BACKGROUND: In physical diseases including cardiovascular diseases (CVDs), illness perception (IP) plays an important role in illness outcomes. Fatigue is a major bothersome symptom after myocardial infarction (MI). This manuscript presents the research design, methodology, and primary findings of a study on factors in relation with fatigue and IP in patients with MI, and changes in fatigue after intervention on IP. METHODS: 241 patients with MI who experienced a first-time acute MI (AMI) participated in this study in 2016-2017. During hospitalization, the demographic and clinical information of participants were collected. After four months, the information regarding fatigue, IP, coping with stress, type D personality, perceived social support (PSS), and locus of control of the participants was collected at their houses. About one year later, based on the results of phase one of the study, a psychoeducation course was conducted for 35 of the patients as intervention group while 36 patients were supervised as control group. Two months later, the role of IP in fatigue changes of the participants was assessed. RESULTS: 155 (65%) of the patients had positive family history of coronary heart disease (CHD). 103 (43%) were cigarette smokers, 100 (43.5%) had high blood cholesterol, and 72 (30%) had sedentary life style before MI. CONCLUSION: The overview of the factors related to fatigue and IP of the patients with MI could help the care teams to provide better care in the recovery period of the illness.
BACKGROUND: To evaluate the efficacy of different ways of communications on prevention of suicidal reattempt, we compared the efficacy of phone call versus face-to-face follow-up in patients with previous attempt. MATERIALS AND METHODS: In a randomized controlled clinical trial, 55 suicide reattempters who were admitted to the poisoning emergency were divided into phone call (29 patients) and face-to-face (26 patients) groups randomly. They were followed at 8 occasions: 2nd and 4th weeks, and the 2nd, 3rd, 4th, 5th, 6th, and 8th months. The suicidal reattempt, suicidal thought, hope, and interest of the patients were assessed on each occasion, and the patients were guided to visit by a therapist, if needed. The findings were analyzed by Mann-Whitney, Chi-square, Cochran, Friedman, and independent t-tests using SPSS 20. RESULTS: The status of "hope" and "interest" improved in both groups, but it showed more significant difference in the face-to-face group. Suicidal thoughts in both groups decreased over time, and this was more significant in the face-to-face group. However, we did not found any significant difference in the frequency of the suicidal reattempts between two groups. CONCLUSION: Face-to-face versus phone call follow-up of suicide attempters can significantly alleviate suicidal thoughts and improve hopes and interests.
OBJECTIVE: The present study aimed to evaluate the effect of parenting education on improvement of reading and writing disabilities in children. METHODS: A randomized controlled trial was done on primary school students with reading and writing disabilities and their mothers. The subjects were divided into three groups with 26 members in each group. The first group (mothers' education group) received 6 one-hour new educational sessions. The second group (standard group) received 12-15 standard educational sessions for learning disability, and the third group (control group) which consisted of students with learning disability did not receive any treatments. Research instruments included reading and writing tests, and demographic questionnaire. The three groups were evaluated via pretest and posttests at baseline and after one and three months of educational interventions. Data were analyzed using the chi-square, t-test, and repeated measures multivariate analysis of variance (MANOVA). RESULTS: The mean reading speed had the most progression in the mothers' education group. Comparison among reading speed, reading accuracy, and spelling scores has been statistically significant (F 2, 6 = 90.64;p < 0.001) but the mean of these scores has been insignificant among the three groups (F 2, 67 = 0.583;p > 0.05). The mean reading accuracy, mostly increased after 3-month interventions in the mothers group. The control group had the lowest mean reading accuracy scores. CONCLUSION: Parenting education in mothers had a positive effect on the treatment of children with reading and writing disabilities. DECLARATION OF INTEREST: None. Clinical Trial Registration-URL: http://www.irct.ir. Unique identifier: IRCT201101205653N1.
BACKGROUND: Multiple factors such as retirement, work disability, social rejection, physical illness and etc., have an impact on general health of the elders. One factor among others is the role of psychological variables. The study is intended to assess the effect of positive and negative perfectionism and type-D personality (distressed) on general health of the elders. METHODS: In this descriptive-correlation study, 80 people (47 male and 33 female) were selected from residents of Nursing Home in Hamadan and Malayer using non-probability (accessible) sampling method. They responded to the questionnaires of type-D Personality, Goldberg and Hillier's General Health and Positive and Negative Perfectionism of Terry-Short et al. RESULTS: Positive perfectionism (r = 0.30) and type-D personality (r = 0.32) had significant correlation with general health. Multiple regression analysis revealed that positive perfectionism and type-D personality could explain at least 49% of the variance in general health. Concerning the variables of negative affectivity, social inhibition and social function, the females' mean was higher than that of males and considering the variables of positive perfectionism, and social functioning, the males' mean was higher than that of females. CONCLUSIONS: Positive perfectionism decreases mental disorder of the elders by creating optimistic attitudes and enhancing social functions. On the other hand, type-D personality, unlike positive perfectionism, makes elders susceptible to physical illness and mental disorder.
BACKGROUND: In some studies, the involvement of dangerous psychological and behavioral factors in etiology and physiotherapy of vascular disturbances have been shown. In other studies, the relationship between the personality type and increase in cardiovascular disease has been demonstrated. The type D personality is defined as having two characteristics of negative affect and social inhibition. It is thought that individuals with type D personality are at increased risk of carotid artery intima-media thickening which predisposes them to vascular disease that is one of the most important factors for the stroke. In this study, we try to determine whether type D personality is a contributing factor to an increase in the intima-media of the carotid artery. This study was done in 2012 in the teaching hospital of Alzahra in Isfahan Iran. METHODS: This is a case/control study which is done at Alzahra hospital in Isfahan in 2011-12. The statistical population in this study is composed of individuals who do not have any risk factors for stroke and are randomly selected among the hospital staff or the patient's family members who accompanied the patient at the hospital. They filled out a questioner that would assist in detecting type D personality. A carotid Doppler ultrasound that measures the intima-media thickness in the selected individuals was performed. The information obtained from the study was evaluated by Statistical Product and Service Solutions (SPSS) software and the intima-media thicknesses were compared in two groups of patients. RESULTS: The average thickness of intima media in two groups, consist of placebo and patients, was 0.739 ± 0.12 and 0.759 ± 0.14 millimeter, respectively. There was no meaningful difference between the two groups based on t-test values (P = 0.19). It is important to note that based on the results, 22.9% of placebos and 48.6% of individuals with type D personality presented with abnormal thickness. The difference between the two groups were meaningful based on Chi-Squared test (P = 0.001). CONCLUSIONS: We conclude that type D personality increases the risk of cardiovascular diseases specially the stroke and myocardial infarction due to the higher prevalence of hormonal imbalances leading to arterial vasospasm and atherosclerotic disease. As a result, it is necessary to evaluate and treat these patients due to increased risk of atherosclerotic diseases, stoke, and myocardial infarction.
BACKGROUND: The aim of this study was to examine the association between left ventricular ejection fraction (LVEF) and incidence of depression following the myocardial infarction (MI). METHODS: In a prospective study, 176 patients aged 32-84 years with the mean age of 56 years (SD = 10.05) with a definitive diagnosis of myocardial infarction and admitted to one of the coronary care units (CCU) of Isfahan during April to August 2006 were selected through consecutive sampling method. The demographic and medical characteristics were collected by their medical record and also the results of the LVEF assessment of the patients were obtained through echocardiography or angiography following the myocardial infarction. Thereafter, the patients were given Beck Depression Inventory for the primary care (BDI-PC) in three months after myocardial infarction. The collected data were analyzed during the hospitalization and follow-up periods using logistic regression method. RESULTS: The findings indicated that left ventricular dysfunction identified by the Left ventricular ejection fraction index was significantly correlated with depression three months after the myocardial infarction (P < 0.01). In addition, the exploratory model (which only includes LVEF variable) had the predictive validity of 64.8% with 55.7% sensitivity and 72.1% specificity. CONCLUSION: Left ventricular dysfunction is associated with increased risk of depression following the myocardial infarction.
BACKGROUND: Studies have shown the association of mood disorders and endothelial dysfunction, and increased risk of cardiovascular disease; however, mediatory mechanisms are not entirely clarified in this regard. We investigated the relationship between depression/anxiety symptoms with systemic inflammation and endothelial function. MATERIALS AND METHODS: This cross-sectional study was performed in 2011 on employees of an oil company located in the Isfahan city (central Iran). Participants were selected with clustered random sampling. Anxiety and depression were evaluated by Hospital Anxiety Depression Scale (HADS). Systemic inflammatory status was evaluated by measuring sensitive C-reactive protein (high sensitive-CRP). To evaluate the endothelial function flow-mediated dilation (FMD) was measured. RESULTS: During the study period, 254 participants (mean age = 51.4 ± 6.1 years) were evaluated. No significant relationship was found between high sensitive-CRP or FMD and any of the variables of anxiety or depression. In multivariate analysis, by controlling the possible confounding factors, no association was found between anxiety score, depression, or the overall score of HADS with high sensitive-CRP or FMD. After the separate analysis of patients with and without diabetes, depression score was correlated inversely with FMD among patients with diabetes (r = 0.525, P = 0.021). CONCLUSION: According to the results, in the studied population, there was no relationship between anxiety/depression with systemic inflammation or endothelial dysfunction, while in individuals with diabetes, depression was associated with endothelial dysfunction. In this regard more cohort studies are recommended.
BACKGROUND: Social support is a complex and multifaceted construct. Thus, It is important that a given social support scale be theoretically grounded and its purview clearly defined. The purpose of this study was to examine the reliability, validity and factor structure of the Iranian version of the Multidimensional Scale of Perceived Social Support (MSPSS). METHODS: The sample study included 176 consecutive myocardial infarction (MI) patients admitted to the coronary care unit (CCU) ward of nine hospitals in Isfahan, Iran, and 71 consecutive subjects from the general population. They all filled out the final Iranian version of the MSPSS and also 71 participants filled out the MSPSS twice over a 2-month period. Factor analysis, Cronbach's α coefficient and Pearson's correlation coefficient correlation were used to analyze data. RESULTS: Factor analysis of the scores of the patient and healthy samples yielded a three-factor structure, including family, friends and significant others. The percentage of variance explained by the three factors in the patient sample and healthy sample were 77.87% and 78.55%, respectively. Cronbach's α coefficient has been found to be 0.84 for the scale and 0.90, 0.93 and 0.85, respectively, for the friends, significant others and family subscales from the patient sample, and 0.92 for the scale and 0.89, 0.92 and 0.87, respectively, for the friends, significant others and family subscales from the healthy sample. Test-retest stability over a 2-month period yielded 0.84 for the scale and 0.73, 0.78 and 0.84, respectively, for the friends, significant others and family subscales from the healthy sample. CONCLUSIONS: The findings proved the three-factor structure of the Iranian version of the MSPSS and indicated that the Iranian version of the MSPSS is a reliable, valid and acceptable measure of perceived social support.
OBJECTIVE: There are many studies indicating the role of psychological factors in the pathogenesis of cardiovascular disorders. Type D as a new personality construct has been proposed by Denollet, characterized by the joint global traits including negative affectivity and social inhibition. The purpose of this study was to examine the link between type D personality and hyperlipidemia in patients with myocardial infarction (MI). MATERIALS AND METHODS: One hundred and seventy-six consecutive patients admitted to the cardiac care unit (CCU) wards of nine hospitals in Isfahan, Iran, following MI, were selected based on the inclusive and exclusive criteria. The patients completed demographic questionnaire and Type D Personality Scale (DS14). Their medical data were obtained from medical records. Chi-squared test, Student's t-test, and multivariate logistic regression were used to analyze the data. RESULTS: Of the 176 subjects, 63 patients (35.8%) were type D. In univariate analysis, hyperlipidemia was the only significant variable (56% vs. 40%, P = 0.041) found to be associated with type D. Also, by multivariable logistic regression analysis, hyperlipidemia [Odds Ratio (OR) 0.374; 95% confidence interval (CI) 0.175-0.796] was the only independently significant variable found to be linked with type D personality. No other statistically significant differences were found between the two groups on demographic and medical factors characteristics. CONCLUSION: The type D personality was associated with hyperlipidemia. Thus, personality factors may make people vulnerable to metabolic syndromes.
BACKGROUND: Nephrolithiasis is a recurrent disease, and one of the most effective methods for prevention of stone recurrence is increasing the urine output (>2 L/day), but it is difficult to achieve it. The aim of this study was to evaluate the effect of behavioral intervention by measurement of urine specific gravity using dipstick on 24-h urine volume in first renal stone patients. MATERIALS AND METHODS: In this prospective randomize clinical study, 80 adult patients with history of first renal stone were included. Patients were divided into two groups with 40 patients in each group. We explained the importance of high fluid intake and high urine volume in the prevention of renal stones for all patients. Group A patients were trained to measure 24-h urine volume every 15 days, and group B patients were trained to keep urine specific gravity below 1.010 by using dipstick. We measured 24-h urine volume in each group before intervention, and at 3 months and 6 months after intervention and compared them. RESULTS: There were no significant differences between the two groups in 24-h urine volume before intervention (P = 0.41), but it was significant 3 months (P = 0.01) and 6 months (P = 0.01) after intervention. Patients' compliance was 20% in group A and 90% in group B (P < 0.05). CONCLUSION: The use of behavioral modification with dipstick is an effective method for control and maintenance of optimal urine volume, and it has resulted in more patient compliance for drinking water and is more effective for prevention of renal stone.
