Health related quality of life in patients with coronary heart disease: psychological and socio-demographical determinants

Coronary heart disease is the universal principal cause for decreased quality of life, morbidity, and mortality in adulthood. This study seeks to indicate the psychological and socio-demographical determinants of the health related quality of life in patients with coronary heart disease in Iran. In this cross-sectional descriptive design, 205 patients with coronary heart disease among the patients diagnosed with coronary heart disease in Shahid Rajayee heart hospital were selected by compliance sampling and were completed the demographical questionnaire, The WHOQOL-BREF, Tehran-Stockholm marital stress scale [TSMSS] and Mental Health Inventory [MHI-38]. Then, data analyzed by stepwise multiple regression analysis by using of the PASW-18. Findings revealed that psychological wellbeing and socio-economic status had significantly positive predictive role on health related quality of life and marital stress, psychological distress, and gender had negatively significant predictive role on health related quality of life [p< 0.001]. There was no significant role at prediction of health related quality of life in terms of patient's age. It concluded that adverse socio-economic status, female gender, decreased psychological well-being, higher psychological distress and higher marital stress might make patients with coronary heart disease more prone to decreased health related quality of life. Thus, it is important to emphasize the worth of tailored intervention for addressing these issues in therapeutic and rehabilitation agendas. Likewise, the identification and treatment of psycho-social correlates in these patients could be very important

effect of sociostructural and collaborative decision-making on diabetes self-management

Diabetic self-management is important for controlling the diabetes complications and promoting health-related quality of life in these patients. The objective of this study was to examine a hypothetical model regarding influences of sociostructural determinants, collaborative decision-making and patient's beliefs system on diabetes self-management. In a cross-sectional descriptive study from Dec 2010 to Mar 2010, 500 patients of Iranian adult patients with type II diabetes attended the outpatient diabetic clinics of the Shariati Hospital in Tehran were selected by convenience sampling. Data were collected by The Demographical Information, Social- Economical Status and Diabetic History Questionnaire and eleven self-reported scales of this research. Structural equation modeling [SEM] with LIZREL software applied for data analysis. The modified model had a desirable fitness to the observed data. Patient's beliefs system directly influenced the diabetes self-management. Sociostructural determinants influenced diabetes self-management indirectly via collaborative decision-making and Patient's beliefs system. In addition, collaborative decision-making significantly influenced patient's beliefs system that thereby impacted diabetes self-management. Sociostructural determinants, collaborative decision-making and patient's beliefs system are integrated and cooperatively affect on diabetes self-management. Comprehensive intervention schedules required to improve these agents for encouragement the type II diabetes self-management

[Effect of cognitive-behavioral group therapy on depression of the patients with chronic low back pain: a 4-months follow up]

Various researches showed that depression is a key modifiable risk factor in maintaining of low back pain. The purpose of this study was to investigate the effectiveness of cognitive-behavioral group therapy on depression reduction of the patients with chronic low back pain. In an experimental study including pre-test, post-test, and following up the control group, thirty-five patients with diagnosis of low back pain compliance randomly selected in clinical centers of one, two and three regions of Tehran and randomly assigned to two experimental groups and one control group. All subjects completed depression subscale of the depression anxiety stress scales [DASS] in three phases of pre-test, post-test and follow-up. Cognitive-behavioral group therapy carried out on the experimental groups 8 sessions once a week. The results of variance analysis with repeated measurements showed that cognitive-behavioral group therapy significantly reduced the depression mean scores of the experimental groups as compared to the control group [P<0.05]. According to the findings, cognitive-behavioral group therapy is an effective method in decreasing depression in patients with chronic low back pain

[Sensitivity, specificity and cutoff point of the Wechsler intelligence scale for children- revised in diagnosis of learning disorders]

This research aimed to determine the sensitivity, specificity and cutoff point of the revised version of Wechsler Intelligence Scale for Children [WISC-R] in diagnosis of learning disorders. Using a cross-sectional descriptive design and multistage cluster sampling, 45 students with learning disorders and 45 students without learning disorders completed a demographical data questionnaire and WISC-R. The data was analysed by Receiver Operating Characteristic [ROC] curve. The cut point 89 can differentiate children with learning disorders in 94.1% of cases with sensitivity of 71.1% and specificity of 95.6% [p<0.05]. Likewise, a score of 44 in Verbal subscale, was differential in 86.7% of cases with sensitivity of 84.4% and specificity of 86.7% [p<0.05]. A Performance subscale score of 44 was differential in 87% of cases with a sensitivity of 44.4% and specificity of 93.3% [p<0.05]. WISC-R can be used to devise diagnostic checklists for learning disorders in children

Individual, psycho-social and disease-related risk factors in diabetic neuropathy

Neuropathy is the mostly prevalent of complications and the major cause of amputation, pain and disability in patients with diabetes. The purpose of this study was to investigate the role of individual, psycho-social, and disease-related risk factors in neuropathy of type 2 diabetes patients. In this retrospective cross-sectional study, 271 patients with type 2 diabetes were selected by convenience sampling in diabetic outpatient clinics of Tehran University of Medical Sciences and the Iranian Diabetic Association. The data were collected by demographical and disease characteristics questionnaires and DASS-42, QOLS, DSMS, and DKS scales. Then, the data were analyzed by r binary logistic regression along with PASW software. Socio-economic status, glycosylated hemoglobin, body mass index, diabetes self-management, depression, quality of life, diabetes knowledge, and diabetes duration were significantly able to differentiate diabetic patients with neuropathy from diabetic patients without neuropathy [p<0.001]. Gender, treatment type and patient age were not significantly able to differentiate two groups [p>0.05]. The total regression model explained that 95.2% of cases were classified correctly. Inappropriate socio-economic status, glycosylated hemoglobin over 9%, being overweight and obesity, poor diabetes self-management, clinical depression, low quality of life, poor diabetes knowledge, and longer diabetes duration contribute to the incidence of neuropathy in patients with type 2 diabetes and attention must be paid to them for neuropathy prevention.