Journal of Hayat

The role of qualitative interviews in cognitive disorders caused by dementia: Methodological ethical challenges (part one)

Nahid Dehghan Nayeri

According to a global report, 47 million people are currently living with dementia, and due to the aging population, its prevalence is expected to triple by 2050. In the future, Iran is expected to experience a significant increase in the elderly population. Currently, in Iran, the prevalence of dementia among individuals over 60 years old is 7.9%. Therefore, this group represents a significant population that warrants further research (1).
The best understanding and explanation of human experiences come from first-hand sources, specifically from people who have experienced those phenomena. Therefore, reliable research sources place great emphasis on including the voices of these individuals (2). Qualitative research out for its collaborative, inclusive, and flexible structure, enabling the exploration of complex issues, including mixed or ambiguous attitudes (2). It can reveal the profound experiences and core values of people with cognitive impairment that may not emerge in quantitative studies. Additionally, qualitative research excels in vividly portraying these experiences and values (3).
Throughout history, people with cognitive impairments have been marginalized from engagement in health and social research, resulting in their voices being inadequately represented in such studies. (2, 4). Instead, their perspectives have been channeled through their legal representatives or guardians, a practice that often entails constraints. These limitations include the inability to accurately predict the patient's decision-making process, the amount and manner of information provided, and the weight of decision-making responsibility placed on them (5).
Furthermore, excluding these individuals from the research process can dehumanize them and perpetuate negative stereotypes about people with cognitive disorders. This also contributes to power imbalances (2). Therefore, it is crucial to develop strategies that ensure the safe participation of these individuals in research endeavors. Through these efforts, we can improve our understanding of policy and measures aimed at promoting health and well-being (6).

The effect of emotion regulation skill training on self-control and psychological distress among opioid-dependent people hospitalized at psychiatric hospital: A quasi-experimental study

Nasrin Rezaee

Background & Aim: A large number of drug users make attempts to cease drug use; however, a relapse tendency often emerges subsequent to the cessation period. The present study aimed to examine the effect of emotion regulation skill training on self-control and psychological distress among opioid-dependent people hospitalized at Zahedan Psychiatric Hospital.
Methods & Materials: This quasi-experimental study was conducted over the fourth quarter of the year 2022, focusing on 80 drug users who underwent treatment at Baharan Psychiatric Hospital in Zahedan. The participants were selected using convenience sampling and subsequently assigned to either the intervention group or the control group. The intervention group received a total of 10 sessions of training in emotion regulation skills. The self-control and psychological distress questionnaires were used to collect the data. The data were analyzed using both descriptive and inferential statistical tests through SPSS software version 22.
Results: The mean and standard deviation of the psychological distress score among opioid addicts in both the intervention group (P<0.001) and the control group significantly decreased (P<0.005). To account for the significant effect of pre-test scores, an analysis of covariance test was conducted, indicating a statistically significant difference in the average psychological distress scores between the two groups after the intervention (P<0.001). Similarly, the self-control score in both the intervention and control groups showed a significant increase in mean and standard deviation (P<0.001). The analysis of covariance test, considering the significant effect of the pre-test scores, also showed a statistically significant difference in the average self-control score between the two groups after the intervention (P<0.001).
Conclusion: The findings showed that emotion regulation skills training among individuals with opioid dependency is associated with a significant decrease in psychological distress and a significant increase in self-control. Consequently, these findings suggest that such regulation may exert positive and inhibitory influences on behaviors contributing to the recurrence of substance use. In light of these findings, it is recommended to implement training programs focused on developing emotion regulation skills as a means to improve psychological distress and self-control among individuals undergoing addiction recovery.

The relationship between spiritual health and social adjustment among parents of children with autism

Sharareh Khosravi

Background & Aim: Parents of children with autism face numerous challenges that hinder their social adjustment. Spiritual health emerges as a relevant components that can potentially enhance their social adjustment. The present study was conducted with the aim of investigating the relationship between spiritual health and social adjustment among parents of children with autism.
Methods & Materials: This is a descriptive correlational study that investigates a sample of 194 parents of children with autism at Hekmat Autism Center in Borujerd and Yekta Autism Center in Khorramabad, during the period of March 2021 to April 2021. To collect data, a demographic information questionnaire, the Paloutzian and Ellison spiritual health questionnaire, and the personal resource questionnaire were employed. Data analysis was conducted using the SPSS software version 26, utilizing the Chi-square test, one-way analysis of variance (ANOVA), and Pearson's correlation coefficient.
Results: There was a statistically significant relationship between the scores of spiritual health (82.03±17.68) and social adjustment (78.52±15.59) among the parents (r=0.572, P=0.0001). The parents with low spiritual health had a mean social adjustment score of 65±0, while those with moderate spiritual health had a mean score of 76.63±15.76, and parents with high spiritual health had a mean score of 89.19±9.45. These results indicate that there was a statistically significant difference in the mean scores of social adjustment across different levels of spiritual health (P<0.001).
Conclusion: There was a significant correlation between spiritual health and social adjustment among parents of children with autism, suggesting that higher levels of spiritual health were associated with increased social adjustment. To enhance the social adjustment of these parents, it is advisable to implement appropriate planning aimed at improving their spiritual health.

Investigating the process of patient flow and identifying opportunities for its improvement based on lean management using the Six Sigma approach in the emergency department

Azam Parvaz

Background & Aim: Given the importance of the emergency department in providing prompt and high-quality services, the emphasis on lean management has increased to minimize non-value-added and wasteful activities within a process. The aim of the study was to determine the process of patient flow and identify opportunities for its improvement using the Six Sigma method as one of the most important subsystems of lean management, in the emergency department of the selected teaching hospital in Kerman.
Methods & Materials: The current research is a sequential mixed-method study conducted in 2022 within the cardiovascular and neurological emergency department in Kerman. The Six Sigma method, specifically the DMAIC approach consisting of four steps, was employed in conjunction with spaghetti charts to implement lean management principles. The research population included 180 patients referred to the cardiovascular and neurological emergency department. The data were collected using researcher-developed forms, and Excel software version 2013 was used to analyze the data.
Results: By examining the processes and using the spaghetti chart, the main problems contributing to prolonged patient admission time in the cardiology and neurology emergency department were identified. The implementation of a strategy involving the presence of admission staff during triage for level 1 to 3 patients will eliminate the additional distance and time required for patient admission.
Conclusion: The use of lean thinking principles in the emergency department with the implementation of Lean Six Sigma and Spaghetti Chart by streamlining the service process, will result in improving patient flow, providing timely quality services, reducing service delivery time, and ultimately increasing patient satisfaction.

The effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with myocardial infarction: A randomized clinical trial

Shahzad Pashaeypoor

Background & Aim: The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.
Methods & Materials: In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.
Results: Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).
Conclusion: The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.
Clinical trial registry: IRCT20201006048953N

The role of virtual networks in adhering to COVID-19 health protocols

Ali Aghajanloo

Background & Aim: Social networks have become an integral part of most people's lives, exerting influence across all aspects of human existence. During the COVID-19 pandemic, virtual networks played a significant role in informing, educating and disseminating news related to the disease. Therefore, the aim of this research is to explain the role of virtual networks in adhering to COVID-19 health protocols.
Methods & Materials: This is a qualitative study that was conducted using the content analysis method. Fourteen participants were included in the study by purposive sampling. Data collection was carried out via semi-structured interviews. The data analysis procedure adhered to the method outlined by Graneheim and Lundman (2004).
Results: From the analysis of the interviews, three main categories and eight subcategories were identified, including "facilitating knowledge sharing", "information screening" and "behavior shaping".
Conclusion: The study findings explained the role of virtual networks in adhering to health protocols. These findings can be used as a basis for designing preventive health programs.

The efficacy of acceptance and commitment training and positive psychotherapy in enhancing mental health and resilience among women with breast cancer

Sareh Ghorbani

Background & Aim: Breast cancer is the most common type of cancer in the world, imposing significant physical problems and psychological burdens on sufferers. Education is one of the ways to reduce the psychological problems of these patients. Therefore, the current study was conducted to compare the efficacy of Acceptance and Commitment Training (ACT) and Positive Psychology (PP) in enhancing the mental health and resilience among women with breast cancer.
Methods & Materials: This study employed a two-group quasi-experimental design with a pretest-posttest design, involving 60 women with breast cancer at Khatamolanbia cancer center in Jahrom during 2020-2021. Participants were selected through convenience sampling and randomly assigned to either the Acceptance and Commitment Training group (focused on accepting uncontrollable factors and committing to enriching life) or the Positive Psychology group (emphasizing individual abilities and positive emotions). Prior to and one week following the sessions, participants completed questionnaires evaluating resilience and mental health. Data analysis was performed using MANCOVA with a significance level set at 0.05.
Results: Based on the MANCOVA findings, there was no statistically significant difference in resilience and mental health scores (F=2.318, P=0.110) between the two intervention groups after adjusting for pretest scores. However, clinically significant improvements were observed in mental health and resilience for 75% and 42% of the ACT group, and 65% and 46% of the Positive Psychology group, respectively.
Conclusion: According to the findings, both group therapies, ACT and Positive Psychology, are effective in enhancing resilience and mental health in breast cancer patients. These findings provide more opportunities for healthcare providers to tailor interventions to the characteristics of caregivers and the personality characteristics of the patients.

Effect of a nursing care program based on Roy's adaptation model on sleep quality in patients undergoing methadone maintenance treatment: A randomized clinical trial

Meysam Rezazadeh

Background & Aim: The misuse of opioids is one of the most important problems in today's world, directly affecting the quality sleep for individuals. This study sought to explore the effect of a nursing care program, based on Roy's adaptation model, on the sleep quality of patients undergoing methadone maintenance treatment.
Methods & Materials: This randomized, single-blind clinical trial was conducted between December 2022 and March 2023, involving 60 opioid abuse patients undergoing methadone maintenance treatment at the Addiction Reduction Center in Isfahan. Convenience sampling was employed, with participants allocated randomly using random sequence generation software into the intervention group (n=30) and the control group (n=30). Data was collected using the Pittsburgh Sleep Quality Questionnaire. The intervention comprised a three-month nursing care program based on Roy's adaptation model, while the control group received routine treatments. Data analysis was performed using SPSS version 26 software, utilizing descriptive and inferential statistics.
Results: The results showed a significant decrease in the total average score of sleep quality in the intervention group after the intervention, indicating an improvement in sleep quality (P<0.001). Before the intervention, there was no statistically significant difference in the total average score of sleep quality between the intervention and control groups (P>0.05); however, a significant difference was observed after the intervention (P<0.001).
Conclusion: The findings indicate that the nursing care program based on Roy's adaptation model is effective in improving the sleep quality of patients undergoing methadone maintenance treatment. Therefore, this model can provide a promising framework for delivering care to such patients.
Clinical trial registry: IRCT20141127020108N6