Journal of Arak University of Medical Sciences

The Effect of Problem-Solving Skills Training on the Moral Distress of Novice Nurses

Mahbobeh Sajadi

Background and Aim Moral stress happens when a person makes a moral decision but cannot accomplish it, mainly due to internal and external organizational limitations. Problem-solving skills training as one of the principles of stress management may be effective in controlling nurses’ moral stress. This study was conducted to investigate the effect of problem-solving skills training on the moral stress of novice nurses.
Methods & Materials This study was a clinical trial performed on 70 novice nurses working in Shohaday Khorramabad Hospital, Khorramabad City, Iran. The samples were selected by convenience sampling and randomly divided into intervention (n=36) and control (n=35) groups. The study data were collected by demographic questionnaire and Corley’s moral distress scale. Before the intervention, participants of both groups completed those questionnaires. Then for the intervention group, a problem-solving skills workshop was held in six 2-hour sessions. After training, the Corley moral distress scale was completed again by participants of both groups. Finally, the data were analyzed by the Chi-square test, paired, and independent t tests in SPSS software v. 16.
Ethical Considerations This study has been approved by the Research Ethics Committee of Arak University of Medical Sciences with the ethical code IR.ARAKMU.REC.1395.449. Informed consent was taken from all participants, and they were assured of keeping their information confidential.
Results In this study, most participants were around 25 years old. Also, 98.5% had Bachler’s degrees, and 1.5% had Master’s degrees. The study results showed that the mean of moral distress in the intervention was significantly different from before the intervention (P<0.05).
Conclusion This study showed that applying problem-solving skills has a significant effect in decreasing the moral distress of novice nurses in the clinical setting.

Evaluation and Comparison of PBK and E2F7 Gene Expression Between Early and Advanced Stages of Colorectal Cancer

Maryam Peymani

Background and Aim PBK is a mitogen-activated protein kinase (MAPKK) among MEK1/2 and MEK7 and can phosphorylate P38, JNK, and ERK in many cellular functions. The E2F transcription factor family also belongs to a class of cellular regulators acting as oncogenes and tumor suppressors. This study aims to investigate the expression of PBK and E2F7 in the early stages of colorectal cancer (CRC) compared to advanced stages based on the experimental and TCGA (The Cancer Genome Atlas) database.
Methods & Materials A total of 32 tissue samples of patients with CRC with the approval of a pathobiologist were collected according to the examination and criteria reported from different stages. After RNA extraction and cDNA synthesis, the RT-qPCR technique was used to evaluate the expression of the desired genes in the study groups. A receiver operating characteristic (ROC) curve analysis was also used to determine the ability of each of the selected genes to differentiate the two populations: stage I+II and stage III+IV.
Ethical Considerations In all stages of this research, codes of ethics of research and publication were observed.
Results In this study, it was shown that the expression of PBK and E2F7 significantly increased in stage I+II samples compared to stage III+IV. These data were confirmed by laboratory results and information extracted from the TCGA database. Also, based on the area under curve obtained from the ROC curves, these two genes are significantly distinguishable between stage I+II and III+IV populations in CRC.
Conclusion According to the results of this study, PBK and E2F7 genes are good markers in the diagnosis of CRC.

Effect of Gentamycin Solution (80 mg) in Combination With Allograft Bone Material in Rat Bone Defect Regeneration

Mojtaba Bayani

Background and Aim The use of allograft alone or in combination with other bone materials has significantly improved bone-augmentation procedures. Therefore, this study aimed to evaluate the effect of topical gentamicin solution (80 mg) with allograft on guided bone regeneration in defects in rat skull.
Methods & Materials Twelve Wistar mice were randomly divided into two groups, with 6 in each group. Three defects were created in their skulls, one filled with demineralized freeze-dried bone (DFDBA) allograft alone, the other with allograft with gentamicin 80 mg solution, and the third defect were left empty as a control group. After 4 and 10 weeks, the mice were killed for histological specimens. Histological and histomorphometric evaluations were performed to qualitatively and quantitatively assess bone formation, a new bone type made, new bone vitality, inflammatory response, connective tissue type, and angiogenesis.
Ethical Considerations This study was approved by the ethics committee of Arak University of Medical Sciences (Code: IR.REC.ARAKMU.1397.30).
Results At the end of 4 and 10 weeks after surgery, the average percentage of ossification in the area of defects was higher in the group that received allografts with gentamicin, and during this period, a significant difference was seen between these groups and the control group.
Conclusion According to the present study, the use of gentamicin in combination with DFDBA has a significant effect on bone regeneration in defects in the rat skull.

The Effect of an Educational Program on Health Belief Model of Preventive Behaviors of Nosocomial Infection by Babol Hospitals Midwives

Reza Tavakoli

Background and Aim Nosocomial infection is a health problem in all countries. Considering the role of midwives in controlling nosocomial infection, the aim of this study was to determine the effect of an educational intervention based on model on preventive behaviors of nosocomial infection by Babol hospitals midwives was done.
Methods & Materials The present study was a quasi-experimental study with intervention and control group. The interventions were performed in three 40-minute sessions in the Shahid Yahya Nejad Hospital in April and May 2017. The data collection tool was a structure Health Belief Model based(Awareness, structure Health Belief Model and behavior) on a questionnaire completed Its validity and reliability were assessed two months before and one month after Midwives who met the inclusion criteria education. Data were collected and analyzed by SPSS software v. 24 by Anova , T-test and ANCO one-way Covariance tests.
Ethical Considerations This research paper has been approved by the ethics committee IR.IAU.TMU.REC.1398.068 and informed consent will be taken from the participants in the study the information will remain confidential.
Results Before the intervention, the two groups did not differ significantly in terms of, mean scores of different model structures. After intervention, there was a significant difference in the mean and standard deviation of the effect of education on knowledge score (1.0±0.3), perceived sensitivity (2.8±1.5), perceived severity (3.6±1.7) Perceived barriers (-6.4±1.3), perceived benefits (5.1±4), self-efficacy (4.6 ± 2.6) and behavior( 3.1±1.1) was seen in the intervention group (P>0.05).
Conclusion By increasing the scores obtained from the structures Especially self-efficacy and reduction of perceived barriers, designing and implementing an educational program based on model in midwives can increase their performance regarding the prevention of nosocomial infections.

Investigating the Relationship Between Stress Management Training and Employee Work Ethics

Amineh Ahmadi

Background and Aim The occupational environment, the type of work overload or underload, physical risks, how individuals adapt to the workplace, and face the family - work constitute the sources of stress or occupational distress. Job stress emerges as the duties and tasks assigned to people are more than their abilities. This study aimed to investigate the relationship between stress management training and work ethics of employees.
Methods & Materials This research was an applied study in terms of purpose, a mixed exploratory (qualitative and quantitative) study in terms of data, a content analysis (qualitative stage) and cross-sectional survey (quantitative stage) in term of conduct. The study population in the qualitative section comprised experts (Experts in Psychology, Educational Management, and Social Medicine) according to the inclusion and exclusion criteria. In the qualitative section, the study population included experts and managers who had received stress management training. Sample size and sampling method in qualitative part was based on the principle of theoretical saturation, resulting in 12 people using purposive sampling method. In the quantitative part, the sampling was based on the Cochran’s formula, resulting in 220 people who were selected using cluster sampling method.
Ethical Considerations This barcode research was presented to the Ethics Committee and registered in the system (IR.IAU.TNB.REC.1400.121).
Results The results showed that to deal with stressful situations, three basic strategies of event-focused coping, anxiety-focused coping, and avoidance-focused coping strategies can be used for stress management training models. Overall, the components presented for coping with stressful conditions have the necessary and appropriate validities. All three main coping strategies (event-focused, anxiety-focused, and refusal-focused) are suitable for explaining and fitting. So, they all are reliable and confirmed in the current research questionnaire of coping with stress.
Conclusion Strategies for coping with stressful situations have a different effect on people’s professional work ethics so that the event-focused coping strategy has a significant positive relationship with professional ethics. On the other hand, the anxiety-focused and avoidance-focused coping strategies have negative and decreasing relationship with professional ethics. The more emphasis on the event-focused coping strategy, the more would be the professional ethics of individuals and the more emphasis on the anxiety-focused and avoidance-focused coping strategies, the less would be the professional ethics of individuals..

Predicting Children’s Socioemotional Problems Based on Parenting Styles With the Mediating Role of Social Support

Shadi Jazayeri

Background and Aim In modern life, emotional and social problems have taken the highest rank among mental illnesses. The present study aimed to provide a causal model for predicting children’s psychosocial problems based on parenting styles with an emphasis on the mediating role of social support.
Methods & Materials The present research was a cross-sectional analytic study. The study population included parents of children (under 5 years old with behavioral-emotional problems) referred to the comprehensive health centers services in Pardis City, Iran, in 2020. Of whom, 230 people were selected by convenience sampling method. Measurement tools included parenting styles, social support, and socioemotional problems questionnaires. Structural equation modeling with SmartPLS software was used to analyze the data.
Ethical Considerations This study was approved by the Ethics Committee of Science and Research Branch, Islamic Azad University (Code: 99527).
Results The Mean±SD age of mothers was 32.87±7.87 years. Also, 60% of children were boys, and 40% were girls, with an Mean±SD age of 4.12±0.78 years. The Mean±SD scores of socioemotional problems, parenting styles, and social support were found to be 40.16±4.73, 152.23±18.10, and 34.66±6.49, respectively. The results of structural equation modeling showed that parenting styles had a significant role in predicting children’s socioemotional problems through social support mediation (P<0.05). Also, the fitting branches of the model showed the proper fit of the model through the composite reliability and the Cronbach alpha calculation.
Conclusion The results of the present study emphasize the critical role of early childhood life and the need to focus on support facilities for mother-child couples at this age. Accordingly, providing psychological and supportive interventions for mothers with high stress can result in parental adjustment and mental health and, subsequently, the child’s normal development.

Comparing the Effectiveness of Acceptance and Commitment Therapy With Compassion-Focused Therapy on the Intensity of Resiliency and Worry in Patients With Multiple Sclerosis

Mohammad Hosseini Bayazi

Background and Aim Given the increasing number of patients with multiple sclerosis and the psychological complications that affect this group, the present study was conducted to compare the effectiveness of acceptance and commitment therapy and compassion-focused therapy for these patients
Methods & Materials This research was a quasi-experimental study with a pre-test-post-test design with a control group. A total of 45 patients with multiple sclerosis were selected from MS patients in Tehran Clinic, Tehran City, Iran, in 2020. They were randomly divided into three groups: the first group was under treatment based on acceptance and commitment therapy, the second group was assigned to the compassion-focused therapy, and the third group was the control. The participants completed the Connor and Davidson resilience questionnaire and the Pennsylvania concern questionnaire in the pretest and post-test stages. The first and second groups participated in eight sessions of acceptance and commitment therapy and ten sessions of compassion-focused therapy, respectively. The control group did not receive any intervention. The post-test was done at the end of the therapy sessions. Data were reported by analysis of covariance.
Ethical Considerations This research was approved by the Torbat Jam Branch, Islamic Azad University (Cod: IR.IAU.TJ.REC.1399.012).
Results The results of univariate analysis of covariance were obtained at the statistical level of P<0.05. In this regard, F=5.88 for resilience and F=42.60 for anxiety intensity were obtained, which indicated the greater effectiveness of acceptance and commitment treatment.
Conclusion Considering the effectiveness of both treatments, it is suggested that these treatments be given more attention to controlling patients’ psychological symptoms.

Examining the miR-93-5p and miR-17-5p Expression in Plasma and Breast Cancer Tissue as Possible Markers in Breast Cancer Prognosis

Mahdieh Salimi

Background and Aim MicroRNAs (miRNAs) are a class of small non-coding RNAs (17-25 nucleotides) that have been studied in many diseases. miRNAs studies in different cancers have shown that miRNAs may be considered oncogene or tumor suppressor. So far, many studies have shown that miR-17-5p and miR-93-5p are important regulatory molecules in some biological processes, such as cell proliferation, associated with cancer formation. This study aimed to investigate and compare the tissue and plasma expression levels of miR-17-5p and miR-93-5p in patients with ductal carcinoma breast cancer with the normal control group.
Methods & Materials The total RNA (including miRNA) was extracted from breast and plasma tissue samples of cancerous and normal samples. The RNA concentration and purity were confirmed using optical absorbance measurements. cDNA was synthesized, and the expression levels of miR-17-5p and miR-93-5p were assessed semi-quantitatively by SYBR Green-based real-time RT-PCR assay in plasma and breast tissues of ductal carcinoma breast cancer compared with the control normal samples with SNORD47 as internal normalizer. Data were statistically evaluated using GraphPad Prism 8.0.2.
Ethical Considerations This study was approved by the Ethics Committee of the institute (IRAN 52d/4922, 6.10.2016). All study individuals signed a consent form to use their clinical samples and personal data under the physician’s supervision.
Results The expression level of miR-17-5p showed significantly higher expression in tissues and plasma of the cancer group compared with the control group (P<0.0001). It was also significantly associated with tumor stage and lymph node, and ER (estrogen receptor) and PR (progesterone receptor) status (P<0.0001). While decreased expression of miR-93-5p in plasma and tumor tissues was shown to be significantly associated with tumor stage and lymph node involvement (P<0.0001).
Conclusion The data revealed that high expression of miR-17-5p and low expression of miR-93-5p in both plasma and breast tumor might be associated with poor prognosis in breast cancer. However, miR-17-5p, due to the greater change in expression and ease of plasma detection, may serve as a possible non-invasive biomarker for breast cancer’s poor prognosis. Further follow-up studies are required to confirm this finding.

Correlation Between Serum Calcium, Phosphorus, and Alkaline Phosphatase Indices With Lumbar Bone Mineral Density In Active And Inactive Postmenopausal Women

Leila Fasihi

Background and Aim Menopause is a period in a woman’s life that can be physically damaging. However, its effect on bone mineral density is still debatable. This study investigated the relationship between serum calcium, phosphorus, and alkaline phosphatase indices with lumbar bone mineral density in active and inactive postmenopausal women.
Methods & Materials The number of subjects was 55 active postmenopausal women and 60 inactive postmenopausal women aged 45 to 85 years. Serum indices of calcium, phosphorus, and alkaline phosphatase and anthropometric of the subjects were measured. The Pearson correlation coefficient test was used to analyze the research data. SPSS software v. 26 was used to analyze the data.
Ethical Considerations This study was approved by the Research Ethics Committee of Allameh Tabataba’i University with code IR.ATU.REC.1399.038.
Results The results showed a significant correlation between serum levels of alkaline phosphatase (P=0.021), calcium (P=0.019), and phosphorus (P=0.011) with lumbar bone mineral density in active postmenopausal women and also between body mass index with lumbar bone mineral density in both groups of active (P=0.014) and inactive (P=0.038) postmenopausal women. No significant relationship was found between other indicators.
Conclusion According to the results of the present study, being active may have had beneficial effects on bone metabolism and has led to a better state of bone mineral density. It may also help to use these blood and anthropometric variables in identifying people at risk for osteoporosis in adulthood and old age.

Examining the Prevalence of Hydatid Cyst in Patients Referred to Imam Reza, Imam Hossein, and Bisotoon Hospitals in Kermanshah City, Iran, During 2014-2018

Naser Nazari

Background and Aim This study aimed to investigate the clinical and laboratory characteristics of hydatid cyst disease in patients admitted to Imam Reza, Imam Hossein, and Bisotoon hospitals in Kermanshah City, Iran, from 2014 to 2018.
Methods & Materials In this descriptive study, we studied and analyzed the medical records of 350 patients with hydatid cysts who were hospitalized and underwent surgical treatment in Kermanshah hospitals from 2014 to 2018. Also, the demographic characteristics of patients, including gender, age, occupation, place of residence, and affected organs, were extracted and recorded.
Ethical Considerations The Ethics Committee of Kermanshah University of Medical Sciences approved this study (Code: IR.KUMS.REC.1398.366).
Results In total, 350 patients with a Mean±SD age of 43.2±19.7 in women and 43.3±20.7 in men were admitted with a diagnosis of hydatid cyst. The highest and lowest prevalence of hydatid cysts were in the age groups of 41-50 (16.5%) years and 1-10 (4.8%) years, respectively. The prevalence was 181 (51.7%) in women and 169 (48.2%) in men. The organs mostly infected with hydatid cysts were the liver, lung, and brain, with 241 cases (68.8%), 55 (15.7%), and 24 (6.8%), respectively.
Conclusion This study shows that hydatid cyst disease is an important disease, especially in rural areas of Kermanshah Province, Iran.

The Mediating Role of Cognitive Emotion Regulation and Mindfulness in the Relationship Between Worry and Generalized Anxiety

Zahra Zanjani

Background and Aim Various research studies have investigated the relationship between anxiety and worry. The present study aimed to examine the mediating role of cognitive emotion regulation and mindfulness in the relationship between anxiety and worry.
Methods & Materials The present study follows a correlational design study. The research sample included 248 students of Kashan universities in Iran studying in the 2017-2018 academic year. The study data were collected using the generalized anxiety disorder (GAD-7), Pennsylvania state worry questionnaire (PSWQ), the Persian short form of cognitive emotion regulation questionnaire (CERQ-P-short form), and five-factor mindfulness questionnaire (FFMQ). Then, the obtained data were analyzed using the SPSS v. 22 and AMOS v. 22 software.
Ethical Considerations The Ethics Committee of Kashan University of Medical Sciences approved the study (Code: IR.KAUMS.REC.1396.36).
Results The results showed a significant relationship between generalized anxiety and worry, worry and cognitive emotion regulation, worry and mindfulness, generalized anxiety and cognitive emotion regulation, and anxiety and mindfulness. The results of the structural equation modeling confirmed the mediating role of cognitive emotion regulation in the relationship between anxiety and worry. Also, the path coefficient of mindfulness and anxiety was removed from the model because it was not significant.
Conclusion Generally, cognitive emotion regulation plays a mediating role in the relationship between anxiety and worry. These findings seem applicable in the individual, family, educational, therapeutic, and interpersonal mental health fields.

Comparing the Effectiveness of Cognitive Therapy Based on Mindfulness and Compassion Therapy on Automatic Negative Thoughts, Psychological Symptoms, Pain Intensity, and Quality of Life in Patients With Fibromyalgia

Mohammad Reza Bayat

Background and Aim Fibromyalgia syndrome is a chronic disease that causes widespread musculoskeletal pain. It primarily affects women and negatively impacts many aspects of a person’s psychological and social life. This study aimed to compare the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia syndrome.
Methods & Materials This research is a quasi-experimental study with a pre-test-post-test design with two experimental and one control group. The statistical study population consisted of all individuals with fibromyalgia syndrome referred to Mehregan Pain Clinic in Mirdamad (District 3), Seyed Khandan Clinic (District 4), and Taleghani Hospital Pain Clinic (District 1) in Tehran City, Iran. Of them, 30 patients were randomly selected and divided into three groups of experimental 1, experimental 2, and control; each group will include 10 people. The instruments used in this study included the World Health Organization quality of life questionnaire (WHOQOL BREF), pain intensity questionnaire (PIS), psychological symptoms questionnaire (Anxiety, Stress and Depression [DASS]), and automatic negative thoughts (QNS).
Ethical Considerations This study was approved by the Research Ethics Committee of Arak Branch, Islamic Azad University (Code: IR.IAU.ARAK.REC.1400.005).
Results The analysis of covariance showed the effectiveness of both cognitive therapies based on mindfulness and compassion therapy on four variables of pain intensity, psychological symptoms, automatic negative thoughts, and quality of life (P<0.05). Comparing the two intervention methods showed that both therapies had almost the same effect on pain intensity, psychological symptoms, and automatic negative thoughts (P<0.05) but the effectiveness of mindfulness intervention on the quality of life was significantly higher than compassion intervention (P<0.05).
Conclusion The results indicate that cognitive therapy based on mindfulness and compassion therapy are suitable for people with fibromyalgia under appropriate treatment.