Journal of Hayat

Effect of integrated consultation based on Ex-PLISSIT model on women's orgasmic disorder: A randomized clinical trial

Raziyeh Maasoumi

Background & Aim: Following hypoactive sexual desire disorder, orgasmic disorder is the most commonly reported sexual dysfunction in women. Consultation based on an integrated approach is one of the suitable methods for treating this problem. Considering the prevalence, importance and impact of orgasmic disorder on the quality of individual, family and social life in women, the study aimed at investigating the effect of integrated consultation based on the Ex-PLISSIT model on women's orgasmic disorder.
Methods & Materials: This randomized clinical trial was performed on 60 women with orgasmic disorder referred to the women's clinic of Arash Women's Comprehensive Hospital in Tehran in 2019. Samples were randomly assigned either to intervention or control group. The intervention was done in the form of individual counseling sessions using an integrated approach based on the Ex-PLISSIT model. Data collection tool included the Female Orgasm Scale. Orgasm rate, satisfaction with the number of orgasms, and satisfaction with orgasm quality were assessed before the intervention, 4 and 8 weeks after the intervention. Data were analyzed by Chi-square test, Fisher exact test, independent t-test, repeated measures analysis of variance and analysis of covariance using the SPSS software version 21.
Results: The two groups were homogeneous in the demographic variables (P>0.05). The mean scores of the number of orgasms, satisfaction with the number of orgasms and satisfaction with orgasm quality were not significantly different between the two groups before the intervention (P>0.05). However, 4 and 8 weeks after the intervention, mean scores of the number of orgasms, satisfaction with the number of orgasms, and satisfaction with orgasm quality showed a statistically significant difference between the two groups (P<0.05), and in both times the mean scores in the intervention group was significantly higher than those of in the control group.
Conclusion: The results of the present study showed the positive effect of integrated consultation based on Ex-PLISSIT model on orgasm rate, satisfaction with the number of orgasms and satisfaction with orgasm quality in women.
Clinical trial registry: IRCT20160808029255N

Patient rights in the Iranian hospitals accreditation system: Explanation of challenges

Alireza Parsapoor

Background & Aim: Accreditation of hospitals plays an important role in promoting the quality, safety and effectiveness of medical services, and increasing the efficiency of hospitals. The effectiveness of the accreditation system depends on the quality of the accreditation standards, the comprehensiveness of the accreditation method, and the quantity and quality of the accreditation appraiser. There is a need for appropriate metrics to review and evaluate the implementation of the charter of patients’ rights in the accreditation of hospitals. The aim of this study was to explain the challenges of patients’ rights in the Iranian hospitals accreditation system.
Methods & Materials: This qualitative study was conducted using a conventional content analysis approach with the participation of 13 key informants. In parallel with the interviews, with the aim of assessing the comprehensiveness, the coverage of the patients’ rights components was assessed by accreditation metrics in four sessions. Data analysis was conducted using the Graneheim and Lundman method.
Results: The challenges of the accreditation system were explained by two categories "Content deficiencies of hospitals accreditation standards", "Managerial challenges of accreditation system".
Conclusion: Accreditation has an effective and serious role in the improvement of hospital services and can be a good monitor for observing the rights of service recipients and the charter of patients’ rights. This study provides useful information on the content deficiencies of the country's accreditation standards in terms of service recipients’ rights and its implementation challenges that can be used by policy makers.

The effect of individual counseling based on the Fogg model on the motivation and fear of natural childbirth in women with previous cesarean section

Mahboobeh Firoozi

Background & Aim: Fear of childbirth is one of the reasons for choosing cesarean section. Given the consequences of repeated cesarean section, interventions that control the fear of childbirth are important in mother's decision for the mode of birth. The aim of the study is to assess the effect of individual counseling based on the Fogg model on the motivation and the fear of natural childbirth in women with previous cesarean section.
Methods & Materials: In this clinical trial, 62 pregnant women with a previous cesarean section, referred to Mashhad Comprehensive Health Centers in 2020, were randomly assigned into intervention or control groups. In the intervention group, individual counseling based on the Fogg model was provided in two face-to-face 45-60 minute sessions biweekly and one non-face-to-face session on the Telegram channel at 28-30 weeks of pregnancy. Data was collected by a demographic form, the motivation questionnaire, and the Wijma expectation/ experience questionnaire at the beginning and two weeks after the intervention. Data analysis was performed using statistical tests by the SPSS software version 25 at a significance level of 0.05.
Results: The mean difference of the fear of childbirth score before and after the intervention was 15.84±20.07 for the intervention group and 6.06±23.28 for the control group. Counseling with the fog approach has significantly changed the fear of childbirth score in the intervention group compared to the control group (P<0.001), but the changes in motivation were not statistically significant.
Conclusion: Counseling with the Fogg approach reduced the fear of childbirth score. It is recommended to use this counseling method to reduce the fear of childbirth, and to use strategies to increase the motivation for natural childbirth after cesarean section.
Clinical trial registry: IRCT20200105046014N1

Relationship of gestational anxiety with sleep quality and gestational diabetes

Marjan Akhavan Amjadi

Background & Aim: Pregnancy is a very important period that is sometimes associated with various complications such as diabetes and poor sleep quality. Therefore, early identification of possible risk factors can play an important role in the health of pregnant women. The purpose of this study was to investigate the relationship of gestational anxiety with sleep quality and gestational diabetes in pregnant women.
Methods & Materials: The present study was a descriptive-analytical study. In this study, 359 pregnant women referred to health centers in Baneh during 24-28 weeks of pregnancy were included through the convenience sampling method. Data collection tools were the demographic information questionnaire, the Petersburg sleep quality questionnaire, the short form of pregnancy-related anxiety questionnaire (PRAQ-17), and gestational diabetes screening result recorded in each patient's health record.
Results: The results revealed that 12.3% of pregnant women were anxious, of which 78.8% suffered from poor sleep quality and 10% had gestational diabetes. Statistical analysis showed that there was no statistically significant relationship between gestational anxiety and poor sleep quality, and gestational diabetes (P>0.05).
Conclusion: It seems that gestational anxiety is not related to sleep disorders and gestational diabetes. However, further research and prospective cohort studies are needed in this regard.

The effect of laughter yoga on depression in cancer patients undergoing chemotherapy: A randomized clinical trial

Mohammad Namazinia

Background & Aim: Diagnosis of cancer causes deep emotional problems such as depression in a patient with cancer. Laughter yoga involves laughter exercises that may be effective in treating depression in patients undergoing chemotherapy. The aim of the study was to determine the effect of laughter yoga on depression in cancer patients undergoing chemotherapy.
Methods & Materials: This two-group randomized clinical trial was conducted on 69 cancer patients undergoing chemotherapy at Reza Medical Center in Mashhad in 2018. Patients were randomly divided into intervention or control groups. For the intervention group, before chemotherapy a 20-30 minute laughter yoga session was performed daily for four days. The control group received routine self-care training. Depression was assessed using the Beck Depression Inventory before and after the laughter yoga sessions. Data were analyzed using Chi-square, independent t-test, Fisher’s exact test, and paired
t-test through the SPSS software version 20.
Results: Women made up 67% (n=46) of the participants in the study. The mean age of patients in the intervention group was 49.0±9.6 years and in the control group 45.2±12.6 years. The mean score of depression in the post-test in the intervention group (7.50±6.04) was significantly lower than that of in the control group (12.54±7.53) (P<0.005). In within-group comparison, there was a significant decrease in the depression score in the intervention group (P<0.001).
Conclusion: Laughter yoga improved depression in the patients undergoing chemotherapy. Thus, its use is recommended for these patients.
Clinical trial registry: IRCT20180429039463N1

The effect of Thi Chi Chuan exercise on the balance status of elderly men: A randomized controlled clinical trial

Mansour Dianati

Background & Aim: Imbalance and risk of falling is one of the most common problems in the elderly. Various interventions have been suggested in order to improve the elderly’s physical performance and balance. The aim of the present study was to determine the effect of Tai Chi Chuan exercise on the balance status of elderly men.
Methods & Materials: In this clinical trial study, 40 elderly men referred to Golabchi health center in Kashan in 2021 were selected by the convenience sampling. Using blocked randomization with the block size of four, they were assigned into intervention or control groups. First, the balance status of the participants was assessed by Fullerton test. The maximum score of this test is 40 and has a direct relationship with the quality of the balance state. Then, the Tai Chi Chuan exercises were performed in the intervention group for 20 sessions of 30-40 minutes. The control group continued their routine visits. Two weeks after the intervention, the balance test was performed again. To compare the demographic variables between the two groups, t-test and Chi-square tests or their non-parametric equivalents were used. ANCOVA test was used to compare the balance status between the two groups using the SPSS software version 20. The significance level was considered less than 0.05.
Results: The results showed the two groups were not significantly different in demographic variables. Although the comparison of the median of two groups before the intervention had no statistically significant difference (P=0.988), ANCOVA showed that considering the scores before the intervention as a covariate, the Fullerton scores after the intervention were significantly higher than those of the control group (P<0.001).
Conclusion: This study showed that Tai Chi Chuan exercises can improves the balance of the elderly men, and its use is recommended for elderly patients to reduce the possibility of falling and related problems.
Clinical trial registry: IRCT20200108046058N1

Assessment of the self-care level against COVID-19 and its related factors among hemodialysis patients

Narges Nargesi Khoramabad

Background & Aim: Today, COVID-19 has become a serious threat to global health. Due to their certain conditions, hemodialysis patients are more at risk than others. Therefore, self-care in these patients is more necessary. We aimed to assess the self-care of hemodialysis patients against COVID-19 disease and the factors influencing self-care.
Methods & Materials: In this cross-sectional study, 219 patients referred to the dialysis ward of selected public hospitals in Lorestan province, were selected by the census method and examined. Patients' information was collected by a demographic questionnaire and a researcher-made questionnaire on self-care against COVID-19. Data were analyzed using the SPSS software version 22, with the significance level of 0.05.
Results: The mean score of self-care against COVID-19 in patients was 186.33, and most patients had a good level of self-care. There was a significant relationship between the self-care score and place of residence (P<0.001), and comorbidity (P=0.044). Among the multiple sources of information, there was a significant difference in the self-care score between cyberspace (P=0.047), and family and relatives (P<0.001). Also, comorbidity, urban residence, and academic education level significantly predicted self-care.
Conclusion: According to the results of this study, developing proper training programs is suggested considering the factors influencing self-care. Also, capacities such as cyberspace and patients' families should be used to make the training more effective.

Comparison of the effect of massage and probiotic consumption on infantile colic: A randomized clinical trial

Mahboubeh Sajadi

Background & Aim: Infantile colic is a stressful tension for the baby and parents, whose cause and certain treatment are still unknown. Therefore, this study was conducted with the aim of comparing the effect of massage and probiotic consumption on infantile colic.
Methods & Materials: This clinical trial was conducted in Tehran’s Children Medical Center in 2020-2021, and 75 colicky infants were included in the study based on ROM IV criteria and assigned into two groups of massage and probiotics. A total of 64 infants (34 in the massage group) and 30 in the probiotics group) completed the study. The duration of the intervention was 14 days. The first group received abdominal massage with olive oil twice a day, and the second group received probiotic drops, five drops a day. The study tool was the Barr Child Daily Measurement Scale. The information related to colic measurement, including the average time of colic crying, sleep, and frequency of defecation was analyzed within and between groups on days 1, 7, and 14.
Results: Abdominal massage and probiotic consumption both reduced infantile colic (P<0.05), but the massage group had more reduction than the probiotics group (P<0.05).
Conclusion: Considering that the massage method was more effective in controlling colic, using massage is recommended for the care of infants with colic, which is a non-drug, safe and simple method and can be easily taught to parents by nurses.
Clinical trial registry: IRCT20200903048602N1