisted of all men with drug abuse referring to Torbat-e-Heydariyeh Adult Drug Abuse Clinic in 2018, 60 of whom were selected by simple random sampling for two experimental groups (DBT, CFT) and a control group. The experimental group was trained for 10 90-min sessions, but the control group was on the waiting list and received no training. Demographic questionnaire and in vitro serum levels of cortisol and serotonin were used for data collection before and after the intervention. Data were analyzed using multivariate analysis of covariance (MANCOVA) in spss 24 software. Results: The results of multivariate analysis of covariance showed that in the two groups of dialectical and compassionate-focused behavioral therapy, intervention on self-control and blood cortisol had a significant effect on post-test (p
Background: Bisphosphonate-associated atypical femoral fracture (AFF) is a rare and serious condition with poorly understood characteristics and management. Objectives: To evaluate the characteristic features and outcomes of AFF in a two-center cohort study.Methods: In a retrospective survey, medical profiles of 22 AFF patients, who have used alendronate for > 12 months, were reviewed. The demographic characteristics such as age, gender, and BMI, the clinical features including symptoms, symptom duration, radiologic characteristics including fracture site, the severity of the fracture, and contralateral involvement, surgical characteristics including the type of surgery union period and postoperative complications such as fixation failure, and union problems were extracted from the patients’ profiles.Results: The study population included 4 males and 18 females with a mean age of 70.6±11.9 years. The mechanism of fracture was falling down in 21 (95.5% ) patients. The mean duration of bisphosphonate consumption was 3.8±2 years. Prodromal symptoms (pain and limping) were recorded in 12 (54.55%) patients. The fracture was in the femoral shaft in 15 (68.2%) and in the subtrochanteric in 7 (31.8%) patients. The fixation device was the intramedullary nail in 18 (81.8%) and plate in 4 (18.2%) patients. The mean union period was 8.3±2.8 months. Union complications (delayed or nonunion) occurred in 6 (27.3%) patients. Fixation failed in 5 (22.7%) patients (3 nails and 2 plate fixation).Conclusions: AFF is associated with a prolonged union. The intramedullary nail provides a more secure fixation. Prodromal symptoms could be used for earlier detection of patients.
Background and aim: Identifying factors that affect high-risk behaviors is one of the fundamental ways to prevent high-risk behaviors. This study aimed to determine the predictive role of social capital and mental health in the tendency to high-risk behaviors in female students of Shahid Beheshti University. Methods: The research method was correlational. The statistical population of this study included all female students of Shahid Beheshti University of Tehran who were studying in the first semester of 2018-19, among which 150 students were selected. The sampling method was stratified random sampling. Data were collected using the Iranian Youth Risk Assessment Scale, General Health Questionnaire, and Social Capital Questionnaire. Data were analyzed using the Pearson correlation coefficient and multiple regression by spss.22. Results: The results showed a negative relationship between the components of social capital and the tendency to risky behaviors. Also, there was a positive relationship between general health components and the tendency to high-risk behaviors (p <0.001). There was a relationship between social capital and the tendency to risky behaviors (p <0.001).Conclusion: It can be concluded that social capital and mental health play a predictive role in the tendency to high-risk behaviors in female students.
Background: Addiction is a condition that is created if a habit is developed in a person to consume substances such as drugs, nicotine, alcohol, or activities.Objectives: The present research was conducted to investigate the effectiveness of the Acceptance and Commitment Therapy (ACT) on the psychological capital and temptation of methadone-treated addicts. Methods: The research was of a quasi-experimental type with a pretest-posttest design and a control group. The statistical population consisted of all methadone-treated addicts in addiction treatment clinics in Mashhad. From this population, 30 people were randomly selected, and by random replacement, the method was divided into two groups: experimental group (15 people) and control group (15 people). The data collection tool was Luthans's Psychological Capital Questionnaire (PCQ) and Wright's Craving Beliefs Questionnaire (CBQ). The data analysis method was performed using univariate and multivariate covariance with the aid of SPSS21 software. Results: The research findings showed that the Acceptance and Commitment Therapy (ACT) approach, had a positive and significant effect on psychological capitals and its components (self-efficacy, hope, resiliency, and optimism) (p <0.001). It also had a significant effect on reducing the recurrence temptation of methadone-treated addicts (p <0.001). Conclusion: Based on the research findings, it can be concluded that Acceptance and Commitment Therapy (ACT) can increase psychological capital and reduce the temptation of methadone-treated addicts.
Introduction: Considering that the health and illness of women can directly affect the general health of the family and society, and the problems originated from this disease not only affect the patients, but also exert a deleterious effect on the members of the family and undermine the foundation of the family. Thus, research on factors associated with the psychological issues of these patients can urge policy makers and healthcare professionals to pay greater attention to this issue. The aim of this study is to determine whether the quality of life of patients with breast cancer could be predicted by spirituality, self-forgiveness and self-blame. Methods: This is a descriptive correlational study in which 120 cancer patients admitted to two university hospitals were selected using cluster-sampling method. The research instruments were the Paloutzian and Ellison’s Spiritual Well-Being Scale (1), self-forgiveness and self-blame scales and World Health Organization Quality of Life questionnaire. According to the level of data and statistical assumptions, multiple linear regression was used to test the hypotheses Results: The results of statistical analysis showed that the components of spiritual wellness, existential wellness, anxiety control and realistic perception were related to the quality of life at a significantly level of 5%. The positive value of these coefficients actually indicates that by improving these components, the quality of life could be enhanced. Also, it was found that negative attitude and self-blame were in a negative relationship with the quality of life. Conclusion: The present study investigated the relationship between spirituality, self-forgiveness and self-blame with quality of life, with the results indicating that personal-level variables, i.e. spirituality, self-forgiveness and self-blame affect the quality of life
