The Effect of Coping Skills Training on Depression, Anxiety, Stress, and Self-Efficacy in Adolescents with Diabetes: A Randomized Controlled Trial

Background: Diabetes patients are at risk of psychosocial problems. Some interventions might decrease these problems. This study aimed to evaluate the effect of coping skills training on depression, anxiety, stress, and self-efficacy of adolescents with type I diabetes. Methods: This randomized controlled trial with pre- and post-test design was performed in the diabetes clinic in Shiraz from June to November 2015. This study was conducted on 100 adolescents with type 1 diabetes who were randomly divided into an intervention (receiving coping skills training in groups for eight sessions) and a control group (usual care). Depression, Anxiety, and Stress Scales (42-items, scores=0-42) and General Self-Efficacy questionnaire (17-items, scores=17-85) were used. The variables were measured at baseline and two months after starting the intervention. Data were analyzed using SPSS, version 16 through Chi-square test, independent t–test, and paired t-test. P<0.05 was significant. Results: After the intervention, the mean scores of depression, anxiety and stress in the intervention group were 5.41±4.58, 6.44±7.01, and 7.46±7.01, and in the control groups they were 19.73±11.80, 18.28±10.51, 21.10±10.94, respectively. Moreover, after the intervention, the mean scores of self-efficacy were 70.82±10.84, and 50.13±15.42 in the intervention and control groups, respectively. The results showed differences between the two groups regarding depression, anxiety, stress, and self-efficacy after starting the intervention (P<0.001). Conclusion: As coping skills training reduced depression, anxiety, and stress and improved the patients’ self-efficacy, the use of this intervention could be a part of community-based nursing practice for adolescents with diabetes and more research for improving evidence-based practice in this regard are warranted. Trial Registration Number: IRCT201505011369N

Feasiability of Using Evidence-Based Virtopsy to Answer the Possible Clinical and Post-Mortem Questions, in Veterinary Practice

A post-mortem examination is an important part of evidence-based medicine to understand the deterioration of clinical signs or causes of death in euthanized or deceased individual animals or even populations. Post-mortem analysis is aimed at improving clinical treatment and therapy, confirming a suspected diagnosis, man-aging breeding strategies, and clarifying the forensic cases (e.g., neglect or animal abuse). In analogy to virtopsy in human medicine, diagnostic imaging modalities have been applied in post-mortem veterinary medicine, which we call vetvirtopsy. We hypothesize that vetvirtopsy can be used as a method to answer certain clinical/post-mortem questions to im-prove the diagnosis reliability. In some questions, vetvirtopsy actually can replace conventional necropsy. This overview study aims to compare vetvirtopsy with conventional necropsy for variable causes of death in animals and to define its possibilities and limitations. Deceased or euthanized pets and wild animals were collected. The imaging techniques, such as post-mortem digital radiography, post-mortem ultrasound, post-mortem computed tomography, and post-mortem magnetic resonance tomography combined with image-guided tissue sampling, were used to address the open questions about clinical symptoms or causes of their death. The case series in this project showed that diagnostic imaging techniques are feasible in answering distinct ante-mortem and post-mortem clinical and forensic questions. However, there is an interdisciplinary collaboration between diagnostic imaging and sampling under imaging guidance

Amniotic Membrane for Pain Control After Cesarean Section

Objectives: Pain is one of the major problems for patients after cesarean section. The aim of this study was to assess the effect of amniotic membrane as cesarean wound dressing on pain after cesarean section. Materials and Methods: This study was conducted on 90 pregnant women who underwent cesarean section in Amir-alMomenin hospital, Gerash, Iran. The participants were divided into 2 groups each of 45. The wound was dressed with amniotic membrane in one group and with simple gauze in the other group. Pain was measured and recorded in the 2 groups by visual analogue scale (VAS). The need for receiving analgesics 24 hours after the cesarean section was also assessed and compared between the 2 groups. Results: The results showed no signifcant difference between the 2 groups regarding the mean pain, 4 and 12 hours after the cesarean section (P=0.308 and P=0.628, respectively). However, a signifcant difference was observed between the 2 groups, in this regard, 24, 36, and 48 hours after the operation (P=0.026, P=0.026, and P=0.004, respectively). Moreover, the patients in the amniotic membrane group needed less analgesics compared to those in the control group 24 hours after cesarean section (P=0.041) Conclusions: Use of amniotic membrane dressing can be effective in reducing pain after cesarean section and can eliminate the patients’ need for analgesics. Hence, it can be used as an effective complementary method along with usual analgesics for pain relief

Effects of a peer-led group education on fear, anxiety and depression levels of patients undergoing coronary angiography

Objective. To investigate the effect of the peer group education on the fear, anxiety and depression levels of the patients undergoing angiography.Methods. In this clinical trial, 70 patients referred to Vali-E-Asr clinic of Fasa (Iran) for undergoing coronary angiography were selected by random sampling and divided into experimental and control groups. The experimental group (n=35) received the necessary instructions about coronary angiography by those in a trained peer group (Two former patients, having experienced in the procedure), while in the control group (n=35) the routine instructions were presented by the department’s nurses. The levels of fear, anxiety and depression of the patients were measured both before and after conducting this intervention.Results. The mean score of the patients’ fear and anxiety after the intervention of the peers in the experimental group was reduced compared to that of the control group (p<0.05). But for the mean of the score of the depression test, no statistically significant differences were found between the two groups after the intervention.Conclusion. The results of this study showed that utilizing the peer group education is effective for reducing the fear and anxiety of patients undergoing coronary angiography.Objetivo. Investigar o efeito da educação grupal realizada por pares sobre os níveis de medo, ansiedade e depressão dos pacientes submetidos a angiografia. Métodos. Neste ensaio clínico, 70 pacientes remitidos à clínica Vali-E-Asr de Fasa (Irão) para submeter-se a uma angiografia coronária foram selecionados por amostragem aleatório e divididos em dois grupos. O grupo experimental (n=35) recebeu as instruções sobre a angiografia coronária por parte de pares (dois pacientes que haviam sido submetidos previamente a angiografia), enquanto que ao grupo de controle (n=35) as enfermeiras do departamento lhes brindaram a instrução de rotina. Os níveis de medo, ansiedade e depressão dos pacientes se mediram antes e depois de realizar esta intervenção. Resultados. A pontuação média do medo e a ansiedade dos pacientes depois da educação grupal efetuada pelos pares no grupo experimental foi menor em comparação com a do grupo de controle (p<0.05), mas para a média da pontuação da prova de depressão, não se encontraram diferenças estatisticamente significativas entre os dois grupos. Conclusão. Os resultados deste estudo mostraram que a utilização dos pares para a educação grupal dos pacientes que serão submetidos a angiografia coronária é efetiva para reduzir o medo e a ansiedade.Objetivo. Investigar el efecto de la educación grupal realizada por pares sobre los niveles de miedo, ansiedad y depresión de los pacientes sometidos a angiografía. Métodos. En este ensayo clínico, 70 pacientes remitidos a la clínica Vali-E-Asr de Fasa (Irán) para someterse a una angiografía coronaria se seleccionaron por muestreo aleatorio y divididos en dos grupos. El grupo experimental (n=35) recibió las instrucciones sobre la angiografía coronaria por parte de pares (dos pacientes que habían sido sometidos previamente a angiografía), mientras que al grupo de control (n=35) las enfermeras del departamento les brindaron la instrucción de rutina. Los niveles de miedo, ansiedad y depresión de los pacientes se midieron antes y después de realizar esta intervención. Resultados. La puntuación media del miedo y la ansiedad de los pacientes después de la educación grupal efectuada por los pares en el grupo experimental fue menor en comparación con la del grupo control (p<0.05), pero para la media del puntaje de la prueba de depresión no se encontraron diferencias estadísticamente significativas entre los dos grupos. Conclusión. Los resultados de este estudio mostraron que la utilización de los pares para la educación grupal de los pacientes que serán sometidos a angiografía coronaria es efectiva para reducir el miedo y la ansiedad

Self-Management experiences in Guillain Barre syndrome patients: a phenomenological study

Introduction: Guillain-Barre Syndrome (GBS) leads to physical and psychosocial impairments. These patients have to manage their difficult situations. Materials and Methods: This study aimed to describe and interpret the meaning of self-management while living with GBS. In this hermeneutic phenomenological study, eleven patients with GBS were recruited. Data were collected by semi-structure interviews. The thematic analysis was used. Results: The five themes emerging from this study are as follows: &ldquo;Recognition of GBS, using coping strategies, being hopeful, relationship with God and received, and perceived social support&rdquo;. The participants looked for and found information concerning the nature of their illness. They used coping strategies such as denial, striving to get back to normal life, and trying to achieve greater emotional balance&rdquo;. They were optimistic for their health would return to normal, and they had hopes for future. Conclusion: The participants used trust in God, praying, accepting their fate, and pleased with God to manage GBS. The patients were received and perceived instrumental, and emotional and financial support from their family members to manage their illness. By being aware of the essence of self-management in living with GBS, healthcare professionals are suggested to conduct interventions regarding this theme to improve self-management in GBS patients

Open-heart Surgery Complications Following Programmed Education and Nurses' Clinical Competence

Heart surgery can lead to certain complications that, if not diagnosed and treated on time, can be fatal. In view of the fact that nurses' clinical competence affects the quality of clinical judgment, the present study aimed to explore the effect of programmed education and nurses' clinical competence on complications following open-heart surgeries. The results of the present study showed that a closer attention to regular and programmed education and informing of open-heart surgery patients, especially before surgery and at the time of discharge, along with the clinical competence of nurses in ICUs, can reduce the incidence of post-surgery complications. Since the nurses' clinical competence greatly affects their clinical judgments and quality of care, paying greater attention to the nurses' education through systematic programs and increasing the clinical competence can lead to fewer post-heart-surgery complications; this, in turn, reduces the length of stay and the ensuing costs

Investigating the relationship between resilience and professional ethics in nurses: a cross-sectional study in southern Iran

Abstract Introduction All businesses that deal directly with clients need to observe ethics, but in the nursing profession due to its nature, compliance with professional ethics becomes more necessary. On the other hand, nurses face tensions and difficult conditions in their daily work environment. Resilience is one of the most important abilities of human beings, which in difficult conditions causes effective adaptation to stress-causing factors. Therefore, the relationship between resilience and professional ethics becomes important. The aim of the study The present study was conducted to investigate the relationship between resilience and professional ethics in nurses of Shahid Ganji Hospital, Borazjan 2022–2023. Methods The current study is a cross-sectional descriptive-analytical study. The study environment was Shahid Ganji Hospital in Borazjan, Bushehr, Iran. The research method of the current study was census, so all 400 nurses of this hospital were invited to participate in the study. Finally, 340 of them were included in the study based on the inclusion criteria. Data collection tools included a demographic information form, Connor-Davidson questionnaire, and Cadozier professional ethics questionnaire. Data analysis was done using SPSS version 22 software. Results Most of the participants were between 25 and 30 years old. The average overall score of resilience and professional ethics of nurses participating in the study was 64.1 ± 16.3 and 34.3 ± 9.4, respectively. No significant difference was observed between the demographic characteristics of nurses with resilience and professional ethics. The Spearman correlation coefficient indicated a statistically significant and inverse relationship between professional ethics and resilience levels (r = -0.265, P < 0.001). Conclusion The present study demonstrated a significant and inverse relationship between professional ethics and resilience among nurses. Furthermore, professional ethics were at a moderate level, while resilience was at a good level. Therefore, it is recommended that enhancing professional ethics skills through the organization of educational workshops for nurses should be considered by nursing managers