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تعیین ژنوتایپ های دیکروسلیومدندریتیکوم جدا شده از حیوانات اهلی در ایلام ، لرستان و کرمانشاه بر مبنای ژن NADH 2 0 0 2005/04/22 1384/2/2 2005/06/25 1384/4/4 جهانگیر عبدی Jahangir Abdi مرکز تحقیقات میکروب شناسی بالینی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران jahangirabdi@yahoo.com سحر شکوهی Sahar Shokohi ایران ## ##

Changes in prevalence of anemia in pregnant women during the past 10 years in Iran-systematic reviews and meta-analysis تغییرات شیوع آنمی در طی 10 سال اخیر در زنان باردار ایران- مرور سیستماتیک و متاآنالیز 2 0 0 2005/04/222009/09/29 1388/7/7 2005/06/252009/10/30 1388/8/8 یزدان رحیم بیگی yazdan rahimbeghi ایران Yazdan911@gmail.yahoo.com کورش سایه میری Kourosh Sayehmiri مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران sayehmiri-k@medilam.ac.ir ## ##

Prevalence and recurrent of recurrent preterm birth and associated factors in Ilam Labor Wards 2013 بررسی میزان شیوع و عود زایمان زودرس و عوامل مرتبط با آن در زایشگاه های شهر ایلام سال 1393 2 0 0 2005/04/222009/09/292013/12/31 1392/10/10 2005/06/252009/10/302014/03/1 1392/12/10 میلاد برجی Milad Borji گروه آموزشی اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران borji_milad@yahoo.com ## ##

Evaluating the expression of miR-135a in the blood sample of patients with depression and comparing with normal samples بررسی بیان miR-135a در نمونه های خونی بیماران مبتلا به افسردگی و مقایسه آن با نمونه های طبیعی 2 1 افسردگی حالتی است که انسان احساس سختی و ناراحتی میکند،پریشان حال و مضطرب است و زندگی را کسالت آور میپندارد. شخص مبتلا به افسردگی حالاتی دارد که وی را منزوی نموده و در موارد شدید حتی ممکن است اقدام به خودکشی نماید. بسیاری از مطالعات روان شناختی به وضوح نشان میدهد که بین افسردگی و اقداماتی مانند خودکشی رابطه معناداری وجود دارد. پیش بینی ها حاکی از آن است که در سال 2020، افسردگی به عنوان اولین عامل ناتوان کنندۀ جامعۀ بشری مطرح گردد. اختلال افسردگی اساسی (Major depressive disorder ) از مهمترین انواع اختلالات خلقی به شمار رفته و میزان وقوع آن در طول عمر، 15% است حتی ممکناست در زنان نیز به 25% نیز برسد. بر اساس اخرین اطلاعت بدست امده در زمینه روش های تشخیصی جهت تسهیل در شناسایی بیماران مبتلا به افسردگی، علیرغم تلاش های زیادی که در این زمینه صورت گرفته است، روش مولکولی خاصی جهت تشخیص این بیماری وجود ندارد. بر این اساس لازم به نظر میرسد که با استمداد از روش های تشخیصی بیوشیمی مولکولی، که تا کنون دستاورد های عظیمی داشته است بهره جست. به این منظور، با احاطه کامل بر این روش ها میتوان علاوه بر شفاف سازی مکانیسم های مولکولی بیماری ها، راهکارهای تشخیصی و درمانی بهتر، دقیقتر و انتخابی تری را ارائه نمود.  مطالعه حاضر بر آن است که با بررسی سطح miR-135aدر نمونه خونی بیماران مبتلا به افسردگی آن را به عنوان هدف تشخیصی و سپس به عنوان هدف دارویی معرفی نماید. تا کنون شواهد زیادی مبنی بر تشخیص مولکولی بیماری افسردگی وجود نداشته و لازم است جهت تشخیص به موقع وکارآمد،  در این زمینه اهداف تشخیصی بیشتری معرفی گردد. 2 Depression is a condition in which a person feels difficult and upset, disturbed and anxious, and finds life boring. A person with depression has conditions that isolate him or her and in severe cases may even lead to suicide. Many psychological studies clearly show that there is a significant relationship between depression and actions such as suicide. It is predicted that in 2020, depression will be the first disabling factor in human society. Major depressive disorder is one of the most important types of mood disorders and its incidence during life is 15% and may even reach 25% in women. According to the latest information in the field of diagnostic methods to facilitate the identification of patients with depression, despite the many efforts that have been made in this field, there is no specific molecular method to diagnose this disease. Therefore, it seems necessary to use the diagnostic methods of molecular biochemistry, which has had great achievements so far. To this end, by fully embracing these methods, in addition to clarifying the molecular mechanisms of diseases, better, more accurate and more selective diagnostic and therapeutic solutions can be provided. The present study aims to evaluate the level of miR-135a in the blood samples of patients with depression and introduce it as a diagnostic target and then as a drug target. So far, there is not much evidence for molecular diagnosis of depression and it is necessary to introduce more diagnostic goals in this field for timely and efficient diagnosis. 0 0 2005/04/222009/09/292013/12/312016/11/25 1395/9/5 2005/06/252009/10/302014/03/12017/01/16 1395/10/27 علی قیصرزاده Ali Gheysarzadeh مرکز تحقیقات میکروب شناسی بالینی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران gheysarzad@gmail.com نورخدا صادقی فرد Nourkhoda Sadeghifard مرکز تحقیقات میکروب شناسی بالینی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران sadeghifard@gmail.com ## ##

The effect of care Plan based on Roy adaptation model on spiritual well-being of women with breast cancer referring to Ahwaz oil hospital in 2017 بررسی تأثیر برنامه مراقبتی بر اساس مدل سازگاری روی بر سلامت معنوی زنان مبتلا به سرطان سینه مراجعه کننده به بیمارستان نفت اهواز در سال 1396 2 1 یکی از نظریه های مهم پرستاری که کاربرد ویژه ای در سازگاری بیماران با بیماری های مزمن و افزایش کیفیت زندگی آنها دارد، نظریه سازگاری روی می باشد. هدف از این تحقیق تعیین تاثیر برنامه مراقبتی بر اساس مدل سازگاری روی بر سلامت معنوی زنان مبتلا به سرطان سینه بود. روش پژوهش: این پژوهش یک مطالعه تجربی با گروه کنترل و تصادفی سازی شده بود که در سال 1396 در بیمارستان نفت اهواز انجام شد. نمونه این پژوهش، 80 نفر از بیماران مبتلا به سرطان پستان مراجعه کننده به این مرکز بودند که به صورت تصادفی در دو گروه آزمون (40 نفر) و کنترل (40 نفر) قرار گرفتند. سپس برنامه مراقبتی برای گروه آزمون با استفاده از فرم بررسی و شناخت الگوی سازگاری روی تدوین شد. بر اساس این فرم، رفتارهای ناسازگار افراد گروه آزمون در چهار بعد سازگاری (فیزیولوژیک، درک از خود، ایفای نقش و وابستگی متقابل) تعیین شده و محرک های اصلی، زمینه ای و باقیمانده این رفتار های ناسازگار مشخص شدند. در ابتدای مطالعه پرسشنامه سلامت معنوی 20 سوالی پولتزین و الیسون در اختیار شرکت کننده های در تحقیق قرار گرفت، بعد از مداخله دوباره این پرسشنامه در اختیار افراد دو گروه قرار گرفت. داده های به دست آمده با روش آماری توصیفی و آمار استنباطی( تی مستقل و تی زوجی) با استفاده از نرم افزار SPSS نسخه 23 در سطح اطمینان 95% مورد تحلیل قرار گرفت. نتایج: نتایج نشان داد بین میانگین نمره سلامت معنوی در دو گروه بعد از مداخله تفاوت معنی داری از نظر آماری وجود داشت (001/0=P). نمره سلامت معنوی در گروه آزمون بعد از مداخله (93/4±90/99) نسبت به قبل از مداخله (11/4±37/73) افزایش معناداری را نشان داد (001/0=P). نمره سلامت معنوی در گروه کنترل بعد از مداخله (58/3±02/72) نسبت به قبل از مداخله (25/4±10/73) کاهش یافت، اما از لحاظ آماری معنادار نبود. نتیجه گیری: با توجه به نتایج حاصل از این مطالعه و موثر بودن الگوی سازگاری روی بر سلامت معنوی زنان مبتلا به سرطان پستان این روش می تواند به صورت دستورالعملی جامع برای ارتقاء وضعیت سلامت معنوی افراد مبتلا به سرطان در تمام بیمارستان های کشور مورد اجرا قرار گیرد. همچنین می توان تاًثیر این مدل را بر روی سایر بیماری ها به صورت کارآزمایی مورد مطالعه قرار داد. 2 Background and Purpose: One of the important nursing theories, which has a special application in adapting patients with chronic diseases and improving their quality of life, is the Roy adaptation model. Therefore, the purpose of this study was investigating the effect of care plan based on Roy adaptation model on spiritual well-being of women with breast cancer. Methodology: This study has an experimental design with a control group that was conducted at Ahwaz Oil Hospital in 2017. In this study, 80 patients with breast cancer who referred to this center were randomly divided into two experimental (40 persons) and control (40 persons) groups. Then, a care plan was developed for the experimental group by using an assesment form and understanding of the adaptive model. Based on this form, the ineffective behaviors of the experimental group were determined in four dimensions of adaptation (physiologic, self-concept, role play, and interdependence), and the focal, contextual and residual stimuli of the ineffective behaviors were identified of these inconsistent behaviors were identified. At the beginning of the study, the paloutzian & Ellison Spiritual well-being Questionnaire was provided to the participants. After the intervention, that questionnaire was completed by the people of the two groups. The data were analyzed using descriptive statistical methods, independent t-paired test and t-test with SPSS software version 23 at 95% confidence level. Results: There was a statistical significant difference between the mean score of spiritual well-being in the two groups after the intervention (P = 0.001). Spiritual well-being score in the exprimental group after intervention (99.9 ± 4.93) was significantly higher than before the intervention (73.77 ± 11.4) (P = 0.001). However, the spiritual well-being score in the control group after intervention (72.02 ± 4.38) was lower before intervention (73.10 ± 4.25), but statistically significant difference was not observed. Discussion and conclusion: Regarding the results of this study and the effect of Roy adaptation model on the spiritual well-being of women with breast cancer, this model can be used as a comprehensive guide to improve the spiritual well-being of these patients in all of the hospitals in Iran. Also the effect of Roy adaptation model can be studied on other patient with chronic disease by randomized clinical trial. 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/26 1396/4/5 2005/06/252009/10/302014/03/12017/01/162017/09/15 1396/6/24 بهاره نظرپور bahare nazarpor ایران baharan_nu83@yahoo.com معصومه اطاقی Masoumeh Otaghi گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران masoome.otaghi@gmail.com Breast Cancer Spiritual well-being Roy adaptation model. سرطان پستان سلامت معنوی برنامه مراقبتی مدل سازگاری روی. 1. Mardani Hamouleh M, Shahraki Vahed A. Relationship between mental health and quality of life in cancer patients. Sciences Medical of University Sadoughi Shaheed of Journal 2010;18(2):111-7.##2. Spillers RL, Wellisch DK, Kim Y, Matthews A, Baker F. Family caregivers and guilt in the context of cancer care. Psychosomatics. 2008;49(6):511-9.##3. Mehri Nejad A, H KS. Stress in Women with Breast Cancer Compared to the Healthy Ones. Daneshvar Raftar 2011;17(43):49-56.##4. Bolhari J, Naziri GH, S Z. The effectiveness of group therapy and spiritual approach to treatment of depression, anxiety and stress in women with breast cancer. Scientific Sociology of Women Quarterly. 2012;3(1):85-116.##5. Mahmoudi M, Kashfee F, Nikoofar A, F H. Risk factors of breast cancer. Iran Journal of Nursing. 2000;13(26):23.##6. Momenighalea Ghasemi T, Mosa Rezae A, Karimiyan J, A E. The relationship between spiritual health and depression in patients with breast cancer in the hospital for Imam Hussein, Isfahan. Special Health Information Management Health Care Management. 2012;8(8):1007-16.##7. Pedram M, Mohammadi M, Naziri GH, N A. Effectiveness of Cognitive Behavioral Group Therapy on the Treatment of Anxiety and Depression Disorders and on Raising Hope in Women with Breast Cancer. Journal of Woman & Society 2010;1(4):61-76.##8. Seyedfatemi N, Rezaei M, Győr A, F H. The effect of prayer on spiritual health of cancer patients. Monitoring Journal. 2007;5(4):295-304.##9. Chuengsatiansup K. Spirituality and health: An initial proposal to incorporate spiritual health in health impact assessment. Environmental Impact Assessment Review. 2003;23(1):3-15.##10. Hamid N, Ahmadian A, Y A. Evaluation of the effectiveness of RCT based on the hope and quality of life in patients with breast cancer. Hormozgan Medical Journal. 2012;16(3):213-21.##11. Hamid N, Ahmadian A, Akbari Shaye Y. Effectiveness of cognitive behavior therapy based on religious believes on hope and quality of life in the patients suffering breast cancer. Bimonthly Journal of Hormozgan University of Medical Sciences. 2012 Aug 15;16(3):213-21.##12. Edelman CL, Mandle CL. Health Promotion Throughout the Life Span-Pageburst on VitalSource: Elsevier Health Sciences; 2009.##13. Ryan CJ, DeVon HA, Horne R, King KB, Milner K, Moser DK, et al. Symptom clusters in acute myocardial infarction: a secondary data analysis. Nursing research. 2007;56(2):72-81.##14. Hakari D, R M. Evaluation of adjustment in women with coronary artery disease, according to quadruple aspects of physiologic, self-perception, role playing and independence-dependence on Shhrtbryz87-1386. Journal of Medical Sciences, Islamic Azad University. 2008;16(3):187-93.##15. Rezaei M, Seyedfatemi N, F H. Spiritual well-being in cancer patients undergoing chemotherapy. Faculty of Nursing and Midwifery, Tehran University of Medical Sciences Hayat. 2008;14(3):33-9.##16. Sajadian A, Haghighat SH, Montazeri A, Kazemnejad A, A F. adjustment in patients with breast cancer before and after treatment. Iranian Journal of Breast Disease. 2011;4(3):47-51.##17. Al‐Azri M, Al‐Awisi H, Al‐Moundhri M. Coping With a Diagnosis of Breast Cancer‐Literature Review and Implications for Developing Countries. The Breast Journal. 2009;15(6):615-22.##18. Sadeghnezhad M, Vanaki Z, R M. The effect of nursing care plan based on Roy adaptation model on physiological adaptation in type II diabetic patients. Bimonthly scientific - research Dtnshvr Medical / Shahed University. 2011;18(92):1-11.##19. Tavan H, Khalafzadeh A, Jamshidbeygi Y, Shojaee S, Kokhazadeh T. Spiritual health nurses working in hospitals and critical care departments of Ilam city in 2015. Journal of Reaserch on Religion & Health. 2016;2(3):46-53.##20. Riley BB, Perna R, Tate DG, Forchheimer M, Anderson C, Luera G. Types of spiritual well-being among persons with chronic illness: Their relation to various forms of quality of life. Archives of physical medicine and rehabilitation. 1998;79(3):258-64.##21. Pesut B. Spirituality and spiritual care in nursing fundamentals textbooks. Journal of Nursing Education. 2008;47(4):167-73.##22. Mueller PS, Plevak DJ, Rummans TA, editors. Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo clinic proceedings; 2001: Elsevier.##23. HOJATI H, Motlagh M, NOURI F, Sharifnia S, Mohammadnezhad E, HEYDARI B. Relationship frequently pray with spiritual health in patients treated with hemodialysis. 2010.##24. McCauley J, Tarpley MJ, Haaz S, Bartlett SJ. Daily spiritual experiences of older adults with and without arthritis and the relationship to health outcomes. Arthritis Care & Research. 2008;59(1):122-8.##25. Saeedi H, Nasab S-HM, Zadeh AM, Ebrahimi HA. The effectiveness of positive psychology interventions with Islamic approach on quality of life in females with multiple sclerosis. Biomedical and Pharmacology Journal. 2015;8(2):965-70.##26. Rezaei M, Fatemi NS, Givari A, Hoseini F. Relation between prayer activity and spiritual well-being in cancer patients undergoing chemotherapy. Iran Journal of Nursing. 2007;20(52):51-61.##27. Aghajani M, Afaze MR, Morasai F. The effect of spirituality counseling on anxiety and depression in hemodialysis patients. Evidence based care. 2014;3(4):19-28.##28. Amundsen DW. Medicine, society, and faith in the ancient and medieval worlds. 1996.##29. Meraviglia MG. Critical analysis of spirituality and its empirical indicators: Prayer and meaning in life. Journal of Holistic Nursing. 1999;17(1):18-33.##30. Emannezhad M, Tavan H, Taghinezhad H, K M. Measuring spiritual health of Nursing and Midwifery University of Medical Sciences students from the Islamic perspective. Journal of School of Nursing and Midwifery, martyr Beheshti University of Medical Sciences and Health Services. 2011;23(80):25-33.##31. Fazel Asgarpoor A, Amini Z, Zeraati A, H E. The impact on fatigue care plan based on the Roy Adaptation Model hemodialysis patients. Nursing and Midwifery, Mashhad. 2011;1(1):77-90.##32. Fawcett J, Desanto-Madeya S. Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories: FA Davis. 2012.##33. Sundaram R. Hand book of sign & symptom. Lippincott Williams Swilkins; 2006.##34. Sadeghnezhad Forotaghe M, Vanaki Z, Memarian R. The effect of nursing care plan based on “Roy Adaptation model” on psychological adaptation in patients with diabetes type II. Evidence Based Care. 2011;1(1):5-20.##35. Fazel Asgarpoor A, Amini Z, Zeraati A, Esmaeli H. The effect of a care plan based on the Roy Adaptation Model on level of Fatigue in hemodialysis patients. Evidence Based Care. 2011;1(1):77-90.##36. Naeim Hassani S, Tabiee S, Saadatjoo S, T K. he effect of an educational program based on Roy adaptation model on the psychological adaptation of patients with heart failure. Mod Care J. 2014;10(4):231-40.##37. Maghsoudi E, Pak MHM, Zareei F, Rashid SP, Sofiyani A, Shahidi L. The effect of care plan application based on Roy adaptation model on the self-efficacy in elderly people in urmia nursing homes. Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2015;6(1):793-9.##38. Li C. Breast cancer epidemiology: Springer; 2010.##39. Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, et al. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal. 2004;170(12):1795-801.##40. Droste SK, Gesing A, Ulbricht S, Müller MB, Linthorst AC, Reul JM. Effects of long-term voluntary exercise on the mouse hypothalamic-pituitary-adrenocortical axis. Endocrinology. 2003;144(7):3012-23.##41. Koohestani H, Baghcheghi N. Burn out in caregivers of patients with stroke and its related factors. 2012.##42. Branch M. Spirituality in nursing: standing on holy ground. ABNF Journal. 1999;10(6):136.##43. Mauk KL, Schmidt NA. Spiritual care in nursing practice: Lippincott Williams & Wilkins; 2004.##44. P Y. Epidemiology of common diseases in Iran. Ministry of Health and Medical Education of the country. 2016;3:39.##45. Hill PC, Hood RW. Measures of religiosity: Religious Education Press Birmingham, AL; 1999.##46. A M. The Effect of Educational Program based on the Roy’s Adaptation Model on Quality of Life in Patients with Heart Failure Hospital Khatam city of Shushtar in 1394 2016.##47. Karaöz S. Turkish nursing students’ perception of caring. Nurse education today. 2005;25(1):31-40.##48. Organization WH, Cancer IAfRo. GLOBOCAN 2008 (IARC) Section of Cancer Information. Acedido em Maio. 2012;29.##49. Sadjadi A, Hislop TG, Bajdik C, Bashash M, Ghorbani A, Nouraie M, et al. Comparison of breast cancer survival in two populations: Ardabil, Iran and British Columbia, Canada. BMC cancer. 2009;9(1):381.##50. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA: a cancer journal for clinicians. 2011;61(2):69-90.##51. Aboulhasani F, Khayamzadeh M, Moradi Laleh M, Jamali A, Salmanian R, M N. The calculation of breast cancer burden in Iran in 2003 and its comparison with the Eastern Mediterranean region in 2002. Quarterly Journal of Monitoring (Payesh).233-41.##52. Organization WH. Guidelines for the early detection and screening of breast cancer. 2006.##53. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. Jama. 2001;286(3):327-34.##54. Tyrer J, Duffy SW, Cuzick J. A breast cancer prediction model incorporating familial and personal risk factors. Statistics in medicine. 2004;23(7):1111-30.##55. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: convergence of incidence rates between black and white women. CA: a cancer journal for clinicians. 2016;66(1):31-42.##56. Tirona MT, Sehgal R, Ballester O. Prevention of breast cancer (part I): epidemiology, risk factors, and risk assessment tools. Cancer investigation. 2010;28(7):743-50.##57. Anderson BO, Braun S, Lim S, Smith RA, Taplin S, Thomas DB. Early detection of breast cancer in countries with limited resources. The breast journal. 2003;9(s2).##58. Amiri P, & et al. Psychometric evaluation of comprehensive spiritual health questionnaire in Iranian society. Medical Ethics Journal. 2014;8(30):25-56.‎ [Persian]##59. Mesbah M, Islamic approach to spiritual health. Tehran: Hoghooghi Publication. 2013.##60. Rahimi A, Concept of spirituality: a conventional content analysis. Journal of Qualitative Research in Health Sciences. 2013 Jun 15;2(1):11-20. [Persian]##61. Selman L, Young T, Vermandere M, Stirling I, Leget C. Research priorities in spiritual care: An international survey of palliative care researchers and clinicians. Journal of Pain and Symptom Management. 2014 Oct 1;48(4):518-31.##62. Abbasi M, Azizi F, Shamsi Goshki E, Nasseri Rad M, Akbari Lakhe M. Conceptual Definition and Health Operations. Medical Ethics Journal. 2012;6(20):11-44.‎ [Persian]##63. Rastgar AA, Farhangi AA. The Presentation and Clarification. Commercial Strategies.2007;1(20): 1-24. [Persian]##64. Jafari HA, Rastegar AA. The emergence of spirituality in organizations: Concepts, Definitions, Presumptions and Conceptual Model. Journal of Management Sciences in Iran.2007; 2(5): 99-121. [Persian]##65. Omidvari S. Spiritual Health; Concepts and Challenges. Interdisciplinary Quaranic Studies. 2008;1(1):117. [Persian]##66. Vader JP. Spiritual health: the next frontier. The European Journal of Public Health.2006;16(5): 457.##67. Taylor EJ. Petersen C, Oyedele O, Haase J. Spirituality and Spiritual Care of Adolescents and Young Adults with Cancer. Seminars in Oncology Nursing.2015; 31(3): 227-41.##68. Safayi RI, Karimi L, Shomoossi N, Ahmadi TM. The relationship between spiritual well-being and mental health of university students. 2010; 17(4): 274-280. [Persian]##69. Dehshiri G, Sohrabi Asromud F, Jafari I, Najafi M. Studying Psychometric Properties of Spiritual Well-being Scale among Students. 2008; 4(3): 129-144. [Persian]##70. Marandi A, Azizi F. The Problem of Status, Definition and Difficulties in Establishing the Concept of Spiritual Health in Iranian Iranian Society. Medical Ethics Journal. 2010;4(14):11-22.‎ [Persian]##71. Miller MA. Culture, spirituality, and women's health. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 1995;24(3): 257-64.##72. Ross L. Spiritual care in nursing: an overview of the research to date. Journal of clinical nursing. 2006 Jul 1;15(7):852-62.##73. Dehghan Naeiri N, FJ. Theory and theories of nursing‬. Tehran: Hakimhidji; 2015: 328.##74. Gholamzadeh S, MH. Application of Roy's adaptation model in patient care. Tehran: Salemi; 2006. 142.##75. Amini Z, Fazel Asgharpour A, Zaraati A, H E. The effect of care plan based on the ROY adaptation model on activities ofdaily living of hemodialysis Patients. Journal of North Khorasan University of Medical Sciences. 2012;4(2):145- 53.##76. Afrasiabifar A, Karimi Z, Hassani P. Roy’s Adaptation Model-Based patient education for promoting the adaptation of hemodialysis patients. Iranian Red Crescent Medical Journal. 2013;15(7):566.##77. Borzou R, Khan Mohammadi S, Falahinia GH, Mousavi S, Khalili Z. Effects of roy’s adaptation model in nursing practice on the quality of life in patients with type II diabetes. Journal of Nursing and Midwifery Sciences. 2015;2(4):1-7.##78. Mohammadpour A, Njafi S, Tavakolizadeh J, FM. The effect of intervention based on “Roy” adaptation model on personal self-concept in primi-gravida women. Journal of Sabzevar University of Medical Sciences. 2016; 22(6):999-1007.##79. Hamzehpor H, Valei S, Majedi MA, Roshani D, J S. Effect of Roy adaptation model in physiologic aspect on the level of consciousness in intensive care unit: a clinical trial. Scientific Journal of Kurdistan university of medical sciences. 2018:1-12.##80. Akyil RÇ, Ergüney S. Roy's adaptation model‐guided education for adaptation to chronic obstructive pulmonary disease. Journal of advanced nursing. 2013;69(5):1063-75.##81. Ursavaş FE, Karayurt Ö, İşeri Ö. Nursing approach based on Roy Adaptation Model in a patient undergoing breast conserving surgery for breast cancer. The journal of breast health. 2014;10(3):134.##82. Apay SE, Pasinlioglu T. Using Roy’s Model to Evaluate the Care Given to Postpartum Women Following Caesarean Delivery. Open Journal of Nursing. 2014;4(11):784.##83. Rosińczuk J, Kołtuniuk A. Zastosowanie modelu adaptacyjnego Callisty Roy w opiece nad chorym ze stwardnieniem rozsianym–opis przypadku. Pielęgniarstwo Neurologiczne i Neurochirurgiczne. 2015 Dec 22(3).##84. Serçekuş P, Mete S. Effects of antenatal education on maternal prenatal and postpartum adaptation. Journal of advanced Nursing. 2010;66(5):999-1010.##85. Malekpoor M, Farahani H, Aghaei A, Bahrami A. Effect life skill education on decrease stress in mothers of mental retardation and usual children. Res Except Child. 2006;20(2):661-76.##86. Mousa Lotfi SM, Gholamrezaii Sh, Raiesi F, F H. The Role of Spiritual Health on Human Mental Health. Journal of Science and Health. 2010;5:204-.##87. Mousa-zadeh E, Mohsenpour M, NH. Effect of spirituality and spiritual wellbeing on life quality. The Journal of research committee students at Sabzevar University Of Medical sciences. 2013;18(2):14-20.##88. Zimmer Z, Jagger C, Chiu C-T, Ofstedal MB, Rojo F, Saito Y. Spirituality, religiosity, aging and health in global perspective: A review. SSM-population health. 2016;2:373-81.##89. Akhbardeh M. Role of spiritual beliefs and prayer in health promotion of chronic patients: A qualitative study. Quran and Medicine. 2011;2011(1, Summer [En]):5-9.##90. mohamad karimi m, shariatnia k. Effectivenness of spiritual therapy on the life quality of the women with breast cancer in Tehran. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2017;15(2):107-18.##91. Alimohammadi N, Taleghani F, Mohammadi E, Akbarian R. The nursing metaparadigm concept of human being in Islamic thought. Nursing inquiry. 2014;21(2):121-9.## ##

The effect of stress management on general health and stress status of hospitalized patients after MI in Mostafa Khomeini hospital of Ilam during 2016 بررسی تاثیر روش های مقابله با استرس بر سلامت عمومی و استرس بیماران پس از MI بستری دربیمارستان شهید مصطفی خمینی ایلام سال96 2 1 با توجه به اینکه آنفارکتوس حاد میوکارد از شایع‌ترین بیماری‌های قلبی و عروقی می‌باشد و سالانه باعث مرگ بیش از 4/2 میلیون نفر در آمریکا، 4 میلیون مرگ و میر در اروپا و شمال آسیا، بیش از یک سوم مرگ و میر در کشورهای توسعه یافته می‌گردد. در سال 2010 بیش از یک میلیون نفر به دلیل آنفارکتوس میوکارد در ایالت متحده آمریکا بستری شده‌اند که برآورد شده هزینه اقتصادی آن حدود 450 میلیارد دلار در آمریکا است(1). علاوه بر هزینه‌های اقتصادی بستری شدن در بیمارستان، بیماران معمولاً بعد از سکته قلبی دوره‌هایی از افسردگی، اضطراب و استرس پس از سانحه و همچنین دچار مشکلاتی در انجام فعالیت‌های روزانه می‌شوند که می‌تواند بر کیفیت زندگی این بیماران تاثیر بگذارد(2). به عقیده برخی پژوهشگران و صاحب نظران بیماری‌های قلبی در سنین پایین در ایران بیش از پیش رو به افزایش نهاده است. که می‌تواند به دلیل شرایط پر استرس و تنش‌زای جوامع کنونی باشد. استرس و تنش‌های روانی اجتماعی، عامل خطر مستقل از جنس، سن و سایر ریسک فاکتورهای کلاسیک جسمانی بیماری‌های قلبی هستند که از طریق مکانیسم‌های روانی_ عصبی_ فیزیولوژیک و تحریک سیستم عصبی خودکار به ویژه بخش سمپاتیک، واکنش‌های قلبی عروقی را افزایش داده و به بروز یا تداوم بیماری‌های قلبی عروقی کمک می‌کنند(3). در طی هفته‌ها و ماه‌ها پس از سندرم حاد کرونری، اغلب بیماران با مرگ یا ناتوانی ناشی از بروز مجدد حوادث قلبی مواجه می‌شوند. بروز سکته مجدد پس از سکته اول در 6 ماهه اول شایع است، 30 درصد از این مرگ و میر در 30 روز اول پس از سکته قلبی رخ می‌دهد. بیماران معمولاً فعالیت‌های معمول آنان محدود شده و در نتیجه سکته قلبی نه تنها راحتی بیمار را تحت تاثیر قرار می‌دهد بلکه ارتباطات اجتماعی، الگوهای معمول زندگی، شغل و سطح درآمد وی را نیز متاثر می‌سازد(4).  بروز علائم اضطراب پس از سکته قلبی یک مشکل روانشناختی بسیار شایع است که اثرات منفی بر پیش آگهی این بیماران دارد. شواهد نشان می‌دهد که در اثر تجربه سکته قلبی به عنوان استرس عمده و در نتیجه افزایش سه برابر ریسک ابتلاء به  PTSD ، این بیماران در مقایسه با افراد سالم سه برابر بیشتر علائم استرس و اضطراب را تجربه می‌کنند. بیماران سکته قلبی ممکن است طیفی از آشفتگی‌های پس از تروما راتجربه نمایند که موجب توسل به مقابله‌های غیر انطباقی شود(5). مطالعات نشان می‌دهد استرس به تنهایی نمی‌تواند بیماری قلبی را در افراد پیش بینی کند، بلکه استرس با نقش واسطه‌ای راهبردهای مقابله‌ای ناکارآمد می‌تواند یک عامل پیش بین برای بیماری‌های قلبی باشد. روانشناسان سلامت راهبردهای مقابله‌ای را به عنوان واسطه بین استرس و بیماری معرفی کرده‌اند. راهبردهای مقابله‌ای به تلاش‌های شناختی و رفتاری جهت پیشگیری، مدیریت و کاهش تنیدگی و استرس اشاره دارند که افراد در موقعیت‌های استرس‌زا از آنها استفاده می‌کنند. مقابله جستجوی حمایت اجتماعی کارآمد، مقابله مبتنی بر برنامه‌ریزی، مقابله فعال و مقابله بردبارانه در قالب راهبردهای مقابله‌ای مسئله محور گنجانده می‌شود. پژوهش‌ها نشان داده که بیماران قلبی در مقایسه با افراد سالم به طور معنی‌داری از راهبردهای ناکارآمدتر مقابله با استرس استفاده می‌کنند(6). مقابله جهت مدیریت استرس در بیماران قلبی به روش‌هایی اطلاق می‌گردد که برای کاهش استرس تجربه شده توسط افراد یا افزایش توانایی آنها در مقابله با استرس‌های زندگی به‌کار گرفته می‌شوند.این مداخلات بیشتر برای افرادی ایجاد شده است که با استرس ناشی از بیماری‌های مزمن و جسمی مانند بیماری‌های قلبی دست و پنجه نرم می‌کنند.استرس علاوه بر این که یکی از عوامل خطرساز بیماری‌های قلبی و عروقی می‌باشد، تلاش برای غلبه بر آن نیز پاسخ‌های فیزیولوژیکی و روانشناختی را ایجاد می‌کند که نتیجه آن به وجود آمدن مشکلات مربوط به سلامتی و اختلال در سلامت عمومی افراد می‌باشد، سلامت عمومی، وضعیت سلامت فرد از نظر جسمانی و روانی می‌باشد و مجموعه علائم جسمانی، اضطراب و بی خوابی، اختلال در کنش اجتماعی و افسردگی را در بر ‌می‌گیرد(7). نتایج برخی پژوهش‌ها نشان داده است که مقابله‌های هیجانی و ناکارآمد در مواجهه با استرس منجر به افزایش تنیدگی گردیده و در نتیجه موجب افزایش واکنش‌های قلبی- عروقی در بیماران می‌شود. اصولاً در بیمارانی که مبتلا به شکل مزمنی مثل ضایعه عروق کرونر هستند، درمان قطعی بیماری یک هدف واقعی و دست یافتنی تلقی نمی‌شود، چرا که این بیماری ناتوان کننده بوده، عوامل متعدد بیرونی و درونی بر تشدید و بهبود آن موثر می‌باشد. پژوهش ها نشان داده است که کاربرد برخی از تکنیک‌های مدیریت استرس از طریق کاهش فشار خون توان انقباض عروقی را کاهش داده و موجب بهبود عملکرد قلب می‌گردد. به نظر می‌رسد که آموزش راه‌های مقابله با استرس با کاهش حالات خلقی منفی و انزوای اجتماعی، کیفیت زندگی و سلامت عمومی را ارتقاء می‌دهد که خود ممکن است منجر به کاهش سطح هورمون‌های استرس و بهبود عملکرد سیستم ایمنی شود(8).    2 Abstract Background and objective: Stress is one of the risk factors for cardiovascular disease and can a reduce general health and stress in cardiac patients. The purpose was to analyze the effectiveness of stress management strategies on general health of patients with myocardial infarction. Materials and Methods: Eighty six patients were selected through random sampling from internal, heart and CCU wards of ShahidMostafa Hospital in Ilam. They were randomly divided into two experimental (43) and control (43) groups. The intervention was conducted through face-to-face training sessions during three sessions and a booklet was provided as well. Cohen questionnaire (14 questions) and GHQ questionnaire (28 questions) were completed in two stages of pre-test and post-test by the members of the two groups. SPSS version 22 was used to analyze the samples. Findings:  In the mean score of stress and general health one month after intervention, the mean score of the intervention group was significantly reduced compared to the control group (P<0.05). This finding persists in the quarterly follow up Conclusion: Stress coping training can reduce the stress and general health of patients after MI Ether. This type of training is recommended as part of the comprehensive treatment and care of patients after MI. 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/262017/10/27 1396/8/5 2005/06/252009/10/302014/03/12017/01/162017/09/152017/12/2 1396/9/11 سمیرا روحی صفایی samira rohi safaee ایران معصومه شوهانی Masoumeh Shohani گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران msh282000@gmail.com Myocardial Infarction Stress Stress Management strategies General Health. 1) Reed Gw, Rossi Je.Acut myocardial infarction.lancet 2017, 389:197-210.##2)Wachelder E.M, Moulaert V.R ,Heugten C. Dealing with a life changing event: The influence of spirituality and coping style on quality of life after survival of a cardiac arrest or myocardial infarction. Europen Resuscitation council.2016؛ 69(37):1-6.##3)Pahlavian A, Gharakhani M, Mahjob H.Comparison of stress and coping strategies in patients with coronary artery Disease and healthy people. Journal of Hamadan University of Medical Sciences&Health Services.2010؛ 17(3):33-39.##4)Niakan M, Pariad E, Shaikholeslami F.Self care behaviors in pationts after myocardial infarction.Comprehensive Nursing&Midwifery.2013؛23(70):63-70.##5) Sararodi R, Marofi M.Coping method in post myocardial infarction patients with anxiety symptoms.Journal of Babol University of medical sciences.2010; 12(3):50-57.##6) Askhari F,Sadeghi A,Mehraban F.Comparison and Relationship between social support dimensions and coping strategies in patients with myocardial infarction and the control group.Journal of shahid sodoughi university of medical sciences.2015;23(4):2127-35.##7) Aminian Z, Mohamadzade SH, Eslami M.The effectiveness of stress coping teaching on quality of life in patients with acute coronary syndrome admitted to selected hospitals of Tehran university of medical sciences in the year.Journal of Islamic Azad University.2013;24(3):168-174.##8) Jabalameli SH, Haidari H, Mostafavi S.The Effectiveness of cognitive-Behavioral stess Management on General health of cardiac patients.Special psychiatric Disorders.2011;4(5):475-80.##9)Malekzade M,SHirazi H, Momeninezhad M.Changes in the general health of patients with myocardial infarction.Zahedan Journal of Research in medical Sciencess.2006;23(2):23-28.##10) Namazi A, Alizade SH, Talemi S.The Relationship between General Health, Emotional Intelligence and Academic Achievement in Midwifery Students. Clinical Journal of Nursing and Midwifery.2015; 4(2):20-28. ##11) Davazdahemami M, Roshan R, Mehrabi A, Atari A. The Effectiveness of Congnitive-Behavioral Stress Management Training on Control of Blood Glucose and Adrenal Gland in Type 2 Diabetic Patients. Iranian Journal of Endocrinology and Metabolism. 2009; 11(4):385-392.## ##12)Svensson TH, Inoue M, Sawada N, Yamahishi K. Coping Strategies and Risk of Cardiovascular Disease Incidence and Mortality: The Japan Public Health Center-Based Prospective Study. European Heart Journal. 2016; 37:890-899.##13) Blumental J, Sherwood A, Babyak M. Effects of Exercise and Stress Management Training on Markers of Cardiovascular Risk in Patients with Ischemic Heart Disease. American Medical Association. 2005; 293(13):1626-1634.##14)SHidfar M.R, SHojaeizade D, Hosseini M, Asasi N.Knowledge Attitude and Life Style of Patients with Unstable Angine in University Hospitals in Mashhad Iran. Department of Public Health Sevices, School of Public Health and Institute reaserch. 2003; (2)2.##15) Sharma M, Rush S. Mindfulness-Based Stress Reduction As a Stress Management Intervention for Healthy Individuals: A Systematic Review. Journal of Evidence Based Complementary & Alternative Medicine. 2014; (1)16.##16) Falahi T, Miri M. The Effect of E-Learning on Health Literacy Dimensions in Patients with Ischemic Heart Disease. Research Analytical Journal of Aligodarz Nursing Faculty. Nursing Development in Health 2017; (8)1:29-36.##17) Edwall L. The regular check-up with the diabetes nurse specialist The meaning of the care meeting for persons with type 2 diabeInstitute of Health and Care Sciences, the Sahlgrenska Academy University of Gothenburg Sweden. 2011.##18) Harrison.Cardiovascular diseases, Principles of Internal Medicine, 19th edition, 2015.##18)Rahimi E, Abyar Z, Homam Zakeri langroudi A. Comparison of General health, Mental Health and Coping Strategies in Patients with Diabetes type 1 & 2 and Patients with Multiple Sclerosis. Health Research Journal. 2016; 2(1):33-41.##19) Khodayaryfard M, Parand A.Stress and Copying Style.Faculty of Psychology and Educational Sciences, University of Tehran. 2006.##20)Mohammadinia N, Rezaei M, Heydarikhayat N. Assessing stressors and coping styles in medical sciences students. Quarterly Journal of Nursing Vision. 2012; 1(1):9-16.##21) Azad Marzabadi E, A´azami Y. Factors Causing Stress from the Perspective of Quran and Hadith. Journal of Military Medicine. 2017; 18(4):299-307.##22) Seyedin H, Goharinezhad S, Vatankhah S. Patient education process in teaching hospitals of Tehran University of Medical Sciences. Medical Journal of the Islamic Republic of Iran.2015; 29(220):1-7.##23) SHidfar M.R, SHojaeizade D, Hosseini M, Asasi N.Knowledge Attitude and Life Style of Patients with Unstable Angine in University Hospitals in Mashhad Iran. Department of Public Health Sevices, School of Public Health and Institute reaserch. 2003; (2)2. ##24) Banihashemian K, Seif M, Moazzen M. Relationship between Pessimism, General Health and Emotional Intelligence in College Students at Shiraz University and Shiraz University of Medical Sciences.Journal Babol University Medical .2009; 11(1):49-56. ##25) Biglar M, Hayati Y, Hojjat R. Study of General Health AmongTehran University of Medical Sciences Hospital’s Administrators. Faculty of Para medicine, Tehran University of Medical Sciences. 2014; 8(1):13-24.##26) Khodayaryfard M, Parand A.Stress and Copying Style.Faculty of Psychology and Educational Sciences, University of Tehran. 2006. ##27)Kholamijam F,Khaftan P,Aghlima M,Sepiddam M. Stress coping techniques and their impact on health promotion.Social Work Quarterly.2015;4(3):18-27.##28) Karami F, Dekhaghele A, Zahrapour M.Factors Affecting the Stress of Tehrani Citizens. Center for Student Thinking in Iran (ISPA).2005, 4(2):91-106.##29) Kiani R, Soudani M, Masoudseidian S. The Effectiveness of Stress Inoculation Group Training on the General Health of the CoronaryHeart Disease Patients in Ahwaz. Journal of Applied Environmental and Biological Sciences. 2014, 4(8)128-134.##30) Taylor R.Cognitive Behavioral Therapy for chronic Illness and Disability.health psychology.2013; 24(6):465-463.##31)Moulaert V, Verbunt J, Heugten C. Activity and Life After Survival of a Cardiac Arrest (ALASCA) and the effectiveness of an early intervention service: design of a randomised controlled trial. BioMed Central. 2007, 7:26.##32) Memarian S, Azaraeen S, Sadri Koupaei M. The Relationship between Stress Coping Strategies and Mental Health in Patients with Cardiovascular Disorders.Journal of Applied Environmental and Biological Sciences. 2015, 5(11S) 869-873.##33) DiGuilio M, Jackson D, Medical-Surgical Nursing Demystified.2016,1-98.##34)Chi Chiang L, Ma W, Huang J. Effect of relaxation-breathing training on anxiety and asthma signs/symptoms of children with moderate-to-severe asthma: A randomized controlled trial.International Journal of Nursing Studies. 2009, 46:1061-1070.##35) Abolghasemi A, Zahed F, Narimani M. A survey on the association of association and personality type in people with D Coronary artery .Disease.Journal of Mental Health. 2009, 3(43):213-222.##36) Hamidizade S, Ahmadi F, Asghari M.The Effect of Relaxation Technique on Anxiety and Stress in Elderly People with High Blood Pressure. Journal of Shahrekord University of Medical Sciences. 2006, 8(2):45-51.##37) Rasuli SH, Moghtader L. Comparison of Copying Strategies with Stress and Resiliece and Optimin Normal People and Heart Patients. The Journal Urmia Nursing Midwifery Faculty. 2017, 15(9):704-712.##38) Kato N, Kinugawa K, Yao A. Relationship of Depressive Symptoms with Hospitalization and Death in Japanese Patients with Heart Failure. Journal of Cardiac Failure.2009, 15(10):912-919.##39) Maleknia N, Kahrazei F. The Relationship between Stress Coping Styles and Quality of Life among Patients with Breast Cancer. Journal of Midwifery & Reproductive health.2015, 3(4):472-478.##40) Gheisari Z, Beiranvand R, KariRelationship between Occupational Stress and Cardiovascular Risk Factors Determination: A Case- control Study. Journal of Research in Medical and Dental Science.2018, 6(3):287-293.##41) Roohafza H, Talaei M, Pourmoghaddas Z. Association of social support and coping strategies with acute coronary syndrome: A case—control study. Journal of Cardiology. 2012, 59:154-159.##41)Khayrjo E, Taher M, Farshbafmanisefat F. Comparison of tolerance of ambiguity, psychological capital and coping styles of cardiac patients Healthy people. Journal of Shahid Madani University of Urmia.2016, 5(18):141-152.##42) Afshani A, Gharoni M, Faghi S. The effect of progressive muscle relaxation on hypertension in elderly patients with myocardial infarction. Iranian aging Journal.2007, 2(5):352-357.##43)Arefnasab Z,Ghanei M,Noorbala A,Alipor A. Correlation of Spirometry and Health- Related Quality of Life with Mental Health in Respiratory Chemical Damaged Veterans. J Mazand Univ Med Sci 2013; 23(107): 49-56.##44) Soltanishal R, Aghamohammadian H, Kareshki H.Emotional intelligence with perceived stress mediation and coping strategies D the role of personality type in the quality of life of heart patients. Monthly Journal of Kermanshah University of Medical Sciences. 2013, 17(7):449-459.##45)Nazifi M,Mokarami H,Akabaritabar A. Reliability, Validity and Factor Structure of the Persian Translation of General Health Questionnaire 28 Questions in Hospitals affiliated to Kerman University of Medical Sciences. Journal of Fasa University of Medical Sciences.2013;3(4):336-42.##46) Ginzburg K.Comorbidity of PTSD and depression following myocardial infarction.2006, 94(1-3):135-143.##47)Bluanes E, Gramstad A, Kjellsdotter Sovig K. Cognitive function and health-related quality of life four years after cardiac arrest.Resuscitation 89. 2015:13-18.##48)Muller J,Hess J,Hager A.Minor Symptoms of depression in patients With congenital heart disease have a larger impact on qualityof life than limited exercise capacity.2012,154(3):265-269.##49) Whalley B, Rees K, Davies P.Psychological interventions for coronary heart disease (Review). London School of Hygiene & Tropical Medicine.2011. ##50) Khodayaryfard M, Parand A.Stress and Copying Style.Faculty of Psychology and Educational Sciences, University of Tehran. 2006. ##51) Blumenthal JA, Sherwood A, Babyak MA, Watkins LL, Waugh R, Georgiades A, et al. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial. JAMA 2005; 293(13): 1626-34.##52) Trzcieniecka-Green A, Steptoe A. The effects of stress management on the quality of life of patients following acute myocardial infarction or coronary bypass surgery. Eur Heart J 1996; 17(11): 1663-70.##53) Ai AL, PetersonC, Bolling SF. Psychological recovery from coronary artery bypass graft surgery: The use of complementary therapies. The Journal of Alternative and Complementary Medicine 1997; 3(4): 343-53.##54) Antoni MH, Ironson G, Schneiderman N. Cognitive-Behavioral Stress Management. New York: Oxford University Press; 2007.##55) Walton KG, Schneider RH, Salerno JW, Nidich SI. Psychosocial stress and cardiovascular disease. Part 3: Clinical and policy implications of research on the transcendental meditation program. Behav Med 2005; 30(4): 173-83##56) Shojai Tehrani H, editor. Textbook of preventive and social medicine, general health services. 2nd ed. Tehran: Samt; 2013.##57) CHobforoush zadeh A, Kalantari M, Molavi H. The effectiveness of cognitive behavioral therapy on quality of life in infertile women. Journal of Clinical Psychology 2009; 4: 85-88.##58) Antoni MH, Ironson G, Schneiderman N, editors. Cognitive-behavioral stress management. New York: OxfordUniversity Press; 2007.##59) Aggarwal, B., Liao, M., Allegrate, P., Mosca, L.Low Social Support Level is Associated with Non- Adherence to Diet at 1 Year in the Family Intervention Trial for Heart Health (FIT Heart). Journal of Nutrition Education and Behavior, (2010), 42:381-388.##60) Aliakbari Dehkordi, M., Salehi, Sh., &Rezayi, A. The compare irrational beliefs and defensive styles in between coronary heart diseaseand ordinary people. HealthPsychology. (2013), 2(2): 18-32.##61) Ruo B, Bertenthal D, Sen S, Bittner V, Ireland CC, Hlatky MA. Self-rated health among women with coronary disease: depression is as important as recent cardiovascular events. Am Heart J. 2006. 152(5). ##62) Besharat MA, Pourang P, Sadeghpour Tabaee A, Pournaghash Tehrani S. The relationship between coping styles and psychological adaptation in the recovery process: patients with coronary heart disease. Tehran Univ Med J 2008; 66 (8): 573-79.##63) Hsanpour-Dehkordi A, Nazari AA, Heidar-Nejad MS, Asadi-Noghabi AA, Forouzandeh N, Kasiri KA. Factors influencing quality of life in patients with myocardial infarction. Ira Nursing 2009; 22(57): 43-5##64) Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF. Robinson DS, Ketcham AS, et al. How coping mediates the effect of optimism and distress: A study of women with early stage breast cancer. J Pers Soc Psychol 2008; 65(2): 375-90.##65) Pourang PA, Besharat MO. An investigation of the relationship between coping styles and psychological adaptation with recovery process in a sample of coronary heart disease patients. J Procedia - Social and Behavioral Sciences. 2011;30:171-5.##.## ##

Comparison of outcomes of insulin therapy مقایسه پیامدهای انسولین درمانی (رضایت از روش درمان، هیپوگلیسمی، درد زمان تزریق، پیروی از درمان) در بیماران دیابتی استفاده کننده از قلم انسولین با تزریق انسولین توسط سرنگ 2 1 مقایسه پیامدهای انسولین درمانی (رضایت از روش درمان، هیپوگلیسمی، درد زمان تزریق، پیروی از درمان) در بیماران دیابتی استفاده کننده از قلم انسولین با تزریق انسولین توسط سرنگ مقایسه پیامدهای انسولین درمانی (رضایت از روش درمان، هیپوگلیسمی، درد زمان تزریق، پیروی از درمان) در بیماران دیابتی استفاده کننده از قلم انسولین با تزریق انسولین توسط سرنگمقایسه پیامدهای انسولین درمانی (رضایت از روش درمان، هیپوگلیسمی، درد زمان تزریق، پیروی از درمان) در بیماران دیابتی استفاده کننده از قلم انسولین با تزریق انسولین توسط سرنگمقایسه پیامدهای انسولین درمانی (رضایت از روش درمان، هیپوگلیسمی، درد زمان تزریق، پیروی از درمان) در بیماران دیابتی استفاده کننده از قلم انسولین با تزریق انسولین توسط سرنگمقایسه پیامدهای انسولین درمانی (رضایت از روش درمان، هیپوگلیسمی، درد زمان تزریق، پیروی از درمان) در بیماران دیابتی استفاده کننده از قلم انسولین با تزریق انسولین توسط سرنگ 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/262017/10/272017/10/27 1396/8/5 2005/06/252009/10/302014/03/12017/01/162017/09/152017/12/22017/12/2 1396/9/11 ساناز اعظمی Sanaz Azami گروه آموزشی آموزش پزشکی، دانشکده مرکز توسعه آموزش پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران aazamisanaz@gmail.com ## ##

Determining the effect of implementing an educational package on quality of life among patients with chronic obstructive pulmonary disease referring to teaching hospitals affiliated with Ilam University of Medical Sciences in 2016 بررسی تأثیر اجرای بسته آموزشی بر کیفیت زندگی بیماران انسداد مزمن ریوی مراجعه کننده به بیمارستان‌های آموزشی وابسته به دانشگاه علوم پزشکی ایلام96-1395 2 1 COPD یک بیماری تنفسی قابل پیشگیری که چهارمین علت مرگ در جهان میباشد و اگر مداخلات مناسب و بهموقع برای این بیماران انجام نگیرد به سومین علت مرگ در سال 2030 خواهد رسید. لذا بر آن شدیم تا تاثیر دو روش پمفلت و فیلم آموزشی را بر کیفیت زندگی بیماران بررسی کنیم.روش کار: پژوهش حاضر مطالعهای نیمه تجربی با دو گروه مداخله میباشد که بر روی 80 نفر از بیماران COPD بستری در بخش داخلی بیمارستان شهدا شهرستان قاین در سال 1395-1396 انجام گرفته است، نمونه گیری به صورت مراجعه مداوم به بخش داخلی بیمارستان شهدا قاین صورت گرفت و مشخصات دموگرافیک قبل از آموزش تکمیل شد، سپس بیماران به صورت تصادفی در دو گروه پمفلت و فیلم آموزشی قرار گرفتند و یک ماه بعد از ترخیص پرسشنامه کیفیت زندگی تکمیل شد. در نهایت اطلاعات حاصل از پرسشنامه ها از طریق نرم افزار Spss ویرایش 14 و طبق آزمونهای T – test و Mann whitney و Wilcoxonو pair T -test مورد تجزیه و تحلیل قرار گرفت.یافته ها. میانگین نمره کل کیفیت زندگی و بعد روانی و جسمانی و تمامی هشت بعد کیفیت زندگی، قبل و بعد مداخله در هر دو گروه فیلم آموزشی و پمفلت اختلاف معناداری نشان دادند 001/0≤Pنتیجه گیری: با توجه به بررسی نتایج پژوهش میتوان دریافت که اجرای آموزش باعث بهبود کیفیت زندگی بیماران COPD میشود؛ بنابراین ضرورت اجرای برنامهای که همه ابعاد سلامتی (جسمی، روانی، اجتماعی و...) را مورد بررسی قرار دهد، مطرح میشود     2 Background: In patients with a Chronic Obstructive Pulmonary Disease(COPD) for which cure is not a realistic goal, maximizing patients’ function and well-being should be a primary objective of care. However, quality of life in COPD patients is lower than normal. Hence well examined the Effect of Educational film On Quality Of Life On Patients With Chronic Obstructive Pulmonary Disease(COPD) Materials and Methods: The present research is a semi-experimental study that conducted 0n 40 individuals in inner ward Qaen Shohada Hospital in 1395-1396 academic year. Sampling done in frequent references to inner ward of the hospital. Life quality questionnaires (Sf-36) and demographic features Before and one month after the discharge completed. Finally the data obtained from questionnaire was analyzed by means of spss software version 20 at a significant level of 0.05 based on Wilcoxone, pair T- test. Results: 21 (52.5%) female and 19 (47.5%) were men with an average age of 62.6. The mean score of total quality of life, physical and mental dimensions, and all eight dimensions of quality of life, before and after intervention, were significantly different. (P کلیدواژه‌ها [English] educational film, life quality, Chronic obstructive pulmonary disease مراجع [1].   Lee Y-M. Chronic obstructive pulmonary Disease: Respiratory review of 2014. Tuberculosis and Respiratory Diseases. 2014;77(4):155-160. [2].   Jokar Z, Mohammadi F, Khankeh HR, Fallah Tafti S, Koushesh F. [Comparing Home- based Pulmonary Rehabilitation Nursing on Fatigue and quality of life in Patients with COPD]. J Fasa Univ Med Sci. 2014; 4(2): 168-176. (in Persian) [3].   Burckhardt CS, Anderson KL. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health Qual Life Outcomes. 2003; 1:60. [4].    Karimzadeh Shirazi M, Razavieh A, Kave M. The relationship between quality of life (QOL) and self – efficacy (SE) of the teachers from Shahrekord Univ Med Sci. 2008; 10(1): 28-35. (in Persian) [5].   Ioannidis C. Quality of life in osteoporosis. The Nursing clinics of North America. 2001; 36(3): 65-69. [6].   Mir Bagheri N, Memarian R, Mohammadi A. Effects of regular walking program on quality of life of elderly patients with moderate chronic obstructive pulmonary disease. Ir J Nurs Research. 2008; 2 (6):19-27. (in Persian) [7].   Salik Y, Ozalevli S, Cimrin AH. Cognitive function and its effects on the quality of life status in the patients with chronic obstructive pulmonary disease (COPD). Arch Gerontol Geriatr. 2007; 45(3):273-80. [8].   Gysels M, Higginson IJ. Access to services for patients with chronic obstructive pulmonary disease: the invisibility of breathlessness. J Pain Symptom Manage. 2008; 36(5):451-60. [9].   Oshvandi K, Kavyannejad R, Borzuo R, Gholyaf M, Salavati M. Dialysis adequacy with high flux membrane in hemodialysis patients at shahid beheshti hospital. Hamedan. J Urmia Nurs Midiwifery Fac. 2012; 10(4): 540-548. (in Persian) [10].Ataee E, Haghjoo M, Dalvandi A, Bakhshandeh H. Effect of self-care education on quality of life among patients whit permanent pacemaker. Cardiovascular Nursing Journal. 2013; 1 (4): 40-47. (in Persian) [11].Anton M, Michetti V, Palma AD, Conti G, Pennis MA, Arcangel A, et al. percutaneous Tran‘s laryn geal Versuus surgical tracheostomy: arandomized trial with on year double blind follow – up. Crit can Med. 2005; 33(5): 1015-1020. [12].Wagner D, Bear M. Patient satisfaction with nursing care: a concept analysis within a nursing framework. J Adv Nurs. 2009; 65(3): 692-701. [13].Bagheri H, Memarian R, Elhani F. Survay the effect of group counselling on quality of life in myocardial infarction patient who have been referred to the clinics of Emam Khomeini and shariati Hospital in Tehran. Hakim Research Journa. 2004; 4(6): 95-98. (in Persian) [14].Oterhals K, Hanestad BR, Eide GE, Hanssen TA. The relationship between in-hospital information and patient satisfaction after acute myocardial infarction. Eur J Cardiovasc Nurs. 2006; 5(4): 303-10. [15]. Bastable SB. Nurse educator, principles of teaching and learning for nursing ractice. Boston: Jones and Bartlett; 2003; 513-546. [16].Braz-Pardenjani SH, Mohammadi E, Boroumand B. The Effect of Self-Care Teaching by Video Tape on Physical Problems and Quality of Life in Dialysis Patients. IJN. 2008; 21(54):121-133. (in Persian) [17].Abbaszade F, Baghery A, Mehran N. Quality of Life among Pregnant Women. Hayat. 2009; 15 (1): 41-48. (in Persian) [18].Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): translation and validation study of the Iranian version. Quality of life. 2005; 14: 875-882. (in Persian) [19].McKee G. Are there meaningful longitudinal changes in health related quality of life--SF36, in cardiac rehabilitation patients? Eur J Cardiovasc Nurs. 2009; 8(1):40-7. [20].Gholizadeh M, Akrami R, Tadayonfar M, Akbarzadeh R. An evaluation on the effectiveness of patient care education on quality of life of stroke caregivers: a randomized field trial. Journal of Sabzevar University of Medical Sciences. 2016; 22(6): 955-964. (in Persian) [21].Javadi M, Sepahvand M J, Suri A, Mahmudi H. The effect of life skills training on quality of life in nurses of khorramabad hospitals. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2013; 21(1): 32-42. (in Persian) [22].Narimani K. A Study of the effect of self-care training on the hemodialysis patients’ quality of life. Daneshvar Med. 2009; 16(79): 63-70. (in Persian) [23].Vatandoust S, Mohammadi N, Farahani M, Mehran A. The efficacy of education film on quality of life and satisfaction in patient with tracheostomy. Arak University of Medical Sciences Journal. 2015; 17(11): 80-87. (in Persian) [24].tavafian S S, Jamshidi A, shahmohammadi S. Low back pain educational programs and quality of life in women living with chronic low back pain: a semi experimental study. Iran J Health Educ Health Promot. 2014; 2 (1) :49-56 [25].Mostafavi S, Heidari H, Masoudi S, Saeidi M. Effects of a comprehensive cardiac rehabilitation program on quality of life in patients with coronary artery disease. ARYA Atheroscler. 2013; 9(3): 179-85. (in Persian) [26].Jani M, Razm-Ara M, Safapoor M, Miralijani S, Miri F. The effect of education on quality of life in people with unstable angina. Cardiovascular Nursing Journal. 2017; 5 (4):28-35. (in Persian) [27].Heidari M, Shahbazi S. Effect of Self-Care Training Program on Quality of Life of Elders. IJN. 2012; 25(75): 1-8. (in Persian) [28]. Salimi F, Garmaroudi G, Hosseini S M, Batebi A. Effect of Self–Care Educational Program to Improving Quality of Life among Elderly Referred to Health Centers in Zanjan. JECH. 2015; 2 (2):28-37. (in Persian) [29].Jahanshahi F, Abbasi-Abyaneh N, Ebrahimi-Abyaneh E. Effect of peer education on quality of life in people with heart failure. 2016; 5(2): 38-45. (in Persian) [30].Davoodi A, Rezazadeh H, Somi M H, Rahmani A, Lak Dizaji S, Allah Bakhshian A. Effect of educating self-care program on quality of life in patients with gastric cancer after gastrectomy in Tabriz hospitals. Medical Journal of Tabriz University of Medical Sciences & Health Services. 2012; 34(1):48-55. (in Persian) [31].Arab M, Nassehi A, Borhani F, Abas Zadeh A, Jafari M. The effects of the compliance based education on asthmatic patients’ quality of life. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2012; 20(2):32-42. (in Persian) [32].Shu-Hui Yu, Ai-Min Guo, Xiang-Juan Zhang. Effect of self-management education on quality of life of patients with chronic obstructive pulmonary disease. International Journal of Nursing Sciences. 2014; 1(1):53-57. [33].Al-sheyab N, Gallagher R, Crisp J, Shah S. Peer-led education for adolescents with asthma in Jordan: a cluster-randomized controlled trial. Pediatrics. 2012; 129(1):106-112. [34].Riario S, forza GG, Incorvaia C, et al. Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study. Int J Chron Obstruct Pulmon Dis J. 2009; 4(2): 315-9. [35]. Pitta F, Troosters T, Probst V S, Langer D, Decramer M, Gosselink R. Are ationts with COPD more active after pulmonary rehabilitation?. CHEST. 2008; 134(2); 273-280. [36].Yohannes AM, Connolly MJ. Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease. Clin Rehabil J. 2003; 17(5): 465-71. 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/262017/10/272017/10/272017/10/27 1396/8/5 2005/06/252009/10/302014/03/12017/01/162017/09/152017/12/22017/12/22017/12/2 1396/9/11 مصیب مظفری Mosayeb Mozafari گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران mozafaric@yahoo.com مدینه نادری madineh naderi ایران naderi.m678@gmail.com ساناز اعظمی Sanaz Azami گروه آموزشی آموزش پزشکی، دانشکده مرکز توسعه آموزش پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران aazamisanaz@gmail.com Chronic obstructive pulmonary quality of life treatment آموزش کیفیت زندگی بیماران دارای بیماری انسدادی مزمن ریوی (COPD) Background: In patients with a Chronic Obstructive Pulmonary Disease(COPD) for which cure is not a realistic goal, maximizing patients’ function and well-being should be a primary objective of care. However, quality of life in COPD patients is lower than normal. Hence well examined the Effect of Educational film On Quality Of Life On Patients With Chronic Obstructive Pulmonary Disease(COPD)##Materials and Methods: The present research is a semi-experimental study that conducted 0n 40 individuals in inner ward Qaen Shohada Hospital in 1395-1396 academic year. Sampling done in frequent references to inner ward of the hospital. Life quality questionnaires (Sf-36) and demographic features Before and one month after the discharge completed. Finally the data obtained from questionnaire was analyzed by means of spss software version 20 at a significant level of 0.05 based on Wilcoxone, pair T- test.##Results: 21 (52.5%) female and 19 (47.5%) were men with an average age of 62.6. The mean score of total quality of life, physical and mental dimensions, and all eight dimensions of quality of life, before and after intervention, were significantly different. (P##کلیدواژه‌ها [English]##educational film, life quality, Chronic obstructive pulmonary disease##مراجع##[1]. Lee Y-M. Chronic obstructive pulmonary Disease: Respiratory review of 2014. Tuberculosis and Respiratory Diseases. 2014;77(4):155-160.##[2]. Jokar Z, Mohammadi F, Khankeh HR, Fallah Tafti S, Koushesh F. [Comparing Home- based Pulmonary Rehabilitation Nursing on Fatigue and quality of life in Patients with COPD]. J Fasa Univ Med Sci. 2014; 4(2): 168-176. (in Persian)##[3]. Burckhardt CS, Anderson KL. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health Qual Life Outcomes. 2003; 1:60.##[4]. Karimzadeh Shirazi M, Razavieh A, Kave M. The relationship between quality of life (QOL) and self – efficacy (SE) of the teachers from Shahrekord Univ Med Sci. 2008; 10(1): 28-35. (in Persian)##[5]. Ioannidis C. Quality of life in osteoporosis. The Nursing clinics of North America. 2001; 36(3): 65-69.##[6]. Mir Bagheri N, Memarian R, Mohammadi A. Effects of regular walking program on quality of life of elderly patients with moderate chronic obstructive pulmonary disease. Ir J Nurs Research. 2008; 2 (6):19-27. (in Persian)##[7]. Salik Y, Ozalevli S, Cimrin AH. Cognitive function and its effects on the quality of life status in the patients with chronic obstructive pulmonary disease (COPD). Arch Gerontol Geriatr. 2007; 45(3):273-80.##[8]. Gysels M, Higginson IJ. Access to services for patients with chronic obstructive pulmonary disease: the invisibility of breathlessness. J Pain Symptom Manage. 2008; 36(5):451-60.##[9]. Oshvandi K, Kavyannejad R, Borzuo R, Gholyaf M, Salavati M. Dialysis adequacy with high flux membrane in hemodialysis patients at shahid beheshti hospital. Hamedan. J Urmia Nurs Midiwifery Fac. 2012; 10(4): 540-548. (in Persian)##[10].Ataee E, Haghjoo M, Dalvandi A, Bakhshandeh H. Effect of self-care education on quality of life among patients whit permanent pacemaker. Cardiovascular Nursing Journal. 2013; 1 (4): 40-47. (in Persian)##[11].Anton M, Michetti V, Palma AD, Conti G, Pennis MA, Arcangel A, et al. percutaneous Tran‘s laryn geal Versuus surgical tracheostomy: arandomized trial with on year double blind follow – up. Crit can Med. 2005; 33(5): 1015-1020.##[12].Wagner D, Bear M. Patient satisfaction with nursing care: a concept analysis within a nursing framework. J Adv Nurs. 2009; 65(3): 692-701.##[13].Bagheri H, Memarian R, Elhani F. Survay the effect of group counselling on quality of life in myocardial infarction patient who have been referred to the clinics of Emam Khomeini and shariati Hospital in Tehran. Hakim Research Journa. 2004; 4(6): 95-98. (in Persian)##[14].Oterhals K, Hanestad BR, Eide GE, Hanssen TA. The relationship between in-hospital information and patient satisfaction after acute myocardial infarction. Eur J Cardiovasc Nurs. 2006; 5(4): 303-10.##[15]. Bastable SB. Nurse educator, principles of teaching and learning for nursing ractice. Boston: Jones and Bartlett; 2003; 513-546.##[16].Braz-Pardenjani SH, Mohammadi E, Boroumand B. The Effect of Self-Care Teaching by Video Tape on Physical Problems and Quality of Life in Dialysis Patients. IJN. 2008; 21(54):121-133. (in Persian)##[17].Abbaszade F, Baghery A, Mehran N. Quality of Life among Pregnant Women. Hayat. 2009; 15 (1): 41-48. (in Persian)##[18].Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): translation and validation study of the Iranian version. Quality of life. 2005; 14: 875-882. (in Persian)##[19].McKee G. Are there meaningful longitudinal changes in health related quality of life--SF36, in cardiac rehabilitation patients? Eur J Cardiovasc Nurs. 2009; 8(1):40-7.##[20].Gholizadeh M, Akrami R, Tadayonfar M, Akbarzadeh R. An evaluation on the effectiveness of patient care education on quality of life of stroke caregivers: a randomized field trial. Journal of Sabzevar University of Medical Sciences. 2016; 22(6): 955-964. (in Persian)##[21].Javadi M, Sepahvand M J, Suri A, Mahmudi H. The effect of life skills training on quality of life in nurses of khorramabad hospitals. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2013; 21(1): 32-42. (in Persian)##[22].Narimani K. A Study of the effect of self-care training on the hemodialysis patients’ quality of life. Daneshvar Med. 2009; 16(79): 63-70. (in Persian)##[23].Vatandoust S, Mohammadi N, Farahani M, Mehran A. The efficacy of education film on quality of life and satisfaction in patient with tracheostomy. Arak University of Medical Sciences Journal. 2015; 17(11): 80-87. (in Persian)##[24].tavafian S S, Jamshidi A, shahmohammadi S. Low back pain educational programs and quality of life in women living with chronic low back pain: a semi experimental study. Iran J Health Educ Health Promot. 2014; 2 (1) :49-56##[25].Mostafavi S, Heidari H, Masoudi S, Saeidi M. Effects of a comprehensive cardiac rehabilitation program on quality of life in patients with coronary artery disease. ARYA Atheroscler. 2013; 9(3): 179-85. (in Persian)##[26].Jani M, Razm-Ara M, Safapoor M, Miralijani S, Miri F. The effect of education on quality of life in people with unstable angina. Cardiovascular Nursing Journal. 2017; 5 (4):28-35. (in Persian)##[27].Heidari M, Shahbazi S. Effect of Self-Care Training Program on Quality of Life of Elders. IJN. 2012; 25(75): 1-8. (in Persian)##[28]. Salimi F, Garmaroudi G, Hosseini S M, Batebi A. Effect of Self–Care Educational Program to Improving Quality of Life among Elderly Referred to Health Centers in Zanjan. JECH. 2015; 2 (2):28-37. (in Persian)##[29].Jahanshahi F, Abbasi-Abyaneh N, Ebrahimi-Abyaneh E. Effect of peer education on quality of life in people with heart failure. 2016; 5(2): 38-45. (in Persian)##[30].Davoodi A, Rezazadeh H, Somi M H, Rahmani A, Lak Dizaji S, Allah Bakhshian A. Effect of educating self-care program on quality of life in patients with gastric cancer after gastrectomy in Tabriz hospitals. Medical Journal of Tabriz University of Medical Sciences & Health Services. 2012; 34(1):48-55. (in Persian)##[31].Arab M, Nassehi A, Borhani F, Abas Zadeh A, Jafari M. The effects of the compliance based education on asthmatic patients’ quality of life. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2012; 20(2):32-42. (in Persian)##[32].Shu-Hui Yu, Ai-Min Guo, Xiang-Juan Zhang. Effect of self-management education on quality of life of patients with chronic obstructive pulmonary disease. International Journal of Nursing Sciences. 2014; 1(1):53-57.##[33].Al-sheyab N, Gallagher R, Crisp J, Shah S. Peer-led education for adolescents with asthma in Jordan: a cluster-randomized controlled trial. Pediatrics. 2012; 129(1):106-112.##[34].Riario S, forza GG, Incorvaia C, et al. Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study. Int J Chron Obstruct Pulmon Dis J. 2009; 4(2): 315-9.##[35]. Pitta F, Troosters T, Probst V S, Langer D, Decramer M, Gosselink R. Are ationts with COPD more active after pulmonary rehabilitation?. CHEST. 2008; 134(2); 273-280.##[36].Yohannes AM, Connolly MJ. Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease. Clin Rehabil J. 2003; 17(5): 465-71.##Background: In patients with a Chronic Obstructive Pulmonary Disease(COPD) for which cure is not a realistic goal, maximizing patients’ function and well-being should be a primary objective of care. However, quality of life in COPD patients is lower than normal. Hence well examined the Effect of Educational film On Quality Of Life On Patients With Chronic Obstructive Pulmonary Disease(COPD)##Materials and Methods: The present research is a semi-experimental study that conducted 0n 40 individuals in inner ward Qaen Shohada Hospital in 1395-1396 academic year. Sampling done in frequent references to inner ward of the hospital. Life quality questionnaires (Sf-36) and demographic features Before and one month after the discharge completed. Finally the data obtained from questionnaire was analyzed by means of spss software version 20 at a significant level of 0.05 based on Wilcoxone, pair T- test.##Results: 21 (52.5%) female and 19 (47.5%) were men with an average age of 62.6. The mean score of total quality of life, physical and mental dimensions, and all eight dimensions of quality of life, before and after intervention, were significantly different. (P##کلیدواژه‌ها [English]##educational film, life quality, Chronic obstructive pulmonary disease##مراجع##[1]. Lee Y-M. Chronic obstructive pulmonary Disease: Respiratory review of 2014. Tuberculosis and Respiratory Diseases. 2014;77(4):155-160.##[2]. Jokar Z, Mohammadi F, Khankeh HR, Fallah Tafti S, Koushesh F. [Comparing Home- based Pulmonary Rehabilitation Nursing on Fatigue and quality of life in Patients with COPD]. J Fasa Univ Med Sci. 2014; 4(2): 168-176. (in Persian)##[3]. Burckhardt CS, Anderson KL. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health Qual Life Outcomes. 2003; 1:60.##[4]. Karimzadeh Shirazi M, Razavieh A, Kave M. The relationship between quality of life (QOL) and self – efficacy (SE) of the teachers from Shahrekord Univ Med Sci. 2008; 10(1): 28-35. (in Persian)##[5]. Ioannidis C. Quality of life in osteoporosis. The Nursing clinics of North America. 2001; 36(3): 65-69.##[6]. Mir Bagheri N, Memarian R, Mohammadi A. Effects of regular walking program on quality of life of elderly patients with moderate chronic obstructive pulmonary disease. Ir J Nurs Research. 2008; 2 (6):19-27. (in Persian)##[7]. Salik Y, Ozalevli S, Cimrin AH. Cognitive function and its effects on the quality of life status in the patients with chronic obstructive pulmonary disease (COPD). Arch Gerontol Geriatr. 2007; 45(3):273-80.##[8]. Gysels M, Higginson IJ. Access to services for patients with chronic obstructive pulmonary disease: the invisibility of breathlessness. J Pain Symptom Manage. 2008; 36(5):451-60.##[9]. Oshvandi K, Kavyannejad R, Borzuo R, Gholyaf M, Salavati M. Dialysis adequacy with high flux membrane in hemodialysis patients at shahid beheshti hospital. Hamedan. J Urmia Nurs Midiwifery Fac. 2012; 10(4): 540-548. (in Persian)##[10].Ataee E, Haghjoo M, Dalvandi A, Bakhshandeh H. Effect of self-care education on quality of life among patients whit permanent pacemaker. Cardiovascular Nursing Journal. 2013; 1 (4): 40-47. (in Persian)##[11].Anton M, Michetti V, Palma AD, Conti G, Pennis MA, Arcangel A, et al. percutaneous Tran‘s laryn geal Versuus surgical tracheostomy: arandomized trial with on year double blind follow – up. Crit can Med. 2005; 33(5): 1015-1020.##[12].Wagner D, Bear M. Patient satisfaction with nursing care: a concept analysis within a nursing framework. J Adv Nurs. 2009; 65(3): 692-701.##[13].Bagheri H, Memarian R, Elhani F. Survay the effect of group counselling on quality of life in myocardial infarction patient who have been referred to the clinics of Emam Khomeini and shariati Hospital in Tehran. Hakim Research Journa. 2004; 4(6): 95-98. (in Persian)##[14].Oterhals K, Hanestad BR, Eide GE, Hanssen TA. The relationship between in-hospital information and patient satisfaction after acute myocardial infarction. Eur J Cardiovasc Nurs. 2006; 5(4): 303-10.##[15]. Bastable SB. Nurse educator, principles of teaching and learning for nursing ractice. Boston: Jones and Bartlett; 2003; 513-546.##[16].Braz-Pardenjani SH, Mohammadi E, Boroumand B. The Effect of Self-Care Teaching by Video Tape on Physical Problems and Quality of Life in Dialysis Patients. IJN. 2008; 21(54):121-133. (in Persian)##[17].Abbaszade F, Baghery A, Mehran N. Quality of Life among Pregnant Women. Hayat. 2009; 15 (1): 41-48. (in Persian)##[18].Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): translation and validation study of the Iranian version. Quality of life. 2005; 14: 875-882. (in Persian)##[19].McKee G. Are there meaningful longitudinal changes in health related quality of life--SF36, in cardiac rehabilitation patients? Eur J Cardiovasc Nurs. 2009; 8(1):40-7.##[20].Gholizadeh M, Akrami R, Tadayonfar M, Akbarzadeh R. An evaluation on the effectiveness of patient care education on quality of life of stroke caregivers: a randomized field trial. Journal of Sabzevar University of Medical Sciences. 2016; 22(6): 955-964. (in Persian)##[21].Javadi M, Sepahvand M J, Suri A, Mahmudi H. The effect of life skills training on quality of life in nurses of khorramabad hospitals. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2013; 21(1): 32-42. (in Persian)##[22].Narimani K. A Study of the effect of self-care training on the hemodialysis patients’ quality of life. Daneshvar Med. 2009; 16(79): 63-70. (in Persian)##[23].Vatandoust S, Mohammadi N, Farahani M, Mehran A. The efficacy of education film on quality of life and satisfaction in patient with tracheostomy. Arak University of Medical Sciences Journal. 2015; 17(11): 80-87. (in Persian)##[24].tavafian S S, Jamshidi A, shahmohammadi S. Low back pain educational programs and quality of life in women living with chronic low back pain: a semi experimental study. Iran J Health Educ Health Promot. 2014; 2 (1) :49-56##[25].Mostafavi S, Heidari H, Masoudi S, Saeidi M. Effects of a comprehensive cardiac rehabilitation program on quality of life in patients with coronary artery disease. ARYA Atheroscler. 2013; 9(3): 179-85. (in Persian)##[26].Jani M, Razm-Ara M, Safapoor M, Miralijani S, Miri F. The effect of education on quality of life in people with unstable angina. Cardiovascular Nursing Journal. 2017; 5 (4):28-35. (in Persian)##[27].Heidari M, Shahbazi S. Effect of Self-Care Training Program on Quality of Life of Elders. IJN. 2012; 25(75): 1-8. (in Persian)##[28]. Salimi F, Garmaroudi G, Hosseini S M, Batebi A. Effect of Self–Care Educational Program to Improving Quality of Life among Elderly Referred to Health Centers in Zanjan. JECH. 2015; 2 (2):28-37. (in Persian)##[29].Jahanshahi F, Abbasi-Abyaneh N, Ebrahimi-Abyaneh E. Effect of peer education on quality of life in people with heart failure. 2016; 5(2): 38-45. (in Persian)##[30].Davoodi A, Rezazadeh H, Somi M H, Rahmani A, Lak Dizaji S, Allah Bakhshian A. Effect of educating self-care program on quality of life in patients with gastric cancer after gastrectomy in Tabriz hospitals. Medical Journal of Tabriz University of Medical Sciences & Health Services. 2012; 34(1):48-55. (in Persian)##[31].Arab M, Nassehi A, Borhani F, Abas Zadeh A, Jafari M. The effects of the compliance based education on asthmatic patients’ quality of life. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2012; 20(2):32-42. (in Persian)##[32].Shu-Hui Yu, Ai-Min Guo, Xiang-Juan Zhang. Effect of self-management education on quality of life of patients with chronic obstructive pulmonary disease. International Journal of Nursing Sciences. 2014; 1(1):53-57.##[33].Al-sheyab N, Gallagher R, Crisp J, Shah S. Peer-led education for adolescents with asthma in Jordan: a cluster-randomized controlled trial. Pediatrics. 2012; 129(1):106-112.##[34].Riario S, forza GG, Incorvaia C, et al. Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study. Int J Chron Obstruct Pulmon Dis J. 2009; 4(2): 315-9.##[35]. Pitta F, Troosters T, Probst V S, Langer D, Decramer M, Gosselink R. Are ationts with COPD more active after pulmonary rehabilitation?. CHEST. 2008; 134(2); 273-280.##[36].Yohannes AM, Connolly MJ. Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease. Clin Rehabil J. 2003; 17(5): 465-71. ##

A survey of hospital disaster management in Vali-E-Asr Hospital of Dareshahr during 2016 بررسی میزان آمادگی بیمارستان حضرت ولی عصر (عج) دره شهر در مواجهه با حوادث و بلایا در سال 1396 2 1 مقدمه و هد : بیمارستانها به عنوان یکی از اولین مراکز پذیرش مصدومین به هنگام بروز بلایا، باید از آمتادگی لازم برختوردار باشتند. آمادگی اورژانس بیمارستانها در مقابله با این نوع بلایا لازمه موفقیت آنها در ارائه خدمات باکیفیتت استت. هتدف از ایتن مطالعته ب ررستی وضعیت آمادگی اورژانس مراکز آموزشی درمانی ولیعصر دره شهر در مواجهه با بلایا میباشد. ردادهها از طریق چک لیست پاسخگویی اورژانس بیمارستانهای سازمان جهانی بهداشتت، بصتورت مصاحبه و مشاهده ی مستندات گردآوری شد. تجزیه و تحلیل دادهها با استفاده از شاخصهای مرکزی صورت گرفت. ۶۳ %( و حیطهی مدیریت مواد / نتایج: بیشترین و کمترین میزان آمادگی اورژانسها در برابر بلایا به ترتی در حیطه کنترل و فرماندهی ) ۶ ۶۳ % ارزیابی شد. / و موجودی ) ۷۶ %( بود. بطور کلی میزان آمادگی اورژانس مراکز آموزشی درمانی مورد مطالعه در مقابله با بلایا ۶۳ نتیجه گیری: با توجه به سابقه وقوع بلایا در استان مورد مطالعه و آمادگی خوب مراکز آموزشی درمانی، داشتن برآوردی از منتابع مهتم و ضروری، نگهداری و تعمیر سریع تجهیزات و مقاوم سازی بیمارستانها در ارتقاء آمادگی آنها نقش موثری خواهد داشت. کلمات کلیدی: آمادگی؛ بیمارستان، اورژانس، بلایا، مدیریتی 2 Not all hospitals in Iran have necessity preparation to cope with and reduce financial and moral losses from natural disasters and disaster-prone victims in the country. Evidence suggests that hospitals in Iran are not well prepared to deal with disasters. The aim of this study was to assess the readiness of Valiasr Hospital properness for disasters and disaster-prone events in Darehshahr city. Method: Descriptive cross-sectional study was conducted in Valiasr Hospital, Darehshahr city in 2017. National Health Assessment Tool for assessing hospitals and health centers readiness for accidents and disasters was used to collect data for this study. Data collected were analyzed with SPSS version 18. Results: scores of 9 components: Command and Control11(61.10%), Communication 10(37.04%), Safety and Security 17(51.52%), Triage 16(53.30%), Surge Capacity 13(33.30%), Continuity of Essential services 11(45.83%), Human Resources 25(55.56%), Logistics Management and Supply 17(56.67%), and Post Disaster Recovery 12(44.40%) were assessed. In general, average readiness of Valiasr hospital for natural disasters and disaster-prone events was 48.35%. Conclusion: our result indicated that Valiasr’s Hospital was only moderately prepared for natural disasters at Command and Control component. However, with the others eight component the hospital was not prepared enough to respond appropriately in crisis situations. Even though the city has been designated as disaster-prone zone, the results obtained shown hospitals lack of preparedness for disaster emergencies. Therefore, more planning and attention in this field is necessary. 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/262017/10/272017/10/272017/10/272017/12/26 1396/10/5 2005/06/252009/10/302014/03/12017/01/162017/09/152017/12/22017/12/22017/12/22018/01/27 1396/11/7 حمید تقی نژاد Hamid Taghinejad گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران hamid2005mordad@yahoo.com جلیل عباسی jalil abasi دانشکده پرستاری و مامایی- گروه پرستاری ایران jalil0918@yahoo.com مصیب مظفری Mosayeb Mozafari گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران mozafaric@yahoo.com علی خورشیدی Ali Khorshidi مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران ali_482002@yahoo.com Disasters incidents Hospital preparedness DarehShahr بررسی میزان آمادگی بیمارستان حضرت ولی عصر (عج) دره شهر در مواجهه با حوادث بلایا در سال 1396 17- فهرست منابعی که در بررسی متون استفاده شده( بترتیب ورود در متن درج گردد):##1. Mehrabadi Z. Assesment of safety status of selected Tehran University of Medical Sciences of coping with disasters. Homaye Salamat Journal. 2006;3(5):11-5.##2. Ghanbari V, Maddah S, Khankeh H, Karimloo M. The effect of a disaster nursing education program on nurses’ preparedness for responding to probable natural disasters. Iran Journal of nursing. 2011;24(73):72-80.##3. Williams J, Nocera M, Casteel C. The effectiveness of disaster training for health care workers: a systematic review. Annals of emergency medicine. 2008;52(3):211-22. e2.##4. Guha-Sapir D, Vos F, Below R, Ponserre S. Annual disaster statistical review 2011: the numbers and trends. Centre for Research on the Epidemiology of Disasters (CRED); 2012.##5. Tschoegl L, Below R, Guha-Sapir D. An analytical review of selected data sets on natural disasters and impacts: Centre for Research on the Epidemiology of Disasters Louvain; 2006.##6. Djalali A, Khankeh H, Öhlén G, Castrén M, Kurland L. Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study. Scandinavian journal of trauma, resuscitation and emergency medicine. 2011;19(1):30.##7. Khankeh HR, Mohammadi R, Ahmadi F. Barriers and facilitators of health care services at the time of natural disasters. Archives of Rehabilitation. 2005;6(1):23-30.##8. Vahedparast H, Ravanipour M, Hajinezhad F, Kamali F, Gharibi T, Bagherzadeh R. Assessing hospital disaster preparedness of bushehr province. ISMJ. 2013;16(1):69-76.##9. Ojaghi S, Nourizad S, Mahboobi M, Khazaei M, Najafi G. Disaster crisis handling preparedness level of hospitals in Kermanshah. Journal of Kermanshah University of Medical Sciences (J Kermanshah Univ Med Sci). 2009;13(3).##10. Amiri M, Raei M, Shirvani N, Seiyed D, Mohammadi GR, Afkar A, et al. preparedness of affiliated hospitals of universities in north of iran to confront disasters in the year 2011. Journal of Hospital. 2013;12(1):19-28.##11. Kardanmoghadam V, Moasheri BN, Khazaee M, Kardanmoghadam H, Abolhasan nejad V, Gohari Mehr M, et al. Assessment of Hospital Disaster Preparedness in the City of Birjand, Iran, in 2011. 2. 2014;2(1):19-0.##12. AMIRI M, MOHAMMADI G, KHOSRAVI A, CHAMAN R, ARABI M, SADEGHI E, et al. Hospital preparedness of Semnan province to deal with disasters. 2011.##13. H K. National health assessment tools for emergency events (Persian). Tehran: University of Social Welfare & Rehabilitation Sciences; 2016.##14. Jennings-Sanders A. Teaching disaster nursing by utilizing the Jennings disaster nursing management model. Nurse Education in Practice. 2004;4(1):69-76.##15. M Y. Health teams work in disaster. Arak: Arak University of Medical Sciences; 1385.##16. Saghafinia M, Araghizade H, Nafissi N, Asadollahi R. Treatment management in disaster: A review of the Bam earthquake experience. Prehospital and disaster medicine. 2007;22(6):517-21.##17. Ager A, Baillie Smith M, Barbelet V, Carpenter S, Carter W, Cartwright A, et al. World Disasters Report: Focus on local actors, the key to humanitarian effectiveness. 2015.##18. Khankeh HR ea. Hospital preparedness in disasters. University of Social##Welfare & Rehabilitation Sciences Press2012.##19. Arab M, Zeraati H, Akbari Haghighi F, Ravangard R. A study on the executive managers' knowledge and performance, and their hospitals preparedness against earthquake events and their relationships at public hospitals (affiliated by Tehran University of Medical Sciences (TUMS) 2005-2006). Journal of Health Administration. 2009;11(34):7-14.##20. Khankeh HR, Mohammadi R, Ahmadi F. Health care services at time of natural disasters: a qualitative study. Iran Journal of Nursing. 2007;20(51):85-96.##21. Hosseini Shokouh S, Arab M, Rahimi A, Rashidian A, Sadr Momtaz N. Preparedness of the Iran University of Medical Sciences hospitals against earthquak. Journal of school of public Health and institute of public health research. 2009;6(3):61-77.##22. Khankeh HR, Fallahi M, Ranjbar M, Ahmadi F. Health Management in Disasters with focusing on Rehabilitation. Archives of Rehabilitation. 2008;9(2):66-72.##23. Jakeway CC, LaRosa G, Cary A, Schoenfisch S. The role of public health nurses in emergency preparedness and response: A position paper of the association of state and territorial directors of nursing. Public Health Nursing. 2008;25(4):353-61.##24. Veenema TG. Expanding educational opportunities in disaster response and emergency preparedness for nurses. Nursing Education Perspectives. 2006;27(2):93-9.##25. Kaji AH, Lewis RJ. Hospital disaster preparedness in Los Angeles county. Academic emergency medicine. 2006;13(11):1198-203.##26. Khankeh HR, Khorasani-Zavareh D, Johanson E, Mohammadi R, Ahmadi F, Mohammadi R. Disaster health-related challenges and requirements: a grounded theory study in Iran. Prehospital and disaster medicine. 2011;26(3):151-8.##27. Khankeh H, Mohammadi R, Ahmadi F, Maddah S, Ranjbar M, Khodaee M. Health management in disasters. Rehabilitation. 2006;7(3):49-55.##28. Qassemi F, Khankeh H, Delshad V, Hosseini M. The Effects of Implementing and Activating the Early Warning System on the Preparedness of Sari Imam Khomeini Hospital (RH) in Disasters and Incidents. Health in Emergencies and Disasters Quarterly. 2016; 2 (1): 19-24. 2016.##29. Rajabi S ea. Effects of Comprehensive Risk Management Program on the Preparedness of Rofeide Rehabilitation Hospital. Health in Emergencies and Disasters Quarterly; 2(4):179-186. 2017.##30. Bahrami M, Aliakbari F, Aein F. Team work competence in disaster response: an explorative study about Emergency nurses experiences: A qualitative content analysis study. Journal of Clinical Nursing and Midwifery. 2014;2(4):26-36.##31. Djalali A, Castren M, Khankeh H, Gryth D, Radestad M, Öhlen G, et al. Hospital disaster preparedness as measured by functional capacity: a comparison between Iran and Sweden. Prehospital and disaster medicine. 2013;28(5):454-61.##32. Vali L, Masoud A, JabariBeyrami H, Yaghobian B. Readiness of hospitals affiliated with Tabriz University of Medical Sciences to Face Disasters. Journal of Health and Development. 2014;3(1):62-70.##33. GHAFARI S, KHANKEH H, GHANBARI V, RANJBAR M. The study of affiliated hospitals preparedness to University of Welfare and Rehabilitation Sciences for unexpected disasters in 2011. 2012.##34. Zaboli R., Tofighi Sh., Amerion A., Moghaddasi H. Survey of Tehran City Hospitals Disaster Preparedness for Disaster. Journal of Military Medicine. 2006;8(2):103-11.##35. Shojaei P, Reza Maleki M, Bagherzadeh R. Studying preparedness in teaching hospitals affiliated to Iran University of Medical Sciences, 2006. Disaster Prevention and Management: An International Journal. 2009;18(4):379-87.##36. Paganini M, Borrelli F, Cattani J, Ragazzoni L, Djalali A, Carenzo L, et al. Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity. Scandinavian journal of trauma, resuscitation and emergency medicine. 2016;24(1):101.##37. Mulyasari F, Inoue S, Prashar S, Isayama K, Basu M, Srivastava N, et al. Disaster preparedness: Looking through the lens of hospitals in Japan. International Journal of Disaster Risk Science. 2013;4(2):89-100.##38. Manley WG, Furbee PM, Coben JH, Smyth SK, Summers DE, Althouse RC, et al. Realities of disaster preparedness in rural hospitals. Disaster Management & Response. 2006;4(3):80-7.##مقدمه و هد : بیمارستانها به عنوان یکی از اولین مراکز پذیرش مصدومین به هنگام بروز بلایا، باید از آمتادگی لازم برختوردار باشتند.##آمادگی اورژانس بیمارستانها در مقابله با این نوع بلایا لازمه موفقیت آنها در ارائه خدمات باکیفیتت استت. هتدف از ایتن مطالعته ب ررستی##ودادهها از طریق چک لیست پاسخگویی اورژانس بیمارستانهای سازمان جهانی بهداشتت، بصتورت##مصاحبه و مشاهده ی مستندات گردآوری شد. تجزیه و تحلیل دادهها با استفاده از شاخصهای مرکزی صورت گرفت.##۶۳ %( و حیطهی مدیریت مواد / نتایج: بیشترین و کمترین میزان آمادگی اورژانسها در برابر بلایا به ترتی در حیطه کنترل و فرماندهی ) ۶##۶۳ % ارزیابی شد. / و موجودی ) ۷۶ %( بود. بطور کلی میزان آمادگی اورژانس مراکز آموزشی درمانی مورد مطالعه در مقابله با بلایا ۶۳##نتیجه گیری: با توجه به سابقه وقوع بلایا در استان مورد مطالعه و آمادگی خوب مراکز آموزشی درمانی، داشتن برآوردی از منتابع مهتم و##ضروری، نگهداری و تعمیر سریع تجهیزات و مقاوم سازی بیمارستانها در ارتقاء آمادگی آنها نقش موثری خواهد داشت.##کلمات کلیدی: آمادگی؛ بیمارستان، اورژانس، بلایا، مدیریتی ##

Comparison the effect of face to face and telenursing education on the quality of family caregivers caring in cancer patients referred to oncology ward Shahid Mostafa Khomaieni hospital, Ilam 2017 مقایسه تآثیر آموزش چهره به چهره و تله‌نرسینگ بر کیفیت مراقبت مراقبین خانوادگی بیماران مبتلا به سرطان مراجعه‌کننده به بخش انکولوژی بیمارستان شهید مصطفی خمینی ایلام در سال 1396 2 1 زمینه: مراقبت‌ از بیماران مبتلا به سرطان اغلب در منزل و توسط مراقبین خانوادگی صورت می‌گیرد. با این وجود، این گروه، آموزش‌های لازم در مورد نحوه ارائه مراقبت در منزل را دریافت نمی‌کنند. این پژوهش با هدف، مقایسه‌ی تأثیر دو روش آموزشی «چهره به چهره» و «تله‌نرسینگ» بر کیفیت مراقبت مراقبین خانوادگی بیماران مبتلا به سرطان انجام شد. مواد و روش‌ها: این مطالعه‌ مداخله‌ای بر روی 103 نفر از مراقبین خانوادگی بیماران مبتلا به سرطان مراجعه کننده به بخش اونکولوژی شهر ایلام انجام شدکه به روش در دسترس انتخاب و به طور تصادفی در سه گروه »کنترل= 35 نفر«، »چهره به چهره= 34 نفر« و »تله‌نرسینگ= 34 نفر« اختصاص یافتند. گروه کنترل تنها آموزش‌های رایج بخش را دریافت نمود و گروه‌های چهره به چهره و تله‌نرسینگ به مدت 12 هفته تحت آموزش قرار گرفتند. کیفیت مراقبت با استفاده از پرسشنامه محقق ساخته که دارای ابعاد کیفیت مراقبت جسمی و روانی_ اجتماعی بود، قبل و بعد از مداخله سنجیده ‌شد. در تحلیل داده‌ها از آزمون‌های کای دو، دقیق فیشر، آنالیز واریانس یک طرفه و آزمون‌های تعقیبی LSD استفاده شد. همه مراحل آنالیز با کمک نرم افزار SPSS نسخه 16 انجام شد. یافته‌ها: سه گروه از نظر مشخصات دموگرافیک تفاوت معنی‌داری نداشتند (05/0<p). بعد از مداخله، میانگین (± انحراف معیار) نمره کیفیت مراقبت کل در گروه‌های چهره به چهره (91/13±13/166) و تله‌نرسینگ (24/17±76/157) در مقایسه با گروه کنترل (84/16±51/82) افزایش معنی‌داری داشتند (001/0>p). نتیجه‌گیری: یافته‌های این پژوهش نشان داد که دو روش آموزشی در مجموع به یک میزان بر «کیفیت مراقبت» مراقبین خانوادگی موثر بود که با توجه به یافته‌ها توصیه می‌شود پرستاران در آموزش‌های خود به مددجویان علاوه بر آموزش حضوری و چهره به چهره از تلفن و شبکه‌های اجتماعی برای ارتقاء دانش مراقبت استفاده کنند و همچنین بیمارستان‌ها واحدی برای آموزش و پیگیری تلفنی ایجاد کنند. 2 Background and Aim: Taking care of patients with cancer often occurs at home and by family caregivers. However, this group of caregivers does not receive the necessary training on how to provide care at home. The present study aims to compare the effects of face-to-face and Telenursing training methods on the quality of family caregiver’s services for cancer patients. Materials and Methods: In this interventional study 103 family caregivers of cancer patients were randomly divided into three groups of control (N= 35), face-to-face (N= 34), and telenursing (N= 34). The control group only received the routine training, and while the face-to-face and telenursing groups were trained for 12 weeks. Quality of care was measured using a researcher-made questionnaire with two subs scales; physical and psycosocial before and after intervention. Chi-square, Fisher's exact, ANOVA and LSD tests were used for data analysis. All analytical steps were performed using SPSS16 software. Results: There were not significant differenc between three groups demographic characteristic (p>0.05). After intervention, the total quality score for the care of patients in face-to-face (166.13 ± 13.91) and telenursing (157.76 ± 17.24) groups was significantly higher than the control group (82.51 ± 16.84) (p < 0.001). Conclusion: The results of the study showed that the two methods of training were effective on the quality of care among family caregivers of patients with cancer to a similar extent. It is recommended nurses used telephone, social network and face to face method in patient education. In addition, hospitals establishment a ward for education and patient follow up. 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/262017/10/272017/10/272017/10/272017/12/262017/12/22 1396/10/1 2005/06/252009/10/302014/03/12017/01/162017/09/152017/12/22017/12/22017/12/22018/01/272018/03/2 1396/12/11 معصومه شوهانی Masoumeh Shohani گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران msh282000@gmail.com مصیب مظفری Mosayeb Mozafari گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران mozafaric@yahoo.com علی خورشیدی Ali Khorshidi مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران ali_482002@yahoo.com شهره لطفی Shohreh Lotfi ایران Cancer Family Caregivers Education Telenursing Quality of care سرطان مراقبین خانوادگی آموزش تله‌نرسینگ کیفیت مراقبت ## ##

The relationship between maternal anemia during pregnancy and preterm birth: A systematic review and meta-analysis study ارتباط بین کم خونی مادر طی بارداری با تولد زودرس:مطالعه مرور سیستماتیک و متاآنالیز 2 1 این مطالعه، اولین مطالعه متانالیز و مرور سیستماتیک روی ارتباط کم خونی مادر طی بارداری و کاهش وزن هنگام تولد می باشد که در این زمینه مطالعات مختلف با خطر نسبی و فاصله اطمینان متفاوت انجام گرفته است (8,9,10,11,16,18,19,20,22,23,24,28,29,30,31,32,33). . و  عوامل متعدد مادری از جمله کم خونی مادر، سن، فاصله یبین حاملگی و شاخص توده ی بدنی در کاهش وزن طبق مطالعات انجام گرفته شده موثر است(8). که در مطالعه حاضر به بررسی کم خونی مادر طی بارداری و کم وزنی نوزاد پرداخته شد. نتایج مطالعه نشان داد که ارتباط بین کم خونی مادر در سه ماهه ی اول بارداری و lbw معنی دار است یعنی کم خونی مادر در سه ماهه ی اول بارداری باعث افزایشlbw می شود اما این ارتباط برای کم خونی مادر در سه ماهه ی دوم و سوم و lbw معنی دار نبود. پس نتایج مطالعه متآنالیر با حکمیت نشان داد که کم خونی مادر در سه ماهه ی اول بارداری باعث افزایش lbw می شود ودر آنالیز زیر گروها هم چنین نشان داد این ارتباط بیشتر در قاره های آسیا دیده می شود یعنی کاهش وزن هنگام تولد بیشتر در کشورهای در حال توسعه تا توسعه یافته دیده می شود . در مطالعه مروری SUKART و هماکارا ن در سال 2013 که ارتباط غلظت هموگلوبین و پیامد های بارداری را سنجیده بود نشان داده بود که هموگلوبین زیر 11g/dl خطر LBW را با خطر نسبی و فاصله اطمینان 1.17(95% CI: 1.03-1.32) افزایش می دهد(26,27). نتایج مطالعه متا رگرسیون برای سال انجام مطالعه نشان داد که  از نظر آماری سال انجام مطالعه با p value، 0.48 با اتدازه ی اثر ارتباط معنی داری وجود نداشت. مجموع این مطالعه ایی که انجام داده شد  بر اساس یافته های هم مطالعه های کوهورت و هم مورد شاهدی بود البته بیشتر از مطالعه ها کوهورت بودند. سو گیری انتشار که بیشتر در انجام مطالعات متاآنالیز و مقالات مروری دیده می شود. به این دلیل اتفاق می افتد که مطالعات منتشر شده در آن زمینه، نماینده کل تحقیقات انجام شده در آن زمینه نمی باشد  در واقع مقالات با نتایج معنی دار، طراحی دقیق(با کیفیت بالا) و حجم نمونه بالا شانس بیشتری برای انتشار در مجلات را دارند و همچنین در اتجام مطالعات متآنالیز مقالات با زبان محلی و مقالات انگلسی زبان قابل استفاده می باشند که گویای تمام مقالات چاپ شده در آن زمینه نمی باشند. و همچنین چون سوگیری انتشاردر نتایج بدست آمده نشان می دهد که در این نوغ مطالعه ها سو گیری تاثیر داشته است. معمولا مطالعاتی که به صورت ارتباط سنجی هستند امکان سو گیری وجود دارد چون شانس چاپ مقالات که نتیجه ی مثبت دارند بیشتر است و در جست و جو چنین مقالاتی بیشتر دیده می شود. محدودیت: عدم قابلیت منابع اطلاعاتی داخلی برای جست و جوی ترکیبی کلید واژه ها ست که نمی تواند کلید واژه ها را به صورت ترکیبی استفاده کرد. بر خی از مطالعات به دلیل کیفیت پایین از جمله پایان نامه های پزشکی از مطالعه خذف شدند. خذف بسیاری از مطالعه ها به دلیل نا مشخص بودن سن ماه بارداری متفاوت بودن تعریف کم خونی در مطالعات مختلف خذف یسیاری از مطالعه ها به دلیل عدم گزارش دهی یکسان مقالات و سو گرایی انتشار و بعضی از مقالاتی که رابطه علیتی بدست نیاوردند  ممکن است چاپ نشده اند.. 2 This study is the first study of metanalysis and systematic review on the relationship between maternal anemia during pregnancy and weight loss at birth. 18,19,20,22,23,24,28,29,30,31,32,33). . Numerous maternal factors such as maternal anemia, age, gestational age and body mass index are effective in weight loss according to studies (8). In the present study, maternal anemia during pregnancy and low birth weight were investigated. The results of the study showed that the relationship between maternal anemia in the first trimester of pregnancy and lbw is significant, ie maternal anemia in the first trimester of pregnancy increases lbw, but this relationship for maternal anemia in the second and third trimesters and lbw was not significant. Therefore, the results of the Metanalier study showed that maternal anemia in the first trimester of pregnancy increases lbw and in the analysis of subgroups also showed that this relationship is more seen in Asian continents, ie more birth weight loss in countries in Development can be seen as developed. A review study by SUKART et al. In 2013 that examined the relationship between hemoglobin concentration and pregnancy outcomes showed that hemoglobin below 11 g / dl increased the risk of LBW with a relative risk and a confidence interval of 1.17 (95% CI: 1.03-1.32). Gives (26,27). The results of meta-regression study for the year of the study showed that statistically there was no significant relationship between the year of the study with p value, 0.48 and the effect size. The sum of this study was based on the findings of both cohort studies and case studies, although most of the studies were cohorts. Dissemination bias, which is mostly seen in meta-analysis studies and review articles. It happens because the published studies in that field do not represent the total research done in that field. In fact, articles with meaningful results, accurate design (high quality) and high sample size give a better chance of being published in journals. They can also be used in conducting meta-analysis studies of articles in the local language and English-language articles, which do not reflect all the articles published in that field. Also, because the published bias in the results shows that bias has had an effect on these studies. Studies that are correlational are usually biased because the chances of publishing articles that have a positive result are higher and are seen more in the search for such articles. Limitations: The inability of internal information resources to search for a combination of keywords that can not use keywords in combination. Some studies were excluded from the study due to low quality, including medical dissertations. Deleted many studies due to the unknown age of the month of pregnancy Different definitions of anemia in different studies Dismissal of many studies may not have been published due to lack of uniform reporting of articles and publication bias, and some articles that did not have a causal relationship. 0 0 2005/04/222009/09/292013/12/312016/11/252017/06/262017/10/272017/10/272017/10/272017/12/262017/12/222018/12/26 1397/10/5 2005/06/252009/10/302014/03/12017/01/162017/09/152017/12/22017/12/22017/12/22018/01/272018/03/22019/04/7 1398/1/18 علی دل پیشه Ali Delpisheh مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران alidelpisheh@yahoo.com Anemia motherhood pregnancy preterm birth کم خونی مادر بارداری تولد زودرس 1. Ramazanali F, Vahid Dastjerdi M, Beigi A, Moini A. [The relationship between maternal HCT levels, birth weight and risk of low birth weight]. Iran J Pediatr 2006; 16: 447-454. (In Persian)##2. Pettitt DJ, Jovanovic L. Low birth weight as a risk factor for gestational diabetes, diabetes, and##impaired glucose tolerance during pregnancy. Diabetes Care 2007 Jul;30(Suppl 2):S147-9.##3. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III L, Wenstrom KD. Williams obstetrics. 22nd ed. Philadelphia: McGraw-Hill; 2005:1143-67. ##4. World Health Organization. World Health Report 1997. Conquering Suffering, Enriching Humanity. Geneva: World Health Organization, 1998.##5. Stevens, G., Finucane, M., De-Regil, L., Paciorek, C., Flaxman, S., Branca, F., PeñaRosas, JP., Bhutta, ZA. and Ezzati, M., , et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. The Lancet Global Health. 2013;1(1):e16-e25. doi:10.1016/S2214-109X(13)70001-9.##6. Sayehmiri K, Darvishi Z, Azami M, Qavam S. The prevalence of anemia in first, second and third trimester of pregnancy in iran: a systematic review and meta- analysis. IJOGI 2015;18:7-15. 41.##7. Azami M, Darvishi Z, Sayehmiri K. Systematic Review and Meta-Analysis of the Prevalence of Anemia Among Pregnant Iranian Women (2005 - 2015). Shiraz E-Med J. 2016;17(4-5):e38462. Epub 2016-05-28.##8. Levy A, Fraser D, Katz M, Mazor M, Shiener E. Maternal anemia during pregnancy is a independent risk facor for low birth weight and preterm delivery. Eur J Obstet Gynecol Reprod Biol 2005; 122: 182-186.##9. Bodeau-Livinec F, Briand V, Berger J, Xiong X, Massougbodji A, Day K, Cot M. Maternal Anemia in Benin: Prevalence, Risk Factors, and Association with Low Birth Weight. Am Soc Trop Med Hygiene 2011; 85: 414-420.##10. Hamalainen H, Hakkarainen K, Heinonen S. Anemia in the first but not in the second or third trimester is a risk factor for low birth weight. Clin Nutr 2003; 22: 271-275##11. Kidanto H.L, Mogren I, Lindmark G, Massawe S, Nystrom L. Risks for preterm delivery and low birth weight are independently increased by severity of maternal anaemia. Department of Clinical Science, Obstetrics and Gynaecology, Umeå University. 2009; 99: 98-102 ##12. Azami M, Nasirkandy MP, Mansouri A, Darvishi Z, Rahmati S, Abangah G, et al. Global Prevalence of Helicobacter pylori Infection in Pregnant Women: A Systematic Review and Meta-analysis Study. IJWHR 2017; 5: 30-36.##13. Azami M, Hafezi Ahmadi MR, Sayehmiri K. Hepatitis B Vaccination Efficacy in Iranian Healthcare Workers: A Meta-Analysis Study. Hepat Mon. 2017;17(1):e37781.##14. Garshasbi A, Fallah N. Maternal hematocrite level and risk of low birth weight and preterm Delivery. Tehran Univ Med J 2006; 64: 87-94.##15. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and metaanalyses: the PRISMA statement. Int J Surg 2010; 8(5):336-41.##16. Knotterus JA, Delgado LR, Knipschid PG, Essed GG, Smirt F. Hamatologic parameters and pregnancy outcome. J Clin Epidemiol 1990; 43: 461-466.##17. Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370(9596):1453-7.##18. Zhou LM, Yang WW, Hua JZ, Deng CHQ, Tao X, Rebecca J. Relation of Hemoglobin Measured at Different Times in Pregnancy to Preterm Birth and Low Birth Weight in Shanghai, China. Am J Epidemiol 1998; 148: 998-1006.##19. Abeysena CH, Jayawardana P. Maternal haemoglobin level at booking visit and its effect on adverse pregnancy outcome. Aust N Z J Obstet Gynaecol 2010; 50: 423-427.##20. Chang S-C, O’Brien KO, Nathanson MS, Mancini J, Witter FR. Hemoglobin concentrations influence birth outcomes in pregnant African-American adolescents. The Journal of nutrition. 2003;133(7):2348-55..##21. Lee H, Kim M, Kim M, Kim Y, Kim W. Iron status and its association with pregnancy outcome in Korean pregnant women. European journal of clinical nutrition. 2006;60(9):1130-5.##22. MonawarHosain M, Chatterjee N, Begum A, Saha S.CH. Factors Associated with Low Birthweight in Rural Bangladesh. J Trop Pediatr 2005; 52: 87-91.##23. Xiong X, Buekens P, Alexander S, Wollast E. The relationship between anemia during pregnancy and birth outcome. Archives of Public Health. 1996;53:S136.##24. Kumar A, Chaudhary K, Prasad S. Maternal indicators and obstetric outcome in the north Indian population: a hospital- based study. J Postgraduate Med 2010; 56: 192-195. ##25. Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, Ota E, Gilmour S, Shibuya K. Maternal anemia and risk of adverse birth and health outcomes in low-and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr 2016; 103: 495-504.##26. Sukrat B, Wilasrusmee C, Siribumrungwong B, McEvoy M, Okascharoen C, Attia J, Thakkinstian A. Hemoglobin concentration and pregnancy outcomes: a systematic review and meta-analysis. BioMed Res Int 2013; 2013: 1-9.##27. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Bmj. 2013;346:f344##28. Sekhavat L, Davar R, Hosseinidezoki S. Relationship between maternal hemoglobin concentration and neonatal birth weight. Hematology 2011; 16(6): 373-76.##29. Huang L, Purvarshi G, Wang S, Zhong L, Tang H. The Influence of Iron-deficiency Anemia during the Pregnancy on Preterm Birth and Birth Weight in South China. Journal of Food and Nutrition Research 2015: 3(9): 570-74. 3.##30. Yang J, Cheng Y, Pei L, Jiang Y, Lei F, Zeng L, et al. Maternal iron intake during pregnancy and birth outcomes: a cross-sectional study in Northwest China. British Journal of Nutrition. 2017:1-10.##31. Yildiz Y, Ozgu E, Unlu SB, Salman B, YaparEyi EG. The relationship between third trimester maternal hemoglobin and birth weight/length; results from the tertiary center in Turkey. J Matern F, et al. Neonatal Med 2014; 27(7): 729–32.##32. Nair M, Choudhury MK, Choudhury SS, Kakoty SD, Sarma UC, Webster P, et al. Association between maternal anaemia and pregnancy outcomes: a cohort study in Assam, India. BMJ Global Health. 2016;1(1):e000026.##33. Jwa SC, Fujiwara T, Yamanobe Y, Kozuka K, Sago H. Changes in maternal hemoglobin during pregnancy and birth outcomes. BMC pregnancy and childbirth. 2015;15(1):80.## ##