Mental health of the people of northern Iran during the quarantine time of 2020 following the coronavirus epidemic.

BACKGROUND: Coronavirus (COVID-19) is an infectious respiratory disease. Quarantine is often accompanied by unpleasant experiences for those who go through it. The aim of this study was to determine the mental health status of people during quarantine in northern Iran. MATERIALS AND METHODS: This cross-sectional study was conducted during the quarantine period of coronavirus. Conventional sampling was done from March 6 to April 6. Six hundred and forty-two individuals were included. Inclusion criteria were living in Sari and being home quarantined during the corona outbreak. Exclusion criteria included hospitalization history due to corona and unwillingness to participate in the study. In this study, the General Health Questionnaire-28 was used online to collect the required data. To analyze the data, descriptive and inferential statistics (t-test, analysis of variance, and correlation coefficient) were used. RESULTS: In this study, individuals were included in the investigation with a mean age of 38.74 ± 11.89 (ranged from 15 to 73). Most of the participants were female (72.85%) and married (71.34%). According to the results, 21.5% of the participants had poor mental health. Mean mental health scores have a statistically significant relationship with gender, marital status, education, occupation, quarantine period, patients with corona, and exposure to a patient with corona (P ≤ 0.05). Furthermore, a negative correlation coefficient was observed between age and mental health score (correlation coefficient = -0.31, significance >0.001). CONCLUSION: The average score of mental health has a significant relationship with gender, marital status, education, occupation, quarantine period, corona, and exposure to a patient with corona. Given the high prevalence of mental disorders in people during the COVID-19 epidemic, educating people and planning to reduce the psychological effects of the epidemic can be helpful.

Exploring the Human Factors Affecting Health Service Managers: A Qualitative Study.

BACKGROUND: In recent decades, managing health-service systems has faced multiple challenges. Identifying and resolving these challenges promote the efficiency and effectiveness of hospital activities. AIM: The present study aimed to explore the human factors affecting health service managers. MATERIAL AND METHODS: In this qualitative study, in-depth unstructured interviews were conducted with 29 employees who were in close contact with the health service managers. All the interviews were transcribed verbatim. Data were collected using purposeful sampling and were analysed using conventional content analysis via MAXQDA software. RESULTS: A group of 29 participants were interviewed (male 65.5%, female 34.4%). "Managing managers" has been identified as the primary theme with four supporting secondary themes including the inappropriate appointment of managers, the impact of human and social needs of managers, influential employees, and disrupting organisational communications. These are the challenges faced by managers in managing human resources in health-service organisations. CONCLUSION: Results showed that employees manage their managers within the organisation so that they can prevent managers from concentrating on their management affairs and tasks resulting in the distortion of management practices. The results of this study can help the key policy makers and planners in health-service organisations to guide the organisation to pursue its goals through appointing appropriate managers and identifying influential employees.

Common Causes of Eye Enucleation among Patients.

BACKGROUND: We investigated the contributing causes and factors leading to eye enucleation procedure among the patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran. PATIENTS AND METHODS: We retrospectively analyzed the clinical records of patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran, in the past 3 years. The data retrieved were analyzed. RESULTS: A total of 313 patients underwent eye enucleation during the past 3 years. The average age of the patients was 36.7 years (range: 20-44 years). Two hundred and eight patients (66.5%) were males and 105 (33.5%) were females. One hundred and sixty-nine patients had the right eye enucleation while 144 patients had the left eye enucleation. The various procedures included enucleation (83%), evisceration (13.4%), and exantration (3.6%). The factors leading to these procedures included trauma (33.2%), phthisis bulbi (20.7%), tumors (15.7%), and infections (10.5%). CONCLUSION: In our study population, trauma was the main factor leading to eye enucleation. Hence, measures to increase social awareness and knowledge to reduce trauma cases are necessary as a preventive approach to reduce eye enucleation procedures. Concurrently, ophthalmologists should also pay more attention in early diagnoses and screening of eye health, especially detecting tumor cases such as retinoblastoma and postsurgical care to reduce secondary infections will be effective actions to reduce the overall rate of enucleation.

The study of the relationship between value creation and customer loyalty with the role of trust moderation and customer satisfaction in Sari hospitals.

BACKGROUND: Healthcare providers are competitive, owing to heightened customers' awareness and expectations of health care services. OBJECTIVE: The aim of this study was to determine the relationship between customer value creation and loyalty with mediator trust and customer satisfaction. METHODS: This is a cross sectional survey study. Participants were 196 patients referred to private hospitals in Sari city, Iran from May to June 2014 which were selected by convenience sampling method. Data were collected using questionnaires. Data were analyzed using the structural equation modeling software Smart PLS. RESULTS: The results revealed a relationship between customer value creation and customer loyalty in a Sari city private hospital, and customer satisfaction and trust, mediate the relationship between customer value creation and customer loyalty. The results also revealed significant positive relationship between customer satisfaction and trust (p=0.000 r=0.585). CONCLUSION: customer satisfaction and trust mediate the relationship between customer value creation and customer loyalty.

Social Support in Relation to Fatigue Symptoms Among Patients with Multiple Sclerosis.

BACKGROUND AND AIM: The psychological changes and physiological limitations during multiple sclerosis (MS) disease diminish the social relations. Consequently, losing social supports leads to more physical and psychological complications such as fatigue syndromes. Therefore, this study aimed to investigate the relationship of social support and fatigue syndromes in MS patients. METHODS: This study was a descriptive-analytic which randomly selected 46 patients with MS. The patients evaluated through demographic information, standard modified social support scale, fatigue severity scale, modified fatigue impact scale, and fatigue descriptive scale. Gathered data analyzed using descriptive and inferential statistical Pearson's correlation coefficient. RESULTS: Mean score for variables were as following: Fatigue severity 4/3 ± 1/6, perceived fatigue 34/6 ± 19/5, quality of fatigue 62 ± 3/9, and social support 65/6 ± 23/1, respectively. According to the Pearson statistical test, there was signification association between social support with fatigue severity (P = 0.002 and r = -0.474), fatigue perception (P = 0.001 and = -0.478), and fatigue perception sub-scales, i.e. physical (P = 0.005, r = -0.432), cognitive (P = 0.003, r = -0.0457), and psychosocial (P = 0.009, r = -0.341), respectively. However, there was not significant relationship between social support and fatigue quality (P = 0.59). CONCLUSION: According to the results of current study, all aspects of social support can impact fatigue symptoms in MS patients. Therefore, it is suggested to develop educational programs for caregivers of patients to improve the mental and physical quality of life of patients.

Prevalence of postoperative pressure ulcer: A systematic review and meta-analysis.

INTRODUCTION: A pressure ulcer is a serious safety issue in healthcare systems. The patient's rate of infection with an ulcer, especially a postoperative ulcer, is critical, as it is dictated by factors such as being in a fixed position during surgery, the type of anesthesia used, the duration of surgery, and patient-related factors. The present study was conducted to carry out a systematic assessment of the prevalence of a postoperative pressure ulcer and to find its general prevalence using a meta-analysis. METHODS: The researchers searched databases, including PubMed, Google Scholar, Scopus, Science Direct, the Thomson Reuters' Web of Science (WOS). For English articles published online between January 2000 and October 2015 on the subject of a pressure ulcer, a total of 19 articles were ultimately selected based on the study inclusion criteria. Then results were analyzed in Stata-11. RESULTS: The 19 articles qualified for entering the meta-analysis examined a total of 9527 patients. The studies estimated the general prevalence of a postoperative pressure ulcer as 18.96% (CI 95%: 15.3-22.6); the prevalence by gender was reported as 10.1% (CI 95%: 7.2-13.01) in men and 12.8% (CI 95%: 8.3-17.2) in women. Stage 1 ulcer had a 17.02% prevalence (CI 95%: 11.04-22.9), stage 2 a 6.7% prevalence (CI 95%: 3.8-9.7), stage 3 a 0.9% prevalence (CI 95%: 0.2-1.6), and stage 4 a 0.4% (CI 95%: -0.05-0.8) prevalence. CONCLUSION: The prevalence of a postoperative pressure ulcer is high among the entire population; however, it is still higher in women than in men. The prevalence of a stage 1 ulcer is higher than the prevalence of the other stages of an ulcer.

Effect of acupressure with valerian oil 2.5% on the quality and quantity of sleep in patients with acute coronary syndrome in a cardiac intensive care unit.

The purpose of this three-group double-blind clinical trial study was to investigate the effect of acupressure ( zhǐ ya) with valerian ( xié cǎo) oil 2.5% on the quality and quantity of sleep in patients with acute coronary syndrome (ACS) in a coronary intensive care unit (CCU). This study was conducted on 90 patients with ACS in Mazandaran Heart Center (Sari, Iran) during 2013. The patients were randomly assigned to one of three groups. Patients in the acupressure with valerian oil 2.5% group (i.e., valerian acupressure group) received bilateral acupoint ( xué wèi) massage with two drops of valerian oil for 2 minutes for three nights; including every point this treatment lasted in total 18 minutes. Patients in the acupressure group received massage at the same points with the same technique but without valerian oil. Patients in the control group received massage at points that were 1-1.5 cm from the main points using the same technique and for the same length of time. The quality and quantity of the patients' sleep was measured by the St. Mary's Hospital Sleep Questionnaire (SMHSQ). After the intervention, there was a significant difference between sleep quality and sleep quantity in the patients in the valerian acupressure group and the acupressure group, compared to the control group (p < 0.05). Patients that received acupressure with valerian oil experienced improved sleep quality; however, this difference was not statistically significant in comparison to the acupressure only group. Acupressure at the ear spirit gate ( shén mén), hand Shenmen, glabella ( yìn táng), Wind Pool ( feng chí), and Gushing Spring ( yǒng quán) acupoints can have therapeutic effects and may improve the quality and quantity of sleep in patients with ACS. Using these techniques in combination with herbal medicines such valerian oil can have a greater impact on improving sleep and reducing waking during the night.

Effectiveness of Group Versus Individual Yoga Exercises on Fatigue of Patients with Multiple Sclerosis.

BACKGROUND: Multiple sclerosis disorders poses heavy physical and emotional effect on patients who are associated with the disease. AIM: This study aimed to compare the effectiveness of individual versus group exercises on fatigue on patients with multiple sclerosis. MATERIALS AND METHODS: In this clinical trial, 85 patients with multiple sclerosis were divided in two groups of individualized exercise and team exercise. The intervention was conducted for 6 weeks and comprised of mild stretching and basic yoga exercises twice a day. The data were collected through demographic questionnaire, standard fatigue scale and self-reported checklist. Data analysis was performed by SPSS software. RESULTS: The mean levels of fatigue perception after the intervention in group exercise was 27.9 ± 15.9 and 27.1 ± 17.2 in individual exercise. There was no significant difference between the two groups (P > 0.05). Statistically significant difference was observed in the mean level of perceived fatigue in triplicate measurements (P = 0.013) among patients who completed individual exercise. However, this difference was not significant in the group exercise. CONCLUSION: Performing mild stretching exercises and basic yoga are recommended as a cost-effective method which is easy to perform among patients with mild to moderate disabilities.

Which score should be used in intubated patients' Glasgow coma scale or full outline of unresponsiveness?

BACKGROUND AND AIMS: Today Glasgow coma scale (GCS) is the most well-known and common score for evaluation of the level of consciousness and outcome predict after traumatic brain injuries in the world. Regarding to some advantages of the full outline of unresponsiveness (FOUR) score over GCS in intubated patients, we're going to compare the precision of these two scores in predicting the outcome predict in intubated patients. METHODS: This research was a diagnostic-based study, which was conducted prospectively on 80 patients with Traumatic brain injury who were intubated and admitted to Intensive Care Unit (ICU) of Educational Hospitals of Mazandaran University of Medical Science during February 2013 to August 2013. The scores of FOUR and GCS were measured by the researcher in the first 24 h of admission in ICU. The information's recorded in the check list including the mortality rate of early and late inside of the hospital interred to excel. The findings were analyzed using SPSS software, through descriptive statistics and regression logistic. RESULTS: The results showed of 80 patients 21 patients (20%) were female and 59 patients (80%) were male. The age average of the samples was 33.80 ± 12.60 ranging from 16 to 60 years old. 21 patients (26.2%) died during treatment. Of 21 patients, 15 patients died during first 14 days (18.7%) and 6 patients died after 14 years (7.5%). The area under curve (AUC) of FOUR score in early mortality was 0.90 (C1 = 0.95, 0.88-0.90). The amount AUC for GCS was 0.80 (C1 = 0.95, 0.78-0.84), which in delayed mortality it was ordered as 0.86 (C1 = 0.95, 0.84-0.90) and 0.89 (C1 = 0.95, 0.78-0.88). CONCLUSION: The research results indicated that FOUR score is more exact and more practical in intubated patients regarding lack of verbal response factor in early mortality prediction in GCS. Hence, it is recommended for health professionals to use the FOUR score to predict the early outcome of intubated patients with traumatic brain injuries.

Health, safety and environment conditions in primary schools of Northern Iran.

BACKGROUND: People spend a considerable part of their childhood time in the schools, a phase that coincides with their physical and mental growth. A healthy educational environment is vital to student's health and wellbeing. MATERIALS AND METHODS: This study is a descriptive study conducted in 100 primary schools (both state and nonprofit schools) from Sari's Districts 1 and 2 in Iran. Sampling was performed by census and data were collected using the standard questionnaire by direct interview. Data were analyzed by Excel and SPSS software (Version 20.0. IBM Corp, Armonk), NY: IBM Corp using independent numerical T2 testing. RESULTS: Significant relationship was observed between the kind of schools (P = 0.045) and their locations (P = 0.024), however the health, safety and environment (HSE) ratings among boys only versus girls only schools were similar (P = 0.159). Interestingly private and nongovernment schools and primary schools from Sari's districts one had consistently higher HSE ratings. CONCLUSION: The differential and higher HSE ratings in primary schools run by Private organizations and primary schools from Sari's districts one could be due to manager's awareness and implementation of recommended HSE standards, schools neglecting and overlooking these standards had lower HSE ratings. It is necessary that schools with lower HSE ratings are made aware of the guidelines and necessary infrastructures allocated to improve their HSE ratings.

Substance dependence and mental health in northern Iran.

BACKGROUND: Today, substance dependence and illegal trading of narcotics is considered as a global issue. Since mental disorder has been reported in about 90% of the substance dependents, this study aimed at determining the rate of mental health in the substance dependents in Sari Township in 2011. MATERIALS AND METHODS: In this study, 500 substance-dependent patients were selected using convenience sampling method. To collect data, SCL-90-R was used for the evaluation of their mental health and a demographic questionnaire was employed for identifying their personal information. The obtained data were analyzed by descriptive and inferential statistics using the SPSS software. RESULTS: It was found that 90.4% of the participants were susceptible to mental disorder. Most of them suffered from depression, psychoticism, interpersonal sensitivity, anxiety, and paranoia. Also, there was significant relationship between the mental health of single, divorced and married addicts (P < 0.21). CONCLUSION: Due to the presence of mental disorder in the substance-dependent patients, it is recommended to help treat them by providing them with education, psychotherapy, and psychiatric medication.

A comparison of the diagnostic power of the Full Outline of Unresponsiveness scale and the Glasgow coma scale in the discharge outcome prediction of patients with traumatic brain injury admitted to the intensive care unit.

BACKGROUND AND AIM: This study aimed to determine whether the Full Outline of Unresponsiveness (FOUR) score is an accurate predictorof discharge outcome in traumatic brain injury (TBI) patients and to compare its performanceto Glasgow coma scale (GCS). MATERIALS AND METHODS: Thisis diagnostic study conducted prospectively on 53 TBI patients admitted to ICU of education hospitals of Medical Science University of Mazandaran during February 2013 to June 2013. Data collection was done with a checklist including biographic, clinical information and outcome. The FOUR score and GCS were determined by the researcher in the first 24 hours. Outcomes considered as in-hospital mortality and poor neurologic outcome (Glasgow Outcome Scale (GOS) 1-3) in discharge time from the hospital. RESULTS: In terms of predictive power for in-hospital mortality, the area under the receiver operating characteristic (ROC) curve was 0/92 (95% CI. 0/81-0/97) for FOUR score and 0/96 (95% CI. 0/87-0/99) for GCS. In terms of predictive power of poor neurologic outcome, the area under the ROC curve was 0/95 (95% CI. 0/86-0/99) for FOUR score and 0/90 (95% CI.0/79-0/96) for GCS as evidenced by GOS 1-3. The cut-off of 6 showed sensitivity and specificity of total four score predicting poor outcome at 0/86 and 0/87 while the cut-off of 4 showed the value of in hospital mortality at 0/90 and 0/90. The total GCS score showed sensitivity and specificity 0/100 and 0/61 at cut-off 7 in predicting poor outcome while in predicting mortality at cut-off of 4 this range was 0/100 and 0/92. CONCLUSION: The FOUR score is an accurate predictor of discharge outcome in TBI patients. Thus, researchers recommend for therapeutic Schematizationto use in neurosurgical patients at admission day.

Effect of auditory stimulation on traumatic coma duration in intensive care unit of Medical Sciences University of Mazandarn, Iran.

BACKGROUND: Sensory deprivation is one of the common complications of coma patients in the intensive care unit (ICU). The purpose of this study was to investigate the impact of a familiar voice to consciousness level in coma patients. METHODS: A total of 13 patients with traumatic coma (8 ≥ Glasgow's coma scale [GCS]) admitted in ICU ward were randomly assigned to control and experimental groups. The experimental group was treated twice a daily each time 15 min with a familiar recorded MP3 sound for 2 weeks. The control group received only natural voices of environment. GCS applied to evaluate patients' level of consciousness. FINDING: Findings showed that duration to reach GCS = 15 was significantly shorter in the experimental group (χ(2) = 12/96, P < 0/001). CONCLUSION: These findings imply that providing familiar auditory stimulation programs for coma patients in the ICU could be effective.

Exploring obstacles of administrating AIDS control and prevention strategies in Iran.

BACKGROUND & AIM: Executing a strategy is a complicate process that seeks to reach the best results for guarantee some achievements. To explore barriers related to executing diseases prevention and control, is crucial to resolve weakness and improve administration of therapeutic procedure. This study aims to explore obstacles of implementing acquired immune deficiency syndrome (AIDS) prevention and control strategies in Mazandaran province of Iran. MATERIALS AND METHODS: This cross sectional study was conducted during 2012. The samples included 130 managers, experts and employees of Mazandaran University of Medical science of Iran and the other organization and agencies participating in an AIDS national program. The data were analysed by the chi-square method through SPSS software. RESULTS: The results showed that among eight factors of obstacles of implementing strategy including educational, technological, cultural, communication, legal, political, organizational and economic factors, technology and political issues are recognized as obstacles. CONCLUSIONS: Technology as an inter-organizational factor and political factors as out-organizational factors, could affect the successful executing of AIDS control and prevention strategies, therefore the health care providers should pay more attention on these matters.

Physiological and psychosocial stressors among hemodialysis patients in educational hospitals of northern iran.

BACKGROUND AND AIMS: The hemodialysis (HD) patients are experiencing high biopsychosocial stress on all levels. Therefore, this study was designed to survey on physiologic and psychosocial stressors among HD patients in two educational hospitals of Northern Iran. MATERIALS AND METHODS: This cross-sectional study included 80 HD patients who were referred to Khomeini and Fatemeh Zahra hospitals in Mazandaran (Northern Iran) during the year 2011. Data were collected using a demographic information record sheet and Baldree Hemodialysis Stress Scale. FINDING: THE FOLLOWING PHYSIOLOGIC STRESSORS WERE NOTED: Fatigue (51.25%), limited time and places for enjoyment (46.25%), and physical activation limitation (32.5%). Similarly the following psychosocial stressors were observed: Fistula (58.75%), limitation of drinking water (47.5%), low quality of life (47.5%), travelling difficulties to the dialysis center (45%), treatment cost (41.5%), and low life expectancy. The stress level was high in women who were married, younger, less dialysis vintage, and belonged to a low education level. CONCLUSION: This study reports that HD patients have with significant physical and psychosocial problems and they need education, family, and social supports.

Implementing Benson's Relaxation Training in Hemodialysis Patients: Changes in Perceived Stress, Anxiety, and Depression.

BACKGROUND: Hemodialysis patients usually experience high levels of psychological stress, anxiety, and depression. Reducing these matters in patients provides more psychological resources to cope with their physical situation. AIM: The present study aimed to explore the efficacy of Benson's relaxation technique for stress, anxiety, and depression of patients with hemodialysis. MATERIALS AND METHODS: Eighty hemodialysis patients were selected from two hospitals as an intervention and control groups. Then Benson relaxation training was implemented in the intervention group for 15 min twice a day during 4 weeks. The patients were assessed by depression, anxiety, and stress scale; which was completed before and after the intervention. RESULTS: There were significant differences between stress and anxiety levels in case group before and after intervention (P > 0.001) and there is no meaningful difference between the mean of depression value in case group before and after intervention (P > 0.22). CONCLUSION: Instructing Benson's relaxation technique is accompanied by reducing stress and anxiety level of hemodialysis patients. Reducing stress and anxiety levels can provide more calmness for the patients so that pursuing medical therapy would be accompanied with more tranquility. Authors have suggested to improve and prevent the patients' psychological problems as well as other chronic disorders by applying this practice.