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ABSTRACT Introduction & Objective: Accurate treatment of T.B is the only way for prevention of the disease. Incomplete therapy results in disease recurrence and development of drug resistance. The most important problem in the control of T.B is lack of compliance to therapy one reason of which is side effects of drugs. This study aims at studying the prevalence of the adverse effects of anti-TB drugs in tubercular patients in Shiraz, 2001-2002. Materials & Methods: In this descriptive study, from April 2001 to April 2002, all new T.B patient records registered in our public T.B center(325 cases) were studied. All the patients were trained for the symptoms of drugs side effects. LFT test was done for those who developed drugs adverse effects. Pertinent demographic and lab data were gathered and analyzed. Results: 325 new patients (182 male, 56%, 143 female, 44%) were registered. Among these 113 patients (52 male, 44%, 61 female, 56%) developed drugs side effects. 107 (29.5%) had minor and 16 (5.2%) had major side effects. The incidence of all major adverse effects was 0.4 person-day during this study. There was significant statistical difference between female sex and drugs adverse effect (P<0.05), but no significant difference was found between nation, age and weight of the patients and the adverse effects of drugs. Conclusion: Of 113 patients experiencing side effects, 109 (96.5%) received complete treatment (3 died & 1discontiued). Anti-TB drugs adverse effect isn’t a major reason for discontinuation of therapy. Appropriate treatment of side effects leads to cure of illness.

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Introduction & Objective: ECG is a test which is used for diagnosis and confirmation of cardiovascular diseases. Many studies regarding the validity of this test in different age groups have been performed and different results were obtained. This study was performed to assess the role of ECG on anesthesia planning in elderly patients. Material & Methods: One hundred elderly patients who referred to Nikocari hospital in Tabriz for eye surgery were enrolled in this study. Findings of clinical examination and medical history were compared with those obtained from the interpretation of ECG by anesthetists. Results: The data were analyzed using descriptive statistical methods. Results showed that only 4% of the patients without positive findings in clinical examination had ECG abnormalities 3% had RBBB and 1% had T inversion in pre-cordial leads. It is noticeable that reported abnormalities are not so important on the basis of anesthesia care planning. Conclusion: According to the results obtained, it seems logical to pay more attention to selection of patients for ECG and ordering ECG test only for patients with positive clinical findings.

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Introduction & Objective: Application of antibiotics in prevention and treatment of infectious diseases is a double bladed razor. On one side, it spoils pathogens and on the other hand, it has numerous complications. The most serious among them is selection of resistant agents. Prescription of antibiotics is a complex and scientific process that requires accurate clinical judgment, awareness of the pharmacologic and microbiologic principles on diagnosis, treatment and consideration of the patient's condition and his illness. Materials & Methods: In this study, we assessed 441 prescriptions (prescribed for <14 y /o outpatients children) of 58 GP in Yasj city in Kohgyloyeh and Boyerahmad province in 2004. Results: The average number of drugs in each prescription was 3.6 and 64.4% of the prescriptions included antibiotics that consisted of penicillin group (51.6%), macrolids (24.5%) and cephalosporins (11.2%). Overall 32.2% had diagnosis which included pneumonia (31.7%), URI (21.9%) and pharyngitis (19%). Conclusion: The average number of drug in each prescription was much higher than the world average. Antibiotics have been prescriped a little more than in most of the countries and cities which might be due to age of the patients, unawareness of disease nature and epidemiology of infectious diseases. This pattern of antibiotic prescription causes a decrease in rate of bacterial infections in comparison with the past. However, this form of management, where antibiotic was prescriped for prophylaxis because of fear of future bacterial infection, led to several major outcomes including resistance of microorganisms that itself causes appearance of new agents with serious infection and complication of antibiotic therapy and their side effects that can cause morbidity and mortality.

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ABSTRACT: Introduction & Objective: Zinc is one of the important elements necessary for human growth. CNS utilizes zinc for its biological functions. Zinc is one of the important cofactors of many enzymes in the body and about 200 enzymes contain zinc as their integral part of their structure. If for any reason zinc is omitted from the enzyme structure, those enzymes can not catalyze any biological functions. The fluctuation of this trace element in the body is clinically important. The concentration change of this trace element can lead to some overt and unrecognized manifestations in haemodialysis patients. This study is to determine the possible fluctuation of serum level of zinc in haemodialysis patients before and after dialysis,to explain the differences in concentration of such trace element in these patients. Materials & Methods: This study is a comparative and nonexperimental study which was carried out on 50 haemodialysis patients chosen randomly from the patients referred to the department of haemodialysis in 5th Azar hospital in Gorgan university of medical sciences. The concentration of urea, creatinine, zinc of these patients were determined using laboratory kits and spectrophotometry tchnique before and after the dialysis. The findings were analyzed by wilkacson non parameter analytical method. Results: Results of this study indicated that the average concenteration of zinc in haemodialysis patients after dialysis was 135.32±59.32 microgram / deciliter which markedly increased in comparison to the serum concentration of this trace element before the dialysis which was 78.38±37.46 microgram / deciliter ( p < 0.05). Conclusion: Uremia, dialysis membrane, contaminations, heavy metals, and the quality of consumed water in the dialysis procedure, all can pave the way for the abnormality of trace element and clinical manifestation in haemodialysis patients. The trace element variation concentrations in human body clinically are very important because the decrease and increase in level of each trace element has its own clinical manifestation. The increased concentration of this trace element leads to toxification accompanied with clinical syndromes such as diarrhea and vomiting. Therefore, it is suggested that before the process of dialysis the level of released zinc from the different part of dialysis machine (such as pipeline, consumed water and dialysis membrane) be determined and on the basis of such information the level of zinc in haemodialysis patients can be replaced by proper nutrition.

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Introduction & Objective: The risk of developing chronic hepatitis B virus (HBV) is 5% in general population but can reach up to 20% in HIV patients. The response rate to HBV vaccine in HIV infected patients is 23.8-56 percent. The aim of this study was to evaluate response of HIV-infected patients to 20 µg dose of recombinant HBV vaccine. Materials & Methods: In this quasi experimental study, 51 subjects, sampled through census, were HIV patients who had HBsAg negative test in HIV/AIDS counseling and care center. Patients were vaccinated with 20 µg of recombinant HBV vaccine, IM at intervals of 0, 1 and 6 months. Response to the vaccine was checked 2 months after the last injection. Data were analyzed with SPSS software, using descriptive statistics and nonparametric tests. Results: The mean age of the patients was 33.68±8.37 years. Two patients were female (3.9%) and 49 patients were male (96.1%). Mean of hepatitis B antibody level was 47.55±71.58 mIU/ml. The levels of antibody in different patients were as follow: 31 patients (60.8%) <10 mIU/ml and 20 patients (39.2%)> 10 mIU/ml. There was no significant correlation between antibody levels and CD4+ cell count (correlation coefficient = -0.191). Conclusion: Response to hepatitis B vaccination is low in HIV infected patients. Conventional dose of HBV vaccine is not enough to get protective immunity. Therefore, two-fold dose of vaccine dose, repeat of conventional dose or increasing of interval administration of hepatitis B vaccine should be considered in future studies.

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Background & aim: About 7% of patient referred to hospital are various forms of poisoning. This study was performed to determine the major causes of acute poisoning leading to Hospitalization at Shahid Beheshti Hospital of Yasuj, Iran. Methods: This descriptive study was performed from August 2007 to July 2008 on 470 cases of poisonings referred to Shahid Beheshti hospital of Yasuj. Demographic characteristics, time of poisoning, poisoning factor, history of previous poisoning, history of psychiatric disease, medication and other therapeutic intervention based on questionnaires and interviews with patients or companions of patients were recorded. Data were analyzed by Chi-Square Test. Results: Majority of poisoned patients were single females, in the age range of 21-30 years, unemployed, lived in urban areas, and had at least a diploma. The majority of cases were intentional poisoning with a history of depression, previous poisoning and attempted suicide. Significant relationship were seen between poisoning, age, sex, and job, (p<0.05), while relationship between the place of residency, marital status, and education, with poisoning was not significant (p>0.05). Conclusion: With respect to the results of this study, the majority of these poisonings occurred among young, single and unemployed females due to suicide and drug intoxication. Necessary actions should be done in drug usage and maintenance, taking action against non-prescription drugs and giving proper public education to families.

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Abstract Background & aim: Lack of knowledge and fear of treatment, predisposes individuals to the occurrence and intensity of psychological reactions therefore it is necessary for people to learn appropriate coping strategies.The aim of this study was to determine the effect of education on coping with stress, depression, anxiety and stress among patients with special diseases. Methods: This clinical trial study was performed on 30 patients referred to Shahid Beheshti Hospital of Yasuj, Iran, as specific pre-test and post-test. The patients were divided into two groups randomly. Instruments used included specific questionnaires for depression, anxiety and stress Das 42 Lavybound, and a demographic questionnaire. A seven session period of instruction, each session an hour and a half, was held in coping with stress. The collected data was analyzed by Chi-square tests, t-dependent and-independent tests. Results: Before the intervention of two groups, no significant differences were seen in the levels of depression, anxiety and stress. But after intervention, significant differences were observed in the levels of stress (23.1 before the intervention to 17.5 post-intervention) and anxiety (15 pre-intervention to the 10.9 post-intervention) (P <0/05). Conclusion: The training procedure was effective in decreasing the stress and anxiety in particular diseases and could lead to a relative relief in depression patients. Key words: Special Patients Coping, Depression, Anxiety, Stress

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Abstract Background & aim: Quality of life decreases in cardiac patient and there is a little information about the effect of interval training on this matter. The aim of this study was to compare the eight weeks of high intensity interval training with common continuous training on health-related quality of life in cardiac patients with post-coronary artery bypass graft. Methods: In this clinical trial, 30 cardiac patients of Tehran Heart Center that CABG surgery was done on them were randomly divided into two groups high-intensity interval training and continuous moderate-intensity training (program common). The program of interval group was included 4rep × 4 min at 90-95% HRpeak and continuous group 60-80 minute at 70-85% HRpeak, three sessions per week for 8 weeks. Quality of life was assessed based on the SF-36 questionnaire before and after the training program. The collected data were analyzed using the one way ANOVA test. Results: Physical function, social function, mental health and vitality were significantly increased following the both of training programs (p<0.05). Physical function and social function after high-intensity interval training was more than moderate intensity continuous training (p<0.05). There was no significant differences between two groups in general health and role physical (p>0.05) Conclusion: It seems that, high-intensity interval training program will not only does not be a threat to cardiac patients post-coronary artery bypass graft surgery, but it is more beneficial than moderate intensity continuous training in some parameters of the quality of life such as physical function and social function. Keywords: Exercise, Quality of Life, Cardiac Patients Post-CABG

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Background & aim: Because of emerging multi-drug resistance (MDR) Pseudomonas aeruginosa strains, treatment of burn patients infected by this bacterium is difficult. The aim of this study was to detect antimicrobial profile and molecular epidemiology of metallo-beta-lactamase (MBL) producer strains. Methods: In this cross-sectional investigation 270 Pseudomonas aeruginosa isolates were collected from the burn patients. Carbapenem sresistance strains were detected by phenotypic E-test method. Susceptibility profiles of metallo-β-lactamase (MβL) enzyme producing isolates of this bacterium to 11 antimicrobial drug were determined by disc diffusion method according Clinical and Laboratory Standards Institute (CLSI) guidelines. The genetic correlations between isolates were determined by Pulsed-Field Gel Electrophoresis (PFGE) method. Results: Among 270 P. aeruginosa isolates, 60 (22.2%) strains showed resistant to meropenem (MEM) and imipenem (IMI) and were considered as metallo-β-lactamase positive. All metallo-β-lactamase positive isolates were resistant to five tested antimcrobial while their sensitivities to the three best effective antibiotics including ciprofloxacin, amikacin and ceftazidime were 1.7%, 6.7 % and 23.3%, respectively. Majority of the isolates (71.6%) showed more than 80% similarity based on the drawn dendrogram. Conclusion: Our results showed, the tested antimicrobials are not safe to prescribe for burn patients. According PFGE pulsotypes, a limited number of P.aeruginosa types are common in the hospital burn unit which infect the patients hospitalized in this ward.

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Background & aim: One of the most important problems in the health sector, particularly in clinical centers, is the quality of healthcare. Patient safety is one of the most important elements in creating health care quality due to the fact that it is a critical component to the quality of health care and many errors are present in patient care and treatment practices..                                                               Thus, the aim of the present study was to determine the status of the patient safety culture and its relationship with events reported in Yasuj hospitals.

Methods: The present descriptive cross-sectional study was conducted on 361 medical staff of Yasuj hospitals. The data were collected through a hospital survey on patient safety culture. The collected data were analyzed by using SPSS statistics soft ware version 21, using Descriptive methods, Pearson Coefficient, ANOVA, and T-Test.

Results: The results of the present study revealed that the teamwork among hospital units (71/89percent), with expectations and management measures (66/38%) in the case of safety obtained the most score and non-punitive response to errors (48/79%) and manager support (55/88 percent) obtained the least score. 73/7% of employees of three hospitals in the past 12 months did not report any event. In addition, there was a meaningful statistical relationship between the total score of safety culture and reporting the events. In this study, 15.5 % of respondents assess their safety culture in work as good, 44.3 % as acceptable and 30.5 percent reported poor. The overall safety culture among the three studied hospitals was 61.81 %. Results confirmed that the culture safety of patient in studied hospitals was average.

Conclusions: The hospitals may rely on their strong points in terms of patient safety culture and try to remove their weak points to form a safe environment and appropriate atmosphere. By the same token, increasing the number of workers in administrative sections, a large amount of work, decreasing work time and creating a reporting system may help improve the safety and patient safety culture.

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Background & Aim: The emergency ward at the time of a disaster is the most important ward for providing therapy service to the injured. The purpose of this research study was to study of the effects of increasing the capacity of admission in emergency ward in increasing the rate of patient acceptance at the time of crisis at Razi Educational Hospital, Ahvaz, Iran.

Methods: The present interventional study was performed to determine role of the increase of capacity to emergency ward in increase rate of patient acceptance at the time of disaster. After one year a re-evaluation of the capacity of the emergency department was conducted. Data were analyzed using descriptive statistics.

Results: The results of this study showed that the capacity to accept patients was 16 injured in time of disasters at the emergency ward before reform measures. After performing reforms, this capacity increased to 42 patients. The findings also showed that the implementation of appropriate capacity building increased 2.6 times, thus led to increasing the readiness and service delivery in times of crisis and emergency department of the disaster.

Conclusion: Based on the findings, it could be concluded that planning and action to be carried out in hospital emergency departments by the crisis committee increased the admission capacity of the injured during the crisis.

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Background & Aim: Cancers are the second cause of death after cardiovascular diseases globally. Colorectal cancer is the third most prevalent cancer in the world. This cancer is the third leading cause of death in America and one of the most prevalent cancers of the gastrointestinal tract in Iran. The purpose of this study was to estimate the survival rate of patients with gastric cancer in Chaharmahal and Bakhtiari province, Iran.

Methods: The present observational (the analytical type) study was conducted using the longitudinal and survival study methods. The population study included all patients with gastric cancer in Chaharmahal and Bakhtiari province, Iran. The samples were selected by the census method and all the patients diagnosed with colorectal between the years 2000 to 2010 (estimated to be about 452 cases). After collecting the data and coding them, they were inserted into the SPSS 16 and STATA 12 software. To investigate the survival and the factors influencing the survival time of patients which was the main objective of this study, the Kaplan-Meier method was used. In order to compare the survival function in different subgroups, the log rank test or generalized Wilcoxon test was used.

Results: From the total 452 patients with colorectal cancer, 232 cases were male (51.3%) and 220 were females (48.7%), respectively. The mean age of patients was 59.12 ±19.99 years at the time of diagnosis. The median age of patients was 60 years. The probability of survival at 1, 5 and 10 years after diagnosis of colorectal cancer in both sexes using the Kaplan-Meier was 85.7%, 71.9,% 52.5% respectively.

Conclusion: Although the survival rate of patients with colorectal cancer in Chaharmahal and Bakhtiari province was at a desirable level, the need for further studies to identify prognostic factors is essential.

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Abstract

 

Background & aim: Adherence is the degree of patient's success to do the health experts recommendations. The aim of present research was to study the effects of motivational interviewing on adherence to in obese patients undergoing sleeve gastrectomy surgery.

 

Methods: The design of present semi- experimental study was pre-test, post-test with control group. The statistical population included all obese patients (BMI≥35) that undergone laparoscopic sleeve gastrectomy surgery in Shiraz Ghadir Mother & Child Hospital during the winter of 2015 and the spring of 2016. 30 of them were selected by using available sampling method and they randomly were asssigned to experimental (n=15) and control groups (n=15). The post bariatic surgery self-management behaviors questionnaire was used to collect data in two steps (pre-test and post-test). Motivational interviewing was implemented for the experimental group in four weeks (each week a 1.5 hour session). Data were analysed by using multivariate covariance analysis (MANCOVA).

 

Results: MANCOVA results show that motivational interviewing led to a statistically significant difference between pre-test and post-test BSSQ total scores (P<0.0001) and subscales eating behaviors (P<0.0001), fluid intake (P<0.03), vitamin and mineral supplement intake (P<0.01), fruit, vegitable, whole grain intake and protein (P<0/01) & dumping syndrome management (P<0.002). But there was no significant difference in the score of physical activity (P>0.07).

 

Conclusion: According to the results of the present study, implementation of motivational interviewing in order to enhance adherence and self-management behaviors, achieve favorable weight loss and reduce postoperative complications in obese patients undergoing sleeve gastrectomy surgery, but it appears that longer interventions are necessary to increase the rate of physical activity.

 

 

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Background & aim: In recent decades, the use of media education to control the problems of patients with chronic diseases has been taken into consideration by medical staff, but few studies have been done on their effectiveness in improving the quality of sleep in patients with bronchial asthma. The aim of this study was to determine the effect of film-based education on sleep quality in patients with bronchial asthma.

 

Methods: The present study was a quasi-experimental study and all of the patients with bronchial asthma referred to the Asthma clinic of Boroujen were included in this study. Fifty one patients who were eligible for inclusion in the study were selected by non probability sampling method. The samples were assigned to randomly assigned blocks between the two test and control groups. For patients in the test group, patient education was performed through a 15-minute video clip by computer, DVD player and mobile phone, but patients in the control group only received routine care. The Pittsburgh Sleep Quality Index questionnaire was used to collect data one week before intervention and one month after intervention. The collected data were analyzed by descriptive statistics and t-test, Chi-square, Mann-Whitney and Wilcoxon tests.

 

Results: There was no significant difference before the intervention, in the overall score of sleep quality and its dimensions in the two groups (p = 0.66). There was a significant difference between the two groups after the intervention in the general score of sleep quality and the dimensions of sleep quality, sleep disturbances and sleep latency (p = 0.001) However, there was no significant difference in the use of sleep apnea, sleep duration, adequacy of sleep and daily dysfunction in the test and control groups.

 

Conclusion: The movie-based instruction has been able to improve the quality of sleep in patients with bronchial asthma. Considering the ease of implementation of this educational method, suggesting other researches to evaluate its effect on other patients with chronic diseases, it should be considered as a method of patient education for self-care at home.

 

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Abstract
 
Background & aim: Improving the quality of health care services is one of the main concerns of organizations providing health services. Patient safety means is the absence of any damage caused by the provision of health services. In the intensive care unit, due to complications of the patient's condition and the treatment process, the chance of occurrence of unexpected errors and events is maximized and serious attention is required . The purpose of this study was to determine the level of compliance of patient-related nursing care with standards in intensive care units.
 
Methods: In this descriptive study, 1998 nursing care associated with patient safety were assessed during the morning shift function of 54 nurses in three Intensive care unit of selected hospitals of Yasuj University of Medical Sciences using a researcher-made checklist containing 37 terms and 6 domains in winter 2015. These areas include the initial acceptance and evaluation of the patient, the correct procedure in the correct location of the patient's body, avoiding inappropriate connections between the tubes and the patient's catheter, preventing the patient falling down, preventing ulcer and nosocomial infections. The checklist after determining the face validity and content (96% = CVI) and reliability by means of calculating the agreement coefficient between viewers (99% = ICC), via observing the performance by the researcher in morning shifts was completed for 54 nurses. Collected data were analyzed using Descriptive statistics.
 
Results: In view of the performance of 54 nurses in intensive care units, the average level of compliance of patient-related nursing care in comparison with the checklist was less than 100 points which was unfaroble(46.75). The highest correlation with the patient's avoidance domain was relatively favorable (50.25) and the lowest level was related to the area of ​​undesirable subsoil prevention (1.87).
 
Conclusion: The compliance rate of patient-related nursing care in ICU is far from standards. The managers of the area of ​​treatment in order to improve the quality of nursing care provided by the nurse in relation to patient safety indicators in the intensive care unit and, consequently, to increase the safety of patients in order to prevent their injury as a result of the provision of these care, and regular monitoring of nursing care and continuing education programs will be more emphasis.
 

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Abstract
 
Introduction: Cardiovascular diseases are the most and common cause of death and debilitation worldwide. Psychological factors compose more than 50 percent of the factors affecting heart diseases. Therefore, this research has been performed aiming to investigate the relationship between religiosity, humor styles and Type- D Personality with general health in the patients with heart disease.
 
Methods: This study is descriptive of correlation type. The statistical population of this research includes all patients with heart disease is the city of Yazd in the years 2016. The study sample consisted of 210 patients with heart failure who were selected by means of verge criteria and were selected by purposeful sampling and based on the Kerjesy and Morgan tables. Research variables Measurement tools are included Serajzadeh questionnaire with 24 items of religiosity (DS-14), Martin’s 32-items questionnaire of humor (HSQ-R), Denollet’s type D personality questionnaire, and Goldberg28 items General Health Questionnaire (GHQ-28). Data was analyzed Using SPSS and AMOS Statistical softwares and path analysis within the framework of structural modeling.
 
Results: The results of data analysis showed that there is a positive and significant relationship between the affective religiosity (b=0.08; P<0.05), other component of religiosity Other components of religiosity including religious beliefs, consequential religions and religious rituals do not show a significant relationship with general health (P>0.05). Affiliative humor had positive and significant relationship with general health (b=0.18; P<0.05), While other humor styles, including self-enhancing wit, aggressive humor and selfish wit, do not show a meaningful relationship with general health (P>0.05). Finally, two component of type D personality including social inhibition (b=-0.20; P<0.01), and negative affect (b=-0.28; P<0.01), have a negative and significant relationship with general health.
 
Conclusion: Base on the result of this research affective religiosity, affiliative humor styles, and Type- D personality are important and affecting risk factors in the general health of patients with heart disease. So, by recognizing such factors, the individuals predisposed to this disease can be identified for preventative measures and helping in treatment.
 
 

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Abstract

 

Background and Aim: Cardiac rehabilitation improves the functional capacity of patients with heart failure. Therefore, the aim of this study was to investigate the effect of eight weeks of high frequency periodic training on mutagenic fraction and serigalctin 3 levels in cardiac patients.

 

Methods: In this quasi-experimental study, 24 heart patients (57.18 ± 6.17 years, 76.5 ± 13.89 kg, 25.34 ± 3.39 mm, 5.5 ± 5.5 cm) (169 cm) in Alzahra hospital in an injection fraction of 40-50% were randomly divided into two groups of severe routine exercises and control group. The exercise program included 12 repetitions of 1.5 minutes of activity on a bicycle and 8 repetitions of 1.5 times the activity on the treadmill, and between each period, 45 to 60 seconds of active rest with a 40-60% VO2peak intensity, which lasted for 8 Weekly and 3 sessions per week. The intensity of exercise with 50-60% of VO2peak started in the first week and was gradually increased by 10% every week and lasted from the week 4 to the end of the training protocol at an intensity of 80-90%. Blood samples were taken before and 48 hours after the last training session in the same conditions in both groups. Serigalcine 3 levels were measured using ELISA kit. The collected data were analyzed using independent t-test and paired T-test.

 

Results: The results showed that in the post-intensive training group, the level of Galactine 3 decreased (p = 0.003) and the mutation fraction increased (p = 0.001) in the training group, before the training, and in the control group Compared to pre and post test, Galactin Level 3 was found to increase (p = 0.001) and decrease in mutation fraction (p = 0.003). Comparing the two groups, the training group showed a significant decrease in Galactin 3 (p = 0.001) and a significant increase in the mutation fraction (p = 0.001).

 

Conclusion: Severe periodic exercises to reduce galactin levels 3 and increase the injectable fraction can improve cardiac function in cardiovascular patients.

 

 

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Background & aim: Psoriasis is a prevalent, inflammatory and chronic disease which is accompanied by various psychological problems for the patient. So far, few psychological interventions have been designed and conducted for reducing mental problems and enhancing mental health among these patients. Compassion-focused therapy is a new therapeutic method which was formed with the aim of reducing self-criticism and shame in individuals. According to the fact that patients with psoriasis experience great shame due to undesirable effects of this disease on their beauty, therefore, the present study was conducted by the aim of investigating the effectiveness of group compassion-focused therapy (CFT) on internalized shame in patients with psoriasis.

 

Methods: In the frame of a semi-experimental study with pretest-posttest-follow up with control group design, 40 patients with psoriasis referring to the specialized dermatology clinics of Hakim Jarjani hospital and Shahid Sayad Shirazi hospital in Gorgan, Iran, in 2018, were selected by available sampling method, and then, they were assigned into two experiment and control groups (20 subjects per group). For gathering the data, Cook’s internalized shame scale was used which was completed by the subjects of both groups in pretest, posttest and one-month follow up stages. The subjects of the experiment group received eight 2-hour sessions of compassion focused therapy while the control group received no therapy until the end of the follow up stage. for analyzing the data, the Variance analysis test with repeated measures in SPSSv20 were used.

 

Results: Mean and standard deviation of the scores of internalized shame in subjects of the experiment group was 77.40±3.53 in pretest, 62±3.37 in posttest, and 60.50±3.63 in follow up. In the control group, mean and standard deviation of the scores of internalized shame was 77.25±5.04 in pretest, 78.65 ± 4.20 in posttest and 76.85±4.67 in follow up. Results of the variance analysis with repeated measures indicated that compassion focused therapy led to significant reduction in internalized shame among patients of the intervention group in posttest and follow up stages (p<0.01).

 

Conclusion: According to the findings of the present research, it is recommended that compassion focused therapy would be used in specialized dermatology clinics for the purpose of reducing mental problems and improving mental health among dermatological patients.

 

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Background & aim: Performance Indicators consist of standards, evaluation tools and identifications to check current situations in organizations.  Hospitals as the center of gravity to provide   health and therapy care are of no exception. The present study aimed to determe the performance indicators in selected hospitals of Tehran province.
 
Methods: The present inquiry was a cross-sectional descriptive-analytical study. The statistical population of all public hospitals was covered by Tehran University of Medical Sciences and Shahid Beheshti. 14 educational and 9 non-educational cases were examined. Data collection tools were data entry forms for hospital performance indicators, which included general information on the studied hospitals and performance indicators, bed occupancy rate, average patient stay, and bed turnover rate. Data were analyzed using Chi-square and Kolmogorov-Smirnov tests.
 
Results: The average patient stay was 5.89 days, which was only 7.15 percent desirable by standards. The bed occupancy rate was 76.35 and the bed turnover was 45.97 times a year. The status of these two indicators was optimal based on the standards available in 92.85% of the cases. Also, based on the results of the present study, the mean average patient stay was 2.91 days, which was desirable in 77.77% of the cases according to the standards. The bed occupancy rate was 62.70 and only 11.11% of the cases were favorable. The bed turnover was set at 65.44 times a year. In relation to this index, in 100% of cases, the situation was favorable.
 
Conclusion: The non-educational hospitals of Tehran University of Medical Sciences were in a better position regarding the length of the patient's stay than the indicators of the Ministry of Health and even compared to the hospitals of other provinces. In relation to educational hospitals, due to the fact that according to the Ministry of Health, the optimal condition of the average patient stay is less than 3.5 days and more than 4 days is a sign of weakness and inefficiency of the hospital, the studied hospitals with an average of 5.69 days. They differ significantly from the standard. In the other two indicators, both educational and non-educational hospitals were in good condition.
 
 
 

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Background & aim: Diabetes is as a chronic disorder, which produce lots of limitation in patients' activities and psychological quality. The aim of the present study was to investigate the efficacy of cognitive-behavioral therapy based on Lazarus's multimodal approach to psychological weakness and thoughts fusion among diabetic patients with wounds.
 
Methods: The present study was a semi-experimental (pre-test, post-test) with a control and experimental group. The statistical population of study consisted of 50 diabetic patients with wounds in Tabriz Sina Hospital, 24 patients with Purposive sampling selected and randomly divided into two experimental and control groups (each group was 12). The experimental group participated in group sessions for 8 sessions of 120 minutes, while the control group did not receive any intervention. Subjects in both experimental and control groups were assessed with the Minnesota Multiplier Questionnaire (MMPI) Questionnaire (Pt sub-scale) and Thought Fusion Inventory (TFI) before and after treatment. Data were analyzed by descriptive statistics (such as mean and standard deviation), ANCOVA and MANCOVA.
 
Results: Results indicated that there were significant differences in post-test mean scores of experimental and control groups and cognitive behavior therapy could significantly reduce psychological weakness (F=41/138, p=0.01) and increase thought fusion (F=9/306, P<0.007).
Conclusion: Cognitive behavioral therapy with changing maladaptive thought and helping to accept disease, resulted in behavior change in diabetic patients.