[Effectiveness of stress coping skills training with psycho-educational approach among caregivers` of schizophrenic patients on family function and psychological wellbeing]

Introduction: Living with schizophrenic patients is stressful. Caregivers without sufficient knowledge cannot perform their responsibilities very well. This situation leads to relapse and re-hospitalization. Families experience a lot of stress facing such difficult situations which results in discomfort, tensions or despair in family members. High tensions impair family function unless the family adapt to the new situation

Objective: This study aimed to determine effectiveness of stress coping skills training with psycho-educational approach among caregivers` of schizophrenic patients on family function and psychological well-being

Methods: This is an experimental study with pretest-post test design and a control group comprising of main following variables; coping skills training with a psycho-educational approach[the independent variable] and family function and psychological well-being [two dependent variables]. The study population included 220 caregivers of patients with schizophrenia who had referred to psychiatric clinic and had a history of hospitalization. Since the number of members in a psychotherapy group should be very limited, the sample size was considered 30. Sampling was performed with convenience method. Data collection tools included Ryff Psychological Well-Being and Family Assessment Device questionnaires. The psychometrics of both questionnaires had been confirmed in Iran. Ryff assesses six main components of psychological well-being. Therefore, it has 6 subscales [each subscale contains 14 items] and 84 items. The subjects specified their level of agreement, "agree "to" disagree", in a 6-point Likert scale. To obtain a score for each subscale, the score of each item on the related subscale should be summed. The total score of all 84 items equals the total psychological well-being. The subscales include self-acceptance, positive relations with others, autonomy, environmental mastery, purposeful life and personal growth. Family Assessment Device is a questionnaire with 60 items in domains of problem-solving, relationships, roles, effective response, effective involvement, behavior control, and general functioning. They were answered in a 4-Likert scale. In order to obtain the score of each subscale, all subscale scores have to be added then divided by number of items of each subscale. Higher scores show poor functioning. In this study, the mean score was used to compare the groups. The researcher referred to the psychiatry clinic and specified the records of patients diagnosed with schizophrenia and had the inclusion criteria; being main caregiver, educated and living in Rasht. The families were then contacted.30 patients were randomly selected whose psychological well-being and family function score had one SD below the mean of questionnaires scores. They were placed in two experimental and control groups [15 per group]. During the intervention, six subjects [3 per group] withdrew due to family problems and the disease recurrence. Again in the last session, the questionnaires were completed by the subjects. The interventions were performed twice a week for 90 minutes in twelve consecutive sessions. Homogeneity of the two groups in terms of evaluated variables was approved using ANOVA. Then, the variance-covariance analysis was used to determine the effectiveness of stress coping skill straining with psyche-educational approach on variables of family function and psychological well-being

Results: Most of the subjects [58.3%] were women with mean age of 53.9 +/- 5.87. Majority of them [79.2%] had secondary education. Analysis of data showed that the mean score of family function in the experimental group in pretest was 183.42 +/- 13.96 and 177.08 +/- 8.23 in the control group. The mean score of the psychological well-being was 224.58 +/- 27.03 in the experimental and 228.33 +/- 12.01in the control group. In the posttest, the mean score of family function equaled121.83 +/- 15.59 and the control group 172.58 +/- 4.25. Moreover, in the post test the mean of psychological well-being of the experimental group and the control group were 373.33 +/- 23.96 and 242.67 +/- 7.27, respectively. Analysis of variance test with Wilks' lambda to determine the effectiveness of stress coping skills training on family function and psychological well-being in combination, indicated the significant impact of education [p<0.0001]. Using ANOVA confirmed the significant effect of these training on family function [p<0.0001] and psychological well-being [p<0.0001] as well. Stress coping skills training with the psycho-educational approach is effective on family function and psycho-educational well-being in caregivers of schizophrenic patients

[Role of career factors on marital satisfaction of nurses]

Introduction: marital satisfactions are the key to strength the family and heighten the physical, mental health and economic development which could effect on life and job satisfaction. Professional nurses are under various stresses during their shift work to provide excellent quality of life for patients. They have responsibility for their own personal life too. Due to multiplicity of nurse's roles they suffer under several psychological and physical stresses. Understanding the factors related to their employment such as shift work can improve validity and efficiency of this force which is important in human

Objective: this study aimed to determine the role of shift work and predictor variables on marital satisfaction of employed nurses through educational - medical centers

Methods: in this cross - sectional study, 500 marital employed nurses from 8 training medical centers in Rasht were selected using stratified random sampling. Information was collected using ENRICH marital satisfaction questionnaire for demographic data, social and shift work. For data analysis spss16, descriptive and inferential statistical tests [linear regression, Pearson's test, Regression Logistic Ordinal Model] were applied

Results: results showed that there is a significant relationship between marital satisfaction and shift work [P=0/003], history job [P=0/0001], personal income [P=0/002], the place of service [P=0/0001], employment status [P=0/0001], age [P=0/002]. The findings showed each child can increase 1.65 times chance of lower satisfaction. Psychiatric ward was only ward related to marital satisfaction [p<0.0001]. But there was not significant relationship between marital satisfaction job degree, sex and educational level

Conclusion: according to this findings, shift work, and some occupational factors [history job, income, place of service, employment status] are related to marital satisfaction for nurses. Therefore, applying the appropriate ways and moderating factors to improve the marital and career state of nurses are essential

[Association between vitamin D deficiency and cardiovascular disease]

In cross-sectional studies, low serum levels of 25-hydroxyvitamin D are associated with a higher prevalence of cardiovascular risk factors. This study aimed to determine whether vitamin D deficiency is related to cardiovascular disease. This nested case-control study was performed within the framework of a population-based Cohort study [Tehran Lipid and Glucose Study, TLGS] among male and female participants, aged 30 years or older [mean [SD] age, 56.7 [10.6] years], free of diagnosed cardiovascular disease at initial blood collection. Using risk set sampling, controls [n=251] were selected in a 1:1 ratio and matched for age, sex and date of blood collection. We measured serum 25-hydroxyvitamin D levels in serum specimens, kept at -80°C until assay. Median serum 25 [OH] D was significantly lower in the CVD group than in controls [p<0.001]. For 25 [OH] D values of less than 10 ng/ml, compared with values more than 20 ng/ml [reference], the multivariable-adjusted OR [with 95% confidence intervals] for incident cardiovascular events was 3.21 [1.75-5.88]. Low levels of 25[OH]D are independently associated with higher risk of cardiovascular events in a graded manner, even after adjustment for factors known to be associated with coronary artery disease

[Effect of long-term continuous methimazole treatment of thyrotoxicosis: comparison with radioiodine]

The major complication of radioiodine therapy for thyrotoxicosis is hypothyroidism, the long-term management of which is often problematic. In this study, the long-term effects of continuous methimazole [MMI] therapy are investigated. One hundred and thirty-two patients, aged between 36-66 years, with Graves recurrence, were semi randomly randomized in 2 groups for continuous antithyroid and radioiodine treatment. The number of thyroid dysfunctions in each patient were recorded and serum TSH, FT4, Anti TPO, TRAb, FBS, HOMA IR, and lipid profiles were measured. Bone mineral density and echocardiography were performed. There was no significant differences in age, duration of symptoms and thyroid function between the 2 groups. No serious complications occurred in the MMI group and no difference in any of parameters was seen between groups 1 and 2. Goiter rate and anti TPO concentration were higher in group 1 than in group 2. Serum triglycerides and cholesterol were increased in group 2 as compared to group 1. Bone mineral density was more reduced in group 2, especially in the spine. Echocardiography showed diastolic dysfunction in group 2 as compared to group 1. Some parameters in neuro-pschyciatric evaluation were significantly better in the MMI group, as compared to the radioiodine one. Considering it is a safe treatment and has fewer complications, methimazole is another option for patients with recurrent Graves', who do not wish to use radioiodine

[ effect of group therapy on depression and anxiety levels of the patients with MI]

Introduction: Since about 65% of the patients with MI experience psychological and mental disorders such as depression and anxiety that set back their return to work period, lower their quality of life and enhance their risk of death, treatment of these reactions can speed their recovery and make their life span longer. This study has tried to define and compare mean depression and anxiety scores in patients before, after and a month after intervention in both groups of study and control

Methods: This is a clinical experiment on 22 patients with MI hospitalized in CCUs of Medical university hospital for the first time, being discharged and randomly selected as study and control groups. The data were collected by Beck depression scale and kattle anxiety scale. In order to access the results, pair-test, ANOVA with reobservations and T- student test were used in SPSS software

Results: The findings showed that depression and anxiety levels in patients with MI significantly decreased after group therapy sessions and a month after that compared with before intervention. There was a significant difference in study group

Discussion: Regarding the continuous effect of group therapy on depression and anxiety levels of the patients, manipulating this method seems essential in all stages of prevention and treatment of the patients with MI