The Experience of Angina Pectoris characteristics and coping with Coronary Heart Disease illustrated by Iranian patients from a gender-related perspective

Coronary Heart Disease (CHD) is a major cause of death for both men and women around the world. Therefore, it is of great importance to identify effective ways and plans to prevent CHD and to ensure patients with Angina Pectoris (AP) seek medical care. A critical issue for developing these plans is to consider the symptom experiences of patients with CHD. Patients with CHD have to live and deal with this life-long disease. Nurses as health-care providers need to be aware of this process for helping patients to cope with the illness and its symptoms. Moreover, gender as a socio-cultural concept might influence how patients experience AP characteristics and cope with CHD. Thus, it needs to be investigated particularly in Iran where there is a lack of information about this issue. This doctoral thesis aims at exploring and describing experiences of AP characteristics and coping with CHD from a gender-related perspective. The doctoral thesis includes four sub-studies. The first two sub-studies regarded instrumentation. The AP characteristics questionnaire, which includes the Modified Rose Questionnaire (MRQ), the Short Form-McGill pain Questionnaire (SF-MPQ) and the accompanying symptom checklist, was utilized. The aims of sub-study I were to describe the process of translating the SF-MPQ, MRQ and accompanying symptom checklist from English to Persian and to evaluate substantial psychometric works (content and construct validity) for the entire instrument and each part of it (SF-MPQ, MRQ and accompanying symptom checklist). The aim of sub-study II was to evaluate internal consistency and test–retest reliability of the Iranian version of the AP characteristics questionnaire. The instrument was translated through a combined approach. Then, one hundred and ten patients with CHD (diagnosis on the basis of angiography) who experienced AP were selected for evaluating the reliability and validity of the instrument. According to the results, the Iranian version of AP characteristics questionnaire was a valid, consistent and reliable tool for evaluating AP in Iranian patients with CHD. The aim of sub-study III was to examine gender differences in the description, intensity and location of AP in patients with CHD to determine gender-specific variations in the characteristics of AP symptoms. In this cross-sectional study, five hundred patients with AP were chosen and filled out the Iranian version of AP characteristics questionnaire. The results indicated that, in comparison with men, women felt a greater intensity of pain, chose more pain descriptors, and were more likely to report pain in the neck and left arm, hand, and scapula. Sub-study IV which was a grounded theory study aimed at exploring and describing the experiences of and coping with CHD and how gender influences on 3 experiences reported by the participants. Twenty four patients were chosen through purposive sampling. The sampling was continued with theoretical sampling. The findings indicated that patients with CHD who experienced AP tried to cope with the illness and its consequences. The findings are presented as the process of “transitioning to normalize life” with the following categories: 1) losing normal life: experiencing emotions and consequences of illness, 2) coming to terms and using coping strategies and 3) recreating normal life. Men and women showed differences in some of the issues such as interpersonal relationships, responding to illness, searching for information and receiving the family support. In conclusion, men and women with CHD experience a variety of symptoms which can be related to various psycho-physiological, clinical, and anatomical factors, anxiety sensitivity, depression and communication abilities. During the coping process, the participants transitioned to living normally again. However, there were gender-related differences in some aspects of coping such as using coping strategies and receiving support. The findings can be useful for considering gender perspectives in health-care services, training health professionals, and also educating society to become aware of gender differences in experiencing AP characteristics and coping with CHD

The Evaluation of Functional Quality in Bachelor Midwifery Students based on Objective Structured Clinical Examination (OSCE) in Islamic Azad University-Mashhad Branch

Abstract Introduction: Objective Structured Clinical Examination (OSCE) is one of the standardized and accepted methods for the certification of undergraduate midwifery in the world. OSCE is a type of examination often used in health sciences (e.g. midwifery), which is designed to test clinical skill performance and competence in skills such as clinical examination, medical procedures / prescription, exercise prescription, manipulation techniques. The aim of this study is to evaluate the quality of midwifery students’ performance before the final exam through the OSCE method in Islamic Azad University of Mashhad. Methods: This cross-sectional study was conducted in the summer of 1396 on 75 midwifery students before entering the final exam. Checklists for evaluation of skills were analyzed by the experts’ panel to increase the validity of checklists. For examining the reliability of the exam in studied population, the spilt-half method was used. Evaluation of the quality of students’ performance in various areas of pregnancy and childbirth, gynecological diseases, maternal and child health and they were carried out at three levels of diagnosis, decision making and therapeutic interventions. The exam was also carried out in 12 sections along with a rest one. Results: 75 volunteers were divided equally according existing stations. 89/3% were under the age of 25 years old 48% were single and 52% were married. The average score was calculated, when the students were able to answer 50% of the items in each domain. If the volunteer answered more than 50% of the items, she would be in good shape, while the volunteer answered fewer than 50% of the items, she would be weak. The performance of midwifery students was moderate and good at all stations except for Pap smear in gynecology domain, fetal health evaluation in pregnancy and childbirth domain, and Vaccination in maternal and child health domain. (PV<0.848, PV<0.666, PV<0.711 respectively both diagnosis and decision making level. Conclusions: Since the OSCE examines the strengths and weaknesses of students, this study indicated that weakness of midwifery students of Mashhad Azad University lied in some important areas such as, fetal health evaluation, Pap smear and Vaccination which should be more considered and emphasized on by the instructors and educational planners

Challenges of implementing family-based dignity intervention

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The Effectiveness of Attribution Retraining on Health Enhancement of Epileptic Children

How to Cite This Article: Najafi Fard T, Pourmohamadreza-Tajrishi M, Sajedi F, Rezasoltani P, Delavar Kasmaei H. The Effectiveness of Attribution Retraining on Health Enhancement of Epileptic Children. Iran J Child Neurol. Spring 2016; 10(2):53-59.AbstractObjectiveEpilepsy is a chronic neurological disease. Evidence has indicated that epilepsy has an impact on mental and physical health of children. The present study aimed to determine the effectiveness of attribution retraining on health enhancement of epileptic children.Materials & MethodsThis was an experimental study with a pre-test and a post-test design with a control group. Thirty students with epilepsy (11 female and 19 male students) were selected in convenience from Iranian Epilepsy Association. They were assigned to experimental and control groups and their mothers completed Child Health Questionnaire (CHQ-PF.28) before and after the intervention.The experimental group attended to eleven sessions (each session 45 minutes; twice a week). Subjects were trained by attribution retraining program, but control group was not. Multivariate analysis of covariance (MANCOVA) was used for analyzing the data.ResultsHealth (both psychosocial and physical) of experimental group enhanced significantly after the intervention sessions compared to control group.ConclusionAttribution retraining is an effective intervention to enhance the psychosocial and physical health of epileptic children. References 1. Sadock B, Sadock V, Ruiz P. Comprehensive textbook of psychiatry. Philadelphia: Williams and wilkins. 2009.2. Walter G, Bradley R. Neurology in clinical practice. B & H Elsevier. 2008; 66:63-74.3. Baker GA, Hargis E, Hsih MMS, Mounfield H, Arzimanoglou A, Glauser T, et al. Perceived impact of epilepsy in teenagers and young adults: an international survey. Epilepsy Behav 2008; 12(3):395-401.4. Konda K, Ablah E, Kond K, Liow K. Health behavior and conditions of persons with epilepsy: A bivariate analysis of 2002 Buffs data 2009; 16:120-127.5. Mushi D, Hunter E, Mtuya C, Mshana G, Aris E, Walker R. Social–cultural aspects of epilepsy in Kilimanjaro Region, Tanzania: knowledge and experience among patients and carers. Epilepsy Behav 2011; 20(2):338-43.6. Loughin J. College and epilepsy. J Clin Psychiat 2011; 38(3):295-300.7. Rodenburg R, Wagner JL, Austin JK, Kerr M, Dunn DW. Psychosocial issues for children with epilepsy. Epilepsy Behav 2011; 22(1):47-54.8. Quintas R, Raggi A, Giovannetti AM, Pagani M, Sabariego C, Cieza A, et al. Psychosocial difficulties in people with epilepsy: a systematic review of literature from 2005 until 2010. Epilepsy Behav 2012; 25(1):60-7.9. Vázquez C, Jiménez F, Saura F, Avia MD. The importance of “importance”: A longitudinal confirmation of the attributional-stress model of depression measuring the importance of the attributions and the impact of the stressor. Personal Individual Diff 2001; 31(2):205-14.10. Sepahvand T, Gilani B, Zamani R. Relationship between Attributional Styles with Stressful Life Events and General Health. Psychol Res 2007; 9(3,4): 33-46.11. Endermann M. Predictors of health-related and global quality of life among young adults with difficult-to-treat epilepsy and mild intellectual disability. Epilepsy Behav 2013; 26(2):188-95.12. Jackson B, Sellers R, Peterson C. Pessimistic explanatory style moderate the effect of stress on physical illness. Personal Individual Diff 2002; 32:567-73. 13. Seligman ME, Walker EF, Rosenhan DL, Norton W. Abnormal psychology. 4, editor. New York: Norton London; 2001.14. Schultz D, Schultz S. Theories of personality. Tehran: Virayesh Publication; 2010.15. Seligman ME. The optimistic child: A proven program to safeguard children against depression and build lifelong resilience. Tehran: Roshd Publication; 2004.16. Saif A. Modern educational psychology (psychology of learning and instruction). Tehran: Dowran Publishing Company; 2008.17. Salehi M, Haghighat S. Attribution retraining on student achievement an successful girl. Psychol Res 2008; 1(1):27-39.18. Rosendal M, Fink P, Bro F, Olesen F. Somatization, heartsink patients, or functional somatic symptoms? Towards a clinical useful classification in primary health care. Scandinavian J Primary Health Care 2005; 23(1):3-10.19. Larisch A, Schweickhardt A, Wirsching M, Fritzsche K. Psychosocial interventions for somatizing patients by the general practitioner: a randomized controlled trial. J Psychosom Res 2004; 57(6):507-514.20. Vazehie Ashtiani A. Effect of training documents on attributional style, self-esteem, performance and persistence in mathematics students. J Psychiatr Clin Psychol 2003; 35-87.21. Qaympnah Z, Azadfallah P, & Tabatabai K. [Psychometric standards and standardization of the Persian version of the Child Health Questionnaire. (Persian)]. Journal of Kermanshah University of Medical Sciences 2013;17(7), 431-441 (In Persian).22. Ashouri M, Pourmohamadreza-Tajrishi M, Jalil-Abkenar S, & Ashouri J.[The effectiveness of learning strategies and attribution retraining instruction methods on mathematics problem solving in intellectually disabled students (Persian).] Developmental Psychology: Iran Psychol J 2011;8(31), 247-255.23. Holder EE, Levi DJ. Mental health and locus of control: SCL-90-R and Levenson’s IPC scales. J Clin Psychol 1988; 44(5):753-5.24. Wang D, Wang Y, Zhang Y. The relationship between locus of control, depression, shame, and self esteem. J Mental Health 1992; 6(5):207-21.25. Iravani M, Izadi M. Relationship between attribution and mental health in student of Azad University Khorasegan Branch. Knowledge Res Appl Psychol 2000; (1):7-20. 26. Peterson C, Seligman ME. Explanatory style and illness. J Personal 1987; 55(2):237-65.27. Pourmohamadreza-Tajrishi M, Abbasi S, Najafi Fard T, Yousefi S, Malek Abadi AM, Delavar Kasmaei H. Efficacy of attribution retraining on mental health of epileptic children. Iran Red Cresc Med J 2015; 17(10):1-7

Socioeconomic status and mortality after acute myocardial infarction: a study from Iran

<p>Abstract</p> <p>Background</p> <p>Studies have shown an inverse relationship between socioeconomic status (SES) and mortality due to coronary heart disease (CHD). Little is known about this association in Iran. This study aimed to investigate whether mortality after myocardial infarction (MI) varies by SES.</p> <p>Methods</p> <p>In a retrospective study, 1283 MI patients who hospitalized in Tehran Heart Center from March 2005 to March 2006 were followed up in March 2008. Demographic, clinical and SES data were collected from case records and by telephone interviews. Multiple logistic regression analysis was performed to estimate the predictive effect of socioeconomic factors on outcome.</p> <p>Results</p> <p>In all 664 patients were studied. Of these, 500 patients were alive and 164 were dead due to MI (64 died at hospital and 100 died at home). The results of regression analysis showed that in addition to treatment (OR = 9.52, 95%CI 4.84-18.7), having diabetes (OR = 1.78, 95% CI 1.12-2.81) or hyperlipidemia (OR = 1.82, 95% CI 1.14-2.90), socioeconomic variables including living area in square per person (lowest level vs. upper level OR = 4.92, 95% CI 2.11-11.4), unemployment (OR = 3.50, 95% CI 1.50-8.13) and education (OR for illiterate patients = 2.51, 95% CI 1.00-6.31) were the most significant contributing factors to increased mortality after MI.</p> <p>Conclusion</p> <p>Although the findings should be interpreted with caution, the study results indicated that socioeconomic variables were significant contributing factors to increased mortality after myocardial infarction. The underlying role of socioeconomic status on increased mortality after MI deserves further investigation.</p

Multi Objective and Multi-Product Perishable Supply Chain with Vendor-Managed Inventory and IoT-Related Technologies

With the emergence of the fourth industrial revolution, the use of intelligent technologies in supply chains is becoming increasingly common. The aim of this research is to propose an optimal design for an intelligent supply chain of multiple perishable products under a vendor-managed inventory management policy aided by IoT-related technologies to address the challenges associated with traditional supply chains. Various levels of the intelligent supply chain employ technologies such as Wireless Sensor Networks (WSNs), Radio Frequency Identification (RFID), and Blockchain. In this paper, we develop a bi-objective nonlinear integer mathematical programming model for designing a four-level supply chain consisting of suppliers, manufacturers, retailers, and customers. The model determines the optimal network nodes, production level, product distribution and sales, and optimal choice of technology for each level. The objective functions are total cost and delivery times. The GAMS 24.2.1 optimization software is employed to solve the mathematical model in small dimensions. Considering the NP-Hard nature of the problem, the Grey Wolf Optimizer (GWO) algorithm is employed, and its performance is compared with the Multi-Objective Whale Optimization Algorithm (MOWOA) and NSGA-III. The results indicate that the adoption of these technologies in the supply chain can reduce delivery times and total supply chain costs