Implementation of the McMaster Model in Family Therapy: Effects on Family Function in Married Couples.

Objective: Family function is one of the main effective factors on stability of the family. Family therapy can promote family function and performances. This study aimed to assess the effects of family therapy on family function among couples in Yazd province (Iran) based on the McMaster model. Method : The research population was selected from volunteer couples in Yazd in 2017 who were invited by publicity announcement to participate in this research. Finally, 40 couples were selected and randomly divided into 2 intervention and control groups. Participants answered to the demographic and Family Assessment Device (FAD) questionnaires. The acquired information was analyzed using inferential and descriptive statistics and SPSS 21 software. Results: The outcomes showed significant differences between the intervention and control groups in problem-solving (p = 0.01), communication (p < 0.0001), emotional responsiveness (p = 0.01), emotional involvement (p < 0.0001), and general function (p = 0.04). The roles and behavior control domains were improved after the intervention in 2 groups, but the differences were not significant. Conclusion: Family therapy based on McMaster model can promote the skills of problem- solving, family communication, emotional responsiveness, emotional involvement, and general function in couples. Healthy family functioning is a substantial domain of concern for mental health specialists who provide family interventions. Our findings enhance considerably to family professionals' knowledge about patterns of family function in Iranian families.

The Effect of Non-verbal Music on Posttraumatic Stress Disorder in Mothers of Premature Neonates.

BACKGROUND: Hospitalization of a premature neonate in the Neonatal Intensive Care Unit (NICU) is stressful for mothers. They show symptoms of Post-Traumatic Stress Disorder (PTSD). It is important to use the proper strategy to manage PTSD. This study was designed to investigate the effect of non-verbal music on the PTSD in mothers of premature neonates hospitalized in NICU. MATERIALS AND METHODS: In this clinical trial study, the convenience sampling method was applied and 45 mothers of premature neonates were selected and categorized randomly into the intervention (N = 23) and control (N = 22) groups in 2018. The babies were hospitalized in one of the NICUs in Yazd (Iran). The intervention group were supposed to listen to the non-verbal music for 20 minutes daily for two weeks using MP3 player and headphones. All participants completed the Perinatal PTSD Questionnaire (PPQ). The data were analyzed by SPSS 21 using paired t-test, independent t-test, and Chi-square test. RESULTS: The PTSD mean (SD) scores before and after the intervention was 9.39 (1.67) and 4.39 (1.49), respectively, in experimental group. It was 8.54 (1.59) and 5.31 (1.71) in control group. The severity of PTSD decreased in the intervention (p = 0.003) and control (p < 0.001) groups after the intervention. The difference between the two groups was significant (F1,07 = 1058, p < 0.03), which confirmed the significant effect of the non-verbal music on decreasing the PTSD severity (0.92). CONCLUSIONS: Non-verbal music can be used as an effective and low-cost intervention for managing PTSD in mothers of premature neonates hospitalized in the NICU.

Validation of the Family Stability Questionnaire in married couples: a confirmatory factor analysis.

BACKGROUND: Marital conflicts and divorce are among the most crucial problems of society. Therefore, it is important to maintain family stability at the optimal level in order to prevent divorce and its consequences in the family and community. OBJECTIVE: This study was conducted to design and validate the Family Stability Questionnaire (FSQ) in married couples. METHODS: This study was the second stage of a large study. The FSQ was constructed based on a qualitative research in our previous study in 2016. It was developed through interviews by family therapists, psychiatrists, and couples on 10 dimensions (areas) and was based on McMaster's Family Assessment Device (FAD). Then, in the present study, a confirmatory factor analysis was conducted on 270 males and females (135 couples) of Yazd City (Iran) from January to May 2017. The construct validity and reliability of the scales were examined using exploratory and confirmatory factor analyses (EFA and CFA) and Cronbach's alpha coefficient, respectively. Test-retest reliability was assessed with intra-class correlation coefficients (ICC) for the agreement between the individual items and domains. SPSS 21 and AMOS 21 were used for statistical analyses (p≤0.05). RESULTS: At first, the results of the CFA on 70 items of FSQ could not confirm (RMSEA=0.06, CFI=0.91, GFI=0.72), but FSQ with 56 questions indicated that it had sufficiently high validity and reliability to measure family stability (RMSEA=0.04, CFI=0.95, GFI=0.96) with an acceptable fit index. A positive significant correlation was observed between the FSQ and FAD (r=0.45, p<0.001) indicating that FSQ has convergent validity. The Cronbach's alpha and ICC of more than 0.7 in 10 domains of this tool indicated a good internal consistency among the items and their high relevance (0.90 and 0.84, respectively). CONCLUSION: FSQ, as a multi-dimensional questionnaire, is a useful and reliable instrument to assess family stability. It consists of ten factors, which were constructed for the first time in Iran. Given the proper features, this instrument can be utilized to carry out more research regarding family stability in Iranian populations.

Deficiency of Self-Efficacy in Problem-Solving as a Contributory Factor in Family Instability: A Qualitative Study.

Objective: Problem-solving ability is one of the most important means of family stability that enables the families to understand their roles, functions, and performances. Self-efficacy deficiency in problem-solving runs through many families. This qualitative study was conducted to investigate and describe how couples solve problems in their families. Method: This study was conducted to detect couples' self-efficacy deficiency in problem-solving using purposive sampling method. Several deep semi-structured interviews based on McMaster model and observations were conducted by nine family therapists and psychiatrists on four couples (eight persons) living in Yazd (Iran).The interviews were performed, audio-recorded, and transcribed verbatim. The analysis was interpreted through directed content analysis methods. Results: Families in Yazd (Iran) made some attempts to solve their problems, but their efforts were not enough, and thus they suffered from self-efficacy deficiency, which included 8 categories. The main theme distilled from the data of 17 participants was self-efficacy deficiency, which included the following categories: avoidance, insolvency, interference from others, ineffective self-treatment, behavioral problems, stubbornness, superficiality, and denial. Conclusion: It is of paramount importance to identify self-efficacy deficiency in families and promote problem- solving programs to increase family stability. In the present study, the main deficiencies in problem-solving were detected.

A Qualitative Approach to Women's Perspectives on Exercise in Iran.

BACKGROUND: It is believed that women of all ages do less physical activities compared to men. The development of interventional projects for increasing the women's participation in physical activity needs the recognition of resources and exploration of women's perspectives on exercise in their lives in the Iranian culture and context. METHODS: This qualitative study was conducted in an urban area of Iran on 46 women attending healthcare centers, volunteer health care providers, university students, sportswomen and one of the officials of the provincial women's sports. This study was done from April 2015 to June 2016. Four focus group discussions and one in depth semi-structured interview was conducted. A qualitative conventional content analysis approach was used for data analysis. RESULTS: Four categories were developed as follows: 'preferences', 'planning', 'motivators' and 'inhibitors'. Preferences had three distinct subcategories: preferences to do exercise in specific settings, specific exercise and group exercise. The family role, exercise as one part of daily routines, and exercise as a habit were subcategories of planning. Motivators were physical, emotional and social benefits; physician advice and encouragement; being alarmed; and championship. The inhibitors of doing exercise were various: gender issues, economical and costs issues, geographical access, making excuses, cultural infrastructures, shortage of sports experts, fears, concerns and misconceptions, inappropriate facilities and inadequate administrative cooperation and official barriers. CONCLUSION: The findings showed that the women were sensitive to and interested in doing exercise. However, barriers to exercise were multiple and complex. Nursing interventions are required to increase the individuals' awareness of misconceptions and also develop strategic programs for improving exercise among women.

Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility.

BACKGROUND: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. OBJECTIVE: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. MATERIALS AND METHODS: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. RESULTS: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. CONCLUSION: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women.

The comparison of anxiety and depression rate between medical staff of infertility centers and obstetrics and gynecology centers of Yazd, Shiraz, Isfahan and Kerman hospitals.

BACKGROUND: Regarding the close and continuous interaction of infertility staff with hopeless infertile couples and in the contrary the atmosphere of happiness especially in obstetric wards make a sense that considering anxiety and depression it would be a difference between these two wards. OBJECTIVE: The objective of this study is the comparison of the rate of depression and anxiety between the two wards of infertility and obstetrics and gynecology. MATERIALS AND METHODS: This study is a descriptive-correlation study based on cross-sectional method. 199 individuals who were the staff of infertility and obstetrics and gynecology wards in four provinces enrolled in this study through stratified sampling. Data collection was done by demographic questionnaire, Spiel Berger and Beck depression inventory tests. Data were analyzed by SPSS software using ANOVA test. RESULTS: The result showed the rate of anxiety in obstetrics and gynecology staff of Isfahan center (54.69±13.58) and depression rate had increased level in infertility staff of Shiraz center (14.94±10.87). Overall, there was significant correlation between anxiety, depression and work place (p=0.047, 0.008 respectively). According to ANOVA test, the mean value of anxiety level was higher in the staff of four obstetrics and gynecology centers and one infertility center Conclusion: As long as we know that infertile couples have little chance for success rate and obstetrics and gynecology wards patients have little risk of failure in treatment, it could be mentioned that the anxiety and depression in the staff are not correlated with the client illness.

Responsible of Socio-economic Factors with Addiction in Yazd, Iran: An Opinion Survey.

BACKGROUND: Addiction has a long history in Iran and it is one of the social problems that create psychological and social conflicts for addicts and their families. Addiction just like other social deviations affects young who are the most valuable assets of a nation. Recognition of socio-economic factors responsible for addiction can help planning and management of programs to fight against addiction. METHODS: This cross-sectional study was conducted using a questionnaire on 261 spouses of addicts referring to the detoxification centers of Yazd, Iran who were selected randomly. Their perspectives regarding factors thought to be effective in addiction were examined. Statistical tests included chi-square and Kruskal-Wallis tests. FINDINGS: Economic problems, divorce, marital problems, lack of familial supervision, unemployment, psychological and physical problems had a statistically significant relationship with the income of the family (P < 0.05), such that with an increase in income of the family these factors played a lesser significant role in addiction. CONCLUSION: Control of surrounding factors and increase in self-esteem are two important factors that can help effectively control addiction in the young population. After addiction, though environmental and surrounding factors play a role in preventing return to addiction, their role is reduced.

Effectiveness of regular breathing technique (hey-hu) on reduction of intrathecal injection pain in leukemic children: a randomized clinical trial.

OBJECTIVE: Children with chronic diseases such as leukemia are subjected to pain during various procedures. Injection pain in children is so important that it is considered as the most stressful aspect of their disease. Distraction is one of the easiest and least costly methods of non-pharmacological pain relief that has not been paid attention to by nurses. In the present study, the effectiveness of regular breathing method (Hey-Hu) in reduction of pain of intrathecal injection in leukemic children was evaluated. METHODS: This study was conducted as a single blind randomized clinical trial among 100 patients coming to a referral hospital related to Shahid Sadoughi University of Medical Sciences, Yazd, Iran. The patients were 6-15 years old children coming to oncology ward suffering from leukemia. They were selected and randomly allocated to either regular breathing group or control group in equal numbers. The pain of children was assessed by Wong pain face scale and also general behaviors of the samples were evaluated by the researcher. In Pain Rating Scale, face 0 is considered happy because there is no hurt and face 5 denotes maximum pain. FINDINGS: Mean pain score in the regular breathing group was significantly lesser than the control group (2.98±1.68 and 3.80±1.30, respectively; P=0.01). There was no significant difference between the two sexes but in the regular breathing group, mean pain score was significantly lower in children aged above 10 years. CONCLUSION: This study showed that regular breathing can significantly reduce the pain of intrathecal injection in leukemic children, especially in those aged above 10 years. Considering the key role of nurses in a health care team, the researchers hope that the results of this study can help them learn this method and implement it in hospitalized children who undergo painful procedures.