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  Background & Aim: Psychological and social factors such as attachment styles may influence chronic diseases through self-care behaviors. This study was conducted to determine the relationship between attachment styles and self-care behaviors in patients with heart failure .

  Methods & Materials: In this correlational study, 180 patients with heart failure hospitalized in CCUs and Post CCUs of educational hospitals in Zahedan in 2014 were selected through convenience sampling. Data collection tools included the Experiences in Close Relationships-Revised (ECR-R) questionnaire and Self-Care of Heart Failure Index (SCHFIV6.2). Data were analyzed in the SPSS-20 using the descriptive statistics, independent T-Test, Pearson's correlation and regression analysis . 

  Results: The mean and standard deviation of self-care behaviors score of the group with secure attachment style (62.89 ± 12.66) was significantly higher than the group with insecure attachment style (40.43 ± 16.11) (P<0.05). Also, the regression model showed that the score of anxiety, attachment avoidance and age were as predictors of the self care scores in patients .

  Conclusion: Regarding the relationship between attachment styles and self-care behaviors and the low level of self-care in patients with insecure attachment style, psychological interventions should be considered through long-term treatment of chronic heart failure .

  

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Background & Aim: The physiological and psychological changes in pregnancy, can affect the lives of couples. The present study aimed to determine the effect of sex education on the marital relationship quality of pregnant women.

Methods & Materials: This study is a quasi-experimental. In this study, 100 pregnant women referred to health centers in Zahedan in 2015, were selected and assigned into two groups of intervention and control (50 in each group). Data collection tool was the perceived marital relationship quality components questionnaire. Questionnaires were completed by the both groups before and six weeks after the sex education sessions. Data were analyzed using descriptive and inferential statistics through SPSS software version 20.

Results: There was no statistically significant difference between the two groups (P<0.05) in terms of age, the duration of marriage, gestational age and gravidity. In post-test measurement, the mean of the total score of marital relationship quality and components such as satisfaction, sexual excitement, love, commitment, intimacy, and trust, were significantly higher in the intervention group than in the control group. Analysis of covariance also showed that the total score mean for the marital relationship and its components had significant difference in the pregnant women in two groups, after sex education (P<0.001).

Conclusion: Given the effectiveness of sex education in the improvement of marital relationship quality in pregnant women, this educational intervention is recommended to be integrated into the education program and prenatal care of pregnant women in order to improve the couple’s relationship quality in pregnancy.

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Background & Aim: Improving the mental health of mothers of children with thalassemia major who experience great caregiving burden, requires an efficient supportive training to be developed and implemented. Therefore, this study aimed to determine the impact of a group supportive training on caregiving burden in the mothers of children with thalassemia major.

Methods & Materials: A quasi-experimental study (IRCT2016122731612N1) was conducted on 80 mothers of children with thalassemia, referred to Aliasghar hospital in Zahedan in summer 2016. The mothers were selected through convenience sampling method and divided into two intervention and control groups of 40 each. The intervention group received four sessions of supportive training during four weeks. Data were collected by the Caregiver Burden Inventory. SPSS version 21 and independent t test, paired t-test and the analysis of covariance were used to analyze the data.

Results: The mean score of caregiving burden before training in the intervention and control groups were respectively, 86.60±13.55 and 92.37±8.54 and declined to 59.62±9.90 and 89.57±5.83 after the intervention. Furthermore, The caregiving burden score in  five dimensions including  temporal,  developmental, physical, social and emotional was significantly lower in the intervention group than in the control group  (P<0.05).

Conclusion: The findings showed that collective supportive training leads to a decrease in caregiving burden in the mothers of children with thalassemia. Thus, this training could be an effective method in reducing the mothers’ caregiving burden. This program could be used in health centers in order to maintain and improve the mental health of mothers.

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Background & Aim: In pregnancy following stillbirth, the parental relationship and attachment to the dead child are denied, and this can impair the mother’s attachment to the new child. The present study aimed to determine the effect of cognitive behavioral training on maternal-fetal attachment in subsequent pregnancy following stillbirth.
Methods & Materials: This quasi-experimental study was performed on 100 pregnant women with the history of stillbirth, referred to health centers in Zahedan in 2017. Mothers were selected using convenience sampling and assigned into two groups of 50 each. Data were collected by a demographic questionnaire and the Cranley maternal-fetal attachment scale. After pre-test, the intervention group received 4 sessions of cognitive behavioral training during 4 weeks. After 8 weeks, the post-test was performed for two groups and data were analyzed using independent t-test, chi-square, Fisher's exact and ANCOVA tests through the SPSS software version 21.
Results: The mean score for maternal-fetal attachment was not significantly different in the baseline but was significantly higher in the intervention group (92.36±11.89) than in the control group (80.90±16.36) after the intervention (P<0.001). The adjustment for the pre-test score, optimism and visit numbers in ANCOVA the mean score for maternal-fetal attachment in the post-test were still significant (P<0.001).
Conclusion: Considering the effect of cognitive behavioral training on the promotion of maternal-fetal attachment, it is recommended that this training be integrated into the care program for pregnant women with a history of stillbirth.
 

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Background & Aim: Waterpipe smoking during pregnancy is a health problem, and interventions must be designed for its cessation. The present study was conducted to examine the effect of motivational interviewing (MI) on self-efficacy to quit hookah smoking in pregnant women.
Methods & Materials: The randomized clinical trial was conducted on 140 pregnant women who smoked hookah and lived in the marginal settlements in Zahedan in 2017. The convenience samples were randomly assigned to intervention and control groups. Data were collected using demographic characteristics and self-efficacy to quit hookah smoking questionnaires. Participants in the intervention received four group sessions of MI, while those in the control only received usual recommendations for quitting hookah smoking. The post-test was performed eight weeks after the completion of the intervention. Independent t-test, paired t-test, Chi-square, and Analysis of Covariance (ANCOVA) were used for data analysis through the SPSS software version 21.
Results: The demographic characteristics and gestational age of women were comparable between two groups, but the duration of hookah consumption in the intervention was more than the control (P=0.008). While the mean score of self-efficacy of two groups in pre-test was alike, in the post-test the score of self-efficacy in the intervention (60.85±7.25) was higher than the control (22.77±3.79) (P<0.001).
Conclusion: Given that MI approach has a positive effect on self-efficacy to quit hookah smoking, it is suggested that this counseling strategy is integrated into health care programs for pregnant women smoking hookah.
Clinical trial registry: IRCT201609240299954N5
 

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Background & Aim: Menopause has been recognized as a critical stage in women’s life. Menopausal symptoms and problems can affect women’s health and well-being. Health promoting behaviors may be useful in alleviating these symptoms. The purpose of this study was to determine the effect of couple counseling on severity of menopausal symptoms in women.
Methods & Materials: In a quasi-experimental study, 80 women with their husbands were selected by the convenience sampling method from health care centers in Zahedan in 2017, and were assigned to either experimental or control group. The data gathering tool included a demographic questionnaire and Menopuse Rating Scale questionnaire. Couple counseling for the intervention group was conducted in four 60-minute sessions. Data were collected before and 12 weeks after the intervention, and analyzed by independent and paired t-test, analysis of covariance and χ2 using the SPSS software version 21.
Results: There was no significant difference between the two groups in terms of demographic variables, but the mean of score changes for menopausal symptoms in the intervention group was -1.42±1.95 and in the control group was -0.10±1.10. The independent t-test showed a significant difference in the mean of score changes for menopausal symptoms in the two groups (P<0.0001).
Conclusion: Given that couple counseling has a positive effect on severity of menopausal symptoms in women, it is suggested that this counseling strategy be integrated into healthcare programs for menopausal women.
 

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Background & Aim: The experience of domestic violence has negative consequences on the mental health of pregnant women, and interventions must be designed to reduce these negative consequences. Therefore, the aim of this study was to determine the effect of supportive-educational intervention on psychological distress among pregnant women subjected to domestic violence.
Methods & Materials: This clinical trial was conducted on 100 pregnant women subjected to domestic violence, referred to comprehensive health centers of Zahedan for receiving prenatal care in 2018. Eligible women were selected by the convenience sampling method and randomly assigned into two groups of intervention and control. The intervention group received four supportive-educational individual sessions during two weeks. The control group received routine care during this period. Data were collected in two groups by the Kessler Psychological Distress Scale (K10) and Hurts, Insults, Threaten, Screams (HITS), before the intervention and four weeks after the intervention. The data were analyzed by statistical tests using the SPSS software version 21.
Results: The results showed that the mean score of psychological distress of pregnant women dropped from 30.9±4.58 to 22.18±3.81 (mean change score -8.72±3.93) in the intervention group and from 25.22±4.15 to 24.06±4.16 (mean change score -1.16±1.48) in the control group. Analysis of covariance demonstrated that there was a statistically significant difference in the mean score of psychological distress of pregnant women exposed to violence between the two groups after the supportive-educational intervention (P<0.001).
Conclusion: The results of this study showed that the supportive-educational intervention is effective in reducing psychological distress in pregnant women subjected to violence. Therefore, it is recommended to integrate supportive-educational interventions into prenatal care for pregnant women subjected to violence in order to improve fetal and maternal health.
 

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Background & Aim: Substance use as a crisis and a long-term chronic disorder can lead to psychological burden and reduce the quality of life of family caregivers. The aim of this study was to determine the effect of the quality of life therapy intervention on the burden of the family caregivers of addicts.
Methods & Materials: This is a clinical trial. The research population included all the family caregivers of the recovering addicts, admitted to Baharan psychiatric hospital in Zahedan in 2018. The samples were 80 people who were randomly divided into either intervention or control group. Caregivers in the intervention group received eight sessions of group counseling based on the quality of life therapy and on the basis of the determined content, every other day. Before the intervention and eight weeks after the intervention, the data were collected using the Zarit burden questionnaire and were analyzed by statistical tests through the SPSS software version 21.
Results: Before the intervention, there was no significant difference in the mean score of burden between the two groups (P=0.25). After the intervention, the mean score of family caregiver burden in the intervention group (40.10±12.92) was significantly lower than in the control group (46.80±13.58) (P<0.01).
Conclusion: The quality of life therapy intervention in this study had a positive and significant effect on reducing the burden of family caregivers of addicts. Therefore, it is recommended that healthcare providers use this counseling approach along with addiction treatment programs to improve the psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 

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Background & Aim: Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts.
Methods & Materials: This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance.
Results: After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P<0.01). There were no significant differences in these variables between the two groups before the intervention.
Conclusion: Counseling based on quality of life therapy in this study had a positive and significant effect on reducing the severity of psychological reactions in family caregivers of addicts. Therefore, health care providers are recommended to use this counseling approach along with addiction treatment programs to increase the welfare and psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 
 

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Background & Aim: Pre-hospital emergencies are one of the most stressful medical professions. Stressful jobs affect employees’ resilience and their ability to control anger. The aim of this study is to determine the effect of psycho-education on the level of anger and resilience among pre-hospital emergency staff.
Methods & Materials: In this quasi-experimental study, 120 people employed in urban and road centers in Zahedan were included through the convenience sampling method. To determine the intervention and control group, out of 24 available centers, 12 centers were randomly assigned to the intervention group and 12 centers to the control group. First, a demographic information form and the self-reported anger and resilience questionnaires were completed by both groups. Then, the intervention group participated in five sessions of psycho-education in groups of 8-12 people. The questionnaires were completed again by both groups two months after the intervention. Data was analyzed by the SPSS software version 16 using descriptive (mean and standard deviation) and inferential statistics (Chi-square test, independent t-test and paired t-test).
Results: The results of independent t-test showed no significant difference in the mean and standard deviation of resilience score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.492), but after the intervention the difference was significant (P=0.009). Also, the results of independent t-test showed no significant difference in the mean and standard deviation of anger control score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.672), but after the intervention, mean and standard deviation of anger control score in the intervention group were significantly higher than those of in the control group (P<0.001).
Conclusion: The present study showed that psycho-education improved the resilience of emergency workers, and the employees were able to control their anger by enhancing resilience. It is suggested that in-service training programs for pre-hospital emergency staff include a psycho-education program to enhance resilience and control anger in those who face many stressful situations.
 

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Background & Aim: The utilization of emotional expression methods, including narrative counseling and written emotional expression, has been shown to be efficacious in mitigating the intensity of diverse psychological issues such as depression and acute stress, particularly following traumatic events. Additionally, emergency cesarean section is commonly acknowledged as a traumatic event that may lead to psychological challenges for the mother. The purpose of this research was to compare the effectiveness of emotional expression through writing and narration in reducing post-traumatic stress and postpartum depression among women undergoing emergency cesarean section.
Methods & Materials: This quasi-experimental study was conducted in Zahedan, involving a total of 120 women who underwent emergency cesarean section and were admitted to Ali Ibn Abi Talib (AS) hospital during the period of 2021-2022. The participants were selected using convenience sampling and were randomly divided into three groups: written emotional expression, narration and control, with each group consisting of 40 participants. The intervention consisted of one face-to-face session and two non-face-to-face sessions. Data collection involved the use of the Edinburgh Depression Questionnaire and PTSD assessments, administered before and six weeks after the intervention across all three groups. The data were analyzed using SPSS version 24, employing descriptive and inferential tests such as ANOVA and Tukey's post hoc analysis.
Results: The results showed a significant decrease in the average scores of post-traumatic stress and postpartum depression in the written emotional expression and narration groups, compared to the control group, after the intervention (P<0.05). However, before the intervention, there were no significant differences observed among the three groups (P>0.05). Furthermore, a higher mean difference was observed in both post-traumatic stress and postpartum depression scores before and after the intervention in the written emotional expression group, compared to the narration group, indicating a greater effect of written emotional expression (P<0.001).
Conclusion: Based on the research findings, highlighting the positive effect of both narration and written emotional expression, it is recommended to incorporate these techniques as supplementary components within comprehensive educational and care programs for women experiencing traumatic childbirth.

 

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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.

 

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Background & Aim: Self-efficacy disruption poses a significant challenge for patients with a stoma, affecting their ability to engage in community life and carry out daily activities. Utilizing remote training methods for patients presents an opportunity to maximize the use of these resources. This study aims to determine the effect of a telenursing-based training program on the self-efficacy of patients with a stoma.
Methods & Materials: This quasi-experimental study involved a convenient sample of 80 patients with a stoma in Zahedan in 2023, who were randomly assigned to two groups: intervention and control, each comprising 40 participants. The intervention group received the telenursing-based program application. Self-efficacy was assessed using the self-efficacy of stoma patients questionnaire before the intervention, as well as one and three months after the intervention. Data were analyzed using Chi-square test and a two-way repeated measures analysis of variance through SPSS software version 26.
Results: The intervention group exhibited a mean (SD) age of 42.84±12.98 years, while the control group had a mean (SD) age of 46.26±11.89 years (P=0.320). The self-efficacy total scores in the intervention group showed values of 69.75±8.05 before the intervention, 77.28±7.57 at one month, and 92.72±6.43 at three months post-intervention, suggesting a significant effect of the telenursing-based training on self-efficacy levels (P<0.001).
Conclusion: The results of the present study show the effect of the telenursing training program on improving self-efficacy levels in patients with stoma. Therefore, it is recommended to implement such programs to support this patient population.