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Background & Aim: The premenstrual syndrome (PMS) is a set of physical and psychological symptoms that occurs periodically and affects women’s social and individual functionings. This study aimed to investigate the effect of stress management group counseling on the symptoms of premenstrual syndrome.
Methods & Materials: This semi-experimental study (IRCT2016052127994N1) was conducted on 44 students with PMS (22 in the intervention group and 22 in the control group) from Zanjan University of Medical Sciences in 2016. Data were collected using a demographic characteristics form and premenstrual symptoms screening test (PSST). Descriptive and inferential statistics including independent t-test, Chi-square, ANCOVA and repeated measurement test were used for data analysis via the SPSS software version 21.
Results: Before treatment, the mean scores of mood-behavioral symptoms, physical symptoms and the impact of symptoms on life had not any significant differences between the two groups. At the first month after treatment, mood-behavioral symptoms (P<0.001) and the impact of symptoms on life (P=0.007) were different between the two groups. Two months after the intervention, the mean scores of mood-behavioral symptoms in the intervention group (53.2±4.84) were significantly different from those in the control group (70.2±4.81). There was a significant difference in the mean score of physical symptoms between the intervention group (36.7±5.87) and control group (64.9±7.84). Also, the mean score of the impact of symptoms on life had a significant difference between the intervention group (36±4.73) and control group (58.3±2.73) (P<0.001).
Conclusion: Stress management group counseling is effective in reducing the symptoms of premenstrual syndrome, and it can be used as a non-pharmacological method with no side effects.
 

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Background & Aim: Women with cancer face many stresses. Social support can facilitate coping skills and improve active coping strategies. The purpose of this study was to assess perceived stress and its relationship with perceived social support in women undergoing chemotherapy for genital cancers.
Methods & Materials: This descriptive, correlational study was conducted from March to May 2016 on 151 patients undergoing chemotherapy for gynecologic cancers in oncology wards of Alzahra and Shahid Ghazi hospitals in Tabriz. The perceived stress scale (PSS) and perceived social support scale (PRQ-85-part2) were completed through interviews with patients. Data analysis was performed using the Pearson correlation test, one-way ANOVA and independent t-test.
Results: Mean (and standard deviation) total score of perceived stress for women was 42.26 (3.97) in the score range of 0-56. Mean (and standard deviation) total score of perceived social support for women was 127.55 (16.64) in the score range of 25-175. Based on the Pearson correlation test, no statistically significant correlation was observed between perceived stress and perceived social support (P=0.324, r=0.08).
Conclusion: The findings indicated that the perceived stress score for women with genital cancers was high. Nevertheless, no relationship was observed between perceived stress and perceived social support. Therefore, further studies are needed in this area.
 

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Background & Aim: Pregnancy during adolescence is in conflict with the identity structures of adolescents, that can have a negative effect on maternal mental health, and especially cause stress. This study aimed to evaluate the effect of neonatal care education on perceived stress in adolescent mothers.
Methods & Materials: This quasi-experimental study was conducted on 116 adolescent pregnant women referred to Zahedan health centers in 2016. Samples were selected by the convenience sampling method and assigned into two groups of 58 people each. The pre-test was performed before the first session using demographic and perceived stress questionnaires. The intervention group received three educational sessions on neonatal care and stress reduction methods. Routine prenatal education was provided to the control group. A post-test was performed at 38 week of pregnancy and 30 days after delivery. The data were analyzed using the Mann-Whitney, Monte Carlo and Fisher tests through the SPSS software version 21.
Results: Before the intervention, the stress score for the intervention group was higher than that for the control group (P=0.007), but the mean score of perceived stress for the intervention group significantly decreased at the 38th week of pregnancy and 30 days after delivery, compared to the control group. According to the Mann-Whitney test, the decrease was significant (P˂0.001).
Conclusion: Considering the effect of the neonatal care education on reducing stress in adolescent mothers, it is recommended that this type of educational intervention be integrated into care program for adolescent pregnant mothers.
 

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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: Diagnosis of cancer can cause emotional problems such as stress, anxiety, depression and incompatibility with the disease in the patient and his/her family, leading to adverse consequences in the improvement process and an increase in the complications of the disease. Considering the importance of this topic, the study was conducted to investigate the effect of Roy’s adaptation model-based care plan on the severity of depression, anxiety and stress in patients with colorectal cancer hospitalized in the treatment and educational centers of Urmia.
Methods & Materials: In this randomized clinical trial study, 36 patients with colorectal cancer (at the third or fourth stage of disease) hospitalized in the treatment and educational centers of Urmia were selected by a convenience sampling and were assigned to the intervention group or control group in 2016. Data collection tools were a form for assessing the Roy’s adaptation model and the depression, anxiety, and stress scale (DASS-21). The Roy’s adaptation model-based care plan was administered to the intervention group. Data analysis was performed using the SPSS software version 18 and t test and Chi-square test.
Results: The study results showed before the intervention, the mean scores of depression, anxiety and stress were 12.7±4.5, 13.9±4.8, 16.4±4.7 for the control group and were 15.7±4.5, 13.0±4.6, 12.6±4.2 for the intervention group, respectively. There was no statistically significant difference between the two groups (P<0.05). However, after the intervention, the mean scores of the studied variables increased in the control group (13.7±4.8, 13.93±4.9, 17.16±4.4) and decreased in the intervention group (10.46±3.1, 11.00±3.4, 13.8±5.2). There was a significant difference between the two groups (P<0.05).
Conclusion: Due to the severity of depression, anxiety, and stress among cancer patients, more cost-effective and non-pharmacological methods such as the Roy’s adaptation model, can be useful to control these complications and create a less stressful environment for these patients.
Clinical trial registry: IRCT20160220026662N5
 

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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: The caregivers of Alzheimer's patients frequently experience more psychological illness, depression, stress, and discomfort than their peers who do not care for Alzheimer's patients or care for physically ill patients. The aim of this study was to determine the effect of problem-oriented coping strategies training on perceived stress in the family caregivers of the elderly with Alzheimer.
Methods & Materials: The present study was a randomized field trial. The study population consisted of the family caregivers of the elderly with Alzheimer's disease living in Kerman in 2017. The samples were 72 people who were randomly assigned into the control or intervention groups. The caregivers in the intervention group received eight 45-minute sessions about the problem-focused coping strategies based on the specified content, once a week. Data were collected using a 14-item version of the Cohen’s Perceived Stress Scale before and two weeks after the intervention, and were analyzed using independent t-test, paired t-test and chi-square tests through the SPSS software version 18.
Results: Due to the significant difference in the perceived stress score between the intervention and control groups in the pre-intervention stage (P=0.030), and the lack of significant difference between the two groups after the intervention (P=0.06), in order to determine the effect of the intervention, the mean of changes between the two groups were compared and a significant difference was observed in the intervention group compared to the control group (P=0.02).
Conclusion: Considering the positive effect of the problem-focused coping strategy training on reducing perceived stress in the caregivers of the elderly with Alzheimer, designing and implementing interventions with an educational approach can promote the health of caregivers and in turn improve the quality of care for Alzheimer's patients.
Clinical trial registry: IRCT2016050327736N1
 

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Background & Aim: Midwives experience high levels of stress due to the nature of their work. Some factors can play a significant role in the occupational stress experience. The aim of the study was to investigate the predictive role of emotional intelligence and individual-occupational factors on occupational stress among the midwives working in Rasht.
Methods & Materials: In this descriptive, correlational study, 250 midwives working in health centers and hospitals in Rasht, from May to September 2018 were included using stratified random sampling. Questionnaires on demographic characteristics, emotional intelligence and occupational stress were used to collect the data. Data were analyzed through the SPSS software version 23 using descriptive and inferential statistics including independent t-test, one-way ANOVA, Pearson correlation, multiple linear regression at the significant level of 0.05.
Results: The mean and standard deviation of emotional intelligence and occupational stress were 114.20±12.55, 119.66±15.48 respectively. Predictors of occupational stress (P<0.05) included workplace variables (private hospital: β=-0.19, P=0.012), overtime hours (β=-0.33, P<0.001), sleeping hours (β=0.13, P=0.011), social activity (β=0.11, P=0.029), age (β=0.25, P=0.045) and the overall score of emotional intelligence (β=0.55, P<0.001). These variables explained 54% of variance of occupational stress.
Conclusion: Overall, in the adjusted model of the workplace variables, overtime hours, sleeping hours, level of social activity, midwife’s age and the overall score of emotional intelligence were significant predictors of occupational stress. Accordingly, designing effective programs can improve the performance of midwives.
 

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Background & Aim: The average growth indicators in babies from unwanted pregnancy are lower than other babies. Perceived stress in these mothers can have a double effect on the reduction of milk. Considering the importance of breastfeeding in the health of mother and child, the present study aimed to determine the effect of couples counseling on perceived stress and the improvement of breastfeeding self-efficacy in women with an unwanted pregnancy.
Methods & Materials: In this randomized controlled trial study, 60 women with an unwanted pregnancy referred to comprehensive health centers of Khodabandeh city in 2021 were selected using the convenience sampling method and randomly allocated into two intervention and control groups in blocks of four. The control group received routine care, and the intervention group received six sessions of couples counseling based on spousal support twice a week. The data were collected using the Dennis Breastfeeding Self-efficacy Questionnaire, and the Cohen's Perceived Stress Questionnaire in three stages; before, immediately after the intervention and six weeks after delivery. The data were analyzed using the SPSS software version 16 by descriptive statistics, chi-square test, Fisher’s exact test, independent t-test and repeated measures ANOVA at a 95% confidence level.
Results: In the counseling group, the mean score of breastfeeding self-efficacy increased immediately after the intervention and six weeks after delivery compared to before the intervention, and decreased in the control group (P<0.001). In the counseling group, the mean score of perceived stress decreased immediately after the intervention and six weeks after delivery compared to before the intervention, and increased significantly in the control group (P<0.001).
Conclusion: Couples counseling based on spousal support was effective in improving breastfeeding self-efficacy and reducing perceived postpartum stress in women with an unwanted pregnancy. The presence of spouses in the breastfeeding counseling program appears to be a suitable measure that can be taken into consideration by planners in this field.
Clinical trial registry: IRCT20150731023423N18

 

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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: Nurses, due to the demands of their profession, are frequently exposed to high-stress clinical situations, such as the COVID-19 pandemic, which can lead to moral distress and affect their resilience, ultimately contributing to job burnout. This study aims to investigate the relationship between moral distress, resilience, and burnout among nurses.
Methods & Materials: In this descriptive, cross-sectional study, 188 nurses working in hospitals affiliated with the Birjand University of Medical Sciences during the years 2021-2022 were selected through simple random sampling. The data collection tools included demographic information, the Moral Distress Scale, the Davidson Resilience Scale, and the Maslach Burnout Inventory. Data were analyzed using descriptive and inferential statistics in SPSS software version 21.
Results: The results indicated that the nurses experienced low moral distress (30.28±12.59), high resilience (63.70±13.44), and high levels of burnout (54.98±12.30). A direct and significant relationship was found between moral distress and burnout, while a weak and significant inverse relationship was observed between moral distress and resilience (P<0.001).
Conclusion: Given the significant relationship between moral distress, resilience, and burnout, it is recommended that policymakers develop strategies to enhance resilience, which could lead to a reduction in moral distress and burnout among nurses.