Eye movements desensitization and reprocessing with finger movements and Elite mobile health software on guilt feeling of parents of children with autism: A randomized trial.

WHAT IS KNOWN ON THE SUBJECT?: Taking care of an autistic child at home can be tough for parents. They struggle to balance caring for their child and other tasks. This can affect their emotional well-being and cause guilt and other psychological problems. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Eye movement desensitization and reprocessing with finger movements can reduce guilt in parents of autistic children. Eye movement desensitization and reprocessing with Elite mobile health software movements can reduce guilt in parents of autistic children. The bilateral eye stimulation method using finger movements has a more sustained impact than the Elite app's bilateral stimulation method. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Healthcare providers are encouraged to learn Eye Movements Desensitization and Reprocessing. Healthcare providers are encouraged to use these methods to help with psychological issues in children with autism. Psychiatric nurses are encouraged to utilize this treatment approach for parents of children with autism, as well as to help alleviate feelings of guilt more broadly. ABSTRACT: INTRODUCTION: Caring for an autistic child at home can be challenging for parents, as it can make it difficult to balance their responsibilities. This imbalance can negatively affect the emotional well-being of the caregiver and lead to feelings of guilt. While this is a known issue, there may be gaps in knowledge specific to Iran. In this study, a new method was introduced to address this issue. AIM: This study aimed to examine the impact of desensitization with eye movements and reprocessing (EMDR) on reducing parental guilt among autistic children's families. We aim to examine the effectiveness of two different treatment methods. METHODS: This study involved 90 parents (60 mothers, 30 fathers) of autistic children randomly assigned to either an experimental or control group. The two experimental groups received a 45-min intervention session once a week for 3 weeks, while the control group did not receive any intervention. Data on feelings of guilt was collected using a questionnaire. After 30 days, both groups took a follow-up test. The data were analysed using statistical software. RESULTS: This study found that there were significant differences in guilt feelings among different groups of EMDR therapy and a control group. Specifically, no significant differences were observed in the mean guilt scores between the experimental and control groups at the pre-intervention stage (p > .05). However, the experimental groups exhibited significantly lower mean guilt scores immediately after the intervention and 1 month later than the control group (p < .05). Immediately after the intervention and 1 month later, no significant differences were observed between the two experimental groups (p > .05). CONCLUSIONS: The findings of this study demonstrate the efficacy of desensitization treatment using eye movements and reprocessing in reducing feelings of guilt among autistic children's parents. In the follow-up phase, it seems that the two-way stimulation method with finger movements is more effective than Elite software in terms of the continuity of the effect. Healthcare providers are encouraged to learn and use these methods to help prevent and treat psychological issues in autistic children.

Unheard voices: The sexual challenges of families of patients with bipolar disorder: A qualitative content analysis.

OBJECTIVES: The aim of this study was to explore the voices of the family members of Bipolar Disorder (BD) patients about the challenges ahead of them. METHODS: In this qualitative study, 22 participants shared their experiences of sexual challenges of patients with BD through in-depth, face-to-face, semi-structured interviews. Qualitative content analysis was used for data analysis. RESULTS: An overarching theme entitled "Unheard voices" reflected this experience. It comprised four main categories include sexual promiscuity, a change in sexual patterns, sexual support, and sexual indifference. The results revealed that the families of patients with BD have to deal with sexual promiscuity and change in sexual patterns in their family, and the family system attempts to respond to these changes by sexual support mechanisms and sexual indifference. CONCLUSIONS: Given the significant impact of healthy sexual behaviors on the quality of life of both the individual and the family, therapists and family support systems are advised to strengthen and educate families to support their patients' sexual health and needs and protect their sexual existence; they should also address the sexual challenges faced by these families as a diagnostic and therapeutic priority, and early sexual health interventions should be provided to these families.

Self-Management and Its Predictors in adult Patients with Epilepsy: A Cross-Sectional Study.

Background: Appropriate self-management (SM) is crucial in controlling epilepsy and improving self-efficacy, medication adherence and avoidance of seizure triggers in patients with epilepsy (PWE. The aim of this study was to evaluate SM and its predictors among adult PWE in Iran. Methods: This cross-sectional study was conducted in 2021. The participants were 335 adult PWEs that were selected from healthcare settings in Hamadan, Iran. Epilepsy Self-Management Scale (ESMS) was used to measure patients' self-management behaviors. Data were analyzed using the independent samples t-test, Pearson's and Spearman's correlation analyses and multiple linear regression analysis. Results: The mean score of SM was 114.37±11, indicating moderate level of SM, and the mean scores of SM in the medication management, seizure management, and safety management subscales were significantly more than the mean scores of the other subscales (P < 0.05). Age, place of residence, marital status, seizure type, seizure frequency, and epilepsy duration significantly predicted 53% of the variance of SM (adjusted R square = 0.532). Conclusion: PWEs have moderate SM and need SM-related education, particularly about lifestyle management and information management. Predictors of SM should be considered to boost SM practice.

Balance-energy of resting state network in obsessive-compulsive disorder.

Stability of the brain functional network is directly linked to organization of synchronous and anti-synchronous activities. Nevertheless, impact of arrangement of positive and negative links called links topology requires to be well understood. In this study, we investigated how topology of the functional links reduce balance-energy of the brain network in obsessive-compulsive disorder (OCD) and push the network to a more stable state as compared to healthy controls. Therefore, functional associations between the regions were measured using the phase synchrony between the EEG activities. Subsequently, balance-energy of the brain functional network was estimated based on the quality of triadic interactions. Occurrence rates of four different types of triadic interactions including weak and strong balanced, and unbalanced interactions were compared. In addition, impact of the links topology was also investigated by looking at the tendency of positive and negative links to making hubs. Our results showed although the number of positive and negative links were not statistically different between OCD and healthy controls, but positive links in OCDs' brain networks have more tendency to make hub. Moreover, lower number of unbalanced triads and higher number of strongly balanced triad reduced the balance-energy in OCDs' brain networks that conceptually has less requirement to change. We hope these findings could shed a light on better understanding of brain functional network in OCD.

Child exposure to domestic violence, substance dependence and suicide resilience in child laborers.

BACKGROUND: Child laborers are often defined as work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development. Child laborers are one of the most vulnerable groups in domestic violence. Domestic violence severely affects the physical and mental health, and consequently affects substance dependence and resilience to suicide of these children. Accordingly, it is essential to examine domestic violence, substance dependence, and suicidal ideation in working children. OBJECTIVES: the present study aimed to investigate the relationship between exposure to domestic violence and substance dependence and suicide resilience on the other among child laborers in Iran. METHODS: This study employed cross-sectional research. 600 child laborers were selected via convenience and snow ball sampling from one rehabilitation and welfare center and three charity organization societies in the west of Iran, from January to August 2022. They completed questionnaires. Data were analyzed by SPSS software version 22 and with using descriptive statistics (frequency, percentage, mean and standard deviation) and ANOVA, independent t-test and the multiple linear regression model with a backward strategy. RESULTS: Findings showed that exposure to domestic violence has a strong and direct correlation with substance dependence (r = 0.94, p < 0.001) and strong and indirect correlation with suicide resilience (r =- 0.91, p < 0.001). Also substance dependence has a strong and direct correlation with suicide resilience (r = -0.87, p < 0.001) in child laborers. Variables of substance dependence, suicide resilience, gender, guardian's disease status, living status and age can predict 76.51% of the variance in domestic violence in these children. CONCLUSION: Child laborers experience a lot of domestic violence, which severely affects their suicide resilience and substance dependence in them. Therefore, there is an urgent need for systematic support programs with content (teaching self-care behaviors, stress management, avoiding tense and violent environments) in order to support of these children and reduce domestic violence against them and subsequently reduce substance improve abuse resilience to suicide in these children.

The psychosocial challenges of mothers of children with thalassemia: A qualitative study.

BACKGROUND: Caring for the children suffering from thalassemia is a stressful experience with various aspects making the mothers face various challenges. Thus, the present study aimed to explain the psychosocial challenges of mothers with thalassemia children based on their lived experience. MATERIALS AND METHODS: In this qualitative study, which was conducted using the phenomenological method, 14 mothers with thalassemia children were selected from two thalassemia treatment centers in Hamadan and Babol (Iran) in 2020 using the purposive sampling method. Data were collected using in-depth and semi-structured interviews and were analyzed by van Manen's phenomenological methodology. RESULTS: In the first stage of data analysis, 534 initial codes were extracted, which were reduced to 290 by comparison and integration. The primary themes turned into 24 secondary themes after clustering. By comparing the secondary themes, three main themes (i.e., "psychological distress," "bodily burnout," and "mothers' need to empathy and support") with 7 secondary themes (i.e., "emotional exhaustion," "mental strain," "social stigma," "acute psychosomatic reactions," "long-term psychosomatic consequences," "expectation of family support," and support needs outside the family) were extracted. CONCLUSION: The results indicated that mothers with thalassemia children experience several challenges in various aspects. Therefore, they require care interventions and psychosocial support.

Effect of progressive muscle relaxation technique on self-esteem and self-efficacy in multiple sclerosis patients: A clinical trial study.

BACKGROUND: Low self-esteem and inefficiency are major problems in multiple sclerosis (MS) patients. A progressive muscle relaxation technique is one of the complementary therapies. The objective of this study was to investigate the effect of progressive muscle relaxation techniques on self-esteem and self-efficacy in MS patients. MATERIALS AND METHODS: This clinical trial was conducted on 100 MS patients were randomly divided into two groups of experimental (n = 50) and control (n = 50). The experimental group received progressive muscle relaxation techniques in eight 60-min sessions twice a week for 4 weeks. Rosenberg's Self-Esteem Scale and Self-Efficacy Scales of MS patients were completed before, immediately, and 4 weeks after the intervention. Data were analyzed using the SPSS software version 16. RESULTS: The mean score of self-esteem was not significantly different between the control (26.02 ± 5.83) and experimental (26.40 ± 6.06) groups before intervention (P = 0.247). The mean score of self-esteem in the control group (27.16 ± 7.45) and the experimental group (29.06 ± 6.61) immediately after the intervention (P = 0.083) was not significantly different. 4 weeks after the intervention, the mean scores of self-esteem in the control (26.96 ± 8.33) and the experimental (29.98 ± 7.02) groups were significantly different (P = 0.012). The mean score of self-efficacy was significantly different between the control (41.62 ± 4.46) and experimental (39.32 ± 4.31) groups before intervention (P = 0.010). The mean scores of self-efficacy in the control group (38.38 ± 5.07) and the experimental group (44 ± 4.46) immediately after the intervention (P < 0.001) and 4 weeks after intervention showed a significant difference between the control group (38.04 ± 5.46) and the experimental (46.40 ± 5.04) groups (P < 0.001). CONCLUSION: Due to the effect of progressive muscle relaxation on self-esteem and self-efficacy of MS patients, its safety and simplicity, this technique can be used as a complementary therapy to enhance the level of self-esteem and self-efficacy of MS patients.

Identifying Important Challenges of Coping with Female Breast Cancer among Iranian Spouses: A Qualitative Study.

Objective: Breast cancer is a multidimensional crisis for women and their spouses that affects every aspect of their life. Coping with this disease requires investigating and resolving the challenges faced by all those affected by it. The present study was conducted to clarify these challenges on the basis of lived experiences of the spouses of women with breast cancer. Method : The present qualitative research performed an interpretive phenomenological analysis in Iran.Purposive sampling was employed to select twenty spouses of women with breast cancer. The data collected through unstructured face-to-face interviews were analyzed using van Manen's method. To ensure the rigor of the study, Lincoln and Guba's criteria were evaluated in the qualitative process. Results: Lived experiences of the spouses of the women with breast cancer in coping with challenges included the four themes of emotional confusion, shouldering the burden of care, psychophysical suffering caused by the disease and life without cohesion. Conclusion: Spouses of the women with breast cancer in the Iranian community faced several challenges and issues. The socioeconomic support provided by supporting organizations and medical personnel appear to help moderate these challenges and improve coping in this group.

Emergency Medical Service Providers' Perception of Health-Threatening Stressors in Emergency Missions: A qualitative Study.

BACKGROUND: Unknown and unpredictable situations cause emergency medical service (EMS) providers to experience various stressful factors. These factors are affected by sociocultural conditions and expectations of the casualty and affect EMS providers' performance and health at the incident scene. The present study was conducted to explore EMS providers' perception of stressful and health-threatening factors in emergency missions. METHOD: This qualitative conventional content analysis was conducted in 2020. The participants included 16 EMS providers working at the Emergency Medical Services Department in Hamadan Province, Iran. The participants were selected using purposive sampling and underwent semi-structured interviews until data saturation. Data were analyzed using the Graneheim and Lundman method. RESULTS: Analysis of the interview data yielded six subcategories (i.e., incident scene hazards, violence-related injuries, physical injuries caused by patient care/handling, ambulance crash-related injuries, emotional impact of patients' suffering and ailments, and highly stressful missions), two main categories (i.e., physical injuries and psychological tensions), and a theme of occupational injuries. CONCLUSIONS: According to the results, in addition to having concerns about caring for patients and saving the injured, EMS providers also worry about potential threats to their own health. The present study identified and described some major stressors in emergency missions. Thus, for a better and more effective efficiency, the present study results can be used to reduce or modify stressors in EMS providers.

The concept of coping in male spouses of Iranian women with breast cancer: A qualitative study using a phenomenological approach.

INTRODUCTION: Breast cancer is a multidimensional crisis that affects not just the patient, but the spouse and other family members. Coping with this phenomenon, as one of the important challenges for the families and spouses, requires investigation. Understanding more about how spouses of women with breast cancer cope with this crisis could lead to better performance of spouses in front of their wives and raise their wives' quality of life. PURPOSE: The study was conducted to explore the concept of coping based on the lived experiences of spouses of women with breast cancer. METHODS: This qualitative study was conducted with a phenomenological approach in Hamedan and Rasht cities in Iran in 2019. Participants included 20 spouses of women with breast cancer selected by a purposive sampling method. Data were collected through unstructured face-to-face interviews and analyzed using van Manen's six-stage phenomenological method. RESULTS: The lived experiences of participants showed that the phenomenon of coping in spouses of women with breast cancer included five themes: Emotional pain, Shouldering the burden of care, Striving for family life cohesion, Future in ambiguity, and Sense of loss of self concept. Understanding the concept of coping in the spouses of women with breast cancer in health strategies can help wives achieve effective adaptation and also help professionals take effective measures in the field of medical care for patients and their spouses.

Concept d'adaptation chez les conjoints de femmes iraniennes atteintes du cancer du sein: étude qualitative basée sur une approche phénoménologique.

INTRODUCTION: Le cancer du sein provoque une crise multidimensionnelle qui ébranle non seulement la patiente, mais aussi le conjoint et les autres membres de sa famille. Il convient donc d'étudier l'adaptation à ce phénomène, qui constitue l'une des principales difficultés pour les proches. En comprenant mieux comment les conjoints de femmes atteintes d'un cancer du sein font face à cette crise, ces derniers pourraient mieux prendre soin de leurs épouses et améliorer leur qualité de vie. BUT DE L'ÉTUDE: L'étude visait à explorer le concept d'adaptation à partir d'expériences vécues par les conjoints de femmes souffrant d'un cancer du sein. MÉTHODOLOGIE: Cette étude qualitative a été réalisée en 2019 selon une approche phénoménologique dans les villes de Hamadan et Rasht, en Iran. Le groupe de participants comptait 20 conjoints de femmes atteintes du cancer du sein, recrutés grâce à une méthode d'échantillonnage par choix raisonné. Les données ont été recueillies au moyen d'entretiens non structurés en personne; elles ont été analysées à l'aide de la méthode phénoménologique en six étapes de van Manen. RÉSULTATS: Les expériences vécues par les participants ont montré que le phénomène d'adaptation des conjoints au cancer du sein de leur femme se décline en cinq thèmes: souffrance émotionnelle, fardeau des soins, maintien de la cohésion familial, incertitude de l'avenir et sentiment de perte du concept de soi. La compréhension du concept d'adaptation chez les conjoints de femmes atteintes du cancer du sein dans les stratégies de santé peut aider les femmes à bien s'adapter, tout en aidant les professionnels à adopter des mesures efficaces dans le domaine des soins médicaux, pour les patientes et leurs conjoints.

The mental health crises of the families of COVID-19 victims: a qualitative study.

BACKGROUND: The bereaved families of COVID-19 victims are among the most vulnerable social groups in the COVID-19 pandemic. This highly infectious and contagious disease has afflicted these families with numerous psychological crises which have not been studied much yet. The present study is an attempt at investigating the psychological challenges and issues which the families of COVID-19 victims are faced with. The present study aims to identify the Mental Health crises which the families of COVID-19 deceased victims are going through. METHODS: A qualitative research, the present study uses a conventional content analysis design. The participants were 16 members of the families of COVID-19 victims selected from medical centers in Iran from February to May 2020 via purposeful sampling. Sampling continued to the point of data saturation Data were collected via semi-structured individual interviews conducted online. The collected data were analyzed according to the conventional qualitative content analysis approach. RESULTS: Analyses of the data yielded two main themes and seven categories. Emotional shock included (feelings of guilt and rumination, bitter farewell, strange burial and concern about unreligious burial), and fear of the future included (instability in the family, lack of job security and difficult financial conditions, Stigmatization and complications in social interactions). CONCLUSION: The families of COVID-19 deceased victims are affected by various psychological crises which have exposed them to a deep sense of loss and emotional shock. Therefore, there is an urgent need for a cultural context which recognizes and supports all the various aspects of the mental health of these families.

Complexity of information processing in obsessive-compulsive disorder based on fractal analysis of EEG signal.

The human brain is considered as a self-organizing system with self-similarities at various temporal and spatial scales called "fractals". In this scale-free system, it is possible to decode the complexity of information processing using fractal behavior. For instance, the complexity of information processing in the brain can be evaluated by fractal dimensions (FDs). However, it is unclear how over-elaboration of information processing impacts the dimensionality of its fractal behavior. In this study, we hypothesized that FDs of electroencephalogram (EEG) in obsessive-compulsive disorder (OCD) should be higher than healthy controls (HCs) because of exaggeration of information processing mainly in the frontal regions. Therefore, a group of 39 OCDs (age: 34.76±8.22, 25 female, 3 left-handed) and 19 HCs (age: 31.94±8.22, 11 female, 1 left-handed) were recruited and their brain activities were recorded using a 19-channel EEG recorder in the eyes-open resting-state condition. Subsequently, fractal dimensions of the cleaned EEG data were calculated using Katz's method in a frequency band-specific manner. After the test of normality, significant changes in the OCDs as compared to the HCs were calculated using a two-sample t-test. OCDs showed higher FDs in the frontal regions in all frequency bands as compared to HCs. Although, significant increases were only observed in the beta and lower gamma bands, mainly at the high beta. Interestingly, neurophysiological findings also show association with severity of obsessive behaviors. The results demonstrate that complexity of information processing in the brain follows an intimate nature of structural and functional impairments of the brain in OCD.

Perceived occupational stressors among emergency medical service providers: a qualitative study.

INTRODUCTION: Emergency medical services (EMS) providers are at continuous exposure to occupational stressors which negatively affect their health and professional practice. This study explored perceived occupational stressors among EMS providers. METHODS: This qualitative study was conducted from December 2019 to April 2020 using conventional content analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured interviews (with length of 45-60 min) were held for data collection. Data were analyzed through Graneheim and Lundman's conventional content analysis approach. FINDINGS: Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and personal and professional conflicts. The six categories of these two themes were complexity of patients' clinical conditions, interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts. CONCLUSION: Besides the stress associated with emergency patient care, EMS providers face many different occupational stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress among EMS providers and thereby, improve their health and care quality.

A Qualitative Study Exploring the Experiences of Mothers Caring for Their Children with Thalassemia in Iran.

Background: Mothers of children with thalassemia usually experience many sufferings and challenges in caring of their children. The present study aimed to explore the experiences of mothers caring for their children with thalassemia. Methods: In this qualitative study, 14 mothers caring for their children with thalassemia in Hamedan and Babol Cities, Iran were selected using purposeful sampling, from December 2019 to August 2020. Data were collected through semi-structured face-to-face interviews. Graneheim and Lundman's approach of conventional content analysis was used for data analysis. Results: After data analyzing, four themes, including physical distress, psychological suffering, hellish life, and self-negligence, as well as nine categories, including the mother's physical problems, physical weakness, confusion, painful emotions, restless life, involvement in a painful caring process, turmoil in the family, neglect of one's health, and disregard for the occurrence of psychosomatic illnesses, were extracted. Conclusion: Our findings provide a broad range of context-specific challenges that mothers of thalassemic child faced during caring of their children that can affect different aspects of their life and health. Thus, mothers of children with thalassemia need various types of support such as social, emotional, and informational support during caring process of their children.

The relationship between internet addiction and psychosomatic disorders in Iranian undergraduate nursing students: a cross-sectional study.

Internet addiction has an important impact on individuals, families, and communities. The effects of internet addiction are cumulative, significantly contributing to costly physical, mental, social, and public health problems. Thus, this study sought to examine relationships between internet addiction and psychosomatic disorders in Iranian undergraduate nursing students. This cross-sectional study was conducted on 300 undergraduate nursing students in the city of Hamadan in Iran, in 2018. Data collection tools included socio-demographic, the internet addiction test (IAT), and the psychosomatic complaints questionnaire. Data were analyzed by a Pearson's and independent t-tests using SPSS-18.0. The mean age of the students were 22.3 ± 3.02. The findings showed that 78.7% of nursing students reported mild, 20% moderate and 1.3% severe internet addiction, and there was a significant positive correlation between internet addiction and psychosomatic disorders (P < 0.05, r = 0.132). Internet addiction and psychosomatic disorders in nursing students can jeopardize their mental and physical health, and affect their future academic and professional activities. Therefore, providing educational and counseling interventions and reducing the negative effects of the internet can help to improve student health.

Effect of Stress Management Training on Stigma and Social Phobia in HIV-Positive Women.

The purpose of this study was to investigate the effect of stress management training on stigma and social phobia among HIV-positive women. This quasi-experimental pre- and posttest study was performed on a single group of 55 HIV-positive females Hamadan city, Iran, in 2018. The samples were taken through a convenience sampling method and the data collection tool were Berger HIV Stigma and Connor Social Phobia Scale. The mean scores of the stigma were 119.98 ± 21.15 and 94.78 ± 16.34 and social phobia were 24 ± 17.4 and 11.2 ± 9.68 before and after the intervention, respectively. The results of the paired sample t test indicated a significant difference in the stigma and social phobia mean scores before and after the intervention in HIV-positive women (P < .05). The results of the study revealed that stigma and social phobia are big challenges for HIV-positive women since these people are always judged by others and are subjected to labeling and rejection.

Exploring the lived experiences of the suicide attempt survivors: a phenomenological approach.

Purpose: Suicide is a complex phenomenon that needs to be studied with a variety of approaches. The purpose of this study is to explore the lived experience of attempted suicide with the phenomenology approach.Method: An interpretive phenomenological approach was used to analyse semi-structured, in-depth interviews with 16 participants (ages 19-57) who were recruited by means of purposive sampling from October to November 2017 at the Farshchian Psychiatric Hospital in Hamadan/Iran. Data analysis was conducted according to van Manen's phenomenological method.Results: Identified three themes and eight subthemes: Mental pain (subthemes: living through grief, internal conflict, the world is better without me), Social challenges (lack of social connection, financial problems, social support services) and Need for love and belonging (feeling understood, need of empathy).Conclusions: Outcomes and key implications of the study related primarily to improving the treatment experiences of suicide attempt survivors and other at-risk population, and also advancing suicide prevention efforts and to provide support for suicide attempt survivors.