The Effect of Group Counseling on the Quality of Life in Patients with Major Thalassemia Referred to the Thalassemia Treatment Center in Bushehr

Background and Objective: Major Thalassemia is the most common hereditary disease in the world and in Iran. The chronic nature of the disease and complications associated with clinical signs and protests of the disease and its treatment make multiple physical, psychological and social problems and effects on the quality of life in these patients. The aim of this study was to determine the effect of group counseling on quality of life in patients with thalassemia major. Materials and Methods: This study was a randomized controlled clinical trial. The total number of subjects included 62 patients with thalassemia major from thalassemia treatment center in the Bushehr in 2016, were randomly divided into two groups of 31 people of intervention and control. For intervention group, four sessions of group counseling in behavioral cognitive approach held in two weeks. The quality of life in patients in both groups evaluated before the intervention and one month after the intervention, using the SF-36 questionnaire. The results were analyzed by SPSS software version 23 at a significant level of 0.05. Results: The results of analytical tests showed that there was no statistically significant difference between the two groups in demographic variables (P > 0.05). However, the intervention group gained a significant increase in total score of quality of life and its sub-domains after counseling. (P < 0/001). Also, the difference between the mean total scores of quality of life and its sub-domains in the intervention and control groups was statistically significant (P < 0.001). Conclusion: This study showed that the treatment group counseling with cognitive behavioral approach significantly improves the quality of life in patients with Thalassemia major. Therefore it is recommended that this treatment helped to improve the quality of life in these patients. m

Investigating the effective factors on patients' escape from one of the public hospitals in Bushehr city in 2017-2018: A descriptive, cross-sectional study

چکیده زمینه و هدف: خروج از بیمارستان بدون اطلاع پزشک و پرسنل یا به عبارتی فرار از بیمارستان، یکی از چالش های&nbsp; بزگ نظام سلامت محسوب می شود چرا که می تواند باعث ایجاد هزینه های اقتصادی برای سیستم و زیان جانی برای بیمار گردد . هدف از این مطالعه بررسی عوامل موثر در فرار بیماران و بار مالی ناشی از آن&nbsp; در یکی از بیمارستان های عمومی شهر بوشهر می‌باشد. مواد و روش‌ها: این پژوهش یک مطالعه توصیفی- مقطعی است که در یکی از بیمارستان‌های شهر بوشهر انجام گرفته است. در این مطالعه، اطلاعات بیماران با روش سرشماری و با استفاده از یک چک لیست &nbsp;استخراج گردیده است. این چک لیست حاوی سئوالات دموگرافیک، بالینی و اقتصادی می‌باشد. تحلیل داده ها از آمار توصیفی در محیط&nbsp; نرم افزار spss &nbsp;نسخه 25 &nbsp;بهره گرفته شد. یافته‌ها: بنابر نتایج حاصل از آنالیزهای آماری نرخ فرار از بیمارستان0018/0 برآورد می‌شود. یعنی به طور میانگین، هر ماه 6 نفر از بیماران فرار کرده‌اند. زیان مالی وارد شده به بیمارستان شهدای خلیج فارس بوشهر بابت فرار بیماران در سالهای 1396 و 1397 بالغ بر ده میلیارد ریال بوده است که سهم بیمارانی که بیمه داشتند در آن بیشتر از افراد فاقد بیمه بوده است. نتیجه گیری: نرخ فرار در بیمارستان مورد پژوهش کم بود. با این حال به دلیل این که فرار علاوه بر زیان مالی قابل توجهی که به بیمارستان ها وارد می‌کند می‌تواند مشکلاتی را برای خود بیماران، خانواده‌‌‌‌هایشان و نیز جامعه ایجاد کند، لازم است تلاش ها در جهت کاهش وقوع این معضل توسط مدیران&nbsp; به کار گرفته شود. &nbsp;Background and Aims: Absconding from hospitals presents big challenges to the health care systems, with consequences such as delay and incomplete treatment process. Also it may result in increased personal workload and the cost burden of health system. The aim of this study was to determine absconding rate and its driving factors in a public hospital in Bushehr city in 2017-2018. Materials and Methods: The present descriptive cross-sectional study was conducted in a general hospital in Bushehr. During the study, patients' information was extracted by a checklist from their medical records between 20 March 2017 and 1 March 2018 using census method. Ethical criteria such as confidentiality of patients' names and the hospital under study were observed. Results: Absconding rate was found to be 0.18 percentage. The highest number of escapes was noticed in emergency wards (137 and 92%), meaning that in average 6 persons have escaped each month. Mean age of the patients was 29.02 and they stayed 2.07 days in the hospital. The highest frequency of escape was observed in male patients and in singles which occurred in night shift. About 72%&nbsp; (117) of patients did not have health insurance, but 88% of&nbsp; unpaid amount was belonged to insured persons. The total amount of damages was estimated to be 1,411,950,080 Rials. The average cost per patient was also appraised to be 9,540,203 Rials. Conclusion: Despite the low escape rate at the studied hospital, the property damage was significant. Installation of gates and controlling the entry and exit of patients, coupled with increasing the number of physical protection staff and insurance offices, as well as reforming the clearance process and insurance laws are proposed to reduce the occurrence of this problem

A survival analysis of socio-demographic and clinical predictors among hospitalized COVID-19 patients in Southern Iran

Background: This study aimed to evaluate the socio-demographic, clinical, and laboratory risk factors in hospitalized COVID-19 patients during the first 6 months of the SARS-CoV-2 epidemic. Method: This retrospective hospital-based cross-sectional study included all laboratory-confirmed cases of the COVID-19 virus that were admitted to the Shohadaye-Khalije-Fars Hospital in Bushehr, Iran, from February 22, 2020 to September 21, 2020. The patients' records were reviewed during the hospitalization period. The global COVID-19 clinical platform, i.e., the World Health Organization Rapid Case Report Form was used as the data collection tool. We conducted the survival analysis using the Kaplan–Meier and the Stepwise Cox regression analyses. Results: The analysis included 2108 confirmed cases of COVID-19 with a mean age of 47.81 years (SD 17.78); 56.8% men, 43.2% women and 6.3% (n = 133) deaths. After adjustment, it was found that factors associated with an increased risk of death consisted of chronic kidney disease, intensive care unit admission, cancer, and hemoptysis. The 7-day survival rate was 95.8%, which decreased to 95.1%, 94.0%, and 93.8% on days 14, 21, and 28 of hospitalization, respectively. Discussion and conclusion: Older COVID-19 patients with manifestation of hemoptysis and a past medical history of chronic kidney disease and cancer, should be closely monitored to prevent disease deterioration and death, and also should be admitted to the intensive care unit

Effectiveness of Cognitive Behavioral Group Therapy (C.B.G.T) in Increasing the Self Esteem & Decreasing the Hopelessness of β-Thalassemic Adolescents

Background: Thalassemic patients are prone to impair self-esteem duo to life-long side effects. Abnormal appearance at young age and higher risk of blood infections such as AIDS and hepatitis, affect their marriage opportunities. These side effects lead to hopelessness and isolation.. This experimental study was carried out to determine the effectiveness of cognitive behavioral group therapy (C.B.G.T) on stimulation of self-esteem in β-Thalasemic adolescents. Methods: A total of 59 Thalassemic patients were recruited and randomly assigned into experimental or control group. The experimental group participated in eight C.B.G.T sessions of 90 minutes each, following a manualized treatment protocol. The findings were assessed by using independent group t-test, two way ANOVA and regression analysis to examine the effect of the intervention on dependent variables (self-esteem and hopelessness). Results: The score of hopelessness was decreased significantly (p<.001) and self-esteem was increased significantly (p<.001). There was positive direct correlation on self-esteem and hopelessness (P0.05). Conclusion: Based on the results of this study, cognitive behavioral group therapy leads to decrease in hopelessness and increase in self-esteem in general, familial, and educational level but it doesn’t lead to increasing social self esteem. It is necessary to increase social supports for these patients

Investigating the impact of virtual stress management education on the occupational stress of healthcare providers in Bushehr City: An application of self-efficacy theory

Introduction: Healthcare workers, who work at the frontline of providing health services, are at risk of occupational stress due to several conditions. Therefore, the present study was conducted to determine the effects of virtual training based on Bandura's self-efficacy theory on occupational stress of healthcare workers in Bushehr, Iran. Material & Methods: This semi-experimental study was conducted on 63 healthcare workers in Bushehr city in 10 comprehensive healthcare centers randomly selected as intervention and control centers (n=5 each). The intervention group received four sessions of virtual training based on self-efficacy theory in the form of a webinar, while the control group received no training. The information of the studied subjects was collected using a questionnaire consisting of four sections, namely demographic information assessment, self-efficacy assessment, and occupational stress assessment before, two weeks, and one month after the educational intervention. The data were analyzed using SPSS software version 24. Findings: In general, knowledge and self-efficacy increased in the intervention group after training, and changes in knowledge and self-efficacy were significantly different between the two groups during the study period (P<0.001). In the intervention group, occupational stress improved two weeks and one month after training, compared to the pre-training period, whereas in the control group, although the changes were significant, these changes manifested as an increase in stress intensity. There was a significant difference in occupational stress changes between the two groups during the study period (P<0.001), and the condition improved in the intervention group. Discussion & Conclusion: The results of this study suggested that virtual stress management education based on self-efficacy theory could increase knowledge levels and self-efficacy and improve occupational stress in healthcare workers

Evaluation of factors affecting on the incidence of anxiety disorders and generalized anxiety in children in Bushehr in 2019: *Anxiety in preschool children

زمینه و اهداف: اختلالات اضطرابی، شایعترین اختلال روانی کودکان است که شیوع بالایی در ایران دارد. شناسایی علل و &nbsp;تشخیص زود هنگام این گروه از اختلالات &nbsp;می‌تواند اثرات طولانی مدت آن را به حداقل برساند.لذا هدف از این مطالعه بررسی عوامل‌ مؤثر در بروز اختلالات اضطرابی و اضطراب فراگیر درکودکان شهر بوشهر می‌باشد. مواد و روش‌ها: این مطالعه از نوع مقطعی است که در سال ۱۳۹۸ در شهر بوشهر انجام شد. جامعه پژوهش، تمام کودکان ۴تا ۶ سال پیش دبستانی و مهدکودک های این شهر بودندکه به صورت خوشه ای از بین آنها ، نمونه ای به حجم &nbsp;428 انتخاب شد. ابزار پژوهش، پرسشنامه سنجش اضطراب اسپنس (فرم والدین) بود. به منظور توصیف و تجزیه و تحلیل داده‌ها از روش‌های آمار توصیفی (فراوانی و درصد) و آمار استبناطی (آنالیز واریانس یک طرفه و آزمون تعقيبي شفه) در سطح معنی‌داری 5 درصد در محیط نرم افزار SPSS نسخه ۲۴ استفاده گردید. یافته­ ها: تعداد اعضای خانواده (003/0=P-value)، تحصیلات پدر (00۱/0=P-value) و مادر (00۱/0=P-value)، وضعیت اشتغال پدر (0۳/0=P-value) و جدايي والدین از یکدیگر (00۲/0=P-value)، نوع سرپرست (00۱/0P-value&lt;) و سابقه رویداد ناخوشایند &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(00۱/0 P-value&lt;) در بروز اضطراب فراگیر کودکان موثر بودند. همچنین&nbsp; بروز همه انواع اختلالات اضطرابی مورد بررسی، سطح تحصیلات والدین ، سابقه رویداد ناخوشایند و تعداد اعضای خانواده (به جز در جراحات جسمانی) نقش داشته­اند. نتیجه‌گیری: براساس یافته‌های این پژوهش، عوامل اجتماعی و فرهنگی خانواده نقش زیادی در اضطراب کودکان دارد. بنابراین لازم است آموزش‌های والدین جهت پیشگیری از ابتلا کودکان به اضطراب، مد نظر سیاست‌گذاران حوزه سلامت قرار گیرد.Background and Aims: Anxiety disorders are the most common mental disorders in children, which are highly prevalent in Iran. Identifying the causes and early diagnosis of this group of disorders can minimize its long-term effects. The aim of this study was to investigate the factors affecting in the incidence of generalized anxiety and anxiety disorders in children in Bushehr. &nbsp;Materials and Methods: This cross-sectional study was conducted in Bushehr in 2019. The study population consisted of all children aged 4 to 6 years of preschool and kindergartens of this city, among whom a sample of 428 was selected by multi-stage cluster sampling method. The research instrument was the Spence Anxiety Inventory (Parent Form). In order to describe and analyze the data, descriptive statistics (frequency and percentage) and based statistics (one-way analysis of variance and Scheffe post hoc test) were used at a significant level of 5% in SPSS software version 24. Results: The number of family members (p-value = 0.003), father's education (p-value = 0.001) and mother's education (p-value = 0.001), father's employment status (p-value = 0.03) and parental separation (p-value = 0.002), type of caregiver (p-value &lt; 0.001) and unpleasant events history (p-value &lt; 0.002) were effective in the incidence of generalized anxiety in children. Also, all types of anxiety disorders, parents' education level, unpleasant event history and number of family members (except in physical injuries) have played a role. Conclusion: According to the findings of this study, social and cultural factors of the family play a major role in children's anxiety. Therefore, it is necessary that parents' education to be considered by health policy makers to prevent children from developing anxiety