Comparison of the effectiveness of a 12 step substance use recovery program on quality of life.

Substance-related disorders can adversely impact quality of life. This study assessed a 12 step program on health-related quality of life for Iranian individuals seeking to recover from substance use. The study used a quasi-experimental, two group, three stage, pre- and post-test design and collected data at baseline, and at 1 and 3 months' post-intervention. The treatment group comprised 35 participants in a 12 step program with a non-equivalent comparison group of individuals admitted to addiction treatment centers. Physical and mental health quality-of-life domains were assessed using the Short Form 36 Health Survey Questionnaire. The treatment group improved in all aspects of health-related quality of life. The treatment group improved compared to the comparison group for two of eight quality of life dimensions - physical functioning and role limitations due to emotional problems - at 1 month post-intervention. There were additional improvements at 3 months' follow up in six of eight quality-of-life subscales compared to the comparison group. The benefits to quality of life related to mental health recovery extended beyond the treatment program, indicating that the program principles were effectively implemented in daily life.

Effect of a Supportive Training Program on Anxiety in Children with Chronic Kidney Problems and their Mothers' Caregiver Burden.

BACKGROUND: Chronic problems have a long course of treatment and are one of the important causes of the childhood hospitalization. The aim of this study was to determine the effect of a supportive training program on the children's anxiety and their mothers' caregiver burden. MATERIALS AND METHODS: This study was a randomized controlled clinical trial, performed on two groups in three stages in the autumn of 2017 on 112 individuals. The study population consisted of all children with chronic kidney problems who hospitalized in Emam Hossein Hospital (Isfahan, Iran) and their mothers. Sampling selection method was convenient. Participants were randomly assigned to experimental (n = 56) and control (n = 56) groups and the supportive training program, that was a self-regulating program, was done for the experimental group. The Face Anxiety Scale and the Zarit Caregiver Burden Scale were completed by both groups before, after and 1 month after the intervention. Statistical significance was set at 5%. RESULTS: There was a significant difference in the mean scores of anxiety and caregiver burden in the experimental group preintervention [anxiety: (t54= 0.31, p = 0.75); caregiver burden: (t54= 1.34, p = 0.18)], postintervention [anxiety: (t54= 5.30, p < 0.001); caregiver burden: (t54= 2.72, p = 0.009)], and follow-up [anxiety: (t54= 2.39, p = 0.01); caregiver burden: (t54= 3.06, p = 0.003)], whereas there was no significant difference in the mean scores of anxiety and caregiver burden in the control group. In order to controlling for pretest scores, the repeated measure analysis of covariance was adopted. CONCLUSIONS: The results showed that the supportive training program can reduce children's anxiety and their mothers' caregiver burden and suggesting to nurses, an effective program to reduce the negative effects of hospitalization on children and their mothers.

Evaluating the Effect of a Need-based Program for Caregivers on the Stress, Anxiety, Depression, and the Burden of Care in Families of Children with Attention Deficit-hyperactive Disorder.

BACKGROUND: Attention-deficit hyperactive disorder (ADHD) is the most common behavioral disorder of childhood, and due to its chronic nature, it would affect all the aspects of life of the child and the caregiver. Therefore, this study was conducted to determine the effect of a program based on the needs of caregivers on stress, anxiety, depression, and burden of care in families of children with ADHD. MATERIALS AND METHODS: This randomized clinical trial was conducted on 70 family caregivers of children with ADHD from June to September of 2016. After convenience sampling, eligible samples were randomly allocated into two groups of control and intervention. The intervention group received the need-based educational program in eight sessions and the participants of the control group participated in two group sessions where they expressed their problems and experiences. Data were gathered through Zarit Burden Interview and Depression Anxiety and Stress Scale (DASS)-42 and then were analyzed using descriptive and inferential statistics. RESULTS: The mean scores of stress, anxiety, depression, and burden of care had a significant difference between both groups right after and 1 month after the intervention (p < 0.001), whereas in the control group, there was no gradual decrease in the mean scores of the dependent variables. CONCLUSIONS: The need-based educational program might reduce the level of stress, anxiety, depression, and burden of care in families of children with ADHD. It is recommended to develop similar programs and evaluate them through various studies. The use of nonpharmacological treatment of these children is evident in the results.

The Effect of a Family-Based Training Program on the Care Burden of Family Caregivers of Patients Undergoing Hemodialysis.

BACKGROUND: The family caregivers of patients undergoing hemodialysis are faced with multiple physical, psychological, social, economic, and spiritual problems that increase their care burden. The present study was conducted to determine the effects of a family-based training program on the care burden of family caregivers of patients undergoing hemodialysis. MATERIALS AND METHODS: The present controlled, randomized, clinical trial was conducted on 70 caregivers of patients undergoing hemodialysis in Ali Asghar and Zahray-e Marzieh hospitals in Isfahan, Iran, in 2017. After conducting convenient sampling, 70 participants were randomly assigned into 2 groups (35 in each group). The experimental group received the family-based training program and the control group received usual care plan. Data were collected using the Zarit Burden Scale before, immediately after, and 1 month after the intervention and were then analyzed by independent t-test, Chi-square, and Analysis of Covariance (ANCOVA) repeated measure. RESULTS: The results showed that both groups were homogeneous in terms of their demographic data and showed no significant differences. The main effect of group was significant, indicating a significant decrease in care burden in the experimental group after the intervention (F 1,67 = 1089, p < 0.001). However, the interaction of time and group was not significant, indicating insignificant difference in burden 1 month after intervention (p > 0.05). CONCLUSIONS: Since the family-based training program successfully reduced the burden of care immediately after intervention, similar family-based training programs are recommended to be designed and developed. However, insignificant time effect suggests further researches of long time effects of such program.

The Effect of Cognitive Behavioral Therapy on the Burden in Drug Dependent Persons' Caregivers: A Randomized Controlled Clinical Trial.

BACKGROUND: Drug dependence is one of the current problems that leads to the drug dependents persons' suffer and imposes a huge mental burden to their family members. This study aimed investigating to determine the effect of cognitive- behavioral therapy (CBT) on the burden of the caregivers of drug dependent people. In CBT, caregivers discover thought and behavioral mistakes and recover them. MATERIALS AND METHODS: This randomized controlled clinical trial was conducted on 64 caregivers of drug dependent individuals referring to one of the clinical and educational centers in Isfahan, Iran, which were randomly assigned to two equal groups (intervention and control) in 2016. Intervention group under went eight 90-min CBT sessions, whereas control group attended 3 group sessions to express their experiences. Data were collected by Zarit Burden scale and the demographic questionnaire and analyzed by independent t-test, Chi-square, and ANCOVA repeated measure through SPSS 18. RESULTS: Before the intervention, no statistical difference was observed among two groups in the mean scores of burden (t = 0.75, p = 0.46). There was a significant difference between three time points in the intervention group (F = 3.24, p < 0.001). However, care burden mean score did not show a significant reduction in the control group (F = 0.17, p = 0.96). CONCLUSIONS: The CBT can lead to reduction of burden in drug dependent caregivers'. We suggest encouraging nurses to establish educational programs such as CBT to maintain and improve caregiver's mental health.

Exploring the Needs of Family Caregivers of Children with Attention Deficit Hyperactivity Disorder: A Qualitative Study.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the most common chronic childhood disorders that lead to dysfunction and disability in childhood and subsequently be careful. This study aimed to understand the needs of the children's caregivers in Iran. MATERIALS AND METHODS: This qualitative research was conducted in 2016. Using purposive sampling, 27 participants from 20 families of children with ADHD were interviewed. Unstructured interviews were conducted within 6 months in Isfahan. Data gathering continued until no new data were accessed. Data were analyzed using qualitative content analysis. RESULTS: The results of this research are shown in three main categories: (1) The caregiver's need for having sufficient information about the disorder, its cause and treatments (pharmacological and nonpharmacological); (2) the need to have enough knowledge about communication problems while caring for a sick child; and (3) the need to improve the performance of care. They were classified under the relevant concept. CONCLUSIONS: Caregivers of children with ADHD have different needs and problems and assessing them would decrease the child's problems and consequently, the family's problems. It would also increase the sense of control and authority over the child's condition in the caregivers. Since this disorder is chronic and permanent, ignoring the needs of caregivers not only would cut the process of the child's treatment but would also intensify the family's and child's problems. So it is recommended to conduct further studies about each of the resulted concepts in this study and the obstacles for reaching them.

The Effect of Group Cognitive Behavioral Therapy on Stress, Anxiety, and Depression of Women with Multiple Sclerosis.

BACKGROUND: One of the factors that could influence the quality of life in patients with multiple sclerosis, which is usually overlooked, is its psychological aspects. Considering the increasing acceptance of complementary medicine in the health system, this study was designed and conducted to determine the effect of group cognitive therapy on the stress, anxiety, and depression of women suffering from multiple sclerosis. MATERIALS AND METHODS: This clinical trial was conducted among 70 women suffering from multiple sclerosis who were referred to the health centers of Isfahan. Participants were randomly allocated into two groups of intervention and control, each containing 35 patients. The intervention group received cognitive behavioral therapy as 8 90-minute group sessions (a session per week), and the control group participated in 4 group sessions to express their feelings and experiences. Data were gathered using the Depression Anxiety Stress Scale (DASS-24). RESULTS: There was a significant difference between the mean score of stress (P = 0.03), anxiety (P = 0.02), and depression (P = 0.03) of the intervention and the control group immediately after and 1 month after the intervention. Least squares difference test showed that the mean score of stress (P = 0.02), anxiety (P = 0.02), and depression (P = 0.03) immediately and 1 month after the intervention was significantly lower in the intervention group. CONCLUSIONS: According to the results of the present study, cognitive behavioral therapy could decrease stress, anxiety, and depression in patients suffering from multiple sclerosis.

The Effect of Barkley's Family-Oriented Program on the Burden of Care on Families of Children with Attention Deficit-Hyperactive Disorder.

BACKGROUND: Attention deficit-hyperactive disorder (ADHD) is the most common behavioral disorders during childhood whose treatment is greatly dependent on families; therefore, families of such children should improve their relation with them so that they could enjoy their lives. Hence, this study was conducted to evaluate the effect of Barkley's family-oriented program on the burden of care on such families. MATERIALS AND METHODS: This clinical trial was conducted among 64 family care givers for children with ADHD. By simple sampling, samples passing the inclusion criteria were selected and randomly allocated into two groups of control and intervention. The intervention group received Barkley's family education program through 9 sessions; the control group participated in 3 group sessions and expressed their problems and experiences. Data were collected and analyzed using the Zarit Burden Interview. RESULTS: Burden of care was gradually reduced through the study in the intervention group, however, the mean score of burden of care did not have a significant reduction in the control group. CONCLUSIONS: Because Barkley's family-oriented program was able to reduce the burden of care in families of children with ADHD, it is recommended to develop similar programs and evaluate them through various studies.

Effects of progressive muscle relaxation, guided imagery and deep diaphragmatic breathing on quality of life in elderly with breast or prostate cancer.

BACKGROUND AND OBJECTIVES: Due to the increasing number of elderly and an increase in the number of cases of cancer by age, cancer is a common problem in the elderly. For elderly patients with cancer, the disease and its treatment can have long-term negative effects on their quality of life (QoL). The purpose of this study was to evaluate the effect of progressive muscle relaxation, body image and deep diaphragmatic breathing on the QoL in the elderly with cancer. MATERIALS AND METHODS: This study was a randomized controlled trial in which 50 elderly patients with breast or prostate cancer were randomized into study and control groups. Progressive muscle relaxation, guided imagery, and deep diaphragmatic breathing were given to the study group, but not to the control group. The effect of the progressive muscle relaxation, guided imagery and deep diaphragmatic breathing was measured at three different time points. European Organization for Research and Treatment of Cancer and QoL Questionnaire-Core questionnaires was completed before, after and 6 weeks after the intervention for the patients in both groups simultaneously. The data were analyzed by SPSS. RESULTS: There was statistically significant improvement in QoL (P < 0.001) and physical functioning (P < 0.001) after progressive muscle relaxation, guided imagery and deep diaphragmatic breathing intervention. CONCLUSIONS: The findings indicated that concurrent application of progressive muscle relaxation, guided imagery, and deep diaphragmatic breathing would improve QoL in the elderly with breast or prostate cancer.

Effect of happiness educational program on the level of stress, anxiety and depression of the cancer patients' nurses.

BACKGROUND: Nurses face a great amount of stress that can threaten their health and reduce their motivation. Nurses' present working conditions lead to an increase in emotional pressures and depression. Conducting a study on this seems to be necessary, with regard to nurses' stressful working conditions, in order to take steps toward achieving different and non-meditational treatments to treat their stress, anxiety, and depression and, consequently, promote nurses' and patients' health. MATERIALS AND METHODS: This is a randomized clinical trial conducted on 52 nurses working in cancer patients wards, who were randomly assigned to intervention and control groups. Happiness educational program was administered for six sessions once a week in the study group and a communication training sessions with the patients in the control group, and DASS-42 questionnaire was completed before, immediately after, and 1 month after intervention by the subjects in both study and control groups. Data were analyzed by Chi-square, independent t-test, and analysis of variance (ANOVA) through SPSS 18. RESULTS: Mean scores of stress, anxiety, and depression showed no significant difference before and after intervention. Meanwhile, independent t-test showed that mean scores of stress, anxiety, and depression were significantly lower in the study group compared to the control group immediately after and 1 month after intervention (P < 0.05). CONCLUSIONS: Educational planning of happiness can reduce nurses' depression, anxiety, and stress in the cancer patients' wards. Psychiatric nurses can reduce depression, anxiety, and stress of nurses working in other hospitals also through application of this program.

Effectiveness of Cognitive Behavioral Therapy on the Quality of Sleep in Women with Multiple Sclerosis: A Randomized Controlled Trial Study.

BACKGROUND: Multiple sclerosis is accompanied by secondary clinical signs such as insomnia. Considering the side effects of drugs and also increasing acceptability of psychotherapy methods in health systems, we aimed to determine the effect of group cognitive behavioral therapy on the quality of sleep in women with multiple sclerosis in 2014. METHODS: This study is a randomized controlled clinical conducted on 72 women with multiple sclerosis who referred to medical centers of Isfahan. After convenience sampling, participants were randomly allocated into two equal groups of control (n=36) and intervention (n=36). In the intervention group, cognitive behavioral therapy was performed in 8 sessions. The control group, along with receiving the common drugs, participated in 3 group sessions and talked about their feelings and experiences. Data were gathered using Pittsburgh Sleep Quality Index (PSQI) and analyzed through independent t-test, Chi-square, Mann Whitney, ANOVA with repeated measure, using SPSS 18. RESULTS: There was a significant difference between the mean score of sleep quality of the control and intervention groups immediately and one month after the intervention (P<0.001). ANOVA with repeated measure test showed that the mean score of sleep quality of patients in the intervention group had a significant difference at three stages of before, immediately and one month after the intervention. CONCLUSIONS: According to the results of this study, cognitive behavioral therapy, as an effective and cost-effective therapy, could improve sleep quality in patients with multiple sclerosis. Trial Registration Number: IRCT2015012720833N1.

The effect of group psycho-education program on the burden of family caregivers with multiple sclerosis patients in Isfahan in 2013-2014.

BACKGROUND: Lack of adequate training and support of primary caregivers of multiple sclerosis (MS) patients is the major factor in causing stress, anxiety, and increase of burden. Therefore, the treatment team members such as psychiatric nurses can help these vulnerable people overcome psychiatric pressures effectively not only through their care and referral role but also through their supportive characteristic, which helps the patients improve their clinical status, together with their social, familial, and work adaptation. Therefore, the researcher tried to identify the effect of a group psycho-education program on the burden family caregivers with MS patients. MATERIALS AND METHODS: This is a two-group three-stage clinical trial. The researcher referred to the heads of neurology clinics to present the purpose of the study and to start the sampling. The neurology clinics of AL Zahra University Hospital, and also a Private Neurology Clinic were selected to collect the data of the study. The subjects were randomly selected, and then, assigned to two groups of study and control. RESULTS: Independent t-test showed a significant reduction in family caregivers' burden immediately after and 1-month after intervention in the study group, compared to control. Repeated measure ANOVA showed a significant reduction in caregivers' burden mean score in the study group (P < 0.001). CONCLUSIONS: As group psycho-education reduced family caregivers' burden, it is recommended to develop and design other programs for the family caregivers of the patients with MS.

Efficacy of communication skills training workshop on sexual function in infertile women.

BACKGROUND: Sexual function is reduced in an infertile woman. This study aimed to determine the effect of a communication skills training program on sexual function in infertile women referring to the medical centers in Isfahan in 2012. MATERIALS AND METHODS: This study is a field trial study using control groups in which 32 infertile couples were selected by convenience sampling, and then, were randomly divided into control and training groups. Data were collected before (T1), 1 week after (T2), and 1 month after (T3) the training. In the intervention group, education was conducted in the form of five 3-h sessions, sequentially held with 1 week interval. Female Sexual Function Index (FISI) scale and Individual Fertility questionnaire were used to collect the data. Data were analyzed by descriptive statistical tests [t-test, analysis of variance (ANOVA), and least significant difference (LSD)]. RESULTS: Communication skills training increased the sexual function in infertile women. ANOVA showed that women's sexual function was significantly greater in the intervention group compared to the control group, after training. LSD test showed no significant difference in sexual function in T2 and T3. CONCLUSIONS: Communication skills can have a significant impact on the sexual function of infertile couples, and communication skills training can improve the quality of marital life skills through the counseling sessions conducted with infertile couples.

The effect of laughter Yoga on general health among nursing students.

BACKGROUND: Promotion and provision of individuals' health is one of the bases for development in societies. Students' mental health is very important in each society. Students of medical sciences universities, especially nursing students, are under various stresses in clinical environment, in addition to the stress they experience in theoretical education environment. With regard to the importance of nursing students' general health and considering the various existing strategies to promote general health components, use of complementary treatments is more considered because of their better public acceptance, low costs, and fewer complications. One of the new strategies in this regard is laughter Yoga. The present study was conducted with an aim to define the effect of laughter Yoga on general health among nursing students. MATERIALS AND METHODS: This is a quasi-experimental two-group three-step study conducted on 38 male nursing students in the nursing and midwifery school of Isfahan University of Medical Sciences in 2012. In the study group, eight 1 h sessions of laughter Yoga were held (two sessions a week), and in the control group, no intervention was conducted. The data of the present study were collected by Goldberg and Hiller's General Health Questionnaire and analyzed by SPSS version 12. RESULTS: The findings showed a significant difference in the mean scores of general health before and after laughter Yoga intervention in the two groups of study and control. CONCLUSIONS: The findings showed that laughter Yoga had a positive effect on students' general health and improved the signs of physical and sleep disorders, lowered anxiety and depression, and promoted their social function. Therefore, laughter Yoga can be used as one of the effective strategies on students' general health.

The effect of yoga on coping strategies among intensive care unit nurses.

INTRODUCTION: Nowadays, it has been known that individuals handle coping strategies when faced with stressful events. These strategies play an important role in individuals. Nurses are exposed to high stress, which directly affects their job satisfaction and the quality of their services. Therefore, the present study tried to investigate the effect of Yoga on stress coping strategies among nurses working in intensive care units (ICUs). MATERIALS AND METHODS: In this quasi-experimental study, 34 female nurses working in ICU who were qualified to enter the study were selected. Yoga exercises were administrated two sessions a week for 8 weeks in the study group. CS-R questionnaire was filled before and after intervention. The data were analyzed by descriptive and inferential (t test) statistical tests. RESULTS: The results of statistical tests showed that the highest application of stress coping strategies was for inconsistent stress coping strategy. There was a significant difference in the mean scores of coping strategies of stress focus, emotion focus, and ineffectiveness after Yoga exercises compared with those before the yoga sessions. DISCUSSION: With regard to the findings, 8 weeks exercises of Yoga can be considered as a complementary treatment to amend stress coping strategies. Further studies in this field are suggested.

The effectiveness of stress management training program on depression, anxiety and stress of the nursing students.

BACKGROUND: Stress has been defined as a barrier to concentration, problem solving, decision making, and other necessary abilities for students' learning; it also has some symptoms and illnesses in the students such as depression and anxiety. In reviewing stress and its consequences, the methods of coping with stress in the method of response to it would be more important than the nature of stress itself. Therefore, this study aimed to determine the effectiveness of stress management training program on depression, anxiety and stress rate of the nursing students. METHODS: This parallel group randomized quasi-experimental trial, was done on 68 Bs nursing students of Nursing and Midwifery School in Isfahan University of Medical Sciences from 2010 to 2011. The questionnaires of this study consisted of individual characteristics and Depression, Anxiety and Stress Scale (DASS-42). In a random fashion, The intervention group was trained with stress management training program in 8 two hours sessions, twice a week. The questionnaires were completed by both groups before, after and one month after the study. RESULTS: The results of the study indicated that there was no significant difference before the intervention in depression, anxiety and stress mean scores in the two groups. After the intervention, the mean scores of anxiety and stress in the intervention group was 5.09 (4.87) and 8.93 (6.01) and in the control group was 10 (6.45) and 13.17 (7.20), that reduction in depression mean score was significantly greater in the intervention group in the control group (p = 0.040). Furthermore, the mean scores of anxiety and stress showed a significant difference between the two groups (Anxiety p = 0.001; Stress p = 0.011); this reduction also had been remained after a month. CONCLUSIONS: According to the results of the present study, holding stress management training program workshops in different courses of the mental health department can improve mental health of the students.

The role of community health nurses in behavioral modification of parents of children with behavioral disorders in primary schools in Isfahan.

BACKGROUND: Mental health is of great importance in childhood and the foundation of personality of every individual is laid during this period. Moreover, behavioral problems are common in children, and a lot of the individual, familial, and social disorders originate from the fact that these problems are not treated at the right time. More important is that the behavioral problems of children are rooted in the behavior and upbringing of parents. Therefore, we carried out the present study to investigate the role of community health nurses in modifying the behavior of parents whose children have behavioral problems. METHODS: This research was a pre- and post-training quasi-experimental study. The study was carried out with the participation of the parents of 44 first-grade primary school children with reported behavioral problems. The instrument used in the study was a self-made questionnaire. The data was analyzed by SPSS software, using descriptive and inferential statistical methods (t-test and repeated ANOVA). RESULTS: The mean scores of parents' behavior before, immediately after, and one month after training exhibited a significant difference in both fathers and mothers (p = 0.04 in fathers and p < 0.001 in mothers). Moreover, the mean scores of mothers before and immediately after training and also before and one month after training showed a significant difference (p < 0.001 and p < 0.001, respectively). However, the mean scores of mothers immediately after and one month after training were not significantly different (p=0.53). Furthermore, the mean scores of fathers before and immediately after training and also before and one month after training were significantly different (p < 0.001 and p < 0.001, respectively). But, the mean scores of fathers immediately after and one month after training did not show a significant difference (p = 0.33). CONCLUSIONS: Since the group training of parents led to a change in their behavior towards children, it is advisable to prepare and implement such programs.

The effect of relaxation techniques to ease the stress in infertile women.

BACKGROUND: Infertility causes psychological and emotional tension in the couples and makes severe stress on infertile men and women. Relaxation technique is one of the methods that reduces the stress and can balance the human's emotions. This study aimed to determine the effect of relaxation on the infertile women's stress score. METHODS: This was a semi-experimental and clinical trial study. Participants randomly divided into two groups. At the beginning, the stress scores were assessed in both groups using Newton's infertility stress questionnaire. The participants' stress scores were evaluated and then, the relaxation technique was implemented on the intervention group. This technique was performed in twelve sessions. All the questionnaires were completed under supervision of the researcher after embryo was transferred to the uterus (after 2 weeks) and before conducting the pregnancy test. RESULTS: Independent t-test showed that the total stress score did not have a significant difference in groups before the intervention (p > 0.05) whereas independent t-test indicated a significant difference in stress scores between the two groups after the intervention (p < 0.05). Stress score was higher in the control group in comparison with the intervention group. CONCLUSIONS: Relaxation technique can reduce the stress score in infertile women as a complementary and alternative medicine method.