Effect of Roy’s Adaptation Model-Guided Education on Coping Strategies of the Veterans with Lower Extremities Amputation: A Double-Blind Randomized Controlled Clinical Trial

Background: Any defect in the extremities of the body can affect different life aspects. The purpose of this study was to investigate the effect of Roy’s adaptation model-guided education on coping strategies of the veterans with lower extremities amputation. Methods: In a double-blind randomized controlled clinical trial, 60 veterans with lower extremities amputation referring to Kowsar Orthotics and Prosthetics Center of Veterans Clinic in Tehran, Iran were recruited using convenience method and randomly assigned to intervention and control groups in 2013-2014. Lazarus and Folkman coping strategies questionnaire was used to collect the data. After completing the questionnaires in both groups, maladaptive behaviours were determined in the intervention group and an education program based on Roy’s adaptation model was implemented. After 2 months, both groups completed the questionnaires again. Data were analyzed using SPSS software. Results: Independent T-test showed that the score of the dimensions of coping strategies did not have a statistically significant difference between the intervention and control groups in the pre-intervention stage (P>0.05). This test showed a statistically significant difference between the two groups in the post-intervention stage in terms of the scores of different dimensions of coping strategies (P>0.05), except in dimensions of social support seeking and positive appraisal (P>0.05). Conclusion: The findings of this research indicated that the Roy’s adaptation model-guided education improved the majority of coping strategies in veterans with lower extremities amputation. It is recommended that further interventions based on Roy’s adaptation model should be performed to improve the coping of the veterans with lower extremities amputation

Structure of Pre-Hospital Rapid Response Teams to Chemical, Biological, Radiation and Nuclear Accidents in Iran, A Qualitative Study

Background and Aim: The field of pre-hospital rapid response teams is facing major challenges in the field of chemical, biological, radiation and nuclear accidents. Considering that the country of Iran is exposed to the occurrence of these incidents, the possibility of the danger of these incidents and threats cannot be ignored. This study was conducted with the aim of determining effective factors in the formation of pre-hospital rapid response teams in the field of health in response to CBRN accidents. Materials and Methods: the current study is qualitative research with a content analysis approach; which was conducted using semi-structured in-depth interviews with 18 specialists and experts through purposive and snowball sampling. Sampling was done until data saturation. Thematic analysis method was used to analyze the data. The study aimed to extract effective factors in the formation of pre-hospital rapid response teams in the field of health in response to chemical, biological, radiation and nuclear accidents in Iran in 2022. Results: The factors affecting the formation of the team were divided into 5 main classes and 5 subgroups including capacity building (Education, training), operational requirements (information and communication, command and control, emergency response operational plan, internal and external coordination), required resources (equipment, financing), team formation requirements (decontamination requirements, structural requirements) and team formation structure (general team composition, specialized team composition). The highest number of codes with 39% was related to the emergency response operational plan subcategory and the lowest number of codes with 8% was related to the equipment subcategory. Conclusion: This study presented the design of the local pre-hospital rapid response team in the field of health in chemical, biological, radiation and nuclear accidents in Iran. This plan is for quick pre-hospital response to attend and intervene in the acute phase of these incidents. In order to increase the response capacity and capability of these teams, in addition to the general composition of the team, in order to improve the specialized preparation to deal with the health effects of these incidents, a specialized composition has also been provided. It is suggested; A separate team should be formed for each CBRN area based on the risk assessment of the offending areas of the country