@article{ author = {Ranjbar, M and SeyedFatemi, N and MardaniHamooleh, M and Esmaeeli, N and Haghani, SH}, title = {Correlation of Stigma with Self-compassion in Patients with Bipolar Disorder}, abstract ={Background & Aims: The bipolar disorder is important mental disorder, which is characterized by recurrent episodes of mania and depression. This chronic and complex disease affects the mood of the patient, causing continuous and abnormal mood changes from extremely good to extremely poor and depressed. These fluctuations often last for weeks or months. Frequent episodes of depression and mania affect the functioning of the individual in personal, professional, family, social, and cultural domains. Patients with the bipolar disorder experience a phenomenon known as stigma. Stigma is defined as a set of cognitions and behaviors that are activated by labeling, leading to social exclusion and isolation. The stigma of mental illness distinguishes the patients from other populations. The stigma of mental illness renders the patients incapacitated and socially isolated. In addition, the experience of stigma decreases the quality of life and health-seeking behaviors of the patients, threatening their socio-economic health. Subsequently, the social participation of patients with mental illness is disrupted, and they refrain from seeking social assistance. In fact, stigma leads to the rejection of patients with mental illness by the society, disrupting their emotional regulation and making them unable to have proper emotional regulation strategies. Furthermore, the stigma of mental illness causes the patients not to have appropriate coping strategies for the disease, hide their medical history from the medical staff, and avoid communicating with their friends after discharge from the hospital. Given the importance of the concept of stigma, identifying the positively correlated behaviors seems essential. Self-compassion is a positive behavior that may be associated with stigma. Individuals with high self-compassion are more likely to accept negative life events and have more accurate self-assessments and better mental health. Self-compassion is an important factor in the adaptive responses to the mood problems in patients with a history of recurrent depression. High self-compassion reduces the mental vulnerability of patients with mental illness to problems, their depression and social anxiety, shame caused by the illness, and self-criticism. In contrast, the lack of self-compassion leads to self-judgment, a sense of further isolation, and a rush of negative emotions about oneself, which ultimately lead to the loss of intimacy in the relationships with others. Low self-compassion is present in a wide range of individuals with mental disorders and causes emotional distress, so that individuals with mental illness and low self-compassion are more likely to have suicidal thoughts. The present study aimed to assess the correlation between stigma and self-compassion in patients with the bipolar disorder. Materials & Methods: This cross-sectional, descriptive-analytical study was conducted on 200 patients with the bipolar disorder admitted to Iran Psychiatric Center in Tehran, Iran, who were selected via continuous sampling. Data were collected using a demographic data form and stigma and self-compassion tools. The demographic data form included data on age, gender, marital status, number of children, education level, occupation status, family history of mental disorders, number of family members, and number of admissions. The researcher evaluated the validity and reliability of the instruments. To determine validity, the instruments were provided to seven professors of the department of psychiatric nursing at Iran and Tehran universities of medical sciences, and the content validity was confirmed. In addition, the retest method was used to determine the reliability of the tools. For this purpose, the tools were completed by 15 individuals with the same characteristics as the research community, who were not among the research samples, and re-completed by the same individuals two weeks later. Afterwards, Pearson's correlation-coefficient was calculated for two tests. In terms of ethical considerations, the required permit was obtained from the Ethics Committee of Iran University of Medical Sciences, and after receiving the letter of introduction from the university, the necessary coordination was made with the management of Iran Psychiatric Center. The research process was explained to the participants, and they were ethically informed that participation in the research was voluntary. Furthermore, the patients were reassured of the confidentiality of their personal information. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics. Pearson's correlation-coefficient was applied to determine the correlation between the two main variables, independent t-test was used to compare the mean scores of the two groups, and the analysis of variance (ANOVA) was employed to compare the mean scores of more than two groups. In all the statistical analyses, the P-value of less than 0.05 was considered significant. Results: The mean scores of stigma and self-compassion were 77.03±7.06 and 77.57±4.47, respectively. Pearson's correlation-coefficient showed no significant correlation between stigma and self-compassion in the patients (P=0.301; r=-0.073). On the other hand, significant correlations were observed between the subscales of discrimination (P=0.030; r=-0.153), disclosure (P=0.045; r=-0.142), and positive aspects of stigma with the isolation dimension of self-compassion (P=0.034; r=-0.150), which were inverse, weak correlations as reduced isolation was associated with increased stigma in these subscales. Among the demographic variables, significant correlations were denoted between the number of family members, age, and family history of mental disorders with stigma (P<0.05). However, no significant associations were observed between the demographic characteristics and self-compassion. Conclusion: The results indicated no significant correlation between stigma and self-compassion. However, significant associations were observed between the subscales of stigma with the isolation dimension of self-compassion, which were inversely and significantly correlated. Therefore, it could be concluded that as the patients further perceived the dimensions of discrimination, disclosure, and positive aspects of stigma, they were less inclined toward isolation. Stigma is an inherent cultural element rooted in the community, which is so strong and complex that even high self-compassion could not diminish its effects.}, Keywords = {Stigma, Self-compassion, Bipolar Disorder}, volume = {32}, Number = {122}, pages = {1-13}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {ارتباط انگ با خود- دلسوزی در مبتلایان به اختلال دوقطبی}, abstract_fa ={زمینه و هدف: مبتلایان به اختلال دوقطبی با پدیده انگ مواجه هستند. از طرفی، خود- دلسوزی، یک نقش کلیدی در بهبود سلامت روانی آنان ایفا می‌نماید. این مطالعه با هدف تعیین ارتباط انگ با خود- دلسوزی در مبتلایان به اختلال دوقطبی انجام شد. روش بررسی: در این مطالعه مقطعی از نوع همبستگی توصیفی، شرکت کنندگان 200 نفر از مبتلایان به اختلال دوقطبی بستری در مرکز روانپزشکی ایران بودند که به روش نمونه‌گیری مستمر انتخاب شدند. داده‌ها با کمک فرم مشخصات فردی و ابزارهای روا و پایا شده انگ و خود- دلسوزی گردآوری و با استفاده از آمار توصیفی (میانگین و انحراف معیار) و استنباطی (آزمون‌های ضریب همبستگی پیرسون، تی مستقل و آنالیز واریانس) تحلیل شدند. یافته‌ها: میانگین و انحراف معیار نمرات انگ 06/7 ± 03/77 و خود- دلسوزی 47/4 ± 57/77 به دست آمد. نتایج آزمون همبستگی پیرسون نشان داد که متغیرهای انگ و خود- دلسوزی، همبستگی معنی‌دار آماری نداشتند (301/0P= و 073/0-r=). به علاوه، خرده مقیاس انزوا از خود- دلسوزی با خرده مقیاس‌های تبعیض (030/0P= و 153/0- r=)، آشکار سازی (045/0P= و 142/0- r=) و جنبه‌های مثبت (034/0P= و 150/0- r=) از انگ همبستگی معنی‌دار آماری داشت که این همبستگی به صورت معکوس و ضعیف بود یعنی با کاهش انزوا، انگ در این ابعاد افزایش می‌یافت. در میان مشخصات فردی، بین انگ با تعداد افراد خانواده، سن و سابقه اختلال روانی در خانواده ارتباط معنی‌دار وجود داشت (05/0P<). بین خود- دلسوزی با هیچ یک از مشخصات فردی ارتباط معنی‌دار دیده نشد. نتیجه‌گیری کلی: در پژوهش حاضر، بین دو متغیر انگ با خود- دلسوزی در مبتلایان به اختلال دوقطبی، ارتباط معنی‌دار آماری وجود نداشت اما بین خرده مقیاس‌های مختلف انگ، با خرده مقیاس انزوا از خود- دلسوزی، ارتباط معنی‌دار در جهت معکوس، وجود داشت یعنی هرچه مبتلایان، ابعاد تبعیض، آشکارسازی و جنبه‌های مثبت از انگ را پررنگ‌تر دیده‌اند، کمتر به سوی انزوا رفته‌اند. انگ به عنوان یک متغیر اجتماعی که ریشه در فرهنگ جوامع دارد، به گونه‌ای در بطن جامعه ریشه دوانده که حتی برخورداری از خود- دلسوزی، نمی‌تواند از بار منفی آن بکاهد.}, keywords_fa = {انگ, خود- دلسوزی, اختلال دوقطبی}, doi = {10.29252/ijn.32.122.1}, url = {http://ijn.iums.ac.ir/article-1-3080-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3080-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {Peyrovi, H and NajafiGhezeljeh, T}, title = {The Preparedness of the Faculty Members of Iran University of Medical Sciences for the Training of International Students}, abstract ={Background & Aims: Internationalization refers to the process of integrating an international and intercultural dimension into the teaching, research, and service functions of the institution. The internationalization of education emphasizes the process of including the international dimension in all aspects of education, and its main objective is to expand knowledge, abilities, attitudes, and values that are recognized at the international level. Focusing on professors as the main component of the internationalization process is vital, and their attitudes, beliefs, experiences, and levels of engagement are related to their participation in the internationalization process. One of the basic pillars of the process of internationalization of medical education is the assessment of readiness to participate in the international education market. The data obtained by this assessment is a basis for determining policies and directing academic planning. Given the growing emphasis on attracting international students and the moral responsibility of schools and departments in providing and facilitating conditions, the present study aimed to determine the preparedness of professors in educational departments of Iran University of Medical Sciences to train international students. Materials & Methods: This descriptive, cross-sectional study was performed in nine schools and 99 educational departments of Iran University of Medical Sciences in 2018-2019. The subjects were selected by the voluntary method from all professors of the university (n=900). In total, 378 professors filled the questionnaires. Data were collected through self-report, and research tools included a researcher-made questionnaire based on the professors’ attitudes and abilities to train international students. The questionnaires were distributed in various groups in person. Due to the low participation of members and the problems related to access to some people, the questionnaire was subsequently emailed to the professors five times. The questionnaire contained items related to assessing the attitude of professors (14 items) and items related to assessing the ability of professors (7 items) in the form of self-report. In addition, a general question (regardless of the level of capability in the field of international student education, are you willing to cooperate in this field? Explain the causes?) was asked, and data analysis was performed in SPSS version 16 using descriptive and inferential statistics, analysis of variance, Scheffe test, independent t-test, Fisher’s exact test, and Chi-square. Moreover, the open question related to the reasons for the willingness/unwillingness to cooperate in international student education was analyzed using the qualitative content analysis method. Results: In this study, the mean age of the participants was 47.08±8.04 years. In addition, the majority of the participants were female (52.1%) and had a specialized PhD or PhD (44.2%) and had the academic rank of assistant professor (54.0%). About 42.9% of the participants had previous experience of training international students and mean teaching experience to foreign students of 4.09±4.06 years. Furthermore, 28.8% of the subjects had an experience of educational mission or studying abroad with a mean education experience of 1.01±2.54 years. Most of the participants had the experience of living abroad (63.8%) and the majority of the participants had an English Language Certificate (62.2%). The mean score of attitude and abilities of the subjects in training international students was relatively favorable and reported to be 53.14±8.65 and 23.32±5.17, respectively. According to the results, there was a direct, weak, and significant relationship between work experience and ability in the field of international student education (P=0.005). In people with more work experience, the tendency to cooperate in international student training was higher (P=0.038) and professors with international student training experience expressed more ability in this field. Moreover, there was a direct, weak, and significant association between the duration of international student training and competence in this field (P=0.025). The participants with a history of educational mission or study abroad as well as living abroad reported a positive attitude and ability in educating international students. On the other hand, no significant relationship was observed between the duration of study abroad with the attitude and ability to train an international student and the desire to train an international student (P=0.00). Regarding English language proficiency, those with an English Language Certificate had a higher ability to train international students (P=0.022). In terms of gender, men had a more positive and empowered attitude towards foreign student education, although women were more willing than men to cooperate in internationalization. According to the results, 61.4% of the subjects were reluctant to cooperate in educating international students. Reasons related to an unwillingness to cooperate in international student education were divided into two categories of individual and academic, and causes related to willingness to cooperate were divided into four categories of individual and professional, educational group, university, and country. Conclusion: According to the results of the study, the professors expressed a relatively favorable attitude and ability in the field of international student education. A review of the literature revealed that professors’ behavior is affected by two individual and social knowledge factors. In this regard, individual factors were demographic characteristics, job characteristics, and professions of professors and the social knowledge was recognized as professors’ perception of the values and expectations of the educational institution, rewards, and teachers' self-learning that shape the behavior of faculty members. Some of the causes of professors’ willingness to participate in training foreign students were promoting individual and professional competence, increasing competence in English, educational methods, gaining experience, opportunities for scientific exchange, contributing to individual dynamism, emerging individual competence and familiarity with other cultures. On the other hand, individual causes for unwillingness to cooperate in foreign student education were lack of financial benefits, job motivation and security, lack of English language proficiency, multiple job descriptions, lack of time, high workload, and foreign student education as increasing workload and stress. One of the most important mechanisms in the internationalization process is to prepare professors in the internationalization process. Therefore, the necessary infrastructures must be provided in universities to improve internationalization. It is suggested that motivational and empowerment programs be designed by university officials to improve professors’ attitude and enhance their ability to cooperate in international student education.}, Keywords = {Internationalization, Education, Attitude, Empowerment, Professors}, volume = {32}, Number = {122}, pages = {14-29}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {آمادگی استادان گروه‌های آموزشی دانشگاه علوم پزشکی ایران در زمینه تربیت دانشجوی بین الملل}, abstract_fa ={زمینه و هدف: یکی از ارکان اساسی فرآیند بین المللی‌سازی آموزش پزشکی ارزیابی آمادگی جهت حضور در بازار آموزش بین المللی است. داده‌های این ارزیابی می‌تواند پایه‌ای برای تعیین سیاست‌ها و جهت‌دهی برنامه‌ریزی‌های دانشگاه باشد. این پژوهش با هدف تعیین آمادگی استادان گروه‌های آموزشی دانشگاه علوم پزشکی ایران برای تربیت دانشجوی بین الملل صورت گرفت. روش بررسی: در این پژوهش توصیفی مقطعی، که در 9 دانشکده و 88 گروه آموزشی دانشگاه علوم پزشکی ایران در سال 1397-1398 انجام شد، از 900 پرسشنامه ارسالی برای اعضای هیئت علمی دانشگاه، 378 نفر پرسشنامه‌ها را تکمیل کردند. روش جمع‌آوری داده‌ها خودگزارشی و ابزار جمع‌آوری داده‌ها پرسشنامه محقق ساخته مشتمل بر نگرش و نیز توانمندی استادان در زمینه تربیت دانشجوی بین الملل بود. پرسشنامه به صورت الکترونیک و در پنج نوبت به ایمیل استادان ارسال شد. نهایتاّ داده‌های پژوهش با آمار توصیفی و استنباطی (ANOVA، تست تعقیبی شفه، t مستقل، آزمون دقیق فیشر و کای اسکوئر) در نرم افزار SPSS نسخه 16 تحلیل شد. یافته‌ها: میانگین نمره نگرش و توانمندی واحدهای مورد پژوهش در زمینه تربیت دانشجوی بین الملل نسبتاّ مطلوب و به ترتیب 65/8 ± 14/53 و 17/5 ± 32/23 بود. براساس نتایج، 4/61 درصد واحدهای مورد پژوهش تمایلی برای همکاری در تربیت دانشجوی بین الملل نداشتند. علل مرتبط با نداشتن تمایل به همکاری در تربیت دانشجوی بین الملل، در دو طبقه علل فردی و دانشگاهی و علل مرتبط با تمایل به همکاری به چهار دسته علل فردی و حرفه‌ای، گروه آموزشی، دانشگاهی و کشوری دسته بندی شدند. نتیجه‌گیری کلی: براساس یافته‌ها، ضروری است بستر و زیرساخت‌های لازم در جهت بین المللی‌سازی دانشگاه فراهم شود و در راستای بهبود نگرش}, keywords_fa = {بین المللی‌سازی, نگرش, توانمندی, استادان}, doi = {10.29252/ijn.32.122.14}, url = {http://ijn.iums.ac.ir/article-1-3098-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3098-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {HassanpourDehkordi, A and Soleymani, F and Habibi, Z and Kheiri, S and Salehitali, SH}, title = {The Effects of the Family-oriented Empowerment Model on the Fatigue Level of the Patients with Chronic Obstructive Pulmonary Disease Admitted to the Hospitals Affiliated to Shahrekord University of Medical Sciences, Iran (2018)}, abstract ={Background & Aims: Fatigue is the second most common symptom in patients with chronic obstructive pulmonary disease (COPD). Fatigue prevents carrying out individual and social roles and responsibilities and decreases people’s ability to work and make efforts to maintain natural life and perform favorite and enjoyable activities. Therefore, it has many negative effects on the economic status and quality of life of those with this condition. In addition, fatigue exacerbates the disease, increases the disease load, decreases occupational productivity, ability to concentrate, and sexual function. Overcoming these issues requires the participation of the patient and the family in the disease management and care process. Moreover, caregivers’ participation and ability will improve patients’ health. This study aimed to evaluate the effect of a family-centered empowerment model (FCEM) on the fatigue of individuals with COPD. Materials & Methods: This clinical trial was performed on 72 patients with COPD accompanied by their family members. The subjects were selected by simple sampling and randomly divided into two intervention and control groups of 36. Inclusion criteria were COPD diagnosis by a physician, hospitalization of patients in internal medicine wards of hospitals affiliated to Shahrekord University of Medical Sciences, psychological health, the stability of physical condition, ability to participate in educational sessions, spirometry in the diagnostic file with FEV1 level above 35%, and being literate. On the other hand, the exclusion criteria were lack of cooperation with the research, worsened clinical conditions, and inability to participate in sessions. Data were collected using a demographic characteristics questionnaire (age, gender, marital status, level of education, history of other chronic diseases, and FEV1 index), and fatigue severity scale by Crop et al. The educational program was developed based on FCEM and included four steps of perceived threat, problem-solving, educational participation and assessment. In total, four 90-minute panels were held for groups of 10-15 participants in the intervention group in the presence of their family members. In the first and second sessions, group discussions were made based on the step of the perceived threat of FCEM. In the first session, information was provided about the disease and its process, prognosis, symptoms, complications, risk factors, and failure to follow the treatment plan. The second session included a description of COPD control and prevention methods, as well as self-care behaviors and their importance. Moreover, the second and fourth sessions focused on problem-solving stages, which included detecting the problem (disease process, causative agents of the disease, and complications caused by the disease) and analyzing the problem based on the causes of diagnosis, determining goals, providing solutions, selecting the best solution, and discussing how to carry out the solution to achieve the goal according to the abilities and facilities of patients and their family members. The evaluation of the process during the intervention was performed by the researcher in all sessions, in a way that the patient and family members were asked about learning the material presented and the content was repeated for those who needed more explanation. Afterwards, the intervention group was followed up by the research team for three months and the questions and problems of care and the knowledge required for their care were answered. The final assessment was performed three months after the intervention by completing the fatigue questionnaire. Data analysis was performed in SPSS version 16 using frequency and percentage indexes for qualitative variables and mean and standard indexes for quantitative data with a normal distribution. Other tests applied included Fisher’s exact test, Chi-square (for qualitative variables), and independent and paired t-test (for normal quantitative variables). Notably, a P-value of below 0.05 was considered statistically significant. Results: In this study, the mean age of the participants in the intervention and control groups was 64.83 ± 11.97 and 62.11 ± 6.29 years, respectively. According to the independent t-test, there was no significant difference between the groups in terms of age (P=0.23). Moreover, the mean first-second rapid exhalation was reported to be 57.83 ± 9.64 and 58.46 ± 11.15 in the intervention and control groups, respectively. However, no significant difference was observed between the groups in this regard (P=0.8). overall, the two groups were homogenous in terms of gender, history of chronic diseases, and level of education. At the beginning of the study, the mean and standard deviation of fatigue score in the intervention and control groups was 41.10 ± 08.58 and 39.46 ± 9.67, respectively. In this respect, no significant difference was observed between the groups (P=0.5). After the intervention, the mean fatigue score was reported at 34.75 ± 6.25 and 41.7 ± 11.83 in the intervention and control groups, respectively, demonstrating a significant difference in this regard (P=0.01). According to the results, the mean fatigue score was significantly decreased in the intervention group after the intervention, compared to the control group (P=0.01). Conclusion: According to the results of the study, the involvement of patients’ caregivers in understanding the threats perceived from the disease and increase of their knowledge about the disease and related care will not only enhance their cooperation in the process of patient care but also will pave the way for more effective care in patients. Empowering family members responsible for the care of patients with COPD reduces the level of fatigue in these individuals. Therefore, care and treatment programs for chronic patients pay attention to patients’ caregivers in addition to paying attention to the patients.  }, Keywords = {Chronic Obstructive Pulmonary Disease, Family-oriented Empowerment, Fatigue}, volume = {32}, Number = {122}, pages = {30-40}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {تأثیر الگوی توانمندسازی خانواده محور بر خستگی افراد مبتلابه بیماری مزمن انسدادی ریه بستری در بیمارستان‌های وابسته به دانشگاه علوم پزشکی شهرکرد در سال 1397}, abstract_fa ={زمینه و هدف: خستگی در بیماران مزمن انسدادی ریه بهره‌وری شغلی، توانایی تمرکز، قوای جنسی و عملکرد بیمار را کاهش داده و فرد را به سمت سستی و بی‌حال سوق می‌دهد. غلبه بر این امر نیازمند مشارکت بیمار و خانواده در امر مراقبت و مدیریت بیماری است. هدف از این مطالعه تأثیر الگوی توانمندسازی خانواده محور بر خستگی افراد مبتلابه بیماری مزمن انسدادی ریه است. روش بررسی: در مطالعه کار آزمایی بالینی حاضر تعداد 72 بیمار نارسایی مزمن انسداد ریه همراه با مراقب خانوادگی آنها به روش نمونه‌گیری آسان انتخاب و سپس به روش تصادفی در دو گروه 36 نفره مداخله و کنترل تقسیم شدند. برنامه آموزشی مبتنی بر الگوی توانمندسازی خانواده محور در چهار جلسه 90 دقیقه‌ای مبتنی بر چهار گام تهدید درک شده، مشکل‌گشایی، مشارکت آموزشی و ارزشیابی در گروه‌های 10 تا 15 نفره با حضور اعضای خانواده به صورت پانل برای گروه مداخله ارائه گردید. سپس به مدت 3 ماه گروه مداخله توسط تیم تحقیق پیگیری شد و به سئوالات و مشکلات مراقبتی و دانش مورد نیاز مراقبتی آنها پاسخ داده شد. ارزشیابی نهایی پس از گذشت سه ماه از اجرای مداخله با تکمیل مجدد پرسشنامه خستگی انجام شد. داده‌ها توسط آزمون‌های تی زوجی، تی مستقل، آزمون دقیق فیشر و مجذور کای توسط نرم‌افزار SPSS نسخه 16 تحلیل شدند. یافته‌ها: در بدو مطالعه دو گروه مداخله و کنترل، تفاوت معنی‌داری از نظر میانگین نمره خستگی نداشته اند )5/0  (P=. بعد از مداخله، میانگین نمره خستگی گروه مداخله نسبت به گروه کنترل تفاوت معنی‌داری داشته است )01/0 (P=. در گروه مداخله میانگین نمره خستگی بعد از مداخله نسبت به قبل از مداخله، کاهش معنی‌داری داشته است )01/0 (P=. نتیجه‌گیری کلی: نتایج مطالعه بیانگر آن بوده که توانمند کردن اعضای خانواده مسئول مراقبت بیمار نارسایی مزمن ریه باعث کاهش سطح خستگی در بیماران شده است، بنابراین برنامه‌های مراقبتی و درمانی بیماران مزمن علاوه بر توجه به بیمار باید به مراقبین بیمار نیز توجه کنند.  }, keywords_fa = {بیماری مزمن انسدادی ریه, توانمندسازی خانواده محور, خستگی}, doi = {10.29252/ijn.32.122.30}, url = {http://ijn.iums.ac.ir/article-1-3132-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3132-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {MohammadAliha, J and NajafiGhezeljeh, T and Haghani, SH and NasrollahNejhad, SH}, title = {The Attitude and Performance of Nurses Regarding Pain Management in the Patients Admitted to the Emergency Department}, abstract ={Background & Aims: Pain management is an integral part of patient care in emergency departments. Nurses play a key role in the pain management of patients, and all patients deserve to be free of pain. One of the biggest challenges in nursing is ensuring patients’ comfort and lack of pain. Not only effective pain relief in patients results in their physical comfort but also increases their quality of life and rapid return to daily life and decreases their hospital stay duration and costs. Nurses are the first people present at the patient's bedside during pain and have the longest stay with the patient. Therefore, the most successful nurses are those who have competence in assessing pain. Nurses are required to make timely decisions in the dynamic and changing situation of clients by using technical skills and professional knowledge. In addition, they must make a proper clinical judgment about patients’ health status through acquiring basic information about clients, determining natural and unnatural functions and abilities of clients, and using proper information. Positive attitude and proper performance of health care providers towards pain management is very important and is part of patients' rights. Therefore, the present study aimed to determine the knowledge of nurses regarding pain management in the patient referring to the emergency departments of the hospitals. Materials & Methods: This descriptive, cross-sectional study was conducted on 150 emergency department nurses selected via census sampling in the hospitals affiliated to Iran University of Medical Sciences in 2018. The inclusion criteria were the minimum education level of master's degree and six months of work experience in the emergency department. Data were collected using the demographic questionnaire (included six items to determine the demographic characteristics of nurses such as age, gender, level of education, type of hospital, and work experience) and the questionnaire of knowledge of pain management (included 20 items), in which the responses of the participants determined their attitude toward the use of narcotics, the person responsible for pain control and use of non-pharmaceutical interventions). The items were scored based on a four-point Likert scale from completely agree (four scores) to completely disagree (one score). In addition, the score range of the instrument was 35-62, where a score above 62%, between 35% and 62%, and below 35% was indicative of positive, moderate and negative attitude, respectively. The construct validity of the tool was assessed by comparing the scores of experienced and skilled nurses, which demonstrated a difference in the expertise of different groups. On the other hand, the performance questionnaire encompassed four items on patients’ pain level and type, analgesics and one item on the tools applied to measure pain (the name of the tool used to measure pain). The tool was completed by nurses (through self-report) and the scores were 0-2 (0=no, 1=to some extent, and 2=yes). In the end, the performance score was obtained, where the lowest and highest scores were zero and eight, respectively. In this respect, a score higher than the median (i.e., four) indicated good performance, whereas a score below the median demonstrated poor performance. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency tables, mean, and standard deviation) and inferential statistics (Pearson's correlation coefficient). Results: Mean age of the participants was 31.98 ± 5.52 years. The majority of the nurses (82.9%) had no prior experience of pain management training. Regarding pain management in the emergency department, 82.7% of the subjects had a moderate attitude (35-62 scores) while 17.3% had a positive attitude and no subject had a negative attitude. Moreover, the mean attitude score was reported to be 57.16 ± 5.22, and the mean and standard deviation of performance was 6.02 ± 2.53, which was higher than the median score of the tool. The results indicated no significant difference between the mean scores of attitude and performance with the demographic characteristics of the participants (P>0.05). Conclusion: According to the results, the emergency department nurses had a moderate knowledge level regarding pain management. In addition, they declared proper performance in this regard. Nevertheless, they had insufficient knowledge of pain tools and their method of use. The findings of the present study showed that although the nurses stated that they had good performance and knowledge about the importance of recording and controlling pain, it seems that the necessity of completing the initial assessment form caused nurses to repeat and practice how to complete the form. In this respect, the forms demonstrated better performance of nurses while they had insufficient knowledge of the tools. Therefore, the provision of periodic training and pain assessment facilities and the implementation of proper policies and methods for pain assessment could be effective in this regard. In addition, the performance of nurses in managing patients' pain in the present study was indicated through a self-report questionnaire. As such, it is recommended that the performance of nurses be assessed through observation. It is also suggested that pain management by nurses in emergency departments be assessed from the viewpoint of patients and the effect of pain management education on the knowledge and performance of nurses.}, Keywords = {Attitude, Performance, Pain Management, Emergency Ward}, volume = {32}, Number = {122}, pages = {41-54}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {نگرش و عملکرد پرستاران در رابطه با مدیریت درد بیماران در بخش‌های اورژانس}, abstract_fa ={زمینه و هدف: مدیریت درد یکی از مهم‌ترین اجزای مراقبت درد بیماران در بخش اورژانس است و پرستار نقش کلیدی در مدیریت درد دارد. نگرش مثبت و عملکرد مناسب مراقبین سلامت نسبت به مدیریت درد بسیار مهم می‌باشد و این مسئله جز حقوق بیماران است. بنابراین مطالعه حاضر با هدف تعیین نگرش و عملکرد پرستاران در رابطه با مدیریت درد بیماران مراجعه کننده به بخش‌های اورژانس صورت گرفت. روش بررسی: پژوهش حاضر یک مطالعه مقطعی- توصیفی است که به روش تمام شماری بر روی 150 پرستار شاغل در بخش‌های اورژانس بیمارستان‌های آموزشی و درمانی وابسته به دانشگاه علوم پزشکی ایران در سال 1397 انجام شد. معیارهای ورود به مطالعه شامل دارا بودن تحصیلات کارشناسی و بالاتر و حداقل شش ماه سابقه کار در بخش اورژانس بودند. ابزار مطالعه پرسشنامه اطلاعات جمعیت شناختی و پرسشنامه نگرش و عملکرد در رابطه با مدیریت درد بود. داده‌های جمع آوری شده با استفاده از آمار توصیفی و استنباطی و با نرم افزار آماری SPSS نسخه 16 تجزیه و تحلیل شدند. یافته‌ها: میانگین سن واحدهای مورد پژوهش 98/31 و با انحراف معیار 52/5 بود. بیشتر واحدهای مورد پژوهش (9/82 درصد) سابقه دریافت آموزش در زمینه درد نداشتند. در ارتباط با مدیریت درد بیماران بخش اورژانس، میانگین نمره نگرش 22/5 ± 16/57 و میانگین نمره عملکرد (53/2 ± 02/6) بود. بیشتر واحد‌های مورد پژوهش (9/82 درصد) سابقه آموزش درد نداشتند. تفاوت معنی‌دار آماری بین میانگین نمرات نگرش و عملکرد با مشخصات جمعیت شناختی وجود نداشت )05/0 < (P. نتیجه‌گیری کلی: نتایج مطالعه نشان داد که پرستاران نگرش متوسط در مورد مدیریت درد داشتند و در خوداظهاری عملکرد خوبی نسبت به مدیریت درد بیماران بیان کردند ولی آگاهی و شناخت کافی از ابزارهای درد و نحوه استفاده از ابزارها را نداشتند. بنابراین آموزش و برگزاری کلاس‌های بازآموزی ضمن خدمت در جهت ارتقاء مدیریت صحیح درد بیماران و ارتقاء کیفیت مراقبت درمانی و آموزش استفاده از ابزار سنجش درد پیشنهاد می‌شود}, keywords_fa = {نگرش, عملکرد, مدیریت درد, اورژانس}, doi = {10.29252/ijn.32.122.41}, url = {http://ijn.iums.ac.ir/article-1-3133-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3133-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {Monfared, A and MirzaeeJirdehi, M and MansourGhanaei, F and Joukar, F and KazemnezhadLeyli, E}, title = {The Effect of Lavender Essential Oil Aromatherapy on the Anxiety of Endoscopy Candidates: A Clinical Trial}, abstract ={Background & Aims: Endoscopy causes significant anxiety in the patients in the clinical setting. Relieving anxiety through non-pharmacological methods is an important task of nurses. Nurses take the steps to reducing the anxiety of these patients before performing diagnostic and therapeutic procedures. Aromatherapy is a complementary medicine technique used to alleviate anxiety. Aromatherapy involves the use of the essential oils of aromatic plants or other compounds to enhance health and recovery. Lavender essential oil is used in aromatherapy, which stimulates the parasympathetic system and induces relaxation by reducing the heart rate, respiration, and blood pressure. The present study aimed to assess the effect of aromatherapy with lavender essential oil on the preoperative anxiety of endoscopy candidates in Iran. Materials & Methods: This single-blind clinical trial was conducted at the endoscopy department of Razi Hospital in Rasht city, Iran during January 2018-August 2019. The sample population included 70 patients who were selected via convenience sampling based on the inclusion criteria and randomly divided into two groups of intervention and placebo. The inclusion criteria were the age of ≥18 years, full consciousness (relative to place, time, and surroundings), willingness to participate in the study, ability to understand and speak Persian, and endoscopy of the gastrointestinal tract for the first time. The exclusion criteria were admission for emergency endoscopy, acute pain while completing the questionnaire, active mental and anxiety disorders, mental retardation, blindness/deafness, history of eczema and allergies to plants, history of migraine/chronic headaches, olfactory disorders, use of anti-anxiety drugs and narcotics, and history of severe psychological trauma (e.g., death of relatives) around the time of endoscopy. In the sampling, nine patients were excluded from the study (six cases patients due to eligibility based on the inclusion/exclusion criteria and three cases due to withdrawal), with the attrition rate considered 11% and new samples added by drawing lots. The study was registered in the Iranian Registry of Clinical Trials after the approval of the Ethics Committee of the Deputy of Research and Technology at Guilan University of Medical Sciences. The researcher referred to the research environment and attained the required permit. After obtaining written informed consent from the subjects, data were collected using a demographic questionnaire (age, gender, education level, marital status, occupation status, type of gastrointestinal disease, length of hospital stay, history of hospitalization, and smoking habits) and Spielberger state-trait anxiety inventory. The standard anxiety questionnaire consists of 20 items, which are scored based on a Likert scale (1=Very Low, 2=Low, 3=High, 4=Very High), and the total score of the anxiety scale is within the range of 20-80; the minimum score of 20 shows no anxiety, and the maximum score of 80 shows the highest level of anxiety. In addition, scores 21-39 indicate mild anxiety, scores 40-59 indicate moderate anxiety, and scores 60-80 indicate severe anxiety. One hour before endoscopy, the intervention group received aromatherapy with lavender essential oil, and the placebo group received aromatherapy with placebo for 30 minutes. The anxiety inventory was completed again before endoscopy. In the intervention group, two drops of 10% lavender essential oil were sprayed on a cotton ball and pinned to the collar of the patient's clothes, and the patients were asked to breathe normally for 30 minutes. In the placebo group, two drops of odorless soybean oil were used. Afterwards, the Spielberger anxiety inventory was completed again before endoscopy. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent and paired t-test) (P<0.05). Results: The mean age of the patients was 47.12 ± 16.75 years (age range: 18-78 years), which had no significant difference between the groups (P=0.19). The mean duration of the disease was 16.15 ± 26.84 months (range: 1-144 months). The majority of the participants were female (51.4%), married (81.4%), housewife (40%), and had an undergraduate degree (58.6%). Regarding the disease symptoms, most of the patients experienced pain (61.4%) and indigestion and heartburn (25.7%). In addition, 8.6% of the patients had smoking habits. However, no significant differences were observed between the intervention and placebo groups in terms of these variables (P<0.05). On the other hand, 45.7% of the patients reported a history of hospitalization. The results indicated that the patients had moderate anxiety in the intervention and placebo groups before and after the intervention. The mean score of anxiety before aromatherapy in the intervention group (45.91) and placebo group (50.45) was not significantly different, while after the intervention, the mean score of anxiety in the patients receiving lavender aromatherapy decreased (41.37) compared to the placebo group (49.94), indicating a significant difference in this regard (P=0.001). The results of paired t-test showed that the mean score of anxiety decreased significantly after the intervention compared to before the intervention (P<0.0001), so that after aromatherapy, the score of anxiety decreased from 45.91 to 41.37. However, the difference was not considered significant in the placebo group (P=0.110), and the mean score of anxiety reduced from 50.45 to 49.49.  Conclusion: According to the results, aromatherapy with lavender essential oil was effective in the reduction of pre-endoscopic anxiety in the patients. Due to the reduced anxiety of the patients before endoscopy, it seems that this aromatherapy method could be used before such an invasive and stressful procedure without the unwanted side-effects of chemical drugs. Considering the cost-efficiency, safety, and simplicity of this method, aromatherapy could be used as a complementary measure to reduce anxiety in patients before endoscopy. Therefore, it is recommended that randomized controlled clinical trials with control groups be performed to compare the effects of lavender aromatherapy in with various demographic characteristics and disease-related factors (e.g., history of hospitalization in patients undergoing endoscopy).  }, Keywords = {Anxiety, Endoscopy, Aromatherapy, Lavender Oil}, volume = {32}, Number = {122}, pages = {55-68}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {تأثیر رایحه درمانی اسطوخودوس بر اضطراب بیماران کاندید آندوسکوپی: یک کارآزمایی بالینی}, abstract_fa ={زمینه و هدف: یکی از موقعیت‌های اضطراب‌آور برای بسیاری از بیماران در محیط‌های بالینی، آندوسکوپی است. رایحه‌درمانی یکی از روش‌های طب مکمل برای کاهش اضطراب است. این پژوهش با هدف تعیین تأثیر رایحه درمانی با اسانس اسطوخودوس بر اضطراب بیماران قبل از آندوسکوپی در ایران انجام شد. روش بررسی: این پژوهش یک کار آزمایی بالینی در بخش آندوسکوپی بیمارستان رازی رشت، از بهمن ماه ۱۳۹۷ تا شهریور ماه ۱۳۹۸ می‌باشد. ۷۰ نفر به روش در دسترس از افراد واجد شرایط ورود به مطالعه، به طور تصادفی در دو گروه مداخله و پلاسبو قرار گرفتند. پس از تکمیل فرم رضایت آگاهانه، پرسشنامه‌ی اطلاعات جمعیت شناختی و اضطراب Spielberger تکمیل شد. یک ساعت قبل از آندوسکوپی، گروه مداخله تحت رایحه درمانی با اسانس اسطوخودوس ۱۰ درصد و گروه پلاسبو تحت رایحه درمانی با پلاسبو به مدت ۳۰ دقیقه قرار گرفتند. سپس پرسشنامه‌ی اضطراب مجدداً قبل از آندوسکوپی تکمیل گردید. داده‌ها توسط نرم افزار SPSS نسخه ۱۶ و با استفاده از آزمون‌های آماری مورد تجزیه و تحلیل قرار گرفتند (۰۵/۰P<). یافته‌ها: نتایج حاصل از مطالعه نشان داد میانگین سنی افراد شرکت کننده در مطالعه ۷۵/۱۶ ± ۱۲/۴۷ بود. بیشتر نمونه‌ها زن بودند. پس از انجام مداخله، میانگین نمره اضطراب در گروه مداخله نسبت به گروه پلاسبو کاهش یافته بود، که از نظر آماری تفاوت معنی‌داری را نشان داد (۰۰۱/۰=P). نتیجه‌گیری کلی: نتایج حاصل از مطالعه نشان داد که رایحه درمانی با اسانس اسطوخودوس بر اضطراب بیماران قبل از آندوسکوپی مؤثر بود. رایحه‌درمانی با توجه به هزینه‌ی کم، ایمنی و سادگی آن، می‌تواند به عنوان یک اقدام مکمل برای کاهش اضطراب در بیماران قبل از آندوسکوپی استفاده گردد.}, keywords_fa = {اضطراب, آندوسکوپی, رایحه درمانی, روغن اسطوخودوس}, doi = {10.29252/ijn.32.122.55}, url = {http://ijn.iums.ac.ir/article-1-3135-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3135-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {Seyedoshohadaee, M and Seraj, A and Haghani, H}, title = {The Correlation of Resilience and Anxiety in the Candidate Burn Patients for Skin Grafting}, abstract ={Background & Aims: Burns affect all aspects of life. In fact, burn victims face various problems and the incidence affects their life quality, especially the psychological dimension. The majority of burn victims suffer from psychological disorders after the incident. On the other hand, burn treatment is a prolonged and difficult process associated with painful procedures, physical problems, and deformities, long hospital stays, surgical treatments, and numerous psychological problems. Burn victims deal with a wide range of stressors that severely change their vital signs and may cause irreversible damages to various body systems, including anxiety. People with burn injuries often experience anxiety, which is usually associated with worry, physical changes (e.g., hypertension and increased heart rate), and tension. Pre-surgery anxiety is also one of the experiences of skin graft candidates. In general, anxiety is a physiological reaction that can prevent improvement and increase the need for anesthesia and post-surgical sedatives. In addition, it decreases the body’s immune responses and increases the risk of infection in patients. Resilience is a coping strategy that helps individuals deal with stressful situations and survive pathogenic disorders. In fact, resilience is a dynamic process that leads to the manifestation of positive adaptive behaviors in individuals when facing hardship. With this background in mind, this study aimed to determine the relationship between resilience and anxiety in skin graft burn candidates. Materials & Methods: In this descriptive, correlational, and cross-sectional study, we selected samples using continuous sampling based on the inclusion criteria. The participants included skin graft candidates and the research setting was Mottahari Burns Hospital affiliated to Iran University of Medical Sciences. The sample size was determined at a 95% confidence interval and 80% test power while assuming a minimum correlation coefficient of 0.25 between resilience and anxiety of skin graft burn candidates following quantification in the formula. After receiving an introduction letter from the nursing and midwifery school and a license from the ethics committee of the university, the researcher referred to the mentioned hospital and explained the research objectives to supervisors and head nurses to gain their agreement and consent before sampling. In total, 130 subjects were selected including 65 men and 65 women in an age range of 18-60 years. Continuous sampling was carried out for one month (June 21st-July 22nd, 2019). It is notable that codes were used instead of names, and the research objectives were explained to the participants prior to the study. In addition, written informed consent was obtained from the participants or one of the immediate family members. Research tools included: 1) demographic characteristics questionnaire, Beck’s anxiety inventory (BAI), and the Connor-Davidson Resilience Scale (CD-RISC), which were filled 20-30 minutes before the surgery. In addition, data analysis was performed in SPSS version 16 using descriptive and inferential statistics in the form of a table and numerical indexes to describe research units. Moreover, mean and standard deviation, as well as Pearson’s correlation coefficient, analysis of variance, and independent t-test were applied to analyze the data. Results: In this study, 66.2% of the patients received a resilience score above 50 and a mean resilience score of 64.57±22.25 was obtained. On the other hand, the mean anxiety score of 45.4% of the patients was extremely low (12.88±10.45), and reverse, a significant correlation was observed between the resilience and anxiety of the participants. In other words, an increase in the resilience score of the participants led to a decrease in their anxiety levels (r=-0.0808, P<0.001). The results were also indicative of a significant relationship between resilience and the variables of the level of education (P<0.001), economic status (P=0.001), occupational status (P=0.02), and place of residence (P=0.035). Furthermore, a significant association was found between the participants’ anxiety and the variables of the level of education (P=0.004), economic status (P=0.011), occupational status (P=0.03), and place of residence (P=0.016). Conclusion: According to the results of the study, there was a reverse, significant correlation between resilience and anxiety, meaning that an increase in the resilience score led to a decrease in patients’ anxiety. In other words, the higher the resilience of patients, the lower their anxiety. Overall, skin graft burn candidates had low anxiety levels and moderate resilience. According to the results of the study, it is recommended that resilience be taught as a supplementary action along with other therapeutic approaches to reduce anxiety in burn victims before a skin graft. Moreover, due to the fact that the rate of resilience was lower in illiterate and low-income people, it is necessary to empower burn candidates to adapt to the conditions, prepare them before skin graft surgery, and prevent complications before, during, and after surgery. By doing so, we can increase resilience and decrease anxiety in these individuals. Our findings can help nursing managers hold in-service educational classes to emphasize the importance of resilience in a decrease of pre-surgical anxiety and increase their life quality.}, Keywords = {Resilience, Anxiety, Skin Graft, Burn}, volume = {32}, Number = {122}, pages = {69-79}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {ارتباط تاب آوری با اضطراب بیماران سوختگی کاندید پیوند پوست}, abstract_fa ={زمینه و هدف:. قربانیان سوختگی با مشکلات روانشناختی بسیاری از جمله اضطراب روبه رو هستند، اضطراب قبل از عمل امری عادی و بسیار رایج است. یکی از راهبردهای مقابله‌ای که به فرد کمک می‌کند تا با شرایط استرس زا روبرو شود، تاب آوری است. این مطالعه با هدف تعیین ارتباط تاب آوری با اضطراب بیماران سوختگی کاندید پیوند پوست انجام شد. روش بررسی: مطالعه مقطعی و از نوع توصیفی همبستگی بود. روش نمونه‌گیری مستمر و با توجه به معیارهای ورود به مطالعه انجام شد. ابزار مورد استفاده، پرسشنامه اضطرابBeck Anxiety Inventory)  (BAI) و تاب آوری (CD-RISC) بود و۲۰ الی ۳۰ دقیقه قبل از عمل در بخش بستری بیمار تکمیل شد. داده‌های جمع آوری شده در تیرماه ۹۸، با استفاده ازSPSS  نسخه ۱۶ و با استفاده از آمار توصیفی و استنباطی در قالب جدول و شاخص‌های عددی توصیف و سپس برای رسیدن به اهداف و پاسخ به سئوالات پژوهش آزمون‌های آنالیز واریانس، تی مستقل و ضریب همبستگی پیرسن حهت تجزیه و تحلیل مورد استفاده قرار گرفت. یافته‌ها :۲/۶۶ درصد از بیماران نمره تاب آوری بالای ۵۰ داشتند. میانگین تاب آوری ۵۷/۶۴، انحراف معیار ۲۵/۲۲، میانگین نمره اضطراب ۸۸/۱۲، انحراف معیار ۴۵/۱۰ بدست آمد. بین تاب آوری و اضطراب همبستگی معنی‌دار آماری وجود داشت، یعنی با افزایش نمره تاب آوری، اضطراب کاهش پیدا کرد (۰۰۱/۰P<) و)۰۸/۰(r= تحصیلات (۰۰۱/۰P <) وضعیت اقتصادی (۰۰۱/۰P =) وضعیت اشتغال (۰۲/۰P =) و محل سکونت (۰۳۵/۰P =) با تاب آوری ارتباط معنی‌دار آماری داشت. تحصیلات (۰۰۴/۰P =) وضعیت اقتصادی (۰۱۱/۰P =) وضعیت اشتغال (۰۳/۰P =) و محل سکونت (۰۱۶/۰ P =) با اضطراب ارتباط معنی‌دار آماری داشت. نتیجه‌گیری کلی: تاب آوری و اضطراب با یکدیگر ارتباط داشتند یعنی هرچه تاب آوری بالاتر باشد، اضطراب کمتر می‌شود. بیماران مبتلا به سوختگی کاندید پیوند پوست دارای اضطراب خفیف و تاب آوری متوسط بودند. بر اساس نتایج جهت کاهش میزان اضطراب بیماران قبل از عمل آموزش تاب آوری پیشنهاد می‌شود.}, keywords_fa = {تاب آوری, اضطراب, سوختگی, پیوند پوست}, doi = {10.29252/ijn.32.122.69}, url = {http://ijn.iums.ac.ir/article-1-3136-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3136-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {Amini, L and Ghorbani, B and Afshar, B}, title = {The Comparison of Infertility Stress and Perceived Social Support in Infertile Women and Spouses of Infertile Men}, abstract ={Background & Aims: Infertility is a stressful condition, which could adversely affect the mental health of couples. Although the diagnosis and treatment fertility may be a frustrating crisis affecting both spouses and causing mental distress, a sense of loneliness, disappointment, and lack of control, it seems that these issues are more apparent in women than men since the physical and mental burden of infertility and the consequences of the possible failure mostly falls on women. Women (especially in eastern communities and Iranian women) live in a culture in which having a child and fertility are revered more than other communities. Even when a woman is fertile and has an infertile spouse, infertility stress is experienced similarly since regardless of the cause of infertility, the outcome is eventually is childlessness. The social stigmas experienced by infertile women become more intense when they do not enjoy familial support, causing depression in these women. Therefore, the social support of these individuals could play a key role in their adaptation process to the issue of infertility. In Iran, several studies have been focused on the quality of life and psychological issues of infertile individuals, while most of these studies have investigated the psychological issues of infertile women without much regard for the spouses of infertile men. The present study aimed to compare infertility stress and perceived social support in infertile women and the spouses of the infertile men referring to Akbar Abadi Teaching Hospital in Tehran, Iran. Materials & Methods: This cross-sectional study was conducted on 164 infertile women and 93 spouses of infertile men referring to the infertility clinic of Akbar Abadi hospital in Tehran during 2015-2016. After obtaining the required permit from Iran University of Medical Sciences by the researcher and co-researcher, they visited the clinic on working days for sampling. After providing the necessary explanations to the hospital authorities and conforming to ethical principles (e.g., obtaining written consent), continuous sampling was performed until the completion of the sample size. The inclusion criteria were the Iranian nationality of the couples, infertility in only one spouse, willingness to participate in the study, absence of chronic physical diseases or known mental disorders, and no consumption of the medications affecting the nervous system by the couples. The subjects were allowed to withdraw from the study at any stages. Data were collected using a demographic questionnaire, Newton infertility stress inventory, and the functional social support questionnaire, which were completed in a self-report manner or with the help of the researcher, enquiring the subjects, and review of their medical records. Data analysis was performed in SPSS version 16 using descriptive and inferential statistics, including Chi-square and independent t-test at the significance level of P<0.05. Results: No significant differences were observed between the two study groups in terms of age (infertile women: 31.24±5.68 years; spouses of infertile men: 30.79±5.19 years), duration of marriage (infertile women: 7.29±4.81 years; spouses of infertile men: 7.54±4.13 years), duration of infertility (infertile women: 4.52±4.01 years; spouses of infertile men: 4.66±3.45 years), education level, occupation status, and economic status. In addition, 63.6% of the infertile women and 77.3% of the spouses of infertile men had primary infertility, while no significant difference was observed between the groups in this regard. No significant differences were denoted between the groups in terms of the scores of the subscales of infertility stress, including social concerns, sexual concerns, communicational concerns, and concerns regarding the lifestyle without a child, with the exception of the subscale of the need for parenthood (P=0.038). In addition, the total score of infertility stress had no significant difference between the study groups (P=0.043). The comparison of the mean perceived social support in the infertile women and spouses of infertile men indicated no significant difference in this regard.  Conclusion: Although it seems that regardless of the male or female cause of infertility, women experience stress in case of infertility, the overall stress and stress induced by the need for parenthood were higher in the infertile women compared to the spouses of the infertile men. According to the results, the spouses of the infertile men were as stressed as the infertile women in many subscales of infertility. This could be due to the fact that even when the male gender is the cause of infertility, diagnostic and therapeutic procedures are often imposed on women, which increases their concerns compared to their spouses. In the face of infertility stress, women react through anxiety, stress, depression, and grief. One of the major causes of such stress in these women is the fear of divorce and loss of the ability of motherhood. Since pregnancy and the motherhood role are exclusive to women, social expectations are higher in the case of women compared to men, and the fear of the stigma of infertility is more severe in women. It could be stated that due to cultural components and the pre-defined social expectations, the foremost expectation and predicted role for married men and women is to have a child, and lack thereof is frowned upon in the Iranian culture. This shows that in the Iranian culture, the inability to have a child is synonymous with the absence of a fruitful life. Although social support could diminish the stress of infertile individuals, they may still feel the emptiness of their childless life in private, which in turn adversely affects marital relations. Furthermore, it seems that having a child is more important to women than men, and men are able to cope with a childless life more easily than women. Regardless of the cause of infertility, the findings of this study indicated that social support in both the infertile women and spouses of infertile men was similar.}, Keywords = {Infertility, Social Support, Stress, Depression, Anxiety}, volume = {32}, Number = {122}, pages = {80-90}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {مقایسه استرس ناباروری و حمایت اجتماعی درک شده زنان نابارور و همسران مردان نابارور}, abstract_fa ={زمینه و هدف: ناباروری به یک موقعیت استرس آور بوده که می‌‌تواند سلامت روانی زوجین را تحت تأثیر قرار دهد. هدف از این مطالعه مقایسه استرس ناباروری و حمایت اجتماعی درک شده در زنان نابارور و همسران مردان نابارورمراجعه کننده به مرکز آموزشی درمانی شهید اکبر آبادی تهران بود. روش بررسی: این مطالعه مقطعی برروی 164زن نابارور 93 نفر از همسران مردان نابارور مراجعه کننده به درمانگاه ناباروری شهیداکبر آبادی شهر تهران در سال 95 -1394انجام شد و نمونه‌گیری به شکل مستمر بود. ابزار جمع آوری اطلاعات شامل فرم مشخصات فردی، پرسشنامه استرس ناباروری Newton و همکاران و پرسشنامه حمایت اجتماعی عملکردی بود که به شکل خودگزارش‌دهی تکمیل گردید. اطلاعات توسط نرم افزار SPSS نسخه 16 و ازطریق آزمون های تی مستقل و کای دو مورد تجزیه و تحلیل قرار گرفتند. یافته‌ها: یافته‌های حاصل از این پژوهش نشان داد که نمرات تمامی حیطه‌های استرس ناباروری به جز حیطه نیاز به والد شدن (038/0= p) و نمره کل استرس ناباروری (043/0= p) در بین دو گروه مورد مطالعه تفاوت آماری معنی‌داری نداشت. همچنین مقایسه میانگین حمایت اجتماعی درک شده در زنان نابارور و همسران مردان نابارور شرکت کننده در پژوهش نشان داد که دوگروه از این نظر نیز دارای اختلاف آماری معنی‌داری نبودند. نتیجه گیری کلی: اگرچه به نظر می‌رسد صرف نظر از عامل مردانه و یا زنانه ناباروری، زنان در موارد مواجهه با ناباروری دچار استرس هستند و لیکن استرس کلی و استرس نیاز به والد شدن در زنان نابارور نسبت به همسران مردان نابارور بالاتر می‌باشد. با این وجود این دو گروه از نظر حمایت اجتماعی تفاوت معنی‌داری ندارند.}, keywords_fa = {ناباروری, حمایت اجتماعی, استرس, افسردگی, اضطراب}, doi = {10.29252/ijn.32.122.80}, url = {http://ijn.iums.ac.ir/article-1-3139-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3139-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} } @article{ author = {Inanlou, M and Basiri, SH and Zamani, N and Haghani, H}, title = {Help-seeking for Suicidal Thoughts in the Poisoned Patients at Loghman Hakim Teaching Hospital in Tehran, Iran}, abstract ={Background & Aims: A history of suicide attempt is the most important risk factor for repeated and successful suicide. Seeking help is essential to access to proper mental healthcare services, and appropriate help-seeking could protect individuals against the risks of suicidal thoughts and behavioral progress in this regard. In addition, seeking help from a professional or personal source that could facilitate access to professional psychological help mitigates or eliminates the immediate risk of successful suicide in those with suicidal thoughts or manifesting suicidal behaviors. The level of help-seeking is higher in the areas where the suicide rate is lower. Considering the role of cultural background in help-seeking, studies must be conducted in Iran to gain insight into the intention of help-seeking for suicidal thoughts. The present study aimed to determine the intention of help-seeking from formal sources for suicidal thoughts and assess its correlation demographic factors in the poisoned patients with a history of suicide attempt prior to the current condition in Loghman Hakim teaching hospital in Tehran, Iran. Materials &Methods: This cross-sectional, descriptive study was conducted on all the poisoned patients with a history of suicide attempt prior to the current condition, who were being discharged from the men's and women's poison wards of Loghman Hakim teaching hospital affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. In total, 130 patients were selected via continuous sampling from late April to late June, 2019. In addition to the demographic form (age, gender, education level, marital status, occupation status, economic status, number of suicide attempts, family history of suicide, history of receiving consultative and psychological services, history of psychiatric medication use under the supervision of a physician, and history of admission to the psychological ward), data were collected using the general help-seeking questionnaire (GHSQ) developed by Wilson et al. (2005) in Australia for the measurement of help-seeking intentions. To confirm the validity of the GHSQ, the process of translation and re-translation was utilized. Moreover, the reliability of the scale was confirmed by 15 eligible poisoned patients (not the main research units) who completed the questionnaire, and the Cronbach’s alpha coefficient was calculated to be 0.70. After obtaining informed consent and explaining the responding process of the questionnaires, the demographic form and GHSQ were completed for each research unit by the researcher based on the responses of the patients within 15-20 minutes at their bedside. Data were obtained from 130 completed questionnaires. Data analysis was performed in SPSS version 20, and descriptive statistics were used in the form of tables and numerical measures in order to describe the research units. To determine the correlations between the demographic variables and help-seeking intentions, the data were analyzed using Pearson's correlation-coefficient, independent t-test, and the analysis of variance (ANOVA) at the significance level of P<0.05. Results: In total, 76.9% of the participants were female, and the age of the patients was within the range of 18-57 years (mean: 26.76±9.1 years). Among the patients, 40.0% had a high school diploma, 56.9% were single, 61.5% were unemployed, and 41.5% had an average economic status. The number of suicide attempts was 2-14 times (mean: 2.91±2.3), and 11.5% of the subjects had a family history of suicide attempt. In addition, 41.5% had no history of receiving consultative and psychological services, 52.3% had no history of psychiatric medication use under the supervision of a physician, and 20.8% had a history of admission to the psychiatric ward. The help-seeking intentions for suicidal thoughts from formal sources were low, with the mean of 2.51±1.18 (achievable range: 1-7), and the most significant formal sources of help-seeking intentions were psychologists (3.78±2.65), psychiatrists (3.64±2.58), and social services hotlines (2.34±2.08), respectively. Among the demographic variables, no significant correlations were observed between help-seeking intentions from formal sources and age, gender, education level, marital status, occupation status, economic status, number of suicide attempts, history of receiving consultative and psychological services, history of psychiatric medication use under the supervision of a physician, and history of admission to the psychiatric ward. History of suicide attempt in the first-degree family members was the only demographic variable that had a significant correlation with help-seeking intentions from formal sources (P=0.021), and the mean score of help-seeking intentions from formal sources was higher in the patients with a family history of suicide attempt. Conclusion: According to the results, the help-seeking intentions from formal sources for suicidal thoughts were low in the poisoned patients with a history of suicide attempt. Help-seeking is an effective coping strategy when experiencing suicidal thoughts, which facilitates access to professional psychological help and plays a key role in reducing the rate of suicide; therefore, efforts should be made to promote help-seeking. The individuals who are at the risk of suicide need interventions developed to improve mental health care, especially primary care to encourage quicker help-seeking from proper sources. In this regard, measures such as the normalizing of help-seeking from formal sources, expanding insurance coverage to cover mental healthcare services, and improving communication skills in the families of those with a history of suicide could act as the facilitators of help-seeking from formal sources, as well as the training, identification, and referral of these individuals to available professionals, such as teachers and clerics. The familiarity of these individuals with various help-seeking sources (e.g., social aid hotlines and media campaigns) to increase the level of help-seeking may also facilitate the access of individuals to proper help-seeking sources. Moreover, the barriers against help-seeking in the individuals attempting suicide must be identified and mitigated. In this study, only about half of the individuals with a history of suicide attempt had a history of visiting a professional psychologist or using psychiatric medications under the supervision of a physician, while their intention of help-seeking from formal sources was relatively low. Therefore, the prevention of suicide required investment for creating a positive image of mental health care, which must be made accessible to the highest extent possible to the individuals who need to seek help from formal sources.}, Keywords = {Help-seeking, Suicide, Poisoned}, volume = {32}, Number = {122}, pages = {91-106}, publisher = {دانشگاه علوم پزشکی ایران}, title_fa = {یاری جویی برای افکار خودکشی در مسمومین مرکز آموزشی درمانی لقمان حکیم تهران}, abstract_fa ={زمینه و هدف: داشتن سابقه اقدام به خودکشی، مهم‌ترین عامل خطر مرگ بر اثر خودکشی است. یاری جویی مناسب، دارای توانایی محافظت از فرد در برابر خطرات ناشی از پیشرفت افکار و رفتار خودکشی می‌باشد. مطالعه حاضر با هدف تعیین قصد یاری جویی از منابع رسمی در مسمومین با سابقه قبلی اقدام به خودکشی پیش از مورد فعلی در مرکز آموزشی درمانی لقمان حکیم انجام گرفته است. روش بررسی: پژوهش حاضر یک مطالعه مقطعی از نوع توصیفی می‌باشد. جامعه پژوهش شامل تمامی مسمومین با سابقه قبلی اقدام به خودکشی پیش از مورد فعلی که در حال ترخیص از بخش‌های مسمومین مرکز آموزشی درمانی لقمان حکیم بودند، می‌باشد. 130 نفر با نمونه‌گیری مستمر از اواخر فروردین تا اواخر خرداد 98 وارد پژوهش شدند. فرم اطلاعات جمعیت شناختی و پرسش نامه یاری جویی عمومی (GHSQ) برای هر نمونه توسط پژوهش‌گر در مدت 15 تا 20 دقیقه تکمیل گردید. اطلاعات به دست آمده وارد نرم افزارSPSS  نسخه 16 شد و توسط آزمون های ضریب همبستگی پیرسون، تی مستقل و آنالیز واریانس در سطح معنی‌داری 05/0P < مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: قصد یاری جویی برای افکار خودکشی از منابع رسمی با میانگین 18/1 ± 51/2 در سطح پایین بود. بیشترین قصد یاری جویی از میان منابع رسمی به ترتیب مربوط به روان شناسان )میانگین= 78/3(، روان پزشکان )میانگین= 64/3( و خطوط تلفن‌های امداد اجتماعی ) میانگین= 34/2( بود. تنها متغیر جمعیت شناختی که با قصد یاری جویی از منابع رسمی ارتباط معنی‌دار آماری داشت، سابقه اقدام به خودکشی در اعضای درجه اول خانواده بود (021/0 P =). نتیجه‌گیری کلی: قصد یاری جویی از منابع رسمی در افراد با سابقه اقدام به خودکشی مجدد، پایین بود. از آن جا که یاری جویی یک راهکار مقابله‌ای مؤثر در زمان تجربه نمودن افکار خودکشی می‌باشد و در کاهش میزان خودکشی نقش دارد، تلاش برای ارتقای یاری جویی ضروری می‌باشد.}, keywords_fa = {یاری جویی, خودکشی, مسمومین}, doi = {10.29252/ijn.32.122.91}, url = {http://ijn.iums.ac.ir/article-1-3142-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-3142-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2020} }