Jundishapur Journal of Chronic Disease Care

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In Collaboration with School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences

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Jundishapur Journal of Chronic Disease Care (JJCDC) is the official peer-reviewed research journal of Ahvaz Nursing & Midwifery School and is devoted to a wide range of research that will contribute to the chronic disease of the caring professions.

JJCDC is an authoritative caring journal which its content is devoted to the particular compilation of the latest worldwide and interdisciplinary approach and findings, including original manuscripts (quantitative or qualitative), meta-analyses and reviews, case reports, debates in the field of all types of chronic diseases. In addition, consensus evidential reports not only highlight the new observations, original research, and results accompanied by innovative cares, treatment, and all the other relevant topics but also include highlighting chronic disease impacts or important clinical observations and letters on articles published in this journal.

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1) Double-Blind Peer Review System

2) Open Peer Review (since Aug 2019), Show List of All Published Reviewers' Comments

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Design and Evaluation of a Mobile Health Application for Self-Care of Diabetic Retinopathy Patients: Participatory Design Study
(Brieflands, 2025-01-31) Hossein Valizadeh Laktarashi; Seyede Maryam Bazrmanesh; Zeynab Naseri; Amirhossein Daeechini; Sadegh Sharafi; Mohammad Naeim Mirzazadeh; Farshid Mohammad Mousaei
Background: Diabetic retinopathy (DR) is a significant complication of diabetes, potentially leading to vision loss. Effective self-care and management are crucial to prevent its progression. Mobile Health (mHealth) applications offer a promising solution for supporting DR patients in self-care by providing continuous monitoring, education, and reminders. Objectives: This Participatory Design study aimed to create and assess a mobile health app to help diabetic retinopathy patients manage their condition through self-care. Methods: This practical research was carried out in 2024 over two stages: Design and Evaluation. First, we determined the functional requirements and developed a conceptual model of the application using Microsoft Visio 2021. In the next stage, we evaluated the application using the Mobile Application Usability Questionnaire (MAUQ) and gathered feedback from patients with diabetic retinopathy to understand their views on the application's usability. Results: The application's main features included reminders, alerts, educational content, and useful links. Thirty users with diabetic retinopathy participated in the usability testing. The participants expressed a high level of satisfaction with the application (mean score: 5.67 ± 1.04 out of a maximum of 7.00). Conclusions: The mHealth application for diabetic retinopathy self-care demonstrated high usability and potential to support patients in managing their condition. Future work should focus on integrating more advanced features and conducting long-term studies to assess the app's impact on clinical outcomes.
Effect of a Social Support Program on the Health-Promoting Lifestyle of Family Caregivers of Older Adults with Cancer
(Brieflands, 2025-01-31) Mojtaba Raji; Shahzad Pashaeypoor; Narjes Kazemi; Leyla Sahebi; Mehrnoosh Partovirad; Nasrin Nikpeyma
Background: Cancer is one of the common diseases in old age that imposes the burden of care on family caregivers, and by creating physical, psychological, and social problems for caregivers, it affects their healthy lifestyle. Objectives: This study aimed to determine the impact of the social support program on the health-promoting lifestyle of family caregivers of older adults with cancer. Methods: This quasi-experimental study was conducted in 2021 in Dezful-Iran. 58 eligible samples were selected consecutively and divided into intervention and control groups. The intervention group received social support. Walker and Hill-Polerecky’s Health-Promoting Lifestyle tool was completed before and 6 weeks after the intervention in both groups. Data analysis was done using SPSS software v.16. Results: The overall score of the health-promoting lifestyle in the intervention (129.58 ± 15.21) and control (116.13 ± 24.62) groups had a statistically significant difference (P = 0.01). Also, after the intervention, the interpersonal relations subscale in the intervention (24.58 ± 3.00) and control (21.62 ± 5.41) groups and the health responsibility subscale in the intervention (26.68 ± 2.79) and control (5.37 ± 22.00) groups, there was a statistically significant difference (P < 0.05). However, this difference was insignificant in other subscales in the two groups after the intervention (P > 0.05). Conclusions: Social Support Programs, in addition to enhancing the lifestyle of family caregivers, can also contribute to improving the quality of care for older adults. The findings of this study recommend sharing insights with nurses, formal and family caregivers of older adults with cancer, and health services policymakers to inform and guide the development of targeted interventions and support systems that can enhance the health-promoting lifestyle of family caregivers of older adults with cancer.
Investigating the Effect of Electronic Learning Through Social Media on the Knowledge and Performance of Nurses Regarding Tube Feeding In ICU
(Brieflands, 2025-01-31) Roya Geravandian; Marziyeh Asadizaker; Shahram Molavynejad; Mohammad Hosein Haghighizadeh
Background: Updating the knowledge and having the best performance of nurses in the ICUs, due to their heavy work shifts, requires choosing the appropriate educational method. Objectives: This study was conducted with the aim of determining the effect of e-learning through social media on the knowledge and performance of ICU nurses regarding tube feeding. Methods: This quasi-experimental study was conducted on 76 ICU nurses who were eligible to enter the study and were divided into two intervention and control groups using the random allocation method. The data collection tools included demographic, knowledge level questionnaires, and nurses' performance checklist regarding tube feeding. The intervention group was given 8 sessions of group training using PowerPoint and Online questions and answers through WhatsApp social media. Before and two weeks after the training, the questionnaire and checklist of nurses' knowledge and performance were completed. Finally, the data was analyzed with SPSS 22 software. Results: The two groups were homogeneous in terms of demographic variables (P > 0.05), except for gender. To compare the knowledge score after the intervention, by controlling the confounding effects and the possible effects of the knowledge score before the intervention, analysis of covariance was used. There was a significant difference between the knowledge score of the intervention and control groups after training on WhatsApp (P = 0.001). There was no significant difference between the two groups in the mean performance scores before the intervention (P = 0.833). This difference was significant after the intervention (P < 0.001), so that the performance scores of the intervention group were higher than the control group. Conclusions: Due to nurses' heavy work shifts, the possibility of face-to-face education program is less; learning using social media can lead to an increase in the knowledge and performance of nurses in ICU in the field of tube feeding.
Comparison of the Effects of Brief Intervention (BI) on Relapse Prevention and Withdrawal Permanency in Opioid Addicts and Stimulant Users: A Quasi-Experimental Study
(Brieflands, 2025-01-31) Seyed Esmaeil Hashemi; Ghodsieh Hakimzadeh
Background: Addiction to narcotics and stimulants is a major social and health challenge worldwide. Objectives: Considering the importance of non-medical treatments in addiction rehabilitation and the necessity of psychotherapy programs in substance abuse rehabilitation centers, the present study aimed to compare the effects of Brief Intervention (BI) on relapse prevention and sustained abstinence in opioid addicts and stimulant abusers seeking help from drop-in-centers (DICs) dedicated to harm reduction in Ahvaz, a city in southwestern Iran. Methods: This applied, quasi-experimental study employed a pre-test, post-test, and follow-up design. The statistical population included 120 male substance abusers and opioid addicts aged 18 to 59, systematically selected from 467 individuals with active files in Iran’s Drug and Alcohol Treatment Information System (IDATIS) under the Ministry of Health in 2023. Participants were selected based on inclusion and exclusion criteria and randomized into four groups: Two experimental groups and two control groups, each with 30 participants. Results: The study demonstrated that BI was significantly effective in relapse prevention and promoting sustained abstinence in opioid addicts attending harm reduction centers in Ahvaz (P < 0.001). However, BI was not effective in preventing relapse or promoting abstinence in stimulant abusers (P = 0.235). Conclusions: The findings suggest that BI is an effective intervention for preventing relapse and promoting abstinence in opioid abusers. It is recommended that executive managers of addiction harm reduction centers guide their experienced social workers to implement this method as a selective psychotherapy approach complementary to medical treatment for opioid addicts.
The Role of Resilience and Defense Styles in Caregiver Burden Among the Mothers of Children with Cancer: A Descriptive-Correlational Study
(Brieflands, 2025-01-31) Mohammad-Rasool Javeri; Fatemeh Ghaedi-Heidari; Sima Ghezelbash
Background: The diagnosis of childhood cancer can be considered a multidimensional crisis for parents, particularly mothers. Objectives: This study aimed to determine the predictive role of defense styles and resilience in the caregiver burden experienced by mothers of children with cancer. Methods: This descriptive-analytical study focuses on mothers of children with cancer who were hospitalized in the pediatric wards of Seyed al-Shohada Hospital in Isfahan, Iran. A total of 136 participants were selected using convenience sampling. The study utilized the Defense Styles Questionnaire (DSQ-40), the Zarit Burden Scale (ZBS), and the Connor-Davidson Resilience Scale (CD-RISC) to collect data. The data were analyzed using STATA16. Results: On average, mothers had a caregiver burden score of 38.65 and a resilience score of 93.51. The majority of mothers (62.5%) exhibited neurotic defensive styles. The regression test results indicated a significant inverse relationship between caregiver burden and resilience (P = 0.002), as well as a significant relationship between the child’s sex and caregiver burden (P < 0.05). Conclusions: Based on the study's findings, it is recommended that counseling and psycho-cognitive programs be designed, developed, implemented, and evaluated to enhance the resilience of mothers of children with cancer and thereby reduce their caregiver burden.
Zinc Sulfate: An Effective Micronutrient for Common Colds in Children: A Double-Blind Placebo Controlled Trial
(Brieflands, 2017-10-31) Mehdi Gholamzadeh Baeis; Mohammad Javad Qasemzadeh
Background: Cold is defined as a viral infection of the upper respiratory tract. The disease is more common in children than in adults and usually requires greater attention and care. Methods: This double-blind randomized placebo-controlled trial (zinc versus placebo of zinc) was carried out using a repeated measures design. After excluding the cases that met the exclusion criteria, data was collected from 120 participants and analyzed. The study was conducted over a period of 3 months (June 2015 to August 2015). The intervention group received Zinc (1 mg/kg) for 7 days and the control group received the same amount of placebo. Results: The durations of runny nose and nasal congestion was significantly shorter in patients in the intervention group, who had received zinc, when compared with the control group (P = 0.017 and P = 0.001, respectively). Moreover, there were significant differences between patients, who received zinc and those, who did not receive the drug, in terms of the duration, severity of signs and symptoms, severity of illness, and weakness (P = 0.018). Conclusions: Based on the results of this study and other similar studies, zinc sulfate has positive effects on children with colds. Thus, the results of these studies could be utilized by medical teams to adopt a more accurate and complete clinical approach towards the use of zinc sulfate for patients with colds.
Evaluation of Celiac Disease Prevalence Among Patients with Refractory Hypothyroidism: A Cross-sectional Study
(Brieflands, 2021-07-31) Pezhman Alavinejad; Hajieh Bibi Shahbazian; Alireza Jahanshahi; Mohamad Faramarzi; Zahra Shokati Eshkiki
Background: The association of celiac disease (CD) with refractory hypothyroidism is a known but less common condition. Objectives: This study aimed to evaluate the prevalence of CD among patients with refractory hypothyroidism and compare the accuracy of different diagnostic procedures of CD in these patients. Methods: During a six-month period, 25 patients with refractory hypothyroidism were included from the endocrinology outpatient clinics of Ahvaz Jundishapur University of Medical Sciences, Khuzestan, Iran. For all the participants, the serological profile of CD, including anti-tissue transglutaminase (anti-tTG), anti-endomysial antibody (anti-EMA), and total immunoglobulin A, was determined, and then they were referred to undergo upper endoscopy and random biopsies from the first and second parts of the duodenum. Results: The average duration of hypothyroidism among the participants was 7 months. In addition, 75% of the patients (n = 19) were female. The mean age values of male and female subjects were 31.3 ± 17 and 34.3 ± 8.5 years, respectively (age range: 17 - 53 years). The average daily dosage of levothyroxine was 285.1 ± 89.9 mg. The most common comorbidities were anemia (72%) and diarrhea (24%). The most frequent serologic findings in these patients were positive anti-tTG (28%) and anti-EMA (16%). The most common results of upper endoscopy were normal mucosa (48%), gastritis (28%), duodenal fissuring (8%), duodenal atrophy (8%), and duodenal erythema (8%). Based on the results of the pathology report, 20% of the patients (n = 5) were diagnosed with CD (mostly marsh 1 and 0 stages). The sensitivity and specificity of tTG were 33 and 87.5%, respectively. The sensitivity and specificity of EMA were 11.1 and 87.5%, respectively. Conclusions: Based on the results of this pilot study, the prevalence of CD among cases with refractory hypothyroidism is higher than that of global reports. Furthermore, routine screening of CD in these patients is highly recommended even with negative serology. The endoscopic view is not adequate for the diagnosis of CD among patients with refractory hypothyroidism. In addition, it is necessary to focus on pathology reports and antibody titer.
Factors Associated With Quality of Life in Patients With Diabetic Foot Ulcers
(Brieflands, 2015-01-01) Fariba Nasiriziba; Davood Rasouli; Zahra Safaei; Dariush Rokhafrooz; Alireza Rahmani
Background: Diabetic foot ulcer (DFU) is a serious and costly complication in diabetes which affects approximately 15% of patients with diabetes and affects their quality of life (QOL). Objectives: The purpose of this study was to investigate the factors associated with QOL in patients with DFU. Patients and Methods: This cross-sectional study was performed on 60 patients (32 males and 28 females) hospitalized for DFU, performed through convenience sampling. Data related factors and the QOL questionnaire for patients with DFU were abridged. This questionnaire has 29 questions in six dimensions of enjoying life, physical health, daily activities dependence, negative emotions, concern about wound, and wound caring, which evaluate the QOL in patients with DFU. The scoring method for this tool is five optional Likert. Descriptive and analytic statistical methods were used to analyze the data. Results: Of the 60 patients with DFU, 53% were male and 47% female with an average age of 58.08 ± 11.95 years and average QOL of 41.1 ± 9.15. Statistical analysis showed that age (P = 0.002), employment (P ≤ 0001), socioeconomic status (P = 0.016), leg ulcer (P ≤ 0001), and the number of foot ulcer (P = 0.017) had a statistically significant relationship with QOL and its dimensions. Other variables did not have a significant relationship with QOL, but some of them such as smoking during negative emotions (P = 0.046) and marital status affecting the foot care difficulties (P = 0.03) had significant statistical relationships with QOL. Conclusions: Diabetic foot ulcer affects different aspects of life and can reduce patient’s QOL. To improve the care behaviors and have a better control of foot ulcers and improve the QOL for these patients, taking into account factors such as age, occupation, marital status, number of wounds, and economic status is essential to plan for care and health needs in these patients.
The Effects of Wet-Cupping on Intensity of Headache in Migraine Sufferers
(Brieflands, 2014-04-18) Amir Tabatabaee; Mohammad Zarei; Seyed Ali Javadi; Ali Mohammadpour; Ali akbarBidaki
Introduction: Migraine has a collection of symptoms characterized by recurrent and severe headaches. Complementary methods can reduce the use of analgesics and might be effective in reducing pain in patients waiting for analgesics. The purpose of this study was to determine the effect of wet-cupping on patients within 20 to 60 years of age diagnosed with migraine headaches. Materials and Methods: This study was carried out before and after clinical trial; the samples were 47 patients diagnosed with migraine headaches. Inclusion criteria consisted of a confirmed diagnosis of migraine and all the patients had to be 20 years old or above. The pain severity was evaluated twice; at the beginning and after 14 days following two sessions of wet cupping with an interval of 2 weeks. The visual pain scale was evaluated in the patients. Data were analyzed by paired t-test and Fisher's exact test using SPSS, version 17. Results: The means for pain intensity at the beginning and the end of the study were significantly decreased (P = 0.001). In most patients pain was intolerable before wet-cupping (averagely 7.79%), however, after the first (53.1%) and second (48.9%) sessions of wet-cupping, pain respectively lessened (3.15%). There was no statistically significant correlation between pain, educational level, marital status, or employment in the statistics from the beginning to the end of the study. The mean of pain reduction in women was more than in men, but the difference was not significant. Conclusions: Findings of the research indicate that using wet-cupping as a complementary method can influence the intensity of migraine pains. Due to the free count use of complementary medicine techniques, training competent qualified persons to provide services in traditional and complementary medicine is necessary. Yet further studies on larger number of patients are suggested by the results of this pilot study as the researchers commented.
The Correlation Between Efficacy of Asthma Control and Quality of Life in Asthmatic Patients
(Brieflands, 2016-07-01) Manijheh Esmaeily; Hadi Hassankhani; Alireza Mohajjel Aghdam; Reza Gharemohammadloo
Background: The improvement of self-caring and self-efficacy behaviors is vital in the successful management of asthma. Objectives: The aim of the research is to determine the relation between self-efficacy of asthma control and quality of life in Iranian asthmatic patients. Patients and Methods: This research represents a descriptive-analytical study. The 257 asthmatic patients referred to the clinic were selected as the research sample. The data collection instrument was a questionnaire consisting of four parts on personal-social characteristics, the asthma self-efficacy scale (ASES), asthma control questionnaire (ACQ), asthma quality of life questionnaire (AQLQ), and the parameters of spirometry. The data were collected after determining the validity and reliability of the questionnaires and analyzed by applying descriptive and analytical statics. Results: The results indicated that ASES scores were negatively correlated with ACQ total scores (r = -0.378, P = 0.001) and individual item scores, with the exception of item 7. Moreover, they were positively correlated with the AQLQ total (r = 0.442, P = 0.001) and subscale scores. Conclusions: The findings of this study showed that having confidence in one’s abilities is related with a better quality of life and control of asthma to control the symptoms.
Relationship Between Stress and Anxiety Regarding COVID-19 with Some Individual-Familial Characteristics Among First-Semester Students
(Brieflands, 2023-01-31) Alireza Salmani; Jahangir Maghsoudi; Bahareh Yousefi; Seyed Reza Mousavi
Background: The coronavirus disease 2019 (COVID-19) pandemic has had many effects on various aspects of individuals’ lives, including causing physical and mental problems. One of the most common psychological problems, especially among first-semester students, is stress and anxiety related to COVID-19. Objectives: This study aimed to investigate the relationship between stress and anxiety with some individual-familial characteristics of first-semester students. Methods: The current descriptive-analytical study was conducted on 106 first-semester nursing students with different educational levels at Isfahan University of Medical Sciences, Isfahan, Iran, in 2021. The sampling method in this study was census sampling. A researcher-made demographics questionnaire, the Perceived Stress Reactivity Scale, and the Corona Disease Anxiety Scale were used for data collection. In the current study, the data were collected online using electronic questionnaires. SPSS software (version 26.0) and independent t-test, Spearman’s correlation, and analysis of variance (ANOVA) were used for data analysis. Results: The mean age of the participant was 22.3 ± 10.94 years. The total scores of anxiety and stress were 8.23 ± 5.85 and 19.38 ± 5.62, respectively. The results of Spearman’s correlation test showed a significant relationship between age and stress (P = 0.001, r = 0.290). The results of the t-test showed that there were significant differences between gender (P = 0.034), marital status (P = 0.003), and work experience (P = 0.008) with stress. In addition, a significant difference was observed between educational level and stress using ANOVA (P = 0.029). Conclusions: Paying more attention to the psychological health of first-semester students provides a favorable environment for their educational success during the COVID-19 pandemic because stress and anxiety affect students’ performance in various aspects of their individual and social lives.
Estimation of PM_2.5 Pollutant and Risk of Chronic Obstructive Pulmonary Disease (COPD) in Ahvaz, Iran
(Brieflands, 2020-10-31) Elahe Zallaghi; Gholamreza Goudarzi; Sima Sabzalipour; Alireza Zarasvandi
Background: Urban air pollution was known to be one of the most important environmental problems due to its serious impact on human and environmental health. Among air pollutants, PM2.5 was the most common pollutant emitted by vehicles and dust and had negative consequences for human health, including chronic obstructive pulmonary disease (COPD). Objectives: This study aimed to assess the change levels of PM2.5 pollutants and their effect on COPD outcomes in ten years (2008 - 2017) in Ahvaz. Methods: Data were taken from the Ahvaz Department of Environment (ADoE). Data validation was performed using WHO criteria. The average time of PM2.5 was computed, and its health effects were obtained by entering its annual data and population at risk, baseline incidence (BI), and relative risk index for COPD outcomes in AirQ + software. The PM2.5 concentration average in total time changes in Ahvaz city was higher than the standard concentration set by WHO. The AQI index indicated that the city of Ahvaz did not have a good day in total during the ten-year time. Results: The result of time changes and AQI index indicated that 2010 was the most polluted year with 47 unhealthy days and 27 dangerous days. Also, with the enhancement in the PM2.5 annual concentrations, the mortality attributed to this pollution has increased as a consequence of the COPD outcome. The highest and lowest average cases COPD were 24 people in 2010 and 18 people in 2014, respectively. Conclusions: According to the results of this study, the air quality of Ahvaz city was in an unfavorable condition in terms of PM2.5 pollutions and the authorities should take the necessary measures to control and reduce pollution in the metropolis of Ahvaz for PM2.5 and reduce the mortality for the COPD health outcome.
Evaluating the Relationship Between Emotion Regulation and Pain Self-efficacy with Psychosocial Adjustment in Athletes with Chronic Pain Considering the Mediating Role of Mental Fatigue
(Brieflands, 2022-01-31) Mina Karami; Zohreh Rafezi; Maryam Sadat Motavalli; Nader Ayadi
Background: Pain is a pervasive and disabling barrier for the injured athlete threatening his/her ability to participate in sporting events and professional goals. However, psychological factors in the treatment process of chronic diseases are an important factor in involving the patient in treatment and making treatment decisions. Objectives: This research aimed to investigate the relationship between emotion regulation and pain self-efficacy with psychosocial adjustment in athletes with chronic pain, considering the mediating role of mental fatigue. Methods: The statistical population of this descriptive correlational study was all athletes with chronic pain referred to the Iranian Sports Medicine Federation. Using the convenience sampling method, a total of 200 injured athletes were selected as the sample size. For data collection, Psychosocial Adjustment to Illness Scale (PAIS), Pain Self-efficacy Questionnaire (PSEQ), Pain Fatigue Scale (PFS), and Cognitive Emotion Regulation Questionnaire (CERQ-short) were used. Descriptive statistics, correlation matrix, and path analysis (structural model) were used to analyze data. Also, SPSS (v21) and AMOS (v23) software were used to analyze the data. Results: According to the results, pain self-efficacy (β = 0.18), adaptive emotion regulation (β = 0.27), and mental fatigue (β = -0.19) had a direct positive and significant impact on psychosocial adjustment. Also, the direct effect of pain self-efficacy (β = -0.19), maladaptive emotion regulation (β = 0.17), and adaptive emotion regulation (β = -0.12) on mental fatigue was significant. In addition, the indirect effect of pain self-efficacy and maladaptive emotions on psychosocial adjustment via mental fatigue was significant. Conclusions: Mental fatigue plays a good mediating role between pain self-efficacy and emotion regulation with psychosocial adjustment of athletes with chronic pain.
A study of Elderly Life Experiences as Potential Conditions for Reducing Risk Factors of Chronic Diseases
(Brieflands, 2014-04-18) Heidarali Abedi; Mryam Lali; Shamim Keyvanniya; Akram Nikbakht
Introduction: The human life span has different phases, the final stage of which is old age, is not itself a disease, but elderly people are more liable to chronic illnesses than young people. Many chronic diseases affect all aspects of the elderly life and this indicates the need for the continuous or periodic changes in the physical, occupational and social activities. This research aimed to study the elderly life experiences as potential conditions for reducing risk factors of chronic diseases. Materials and Methods: This study applied phenomenology method. The purposive sampling was conducted among those elderly came to the parks to spend their spare time and they interviewed deeply. The data was analyzed through Colaizzi method. Results: The interviews were analyzed and the related concepts were extracted as the initial codes that were classified in to 5 themes including: leisure time, spending time, freshness, peace of mind and memories. Conclusions: Of primary concern are age-associated changes and the presence of multiple chronic diseases. Moreover, the healthy life style in an ageing period requires increasing the expertise and attention of all chairmen and planners especially in the public education field. This study showed that everyday activities of the elderly are a stroll in the park to help the m to prevent chronic diseases.
Cancer Screening Benefits Maximization Using Markov Decision Process Models: A Systematic Review
(Brieflands, 2024-07-31) Naser Mohamadkhani; Mohammad Hadian
Context: Due to the chronic nature of cancer, screening programs were a set of sequential decisions taken over time. Markov decision process (MDP) and partially observable Markov decision process (POMDP) models were the mathematical tools applied in studies, including sequential decision-making such as screening protocols for medical decision-making. Objectives: The main goal of this study was to investigate optimal policy for cancer screening using MDP and POMDP models. Methods: We performed a review of articles published within July 2000 to November 2022 in PubMed, Web of Science, and Scopus databases. The stopping age, the type of optimal strategy, the benefits of the optimal policy, and the relationship between age and risk threshold were extracted. Studies that did not use MDPs and POMDPs as the mathematical maximization models in cancer screening, review articles, editorials or commentaries, non-English articles, and those that did not focus on optimization were excluded. Results: From 532 articles, 6 studies met the study criteria. All studies suggested that the optimal policy was control-limit, and the cancer risk threshold was a non-decreasing function of age. Three studies specified a stopping age for cancer screening. In five studies, the optimal policies outperformed the guidelines or no screening strategy. Conclusions: Two essential factors in screening decisions were cancer risk and age, which were individual variables. The control-limit policy included these factors in decision-making for cancer screening. These policies highlighted personalized screening and showed that this type of screening could outperform cancer screening guidelines regarding economic and clinical benefits.
Pregnancy rate after laparoscopy in the infertile women referring to
(Brieflands, 2012-08-17) Jamali S; Rasekh Jahromi A
Introduction: Approximately 80 million people in the world suffer from infertility. Laparoscopy is a golden standard method which helps diagnose peritoneal and the fallopian tube problems. It is also provides the opportunity to examine all the pelvic organs. The aim of this study was to assess the pregnancy rate after laparoscopy in the infertile women reffered to the Paymanieh hospital, Jahrom. : Materials & Methods: In this cross-sectional study,162 infertile women referring to the Honari Clinic of Jahrom from 2008 to 2010 were enrolled. Laparoscopy was applied for these women due to other unsuccessful treatments. Information about patients including age, job, number of marriages, type of infertility, results of hysterosalpingography and rate of pregnancy after surgery was collected. Data was analysed using descriptive statistics including frequenc, mean and standard deviation by SPSS 16. : Results: The mean age was 27.25.31 (16-43 years). The rate of pregnancy after laparoscopic surgery was 54.9%, which most of them (84.6%) had happened after cauterization of polycystic ovaries. All of these pregnancies were spontaneous, of which 83.15% had led to termination and 16.85% has ended in abortion. None of the cases were ectopic pregnancy or any other problem. : Conclusion: The most common cause of women's infertility in Jahrom is polycystic ovaries, 89 out of 162 cases were concieved, which most of them (84.26%) concieved after electro-cautery, ovarian cyst removals or treatment of polycystic ovaries. This shows that the spontaneous ovulation after ovarian cauterization have been very satisfactory, which in turn is comparable to other similar studies. Hence cauterization of ovaries by laparoscopy has proved as an effective treatment for infertility. : Keywords: Infertility; Polycystic ovary; Laparoscopy; Pregnancy
Evaluating the Effectiveness of Integrated Intervention Program in Improving on Quality of Life and Personality Type in Heart Disease Patients
(Brieflands, 2019-01-31) Reza Soltani Shal
Background: Non-communicable diseases such as cardiovascular diseases (CVDs) are the main cause of death worldwide. Besides, major risk factors such as age, gender, race, and modifiable or psychological risk factors have a significant role in the incidence of CVDs. This study established an integrated intervention program based on psychological risk factors for Iranian cardiovascular patients, and tried to validate its effectiveness in improving quality of life and personality type. Objectives: Therefore, the aim of this study was to evaluate the efficiency of integrated intervention program in type D personality and quality of life among the cardiovascular patients. Methods: In an experimental randomized controlled trial, a total of 60 patients (29 - 42 years old, 67% males and 33% females, and all married) were assigned randomly either to the experimental (30 patients) or the control group (30 patients). The patients in the experimental group participated in the intervention program for one month. The content of the integrated intervention program included understanding the role of psychological factors on cardiovascular diseases, understanding personality types, understanding hardiness and resiliency, healthy heart lifestyle, thoughts and behavior, understanding coping styles and emotion regulation, understanding spirituality and personal growth, understanding social support, and learning relaxation techniques. Quality of life and personality type in two groups were measured through WHOQOL and type D personality questionnaire before and after the intervention. All analyses were conducted using SPSS version 20. Results: The patients in the experimental group had significantly more quality of life (P < 0.001) and less type D personality traits (P < 0.001), which support the effectiveness of the cardiac integrated intervention program. Conclusions: The results from meta-analyses indicated the role of psychological risk factors in the development of CVDs. The findings of the current study suggested that cardiac integrated intervention program increases the quality of life and reduces the type D personality traits in cardiovascular patients. Furthermore, it is recommended that cardiac care professionals use this effective treatment to improve the recovery of cardiac patients.
Artificial Neural Network-Based Prediction of Death Anxiety in HIV-Positive Cases through Social Support and Distress Tolerance
(Brieflands, 2022-10-31) Fariba Asadi; Saeed Bakhtiarpour
Background: Distress tolerance has increasingly been used as an important construct to develop a novel insight into the onset and persistence of psychological traumas as well as prevention and treatment. Objectives: The present study investigated the relationship between social support and distress tolerance with death anxiety using artificial neural networks (ANN) in human immunodeficiency virus (HIV)-positive cases. Methods: The research method was descriptive-correlational. The statistical population included all the HIV-positive cases of Ahvaz in 2021. The convenience sampling method was employed to select 91 participants as the research sample. The research instruments included the Death Anxiety Scale (DAS), the Social Support Survey (SSS), and the Distress Tolerance Scale (DTS). The Pearson correlation coefficient, simultaneous regression, and ANN were used for data analysis. Results: The mean and standard deviation (SD) of death anxiety, social support, and distress tolerance were 9.07 ± 2.76, 63.78 ± 18.05, and 37.49 ± 12.91, respectively. The results showed a negative correlation between death anxiety, social support, and distress tolerance. Also, there was a significant negative relationship between social support and death anxiety (β = -0.31, P < 0.001). There was also a significant negative relationship between distress tolerance and death anxiety in HIV-positive cases (β = -0.53, P < 0.001). Conclusions: It is now more necessary than ever before to consider the effects of social support and distress tolerance on death anxiety in HIV-positive cases. Apparently, their death anxiety is affected by other factors and their interactive effects.
The Association Between Self-Concept and Self-Efficacy in Patients Under Treatment by Hemodialysis
(Brieflands, 2015-07-01) Marziyeh Jafari; Reza Mannani; Kourosh Zarea
Background: Hemodialysis, as one of the most common methods of controlling chronic renal failure, causes the change in the ways of living as well as physical and mental health status and leads to changes in the family and social rolls of the individual. All these factors influence self-concept and self-efficacy to some extent. Objectives: This study was conducted to analyze the association between self-concept and self-efficacy in the patients under treatment by hemodialysis in the selected hospitals of Jundishapur University of Medical Sciences, Ahvaz, Iran, in 2014. Patients and Methods: In this descriptive-correlation study, 200 patients under treatment by hemodialysis were selected using convenience sampling method. Data collection was completed using a three-part questionnaire including 1) demographic information and information related to the illness, 2) Beck’s self-concept questionnaire, and 3) Sherer self-efficacy questionnaire. All questionnaires were handed to the patients in different shifts and were answered in the presence of the researcher after he explained the methodology and obtained their consent. Finally, data were analyzed using descriptive and inferential statistics using Mann-Whitney U statistics tests, Kruskal-Wallis tests, and Spearman’s correlation coefficient in the SPSS 22. Results: According to the results, a direct and significant correlation was observed between self-efficacy and self-concept, so that with an Increase in self-concept, the self-efficacy increased (P Conclusions: Although there is an association between self-concept and self-efficacy, developing more regular and detailed programs to promote self-concept, especially self-efficacy of the patients, is needed. Due to the high potentiality of mental and psychologic factors in predicting self-efficacy and performing self-care behaviors, and low level of self-efficacy in these patients, there should be much more attention to educational planning in order to promote self-efficacy. The nurses should increase patients’ self-care by designing and implementing patient-focused intervention to improve the self-efficacy and self-perception of these patients, especially in acquiring skill related to self-care.
Relationship Between Chronic Pain and Quality of Life in Patients With Acute Leukemia Undergoing Chemotherapy
(Brieflands, 2015-07-01) Mojtaba Miladinia; Shahram Baraz; Abdolali Shariati; Amal Saki Malehi; Ahmad Amadzadeh
Background: Chronic pain is one of the most prevalent symptoms in patients with acute leukemia and can affect patients' Quality of Life (QOL) that is a significant factor in assessment of cancer treatments. Also, the goal of curing hematological malignancies is to reach to increased survival and improvement of patients; and this goal will be fulfilled when QOL in patients is promoted. Objectives: The present study aimed to investigate the correlation between chronic pain and Health-Related QOL (HR-QOL) in patients with acute leukemia under chemotherapy in Ahvaz City, Iran. Patients and Methods: This descriptive-analytical study was performed on 90 patients (age range, 18 - 50 years) with acute leukemia under chemotherapy referred to Shafa Hospital in Ahvaz, Iran. The participants were selected through convenient sampling. The outcome measures included the Iranian version of the Short-Form 36 (SF-36) health survey, Numeric Rating Scale (NRS) for assessing the pain, and demographic questionnaire. Data analysis was performed using ANOVA, t-test, chi-square, with the significance level of 95%. Results: The average of pain severity was 6.03 ± 2.06, and the total average of HR-QOL was 46.83 ± 3.62, and the lowest average belonged to physical function (42.17 ± 25.75). No significant difference was found in the average pain between the two genders (P = 0.487); however, there was a statistically significant difference between HR-QOL and gender (P = 0.005). Moreover, no significant difference was detected between the average pain severity and acute leukemia type (P = 0.152). The findings also revealed a significant relationship between pain severity and aspects of HR-QOL, So that, all aspects of QOL were decreased with increased pain severity. Conclusions: The results of the study indicate that chronic pain and HR-QOL in patients with acute leukemia in Ahvaz are in a very adverse condition and require serious reform. The findings of the study can be helpful in the clinical decisions and health care programs to the therapeutic team.

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