Effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral problems in elementary school boys: a preliminary randomized controlled trial.

This study aimed to examine the effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral issues in elementary school boys. A randomized controlled trial design (pretest-posttest with a control group) was utilized. Thirty elementary school boys with school refusal issues were randomly assigned to intervention (n = 15) and control (n = 15) groups. The intervention group received ten sessions of cognitive-behavioral group play therapy. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire and Rutter's Children's Behavior Questionnaire were used as assessment tools. Mean scores for anxiety-based school refusal and behavioral problems in the intervention group showed a significant decrease (p < 0.001). Cognitive-behavioral group play therapy is a practical approach to reducing anxiety levels and behavior problems in children with anxiety-based school refusal in primary school grades.

Effects of positive psychology interventions on happiness in women with unintended pregnancy: randomized controlled trial.

BACKGROUND: Undesirable effects Negative feelings among women with unintended pregnancies may have undesirable effects on pregnancy. However, little is known about the effect of positive feelings and protective factors on prenatal mental health of pregnant women. The aim of the present study was to determine the effect of positive psychology-based interventions (PPI) on the happiness of women with unintended pregnancies. METHODS: This randomized controlled trial that included 40 women with unintended pregnancies was conducted between March and July 2017. The subjects were randomly assigned to receive 10 weekly training sessions based on positive psychology (PPI) (N = 20) or routine prenatal care (N = 20). All subjects received usual prenatal care. The level of happiness and its five domains were measured in three time points: at baseline, immediately after completing the intervention, and 45 days after the end of the intervention. The happiness was assessed using the Oxford Happiness Inventory (OHI). RESULTS: In the intervention group, the mean total OHI score increased from 31.3 (at baseline) to 42.5 (after completing ten sessions of PPI), and the increase remained statistically significant at a 45-day follow-up (39.8); P = 0.001. However, the total OHI score did not change significantly during the follow-up (P = 0.339). Satisfaction with life, self-esteem, and subjective well-being improved significantly after the interventions, whereas the increases observed in the scores of positive mood and self-efficacy dimensions were not significant. CONCLUSION: PPIs can improve happiness and its dimensions among women with unintended pregnancies. It is suggested that healthcare planners help women with unplanned pregnancies adapt by formulating strategies to hold training courses with a positive psychology approach and recognize and promote their positive aspects and strengths.

The effect of positive psychology intervention on quality of life among women with unintended pregnancy.

BACKGROUND: Studies have shown that quality of life in women with unintended pregnancy is significantly less than the ones with wanted gestation. Therefore, this study was aimed to determine the effect of intervention based on the positive psychology interventions on women's QoL with unintended pregnancies in Kermanshah, Iran. MATERIALS AND METHODS: In this randomized clinical trial, 40 women with unintended pregnancy met the eligibility criteria and were randomized into experimental (n = 20) or control (n = 20) groups. The Short-form 36-item Questionnaire (SF-36) was administered at pretest, post-test, and six weeks after the intervention. Positive psychology interventions were performed in each session once a week for 10 weeks, with a duration of 90 minutes. The Friedman test and Mann-Whitney U-test were used to analyze QoL and all eight domains for within-group and between-group comparisons, respectively. The level of confidence was set at 0.05 significant. RESULTS: Distribution of matched variables was not significantly different between the two trial groups. Over the intervention period, the mean of total scores of QoL and seven dimensions showed significant improvement among the experimental group, whereas in the control group, it decreased significantly (P < 0.05). In addition, in the posttest and follow-up stages, the mean score of six dimensions of QoL was higher than the control group (P < 0.05). CONCLUSION: According to the results of the present study, unintended pregnancy has side effects on QoL in women. Positive counseling interventions can improve the quality of life in women with unintended pregnancy.

Validation of Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (PACSLAC-II) in Iranian older adults with dementia living in nursing homes.

BACKGROUND: Some dementia patients can self-report pain although the reports are not valid in severe dementia. Observational scales have been developed for pain assessment in these patients. This study aimed to assess the psychometric properties of the Persian version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (PACSLAC-II). METHODS: This validation study was conducted on 138 older adults with dementia suffering from chronic pain who lived in nursing homes. The PACSLAC-II Persian version was applied through observations during activity and rest. Reliability of the PACSLAC-II was evaluated by Cronbach's alpha and intra-class correlation coefficients. Construct validity was determined by confirmatory factor analysis, divergent and convergent validity. The Spearman's rank correlation between PACSLAC-II scores and Faces Pain Scale was calculated for concurrent validity. Known-group validity during activity and rest was calculated by Wilcoxon signed ranks test. RESULTS: Cronbach's alpha coefficient for facial expression (0.82), verbalisation (0.72), and body movement (0.84) subscales indicated good internal consistency. The intra-class correlation coefficients between two raters was 0.76 and in three times evaluation, the value was 0.76. Convergent validity with Iranian Brief Pain Inventory and divergent validity with 15-item Geriatric Depression Scale confirmed the construct validity of PACSLAC-II. Three factors structure of PACSLAC-II was approved, and most of the variance was explained by facial expressions. The PACSLAC-II can discriminate between pain and non-pain events and has a moderate correlation with Faces Pain Scale (r = 0.33). CONCLUSIONS: PACSLAC-II Persian version is a valid and reliable scale for pain assessment in older adults with dementia.

Validity and Reliability of 11-face Faces Pain Scale in the Iranian Elderly Community with Chronic Pain.

BACKGROUND: Accurate pain assessment in elderly population is essential for pain management and nurses have a pivotal role. The 11-face Faces Pain Scale (FPS-11) is a well-established pain assessment measure that has not been validated in the Iranian elderly. AIM: The aim was to study the property assessment of the Iranian version of FPS-11 (FPS-11-IR) among elderly outpatients with chronic pain. METHODS: This is a cross-sectional validation study that conducted in three outpatient clinics in Tehran, Iran, in 2017. Older people aged ≥60 years (n = 217) with chronic knee pain due to degenerative joint disease were participated. The construct validity was examined by applying contrast constructs, and the face validity was determined by rank-ordering test. To assess concurrent validity, the Spearman's correlation coefficient was calculated between the scores of 11-point Numeric Rating Scale (NRS) and FPS-11-IR. Test-retest reliability was determined in 1-week interval. RESULTS: Most of elderly participants (72%) agreed that pain construct displays in faces of the FPS-11-IR and participants" agreement on face rank ordering were vary for each face, ranging from 80% to 100%. Spearman's correlation coefficient between FPS-11-IR and NRS scores was very strong (r = 0.91, P < 0.01). Intraclass correlation coefficient between test-retest scores was 0.96 that indicates excellent reliability. CONCLUSIONS: The FPS-11-IR is a reliable and valid pain assessment scale to use in geriatric patients chronic pain.

Insulin changes in preeclamptic women during pregnancy.

BACKGROUND: The etiology of preeclampsia remains obscure. To study the role of insulin resistance in preeclampsia, we compared fasting insulin and glucose changes during the second and third trimesters in preeclamptic women with a normal control group. PATIENTS AND METHODS: In a nested case-control study, subjects were selected from a population-based cohort of 674 pregnant women from whom serum was collected for this study between the 20th and 24th week of gestation. For 16 women who developed preeclampsia (cases), 16 women who remained normotensive were selected as controls. Controls were matched with each case for pregestational body mass index, age, gestational age, and parity. Fasting glucose and insulin levels of the second trimester (20th to 24th weeks) of pregnancy were compared based on serological data. The comparisons were also carried out in the third trimester when preeclampsia occurred. RESULTS: Fasting insulin levels increased from 15.3+/-1.3 microlU/mL to 25.3+/-1.4 microlU/mL between the second and third trimesters in the preeclamptic group (P<0.01) and from 10.4+/-0.9 microlU/mL to 16.2+/-1.3 microlU/mL in the control group (P<0.01). There was no significant change in glucose levels during pregnancy in either group. CONCLUSION: Women who develop preeclampsia have higher insulin levels before clinical evidence of disease than women who remain normotensive during pregnancy. The increase in insulin levels in the third trimester was greater in preeclamptic than in non-preeclamptic women.