OTHERS_CITABLE «نامه به سردبیر» مراقبت از راه دور، راهکاری در چالش‌های ارائه مراقبت تسکینی در بحران کرونا سردبیر محترم پاندمی کرونا در جهان در کنار ایجاد بحران سلامتی در سیستم‌های بهداشتی درمانی، سایر ابعاد زندگی افراد از جمله ابعاد اقتصادی و اجتماعی را در جوامع دچار تغییر کرده است(1) و همچنان در برخی از کشورها روند رو به رشدی را داشته است(2). ادامه داشتن این روند در نظام سلامت، سایر حیطه‌های درمانی و مراقبتی مثل مراقبت از بیماران مبتلا به بیماری‌های تهدید کننده حیات را هم تحت الشعاع خود قرار داده است(3). یکی از جنبه‌های اساسی مراقبت، مراقبت تسکینی است که این رویکرد مراقبتی به دنبال بحران کرونا تحت تأثیر قرار گرفته است؛ چرا که مراقبت تسکینی دارای ابعاد و ویژگی‌هایی همچون برقراری ارتباط مؤثر، در دسترس بودن و همکاری تیمی است که پاندمی کرونا می‌تواند آن‌ها را دچار چالش نماید(4). نظام ارائه مراقبت تسکینی در کشور ایران، یک نظام نوپا بوده و خدمات مراقبت تسکینی غالباّ به صورت بستری شدن بیماران در بیمارستان انجام می‌گیرد. هر چند مراکز محدودی وجود دارند که در ارائه خدمات به بیماران در منزل هم فعالیت می‌کنند و گروه‌های مختلف ارائه دهنده مراقبت همچون پزشک و پرستار با توجه به نیازهای بیماران ویزیت و ارائه خدمات در منزل را انجام می‌دهند(5). در هر دو حالت بستری شدن در بیمارستان یا مراقبت در منزل امکان تماس افراد با همدیگر را زیاد کرده و زمینه‌ای برای گسترش ویروس کرونا می‌باشد. از طرفی دیگر بیماران نیازمند مراقبت تسکینی که مبتلا به بیماری‌های تهدید کننده حیات می‌باشند، رنج‌های مختلفی از ابعاد جسمی، روانی، معنوی و عاطفی را تجربه می‌کنند که این مسائل بیماران را در برابر خطر ابتلا به کرونا آسیب پذیر می‌کند(6). بنابرین ارائه مراقبت تسکینی در بحران کرونا با چالش‌هایی همراه است که باید با ارایه راهکاری مناسب، تهدیدهایی که در زمینه ارائه مراقبت وجود دارد را تعدیل نمود تا بیماران و خانواده‌ها و همچنین سیستم مراقبتی دچار آسیب‌های جدی نشوند. هدف در این نامه به سردبیر تعیین جایگاه مراقبت از راه دور به عنوان راهکار مراقبتی مؤثر در عرصه مراقبت تسکینی در کشور ایران در زمان بحران کرونا می‌باشد. 4 قبل از پاندمی کرونا در جهان، پزشکی و مراقبت از راه دور به طور فزآینده‌ای استفاده می‌شد تا مراقبت‌های تسکینی را در خانه بیماران و خانواده‌های آنها وارد کنند(7) و استفاده از این رویکرد نتایج مثبتی همچون افزایش کیفیت زندگی، کاهش بستری شدن و کاهش هزینه‌ها به دنبال داشته است(8). با ظهور بحران کرونا، نقش این رویکرد در ارائه مراقبت تسکینی، بیش از بیش آشکار می‌گردد؛ چرا که با گسترش کرونا ویروس، چالش‌هایی در ارائه مراقبت‌های تسکینی ایجاد می‌گردد که با سازماندهی مراقبت از راه دور میتوان این چالش‌ها را تا حدودی رفع نمود. با توجه به اینکه در زمان بحران کرونا حفظ محدودیت‌های اجتماعی موضوعی با اهمیت می‌باشد، برقراری ارتباط بین ارائه دهندگان مراقبت با بیماران و خانواده‌های آنان که یکی از ارکان مهم ارائه مراقبت تسکینی می‌باشد به چالش کشیده می‌شود. در عرصه مراقبت تسکینی ایران، برقراری ارتباط مؤثر بین ارائه‌دهندگان مراقبت و بیماران با ابعاد و ویژگی‌هایی همچون حضور در کنار بیماران، در دسترس بودن برای بیماران، صمیمیت و تلاش برای رسیدن به درک مشترک با بیماران مشخص شده است(9) که در زمان بحران کرونا برخی از این ابعاد مثل حضور ارائه دهنده مراقبت در کنار بیمار با محدودیت‌هایی روبرو شده است با این وجود برای داشتن ارتباطی مؤثر با بیماران از طریق مراقبت از راه دور می‌توان تا حدودی سایر ابعاد برقراری ارتباط را پوشش داد. به منظور استفاده از از مراقبت از راه دور تمهیداتی از قبیل ایجاد شبکه برقراری ارتباط با بیماران لازم است و در این شبکه ارتباطی، ارائه دهندگان مراقبت به صورت 24 ساعته، در دسترس بیماران و خانواده‌های آنها می‌باشند. در این راستا لازم است بیماران نیز به امکانات استفاده از شبکه برقراری ارتباط همچون تلفن هوشمند دسترسی داشته باشند. استفاده از نرم افزارهای ارتباط تصویری، می‌تواند شبکه برقراری ارتباط از راه دور را بسیار کارآمد نماید؛ به طوریکه استفاده از جلسات تماس تصویری در راستای بررسی دغدغه‌های بیماران و خانواده‌های آنها و رفع این دغدغه ها بسیار مؤثر هستند. در دسترس بودن ارائه دهندگان مراقبت برای بیماران و خانواده‌های آنان از طریق برقراری ارتباط با جلسات تماس تصویری شرایطی را فراهم می‌کند که علاوه بر ارتباط کلامی، به نشانه‌ها و علایم غیر کلامی بیمار هم توجه گردد که هدایت کننده جریان ارتباط و احساسات طرفین می‌باشد و این موضوع فراتر از برقراری ارتباط کلامی از طریق تماس صوتی است. اگرچه برخی از استراتژی‌های برقراری ارتباط از قبیل حضور داشتن کنار بیمار از طریق مراقبت از راه دور فراهم نیست، با این وجود برخی دیگر از استراتژی‌ها همچون گوش دادن فعال به بیمار، درک کردن احساسات بیمار را از طریق تماس تصویری فراهم می‌شوند؛ بنابرین مراقبت از راه دور روشی مناسب در برقراری ارتباط مؤثر با بیماران و خانواده‌های آنها در بحران کرونا محسوب می‌شود و فراهم ساختن ساختارهای لازم برای مراقبت از راه دور ضروری به نظر می‌رسد. اگر چه در ارائه مراقبت از راه دور، تکنولوژی سخت افزاری و نرم افزاری به عنوان زیرساخت مهم مطرح هستند(10) ولی باید علاوه بر آن، نیروی انسانی و کاربران نیز مد نظر قرار گیرند(11). با توجه شرایط ایجاد شده در بحران کرونا ارائه دهندگان مراقبت و بیماران و خانواده‌ها باید سازگاری کافی را با تغییر رویه مراقبت و ایجاد جو مناسب برای مراقبت از راه دور داشته باشند. بنابرین علاوه بر تأمین زیرساخت‌های برقراری ارتباط از راه دور لازم است محتوی و فرآیند مراقبتی هم مد نظر قرار گیرد؛ در این راستا لازم است سیستم‌های بهداشتی و درمانی، تیم‌ها و تکنولوژی لازم در این زمینه را منعطف و توانمند سازند و به هنگام اجرای طرح جدید الویت‌ها و اهداف مشخصی برای خودشان تعریف نمایند و همچنین محدودیت‌های مسیر اجرای طرح جدید را کم نمایند. 5 یکی از چالش‌های اساسی در ارائه مراقبت تسکینی در زمان بحران کرونا کمبود امکانات مختلف از جمله وسایل حفاظت فردی برای بیماران و ارائه دهندگان مراقبت به خصوص در کشورهای کمتر توسعه یافته است(12). همچنین بستری شدن تعداد زیاد بیماران در بیمارستان در این برهه زمانی، سیستم بهداشتی درمانی را با کمبود تخت‌های بیمارستانی مواجه کرده است به طوریکه خیلی از مراکز مراقبتی به ناچار به مراکز ارائه خدمات برای بیماران مبتلا به کرونا تغییر رویه داده‌اند. در راستای کمبود تجهیزات حفافظت فردی و کمبود تخت بیمارستانی برای بیماران غیر کرونایی مثل بیماران مبتلا به بیماری‌های تهدیدکننده حیات که نیازمند دریافت مراقبت تسکینی هستند، رویکرد مراقبت از راه دور می‌تواند به جلوگیری از صرف هزینه‌های تأمین این تجهیزات کمک نماید. بنابرین مراقبت از راه دور در حفاظت فردی بیماران، خانواده‌ها و ارائه دهندگان مراقبت مفید بوده، استفاده از تجهیزات حفاظت فردی را کاهش می‌دهد و همچنین خدماتی مناسب به بیماران و خانواده‌ها ارایه می‌دهد. از طرفی با بستری نشدن بیمارانی که نیازمند مراقبت‌های اورژانسی نبوده و در عین حال نیازمند دریافت مراقبت تسکینی هستند، تخت‌های بیمارستانی کافی برای ارائه خدمات به بیماران مبتلا به کرونا فراهم می‌گردد. یکی دیگر از چالش‌های سیستم‌های بهداشتی درمانی در ارایه مراقبت‌های تسکینی در بحران کرونا، کمبود نیروی ارائه دهنده خدمت می‌باشد؛ چرا که کارکرد واحدهای مختلف مراقبتی تغییر پیدا کرده و بسیاری از پرستاران از عرصه‌های مختلف مراقبتی مثل مراقبت تسکینی، در خدمت مراکز مرتبط با کرونا قرار گرفته‌اند و این مسئله ارائه خدمات به بیماران مبتلا به بیماری‌های تهدیدکننده حیات را تحت تأثیر قرار می‌دهد. از طرفی ارائه دهندگان مراقبت در بحران‌ها تمایل به ارائه خدمات بشردوستانه و نوع دوستانه داشته و این مسئله دغدغه‌های ذهنی آنها را در ارائه مراقبت به بیماران نیازمند زیاد می‌کند(13)، به طوری‌که پرستاران در کمک به کنترل وضعیت بحرانی و ارایه خدمات داوطلب می‌شوند و این مسأله می‌تواند موجب انتقال نیروی انسانی از یک عرصه مراقبتی خاص مثل عرصه مراقبت تسکینی به سمت مدیریت بحران گردد؛ بنابرین لازم است سیاست گذاری مراقبت در این شرایط بنحوی اتخاذ گردد که با وجود کمبود نیروی انسانی، خدماتی مناسب به بیماران مبتلا به بیماری‌های تهدید کننده حیات ارائه گردد که در این راستا بکارگیری روش‌ها و طرح‌های جدید مراقبتی مثل مراقبت از راه دور کمک‌کننده است. با توجه به اینکه مراقبت تسکینی با همکاری گروه‌های مختلف مراقبتی انجام می‌شود، برای تصمیم‌گیری در مورد فرآیند ارائه مراقبت از راه دور باید از تخصص‌ها و ارائه دهندگان مراقبت در تخصص‌های مختلف نظرخواهی نمود که این مسأله همکاری تیمی را تسهیل می‌نماید. چگونگی ارائه مراقبت باید به گونه‌ای برنامه‌ریزی شود که چالش کمبود نیرو را مرتفع ساخته و فشار کاری زیادی بر دوش ارائه دهندگان مراقبت نباشد و سیاست‌گذاری سلامت باید به نحوی باشد که ارائه دهندگان مراقبت در برابر عوامل بحران‌زا مثل کرونا دچار آسیب نشوند تا اجرای طرح‌های جدید مراقبتی به بن بست ختم نشود. یکی از راهکارهای کمک کننده به ارائه خدمات، تربیت نیروهای غیر حرفه‌ای قبل از وقوع شرایط بحرانی و بکارگیری از توان آنها در شرایط بحرانی می‌باشد(14). در این راستا، استفاده از نیروهای داوطلب در ارائه مراقبت تسکینی و بکارگیری آنها در رویکرد مراقبت از راه دور تاحدودی کمک کننده است. اما لازم است عمکلرد آنها توسط کارکنان حرفه‌ای مدیریت گردد. این افراد دسترسی 24 ساعته بیماران و خانواده‌های آنها به مراقبت‌های تسکینی را تسهیل می‌نماید. به طوریکه در برنامه‌ریزی مراقبتی از افراد غیر حرفه‌ای می‌توان به عنوان رابطی برای برنامه‌های آموزشی از طریق جلسات تماس تصویری استفاده نمود. http://ijn.iums.ac.ir/article-1-3482-fa.pdf 2021-10-02 1 7 10.52547/ijn.34.132.1 کرونا ویروس کووید- 19 مراقبت تسکینی مراقبت از راه دور “Letter to Editor” Telecare; An Approach to the Challenges of Providing Palliative Care during the Corona Crisis Dear editor Along with the health crisis in medical-health systems, the COVID-19 pandemic has transformed other dimensions of humans’ lives such as the socioeconomic conditions in the societies and it stills follows a growing trend in some countries (until the time of writing the present paper). The continuation of this trend in the health system has overshadowed other medical and care domains like caring for patients with life-threatening diseases. One of the main domains affected by the COVID-19 crisis is palliative care; as palliative care has certain dimensions and characteristics such as effective communication, availability, and teamwork that are challenged by the coronavirus pandemic. The palliative care provision in Iran is an infant system and palliative care service is often provided in the form of hospitalizing the patients in the hospitals although few centers are actively providing home service to the patients and various care providing groups such as physicians and nurses visit and provide service at home considering the patients’ needs. On one hand, both conditions, i.e., the patient getting hospitalized or being provided with home care services have increased individuals' contact which in turn has paved the ground for the proliferation of COVID-19. On the one hand, the patients requiring palliative care, particularly those with life-threatening diseases suffer from diverse physical, psychological, spiritual, and affective pain, which make them susceptible to Coronavirus risks. Thus, providing palliative care during the COVID-19 crisis is accompanied by some challenges which make it necessary to moderate the threats of care provision by providing appropriate strategies so that the patients and the families, and the care system do not suffer from serious problems. As thousands of COVID-19 patients are hospitalized in the country, the process of care provision in different areas, in particular, palliative care has changed, and in order to satisfy the diverse demands of the patients needing palliative care, taking new measures is a must. Therefore, the aim of this paper was to assess telecare as an effective care strategy in the field of palliative care in Iran during the Corona crisis. Before the COVID-19 pandemic, telemedicine and telecare were used increasingly to provide home-based palliative care for the patients and their families. This approach has resulted in some positive outcomes like the increase in the quality of life, the reduction of hospitalization cases, and the reduction of costs. The emergence of COVID-19 further highlighted the role of this approach in palliative care provision since the spread of coronavirus created challenges in providing palliative care that can be partially addressed by organizing telecare. Regarding the strict restrictions in providing hospital services during the COVID-19 pandemic and the restrictions in the presence of the professional care providers at home, telecare provision is significant for maintaining care at a befitting level. Therefore, considering that observing social distancing is of utmost significance during the COVID-19 pandemic, communication between care providers and the patients and their families, as one of the most important factors of palliative care provision is challenged. In the area of palliative care in Iran, effective communication between care providers and patients with dimensions and characteristics such as attending the patients, being available for the patients, intimacy, and efforts to reach a mutual understanding with the patients have revealed that some of these aspects like the care provider attending the patient have encountered some restrictions at the time of the COVID-19 pandemic. However, in order to effectively communicate with the patients through telecare, it is possible to cover some other aspects of communication. To utilize telecare, some measures have to be taken into account including the communication network with the patients and in this communication network, the care providers are available for the patients and their families 24 hours a day. Therefore, it is essential for the patients to be equipped with facilities such as smartphones to be able to benefit from a communication network. Employing video communication apps can make telecommunication networks very efficient. Therefore, video conferencing is effective in line with assessing and resolving the concerns of the patients and their families. The availability of care providers to the patients and their families through video conferencing communication creates conditions that make it possible to pay attention to the non-verbal symptoms of the patients in addition to their verbal symptoms which direct the communication flow and the two parties’ feelings and is beyond verbal communication through voice call. Although some of the communication strategies such as being present beside the patient through telecare are not provided, some other ones like listening actively to the patient and understanding the patient’s feelings can be achieved by video conferencing. Thus telecare is an appropriate practice for effectively communicating with the patients and their families during the COVID-19 crisis and providing the needed structures for telecare seems to be necessary. Although in providing telecare, software and hardware technologies are fundamental infrastructures, human force and the users have to be taken into account as well. Considering the conditions created during the COVID-19 pandemic, the care providers, the patients and the families should adapt themselves to the changing care practice and prepare a suitable atmosphere for telecare. Therefore, besides supplying the infrastructures of telecommunication, it is essential to consider the care content and process; and in this regard, it is critical to make the health and medical systems, teams, and the essential technology flexible and empowered to define their priorities and goals when executing the new scheme and also reduce the restrictions of execution of the new scheme. 2 One of the basic challenges of providing palliative care during the COVID-19 pandemic is the inadequacy of various facilities including the personal protective equipment for the patients and care providers, especially in underdeveloped countries. Moreover, the hospitalization of a large number of patients during this time has created challenges with the shortage of beds so that most of the care centers have inevitably resorted to service centers for the patients suffering from Coronavirus. In line with a lack of personal protective equipment and the shortage of hospital beds for non-COVID-19 patients such as those suffering from life-threatening diseases demanding palliative care, the telecare approach could reduce the costs of supplying such equipment. Thus, telecare is effective in protecting patients, their families, and care providers, reducing the use of personal protective equipment, and also providing the patients and their families with befitting service. By not hospitalizing the patients who do not need urgent care and at the same time, require palliative care, there would be enough hospital beds for providing service to COVID-19 sufferers. Another challenge of the medical-health systems providing care services during the COVID-19 crisis is the shortage of care providers. The function of different care units has changed and most nurses from diverse care fields like palliative care have started working with COVID-19 associated centers, which affect providing service to patients suffering from life-threatening diseases. In addition, care providers are willing to provide humanitarian and altruistic services in times of crisis and this issue increases their mental preoccupations in providing care to the patients in need. Therefore, nurses have to volunteer to control the crisis and provide services, which leads to the transfer of human forces from a specific care area to another area; for example, from palliative care to crisis management. Therefore, it is necessary to adopt care policy in these conditions in such a way as to provide appropriate services to patients with life-threatening diseases despite lack of human forces, and in this regard, the use of new methods and care plans such as telecare is helpful. Palliative care is provided in collaboration with different care groups, and to decide on the process of telecare, one should consult with specialties and care providers in different specialties, which facilitates teamwork. In the new care schemes, care provision has to be planned in such a way as to resolve the shortage of workforce and mitigate the heavy workload of care providers and health policy should be provided in a way to protect care providers against crises such as the coronavirus so that implementing the new care schemes does not reach a deadlock. One of the strategies boosting service provision is to train non-professional forces ahead of critical situations and utilize their power under critical circumstances. In this regard, benefitting from voluntary forces in providing palliative care and hiring them in the telecare approach is helpful to some extent. Meanwhile, it is necessary to manage their performance by the professional staff. These individuals facilitate the 24-hour accessibility of palliative cares for the patients and their families, so that in care planning, the non-professional individuals can be hired to serve as an intermediary for training programs through videoconferences. http://ijn.iums.ac.ir/article-1-3482-en.pdf 2021-10-02 1 7 10.52547/ijn.34.132.1 Coronavirus COVID-19 Palliative Care Telecare M Aghaei 1 PhD in Nursing, Institute of Health Education, Ardabil University of Medical Sciences, Ardabil, Iran AUTHOR https://orcid.org/0000-0002-0028-7887 H Soltani 2 Master of Medical Surgical Nursing, Institute of Health Education, Ardabil University of Medical Sciences, Ardabil, Iran (Corresponding author) Tel: +98-4532545936 Email: h.soltani@arums.ac.ir AUTHOR https://orcid.org/0000-0002-0764-7339 S Bodaghi 3 Bachelor of Nursing, Institute of Health Education, Ardabil University of Medical Sciences, Ardabil, Iran AUTHOR https://orcid.org/0000-0002-5889-7940
OTHERS_CITABLE ارتباط کیفیت زندگی با تیپ‌های شبانه روزی و اضطراب افراد با اختلال صرع عضو انجمن صرع ایران در سال 1399 زمینه و هدف: صرع یکی از شایع‌ترین اختلالات عصبی مزمن است و افراد مبتلا به آن مستعد بیماری‌های جسمی و روانی بوده و با شرایطی روبرو هستند که می‌تواند بر کیفیت زندگی آنها در چندین حوزه مانند اضطراب تأثیر گزار باشد. ترجیحات روزانه و ریتم‌های شبانه روزی به عنوان یکی از عوامل دخیل در کیفیت زندگی بیماران مبتلا به صرع مطرح هستند. پژوهش حاضر با هدف تعیین ارتباط کیفیت زندگی با تیپ‌های شبانه روزی و اضطراب افراد با اختلال صرع عضو انجمن صرع ایران در سال 1399 انجام شد. روش بررسی: این پژوهش به‌صورت مقطعی، از نوع همبستگی- توصیفی بود. 120 نفر از افراد مراجعه کننده به انجمن صرع به روش نمونه‌گیری مستمر انتخاب و براساس معیار ورود به مطالعه واردشدند. بازه زمانی نمونه‌گیری از خرداد تا مرداد ماه سال 1399 بود. شرکت کنندگان فرم اطلاعات جمعیت شناختی، پرسشنامه صبحی– عصری (MEQ) ، پرسشنامه اضطراب بک Beck Anxiety Inventory BAI) ( و پرسشنامه کیفیت زندگی Quality of Life in Epilepsy Inventory 31-Item (QOLIE-31-P) را تکمیل کردند. برای تحلیل داده‌ها، از آمار توصیفی، آمار استنباطی و آمار همبستگی و جهت تعیین عوامل پیش بینی‌کننده کیفیت زندگی مبتلایان به صرع از مدل رگرسیون خطی چندگانه استفاده گردید. داده‌های جمع‌آوری‌شده ، توسط نرم‌افزار آماری SPSS، نسخه 16 مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: میانگین سنی افراد مورد پژوهش 14/42 سال بود. بیشتر نمونه‌ها از نظر تیپ‌های شبانه روزی در وضعیت بینابینی قرار داشتند و کمترین فراوانی مربوط به حالت کاملاّ صبحی بود. همچنین ارتباطی میان ابعاد کیفیت زندگی با تیپ‌های شبانه روزی به دست نیامد. کیفیت زندگی در بعد نگرانی از تشنج با میانگین 47/57 بالاترین میانگین و در بعد عملکرد اجتماعی (76/45) کمترین میانگین نمره را داشتند. کیفیت زندگی و همه ابعاد آن با اضطراب همبستگی معنی‌دار آماری داشتند و این همبستگی منفی است یعنی با افزایش اضطراب، کیفیت زندگی و ابعاد آن کاهش می‌یابد. همچنین اضطراب با سطح تحصیلات، وضعیت اشتغال، درآمد، دفعات بستری رابطه معنی‌داری داشته است. نتیجه‌گیری کلی: یافته‌های پژوهش که نشان داد کیفیت زندگی و همه ابعاد آن با اضطراب همبستگی معنی‌دار آماری داشتند که این همبستگی منفی بود. به نظر می‌رسد که می‌توان با بالا بردن سطح آگاهی، تحصیلات حداقل در سطح دیپلم و ایجاد شغل با درآمد مناسب، برداشتن موانع سازمانی مانند تسهیل استخدام آنها نقش مؤثری در گسترش رفتارهای به دور از اضطراب و به تبع آن افزایش کیفیت زندگی بیماران مبتلا به صرع گام برداشت. http://ijn.iums.ac.ir/article-1-3484-fa.pdf 2021-10-04 8 20 10.52547/ijn.34.132.8 صرع اضطراب کیفیت زندگی تیپ‌های شبانه روزی Evaluation of the Relationship between Life Quality and Circadian Types and Anxiety in Iranian Epilepsy Association Members with Epilepsy in 2020 Background & Aims: Epilepsy is one of the most common chronic neurological disorders, and epileptic patients are prone to physical and psychological diseases and can experience issues such as anxiety, which affect their life quality. In general, epilepsy reduces life quality indexes and life expectancy, which has considerable economic effects on the person and the society and will ultimately lead to problems such as isolation, dependence, psychological damages and disorders, remaining single, unemployment and declining quality of life. Daily preferences and circadian rhythms are recognized as factors affecting epileptic patients’ life quality. As a mental feeling, quality of life is a psychological phenomenon that may play a role in patients’ life quality through personal traits such as daily preferences and circadian rhythms. In other words, circadian rhythms and anxiety are important issues found in epileptic patients, which can affect their quality of life. Therefore, the present study aimed to determine the relationship between life quality and circadian rhythms and anxiety in epileptic patient members of the Iranian Epilepsy Association. Materials & Methods: This was a cross-sectional, descriptive and correlational study performed on 120 individuals who referred to the Iranian Epilepsy Association. The participants were selected by continuous sampling and based on the inclusion criteria. The sampling process continued for a period of June-August, 2020. Data were collected using a demographic characteristics questionnaire, including age, gender, level of education, marital status, occupational status, average monthly family income, and medical information related to other diseases, duration of diagnosis, and diagnosis of epilepsy in other family members. In addition, we applied the Morningness-Eveningness Questionnaire (MEQ), which comprises 19 questions about the sleep and waking times and appropriate times for physical, mental and conscious functioning after waking up. Moreover, we used the Beck Anxiety Inventory (BAI), which has 21 items about cognitive and physical signs of anxiety. Furthermore, we exploited the Quality of Life in Epilepsy (QOLIE-31-P) was exploited, which encompasses subscales of concern about epilepsy, psychological health, energy/fatigue, cognitive performance, drug effects, social performance and overall quality of life. The instruments were filled by the participants in a pre-determined location through self-report. Notably, the process took 20-30 minutes per subject. Data analysis was performed in SPSS version 16 using descriptive, inferential and correlational statistics and multiple linear regression model to determine the predictors of quality of life in patients with epilepsy. Results: In this study, the mean age of the subjects was 4.14 years. Regarding circadian rhythms, most participants were in an intermediate position (71.7%), which had the highest frequency compared to other circadian rhythms. However, the lowest frequency was related to the complete morningness state. On the other hand, there was no significant relationship between life quality scales and circadian rhythms. Quality of life had the highest score in the dimension of seizure anxiety with an average of 57.47 and in the dimension of social functioning with an average of 45.76 had the lowest mean score among other dimensions. Moreover, the average score of quality of life was 50.32 with a standard deviation of 23.03, which was close to the median of the instrument score- i.e., 50. There was a significant negative correlation between the quality of life and all of its dimensions with anxiety, meaning that quality of life and its dimensions decreased with an increase in anxiety (r=-0.673, P<-0.001). In addition, a significant association was observed between anxiety and variables of the level of education, occupational status, income level and hospitalization frequency. Moreover, diagnosis of other diseases (P=0.001) and five-six hospitalization times (P<0.001) were the only significant variables in the regression model. Conclusion: According to the results of the study, there was a negative significant correlation between the quality of life and all of its dimensions with anxiety. It seems that effective steps could be taken toward promoting anxiety-free behaviors, which increases the life quality of patients with epilepsy, through raising awareness, considering a minimum level of education of high school diploma as a recruitment criterion, creating jobs with suitable income levels, and eliminating organizational barriers (e.g., facilitation of staff recruitment). http://ijn.iums.ac.ir/article-1-3484-en.pdf 2021-10-04 8 20 10.52547/ijn.34.132.8 Epilepsy Anxiety Quality of Life Circadian types M Seyedoshohadaee 1 Department of Internal- Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0001-5719-7674 GH Salighedar 2 Department of Internal- Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding Author) Tel: 021 4365 1000 Email: salighehdar.gh@iums.ac.ir AUTHOR https://orcid.org/0000-0002-2270-2244 H Haghani 3 Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-2239-7193
OTHERS_CITABLE تأثیر آموزش مبتنی بر خود- شفقت‌ورزی بر عاطفه مثبت و منفی دانشجویان پرستاری: یک مطالعه نیمه‌تجربی زمینه و هدف: توجه به سلامت روانی دانشجویان پرستاری که بزرگترین گروه بهداشتی و درمانی را در آینده تشکیل خواهند داد، بسیار حائز اهمیت است. دانشجویانی که آموزش مبتنی بر شفقت‌ورزی دریافت می‌نمایند در مقایسه با همتایان خود از امید، عزت نفس و به طور کلی سلامت روانی بیشتری نیز برخوردارند. هدف پژوهش حاضر تعیین اثر آموزش مبتنی بر خود- شفقت‌ورزی بر عاطفه مثبت و منفی دانشجویان پرستاری بود. روش بررسی: پژوهش حاضر از نوع ارزشیابی اثر آموزش به صورت تک گروهی و با طرح پیش آزمون- پس آزمون بود که با مشارکت 50 نفر از دانشجویان پرستاری مقطع کارشناسی در نیمسال دوم تحصیلی 99-98 در دانشگاه علوم پزشکی ایران، انجام شد. دانشجویان به شیوه نمونه‌گیری در دسترس از جامعه پژوهش انتخاب شده و از آنان پیش آزمون گرفته شد. سپس، دانشجویان به مدت هشت جلسه طی یک ماه یعنی هر هفته دو جلسه تحت آموزش مجازی (از طریق شبکه اجتماعی واتساپ) قرار گرفتند. یک ماه پس از آخرین جلسه نیز از دانشجویان پس آزمون گرفته شد. ابزار مورد استفاده، فرم مشخصات فردی و مقیاس عاطفه مثبت و منفی Positive Affect and Negative Affect Scales (PANAS) بود. تحلیل داده‌ها با بهره‌گیری از نرم افزار SPSS نسخه 16 و با استفاده از آمار توصیفی و استنباطی، انجام شد. یافته‌ها: نتیجه آزمون تی زوجی نشان داد عاطفه مثبت دانشجویان پرستاری در مرحله پس آزمون با میانگین نمره (5/2 ± 9/37)، به طور معنی‌داری بیشتر از مرحله پیش آزمون (36/2 ± 24/21) بود که به معنی وضعیت بهتر عاطفه مثبت پس از مداخله بوده است (001/0 P<و 388/23t=). همچنین آزمون تی زوجی نشان داد عاطفه منفی در مرحله پس آزمون با میانگین نمره (5/2 ± 44/12) به طور معنی‌داری کمتر از مرحله پیش آزمون (72/1 ± 34/20) بوده است که به معنای وضعیت بهتر عاطفه منفی دانشجویان پرستاری بعد از مداخله بود (001/0 P<و 89/19t=). نتیجه‌گیری کلی: آموزش خود- شفقت‌ورزی، باعث کاهش معنی‌دار عاطفه منفی و افزایش عاطفه مثبت در دانشجویان پرستاری شد. لذا مداخله مذکور می‌تواند به عنوان آموزشی با قابلیت اجرای بالا در دانشکده‌های پرستاری در قالب برگزاری کارگاه‌های آموزشی جهت ارتقای سلامت روانی دانشجویان مورد استفاده قرار گیرد. http://ijn.iums.ac.ir/article-1-3485-fa.pdf 2021-10-06 21 32 10.52547/ijn.34.132.21 آموزش خود- شفقت‌ورزی عاطفه مثبت عاطفه منفی دانشجوی پرستاری Effects of Self-compassion Training on the Positive and Negative Emotions of Nursing Students: A Quasi-experimental Study Background & Aims: Paying attention to positive and negative emotions is very important and is one of the predictors of happiness and satisfaction in life. When judging the happiness and satisfaction of their lives, some people pay attention to the level of their negative and positive emotions, which indicates that their positive emotions prevail over negative ones. Nursing students experience a range of positive and negative emotions during their studies, and in the meantime, negative emotions and feelings can become more troublesome and hinder their learning. Studies show that emotions students experience in different learning environments can act as facilitators for their academic success, academic adjustment, and psychological well-being. Also, the results of studies show a significant positive relationship between students' positive emotion and their academic achievement. Students who receive compassion-based education have more hope, self-esteem, and overall mental health than their peers. The present study aimed to evaluate the effects of self-compassion training on the positive and negative emotions of nursing students. Materials & Methods: This was a quasi-experimental study with pre-test and post-test design, which was conducted on 50 undergraduate nursing students studying at Iran University of Medical Sciences in the second semester of 2020. Inclusion criteria were being a bachelor student, not using psychiatric drugs, no stressful events such as divorce, death of loved ones, etc. in the past four months and a history of attending similar training classes. Exclusion criteria were not answering the exercises for at least 2 sessions. The students were selected through convenience sampling method and took the pretest. Then, students underwent training for eight 60-minute sessions (during one month and for two sessions each week). Some tasks were considered for the students in the interval of two sessions that were held during a week, and the students sent the answers of these exercises individually to the researcher. The students took the posttest one month after the last session. The instruments used were demographic profile and the reliable and valid Positive Affect and Negative Affect Scale (PANAS). Data analysis was performed using SPSS 16 through descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (paired t-test). In order to comply with ethical considerations, after obtaining permission from the ethics committee of Iran University of Medical Sciences, along with obtaining written consent from the samples, they were told that the information contained in the tools would remain confidential and there would be no obligation to participate in the research. The results of paired t-test showed that the positive emotions of the nursing students in the posttest with a mean score of 37.2 ± 9.5 was significantly higher than the pretest with a mean score of 21.24 ± 2.36, which indicates the superiority of the numerical indicators of positive emotion (P=0.001; t=23.388). Also, the results of paired t-test on negative emotions showed that the posttest score (12.2 ± 44.5) was significantly lower than the pretest score (20.34 ± 1.72), which indicates the superiority of the numerical indicators of negative emotion of nursing students (P<0.001; t=19.89). The results indicated that in the posttest, the scores of positive emotions increased significantly in all the time dimensions, while the scores of negative emotions decreased significantly. Conclusion: The results of present study show that self-compassion-based education was effective on reducing negative emotions of nursing students, and therefore, affirm the research hypothesis that self-compassion-based education can increase the positive emotion scores and decrease negative emotion scores in the posttest. Based on the results of the research, self-compassion education can be employed as a high capability method for increasing positive emotions and reducing negative emotions of nursing students. The results of this study are useful for counseling centers of medical universities to better manage counseling for students. In the field of nursing students' education, the self-compassion training content presented in this study can be provided to nursing professors to acquaint their students with this content and these students can use this content as much as possible in their care plans for clients as self-compassion is a concept that applies to both healthy and sick groups in society. It is suggested that similar studies be performed on nursing students in other medical universities of the country and also on other fields of medical sciences to compare their results.   http://ijn.iums.ac.ir/article-1-3485-en.pdf 2021-10-06 21 32 10.52547/ijn.34.132.21 Self-compassion Training Positive Emotions Negative Emotions Nursing Students F Alirezaee 1 Department of Psychiatric Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-1760-3946 M Mardani Hamooleh 2 Department of Psychiatric Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: 02143651804 Email: mardanihamoole.m@iums.ac.ir AUTHOR https://orcid.org/0000-0001-5945-9121 N Seyedfatemi 3 Department of Psychiatric Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-5292-4219 M Ghaljeh 4 Community Nursing Research Center, Department of Nursing Management, Zahedan University of Medical Sciences, Zahedan, Iran AUTHOR https://orcid.org/0000-0001-9631-7923 SH Haghani 5 Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0003-3691-8246
OTHERS_CITABLE رابطه بین دوسوگرایی در ابراز هیجان و حمایت اجتماعی با پیروی از درمان در بیماران مبتلا به سرطان زمینه و هدف: سرطان بیماری مزمن شایعی است که منجر به واکنش‌های روان‌شناختی متعددی در مبتلایان به این بیماری شده و بر واکنش‌های افراد در برابر نشانه‌های جسمانی بیماری و پیروی از درمان در بیماران تأثیر می‌گذارد. از این رو هدف پژوهش حاضر تعیین رابطه بین دوسوگرایی در ابراز هیجان و حمایت اجتماعی با پیروی از درمان در افراد مبتلا به سرطان بود. روش بررسی: پژوهش حاضر از نوع همبستگی پیش بین است. جامعه آماری پژوهش حاضر را تمام بیماران مبتلا به سرطان (بر اساس تشخیص آنکولوژیست)، مراجعه کننده به مراکز درمانی دزفول در ماه‌های فروردین تا تیر سال 1399 تشکیل می‌دادند. نمونه مورد مطالعه در این پژوهش شامل 206 نفر (زن و مرد)، مبتلا به هر یک از انواع سرطان از جامعه مذکور بودند که به روش نمونه‌گیری متوالی انتخاب شدند و پرسشنامه‌‌های ویژگی‌های دموگرافیک و دوسوگرایی در ابراز هیجان و مقیاس‌های حمایت اجتماعی و پیروی از درمان را تکمیل کردند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار SPSS نسخه 16 و روش همبستگی پیرسون و رگرسیون گام به گام انجام شد. یافته‌ها: نتایج نشان داد که بین متغیر دوسوگرایی در ابراز هیجان با متغیر پیروی از درمان (184/0- r=)، (05/0P≤) رابطه منفی معنی‌دار وجود دارد و بین متغیر حمایت اجتماعی با پیروی از درمان رابطه معنی‌داری مشاهده نشد )022/0(r=. همچنین متغیر دوسوگرایی در ابراز هیجان در مجموع 3 درصد از پیروی از درمان در مبتلایان به سرطان را پیش بینی می‌کند (034/0=R2). نتیجه‌گیری کلی: تغییرات هیجانی که بیماران مبتلا به سرطان در طول مراحل مختلف تشخیص تا درمان و حتی پس از آن تجربه می‌کنند، همچنین طولانی و پیچیده بودن روند درمان و عوارض ناشی از درمان و بیماری، می‌تواند بر پیروی از درمان در بیماران مؤثر باشد. حمایت اجتماعی نیز ممکن است از طریق متغیرهای واسطه‌ای بر پیروی از درمان تأثیر بگذارد. http://ijn.iums.ac.ir/article-1-3474-fa.pdf 2021-10-09 33 46 10.52547/ijn.34.132.33 دوسوگرایی در ابراز هیجان حمایت اجتماعی پیروی از درمان سرطان Correlations of Ambivalence over Emotional Expression and Social Support with Adherence to Treatment in Cancer Patients Background & Aims: Cancer is a common chronic disease that leads to numerous psychological reactions in patients and affects the reactions of individuals to the physical symptoms of the disease and adherence to treatment in patients. According to forecasts, the number of new cases of cancer in 2025 will reach more than 130,000 people in Iran, which is about 35% more than the present time. The complex and longitudinal process of cancer treatment leads to many psychological complications in patients and their families and causes severe damage to their mental health and quality of family and social life. Various studies have identified several psychological factors that affect people's reactions to physical symptoms of the disease and adherence to treatment in patients. One of the psychological factors affecting health and illness is emotion. It is believed that expressing or not expressing emotion alone cannot be problematic. What causes the problem is the conflict or ambivalence that one experiences in expressing emotion. On the other hand, expressing emotions towards others has a positive relationship with social support. Those who are ambivalent about expressing their emotions toward others are more likely to miss out on the opportunity to receive support from others; while, supporting cancer patients protects them against the negative consequences of this disease and acts like a cure, and has a strong relationship with patients' psychological performance. On the other hand, one of the important issues about patients with chronic diseases which affects the effectiveness of planned therapies is the patient's adherence to treatment. In chronic diseases in which the treatment process takes a long time, adherence to treatment usually decreases; while, adherence to treatment is one of the most important factors in controlling these diseases, and poor adherence to treatment is an alarm for both patients and health care delivery systems, because from a clinical point of view, not following the treatment can reduce the beneficial therapeutic effects, increase complications, and increase hospitalization or even death in patients. The above mentioned points and review of previous researches indicate that many studies have examined psychological variables in cancer patients. However, less attention has been paid to ambivalence over emotional eexpressions in patients and following the medication and treatment regimen and cognitive-behavioral factors involved in them. Therefore, the present study aims to investigate the relationship between ambivalence over emotional eexpressions and social support with adherence to treatment in the cancer patients. Materials & Methods: The present study is a descriptive correlational study and has employed Pearson correlation and stepwise regression methods for data analysis due to the nature of the design. The statistical population of the present study consisted of all cancer patients (based on the diagnosis of oncologist), referred to Dezful medical centers from April to June 2020. The sample of the study included 206 people (men and women) with each type of cancer selected from the mentioned population based on convenience sampling. The samples completed Demographic Characteristics Questionnaire, Ambivalence over Emotional Expression Questionnaire (AEQ), Social Support Scale (MOS-SSS), and General Adherence Scale (GAS). Statistical analyses were conducted in SPSS version 16 using Pearson correlation coefficient and stepwise regression. Results: Based on data, the average age of the sample was 44.90 years. The sample included 175 females (85%) and 31 males (15%). They had high school to master's degrees. In terms of marital status, 26 (12.6%) were single, 169 (82%) were married, and 11 (5.3%) were divorced. Regarding the stage of the disease at the time of diagnosis, 23 patients (11.2%) were in stage one, 95 patients (46.1%) in stage two, 73 patients (35.4%) in stage three, and 15 patients (7.3%) in stage four of the disease. Also, 37 patients (18%) reported metastatic disease and 83 patients (40.3%) reported a family history of cancer. Thirteen patients (6.3%) reported drug and tobacco use and alcohol consumption. In terms of insurance coverage and medical services, 169 (82%) of the samples were covered by insurance. Among the dimensions of ambivalence over emotional expression, the highest mean belonged to expressing negative emotions (42.59). Among the various dimensions of social support, the highest mean belonged to the emotional/information support dimension (25.53). And in general, among the three variables of ambivalence over emotional expressions, social support, and adherence to treatment, the highest mean belonged to the variables of ambivalence over emotional eexpressions (76.04), and there was a negative and significant relationship between ambivalence over emotional expressions and adherence to treatment (r=-0.184; P<0.05). However, there was no significant relationship between social support and adherence to treatment. In addition, ambivalence over emotional expressions predicted a total of 3% of adherence to treatment in cancer patients (R2=0.034). Conclusion: Emotional changes that cancer patients experience during the various stages of diagnosis to treatment and even afterwards, as well as, the length and complexity of the treatment process and the complications of treatment and disease, can have significant effects on treatment adherence in patients. On the other hand, non-adherence to treatment is associated with several individual and social consequences, and imposes high costs on patients and their families. Given that nurses, as part of the treatment team, have the closest relationship with patients and their families during the treatment process, they can identify behavioral, cognitive, and emotional factors involved in poor adherence or non- adherence to treatment instructions to develop the necessary training and provide it to patients and their families. Also, according to the results of research on the high level of ambivalence over emotional expressions in cancer patients and its negative effects on adherence to treatment, nurses can have a significant role in reducing ambivalence over emotional expressions in patients by communicating and empathizing with patients and encouraging them to recognize and express their emotions and concerns and promote their self-expression. This way, the nurses can provide better treatment and higher quality of life for patients. The research had some limitations, including the limited and specific statistical community and it is suggested that this research be conducted in other cities and provinces and with different cultures in order to increase the generalizability of the research results. It is also suggested that due to the different complications and problems of different types of cancers in patients, this study be performed on different types of cancers separately and review the results. http://ijn.iums.ac.ir/article-1-3474-en.pdf 2021-10-09 33 46 10.52547/ijn.34.132.33 Emotions Social Support Treatment Adherence Cancer A Bashiri Nejadian 1 Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran AUTHOR https://orcid.org/0000-0001-5248-5132 M H Bayazi 2 Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran (Corresponding author) Tel: 05152510222 Email: bayazi123@gmail.com AUTHOR https://orcid.org/0000-0002-3081-9282 R Johari Fard 3 Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran AUTHOR https://orcid.org/0000-0003-0505-0501 AR Rajaei 4 Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran AUTHOR https://orcid.org/0000-0002-3806-1875
OTHERS_CITABLE تجارب آسیب زا در خوردن هیجانی زنان فزون وزن ایرانی: یک مطالعه پدیدار شناسی زمینه و هدف: خوردن هیجانی، به صورت گرایش به خوردن در پاسخ به استرس یا هیجانات منفی تعریف شده است. بر اساس شواهد پژوهشی؛ خوردن هیجانی برای سلامتی آسیب زاست. بنابراین شناخت عواملی که موجب آسیب زایی خوردن هیجانی می‌شوند، مهم است. همچنین؛ شیوع خوردن هیجانی در افراد فزون وزن زیادتر از افراد با وزن طبیعی است و زنان در برابر خوردن هیجانی آسیب پذیرتر از مردان هستند، بنابراین؛ هدف این پژوهش تبیین آسیب زایی خوردن هیجانی در زنان جوان فزون وزن، انتخاب شد. روش بررسی: این مطالعه به روش کیفی و با رویکرد پدیدار شناسی هرمنوتیک، در سال 1399 انجام شد. مشارکت کنندگان در این مطالعه؛ 17 زن جوان گروه سنی 25 تا 45 ساله ساکن در شهرهای کرمانشاه یا کرج بودند که تجربه خوردن هیجانی داشتند و دارای شاخص توده بدنی 30 و بالاتر بودند. زنان باردار به دلیل متفاوت بودن نمایه توده بدنی آنها، وارد این مطالعه نشدند. مشارکت کنندگان با استفاده از روش نمونه‌گیری هدفمند و با رویکرد حداکثر تنوع انتخاب شدند. داده‌ها از طریق مصاحبه‌های عمیق انفرادی و چهره به چهره گردآوری شد. برای تحلیل داده‌ها از روش هفت مرحله‌ای  Diekelmannو همکاران، استفاده شد. یافته‌ها: در تحلیل داده‌ها، مضمونی اصلی به نام "همراهان آسیب زا" پدیدار شد که نشان می‌داد؛ هنگامی که مشارکت کنندگان تجربه خوردن هیجانی داشتند، برخی تجارب دیگر با خوردن هیجانی آنها همراهی می‌کردند و این تجارب موجب می‌شد؛ خوردن هیجانی از لحاظ جسمی، روانی و اجتماعی برای این افراد آسیب زا شود. مضمون اصلی "همراهان آسیب زا" از هفت زیر مضمون تشکیل شده است که با عناوین؛ ناخویشتن‌داری در رفتار خوردن، خوردن ناخودآگاه، سوء استفاده از بدن، تجارب متناقض، اعتیاد به خوردن، افراط در خوردن خوراکی‌های خاص و خوردن مخفیانه، نام گذاری شدند.   نتیجه‌گیری کلی: تجارب آسیب زایی که با خوردن هیجانی همراهی می‌کنند؛ موجب پیچیدگی شناخت و مدیریت خوردن هیجانی می‌شوند و نیاز است در برنامه‌های روان درمانی که برای مدیریت پرخوری هیجانی؛ بویژه در زنان، طرح‌ریزی می‌گردد، به "همراهان آسیب زا"ی خوردن هیجانی توجه شود. http://ijn.iums.ac.ir/article-1-3491-fa.pdf 2021-10-11 47 62 10.52547/ijn.34.132.47 پدیدار شناسی هرمنوتیک تجارب زیسته خوردن هیجانی فزون وزنی Harmful Experiences Associated with Emotional Eating of Iranian Obese Women: A Phenomenological Study Background & Aims: Emotional eating is defined as the tendency to eat in response to stress or negative emotions in order to overcome negative emotions. According to research evidence, emotional eating is harmful to health. For example, emotional eating is associated with weight gain, increased risk of type 2 diabetes, metabolic syndrome, high blood pressure, and hyperlipidemia. Therefore, it is important to identify the factors that cause emotional eating to be harmful, as it helps us to get a deeper insight into emotional eating and its harms and plan more effective educational and psychological interventions to manage emotional eating. To do this, we need to analyze the experiences of people who have had emotional eating, to explore and explain this behavior from their point of view. As a result, we can identify the various psychological, social, and cultural dimensions of emotional eating. In addition, research evidence shows that emotional eating is more common in obese people than normal weight people, and women are more vulnerable to emotional eating than men. In addition to being universal, emotional eating behavior also has culture-related characteristics. According to these points, the aim of this study was to explain the harmfulness of emotional eating in young Iranian obese women. Materials & Methods: The present study was conducted using a qualitative method and a hermeneutic phenomenological approach in 2020. Participants in this study were 17 young women aged 25 - 45 years living in Kermanshah or Karaj, with emotional eating experience and a body mass index of 30 or higher. Pregnant women were not included in this study due to their different body mass index. Participants were selected using purposive sampling method with maximum diversity approach. Data were collected through in-depth individual and face-to-face interviews. Sampling and interviews continued until the data saturation stage. The main questions asked of the participants during the interview were as follows: 1) Describe one of your emotional eating experiences and explain the thoughts, ideas, emotions and physical feelings that led you to eat at that time. 2) What other experience in your life is similar to this experience, and what does it mean to you? 3) Under what circumstances do you have the most emotional eating? And what do you think the relationship between these conditions and emotional eating means? 4) What is the difference between the times when you eat emotionally and the times when you eat normally? Also, exploratory questions were asked to analyze the deeper layers of the participants' lived experiences. Some of the exploratory questions asked in the present study were as follows: What did you mean by ....? Could you explain more? Please give an example in this regard? Data analysis began at the same time as data collection process. Dickelman's 7-step method was used to analyze the data. Results: In data analysis, a major theme emerged called "harmful companions" which showed that while participants experienced emotional eating, some other experiences accompanied their emotional eating, causing emotional eating to be harmful for these people. The main theme of "harmful companions" consists of seven sub-themes named lack of self-control in eating behavior, unconscious eating, body abuse, contradictory experiences, eating addiction, excessive eating of certain foods, and secretive eating. Lack of self-control in eating behavior means that emotional eaters do not have enough control over their eating behavior and their emotional eating is accompanied by fast eating, overeating, eating regardless of food quality, swallowing unchewed food, eating at the wrong time, and etc. The sub- theme of "unconscious eating" includes those experiences accompanying emotional eating that are not within the control of the conscious mind, and includes eating without consciousness, eating without will, eating involuntarily, eating without thinking, eating without purpose, unwanted eating, and eating without the right to choose. The sub- theme of "body abuse" refers to the victimization of the body, especially the gastrointestinal tract, during emotional eating experiences, and includes distracting from negative emotions by engaging the mouth and stomach through eating, replacing pain caused by filling the stomach with psychological pain of anxiety and chewing foods with clenching teeth to vent anger. The sub- theme of "contradictory experiences" includes the functions of positive and negative emotional eating and contradictions in attitude, feelings, and behavior of participants during emotional eating; Like enjoying eating but with a sense of shame for how you eat, eating pleasantly but with a guilty conscience; eating with craving but without pleasure, eating with craving but unwanted and the necessity of eating unnecessary. The sub- theme of "eating addiction" includes quasi-addictive traits found in emotional eaters, such as; mental temptation to eat, eating out of habit, physical urge to eat, psychological dependence on eating, compulsive eating, and searching behavior to find food. The sub- theme of "excessive eating of certain foods" means that although the participants' overeating included a variety of foods; in particular, they ate more sugary foods, high caffeine foods, starchy or fatty foods, and high-fat and salty snacks. The sub- theme of "secretive eating" means that participants ate secretly to avoid negative judgments and blame for their overeating, or that secretive eating was to passively eat their share of the food. Conclusion: The results of this study showed that emotional eating alone is not harmful, but some other experiences that accompany it, cause it to be harmful in physical, psychological, and social dimensions. An interesting finding of this study is the sub-theme of "body abuse". This sub-theme expresses the need for people to maintain their mental cohesion even at the cost of harming their body. Another important point of this study is that; the "harmful companions" of emotional eating that emerged in the form of seven sub-themes complicate the cognition and management of emotional eating, and it is necessary to pay attention to harmful companions in psychotherapy programs to manage emotional overeating especially in women.   http://ijn.iums.ac.ir/article-1-3491-en.pdf 2021-10-11 47 62 10.52547/ijn.34.132.47 Phenomenology Hermeneutic Lived Experiences Emotional Eating Obesity E Ebrahimi 1 Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran AUTHOR https://orcid.org/0000-0001-8539-6849 F Mohammadi Shirmahaleh 2 Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran (Corresponding author) Tel:09126081389 Email:Fatemeh.mohamadi@kiau.ac.ir AUTHOR https://orcid.org/0000-0002-3179-4099 M Habibi 3 Health Promotion Research Center, Department of Health Psychology, School of Behavioral Sciences & Mental Health, Iran University of Medical Sciences. Tehran, Iran AUTHOR https://orcid.org/0000-0002-5011-2823 M Mardani Hamooleh 4 Department of Psychiatric Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0001-5945-9121
OTHERS_CITABLE رابطه ابعاد انگیزش شغلی با بهزیستی ذهنی پرستاران از طریق نقش میانجی‌گر انرژی در محیط کار زمینه و هدف: پرستاران در محیط‌هایی مشغول به کار هستند که در آن مرگ و زندگی و تأمین سلامتی بیماران از اهم مسائل می‌باشد، بنابراین سلامت و بهزیستی آنان و داشتن یک روحیه شاد و مثبت می‌تواند در امر سلامتی آنان و نیز بیمارانشان کمک نماید. از این رو، هدف پژوهش حاضر تعیین رابطه ابعاد انگیزش شغلی با بهزیستی ذهنی پرستاران از طریق نقش میانجی‌گر انرژی در محیط کار بود. روش بررسی: طرح پژوهش حاضر، همبستگی از طریق مدل‌یابی معادلات ساختاری (SEM) بود. جامعه‌ آماری این پژوهش شامل تمامی پرستاران بیمارستان بقایی دو شهر اهواز در سال 1399 بود. مشارکت‌کنندگان در پژوهش شامل 200 نفر بودند که به روش سرشماری انتخاب شدند. معیارهای ورود در این پژوهش شامل حداقل مدرک تحصیلی کارشناسی و حداقل سابقه کار یک سال در بیمارستان مورد مطالعه بود. از میان پرسشنامه‌های جمع‌آوری شده، 193 پرسشنامه قابل تحلیل بودند. جهت جمع‌آوری داده‌های پژوهش از مقیاس انگیزش شغلی چندبُعدی (MWMS) Gagné و همکاران، مقیاس انرژی (ES) Atwater and Carmeli، و مقیاس بهزیستی ذهنی (SWBS) Diener و همکاران استفاده شد. ارزیابی الگوی نظری پژوهش و اثرات غیرمستقیم، از طریق مدل‌یابی معادلات ساختاری با رویکرد حداقل مربعات جزئی (PLS-SEM) و با استفاده از نرم‌افزار Smart-PLS3 انجام شد. یافته‌ها: 9/82 درصد نمونه را زنان و 1/17 درصد را مردان تشکیل داده‌اند. کمترین سابقه‌ کاری یک سال و بیشترین آن 26 سال بود. همچنین، شرکت‌کنندگان در‌ پژوهش دارای میانگین سنی 39/33 سال با انحراف معیار 10/7 بودند. نتایج پژوهش نشان داد که انگیزش درونی (001/0p< ،43/0β=) و بی‌انگیزگی (037/0p< ،19/0-β=) به ترتیب رابطه مثبت و منفی معنی‌داری با انرژی در محیط کار داشتند. علاوه بر این، رابطه انرژی در محیط کار و بهزیستی ذهنی نیز مثبت و معنی‌دار بود (0001/0p< ،68/0β=). در مجموع، انگیزش درونی و بی‌انگیزگی (39%) واریانس انرژی در محیط کار، و انرژی در محیط کار نیز (46%) بهزیستی ذهنی را تبیین کرده‌اند. نتایج نشان داد که انرژی در محیط کار در رابطه بین انگیزش درونی و بهزیستی ذهنی (001/0p< ،29/0β=) و نیز رابطه بین بی‌انگیزگی و بهزیستی ذهنی (042/0p< ،13/0-β=) نقش میانجی‌گر دارد. نتیجه‌گیری کلی: با توجه به نتایج این پژوهش، انگیزش درونی و بی‌انگیزگی بر انرژی پرستاران در محیط کار تأثیرگذار است. بنابراین، پیشنهاد می‌شود که مدیران و مسئولان ذی‌صلاح بیمارستانی (به طور مثال، سوپروایزر و یا سرپرستاران) تمهیداتی را جهت افزایش انگیزش درونی و نیز کاهش بی‌انگیزگی پرستاران فراهم کنند. علاوه بر این، با توجه به نقش مثبت انرژی در محیط کار بر بهزیستی ذهنی، پیشنهاد می‌شود با اتخاذ رویکردهایی در محیط کار همچون ایجاد وقفه‌های کوتاه در حین کار، ارائه پاداش و تشویق‌های مالی و غیرمالی، و یا اجرای کارگاه‌های آموزشی با هدف افزایش انرژی روانی، سطح انرژی پرستاران در محیط کار افزایش داده شود. http://ijn.iums.ac.ir/article-1-3494-fa.pdf 2021-10-13 63 76 10.52547/ijn.34.132.63 انگیزش انرژی بهزیستی پرستاران The Relationship between Job Motivation Dimensions and Nurses\' Subjective Well-being through the Mediating Role of Energy at Workplace Background & Aims: Nurses are the largest group of professionals among health care workers who play a significant role in the community health system. Nurses work in environments where the life and death of patients are the most important issues, so their health and well-being become important and having a happy and positive spirit can help them improve their health and that of their patients. Organizations are also increasingly aware of the importance of their employees' well-being in striving to gain sustainable competitive advantages. Over the past decade, the concept of subjective well-being (SWB) has become a popular research topic, and many researchers have examined its implications at the organizational, group, and individual levels in the workplace. Subjective well-being helps organizations to effectively engage their employees at work in an attempt to achieve a sustainable competitive advantage. Sustaining employees' subjective well-being is a difficult task. Therefore, the present study aimed to investigate the relationship between intrinsic motivation, extrinsic motivation, and amotivation with nurses' subjective well-being through the mediating role of energy in the workplace. Materials & Methods: This correlational study was conducted in 2020 following structural equation modeling (SEM). The statistical population of this study included all nurses at Baqai Hospital in Ahvaz. The total number of nurses in this hospital was about 200. According to the population size, all nurses were selected as the sample through census method. Among the collected questionnaires, 193 questionnaires were analyzed. The instruments used in this study were: Multidimensional Work Motivation Scale (MWMS) developed by Gagné et al., Energy Scale (ES) developed by Atwater and Carmeli, and Subjective Well-Being Scale (SWBS) developed by Diener et al. The theoretical research model and indirect effects were evaluated using structural equation modeling with partial least squares (PLS-SEM) approach in Smart-PLS3 software. Results: According to the results, the scales used in the present study were reliable, and their reliability indices were estimated as follows: (Cronbach’s alpha: intrinsic motivation=0.91, extrinsic motivation=0.83, amotivation=0.77, energy=0.90, subjective well-being=0.89; composite reliability: intrinsic motivation=0.93, extrinsic motivation=0.89, amotivation=0.87, energy=0.92, subjective well-being=0.92) and convergent validity (AVE: intrinsic motivation=0.68, extrinsic motivation=0.65, amotivation=0.69, energy=0.59, subjective well-being=0.69). The discriminant validity was acceptable as well. Also, the general model of the present study had a strong and very good fit according to the goodness of fit index (GoF = 0.53). The results showed that intrinsic motivation (β = 0.43, p <0.001) and amotivation (β = -0.19, p <0.037) had significant positive and negative relationships with energy, respectively. The relationship between extrinsic motivation and energy was not significant (p > 0.05). Also, the relationship between energy and subjective well-being was positive and significant (β = 0.68, p <0.0001). Overall, intrinsic motivation and amotivation predicted 39% of energy variance, and energy predicted 46% of mental well-being. Regarding the mediating role of energy, the results showed that energy mediated the relationship between intrinsic motivation and subjective well-being (β =0.29, p <0.001) and the relationship between amotivation and subjective well-being (β =-0.13, p <0.042). Conclusion: According to the results, intrinsic motivation and amotivation affect nurses' energy in the workplace. Therefore, the researchers of the present study have several practical suggestions for managers to conserve and nurture the energy and subjective well-being of their workforce. In this regard, it is suggested that managers increase the internal motivation of employees and reduce their amotivation by increasing participation, increasing the level of authority, the possibility of career advancement, as well as determining more benefits. Creating opportunities for the growth and development of individual skills through empowerment programs, as well as facilitating success by minimizing barriers and reducing pressures and requirements, can also provide the basis for increasing employees' intrinsic motivation. Also, our findings demonstrate that energy is closely related to subjective well-being. Therefore, we recommend that HR practitioners carefully recruit resilient and enthusiastic individuals with high energy levels and an overall positive approach even in adverse and stressful conditions. Moreover, firms should make sincere efforts to promote optimal employee energy levels by formal and informal ways such as: (1) encouraging them to behave enthusiastically, (2) showing persistence even when they encounter negative situations, (3) providing a flexible work environment by allowing short breaks so that employees can relax with co-workers, and (4) holding training and energy management workshops. Here, the real challenge for management is not only to reach an optimal level of employee energy but also to maintain that level. Our study contributes to the subjective well-being literature by bringing attention to the direct and indirect mechanisms that influence the relationship between employee motivation and subjective well-being. We believe that further research in this area will better allow managers to understand how to promote employee happiness and overall well-being. There are few limitations that are needed to be considered while interpreting our research findings. The first limitation of this study is common method variance and mono-method since we utilized self-reported measures for all the study variables, which may inflate or deflate the association between study variables. Future researchers may utilize alternative data sources to reduce mono-method bias, such as manager’s appraisals for assessing employee energy level and peer/colleague rating of work motivation in order to verify our proposed model. The second potential limitation is that causality among the study variables cannot be drawn because this study is correlational. Therefore, future studies may try to examine the causation among the study variables by utilizing longitudinal and experimental study designs. http://ijn.iums.ac.ir/article-1-3494-en.pdf 2021-10-13 63 76 10.52547/ijn.34.132.63 Motivation Energy Well-being Nurses N Kaabomeir 1 Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran AUTHOR https://orcid.org/0000-0001-5532-3859 P Hasanalipour 2 Department of Statistics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, Iran (Corresponding Author) Tel: +989113413741 Email: hasanalipour@alumni.um.ac.ir AUTHOR https://orcid.org/0000-0002-6989-3059 SH Mousavi 3 Department of Nursing, Faculty of Nursing and Midwifery, Ahwaz Jundishapur University of Medical Sciences, Ahvaz, Iran AUTHOR https://orcid.org/0000-0002-7204-3021
OTHERS_CITABLE تأثیر ماساژ نوزاد بر خلق افسرده مادران نوزادان نارس سابقه و هدف: ضروری است در تولد نوزادان نارس، سلامت روان مادران مورد توجه قرار گیرد. مطالعه حاضر با هدف تعیین تأثیر ماساژ نوزاد بر خلق افسرده مادران نوزادان نارس انجام شد. روش بررسی: در این مطالعه نیمه تجربی که از مهرماه 1394 الی فروردین 1395انجام شد، تعداد 70 جفت مادر و نوزاد نارس آنها که بر اساس ویزیت پزشک متخصص در طی 24 ساعت آینده از بخش مراقبت‌های ویژه نوزادان ترخیص می‌شدند و دارای معیاری‌های ورود به مطالعه بودند، در یکی از گروه‌های آزمون و کنترل قرار گرفتند. در نوبت صبح روز قبل از ترخیص، سؤالات مربوط به بخش خلق افسرده‌ی پرسشنامه خلق و خوی McNair  توسط مادران دو گروه تکمیل گردید. سپس در گروه آزمون، مداخله به مدت 0هشت دقیقه ماساژ شامل دو بخش یکسان (هر بخش چهار دقیقه) انجام شد. بخش اول مداخله توسط محقق و بخش دوم توسط مادر انجام می‌شد. ماساژ در دو بخش ذکر شده مجدداّ در روز ترخیص تکرار می‌گردید. پس از پایان مداخله، خلق افسرده مادران مجدداّ اندازه‌گیری گردید. در گروه کنترل مداخله‌ای انجام نمی‌شد. یافته‌ها: دو گروه از نظر مشخصات جمعیت شناختی تفاوت معنی‌داری نداشتند. در روز ترخیص، میانگین نمره خلق افسرده‌ی مادران گروه ماساژ نوزاد، به طور معنی داری کمتر از گروه کنترل بود (به ترتیب 54/3 ± 37/6 و 27/5 ± 34/9، 007/0 p=)، هم چنین نمره خلق افسرده در هر دو گروه آزمون و کنترل در مقایسه با روز قبل از ترخیص کاهش آماری معنی‌داری یافته بود (001/0P<). نتیجه‌گیری کلی: با توجه به تأثیر مثبت انجام ماساژ نوزاد نارس توسط مادر بر خلق افسرده آنها، انجام این روش توسط مادران نوزادان نارس بستری در بخش مراقبت‌های ویژه نوزادان توصیه می‌شود. بدون شک ادامه‌ی اجرای ماساژ نوزاد توسط مادر در محیط خانواده به عنوان گسترش یک عادت، طرز فکر و باور بهداشتی در جهت بهبود شرایط روحی این مادران، از اهمیت فراوانی برخوردار است. http://ijn.iums.ac.ir/article-1-3496-fa.pdf 2021-10-16 77 88 10.52547/ijn.34.132.77 ماساژ نوزاد خلق افسرده مادران Effects of Infant Massage on Depressed Mood in Mothers of Preterm Infants Background & Aims: According to statistics, about 10% to 12% of babies born in developing countries are preterm. Iran is among the countries with a high incidence of preterm birth. Some babies require care in a neonatal intensive care unit (NICU). Premature birth is an emotional crisis for parents, and the hospitalization of preterm infants in the NICU is a cause of many families' suffering. Mothers of preterm infants experience emotional shock and may express feelings such as a depressed mood. Approximately, 28 to 70% of the mothers of preterm infants experience significant degrees of stress. Parents of preterm infants often suffer much psychological distress due to enduring the infant's unknown clinical conditions in the NICU, observation of aggressive treatments, and not participating in infant care. Therefore, it is essential to pay attention to the mental health of mothers of preterm infants. Previous studies have revealed limited information on the mood and mental state of mothers of preterm infants. Most studies have examined the effects of massage on the physical and psychological state of preterm infants, but few studies have investigated the effect of massage on their mothers' moods. The purpose of this study was to investigate the impact of infant massage on depressed mood of mothers of preterm infants who were discharged from the NICU. Materials & Methods: In this quasi-experimental clinical trial which was conducted during October 2015-April 2016, 70 mothers and their preterm infants with fetal age of 32-37 weeks were assigned to one experimental and one control group. The study population was primiparous Iranian women whose preterm infants were hospitalized in the NICU for at least two days and were supposed to be discharged from the ward within the next 24 hours. A continuous sampling method was used so that on consecutive days in the morning shift, research samples were selected from eligible mothers and infants. After studying the infants' records and visiting a specialist, eligible mothers whose infants were ordered to be discharged within the next 24 hours were included in the study. The following cases were removed from the study: mothers who were not willing to continue participating in the study, early discharge of the infant with the personal consent of the parents, and the need to extend the infant's hospitalization days. To prevent the exchange of information between mothers, different groups participated in sampling every week. Code 1 or 2 was assigned to each group. Sampling was started by selecting one of the two cards marked with numbers 1 and 2 assigned to each group. Data were collected by a research assistant who was blind to the groups' assignment. In the morning shift, before the day of discharge, the depressed mood of Profile of Mood States Questionnaire (POMS) was completed by the mothers of the two groups. A depressed mood score was obtained in response to 15 questions of the depressed mood of McNair's questionnaire. In the experimental group, the intervention consisted of 8 minutes of massage consisting of two identical standard parts (four minutes each part). The first part was performed by the researcher, and the second part by the mother. To prevent friction, the researcher dripped his fingertips in almond oil and placed the baby in a prone position, and massaged the child with his palms at medium pressure for four one-minute periods. Each minute consisted of 12 movements and each movement took five seconds, from the tip of the head down to the neck and vice versa and from the upper part of the back down to the waist and vice versa. It should be noted that the two movements were performed once on the right side and once on the left side of the baby's body, and in performing the movement on the baby's back, the baby's spine was not touched at all. The mother then repeated the massage movements performed by the researcher for four minutes. The massage was repeated in two parts on the day of discharge, so that the massage was done in the first 4 minutes by the researcher and in the second 4 minutes by the mother. After the intervention, the depressed mood was re-measured. In all stages of massage, in case of infant crying, urination, or defecation, tactile stimuli were stopped and then intervention continued. The control group received no intervention. Results: Out of 75 mother-infant dyad participating in the study, 70 completed the study. 5 cases withdrew from the study (three and two mother-infant dyad in the experimental and control groups, respectively). Three samples were excluded from the study due to readmission (two in the experimental group and one in the control group) and two samples were removed from the study due to discharge with the personal consent of the parents (one in each group). Out of 70 mother-infant dyad, 35 remained in each group. There was no significant difference between the two groups in terms of demographic characteristics. On the day of discharge, there was a significant difference in the mean scores of depressed mood between the experimental and control group (6.37 ± 3.54 and 9.34 ± 5.27, p=0/007, respectively). In addition, on the day of discharge, the mean of depressed mood significantly decreased in the two groups (p=0/001). Conclusion: The results showed that observing the infant massage and then performing this massage by the mother twice (once the day before discharge and once on the day of infant discharge) reduced the mean scores of their depressed mood compared to mothers in the control group. However, the mean score of depressed mood in both groups on the day of discharge significantly decreased compared to the previous day, which could be due to reduced anxiety of mothers in both groups when discharging their babies. Hospitalization in the neonatal intensive care unit increases parental concern, anxiety, and depression. The use of simple, inexpensive, and accessible methods, including tactile communication between mother and baby, will positively affect mothers' moods and mental states while creating numerous benefits for the baby. Undoubtedly, the mother's continuation of baby massage in the family environment as the development of healthy habits, way of thinking, and belief in improving these mothers' mental conditions under complex mental states is of great importance. Researches on maternal postpartum behaviors are related to the oxytocin and the placental corticotrophin-releasing hormone. One of the mechanisms of the effect of infant massage on the mother is its effect on the oxytocin. Oxytocin plays a crucial role in developing behaviors related to interpersonal relationships, including the emotional relationship between mother, infant, and child. Therefore, the mechanism of oxytocin action in the central nervous system and the occurrence of certain behaviors due to its effect has recently been considered by psychiatrists. Undoubtedly, identifying the mothers of infants with a depressed mood and providing support for these mothers will significantly reduce the incidence of postpartum depression. Training mothers on how to perform massage has an essential role in the mother's mental health and reduces the mother's mood disorders. Community-based health care must be at the forefront of care planning. http://ijn.iums.ac.ir/article-1-3496-en.pdf 2021-10-16 77 88 10.52547/ijn.34.132.77 Infant massage Preterm infants Mothers' depressed mood M Keshavarz 1 Department of Midwifery and Reproductive Health, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding Author) Tel: 021-43651183 Email: Keshavarz.m@iums.ac.ir AUTHOR https://orcid.org/0000-0001-7776-8171 A Montazeri 2 Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran AUTHOR https://orcid.org/0000-0002-5198-9539
OTHERS_CITABLE تأثیر آموزش برنامه‌ی خود‌مراقبتی بر کیفیت زندگی افراد با ضایعات نخاعی زمینه و هدف: از آنجایی که ضایعه نخاعی معمولاً ناتوان کننده بوده و به علت وجود عوارض ثانویه، تأثیرات منفی زیادی بر کیفیت زندگی افراد مبتلا دارد لذا مطالعه‌ی حاضر با هدف تعیین اثر آموزش خود‌مراقبتی بر کیفیت‌زندگی افراد با ضایعه نخاعی مراجعه کننده به بیمارستان خاتم الانبیاء (ص) شهر تهران انجام شد. روش بررسی:.پژوهش حاضر از نوع نیمه تجربی با گروه کنترل بوده و به همین منظور 84 نفر از افراد با ضایعه نخاعی مراجعه کننده به بیمارستان خاتم الانبیاء (ص) شهر تهران در شش ماه اول سال 1399 با شیوه نمونه‌گیری تصادفی سیستماتیک انتخاب و در دو گروه مداخله و کنترل قرار گرفتند. پرسشنامه به کار رفته در این پژوهش، فرم کوتاه شده پرسشنامه کیفیت ‌زندگی سازمان بهداشت جهانی WHO Quality of Life Group. WHOQOL-BREF Introduction) ) است. پس از جمع آوری داده‌ها با استفاده از نرم‌افزار آماری SPSS نسخه 16 و از طریق آزمون‌های توصیفی و استنباطی مورد تجزیه و تحلیل قرار گرفتند. یافته‌ها: نتایج این بررسی نشان داد که بین دو گروه مداخله و کنترل از نظر توزیع متغیرهای زمینه‌ای تفاوتی وجود نداشت. میانگین سطح کیفیت زندگی افراد قبل از انجام مداخله درگروه مداخله، 57/14 ± 10/13 و در گروه کنترل، 97/13 ± 43/13 بود. یک هفته بعد از انجام مداخله، میانگین سطح کیفیت زندگی در گروه مداخله به 98/13 ± 38/22 و در گروه کنترل به 48/14 ± 00/15 رسید. این اختلاف در گروه مداخله معنی‌دار بود (001/0p<). نتیجه‌گیری کلی: نتایج به دست آمده حاکی از آن است که آموزش برنامه‌ی خود‌مراقبتی در افزایش کیفیت زندگی افراد مبتلا به ضایعه نخاعی مؤثر است. بنابراین می‌توان روش به کار گرفته شده در پژوهش حاضر را به عنوان یک روش ساده، غیر تهاجمی، کم هزینه و مؤثر در افزایش کیفیت زندگی افراد با ضایعه نخاعی را به پرستاران پیشنهاد نمود. http://ijn.iums.ac.ir/article-1-3499-fa.pdf 2021-10-18 89 101 10.52547/ijn.34.132.89 آموزش خودمراقبتی کیفیت زندگی ضایعه نخاعی افراد Evaluation of The effect of Self-Care Education on Quality of Life in People with Spinal Cord Injury Background & Aims: Spinal cord injury is usually debilitating and has many negative effects on the quality of life of people due to secondary complications. Therefore, improving the quality of life of people with spinal cord injury is one of the main priorities in the nursing profession. Also, educating self-care behaviors and obtaining information from nurses can be helpful for people with this problem. Self-care is also the most important form of primary care for chronic diseases in the health sector. The aim of this study was to determine the effect of self-care education on the quality of life of people with spinal cord injury referred to Khatam Ol-Anbia Hospital in Tehran. Materials & Methods: The present study was a quasi-experimental study with a control group. 84 patients with spinal cord injury referred to Khatam Ol-Anbia Hospital in Tehran in the first 6 months of 2020 were selected through systematic random sampling and divided in two groups; an intervention group and a control group.  The questionnaire used in this study is an abbreviated form of WHO Quality of Life Assessment Group. WHOQOL-BREF Introduction is a 26-item questionnaire that measures a person's overall quality of life. This questionnaire has four subscales and an overall score. These subscales include: physical health, mental health, social relationships, environmental health, and an overall score. The reliability of Quality of Life questionnaire was achieved through Cronbach's alpha which was equal to α= 0.79 and internal correlation coefficient was calculated for relative reliability which was equal to 0.85. After coordination with the officials of Khatam Ol-Anbia Hospital in Tehran, the researcher referred to the spinal cord injury wards and after introducing himself, explaining the nature and objective of the research, and the procedures to conduct the study to the ward staff, the patients, and their companions, received informed consent from the patients. The pre-test was performed for both groups and before the intervention, the questionnaires of demographic characteristics and WHO Quality of Life were completed by patients admitted to the spinal cord injury wards. Then, the intervention group was formed in the social network entitled "Self-care and spinal cord injuries" and in addition to the usual training, 30-session self-care training was conducted every day for 30 minutes which lasted a month. The training included description of the disease, complications of the disease, types of pharmacological and non-pharmacological treatments for disease control, self-care and its importance in rehabilitation, how to follow a proper diet, how to follow the prescribed medication and daily activities, exercise and physical activity, counseling and talking with friends, family and non- family support, the skills of how to change the position, transfer, increase performance and independence of patients with spinal cord injury. In this study, 42 patients participated in each group, and 4 patients in the intervention group and 2 in the control group were excluded from the study for reasons such as cancellation of cooperation, not completing the questionnaire in pre-test or post-test stages, not studying the material submitted for more than three sessions (according to the feedback, the daily review of message information, analyzing Read or Delivered option in the social network), and finally a total of 38 patients comprised the intervention group and 40 patients the control group.  At first, the patients were asked not to post irrelevant material and to express their views if they had any questions or concerns about the training provided. Also, only routine trainings were performed for the control group. To perform the post-test, one month after the end of the educational intervention, the tools were completed again by the two groups. The post-test was performed for the patients who returned to the hospital and the spinal cord injury wards on time, but for other patients, the questionnaires were sent privately to the social network and were completed remotely. After the posttest, the educational booklet was given to the control group. In this research, educational content was prepared by referring to the available library resources and with the guidance of supervisors and consultants. The validity of the educational content was assessed qualitatively by a survey of 3 faculty members. After collecting data, the results were analyzed through descriptive and inferential tests such as Fisher's exact test, Chi-square, independent t-test, and paired t-test in SPSS 16. Results: The results indicated no difference between the two groups in terms of distribution of underlying variables. Comparison of quality of life showed that the quality of life in patients with spinal cord lesions was not statistically significant before and after the intervention (P >0.05) and also the quality of life in the two groups was improved after the intervention and a statistically significant difference was observed (P <0.001). Regarding the changes in quality of life score, the mean quality of life of patients with spinal cord injury before the intervention was 13.10 ± 14.57 in the intervention group and 13.43 ± 13.97 in the control group. One week after the intervention, the mean quality of life of patients with spinal cord injury was 22.38 ± 13.98 in the intervention group and 15 ± 14.48 in the control group. Conclusion: The results indicate that self-care program training is effective in improving the quality of life of patients with spinal cord injury. According to the researcher, several factors affect the results, including the nature of the disease, involvement of all body systems, and difficult conditions (lack of definitive treatment, dependence on nurses and informal caregivers) that make it difficult to control the disease. On the other hand, environmental conditions and economic situation, as well as lack of easy access to some drugs may have been involved in assessing the quality of life of these patients. According to the results, the method used in the present study can be suggested to nurses as a simple, non-invasive, low-cost, and effective method in improving the quality of life of patients with spinal cord injury.   http://ijn.iums.ac.ir/article-1-3499-en.pdf 2021-10-18 89 101 10.52547/ijn.34.132.89 Education Self-Care Quality of Life Spinal Cord Injuries Patients F Nasiri Ziba 1 Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-0204-6956 F Shafie Bafti 2 Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding Author) Tel: 09136782876 Email: shafiebafti.f@iums.ac.ir AUTHOR https://orcid.org/0000-0001-7571-8859 N Seyedfatemi 3 Department of Psychiatric Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-5292-4219 T Doroudi 4 Department of Psychology, Shefa Neuroscience Research Center, Khatam- Ol-Anbia Hospital, Tehran, Iran AUTHOR https://orcid.org/0000-0002-5054-0641 H Haghani 5 Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-2239-7193