Journal of Hayat

Qualitative interviews in cognitive disorders caused by dementia: Addressing methodological, ethical challenges (Part II)

Nahid Dehghan Nayeri

As explained in the first part, the acquisition of firsthand experiences is an essential element of qualitative research for uncovering and enriching study findings. However, individuals with cognitive disorders are often excluded due to various challenges. In these cases, researchers may rely on caregivers or close associates to understand their feelings and views. This approach not only reduces these individuals to mere objects but also presents ethical dilemmas, thereby impacting the depth and richness of study findings (1). Given that the methods of data collection significantly impacts the results of studies (2), it is imperative for qualitative researchers to strive towards directly gathering information from the individuals themselves. Understanding the experiences of people with cognitive impairments is crucial for providing evidence-based services. However, these patients often encounter challenges such as speech difficulties (3), ‘pseudo-reminiscences’ (4-6), mood fluctuations and behavioral problems (7), and other issues. Therefore, researchers should take into consideration certain factors when conducting interviews with these individuals as in-depth interviews aim to gain a deeper understanding of participants' life experiences (8,9). These interviews require specialized skills across various stages, encompassing the development of interview guides, participant recruitment, obtaining consent, conducting effective interviews, data analysis and interpretation, and proficient communication and dissemination of research findings. This section delves into the key aspects of each of these phases. During interviews, it is important to prioritize the well-being of both the researcher and the participant while reflecting on and ensuring the depth and richness of the interview content (6).

Psychometric evaluation and adaptation of the nursing informatics competency self-assessment tool

Arghavan Afra

Background & Aim: Modern professional nursing necessitates the use of information technology to facilitate clinical decision-making and obtain optimal patient care outcomes. The aim of this study was to conduct a psychometric evaluation and adapt the Nursing Informatics Competency Self-Assessment tool for use in Iran.
Methods & Materials: The present research employed a descriptive and methodological design. Initially, the original tool was translated into Persian following a standardized procedure. Subsequent assessments of face and content validity were conducted through expert reviews and the calculation of the content validity index. Reliability was evaluated using both Cronbach's alpha and test-retest methods, including the calculation of the intraclass correlation coefficient. Data analysis was conducted using confirmatory factor analysis on a convenience sample of 300 nursing students from the School of Nursing and Midwifery at Abadan University of Medical Sciences, utilizing SPSS version 22 and LISREL version 8.8.
Results: The content validity index for all items exceeded the standard threshold of 0.79, indicating satisfactory validity scores for each item. The final version of the tool demonstrated acceptable reliability with a Cronbach's alpha coefficient of 0.898 and an intraclass correlation coefficient of 0.893. Confirmatory factor analysis indicated the fitness of a five-factor structure for the Persian version of the tool. Standardized factor loadings showed a good fit and satisfactory construct validity for the tool within the Iranian context.
Conclusion: The Persian version of the Nursing Informatics Competency Self-Assessment Tool exhibits acceptable psychometric properties within the Iranian nursing population and is recommended for use as a credible instrument in nursing practice.

Comparison of the effects of puberty counseling for mothers and adolescents on the aggression levels of female adolescents

Reza Zeighami

Background & Aim: Adolescence is characterized by social, emotional, and physical development, during which aggression emerges as a significant psychological risk factor. This study was designed to compare the effects of puberty counseling for mothers and adolescents on the aggression levels of female adolescents.
Methods & Materials: This field trial was conducted with 92 participants divided into three groups: two intervention groups (mothers and adolescents) and one control group. The study was carried out in schools in Qazvin in 2023, with data collected before and after the intervention. Sampling was conducted using a multi-stage random sampling method, and participants were randomly allocated into three groups across six blocks. Each intervention group attended six one-hour face-to-face sessions, while the control group received no intervention. Data were collected using the Novaco Aggression Questionnaire and analyzed with multivariate covariance analysis in SPSS software version 25.
Results: The mean aggression scores before the intervention were 50.10±21.68 for the girls’ group, 57.10±93.32 for the mothers’ group, and 54.56±10.61 for the control group (P=0.018). After the intervention, the scores were 37.68±10.16 for the girls’ group, 43.14±76.66 for the mothers’ group, and 49.60±16.11 for the control group, showing a statistically significant difference (P=0.014). Additionally, the intervention had a significant overall effect on reducing the total aggression score (P=0.020), with an effect size estimated at 0.09 based on Partial Eta Squared.
Conclusion: The results of this study suggest that puberty education for mothers, as well as for adolescents, can effectively reduce aggression levels in female adolescents.

Psychological factors affecting post-treatment follow-up care in breast cancer patients attending healthcare centers in western Mazandaran (2021-2022)

Ali Pourhabib

Background & Aim: Post-treatment follow-up care for breast cancer is crucial in reducing mortality rates, minimizing treatment costs, and enhancing patients' quality of life. This study aims to identify the psychosocial factors affecting post-treatment follow-up care in breast cancer patients.
Methods & Materials: This descriptive-analytical study involved 180 breast cancer patients from Babol and other cities of western Mazandaran province. Participants were selected using a simple random sampling method between 2021 and 2022. Data were collected through personal information questionnaires, the Zigmond Hospital Anxiety and Depression Scale, the Psychological Distress Thermometer, the Fear of Cancer Recurrence Scale, and a post-treatment breast cancer follow-up care checklist. Data analysis was conducted using SPSS version 18, employing descriptive and inferential statistical methods.
Results: The average age of the participants was 51.49 years (SD=12.01). The mean and standard deviation scores for depression, anxiety, and psychological distress were 6.16±2.71, 10.70±4.13, and 5.98±2.54, respectively. The results showed that individuals with higher levels of anxiety, depression, psychological distress, and fear of recurrence are less likely to engage in follow-up care (P<0.05).
Conclusion: The results suggest that health policymakers should address the psychological challenges faced by breast cancer patients. Specifically, providing insurance coverage for the screening and treatment of mental health problems may improve mental well-being, encourage self-care behaviors, and promote overall health.

Trends in osteoporosis-related fractures among the elderly in Kashan (2017-2021)

Soudabeh Yarmohammadi

Background & Aim: Osteoporosis is a common condition in the elderly, contributing to fracture incidence and associated pain. This study aims to analyze trends in osteoporosis-related fractures within the elderly population from 2017 to 2021.
Methods & Materials: A descriptive cross-sectional study was conducted in 2024 involving 448 elderly people over 60 who experienced pelvic, hip, distal hand, or spinal injuries during 2017-2021 in Kashan. Data were extracted from the National Trauma Registry of Iran, including demographic information, injury severity, and frequency of fractures. The data were analyzed using analysis of variance and chi-square tests, with a significance level set at P<0.05.
Results: Among the 448 participants, 244 were female (54.5%), with an average age exceeding 75 years among those diagnosed with osteoporosis. The most common fracture types included hip and pelvic fractures, affecting 331 individuals (73.9%), followed by distal hand fractures in 71 individuals (15.8%), and spinal fractures in 65 individuals (14.5%). The average injury severity score increased from 8.43±2.80 in 2017 to 8.96±2.77 in 2021. No significant changes were observed in the age distribution of the elderly population during this period; however, the proportion of males increased by approximately 6%.
Conclusion: The study results indicate a rising trend in hip fractures among the elderly in Kashan. To reduce fracture incidence, it is recommended to implement proactive screening for osteoporosis risk factors in this population.

The effect of lavender inhalation aromatherapy on systolic and diastolic blood pressure in patients with prehypertension

Amir Musarezaie

Background & Aim: The evidence shows that prehypertension is related to an increased risk of cardiovascular complications. This study aims to determine the effect of lavender inhalation aromatherapy on systolic and diastolic blood pressure (SBP & DBP) in people with prehypertension in Isfahan.
Methods & Materials: This two-group quasi-experimental study was conducted in 2023, involving 70 prehypertensive patients selected from comprehensive health service centers in Isfahan. Participants were selected through convenience sampling and were randomly assigned to either the experimental or control group. The intervention included inhalation aromatherapy using two drops of 100% pure lavender essential oil for 20 minutes in a single session. Blood pressure measurements were taken before, immediately after, and 10 and 20 minutes post-intervention under standardized conditions. The control group received routine health center training. Data analysis was performed using SPSS software version 26, employing descriptive and inferential statistics, including repeated measures analysis of variance (RMA) and analysis of covariance (ANCOVA), with a significance level set at 0.05.
Results: The results of the RMA indicated a significant interaction between time and group for both SBP (P<0.001) and DBP (P<0.001). Also, the intergroup effect for SBP was significant (P<0.001), demonstrating that the intervention group experienced a significantly greater reduction in average SBP compared to the control group. Intra-group analysis revealed a significant decrease in SBP before and after aromatherapy in the intervention group (P<0.001). In contrast, the control group did not show a significant change (P=0.068). Unlike SBP, the intergroup analysis for DBP did not yield significant results (P=0.141).
Conclusion: Considering the rising trend of high blood pressure and its widespread complications, along with the positive effects of aromatherapy as a cost-effective and accessible intervention, lavender inhalation aromatherapy is recommended as a complementary treatment strategy in conjunction with other methods.

The effect of life skills group counseling with a cognitive-behavioral approach on coping strategies among abused women

Sakineh Taherkhani

Background & Aim: The coping strategies employed by women in facing violence can influence the frequency and intensity of violence or related stress. Life skills training may serve as a way for improving these coping strategies. This study aims to determine the effect of life skills group counseling, using a cognitive-behavioral approach, on the coping strategies of abused women.
Methods & Materials: This quasi-experimental study involved 120 abused women who attended health centers affiliated to Arak University of Medical Sciences in 2022. Participants were assigned to an intervention group or a control group (60 people each). The intervention group participated in eight group counseling sessions focused on life skills training through a cognitive-behavioral approach. Data were collected using a demographic questionnaire, the Conflict Tactics Scale, and the Ways of Coping Questionnaire. Coping strategies were assessed at the end of the intervention and again 12 weeks later. Descriptive and inferential statistical analyses were conducted to analyze the data.
Results: The intervention led to a significant increase in mean scores for the subscales “distancing” (P<0.001), “planning” (P<0.001), “seeking social support” (P=0.002), and “problem-solving” (P<0.001) in the intervention group compared to the control group. Conversely, there was a significant reduction in the mean score for the “wishful thinking” subscale (P<0.001). The most substantial effect of the intervention was observed in the “planning” subscale, while the “seeking social support” subscale exhibited the least effect. Specifically, the mean±standard deviation scores for the “planning” subscale in the intervention group were 8.95±3.61 pre-test and 14.82±2.40 post-test. For the “seeking social support” subscale, the scores were 5.28±3.21 pre-test and 7.03±1.77 post-test.
Conclusion: Life skills group counseling, utilizing a cognitive-behavioral approach, significantly increased the adoption of coping strategies, such as distancing, planning, seeking social support, and problem-solving, while reducing reliance on wishful thinking among abused women. Therefore, this method can serve as a means to promote coping strategies for abused women.