2023 CiteScore: 4
pISSN: 1735-4587
eISSN: 2008-2215
Editor-in-Chief:
Mohammad Reza Mohammadi, MD.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol 17 No 4 (2022)
Original Article(s)
-
Objective: Stress and anxiety in the mother as one of the most important members of the child's health can delay recovery and prolong hospitalization of the child. However, families feel very anxious or stressed because of the limitations imposed by COVID-19; therefore, it is important for physicians and nurses who work with children and families to recognize and reduce family stress. This study aimed to investigate the effect of implementing an educational-supportive program on improving family-centered care with bedside telehealth.
Method: In this clinical trial, 40 parents with hospitalized children were selected and randomly assigned to control and intervention groups. The intervention group received a supportive training program, including teaching parental roles and supportive methods for the child and mother during the illness, while nurse counseling and support role was performed virtually as part of the intervention. After the virtual and visual implementation of the training, the father established online video communication with the child and the mother as the primary caregiver. Data collection tools were a demographic questionnaire and Stress Response Inventory (SRI) completed by the mother before and after seven days of intervention. The control group received routine care.
Results: After the intervention, mothers in the intervention group showed significantly lower levels of stress than before the intervention (P < 0.05). Stress level of mothers in the control group did not demonstrate significant difference before and after the intervention (P > 0.05). Also, a comparison of mothers' stress scores post-intervention showed significant difference between the two groups (P < 0.05).
Conclusion: Planning and maintaining family integrity during the COVID-19 pandemic along with educating and supporting fathers through the supportive role of spouses can reduce stress of mothers with hospitalized children.
-
Objective: With the increasing effects of stress caused by the COVID-19 pandemic and occupational stress on the mental health of frontline nurses, it is imperative to further investigate how these stresses affect nurses’ mental health and secondary traumatic stress syndrome. This research aimed to investigate the relationship of nurses' occupational stress and concerns about COVID-19 with secondary traumatic stress syndrome, and also to investigate the mediating effect that concerns about the COVID-19 pandemic have on the relationship between nurses' occupational stress and secondary traumatic stress syndrome.
Method: A cross-sectional design was adopted. The population of the study was defined as all front-line nurses in Shiraz hospitals, from which 225 nurses of two corona care hospitals were selected using convenience sampling. The degree of secondary traumatic stress, concerns about the COVID-19, and nurses' occupational stress were assessed using Bride’s Secondary Traumatic Stress Scale (STSS), an adopted version of Level of Concerns about the COVID-19 questionnaire, and the Nurses’ Occupational Stressor Scale (NOSS) among Hospital-based Healthcare Workers. Structural equation modeling (SEM) was used to examine the relationships among variables.
Results: Results showed that nurses’ occupational stresses presented a direct effect on nurses’ level of concern about the COVID-19 pandemic (β = 0.85, P < 0.001), and concern about the COVID-19 pandemic was directly related to front-line nurse's secondary traumatic stress syndrome (β = 0.83, P < 0.001). In addition, nurses’ level of concern about the COVID-19 pandemic fully mediated the effects of nurses’ occupational stresses on their secondary traumatic stress (β = 0.70, P < 0.001). This indirect effect has explained 68% of the variance in nurses’ secondary traumatic stress.
Conclusion: These results emphasized the indirect effect of nurses’ occupational stresses on secondary traumatic stress syndrome via mediating the level of concern about COVID-19. Therefore, to reduce the secondary traumatic stress of nurses who have dealt directly with COVID-19 patients, it seems necessary to pay serious attention to the sources of their occupational stress, which probably existed even before this pandemic and increased their concerns in pandemic conditions.
-
Objective: Breast cancer is a multidimensional crisis for women and their spouses that affects every aspect of their life. Coping with this disease requires investigating and resolving the challenges faced by all those affected by it. The present study was conducted to clarify these challenges on the basis of lived experiences of the spouses of women with breast cancer.
Method: The present qualitative research performed an interpretive phenomenological analysis in Iran.Purposive sampling was employed to select twenty spouses of women with breast cancer. The data collected through unstructured face-to-face interviews were analyzed using van Manen’s method. To ensure the rigor of the study, Lincoln and Guba’s criteria were evaluated in the qualitative process.
Results: Lived experiences of the spouses of the women with breast cancer in coping with challenges included the four themes of emotional confusion, shouldering the burden of care, psychophysical suffering caused by the disease and life without cohesion.
Conclusion: Spouses of the women with breast cancer in the Iranian community faced several challenges and issues. The socioeconomic support provided by supporting organizations and medical personnel appear to help moderate these challenges and improve coping in this group.
-
Objective: Happiness is an essential component in measuring quality of life. Today, rapid internet use proliferation has led to adverse effects on this behavior of individuals and family structures.
Method: The statistical population consisted of 500 high school girls aged between 15 and 18 studying in 10th, 11th, and 12th grades at Shiraz, Iran, from February 2018 to March 2019. The data were collected using the Oxford Happiness Questionnaire (OHQ) and the Young’s Internet Addiction Test (IAT). The test and the questionnaire were translated into Persian. The validity and reliability were approved by earlier studies in Iran. Five hundred high school students participated in the study.
Results: The mean age of the participants was 16.7 ± 0.97 years, and their grade point average (GPA) was 18.41 ± 7.92. Among the 500 participants, 55% (275) of fathers and 65.8% (329) of mothers had parents with a diploma degree, and 162 (32.4%) were affected by Internet Addiction (IA). The univariate analysis showed that participants' education field, parents' educational status, each parent's vocational status, participants' GPA, and their duration of Internet usage correlated with the IA (P ≤ 0.2). Furthermore, multiple logistic analyses showed that mothers’ education (P < 0.055) and participants’ minutes of Internet usage (P < 0.001) correlated with IA.
Conclusion: There is a negative correlation between happiness score and internet addiction among high school female students in Shiraz, Iran.
-
Objective: Clients with borderline personality disorder (BPD) often engage in high-risk sexual behaviors. Online sexual platforms convey abusive and harmful themes, especially for this group of sexually impulsive patients. We hypothesized a correlation between their online sexual activities and the severity of BPD symptoms.
Method: Fifty clients with BPD who were referred to Iran psychiatric hospital and Tehran Psychiatric Institute in 2020 participated in this research. The Borderline Evaluation of Severity over Time (BEST) questionnaire was used to assess the severity of BPD symptoms, and the Internet Sex Screening Test (ISST) was used to evaluate online sexual behaviors. A psychiatric interview considered substance abuse and other confounding factors.
Results: The mean ISST and BEST scores were 7.82 ± 5.74 and 41.7 ± 12.5, respectively. There was a positive and significant correlation between the severity of BPD symptoms and online sexual activities (P < 0.001, r = 0.480). There was also a significant relationship between online sexual activities and a history of substance abuse (P = 0.003, F = 25.06).
Conclusion: Online sexual activity can harm clients with BPD who are more vulnerable to high-risk sexual behaviors. More severe borderline personality traits were associated with more online sexual activity, which underlines the importance of providing education about and managing such activities in clients with BPD.
-
Objective: The COVID-19 pandemic is a crisis accompanied by multiple psychological consequences (including fear of COVID-19) and threatens the food security status of millions of people. This study aimed to examine the association between fear of COVID-19 and food insecurity, mediated by perceived stress.
Method: This cross-sectional study was conducted among 2871 Iranian participants (18-80 years), recruited through the Social Media during the COVID-19 epidemic. The demographic and socio-economic information questionnaire, Household Food Insecurity Access Scale (HFIAS), COVID-19 fear scale (FCV-19S), Cohen's Perceived Stress Scale (PSS-14) and Perceived Social Support Questionnaire (MSPSS) were used in data gathering. Descriptive and analytical analyses were done using SPSS 22.0 and Amos 22.0 was used for structural equation modeling (SES).
Results: Food insecurity has significant positive direct and indirect (mediated by perceived stress) correlations with fear of COVID-19 (P < 0.05). It was also shown that perceived social support could negatively relate to fear of COVID-19 through the pathways of food security status or perceived stress (P < 0.05). Among women, the presence of a child under 5 had a significant direct association with fear of COVID-19 (P < 0.05).
Conclusion: Food insecurity was associated with more perceived fear of COVID-19 among the studied population. The crisis caused by COVID-19 highlights the need to increase social resilience through developing and implementing appropriate strategies to prevent and mitigate social costs (whether physical, psychological, or nutritional).
-
Objective: Nowadays, loneliness is one of the foremost common issues among university students that may negatively affect their physical and mental states and academic performance. Accordingly, this research project intended to investigate the incidence of loneliness and its related risk factors among students studying at universities of medical sciences.
Method: The participants in this cross-sectional study were 538 Tabriz University of Medical Sciences students, selected using a simple random sampling method. Loneliness was measured using the UCLA Loneliness questionnaire with 20 questions. Descriptive statistics, multiple logistic regression, and Chi-square were used to identify factors affecting loneliness.
Results: The results showed that the mean loneliness score and the magnitude of the students' loneliness were 41.42 and 26.4%, respectively. The magnitude of loneliness was higher among female respondents (OR = 1.86, P = 0.005), cigarette smokers (OR = 0.39, P < 0.001), freshman students (OR = 2.76, P = 0.021), sophomore students (OR = 2.36, P = 0.040), those with low financial status (OR = 1.80, P = 0.037), and those residing in dormitories (OR = 1.73, P = 0.013).
Conclusion: In general, loneliness was widespread among the students. Based on the findings, the magnitude of loneliness was higher among the first-year student group, female students, students with poor economic status, and those who smoked and lived in dormitories. Therefore, this study's findings underline the significance of making students aware of loneliness, investigating the circumstances and factors that exacerbate this sensation among first-year students (mainly between 18-21 years old), and devising intervention to alleviate it.
-
Objective: Marital commitments and mental health are the important indicators of marital quality. Considering the
modern and mixed marriage pattern in recent years, compared to the traditional pattern, as well as the increase in divorce rates due to reduced marital commitment, the present study was conducted to compare marital commitment and mental health in various patterns of mate selection among married women.
Method: This cross-sectional study was performed on 160 married women aged 15-49 years in Babol city, Iran, who were selected by convenience sampling from health centers under the auspices of Babol University of Medical Sciences. Data collection tools included the spouse-selecting style, marital commitment (Adams and Jones), and general health questionnaires. Data analysis was performed in SPSS V.25 software, using analysis of variance (ANOVA), and Chi-square tests.
Results: Results showed that the mean score of marital commitment and its three dimensions (commitment to spouse, commitment to marriage and sense of commitment); general health; physical, anxiety and sleep disorders; as well as social function of married women are not significantly different in traditional, mixed and modern marriage patterns. There was a significant difference in the mean score of depression between traditional, mixed and modern marriage patterns. Pairwise, ANOVA revealed that the mean of the depression score was significantly higher in traditional marriage than in the mixed marriage pattern (P = 0.012). Different marriage patterns had statistically significant differences in demographic variables such as age, the place of birth of the wife and the husband, duration of marriage, number of children and the level of education (P < 0.05).
Conclusion: It seems that there is a kind of convergence in marital commitment in various patterns of marriage among married women in Babol city.
-
Objective: Mental health in people with chronic diseases undergoes many changes due to conflict with the pain caused by the disease, which can have a reciprocal effect on the course and quality of the patient's treatment. The goal of the present study is to compare the correlation between locus of control, relationship quality, pain intensity and resilience with dialysis adequacy and laboratory indicators in peritoneal dialysis and hemodialysis patients.
Method: This causal-comparative study was conducted on 30 hemodialysis (HD) and 30 peritoneal dialysis (PD) patients through the convenience sampling method. The data was collected using Pierce Quality Relationship Inventory (QRI), Conner-Davidson Resilience Scale (CD-RISC), Rotter’s Locus of Control Scale (RLOC), and Von Korff’s Chronic Pain Grade Scale (CPGS), and experimental data collected through blood and urine sampling and analyzed with Fisher's test and multivariate analysis of variance.
Results: Conclusion of the Fisher test evinced that there was a significant difference between quality of relationships with parents and amount of Potassium (K), Phosphorus (P) and Parathyroid Hormone (PTH) as well between quality of relationships with friends and amount of Creatinine (Cr), and between the intensity of pain with K and Albumin (Alb) in patients with PD and HD (P < 0.05, P < 0.01). Conclusion of analysis of variance showed that the mean scores of quality of relationships with friends, K, Blood Urea Nitrogen (BUN), Cr, Alb and PTH in the PD group were significantly lower than the mean scores of HD patients (P < 0.05, P < 0.01). Also, mean of dialysis adequacy in patients with PD was significantly higher (P < 0.01).
Conclusion: Based on findings, in order to increase dialysis adequacy of patients, along with medical interventions, psychological variables and mental health improvement of patients should also be considered.
-
Objective: This study aimed to determine the level of post-traumatic stress disorder (PTSD) among nurses and its relationship with occupational burnout.
Method: This online cross-sectional survey was conducted from late November to early January 2020 in six hospitals in Iran. 309 frontline nurses in COVID-19 wards were selected via stratified random sampling and asked to complete a sociodemographic questionnaire, the Impact of Event Scale-revised version (IES-R), and the Maslach Burnout Inventory–Human Services Survey (MBI-HSS) in an anonymous online survey. Data management and analysis were performed in SPSS 25.0 using descriptive and inferential statistics, including Pearson’s correlation coefficient, independent samples t-test, ANOVA, and linear regression.
Results: The majority of the participants were women (81.6%) with a mean ± SD age of 31.56 ± 6.42 years. The mean ± SD of the total PTSD score was 39.2 ± 16.44 years, indicating severe PTSD among nurses. The mean ± SD of the total occupational burnout score was 82.77 ± 19.38, expressing moderate burnout. The findings also demonstrated a significant moderate correlation between PTSD and occupational burnout (r = 0.363, P < 0.001). Univariate analysis revealed a significant relationship of occupational burnout with PTSD, work experience, number of night shifts per month, and employment status (P < 0.05). However, in multivariate analysis, only PTSD had a positive and significant relationship with occupational burnout (P < 0.001; R2 = 160; β = 0.339) and was a predicting factor for it.
Conclusion: We found that both PTSD and burnout are common among nurses. Given the role of PTSD especially as a predictor of burnout and the significant impact of these disorders on occupational and non-occupational activities, immediate and appropriate measures are necessary to monitor and reduce their effects on the nurses who are at the forefront of fighting the pandemic.
-
Objective: This cross-sectional study aimed to assess the effects of different coping strategies on the mood states (anxiety and depression) of healthcare providers in the novel coronavirus disease (COVID-19) pandemic.
Method: From February to April 2020, we asked medical staff in 4 referral hospitals in Iran to voluntarily complete online questionnaires including: Generalized Anxiety Disorder (GAD-2) questionnaire, Patient Health Questionnaire (PHQ-2) and the Coping Strategies Questionnaire-28. Univariate and multiple logistic regressions were applied to identify the associations of coping strategies and mood states.
Results: 258 people filled out the online questionnaire. Of them, 39.9% and 39.1% reported anxiety and depression, respectively, with age as a risk factor. Overall, participants used more emotion-based coping strategies. Anxiety and depression were associated with applying more of emotion-based and less of problem-based coping mechanisms. The findings remained stable even after adjustment for confounding variables including age, gender and direct contact with COVID-19 patients.
Conclusion: Providing social support to health workers, planning to reduce their perceived stigma, and educating them about how to use more effective coping mechanisms can be beneficial in reducing the psychological impact on this segment of the population in the event of COVID-19.
-
Objective: Sleep disturbance is one of the most prevalent problems in post-menopausal females. The current research intended to evaluate the effects of Dracocephalum on sleep disorder in post-menopausal females.
Method: The current study is a randomized, double-blind controlled trial, in which 110 post-menopausal women were randomly allocated to Dracocephalum or placebo groups. The intervention group took Dracocephalum capsules containing 250 mg Dracocephalum extract twice daily for one month. While, the placebo group took the same capsule containing 250 mg of starch twice daily for one month. Pittsburgh Sleep Quality Index was completed by the participants of both groups before and after the treatment and the data obtained were analyzed with Chi-square, paired and independent t-test in SPSS (version 20).
Results: The mean score of sleep quality before and after the treatment was 12.69 ± 3.98 and 8.58 ± 1.97 in the treatment group, respectively. Also, the score of sleep quality in the placebo group was 13.48 ± 2.60 and 11.21 ± 2.74 at the beginning and end of the research, respectively. The symptoms of sleep disorder in the intervention group significantly improved after the treatment (P < 0.001), while this was not the case with the placebo group (P = 0.155). Besides, there was a significant difference between the two groups in the mean score of sleep quality after the treatment (P = 0.012).
Conclusion: Dracocephalum extracts are effective in reducing symptoms of sleep disorders in post-menopausal women.
-
The Relationship between the Severity of the COVID-19 Disease, Temperament and Psychological Factors
Objective: The coronavirus (COVID-19) pandemic negatively affects public mental health around the world. Individuals’ reactions to COVID-19 vary depending on their temperament, individual differences, and personality traits. Therefore, the current study is conducted to assess the association of demographical features, Persian temperament, and psychological characteristics with the severity of COVID-19.
Method: An online survey was sent to COVID-19 patients to collect their demographic information, COVID-19 symptoms, and clinical data. The Depression, Anxiety and Stress Scale (DAAS-21) questionnaire, Beck Depression Inventory (BDI-II), Spiel Berger State-Trait Anxiety Inventory (STAI) , Pittsburgh Sleep Quality Inventory (PSQI), and Persian general and brain temperament Questionnaire were also completed by 258 participants (127 men and 131 women) 45 days after recovery from COVID-19. Non-parametric analysis was used for statistical analysis.
Results: Results showed the significant relationship of demographic factors such as weight, age and gender with the severity of the COVID-19 (P < 0.05). Mean scores of brain temperament (warm/cold) in the severe group were significantly lower than the moderate and mild groups (P < 0.05). There was a significant increase in the dry/wet temperament of the brain in the severe and moderate groups compared to the mild group (P < 0.05). The results of DASS-21 showed a significantly higher anxiety in patients with severe COVID-19 compared with moderate and mild groups (P < 0.05). The severe group was found to be significantly different compared to moderate group in the results of BDI-II (P < 0.05). The result of STAI (state and trait) showed a significant difference between the severe group and the mild and moderate groups. The score of PSQI between the moderate and mild groups was significant (P < 0.05).
Conclusion: These results indicate the relationship between demographic factors such as weight, age and gender, brain temperament, as well as some psychological factors such as sleep quality and anxiety with the severity of the COVID-19 disease.
-
Objective: The growing popularity of computer games has attracted the attention of researchers in this field. The underlying psychological motives of gamers are important to prevention of disorders related to online gaming. This study was aimed at evaluating the psychometric characteristics of the Iranian version of the Motives for Online Gaming Questionnaire (I-MOGQ) and its association with Internet Gaming Disorders (IGD).
Method: Four hundred and fifty-two Iranian adult gamers (mean age = 21.5 years, SD = 4.14) voluntarily responded to the anonymous survey online. All participants in this study were males. The questionnaires used in this study were MOGQ and IGD Scale. We performed confirmatory factor analysis (CFA) for MOGQ. Also, the correlation between MOGQ and IGD was evaluated.
Results: CFA supports the construct validity of the questionnaire (RMSEA < 0.08). Cronbach's alpha, as an indicator of internal consistency of the questionnaire, was 0.91 (Social = 0.85, Escape = 0.84, Competition = 0.83, Coping = 0.79, Skill Development = 0.89, Fantasy = 0.85 and Recreation = 0.83). Also, the scale displayed adequate convergent validity, as shown by significant positive correlations with IGD scores. The highest correlation was found with the Escape motive (0.57) and the lowest was found with Recreation (0.15).
Conclusion: This study showed that the Iranian version of the MOGQ is a valid and reliable scale for identifying the motives for online gaming among young adults.
-
Objective: Methylphenidate, a psychostimulant agent, is used in first-line psychopharmacological treatment in children and adolescents with attention-deficit/hyperactivity disorder. Common side effects associated with methylphenidate use in children and adolescents are insomnia, anorexia, headache, and nausea. Thrombocytopenia, nasal bleeding and menstrual bleeding disorders are very rarely reported during methylphenidate use. One of the least expected side effects during methylphenidate usage is menorrhagia.
Method: In this article, we report methylphenidate monotherapy-induced menorrhagia in two adolescent identical twins. To our knowledge, this is the first report of menorrhagia associated with methylphenidate use in children and adolescents.
Results: In both cases, menorrhagia has started after methylphenidate monotherapy and stopped after discontinuation. Other possible etiologies have excluded with clinical and laboratory evaluations. Naranjo Adverse Drug Reaction Probability Score was found 7, indicates probable side effect.
Conclusion: Menorrhagia is a rare adverse effect of methylphenidate use and clinicians should be aware of this phenomenon.
