Prevalence of Cardiac Depression and its Related Factors among Patients with Acute Coronary Syndrome

Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS).This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. Thiscross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to theMazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac DepressionScale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear modelmultivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49(CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate,and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a differencebetween cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients,it is necessary to develop measures for routine screening in cardiac treatment units

Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients’ inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning

Psychometric Properties of the Persian Version of Spiritual Well-Being Scale in Patients with Acute Myocardial Infarction

The purpose of this study was to assess the psychometric properties of the Persian version of Spiritual Well-Being Scale (SWBS) in patients with acute myocardial infarction. A multisite, cross-sectional survey was employed to determine the instrument’s reliability (Cronbach’s a and construct reliability) and validity (face, content, and construct). Using systematic sampling of adult outpatients at primary care clinic sites in the Qazvin City, Iran (N = 300), it was found that the Cronbach’s alpha and construct reliability of both factors associated with the SWBS were above 0.7. The construct validity of the scale was determined using exploratory factor analysis. The findings supported two factors: relation with God and relation with life. Further investigation through confirmator

Relationship between Ageing Perception and Attachments Styles in Elders Living in Qazvin, 2015

Abstract Background: Ageing leads to problems related to this stage of life. Perception of an old aged is an important factor in predicting of experiencing successful aging. As well, attachment is considered as one of the main concerns and challenges that is associated with aging and perception of that among elders. This study aimed to investigate the relationship between ageing perception and attachment styles in elders living in Qazvin, 2015. Materials and methods: A descriptive-correlational design was conducted on 300 elders who were recruited to the 23 clinics and health centers in Qazvin during the period of August to October, 2015. Data were collected using demographic information, Barker`s ageing perception questionnaire, and Collins and Read`s revised adult attachment scale. The analyses were performed using descriptive and inferential statistics using SPSS-PC (v.22). Results: The results showed that older people have average ageing perception (159.10±11.10). Also there was statistically significant relationship between ageing perception and fearful attachment style (r=.030, p=.126). It wasn`t found any significant relationship between ageing perception with other attachment styles. Among the demographic variables, male gender, being single, academic education, living at children`s house, poor economic status, low relatives visiting as well as emotional support from the family were related in increasing the ageing perception. Furthermore, it wasn`t found a significant relationship between the main source of income and experiencing of mental health problems. Also, the majority of elders reported secure attachment in attachment styles. Mean differences in attachment styles wasn’t significant in variables such as age, sex, marital status, education level, living place, socioeconomic status, main source of income, and history of mental and emotional problems. Chi-square test results showed that relative visitings and receiving emotional support from family were correlated with secure attachment styles (p<.05). Conclusions: This study was an important step in the understanding of ageing perception and attachment styles in elders. The concept and influencing factors of these two variables are considered as the determinants agents in mental health, creating adaptation, and positive experience about ageing. So greater researches in this area is recommended in order to compare the results with the present study

Exploring the Relationship Between Spiritual Well-Being and Death Anxiety in Survivors of Acute Myocardial Infarction: Moderating Role of Sex, Marital Status and Social Support

Previous empirical studies have shown that both spiritual well-being (SWB) and death anxiety (DA) significantly affect the mental health of patients with acute diseases. In this regard, our paper contributes to the extant literature by scrutinizing the conditional relationship between SWB and DA as well as the various mechanisms underpinning such a relationship in patients with acute myocardial infraction (AMI). A descriptive, correlational methodology was utilized. Our main sample consisted of 300 patients with acute myocardial infraction who were hospitalized in a specialized medical institution in Iran throughout a two-month period (i.e. August–October 2015). Patients completed Spiritual Well-Being Scale (SWBS) and Templer’s Death Anxiety Scale (TDAS). Even though our study showed that the relationship between SWB and DA in patients with AMI is nonsignificant, we found that (1) single patients with higher SWB have lower DA, (2) single patients with higher SWB as well as social support have significantly lower DA, and (3) for single men/men without social support, there is a negative relationship between SWB and DA. The relationship between SWB and DA is influenced by factors such as sex, marital status and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences. Result revealed that although relationship between SWB and DA is non-significant, this is influenced by factors such as sex and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences

Researcher as an Instrument in Qualitative Research: Challenges and Opportunities

AbstractBackground and aim:Researchers, in qualitative researches, both influences on and take effect from the research process. One of the mainissues in qualitative research is validity of the researcher as an instrument of data collection. If the researcher doesnot have enough validity in the data collection, the results of the study will also not be cited. The researcher asinstrument provides an opportunity for researchers to enter into the unknown world of individual about thephenomena in question and sometimes faced many challenges in reaching this goal. This study has been reviewingthe opportunities and challenges of researchers as an instrument in the qualitative research.Materials and methods:This was a review study on the methodology of qualitative research. Using keywords including qualitative research,instrument, challenges, and opportunities, articles and available books were investigated in PubMed, Scopus,Science Direct, Proquest, Magiran ¡SCI ¡IranDoc, SID, Medlib, IranMedex databases with no time limit. TheQuality of the articles was assessed by using the McMaster Critical Review Form for Qualitative studies.Findings:Studies over 12 books and 18 articles showed that the role of the researcher can be varied in different qualitativeresearch designs such as phenomenology researches, grounded theory, ethnography, and content analysis researches.Also previous experience and skills in the process of observation and interview, having effective communicationand asking the appropriate questions have an important impact on the role of researchers as a key factor inqualitative research.Conclusions:Researchers have the main role, especially in data gathering of different types of qualitative researches. Actuallythey are factors that validate the data. Experience and skills, ability to communicate, asking the right questions arethe most important factors that have an influence on doing qualitative research in an appropriate ways.Key words:Qualitative Research, Instrument, Challenge, OpportunityREFERENCES‐ Abedi H A (2010) [Application of phenomenological research in clinical sciences]. Jounal ofRahbord 19(54) 207-24. (persian)  ‐ Alvandi S M and Boudlaei H (2010) [Phenomenology in entrepreneurship studies]. IranianJournal of Management Sciences 5(19) 33-61. (persian)  ‐ Bogdan R and Biklen S K (1997). Qualitative research for education, Fourth Edition, New York,Allyn &amp; Bacon, 1997  ] Briggs D (2013) Emotions, ethnography and crack cocaine users. 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(2012) [Sampling in qualitative research: A Guidefor beginning]. Journal of Army University of Medical Sciences 10(3) 238-250. (Persian)  ‐ Rouhani H (2010) [Qualitative research: Background and approaches]. Journal of Rahbord19(54) 7-29. (persian)  ‐ Soleimani M A, Negarandeh, R and Bastani F (2015) [Exploring for self-care Process in patientswith parkinson's disease: A grounded theory study]. Hayat 21(1) 6-22. (persian)  ‐  Soleimani M A, Negarandeh R, Bastani F, et al. (2014) Disrupted social connectedness in peoplewith Parkinson's disease. British Journal of Community Nursing 19(3) 136-4.  ‐  Speziale H S, Streubert H J and Carpenter D R (2011) Qualitative research in nursing:Advancing the humanistic imperative, Philadelphia, Lippincott Williams &amp; Wilkins.  ‐  Steen M and Roberts T (2011) The handbook of midwifery research. 1st Edition, New Jersey,John Wiley &amp; Sons.  ‐ Weeks M R and Schensul J J (2014) Ethnographic Research on AIDS Risk Behavior and theMaking of Policy. 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Effect of Face-to-face Education, Problem-based Learning, and Goldstein Systematic Training Model on Quality of Life and Fatigue among Caregivers of Patients with Diabetes.

BACKGROUND Education is a fundamental component for patients with diabetes to achieve good glycemic control. In addition, selecting the appropriate method of education is one of the most effective factors in the quality of life. The present study aimed to evaluate the effect of face-to-face education, problem-based learning, and Goldstein systematic training model on the quality of life (QOL) and fatigue among caregivers of patients with diabetes. MATERIALS AND METHODS This randomized clinical trial was conducted in Hajar Hospital (Shahrekord, Iran) in 2012. The study subjects consisted of 105 family caregivers of patients with diabetes. The participants were randomly assigned to three intervention groups (35 caregivers in each group). For each group, 5-h training sessions were held separately. QOL and fatigue were evaluated immediately before and after the intervention, and after 1, 2, 3, and 4 months of intervention. RESULTS There was a significant increase in QOL for all the three groups. Both the problem-based learning and the Goldstein method showed desirable QOL improvement over time. The desired educational intervention for fatigue reduction during the 4-month post-intervention period was the Goldstein method. A significant reduction was observed in fatigue in all three groups after the intervention (P < 0.001). CONCLUSIONS The results of the present study illustrated that the problem-based learning and Goldstein systematic training model improve the QOL of caregivers of patients with diabetes. In addition, the Goldstein systematic training model had the greatest effect on the reduction of fatigue within 4 months of the intervention

The Relationship between Sleep Quality with Depression in Patient with Acute Myocardial Infarction

Background and Objectives: Depression is one of the most psychological outcomes in patients with acute myocardial infraction, which can affect the sleep quality in these patients. Given that adequate sleep has important effect on heart function, the present study was conducted with the aim of determining the correlation between sleep quality with death and cardiac depression in patient with acute myocardial infarction (AMI). &nbsp; Methods: In this descriptive-correlational study, 407 patients with acute myocardial infarction, who were admitted to the CCU wards of the Fatemeh Zahra Educational Center of Sari city, were selected using simple random sampling method. Data were collected by Cardiac Depression Scale (CDS), Death Depression Scale (DDS), and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Data were analyzed using Kolmogorov-Smirnov and Pearson correlation tests. &nbsp; Results: The mean age of the male patients (64.95&plusmn;17.00; CI95: 62.71-67.19) was more than the mean age of women (62.22&plusmn;15.48; CI95: 59.96-64.48). The mean score of death depression (68.94&plusmn;17.24; CI95: 67.26-70.62) and cardiac depression (109.00&plusmn;16.49; CI95: 107.39-110.60), were below the fifth percentile. Multivariate regression analysis showed that change in cardiac depression score (B=0.036, &beta;=0.153), increasing education levels (B=1.55, &beta;=-0.121), and no history of antidepressant usage (B=4.32, &beta;=0.123), can be significantly independent predictive factors of the variance of sleep quality score in acute myocardial infarction patients. &nbsp; Conclusion: According to the results of this study, although cardiac depression, education level, and non-use of antidepressant drugs are considered as affecting factors in the prediction of sleep quality in acute myocardial infarction patients, sleep quality is affected by more factors. Therefore, further studies are needed in this area. &nbsp; &nbsp

Explaining the process of formation of ageism among the iranian older adults

Abstract Background Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people. Methods The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding. Results Fear of loneliness and rejection striving to tackle ageism “was identified as the core category of the study. Concepts such as “family context” and “cultural context” were relevant. After identifying the strategies used by the older adults in response to the context (“maintaining integrity”, “socio-cultural care” and “proper health care”, “striving to tackle ageism”) was the most important process in ageism by the Iranian older adults. Conclusion Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect