Mental health status during COVID-19 pandemic in Fars Province, Iran: timely measures.

BACKGROUND: The current corona virus pandemic is acting as a stressor or trauma, which not only threats physical health status, but also threats mental health status and well-being of people. Currently, COVID-19 pandemic is a life-threatening unpredictable condition accompanied with a large number of uncertainties. The present study has mainly aimed to assess mental health and the relevant social factors during this pandemic in Fars province. METHODS: This cross-sectional study was performed on 922 participants in Fars province, Iran, using internet-based data collection technique. All the included participants filled out the General Health Questionnaire (GHQ-28). Moreover, demographic variables and some social factors were evaluated by asking some questions. All the participants were ensured of the confidentiality of the collected data, and willingly completed the questionnaire. RESULTS: Among the participants, there were 629 women (68.2%) and 293 men (31.2%). The mean age of the participants was 36.98 ± 11.08 years old. Four hundred twenty-five subjects (46.1%) obtained GHQ-28 scores above the cut-off point, and accordingly, they were suspected of having poor mental health statuses. Women, in comparison to men (OR = 2.034, 95%:1.62-3.28), and individuals aged < 50 years old, in comparison to those aged > 50 years old (OR: 4.01 95%:2.15-7.50), have poorer mental health statuses. Trusting on media, health authorities, and cooperation with policy makers, as well as having uncertainty on information about Coronavirus pandemic were also shown to be associated with poor mental health condition (P < 0.05). CONCLUSION: The present study revealed that the number of those people with suspected poor mental health in Fars province significantly increased compared to a previous study using the same questionnaire. Furthermore, the participants who had less trust in media and policymakers were more prone to mental health problems. Therefore, it can be concluded that supporting people in these life-threatening pandemic crises is of great importance, so the policy makers and media must present reliable and valid information to people as soon as possible.

Burnout among Nurses during Coronavirus Disease 2019 Outbreak in Shiraz.

BACKGROUND: The function of healthcare workers, particularly nursing staff, in taking care of coronavirus disease 2019 (COVID-19) patients, cannot be overemphasized. As the pandemic lasts, burnout among the nursing staff needs to be considered as an important challenge. This was aimed to assess the nurses' burnout and factors affecting this variable. MATERIALS AND METHODS: In this cross-sectional study, Maslach Burnout Inventory was completed by 261 nurses in Shiraz hospitals (Iran) in April 2020. This questionnaire addresses different aspects, including emotional exhaustion, personal achievement, and depersonalization, to determine the intensity of perceived burnout among nurses during the outbreak. RESULTS: Our data demonstrated that the nurses' burnout in Shiraz hospitals during the COVID-19 pandemic was high (64.6%). Emotional exhaustion and depersonalization were observed in 63.6 and 53.3 percent of the participants, respectively. Moreover, the rate of successful personal achievement among these nurses was >97%. Work experience <10 years (P=0.016), hospital ward (P=0.044), the number of deaths observed by nurses during the COVID-19 pandemic (P<0.001), and the total number of shifts during the COVID-19 pandemic (P=0.006) had a positive correlation with emotional exhaustion. CONCLUSION: Workload and stress resulting from the COVID-19 outbreak seem to be one of the major causes of emotional exhaustion in nurses. The emotional exhaustion among nurses must be considered in epidemics, such as COVID-19.

Explaining Perceived Priorities in Women with Breast Cancer: A Qualitative Study.

OBJECTIVE: Cancer is a stressful event in life, and the dreadful impact and problems created for patients and families
by cancer negatively affect their quality of life. Therefore, regarding the increasing number of cancer patients and the
nature of this disease, the need to recognize and understand the priorities and problems of patients after the diagnosis of
cancer is of high importance. This study was designed and implemented with the aim of identifying the perceived
priorities of women with breast cancer. METHODS: This study is a qualitative research of content analysis type. To collect
data, purposeful sampling and deep semi-structured individual interviews were used. The subjects were women with
breast cancer who visited the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz, and the data were
saturated after 15 interviews. The four criteria presented by Lincken and Guba were used to evaluate the validity and
reliability. To analyze the qualitative data, conventional qualitative data analysis and MAXQDA10 software were used.
Two themes were obtained in the assessment of interviews and analysis of data: 1) Supportive relief; 2) Therapeutic
support. RESULTS: Some of the participants highlighted the role of social and family support in coping with the disease,
and considered social communication and continued support in the form of empathic relationship as a turning point
in their lives. The absence of a fertility specialist in the cancer treatment system was the main complaint of most
participants. The results showed that receiving support from family and the healthcare system is the most important
perceived priorities in breast cancer patients. CONCLUSION: The results of this study show the importance of social support
as a perceived priority in breast cancer patients to improve their quality of life. Development and reinforcement of the
supportive network seem to be essential to provide the best possible help to these patients.

A study of comparing two cognitive-behavioral workshop for college students: Sleep, wakefulness program and perseverance program.

INTRODUCTION AND AIM: Researchers and specialists believe that health maintenance and improvement through university students, as a part of society, play a crucial role in community configuration which should not be ignored. Since there was a few studies in these fields, researchers have sought to explore how mentioned workshops is related to cognitive emotion regulation, anxiety, depression, and sleep quality for the student volunteers of Shiraz University of Medical Sciences. MATERIALS AND METHODS: In a randomized controlled trial, 152 students were allocated into the 3 equal groups (study1: "perseverance workshop" study2:"sleep and wakefulness workshop" and control group). Data collection instruments were the Granovsky cognitive emotion regulation scale, the Beck depression and anxiety inventories and Pittsburgh sleep Quality Index (PSQI-P) Questionnaire. RESULTS: The results of comparing the anxiety and depression between groups showed that there was a decreasing and significant trend in the two intervention groups, before and after the two workshops (P < 0.001). For PSQ analysis, within-group comparisons in those who have participated sleep and wakefulness workshop showed that the change trend was significant and in linear form. In addition, to compare those who have participated in perseverance workshop with the control group, there was a significant difference between the pretest and posttest results in the Cognitive Emotion Regulation subgroups. CONCLUSION: It can be said that the implementation of the workshops could improve the emotional state of the participants in comparison to the control group.

Thyroid autoimmunity in pregnancy and its influences on maternal and fetal outcome in Iran (a prospective study).

AIM OF THE STUDY: Thyroid dysfunction and autoimmunity are common problems in women of child-bearing age. It could be associated with pregnancy morbidities in the mother and fetus. Due to lack of sufficient data about the prevalence of thyroid autoimmunity in pregnant women in Iran, and controversies about its complications on pregnancy outcomes, this study was conducted. MATERIALS AND METHODS: This is a prospective study on 600 singleton pregnant women in 15-28 weeks of pregnancy; they were residents of Fars province. We evaluated the prevalence of preeclampsia, intra-uterine growth retardation (IUGR), preterm delivery and low Apgar score and their association with TSH, thyroid peroxidase (TPO), and thyroglobulin (Tg) antibodies. RESULTS: Prevalence of anti-TPO and anti-Tg positivity is 12.8% and 8.5% among Iranian pregnant women. Mothers with either positive TPO or Tg antibody have a higher risk of preeclampsia (p = 0.019), preterm delivery (p < 0.001), IUGR (p < 0.001), and low first minute Apgar score (p < 0.001). This association was independent of thyroid dysfunction for preterm delivery (RR = 5, p < 0.001), and low Apgar score neonates (RR = 8.8, p < 0.001), but this association for preeclampsia was due to thyroid dysfunction (RR = 3.7, p = 0.003). About IUGR in either TPO or Tg positive mothers, this association results from the additive effect of thyroid dysfunction and thyroid autoimmunity (RR = 8.3, p < 0.001). Cesarean section delivery was significantly higher in abnormal TSH/positive anti-Tg mothers (p = 0.045). CONCLUSION: Thyroid autoimmunity independent of thyroid dysfunction could have significant adverse outcomes in the mother and fetus. Further investigation should be done to reveal the significance of screening and treating the thyroid autoimmunity during pregnancy.

Thyroid function in pregnancy and its influences on maternal and fetal outcomes.

BACKGROUND: Maternal thyroid function alters during pregnancy. Inadequate adaptation to these changes results in thyroid dysfunction and pregnancy complications. OBJECTIVES: This prospective study aimed to evaluate the prevalence of thyroid diseases in pregnancy and its outcomes in south of Iran. MATERIALS AND METHODS: This prospective study was conducted on 600 healthy singleton pregnant women who aged 18 to 35 years old at 15 to 28 weeks of gestation. We investigated the prevalence of thyroid dysfunctions in women. Multivariate analysis was performed to determine the effect thyroid dysfunction on obstetric and neonatal outcome. RESULTS: Thyroid stimulating hormone (TSH) levels of 0.51, 1.18, 1.68, 2.4, and 4.9 mIU/L were at 2.5th, 25th, 50th, 75th, and 97.5th percentile in our population. The prevalence of clinical hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism, and subclinical hyperthyroidism in all pregnant women was 2.4%, 11.3%, 1.2%, and 0.3%, respectively. In addition, 1.4% of patients had isolated hypothyroxinemia. Clinical hypothyroidism was associated with increased risk of preterm delivery (P = 0.045). Subclinical hypothyroidism had a significant association with intrauterine growth restriction (IUGR) (P = 0.028) as well as low Apgar score at first minute (P = 0.022). Maternal hyperthyroidism was associated with IUGR (P = 0.048). CONCLUSIONS: We revealed that thyroid dysfunction during pregnancy was associated with IUGR and low Apgar score even in subclinical forms. Further studies are required to determine whether early diagnosis and treatment of thyroid diseases, even in subclinical form, can prevent their adverse effect on fetus.

A prospective study of selenium concentration and risk of preeclampsia in pregnant Iranian women: a nested case-control study.

Preeclampsia remains a leading cause of maternal and perinatal mortality and morbidity worldwide; however, its specific etiology still remains obscure. Some studies implicate poor maternal selenium status predisposing the mother to preeclampsia. This study was designed to determine changes in plasma selenium levels in women having preeclampsia as compared with those with normal pregnancy. In a nested case-control study, 650 normal primigravida in their first 24-28 weeks participated in the study. After 3 months of follow-up of all subjects, blood selenium levels were measured in 38 women presenting consecutively with preeclampsia and in 38 women having a normal pregnancy by atomic absorption spectrophotometry. Birth outcomes were recorded, such as gestational age at delivery, height, weight, birth head circumflex and 1-min Apgar score. Preeclampsia affects about 5.84 % of pregnancies, and in our study, there were no significant differences in age, anthropometric indices, and family history of preeclampsia between the preeclamptic and control groups. The selenium concentrations in plasma in women with preeclampsia were significantly lower as compared with those in women with normal pregnancy (70.63 ± 21.41 versus 82.03 ± 15.54 µg/L, p < 0.05). Being in the bottom tertile of selenium concentration (less than 62.2 µg/L) was associated with greater risk of preeclampsia in pregnant women. The reduced selenium in the maternal circulations observed in the preeclamptic mothers support the hypothesis that insufficient selenium concentration may be a contributing factor to the pathophysiological mechanisms associated with preeclampsia, and optimizing the dietary selenium intake through supplementation could produce demonstrable clinical benefits.